ST VINCENT HOSPITAL - Price Transparency,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Site,Svc_Cd,HCPC/Cpt_Cd,CDM_Svc_Descr,Rev_Cd, Quantity/Units , Hospital_gross_Charge , Self_Pay_Chg , Minimum_Negotiated_Chg , Maximum_Negotiated_Chg , AETNA HSHS , ANTEHM MEDICAID , ANTHEM , ANTHEM HMO , ANTHEM MEDICARE ADVANTAGE HMO , ARISE HEALTH PLAN , CHOICE CARE , CIGNA , COMMUNITY CARE FAMILY CARE , FIRST HEALTH NETWORK , HEALTHEOS , HEALTHSMART , HUMANA CHOICE CARE HMO , HUMANA CHOICE CARE PPO , HUMANA MEDICARE ADVANTAGE , HUMANA NATIIONAL POS HMO , HUMANA PREFERRED BHCG , INTERPLAN HEALTH GROUP , MANAGED HEALTH SERVICES MCD , MANAGED MEDICARE NO SEQUESTRATION , MOLINA MARKETPLACE , MOLINA MEDICAID , MULTIPLAN , NAPHCARE , NEHA , NETWORK HEALTH PLAN , P360 SMALL GROUP , PREVEA 360 EMPLOYEES , PREVEA 360 HSHS EMPLOYEES , PREVEA 360 NON EMPLOYEES , PREVEA HEALTH NETWORK , SECURITY HEALTH PLAN , SECURITY HEALTH PLAN OF WISCONSIN , TRILOGY , TRILOGY MEDICAID , UHC ONEIDA NATION , UNITED HEALTH ALL PAYOR , UNITED HEALTH CARE MEDICARE , UNITED HEALTH CARE OPTIONS PPO , UNITY HOSPICE , WEA INSURANCE CORPORATION , WEA INSURANCE CORPORATION 1 , WEA INSURANCE CORPORATION 2 , WEA TRUST PPP/TRUST PREFERRED , WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION ST VINCENT HOSPITAL - ACUTE,10020001,N/A,HC DAILY BEHAVIORAL HLTH RESIDENTIAL CDP,100,1 ,$745.00 ,$372.50 ,$372.50 ,$745.00 ,$481.27 , Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ",$633.25 ,$521.50 , Inpt Medicaid ,$707.75 ,$536.40 ,$543.85 ,"$15,194.00 ",$633.25 , Inpt Medicare ,"$15,194.00 ",$596.00 ,$543.85 , Inpt Medicaid , Inpt Medicare ,"$11,590.04 ",$745.00 ,$633.25 , Inpt Medicare +100% ,$685.40 ,$521.50 ,"$10,353.00 ","$11,132.28 ",$453.71 ,"$10,353.00 ",$514.80 ,$521.50 , Inpt Medicare +1% ,$536.40 , Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,$536.40 ,$461.90 ,$536.40 ,$536.40 ,"$16,452.63 " ST VINCENT HOSPITAL - ACUTE,10020002,N/A,HC DAILY RESIDENTIAL TREATMENT,911,1 ,$449.00 ,$224.50 ,$188.58 ,$449.00 ,$290.05 , N/A ,$291.85 ,$291.85 , Inpt Medicare ,"$15,711.03 ",$381.65 ,$314.30 , N/A ,$426.55 ,$323.28 ,$327.77 ,"$15,194.00 ",$381.65 , N/A ,"$15,194.00 ",$359.20 ,$327.77 , N/A , N/A ,"$11,590.04 ",$449.00 ,$381.65 , N/A ,$413.08 ,$314.30 ,"$10,353.00 ","$11,132.28 ",$273.44 ,"$10,353.00 ",$310.26 ,$314.30 , Inpt Medicare +1% ,$323.28 , N/A ,"$14,334.00 ","$14,334.00 ", N/A ,"$14,334.00 ", N/A ,$323.28 ,$278.38 ,$323.28 ,$323.28 ,"$16,452.63 " ST VINCENT HOSPITAL - ACUTE,10020003,N/A,HC DAILY RESIDENTIAL CCS,100,1 ,$72.00 ,$36.00 ,$36.00 ,$72.00 ,$46.51 , Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ",$61.20 ,$50.40 , Inpt Medicaid ,$68.40 ,$51.84 ,$52.56 ,"$15,194.00 ",$61.20 , Inpt Medicare ,"$15,194.00 ",$57.60 ,$52.56 , Inpt Medicaid , Inpt Medicare ,"$11,590.04 ",$72.00 ,$61.20 , Inpt Medicare +100% ,$66.24 ,$50.40 ,"$10,353.00 ","$11,132.28 ",$43.85 ,"$10,353.00 ",$49.75 ,$50.40 , Inpt Medicare +1% ,$51.84 , Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,$51.84 ,$44.64 ,$51.84 ,$51.84 ,"$16,452.63 " ST VINCENT HOSPITAL - ACUTE,12100001,N/A,HC DAILY SERVICE,121,1 ,"$1,480.00 ",$740.00 ,$740.00 ,"$1,480.00 ",$956.08 , Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ","$1,258.00 ","$1,036.00 ", Inpt Medicaid ,"$1,406.00 ","$1,065.60 ","$1,080.40 ","$15,194.00 ","$1,258.00 ", Inpt Medicare ,"$15,194.00 ","$1,184.00 ","$1,080.40 ", Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$1,480.00 ","$1,258.00 ", Inpt Medicare +100% ,"$1,361.60 ","$1,036.00 ","$10,353.00 ","$11,132.28 ",$901.32 ,"$10,353.00 ","$1,022.68 ","$1,036.00 ", Inpt Medicare +1% ,"$1,065.60 ", Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,"$1,065.60 ",$917.60 ,"$1,065.60 ","$1,065.60 ","$16,452.63 " ST VINCENT HOSPITAL - ACUTE,12800001,N/A,HC DAILY REHAB SERVICE,128,1 ,"$1,400.00 ",$700.00 ,$700.00 ,"$1,400.00 ",$904.40 , Inpt Medicaid ,"$2,424.00 ","$2,424.00 ", Inpt Medicare ,"$2,991.63 ","$1,190.00 ",$980.00 , Inpt Medicaid ,"$1,330.00 ","$1,008.00 ","$1,022.00 ","$2,605.00 ","$1,190.00 ", Inpt Medicare ,"$2,605.00 ","$1,120.00 ","$1,022.00 ", Inpt Medicaid , Inpt Medicare ,"$1,986.86 ","$1,400.00 ","$1,190.00 ", Inpt Medicare +100% ,"$1,288.00 ",$980.00 ,"$1,085.48 ","$1,372.92 ",$852.60 ,"$1,277.04 ",$967.40 ,$980.00 , Inpt Medicare +1% ,"$1,008.00 ", Inpt Medicaid +6% ,"$1,886.00 ","$1,886.00 ", Inpt Medicare ,"$1,886.00 ", Inpt Medicare ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ","$2,991.63 " ST VINCENT HOSPITAL - ACUTE,12800002,N/A,HC DAILY SERVICE LIBERTAS,128,1 ,"$1,850.00 ",$925.00 ,$925.00 ,"$1,850.00 ","$1,195.10 ", Inpt Medicaid ,"$2,424.00 ","$2,424.00 ", Inpt Medicare ,"$2,991.63 ","$1,572.50 ","$1,295.00 ", Inpt Medicaid ,"$1,757.50 ","$1,332.00 ","$1,350.50 ","$2,605.00 ","$1,572.50 ", Inpt Medicare ,"$2,605.00 ","$1,480.00 ","$1,350.50 ", Inpt Medicaid , Inpt Medicare ,"$1,986.86 ","$1,850.00 ","$1,572.50 ", Inpt Medicare +100% ,"$1,702.00 ","$1,295.00 ","$1,085.48 ","$1,372.92 ","$1,126.65 ","$1,277.04 ","$1,278.35 ","$1,295.00 ", Inpt Medicare +1% ,"$1,332.00 ", Inpt Medicaid +6% ,"$1,886.00 ","$1,886.00 ", Inpt Medicare ,"$1,886.00 ", Inpt Medicare ,"$1,332.00 ","$1,147.00 ","$1,332.00 ","$1,332.00 ","$2,991.63 " ST VINCENT HOSPITAL - ACUTE,12800003,N/A,HC DAILY BEHAVIORAL HLTH MEDICAL MGMT,128,1 ,"$1,215.00 ",$607.50 ,$607.50 ,"$1,215.00 ",$784.89 , Inpt Medicaid ,"$2,424.00 ","$2,424.00 ", Inpt Medicare ,"$2,991.63 ","$1,032.75 ",$850.50 , Inpt Medicaid ,"$1,154.25 ",$874.80 ,$886.95 ,"$2,605.00 ","$1,032.75 ", Inpt Medicare ,"$2,605.00 ",$972.00 ,$886.95 , Inpt Medicaid , Inpt Medicare ,"$1,986.86 ","$1,215.00 ","$1,032.75 ", Inpt Medicare +100% ,"$1,117.80 ",$850.50 ,"$1,085.48 ","$1,372.92 ",$739.94 ,"$1,277.04 ",$839.57 ,$850.50 , Inpt Medicare +1% ,$874.80 , Inpt Medicaid +6% ,"$1,886.00 ","$1,886.00 ", Inpt Medicare ,"$1,886.00 ", Inpt Medicare ,$874.80 ,$753.30 ,$874.80 ,$874.80 ,"$2,991.63 " ST VINCENT HOSPITAL - ACUTE,12800004,N/A,HC DAILY BEHAVIORAL HLTH MEDICAL MONITORED,128,1 ,$995.00 ,$497.50 ,$497.50 ,$995.00 ,$642.77 , Inpt Medicaid ,"$2,424.00 ","$2,424.00 ", Inpt Medicare ,"$2,991.63 ",$845.75 ,$696.50 , Inpt Medicaid ,$945.25 ,$716.40 ,$726.35 ,"$2,605.00 ",$845.75 , Inpt Medicare ,"$2,605.00 ",$796.00 ,$726.35 , Inpt Medicaid , Inpt Medicare ,"$1,986.86 ",$995.00 ,$845.75 , Inpt Medicare +100% ,$915.40 ,$696.50 ,"$1,085.48 ","$1,372.92 ",$605.96 ,"$1,277.04 ",$687.55 ,$696.50 , Inpt Medicare +1% ,$716.40 , Inpt Medicaid +6% ,"$1,886.00 ","$1,886.00 ", Inpt Medicare ,"$1,886.00 ", Inpt Medicare ,$716.40 ,$616.90 ,$716.40 ,$716.40 ,"$2,991.63 " ST VINCENT HOSPITAL - ACUTE,12800005,N/A,HC DAILY BEHAVIORAL HLTH MEDICAL MGMT INTENSIVE,128,1 ,"$1,850.00 ",$925.00 ,$925.00 ,"$1,850.00 ","$1,195.10 ", Inpt Medicaid ,"$2,424.00 ","$2,424.00 ", Inpt Medicare ,"$2,991.63 ","$1,572.50 ","$1,295.00 ", Inpt Medicaid ,"$1,757.50 ","$1,332.00 ","$1,350.50 ","$2,605.00 ","$1,572.50 ", Inpt Medicare ,"$2,605.00 ","$1,480.00 ","$1,350.50 ", Inpt Medicaid , Inpt Medicare ,"$1,986.86 ","$1,850.00 ","$1,572.50 ", Inpt Medicare +100% ,"$1,702.00 ","$1,295.00 ","$1,085.48 ","$1,372.92 ","$1,126.65 ","$1,277.04 ","$1,278.35 ","$1,295.00 ", Inpt Medicare +1% ,"$1,332.00 ", Inpt Medicaid +6% ,"$1,886.00 ","$1,886.00 ", Inpt Medicare ,"$1,886.00 ", Inpt Medicare ,"$1,332.00 ","$1,147.00 ","$1,332.00 ","$1,332.00 ","$2,991.63 " ST VINCENT HOSPITAL - ACUTE,17100001,N/A,HC DAILY INFANT SERVICE LEV 1,171,1 ,"$1,150.00 ",$575.00 ,$575.00 ,"$1,150.00 ",$742.90 , Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ",$977.50 ,$805.00 , Inpt Medicaid ,"$1,092.50 ",$828.00 ,$839.50 ,"$15,194.00 ",$977.50 , Inpt Medicare ,"$15,194.00 ",$920.00 ,$839.50 , Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$1,150.00 ",$977.50 , Inpt Medicare +100% ,"$1,058.00 ",$805.00 ,"$10,353.00 ","$11,132.28 ",$700.35 ,"$10,353.00 ",$794.65 ,$805.00 , Inpt Medicare +1% ,$828.00 , Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,$828.00 ,$713.00 ,$828.00 ,$828.00 ,"$16,452.63 " ST VINCENT HOSPITAL - ACUTE,17200001,N/A,HC DAILY SERVICE NICU LEV 2,172,1 ,"$2,300.00 ","$1,150.00 ","$1,150.00 ","$2,300.00 ","$1,485.80 ", Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ","$1,955.00 ","$1,610.00 ", Inpt Medicaid ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$15,194.00 ","$1,955.00 ", Inpt Medicare ,"$15,194.00 ","$1,840.00 ","$1,679.00 ", Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$2,300.00 ","$1,955.00 ", Inpt Medicare +100% ,"$2,116.00 ","$1,610.00 ","$10,353.00 ","$11,132.28 ","$1,400.70 ","$10,353.00 ","$1,589.30 ","$1,610.00 ", Inpt Medicare +1% ,"$1,656.00 ", Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,"$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$16,452.63 " ST VINCENT HOSPITAL - ACUTE,17200002,N/A,HC DAILY INFANT SERVICE LEV 2,172,1 ,"$1,500.00 ",$750.00 ,$750.00 ,"$1,500.00 ",$969.00 , Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ","$1,275.00 ","$1,050.00 ", Inpt Medicaid ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$15,194.00 ","$1,275.00 ", Inpt Medicare ,"$15,194.00 ","$1,200.00 ","$1,095.00 ", Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$1,500.00 ","$1,275.00 ", Inpt Medicare +100% ,"$1,380.00 ","$1,050.00 ","$10,353.00 ","$11,132.28 ",$913.50 ,"$10,353.00 ","$1,036.50 ","$1,050.00 ", Inpt Medicare +1% ,"$1,080.00 ", Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ","$16,452.63 " ST VINCENT HOSPITAL - ACUTE,17300001,N/A,HC DAILY SERVICE NICU LEV 3,173,1 ,"$4,200.00 ","$2,100.00 ","$2,100.00 ","$4,200.00 ","$2,713.20 ", Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ","$3,570.00 ","$2,940.00 ", Inpt Medicaid ,"$3,990.00 ","$3,024.00 ","$3,066.00 ","$15,194.00 ","$3,570.00 ", Inpt Medicare ,"$15,194.00 ","$3,360.00 ","$3,066.00 ", Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$4,200.00 ","$3,570.00 ", Inpt Medicare +100% ,"$3,864.00 ","$2,940.00 ","$10,353.00 ","$11,132.28 ","$2,557.80 ","$10,353.00 ","$2,902.20 ","$2,940.00 ", Inpt Medicare +1% ,"$3,024.00 ", Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,"$3,024.00 ","$2,604.00 ","$3,024.00 ","$3,024.00 ","$16,452.63 " ST VINCENT HOSPITAL - ACUTE,17300002,N/A,HC DAILY INFANT SERVICE LEV 3,173,1 ,"$1,700.00 ",$850.00 ,$850.00 ,"$1,700.00 ","$1,098.20 ", Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ","$1,445.00 ","$1,190.00 ", Inpt Medicaid ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$15,194.00 ","$1,445.00 ", Inpt Medicare ,"$15,194.00 ","$1,360.00 ","$1,241.00 ", Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$1,700.00 ","$1,445.00 ", Inpt Medicare +100% ,"$1,564.00 ","$1,190.00 ","$10,353.00 ","$11,132.28 ","$1,035.30 ","$10,353.00 ","$1,174.70 ","$1,190.00 ", Inpt Medicare +1% ,"$1,224.00 ", Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$16,452.63 " ST VINCENT HOSPITAL - ACUTE,17400001,N/A,HC DAILY SERVICE NICU LEV 4,174,1 ,"$5,600.00 ","$2,800.00 ","$2,800.00 ","$5,600.00 ","$3,617.60 ", Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ","$4,760.00 ","$3,920.00 ", Inpt Medicaid ,"$5,320.00 ","$4,032.00 ","$4,088.00 ","$15,194.00 ","$4,760.00 ", Inpt Medicare ,"$15,194.00 ","$4,480.00 ","$4,088.00 ", Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$5,600.00 ","$4,760.00 ", Inpt Medicare +100% ,"$5,152.00 ","$3,920.00 ","$10,353.00 ","$11,132.28 ","$3,410.40 ","$10,353.00 ","$3,869.60 ","$3,920.00 ", Inpt Medicare +1% ,"$4,032.00 ", Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,"$4,032.00 ","$3,472.00 ","$4,032.00 ","$4,032.00 ","$16,452.63 " ST VINCENT HOSPITAL - ACUTE,20000001,N/A,HC DAILY SERVICE ICU,200,1 ,"$4,100.00 ","$2,050.00 ","$2,050.00 ","$4,100.00 ","$2,648.60 ", Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ","$3,485.00 ","$2,870.00 ", Inpt Medicaid ,"$3,895.00 ","$2,952.00 ","$2,993.00 ","$15,194.00 ","$3,485.00 ", Inpt Medicare ,"$15,194.00 ","$3,280.00 ","$2,993.00 ", Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$4,100.00 ","$3,485.00 ", Inpt Medicare +100% ,"$3,772.00 ","$2,870.00 ","$10,353.00 ","$11,132.28 ","$2,496.90 ","$10,353.00 ","$2,833.10 ","$2,870.00 ", Inpt Medicare +1% ,"$2,952.00 ", Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,"$2,952.00 ","$2,542.00 ","$2,952.00 ","$2,952.00 ","$16,452.63 " ST VINCENT HOSPITAL - ACUTE,20000002,N/A,HC DAILY SERVICE CVICU,200,1 ,"$4,200.00 ","$2,100.00 ","$2,100.00 ","$4,200.00 ","$2,713.20 ", Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ","$3,570.00 ","$2,940.00 ", Inpt Medicaid ,"$3,990.00 ","$3,024.00 ","$3,066.00 ","$15,194.00 ","$3,570.00 ", Inpt Medicare ,"$15,194.00 ","$3,360.00 ","$3,066.00 ", Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$4,200.00 ","$3,570.00 ", Inpt Medicare +100% ,"$3,864.00 ","$2,940.00 ","$10,353.00 ","$11,132.28 ","$2,557.80 ","$10,353.00 ","$2,902.20 ","$2,940.00 ", Inpt Medicare +1% ,"$3,024.00 ", Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,"$3,024.00 ","$2,604.00 ","$3,024.00 ","$3,024.00 ","$16,452.63 " ST VINCENT HOSPITAL - ACUTE,20600001,N/A,HC DAILY SERVICE CVIMCU,206,1 ,"$3,000.00 ","$1,500.00 ","$1,500.00 ","$3,000.00 ","$1,938.00 ", Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ","$2,550.00 ","$2,100.00 ", Inpt Medicaid ,"$2,850.00 ","$2,160.00 ","$2,190.00 ","$15,194.00 ","$2,550.00 ", Inpt Medicare ,"$15,194.00 ","$2,400.00 ","$2,190.00 ", Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$3,000.00 ","$2,550.00 ", Inpt Medicare +100% ,"$2,760.00 ","$2,100.00 ","$10,353.00 ","$11,132.28 ","$1,827.00 ","$10,353.00 ","$2,073.00 ","$2,100.00 ", Inpt Medicare +1% ,"$2,160.00 ", Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$16,452.63 " ST VINCENT HOSPITAL - ACUTE,20600002,N/A,HC DAILY SERVICE IMCU,206,1 ,"$3,000.00 ","$1,500.00 ","$1,500.00 ","$3,000.00 ","$1,938.00 ", Inpt Medicaid ,"$18,180.00 ","$18,180.00 ", Inpt Medicare ,"$15,711.03 ","$2,550.00 ","$2,100.00 ", Inpt Medicaid ,"$2,850.00 ","$2,160.00 ","$2,190.00 ","$15,194.00 ","$2,550.00 ", Inpt Medicare ,"$15,194.00 ","$2,400.00 ","$2,190.00 ", Inpt Medicaid , Inpt Medicare ,"$11,590.04 ","$3,000.00 ","$2,550.00 ", Inpt Medicare +100% ,"$2,760.00 ","$2,100.00 ","$10,353.00 ","$11,132.28 ","$1,827.00 ","$10,353.00 ","$2,073.00 ","$2,100.00 ", Inpt Medicare +1% ,"$2,160.00 ", Inpt Medicaid +6% ,"$14,334.00 ","$14,334.00 ", Inpt Medicare ,"$14,334.00 ", Inpt Medicare ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$16,452.63 " ST VINCENT HOSPITAL - ACUTE,23100001,N/A,HC DAILY SERVICE BOARDER,231,1 ,$124.00 ,$62.00 ,$52.08 ,$124.00 ,$80.10 , N/A ,$80.22 ,$80.22 , N/A ,$74.40 ,$105.40 ,$86.80 , N/A ,$117.80 ,$89.28 ,$90.52 ,"$15,194.00 ",$105.40 , N/A ,$80.60 ,$99.20 ,$90.52 , N/A , N/A ,$52.08 ,$124.00 ,$105.40 , N/A ,$114.08 ,$86.80 ,$62.00 ,$74.40 ,$75.52 ,$62.00 ,$85.68 ,$86.80 , Inpt Medicare +1% ,$89.28 , N/A ,$74.40 ,$74.40 , N/A ,$74.40 , N/A ,$89.28 ,$76.88 ,$89.28 ,$89.28 ,$74.40 ST VINCENT HOSPITAL - ACUTE,23300001,N/A,HC SURCHARGE ICU/HR,233,1 ,$110.00 ,$55.00 ,$46.20 ,$110.00 ,$71.06 , N/A ,$71.16 ,$71.16 , N/A ,$66.00 ,$93.50 ,$77.00 , N/A ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 , N/A ,$71.50 ,$88.00 ,$80.30 , Inpt Medicaid , N/A ,$46.20 ,$110.00 ,$93.50 , N/A ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 , Inpt Medicare +1% ,$79.20 , N/A ,$66.00 ,$66.00 , N/A ,$66.00 , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,23300002,N/A,HC SURCHARGE IMCU/HR,233,1 ,$65.00 ,$32.50 ,$27.30 ,$65.00 ,$41.99 , N/A ,$42.05 ,$42.05 , N/A ,$39.00 ,$55.25 ,$45.50 , N/A ,$61.75 ,$46.80 ,$47.45 ,$42.25 ,$55.25 , N/A ,$42.25 ,$52.00 ,$47.45 , Inpt Medicaid , N/A ,$27.30 ,$65.00 ,$55.25 , N/A ,$59.80 ,$45.50 ,$32.50 ,$39.00 ,$39.59 ,$32.50 ,$44.92 ,$45.50 , Inpt Medicare +1% ,$46.80 , N/A ,$39.00 ,$39.00 , N/A ,$39.00 , N/A ,$46.80 ,$40.30 ,$46.80 ,$46.80 ,$39.00 ST VINCENT HOSPITAL - ACUTE,23300003,N/A,HC OPO HOURLY SURCHARGE ROOM,233,1 ,$170.00 ,$85.00 ,$71.40 ,$170.00 ,$109.82 , N/A ,$109.97 ,$109.97 , N/A ,$102.00 ,$144.50 ,$119.00 , N/A ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 , N/A ,$110.50 ,$136.00 ,$124.10 , Inpt Medicaid , N/A ,$71.40 ,$170.00 ,$144.50 , N/A ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 , Inpt Medicare +1% ,$122.40 , N/A ,$102.00 ,$102.00 , N/A ,$102.00 , N/A ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,23900001,N/A,HC HIGH RISK BABY TRANS/HR,239,1 ,$540.00 ,$270.00 ,$226.80 ,$540.00 ,$348.84 , N/A ,$349.33 ,$349.33 , N/A ,$324.00 ,$459.00 ,$378.00 , N/A ,$513.00 ,$388.80 ,$394.20 ,$351.00 ,$459.00 , N/A ,$351.00 ,$432.00 ,$394.20 , Inpt Medicaid , N/A ,$226.80 ,$540.00 ,$459.00 , N/A ,$496.80 ,$378.00 ,$270.00 ,$324.00 ,$328.86 ,$270.00 ,$373.14 ,$378.00 , Inpt Medicare +1% ,$388.80 , N/A ,$324.00 ,$324.00 , N/A ,$324.00 , N/A ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,23900002,N/A,HC ASSIST HI RISK DELIV BEL,239,1 ,$540.00 ,$270.00 ,$226.80 ,$540.00 ,$348.84 , N/A ,$349.33 ,$349.33 , N/A ,$324.00 ,$459.00 ,$378.00 , N/A ,$513.00 ,$388.80 ,$394.20 ,$351.00 ,$459.00 , N/A ,$351.00 ,$432.00 ,$394.20 , Inpt Medicaid , N/A ,$226.80 ,$540.00 ,$459.00 , N/A ,$496.80 ,$378.00 ,$270.00 ,$324.00 ,$328.86 ,$270.00 ,$373.14 ,$378.00 , Inpt Medicare +1% ,$388.80 , N/A ,$324.00 ,$324.00 , N/A ,$324.00 , N/A ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,25000280,N/A,HC SALINE NORMAL 1000,258,1 ,$48.00 ,$24.00 ,$20.16 ,$48.00 ,$31.01 , N/A ,$31.05 ,$31.05 , N/A ,$28.80 ,$40.80 ,$33.60 , N/A ,$45.60 ,$34.56 ,$35.04 ,$31.20 ,$40.80 , N/A ,$31.20 ,$38.40 ,$35.04 , Inpt Medicaid , N/A ,$20.16 ,$48.00 ,$40.80 , N/A ,$44.16 ,$33.60 ,$24.00 ,$28.80 ,$29.23 ,$24.00 ,$33.17 ,$33.60 , Inpt Medicare +1% ,$34.56 , N/A ,$28.80 ,$28.80 , N/A ,$28.80 , N/A ,$34.56 ,$29.76 ,$34.56 ,$34.56 ,$28.80 ST VINCENT HOSPITAL - ACUTE,26000000,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$400.00 ,$200.00 ,$100.19 ,$443.45 ,$258.40 ,$100.19 ,$258.76 ,$258.76 ,$197.09 ,$240.00 ,$340.00 ,$280.00 ,$100.19 ,$380.00 ,$288.00 ,$292.00 ,$260.00 ,$340.00 ,$197.09 ,$260.00 ,$320.00 ,$292.00 , Inpt Medicaid ,$197.09 ,$168.00 ,$400.00 ,$340.00 ,$443.45 ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 , Inpt Medicare +1% ,$288.00 ,$106.20 ,$200.00 ,$200.00 ,$197.09 ,$200.00 ,$197.09 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,26000001,96361,HC HYDRATION THERAPY EA ADDL HR,260,1 ,$160.00 ,$80.00 ,$38.74 ,$160.00 ,$103.36 ,$145.88 ,$103.50 ,$103.50 ,$38.74 ,$96.00 ,$136.00 ,$112.00 ,$145.88 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 ,$38.74 ,$104.00 ,$128.00 ,$116.80 , Inpt Medicaid ,$38.74 ,$67.20 ,$160.00 ,$136.00 ,$87.17 ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , Inpt Medicare +1% ,$115.20 ,$154.63 ,$80.00 ,$80.00 ,$38.74 ,$80.00 ,$38.74 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,26000002,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$480.00 ,$240.00 ,$100.19 ,$480.00 ,$310.08 ,$100.19 ,$310.51 ,$310.51 ,$197.09 ,$288.00 ,$408.00 ,$336.00 ,$100.19 ,$456.00 ,$345.60 ,$350.40 ,$312.00 ,$408.00 ,$197.09 ,$312.00 ,$384.00 ,$350.40 , Inpt Medicaid ,$197.09 ,$201.60 ,$480.00 ,$408.00 ,$443.45 ,$441.60 ,$336.00 ,$240.00 ,$288.00 ,$292.32 ,$240.00 ,$331.68 ,$336.00 , Inpt Medicare +1% ,$345.60 ,$106.20 ,$240.00 ,$240.00 ,$197.09 ,$240.00 ,$197.09 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,26000003,96366,HC INFUSION THERAPY EA ADDL HR,260,1 ,$160.00 ,$80.00 ,$38.74 ,$160.00 ,$103.36 ,$145.88 ,$103.50 ,$103.50 ,$38.74 ,$96.00 ,$136.00 ,$112.00 ,$145.88 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 ,$38.74 ,$104.00 ,$128.00 ,$116.80 , Inpt Medicaid ,$38.74 ,$67.20 ,$160.00 ,$136.00 ,$87.17 ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , Inpt Medicare +1% ,$115.20 ,$154.63 ,$80.00 ,$80.00 ,$38.74 ,$80.00 ,$38.74 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,26000004,96367,HC IV INF ADDL SEQ INIT HR,260,1 ,$150.00 ,$75.00 ,$60.02 ,$150.00 ,$96.90 ,$100.19 ,$97.04 ,$97.04 ,$60.02 ,$90.00 ,$127.50 ,$105.00 ,$100.19 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 ,$60.02 ,$97.50 ,$120.00 ,$109.50 , Inpt Medicaid ,$60.02 ,$63.00 ,$150.00 ,$127.50 ,$135.04 ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 , Inpt Medicare +1% ,$108.00 ,$106.20 ,$75.00 ,$75.00 ,$60.02 ,$75.00 ,$60.02 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,26000005,96368,HC INFUS CONCURRENT,260,1 ,$230.00 ,$115.00 ,$96.60 ,$230.00 ,$148.58 ,$100.19 ,$148.79 ,$148.79 , N/A ,$138.00 ,$195.50 ,$161.00 ,$100.19 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 , N/A ,$149.50 ,$184.00 ,$167.90 , Inpt Medicaid , N/A ,$96.60 ,$230.00 ,$195.50 , N/A ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 , Inpt Medicare +1% ,$165.60 ,$106.20 ,$115.00 ,$115.00 , N/A ,$115.00 , N/A ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,26000010,96370,HC IV INFUSION THERPAY/PROPH SUBQ EA ADDL HR,260,1 ,$160.00 ,$80.00 ,$38.74 ,$160.00 ,$103.36 ,$145.88 ,$103.50 ,$103.50 ,$38.74 ,$96.00 ,$136.00 ,$112.00 ,$145.88 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 ,$38.74 ,$104.00 ,$128.00 ,$116.80 , Inpt Medicaid ,$38.74 ,$67.20 ,$160.00 ,$136.00 ,$87.17 ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , Inpt Medicare +1% ,$115.20 ,$154.63 ,$80.00 ,$80.00 ,$38.74 ,$80.00 ,$38.74 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,26000011,96371,HC IV INFUSION THERPAY/PROPH SUBQ SECOND LOCATION,260,1 ,$160.00 ,$80.00 ,$60.02 ,$160.00 ,$103.36 ,$100.19 ,$103.50 ,$103.50 ,$60.02 ,$96.00 ,$136.00 ,$112.00 ,$100.19 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 ,$60.02 ,$104.00 ,$128.00 ,$116.80 , Inpt Medicaid ,$60.02 ,$67.20 ,$160.00 ,$136.00 ,$135.04 ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , Inpt Medicare +1% ,$115.20 ,$106.20 ,$80.00 ,$80.00 ,$60.02 ,$80.00 ,$60.02 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,26000012,96369,HC INFUSION THERAPY/PROPHLAXIS INIT <1HR,260,1 ,$480.00 ,$240.00 ,$100.19 ,$480.00 ,$310.08 ,$100.19 ,$310.51 ,$310.51 ,$197.09 ,$288.00 ,$408.00 ,$336.00 ,$100.19 ,$456.00 ,$345.60 ,$350.40 ,$312.00 ,$408.00 ,$197.09 ,$312.00 ,$384.00 ,$350.40 , Inpt Medicaid ,$197.09 ,$201.60 ,$480.00 ,$408.00 ,$443.45 ,$441.60 ,$336.00 ,$240.00 ,$288.00 ,$292.32 ,$240.00 ,$331.68 ,$336.00 , Inpt Medicare +1% ,$345.60 ,$106.20 ,$240.00 ,$240.00 ,$197.09 ,$240.00 ,$197.09 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,27000065,Q4006,HC CAST LONG ARM ADULT FIBERGLASS,270,1 ,$112.00 ,$56.00 ,$30.60 ,$112.00 ,$72.35 , N/A ,$30.60 ,$30.60 , N/A ,$67.20 ,$95.20 ,$78.40 , N/A ,$106.40 ,$80.64 ,$81.76 ,$72.80 ,$95.20 , N/A ,$72.80 ,$89.60 ,$81.76 , Inpt Medicaid , N/A ,$47.04 ,$112.00 ,$95.20 , N/A ,$103.04 ,$78.40 ,$56.00 ,$67.20 ,$68.21 ,$56.00 ,$77.39 ,$78.40 , Inpt Medicare +1% ,$80.64 , N/A ,$67.20 ,$67.20 , N/A ,$67.20 , N/A ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,27000066,Q4008,HC CAST LONG ARM PEDIATRIC FIBERGLASS,270,1 ,$112.00 ,$56.00 ,$15.30 ,$112.00 ,$72.35 , N/A ,$15.30 ,$15.30 , N/A ,$67.20 ,$95.20 ,$78.40 , N/A ,$106.40 ,$80.64 ,$81.76 ,$72.80 ,$95.20 , N/A ,$72.80 ,$89.60 ,$81.76 , N/A , N/A ,$47.04 ,$112.00 ,$95.20 , N/A ,$103.04 ,$78.40 ,$56.00 ,$67.20 ,$68.21 ,$56.00 ,$77.39 ,$78.40 , N/A ,$80.64 , N/A ,$67.20 ,$67.20 , N/A ,$67.20 , N/A ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,27000067,Q4010,HC CAST SHORT ARM ADULT FIBERGLASS,270,1 ,$112.00 ,$56.00 ,$20.40 ,$112.00 ,$72.35 , N/A ,$20.40 ,$20.40 , N/A ,$67.20 ,$95.20 ,$78.40 , N/A ,$106.40 ,$80.64 ,$81.76 ,$72.80 ,$95.20 , N/A ,$72.80 ,$89.60 ,$81.76 , N/A , N/A ,$47.04 ,$112.00 ,$95.20 , N/A ,$103.04 ,$78.40 ,$56.00 ,$67.20 ,$68.21 ,$56.00 ,$77.39 ,$78.40 , N/A ,$80.64 , N/A ,$67.20 ,$67.20 , N/A ,$67.20 , N/A ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,27000068,Q4012,HC CAST SHORT ARM PEDIATRIC FIBERGLASS,270,1 ,$112.00 ,$56.00 ,$10.22 ,$112.00 ,$72.35 , N/A ,$10.22 ,$10.22 , N/A ,$67.20 ,$95.20 ,$78.40 , N/A ,$106.40 ,$80.64 ,$81.76 ,$72.80 ,$95.20 , N/A ,$72.80 ,$89.60 ,$81.76 , N/A , N/A ,$47.04 ,$112.00 ,$95.20 , N/A ,$103.04 ,$78.40 ,$56.00 ,$67.20 ,$68.21 ,$56.00 ,$77.39 ,$78.40 , N/A ,$80.64 , N/A ,$67.20 ,$67.20 , N/A ,$67.20 , N/A ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,27000069,Q4014,HC CAST LOWER FOREARM/HAND ADULT FIBERGLASS,270,1 ,$137.00 ,$68.50 ,$27.83 ,$137.00 ,$88.50 , N/A ,$27.83 ,$27.83 , N/A ,$82.20 ,$116.45 ,$95.90 , N/A ,$130.15 ,$98.64 ,$100.01 ,$89.05 ,$116.45 , N/A ,$89.05 ,$109.60 ,$100.01 , N/A , N/A ,$57.54 ,$137.00 ,$116.45 , N/A ,$126.04 ,$95.90 ,$68.50 ,$82.20 ,$83.43 ,$68.50 ,$94.67 ,$95.90 , N/A ,$98.64 , N/A ,$82.20 ,$82.20 , N/A ,$82.20 , N/A ,$98.64 ,$84.94 ,$98.64 ,$98.64 ,$82.20 ST VINCENT HOSPITAL - ACUTE,27000070,Q4016,HC CAST LOWER FOREARM/HAND PEDIATRIC FIBERGLASS,270,1 ,$137.00 ,$68.50 ,$13.91 ,$137.00 ,$88.50 , N/A ,$13.91 ,$13.91 , N/A ,$82.20 ,$116.45 ,$95.90 , N/A ,$130.15 ,$98.64 ,$100.01 ,$89.05 ,$116.45 , N/A ,$89.05 ,$109.60 ,$100.01 , N/A , N/A ,$57.54 ,$137.00 ,$116.45 , N/A ,$126.04 ,$95.90 ,$68.50 ,$82.20 ,$83.43 ,$68.50 ,$94.67 ,$95.90 , N/A ,$98.64 , N/A ,$82.20 ,$82.20 , N/A ,$82.20 , N/A ,$98.64 ,$84.94 ,$98.64 ,$98.64 ,$82.20 ST VINCENT HOSPITAL - ACUTE,27000071,Q4038,HC CAST SHORT LEG ADULT FIBERGLASS,270,1 ,$80.00 ,$40.00 ,$33.60 ,$80.00 ,$51.68 , N/A ,$43.15 ,$43.15 , N/A ,$48.00 ,$68.00 ,$56.00 , N/A ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 , N/A ,$52.00 ,$64.00 ,$58.40 , N/A , N/A ,$33.60 ,$80.00 ,$68.00 , N/A ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 , N/A ,$57.60 , N/A ,$48.00 ,$48.00 , N/A ,$48.00 , N/A ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,27000072,Q4040,HC CAST SHORT LEG PEDIATRIC FIBERGLASS,270,1 ,$80.00 ,$40.00 ,$21.58 ,$80.00 ,$51.68 , N/A ,$21.58 ,$21.58 , N/A ,$48.00 ,$68.00 ,$56.00 , N/A ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 , N/A ,$52.00 ,$64.00 ,$58.40 , N/A , N/A ,$33.60 ,$80.00 ,$68.00 , N/A ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 , N/A ,$57.60 , N/A ,$48.00 ,$48.00 , N/A ,$48.00 , N/A ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,27000081,N/A,HC BREAST MILK PER CC,270,1 ,$0.18 ,$0.09 ,$0.08 ,$0.18 ,$0.12 , N/A ,$0.12 ,$0.12 , N/A ,$0.11 ,$0.15 ,$0.13 , N/A ,$0.17 ,$0.13 ,$0.13 ,$0.12 ,$0.15 , N/A ,$0.12 ,$0.14 ,$0.13 , N/A , N/A ,$0.08 ,$0.18 ,$0.15 , N/A ,$0.17 ,$0.13 ,$0.09 ,$0.11 ,$0.11 ,$0.09 ,$0.12 ,$0.13 , N/A ,$0.13 , N/A ,$0.11 ,$0.11 , N/A ,$0.11 , N/A ,$0.13 ,$0.11 ,$0.13 ,$0.13 ,$0.11 ST VINCENT HOSPITAL - ACUTE,27100061,N/A,HC HELI OX PER HOUR,271,1 ,$33.00 ,$16.50 ,$13.86 ,$33.00 ,$21.32 , N/A ,$21.35 ,$21.35 , N/A ,$19.80 ,$28.05 ,$23.10 , N/A ,$31.35 ,$23.76 ,$24.09 ,$21.45 ,$28.05 , N/A ,$21.45 ,$26.40 ,$24.09 , N/A , N/A ,$13.86 ,$33.00 ,$28.05 , N/A ,$30.36 ,$23.10 ,$16.50 ,$19.80 ,$20.10 ,$16.50 ,$22.80 ,$23.10 , N/A ,$23.76 , N/A ,$19.80 ,$19.80 , N/A ,$19.80 , N/A ,$23.76 ,$20.46 ,$23.76 ,$23.76 ,$19.80 ST VINCENT HOSPITAL - ACUTE,27100073,N/A,SVG HC INRAD SITE MARKER,271,1 ,$201.00 ,$100.50 ,$84.42 ,$201.00 ,$129.85 , N/A ,$130.03 ,$130.03 , N/A ,$120.60 ,$170.85 ,$140.70 , N/A ,$190.95 ,$144.72 ,$146.73 ,$130.65 ,$170.85 , N/A ,$130.65 ,$160.80 ,$146.73 , N/A , N/A ,$84.42 ,$201.00 ,$170.85 , N/A ,$184.92 ,$140.70 ,$100.50 ,$120.60 ,$122.41 ,$100.50 ,$138.89 ,$140.70 , N/A ,$144.72 , N/A ,$120.60 ,$120.60 , N/A ,$120.60 , N/A ,$144.72 ,$124.62 ,$144.72 ,$144.72 ,$120.60 ST VINCENT HOSPITAL - ACUTE,27100079,N/A,HC LARGE VAGINAL DILATOR,271,1 ,$46.00 ,$23.00 ,$19.32 ,$46.00 ,$29.72 , N/A ,$29.76 ,$29.76 , N/A ,$27.60 ,$39.10 ,$32.20 , N/A ,$43.70 ,$33.12 ,$33.58 ,$29.90 ,$39.10 , N/A ,$29.90 ,$36.80 ,$33.58 , N/A , N/A ,$19.32 ,$46.00 ,$39.10 , N/A ,$42.32 ,$32.20 ,$23.00 ,$27.60 ,$28.01 ,$23.00 ,$31.79 ,$32.20 , N/A ,$33.12 , N/A ,$27.60 ,$27.60 , N/A ,$27.60 , N/A ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,27100082,N/A,HC LEV I FLUID WARMR/FILTER,271,1 ,"$1,957.00 ",$978.50 ,$821.94 ,"$1,957.00 ","$1,264.22 ", N/A ,"$1,265.98 ","$1,265.98 ", N/A ,"$1,174.20 ","$1,663.45 ","$1,369.90 ", N/A ,"$1,859.15 ","$1,409.04 ","$1,428.61 ","$1,272.05 ","$1,663.45 ", N/A ,"$1,272.05 ","$1,565.60 ","$1,428.61 ", N/A , N/A ,$821.94 ,"$1,957.00 ","$1,663.45 ", N/A ,"$1,800.44 ","$1,369.90 ",$978.50 ,"$1,174.20 ","$1,191.81 ",$978.50 ,"$1,352.29 ","$1,369.90 ", N/A ,"$1,409.04 ", N/A ,"$1,174.20 ","$1,174.20 ", N/A ,"$1,174.20 ", N/A ,"$1,409.04 ","$1,213.34 ","$1,409.04 ","$1,409.04 ","$1,174.20 " ST VINCENT HOSPITAL - ACUTE,27100084,N/A,HC MEDIUM VAGINAL DILATOR,271,1 ,$40.00 ,$20.00 ,$16.80 ,$40.00 ,$25.84 , N/A ,$25.88 ,$25.88 , N/A ,$24.00 ,$34.00 ,$28.00 , N/A ,$38.00 ,$28.80 ,$29.20 ,$26.00 ,$34.00 , N/A ,$26.00 ,$32.00 ,$29.20 , N/A , N/A ,$16.80 ,$40.00 ,$34.00 , N/A ,$36.80 ,$28.00 ,$20.00 ,$24.00 ,$24.36 ,$20.00 ,$27.64 ,$28.00 , N/A ,$28.80 , N/A ,$24.00 ,$24.00 , N/A ,$24.00 , N/A ,$28.80 ,$24.80 ,$28.80 ,$28.80 ,$24.00 ST VINCENT HOSPITAL - ACUTE,27100097,N/A,HC NITRIC OXIDE HR ADULT,271,1 ,$559.00 ,$279.50 ,$234.78 ,$559.00 ,$361.11 , N/A ,$361.62 ,$361.62 , N/A ,$335.40 ,$475.15 ,$391.30 , N/A ,$531.05 ,$402.48 ,$408.07 ,$363.35 ,$475.15 , N/A ,$363.35 ,$447.20 ,$408.07 , N/A , N/A ,$234.78 ,$559.00 ,$475.15 , N/A ,$514.28 ,$391.30 ,$279.50 ,$335.40 ,$340.43 ,$279.50 ,$386.27 ,$391.30 , N/A ,$402.48 , N/A ,$335.40 ,$335.40 , N/A ,$335.40 , N/A ,$402.48 ,$346.58 ,$402.48 ,$402.48 ,$335.40 ST VINCENT HOSPITAL - ACUTE,27100098,N/A,HC NITRIC OXIDE HR CARDIAC,271,1 ,$559.00 ,$279.50 ,$234.78 ,$559.00 ,$361.11 , N/A ,$361.62 ,$361.62 , N/A ,$335.40 ,$475.15 ,$391.30 , N/A ,$531.05 ,$402.48 ,$408.07 ,$363.35 ,$475.15 , N/A ,$363.35 ,$447.20 ,$408.07 , N/A , N/A ,$234.78 ,$559.00 ,$475.15 , N/A ,$514.28 ,$391.30 ,$279.50 ,$335.40 ,$340.43 ,$279.50 ,$386.27 ,$391.30 , N/A ,$402.48 , N/A ,$335.40 ,$335.40 , N/A ,$335.40 , N/A ,$402.48 ,$346.58 ,$402.48 ,$402.48 ,$335.40 ST VINCENT HOSPITAL - ACUTE,27100099,N/A,HC NITRIC OXIDE HR NICU,271,1 ,$559.00 ,$279.50 ,$234.78 ,$559.00 ,$361.11 , N/A ,$361.62 ,$361.62 , N/A ,$335.40 ,$475.15 ,$391.30 , N/A ,$531.05 ,$402.48 ,$408.07 ,$363.35 ,$475.15 , N/A ,$363.35 ,$447.20 ,$408.07 , N/A , N/A ,$234.78 ,$559.00 ,$475.15 , N/A ,$514.28 ,$391.30 ,$279.50 ,$335.40 ,$340.43 ,$279.50 ,$386.27 ,$391.30 , N/A ,$402.48 , N/A ,$335.40 ,$335.40 , N/A ,$335.40 , N/A ,$402.48 ,$346.58 ,$402.48 ,$402.48 ,$335.40 ST VINCENT HOSPITAL - ACUTE,27100107,N/A,HC OXYGEN HOURLY,271,1 ,$22.00 ,$11.00 ,$9.24 ,$22.00 ,$14.21 , N/A ,$14.23 ,$14.23 , N/A ,$13.20 ,$18.70 ,$15.40 , N/A ,$20.90 ,$15.84 ,$16.06 ,$14.30 ,$18.70 , N/A ,$14.30 ,$17.60 ,$16.06 , N/A , N/A ,$9.24 ,$22.00 ,$18.70 , N/A ,$20.24 ,$15.40 ,$11.00 ,$13.20 ,$13.40 ,$11.00 ,$15.20 ,$15.40 , N/A ,$15.84 , N/A ,$13.20 ,$13.20 , N/A ,$13.20 , N/A ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,27100113,N/A,HC PAVLIK HARNESS,271,1 ,$168.00 ,$84.00 ,$70.56 ,$168.00 ,$108.53 , N/A ,$108.68 ,$108.68 , N/A ,$100.80 ,$142.80 ,$117.60 , N/A ,$159.60 ,$120.96 ,$122.64 ,$109.20 ,$142.80 , N/A ,$109.20 ,$134.40 ,$122.64 , N/A , N/A ,$70.56 ,$168.00 ,$142.80 , N/A ,$154.56 ,$117.60 ,$84.00 ,$100.80 ,$102.31 ,$84.00 ,$116.09 ,$117.60 , N/A ,$120.96 , N/A ,$100.80 ,$100.80 , N/A ,$100.80 , N/A ,$120.96 ,$104.16 ,$120.96 ,$120.96 ,$100.80 ST VINCENT HOSPITAL - ACUTE,27100126,N/A,HC SMALL VAGINAL DILATOR,271,1 ,$35.00 ,$17.50 ,$14.70 ,$35.00 ,$22.61 , N/A ,$22.64 ,$22.64 , N/A ,$21.00 ,$29.75 ,$24.50 , N/A ,$33.25 ,$25.20 ,$25.55 ,$22.75 ,$29.75 , N/A ,$22.75 ,$28.00 ,$25.55 , N/A , N/A ,$14.70 ,$35.00 ,$29.75 , N/A ,$32.20 ,$24.50 ,$17.50 ,$21.00 ,$21.32 ,$17.50 ,$24.19 ,$24.50 , N/A ,$25.20 , N/A ,$21.00 ,$21.00 , N/A ,$21.00 , N/A ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,27100148,L3908,HC SPLINT THUMB SPICA FIT AND ADJUST,274,1 ,$97.00 ,$48.50 ,$40.74 ,$164.21 ,$62.66 , N/A , N/A , N/A ,$72.98 ,$58.20 ,$82.45 ,$67.90 , N/A ,$92.15 ,$69.84 ,$70.81 , N/A ,$82.45 ,$72.98 , N/A ,$77.60 ,$70.81 , N/A ,$72.98 ,$40.74 ,$97.00 ,$82.45 ,$164.21 ,$89.24 ,$67.90 ,$48.50 ,$58.20 ,$59.07 ,$48.50 ,$67.03 ,$67.90 ,$73.71 ,$69.84 , N/A , N/A , N/A ,$72.98 , N/A ,$72.98 ,$69.84 ,$60.14 ,$69.84 ,$69.84 ,$58.20 ST VINCENT HOSPITAL - ACUTE,27100171,N/A,HC X SMALL VAGINAL DILATOR,271,1 ,$35.00 ,$17.50 ,$14.70 ,$35.00 ,$22.61 , N/A ,$22.64 ,$22.64 , N/A ,$21.00 ,$29.75 ,$24.50 , N/A ,$33.25 ,$25.20 ,$25.55 ,$22.75 ,$29.75 , N/A ,$22.75 ,$28.00 ,$25.55 , N/A , N/A ,$14.70 ,$35.00 ,$29.75 , N/A ,$32.20 ,$24.50 ,$17.50 ,$21.00 ,$21.32 ,$17.50 ,$24.19 ,$24.50 , N/A ,$25.20 , N/A ,$21.00 ,$21.00 , N/A ,$21.00 , N/A ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,27100179,N/A,HC SURGICAL BRA,271,1 ,$102.00 ,$51.00 ,$42.84 ,$102.00 ,$65.89 , N/A ,$65.98 ,$65.98 , N/A ,$61.20 ,$86.70 ,$71.40 , N/A ,$96.90 ,$73.44 ,$74.46 ,$66.30 ,$86.70 , N/A ,$66.30 ,$81.60 ,$74.46 , N/A , N/A ,$42.84 ,$102.00 ,$86.70 , N/A ,$93.84 ,$71.40 ,$51.00 ,$61.20 ,$62.12 ,$51.00 ,$70.48 ,$71.40 , N/A ,$73.44 , N/A ,$61.20 ,$61.20 , N/A ,$61.20 , N/A ,$73.44 ,$63.24 ,$73.44 ,$73.44 ,$61.20 ST VINCENT HOSPITAL - ACUTE,27200005,B4087,HC MAGNA PORT G-TUBE SET,272,1 ,$53.00 ,$26.50 ,$22.26 ,$53.00 ,$34.24 , N/A ,$29.40 ,$29.40 , N/A ,$31.80 ,$45.05 ,$37.10 , N/A ,$50.35 ,$38.16 ,$38.69 ,$34.45 ,$45.05 , N/A ,$34.45 ,$42.40 ,$38.69 , N/A , N/A ,$22.26 ,$53.00 ,$45.05 ,$31.80 ,$48.76 ,$37.10 ,$26.50 ,$31.80 ,$32.28 ,$26.50 ,$36.62 ,$37.10 , N/A ,$38.16 , N/A ,$31.80 ,$31.80 , N/A ,$31.80 , N/A ,$38.16 ,$32.86 ,$38.16 ,$38.16 ,$31.80 ST VINCENT HOSPITAL - ACUTE,27200009,C1724,HC ROTABLATOR BURR,272,1 ,"$1,744.00 ",$872.00 ,$732.48 ,"$1,744.00 ","$1,126.62 ", N/A ,"$1,128.19 ","$1,128.19 ", N/A ,"$1,046.40 ","$1,482.40 ","$1,220.80 ", N/A ,"$1,656.80 ","$1,255.68 ","$1,273.12 ","$1,133.60 ","$1,482.40 ", N/A ,"$1,133.60 ","$1,395.20 ","$1,273.12 ", N/A , N/A ,$732.48 ,"$1,744.00 ","$1,482.40 ", N/A ,"$1,604.48 ","$1,220.80 ",$872.00 ,"$1,046.40 ","$1,062.10 ",$872.00 ,"$1,205.10 ","$1,220.80 ", N/A ,"$1,255.68 ", N/A ,"$1,046.40 ","$1,046.40 ", N/A ,"$1,046.40 ", N/A ,"$1,255.68 ","$1,081.28 ","$1,255.68 ","$1,255.68 ","$1,046.40 " ST VINCENT HOSPITAL - ACUTE,27200011,C1724,HC ROTALINK PLUS,272,1 ,"$2,224.00 ","$1,112.00 ",$934.08 ,"$2,224.00 ","$1,436.70 ", N/A ,"$1,438.71 ","$1,438.71 ", N/A ,"$1,334.40 ","$1,890.40 ","$1,556.80 ", N/A ,"$2,112.80 ","$1,601.28 ","$1,623.52 ","$1,445.60 ","$1,890.40 ", N/A ,"$1,445.60 ","$1,779.20 ","$1,623.52 ", N/A , N/A ,$934.08 ,"$2,224.00 ","$1,890.40 ", N/A ,"$2,046.08 ","$1,556.80 ","$1,112.00 ","$1,334.40 ","$1,354.42 ","$1,112.00 ","$1,536.78 ","$1,556.80 ", N/A ,"$1,601.28 ", N/A ,"$1,334.40 ","$1,334.40 ", N/A ,"$1,334.40 ", N/A ,"$1,601.28 ","$1,378.88 ","$1,601.28 ","$1,601.28 ","$1,334.40 " ST VINCENT HOSPITAL - ACUTE,27200022,C1726,HC CATH UROMAX ULTRA BALOON,272,1 ,$987.54 ,$493.77 ,$414.77 ,$987.54 ,$637.95 , N/A ,$638.84 ,$638.84 , N/A ,$592.52 ,$839.41 ,$691.28 , N/A ,$938.16 ,$711.03 ,$720.90 ,$641.90 ,$839.41 , N/A ,$641.90 ,$790.03 ,$720.90 , N/A , N/A ,$414.77 ,$987.54 ,$839.41 , N/A ,$908.54 ,$691.28 ,$493.77 ,$592.52 ,$601.41 ,$493.77 ,$682.39 ,$691.28 , N/A ,$711.03 , N/A ,$592.52 ,$592.52 , N/A ,$592.52 , N/A ,$711.03 ,$612.27 ,$711.03 ,$711.03 ,$592.52 ST VINCENT HOSPITAL - ACUTE,27200029,C1726,HC DILATOR BALLOON,272,1 ,"$1,003.00 ",$501.50 ,$421.26 ,"$1,003.00 ",$647.94 , N/A ,$648.84 ,$648.84 , N/A ,$601.80 ,$852.55 ,$702.10 , N/A ,$952.85 ,$722.16 ,$732.19 ,$651.95 ,$852.55 , N/A ,$651.95 ,$802.40 ,$732.19 , N/A , N/A ,$421.26 ,"$1,003.00 ",$852.55 , N/A ,$922.76 ,$702.10 ,$501.50 ,$601.80 ,$610.83 ,$501.50 ,$693.07 ,$702.10 , N/A ,$722.16 , N/A ,$601.80 ,$601.80 , N/A ,$601.80 , N/A ,$722.16 ,$621.86 ,$722.16 ,$722.16 ,$601.80 ST VINCENT HOSPITAL - ACUTE,27200034,C1729,HC CATHETER DRAINAGE,272,1 ,$519.00 ,$259.50 ,$217.98 ,$519.00 ,$335.27 , N/A ,$335.74 ,$335.74 , N/A ,$311.40 ,$441.15 ,$363.30 , N/A ,$493.05 ,$373.68 ,$378.87 ,$337.35 ,$441.15 , N/A ,$337.35 ,$415.20 ,$378.87 , N/A , N/A ,$217.98 ,$519.00 ,$441.15 , N/A ,$477.48 ,$363.30 ,$259.50 ,$311.40 ,$316.07 ,$259.50 ,$358.63 ,$363.30 , N/A ,$373.68 , N/A ,$311.40 ,$311.40 , N/A ,$311.40 , N/A ,$373.68 ,$321.78 ,$373.68 ,$373.68 ,$311.40 ST VINCENT HOSPITAL - ACUTE,27200035,C1729,HC CATHETER DRAINAGE PLEUREX,272,1 ,"$1,005.00 ",$502.50 ,$422.10 ,"$1,005.00 ",$649.23 , N/A ,$650.13 ,$650.13 , N/A ,$603.00 ,$854.25 ,$703.50 , N/A ,$954.75 ,$723.60 ,$733.65 ,$653.25 ,$854.25 , N/A ,$653.25 ,$804.00 ,$733.65 , N/A , N/A ,$422.10 ,"$1,005.00 ",$854.25 , N/A ,$924.60 ,$703.50 ,$502.50 ,$603.00 ,$612.05 ,$502.50 ,$694.46 ,$703.50 , N/A ,$723.60 , N/A ,$603.00 ,$603.00 , N/A ,$603.00 , N/A ,$723.60 ,$623.10 ,$723.60 ,$723.60 ,$603.00 ST VINCENT HOSPITAL - ACUTE,27200044,C1729,HC STENT BILIARY PLASTIC,272,1 ,$320.00 ,$160.00 ,$134.40 ,$320.00 ,$206.72 , N/A ,$207.01 ,$207.01 , N/A ,$192.00 ,$272.00 ,$224.00 , N/A ,$304.00 ,$230.40 ,$233.60 ,$208.00 ,$272.00 , N/A ,$208.00 ,$256.00 ,$233.60 , N/A , N/A ,$134.40 ,$320.00 ,$272.00 , N/A ,$294.40 ,$224.00 ,$160.00 ,$192.00 ,$194.88 ,$160.00 ,$221.12 ,$224.00 , N/A ,$230.40 , N/A ,$192.00 ,$192.00 , N/A ,$192.00 , N/A ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,27200050,C1732,HC RF ABLATION CATHETER,272,1 ,"$2,871.00 ","$1,435.50 ","$1,205.82 ","$2,871.00 ","$1,854.67 ", N/A ,"$1,857.25 ","$1,857.25 ", N/A ,"$1,722.60 ","$2,440.35 ","$2,009.70 ", N/A ,"$2,727.45 ","$2,067.12 ","$2,095.83 ","$1,866.15 ","$2,440.35 ", N/A ,"$1,866.15 ","$2,296.80 ","$2,095.83 ", N/A , N/A ,"$1,205.82 ","$2,871.00 ","$2,440.35 ", N/A ,"$2,641.32 ","$2,009.70 ","$1,435.50 ","$1,722.60 ","$1,748.44 ","$1,435.50 ","$1,983.86 ","$2,009.70 ", N/A ,"$2,067.12 ", N/A ,"$1,722.60 ","$1,722.60 ", N/A ,"$1,722.60 ", N/A ,"$2,067.12 ","$1,780.02 ","$2,067.12 ","$2,067.12 ","$1,722.60 " ST VINCENT HOSPITAL - ACUTE,27200052,C1730,HC QUADRIPOLAR CATHETER,272,1 ,$745.00 ,$372.50 ,$312.90 ,$745.00 ,$481.27 , N/A ,$481.94 ,$481.94 , N/A ,$447.00 ,$633.25 ,$521.50 , N/A ,$707.75 ,$536.40 ,$543.85 ,$484.25 ,$633.25 , N/A ,$484.25 ,$596.00 ,$543.85 , N/A , N/A ,$312.90 ,$745.00 ,$633.25 , N/A ,$685.40 ,$521.50 ,$372.50 ,$447.00 ,$453.71 ,$372.50 ,$514.80 ,$521.50 , N/A ,$536.40 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$536.40 ,$461.90 ,$536.40 ,$536.40 ,$447.00 ST VINCENT HOSPITAL - ACUTE,27200056,C1757,HC ANGIOJET CATHETER,272,1 ,"$3,297.00 ","$1,648.50 ","$1,384.74 ","$3,297.00 ","$2,129.86 ", N/A ,"$2,132.83 ","$2,132.83 ", N/A ,"$1,978.20 ","$2,802.45 ","$2,307.90 ", N/A ,"$3,132.15 ","$2,373.84 ","$2,406.81 ","$2,143.05 ","$2,802.45 ", N/A ,"$2,143.05 ","$2,637.60 ","$2,406.81 ", N/A , N/A ,"$1,384.74 ","$3,297.00 ","$2,802.45 ", N/A ,"$3,033.24 ","$2,307.90 ","$1,648.50 ","$1,978.20 ","$2,007.87 ","$1,648.50 ","$2,278.23 ","$2,307.90 ", N/A ,"$2,373.84 ", N/A ,"$1,978.20 ","$1,978.20 ", N/A ,"$1,978.20 ", N/A ,"$2,373.84 ","$2,044.14 ","$2,373.84 ","$2,373.84 ","$1,978.20 " ST VINCENT HOSPITAL - ACUTE,27200077,C1764,HC REVEAL LOOP RECORDER,272,1 ,"$10,645.00 ","$5,322.50 ","$4,470.90 ","$10,645.00 ","$6,876.67 ", N/A ,"$6,886.25 ","$6,886.25 ", N/A ,"$6,387.00 ","$9,048.25 ","$7,451.50 ", N/A ,"$10,112.75 ","$7,664.40 ","$7,770.85 ","$6,919.25 ","$9,048.25 ", N/A ,"$6,919.25 ","$8,516.00 ","$7,770.85 ", N/A , N/A ,"$4,470.90 ","$10,645.00 ","$9,048.25 ", N/A ,"$9,793.40 ","$7,451.50 ","$5,322.50 ","$6,387.00 ","$6,482.81 ","$5,322.50 ","$7,355.70 ","$7,451.50 ", N/A ,"$7,664.40 ", N/A ,"$6,387.00 ","$6,387.00 ", N/A ,"$6,387.00 ", N/A ,"$7,664.40 ","$6,599.90 ","$7,664.40 ","$7,664.40 ","$6,387.00 " ST VINCENT HOSPITAL - ACUTE,27200078,C1765,HC INTERCEED ADHESION BARRIER,272,1 ,$509.00 ,$254.50 ,$213.78 ,$509.00 ,$328.81 , N/A ,$329.27 ,$329.27 , N/A ,$305.40 ,$432.65 ,$356.30 , N/A ,$483.55 ,$366.48 ,$371.57 ,$330.85 ,$432.65 , N/A ,$330.85 ,$407.20 ,$371.57 , N/A , N/A ,$213.78 ,$509.00 ,$432.65 , N/A ,$468.28 ,$356.30 ,$254.50 ,$305.40 ,$309.98 ,$254.50 ,$351.72 ,$356.30 , N/A ,$366.48 , N/A ,$305.40 ,$305.40 , N/A ,$305.40 , N/A ,$366.48 ,$315.58 ,$366.48 ,$366.48 ,$305.40 ST VINCENT HOSPITAL - ACUTE,27200117,C1769,SVG HC WAVE WIRE,272,1 ,"$1,028.00 ",$514.00 ,$431.76 ,"$1,028.00 ",$664.09 , N/A ,$665.01 ,$665.01 , N/A ,$616.80 ,$873.80 ,$719.60 , N/A ,$976.60 ,$740.16 ,$750.44 ,$668.20 ,$873.80 , N/A ,$668.20 ,$822.40 ,$750.44 , N/A , N/A ,$431.76 ,"$1,028.00 ",$873.80 , N/A ,$945.76 ,$719.60 ,$514.00 ,$616.80 ,$626.05 ,$514.00 ,$710.35 ,$719.60 , N/A ,$740.16 , N/A ,$616.80 ,$616.80 , N/A ,$616.80 , N/A ,$740.16 ,$637.36 ,$740.16 ,$740.16 ,$616.80 ST VINCENT HOSPITAL - ACUTE,27200138,C1773,HC SNARE RETRIEVAL DEVICE,272,1 ,$514.00 ,$257.00 ,$215.88 ,$514.00 ,$332.04 , N/A ,$332.51 ,$332.51 , N/A ,$308.40 ,$436.90 ,$359.80 , N/A ,$488.30 ,$370.08 ,$375.22 ,$334.10 ,$436.90 , N/A ,$334.10 ,$411.20 ,$375.22 , N/A , N/A ,$215.88 ,$514.00 ,$436.90 , N/A ,$472.88 ,$359.80 ,$257.00 ,$308.40 ,$313.03 ,$257.00 ,$355.17 ,$359.80 , N/A ,$370.08 , N/A ,$308.40 ,$308.40 , N/A ,$308.40 , N/A ,$370.08 ,$318.68 ,$370.08 ,$370.08 ,$308.40 ST VINCENT HOSPITAL - ACUTE,27200145,C1874,HC STENT EXPANDABLE COVERED,278,1 ,"$4,466.00 ","$2,233.00 ","$1,875.72 ","$4,466.00 ","$2,885.04 ", N/A ,"$2,222.28 ","$2,222.28 ", N/A ,"$2,679.60 ","$3,796.10 ","$3,126.20 ", N/A ,"$4,242.70 ","$3,215.52 ","$3,260.18 ","$2,233.00 ","$3,796.10 ", N/A ,"$2,233.00 ","$3,572.80 ","$3,260.18 ", N/A , N/A ,"$1,875.72 ","$4,466.00 ","$3,796.10 ", N/A ,"$4,108.72 ","$3,126.20 ","$2,233.00 ","$2,679.60 ","$2,719.79 ","$2,233.00 ","$3,086.01 ","$3,126.20 ", N/A ,"$3,215.52 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,215.52 ","$2,768.92 ","$3,215.52 ","$3,215.52 ","$2,679.60 " ST VINCENT HOSPITAL - ACUTE,27200152,C1884,HC EMBOLIZATION PROTECTION SYSTEM,272,1 ,"$3,060.00 ","$1,530.00 ","$1,285.20 ","$3,060.00 ","$1,976.76 ", N/A ,"$1,979.51 ","$1,979.51 ", N/A ,"$1,836.00 ","$2,601.00 ","$2,142.00 ", N/A ,"$2,907.00 ","$2,203.20 ","$2,233.80 ","$1,989.00 ","$2,601.00 ", N/A ,"$1,989.00 ","$2,448.00 ","$2,233.80 ", N/A , N/A ,"$1,285.20 ","$3,060.00 ","$2,601.00 ", N/A ,"$2,815.20 ","$2,142.00 ","$1,530.00 ","$1,836.00 ","$1,863.54 ","$1,530.00 ","$2,114.46 ","$2,142.00 ", N/A ,"$2,203.20 ", N/A ,"$1,836.00 ","$1,836.00 ", N/A ,"$1,836.00 ", N/A ,"$2,203.20 ","$1,897.20 ","$2,203.20 ","$2,203.20 ","$1,836.00 " ST VINCENT HOSPITAL - ACUTE,27200153,C1885,HC TURBO ELITE LASER CATH,272,1 ,"$5,157.00 ","$2,578.50 ","$2,165.94 ","$5,157.00 ","$3,331.42 ", N/A ,"$3,336.06 ","$3,336.06 ", N/A ,"$3,094.20 ","$4,383.45 ","$3,609.90 ", N/A ,"$4,899.15 ","$3,713.04 ","$3,764.61 ","$3,352.05 ","$4,383.45 ", N/A ,"$3,352.05 ","$4,125.60 ","$3,764.61 ", N/A , N/A ,"$2,165.94 ","$5,157.00 ","$4,383.45 ", N/A ,"$4,744.44 ","$3,609.90 ","$2,578.50 ","$3,094.20 ","$3,140.61 ","$2,578.50 ","$3,563.49 ","$3,609.90 ", N/A ,"$3,713.04 ", N/A ,"$3,094.20 ","$3,094.20 ", N/A ,"$3,094.20 ", N/A ,"$3,713.04 ","$3,197.34 ","$3,713.04 ","$3,713.04 ","$3,094.20 " ST VINCENT HOSPITAL - ACUTE,27200163,C1892,HC EP PEEL AWAY SHEATH C1892,272,1 ,$135.00 ,$67.50 ,$56.70 ,$135.00 ,$87.21 , N/A ,$87.33 ,$87.33 , N/A ,$81.00 ,$114.75 ,$94.50 , N/A ,$128.25 ,$97.20 ,$98.55 ,$87.75 ,$114.75 , N/A ,$87.75 ,$108.00 ,$98.55 , N/A , N/A ,$56.70 ,$135.00 ,$114.75 , N/A ,$124.20 ,$94.50 ,$67.50 ,$81.00 ,$82.22 ,$67.50 ,$93.29 ,$94.50 , N/A ,$97.20 , N/A ,$81.00 ,$81.00 , N/A ,$81.00 , N/A ,$97.20 ,$83.70 ,$97.20 ,$97.20 ,$81.00 ST VINCENT HOSPITAL - ACUTE,27200176,C2618,HC CRYO ABLATION SYSTEM,272,1 ,"$6,699.00 ","$3,349.50 ","$2,813.58 ","$6,699.00 ","$4,327.55 ", N/A ,"$4,333.58 ","$4,333.58 ", N/A ,"$4,019.40 ","$5,694.15 ","$4,689.30 ", N/A ,"$6,364.05 ","$4,823.28 ","$4,890.27 ","$4,354.35 ","$5,694.15 ", N/A ,"$4,354.35 ","$5,359.20 ","$4,890.27 ", N/A , N/A ,"$2,813.58 ","$6,699.00 ","$5,694.15 ", N/A ,"$6,163.08 ","$4,689.30 ","$3,349.50 ","$4,019.40 ","$4,079.69 ","$3,349.50 ","$4,629.01 ","$4,689.30 ", N/A ,"$4,823.28 ", N/A ,"$4,019.40 ","$4,019.40 ", N/A ,"$4,019.40 ", N/A ,"$4,823.28 ","$4,153.38 ","$4,823.28 ","$4,823.28 ","$4,019.40 " ST VINCENT HOSPITAL - ACUTE,27200185,C1733,HC CRYOABLATION CATHETER,272,1 ,"$7,720.00 ","$3,860.00 ","$3,242.40 ","$7,720.00 ","$4,987.12 ", N/A ,"$4,994.07 ","$4,994.07 ", N/A ,"$4,632.00 ","$6,562.00 ","$5,404.00 ", N/A ,"$7,334.00 ","$5,558.40 ","$5,635.60 ","$5,018.00 ","$6,562.00 ", N/A ,"$5,018.00 ","$6,176.00 ","$5,635.60 ", N/A , N/A ,"$3,242.40 ","$7,720.00 ","$6,562.00 ", N/A ,"$7,102.40 ","$5,404.00 ","$3,860.00 ","$4,632.00 ","$4,701.48 ","$3,860.00 ","$5,334.52 ","$5,404.00 ", N/A ,"$5,558.40 ", N/A ,"$4,632.00 ","$4,632.00 ", N/A ,"$4,632.00 ", N/A ,"$5,558.40 ","$4,786.40 ","$5,558.40 ","$5,558.40 ","$4,632.00 " ST VINCENT HOSPITAL - ACUTE,27200252,N/A,HC AORTIC EXTENDER,272,1 ,"$3,930.00 ","$1,965.00 ","$1,650.60 ","$3,930.00 ","$2,538.78 ", N/A ,"$2,542.32 ","$2,542.32 ", N/A ,"$2,358.00 ","$3,340.50 ","$2,751.00 ", N/A ,"$3,733.50 ","$2,829.60 ","$2,868.90 ","$2,554.50 ","$3,340.50 ", N/A ,"$2,554.50 ","$3,144.00 ","$2,868.90 ", N/A , N/A ,"$1,650.60 ","$3,930.00 ","$3,340.50 ", N/A ,"$3,615.60 ","$2,751.00 ","$1,965.00 ","$2,358.00 ","$2,393.37 ","$1,965.00 ","$2,715.63 ","$2,751.00 ", N/A ,"$2,829.60 ", N/A ,"$2,358.00 ","$2,358.00 ", N/A ,"$2,358.00 ", N/A ,"$2,829.60 ","$2,436.60 ","$2,829.60 ","$2,829.60 ","$2,358.00 " ST VINCENT HOSPITAL - ACUTE,27200280,N/A,HC ASAHI CORSAIR MICROCATHETER,272,1 ,"$2,224.00 ","$1,112.00 ",$934.08 ,"$2,224.00 ","$1,436.70 ", N/A ,"$1,438.71 ","$1,438.71 ", N/A ,"$1,334.40 ","$1,890.40 ","$1,556.80 ", N/A ,"$2,112.80 ","$1,601.28 ","$1,623.52 ","$1,445.60 ","$1,890.40 ", N/A ,"$1,445.60 ","$1,779.20 ","$1,623.52 ", N/A , N/A ,$934.08 ,"$2,224.00 ","$1,890.40 ", N/A ,"$2,046.08 ","$1,556.80 ","$1,112.00 ","$1,334.40 ","$1,354.42 ","$1,112.00 ","$1,536.78 ","$1,556.80 ", N/A ,"$1,601.28 ", N/A ,"$1,334.40 ","$1,334.40 ", N/A ,"$1,334.40 ", N/A ,"$1,601.28 ","$1,378.88 ","$1,601.28 ","$1,601.28 ","$1,334.40 " ST VINCENT HOSPITAL - ACUTE,27200283,N/A,HC ATRIUM CHEST DRAINAGE,272,1 ,$201.00 ,$100.50 ,$84.42 ,$201.00 ,$129.85 , N/A ,$130.03 ,$130.03 , N/A ,$120.60 ,$170.85 ,$140.70 , N/A ,$190.95 ,$144.72 ,$146.73 ,$130.65 ,$170.85 , N/A ,$130.65 ,$160.80 ,$146.73 , N/A , N/A ,$84.42 ,$201.00 ,$170.85 , N/A ,$184.92 ,$140.70 ,$100.50 ,$120.60 ,$122.41 ,$100.50 ,$138.89 ,$140.70 , N/A ,$144.72 , N/A ,$120.60 ,$120.60 , N/A ,$120.60 , N/A ,$144.72 ,$124.62 ,$144.72 ,$144.72 ,$120.60 ST VINCENT HOSPITAL - ACUTE,27200284,N/A,HC ATRIUM CHEST SET ADULT,272,1 ,$192.00 ,$96.00 ,$80.64 ,$192.00 ,$124.03 , N/A ,$124.20 ,$124.20 , N/A ,$115.20 ,$163.20 ,$134.40 , N/A ,$182.40 ,$138.24 ,$140.16 ,$124.80 ,$163.20 , N/A ,$124.80 ,$153.60 ,$140.16 , N/A , N/A ,$80.64 ,$192.00 ,$163.20 , N/A ,$176.64 ,$134.40 ,$96.00 ,$115.20 ,$116.93 ,$96.00 ,$132.67 ,$134.40 , N/A ,$138.24 , N/A ,$115.20 ,$115.20 , N/A ,$115.20 , N/A ,$138.24 ,$119.04 ,$138.24 ,$138.24 ,$115.20 ST VINCENT HOSPITAL - ACUTE,27200553,N/A,HC BONE MARROW KIT,272,1 ,$79.00 ,$39.50 ,$33.18 ,$79.00 ,$51.03 , N/A ,$51.11 ,$51.11 , N/A ,$47.40 ,$67.15 ,$55.30 , N/A ,$75.05 ,$56.88 ,$57.67 ,$51.35 ,$67.15 , N/A ,$51.35 ,$63.20 ,$57.67 , N/A , N/A ,$33.18 ,$79.00 ,$67.15 , N/A ,$72.68 ,$55.30 ,$39.50 ,$47.40 ,$48.11 ,$39.50 ,$54.59 ,$55.30 , N/A ,$56.88 , N/A ,$47.40 ,$47.40 , N/A ,$47.40 , N/A ,$56.88 ,$48.98 ,$56.88 ,$56.88 ,$47.40 ST VINCENT HOSPITAL - ACUTE,27200572,N/A,HC BREAST PUMP REPLACEMENT KIT,272,1 ,$46.00 ,$23.00 ,$19.32 ,$46.00 ,$29.72 , N/A ,$29.76 ,$29.76 , N/A ,$27.60 ,$39.10 ,$32.20 , N/A ,$43.70 ,$33.12 ,$33.58 ,$29.90 ,$39.10 , N/A ,$29.90 ,$36.80 ,$33.58 , N/A , N/A ,$19.32 ,$46.00 ,$39.10 , N/A ,$42.32 ,$32.20 ,$23.00 ,$27.60 ,$28.01 ,$23.00 ,$31.79 ,$32.20 , N/A ,$33.12 , N/A ,$27.60 ,$27.60 , N/A ,$27.60 , N/A ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,27200573,N/A,HC BREAST PUMP VALVE CAP,272,1 ,$33.00 ,$16.50 ,$13.86 ,$33.00 ,$21.32 , N/A ,$21.35 ,$21.35 , N/A ,$19.80 ,$28.05 ,$23.10 , N/A ,$31.35 ,$23.76 ,$24.09 ,$21.45 ,$28.05 , N/A ,$21.45 ,$26.40 ,$24.09 , N/A , N/A ,$13.86 ,$33.00 ,$28.05 , N/A ,$30.36 ,$23.10 ,$16.50 ,$19.80 ,$20.10 ,$16.50 ,$22.80 ,$23.10 , N/A ,$23.76 , N/A ,$19.80 ,$19.80 , N/A ,$19.80 , N/A ,$23.76 ,$20.46 ,$23.76 ,$23.76 ,$19.80 ST VINCENT HOSPITAL - ACUTE,27200732,N/A,HC CAPSULE,272,1 ,$37.00 ,$18.50 ,$15.54 ,$37.00 ,$23.90 , N/A ,$23.94 ,$23.94 , N/A ,$22.20 ,$31.45 ,$25.90 , N/A ,$35.15 ,$26.64 ,$27.01 ,$24.05 ,$31.45 , N/A ,$24.05 ,$29.60 ,$27.01 , N/A , N/A ,$15.54 ,$37.00 ,$31.45 , N/A ,$34.04 ,$25.90 ,$18.50 ,$22.20 ,$22.53 ,$18.50 ,$25.57 ,$25.90 , N/A ,$26.64 , N/A ,$22.20 ,$22.20 , N/A ,$22.20 , N/A ,$26.64 ,$22.94 ,$26.64 ,$26.64 ,$22.20 ST VINCENT HOSPITAL - ACUTE,27200781,C1730,HC CATH DECAPOLAR,272,1 ,"$1,319.00 ",$659.50 ,$553.98 ,"$1,319.00 ",$852.07 , N/A ,$853.26 ,$853.26 , N/A ,$791.40 ,"$1,121.15 ",$923.30 , N/A ,"$1,253.05 ",$949.68 ,$962.87 ,$857.35 ,"$1,121.15 ", N/A ,$857.35 ,"$1,055.20 ",$962.87 , N/A , N/A ,$553.98 ,"$1,319.00 ","$1,121.15 ", N/A ,"$1,213.48 ",$923.30 ,$659.50 ,$791.40 ,$803.27 ,$659.50 ,$911.43 ,$923.30 , N/A ,$949.68 , N/A ,$791.40 ,$791.40 , N/A ,$791.40 , N/A ,$949.68 ,$817.78 ,$949.68 ,$949.68 ,$791.40 ST VINCENT HOSPITAL - ACUTE,27200828,N/A,HC CATH FOLEY TEMPERATURE PROBE 16FR,272,1 ,$118.00 ,$59.00 ,$49.56 ,$118.00 ,$76.23 , N/A ,$76.33 ,$76.33 , N/A ,$70.80 ,$100.30 ,$82.60 , N/A ,$112.10 ,$84.96 ,$86.14 ,$76.70 ,$100.30 , N/A ,$76.70 ,$94.40 ,$86.14 , N/A , N/A ,$49.56 ,$118.00 ,$100.30 , N/A ,$108.56 ,$82.60 ,$59.00 ,$70.80 ,$71.86 ,$59.00 ,$81.54 ,$82.60 , N/A ,$84.96 , N/A ,$70.80 ,$70.80 , N/A ,$70.80 , N/A ,$84.96 ,$73.16 ,$84.96 ,$84.96 ,$70.80 ST VINCENT HOSPITAL - ACUTE,27200980,N/A,HC COOL LINE CATH KIT,272,1 ,"$1,050.00 ",$525.00 ,$441.00 ,"$1,050.00 ",$678.30 , N/A ,$679.25 ,$679.25 , N/A ,$630.00 ,$892.50 ,$735.00 , N/A ,$997.50 ,$756.00 ,$766.50 ,$682.50 ,$892.50 , N/A ,$682.50 ,$840.00 ,$766.50 , N/A , N/A ,$441.00 ,"$1,050.00 ",$892.50 , N/A ,$966.00 ,$735.00 ,$525.00 ,$630.00 ,$639.45 ,$525.00 ,$725.55 ,$735.00 , N/A ,$756.00 , N/A ,$630.00 ,$630.00 , N/A ,$630.00 , N/A ,$756.00 ,$651.00 ,$756.00 ,$756.00 ,$630.00 ST VINCENT HOSPITAL - ACUTE,27200983,N/A,HC COOLGUARD SYSTEM,272,1 ,$286.00 ,$143.00 ,$120.12 ,$286.00 ,$184.76 , N/A ,$185.01 ,$185.01 , N/A ,$171.60 ,$243.10 ,$200.20 , N/A ,$271.70 ,$205.92 ,$208.78 ,$185.90 ,$243.10 , N/A ,$185.90 ,$228.80 ,$208.78 , N/A , N/A ,$120.12 ,$286.00 ,$243.10 , N/A ,$263.12 ,$200.20 ,$143.00 ,$171.60 ,$174.17 ,$143.00 ,$197.63 ,$200.20 , N/A ,$205.92 , N/A ,$171.60 ,$171.60 , N/A ,$171.60 , N/A ,$205.92 ,$177.32 ,$205.92 ,$205.92 ,$171.60 ST VINCENT HOSPITAL - ACUTE,27200984,N/A,HC COOLGUARD TUBING STARTUP KIT,272,1 ,$749.00 ,$374.50 ,$314.58 ,$749.00 ,$483.85 , N/A ,$484.53 ,$484.53 , N/A ,$449.40 ,$636.65 ,$524.30 , N/A ,$711.55 ,$539.28 ,$546.77 ,$486.85 ,$636.65 , N/A ,$486.85 ,$599.20 ,$546.77 , N/A , N/A ,$314.58 ,$749.00 ,$636.65 , N/A ,$689.08 ,$524.30 ,$374.50 ,$449.40 ,$456.14 ,$374.50 ,$517.56 ,$524.30 , N/A ,$539.28 , N/A ,$449.40 ,$449.40 , N/A ,$449.40 , N/A ,$539.28 ,$464.38 ,$539.28 ,$539.28 ,$449.40 ST VINCENT HOSPITAL - ACUTE,27200990,N/A,HC COSCO CAR BED,272,1 ,$97.00 ,$48.50 ,$40.74 ,$97.00 ,$62.66 , N/A ,$62.75 ,$62.75 , N/A ,$58.20 ,$82.45 ,$67.90 , N/A ,$92.15 ,$69.84 ,$70.81 ,$63.05 ,$82.45 , N/A ,$63.05 ,$77.60 ,$70.81 , N/A , N/A ,$40.74 ,$97.00 ,$82.45 , N/A ,$89.24 ,$67.90 ,$48.50 ,$58.20 ,$59.07 ,$48.50 ,$67.03 ,$67.90 , N/A ,$69.84 , N/A ,$58.20 ,$58.20 , N/A ,$58.20 , N/A ,$69.84 ,$60.14 ,$69.84 ,$69.84 ,$58.20 ST VINCENT HOSPITAL - ACUTE,27201085,N/A,HC DISPOSABLE CLIPS USED >4 EACH CLIP,272,1 ,$170.00 ,$85.00 ,$71.40 ,$170.00 ,$109.82 , N/A ,$109.97 ,$109.97 , N/A ,$102.00 ,$144.50 ,$119.00 , N/A ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 , N/A ,$110.50 ,$136.00 ,$124.10 , N/A , N/A ,$71.40 ,$170.00 ,$144.50 , N/A ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 , N/A ,$122.40 , N/A ,$102.00 ,$102.00 , N/A ,$102.00 , N/A ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,27201086,C1769,HC GUIDEWIRE,272,1 ,$281.00 ,$140.50 ,$118.02 ,$281.00 ,$181.53 , N/A ,$181.78 ,$181.78 , N/A ,$168.60 ,$238.85 ,$196.70 , N/A ,$266.95 ,$202.32 ,$205.13 ,$182.65 ,$238.85 , N/A ,$182.65 ,$224.80 ,$205.13 , N/A , N/A ,$118.02 ,$281.00 ,$238.85 , N/A ,$258.52 ,$196.70 ,$140.50 ,$168.60 ,$171.13 ,$140.50 ,$194.17 ,$196.70 , N/A ,$202.32 , N/A ,$168.60 ,$168.60 , N/A ,$168.60 , N/A ,$202.32 ,$174.22 ,$202.32 ,$202.32 ,$168.60 ST VINCENT HOSPITAL - ACUTE,27201087,N/A,HC TRACH KIT BEDSIDE,272,1 ,"$1,063.00 ",$531.50 ,$446.46 ,"$1,063.00 ",$686.70 , N/A ,$687.65 ,$687.65 , N/A ,$637.80 ,$903.55 ,$744.10 , N/A ,"$1,009.85 ",$765.36 ,$775.99 ,$690.95 ,$903.55 , N/A ,$690.95 ,$850.40 ,$775.99 , N/A , N/A ,$446.46 ,"$1,063.00 ",$903.55 , N/A ,$977.96 ,$744.10 ,$531.50 ,$637.80 ,$647.37 ,$531.50 ,$734.53 ,$744.10 , N/A ,$765.36 , N/A ,$637.80 ,$637.80 , N/A ,$637.80 , N/A ,$765.36 ,$659.06 ,$765.36 ,$765.36 ,$637.80 ST VINCENT HOSPITAL - ACUTE,27201164,N/A,HC MINNESOTA 4 LUMEN TUBE,272,1 ,$877.00 ,$438.50 ,$368.34 ,$877.00 ,$566.54 , N/A ,$567.33 ,$567.33 , N/A ,$526.20 ,$745.45 ,$613.90 , N/A ,$833.15 ,$631.44 ,$640.21 ,$570.05 ,$745.45 , N/A ,$570.05 ,$701.60 ,$640.21 , N/A , N/A ,$368.34 ,$877.00 ,$745.45 , N/A ,$806.84 ,$613.90 ,$438.50 ,$526.20 ,$534.09 ,$438.50 ,$606.01 ,$613.90 , N/A ,$631.44 , N/A ,$526.20 ,$526.20 , N/A ,$526.20 , N/A ,$631.44 ,$543.74 ,$631.44 ,$631.44 ,$526.20 ST VINCENT HOSPITAL - ACUTE,27201249,N/A,HC EPIDURAL TRAY CONTINUOUS,272,1 ,$112.00 ,$56.00 ,$47.04 ,$112.00 ,$72.35 , N/A ,$72.45 ,$72.45 , N/A ,$67.20 ,$95.20 ,$78.40 , N/A ,$106.40 ,$80.64 ,$81.76 ,$72.80 ,$95.20 , N/A ,$72.80 ,$89.60 ,$81.76 , N/A , N/A ,$47.04 ,$112.00 ,$95.20 , N/A ,$103.04 ,$78.40 ,$56.00 ,$67.20 ,$68.21 ,$56.00 ,$77.39 ,$78.40 , N/A ,$80.64 , N/A ,$67.20 ,$67.20 , N/A ,$67.20 , N/A ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,27201340,N/A,SVG HC GELFOAM ANGIO AVITENE,272,1 ,$725.00 ,$362.50 ,$304.50 ,$725.00 ,$468.35 , N/A ,$469.00 ,$469.00 , N/A ,$435.00 ,$616.25 ,$507.50 , N/A ,$688.75 ,$522.00 ,$529.25 ,$471.25 ,$616.25 , N/A ,$471.25 ,$580.00 ,$529.25 , N/A , N/A ,$304.50 ,$725.00 ,$616.25 , N/A ,$667.00 ,$507.50 ,$362.50 ,$435.00 ,$441.53 ,$362.50 ,$500.98 ,$507.50 , N/A ,$522.00 , N/A ,$435.00 ,$435.00 , N/A ,$435.00 , N/A ,$522.00 ,$449.50 ,$522.00 ,$522.00 ,$435.00 ST VINCENT HOSPITAL - ACUTE,27201382,N/A,HC HALO HEAD SCREWS,272,1 ,"$1,223.00 ",$611.50 ,$513.66 ,"$1,223.00 ",$790.06 , N/A ,$791.16 ,$791.16 , N/A ,$733.80 ,"$1,039.55 ",$856.10 , N/A ,"$1,161.85 ",$880.56 ,$892.79 ,$794.95 ,"$1,039.55 ", N/A ,$794.95 ,$978.40 ,$892.79 , N/A , N/A ,$513.66 ,"$1,223.00 ","$1,039.55 ", N/A ,"$1,125.16 ",$856.10 ,$611.50 ,$733.80 ,$744.81 ,$611.50 ,$845.09 ,$856.10 , N/A ,$880.56 , N/A ,$733.80 ,$733.80 , N/A ,$733.80 , N/A ,$880.56 ,$758.26 ,$880.56 ,$880.56 ,$733.80 ST VINCENT HOSPITAL - ACUTE,27201389,N/A,HC HEAD RESTRAINT,272,1 ,$72.00 ,$36.00 ,$30.24 ,$72.00 ,$46.51 , N/A ,$46.58 ,$46.58 , N/A ,$43.20 ,$61.20 ,$50.40 , N/A ,$68.40 ,$51.84 ,$52.56 ,$46.80 ,$61.20 , N/A ,$46.80 ,$57.60 ,$52.56 , N/A , N/A ,$30.24 ,$72.00 ,$61.20 , N/A ,$66.24 ,$50.40 ,$36.00 ,$43.20 ,$43.85 ,$36.00 ,$49.75 ,$50.40 , N/A ,$51.84 , N/A ,$43.20 ,$43.20 , N/A ,$43.20 , N/A ,$51.84 ,$44.64 ,$51.84 ,$51.84 ,$43.20 ST VINCENT HOSPITAL - ACUTE,27201423,N/A,HC HYSTEROSALPINGEOGRAM CATH,272,1 ,$147.00 ,$73.50 ,$61.74 ,$147.00 ,$94.96 , N/A ,$95.09 ,$95.09 , N/A ,$88.20 ,$124.95 ,$102.90 , N/A ,$139.65 ,$105.84 ,$107.31 ,$95.55 ,$124.95 , N/A ,$95.55 ,$117.60 ,$107.31 , N/A , N/A ,$61.74 ,$147.00 ,$124.95 , N/A ,$135.24 ,$102.90 ,$73.50 ,$88.20 ,$89.52 ,$73.50 ,$101.58 ,$102.90 , N/A ,$105.84 , N/A ,$88.20 ,$88.20 , N/A ,$88.20 , N/A ,$105.84 ,$91.14 ,$105.84 ,$105.84 ,$88.20 ST VINCENT HOSPITAL - ACUTE,27201424,N/A,HC IABP BALLOON,272,1 ,"$2,404.00 ","$1,202.00 ","$1,009.68 ","$2,404.00 ","$1,552.98 ", N/A ,"$1,555.15 ","$1,555.15 ", N/A ,"$1,442.40 ","$2,043.40 ","$1,682.80 ", N/A ,"$2,283.80 ","$1,730.88 ","$1,754.92 ","$1,562.60 ","$2,043.40 ", N/A ,"$1,562.60 ","$1,923.20 ","$1,754.92 ", N/A , N/A ,"$1,009.68 ","$2,404.00 ","$2,043.40 ", N/A ,"$2,211.68 ","$1,682.80 ","$1,202.00 ","$1,442.40 ","$1,464.04 ","$1,202.00 ","$1,661.16 ","$1,682.80 ", N/A ,"$1,730.88 ", N/A ,"$1,442.40 ","$1,442.40 ", N/A ,"$1,442.40 ", N/A ,"$1,730.88 ","$1,490.48 ","$1,730.88 ","$1,730.88 ","$1,442.40 " ST VINCENT HOSPITAL - ACUTE,27201426,N/A,HC ICP TRANSDUCER,272,1 ,$30.00 ,$15.00 ,$12.60 ,$30.00 ,$19.38 , N/A ,$19.41 ,$19.41 , N/A ,$18.00 ,$25.50 ,$21.00 , N/A ,$28.50 ,$21.60 ,$21.90 ,$19.50 ,$25.50 , N/A ,$19.50 ,$24.00 ,$21.90 , N/A , N/A ,$12.60 ,$30.00 ,$25.50 , N/A ,$27.60 ,$21.00 ,$15.00 ,$18.00 ,$18.27 ,$15.00 ,$20.73 ,$21.00 , N/A ,$21.60 , N/A ,$18.00 ,$18.00 , N/A ,$18.00 , N/A ,$21.60 ,$18.60 ,$21.60 ,$21.60 ,$18.00 ST VINCENT HOSPITAL - ACUTE,27201427,N/A,HC ICY CATH KIT,272,1 ,"$1,925.00 ",$962.50 ,$808.50 ,"$1,925.00 ","$1,243.55 ", N/A ,"$1,245.28 ","$1,245.28 ", N/A ,"$1,155.00 ","$1,636.25 ","$1,347.50 ", N/A ,"$1,828.75 ","$1,386.00 ","$1,405.25 ","$1,251.25 ","$1,636.25 ", N/A ,"$1,251.25 ","$1,540.00 ","$1,405.25 ", N/A , N/A ,$808.50 ,"$1,925.00 ","$1,636.25 ", N/A ,"$1,771.00 ","$1,347.50 ",$962.50 ,"$1,155.00 ","$1,172.33 ",$962.50 ,"$1,330.18 ","$1,347.50 ", N/A ,"$1,386.00 ", N/A ,"$1,155.00 ","$1,155.00 ", N/A ,"$1,155.00 ", N/A ,"$1,386.00 ","$1,193.50 ","$1,386.00 ","$1,386.00 ","$1,155.00 " ST VINCENT HOSPITAL - ACUTE,27201450,N/A,HC INTRODUCER KIT,272,1 ,$180.00 ,$90.00 ,$75.60 ,$180.00 ,$116.28 , N/A ,$116.44 ,$116.44 , N/A ,$108.00 ,$153.00 ,$126.00 , N/A ,$171.00 ,$129.60 ,$131.40 ,$117.00 ,$153.00 , N/A ,$117.00 ,$144.00 ,$131.40 , N/A , N/A ,$75.60 ,$180.00 ,$153.00 , N/A ,$165.60 ,$126.00 ,$90.00 ,$108.00 ,$109.62 ,$90.00 ,$124.38 ,$126.00 , N/A ,$129.60 , N/A ,$108.00 ,$108.00 , N/A ,$108.00 , N/A ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,27201458,N/A,HC INTROSYTE PED 1.9FR,272,1 ,$57.00 ,$28.50 ,$23.94 ,$57.00 ,$36.82 , N/A ,$36.87 ,$36.87 , N/A ,$34.20 ,$48.45 ,$39.90 , N/A ,$54.15 ,$41.04 ,$41.61 ,$37.05 ,$48.45 , N/A ,$37.05 ,$45.60 ,$41.61 , N/A , N/A ,$23.94 ,$57.00 ,$48.45 , N/A ,$52.44 ,$39.90 ,$28.50 ,$34.20 ,$34.71 ,$28.50 ,$39.39 ,$39.90 , N/A ,$41.04 , N/A ,$34.20 ,$34.20 , N/A ,$34.20 , N/A ,$41.04 ,$35.34 ,$41.04 ,$41.04 ,$34.20 ST VINCENT HOSPITAL - ACUTE,27201473,N/A,SVG HC JEJUNOSTOMY TUBE,272,1 ,$281.00 ,$140.50 ,$118.02 ,$281.00 ,$181.53 , N/A ,$181.78 ,$181.78 , N/A ,$168.60 ,$238.85 ,$196.70 , N/A ,$266.95 ,$202.32 ,$205.13 ,$182.65 ,$238.85 , N/A ,$182.65 ,$224.80 ,$205.13 , N/A , N/A ,$118.02 ,$281.00 ,$238.85 , N/A ,$258.52 ,$196.70 ,$140.50 ,$168.60 ,$171.13 ,$140.50 ,$194.17 ,$196.70 , N/A ,$202.32 , N/A ,$168.60 ,$168.60 , N/A ,$168.60 , N/A ,$202.32 ,$174.22 ,$202.32 ,$202.32 ,$168.60 ST VINCENT HOSPITAL - ACUTE,27201487,N/A,HC KIT ARROW 9 MAC TWO LUMEN,272,1 ,$369.00 ,$184.50 ,$154.98 ,$369.00 ,$238.37 , N/A ,$238.71 ,$238.71 , N/A ,$221.40 ,$313.65 ,$258.30 , N/A ,$350.55 ,$265.68 ,$269.37 ,$239.85 ,$313.65 , N/A ,$239.85 ,$295.20 ,$269.37 , N/A , N/A ,$154.98 ,$369.00 ,$313.65 , N/A ,$339.48 ,$258.30 ,$184.50 ,$221.40 ,$224.72 ,$184.50 ,$254.98 ,$258.30 , N/A ,$265.68 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$265.68 ,$228.78 ,$265.68 ,$265.68 ,$221.40 ST VINCENT HOSPITAL - ACUTE,27201527,N/A,HC KIT NASAL BLIMP(RHINO ROCKET),272,1 ,$84.00 ,$42.00 ,$35.28 ,$84.00 ,$54.26 , N/A ,$54.34 ,$54.34 , N/A ,$50.40 ,$71.40 ,$58.80 , N/A ,$79.80 ,$60.48 ,$61.32 ,$54.60 ,$71.40 , N/A ,$54.60 ,$67.20 ,$61.32 , N/A , N/A ,$35.28 ,$84.00 ,$71.40 , N/A ,$77.28 ,$58.80 ,$42.00 ,$50.40 ,$51.16 ,$42.00 ,$58.04 ,$58.80 , N/A ,$60.48 , N/A ,$50.40 ,$50.40 , N/A ,$50.40 , N/A ,$60.48 ,$52.08 ,$60.48 ,$60.48 ,$50.40 ST VINCENT HOSPITAL - ACUTE,27201559,N/A,HC L CATH 24G 30CM 1.9FR,272,1 ,$392.00 ,$196.00 ,$164.64 ,$392.00 ,$253.23 , N/A ,$253.58 ,$253.58 , N/A ,$235.20 ,$333.20 ,$274.40 , N/A ,$372.40 ,$282.24 ,$286.16 ,$254.80 ,$333.20 , N/A ,$254.80 ,$313.60 ,$286.16 , N/A , N/A ,$164.64 ,$392.00 ,$333.20 , N/A ,$360.64 ,$274.40 ,$196.00 ,$235.20 ,$238.73 ,$196.00 ,$270.87 ,$274.40 , N/A ,$282.24 , N/A ,$235.20 ,$235.20 , N/A ,$235.20 , N/A ,$282.24 ,$243.04 ,$282.24 ,$282.24 ,$235.20 ST VINCENT HOSPITAL - ACUTE,27201625,N/A,HC LOOP RESECTION HF24/26FR,272,1 ,"$1,244.88 ",$622.44 ,$522.85 ,"$1,244.88 ",$804.19 , N/A ,$805.31 ,$805.31 , N/A ,$746.93 ,"$1,058.15 ",$871.42 , N/A ,"$1,182.64 ",$896.31 ,$908.76 ,$809.17 ,"$1,058.15 ", N/A ,$809.17 ,$995.90 ,$908.76 , N/A , N/A ,$522.85 ,"$1,244.88 ","$1,058.15 ", N/A ,"$1,145.29 ",$871.42 ,$622.44 ,$746.93 ,$758.13 ,$622.44 ,$860.21 ,$871.42 , N/A ,$896.31 , N/A ,$746.93 ,$746.93 , N/A ,$746.93 , N/A ,$896.31 ,$771.83 ,$896.31 ,$896.31 ,$746.93 ST VINCENT HOSPITAL - ACUTE,27201635,N/A,SVG HC MAMMOTOME NEEDLE AND TUBE,272,1 ,$512.00 ,$256.00 ,$215.04 ,$512.00 ,$330.75 , N/A ,$331.21 ,$331.21 , N/A ,$307.20 ,$435.20 ,$358.40 , N/A ,$486.40 ,$368.64 ,$373.76 ,$332.80 ,$435.20 , N/A ,$332.80 ,$409.60 ,$373.76 , N/A , N/A ,$215.04 ,$512.00 ,$435.20 , N/A ,$471.04 ,$358.40 ,$256.00 ,$307.20 ,$311.81 ,$256.00 ,$353.79 ,$358.40 , N/A ,$368.64 , N/A ,$307.20 ,$307.20 , N/A ,$307.20 , N/A ,$368.64 ,$317.44 ,$368.64 ,$368.64 ,$307.20 ST VINCENT HOSPITAL - ACUTE,27201640,N/A,HC MANUAL HAND BREAST PUMP,272,1 ,$50.00 ,$25.00 ,$21.00 ,$50.00 ,$32.30 , N/A ,$32.35 ,$32.35 , N/A ,$30.00 ,$42.50 ,$35.00 , N/A ,$47.50 ,$36.00 ,$36.50 ,$32.50 ,$42.50 , N/A ,$32.50 ,$40.00 ,$36.50 , N/A , N/A ,$21.00 ,$50.00 ,$42.50 , N/A ,$46.00 ,$35.00 ,$25.00 ,$30.00 ,$30.45 ,$25.00 ,$34.55 ,$35.00 , N/A ,$36.00 , N/A ,$30.00 ,$30.00 , N/A ,$30.00 , N/A ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,27201644,N/A,HC DOUBLE BREAST PUMP KT,272,1 ,$102.00 ,$51.00 ,$42.84 ,$102.00 ,$65.89 , N/A ,$65.98 ,$65.98 , N/A ,$61.20 ,$86.70 ,$71.40 , N/A ,$96.90 ,$73.44 ,$74.46 ,$66.30 ,$86.70 , N/A ,$66.30 ,$81.60 ,$74.46 , N/A , N/A ,$42.84 ,$102.00 ,$86.70 , N/A ,$93.84 ,$71.40 ,$51.00 ,$61.20 ,$62.12 ,$51.00 ,$70.48 ,$71.40 , N/A ,$73.44 , N/A ,$61.20 ,$61.20 , N/A ,$61.20 , N/A ,$73.44 ,$63.24 ,$73.44 ,$73.44 ,$61.20 ST VINCENT HOSPITAL - ACUTE,27201723,N/A,HC NEO PICC TRAY,272,1 ,$123.00 ,$61.50 ,$51.66 ,$123.00 ,$79.46 , N/A ,$79.57 ,$79.57 , N/A ,$73.80 ,$104.55 ,$86.10 , N/A ,$116.85 ,$88.56 ,$89.79 ,$79.95 ,$104.55 , N/A ,$79.95 ,$98.40 ,$89.79 , N/A , N/A ,$51.66 ,$123.00 ,$104.55 , N/A ,$113.16 ,$86.10 ,$61.50 ,$73.80 ,$74.91 ,$61.50 ,$84.99 ,$86.10 , N/A ,$88.56 , N/A ,$73.80 ,$73.80 , N/A ,$73.80 , N/A ,$88.56 ,$76.26 ,$88.56 ,$88.56 ,$73.80 ST VINCENT HOSPITAL - ACUTE,27201729,N/A,HC NEOPUFF CIRCUIT AND MASK,272,1 ,$59.00 ,$29.50 ,$24.78 ,$59.00 ,$38.11 , N/A ,$38.17 ,$38.17 , N/A ,$35.40 ,$50.15 ,$41.30 , N/A ,$56.05 ,$42.48 ,$43.07 ,$38.35 ,$50.15 , N/A ,$38.35 ,$47.20 ,$43.07 , N/A , N/A ,$24.78 ,$59.00 ,$50.15 , N/A ,$54.28 ,$41.30 ,$29.50 ,$35.40 ,$35.93 ,$29.50 ,$40.77 ,$41.30 , N/A ,$42.48 , N/A ,$35.40 ,$35.40 , N/A ,$35.40 , N/A ,$42.48 ,$36.58 ,$42.48 ,$42.48 ,$35.40 ST VINCENT HOSPITAL - ACUTE,27201732,N/A,HC NEWBORN OSTOMY POUCH,272,1 ,$180.00 ,$90.00 ,$75.60 ,$180.00 ,$116.28 , N/A ,$116.44 ,$116.44 , N/A ,$108.00 ,$153.00 ,$126.00 , N/A ,$171.00 ,$129.60 ,$131.40 ,$117.00 ,$153.00 , N/A ,$117.00 ,$144.00 ,$131.40 , N/A , N/A ,$75.60 ,$180.00 ,$153.00 , N/A ,$165.60 ,$126.00 ,$90.00 ,$108.00 ,$109.62 ,$90.00 ,$124.38 ,$126.00 , N/A ,$129.60 , N/A ,$108.00 ,$108.00 , N/A ,$108.00 , N/A ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,27201739,N/A,HC NO STING WIPES,272,1 ,$84.00 ,$42.00 ,$35.28 ,$84.00 ,$54.26 , N/A ,$54.34 ,$54.34 , N/A ,$50.40 ,$71.40 ,$58.80 , N/A ,$79.80 ,$60.48 ,$61.32 ,$54.60 ,$71.40 , N/A ,$54.60 ,$67.20 ,$61.32 , N/A , N/A ,$35.28 ,$84.00 ,$71.40 , N/A ,$77.28 ,$58.80 ,$42.00 ,$50.40 ,$51.16 ,$42.00 ,$58.04 ,$58.80 , N/A ,$60.48 , N/A ,$50.40 ,$50.40 , N/A ,$50.40 , N/A ,$60.48 ,$52.08 ,$60.48 ,$60.48 ,$50.40 ST VINCENT HOSPITAL - ACUTE,27201768,N/A,HC OUTBACK LTD CATHETER,272,1 ,"$4,369.00 ","$2,184.50 ","$1,834.98 ","$4,369.00 ","$2,822.37 ", N/A ,"$2,826.31 ","$2,826.31 ", N/A ,"$2,621.40 ","$3,713.65 ","$3,058.30 ", N/A ,"$4,150.55 ","$3,145.68 ","$3,189.37 ","$2,839.85 ","$3,713.65 ", N/A ,"$2,839.85 ","$3,495.20 ","$3,189.37 ", N/A , N/A ,"$1,834.98 ","$4,369.00 ","$3,713.65 ", N/A ,"$4,019.48 ","$3,058.30 ","$2,184.50 ","$2,621.40 ","$2,660.72 ","$2,184.50 ","$3,018.98 ","$3,058.30 ", N/A ,"$3,145.68 ", N/A ,"$2,621.40 ","$2,621.40 ", N/A ,"$2,621.40 ", N/A ,"$3,145.68 ","$2,708.78 ","$3,145.68 ","$3,145.68 ","$2,621.40 " ST VINCENT HOSPITAL - ACUTE,27201825,N/A,HC PED PICC 1.9FR 30CM,272,1 ,$135.00 ,$67.50 ,$56.70 ,$135.00 ,$87.21 , N/A ,$87.33 ,$87.33 , N/A ,$81.00 ,$114.75 ,$94.50 , N/A ,$128.25 ,$97.20 ,$98.55 ,$87.75 ,$114.75 , N/A ,$87.75 ,$108.00 ,$98.55 , N/A , N/A ,$56.70 ,$135.00 ,$114.75 , N/A ,$124.20 ,$94.50 ,$67.50 ,$81.00 ,$82.22 ,$67.50 ,$93.29 ,$94.50 , N/A ,$97.20 , N/A ,$81.00 ,$81.00 , N/A ,$81.00 , N/A ,$97.20 ,$83.70 ,$97.20 ,$97.20 ,$81.00 ST VINCENT HOSPITAL - ACUTE,27201829,N/A,HC PELVIC BINDER,272,1 ,$588.00 ,$294.00 ,$246.96 ,$588.00 ,$379.85 , N/A ,$380.38 ,$380.38 , N/A ,$352.80 ,$499.80 ,$411.60 , N/A ,$558.60 ,$423.36 ,$429.24 ,$382.20 ,$499.80 , N/A ,$382.20 ,$470.40 ,$429.24 , N/A , N/A ,$246.96 ,$588.00 ,$499.80 , N/A ,$540.96 ,$411.60 ,$294.00 ,$352.80 ,$358.09 ,$294.00 ,$406.31 ,$411.60 , N/A ,$423.36 , N/A ,$352.80 ,$352.80 , N/A ,$352.80 , N/A ,$423.36 ,$364.56 ,$423.36 ,$423.36 ,$352.80 ST VINCENT HOSPITAL - ACUTE,27201844,N/A,HC PICC CATH DUAL LUMAN 1.9F,272,1 ,$459.00 ,$229.50 ,$192.78 ,$459.00 ,$296.51 , N/A ,$296.93 ,$296.93 , N/A ,$275.40 ,$390.15 ,$321.30 , N/A ,$436.05 ,$330.48 ,$335.07 ,$298.35 ,$390.15 , N/A ,$298.35 ,$367.20 ,$335.07 , N/A , N/A ,$192.78 ,$459.00 ,$390.15 , N/A ,$422.28 ,$321.30 ,$229.50 ,$275.40 ,$279.53 ,$229.50 ,$317.17 ,$321.30 , N/A ,$330.48 , N/A ,$275.40 ,$275.40 , N/A ,$275.40 , N/A ,$330.48 ,$284.58 ,$330.48 ,$330.48 ,$275.40 ST VINCENT HOSPITAL - ACUTE,27201888,N/A,HC PREMIE OSTOMY POUCH,272,1 ,$269.00 ,$134.50 ,$112.98 ,$269.00 ,$173.77 , N/A ,$174.02 ,$174.02 , N/A ,$161.40 ,$228.65 ,$188.30 , N/A ,$255.55 ,$193.68 ,$196.37 ,$174.85 ,$228.65 , N/A ,$174.85 ,$215.20 ,$196.37 , N/A , N/A ,$112.98 ,$269.00 ,$228.65 , N/A ,$247.48 ,$188.30 ,$134.50 ,$161.40 ,$163.82 ,$134.50 ,$185.88 ,$188.30 , N/A ,$193.68 , N/A ,$161.40 ,$161.40 , N/A ,$161.40 , N/A ,$193.68 ,$166.78 ,$193.68 ,$193.68 ,$161.40 ST VINCENT HOSPITAL - ACUTE,27201896,N/A,HC PREVENA INCISION SYSTEM,272,1 ,$844.00 ,$422.00 ,$354.48 ,$844.00 ,$545.22 , N/A ,$545.98 ,$545.98 , N/A ,$506.40 ,$717.40 ,$590.80 , N/A ,$801.80 ,$607.68 ,$616.12 ,$548.60 ,$717.40 , N/A ,$548.60 ,$675.20 ,$616.12 , N/A , N/A ,$354.48 ,$844.00 ,$717.40 , N/A ,$776.48 ,$590.80 ,$422.00 ,$506.40 ,$514.00 ,$422.00 ,$583.20 ,$590.80 , N/A ,$607.68 , N/A ,$506.40 ,$506.40 , N/A ,$506.40 , N/A ,$607.68 ,$523.28 ,$607.68 ,$607.68 ,$506.40 ST VINCENT HOSPITAL - ACUTE,27202002,N/A,HC SCD SLEEVE KNEE,272,1 ,$168.00 ,$84.00 ,$70.56 ,$168.00 ,$108.53 , N/A ,$108.68 ,$108.68 , N/A ,$100.80 ,$142.80 ,$117.60 , N/A ,$159.60 ,$120.96 ,$122.64 ,$109.20 ,$142.80 , N/A ,$109.20 ,$134.40 ,$122.64 , N/A , N/A ,$70.56 ,$168.00 ,$142.80 , N/A ,$154.56 ,$117.60 ,$84.00 ,$100.80 ,$102.31 ,$84.00 ,$116.09 ,$117.60 , N/A ,$120.96 , N/A ,$100.80 ,$100.80 , N/A ,$100.80 , N/A ,$120.96 ,$104.16 ,$120.96 ,$120.96 ,$100.80 ST VINCENT HOSPITAL - ACUTE,27202013,N/A,HC SEALANT FLOSEAL MATRIX,272,1 ,$284.00 ,$142.00 ,$119.28 ,$284.00 ,$183.46 , N/A ,$183.72 ,$183.72 , N/A ,$170.40 ,$241.40 ,$198.80 , N/A ,$269.80 ,$204.48 ,$207.32 ,$184.60 ,$241.40 , N/A ,$184.60 ,$227.20 ,$207.32 , N/A , N/A ,$119.28 ,$284.00 ,$241.40 , N/A ,$261.28 ,$198.80 ,$142.00 ,$170.40 ,$172.96 ,$142.00 ,$196.24 ,$198.80 , N/A ,$204.48 , N/A ,$170.40 ,$170.40 , N/A ,$170.40 , N/A ,$204.48 ,$176.08 ,$204.48 ,$204.48 ,$170.40 ST VINCENT HOSPITAL - ACUTE,27202051,N/A,HC SHEATH KIT,272,1 ,"$1,295.00 ",$647.50 ,$543.90 ,"$1,295.00 ",$836.57 , N/A ,$837.74 ,$837.74 , N/A ,$777.00 ,"$1,100.75 ",$906.50 , N/A ,"$1,230.25 ",$932.40 ,$945.35 ,$841.75 ,"$1,100.75 ", N/A ,$841.75 ,"$1,036.00 ",$945.35 , N/A , N/A ,$543.90 ,"$1,295.00 ","$1,100.75 ", N/A ,"$1,191.40 ",$906.50 ,$647.50 ,$777.00 ,$788.66 ,$647.50 ,$894.85 ,$906.50 , N/A ,$932.40 , N/A ,$777.00 ,$777.00 , N/A ,$777.00 , N/A ,$932.40 ,$802.90 ,$932.40 ,$932.40 ,$777.00 ST VINCENT HOSPITAL - ACUTE,27202140,N/A,HC STENT PANCREATIC PLASTIC,272,1 ,$320.00 ,$160.00 ,$134.40 ,$320.00 ,$206.72 , N/A ,$207.01 ,$207.01 , N/A ,$192.00 ,$272.00 ,$224.00 , N/A ,$304.00 ,$230.40 ,$233.60 ,$208.00 ,$272.00 , N/A ,$208.00 ,$256.00 ,$233.60 , N/A , N/A ,$134.40 ,$320.00 ,$272.00 , N/A ,$294.40 ,$224.00 ,$160.00 ,$192.00 ,$194.88 ,$160.00 ,$221.12 ,$224.00 , N/A ,$230.40 , N/A ,$192.00 ,$192.00 , N/A ,$192.00 , N/A ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,27202180,N/A,HC SUPPLEMENTAL NURSING SYSTEM,272,1 ,$52.00 ,$26.00 ,$21.84 ,$52.00 ,$33.59 , N/A ,$33.64 ,$33.64 , N/A ,$31.20 ,$44.20 ,$36.40 , N/A ,$49.40 ,$37.44 ,$37.96 ,$33.80 ,$44.20 , N/A ,$33.80 ,$41.60 ,$37.96 , N/A , N/A ,$21.84 ,$52.00 ,$44.20 , N/A ,$47.84 ,$36.40 ,$26.00 ,$31.20 ,$31.67 ,$26.00 ,$35.93 ,$36.40 , N/A ,$37.44 , N/A ,$31.20 ,$31.20 , N/A ,$31.20 , N/A ,$37.44 ,$32.24 ,$37.44 ,$37.44 ,$31.20 ST VINCENT HOSPITAL - ACUTE,27202641,N/A,HC SYRINGE/GAUGE ASSEMBLY/HANDLE,272,1 ,$191.00 ,$95.50 ,$80.22 ,$191.00 ,$123.39 , N/A ,$123.56 ,$123.56 , N/A ,$114.60 ,$162.35 ,$133.70 , N/A ,$181.45 ,$137.52 ,$139.43 ,$124.15 ,$162.35 , N/A ,$124.15 ,$152.80 ,$139.43 , N/A , N/A ,$80.22 ,$191.00 ,$162.35 , N/A ,$175.72 ,$133.70 ,$95.50 ,$114.60 ,$116.32 ,$95.50 ,$131.98 ,$133.70 , N/A ,$137.52 , N/A ,$114.60 ,$114.60 , N/A ,$114.60 , N/A ,$137.52 ,$118.42 ,$137.52 ,$137.52 ,$114.60 ST VINCENT HOSPITAL - ACUTE,27202728,N/A,HC TRANSDUCER-RADIAL PREMIE,272,1 ,$46.00 ,$23.00 ,$19.32 ,$46.00 ,$29.72 , N/A ,$29.76 ,$29.76 , N/A ,$27.60 ,$39.10 ,$32.20 , N/A ,$43.70 ,$33.12 ,$33.58 ,$29.90 ,$39.10 , N/A ,$29.90 ,$36.80 ,$33.58 , N/A , N/A ,$19.32 ,$46.00 ,$39.10 , N/A ,$42.32 ,$32.20 ,$23.00 ,$27.60 ,$28.01 ,$23.00 ,$31.79 ,$32.20 , N/A ,$33.12 , N/A ,$27.60 ,$27.60 , N/A ,$27.60 , N/A ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,27202956,N/A,HC UMBIL VESS CATH 5.0 TRIP,272,1 ,$208.00 ,$104.00 ,$87.36 ,$208.00 ,$134.37 , N/A ,$134.56 ,$134.56 , N/A ,$124.80 ,$176.80 ,$145.60 , N/A ,$197.60 ,$149.76 ,$151.84 ,$135.20 ,$176.80 , N/A ,$135.20 ,$166.40 ,$151.84 , N/A , N/A ,$87.36 ,$208.00 ,$176.80 , N/A ,$191.36 ,$145.60 ,$104.00 ,$124.80 ,$126.67 ,$104.00 ,$143.73 ,$145.60 , N/A ,$149.76 , N/A ,$124.80 ,$124.80 , N/A ,$124.80 , N/A ,$149.76 ,$128.96 ,$149.76 ,$149.76 ,$124.80 ST VINCENT HOSPITAL - ACUTE,27202957,N/A,HC UMBILC VESS CATH 3.5 DUA,272,1 ,$123.00 ,$61.50 ,$51.66 ,$123.00 ,$79.46 , N/A ,$79.57 ,$79.57 , N/A ,$73.80 ,$104.55 ,$86.10 , N/A ,$116.85 ,$88.56 ,$89.79 ,$79.95 ,$104.55 , N/A ,$79.95 ,$98.40 ,$89.79 , N/A , N/A ,$51.66 ,$123.00 ,$104.55 , N/A ,$113.16 ,$86.10 ,$61.50 ,$73.80 ,$74.91 ,$61.50 ,$84.99 ,$86.10 , N/A ,$88.56 , N/A ,$73.80 ,$73.80 , N/A ,$73.80 , N/A ,$88.56 ,$76.26 ,$88.56 ,$88.56 ,$73.80 ST VINCENT HOSPITAL - ACUTE,27202964,N/A,HC URI-CATH 5FR/8FR,272,1 ,$102.00 ,$51.00 ,$42.84 ,$102.00 ,$65.89 , N/A ,$65.98 ,$65.98 , N/A ,$61.20 ,$86.70 ,$71.40 , N/A ,$96.90 ,$73.44 ,$74.46 ,$66.30 ,$86.70 , N/A ,$66.30 ,$81.60 ,$74.46 , N/A , N/A ,$42.84 ,$102.00 ,$86.70 , N/A ,$93.84 ,$71.40 ,$51.00 ,$61.20 ,$62.12 ,$51.00 ,$70.48 ,$71.40 , N/A ,$73.44 , N/A ,$61.20 ,$61.20 , N/A ,$61.20 , N/A ,$73.44 ,$63.24 ,$73.44 ,$73.44 ,$61.20 ST VINCENT HOSPITAL - ACUTE,27203025,N/A,HC EMBOLIZATION COIL,272,1 ,$293.00 ,$146.50 ,$123.06 ,$293.00 ,$189.28 , N/A ,$189.54 ,$189.54 , N/A ,$175.80 ,$249.05 ,$205.10 , N/A ,$278.35 ,$210.96 ,$213.89 ,$190.45 ,$249.05 , N/A ,$190.45 ,$234.40 ,$213.89 , N/A , N/A ,$123.06 ,$293.00 ,$249.05 , N/A ,$269.56 ,$205.10 ,$146.50 ,$175.80 ,$178.44 ,$146.50 ,$202.46 ,$205.10 , N/A ,$210.96 , N/A ,$175.80 ,$175.80 , N/A ,$175.80 , N/A ,$210.96 ,$181.66 ,$210.96 ,$210.96 ,$175.80 ST VINCENT HOSPITAL - ACUTE,27203043,N/A,HC TRANSESOPHAGEAL SUPPLIES,272,1 ,$403.00 ,$201.50 ,$169.26 ,$403.00 ,$260.34 , N/A ,$260.70 ,$260.70 , N/A ,$241.80 ,$342.55 ,$282.10 , N/A ,$382.85 ,$290.16 ,$294.19 ,$261.95 ,$342.55 , N/A ,$261.95 ,$322.40 ,$294.19 , N/A , N/A ,$169.26 ,$403.00 ,$342.55 , N/A ,$370.76 ,$282.10 ,$201.50 ,$241.80 ,$245.43 ,$201.50 ,$278.47 ,$282.10 , N/A ,$290.16 , N/A ,$241.80 ,$241.80 , N/A ,$241.80 , N/A ,$290.16 ,$249.86 ,$290.16 ,$290.16 ,$241.80 ST VINCENT HOSPITAL - ACUTE,27203056,N/A,HC SEPS SUBDURAL EVACUATION TRAY,272,1 ,"$3,796.00 ","$1,898.00 ","$1,594.32 ","$3,796.00 ","$2,452.22 ", N/A ,"$2,455.63 ","$2,455.63 ", N/A ,"$2,277.60 ","$3,226.60 ","$2,657.20 ", N/A ,"$3,606.20 ","$2,733.12 ","$2,771.08 ","$2,467.40 ","$3,226.60 ", N/A ,"$2,467.40 ","$3,036.80 ","$2,771.08 ", N/A , N/A ,"$1,594.32 ","$3,796.00 ","$3,226.60 ", N/A ,"$3,492.32 ","$2,657.20 ","$1,898.00 ","$2,277.60 ","$2,311.76 ","$1,898.00 ","$2,623.04 ","$2,657.20 ", N/A ,"$2,733.12 ", N/A ,"$2,277.60 ","$2,277.60 ", N/A ,"$2,277.60 ", N/A ,"$2,733.12 ","$2,353.52 ","$2,733.12 ","$2,733.12 ","$2,277.60 " ST VINCENT HOSPITAL - ACUTE,27203094,N/A,HC SPECIAL NEEDS FEEDER,272,1 ,$35.00 ,$17.50 ,$14.70 ,$35.00 ,$22.61 , N/A ,$22.64 ,$22.64 , N/A ,$21.00 ,$29.75 ,$24.50 , N/A ,$33.25 ,$25.20 ,$25.55 ,$22.75 ,$29.75 , N/A ,$22.75 ,$28.00 ,$25.55 , N/A , N/A ,$14.70 ,$35.00 ,$29.75 , N/A ,$32.20 ,$24.50 ,$17.50 ,$21.00 ,$21.32 ,$17.50 ,$24.19 ,$24.50 , N/A ,$25.20 , N/A ,$21.00 ,$21.00 , N/A ,$21.00 , N/A ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,27203106,N/A,HC BIOPSY FORCEPS DISP,272,1 ,$163.00 ,$81.50 ,$68.46 ,$163.00 ,$105.30 , N/A ,$105.44 ,$105.44 , N/A ,$97.80 ,$138.55 ,$114.10 , N/A ,$154.85 ,$117.36 ,$118.99 ,$105.95 ,$138.55 , N/A ,$105.95 ,$130.40 ,$118.99 , N/A , N/A ,$68.46 ,$163.00 ,$138.55 , N/A ,$149.96 ,$114.10 ,$81.50 ,$97.80 ,$99.27 ,$81.50 ,$112.63 ,$114.10 , N/A ,$117.36 , N/A ,$97.80 ,$97.80 , N/A ,$97.80 , N/A ,$117.36 ,$101.06 ,$117.36 ,$117.36 ,$97.80 ST VINCENT HOSPITAL - ACUTE,27203112,C1885,HC TURBO TANDEM LASER CATHETER,272,1 ,"$7,593.00 ","$3,796.50 ","$3,189.06 ","$7,593.00 ","$4,905.08 ", N/A ,"$4,911.91 ","$4,911.91 ", N/A ,"$4,555.80 ","$6,454.05 ","$5,315.10 ", N/A ,"$7,213.35 ","$5,466.96 ","$5,542.89 ","$4,935.45 ","$6,454.05 ", N/A ,"$4,935.45 ","$6,074.40 ","$5,542.89 ", N/A , N/A ,"$3,189.06 ","$7,593.00 ","$6,454.05 ", N/A ,"$6,985.56 ","$5,315.10 ","$3,796.50 ","$4,555.80 ","$4,624.14 ","$3,796.50 ","$5,246.76 ","$5,315.10 ", N/A ,"$5,466.96 ", N/A ,"$4,555.80 ","$4,555.80 ", N/A ,"$4,555.80 ", N/A ,"$5,466.96 ","$4,707.66 ","$5,466.96 ","$5,466.96 ","$4,555.80 " ST VINCENT HOSPITAL - ACUTE,27203113,C1766,HC EP STEERABLE NON PEEL AWAY SHEATH C1766,272,1 ,"$2,457.00 ","$1,228.50 ","$1,031.94 ","$2,457.00 ","$1,587.22 ", N/A ,"$1,589.43 ","$1,589.43 ", N/A ,"$1,474.20 ","$2,088.45 ","$1,719.90 ", N/A ,"$2,334.15 ","$1,769.04 ","$1,793.61 ","$1,597.05 ","$2,088.45 ", N/A ,"$1,597.05 ","$1,965.60 ","$1,793.61 ", N/A , N/A ,"$1,031.94 ","$2,457.00 ","$2,088.45 ", N/A ,"$2,260.44 ","$1,719.90 ","$1,228.50 ","$1,474.20 ","$1,496.31 ","$1,228.50 ","$1,697.79 ","$1,719.90 ", N/A ,"$1,769.04 ", N/A ,"$1,474.20 ","$1,474.20 ", N/A ,"$1,474.20 ", N/A ,"$1,769.04 ","$1,523.34 ","$1,769.04 ","$1,769.04 ","$1,474.20 " ST VINCENT HOSPITAL - ACUTE,27203115,C1731,HC HALO/LASSO CATHETER,272,1 ,"$2,680.00 ","$1,340.00 ","$1,125.60 ","$2,680.00 ","$1,731.28 ", N/A ,"$1,733.69 ","$1,733.69 ", N/A ,"$1,608.00 ","$2,278.00 ","$1,876.00 ", N/A ,"$2,546.00 ","$1,929.60 ","$1,956.40 ","$1,742.00 ","$2,278.00 ", N/A ,"$1,742.00 ","$2,144.00 ","$1,956.40 ", N/A , N/A ,"$1,125.60 ","$2,680.00 ","$2,278.00 ", N/A ,"$2,465.60 ","$1,876.00 ","$1,340.00 ","$1,608.00 ","$1,632.12 ","$1,340.00 ","$1,851.88 ","$1,876.00 ", N/A ,"$1,929.60 ", N/A ,"$1,608.00 ","$1,608.00 ", N/A ,"$1,608.00 ", N/A ,"$1,929.60 ","$1,661.60 ","$1,929.60 ","$1,929.60 ","$1,608.00 " ST VINCENT HOSPITAL - ACUTE,27203116,N/A,HC NAV-X PATCHES,272,1 ,"$2,127.00 ","$1,063.50 ",$893.34 ,"$2,127.00 ","$1,374.04 ", N/A ,"$1,375.96 ","$1,375.96 ", N/A ,"$1,276.20 ","$1,807.95 ","$1,488.90 ", N/A ,"$2,020.65 ","$1,531.44 ","$1,552.71 ","$1,382.55 ","$1,807.95 ", N/A ,"$1,382.55 ","$1,701.60 ","$1,552.71 ", N/A , N/A ,$893.34 ,"$2,127.00 ","$1,807.95 ", N/A ,"$1,956.84 ","$1,488.90 ","$1,063.50 ","$1,276.20 ","$1,295.34 ","$1,063.50 ","$1,469.76 ","$1,488.90 ", N/A ,"$1,531.44 ", N/A ,"$1,276.20 ","$1,276.20 ", N/A ,"$1,276.20 ", N/A ,"$1,531.44 ","$1,318.74 ","$1,531.44 ","$1,531.44 ","$1,276.20 " ST VINCENT HOSPITAL - ACUTE,27203123,C2618,HC MICROWAVE ABLATION SYSTEM,272,1 ,"$5,099.00 ","$2,549.50 ","$2,141.58 ","$5,099.00 ","$3,293.95 ", N/A ,"$3,298.54 ","$3,298.54 ", N/A ,"$3,059.40 ","$4,334.15 ","$3,569.30 ", N/A ,"$4,844.05 ","$3,671.28 ","$3,722.27 ","$3,314.35 ","$4,334.15 ", N/A ,"$3,314.35 ","$4,079.20 ","$3,722.27 ", N/A , N/A ,"$2,141.58 ","$5,099.00 ","$4,334.15 ", N/A ,"$4,691.08 ","$3,569.30 ","$2,549.50 ","$3,059.40 ","$3,105.29 ","$2,549.50 ","$3,523.41 ","$3,569.30 ", N/A ,"$3,671.28 ", N/A ,"$3,059.40 ","$3,059.40 ", N/A ,"$3,059.40 ", N/A ,"$3,671.28 ","$3,161.38 ","$3,671.28 ","$3,671.28 ","$3,059.40 " ST VINCENT HOSPITAL - ACUTE,27203166,N/A,HC NEEDLE BONE BIOPSY SNARE COIL,272,1 ,$81.00 ,$40.50 ,$34.02 ,$81.00 ,$52.33 , N/A ,$52.40 ,$52.40 , N/A ,$48.60 ,$68.85 ,$56.70 , N/A ,$76.95 ,$58.32 ,$59.13 ,$52.65 ,$68.85 , N/A ,$52.65 ,$64.80 ,$59.13 , N/A , N/A ,$34.02 ,$81.00 ,$68.85 , N/A ,$74.52 ,$56.70 ,$40.50 ,$48.60 ,$49.33 ,$40.50 ,$55.97 ,$56.70 , N/A ,$58.32 , N/A ,$48.60 ,$48.60 , N/A ,$48.60 , N/A ,$58.32 ,$50.22 ,$58.32 ,$58.32 ,$48.60 ST VINCENT HOSPITAL - ACUTE,27203169,C1769,HC TRUEPATH,272,1 ,"$4,020.00 ","$2,010.00 ","$1,688.40 ","$4,020.00 ","$2,596.92 ", N/A ,"$2,600.54 ","$2,600.54 ", N/A ,"$2,412.00 ","$3,417.00 ","$2,814.00 ", N/A ,"$3,819.00 ","$2,894.40 ","$2,934.60 ","$2,613.00 ","$3,417.00 ", N/A ,"$2,613.00 ","$3,216.00 ","$2,934.60 ", N/A , N/A ,"$1,688.40 ","$4,020.00 ","$3,417.00 ", N/A ,"$3,698.40 ","$2,814.00 ","$2,010.00 ","$2,412.00 ","$2,448.18 ","$2,010.00 ","$2,777.82 ","$2,814.00 ", N/A ,"$2,894.40 ", N/A ,"$2,412.00 ","$2,412.00 ", N/A ,"$2,412.00 ", N/A ,"$2,894.40 ","$2,492.40 ","$2,894.40 ","$2,894.40 ","$2,412.00 " ST VINCENT HOSPITAL - ACUTE,27203207,N/A,HC IVB VALVE,272,1 ,"$5,807.00 ","$2,903.50 ","$2,438.94 ","$5,807.00 ","$3,751.32 ", N/A ,"$3,756.55 ","$3,756.55 ", N/A ,"$3,484.20 ","$4,935.95 ","$4,064.90 ", N/A ,"$5,516.65 ","$4,181.04 ","$4,239.11 ","$3,774.55 ","$4,935.95 ", N/A ,"$3,774.55 ","$4,645.60 ","$4,239.11 ", N/A , N/A ,"$2,438.94 ","$5,807.00 ","$4,935.95 ", N/A ,"$5,342.44 ","$4,064.90 ","$2,903.50 ","$3,484.20 ","$3,536.46 ","$2,903.50 ","$4,012.64 ","$4,064.90 ", N/A ,"$4,181.04 ", N/A ,"$3,484.20 ","$3,484.20 ", N/A ,"$3,484.20 ", N/A ,"$4,181.04 ","$3,600.34 ","$4,181.04 ","$4,181.04 ","$3,484.20 " ST VINCENT HOSPITAL - ACUTE,27203225,N/A,HC MRI BREAST BIOPSY KIT,272,1 ,"$1,290.00 ",$645.00 ,$541.80 ,"$1,290.00 ",$833.34 , N/A ,$834.50 ,$834.50 , N/A ,$774.00 ,"$1,096.50 ",$903.00 , N/A ,"$1,225.50 ",$928.80 ,$941.70 ,$838.50 ,"$1,096.50 ", N/A ,$838.50 ,"$1,032.00 ",$941.70 , N/A , N/A ,$541.80 ,"$1,290.00 ","$1,096.50 ", N/A ,"$1,186.80 ",$903.00 ,$645.00 ,$774.00 ,$785.61 ,$645.00 ,$891.39 ,$903.00 , N/A ,$928.80 , N/A ,$774.00 ,$774.00 , N/A ,$774.00 , N/A ,$928.80 ,$799.80 ,$928.80 ,$928.80 ,$774.00 ST VINCENT HOSPITAL - ACUTE,27203235,N/A,HC PRESEP OXIMETRY CATH KIT,272,1 ,"$1,267.00 ",$633.50 ,$532.14 ,"$1,267.00 ",$818.48 , N/A ,$819.62 ,$819.62 , N/A ,$760.20 ,"$1,076.95 ",$886.90 , N/A ,"$1,203.65 ",$912.24 ,$924.91 ,$823.55 ,"$1,076.95 ", N/A ,$823.55 ,"$1,013.60 ",$924.91 , N/A , N/A ,$532.14 ,"$1,267.00 ","$1,076.95 ", N/A ,"$1,165.64 ",$886.90 ,$633.50 ,$760.20 ,$771.60 ,$633.50 ,$875.50 ,$886.90 , N/A ,$912.24 , N/A ,$760.20 ,$760.20 , N/A ,$760.20 , N/A ,$912.24 ,$785.54 ,$912.24 ,$912.24 ,$760.20 ST VINCENT HOSPITAL - ACUTE,27203276,N/A,HC L CATH PICC 26GA 30CM 1.95,272,1 ,$118.00 ,$59.00 ,$49.56 ,$118.00 ,$76.23 , N/A ,$76.33 ,$76.33 , N/A ,$70.80 ,$100.30 ,$82.60 , N/A ,$112.10 ,$84.96 ,$86.14 ,$76.70 ,$100.30 , N/A ,$76.70 ,$94.40 ,$86.14 , N/A , N/A ,$49.56 ,$118.00 ,$100.30 , N/A ,$108.56 ,$82.60 ,$59.00 ,$70.80 ,$71.86 ,$59.00 ,$81.54 ,$82.60 , N/A ,$84.96 , N/A ,$70.80 ,$70.80 , N/A ,$70.80 , N/A ,$84.96 ,$73.16 ,$84.96 ,$84.96 ,$70.80 ST VINCENT HOSPITAL - ACUTE,27203277,N/A,HC L CATH PICC 28GA 25CM 1.2FR,272,1 ,$168.00 ,$84.00 ,$70.56 ,$168.00 ,$108.53 , N/A ,$108.68 ,$108.68 , N/A ,$100.80 ,$142.80 ,$117.60 , N/A ,$159.60 ,$120.96 ,$122.64 ,$109.20 ,$142.80 , N/A ,$109.20 ,$134.40 ,$122.64 , N/A , N/A ,$70.56 ,$168.00 ,$142.80 , N/A ,$154.56 ,$117.60 ,$84.00 ,$100.80 ,$102.31 ,$84.00 ,$116.09 ,$117.60 , N/A ,$120.96 , N/A ,$100.80 ,$100.80 , N/A ,$100.80 , N/A ,$120.96 ,$104.16 ,$120.96 ,$120.96 ,$100.80 ST VINCENT HOSPITAL - ACUTE,27203287,N/A,HC MISC SUPPLY CATH LAB TIER 1,272,1 ,$112.00 ,$56.00 ,$47.04 ,$112.00 ,$72.35 , N/A ,$72.45 ,$72.45 , N/A ,$67.20 ,$95.20 ,$78.40 , N/A ,$106.40 ,$80.64 ,$81.76 ,$72.80 ,$95.20 , N/A ,$72.80 ,$89.60 ,$81.76 , N/A , N/A ,$47.04 ,$112.00 ,$95.20 , N/A ,$103.04 ,$78.40 ,$56.00 ,$67.20 ,$68.21 ,$56.00 ,$77.39 ,$78.40 , N/A ,$80.64 , N/A ,$67.20 ,$67.20 , N/A ,$67.20 , N/A ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,27203288,N/A,HC MISC SUPPLY CATH LAB TIER 2,272,1 ,$224.00 ,$112.00 ,$94.08 ,$224.00 ,$144.70 , N/A ,$144.91 ,$144.91 , N/A ,$134.40 ,$190.40 ,$156.80 , N/A ,$212.80 ,$161.28 ,$163.52 ,$145.60 ,$190.40 , N/A ,$145.60 ,$179.20 ,$163.52 , N/A , N/A ,$94.08 ,$224.00 ,$190.40 , N/A ,$206.08 ,$156.80 ,$112.00 ,$134.40 ,$136.42 ,$112.00 ,$154.78 ,$156.80 , N/A ,$161.28 , N/A ,$134.40 ,$134.40 , N/A ,$134.40 , N/A ,$161.28 ,$138.88 ,$161.28 ,$161.28 ,$134.40 ST VINCENT HOSPITAL - ACUTE,27203289,N/A,HC MISC SUPPLY CATH LAB TIER 3,272,1 ,$392.00 ,$196.00 ,$164.64 ,$392.00 ,$253.23 , N/A ,$253.58 ,$253.58 , N/A ,$235.20 ,$333.20 ,$274.40 , N/A ,$372.40 ,$282.24 ,$286.16 ,$254.80 ,$333.20 , N/A ,$254.80 ,$313.60 ,$286.16 , N/A , N/A ,$164.64 ,$392.00 ,$333.20 , N/A ,$360.64 ,$274.40 ,$196.00 ,$235.20 ,$238.73 ,$196.00 ,$270.87 ,$274.40 , N/A ,$282.24 , N/A ,$235.20 ,$235.20 , N/A ,$235.20 , N/A ,$282.24 ,$243.04 ,$282.24 ,$282.24 ,$235.20 ST VINCENT HOSPITAL - ACUTE,27203290,N/A,HC ABVISER AUTOVALVE IAP DEVICE,272,1 ,$231.00 ,$115.50 ,$97.02 ,$231.00 ,$149.23 , N/A ,$149.43 ,$149.43 , N/A ,$138.60 ,$196.35 ,$161.70 , N/A ,$219.45 ,$166.32 ,$168.63 ,$150.15 ,$196.35 , N/A ,$150.15 ,$184.80 ,$168.63 , N/A , N/A ,$97.02 ,$231.00 ,$196.35 , N/A ,$212.52 ,$161.70 ,$115.50 ,$138.60 ,$140.68 ,$115.50 ,$159.62 ,$161.70 , N/A ,$166.32 , N/A ,$138.60 ,$138.60 , N/A ,$138.60 , N/A ,$166.32 ,$143.22 ,$166.32 ,$166.32 ,$138.60 ST VINCENT HOSPITAL - ACUTE,27203292,C1732,HC THERMACOOL ABLATION CATH,272,1 ,"$3,424.00 ","$1,712.00 ","$1,438.08 ","$3,424.00 ","$2,211.90 ", N/A ,"$2,214.99 ","$2,214.99 ", N/A ,"$2,054.40 ","$2,910.40 ","$2,396.80 ", N/A ,"$3,252.80 ","$2,465.28 ","$2,499.52 ","$2,225.60 ","$2,910.40 ", N/A ,"$2,225.60 ","$2,739.20 ","$2,499.52 ", N/A , N/A ,"$1,438.08 ","$3,424.00 ","$2,910.40 ", N/A ,"$3,150.08 ","$2,396.80 ","$1,712.00 ","$2,054.40 ","$2,085.22 ","$1,712.00 ","$2,365.98 ","$2,396.80 ", N/A ,"$2,465.28 ", N/A ,"$2,054.40 ","$2,054.40 ", N/A ,"$2,054.40 ", N/A ,"$2,465.28 ","$2,122.88 ","$2,465.28 ","$2,465.28 ","$2,054.40 " ST VINCENT HOSPITAL - ACUTE,27203294,C1893,HC EP NON PEEL AWAY SHEATH C1893,272,1 ,"$2,457.00 ","$1,228.50 ","$1,031.94 ","$2,457.00 ","$1,587.22 ", N/A ,"$1,589.43 ","$1,589.43 ", N/A ,"$1,474.20 ","$2,088.45 ","$1,719.90 ", N/A ,"$2,334.15 ","$1,769.04 ","$1,793.61 ","$1,597.05 ","$2,088.45 ", N/A ,"$1,597.05 ","$1,965.60 ","$1,793.61 ", N/A , N/A ,"$1,031.94 ","$2,457.00 ","$2,088.45 ", N/A ,"$2,260.44 ","$1,719.90 ","$1,228.50 ","$1,474.20 ","$1,496.31 ","$1,228.50 ","$1,697.79 ","$1,719.90 ", N/A ,"$1,769.04 ", N/A ,"$1,474.20 ","$1,474.20 ", N/A ,"$1,474.20 ", N/A ,"$1,769.04 ","$1,523.34 ","$1,769.04 ","$1,769.04 ","$1,474.20 " ST VINCENT HOSPITAL - ACUTE,27203298,N/A,HC HEMOSTATIC PARTICLES,272,1 ,"$2,989.00 ","$1,494.50 ","$1,255.38 ","$2,989.00 ","$1,930.89 ", N/A ,"$1,933.58 ","$1,933.58 ", N/A ,"$1,793.40 ","$2,540.65 ","$2,092.30 ", N/A ,"$2,839.55 ","$2,152.08 ","$2,181.97 ","$1,942.85 ","$2,540.65 ", N/A ,"$1,942.85 ","$2,391.20 ","$2,181.97 ", N/A , N/A ,"$1,255.38 ","$2,989.00 ","$2,540.65 ", N/A ,"$2,749.88 ","$2,092.30 ","$1,494.50 ","$1,793.40 ","$1,820.30 ","$1,494.50 ","$2,065.40 ","$2,092.30 ", N/A ,"$2,152.08 ", N/A ,"$1,793.40 ","$1,793.40 ", N/A ,"$1,793.40 ", N/A ,"$2,152.08 ","$1,853.18 ","$2,152.08 ","$2,152.08 ","$1,793.40 " ST VINCENT HOSPITAL - ACUTE,27203302,N/A,HC RADIAL ART CATH SET GH04120,272,1 ,$38.00 ,$19.00 ,$15.96 ,$38.00 ,$24.55 , N/A ,$24.58 ,$24.58 , N/A ,$22.80 ,$32.30 ,$26.60 , N/A ,$36.10 ,$27.36 ,$27.74 ,$24.70 ,$32.30 , N/A ,$24.70 ,$30.40 ,$27.74 , N/A , N/A ,$15.96 ,$38.00 ,$32.30 , N/A ,$34.96 ,$26.60 ,$19.00 ,$22.80 ,$23.14 ,$19.00 ,$26.26 ,$26.60 , N/A ,$27.36 , N/A ,$22.80 ,$22.80 , N/A ,$22.80 , N/A ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,27203306,N/A,HC ARCTIC SUN TEMP MANAGEMENT SYSTEM,272,1 ,$224.00 ,$112.00 ,$94.08 ,$224.00 ,$144.70 , N/A ,$144.91 ,$144.91 , N/A ,$134.40 ,$190.40 ,$156.80 , N/A ,$212.80 ,$161.28 ,$163.52 ,$145.60 ,$190.40 , N/A ,$145.60 ,$179.20 ,$163.52 , N/A , N/A ,$94.08 ,$224.00 ,$190.40 , N/A ,$206.08 ,$156.80 ,$112.00 ,$134.40 ,$136.42 ,$112.00 ,$154.78 ,$156.80 , N/A ,$161.28 , N/A ,$134.40 ,$134.40 , N/A ,$134.40 , N/A ,$161.28 ,$138.88 ,$161.28 ,$161.28 ,$134.40 ST VINCENT HOSPITAL - ACUTE,27203307,N/A,HC ARCTIC SUN PADS,272,1 ,"$1,830.00 ",$915.00 ,$768.60 ,"$1,830.00 ","$1,182.18 ", N/A ,"$1,183.83 ","$1,183.83 ", N/A ,"$1,098.00 ","$1,555.50 ","$1,281.00 ", N/A ,"$1,738.50 ","$1,317.60 ","$1,335.90 ","$1,189.50 ","$1,555.50 ", N/A ,"$1,189.50 ","$1,464.00 ","$1,335.90 ", N/A , N/A ,$768.60 ,"$1,830.00 ","$1,555.50 ", N/A ,"$1,683.60 ","$1,281.00 ",$915.00 ,"$1,098.00 ","$1,114.47 ",$915.00 ,"$1,264.53 ","$1,281.00 ", N/A ,"$1,317.60 ", N/A ,"$1,098.00 ","$1,098.00 ", N/A ,"$1,098.00 ", N/A ,"$1,317.60 ","$1,134.60 ","$1,317.60 ","$1,317.60 ","$1,098.00 " ST VINCENT HOSPITAL - ACUTE,27203312,N/A,HC FLOTRAC SENSOR,272,1 ,$782.00 ,$391.00 ,$328.44 ,$782.00 ,$505.17 , N/A ,$505.88 ,$505.88 , N/A ,$469.20 ,$664.70 ,$547.40 , N/A ,$742.90 ,$563.04 ,$570.86 ,$508.30 ,$664.70 , N/A ,$508.30 ,$625.60 ,$570.86 , N/A , N/A ,$328.44 ,$782.00 ,$664.70 , N/A ,$719.44 ,$547.40 ,$391.00 ,$469.20 ,$476.24 ,$391.00 ,$540.36 ,$547.40 , N/A ,$563.04 , N/A ,$469.20 ,$469.20 , N/A ,$469.20 , N/A ,$563.04 ,$484.84 ,$563.04 ,$563.04 ,$469.20 ST VINCENT HOSPITAL - ACUTE,27203328,N/A,HC CATH SET ICU EMERGENCY CRICOTHYROTOMY,272,1 ,"$1,115.00 ",$557.50 ,$468.30 ,"$1,115.00 ",$720.29 , N/A ,$721.29 ,$721.29 , N/A ,$669.00 ,$947.75 ,$780.50 , N/A ,"$1,059.25 ",$802.80 ,$813.95 ,$724.75 ,$947.75 , N/A ,$724.75 ,$892.00 ,$813.95 , N/A , N/A ,$468.30 ,"$1,115.00 ",$947.75 , N/A ,"$1,025.80 ",$780.50 ,$557.50 ,$669.00 ,$679.04 ,$557.50 ,$770.47 ,$780.50 , N/A ,$802.80 , N/A ,$669.00 ,$669.00 , N/A ,$669.00 , N/A ,$802.80 ,$691.30 ,$802.80 ,$802.80 ,$669.00 ST VINCENT HOSPITAL - ACUTE,27203329,N/A,HC PLEURAL CHEST DRAIN,272,1 ,$195.00 ,$97.50 ,$81.90 ,$195.00 ,$125.97 , N/A ,$126.15 ,$126.15 , N/A ,$117.00 ,$165.75 ,$136.50 , N/A ,$185.25 ,$140.40 ,$142.35 ,$126.75 ,$165.75 , N/A ,$126.75 ,$156.00 ,$142.35 , N/A , N/A ,$81.90 ,$195.00 ,$165.75 , N/A ,$179.40 ,$136.50 ,$97.50 ,$117.00 ,$118.76 ,$97.50 ,$134.75 ,$136.50 , N/A ,$140.40 , N/A ,$117.00 ,$117.00 , N/A ,$117.00 , N/A ,$140.40 ,$120.90 ,$140.40 ,$140.40 ,$117.00 ST VINCENT HOSPITAL - ACUTE,27203400,C1725,HC BALLOON TIER 1,272,1 ,$671.00 ,$335.50 ,$281.82 ,$671.00 ,$433.47 , N/A ,$434.07 ,$434.07 , N/A ,$402.60 ,$570.35 ,$469.70 , N/A ,$637.45 ,$483.12 ,$489.83 ,$436.15 ,$570.35 , N/A ,$436.15 ,$536.80 ,$489.83 , N/A , N/A ,$281.82 ,$671.00 ,$570.35 , N/A ,$617.32 ,$469.70 ,$335.50 ,$402.60 ,$408.64 ,$335.50 ,$463.66 ,$469.70 , N/A ,$483.12 , N/A ,$402.60 ,$402.60 , N/A ,$402.60 , N/A ,$483.12 ,$416.02 ,$483.12 ,$483.12 ,$402.60 ST VINCENT HOSPITAL - ACUTE,27203401,C1725,HC BALLOON TIER 2,272,1 ,"$1,005.00 ",$502.50 ,$422.10 ,"$1,005.00 ",$649.23 , N/A ,$650.13 ,$650.13 , N/A ,$603.00 ,$854.25 ,$703.50 , N/A ,$954.75 ,$723.60 ,$733.65 ,$653.25 ,$854.25 , N/A ,$653.25 ,$804.00 ,$733.65 , N/A , N/A ,$422.10 ,"$1,005.00 ",$854.25 , N/A ,$924.60 ,$703.50 ,$502.50 ,$603.00 ,$612.05 ,$502.50 ,$694.46 ,$703.50 , N/A ,$723.60 , N/A ,$603.00 ,$603.00 , N/A ,$603.00 , N/A ,$723.60 ,$623.10 ,$723.60 ,$723.60 ,$603.00 ST VINCENT HOSPITAL - ACUTE,27203402,C1725,HC BALLOON TIER 3,272,1 ,"$2,010.00 ","$1,005.00 ",$844.20 ,"$2,010.00 ","$1,298.46 ", N/A ,"$1,300.27 ","$1,300.27 ", N/A ,"$1,206.00 ","$1,708.50 ","$1,407.00 ", N/A ,"$1,909.50 ","$1,447.20 ","$1,467.30 ","$1,306.50 ","$1,708.50 ", N/A ,"$1,306.50 ","$1,608.00 ","$1,467.30 ", N/A , N/A ,$844.20 ,"$2,010.00 ","$1,708.50 ", N/A ,"$1,849.20 ","$1,407.00 ","$1,005.00 ","$1,206.00 ","$1,224.09 ","$1,005.00 ","$1,388.91 ","$1,407.00 ", N/A ,"$1,447.20 ", N/A ,"$1,206.00 ","$1,206.00 ", N/A ,"$1,206.00 ", N/A ,"$1,447.20 ","$1,246.20 ","$1,447.20 ","$1,447.20 ","$1,206.00 " ST VINCENT HOSPITAL - ACUTE,27203403,C1769,HC GUIDEWIRE TIER 1,272,1 ,$112.00 ,$56.00 ,$47.04 ,$112.00 ,$72.35 , N/A ,$72.45 ,$72.45 , N/A ,$67.20 ,$95.20 ,$78.40 , N/A ,$106.40 ,$80.64 ,$81.76 ,$72.80 ,$95.20 , N/A ,$72.80 ,$89.60 ,$81.76 , N/A , N/A ,$47.04 ,$112.00 ,$95.20 , N/A ,$103.04 ,$78.40 ,$56.00 ,$67.20 ,$68.21 ,$56.00 ,$77.39 ,$78.40 , N/A ,$80.64 , N/A ,$67.20 ,$67.20 , N/A ,$67.20 , N/A ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,27203404,C1769,HC GUIDEWIRE TIER 2,272,1 ,$302.00 ,$151.00 ,$126.84 ,$302.00 ,$195.09 , N/A ,$195.36 ,$195.36 , N/A ,$181.20 ,$256.70 ,$211.40 , N/A ,$286.90 ,$217.44 ,$220.46 ,$196.30 ,$256.70 , N/A ,$196.30 ,$241.60 ,$220.46 , N/A , N/A ,$126.84 ,$302.00 ,$256.70 , N/A ,$277.84 ,$211.40 ,$151.00 ,$181.20 ,$183.92 ,$151.00 ,$208.68 ,$211.40 , N/A ,$217.44 , N/A ,$181.20 ,$181.20 , N/A ,$181.20 , N/A ,$217.44 ,$187.24 ,$217.44 ,$217.44 ,$181.20 ST VINCENT HOSPITAL - ACUTE,27203405,C1769,HC GUIDEWIRE TIER 3,272,1 ,"$1,028.00 ",$514.00 ,$431.76 ,"$1,028.00 ",$664.09 , N/A ,$665.01 ,$665.01 , N/A ,$616.80 ,$873.80 ,$719.60 , N/A ,$976.60 ,$740.16 ,$750.44 ,$668.20 ,$873.80 , N/A ,$668.20 ,$822.40 ,$750.44 , N/A , N/A ,$431.76 ,"$1,028.00 ",$873.80 , N/A ,$945.76 ,$719.60 ,$514.00 ,$616.80 ,$626.05 ,$514.00 ,$710.35 ,$719.60 , N/A ,$740.16 , N/A ,$616.80 ,$616.80 , N/A ,$616.80 , N/A ,$740.16 ,$637.36 ,$740.16 ,$740.16 ,$616.80 ST VINCENT HOSPITAL - ACUTE,27203406,C1887,HC CATHETER TIER 1,272,1 ,$57.00 ,$28.50 ,$23.94 ,$57.00 ,$36.82 , N/A ,$36.87 ,$36.87 , N/A ,$34.20 ,$48.45 ,$39.90 , N/A ,$54.15 ,$41.04 ,$41.61 ,$37.05 ,$48.45 , N/A ,$37.05 ,$45.60 ,$41.61 , N/A , N/A ,$23.94 ,$57.00 ,$48.45 , N/A ,$52.44 ,$39.90 ,$28.50 ,$34.20 ,$34.71 ,$28.50 ,$39.39 ,$39.90 , N/A ,$41.04 , N/A ,$34.20 ,$34.20 , N/A ,$34.20 , N/A ,$41.04 ,$35.34 ,$41.04 ,$41.04 ,$34.20 ST VINCENT HOSPITAL - ACUTE,27203407,C1887,HC CATHETER TIER 2,272,1 ,$224.00 ,$112.00 ,$94.08 ,$224.00 ,$144.70 , N/A ,$144.91 ,$144.91 , N/A ,$134.40 ,$190.40 ,$156.80 , N/A ,$212.80 ,$161.28 ,$163.52 ,$145.60 ,$190.40 , N/A ,$145.60 ,$179.20 ,$163.52 , N/A , N/A ,$94.08 ,$224.00 ,$190.40 , N/A ,$206.08 ,$156.80 ,$112.00 ,$134.40 ,$136.42 ,$112.00 ,$154.78 ,$156.80 , N/A ,$161.28 , N/A ,$134.40 ,$134.40 , N/A ,$134.40 , N/A ,$161.28 ,$138.88 ,$161.28 ,$161.28 ,$134.40 ST VINCENT HOSPITAL - ACUTE,27203408,C1887,HC CATHETER TIER 3,272,1 ,$448.00 ,$224.00 ,$188.16 ,$448.00 ,$289.41 , N/A ,$289.81 ,$289.81 , N/A ,$268.80 ,$380.80 ,$313.60 , N/A ,$425.60 ,$322.56 ,$327.04 ,$291.20 ,$380.80 , N/A ,$291.20 ,$358.40 ,$327.04 , N/A , N/A ,$188.16 ,$448.00 ,$380.80 , N/A ,$412.16 ,$313.60 ,$224.00 ,$268.80 ,$272.83 ,$224.00 ,$309.57 ,$313.60 , N/A ,$322.56 , N/A ,$268.80 ,$268.80 , N/A ,$268.80 , N/A ,$322.56 ,$277.76 ,$322.56 ,$322.56 ,$268.80 ST VINCENT HOSPITAL - ACUTE,27203409,C1887,HC CATHETER TIER 4,272,1 ,"$1,061.00 ",$530.50 ,$445.62 ,"$1,061.00 ",$685.41 , N/A ,$686.36 ,$686.36 , N/A ,$636.60 ,$901.85 ,$742.70 , N/A ,"$1,007.95 ",$763.92 ,$774.53 ,$689.65 ,$901.85 , N/A ,$689.65 ,$848.80 ,$774.53 , N/A , N/A ,$445.62 ,"$1,061.00 ",$901.85 , N/A ,$976.12 ,$742.70 ,$530.50 ,$636.60 ,$646.15 ,$530.50 ,$733.15 ,$742.70 , N/A ,$763.92 , N/A ,$636.60 ,$636.60 , N/A ,$636.60 , N/A ,$763.92 ,$657.82 ,$763.92 ,$763.92 ,$636.60 ST VINCENT HOSPITAL - ACUTE,27203410,C1894,HC DIAGNOSTIC SHEATH TIER 1,272,1 ,$112.00 ,$56.00 ,$47.04 ,$112.00 ,$72.35 , N/A ,$72.45 ,$72.45 , N/A ,$67.20 ,$95.20 ,$78.40 , N/A ,$106.40 ,$80.64 ,$81.76 ,$72.80 ,$95.20 , N/A ,$72.80 ,$89.60 ,$81.76 , N/A , N/A ,$47.04 ,$112.00 ,$95.20 , N/A ,$103.04 ,$78.40 ,$56.00 ,$67.20 ,$68.21 ,$56.00 ,$77.39 ,$78.40 , N/A ,$80.64 , N/A ,$67.20 ,$67.20 , N/A ,$67.20 , N/A ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,27203411,C1894,HC DIAGNOSTIC SHEATH TIER 2,272,1 ,$224.00 ,$112.00 ,$94.08 ,$224.00 ,$144.70 , N/A ,$144.91 ,$144.91 , N/A ,$134.40 ,$190.40 ,$156.80 , N/A ,$212.80 ,$161.28 ,$163.52 ,$145.60 ,$190.40 , N/A ,$145.60 ,$179.20 ,$163.52 , N/A , N/A ,$94.08 ,$224.00 ,$190.40 , N/A ,$206.08 ,$156.80 ,$112.00 ,$134.40 ,$136.42 ,$112.00 ,$154.78 ,$156.80 , N/A ,$161.28 , N/A ,$134.40 ,$134.40 , N/A ,$134.40 , N/A ,$161.28 ,$138.88 ,$161.28 ,$161.28 ,$134.40 ST VINCENT HOSPITAL - ACUTE,27203412,C1894,HC DIAGNOSTIC SHEATH TIER 3,272,1 ,$671.00 ,$335.50 ,$281.82 ,$671.00 ,$433.47 , N/A ,$434.07 ,$434.07 , N/A ,$402.60 ,$570.35 ,$469.70 , N/A ,$637.45 ,$483.12 ,$489.83 ,$436.15 ,$570.35 , N/A ,$436.15 ,$536.80 ,$489.83 , N/A , N/A ,$281.82 ,$671.00 ,$570.35 , N/A ,$617.32 ,$469.70 ,$335.50 ,$402.60 ,$408.64 ,$335.50 ,$463.66 ,$469.70 , N/A ,$483.12 , N/A ,$402.60 ,$402.60 , N/A ,$402.60 , N/A ,$483.12 ,$416.02 ,$483.12 ,$483.12 ,$402.60 ST VINCENT HOSPITAL - ACUTE,27203413,C1894,HC DIAGNOSTIC SHEATH TIER 4,272,1 ,"$1,340.00 ",$670.00 ,$562.80 ,"$1,340.00 ",$865.64 , N/A ,$866.85 ,$866.85 , N/A ,$804.00 ,"$1,139.00 ",$938.00 , N/A ,"$1,273.00 ",$964.80 ,$978.20 ,$871.00 ,"$1,139.00 ", N/A ,$871.00 ,"$1,072.00 ",$978.20 , N/A , N/A ,$562.80 ,"$1,340.00 ","$1,139.00 ", N/A ,"$1,232.80 ",$938.00 ,$670.00 ,$804.00 ,$816.06 ,$670.00 ,$925.94 ,$938.00 , N/A ,$964.80 , N/A ,$804.00 ,$804.00 , N/A ,$804.00 , N/A ,$964.80 ,$830.80 ,$964.80 ,$964.80 ,$804.00 ST VINCENT HOSPITAL - ACUTE,27203414,C1725,HC POLAR CATH KIT,272,1 ,"$3,339.00 ","$1,669.50 ","$1,402.38 ","$3,339.00 ","$2,156.99 ", N/A ,"$2,160.00 ","$2,160.00 ", N/A ,"$2,003.40 ","$2,838.15 ","$2,337.30 ", N/A ,"$3,172.05 ","$2,404.08 ","$2,437.47 ","$2,170.35 ","$2,838.15 ", N/A ,"$2,170.35 ","$2,671.20 ","$2,437.47 ", N/A , N/A ,"$1,402.38 ","$3,339.00 ","$2,838.15 ", N/A ,"$3,071.88 ","$2,337.30 ","$1,669.50 ","$2,003.40 ","$2,033.45 ","$1,669.50 ","$2,307.25 ","$2,337.30 ", N/A ,"$2,404.08 ", N/A ,"$2,003.40 ","$2,003.40 ", N/A ,"$2,003.40 ", N/A ,"$2,404.08 ","$2,070.18 ","$2,404.08 ","$2,404.08 ","$2,003.40 " ST VINCENT HOSPITAL - ACUTE,27203415,C1725,HC BALLOON TIER 4,272,1 ,"$3,126.00 ","$1,563.00 ","$1,312.92 ","$3,126.00 ","$2,019.40 ", N/A ,"$2,022.21 ","$2,022.21 ", N/A ,"$1,875.60 ","$2,657.10 ","$2,188.20 ", N/A ,"$2,969.70 ","$2,250.72 ","$2,281.98 ","$2,031.90 ","$2,657.10 ", N/A ,"$2,031.90 ","$2,500.80 ","$2,281.98 ", N/A , N/A ,"$1,312.92 ","$3,126.00 ","$2,657.10 ", N/A ,"$2,875.92 ","$2,188.20 ","$1,563.00 ","$1,875.60 ","$1,903.73 ","$1,563.00 ","$2,160.07 ","$2,188.20 ", N/A ,"$2,250.72 ", N/A ,"$1,875.60 ","$1,875.60 ", N/A ,"$1,875.60 ", N/A ,"$2,250.72 ","$1,938.12 ","$2,250.72 ","$2,250.72 ","$1,875.60 " ST VINCENT HOSPITAL - ACUTE,27203496,N/A,HC PROLACT PLUS 10 50ML,272,1 ,$587.00 ,$293.50 ,$246.54 ,$587.00 ,$379.20 , N/A ,$379.73 ,$379.73 , N/A ,$352.20 ,$498.95 ,$410.90 , N/A ,$557.65 ,$422.64 ,$428.51 ,$381.55 ,$498.95 , N/A ,$381.55 ,$469.60 ,$428.51 , N/A , N/A ,$246.54 ,$587.00 ,$498.95 , N/A ,$540.04 ,$410.90 ,$293.50 ,$352.20 ,$357.48 ,$293.50 ,$405.62 ,$410.90 , N/A ,$422.64 , N/A ,$352.20 ,$352.20 , N/A ,$352.20 , N/A ,$422.64 ,$363.94 ,$422.64 ,$422.64 ,$352.20 ST VINCENT HOSPITAL - ACUTE,27203497,N/A,HC PROLACT PLUS 6 15 ML,272,1 ,$198.00 ,$99.00 ,$83.16 ,$198.00 ,$127.91 , N/A ,$128.09 ,$128.09 , N/A ,$118.80 ,$168.30 ,$138.60 , N/A ,$188.10 ,$142.56 ,$144.54 ,$128.70 ,$168.30 , N/A ,$128.70 ,$158.40 ,$144.54 , N/A , N/A ,$83.16 ,$198.00 ,$168.30 , N/A ,$182.16 ,$138.60 ,$99.00 ,$118.80 ,$120.58 ,$99.00 ,$136.82 ,$138.60 , N/A ,$142.56 , N/A ,$118.80 ,$118.80 , N/A ,$118.80 , N/A ,$142.56 ,$122.76 ,$142.56 ,$142.56 ,$118.80 ST VINCENT HOSPITAL - ACUTE,27203498,N/A,HC PROLACT CR 10ML,272,1 ,$75.00 ,$37.50 ,$31.50 ,$75.00 ,$48.45 , N/A ,$48.52 ,$48.52 , N/A ,$45.00 ,$63.75 ,$52.50 , N/A ,$71.25 ,$54.00 ,$54.75 ,$48.75 ,$63.75 , N/A ,$48.75 ,$60.00 ,$54.75 , N/A , N/A ,$31.50 ,$75.00 ,$63.75 , N/A ,$69.00 ,$52.50 ,$37.50 ,$45.00 ,$45.68 ,$37.50 ,$51.83 ,$52.50 , N/A ,$54.00 , N/A ,$45.00 ,$45.00 , N/A ,$45.00 , N/A ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,27203499,N/A,HC PROLACT PLUS 8 40ML,272,1 ,$547.00 ,$273.50 ,$229.74 ,$547.00 ,$353.36 , N/A ,$353.85 ,$353.85 , N/A ,$328.20 ,$464.95 ,$382.90 , N/A ,$519.65 ,$393.84 ,$399.31 ,$355.55 ,$464.95 , N/A ,$355.55 ,$437.60 ,$399.31 , N/A , N/A ,$229.74 ,$547.00 ,$464.95 , N/A ,$503.24 ,$382.90 ,$273.50 ,$328.20 ,$333.12 ,$273.50 ,$377.98 ,$382.90 , N/A ,$393.84 , N/A ,$328.20 ,$328.20 , N/A ,$328.20 , N/A ,$393.84 ,$339.14 ,$393.84 ,$393.84 ,$328.20 ST VINCENT HOSPITAL - ACUTE,27203500,N/A,HC PROLACT PLUS 4 20 ML,272,1 ,$266.00 ,$133.00 ,$111.72 ,$266.00 ,$171.84 , N/A ,$172.08 ,$172.08 , N/A ,$159.60 ,$226.10 ,$186.20 , N/A ,$252.70 ,$191.52 ,$194.18 ,$172.90 ,$226.10 , N/A ,$172.90 ,$212.80 ,$194.18 , N/A , N/A ,$111.72 ,$266.00 ,$226.10 , N/A ,$244.72 ,$186.20 ,$133.00 ,$159.60 ,$161.99 ,$133.00 ,$183.81 ,$186.20 , N/A ,$191.52 , N/A ,$159.60 ,$159.60 , N/A ,$159.60 , N/A ,$191.52 ,$164.92 ,$191.52 ,$191.52 ,$159.60 ST VINCENT HOSPITAL - ACUTE,27203501,N/A,HC PROLACT PLUS 6 30 ML,272,1 ,$399.00 ,$199.50 ,$167.58 ,$399.00 ,$257.75 , N/A ,$258.11 ,$258.11 , N/A ,$239.40 ,$339.15 ,$279.30 , N/A ,$379.05 ,$287.28 ,$291.27 ,$259.35 ,$339.15 , N/A ,$259.35 ,$319.20 ,$291.27 , N/A , N/A ,$167.58 ,$399.00 ,$339.15 , N/A ,$367.08 ,$279.30 ,$199.50 ,$239.40 ,$242.99 ,$199.50 ,$275.71 ,$279.30 , N/A ,$287.28 , N/A ,$239.40 ,$239.40 , N/A ,$239.40 , N/A ,$287.28 ,$247.38 ,$287.28 ,$287.28 ,$239.40 ST VINCENT HOSPITAL - ACUTE,27203502,N/A,HC PROLACT PLUS 4 10 ML,272,1 ,$133.00 ,$66.50 ,$55.86 ,$133.00 ,$85.92 , N/A ,$86.04 ,$86.04 , N/A ,$79.80 ,$113.05 ,$93.10 , N/A ,$126.35 ,$95.76 ,$97.09 ,$86.45 ,$113.05 , N/A ,$86.45 ,$106.40 ,$97.09 , N/A , N/A ,$55.86 ,$133.00 ,$113.05 , N/A ,$122.36 ,$93.10 ,$66.50 ,$79.80 ,$81.00 ,$66.50 ,$91.90 ,$93.10 , N/A ,$95.76 , N/A ,$79.80 ,$79.80 , N/A ,$79.80 , N/A ,$95.76 ,$82.46 ,$95.76 ,$95.76 ,$79.80 ST VINCENT HOSPITAL - ACUTE,27203503,N/A,HC CANNULA NASAL HEATED HI FLOW,272,1 ,$100.00 ,$50.00 ,$42.00 ,$100.00 ,$64.60 , N/A ,$64.69 ,$64.69 , N/A ,$60.00 ,$85.00 ,$70.00 , N/A ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 , N/A ,$65.00 ,$80.00 ,$73.00 , N/A , N/A ,$42.00 ,$100.00 ,$85.00 , N/A ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 , N/A ,$72.00 , N/A ,$60.00 ,$60.00 , N/A ,$60.00 , N/A ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,27203657,C1769,HC GUIDEWIRE,272,1 ,$130.00 ,$65.00 ,$54.60 ,$130.00 ,$83.98 , N/A ,$84.10 ,$84.10 , N/A ,$78.00 ,$110.50 ,$91.00 , N/A ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 , N/A ,$84.50 ,$104.00 ,$94.90 , N/A , N/A ,$54.60 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 , N/A ,$93.60 , N/A ,$78.00 ,$78.00 , N/A ,$78.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,27203750,C2628,HC CATHETER BALLOON OCCLUSION,272,1 ,"$2,856.00 ","$1,428.00 ","$1,199.52 ","$2,856.00 ","$1,844.98 ", N/A ,"$1,847.55 ","$1,847.55 ", N/A ,"$1,713.60 ","$2,427.60 ","$1,999.20 ", N/A ,"$2,713.20 ","$2,056.32 ","$2,084.88 ","$1,856.40 ","$2,427.60 ", N/A ,"$1,856.40 ","$2,284.80 ","$2,084.88 ", N/A , N/A ,"$1,199.52 ","$2,856.00 ","$2,427.60 ", N/A ,"$2,627.52 ","$1,999.20 ","$1,428.00 ","$1,713.60 ","$1,739.30 ","$1,428.00 ","$1,973.50 ","$1,999.20 ", N/A ,"$2,056.32 ", N/A ,"$1,713.60 ","$1,713.60 ", N/A ,"$1,713.60 ", N/A ,"$2,056.32 ","$1,770.72 ","$2,056.32 ","$2,056.32 ","$1,713.60 " ST VINCENT HOSPITAL - ACUTE,27204102,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T2,272,1 ,"$3,060.00 ","$1,530.00 ","$1,285.20 ","$3,060.00 ","$1,976.76 ", N/A ,"$1,979.51 ","$1,979.51 ", N/A ,"$1,836.00 ","$2,601.00 ","$2,142.00 ", N/A ,"$2,907.00 ","$2,203.20 ","$2,233.80 ","$1,989.00 ","$2,601.00 ", N/A ,"$1,989.00 ","$2,448.00 ","$2,233.80 ", N/A , N/A ,"$1,285.20 ","$3,060.00 ","$2,601.00 ", N/A ,"$2,815.20 ","$2,142.00 ","$1,530.00 ","$1,836.00 ","$1,863.54 ","$1,530.00 ","$2,114.46 ","$2,142.00 ", N/A ,"$2,203.20 ", N/A ,"$1,836.00 ","$1,836.00 ", N/A ,"$1,836.00 ", N/A ,"$2,203.20 ","$1,897.20 ","$2,203.20 ","$2,203.20 ","$1,836.00 " ST VINCENT HOSPITAL - ACUTE,27204103,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T3,272,1 ,"$6,120.00 ","$3,060.00 ","$2,570.40 ","$6,120.00 ","$3,953.52 ", N/A ,"$3,959.03 ","$3,959.03 ", N/A ,"$3,672.00 ","$5,202.00 ","$4,284.00 ", N/A ,"$5,814.00 ","$4,406.40 ","$4,467.60 ","$3,978.00 ","$5,202.00 ", N/A ,"$3,978.00 ","$4,896.00 ","$4,467.60 ", N/A , N/A ,"$2,570.40 ","$6,120.00 ","$5,202.00 ", N/A ,"$5,630.40 ","$4,284.00 ","$3,060.00 ","$3,672.00 ","$3,727.08 ","$3,060.00 ","$4,228.92 ","$4,284.00 ", N/A ,"$4,406.40 ", N/A ,"$3,672.00 ","$3,672.00 ", N/A ,"$3,672.00 ", N/A ,"$4,406.40 ","$3,794.40 ","$4,406.40 ","$4,406.40 ","$3,672.00 " ST VINCENT HOSPITAL - ACUTE,27204104,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T4,272,1 ,"$8,670.00 ","$4,335.00 ","$3,641.40 ","$8,670.00 ","$5,600.82 ", N/A ,"$5,608.62 ","$5,608.62 ", N/A ,"$5,202.00 ","$7,369.50 ","$6,069.00 ", N/A ,"$8,236.50 ","$6,242.40 ","$6,329.10 ","$5,635.50 ","$7,369.50 ", N/A ,"$5,635.50 ","$6,936.00 ","$6,329.10 ", N/A , N/A ,"$3,641.40 ","$8,670.00 ","$7,369.50 ", N/A ,"$7,976.40 ","$6,069.00 ","$4,335.00 ","$5,202.00 ","$5,280.03 ","$4,335.00 ","$5,990.97 ","$6,069.00 ", N/A ,"$6,242.40 ", N/A ,"$5,202.00 ","$5,202.00 ", N/A ,"$5,202.00 ", N/A ,"$6,242.40 ","$5,375.40 ","$6,242.40 ","$6,242.40 ","$5,202.00 " ST VINCENT HOSPITAL - ACUTE,27204329,C1887,HC CATHETER GUIDING T5,272,1 ,"$2,244.00 ","$1,122.00 ",$942.48 ,"$2,244.00 ","$1,449.62 ", N/A ,"$1,451.64 ","$1,451.64 ", N/A ,"$1,346.40 ","$1,907.40 ","$1,570.80 ", N/A ,"$2,131.80 ","$1,615.68 ","$1,638.12 ","$1,458.60 ","$1,907.40 ", N/A ,"$1,458.60 ","$1,795.20 ","$1,638.12 ", N/A , N/A ,$942.48 ,"$2,244.00 ","$1,907.40 ", N/A ,"$2,064.48 ","$1,570.80 ","$1,122.00 ","$1,346.40 ","$1,366.60 ","$1,122.00 ","$1,550.60 ","$1,570.80 ", N/A ,"$1,615.68 ", N/A ,"$1,346.40 ","$1,346.40 ", N/A ,"$1,346.40 ", N/A ,"$1,615.68 ","$1,391.28 ","$1,615.68 ","$1,615.68 ","$1,346.40 " ST VINCENT HOSPITAL - ACUTE,27204330,C1887,HC CATHETER GUIDING T6,272,1 ,"$2,958.00 ","$1,479.00 ","$1,242.36 ","$2,958.00 ","$1,910.87 ", N/A ,"$1,913.53 ","$1,913.53 ", N/A ,"$1,774.80 ","$2,514.30 ","$2,070.60 ", N/A ,"$2,810.10 ","$2,129.76 ","$2,159.34 ","$1,922.70 ","$2,514.30 ", N/A ,"$1,922.70 ","$2,366.40 ","$2,159.34 ", N/A , N/A ,"$1,242.36 ","$2,958.00 ","$2,514.30 ", N/A ,"$2,721.36 ","$2,070.60 ","$1,479.00 ","$1,774.80 ","$1,801.42 ","$1,479.00 ","$2,043.98 ","$2,070.60 ", N/A ,"$2,129.76 ", N/A ,"$1,774.80 ","$1,774.80 ", N/A ,"$1,774.80 ", N/A ,"$2,129.76 ","$1,833.96 ","$2,129.76 ","$2,129.76 ","$1,774.80 " ST VINCENT HOSPITAL - ACUTE,27205265,N/A,HC SYSTEM DIRECT VISUALIZATION SPYSCOPE,272,1 ,"$6,793.00 ","$3,396.50 ","$2,853.06 ","$6,793.00 ","$4,388.28 ", N/A ,"$4,394.39 ","$4,394.39 ", N/A ,"$4,075.80 ","$5,774.05 ","$4,755.10 ", N/A ,"$6,453.35 ","$4,890.96 ","$4,958.89 ","$4,415.45 ","$5,774.05 ", N/A ,"$4,415.45 ","$5,434.40 ","$4,958.89 ", N/A , N/A ,"$2,853.06 ","$6,793.00 ","$5,774.05 ", N/A ,"$6,249.56 ","$4,755.10 ","$3,396.50 ","$4,075.80 ","$4,136.94 ","$3,396.50 ","$4,693.96 ","$4,755.10 ", N/A ,"$4,890.96 ", N/A ,"$4,075.80 ","$4,075.80 ", N/A ,"$4,075.80 ", N/A ,"$4,890.96 ","$4,211.66 ","$4,890.96 ","$4,890.96 ","$4,075.80 " ST VINCENT HOSPITAL - ACUTE,27205461,N/A,HC SUTURE MONOCRYL 4-0 Y415H,272,1 ,$4.29 ,$2.15 ,$1.80 ,$4.29 ,$2.77 , N/A ,$2.78 ,$2.78 , N/A ,$2.57 ,$3.65 ,$3.00 , N/A ,$4.08 ,$3.09 ,$3.13 ,$2.79 ,$3.65 , N/A ,$2.79 ,$3.43 ,$3.13 , N/A , N/A ,$1.80 ,$4.29 ,$3.65 , N/A ,$3.95 ,$3.00 ,$2.15 ,$2.57 ,$2.61 ,$2.15 ,$2.96 ,$3.00 , N/A ,$3.09 , N/A ,$2.57 ,$2.57 , N/A ,$2.57 , N/A ,$3.09 ,$2.66 ,$3.09 ,$3.09 ,$2.57 ST VINCENT HOSPITAL - ACUTE,27400003,L0120,HC CERVICAL COLLAR,274,1 ,$67.00 ,$33.50 ,$28.14 ,$77.94 ,$43.28 , N/A , N/A , N/A ,$34.64 ,$40.20 ,$56.95 ,$46.90 , N/A ,$63.65 ,$48.24 ,$48.91 , N/A ,$56.95 ,$34.64 , N/A ,$53.60 ,$48.91 , N/A ,$34.64 ,$28.14 ,$67.00 ,$56.95 ,$77.94 ,$61.64 ,$46.90 ,$33.50 ,$40.20 ,$40.80 ,$33.50 ,$46.30 ,$46.90 ,$34.99 ,$48.24 , N/A , N/A , N/A ,$34.64 , N/A ,$34.64 ,$48.24 ,$41.54 ,$48.24 ,$48.24 ,$40.20 ST VINCENT HOSPITAL - ACUTE,27400004,L0140,HC CERVICAL COLLAR ADJUSTABLE,274,1 ,$191.00 ,$95.50 ,$80.22 ,$194.11 ,$123.39 , N/A , N/A , N/A ,$86.27 ,$114.60 ,$162.35 ,$133.70 , N/A ,$181.45 ,$137.52 ,$139.43 , N/A ,$162.35 ,$86.27 , N/A ,$152.80 ,$139.43 , N/A ,$86.27 ,$80.22 ,$191.00 ,$162.35 ,$194.11 ,$175.72 ,$133.70 ,$95.50 ,$114.60 ,$116.32 ,$95.50 ,$131.98 ,$133.70 ,$87.13 ,$137.52 , N/A , N/A , N/A ,$86.27 , N/A ,$86.27 ,$137.52 ,$118.42 ,$137.52 ,$137.52 ,$114.60 ST VINCENT HOSPITAL - ACUTE,27400005,L0150,HC CERVICAL COLLAR-STIFF NECK,274,1 ,$123.00 ,$61.50 ,$51.66 ,$248.76 ,$79.46 , N/A , N/A , N/A ,$110.56 ,$73.80 ,$104.55 ,$86.10 , N/A ,$116.85 ,$88.56 ,$89.79 , N/A ,$104.55 ,$110.56 , N/A ,$98.40 ,$89.79 , N/A ,$110.56 ,$51.66 ,$123.00 ,$104.55 ,$248.76 ,$113.16 ,$86.10 ,$61.50 ,$73.80 ,$74.91 ,$61.50 ,$84.99 ,$86.10 ,$111.67 ,$88.56 , N/A , N/A , N/A ,$110.56 , N/A ,$110.56 ,$88.56 ,$76.26 ,$88.56 ,$88.56 ,$73.80 ST VINCENT HOSPITAL - ACUTE,27400006,L0150,HC PHILADELPHA COLLAR,274,1 ,$123.00 ,$61.50 ,$51.66 ,$248.76 ,$79.46 , N/A , N/A , N/A ,$110.56 ,$73.80 ,$104.55 ,$86.10 , N/A ,$116.85 ,$88.56 ,$89.79 , N/A ,$104.55 ,$110.56 , N/A ,$98.40 ,$89.79 , N/A ,$110.56 ,$51.66 ,$123.00 ,$104.55 ,$248.76 ,$113.16 ,$86.10 ,$61.50 ,$73.80 ,$74.91 ,$61.50 ,$84.99 ,$86.10 ,$111.67 ,$88.56 , N/A , N/A , N/A ,$110.56 , N/A ,$110.56 ,$88.56 ,$76.26 ,$88.56 ,$88.56 ,$73.80 ST VINCENT HOSPITAL - ACUTE,27400010,L0172,HC CERVICAL COLLAR TWO PIECE,274,1 ,$281.00 ,$140.50 ,$118.02 ,$382.36 ,$181.53 , N/A , N/A , N/A ,$169.94 ,$168.60 ,$238.85 ,$196.70 , N/A ,$266.95 ,$202.32 ,$205.13 , N/A ,$238.85 ,$169.94 , N/A ,$224.80 ,$205.13 , N/A ,$169.94 ,$118.02 ,$281.00 ,$238.85 ,$382.36 ,$258.52 ,$196.70 ,$140.50 ,$168.60 ,$171.13 ,$140.50 ,$194.17 ,$196.70 ,$171.64 ,$202.32 , N/A , N/A , N/A ,$169.94 , N/A ,$169.94 ,$202.32 ,$174.22 ,$202.32 ,$202.32 ,$168.60 ST VINCENT HOSPITAL - ACUTE,27400011,L0220,HC RIBBELT,274,1 ,$168.00 ,$84.00 ,$70.56 ,$309.02 ,$108.53 , N/A , N/A , N/A ,$137.34 ,$100.80 ,$142.80 ,$117.60 , N/A ,$159.60 ,$120.96 ,$122.64 , N/A ,$142.80 ,$137.34 , N/A ,$134.40 ,$122.64 , N/A ,$137.34 ,$70.56 ,$168.00 ,$142.80 ,$309.02 ,$154.56 ,$117.60 ,$84.00 ,$100.80 ,$102.31 ,$84.00 ,$116.09 ,$117.60 ,$138.71 ,$120.96 , N/A , N/A , N/A ,$137.34 , N/A ,$137.34 ,$120.96 ,$104.16 ,$120.96 ,$120.96 ,$100.80 ST VINCENT HOSPITAL - ACUTE,27400028,L1830,HC KNEE IMMOBILIZER FIT AND ADJ,274,1 ,$186.00 ,$93.00 ,$78.12 ,$211.57 ,$120.16 , N/A , N/A , N/A ,$94.03 ,$111.60 ,$158.10 ,$130.20 , N/A ,$176.70 ,$133.92 ,$135.78 , N/A ,$158.10 ,$94.03 , N/A ,$148.80 ,$135.78 , N/A ,$94.03 ,$78.12 ,$186.00 ,$158.10 ,$211.57 ,$171.12 ,$130.20 ,$93.00 ,$111.60 ,$113.27 ,$93.00 ,$128.53 ,$130.20 ,$94.97 ,$133.92 , N/A , N/A , N/A ,$94.03 , N/A ,$94.03 ,$133.92 ,$115.32 ,$133.92 ,$133.92 ,$111.60 ST VINCENT HOSPITAL - ACUTE,27400034,L3030,HC ORTHOTIC DEVICE,274,1 ,$157.00 ,$78.50 ,$65.94 ,$208.51 ,$101.42 , N/A , N/A , N/A ,$92.67 ,$94.20 ,$133.45 ,$109.90 , N/A ,$149.15 ,$113.04 ,$114.61 , N/A ,$133.45 ,$92.67 , N/A ,$125.60 ,$114.61 , N/A ,$92.67 ,$65.94 ,$157.00 ,$133.45 ,$208.51 ,$144.44 ,$109.90 ,$78.50 ,$94.20 ,$95.61 ,$78.50 ,$108.49 ,$109.90 ,$93.60 ,$113.04 , N/A , N/A , N/A ,$92.67 , N/A ,$92.67 ,$113.04 ,$97.34 ,$113.04 ,$113.04 ,$94.20 ST VINCENT HOSPITAL - ACUTE,27400035,L3650,HC CLAVICLE STRAP/FIT AND ADJ,274,1 ,$152.00 ,$76.00 ,$63.84 ,$186.89 ,$98.19 , N/A , N/A , N/A ,$83.06 ,$91.20 ,$129.20 ,$106.40 , N/A ,$144.40 ,$109.44 ,$110.96 , N/A ,$129.20 ,$83.06 , N/A ,$121.60 ,$110.96 , N/A ,$83.06 ,$63.84 ,$152.00 ,$129.20 ,$186.89 ,$139.84 ,$106.40 ,$76.00 ,$91.20 ,$92.57 ,$76.00 ,$105.03 ,$106.40 ,$83.89 ,$109.44 , N/A , N/A , N/A ,$83.06 , N/A ,$83.06 ,$109.44 ,$94.24 ,$109.44 ,$109.44 ,$91.20 ST VINCENT HOSPITAL - ACUTE,27400037,L4397,HC SPLINT ANKLE FOOT ORTHOSIS STATIC,274,1 ,$113.00 ,$56.50 ,$47.46 ,$354.08 ,$73.00 , N/A , N/A , N/A ,$157.37 ,$67.80 ,$96.05 ,$79.10 , N/A ,$107.35 ,$81.36 ,$82.49 , N/A ,$96.05 ,$157.37 , N/A ,$90.40 ,$82.49 , N/A ,$157.37 ,$47.46 ,$113.00 ,$96.05 ,$354.08 ,$103.96 ,$79.10 ,$56.50 ,$67.80 ,$68.82 ,$56.50 ,$78.08 ,$79.10 ,$158.94 ,$81.36 , N/A , N/A , N/A ,$157.37 , N/A ,$157.37 ,$81.36 ,$70.06 ,$81.36 ,$81.36 ,$67.80 ST VINCENT HOSPITAL - ACUTE,27400039,L3670,HC SHOULDER IMMOBILIZER FIT AND ADJ,274,1 ,$152.00 ,$76.00 ,$63.84 ,$255.35 ,$98.19 , N/A , N/A , N/A ,$113.49 ,$91.20 ,$129.20 ,$106.40 , N/A ,$144.40 ,$109.44 ,$110.96 , N/A ,$129.20 ,$113.49 , N/A ,$121.60 ,$110.96 , N/A ,$113.49 ,$63.84 ,$152.00 ,$129.20 ,$255.35 ,$139.84 ,$106.40 ,$76.00 ,$91.20 ,$92.57 ,$76.00 ,$105.03 ,$106.40 ,$114.62 ,$109.44 , N/A , N/A , N/A ,$113.49 , N/A ,$113.49 ,$109.44 ,$94.24 ,$109.44 ,$109.44 ,$91.20 ST VINCENT HOSPITAL - ACUTE,27400040,L3763,HC SPLINT FOREARM-STATIC,274,1 ,$727.00 ,$363.50 ,$305.34 ,"$1,557.74 ",$469.64 , N/A , N/A , N/A ,$692.33 ,$436.20 ,$617.95 ,$508.90 , N/A ,$690.65 ,$523.44 ,$530.71 , N/A ,$617.95 ,$692.33 , N/A ,$581.60 ,$530.71 , N/A ,$692.33 ,$305.34 ,$727.00 ,$617.95 ,"$1,557.74 ",$668.84 ,$508.90 ,$363.50 ,$436.20 ,$442.74 ,$363.50 ,$502.36 ,$508.90 ,$699.25 ,$523.44 , N/A , N/A , N/A ,$692.33 , N/A ,$692.33 ,$523.44 ,$450.74 ,$523.44 ,$523.44 ,$436.20 ST VINCENT HOSPITAL - ACUTE,27400041,L3764,HC SPLINT FOREARM-DYNAMIC,274,1 ,$755.00 ,$377.50 ,$317.10 ,"$1,627.60 ",$487.73 , N/A , N/A , N/A ,$723.38 ,$453.00 ,$641.75 ,$528.50 , N/A ,$717.25 ,$543.60 ,$551.15 , N/A ,$641.75 ,$723.38 , N/A ,$604.00 ,$551.15 , N/A ,$723.38 ,$317.10 ,$755.00 ,$641.75 ,"$1,627.60 ",$694.60 ,$528.50 ,$377.50 ,$453.00 ,$459.80 ,$377.50 ,$521.71 ,$528.50 ,$730.61 ,$543.60 , N/A , N/A , N/A ,$723.38 , N/A ,$723.38 ,$543.60 ,$468.10 ,$543.60 ,$543.60 ,$453.00 ST VINCENT HOSPITAL - ACUTE,27400043,L3807,HC FUNCT POSITION HAND SPLT,274,1 ,$460.00 ,$230.00 ,$193.20 ,$618.17 ,$297.16 , N/A , N/A , N/A ,$274.74 ,$276.00 ,$391.00 ,$322.00 , N/A ,$437.00 ,$331.20 ,$335.80 , N/A ,$391.00 ,$274.74 , N/A ,$368.00 ,$335.80 , N/A ,$274.74 ,$193.20 ,$460.00 ,$391.00 ,$618.17 ,$423.20 ,$322.00 ,$230.00 ,$276.00 ,$280.14 ,$230.00 ,$317.86 ,$322.00 ,$277.49 ,$331.20 , N/A , N/A , N/A ,$274.74 , N/A ,$274.74 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,27400044,L3908,HC COCK UP WRIST SPLINT/FIT AND ADJ,274,1 ,$150.00 ,$75.00 ,$63.00 ,$188.06 ,$96.90 , N/A , N/A , N/A ,$83.58 ,$90.00 ,$127.50 ,$105.00 , N/A ,$142.50 ,$108.00 ,$109.50 , N/A ,$127.50 ,$83.58 , N/A ,$120.00 ,$109.50 , N/A ,$83.58 ,$63.00 ,$150.00 ,$127.50 ,$188.06 ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 ,$84.42 ,$108.00 , N/A , N/A , N/A ,$83.58 , N/A ,$83.58 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,27400046,L3908,HC ROYLAN D-RING WRIST BRC,274,1 ,$81.00 ,$40.50 ,$34.02 ,$157.01 ,$52.33 , N/A , N/A , N/A ,$69.78 ,$48.60 ,$68.85 ,$56.70 , N/A ,$76.95 ,$58.32 ,$59.13 , N/A ,$68.85 ,$69.78 , N/A ,$64.80 ,$59.13 , N/A ,$69.78 ,$34.02 ,$81.00 ,$68.85 ,$157.01 ,$74.52 ,$56.70 ,$40.50 ,$48.60 ,$49.33 ,$40.50 ,$55.97 ,$56.70 ,$70.48 ,$58.32 , N/A , N/A , N/A ,$69.78 , N/A ,$69.78 ,$58.32 ,$50.22 ,$58.32 ,$58.32 ,$48.60 ST VINCENT HOSPITAL - ACUTE,27400049,L3913,HC HAND FINGER SPLINT INCL FITTING,274,1 ,$490.00 ,$245.00 ,$205.80 ,$665.84 ,$316.54 , N/A , N/A , N/A ,$295.93 ,$294.00 ,$416.50 ,$343.00 , N/A ,$465.50 ,$352.80 ,$357.70 , N/A ,$416.50 ,$295.93 , N/A ,$392.00 ,$357.70 , N/A ,$295.93 ,$205.80 ,$490.00 ,$416.50 ,$665.84 ,$450.80 ,$343.00 ,$245.00 ,$294.00 ,$298.41 ,$245.00 ,$338.59 ,$343.00 ,$298.89 ,$352.80 , N/A , N/A , N/A ,$295.93 , N/A ,$295.93 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,27400051,L3919,HC SPLINT HAND STATIC,274,1 ,$275.00 ,$137.50 ,$115.50 ,$569.09 ,$177.65 , N/A , N/A , N/A ,$252.93 ,$165.00 ,$233.75 ,$192.50 , N/A ,$261.25 ,$198.00 ,$200.75 , N/A ,$233.75 ,$252.93 , N/A ,$220.00 ,$200.75 , N/A ,$252.93 ,$115.50 ,$275.00 ,$233.75 ,$569.09 ,$253.00 ,$192.50 ,$137.50 ,$165.00 ,$167.48 ,$137.50 ,$190.03 ,$192.50 ,$255.46 ,$198.00 , N/A , N/A , N/A ,$252.93 , N/A ,$252.93 ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,27400052,L3921,HC SPLINT HAND DYNAMIC,274,1 ,$374.00 ,$187.00 ,$157.08 ,$696.53 ,$241.60 ,$232.21 , N/A , N/A ,$309.57 ,$224.40 ,$317.90 ,$261.80 ,$232.21 ,$355.30 ,$269.28 ,$273.02 , N/A ,$317.90 ,$309.57 , N/A ,$299.20 ,$273.02 ,$232.21 ,$309.57 ,$157.08 ,$374.00 ,$317.90 ,$696.53 ,$344.08 ,$261.80 ,$187.00 ,$224.40 ,$227.77 ,$187.00 ,$258.43 ,$261.80 ,$312.67 ,$269.28 ,$246.14 , N/A , N/A ,$309.57 , N/A ,$309.57 ,$269.28 ,$231.88 ,$269.28 ,$269.28 ,$224.40 ST VINCENT HOSPITAL - ACUTE,27400061,L3931,HC SPLINT DORSAL BLOCKING,274,1 ,$201.00 ,$100.50 ,$84.42 ,$433.31 ,$129.85 , N/A , N/A , N/A ,$192.58 ,$120.60 ,$170.85 ,$140.70 , N/A ,$190.95 ,$144.72 ,$146.73 , N/A ,$170.85 ,$192.58 , N/A ,$160.80 ,$146.73 , N/A ,$192.58 ,$84.42 ,$201.00 ,$170.85 ,$433.31 ,$184.92 ,$140.70 ,$100.50 ,$120.60 ,$122.41 ,$100.50 ,$138.89 ,$140.70 ,$194.51 ,$144.72 , N/A , N/A , N/A ,$192.58 , N/A ,$192.58 ,$144.72 ,$124.62 ,$144.72 ,$144.72 ,$120.60 ST VINCENT HOSPITAL - ACUTE,27400063,L4350,HC AIR CAST/FIT AND ADJ,274,1 ,$191.00 ,$95.50 ,$80.22 ,$260.78 ,$123.39 , N/A , N/A , N/A ,$115.90 ,$114.60 ,$162.35 ,$133.70 , N/A ,$181.45 ,$137.52 ,$139.43 , N/A ,$162.35 ,$115.90 , N/A ,$152.80 ,$139.43 , N/A ,$115.90 ,$80.22 ,$191.00 ,$162.35 ,$260.78 ,$175.72 ,$133.70 ,$95.50 ,$114.60 ,$116.32 ,$95.50 ,$131.98 ,$133.70 ,$117.06 ,$137.52 , N/A , N/A , N/A ,$115.90 , N/A ,$115.90 ,$137.52 ,$118.42 ,$137.52 ,$137.52 ,$114.60 ST VINCENT HOSPITAL - ACUTE,27400064,L4360,HC AIRWALKER SPLINT INCL FITTING,274,1 ,$504.00 ,$252.00 ,$211.68 ,$694.60 ,$325.58 , N/A , N/A , N/A ,$308.71 ,$302.40 ,$428.40 ,$352.80 , N/A ,$478.80 ,$362.88 ,$367.92 , N/A ,$428.40 ,$308.71 , N/A ,$403.20 ,$367.92 , N/A ,$308.71 ,$211.68 ,$504.00 ,$428.40 ,$694.60 ,$463.68 ,$352.80 ,$252.00 ,$302.40 ,$306.94 ,$252.00 ,$348.26 ,$352.80 ,$311.80 ,$362.88 , N/A , N/A , N/A ,$308.71 , N/A ,$308.71 ,$362.88 ,$312.48 ,$362.88 ,$362.88 ,$302.40 ST VINCENT HOSPITAL - ACUTE,27400065,L4386,HC ROM WALKER BOOT FIT AND ADJ,274,1 ,$313.00 ,$156.50 ,$131.46 ,$427.34 ,$202.20 , N/A , N/A , N/A ,$189.93 ,$187.80 ,$266.05 ,$219.10 , N/A ,$297.35 ,$225.36 ,$228.49 , N/A ,$266.05 ,$189.93 , N/A ,$250.40 ,$228.49 , N/A ,$189.93 ,$131.46 ,$313.00 ,$266.05 ,$427.34 ,$287.96 ,$219.10 ,$156.50 ,$187.80 ,$190.62 ,$156.50 ,$216.28 ,$219.10 ,$191.83 ,$225.36 , N/A , N/A , N/A ,$189.93 , N/A ,$189.93 ,$225.36 ,$194.06 ,$225.36 ,$225.36 ,$187.80 ST VINCENT HOSPITAL - ACUTE,27400066,L4398,HC DROP FOOT BRACE (AFO),274,1 ,$157.00 ,$78.50 ,$65.94 ,$210.22 ,$101.42 , N/A , N/A , N/A ,$93.43 ,$94.20 ,$133.45 ,$109.90 , N/A ,$149.15 ,$113.04 ,$114.61 , N/A ,$133.45 ,$93.43 , N/A ,$125.60 ,$114.61 , N/A ,$93.43 ,$65.94 ,$157.00 ,$133.45 ,$210.22 ,$144.44 ,$109.90 ,$78.50 ,$94.20 ,$95.61 ,$78.50 ,$108.49 ,$109.90 ,$94.36 ,$113.04 , N/A , N/A , N/A ,$93.43 , N/A ,$93.43 ,$113.04 ,$97.34 ,$113.04 ,$113.04 ,$94.20 ST VINCENT HOSPITAL - ACUTE,27400069,L8501,HC PASSEY MUIR VALVE,274,1 ,$269.00 ,$134.50 ,$112.98 ,$338.49 ,$173.77 , N/A , N/A , N/A ,$150.44 ,$161.40 ,$228.65 ,$188.30 , N/A ,$255.55 ,$193.68 ,$196.37 , N/A ,$228.65 ,$150.44 , N/A ,$215.20 ,$196.37 , N/A ,$150.44 ,$112.98 ,$269.00 ,$228.65 ,$338.49 ,$247.48 ,$188.30 ,$134.50 ,$161.40 ,$163.82 ,$134.50 ,$185.88 ,$188.30 ,$151.94 ,$193.68 , N/A , N/A , N/A ,$150.44 , N/A ,$150.44 ,$193.68 ,$166.78 ,$193.68 ,$193.68 ,$161.40 ST VINCENT HOSPITAL - ACUTE,27400080,L3935,HC THUMB SPLINT FIT AND ADJUST,274,1 ,$224.00 ,$112.00 ,$94.08 ,$464.08 ,$144.70 , N/A , N/A , N/A ,$206.26 ,$134.40 ,$190.40 ,$156.80 , N/A ,$212.80 ,$161.28 ,$163.52 , N/A ,$190.40 ,$206.26 , N/A ,$179.20 ,$163.52 , N/A ,$206.26 ,$94.08 ,$224.00 ,$190.40 ,$464.08 ,$206.08 ,$156.80 ,$112.00 ,$134.40 ,$136.42 ,$112.00 ,$154.78 ,$156.80 ,$208.32 ,$161.28 , N/A , N/A , N/A ,$206.26 , N/A ,$206.26 ,$161.28 ,$138.88 ,$161.28 ,$161.28 ,$134.40 ST VINCENT HOSPITAL - ACUTE,27400091,L0625,HC LUMBAR CORSET,274,1 ,$71.00 ,$35.50 ,$29.82 ,$103.19 ,$45.87 , N/A , N/A , N/A ,$45.86 ,$42.60 ,$60.35 ,$49.70 , N/A ,$67.45 ,$51.12 ,$51.83 , N/A ,$60.35 ,$45.86 , N/A ,$56.80 ,$51.83 , N/A ,$45.86 ,$29.82 ,$71.00 ,$60.35 ,$103.19 ,$65.32 ,$49.70 ,$35.50 ,$42.60 ,$43.24 ,$35.50 ,$49.06 ,$49.70 ,$46.32 ,$51.12 , N/A , N/A , N/A ,$45.86 , N/A ,$45.86 ,$51.12 ,$44.02 ,$51.12 ,$51.12 ,$42.60 ST VINCENT HOSPITAL - ACUTE,27400092,L3927,HC FINGER SPLINT STATIC FIT/ADJUST,274,1 ,$65.00 ,$32.50 ,$27.30 ,$86.81 ,$41.99 , N/A , N/A , N/A ,$38.58 ,$39.00 ,$55.25 ,$45.50 , N/A ,$61.75 ,$46.80 ,$47.45 , N/A ,$55.25 ,$38.58 , N/A ,$52.00 ,$47.45 , N/A ,$38.58 ,$27.30 ,$65.00 ,$55.25 ,$86.81 ,$59.80 ,$45.50 ,$32.50 ,$39.00 ,$39.59 ,$32.50 ,$44.92 ,$45.50 ,$38.97 ,$46.80 , N/A , N/A , N/A ,$38.58 , N/A ,$38.58 ,$46.80 ,$40.30 ,$46.80 ,$46.80 ,$39.00 ST VINCENT HOSPITAL - ACUTE,27400109,L3702,HC ORTHOSIS ELBOW W/O JOINTS CUSTOM,274,1 ,$460.00 ,$230.00 ,$193.20 ,$681.86 ,$297.16 , N/A , N/A , N/A ,$303.05 ,$276.00 ,$391.00 ,$322.00 , N/A ,$437.00 ,$331.20 ,$335.80 , N/A ,$391.00 ,$303.05 , N/A ,$368.00 ,$335.80 , N/A ,$303.05 ,$193.20 ,$460.00 ,$391.00 ,$681.86 ,$423.20 ,$322.00 ,$230.00 ,$276.00 ,$280.14 ,$230.00 ,$317.86 ,$322.00 ,$306.08 ,$331.20 , N/A , N/A , N/A ,$303.05 , N/A ,$303.05 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,27400110,L3808,HC ORTHOSIS WHFO RIGID W/O JOINTS,274,1 ,$640.00 ,$320.00 ,$268.80 ,$873.77 ,$413.44 , N/A , N/A , N/A ,$388.34 ,$384.00 ,$544.00 ,$448.00 , N/A ,$608.00 ,$460.80 ,$467.20 , N/A ,$544.00 ,$388.34 , N/A ,$512.00 ,$467.20 , N/A ,$388.34 ,$268.80 ,$640.00 ,$544.00 ,$873.77 ,$588.80 ,$448.00 ,$320.00 ,$384.00 ,$389.76 ,$320.00 ,$442.24 ,$448.00 ,$392.22 ,$460.80 , N/A , N/A , N/A ,$388.34 , N/A ,$388.34 ,$460.80 ,$396.80 ,$460.80 ,$460.80 ,$384.00 ST VINCENT HOSPITAL - ACUTE,27400112,L3906,HC ORTHOSIS WHO GAUNTLET MOLDED CUSTOM,274,1 ,$900.00 ,$450.00 ,$378.00 ,"$1,238.35 ",$581.40 , N/A , N/A , N/A ,$550.38 ,$540.00 ,$765.00 ,$630.00 , N/A ,$855.00 ,$648.00 ,$657.00 , N/A ,$765.00 ,$550.38 , N/A ,$720.00 ,$657.00 , N/A ,$550.38 ,$378.00 ,$900.00 ,$765.00 ,"$1,238.35 ",$828.00 ,$630.00 ,$450.00 ,$540.00 ,$548.10 ,$450.00 ,$621.90 ,$630.00 ,$555.88 ,$648.00 , N/A , N/A , N/A ,$550.38 , N/A ,$550.38 ,$648.00 ,$558.00 ,$648.00 ,$648.00 ,$540.00 ST VINCENT HOSPITAL - ACUTE,27400133,L4360,HC BOOT WALKING,274,1 ,$199.00 ,$99.50 ,$83.58 ,$557.35 ,$128.55 , N/A , N/A , N/A ,$247.71 ,$119.40 ,$169.15 ,$139.30 , N/A ,$189.05 ,$143.28 ,$145.27 , N/A ,$169.15 ,$247.71 , N/A ,$159.20 ,$145.27 , N/A ,$247.71 ,$83.58 ,$199.00 ,$169.15 ,$557.35 ,$183.08 ,$139.30 ,$99.50 ,$119.40 ,$121.19 ,$99.50 ,$137.51 ,$139.30 ,$250.19 ,$143.28 , N/A , N/A , N/A ,$247.71 , N/A ,$247.71 ,$143.28 ,$123.38 ,$143.28 ,$143.28 ,$119.40 ST VINCENT HOSPITAL - ACUTE,27400220,L3806,HC WRIST/HAND/FINGER ORTHOSIS W/JOINT CUSTOM FAB FIT AND ADJUST,274,1 ,$810.00 ,$405.00 ,$340.20 ,"$1,111.45 ",$523.26 , N/A , N/A , N/A ,$493.98 ,$486.00 ,$688.50 ,$567.00 , N/A ,$769.50 ,$583.20 ,$591.30 , N/A ,$688.50 ,$493.98 , N/A ,$648.00 ,$591.30 , N/A ,$493.98 ,$340.20 ,$810.00 ,$688.50 ,"$1,111.45 ",$745.20 ,$567.00 ,$405.00 ,$486.00 ,$493.29 ,$405.00 ,$559.71 ,$567.00 ,$498.92 ,$583.20 , N/A , N/A , N/A ,$493.98 , N/A ,$493.98 ,$583.20 ,$502.20 ,$583.20 ,$583.20 ,$486.00 ST VINCENT HOSPITAL - ACUTE,27400221,L3809,HC WRIST/HAND/FINGER ORTHOSIS W/O JOINT PREFAB,274,1 ,$460.00 ,$230.00 ,$193.20 ,$618.17 ,$297.16 , N/A , N/A , N/A ,$274.74 ,$276.00 ,$391.00 ,$322.00 , N/A ,$437.00 ,$331.20 ,$335.80 , N/A ,$391.00 ,$274.74 , N/A ,$368.00 ,$335.80 , N/A ,$274.74 ,$193.20 ,$460.00 ,$391.00 ,$618.17 ,$423.20 ,$322.00 ,$230.00 ,$276.00 ,$280.14 ,$230.00 ,$317.86 ,$322.00 ,$277.49 ,$331.20 , N/A , N/A , N/A ,$274.74 , N/A ,$274.74 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,27400222,L3933,HC FINGER ORTHOSIS W/O JOINTS CUSTOM FAB FIT AND ADJUST,274,1 ,$390.00 ,$195.00 ,$163.80 ,$526.37 ,$251.94 , N/A , N/A , N/A ,$233.94 ,$234.00 ,$331.50 ,$273.00 , N/A ,$370.50 ,$280.80 ,$284.70 , N/A ,$331.50 ,$233.94 , N/A ,$312.00 ,$284.70 , N/A ,$233.94 ,$163.80 ,$390.00 ,$331.50 ,$526.37 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$236.28 ,$280.80 , N/A , N/A , N/A ,$233.94 , N/A ,$233.94 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,27500020,C1898,HC MSB PACEMAKER LEAD,275,1 ,$662.00 ,$331.00 ,$278.04 ,$662.00 ,$427.65 , N/A , N/A , N/A , N/A ,$397.20 ,$562.70 ,$463.40 , N/A ,$628.90 ,$476.64 ,$483.26 , N/A ,$562.70 , N/A , N/A ,$529.60 ,$483.26 , N/A , N/A ,$278.04 ,$662.00 ,$562.70 , N/A ,$609.04 ,$463.40 ,$331.00 ,$397.20 ,$403.16 ,$331.00 ,$457.44 ,$463.40 , N/A ,$476.64 , N/A , N/A , N/A , N/A , N/A , N/A ,$476.64 ,$410.44 ,$476.64 ,$476.64 ,$397.20 ST VINCENT HOSPITAL - ACUTE,27500022,C1900,HC MSB LEAD FOR CS,275,1 ,"$3,393.00 ","$1,696.50 ","$1,425.06 ","$3,393.00 ","$2,191.88 ", N/A ,"$1,688.36 ","$1,688.36 ", N/A ,"$2,035.80 ","$2,884.05 ","$2,375.10 ", N/A ,"$3,223.35 ","$2,442.96 ","$2,476.89 ","$1,696.50 ","$2,884.05 ", N/A ,"$1,696.50 ","$2,714.40 ","$2,476.89 ", N/A , N/A ,"$1,425.06 ","$3,393.00 ","$2,884.05 ", N/A ,"$3,121.56 ","$2,375.10 ","$1,696.50 ","$2,035.80 ","$2,066.34 ","$1,696.50 ","$2,344.56 ","$2,375.10 ", N/A ,"$2,442.96 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,442.96 ","$2,103.66 ","$2,442.96 ","$2,442.96 ","$2,035.80 " ST VINCENT HOSPITAL - ACUTE,27500023,C1786,HC MSB PACER SINGLE,275,1 ,"$5,827.00 ","$2,913.50 ","$2,447.34 ","$5,827.00 ","$3,764.24 ", N/A ,"$2,899.52 ","$2,899.52 ", N/A ,"$3,496.20 ","$4,952.95 ","$4,078.90 ", N/A ,"$5,535.65 ","$4,195.44 ","$4,253.71 ","$2,913.50 ","$4,952.95 ", N/A ,"$2,913.50 ","$4,661.60 ","$4,253.71 ", N/A , N/A ,"$2,447.34 ","$5,827.00 ","$4,952.95 ", N/A ,"$5,360.84 ","$4,078.90 ","$2,913.50 ","$3,496.20 ","$3,548.64 ","$2,913.50 ","$4,026.46 ","$4,078.90 ", N/A ,"$4,195.44 ", N/A ,"$2,913.50 ","$2,913.50 ", N/A ,"$2,913.50 ", N/A ,"$4,195.44 ","$3,612.74 ","$4,195.44 ","$4,195.44 ","$3,496.20 " ST VINCENT HOSPITAL - ACUTE,27500024,C1785,HC MSB PACER DUAL,275,1 ,"$7,837.00 ","$3,918.50 ","$3,291.54 ","$7,837.00 ","$5,062.70 ", N/A ,"$3,899.69 ","$3,899.69 ", N/A ,"$4,702.20 ","$6,661.45 ","$5,485.90 ", N/A ,"$7,445.15 ","$5,642.64 ","$5,721.01 ","$3,918.50 ","$6,661.45 ", N/A ,"$3,918.50 ","$6,269.60 ","$5,721.01 ", N/A , N/A ,"$3,291.54 ","$7,837.00 ","$6,661.45 ", N/A ,"$7,210.04 ","$5,485.90 ","$3,918.50 ","$4,702.20 ","$4,772.73 ","$3,918.50 ","$5,415.37 ","$5,485.90 ", N/A ,"$5,642.64 ", N/A ,"$3,918.50 ","$3,918.50 ", N/A ,"$3,918.50 ", N/A ,"$5,642.64 ","$4,858.94 ","$5,642.64 ","$5,642.64 ","$4,702.20 " ST VINCENT HOSPITAL - ACUTE,27500025,C2621,HC MSB PACER BI-V,275,1 ,"$13,664.00 ","$6,832.00 ","$5,738.88 ","$13,664.00 ","$8,826.94 ", N/A ,"$6,799.21 ","$6,799.21 ", N/A ,"$8,198.40 ","$11,614.40 ","$9,564.80 ", N/A ,"$12,980.80 ","$9,838.08 ","$9,974.72 ","$6,832.00 ","$11,614.40 ", N/A ,"$6,832.00 ","$10,931.20 ","$9,974.72 ", N/A , N/A ,"$5,738.88 ","$13,664.00 ","$11,614.40 ", N/A ,"$12,570.88 ","$9,564.80 ","$6,832.00 ","$8,198.40 ","$8,321.38 ","$6,832.00 ","$9,441.82 ","$9,564.80 ", N/A ,"$9,838.08 ", N/A ,"$6,832.00 ","$6,832.00 ", N/A ,"$6,832.00 ", N/A ,"$9,838.08 ","$8,471.68 ","$9,838.08 ","$9,838.08 ","$8,198.40 " ST VINCENT HOSPITAL - ACUTE,27500026,C1722,HC MSB ICD SINGLE,275,1 ,"$24,116.00 ","$12,058.00 ","$10,128.72 ","$24,116.00 ","$15,578.94 ", N/A ,"$12,000.12 ","$12,000.12 ", N/A ,"$14,469.60 ","$20,498.60 ","$16,881.20 ", N/A ,"$22,910.20 ","$17,363.52 ","$17,604.68 ","$12,058.00 ","$20,498.60 ", N/A ,"$12,058.00 ","$19,292.80 ","$17,604.68 ", N/A , N/A ,"$10,128.72 ","$24,116.00 ","$20,498.60 ", N/A ,"$22,186.72 ","$16,881.20 ","$12,058.00 ","$14,469.60 ","$14,686.64 ","$12,058.00 ","$16,664.16 ","$16,881.20 ", N/A ,"$17,363.52 ", N/A ,"$12,058.00 ","$12,058.00 ", N/A ,"$12,058.00 ", N/A ,"$17,363.52 ","$14,951.92 ","$17,363.52 ","$17,363.52 ","$14,469.60 " ST VINCENT HOSPITAL - ACUTE,27500027,C1721,HC MSB ICD DUAL,275,1 ,"$27,135.00 ","$13,567.50 ","$11,396.70 ","$27,135.00 ","$17,529.21 ", N/A ,"$13,502.38 ","$13,502.38 ", N/A ,"$16,281.00 ","$23,064.75 ","$18,994.50 ", N/A ,"$25,778.25 ","$19,537.20 ","$19,808.55 ","$13,567.50 ","$23,064.75 ", N/A ,"$13,567.50 ","$21,708.00 ","$19,808.55 ", N/A , N/A ,"$11,396.70 ","$27,135.00 ","$23,064.75 ", N/A ,"$24,964.20 ","$18,994.50 ","$13,567.50 ","$16,281.00 ","$16,525.22 ","$13,567.50 ","$18,750.29 ","$18,994.50 ", N/A ,"$19,537.20 ", N/A ,"$13,567.50 ","$13,567.50 ", N/A ,"$13,567.50 ", N/A ,"$19,537.20 ","$16,823.70 ","$19,537.20 ","$19,537.20 ","$16,281.00 " ST VINCENT HOSPITAL - ACUTE,27500028,C1882,HC MSB ICD BI-V,275,1 ,"$38,805.00 ","$19,402.50 ","$16,298.10 ","$38,805.00 ","$25,068.03 ", N/A ,"$19,309.37 ","$19,309.37 ", N/A ,"$23,283.00 ","$32,984.25 ","$27,163.50 ", N/A ,"$36,864.75 ","$27,939.60 ","$28,327.65 ","$19,402.50 ","$32,984.25 ", N/A ,"$19,402.50 ","$31,044.00 ","$28,327.65 ", N/A , N/A ,"$16,298.10 ","$38,805.00 ","$32,984.25 ", N/A ,"$35,700.60 ","$27,163.50 ","$19,402.50 ","$23,283.00 ","$23,632.25 ","$19,402.50 ","$26,814.26 ","$27,163.50 ", N/A ,"$27,939.60 ", N/A ,"$19,402.50 ","$19,402.50 ", N/A ,"$19,402.50 ", N/A ,"$27,939.60 ","$24,059.10 ","$27,939.60 ","$27,939.60 ","$23,283.00 " ST VINCENT HOSPITAL - ACUTE,27500029,C1777,HC MSB ICD LEAD ENDO SINGLE C1777,275,1 ,"$7,433.00 ","$3,716.50 ","$3,121.86 ","$7,433.00 ","$4,801.72 ", N/A ,"$3,698.66 ","$3,698.66 ", N/A ,"$4,459.80 ","$6,318.05 ","$5,203.10 ", N/A ,"$7,061.35 ","$5,351.76 ","$5,426.09 ","$3,716.50 ","$6,318.05 ", N/A ,"$3,716.50 ","$5,946.40 ","$5,426.09 ", N/A , N/A ,"$3,121.86 ","$7,433.00 ","$6,318.05 ", N/A ,"$6,838.36 ","$5,203.10 ","$3,716.50 ","$4,459.80 ","$4,526.70 ","$3,716.50 ","$5,136.20 ","$5,203.10 ", N/A ,"$5,351.76 ", N/A ,"$3,716.50 ","$3,716.50 ", N/A ,"$3,716.50 ", N/A ,"$5,351.76 ","$4,608.46 ","$5,351.76 ","$5,351.76 ","$4,459.80 " ST VINCENT HOSPITAL - ACUTE,27500030,C1895,HC MSB ICD LEAD ENDO DUAL,275,1 ,"$7,433.00 ","$3,716.50 ","$3,121.86 ","$7,433.00 ","$4,801.72 ", N/A ,"$3,698.66 ","$3,698.66 ", N/A ,"$4,459.80 ","$6,318.05 ","$5,203.10 ", N/A ,"$7,061.35 ","$5,351.76 ","$5,426.09 ","$3,716.50 ","$6,318.05 ", N/A ,"$3,716.50 ","$5,946.40 ","$5,426.09 ", N/A , N/A ,"$3,121.86 ","$7,433.00 ","$6,318.05 ", N/A ,"$6,838.36 ","$5,203.10 ","$3,716.50 ","$4,459.80 ","$4,526.70 ","$3,716.50 ","$5,136.20 ","$5,203.10 ", N/A ,"$5,351.76 ", N/A ,"$3,716.50 ","$3,716.50 ", N/A ,"$3,716.50 ", N/A ,"$5,351.76 ","$4,608.46 ","$5,351.76 ","$5,351.76 ","$4,459.80 " ST VINCENT HOSPITAL - ACUTE,27500031,C1896,HC MSB ICD LEAD NON ENDO SGL OR DUAL,275,1 ,"$26,125.00 ","$13,062.50 ","$10,972.50 ","$26,125.00 ","$16,876.75 ", N/A ,"$12,999.80 ","$12,999.80 ", N/A ,"$15,675.00 ","$22,206.25 ","$18,287.50 ", N/A ,"$24,818.75 ","$18,810.00 ","$19,071.25 ","$13,062.50 ","$22,206.25 ", N/A ,"$13,062.50 ","$20,900.00 ","$19,071.25 ", N/A , N/A ,"$10,972.50 ","$26,125.00 ","$22,206.25 ", N/A ,"$24,035.00 ","$18,287.50 ","$13,062.50 ","$15,675.00 ","$15,910.13 ","$13,062.50 ","$18,052.38 ","$18,287.50 ", N/A ,"$18,810.00 ", N/A ,"$13,062.50 ","$13,062.50 ", N/A ,"$13,062.50 ", N/A ,"$18,810.00 ","$16,197.50 ","$18,810.00 ","$18,810.00 ","$15,675.00 " ST VINCENT HOSPITAL - ACUTE,27500035,C1898,HC MSB MRI PACEMAKER LEAD C1898,275,1 ,"$2,010.00 ","$1,005.00 ",$844.20 ,"$2,010.00 ","$1,298.46 ", N/A ,"$1,000.18 ","$1,000.18 ", N/A ,"$1,206.00 ","$1,708.50 ","$1,407.00 ", N/A ,"$1,909.50 ","$1,447.20 ","$1,467.30 ", N/A ,"$1,708.50 ", N/A , N/A ,"$1,608.00 ","$1,467.30 ", N/A , N/A ,$844.20 ,"$2,010.00 ","$1,708.50 ", N/A ,"$1,849.20 ","$1,407.00 ","$1,005.00 ","$1,206.00 ","$1,224.09 ","$1,005.00 ","$1,388.91 ","$1,407.00 ", N/A ,"$1,447.20 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,447.20 ","$1,246.20 ","$1,447.20 ","$1,447.20 ","$1,206.00 " ST VINCENT HOSPITAL - ACUTE,27500036,C1786,HC MSB MRI PACER SINGLE C1786,275,1 ,"$8,039.00 ","$4,019.50 ","$3,376.38 ","$8,039.00 ","$5,193.19 ", N/A ,"$4,000.21 ","$4,000.21 ", N/A ,"$4,823.40 ","$6,833.15 ","$5,627.30 ", N/A ,"$7,637.05 ","$5,788.08 ","$5,868.47 ","$4,019.50 ","$6,833.15 ", N/A ,"$4,019.50 ","$6,431.20 ","$5,868.47 ", N/A , N/A ,"$3,376.38 ","$8,039.00 ","$6,833.15 ", N/A ,"$7,395.88 ","$5,627.30 ","$4,019.50 ","$4,823.40 ","$4,895.75 ","$4,019.50 ","$5,554.95 ","$5,627.30 ", N/A ,"$5,788.08 ", N/A ,"$4,019.50 ","$4,019.50 ", N/A ,"$4,019.50 ", N/A ,"$5,788.08 ","$4,984.18 ","$5,788.08 ","$5,788.08 ","$4,823.40 " ST VINCENT HOSPITAL - ACUTE,27500037,C1785,HC MSB MRI PACER DUAL C1785,275,1 ,"$8,039.00 ","$4,019.50 ","$3,376.38 ","$8,039.00 ","$5,193.19 ", N/A ,"$4,000.21 ","$4,000.21 ", N/A ,"$4,823.40 ","$6,833.15 ","$5,627.30 ", N/A ,"$7,637.05 ","$5,788.08 ","$5,868.47 ","$4,019.50 ","$6,833.15 ", N/A ,"$4,019.50 ","$6,431.20 ","$5,868.47 ", N/A , N/A ,"$3,376.38 ","$8,039.00 ","$6,833.15 ", N/A ,"$7,395.88 ","$5,627.30 ","$4,019.50 ","$4,823.40 ","$4,895.75 ","$4,019.50 ","$5,554.95 ","$5,627.30 ", N/A ,"$5,788.08 ", N/A ,"$4,019.50 ","$4,019.50 ", N/A ,"$4,019.50 ", N/A ,"$5,788.08 ","$4,984.18 ","$5,788.08 ","$5,788.08 ","$4,823.40 " ST VINCENT HOSPITAL - ACUTE,27500038,C1721,HC MSB MRI ICD DUAL,275,1 ,"$30,910.00 ","$15,455.00 ","$12,982.20 ","$30,910.00 ","$19,967.86 ", N/A ,"$15,380.82 ","$15,380.82 ", N/A ,"$18,546.00 ","$26,273.50 ","$21,637.00 ", N/A ,"$29,364.50 ","$22,255.20 ","$22,564.30 ","$15,455.00 ","$26,273.50 ", N/A ,"$15,455.00 ","$24,728.00 ","$22,564.30 ", N/A , N/A ,"$12,982.20 ","$30,910.00 ","$26,273.50 ", N/A ,"$28,437.20 ","$21,637.00 ","$15,455.00 ","$18,546.00 ","$18,824.19 ","$15,455.00 ","$21,358.81 ","$21,637.00 ", N/A ,"$22,255.20 ", N/A ,"$15,455.00 ","$15,455.00 ", N/A ,"$15,455.00 ", N/A ,"$22,255.20 ","$19,164.20 ","$22,255.20 ","$22,255.20 ","$18,546.00 " ST VINCENT HOSPITAL - ACUTE,27500039,C1722,HC MSB MRI ICD SINGLE,275,1 ,"$28,997.00 ","$14,498.50 ","$12,178.74 ","$28,997.00 ","$18,732.06 ", N/A ,"$14,428.91 ","$14,428.91 ", N/A ,"$17,398.20 ","$24,647.45 ","$20,297.90 ", N/A ,"$27,547.15 ","$20,877.84 ","$21,167.81 ","$14,498.50 ","$24,647.45 ", N/A ,"$14,498.50 ","$23,197.60 ","$21,167.81 ", N/A , N/A ,"$12,178.74 ","$28,997.00 ","$24,647.45 ", N/A ,"$26,677.24 ","$20,297.90 ","$14,498.50 ","$17,398.20 ","$17,659.17 ","$14,498.50 ","$20,036.93 ","$20,297.90 ", N/A ,"$20,877.84 ", N/A ,"$14,498.50 ","$14,498.50 ", N/A ,"$14,498.50 ", N/A ,"$20,877.84 ","$17,978.14 ","$20,877.84 ","$20,877.84 ","$17,398.20 " ST VINCENT HOSPITAL - ACUTE,27500202,C1786,HC PACEMAKER SINGLE MICRA C1786,275,1 ,"$18,661.00 ","$9,330.50 ","$7,837.62 ","$18,661.00 ","$12,055.01 ", N/A ,"$9,285.71 ","$9,285.71 ", N/A ,"$11,196.60 ","$15,861.85 ","$13,062.70 ", N/A ,"$17,727.95 ","$13,435.92 ","$13,622.53 ","$9,330.50 ","$15,861.85 ", N/A ,"$9,330.50 ","$14,928.80 ","$13,622.53 ", N/A , N/A ,"$7,837.62 ","$18,661.00 ","$15,861.85 ", N/A ,"$17,168.12 ","$13,062.70 ","$9,330.50 ","$11,196.60 ","$11,364.55 ","$9,330.50 ","$12,894.75 ","$13,062.70 ", N/A ,"$13,435.92 ", N/A ,"$9,330.50 ","$9,330.50 ", N/A ,"$9,330.50 ", N/A ,"$13,435.92 ","$11,569.82 ","$13,435.92 ","$13,435.92 ","$11,196.60 " ST VINCENT HOSPITAL - ACUTE,27600001,V2785,HC CORNEA PROCESSING,276,1 ,"$5,692.00 ","$2,846.00 ",$764.52 ,"$5,692.00 ","$3,677.03 ",$764.52 ,"$2,832.34 ","$2,832.34 ", N/A ,"$3,415.20 ","$4,838.20 ","$3,984.40 ",$764.52 ,"$5,407.40 ","$4,098.24 ","$4,155.16 ","$2,846.00 ","$4,838.20 ", N/A ,"$2,846.00 ","$4,553.60 ","$4,155.16 ",$764.52 , N/A ,"$2,390.64 ","$5,692.00 ","$4,838.20 ", N/A ,"$5,236.64 ","$3,984.40 ","$2,846.00 ","$3,415.20 ","$3,466.43 ","$2,846.00 ","$3,933.17 ","$3,984.40 ", N/A ,"$4,098.24 ",$810.39 , N/A , N/A , N/A , N/A , N/A ,"$4,098.24 ","$3,529.04 ","$4,098.24 ","$4,098.24 ","$3,415.20 " ST VINCENT HOSPITAL - ACUTE,27800123,C1724,HC DIAMONDBACK BURR AND LUBRICANT,278,1 ,"$6,327.00 ","$3,163.50 ","$2,657.34 ","$6,327.00 ","$4,087.24 ", N/A ,"$3,148.32 ","$3,148.32 ", N/A ,"$3,796.20 ","$5,377.95 ","$4,428.90 ", N/A ,"$6,010.65 ","$4,555.44 ","$4,618.71 ","$3,163.50 ","$5,377.95 ", N/A ,"$3,163.50 ","$5,061.60 ","$4,618.71 ", N/A , N/A ,"$2,657.34 ","$6,327.00 ","$5,377.95 ", N/A ,"$5,820.84 ","$4,428.90 ","$3,163.50 ","$3,796.20 ","$3,853.14 ","$3,163.50 ","$4,371.96 ","$4,428.90 ", N/A ,"$4,555.44 ", N/A ,"$3,163.50 ","$3,163.50 ", N/A ,"$3,163.50 ", N/A ,"$4,555.44 ","$3,922.74 ","$4,555.44 ","$4,555.44 ","$3,796.20 " ST VINCENT HOSPITAL - ACUTE,27800124,C1724,HC SILVERHAWK DIRECTIONAL ATHERECTOMY DEV,278,1 ,"$6,743.00 ","$3,371.50 ","$2,832.06 ","$6,743.00 ","$4,355.98 ", N/A ,"$3,355.32 ","$3,355.32 ", N/A ,"$4,045.80 ","$5,731.55 ","$4,720.10 ", N/A ,"$6,405.85 ","$4,854.96 ","$4,922.39 ","$3,371.50 ","$5,731.55 ", N/A ,"$3,371.50 ","$5,394.40 ","$4,922.39 ", N/A , N/A ,"$2,832.06 ","$6,743.00 ","$5,731.55 ", N/A ,"$6,203.56 ","$4,720.10 ","$3,371.50 ","$4,045.80 ","$4,106.49 ","$3,371.50 ","$4,659.41 ","$4,720.10 ", N/A ,"$4,854.96 ", N/A ,"$3,371.50 ","$3,371.50 ", N/A ,"$3,371.50 ", N/A ,"$4,854.96 ","$4,180.66 ","$4,854.96 ","$4,854.96 ","$4,045.80 " ST VINCENT HOSPITAL - ACUTE,27800133,C1751,HC HICKMAN,278,1 ,$894.00 ,$447.00 ,$375.48 ,$894.00 ,$577.52 , N/A , N/A , N/A , N/A ,$536.40 ,$759.90 ,$625.80 , N/A ,$849.30 ,$643.68 ,$652.62 , N/A ,$759.90 , N/A , N/A ,$715.20 ,$652.62 , N/A , N/A ,$375.48 ,$894.00 ,$759.90 , N/A ,$822.48 ,$625.80 ,$447.00 ,$536.40 ,$544.45 ,$447.00 ,$617.75 ,$625.80 , N/A ,$643.68 , N/A , N/A , N/A , N/A , N/A , N/A ,$643.68 ,$554.28 ,$643.68 ,$643.68 ,$536.40 ST VINCENT HOSPITAL - ACUTE,27800159,C1752,HC DUAL LUMEN CATH-STRAIGHT,278,1 ,$731.00 ,$365.50 ,$307.02 ,$731.00 ,$472.23 , N/A , N/A , N/A , N/A ,$438.60 ,$621.35 ,$511.70 , N/A ,$694.45 ,$526.32 ,$533.63 , N/A ,$621.35 , N/A , N/A ,$584.80 ,$533.63 , N/A , N/A ,$307.02 ,$731.00 ,$621.35 , N/A ,$672.52 ,$511.70 ,$365.50 ,$438.60 ,$445.18 ,$365.50 ,$505.12 ,$511.70 , N/A ,$526.32 , N/A , N/A , N/A , N/A , N/A , N/A ,$526.32 ,$453.22 ,$526.32 ,$526.32 ,$438.60 ST VINCENT HOSPITAL - ACUTE,27800160,C1752,HC SHORT TERM DIALYSIS CATH,278,1 ,$894.00 ,$447.00 ,$375.48 ,$894.00 ,$577.52 , N/A , N/A , N/A , N/A ,$536.40 ,$759.90 ,$625.80 , N/A ,$849.30 ,$643.68 ,$652.62 , N/A ,$759.90 , N/A , N/A ,$715.20 ,$652.62 , N/A , N/A ,$375.48 ,$894.00 ,$759.90 , N/A ,$822.48 ,$625.80 ,$447.00 ,$536.40 ,$544.45 ,$447.00 ,$617.75 ,$625.80 , N/A ,$643.68 , N/A , N/A , N/A , N/A , N/A , N/A ,$643.68 ,$554.28 ,$643.68 ,$643.68 ,$536.40 ST VINCENT HOSPITAL - ACUTE,27800161,C1753,HC IVUS CATHETER,278,1 ,"$1,777.00 ",$888.50 ,$746.34 ,"$1,777.00 ","$1,147.94 ", N/A ,$884.24 ,$884.24 , N/A ,"$1,066.20 ","$1,510.45 ","$1,243.90 ", N/A ,"$1,688.15 ","$1,279.44 ","$1,297.21 ", N/A ,"$1,510.45 ", N/A , N/A ,"$1,421.60 ","$1,297.21 ", N/A , N/A ,$746.34 ,"$1,777.00 ","$1,510.45 ", N/A ,"$1,634.84 ","$1,243.90 ",$888.50 ,"$1,066.20 ","$1,082.19 ",$888.50 ,"$1,227.91 ","$1,243.90 ", N/A ,"$1,279.44 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,279.44 ","$1,101.74 ","$1,279.44 ","$1,279.44 ","$1,066.20 " ST VINCENT HOSPITAL - ACUTE,27800166,C1760,HC DEVICE VASCULAR CLOSURE,278,1 ,$498.00 ,$249.00 ,$209.16 ,$498.00 ,$321.71 , N/A , N/A , N/A , N/A ,$298.80 ,$423.30 ,$348.60 , N/A ,$473.10 ,$358.56 ,$363.54 , N/A ,$423.30 , N/A , N/A ,$398.40 ,$363.54 , N/A , N/A ,$209.16 ,$498.00 ,$423.30 , N/A ,$458.16 ,$348.60 ,$249.00 ,$298.80 ,$303.28 ,$249.00 ,$344.12 ,$348.60 , N/A ,$358.56 , N/A , N/A , N/A , N/A , N/A , N/A ,$358.56 ,$308.76 ,$358.56 ,$358.56 ,$298.80 ST VINCENT HOSPITAL - ACUTE,27800171,N/A,HC VASCULAR PLUG,278,1 ,"$1,514.00 ",$757.00 ,$635.88 ,"$1,514.00 ",$978.04 , N/A ,$753.37 ,$753.37 , N/A ,$908.40 ,"$1,286.90 ","$1,059.80 ", N/A ,"$1,438.30 ","$1,090.08 ","$1,105.22 ", N/A ,"$1,286.90 ", N/A , N/A ,"$1,211.20 ","$1,105.22 ", N/A , N/A ,$635.88 ,"$1,514.00 ","$1,286.90 ", N/A ,"$1,392.88 ","$1,059.80 ",$757.00 ,$908.40 ,$922.03 ,$757.00 ,"$1,046.17 ","$1,059.80 ", N/A ,"$1,090.08 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,090.08 ",$938.68 ,"$1,090.08 ","$1,090.08 ",$908.40 ST VINCENT HOSPITAL - ACUTE,27800493,C1788,HC PORT,278,1 ,$894.00 ,$447.00 ,$375.48 ,$894.00 ,$577.52 , N/A , N/A , N/A , N/A ,$536.40 ,$759.90 ,$625.80 , N/A ,$849.30 ,$643.68 ,$652.62 , N/A ,$759.90 , N/A , N/A ,$715.20 ,$652.62 , N/A , N/A ,$375.48 ,$894.00 ,$759.90 , N/A ,$822.48 ,$625.80 ,$447.00 ,$536.40 ,$544.45 ,$447.00 ,$617.75 ,$625.80 , N/A ,$643.68 , N/A , N/A , N/A , N/A , N/A , N/A ,$643.68 ,$554.28 ,$643.68 ,$643.68 ,$536.40 ST VINCENT HOSPITAL - ACUTE,27800504,C1817,HC ASD/PFO OCCLUDER,278,1 ,"$12,260.00 ","$6,130.00 ","$5,149.20 ","$12,260.00 ","$7,919.96 ", N/A ,"$6,100.58 ","$6,100.58 ", N/A ,"$7,356.00 ","$10,421.00 ","$8,582.00 ", N/A ,"$11,647.00 ","$8,827.20 ","$8,949.80 ","$6,130.00 ","$10,421.00 ", N/A ,"$6,130.00 ","$9,808.00 ","$8,949.80 ", N/A , N/A ,"$5,149.20 ","$12,260.00 ","$10,421.00 ", N/A ,"$11,279.20 ","$8,582.00 ","$6,130.00 ","$7,356.00 ","$7,466.34 ","$6,130.00 ","$8,471.66 ","$8,582.00 ", N/A ,"$8,827.20 ", N/A ,"$6,130.00 ","$6,130.00 ", N/A ,"$6,130.00 ", N/A ,"$8,827.20 ","$7,601.20 ","$8,827.20 ","$8,827.20 ","$7,356.00 " ST VINCENT HOSPITAL - ACUTE,27800507,C1874,HC STENT COVERED AND DELIVERY SYSTEM,278,1 ,"$9,436.00 ","$4,718.00 ","$3,963.12 ","$9,436.00 ","$6,095.66 ", N/A ,"$4,695.35 ","$4,695.35 ", N/A ,"$5,661.60 ","$8,020.60 ","$6,605.20 ", N/A ,"$8,964.20 ","$6,793.92 ","$6,888.28 ","$4,718.00 ","$8,020.60 ", N/A ,"$4,718.00 ","$7,548.80 ","$6,888.28 ", N/A , N/A ,"$3,963.12 ","$9,436.00 ","$8,020.60 ", N/A ,"$8,681.12 ","$6,605.20 ","$4,718.00 ","$5,661.60 ","$5,746.52 ","$4,718.00 ","$6,520.28 ","$6,605.20 ", N/A ,"$6,793.92 ", N/A ,"$4,718.00 ","$4,718.00 ", N/A ,"$4,718.00 ", N/A ,"$6,793.92 ","$5,850.32 ","$6,793.92 ","$6,793.92 ","$5,661.60 " ST VINCENT HOSPITAL - ACUTE,27800515,C1874,HC WALLSTENT COVERED,278,1 ,"$5,582.00 ","$2,791.00 ","$2,344.44 ","$5,582.00 ","$3,605.97 ", N/A ,"$2,777.60 ","$2,777.60 ", N/A ,"$3,349.20 ","$4,744.70 ","$3,907.40 ", N/A ,"$5,302.90 ","$4,019.04 ","$4,074.86 ","$2,791.00 ","$4,744.70 ", N/A ,"$2,791.00 ","$4,465.60 ","$4,074.86 ", N/A , N/A ,"$2,344.44 ","$5,582.00 ","$4,744.70 ", N/A ,"$5,135.44 ","$3,907.40 ","$2,791.00 ","$3,349.20 ","$3,399.44 ","$2,791.00 ","$3,857.16 ","$3,907.40 ", N/A ,"$4,019.04 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,019.04 ","$3,460.84 ","$4,019.04 ","$4,019.04 ","$3,349.20 " ST VINCENT HOSPITAL - ACUTE,27800522,C1876,HC STENT EXPANDABLE UNCOVERED,278,1 ,"$4,466.00 ","$2,233.00 ","$1,875.72 ","$4,466.00 ","$2,885.04 ", N/A ,"$2,222.28 ","$2,222.28 ", N/A ,"$2,679.60 ","$3,796.10 ","$3,126.20 ", N/A ,"$4,242.70 ","$3,215.52 ","$3,260.18 ","$2,233.00 ","$3,796.10 ", N/A ,"$2,233.00 ","$3,572.80 ","$3,260.18 ", N/A , N/A ,"$1,875.72 ","$4,466.00 ","$3,796.10 ", N/A ,"$4,108.72 ","$3,126.20 ","$2,233.00 ","$2,679.60 ","$2,719.79 ","$2,233.00 ","$3,086.01 ","$3,126.20 ", N/A ,"$3,215.52 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,215.52 ","$2,768.92 ","$3,215.52 ","$3,215.52 ","$2,679.60 " ST VINCENT HOSPITAL - ACUTE,27800542,C1876,HC URETERAL STENT,278,1 ,$313.00 ,$156.50 ,$131.46 ,$313.00 ,$202.20 , N/A , N/A , N/A , N/A ,$187.80 ,$266.05 ,$219.10 , N/A ,$297.35 ,$225.36 ,$228.49 , N/A ,$266.05 , N/A , N/A ,$250.40 ,$228.49 , N/A , N/A ,$131.46 ,$313.00 ,$266.05 , N/A ,$287.96 ,$219.10 ,$156.50 ,$187.80 ,$190.62 ,$156.50 ,$216.28 ,$219.10 , N/A ,$225.36 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.36 ,$194.06 ,$225.36 ,$225.36 ,$187.80 ST VINCENT HOSPITAL - ACUTE,27800548,C1877,HC ANGIO STENT Z,278,1 ,"$1,675.00 ",$837.50 ,$703.50 ,"$1,675.00 ","$1,082.05 ", N/A ,$833.48 ,$833.48 , N/A ,"$1,005.00 ","$1,423.75 ","$1,172.50 ", N/A ,"$1,591.25 ","$1,206.00 ","$1,222.75 ", N/A ,"$1,423.75 ", N/A , N/A ,"$1,340.00 ","$1,222.75 ", N/A , N/A ,$703.50 ,"$1,675.00 ","$1,423.75 ", N/A ,"$1,541.00 ","$1,172.50 ",$837.50 ,"$1,005.00 ","$1,020.08 ",$837.50 ,"$1,157.43 ","$1,172.50 ", N/A ,"$1,206.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,206.00 ","$1,038.50 ","$1,206.00 ","$1,206.00 ","$1,005.00 " ST VINCENT HOSPITAL - ACUTE,27800552,A4648,HC MICROCLIP,278,1 ,$201.00 ,$100.50 ,$84.42 ,$201.00 ,$129.85 , N/A , N/A , N/A , N/A ,$120.60 ,$170.85 ,$140.70 , N/A ,$190.95 ,$144.72 ,$146.73 , N/A ,$170.85 , N/A , N/A ,$160.80 ,$146.73 , N/A , N/A ,$84.42 ,$201.00 ,$170.85 , N/A ,$184.92 ,$140.70 ,$100.50 ,$120.60 ,$122.41 ,$100.50 ,$138.89 ,$140.70 , N/A ,$144.72 , N/A , N/A , N/A , N/A , N/A , N/A ,$144.72 ,$124.62 ,$144.72 ,$144.72 ,$120.60 ST VINCENT HOSPITAL - ACUTE,27800553,A4648,HC TISSUE MARKER IMPLANTABLE,278,1 ,$342.00 ,$171.00 ,$143.64 ,$342.00 ,$220.93 , N/A , N/A , N/A , N/A ,$205.20 ,$290.70 ,$239.40 , N/A ,$324.90 ,$246.24 ,$249.66 , N/A ,$290.70 , N/A , N/A ,$273.60 ,$249.66 , N/A , N/A ,$143.64 ,$342.00 ,$290.70 , N/A ,$314.64 ,$239.40 ,$171.00 ,$205.20 ,$208.28 ,$171.00 ,$236.32 ,$239.40 , N/A ,$246.24 , N/A , N/A , N/A , N/A , N/A , N/A ,$246.24 ,$212.04 ,$246.24 ,$246.24 ,$205.20 ST VINCENT HOSPITAL - ACUTE,27800557,C1880,HC IVC FILTER,278,1 ,"$4,616.00 ","$2,308.00 ","$1,938.72 ","$4,616.00 ","$2,981.94 ", N/A ,"$2,296.92 ","$2,296.92 ", N/A ,"$2,769.60 ","$3,923.60 ","$3,231.20 ", N/A ,"$4,385.20 ","$3,323.52 ","$3,369.68 ","$2,308.00 ","$3,923.60 ", N/A ,"$2,308.00 ","$3,692.80 ","$3,369.68 ", N/A , N/A ,"$1,938.72 ","$4,616.00 ","$3,923.60 ", N/A ,"$4,246.72 ","$3,231.20 ","$2,308.00 ","$2,769.60 ","$2,811.14 ","$2,308.00 ","$3,189.66 ","$3,231.20 ", N/A ,"$3,323.52 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,323.52 ","$2,861.92 ","$3,323.52 ","$3,323.52 ","$2,769.60 " ST VINCENT HOSPITAL - ACUTE,27800581,Q4110,HC SKIN SUBST PRIMATRIX PER SQCM,278,1 ,$84.00 ,$42.00 ,$35.28 ,$84.00 ,$54.26 , N/A , N/A , N/A , N/A ,$50.40 ,$71.40 ,$58.80 , N/A ,$79.80 ,$60.48 ,$61.32 , N/A ,$71.40 , N/A , N/A ,$67.20 ,$61.32 , N/A , N/A ,$35.28 ,$84.00 ,$71.40 , N/A ,$77.28 ,$58.80 ,$42.00 ,$50.40 ,$51.16 ,$42.00 ,$58.04 ,$58.80 , N/A ,$60.48 , N/A , N/A , N/A , N/A , N/A , N/A ,$60.48 ,$52.08 ,$60.48 ,$60.48 ,$50.40 ST VINCENT HOSPITAL - ACUTE,27800602,N/A,HC BONE-CANC CORT CRUSH,278,1 ,"$2,329.00 ","$1,164.50 ",$978.18 ,"$2,329.00 ","$1,504.53 ", N/A ,"$1,158.91 ","$1,158.91 ", N/A ,"$1,397.40 ","$1,979.65 ","$1,630.30 ", N/A ,"$2,212.55 ","$1,676.88 ","$1,700.17 ", N/A ,"$1,979.65 ", N/A , N/A ,"$1,863.20 ","$1,700.17 ", N/A , N/A ,$978.18 ,"$2,329.00 ","$1,979.65 ", N/A ,"$2,142.68 ","$1,630.30 ","$1,164.50 ","$1,397.40 ","$1,418.36 ","$1,164.50 ","$1,609.34 ","$1,630.30 ", N/A ,"$1,676.88 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,676.88 ","$1,443.98 ","$1,676.88 ","$1,676.88 ","$1,397.40 " ST VINCENT HOSPITAL - ACUTE,27800658,N/A,HC FEMOSTOP,278,1 ,$374.00 ,$187.00 ,$157.08 ,$374.00 ,$241.60 , N/A , N/A , N/A , N/A ,$224.40 ,$317.90 ,$261.80 , N/A ,$355.30 ,$269.28 ,$273.02 , N/A ,$317.90 , N/A , N/A ,$299.20 ,$273.02 , N/A , N/A ,$157.08 ,$374.00 ,$317.90 , N/A ,$344.08 ,$261.80 ,$187.00 ,$224.40 ,$227.77 ,$187.00 ,$258.43 ,$261.80 , N/A ,$269.28 , N/A , N/A , N/A , N/A , N/A , N/A ,$269.28 ,$231.88 ,$269.28 ,$269.28 ,$224.40 ST VINCENT HOSPITAL - ACUTE,27801356,N/A,HC FEMOSTOP CATH LAB,278,1 ,$374.00 ,$187.00 ,$157.08 ,$374.00 ,$241.60 , N/A , N/A , N/A , N/A ,$224.40 ,$317.90 ,$261.80 , N/A ,$355.30 ,$269.28 ,$273.02 , N/A ,$317.90 , N/A , N/A ,$299.20 ,$273.02 , N/A , N/A ,$157.08 ,$374.00 ,$317.90 , N/A ,$344.08 ,$261.80 ,$187.00 ,$224.40 ,$227.77 ,$187.00 ,$258.43 ,$261.80 , N/A ,$269.28 , N/A , N/A , N/A , N/A , N/A , N/A ,$269.28 ,$231.88 ,$269.28 ,$269.28 ,$224.40 ST VINCENT HOSPITAL - ACUTE,27801400,Q4121,HC THERASKIN PER SQ CM,278,1 ,$76.00 ,$38.00 ,$31.92 ,$76.00 ,$49.10 , N/A , N/A , N/A , N/A ,$45.60 ,$64.60 ,$53.20 , N/A ,$72.20 ,$54.72 ,$55.48 , N/A ,$64.60 , N/A , N/A ,$60.80 ,$55.48 , N/A , N/A ,$31.92 ,$76.00 ,$64.60 , N/A ,$69.92 ,$53.20 ,$38.00 ,$45.60 ,$46.28 ,$38.00 ,$52.52 ,$53.20 , N/A ,$54.72 , N/A , N/A , N/A , N/A , N/A , N/A ,$54.72 ,$47.12 ,$54.72 ,$54.72 ,$45.60 ST VINCENT HOSPITAL - ACUTE,27801410,C1714,HC CROSSER C1714,278,1 ,"$6,521.00 ","$3,260.50 ","$2,738.82 ","$6,521.00 ","$4,212.57 ", N/A ,"$3,244.85 ","$3,244.85 ", N/A ,"$3,912.60 ","$5,542.85 ","$4,564.70 ", N/A ,"$6,194.95 ","$4,695.12 ","$4,760.33 ","$3,260.50 ","$5,542.85 ", N/A ,"$3,260.50 ","$5,216.80 ","$4,760.33 ", N/A , N/A ,"$2,738.82 ","$6,521.00 ","$5,542.85 ", N/A ,"$5,999.32 ","$4,564.70 ","$3,260.50 ","$3,912.60 ","$3,971.29 ","$3,260.50 ","$4,506.01 ","$4,564.70 ", N/A ,"$4,695.12 ", N/A ,"$3,260.50 ","$3,260.50 ", N/A ,"$3,260.50 ", N/A ,"$4,695.12 ","$4,043.02 ","$4,695.12 ","$4,695.12 ","$3,912.60 " ST VINCENT HOSPITAL - ACUTE,27801430,C2623,HC CATH TRANSLUMINAL DRUG COATED C2623,278,1 ,"$2,818.00 ","$1,409.00 ","$1,183.56 ","$2,818.00 ","$1,820.43 ", N/A ,"$1,402.24 ","$1,402.24 ", N/A ,"$1,690.80 ","$2,395.30 ","$1,972.60 ", N/A ,"$2,677.10 ","$2,028.96 ","$2,057.14 ","$1,409.00 ","$2,395.30 ", N/A ,"$1,409.00 ","$2,254.40 ","$2,057.14 ", N/A , N/A ,"$1,183.56 ","$2,818.00 ","$2,395.30 ", N/A ,"$2,592.56 ","$1,972.60 ","$1,409.00 ","$1,690.80 ","$1,716.16 ","$1,409.00 ","$1,947.24 ","$1,972.60 ", N/A ,"$2,028.96 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,028.96 ","$1,747.16 ","$2,028.96 ","$2,028.96 ","$1,690.80 " ST VINCENT HOSPITAL - ACUTE,27801450,C1751,HC PICC,278,1 ,$671.00 ,$335.50 ,$281.82 ,$671.00 ,$433.47 , N/A , N/A , N/A , N/A ,$402.60 ,$570.35 ,$469.70 , N/A ,$637.45 ,$483.12 ,$489.83 , N/A ,$570.35 , N/A , N/A ,$536.80 ,$489.83 , N/A , N/A ,$281.82 ,$671.00 ,$570.35 , N/A ,$617.32 ,$469.70 ,$335.50 ,$402.60 ,$408.64 ,$335.50 ,$463.66 ,$469.70 , N/A ,$483.12 , N/A , N/A , N/A , N/A , N/A , N/A ,$483.12 ,$416.02 ,$483.12 ,$483.12 ,$402.60 ST VINCENT HOSPITAL - ACUTE,27801451,C1874,HC COVERED STENTS TIER 1,278,1 ,"$7,370.00 ","$3,685.00 ","$3,095.40 ","$7,370.00 ","$4,761.02 ", N/A ,"$3,667.31 ","$3,667.31 ", N/A ,"$4,422.00 ","$6,264.50 ","$5,159.00 ", N/A ,"$7,001.50 ","$5,306.40 ","$5,380.10 ","$3,685.00 ","$6,264.50 ", N/A ,"$3,685.00 ","$5,896.00 ","$5,380.10 ", N/A , N/A ,"$3,095.40 ","$7,370.00 ","$6,264.50 ", N/A ,"$6,780.40 ","$5,159.00 ","$3,685.00 ","$4,422.00 ","$4,488.33 ","$3,685.00 ","$5,092.67 ","$5,159.00 ", N/A ,"$5,306.40 ", N/A ,"$3,685.00 ","$3,685.00 ", N/A ,"$3,685.00 ", N/A ,"$5,306.40 ","$4,569.40 ","$5,306.40 ","$5,306.40 ","$4,422.00 " ST VINCENT HOSPITAL - ACUTE,27801452,C1874,HC COVERED STENTS TIER 2,278,1 ,"$10,048.00 ","$5,024.00 ","$4,220.16 ","$10,048.00 ","$6,491.01 ", N/A ,"$4,999.88 ","$4,999.88 ", N/A ,"$6,028.80 ","$8,540.80 ","$7,033.60 ", N/A ,"$9,545.60 ","$7,234.56 ","$7,335.04 ","$5,024.00 ","$8,540.80 ", N/A ,"$5,024.00 ","$8,038.40 ","$7,335.04 ", N/A , N/A ,"$4,220.16 ","$10,048.00 ","$8,540.80 ", N/A ,"$9,244.16 ","$7,033.60 ","$5,024.00 ","$6,028.80 ","$6,119.23 ","$5,024.00 ","$6,943.17 ","$7,033.60 ", N/A ,"$7,234.56 ", N/A ,"$5,024.00 ","$5,024.00 ", N/A ,"$5,024.00 ", N/A ,"$7,234.56 ","$6,229.76 ","$7,234.56 ","$7,234.56 ","$6,028.80 " ST VINCENT HOSPITAL - ACUTE,27801453,C1876,HC STENT TIER 1,278,1 ,"$1,680.00 ",$840.00 ,$705.60 ,"$1,680.00 ","$1,085.28 ", N/A ,$835.97 ,$835.97 , N/A ,"$1,008.00 ","$1,428.00 ","$1,176.00 ", N/A ,"$1,596.00 ","$1,209.60 ","$1,226.40 ", N/A ,"$1,428.00 ", N/A , N/A ,"$1,344.00 ","$1,226.40 ", N/A , N/A ,$705.60 ,"$1,680.00 ","$1,428.00 ", N/A ,"$1,545.60 ","$1,176.00 ",$840.00 ,"$1,008.00 ","$1,023.12 ",$840.00 ,"$1,160.88 ","$1,176.00 ", N/A ,"$1,209.60 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,209.60 ","$1,041.60 ","$1,209.60 ","$1,209.60 ","$1,008.00 " ST VINCENT HOSPITAL - ACUTE,27801454,C1876,HC STENT TIER 2,278,1 ,"$3,350.00 ","$1,675.00 ","$1,407.00 ","$3,350.00 ","$2,164.10 ", N/A ,"$1,666.96 ","$1,666.96 ", N/A ,"$2,010.00 ","$2,847.50 ","$2,345.00 ", N/A ,"$3,182.50 ","$2,412.00 ","$2,445.50 ","$1,675.00 ","$2,847.50 ", N/A ,"$1,675.00 ","$2,680.00 ","$2,445.50 ", N/A , N/A ,"$1,407.00 ","$3,350.00 ","$2,847.50 ", N/A ,"$3,082.00 ","$2,345.00 ","$1,675.00 ","$2,010.00 ","$2,040.15 ","$1,675.00 ","$2,314.85 ","$2,345.00 ", N/A ,"$2,412.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,412.00 ","$2,077.00 ","$2,412.00 ","$2,412.00 ","$2,010.00 " ST VINCENT HOSPITAL - ACUTE,27801455,C1876,HC STENT TIER 3,278,1 ,"$4,080.00 ","$2,040.00 ","$1,713.60 ","$4,080.00 ","$2,635.68 ", N/A ,"$2,030.21 ","$2,030.21 ", N/A ,"$2,448.00 ","$3,468.00 ","$2,856.00 ", N/A ,"$3,876.00 ","$2,937.60 ","$2,978.40 ","$2,040.00 ","$3,468.00 ", N/A ,"$2,040.00 ","$3,264.00 ","$2,978.40 ", N/A , N/A ,"$1,713.60 ","$4,080.00 ","$3,468.00 ", N/A ,"$3,753.60 ","$2,856.00 ","$2,040.00 ","$2,448.00 ","$2,484.72 ","$2,040.00 ","$2,819.28 ","$2,856.00 ", N/A ,"$2,937.60 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,937.60 ","$2,529.60 ","$2,937.60 ","$2,937.60 ","$2,448.00 " ST VINCENT HOSPITAL - ACUTE,27801460,N/A,HC CRANIAL ACCESS KIT,278,1 ,$894.00 ,$447.00 ,$375.48 ,$894.00 ,$577.52 , N/A , N/A , N/A , N/A ,$536.40 ,$759.90 ,$625.80 , N/A ,$849.30 ,$643.68 ,$652.62 , N/A ,$759.90 , N/A , N/A ,$715.20 ,$652.62 , N/A , N/A ,$375.48 ,$894.00 ,$759.90 , N/A ,$822.48 ,$625.80 ,$447.00 ,$536.40 ,$544.45 ,$447.00 ,$617.75 ,$625.80 , N/A ,$643.68 , N/A , N/A , N/A , N/A , N/A , N/A ,$643.68 ,$554.28 ,$643.68 ,$643.68 ,$536.40 ST VINCENT HOSPITAL - ACUTE,27801461,N/A,HC VENTRICULAR BOLT ICP KIT,278,1 ,"$2,234.00 ","$1,117.00 ",$938.28 ,"$2,234.00 ","$1,443.16 ", N/A ,"$1,111.64 ","$1,111.64 ", N/A ,"$1,340.40 ","$1,898.90 ","$1,563.80 ", N/A ,"$2,122.30 ","$1,608.48 ","$1,630.82 ", N/A ,"$1,898.90 ", N/A , N/A ,"$1,787.20 ","$1,630.82 ", N/A , N/A ,$938.28 ,"$2,234.00 ","$1,898.90 ", N/A ,"$2,055.28 ","$1,563.80 ","$1,117.00 ","$1,340.40 ","$1,360.51 ","$1,117.00 ","$1,543.69 ","$1,563.80 ", N/A ,"$1,608.48 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,608.48 ","$1,385.08 ","$1,608.48 ","$1,608.48 ","$1,340.40 " ST VINCENT HOSPITAL - ACUTE,27801462,N/A,HC INTRACRANIAL PRESSURE MONITOR KIT(BOLT ONLY),278,1 ,"$2,010.00 ","$1,005.00 ",$844.20 ,"$2,010.00 ","$1,298.46 ", N/A ,"$1,000.18 ","$1,000.18 ", N/A ,"$1,206.00 ","$1,708.50 ","$1,407.00 ", N/A ,"$1,909.50 ","$1,447.20 ","$1,467.30 ", N/A ,"$1,708.50 ", N/A , N/A ,"$1,608.00 ","$1,467.30 ", N/A , N/A ,$844.20 ,"$2,010.00 ","$1,708.50 ", N/A ,"$1,849.20 ","$1,407.00 ","$1,005.00 ","$1,206.00 ","$1,224.09 ","$1,005.00 ","$1,388.91 ","$1,407.00 ", N/A ,"$1,447.20 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,447.20 ","$1,246.20 ","$1,447.20 ","$1,447.20 ","$1,206.00 " ST VINCENT HOSPITAL - ACUTE,27801463,N/A,HC EVD DRAINAGE SYSTEM,278,1 ,$559.00 ,$279.50 ,$234.78 ,$559.00 ,$361.11 , N/A , N/A , N/A , N/A ,$335.40 ,$475.15 ,$391.30 , N/A ,$531.05 ,$402.48 ,$408.07 , N/A ,$475.15 , N/A , N/A ,$447.20 ,$408.07 , N/A , N/A ,$234.78 ,$559.00 ,$475.15 , N/A ,$514.28 ,$391.30 ,$279.50 ,$335.40 ,$340.43 ,$279.50 ,$386.27 ,$391.30 , N/A ,$402.48 , N/A , N/A , N/A , N/A , N/A , N/A ,$402.48 ,$346.58 ,$402.48 ,$402.48 ,$335.40 ST VINCENT HOSPITAL - ACUTE,27801464,C1729,HC EXTERNAL DRAINAGE CATHETER,278,1 ,$313.00 ,$156.50 ,$131.46 ,$313.00 ,$202.20 , N/A , N/A , N/A , N/A ,$187.80 ,$266.05 ,$219.10 , N/A ,$297.35 ,$225.36 ,$228.49 , N/A ,$266.05 , N/A , N/A ,$250.40 ,$228.49 , N/A , N/A ,$131.46 ,$313.00 ,$266.05 , N/A ,$287.96 ,$219.10 ,$156.50 ,$187.80 ,$190.62 ,$156.50 ,$216.28 ,$219.10 , N/A ,$225.36 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.36 ,$194.06 ,$225.36 ,$225.36 ,$187.80 ST VINCENT HOSPITAL - ACUTE,27801465,C1729,HC LUMBAR DRAINAGE CATHETER,278,1 ,$448.00 ,$224.00 ,$188.16 ,$448.00 ,$289.41 , N/A , N/A , N/A , N/A ,$268.80 ,$380.80 ,$313.60 , N/A ,$425.60 ,$322.56 ,$327.04 , N/A ,$380.80 , N/A , N/A ,$358.40 ,$327.04 , N/A , N/A ,$188.16 ,$448.00 ,$380.80 , N/A ,$412.16 ,$313.60 ,$224.00 ,$268.80 ,$272.83 ,$224.00 ,$309.57 ,$313.60 , N/A ,$322.56 , N/A , N/A , N/A , N/A , N/A , N/A ,$322.56 ,$277.76 ,$322.56 ,$322.56 ,$268.80 ST VINCENT HOSPITAL - ACUTE,27801466,N/A,HC PROSTHETIC AORTIC VALVE,278,1 ,"$62,202.00 ","$31,101.00 ","$26,124.84 ","$62,202.00 ","$40,182.49 ", N/A ,"$30,951.72 ","$30,951.72 ", N/A ,"$37,321.20 ","$52,871.70 ","$43,541.40 ", N/A ,"$59,091.90 ","$44,785.44 ","$45,407.46 ","$31,101.00 ","$52,871.70 ", N/A ,"$31,101.00 ","$49,761.60 ","$45,407.46 ", N/A , N/A ,"$26,124.84 ","$62,202.00 ","$52,871.70 ", N/A ,"$57,225.84 ","$43,541.40 ","$31,101.00 ","$37,321.20 ","$37,881.02 ","$31,101.00 ","$42,981.58 ","$43,541.40 ", N/A ,"$44,785.44 ", N/A ,"$31,101.00 ","$31,101.00 ", N/A ,"$31,101.00 ", N/A ,"$44,785.44 ","$38,565.24 ","$44,785.44 ","$44,785.44 ","$37,321.20 " ST VINCENT HOSPITAL - ACUTE,27801470,C2616,HC YTTRIUM 90 PER SOURCE,278,1 ,"$30,623.00 ","$15,311.50 ","$4,269.80 ","$39,144.69 ","$19,782.46 ","$4,269.80 ","$15,238.00 ","$15,238.00 ","$17,397.64 ","$18,373.80 ","$26,029.55 ","$21,436.10 ","$4,269.80 ","$29,091.85 ","$22,048.56 ","$22,354.79 ","$15,311.50 ","$26,029.55 ","$17,397.64 ","$15,311.50 ","$24,498.40 ","$22,354.79 ","$4,269.80 ","$17,397.64 ","$12,861.66 ","$30,623.00 ","$26,029.55 ","$39,144.69 ","$28,173.16 ","$21,436.10 ","$15,311.50 ","$18,373.80 ","$18,649.41 ","$15,311.50 ","$21,160.49 ","$21,436.10 ","$17,571.62 ","$22,048.56 ","$4,525.99 ","$15,311.50 ","$15,311.50 ","$17,397.64 ","$15,311.50 ","$17,397.64 ","$22,048.56 ","$18,986.26 ","$22,048.56 ","$22,048.56 ","$18,373.80 " ST VINCENT HOSPITAL - ACUTE,27801707,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T4,278,1 ,"$8,160.00 ","$4,080.00 ","$3,427.20 ","$8,160.00 ","$5,271.36 ", N/A ,"$4,060.42 ","$4,060.42 ", N/A ,"$4,896.00 ","$6,936.00 ","$5,712.00 ", N/A ,"$7,752.00 ","$5,875.20 ","$5,956.80 ","$4,080.00 ","$6,936.00 ", N/A ,"$4,080.00 ","$6,528.00 ","$5,956.80 ", N/A , N/A ,"$3,427.20 ","$8,160.00 ","$6,936.00 ", N/A ,"$7,507.20 ","$5,712.00 ","$4,080.00 ","$4,896.00 ","$4,969.44 ","$4,080.00 ","$5,638.56 ","$5,712.00 ", N/A ,"$5,875.20 ", N/A ,"$4,080.00 ","$4,080.00 ", N/A ,"$4,080.00 ", N/A ,"$5,875.20 ","$5,059.20 ","$5,875.20 ","$5,875.20 ","$4,896.00 " ST VINCENT HOSPITAL - ACUTE,27801708,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T5,278,1 ,"$10,200.00 ","$5,100.00 ","$4,284.00 ","$10,200.00 ","$6,589.20 ", N/A ,"$5,075.52 ","$5,075.52 ", N/A ,"$6,120.00 ","$8,670.00 ","$7,140.00 ", N/A ,"$9,690.00 ","$7,344.00 ","$7,446.00 ","$5,100.00 ","$8,670.00 ", N/A ,"$5,100.00 ","$8,160.00 ","$7,446.00 ", N/A , N/A ,"$4,284.00 ","$10,200.00 ","$8,670.00 ", N/A ,"$9,384.00 ","$7,140.00 ","$5,100.00 ","$6,120.00 ","$6,211.80 ","$5,100.00 ","$7,048.20 ","$7,140.00 ", N/A ,"$7,344.00 ", N/A ,"$5,100.00 ","$5,100.00 ", N/A ,"$5,100.00 ", N/A ,"$7,344.00 ","$6,324.00 ","$7,344.00 ","$7,344.00 ","$6,120.00 " ST VINCENT HOSPITAL - ACUTE,27801796,C1889,HC COIL EMBOLIZATION T3,278,1 ,"$24,450.00 ","$12,225.00 ","$10,269.00 ","$24,450.00 ","$15,794.70 ", N/A ,"$12,166.32 ","$12,166.32 ", N/A ,"$14,670.00 ","$20,782.50 ","$17,115.00 ", N/A ,"$23,227.50 ","$17,604.00 ","$17,848.50 ","$12,225.00 ","$20,782.50 ", N/A ,"$12,225.00 ","$19,560.00 ","$17,848.50 ", N/A , N/A ,"$10,269.00 ","$24,450.00 ","$20,782.50 ", N/A ,"$22,494.00 ","$17,115.00 ","$12,225.00 ","$14,670.00 ","$14,890.05 ","$12,225.00 ","$16,894.95 ","$17,115.00 ", N/A ,"$17,604.00 ", N/A ,"$12,225.00 ","$12,225.00 ", N/A ,"$12,225.00 ", N/A ,"$17,604.00 ","$15,159.00 ","$17,604.00 ","$17,604.00 ","$14,670.00 " ST VINCENT HOSPITAL - ACUTE,27802161,C1889,HC COIL EMBOLIZATION NEUROVASCULAR,278,1 ,"$4,080.00 ","$2,040.00 ","$1,713.60 ","$4,080.00 ","$2,635.68 ", N/A ,"$2,030.21 ","$2,030.21 ", N/A ,"$2,448.00 ","$3,468.00 ","$2,856.00 ", N/A ,"$3,876.00 ","$2,937.60 ","$2,978.40 ","$2,040.00 ","$3,468.00 ", N/A ,"$2,040.00 ","$3,264.00 ","$2,978.40 ", N/A , N/A ,"$1,713.60 ","$4,080.00 ","$3,468.00 ", N/A ,"$3,753.60 ","$2,856.00 ","$2,040.00 ","$2,448.00 ","$2,484.72 ","$2,040.00 ","$2,819.28 ","$2,856.00 ", N/A ,"$2,937.60 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,937.60 ","$2,529.60 ","$2,937.60 ","$2,937.60 ","$2,448.00 " ST VINCENT HOSPITAL - ACUTE,27802162,N/A,HC LIQUID EMBOLICS PVA,278,1 ,$816.00 ,$408.00 ,$342.72 ,$816.00 ,$527.14 , N/A , N/A , N/A , N/A ,$489.60 ,$693.60 ,$571.20 , N/A ,$775.20 ,$587.52 ,$595.68 , N/A ,$693.60 , N/A , N/A ,$652.80 ,$595.68 , N/A , N/A ,$342.72 ,$816.00 ,$693.60 , N/A ,$750.72 ,$571.20 ,$408.00 ,$489.60 ,$496.94 ,$408.00 ,$563.86 ,$571.20 , N/A ,$587.52 , N/A , N/A , N/A , N/A , N/A , N/A ,$587.52 ,$505.92 ,$587.52 ,$587.52 ,$489.60 ST VINCENT HOSPITAL - ACUTE,27802163,N/A,HC LIQUID EMBOLICS ONYX,278,1 ,"$6,120.00 ","$3,060.00 ","$2,570.40 ","$6,120.00 ","$3,953.52 ", N/A ,"$3,045.31 ","$3,045.31 ", N/A ,"$3,672.00 ","$5,202.00 ","$4,284.00 ", N/A ,"$5,814.00 ","$4,406.40 ","$4,467.60 ","$3,060.00 ","$5,202.00 ", N/A ,"$3,060.00 ","$4,896.00 ","$4,467.60 ", N/A , N/A ,"$2,570.40 ","$6,120.00 ","$5,202.00 ", N/A ,"$5,630.40 ","$4,284.00 ","$3,060.00 ","$3,672.00 ","$3,727.08 ","$3,060.00 ","$4,228.92 ","$4,284.00 ", N/A ,"$4,406.40 ", N/A ,"$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ", N/A ,"$4,406.40 ","$3,794.40 ","$4,406.40 ","$4,406.40 ","$3,672.00 " ST VINCENT HOSPITAL - ACUTE,27802164,N/A,HC LIQUID EMBOLICS NBCA,278,1 ,"$7,548.00 ","$3,774.00 ","$3,170.16 ","$7,548.00 ","$4,876.01 ", N/A ,"$3,755.88 ","$3,755.88 ", N/A ,"$4,528.80 ","$6,415.80 ","$5,283.60 ", N/A ,"$7,170.60 ","$5,434.56 ","$5,510.04 ","$3,774.00 ","$6,415.80 ", N/A ,"$3,774.00 ","$6,038.40 ","$5,510.04 ", N/A , N/A ,"$3,170.16 ","$7,548.00 ","$6,415.80 ", N/A ,"$6,944.16 ","$5,283.60 ","$3,774.00 ","$4,528.80 ","$4,596.73 ","$3,774.00 ","$5,215.67 ","$5,283.60 ", N/A ,"$5,434.56 ", N/A ,"$3,774.00 ","$3,774.00 ", N/A ,"$3,774.00 ", N/A ,"$5,434.56 ","$4,679.76 ","$5,434.56 ","$5,434.56 ","$4,528.80 " ST VINCENT HOSPITAL - ACUTE,27802177,Q4139,HC INJECT AMINO BIOMATRIX 1CC,278,1 ,$736.00 ,$368.00 ,$309.12 ,$736.00 ,$475.46 , N/A , N/A , N/A , N/A ,$441.60 ,$625.60 ,$515.20 , N/A ,$699.20 ,$529.92 ,$537.28 , N/A ,$625.60 , N/A , N/A ,$588.80 ,$537.28 , N/A , N/A ,$309.12 ,$736.00 ,$625.60 , N/A ,$677.12 ,$515.20 ,$368.00 ,$441.60 ,$448.22 ,$368.00 ,$508.58 ,$515.20 , N/A ,$529.92 , N/A , N/A , N/A , N/A , N/A , N/A ,$529.92 ,$456.32 ,$529.92 ,$529.92 ,$441.60 ST VINCENT HOSPITAL - ACUTE,27802181,N/A,HC MESH VENTRALIGHT ST ELLIPSE 4X6,278,1 ,"$1,173.00 ",$586.50 ,$492.66 ,"$1,173.00 ",$757.76 , N/A ,$583.68 ,$583.68 , N/A ,$703.80 ,$997.05 ,$821.10 , N/A ,"$1,114.35 ",$844.56 ,$856.29 , N/A ,$997.05 , N/A , N/A ,$938.40 ,$856.29 , N/A , N/A ,$492.66 ,"$1,173.00 ",$997.05 , N/A ,"$1,079.16 ",$821.10 ,$586.50 ,$703.80 ,$714.36 ,$586.50 ,$810.54 ,$821.10 , N/A ,$844.56 , N/A , N/A , N/A , N/A , N/A , N/A ,$844.56 ,$727.26 ,$844.56 ,$844.56 ,$703.80 ST VINCENT HOSPITAL - ACUTE,27871783,C1783,"HC OCULAR IMPLANT, AQUEOUS DRAINAGE ASSIST DEVICE",278,1 ,"$3,626.00 ","$1,813.00 ","$1,522.92 ","$3,626.00 ","$2,342.40 ", N/A ,"$1,804.30 ","$1,804.30 ", N/A ,"$2,175.60 ","$3,082.10 ","$2,538.20 ", N/A ,"$3,444.70 ","$2,610.72 ","$2,646.98 ","$1,813.00 ","$3,082.10 ", N/A ,"$1,813.00 ","$2,900.80 ","$2,646.98 ", N/A , N/A ,"$1,522.92 ","$3,626.00 ","$3,082.10 ", N/A ,"$3,335.92 ","$2,538.20 ","$1,813.00 ","$2,175.60 ","$2,208.23 ","$1,813.00 ","$2,505.57 ","$2,538.20 ", N/A ,"$2,610.72 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,610.72 ","$2,248.12 ","$2,610.72 ","$2,610.72 ","$2,175.60 " ST VINCENT HOSPITAL - ACUTE,29200003,N/A,HC CRUTCHES PER PAIR,271,1 ,$80.00 ,$40.00 ,$33.60 ,$80.00 ,$51.68 , N/A ,$51.75 ,$51.75 , N/A ,$48.00 ,$68.00 ,$56.00 , N/A ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 , N/A ,$52.00 ,$64.00 ,$58.40 , N/A , N/A ,$33.60 ,$80.00 ,$68.00 , N/A ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 , N/A ,$57.60 , N/A ,$48.00 ,$48.00 , N/A ,$48.00 , N/A ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,29200005,N/A,HC METAL CRUTCHES COMPLETE,271,1 ,$80.00 ,$40.00 ,$33.60 ,$80.00 ,$51.68 , N/A ,$51.75 ,$51.75 , N/A ,$48.00 ,$68.00 ,$56.00 , N/A ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 , N/A ,$52.00 ,$64.00 ,$58.40 , N/A , N/A ,$33.60 ,$80.00 ,$68.00 , N/A ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 , N/A ,$57.60 , N/A ,$48.00 ,$48.00 , N/A ,$48.00 , N/A ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,29200012,N/A,HC CAR BED,271,1 ,$218.00 ,$109.00 ,$91.56 ,$218.00 ,$140.83 , N/A ,$141.02 ,$141.02 , N/A ,$130.80 ,$185.30 ,$152.60 , N/A ,$207.10 ,$156.96 ,$159.14 ,$141.70 ,$185.30 , N/A ,$141.70 ,$174.40 ,$159.14 , N/A , N/A ,$91.56 ,$218.00 ,$185.30 , N/A ,$200.56 ,$152.60 ,$109.00 ,$130.80 ,$132.76 ,$109.00 ,$150.64 ,$152.60 , N/A ,$156.96 , N/A ,$130.80 ,$130.80 , N/A ,$130.80 , N/A ,$156.96 ,$135.16 ,$156.96 ,$156.96 ,$130.80 ST VINCENT HOSPITAL - ACUTE,30000001,N/A,HC BLOOD GLUCOSE TEST,300,1 ,$16.00 ,$8.00 ,$6.72 ,$16.00 ,$10.34 , N/A ,$10.35 ,$10.35 , N/A ,$9.60 ,$13.60 ,$11.20 , N/A ,$15.20 ,$11.52 ,$11.68 , N/A ,$13.60 , N/A , N/A ,$12.80 ,$11.68 , N/A , N/A ,$6.72 ,$16.00 ,$13.60 , N/A ,$14.72 ,$11.20 ,$8.00 ,$9.60 ,$9.74 ,$8.00 ,$11.06 ,$11.20 , N/A ,$11.52 , N/A ,$8.00 ,$8.00 , N/A ,$8.00 , N/A ,$11.52 ,$9.92 ,$11.52 ,$11.52 ,$9.60 ST VINCENT HOSPITAL - ACUTE,30000002,N/A,HC CHEMISTRY PANEL-VET,300,1 ,$16.00 ,$8.00 ,$6.72 ,$16.00 ,$10.34 , N/A ,$10.35 ,$10.35 , N/A ,$9.60 ,$13.60 ,$11.20 , N/A ,$15.20 ,$11.52 ,$11.68 , N/A ,$13.60 , N/A , N/A ,$12.80 ,$11.68 , N/A , N/A ,$6.72 ,$16.00 ,$13.60 , N/A ,$14.72 ,$11.20 ,$8.00 ,$9.60 ,$9.74 ,$8.00 ,$11.06 ,$11.20 , N/A ,$11.52 , N/A ,$8.00 ,$8.00 , N/A ,$8.00 , N/A ,$11.52 ,$9.92 ,$11.52 ,$11.52 ,$9.60 ST VINCENT HOSPITAL - ACUTE,30000005,36415,HC BLOOD COLLECTION FOR EVIDENCE,300,1 ,$46.50 ,$23.25 ,$0.72 ,$46.50 ,$30.04 ,$0.72 ,$8.00 ,$6.00 ,$3.00 ,$27.90 ,$39.53 ,$32.55 ,$0.72 ,$44.18 ,$33.48 ,$33.95 ,$5.10 ,$39.53 ,$3.00 ,$5.10 ,$37.20 ,$33.95 ,$0.72 ,$3.00 ,$3.31 ,$46.50 ,$39.53 ,$6.75 ,$42.78 ,$32.55 ,$10.53 ,$11.31 ,$28.32 ,$10.53 ,$32.13 ,$32.55 ,$3.03 ,$33.48 ,$0.76 ,$3.60 ,$3.60 ,$3.00 ,$3.60 ,$3.00 ,$33.48 ,$28.83 ,$33.48 ,$33.48 ,$27.90 ST VINCENT HOSPITAL - ACUTE,30000009,36416,HC CAPILLARY COLLECTION,300,1 ,$30.00 ,$15.00 ,$0.72 ,$30.00 ,$19.38 ,$0.72 ,$8.00 ,$6.00 , N/A ,$18.00 ,$25.50 ,$21.00 ,$0.72 ,$28.50 ,$21.60 ,$21.90 ,$5.03 ,$25.50 , N/A ,$5.03 ,$24.00 ,$21.90 ,$0.72 , N/A ,$12.60 ,$30.00 ,$25.50 , N/A ,$27.60 ,$21.00 ,$15.00 ,$18.00 ,$18.27 ,$15.00 ,$20.73 ,$21.00 , N/A ,$21.60 ,$0.76 ,$3.47 ,$3.47 , N/A ,$3.47 , N/A ,$21.60 ,$18.60 ,$21.60 ,$21.60 ,$18.00 ST VINCENT HOSPITAL - ACUTE,30000010,36415,HC VENIPUNCTURE,300,1 ,$15.00 ,$7.50 ,$0.72 ,$15.00 ,$9.69 ,$0.72 ,$8.00 ,$6.00 ,$3.00 ,$9.00 ,$12.75 ,$10.50 ,$0.72 ,$14.25 ,$10.80 ,$10.95 ,$5.10 ,$12.75 ,$3.00 ,$5.10 ,$12.00 ,$10.95 ,$0.72 ,$3.00 ,$3.31 ,$15.00 ,$12.75 ,$6.75 ,$13.80 ,$10.50 ,$10.53 ,$11.31 ,$9.14 ,$10.53 ,$10.37 ,$10.50 ,$3.03 ,$10.80 ,$0.76 ,$3.60 ,$3.60 ,$3.00 ,$3.60 ,$3.00 ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,30000011,36415,HC CATHETER COLLECTION,300,1 ,$15.00 ,$7.50 ,$0.72 ,$15.00 ,$9.69 ,$0.72 ,$8.00 ,$6.00 ,$3.00 ,$9.00 ,$12.75 ,$10.50 ,$0.72 ,$14.25 ,$10.80 ,$10.95 ,$5.10 ,$12.75 ,$3.00 ,$5.10 ,$12.00 ,$10.95 ,$0.72 ,$3.00 ,$3.31 ,$15.00 ,$12.75 ,$6.75 ,$13.80 ,$10.50 ,$10.53 ,$11.31 ,$9.14 ,$10.53 ,$10.37 ,$10.50 ,$3.03 ,$10.80 ,$0.76 ,$3.60 ,$3.60 ,$3.00 ,$3.60 ,$3.00 ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,30000014,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$110.00 ,$55.00 ,$17.61 ,$243.95 ,$71.06 ,$17.61 ,$71.16 ,$71.16 ,$108.42 ,$66.00 ,$93.50 ,$77.00 ,$17.61 ,$104.50 ,$79.20 ,$80.30 ,$42.64 ,$93.50 ,$108.42 ,$42.64 ,$88.00 ,$80.30 ,$17.61 ,$108.42 ,$46.20 ,$110.00 ,$93.50 ,$243.95 ,$101.20 ,$77.00 ,$110.00 ,$110.00 ,$66.99 ,$110.00 ,$76.01 ,$77.00 ,$109.50 ,$79.20 ,$18.67 , N/A , N/A ,$108.42 , N/A ,$108.42 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30000015,36600,HC ARTERIAL PUNCTURE,300,1 ,$60.00 ,$30.00 ,$17.61 ,$243.95 ,$38.76 ,$17.61 ,$38.81 ,$38.81 ,$108.42 ,$36.00 ,$51.00 ,$42.00 ,$17.61 ,$57.00 ,$43.20 ,$43.80 ,$25.28 ,$51.00 ,$108.42 ,$25.28 ,$48.00 ,$43.80 ,$17.61 ,$108.42 ,$25.20 ,$60.00 ,$51.00 ,$243.95 ,$55.20 ,$42.00 ,$30.00 ,$36.00 ,$36.54 ,$30.00 ,$41.46 ,$42.00 ,$109.50 ,$43.20 ,$18.67 , N/A , N/A ,$108.42 , N/A ,$108.42 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30000016,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$120.00 ,$60.00 ,$17.61 ,$243.95 ,$77.52 ,$17.61 ,$77.63 ,$77.63 ,$108.42 ,$72.00 ,$102.00 ,$84.00 ,$17.61 ,$114.00 ,$86.40 ,$87.60 ,$48.23 ,$102.00 ,$108.42 ,$48.23 ,$96.00 ,$87.60 ,$17.61 ,$108.42 ,$50.40 ,$120.00 ,$102.00 ,$243.95 ,$110.40 ,$84.00 ,$120.00 ,$120.00 ,$73.08 ,$120.00 ,$82.92 ,$84.00 ,$109.50 ,$86.40 ,$18.67 , N/A , N/A ,$108.42 , N/A ,$108.42 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30000101,89051,HC CELL CT BODY FLUID W/DIFF,300,1 ,$60.00 ,$30.00 ,$5.60 ,$60.00 ,$38.76 ,$5.79 ,$21.42 ,$18.36 ,$5.60 ,$36.00 ,$51.00 ,$42.00 ,$5.79 ,$57.00 ,$43.20 ,$43.80 ,$9.52 ,$51.00 ,$5.60 ,$9.52 ,$48.00 ,$43.80 ,$5.79 ,$5.60 ,$6.18 ,$60.00 ,$51.00 ,$12.60 ,$55.20 ,$42.00 ,$26.36 ,$28.31 ,$36.54 ,$26.36 ,$41.46 ,$42.00 ,$5.66 ,$43.20 ,$6.14 ,$6.72 ,$6.72 ,$5.60 ,$6.72 ,$5.60 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30000102,89051,HC CELL CT BODY FLUID W/DIFF (SYN),300,1 ,$92.00 ,$46.00 ,$5.60 ,$92.00 ,$59.43 ,$5.79 ,$21.42 ,$18.36 ,$5.60 ,$55.20 ,$78.20 ,$64.40 ,$5.79 ,$87.40 ,$66.24 ,$67.16 ,$9.52 ,$78.20 ,$5.60 ,$9.52 ,$73.60 ,$67.16 ,$5.79 ,$5.60 ,$6.18 ,$92.00 ,$78.20 ,$12.60 ,$84.64 ,$64.40 ,$26.36 ,$28.31 ,$56.03 ,$26.36 ,$63.57 ,$64.40 ,$5.66 ,$66.24 ,$6.14 ,$6.72 ,$6.72 ,$5.60 ,$6.72 ,$5.60 ,$66.24 ,$57.04 ,$66.24 ,$66.24 ,$55.20 ST VINCENT HOSPITAL - ACUTE,30000104,89055,HC LEUKO ASSESS STOOL QN/SEMI,300,1 ,$37.00 ,$18.50 ,$4.27 ,$37.00 ,$23.90 ,$4.41 ,$16.63 ,$14.25 ,$4.27 ,$22.20 ,$31.45 ,$25.90 ,$4.41 ,$35.15 ,$26.64 ,$27.01 ,$7.26 ,$31.45 ,$4.27 ,$7.26 ,$29.60 ,$27.01 ,$4.41 ,$4.27 ,$4.71 ,$37.00 ,$31.45 ,$9.61 ,$34.04 ,$25.90 ,$20.43 ,$21.94 ,$22.53 ,$20.43 ,$25.57 ,$25.90 ,$4.31 ,$26.64 ,$4.67 ,$5.12 ,$5.12 ,$4.27 ,$5.12 ,$4.27 ,$26.64 ,$22.94 ,$26.64 ,$26.64 ,$22.20 ST VINCENT HOSPITAL - ACUTE,30000105,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$49.00 ,$24.50 ,$7.33 ,$49.00 ,$31.65 ,$7.57 ,$27.83 ,$23.85 ,$7.33 ,$29.40 ,$41.65 ,$34.30 ,$7.57 ,$46.55 ,$35.28 ,$35.77 ,$12.46 ,$41.65 ,$7.33 ,$12.46 ,$39.20 ,$35.77 ,$7.57 ,$7.33 ,$8.09 ,$49.00 ,$41.65 ,$16.49 ,$45.08 ,$34.30 ,$34.26 ,$36.80 ,$29.84 ,$34.26 ,$33.86 ,$34.30 ,$7.40 ,$35.28 ,$8.02 ,$8.80 ,$8.80 ,$7.33 ,$8.80 ,$7.33 ,$35.28 ,$30.38 ,$35.28 ,$35.28 ,$29.40 ST VINCENT HOSPITAL - ACUTE,30000106,89125,HC FAT STAIN,300,1 ,$36.00 ,$18.00 ,$5.88 ,$36.00 ,$23.26 ,$6.08 ,$20.58 ,$17.64 ,$5.88 ,$21.60 ,$30.60 ,$25.20 ,$6.08 ,$34.20 ,$25.92 ,$26.28 ,$10.00 ,$30.60 ,$5.88 ,$10.00 ,$28.80 ,$26.28 ,$6.08 ,$5.88 ,$6.49 ,$36.00 ,$30.60 ,$13.23 ,$33.12 ,$25.20 ,$20.67 ,$22.21 ,$21.92 ,$20.67 ,$24.88 ,$25.20 ,$5.94 ,$25.92 ,$6.44 ,$7.06 ,$7.06 ,$5.88 ,$7.06 ,$5.88 ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,30000107,89190,HC SMEAR NASAL EOSINOPHILS,300,1 ,$38.00 ,$19.00 ,$5.79 ,$38.00 ,$24.55 ,$5.98 ,$20.27 ,$17.37 ,$5.79 ,$22.80 ,$32.30 ,$26.60 ,$5.98 ,$36.10 ,$27.36 ,$27.74 ,$9.84 ,$32.30 ,$5.79 ,$9.84 ,$30.40 ,$27.74 ,$5.98 ,$5.79 ,$6.39 ,$38.00 ,$32.30 ,$13.03 ,$34.96 ,$26.60 ,$22.74 ,$24.43 ,$23.14 ,$22.74 ,$26.26 ,$26.60 ,$5.85 ,$27.36 ,$6.34 ,$6.95 ,$6.95 ,$5.79 ,$6.95 ,$5.79 ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,30000108,89220,HC SPUTUM COLLECTION,300,1 ,$90.00 ,$45.00 ,$10.14 ,$325.04 ,$58.14 ,$10.14 ,$54.76 ,$46.94 ,$144.46 ,$54.00 ,$76.50 ,$63.00 ,$10.14 ,$85.50 ,$64.80 ,$65.70 ,$29.78 ,$76.50 ,$144.46 ,$29.78 ,$72.00 ,$65.70 ,$10.14 ,$144.46 ,$37.80 ,$90.00 ,$76.50 ,$325.04 ,$82.80 ,$63.00 ,$90.00 ,$90.00 ,$54.81 ,$90.00 ,$62.19 ,$63.00 ,$145.90 ,$64.80 ,$10.75 ,$90.00 ,$90.00 ,$144.46 ,$90.00 ,$144.46 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30000109,89230,HC SWEAT COLLECTION,300,1 ,$180.00 ,$90.00 ,$3.54 ,$180.00 ,$116.28 ,$11.38 ,$8.89 ,$7.62 ,$48.19 ,$108.00 ,$153.00 ,$126.00 ,$11.38 ,$171.00 ,$129.60 ,$131.40 ,$3.54 ,$153.00 ,$48.19 ,$3.54 ,$144.00 ,$131.40 ,$11.38 ,$48.19 ,$75.60 ,$180.00 ,$153.00 ,$108.43 ,$165.60 ,$126.00 ,$138.36 ,$148.61 ,$109.62 ,$138.36 ,$124.38 ,$126.00 ,$48.67 ,$129.60 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30000111,89310,HC SPERM COUNT,300,1 ,$265.00 ,$132.50 ,$8.61 ,$265.00 ,$171.19 ,$8.90 ,$33.50 ,$28.71 ,$8.61 ,$159.00 ,$225.25 ,$185.50 ,$8.90 ,$251.75 ,$190.80 ,$193.45 ,$14.64 ,$225.25 ,$8.61 ,$14.64 ,$212.00 ,$193.45 ,$8.90 ,$8.61 ,$9.51 ,$265.00 ,$225.25 ,$19.37 ,$243.80 ,$185.50 ,$41.21 ,$44.26 ,$161.39 ,$41.21 ,$183.12 ,$185.50 ,$8.70 ,$190.80 ,$9.43 ,$10.33 ,$10.33 ,$8.61 ,$10.33 ,$8.61 ,$190.80 ,$164.30 ,$190.80 ,$190.80 ,$159.00 ST VINCENT HOSPITAL - ACUTE,30000113,89320,HC SEMEN ANALYSIS,300,1 ,$56.00 ,$28.00 ,$12.31 ,$56.00 ,$36.18 ,$12.72 ,$46.87 ,$40.17 ,$12.31 ,$33.60 ,$47.60 ,$39.20 ,$12.72 ,$53.20 ,$40.32 ,$40.88 ,$20.93 ,$47.60 ,$12.31 ,$20.93 ,$44.80 ,$40.88 ,$12.72 ,$12.31 ,$13.59 ,$56.00 ,$47.60 ,$27.70 ,$51.52 ,$39.20 ,$56.00 ,$56.00 ,$34.10 ,$56.00 ,$38.70 ,$39.20 ,$12.43 ,$40.32 ,$13.48 ,$14.77 ,$14.77 ,$12.31 ,$14.77 ,$12.31 ,$40.32 ,$34.72 ,$40.32 ,$40.32 ,$33.60 ST VINCENT HOSPITAL - ACUTE,30000114,89325,HC SPERM ANTIBODIES,300,1 ,$64.00 ,$32.00 ,$5.22 ,$64.00 ,$41.34 ,$5.22 ,$41.51 ,$35.58 ,$10.67 ,$38.40 ,$54.40 ,$44.80 ,$5.22 ,$60.80 ,$46.08 ,$46.72 ,$18.14 ,$54.40 ,$10.67 ,$18.14 ,$51.20 ,$46.72 ,$5.22 ,$10.67 ,$11.78 ,$64.00 ,$54.40 ,$24.01 ,$58.88 ,$44.80 ,$51.11 ,$54.89 ,$38.98 ,$51.11 ,$44.22 ,$44.80 ,$10.78 ,$46.08 ,$5.53 ,$12.80 ,$12.80 ,$10.67 ,$12.80 ,$10.67 ,$46.08 ,$39.68 ,$46.08 ,$46.08 ,$38.40 ST VINCENT HOSPITAL - ACUTE,30000115,99001,HC SPECIMEN HAND/CONVEY OTHER,300,1 ,$24.00 ,$12.00 ,$3.92 ,$24.00 ,$15.50 ,$3.92 ,$15.53 ,$15.53 , N/A ,$14.40 ,$20.40 ,$16.80 ,$3.92 ,$22.80 ,$17.28 ,$17.52 ,$10.44 ,$20.40 , N/A ,$10.44 ,$19.20 ,$17.52 ,$3.92 , N/A ,$10.08 ,$24.00 ,$20.40 , N/A ,$22.08 ,$16.80 ,$12.00 ,$14.40 ,$14.62 ,$12.00 ,$16.58 ,$16.80 , N/A ,$17.28 ,$4.16 ,$7.37 ,$7.37 , N/A ,$7.37 , N/A ,$17.28 ,$14.88 ,$17.28 ,$17.28 ,$14.40 ST VINCENT HOSPITAL - ACUTE,30000116,99080,HC EMPL DRUG SCREEN COL,300,1 ,$23.00 ,$11.50 ,$9.66 ,$23.00 ,$14.86 , N/A ,$14.88 ,$14.88 , N/A ,$13.80 ,$19.55 ,$16.10 , N/A ,$21.85 ,$16.56 ,$16.79 , N/A ,$19.55 , N/A , N/A ,$18.40 ,$16.79 , N/A , N/A ,$9.66 ,$23.00 ,$19.55 , N/A ,$21.16 ,$16.10 ,$11.50 ,$13.80 ,$14.01 ,$11.50 ,$15.89 ,$16.10 , N/A ,$16.56 , N/A , N/A , N/A , N/A , N/A , N/A ,$16.56 ,$14.26 ,$16.56 ,$16.56 ,$13.80 ST VINCENT HOSPITAL - ACUTE,30000117,99080,HC LAB PROCESS FEE,300,1 ,$22.00 ,$11.00 ,$9.24 ,$22.00 ,$14.21 , N/A ,$14.23 ,$14.23 , N/A ,$13.20 ,$18.70 ,$15.40 , N/A ,$20.90 ,$15.84 ,$16.06 , N/A ,$18.70 , N/A , N/A ,$17.60 ,$16.06 , N/A , N/A ,$9.24 ,$22.00 ,$18.70 , N/A ,$20.24 ,$15.40 ,$11.00 ,$13.20 ,$13.40 ,$11.00 ,$15.20 ,$15.40 , N/A ,$15.84 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30000120,80306,HC DRUG SCREEN URINE,300,1 ,$300.00 ,$150.00 ,$17.14 ,$300.00 ,$193.80 ,$17.71 ,$59.99 ,$51.42 ,$17.14 ,$180.00 ,$255.00 ,$210.00 ,$17.71 ,$285.00 ,$216.00 ,$219.00 ,$29.14 ,$255.00 ,$17.14 ,$29.14 ,$240.00 ,$219.00 ,$17.71 ,$17.14 ,$18.93 ,$300.00 ,$255.00 ,$38.57 ,$276.00 ,$210.00 ,$60.16 ,$64.62 ,$182.70 ,$60.16 ,$207.30 ,$210.00 ,$17.31 ,$216.00 ,$18.77 ,$20.57 ,$20.57 ,$17.14 ,$20.57 ,$17.14 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,30000121,80306,HC DRUG SCREEN SGL CLASS PRESUMPTIVE INSTRMNT,300,1 ,$61.00 ,$30.50 ,$17.14 ,$61.00 ,$39.41 ,$17.71 ,$59.99 ,$51.42 ,$17.14 ,$36.60 ,$51.85 ,$42.70 ,$17.71 ,$57.95 ,$43.92 ,$44.53 ,$29.14 ,$51.85 ,$17.14 ,$29.14 ,$48.80 ,$44.53 ,$17.71 ,$17.14 ,$18.93 ,$61.00 ,$51.85 ,$38.57 ,$56.12 ,$42.70 ,$60.16 ,$61.00 ,$37.15 ,$60.16 ,$42.15 ,$42.70 ,$17.31 ,$43.92 ,$18.77 ,$20.57 ,$20.57 ,$17.14 ,$20.57 ,$17.14 ,$43.92 ,$37.82 ,$43.92 ,$43.92 ,$36.60 ST VINCENT HOSPITAL - ACUTE,30000122,80306,HC DRUG SCREEN (FLUNITRAZEPAM),300,1 ,$330.00 ,$165.00 ,$17.14 ,$330.00 ,$213.18 ,$17.71 ,$59.99 ,$51.42 ,$17.14 ,$198.00 ,$280.50 ,$231.00 ,$17.71 ,$313.50 ,$237.60 ,$240.90 ,$29.14 ,$280.50 ,$17.14 ,$29.14 ,$264.00 ,$240.90 ,$17.71 ,$17.14 ,$18.93 ,$330.00 ,$280.50 ,$38.57 ,$303.60 ,$231.00 ,$60.16 ,$64.62 ,$200.97 ,$60.16 ,$228.03 ,$231.00 ,$17.31 ,$237.60 ,$18.77 ,$20.57 ,$20.57 ,$17.14 ,$20.57 ,$17.14 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,30000123,80306,HC DRUG SCREEN (HYDROXYBUTYRIC),300,1 ,$183.00 ,$91.50 ,$17.14 ,$183.00 ,$118.22 ,$17.71 ,$59.99 ,$51.42 ,$17.14 ,$109.80 ,$155.55 ,$128.10 ,$17.71 ,$173.85 ,$131.76 ,$133.59 ,$29.14 ,$155.55 ,$17.14 ,$29.14 ,$146.40 ,$133.59 ,$17.71 ,$17.14 ,$18.93 ,$183.00 ,$155.55 ,$38.57 ,$168.36 ,$128.10 ,$60.16 ,$64.62 ,$111.45 ,$60.16 ,$126.45 ,$128.10 ,$17.31 ,$131.76 ,$18.77 ,$20.57 ,$20.57 ,$17.14 ,$20.57 ,$17.14 ,$131.76 ,$113.46 ,$131.76 ,$131.76 ,$109.80 ST VINCENT HOSPITAL - ACUTE,30000124,80307,HC DRUG SCREEN MECONIUM,300,1 ,$370.00 ,$185.00 ,$62.14 ,$370.00 ,$239.02 ,$63.40 ,$226.28 ,$193.95 ,$62.14 ,$222.00 ,$314.50 ,$259.00 ,$63.40 ,$351.50 ,$266.40 ,$270.10 ,$105.64 ,$314.50 ,$62.14 ,$105.64 ,$296.00 ,$270.10 ,$63.40 ,$62.14 ,$68.62 ,$370.00 ,$314.50 ,$139.82 ,$340.40 ,$259.00 ,$226.92 ,$243.73 ,$225.33 ,$226.92 ,$255.67 ,$259.00 ,$62.76 ,$266.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,30000125,G0432,HC HIV I-II SCREEN,300,1 ,$80.00 ,$40.00 ,$2.58 ,$80.00 ,$51.68 ,$2.58 ,$68.50 ,$58.71 ,$19.57 ,$48.00 ,$68.00 ,$56.00 ,$2.58 ,$76.00 ,$57.60 ,$58.40 ,$33.27 ,$68.00 ,$19.57 ,$33.27 ,$64.00 ,$58.40 ,$2.58 ,$19.57 ,$21.61 ,$80.00 ,$68.00 ,$44.03 ,$73.60 ,$56.00 ,$65.64 ,$70.50 ,$48.72 ,$65.64 ,$55.28 ,$56.00 ,$19.77 ,$57.60 ,$2.73 ,$23.48 ,$23.48 ,$19.57 ,$23.48 ,$19.57 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30000126,J2790,HC RH IMMUNE GLOBULIN,300,1 ,$129.00 ,$64.50 ,$21.81 ,$129.00 ,$83.33 ,$21.81 ,$83.45 ,$83.45 , N/A ,$77.40 ,$109.65 ,$90.30 ,$21.81 ,$122.55 ,$92.88 ,$94.17 ,$129.00 ,$109.65 , N/A ,$129.00 ,$103.20 ,$94.17 ,$21.81 , N/A ,$54.18 ,$129.00 ,$109.65 , N/A ,$118.68 ,$90.30 ,$64.50 ,$77.40 ,$78.56 ,$64.50 ,$89.14 ,$90.30 , N/A ,$92.88 ,$23.12 , N/A , N/A , N/A , N/A , N/A ,$92.88 ,$79.98 ,$92.88 ,$92.88 ,$77.40 ST VINCENT HOSPITAL - ACUTE,30000130,80306,HC DRUG SCRN CLS A NON-TLC DVCS,301,1 ,$250.00 ,$125.00 ,$17.14 ,$250.00 ,$161.50 ,$17.71 ,$59.99 ,$51.42 ,$17.14 ,$150.00 ,$212.50 ,$175.00 ,$17.71 ,$237.50 ,$180.00 ,$182.50 ,$29.14 ,$212.50 ,$17.14 ,$29.14 ,$200.00 ,$182.50 ,$17.71 ,$17.14 ,$18.93 ,$250.00 ,$212.50 ,$38.57 ,$230.00 ,$175.00 ,$60.16 ,$64.62 ,$152.25 ,$60.16 ,$172.75 ,$175.00 ,$17.31 ,$180.00 ,$18.77 ,$20.57 ,$20.57 ,$17.14 ,$20.57 ,$17.14 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,30000200,80307,HC MECONIUM SCREEN MAYO,300,1 ,$370.00 ,$185.00 ,$62.14 ,$370.00 ,$239.02 ,$63.40 ,$226.28 ,$193.95 ,$62.14 ,$222.00 ,$314.50 ,$259.00 ,$63.40 ,$351.50 ,$266.40 ,$270.10 ,$105.64 ,$314.50 ,$62.14 ,$105.64 ,$296.00 ,$270.10 ,$63.40 ,$62.14 ,$68.62 ,$370.00 ,$314.50 ,$139.82 ,$340.40 ,$259.00 ,$226.92 ,$243.73 ,$225.33 ,$226.92 ,$255.67 ,$259.00 ,$62.76 ,$266.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,30000205,84311,HC PM SCREEN OXIDANT,300,1 ,$92.00 ,$46.00 ,$8.10 ,$92.00 ,$59.43 ,$8.37 ,$28.35 ,$24.30 ,$8.10 ,$55.20 ,$78.20 ,$64.40 ,$8.37 ,$87.40 ,$66.24 ,$67.16 ,$13.77 ,$78.20 ,$8.10 ,$13.77 ,$73.60 ,$67.16 ,$8.37 ,$8.10 ,$8.94 ,$92.00 ,$78.20 ,$18.23 ,$84.64 ,$64.40 ,$33.49 ,$35.97 ,$56.03 ,$33.49 ,$63.57 ,$64.40 ,$8.18 ,$66.24 ,$8.87 ,$9.72 ,$9.72 ,$8.10 ,$9.72 ,$8.10 ,$66.24 ,$57.04 ,$66.24 ,$66.24 ,$55.20 ST VINCENT HOSPITAL - ACUTE,30000206,80307,HC DRUG SCREEN PANEL 9,300,1 ,$370.00 ,$185.00 ,$62.14 ,$370.00 ,$239.02 ,$63.40 ,$226.28 ,$193.95 ,$62.14 ,$222.00 ,$314.50 ,$259.00 ,$63.40 ,$351.50 ,$266.40 ,$270.10 ,$105.64 ,$314.50 ,$62.14 ,$105.64 ,$296.00 ,$270.10 ,$63.40 ,$62.14 ,$68.62 ,$370.00 ,$314.50 ,$139.82 ,$340.40 ,$259.00 ,$226.92 ,$243.73 ,$225.33 ,$226.92 ,$255.67 ,$259.00 ,$62.76 ,$266.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,30000207,80307,HC DRUG SCREEN PANEL 20,300,1 ,$370.00 ,$185.00 ,$62.14 ,$370.00 ,$239.02 ,$63.40 ,$226.28 ,$193.95 ,$62.14 ,$222.00 ,$314.50 ,$259.00 ,$63.40 ,$351.50 ,$266.40 ,$270.10 ,$105.64 ,$314.50 ,$62.14 ,$105.64 ,$296.00 ,$270.10 ,$63.40 ,$62.14 ,$68.62 ,$370.00 ,$314.50 ,$139.82 ,$340.40 ,$259.00 ,$226.92 ,$243.73 ,$225.33 ,$226.92 ,$255.67 ,$259.00 ,$62.76 ,$266.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,30000209,G0480,HC M-PHENIDATE MET QN URINE DEFINITIVE,300,1 ,$200.00 ,$100.00 ,$63.95 ,$257.47 ,$129.20 ,$63.95 ,$200.00 ,$200.00 ,$114.43 ,$120.00 ,$170.00 ,$140.00 ,$63.95 ,$190.00 ,$144.00 ,$146.00 ,$194.53 ,$170.00 ,$114.43 ,$194.53 ,$160.00 ,$146.00 ,$63.95 ,$114.43 ,$126.35 ,$200.00 ,$170.00 ,$257.47 ,$184.00 ,$140.00 ,$200.00 ,$200.00 ,$121.80 ,$200.00 ,$138.20 ,$140.00 ,$115.57 ,$144.00 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30000210,G0480,HC FENTANYL QN URINE DEFINITIVE,300,1 ,$200.00 ,$100.00 ,$63.95 ,$257.47 ,$129.20 ,$63.95 ,$200.00 ,$200.00 ,$114.43 ,$120.00 ,$170.00 ,$140.00 ,$63.95 ,$190.00 ,$144.00 ,$146.00 ,$194.53 ,$170.00 ,$114.43 ,$194.53 ,$160.00 ,$146.00 ,$63.95 ,$114.43 ,$126.35 ,$200.00 ,$170.00 ,$257.47 ,$184.00 ,$140.00 ,$200.00 ,$200.00 ,$121.80 ,$200.00 ,$138.20 ,$140.00 ,$115.57 ,$144.00 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30000211,80306,HC BUPRENORPHINE SCR/QN URINE,300,1 ,$200.00 ,$100.00 ,$17.14 ,$200.00 ,$129.20 ,$17.71 ,$59.99 ,$51.42 ,$17.14 ,$120.00 ,$170.00 ,$140.00 ,$17.71 ,$190.00 ,$144.00 ,$146.00 ,$29.14 ,$170.00 ,$17.14 ,$29.14 ,$160.00 ,$146.00 ,$17.71 ,$17.14 ,$18.93 ,$200.00 ,$170.00 ,$38.57 ,$184.00 ,$140.00 ,$60.16 ,$64.62 ,$121.80 ,$60.16 ,$138.20 ,$140.00 ,$17.31 ,$144.00 ,$18.77 ,$20.57 ,$20.57 ,$17.14 ,$20.57 ,$17.14 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30000212,G0480,HC BUPRENORPHINE QN URINE,300,1 ,$200.00 ,$100.00 ,$63.95 ,$257.47 ,$129.20 ,$63.95 ,$200.00 ,$200.00 ,$114.43 ,$120.00 ,$170.00 ,$140.00 ,$63.95 ,$190.00 ,$144.00 ,$146.00 ,$194.53 ,$170.00 ,$114.43 ,$194.53 ,$160.00 ,$146.00 ,$63.95 ,$114.43 ,$126.35 ,$200.00 ,$170.00 ,$257.47 ,$184.00 ,$140.00 ,$200.00 ,$200.00 ,$121.80 ,$200.00 ,$138.20 ,$140.00 ,$115.57 ,$144.00 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30000227,89321,HC SEMEN PRESENCE/MOTILITY,300,1 ,$240.00 ,$120.00 ,$12.05 ,$240.00 ,$155.04 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$144.00 ,$204.00 ,$168.00 ,$12.45 ,$228.00 ,$172.80 ,$175.20 ,$20.49 ,$204.00 ,$12.05 ,$20.49 ,$192.00 ,$175.20 ,$12.45 ,$12.05 ,$13.31 ,$240.00 ,$204.00 ,$27.11 ,$220.80 ,$168.00 ,$57.70 ,$61.98 ,$146.16 ,$57.70 ,$165.84 ,$168.00 ,$12.17 ,$172.80 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30000229,89322,HC SEMEN ANALYSIS STRICT MORPHOLOGIC CRITERIA,300,1 ,$359.00 ,$179.50 ,$15.50 ,$359.00 ,$231.91 ,$16.02 ,$60.27 ,$51.66 ,$15.50 ,$215.40 ,$305.15 ,$251.30 ,$16.02 ,$341.05 ,$258.48 ,$262.07 ,$26.35 ,$305.15 ,$15.50 ,$26.35 ,$287.20 ,$262.07 ,$16.02 ,$15.50 ,$17.12 ,$359.00 ,$305.15 ,$34.88 ,$330.28 ,$251.30 ,$74.20 ,$79.70 ,$218.63 ,$74.20 ,$248.07 ,$251.30 ,$15.66 ,$258.48 ,$16.98 ,$18.60 ,$18.60 ,$15.50 ,$18.60 ,$15.50 ,$258.48 ,$222.58 ,$258.48 ,$258.48 ,$215.40 ST VINCENT HOSPITAL - ACUTE,30000236,80307,HC DRUG SCREEN PANEL 4,301,1 ,$370.00 ,$185.00 ,$62.14 ,$370.00 ,$239.02 ,$63.40 ,$226.28 ,$193.95 ,$62.14 ,$222.00 ,$314.50 ,$259.00 ,$63.40 ,$351.50 ,$266.40 ,$270.10 ,$105.64 ,$314.50 ,$62.14 ,$105.64 ,$296.00 ,$270.10 ,$63.40 ,$62.14 ,$68.62 ,$370.00 ,$314.50 ,$139.82 ,$340.40 ,$259.00 ,$226.92 ,$243.73 ,$225.33 ,$226.92 ,$255.67 ,$259.00 ,$62.76 ,$266.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,30000237,80307,HC DRUG SCREEN PANEL 6,301,1 ,$370.00 ,$185.00 ,$62.14 ,$370.00 ,$239.02 ,$63.40 ,$226.28 ,$193.95 ,$62.14 ,$222.00 ,$314.50 ,$259.00 ,$63.40 ,$351.50 ,$266.40 ,$270.10 ,$105.64 ,$314.50 ,$62.14 ,$105.64 ,$296.00 ,$270.10 ,$63.40 ,$62.14 ,$68.62 ,$370.00 ,$314.50 ,$139.82 ,$340.40 ,$259.00 ,$226.92 ,$243.73 ,$225.33 ,$226.92 ,$255.67 ,$259.00 ,$62.76 ,$266.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,30000463,76120,HC CINERADIOGRAPHY 76120,320,1 ,$360.00 ,$180.00 ,$17.72 ,$360.00 ,$232.56 ,$17.72 ,$360.00 ,$323.32 ,$105.54 ,$216.00 ,$306.00 ,$252.00 ,$17.72 ,$342.00 ,$259.20 ,$262.80 ,$189.56 ,$306.00 ,$105.54 ,$189.56 ,$288.00 ,$262.80 ,$17.72 ,$105.54 ,$151.20 ,$360.00 ,$306.00 ,$237.46 ,$331.20 ,$252.00 ,$360.00 ,$360.00 ,$219.24 ,$360.00 ,$248.76 ,$252.00 ,$106.60 ,$259.20 ,$18.78 ,$360.00 ,$360.00 ,$105.54 ,$360.00 ,$105.54 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,30080010,36415,HC VENIPUNCTURE GBO,300,1 ,$15.00 ,$7.50 ,$0.72 ,$15.00 ,$9.69 ,$0.72 ,$8.00 ,$6.00 ,$3.00 ,$9.00 ,$12.75 ,$10.50 ,$0.72 ,$14.25 ,$10.80 ,$10.95 ,$5.10 ,$12.75 ,$3.00 ,$5.10 ,$12.00 ,$10.95 ,$0.72 ,$3.00 ,$3.31 ,$15.00 ,$12.75 ,$6.75 ,$13.80 ,$10.50 ,$10.53 ,$11.31 ,$9.14 ,$10.53 ,$10.37 ,$10.50 ,$3.03 ,$10.80 ,$0.76 ,$3.60 ,$3.60 ,$3.00 ,$3.60 ,$3.00 ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,30080014,36591,HC COLLECT BLOOD PORT/ACCESS DVC GBO,300,1 ,$110.00 ,$55.00 ,$17.61 ,$243.95 ,$71.06 ,$17.61 ,$71.16 ,$71.16 ,$108.42 ,$66.00 ,$93.50 ,$77.00 ,$17.61 ,$104.50 ,$79.20 ,$80.30 ,$42.64 ,$93.50 ,$108.42 ,$42.64 ,$88.00 ,$80.30 ,$17.61 ,$108.42 ,$46.20 ,$110.00 ,$93.50 ,$243.95 ,$101.20 ,$77.00 ,$110.00 ,$110.00 ,$66.99 ,$110.00 ,$76.01 ,$77.00 ,$109.50 ,$79.20 ,$18.67 , N/A , N/A ,$108.42 , N/A ,$108.42 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30080016,36592,HC COLLECT BLD CENTRL/PERPH CATH GBO,300,1 ,$120.00 ,$60.00 ,$17.61 ,$243.95 ,$77.52 ,$17.61 ,$77.63 ,$77.63 ,$108.42 ,$72.00 ,$102.00 ,$84.00 ,$17.61 ,$114.00 ,$86.40 ,$87.60 ,$48.23 ,$102.00 ,$108.42 ,$48.23 ,$96.00 ,$87.60 ,$17.61 ,$108.42 ,$50.40 ,$120.00 ,$102.00 ,$243.95 ,$110.40 ,$84.00 ,$120.00 ,$120.00 ,$73.08 ,$120.00 ,$82.92 ,$84.00 ,$109.50 ,$86.40 ,$18.67 , N/A , N/A ,$108.42 , N/A ,$108.42 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100062,80307,HC AMPHET/METHAMPHET CONFIRM MEC,301,1 ,$120.00 ,$60.00 ,$60.00 ,$139.82 ,$77.52 ,$63.40 ,$120.00 ,$120.00 ,$62.14 ,$72.00 ,$102.00 ,$84.00 ,$63.40 ,$114.00 ,$86.40 ,$87.60 ,$105.64 ,$102.00 ,$62.14 ,$105.64 ,$96.00 ,$87.60 ,$63.40 ,$62.14 ,$68.62 ,$120.00 ,$102.00 ,$139.82 ,$110.40 ,$84.00 ,$120.00 ,$120.00 ,$73.08 ,$120.00 ,$82.92 ,$84.00 ,$62.76 ,$86.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100063,80307,HC COCAINE AND MET CONFIRM MEC,301,1 ,$370.00 ,$185.00 ,$62.14 ,$370.00 ,$239.02 ,$63.40 ,$226.28 ,$193.95 ,$62.14 ,$222.00 ,$314.50 ,$259.00 ,$63.40 ,$351.50 ,$266.40 ,$270.10 ,$105.64 ,$314.50 ,$62.14 ,$105.64 ,$296.00 ,$270.10 ,$63.40 ,$62.14 ,$68.62 ,$370.00 ,$314.50 ,$139.82 ,$340.40 ,$259.00 ,$226.92 ,$243.73 ,$225.33 ,$226.92 ,$255.67 ,$259.00 ,$62.76 ,$266.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,30100064,80307,HC OPIATE CONFIRM MEC,301,1 ,$370.00 ,$185.00 ,$62.14 ,$370.00 ,$239.02 ,$63.40 ,$226.28 ,$193.95 ,$62.14 ,$222.00 ,$314.50 ,$259.00 ,$63.40 ,$351.50 ,$266.40 ,$270.10 ,$105.64 ,$314.50 ,$62.14 ,$105.64 ,$296.00 ,$270.10 ,$63.40 ,$62.14 ,$68.62 ,$370.00 ,$314.50 ,$139.82 ,$340.40 ,$259.00 ,$226.92 ,$243.73 ,$225.33 ,$226.92 ,$255.67 ,$259.00 ,$62.76 ,$266.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,30100065,80307,HC PCP CONFIRM MEC,301,1 ,$120.00 ,$60.00 ,$60.00 ,$139.82 ,$77.52 ,$63.40 ,$120.00 ,$120.00 ,$62.14 ,$72.00 ,$102.00 ,$84.00 ,$63.40 ,$114.00 ,$86.40 ,$87.60 ,$105.64 ,$102.00 ,$62.14 ,$105.64 ,$96.00 ,$87.60 ,$63.40 ,$62.14 ,$68.62 ,$120.00 ,$102.00 ,$139.82 ,$110.40 ,$84.00 ,$120.00 ,$120.00 ,$73.08 ,$120.00 ,$82.92 ,$84.00 ,$62.76 ,$86.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100066,80307,HC THC CONFIRM MEC,301,1 ,$370.00 ,$185.00 ,$62.14 ,$370.00 ,$239.02 ,$63.40 ,$226.28 ,$193.95 ,$62.14 ,$222.00 ,$314.50 ,$259.00 ,$63.40 ,$351.50 ,$266.40 ,$270.10 ,$105.64 ,$314.50 ,$62.14 ,$105.64 ,$296.00 ,$270.10 ,$63.40 ,$62.14 ,$68.62 ,$370.00 ,$314.50 ,$139.82 ,$340.40 ,$259.00 ,$226.92 ,$243.73 ,$225.33 ,$226.92 ,$255.67 ,$259.00 ,$62.76 ,$266.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,30100099,80048,HC SURGICAL VET PANEL,301,1 ,$8.00 ,$4.00 ,$4.00 ,$18.00 ,$5.17 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$4.80 ,$6.80 ,$5.60 ,$8.00 ,$7.60 ,$5.76 ,$5.84 ,$8.00 ,$6.80 ,$8.00 ,$8.00 ,$6.40 ,$5.84 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$6.80 ,$18.00 ,$7.36 ,$5.60 ,$8.00 ,$8.00 ,$4.87 ,$8.00 ,$5.53 ,$5.60 ,$8.08 ,$5.76 ,$8.48 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$5.76 ,$4.96 ,$5.76 ,$5.76 ,$4.80 ST VINCENT HOSPITAL - ACUTE,30100101,80048,HC BASIC METABOLIC PANEL,301,1 ,$87.00 ,$43.50 ,$8.46 ,$87.00 ,$56.20 ,$8.74 ,$32.90 ,$28.20 ,$8.46 ,$52.20 ,$73.95 ,$60.90 ,$8.74 ,$82.65 ,$62.64 ,$63.51 ,$14.38 ,$73.95 ,$8.46 ,$14.38 ,$69.60 ,$63.51 ,$8.74 ,$8.46 ,$9.34 ,$87.00 ,$73.95 ,$19.04 ,$80.04 ,$60.90 ,$40.51 ,$43.51 ,$52.98 ,$40.51 ,$60.12 ,$60.90 ,$8.54 ,$62.64 ,$9.26 ,$10.15 ,$10.15 ,$8.46 ,$10.15 ,$8.46 ,$62.64 ,$53.94 ,$62.64 ,$62.64 ,$52.20 ST VINCENT HOSPITAL - ACUTE,30100103,80051,HC ELECTROLYTE PANEL,301,1 ,$49.00 ,$24.50 ,$7.01 ,$49.00 ,$31.65 ,$7.24 ,$27.27 ,$23.37 ,$7.01 ,$29.40 ,$41.65 ,$34.30 ,$7.24 ,$46.55 ,$35.28 ,$35.77 ,$11.92 ,$41.65 ,$7.01 ,$11.92 ,$39.20 ,$35.77 ,$7.24 ,$7.01 ,$7.74 ,$49.00 ,$41.65 ,$15.77 ,$45.08 ,$34.30 ,$33.59 ,$36.08 ,$29.84 ,$33.59 ,$33.86 ,$34.30 ,$7.08 ,$35.28 ,$7.67 ,$8.41 ,$8.41 ,$7.01 ,$8.41 ,$7.01 ,$35.28 ,$30.38 ,$35.28 ,$35.28 ,$29.40 ST VINCENT HOSPITAL - ACUTE,30100104,80053,HC COMPREHENSIVE METABOL PANEL,301,1 ,$120.00 ,$60.00 ,$10.56 ,$120.00 ,$77.52 ,$10.91 ,$41.09 ,$35.22 ,$10.56 ,$72.00 ,$102.00 ,$84.00 ,$10.91 ,$114.00 ,$86.40 ,$87.60 ,$17.95 ,$102.00 ,$10.56 ,$17.95 ,$96.00 ,$87.60 ,$10.91 ,$10.56 ,$11.66 ,$120.00 ,$102.00 ,$23.76 ,$110.40 ,$84.00 ,$50.58 ,$54.33 ,$73.08 ,$50.58 ,$82.92 ,$84.00 ,$10.67 ,$86.40 ,$11.56 ,$12.67 ,$12.67 ,$10.56 ,$12.67 ,$10.56 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100105,80053,HC COMPREHENSIVE METABOL PANEL VET,301,1 ,$13.00 ,$6.50 ,$6.50 ,$23.76 ,$8.40 ,$10.91 ,$13.00 ,$13.00 ,$10.56 ,$7.80 ,$11.05 ,$9.10 ,$10.91 ,$12.35 ,$9.36 ,$9.49 ,$13.00 ,$11.05 ,$10.56 ,$13.00 ,$10.40 ,$9.49 ,$10.91 ,$10.56 ,$11.66 ,$13.00 ,$11.05 ,$23.76 ,$11.96 ,$9.10 ,$13.00 ,$13.00 ,$7.92 ,$13.00 ,$8.98 ,$9.10 ,$10.67 ,$9.36 ,$11.56 ,$12.67 ,$12.67 ,$10.56 ,$12.67 ,$10.56 ,$9.36 ,$8.06 ,$9.36 ,$9.36 ,$7.80 ST VINCENT HOSPITAL - ACUTE,30100106,80055,HC PRENATAL PANEL,301,1 ,$260.00 ,$130.00 ,$18.84 ,$260.00 ,$167.96 ,$18.84 ,$185.92 ,$159.36 ,$47.81 ,$156.00 ,$221.00 ,$182.00 ,$18.84 ,$247.00 ,$187.20 ,$189.80 ,$81.28 ,$221.00 ,$47.81 ,$81.28 ,$208.00 ,$189.80 ,$18.84 ,$47.81 ,$52.79 ,$260.00 ,$221.00 ,$107.57 ,$239.20 ,$182.00 ,$225.38 ,$242.07 ,$158.34 ,$225.38 ,$179.66 ,$182.00 ,$48.29 ,$187.20 ,$19.97 ,$57.37 ,$57.37 ,$47.81 ,$57.37 ,$47.81 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30100107,80061,HC LIPID PANEL,301,1 ,$90.00 ,$45.00 ,$13.39 ,$90.00 ,$58.14 ,$13.84 ,$52.08 ,$44.64 ,$13.39 ,$54.00 ,$76.50 ,$63.00 ,$13.84 ,$85.50 ,$64.80 ,$65.70 ,$22.76 ,$76.50 ,$13.39 ,$22.76 ,$72.00 ,$65.70 ,$13.84 ,$13.39 ,$14.79 ,$90.00 ,$76.50 ,$30.13 ,$82.80 ,$63.00 ,$64.13 ,$68.88 ,$54.81 ,$64.13 ,$62.19 ,$63.00 ,$13.52 ,$64.80 ,$14.67 ,$16.07 ,$16.07 ,$13.39 ,$16.07 ,$13.39 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100108,80069,HC RENAL PANEL,301,1 ,$100.00 ,$50.00 ,$8.68 ,$100.00 ,$64.60 ,$8.97 ,$33.78 ,$28.95 ,$8.68 ,$60.00 ,$85.00 ,$70.00 ,$8.97 ,$95.00 ,$72.00 ,$73.00 ,$14.76 ,$85.00 ,$8.68 ,$14.76 ,$80.00 ,$73.00 ,$8.97 ,$8.68 ,$9.58 ,$100.00 ,$85.00 ,$19.53 ,$92.00 ,$70.00 ,$41.59 ,$44.67 ,$60.90 ,$41.59 ,$69.10 ,$70.00 ,$8.77 ,$72.00 ,$9.51 ,$10.42 ,$10.42 ,$8.68 ,$10.42 ,$8.68 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100109,80074,HC HEPATITIS PANEL ACUTE,301,1 ,$320.00 ,$160.00 ,$47.63 ,$320.00 ,$206.72 ,$49.22 ,$185.26 ,$158.79 ,$47.63 ,$192.00 ,$272.00 ,$224.00 ,$49.22 ,$304.00 ,$230.40 ,$233.60 ,$80.97 ,$272.00 ,$47.63 ,$80.97 ,$256.00 ,$233.60 ,$49.22 ,$47.63 ,$52.59 ,$320.00 ,$272.00 ,$107.17 ,$294.40 ,$224.00 ,$228.11 ,$245.01 ,$194.88 ,$228.11 ,$221.12 ,$224.00 ,$48.11 ,$230.40 ,$52.17 ,$57.16 ,$57.16 ,$47.63 ,$57.16 ,$47.63 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,30100110,80076,HC LIVER (HEPATIC) PANEL,301,1 ,$70.00 ,$35.00 ,$8.17 ,$70.00 ,$45.22 ,$8.44 ,$31.78 ,$27.24 ,$8.17 ,$42.00 ,$59.50 ,$49.00 ,$8.44 ,$66.50 ,$50.40 ,$51.10 ,$13.89 ,$59.50 ,$8.17 ,$13.89 ,$56.00 ,$51.10 ,$8.44 ,$8.17 ,$9.02 ,$70.00 ,$59.50 ,$18.38 ,$64.40 ,$49.00 ,$39.10 ,$42.00 ,$42.63 ,$39.10 ,$48.37 ,$49.00 ,$8.25 ,$50.40 ,$8.95 ,$9.80 ,$9.80 ,$8.17 ,$9.80 ,$8.17 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100111,80150,HC AMIKACIN,301,1 ,$110.00 ,$55.00 ,$15.08 ,$110.00 ,$71.06 ,$15.58 ,$58.63 ,$50.25 ,$15.08 ,$66.00 ,$93.50 ,$77.00 ,$15.58 ,$104.50 ,$79.20 ,$80.30 ,$25.64 ,$93.50 ,$15.08 ,$25.64 ,$88.00 ,$80.30 ,$15.58 ,$15.08 ,$16.65 ,$110.00 ,$93.50 ,$33.93 ,$101.20 ,$77.00 ,$72.17 ,$77.51 ,$66.99 ,$72.17 ,$76.01 ,$77.00 ,$15.23 ,$79.20 ,$16.51 ,$18.10 ,$18.10 ,$15.08 ,$18.10 ,$15.08 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100112,80335,HC AMITRIPTYLINE,301,1 ,$90.00 ,$45.00 ,$3.23 ,$90.00 ,$58.14 ,$3.23 ,$80.88 ,$69.32 , N/A ,$54.00 ,$76.50 ,$63.00 ,$3.23 ,$85.50 ,$64.80 ,$65.70 ,$38.56 ,$76.50 , N/A ,$38.56 ,$72.00 ,$65.70 ,$3.23 , N/A ,$5.52 ,$90.00 ,$76.50 , N/A ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 , N/A ,$64.80 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100113,80346,HC LORAZEPAM,301,1 ,$106.00 ,$53.00 ,$3.23 ,$106.00 ,$68.48 ,$3.23 ,$80.88 ,$69.32 , N/A ,$63.60 ,$90.10 ,$74.20 ,$3.23 ,$100.70 ,$76.32 ,$77.38 ,$38.56 ,$90.10 , N/A ,$38.56 ,$84.80 ,$77.38 ,$3.23 , N/A ,$17.79 ,$106.00 ,$90.10 , N/A ,$97.52 ,$74.20 ,$53.00 ,$63.60 ,$64.55 ,$53.00 ,$73.25 ,$74.20 , N/A ,$76.32 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$76.32 ,$65.72 ,$76.32 ,$76.32 ,$63.60 ST VINCENT HOSPITAL - ACUTE,30100114,80346,HC CLONOPIN,301,1 ,$38.00 ,$19.00 ,$3.23 ,$38.00 ,$24.55 ,$3.23 ,$38.00 ,$38.00 , N/A ,$22.80 ,$32.30 ,$26.60 ,$3.23 ,$36.10 ,$27.36 ,$27.74 ,$38.00 ,$32.30 , N/A ,$38.00 ,$30.40 ,$27.74 ,$3.23 , N/A ,$17.79 ,$38.00 ,$32.30 , N/A ,$34.96 ,$26.60 ,$19.00 ,$22.80 ,$23.14 ,$19.00 ,$26.26 ,$26.60 , N/A ,$27.36 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,30100115,80346,HC BENZODIAZEPINE GC/MS,301,1 ,$38.00 ,$19.00 ,$3.23 ,$38.00 ,$24.55 ,$3.23 ,$38.00 ,$38.00 , N/A ,$22.80 ,$32.30 ,$26.60 ,$3.23 ,$36.10 ,$27.36 ,$27.74 ,$38.00 ,$32.30 , N/A ,$38.00 ,$30.40 ,$27.74 ,$3.23 , N/A ,$17.79 ,$38.00 ,$32.30 , N/A ,$34.96 ,$26.60 ,$19.00 ,$22.80 ,$23.14 ,$19.00 ,$26.26 ,$26.60 , N/A ,$27.36 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,30100116,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$100.00 ,$50.00 ,$14.57 ,$100.00 ,$64.60 ,$15.06 ,$56.63 ,$48.54 ,$14.57 ,$60.00 ,$85.00 ,$70.00 ,$15.06 ,$95.00 ,$72.00 ,$73.00 ,$24.77 ,$85.00 ,$14.57 ,$24.77 ,$80.00 ,$73.00 ,$15.06 ,$14.57 ,$16.09 ,$100.00 ,$85.00 ,$32.78 ,$92.00 ,$70.00 ,$69.74 ,$74.91 ,$60.90 ,$69.74 ,$69.10 ,$70.00 ,$14.72 ,$72.00 ,$15.96 ,$17.48 ,$17.48 ,$14.57 ,$17.48 ,$14.57 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100117,80157,HC CARBAMAZEPINE FREE,301,1 ,$115.00 ,$57.50 ,$13.25 ,$115.00 ,$74.29 ,$13.69 ,$51.56 ,$44.19 ,$13.25 ,$69.00 ,$97.75 ,$80.50 ,$13.69 ,$109.25 ,$82.80 ,$83.95 ,$22.53 ,$97.75 ,$13.25 ,$22.53 ,$92.00 ,$83.95 ,$13.69 ,$13.25 ,$14.63 ,$115.00 ,$97.75 ,$29.81 ,$105.80 ,$80.50 ,$63.50 ,$68.20 ,$70.04 ,$63.50 ,$79.47 ,$80.50 ,$13.38 ,$82.80 ,$14.51 ,$15.90 ,$15.90 ,$13.25 ,$15.90 ,$13.25 ,$82.80 ,$71.30 ,$82.80 ,$82.80 ,$69.00 ST VINCENT HOSPITAL - ACUTE,30100118,80158,HC CYCLOSPORINE,301,1 ,$90.00 ,$45.00 ,$18.05 ,$90.00 ,$58.14 ,$18.65 ,$70.21 ,$60.18 ,$18.05 ,$54.00 ,$76.50 ,$63.00 ,$18.65 ,$85.50 ,$64.80 ,$65.70 ,$30.69 ,$76.50 ,$18.05 ,$30.69 ,$72.00 ,$65.70 ,$18.65 ,$18.05 ,$19.93 ,$90.00 ,$76.50 ,$40.61 ,$82.80 ,$63.00 ,$86.45 ,$90.00 ,$54.81 ,$86.45 ,$62.19 ,$63.00 ,$18.23 ,$64.80 ,$19.77 ,$21.66 ,$21.66 ,$18.05 ,$21.66 ,$18.05 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100119,80335,HC DESIPRAMINE,301,1 ,$42.00 ,$21.00 ,$3.23 ,$42.00 ,$27.13 ,$3.23 ,$42.00 ,$42.00 , N/A ,$25.20 ,$35.70 ,$29.40 ,$3.23 ,$39.90 ,$30.24 ,$30.66 ,$38.56 ,$35.70 , N/A ,$38.56 ,$33.60 ,$30.66 ,$3.23 , N/A ,$5.52 ,$42.00 ,$35.70 , N/A ,$38.64 ,$29.40 ,$21.00 ,$25.20 ,$25.58 ,$21.00 ,$29.02 ,$29.40 , N/A ,$30.24 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$30.24 ,$26.04 ,$30.24 ,$30.24 ,$25.20 ST VINCENT HOSPITAL - ACUTE,30100120,80162,HC DIGOXIN LEVELS,301,1 ,$132.00 ,$66.00 ,$13.28 ,$132.00 ,$85.27 ,$13.72 ,$51.63 ,$44.25 ,$13.28 ,$79.20 ,$112.20 ,$92.40 ,$13.72 ,$125.40 ,$95.04 ,$96.36 ,$22.58 ,$112.20 ,$13.28 ,$22.58 ,$105.60 ,$96.36 ,$13.72 ,$13.28 ,$14.66 ,$132.00 ,$112.20 ,$29.88 ,$121.44 ,$92.40 ,$63.60 ,$68.31 ,$80.39 ,$63.60 ,$91.21 ,$92.40 ,$13.41 ,$95.04 ,$14.54 ,$15.94 ,$15.94 ,$13.28 ,$15.94 ,$13.28 ,$95.04 ,$81.84 ,$95.04 ,$95.04 ,$79.20 ST VINCENT HOSPITAL - ACUTE,30100121,80164,HC VALPROIC ACID,301,1 ,$90.00 ,$45.00 ,$13.54 ,$90.00 ,$58.14 ,$13.99 ,$52.68 ,$45.15 ,$13.54 ,$54.00 ,$76.50 ,$63.00 ,$13.99 ,$85.50 ,$64.80 ,$65.70 ,$23.02 ,$76.50 ,$13.54 ,$23.02 ,$72.00 ,$65.70 ,$13.99 ,$13.54 ,$14.95 ,$90.00 ,$76.50 ,$30.47 ,$82.80 ,$63.00 ,$64.90 ,$69.71 ,$54.81 ,$64.90 ,$62.19 ,$63.00 ,$13.68 ,$64.80 ,$14.83 ,$16.25 ,$16.25 ,$13.54 ,$16.25 ,$13.54 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100122,80335,HC DOXEPIN,301,1 ,$62.00 ,$31.00 ,$3.23 ,$62.00 ,$40.05 ,$3.23 ,$62.00 ,$62.00 , N/A ,$37.20 ,$52.70 ,$43.40 ,$3.23 ,$58.90 ,$44.64 ,$45.26 ,$38.56 ,$52.70 , N/A ,$38.56 ,$49.60 ,$45.26 ,$3.23 , N/A ,$5.52 ,$62.00 ,$52.70 , N/A ,$57.04 ,$43.40 ,$31.00 ,$37.20 ,$37.76 ,$31.00 ,$42.84 ,$43.40 , N/A ,$44.64 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$44.64 ,$38.44 ,$44.64 ,$44.64 ,$37.20 ST VINCENT HOSPITAL - ACUTE,30100123,80168,HC ZARONTIN,301,1 ,$110.00 ,$55.00 ,$16.34 ,$110.00 ,$71.06 ,$16.88 ,$63.53 ,$54.45 ,$16.34 ,$66.00 ,$93.50 ,$77.00 ,$16.88 ,$104.50 ,$79.20 ,$80.30 ,$27.78 ,$93.50 ,$16.34 ,$27.78 ,$88.00 ,$80.30 ,$16.88 ,$16.34 ,$18.04 ,$110.00 ,$93.50 ,$36.77 ,$101.20 ,$77.00 ,$78.27 ,$84.07 ,$66.99 ,$78.27 ,$76.01 ,$77.00 ,$16.50 ,$79.20 ,$17.89 ,$19.61 ,$19.61 ,$16.34 ,$19.61 ,$16.34 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100124,80170,HC GENTAMICIN,301,1 ,$160.00 ,$80.00 ,$16.38 ,$160.00 ,$103.36 ,$16.93 ,$63.70 ,$54.60 ,$16.38 ,$96.00 ,$136.00 ,$112.00 ,$16.93 ,$152.00 ,$115.20 ,$116.80 ,$27.85 ,$136.00 ,$16.38 ,$27.85 ,$128.00 ,$116.80 ,$16.93 ,$16.38 ,$18.09 ,$160.00 ,$136.00 ,$36.86 ,$147.20 ,$112.00 ,$78.48 ,$84.30 ,$97.44 ,$78.48 ,$110.56 ,$112.00 ,$16.54 ,$115.20 ,$17.95 ,$19.66 ,$19.66 ,$16.38 ,$19.66 ,$16.38 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30100125,80335,HC IMIPRAMINE,301,1 ,$65.00 ,$32.50 ,$3.23 ,$65.00 ,$41.99 ,$3.23 ,$65.00 ,$65.00 , N/A ,$39.00 ,$55.25 ,$45.50 ,$3.23 ,$61.75 ,$46.80 ,$47.45 ,$38.56 ,$55.25 , N/A ,$38.56 ,$52.00 ,$47.45 ,$3.23 , N/A ,$5.52 ,$65.00 ,$55.25 , N/A ,$59.80 ,$45.50 ,$32.50 ,$39.00 ,$39.59 ,$32.50 ,$44.92 ,$45.50 , N/A ,$46.80 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$46.80 ,$40.30 ,$46.80 ,$46.80 ,$39.00 ST VINCENT HOSPITAL - ACUTE,30100126,80176,HC LIDOCAINE,301,1 ,$180.00 ,$90.00 ,$14.69 ,$180.00 ,$116.28 ,$15.18 ,$57.12 ,$48.96 ,$14.69 ,$108.00 ,$153.00 ,$126.00 ,$15.18 ,$171.00 ,$129.60 ,$131.40 ,$24.97 ,$153.00 ,$14.69 ,$24.97 ,$144.00 ,$131.40 ,$15.18 ,$14.69 ,$16.22 ,$180.00 ,$153.00 ,$33.05 ,$165.60 ,$126.00 ,$70.34 ,$75.55 ,$109.62 ,$70.34 ,$124.38 ,$126.00 ,$14.84 ,$129.60 ,$16.09 ,$17.63 ,$17.63 ,$14.69 ,$17.63 ,$14.69 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30100127,80178,HC LITHIUM,301,1 ,$45.00 ,$22.50 ,$6.61 ,$45.00 ,$29.07 ,$6.83 ,$25.73 ,$22.05 ,$6.61 ,$27.00 ,$38.25 ,$31.50 ,$6.83 ,$42.75 ,$32.40 ,$32.85 ,$11.24 ,$38.25 ,$6.61 ,$11.24 ,$36.00 ,$32.85 ,$6.83 ,$6.61 ,$7.30 ,$45.00 ,$38.25 ,$14.87 ,$41.40 ,$31.50 ,$31.66 ,$34.01 ,$27.41 ,$31.66 ,$31.10 ,$31.50 ,$6.68 ,$32.40 ,$7.24 ,$7.93 ,$7.93 ,$6.61 ,$7.93 ,$6.61 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,30100128,80335,HC NORTRIPTYLINE,301,1 ,$85.00 ,$42.50 ,$3.23 ,$85.00 ,$54.91 ,$3.23 ,$80.88 ,$69.32 , N/A ,$51.00 ,$72.25 ,$59.50 ,$3.23 ,$80.75 ,$61.20 ,$62.05 ,$38.56 ,$72.25 , N/A ,$38.56 ,$68.00 ,$62.05 ,$3.23 , N/A ,$5.52 ,$85.00 ,$72.25 , N/A ,$78.20 ,$59.50 ,$42.50 ,$51.00 ,$51.77 ,$42.50 ,$58.74 ,$59.50 , N/A ,$61.20 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$61.20 ,$52.70 ,$61.20 ,$61.20 ,$51.00 ST VINCENT HOSPITAL - ACUTE,30100129,80184,HC PHENOBARBITAL,301,1 ,$90.00 ,$45.00 ,$15.30 ,$90.00 ,$58.14 ,$15.81 ,$53.55 ,$45.90 ,$15.30 ,$54.00 ,$76.50 ,$63.00 ,$15.81 ,$85.50 ,$64.80 ,$65.70 ,$26.01 ,$76.50 ,$15.30 ,$26.01 ,$72.00 ,$65.70 ,$15.81 ,$15.30 ,$16.89 ,$90.00 ,$76.50 ,$34.43 ,$82.80 ,$63.00 ,$54.83 ,$58.89 ,$54.81 ,$54.83 ,$62.19 ,$63.00 ,$15.45 ,$64.80 ,$16.76 ,$18.36 ,$18.36 ,$15.30 ,$18.36 ,$15.30 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100130,80185,HC PHENYTOIN TOTAL,301,1 ,$90.00 ,$45.00 ,$13.25 ,$90.00 ,$58.14 ,$13.69 ,$51.56 ,$44.19 ,$13.25 ,$54.00 ,$76.50 ,$63.00 ,$13.69 ,$85.50 ,$64.80 ,$65.70 ,$22.53 ,$76.50 ,$13.25 ,$22.53 ,$72.00 ,$65.70 ,$13.69 ,$13.25 ,$14.63 ,$90.00 ,$76.50 ,$29.81 ,$82.80 ,$63.00 ,$63.50 ,$68.20 ,$54.81 ,$63.50 ,$62.19 ,$63.00 ,$13.38 ,$64.80 ,$14.51 ,$15.90 ,$15.90 ,$13.25 ,$15.90 ,$13.25 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100131,80186,HC PHENYTOIN FREE,301,1 ,$70.00 ,$35.00 ,$13.76 ,$70.00 ,$45.22 ,$14.22 ,$53.52 ,$45.87 ,$13.76 ,$42.00 ,$59.50 ,$49.00 ,$14.22 ,$66.50 ,$50.40 ,$51.10 ,$23.39 ,$59.50 ,$13.76 ,$23.39 ,$56.00 ,$51.10 ,$14.22 ,$13.76 ,$15.19 ,$70.00 ,$59.50 ,$30.96 ,$64.40 ,$49.00 ,$56.20 ,$60.36 ,$42.63 ,$56.20 ,$48.37 ,$49.00 ,$13.90 ,$50.40 ,$15.07 ,$16.51 ,$16.51 ,$13.76 ,$16.51 ,$13.76 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100132,80188,HC PRIMIDONE,301,1 ,$90.00 ,$45.00 ,$16.59 ,$90.00 ,$58.14 ,$17.14 ,$64.54 ,$55.32 ,$16.59 ,$54.00 ,$76.50 ,$63.00 ,$17.14 ,$85.50 ,$64.80 ,$65.70 ,$28.20 ,$76.50 ,$16.59 ,$28.20 ,$72.00 ,$65.70 ,$17.14 ,$16.59 ,$18.32 ,$90.00 ,$76.50 ,$37.33 ,$82.80 ,$63.00 ,$79.47 ,$85.35 ,$54.81 ,$79.47 ,$62.19 ,$63.00 ,$16.76 ,$64.80 ,$18.17 ,$19.91 ,$19.91 ,$16.59 ,$19.91 ,$16.59 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100133,80192,HC PROCAINEAMIDE,301,1 ,$107.00 ,$53.50 ,$16.75 ,$107.00 ,$69.12 ,$17.31 ,$65.14 ,$55.83 ,$16.75 ,$64.20 ,$90.95 ,$74.90 ,$17.31 ,$101.65 ,$77.04 ,$78.11 ,$28.48 ,$90.95 ,$16.75 ,$28.48 ,$85.60 ,$78.11 ,$17.31 ,$16.75 ,$18.50 ,$107.00 ,$90.95 ,$37.69 ,$98.44 ,$74.90 ,$80.20 ,$86.14 ,$65.16 ,$80.20 ,$73.94 ,$74.90 ,$16.92 ,$77.04 ,$18.35 ,$20.10 ,$20.10 ,$16.75 ,$20.10 ,$16.75 ,$77.04 ,$66.34 ,$77.04 ,$77.04 ,$64.20 ST VINCENT HOSPITAL - ACUTE,30100134,80194,HC QUINIDINE,301,1 ,$102.00 ,$51.00 ,$14.60 ,$102.00 ,$65.89 ,$15.09 ,$56.77 ,$48.66 ,$14.60 ,$61.20 ,$86.70 ,$71.40 ,$15.09 ,$96.90 ,$73.44 ,$74.46 ,$24.82 ,$86.70 ,$14.60 ,$24.82 ,$81.60 ,$74.46 ,$15.09 ,$14.60 ,$16.12 ,$102.00 ,$86.70 ,$32.85 ,$93.84 ,$71.40 ,$69.92 ,$75.10 ,$62.12 ,$69.92 ,$70.48 ,$71.40 ,$14.75 ,$73.44 ,$16.00 ,$17.52 ,$17.52 ,$14.60 ,$17.52 ,$14.60 ,$73.44 ,$63.24 ,$73.44 ,$73.44 ,$61.20 ST VINCENT HOSPITAL - ACUTE,30100135,80195,HC RAPAMYCIN (SIROLIMUS),301,1 ,$80.00 ,$40.00 ,$13.73 ,$80.00 ,$51.68 ,$14.19 ,$53.41 ,$45.78 ,$13.73 ,$48.00 ,$68.00 ,$56.00 ,$14.19 ,$76.00 ,$57.60 ,$58.40 ,$23.34 ,$68.00 ,$13.73 ,$23.34 ,$64.00 ,$58.40 ,$14.19 ,$13.73 ,$15.16 ,$80.00 ,$68.00 ,$30.89 ,$73.60 ,$56.00 ,$65.74 ,$70.61 ,$48.72 ,$65.74 ,$55.28 ,$56.00 ,$13.87 ,$57.60 ,$15.04 ,$16.48 ,$16.48 ,$13.73 ,$16.48 ,$13.73 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100136,G0480,HC SALICYLATE,301,1 ,$180.00 ,$90.00 ,$63.95 ,$257.47 ,$116.28 ,$63.95 ,$180.00 ,$180.00 ,$114.43 ,$108.00 ,$153.00 ,$126.00 ,$63.95 ,$171.00 ,$129.60 ,$131.40 ,$180.00 ,$153.00 ,$114.43 ,$180.00 ,$144.00 ,$131.40 ,$63.95 ,$114.43 ,$126.35 ,$180.00 ,$153.00 ,$257.47 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$115.57 ,$129.60 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30100137,80197,HC TACROLIMUS,301,1 ,$90.00 ,$45.00 ,$13.73 ,$90.00 ,$58.14 ,$14.19 ,$53.41 ,$45.78 ,$13.73 ,$54.00 ,$76.50 ,$63.00 ,$14.19 ,$85.50 ,$64.80 ,$65.70 ,$23.34 ,$76.50 ,$13.73 ,$23.34 ,$72.00 ,$65.70 ,$14.19 ,$13.73 ,$15.16 ,$90.00 ,$76.50 ,$30.89 ,$82.80 ,$63.00 ,$65.74 ,$70.61 ,$54.81 ,$65.74 ,$62.19 ,$63.00 ,$13.87 ,$64.80 ,$15.04 ,$16.48 ,$16.48 ,$13.73 ,$16.48 ,$13.73 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100138,80198,HC THEOPHYLLINE,301,1 ,$80.00 ,$40.00 ,$14.14 ,$80.00 ,$51.68 ,$14.61 ,$54.99 ,$47.13 ,$14.14 ,$48.00 ,$68.00 ,$56.00 ,$14.61 ,$76.00 ,$57.60 ,$58.40 ,$24.04 ,$68.00 ,$14.14 ,$24.04 ,$64.00 ,$58.40 ,$14.61 ,$14.14 ,$15.61 ,$80.00 ,$68.00 ,$31.82 ,$73.60 ,$56.00 ,$67.74 ,$72.76 ,$48.72 ,$67.74 ,$55.28 ,$56.00 ,$14.28 ,$57.60 ,$15.49 ,$16.97 ,$16.97 ,$14.14 ,$16.97 ,$14.14 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100139,80200,HC TOBRAMYCIN,301,1 ,$90.00 ,$45.00 ,$16.13 ,$90.00 ,$58.14 ,$16.67 ,$62.72 ,$53.76 ,$16.13 ,$54.00 ,$76.50 ,$63.00 ,$16.67 ,$85.50 ,$64.80 ,$65.70 ,$27.42 ,$76.50 ,$16.13 ,$27.42 ,$72.00 ,$65.70 ,$16.67 ,$16.13 ,$17.81 ,$90.00 ,$76.50 ,$36.29 ,$82.80 ,$63.00 ,$77.18 ,$82.90 ,$54.81 ,$77.18 ,$62.19 ,$63.00 ,$16.29 ,$64.80 ,$17.67 ,$19.36 ,$19.36 ,$16.13 ,$19.36 ,$16.13 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100140,80201,HC TOPIRAMATE,301,1 ,$90.00 ,$45.00 ,$11.92 ,$90.00 ,$58.14 ,$12.32 ,$46.34 ,$39.72 ,$11.92 ,$54.00 ,$76.50 ,$63.00 ,$12.32 ,$85.50 ,$64.80 ,$65.70 ,$20.26 ,$76.50 ,$11.92 ,$20.26 ,$72.00 ,$65.70 ,$12.32 ,$11.92 ,$13.16 ,$90.00 ,$76.50 ,$26.82 ,$82.80 ,$63.00 ,$57.11 ,$61.34 ,$54.81 ,$57.11 ,$62.19 ,$63.00 ,$12.04 ,$64.80 ,$13.06 ,$14.30 ,$14.30 ,$11.92 ,$14.30 ,$11.92 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100141,80202,HC VANCOMYCIN,301,1 ,$110.00 ,$55.00 ,$13.54 ,$110.00 ,$71.06 ,$13.99 ,$52.68 ,$45.15 ,$13.54 ,$66.00 ,$93.50 ,$77.00 ,$13.99 ,$104.50 ,$79.20 ,$80.30 ,$23.02 ,$93.50 ,$13.54 ,$23.02 ,$88.00 ,$80.30 ,$13.99 ,$13.54 ,$14.95 ,$110.00 ,$93.50 ,$30.47 ,$101.20 ,$77.00 ,$64.90 ,$69.71 ,$66.99 ,$64.90 ,$76.01 ,$77.00 ,$13.68 ,$79.20 ,$14.83 ,$16.25 ,$16.25 ,$13.54 ,$16.25 ,$13.54 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100142,80299,HC WARFARIN,301,1 ,$145.00 ,$72.50 ,$18.64 ,$145.00 ,$93.67 ,$19.26 ,$65.24 ,$55.92 ,$18.64 ,$87.00 ,$123.25 ,$101.50 ,$19.26 ,$137.75 ,$104.40 ,$105.85 ,$31.69 ,$123.25 ,$18.64 ,$31.69 ,$116.00 ,$105.85 ,$19.26 ,$18.64 ,$20.58 ,$145.00 ,$123.25 ,$41.94 ,$133.40 ,$101.50 ,$65.57 ,$70.42 ,$88.31 ,$65.57 ,$100.20 ,$101.50 ,$18.83 ,$104.40 ,$20.42 ,$22.37 ,$22.37 ,$18.64 ,$22.37 ,$18.64 ,$104.40 ,$89.90 ,$104.40 ,$104.40 ,$87.00 ST VINCENT HOSPITAL - ACUTE,30100143,80299,HC FELBAMATE,301,1 ,$150.00 ,$75.00 ,$18.64 ,$150.00 ,$96.90 ,$19.26 ,$65.24 ,$55.92 ,$18.64 ,$90.00 ,$127.50 ,$105.00 ,$19.26 ,$142.50 ,$108.00 ,$109.50 ,$31.69 ,$127.50 ,$18.64 ,$31.69 ,$120.00 ,$109.50 ,$19.26 ,$18.64 ,$20.58 ,$150.00 ,$127.50 ,$41.94 ,$138.00 ,$105.00 ,$65.57 ,$70.42 ,$91.35 ,$65.57 ,$103.65 ,$105.00 ,$18.83 ,$108.00 ,$20.42 ,$22.37 ,$22.37 ,$18.64 ,$22.37 ,$18.64 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100144,80299,HC IBUPROFEN,301,1 ,$114.00 ,$57.00 ,$18.64 ,$114.00 ,$73.64 ,$19.26 ,$65.24 ,$55.92 ,$18.64 ,$68.40 ,$96.90 ,$79.80 ,$19.26 ,$108.30 ,$82.08 ,$83.22 ,$31.69 ,$96.90 ,$18.64 ,$31.69 ,$91.20 ,$83.22 ,$19.26 ,$18.64 ,$20.58 ,$114.00 ,$96.90 ,$41.94 ,$104.88 ,$79.80 ,$65.57 ,$70.42 ,$69.43 ,$65.57 ,$78.77 ,$79.80 ,$18.83 ,$82.08 ,$20.42 ,$22.37 ,$22.37 ,$18.64 ,$22.37 ,$18.64 ,$82.08 ,$70.68 ,$82.08 ,$82.08 ,$68.40 ST VINCENT HOSPITAL - ACUTE,30100145,80187,HC FLECAINAIDE,301,1 ,$50.00 ,$25.00 ,$21.69 ,$61.00 ,$32.30 ,$21.69 ,$50.00 ,$50.00 ,$27.11 ,$30.00 ,$42.50 ,$35.00 ,$21.69 ,$47.50 ,$36.00 ,$36.50 ,$46.09 ,$42.50 ,$27.11 ,$46.09 ,$40.00 ,$36.50 ,$21.69 ,$27.11 ,$29.93 ,$50.00 ,$42.50 ,$61.00 ,$46.00 ,$35.00 ,$25.00 ,$30.00 ,$30.45 ,$25.00 ,$34.55 ,$35.00 ,$27.38 ,$36.00 ,$22.99 ,$32.53 ,$32.53 ,$27.11 ,$32.53 ,$27.11 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30100146,80171,HC GABAPENTIN PLASMA,301,1 ,$110.00 ,$55.00 ,$14.48 ,$110.00 ,$71.06 ,$14.48 ,$75.85 ,$65.01 ,$21.67 ,$66.00 ,$93.50 ,$77.00 ,$14.48 ,$104.50 ,$79.20 ,$80.30 ,$36.84 ,$93.50 ,$21.67 ,$36.84 ,$88.00 ,$80.30 ,$14.48 ,$21.67 ,$23.93 ,$110.00 ,$93.50 ,$48.76 ,$101.20 ,$77.00 ,$63.50 ,$68.20 ,$66.99 ,$63.50 ,$76.01 ,$77.00 ,$21.89 ,$79.20 ,$15.35 ,$26.00 ,$26.00 ,$21.67 ,$26.00 ,$21.67 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100147,80175,HC LAMOTRIGINE,301,1 ,$90.00 ,$45.00 ,$13.25 ,$90.00 ,$58.14 ,$13.69 ,$51.56 ,$44.19 ,$13.25 ,$54.00 ,$76.50 ,$63.00 ,$13.69 ,$85.50 ,$64.80 ,$65.70 ,$22.53 ,$76.50 ,$13.25 ,$22.53 ,$72.00 ,$65.70 ,$13.69 ,$13.25 ,$14.63 ,$90.00 ,$76.50 ,$29.81 ,$82.80 ,$63.00 ,$63.50 ,$68.20 ,$54.81 ,$63.50 ,$62.19 ,$63.00 ,$13.38 ,$64.80 ,$14.51 ,$15.90 ,$15.90 ,$13.25 ,$15.90 ,$13.25 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100148,80183,HC TRILEPTAL,301,1 ,$114.00 ,$57.00 ,$13.25 ,$114.00 ,$73.64 ,$13.69 ,$51.56 ,$44.19 ,$13.25 ,$68.40 ,$96.90 ,$79.80 ,$13.69 ,$108.30 ,$82.08 ,$83.22 ,$22.53 ,$96.90 ,$13.25 ,$22.53 ,$91.20 ,$83.22 ,$13.69 ,$13.25 ,$14.63 ,$114.00 ,$96.90 ,$29.81 ,$104.88 ,$79.80 ,$63.50 ,$68.20 ,$69.43 ,$63.50 ,$78.77 ,$79.80 ,$13.38 ,$82.08 ,$14.51 ,$15.90 ,$15.90 ,$13.25 ,$15.90 ,$13.25 ,$82.08 ,$70.68 ,$82.08 ,$82.08 ,$68.40 ST VINCENT HOSPITAL - ACUTE,30100149,80177,HC KEPPRA,301,1 ,$110.00 ,$55.00 ,$13.25 ,$110.00 ,$71.06 ,$13.69 ,$51.56 ,$44.19 ,$13.25 ,$66.00 ,$93.50 ,$77.00 ,$13.69 ,$104.50 ,$79.20 ,$80.30 ,$22.53 ,$93.50 ,$13.25 ,$22.53 ,$88.00 ,$80.30 ,$13.69 ,$13.25 ,$14.63 ,$110.00 ,$93.50 ,$29.81 ,$101.20 ,$77.00 ,$63.50 ,$68.20 ,$66.99 ,$63.50 ,$76.01 ,$77.00 ,$13.38 ,$79.20 ,$14.51 ,$15.90 ,$15.90 ,$13.25 ,$15.90 ,$13.25 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100150,80203,HC ZONISAMIDE,301,1 ,$100.00 ,$50.00 ,$13.25 ,$100.00 ,$64.60 ,$13.69 ,$51.56 ,$44.19 ,$13.25 ,$60.00 ,$85.00 ,$70.00 ,$13.69 ,$95.00 ,$72.00 ,$73.00 ,$22.53 ,$85.00 ,$13.25 ,$22.53 ,$80.00 ,$73.00 ,$13.69 ,$13.25 ,$14.63 ,$100.00 ,$85.00 ,$29.81 ,$92.00 ,$70.00 ,$63.50 ,$68.20 ,$60.90 ,$63.50 ,$69.10 ,$70.00 ,$13.38 ,$72.00 ,$14.51 ,$15.90 ,$15.90 ,$13.25 ,$15.90 ,$13.25 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100151,80199,HC TIAGABINE,301,1 ,$120.00 ,$60.00 ,$19.70 ,$120.00 ,$77.52 ,$19.70 ,$94.89 ,$81.33 ,$27.11 ,$72.00 ,$102.00 ,$84.00 ,$19.70 ,$114.00 ,$86.40 ,$87.60 ,$46.09 ,$102.00 ,$27.11 ,$46.09 ,$96.00 ,$87.60 ,$19.70 ,$27.11 ,$29.93 ,$120.00 ,$102.00 ,$61.00 ,$110.40 ,$84.00 ,$86.45 ,$92.86 ,$73.08 ,$86.45 ,$82.92 ,$84.00 ,$27.38 ,$86.40 ,$20.88 ,$32.53 ,$32.53 ,$27.11 ,$32.53 ,$27.11 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100152,80299,HC TRAZODONE,301,1 ,$150.00 ,$75.00 ,$18.64 ,$150.00 ,$96.90 ,$19.26 ,$65.24 ,$55.92 ,$18.64 ,$90.00 ,$127.50 ,$105.00 ,$19.26 ,$142.50 ,$108.00 ,$109.50 ,$31.69 ,$127.50 ,$18.64 ,$31.69 ,$120.00 ,$109.50 ,$19.26 ,$18.64 ,$20.58 ,$150.00 ,$127.50 ,$41.94 ,$138.00 ,$105.00 ,$65.57 ,$70.42 ,$91.35 ,$65.57 ,$103.65 ,$105.00 ,$18.83 ,$108.00 ,$20.42 ,$22.37 ,$22.37 ,$18.64 ,$22.37 ,$18.64 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100153,80299,HC RITALIN,301,1 ,$84.00 ,$42.00 ,$18.64 ,$84.00 ,$54.26 ,$19.26 ,$65.24 ,$55.92 ,$18.64 ,$50.40 ,$71.40 ,$58.80 ,$19.26 ,$79.80 ,$60.48 ,$61.32 ,$31.69 ,$71.40 ,$18.64 ,$31.69 ,$67.20 ,$61.32 ,$19.26 ,$18.64 ,$20.58 ,$84.00 ,$71.40 ,$41.94 ,$77.28 ,$58.80 ,$65.57 ,$70.42 ,$51.16 ,$65.57 ,$58.04 ,$58.80 ,$18.83 ,$60.48 ,$20.42 ,$22.37 ,$22.37 ,$18.64 ,$22.37 ,$18.64 ,$60.48 ,$52.08 ,$60.48 ,$60.48 ,$50.40 ST VINCENT HOSPITAL - ACUTE,30100154,80299,HC AMIODARONE,301,1 ,$150.00 ,$75.00 ,$18.64 ,$150.00 ,$96.90 ,$19.26 ,$65.24 ,$55.92 ,$18.64 ,$90.00 ,$127.50 ,$105.00 ,$19.26 ,$142.50 ,$108.00 ,$109.50 ,$31.69 ,$127.50 ,$18.64 ,$31.69 ,$120.00 ,$109.50 ,$19.26 ,$18.64 ,$20.58 ,$150.00 ,$127.50 ,$41.94 ,$138.00 ,$105.00 ,$65.57 ,$70.42 ,$91.35 ,$65.57 ,$103.65 ,$105.00 ,$18.83 ,$108.00 ,$20.42 ,$22.37 ,$22.37 ,$18.64 ,$22.37 ,$18.64 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100155,81099,HC INBORN ERR METABOLISM,301,1 ,$590.00 ,$295.00 ,$0.96 ,$590.00 ,$381.14 ,$0.96 ,$381.67 ,$381.67 , N/A ,$354.00 ,$501.50 ,$413.00 ,$0.96 ,$560.50 ,$424.80 ,$430.70 , N/A ,$501.50 , N/A , N/A ,$472.00 ,$430.70 ,$0.96 , N/A ,$247.80 ,$590.00 ,$501.50 ,$354.00 ,$542.80 ,$413.00 ,$295.00 ,$354.00 ,$359.31 ,$295.00 ,$407.69 ,$413.00 , N/A ,$424.80 ,$1.02 ,$295.00 ,$295.00 , N/A ,$295.00 , N/A ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,30100156,G0480,HC ACETAMINOPHEN,301,1 ,$200.00 ,$100.00 ,$63.95 ,$257.47 ,$129.20 ,$63.95 ,$200.00 ,$200.00 ,$114.43 ,$120.00 ,$170.00 ,$140.00 ,$63.95 ,$190.00 ,$144.00 ,$146.00 ,$194.53 ,$170.00 ,$114.43 ,$194.53 ,$160.00 ,$146.00 ,$63.95 ,$114.43 ,$126.35 ,$200.00 ,$170.00 ,$257.47 ,$184.00 ,$140.00 ,$200.00 ,$200.00 ,$121.80 ,$200.00 ,$138.20 ,$140.00 ,$115.57 ,$144.00 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30100157,82009,HC ACETONE SERUM,301,1 ,$43.00 ,$21.50 ,$4.52 ,$43.00 ,$27.78 ,$4.67 ,$17.57 ,$15.06 ,$4.52 ,$25.80 ,$36.55 ,$30.10 ,$4.67 ,$40.85 ,$30.96 ,$31.39 ,$7.68 ,$36.55 ,$4.52 ,$7.68 ,$34.40 ,$31.39 ,$4.67 ,$4.52 ,$4.99 ,$43.00 ,$36.55 ,$10.17 ,$39.56 ,$30.10 ,$21.62 ,$23.22 ,$26.19 ,$21.62 ,$29.71 ,$30.10 ,$4.57 ,$30.96 ,$4.95 ,$5.42 ,$5.42 ,$4.52 ,$5.42 ,$4.52 ,$30.96 ,$26.66 ,$30.96 ,$30.96 ,$25.80 ST VINCENT HOSPITAL - ACUTE,30100158,82010,HC ACETONE KETONES SERUM QN,301,1 ,$49.00 ,$24.50 ,$8.17 ,$49.00 ,$31.65 ,$8.44 ,$31.78 ,$27.24 ,$8.17 ,$29.40 ,$41.65 ,$34.30 ,$8.44 ,$46.55 ,$35.28 ,$35.77 ,$13.89 ,$41.65 ,$8.17 ,$13.89 ,$39.20 ,$35.77 ,$8.44 ,$8.17 ,$9.02 ,$49.00 ,$41.65 ,$18.38 ,$45.08 ,$34.30 ,$39.14 ,$42.04 ,$29.84 ,$39.14 ,$33.86 ,$34.30 ,$8.25 ,$35.28 ,$8.95 ,$9.80 ,$9.80 ,$8.17 ,$9.80 ,$8.17 ,$35.28 ,$30.38 ,$35.28 ,$35.28 ,$29.40 ST VINCENT HOSPITAL - ACUTE,30100159,82017,HC ACYLCARNITINES QN EA SPEC,301,1 ,$430.00 ,$215.00 ,$16.87 ,$430.00 ,$277.78 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$258.00 ,$365.50 ,$301.00 ,$17.43 ,$408.50 ,$309.60 ,$313.90 ,$28.68 ,$365.50 ,$16.87 ,$28.68 ,$344.00 ,$313.90 ,$17.43 ,$16.87 ,$18.63 ,$430.00 ,$365.50 ,$37.96 ,$395.60 ,$301.00 ,$69.01 ,$74.12 ,$261.87 ,$69.01 ,$297.13 ,$301.00 ,$17.04 ,$309.60 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,30100160,82017,HC FATTY ACID OXIDATION SCREEN,301,1 ,$15.00 ,$7.50 ,$7.50 ,$33.75 ,$9.69 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$9.00 ,$12.75 ,$10.50 ,$15.00 ,$14.25 ,$10.80 ,$10.95 ,$15.00 ,$12.75 ,$15.00 ,$15.00 ,$12.00 ,$10.95 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$12.75 ,$33.75 ,$13.80 ,$10.50 ,$15.00 ,$15.00 ,$9.14 ,$15.00 ,$10.37 ,$10.50 ,$15.15 ,$10.80 ,$15.90 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,30100161,82017,HC ORGANIC ACIDEMIA SCREEN,301,1 ,$15.00 ,$7.50 ,$7.50 ,$33.75 ,$9.69 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$9.00 ,$12.75 ,$10.50 ,$15.00 ,$14.25 ,$10.80 ,$10.95 ,$15.00 ,$12.75 ,$15.00 ,$15.00 ,$12.00 ,$10.95 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$12.75 ,$33.75 ,$13.80 ,$10.50 ,$15.00 ,$15.00 ,$9.14 ,$15.00 ,$10.37 ,$10.50 ,$15.15 ,$10.80 ,$15.90 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,30100162,82017,HC ACYLCARNITINES QN PLASMA MAYO,301,1 ,$387.00 ,$193.50 ,$16.87 ,$387.00 ,$250.00 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$232.20 ,$328.95 ,$270.90 ,$17.43 ,$367.65 ,$278.64 ,$282.51 ,$28.68 ,$328.95 ,$16.87 ,$28.68 ,$309.60 ,$282.51 ,$17.43 ,$16.87 ,$18.63 ,$387.00 ,$328.95 ,$37.96 ,$356.04 ,$270.90 ,$69.01 ,$74.12 ,$235.68 ,$69.01 ,$267.42 ,$270.90 ,$17.04 ,$278.64 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$278.64 ,$239.94 ,$278.64 ,$278.64 ,$232.20 ST VINCENT HOSPITAL - ACUTE,30100163,82024,HC ACTH,301,1 ,$260.00 ,$130.00 ,$38.62 ,$260.00 ,$167.96 ,$39.91 ,$150.19 ,$128.73 ,$38.62 ,$156.00 ,$221.00 ,$182.00 ,$39.91 ,$247.00 ,$187.20 ,$189.80 ,$65.65 ,$221.00 ,$38.62 ,$65.65 ,$208.00 ,$189.80 ,$39.91 ,$38.62 ,$42.64 ,$260.00 ,$221.00 ,$86.90 ,$239.20 ,$182.00 ,$184.98 ,$198.68 ,$158.34 ,$184.98 ,$179.66 ,$182.00 ,$39.01 ,$187.20 ,$42.30 ,$46.34 ,$46.34 ,$38.62 ,$46.34 ,$38.62 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30100164,82040,HC ALBUMIN,301,1 ,$34.00 ,$17.00 ,$4.95 ,$34.00 ,$21.96 ,$5.11 ,$19.25 ,$16.50 ,$4.95 ,$20.40 ,$28.90 ,$23.80 ,$5.11 ,$32.30 ,$24.48 ,$24.82 ,$8.42 ,$28.90 ,$4.95 ,$8.42 ,$27.20 ,$24.82 ,$5.11 ,$4.95 ,$5.47 ,$34.00 ,$28.90 ,$11.14 ,$31.28 ,$23.80 ,$23.69 ,$25.45 ,$20.71 ,$23.69 ,$23.49 ,$23.80 ,$5.00 ,$24.48 ,$5.42 ,$5.94 ,$5.94 ,$4.95 ,$5.94 ,$4.95 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30100165,82040,HC ALBUMIN SERUM,301,1 ,$34.00 ,$17.00 ,$4.95 ,$34.00 ,$21.96 ,$5.11 ,$19.25 ,$16.50 ,$4.95 ,$20.40 ,$28.90 ,$23.80 ,$5.11 ,$32.30 ,$24.48 ,$24.82 ,$8.42 ,$28.90 ,$4.95 ,$8.42 ,$27.20 ,$24.82 ,$5.11 ,$4.95 ,$5.47 ,$34.00 ,$28.90 ,$11.14 ,$31.28 ,$23.80 ,$23.69 ,$25.45 ,$20.71 ,$23.69 ,$23.49 ,$23.80 ,$5.00 ,$24.48 ,$5.42 ,$5.94 ,$5.94 ,$4.95 ,$5.94 ,$4.95 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30100166,82042,HC ALBUMIN BODY FLUID,301,1 ,$60.00 ,$30.00 ,$7.27 ,$60.00 ,$38.76 ,$7.27 ,$27.23 ,$23.34 ,$7.78 ,$36.00 ,$51.00 ,$42.00 ,$7.27 ,$57.00 ,$43.20 ,$43.80 ,$13.23 ,$51.00 ,$7.78 ,$13.23 ,$48.00 ,$43.80 ,$7.27 ,$7.78 ,$8.59 ,$60.00 ,$51.00 ,$17.51 ,$55.20 ,$42.00 ,$24.78 ,$26.62 ,$36.54 ,$24.78 ,$41.46 ,$42.00 ,$7.86 ,$43.20 ,$7.71 ,$9.34 ,$9.34 ,$7.78 ,$9.34 ,$7.78 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100167,82042,HC ALBUMIN CSF,301,1 ,$60.00 ,$30.00 ,$7.27 ,$60.00 ,$38.76 ,$7.27 ,$27.23 ,$23.34 ,$7.78 ,$36.00 ,$51.00 ,$42.00 ,$7.27 ,$57.00 ,$43.20 ,$43.80 ,$13.23 ,$51.00 ,$7.78 ,$13.23 ,$48.00 ,$43.80 ,$7.27 ,$7.78 ,$8.59 ,$60.00 ,$51.00 ,$17.51 ,$55.20 ,$42.00 ,$24.78 ,$26.62 ,$36.54 ,$24.78 ,$41.46 ,$42.00 ,$7.86 ,$43.20 ,$7.71 ,$9.34 ,$9.34 ,$7.78 ,$9.34 ,$7.78 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100168,82043,HC MICROALBUMIN URINE QN,301,1 ,$48.00 ,$24.00 ,$5.78 ,$48.00 ,$31.01 ,$5.97 ,$22.47 ,$19.26 ,$5.78 ,$28.80 ,$40.80 ,$33.60 ,$5.97 ,$45.60 ,$34.56 ,$35.04 ,$9.83 ,$40.80 ,$5.78 ,$9.83 ,$38.40 ,$35.04 ,$5.97 ,$5.78 ,$6.38 ,$48.00 ,$40.80 ,$13.01 ,$44.16 ,$33.60 ,$27.69 ,$29.75 ,$29.23 ,$27.69 ,$33.17 ,$33.60 ,$5.84 ,$34.56 ,$6.33 ,$6.94 ,$6.94 ,$5.78 ,$6.94 ,$5.78 ,$34.56 ,$29.76 ,$34.56 ,$34.56 ,$28.80 ST VINCENT HOSPITAL - ACUTE,30100169,G0480,HC ALCOHOL (ETOH),301,1 ,$180.00 ,$90.00 ,$63.95 ,$257.47 ,$116.28 ,$63.95 ,$180.00 ,$180.00 ,$114.43 ,$108.00 ,$153.00 ,$126.00 ,$63.95 ,$171.00 ,$129.60 ,$131.40 ,$180.00 ,$153.00 ,$114.43 ,$180.00 ,$144.00 ,$131.40 ,$63.95 ,$114.43 ,$126.35 ,$180.00 ,$153.00 ,$257.47 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$115.57 ,$129.60 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30100170,82085,HC ALDOLASE,301,1 ,$60.00 ,$30.00 ,$9.71 ,$60.00 ,$38.76 ,$10.03 ,$37.77 ,$32.37 ,$9.71 ,$36.00 ,$51.00 ,$42.00 ,$10.03 ,$57.00 ,$43.20 ,$43.80 ,$16.51 ,$51.00 ,$9.71 ,$16.51 ,$48.00 ,$43.80 ,$10.03 ,$9.71 ,$10.72 ,$60.00 ,$51.00 ,$21.85 ,$55.20 ,$42.00 ,$46.47 ,$49.91 ,$36.54 ,$46.47 ,$41.46 ,$42.00 ,$9.81 ,$43.20 ,$10.63 ,$11.65 ,$11.65 ,$9.71 ,$11.65 ,$9.71 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100171,82088,HC ALDOSTERONE,301,1 ,$280.00 ,$140.00 ,$40.75 ,$280.00 ,$180.88 ,$42.11 ,$158.48 ,$135.84 ,$40.75 ,$168.00 ,$238.00 ,$196.00 ,$42.11 ,$266.00 ,$201.60 ,$204.40 ,$69.28 ,$238.00 ,$40.75 ,$69.28 ,$224.00 ,$204.40 ,$42.11 ,$40.75 ,$45.00 ,$280.00 ,$238.00 ,$91.69 ,$257.60 ,$196.00 ,$195.16 ,$209.61 ,$170.52 ,$195.16 ,$193.48 ,$196.00 ,$41.16 ,$201.60 ,$44.64 ,$48.90 ,$48.90 ,$40.75 ,$48.90 ,$40.75 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,30100172,82103,HC ALPHA-1 ANTITRYPSIN TOTAL,301,1 ,$92.00 ,$46.00 ,$13.44 ,$92.00 ,$59.43 ,$13.89 ,$52.26 ,$44.79 ,$13.44 ,$55.20 ,$78.20 ,$64.40 ,$13.89 ,$87.40 ,$66.24 ,$67.16 ,$22.85 ,$78.20 ,$13.44 ,$22.85 ,$73.60 ,$67.16 ,$13.89 ,$13.44 ,$14.84 ,$92.00 ,$78.20 ,$30.24 ,$84.64 ,$64.40 ,$64.34 ,$69.10 ,$56.03 ,$64.34 ,$63.57 ,$64.40 ,$13.57 ,$66.24 ,$14.72 ,$16.13 ,$16.13 ,$13.44 ,$16.13 ,$13.44 ,$66.24 ,$57.04 ,$66.24 ,$66.24 ,$55.20 ST VINCENT HOSPITAL - ACUTE,30100173,82103,HC A-1 ANTITRYPSIN TOTAL,301,1 ,$90.00 ,$45.00 ,$13.44 ,$90.00 ,$58.14 ,$13.89 ,$52.26 ,$44.79 ,$13.44 ,$54.00 ,$76.50 ,$63.00 ,$13.89 ,$85.50 ,$64.80 ,$65.70 ,$22.85 ,$76.50 ,$13.44 ,$22.85 ,$72.00 ,$65.70 ,$13.89 ,$13.44 ,$14.84 ,$90.00 ,$76.50 ,$30.24 ,$82.80 ,$63.00 ,$64.34 ,$69.10 ,$54.81 ,$64.34 ,$62.19 ,$63.00 ,$13.57 ,$64.80 ,$14.72 ,$16.13 ,$16.13 ,$13.44 ,$16.13 ,$13.44 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100174,82104,HC ANTITRYPSIN PHENO,301,1 ,$132.00 ,$66.00 ,$14.46 ,$132.00 ,$85.27 ,$14.94 ,$56.25 ,$48.21 ,$14.46 ,$79.20 ,$112.20 ,$92.40 ,$14.94 ,$125.40 ,$95.04 ,$96.36 ,$24.58 ,$112.20 ,$14.46 ,$24.58 ,$105.60 ,$96.36 ,$14.94 ,$14.46 ,$15.97 ,$132.00 ,$112.20 ,$32.54 ,$121.44 ,$92.40 ,$69.25 ,$74.38 ,$80.39 ,$69.25 ,$91.21 ,$92.40 ,$14.60 ,$95.04 ,$15.84 ,$17.35 ,$17.35 ,$14.46 ,$17.35 ,$14.46 ,$95.04 ,$81.84 ,$95.04 ,$95.04 ,$79.20 ST VINCENT HOSPITAL - ACUTE,30100175,82105,HC ALPHA FETOPROTEIN SERUM,301,1 ,$110.00 ,$55.00 ,$16.77 ,$110.00 ,$71.06 ,$17.33 ,$65.24 ,$55.92 ,$16.77 ,$66.00 ,$93.50 ,$77.00 ,$17.33 ,$104.50 ,$79.20 ,$80.30 ,$28.51 ,$93.50 ,$16.77 ,$28.51 ,$88.00 ,$80.30 ,$17.33 ,$16.77 ,$18.52 ,$110.00 ,$93.50 ,$37.73 ,$101.20 ,$77.00 ,$80.34 ,$86.30 ,$66.99 ,$80.34 ,$76.01 ,$77.00 ,$16.94 ,$79.20 ,$18.37 ,$20.12 ,$20.12 ,$16.77 ,$20.12 ,$16.77 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100177,82105,HC QUAD AFP,301,1 ,$121.00 ,$60.50 ,$16.77 ,$121.00 ,$78.17 ,$17.33 ,$65.24 ,$55.92 ,$16.77 ,$72.60 ,$102.85 ,$84.70 ,$17.33 ,$114.95 ,$87.12 ,$88.33 ,$28.51 ,$102.85 ,$16.77 ,$28.51 ,$96.80 ,$88.33 ,$17.33 ,$16.77 ,$18.52 ,$121.00 ,$102.85 ,$37.73 ,$111.32 ,$84.70 ,$80.34 ,$86.30 ,$73.69 ,$80.34 ,$83.61 ,$84.70 ,$16.94 ,$87.12 ,$18.37 ,$20.12 ,$20.12 ,$16.77 ,$20.12 ,$16.77 ,$87.12 ,$75.02 ,$87.12 ,$87.12 ,$72.60 ST VINCENT HOSPITAL - ACUTE,30100178,82105,HC AFP MATERNAL,301,1 ,$110.00 ,$55.00 ,$16.77 ,$110.00 ,$71.06 ,$17.33 ,$65.24 ,$55.92 ,$16.77 ,$66.00 ,$93.50 ,$77.00 ,$17.33 ,$104.50 ,$79.20 ,$80.30 ,$28.51 ,$93.50 ,$16.77 ,$28.51 ,$88.00 ,$80.30 ,$17.33 ,$16.77 ,$18.52 ,$110.00 ,$93.50 ,$37.73 ,$101.20 ,$77.00 ,$80.34 ,$86.30 ,$66.99 ,$80.34 ,$76.01 ,$77.00 ,$16.94 ,$79.20 ,$18.37 ,$20.12 ,$20.12 ,$16.77 ,$20.12 ,$16.77 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100179,82108,HC ALUMINUM,301,1 ,$140.00 ,$70.00 ,$25.48 ,$140.00 ,$90.44 ,$26.33 ,$99.09 ,$84.93 ,$25.48 ,$84.00 ,$119.00 ,$98.00 ,$26.33 ,$133.00 ,$100.80 ,$102.20 ,$43.32 ,$119.00 ,$25.48 ,$43.32 ,$112.00 ,$102.20 ,$26.33 ,$25.48 ,$28.14 ,$140.00 ,$119.00 ,$57.33 ,$128.80 ,$98.00 ,$122.01 ,$131.05 ,$85.26 ,$122.01 ,$96.74 ,$98.00 ,$25.73 ,$100.80 ,$27.91 ,$30.58 ,$30.58 ,$25.48 ,$30.58 ,$25.48 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30100180,82131,HC AMINO ACID QN SINGLE,301,1 ,$152.00 ,$76.00 ,$21.01 ,$152.00 ,$98.19 ,$21.01 ,$80.43 ,$68.94 ,$22.98 ,$91.20 ,$129.20 ,$106.40 ,$21.01 ,$144.40 ,$109.44 ,$110.96 ,$39.07 ,$129.20 ,$22.98 ,$39.07 ,$121.60 ,$110.96 ,$21.01 ,$22.98 ,$25.37 ,$152.00 ,$129.20 ,$51.71 ,$139.84 ,$106.40 ,$80.77 ,$86.75 ,$92.57 ,$80.77 ,$105.03 ,$106.40 ,$23.21 ,$109.44 ,$22.27 ,$27.58 ,$27.58 ,$22.98 ,$27.58 ,$22.98 ,$109.44 ,$94.24 ,$109.44 ,$109.44 ,$91.20 ST VINCENT HOSPITAL - ACUTE,30100181,82131,HC CYSTINE,301,1 ,$152.00 ,$76.00 ,$21.01 ,$152.00 ,$98.19 ,$21.01 ,$80.43 ,$68.94 ,$22.98 ,$91.20 ,$129.20 ,$106.40 ,$21.01 ,$144.40 ,$109.44 ,$110.96 ,$39.07 ,$129.20 ,$22.98 ,$39.07 ,$121.60 ,$110.96 ,$21.01 ,$22.98 ,$25.37 ,$152.00 ,$129.20 ,$51.71 ,$139.84 ,$106.40 ,$80.77 ,$86.75 ,$92.57 ,$80.77 ,$105.03 ,$106.40 ,$23.21 ,$109.44 ,$22.27 ,$27.58 ,$27.58 ,$22.98 ,$27.58 ,$22.98 ,$109.44 ,$94.24 ,$109.44 ,$109.44 ,$91.20 ST VINCENT HOSPITAL - ACUTE,30100182,82139,HC AMINO ACID 6+ QN PLASMA,301,1 ,"$1,000.00 ",$500.00 ,$16.87 ,"$1,000.00 ",$646.00 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$600.00 ,$850.00 ,$700.00 ,$17.43 ,$950.00 ,$720.00 ,$730.00 ,$28.68 ,$850.00 ,$16.87 ,$28.68 ,$800.00 ,$730.00 ,$17.43 ,$16.87 ,$18.63 ,"$1,000.00 ",$850.00 ,$37.96 ,$920.00 ,$700.00 ,$69.01 ,$74.12 ,$609.00 ,$69.01 ,$691.00 ,$700.00 ,$17.04 ,$720.00 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,30100183,82139,HC AMINO ACID 6+ QN URINE,301,1 ,$430.00 ,$215.00 ,$16.87 ,$430.00 ,$277.78 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$258.00 ,$365.50 ,$301.00 ,$17.43 ,$408.50 ,$309.60 ,$313.90 ,$28.68 ,$365.50 ,$16.87 ,$28.68 ,$344.00 ,$313.90 ,$17.43 ,$16.87 ,$18.63 ,$430.00 ,$365.50 ,$37.96 ,$395.60 ,$301.00 ,$69.01 ,$74.12 ,$261.87 ,$69.01 ,$297.13 ,$301.00 ,$17.04 ,$309.60 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,30100184,82139,HC AMINO ACID 6+ QN SERUM,301,1 ,$627.00 ,$313.50 ,$16.87 ,$627.00 ,$405.04 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$376.20 ,$532.95 ,$438.90 ,$17.43 ,$595.65 ,$451.44 ,$457.71 ,$28.68 ,$532.95 ,$16.87 ,$28.68 ,$501.60 ,$457.71 ,$17.43 ,$16.87 ,$18.63 ,$627.00 ,$532.95 ,$37.96 ,$576.84 ,$438.90 ,$69.01 ,$74.12 ,$381.84 ,$69.01 ,$433.26 ,$438.90 ,$17.04 ,$451.44 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$451.44 ,$388.74 ,$451.44 ,$451.44 ,$376.20 ST VINCENT HOSPITAL - ACUTE,30100185,82139,HC AMINO ACID 6+ URINE,301,1 ,$667.00 ,$333.50 ,$16.87 ,$667.00 ,$430.88 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$400.20 ,$566.95 ,$466.90 ,$17.43 ,$633.65 ,$480.24 ,$486.91 ,$28.68 ,$566.95 ,$16.87 ,$28.68 ,$533.60 ,$486.91 ,$17.43 ,$16.87 ,$18.63 ,$667.00 ,$566.95 ,$37.96 ,$613.64 ,$466.90 ,$69.01 ,$74.12 ,$406.20 ,$69.01 ,$460.90 ,$466.90 ,$17.04 ,$480.24 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$480.24 ,$413.54 ,$480.24 ,$480.24 ,$400.20 ST VINCENT HOSPITAL - ACUTE,30100186,82140,HC AMMONIA,301,1 ,$100.00 ,$50.00 ,$14.57 ,$100.00 ,$64.60 ,$15.06 ,$56.67 ,$48.57 ,$14.57 ,$60.00 ,$85.00 ,$70.00 ,$15.06 ,$95.00 ,$72.00 ,$73.00 ,$24.77 ,$85.00 ,$14.57 ,$24.77 ,$80.00 ,$73.00 ,$15.06 ,$14.57 ,$16.09 ,$100.00 ,$85.00 ,$32.78 ,$92.00 ,$70.00 ,$69.78 ,$74.95 ,$60.90 ,$69.78 ,$69.10 ,$70.00 ,$14.72 ,$72.00 ,$15.96 ,$17.48 ,$17.48 ,$14.57 ,$17.48 ,$14.57 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100187,80324,HC AMPHETAMINE,301,1 ,$46.00 ,$23.00 ,$3.23 ,$46.00 ,$29.72 ,$3.23 ,$46.00 ,$46.00 , N/A ,$27.60 ,$39.10 ,$32.20 ,$3.23 ,$43.70 ,$33.12 ,$33.58 ,$38.56 ,$39.10 , N/A ,$38.56 ,$36.80 ,$33.58 ,$3.23 , N/A ,$16.74 ,$46.00 ,$39.10 , N/A ,$42.32 ,$32.20 ,$23.00 ,$27.60 ,$28.01 ,$23.00 ,$31.79 ,$32.20 , N/A ,$33.12 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,30100188,82150,HC AMYLASE,301,1 ,$60.00 ,$30.00 ,$6.48 ,$60.00 ,$38.76 ,$6.70 ,$25.20 ,$21.60 ,$6.48 ,$36.00 ,$51.00 ,$42.00 ,$6.70 ,$57.00 ,$43.20 ,$43.80 ,$11.02 ,$51.00 ,$6.48 ,$11.02 ,$48.00 ,$43.80 ,$6.70 ,$6.48 ,$7.16 ,$60.00 ,$51.00 ,$14.58 ,$55.20 ,$42.00 ,$31.03 ,$33.33 ,$36.54 ,$31.03 ,$41.46 ,$42.00 ,$6.54 ,$43.20 ,$7.10 ,$7.78 ,$7.78 ,$6.48 ,$7.78 ,$6.48 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100189,82157,HC ANDROSTENEDIONE,301,1 ,$200.00 ,$100.00 ,$29.28 ,$200.00 ,$129.20 ,$30.26 ,$113.86 ,$97.59 ,$29.28 ,$120.00 ,$170.00 ,$140.00 ,$30.26 ,$190.00 ,$144.00 ,$146.00 ,$49.78 ,$170.00 ,$29.28 ,$49.78 ,$160.00 ,$146.00 ,$30.26 ,$29.28 ,$32.33 ,$200.00 ,$170.00 ,$65.88 ,$184.00 ,$140.00 ,$140.19 ,$150.57 ,$121.80 ,$140.19 ,$138.20 ,$140.00 ,$29.57 ,$144.00 ,$32.08 ,$35.14 ,$35.14 ,$29.28 ,$35.14 ,$29.28 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30100190,82164,"HC ACE, CSF",301,1 ,$100.00 ,$50.00 ,$14.60 ,$100.00 ,$64.60 ,$15.09 ,$56.77 ,$48.66 ,$14.60 ,$60.00 ,$85.00 ,$70.00 ,$15.09 ,$95.00 ,$72.00 ,$73.00 ,$24.82 ,$85.00 ,$14.60 ,$24.82 ,$80.00 ,$73.00 ,$15.09 ,$14.60 ,$16.12 ,$100.00 ,$85.00 ,$32.85 ,$92.00 ,$70.00 ,$69.92 ,$75.10 ,$60.90 ,$69.92 ,$69.10 ,$70.00 ,$14.75 ,$72.00 ,$16.00 ,$17.52 ,$17.52 ,$14.60 ,$17.52 ,$14.60 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100191,82164,HC ANGIOTENSIN 1 ENZYME (ACE),301,1 ,$100.00 ,$50.00 ,$14.60 ,$100.00 ,$64.60 ,$15.09 ,$56.77 ,$48.66 ,$14.60 ,$60.00 ,$85.00 ,$70.00 ,$15.09 ,$95.00 ,$72.00 ,$73.00 ,$24.82 ,$85.00 ,$14.60 ,$24.82 ,$80.00 ,$73.00 ,$15.09 ,$14.60 ,$16.12 ,$100.00 ,$85.00 ,$32.85 ,$92.00 ,$70.00 ,$69.92 ,$75.10 ,$60.90 ,$69.92 ,$69.10 ,$70.00 ,$14.75 ,$72.00 ,$16.00 ,$17.52 ,$17.52 ,$14.60 ,$17.52 ,$14.60 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100192,82172,HC APOLIPOPROTEIN SERUM,301,1 ,$90.00 ,$45.00 ,$21.09 ,$90.00 ,$58.14 ,$21.79 ,$73.82 ,$63.27 ,$21.09 ,$54.00 ,$76.50 ,$63.00 ,$21.79 ,$85.50 ,$64.80 ,$65.70 ,$35.85 ,$76.50 ,$21.09 ,$35.85 ,$72.00 ,$65.70 ,$21.79 ,$21.09 ,$23.29 ,$90.00 ,$76.50 ,$47.45 ,$82.80 ,$63.00 ,$74.20 ,$79.70 ,$54.81 ,$74.20 ,$62.19 ,$63.00 ,$21.30 ,$64.80 ,$23.10 ,$25.31 ,$25.31 ,$21.09 ,$25.31 ,$21.09 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100193,82175,HC ARSENIC,301,1 ,$47.00 ,$23.50 ,$18.97 ,$47.00 ,$30.36 ,$19.60 ,$47.00 ,$47.00 ,$18.97 ,$28.20 ,$39.95 ,$32.90 ,$19.60 ,$44.65 ,$33.84 ,$34.31 ,$32.25 ,$39.95 ,$18.97 ,$32.25 ,$37.60 ,$34.31 ,$19.60 ,$18.97 ,$20.95 ,$47.00 ,$39.95 ,$42.68 ,$43.24 ,$32.90 ,$47.00 ,$47.00 ,$28.62 ,$47.00 ,$32.48 ,$32.90 ,$19.16 ,$33.84 ,$20.78 ,$22.76 ,$22.76 ,$18.97 ,$22.76 ,$18.97 ,$33.84 ,$29.14 ,$33.84 ,$33.84 ,$28.20 ST VINCENT HOSPITAL - ACUTE,30100194,82175,HC ARSENIC BLOOD,301,1 ,$80.00 ,$40.00 ,$18.97 ,$80.00 ,$51.68 ,$19.60 ,$73.78 ,$63.24 ,$18.97 ,$48.00 ,$68.00 ,$56.00 ,$19.60 ,$76.00 ,$57.60 ,$58.40 ,$32.25 ,$68.00 ,$18.97 ,$32.25 ,$64.00 ,$58.40 ,$19.60 ,$18.97 ,$20.95 ,$80.00 ,$68.00 ,$42.68 ,$73.60 ,$56.00 ,$80.00 ,$80.00 ,$48.72 ,$80.00 ,$55.28 ,$56.00 ,$19.16 ,$57.60 ,$20.78 ,$22.76 ,$22.76 ,$18.97 ,$22.76 ,$18.97 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100195,82175,HC ARSENIC URINE,301,1 ,$80.00 ,$40.00 ,$18.97 ,$80.00 ,$51.68 ,$19.60 ,$73.78 ,$63.24 ,$18.97 ,$48.00 ,$68.00 ,$56.00 ,$19.60 ,$76.00 ,$57.60 ,$58.40 ,$32.25 ,$68.00 ,$18.97 ,$32.25 ,$64.00 ,$58.40 ,$19.60 ,$18.97 ,$20.95 ,$80.00 ,$68.00 ,$42.68 ,$73.60 ,$56.00 ,$80.00 ,$80.00 ,$48.72 ,$80.00 ,$55.28 ,$56.00 ,$19.16 ,$57.60 ,$20.78 ,$22.76 ,$22.76 ,$18.97 ,$22.76 ,$18.97 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100196,82175,HC ARESNIC 24 HR URINE,301,1 ,$80.00 ,$40.00 ,$18.97 ,$80.00 ,$51.68 ,$19.60 ,$73.78 ,$63.24 ,$18.97 ,$48.00 ,$68.00 ,$56.00 ,$19.60 ,$76.00 ,$57.60 ,$58.40 ,$32.25 ,$68.00 ,$18.97 ,$32.25 ,$64.00 ,$58.40 ,$19.60 ,$18.97 ,$20.95 ,$80.00 ,$68.00 ,$42.68 ,$73.60 ,$56.00 ,$80.00 ,$80.00 ,$48.72 ,$80.00 ,$55.28 ,$56.00 ,$19.16 ,$57.60 ,$20.78 ,$22.76 ,$22.76 ,$18.97 ,$22.76 ,$18.97 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100197,82180,HC VITAMIN C (ASCORBIC ACID),301,1 ,$70.00 ,$35.00 ,$9.89 ,$70.00 ,$45.22 ,$10.22 ,$38.43 ,$32.94 ,$9.89 ,$42.00 ,$59.50 ,$49.00 ,$10.22 ,$66.50 ,$50.40 ,$51.10 ,$16.81 ,$59.50 ,$9.89 ,$16.81 ,$56.00 ,$51.10 ,$10.22 ,$9.89 ,$10.92 ,$70.00 ,$59.50 ,$22.25 ,$64.40 ,$49.00 ,$47.31 ,$50.82 ,$42.63 ,$47.31 ,$48.37 ,$49.00 ,$9.99 ,$50.40 ,$10.83 ,$11.87 ,$11.87 ,$9.89 ,$11.87 ,$9.89 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100199,80345,HC BARBITURATE,301,1 ,$38.00 ,$19.00 ,$3.23 ,$38.00 ,$24.55 ,$3.23 ,$38.00 ,$38.00 , N/A ,$22.80 ,$32.30 ,$26.60 ,$3.23 ,$36.10 ,$27.36 ,$27.74 ,$38.00 ,$32.30 , N/A ,$38.00 ,$30.40 ,$27.74 ,$3.23 , N/A ,$12.04 ,$38.00 ,$32.30 , N/A ,$34.96 ,$26.60 ,$19.00 ,$22.80 ,$23.14 ,$19.00 ,$26.26 ,$26.60 , N/A ,$27.36 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,30100200,G0480,HC PENTOBARB,301,1 ,$139.00 ,$69.50 ,$63.95 ,$257.47 ,$89.79 ,$63.95 ,$139.00 ,$139.00 ,$114.43 ,$83.40 ,$118.15 ,$97.30 ,$63.95 ,$132.05 ,$100.08 ,$101.47 ,$139.00 ,$118.15 ,$114.43 ,$139.00 ,$111.20 ,$101.47 ,$63.95 ,$114.43 ,$126.35 ,$139.00 ,$118.15 ,$257.47 ,$127.88 ,$97.30 ,$139.00 ,$139.00 ,$84.65 ,$139.00 ,$96.05 ,$97.30 ,$115.57 ,$100.08 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$100.08 ,$86.18 ,$100.08 ,$100.08 ,$83.40 ST VINCENT HOSPITAL - ACUTE,30100201,82232,HC BETA 2 MICROGLOBULIN,301,1 ,$110.00 ,$55.00 ,$16.18 ,$110.00 ,$71.06 ,$16.72 ,$62.90 ,$53.91 ,$16.18 ,$66.00 ,$93.50 ,$77.00 ,$16.72 ,$104.50 ,$79.20 ,$80.30 ,$27.51 ,$93.50 ,$16.18 ,$27.51 ,$88.00 ,$80.30 ,$16.72 ,$16.18 ,$17.87 ,$110.00 ,$93.50 ,$36.41 ,$101.20 ,$77.00 ,$77.47 ,$83.20 ,$66.99 ,$77.47 ,$76.01 ,$77.00 ,$16.34 ,$79.20 ,$17.72 ,$19.42 ,$19.42 ,$16.18 ,$19.42 ,$16.18 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100202,82247,HC BILIRUBIN TOTAL,301,1 ,$34.00 ,$17.00 ,$4.24 ,$34.00 ,$21.96 ,$4.24 ,$19.50 ,$16.71 ,$5.02 ,$20.40 ,$28.90 ,$23.80 ,$4.24 ,$32.30 ,$24.48 ,$24.82 ,$8.53 ,$28.90 ,$5.02 ,$8.53 ,$27.20 ,$24.82 ,$4.24 ,$5.02 ,$5.54 ,$34.00 ,$28.90 ,$11.30 ,$31.28 ,$23.80 ,$24.01 ,$25.79 ,$20.71 ,$24.01 ,$23.49 ,$23.80 ,$5.07 ,$24.48 ,$4.49 ,$6.02 ,$6.02 ,$5.02 ,$6.02 ,$5.02 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30100203,82248,HC BILIRUBIN DIRECT,301,1 ,$34.00 ,$17.00 ,$4.70 ,$34.00 ,$21.96 ,$4.70 ,$19.50 ,$16.71 ,$5.02 ,$20.40 ,$28.90 ,$23.80 ,$4.70 ,$32.30 ,$24.48 ,$24.82 ,$8.53 ,$28.90 ,$5.02 ,$8.53 ,$27.20 ,$24.82 ,$4.70 ,$5.02 ,$5.54 ,$34.00 ,$28.90 ,$11.30 ,$31.28 ,$23.80 ,$24.01 ,$25.79 ,$20.71 ,$24.01 ,$23.49 ,$23.80 ,$5.07 ,$24.48 ,$4.98 ,$6.02 ,$6.02 ,$5.02 ,$6.02 ,$5.02 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30100205,82270,HC OCCULT BLOOD FECAL SCRN,301,1 ,$23.00 ,$11.50 ,$3.66 ,$23.00 ,$14.86 ,$3.66 ,$15.33 ,$13.14 ,$4.38 ,$13.80 ,$19.55 ,$16.10 ,$3.66 ,$21.85 ,$16.56 ,$16.79 ,$7.45 ,$19.55 ,$4.38 ,$7.45 ,$18.40 ,$16.79 ,$3.66 ,$4.38 ,$4.84 ,$23.00 ,$19.55 ,$9.86 ,$21.16 ,$16.10 ,$15.58 ,$16.74 ,$14.01 ,$15.58 ,$15.89 ,$16.10 ,$4.42 ,$16.56 ,$3.88 ,$5.26 ,$5.26 ,$4.38 ,$5.26 ,$4.38 ,$16.56 ,$14.26 ,$16.56 ,$16.56 ,$13.80 ST VINCENT HOSPITAL - ACUTE,30100206,82271,HC OCCULT BLOOD GASTRIC,301,1 ,$23.00 ,$11.50 ,$4.26 ,$23.00 ,$14.86 ,$4.26 ,$18.62 ,$15.96 ,$5.32 ,$13.80 ,$19.55 ,$16.10 ,$4.26 ,$21.85 ,$16.56 ,$16.79 ,$9.04 ,$19.55 ,$5.32 ,$9.04 ,$18.40 ,$16.79 ,$4.26 ,$5.32 ,$5.87 ,$23.00 ,$19.55 ,$11.97 ,$21.16 ,$16.10 ,$15.58 ,$16.74 ,$14.01 ,$15.58 ,$15.89 ,$16.10 ,$5.37 ,$16.56 ,$4.52 ,$6.38 ,$6.38 ,$5.32 ,$6.38 ,$5.32 ,$16.56 ,$14.26 ,$16.56 ,$16.56 ,$13.80 ST VINCENT HOSPITAL - ACUTE,30100207,82272,HC OCCULT BLOOD FECAL DIAG,301,1 ,$22.00 ,$11.00 ,$4.23 ,$22.00 ,$14.21 ,$4.26 ,$14.81 ,$12.69 ,$4.23 ,$13.20 ,$18.70 ,$15.40 ,$4.26 ,$20.90 ,$15.84 ,$16.06 ,$7.19 ,$18.70 ,$4.23 ,$7.19 ,$17.60 ,$16.06 ,$4.26 ,$4.23 ,$4.67 ,$22.00 ,$18.70 ,$9.52 ,$20.24 ,$15.40 ,$15.58 ,$16.74 ,$13.40 ,$15.58 ,$15.20 ,$15.40 ,$4.27 ,$15.84 ,$4.52 ,$5.08 ,$5.08 ,$4.23 ,$5.08 ,$4.23 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30100208,82274,HC OCCULT BLOOD FECAL HGB,301,1 ,$110.00 ,$55.00 ,$15.92 ,$110.00 ,$71.06 ,$16.45 ,$61.85 ,$53.01 ,$15.92 ,$66.00 ,$93.50 ,$77.00 ,$16.45 ,$104.50 ,$79.20 ,$80.30 ,$27.06 ,$93.50 ,$15.92 ,$27.06 ,$88.00 ,$80.30 ,$16.45 ,$15.92 ,$17.58 ,$110.00 ,$93.50 ,$35.82 ,$101.20 ,$77.00 ,$76.17 ,$81.81 ,$66.99 ,$76.17 ,$76.01 ,$77.00 ,$16.08 ,$79.20 ,$17.44 ,$19.10 ,$19.10 ,$15.92 ,$19.10 ,$15.92 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100209,82300,HC CADMIUM,301,1 ,$78.00 ,$39.00 ,$23.64 ,$78.00 ,$50.39 ,$24.43 ,$78.00 ,$77.16 ,$23.64 ,$46.80 ,$66.30 ,$54.60 ,$24.43 ,$74.10 ,$56.16 ,$56.94 ,$40.19 ,$66.30 ,$23.64 ,$40.19 ,$62.40 ,$56.94 ,$24.43 ,$23.64 ,$26.10 ,$78.00 ,$66.30 ,$53.19 ,$71.76 ,$54.60 ,$78.00 ,$78.00 ,$47.50 ,$78.00 ,$53.90 ,$54.60 ,$23.88 ,$56.16 ,$25.90 ,$28.37 ,$28.37 ,$23.64 ,$28.37 ,$23.64 ,$56.16 ,$48.36 ,$56.16 ,$56.16 ,$46.80 ST VINCENT HOSPITAL - ACUTE,30100210,82300,HC CADMIUM URINE,301,1 ,$80.00 ,$40.00 ,$23.64 ,$80.00 ,$51.68 ,$24.43 ,$80.00 ,$77.16 ,$23.64 ,$48.00 ,$68.00 ,$56.00 ,$24.43 ,$76.00 ,$57.60 ,$58.40 ,$40.19 ,$68.00 ,$23.64 ,$40.19 ,$64.00 ,$58.40 ,$24.43 ,$23.64 ,$26.10 ,$80.00 ,$68.00 ,$53.19 ,$73.60 ,$56.00 ,$80.00 ,$80.00 ,$48.72 ,$80.00 ,$55.28 ,$56.00 ,$23.88 ,$57.60 ,$25.90 ,$28.37 ,$28.37 ,$23.64 ,$28.37 ,$23.64 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100211,82300,HC CADMIUM 24 HR URINE,301,1 ,$80.00 ,$40.00 ,$23.64 ,$80.00 ,$51.68 ,$24.43 ,$80.00 ,$77.16 ,$23.64 ,$48.00 ,$68.00 ,$56.00 ,$24.43 ,$76.00 ,$57.60 ,$58.40 ,$40.19 ,$68.00 ,$23.64 ,$40.19 ,$64.00 ,$58.40 ,$24.43 ,$23.64 ,$26.10 ,$80.00 ,$68.00 ,$53.19 ,$73.60 ,$56.00 ,$80.00 ,$80.00 ,$48.72 ,$80.00 ,$55.28 ,$56.00 ,$23.88 ,$57.60 ,$25.90 ,$28.37 ,$28.37 ,$23.64 ,$28.37 ,$23.64 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100212,82306,HC VITAMIN D 25 OH,301,1 ,$200.00 ,$100.00 ,$29.60 ,$200.00 ,$129.20 ,$30.59 ,$115.12 ,$98.67 ,$29.60 ,$120.00 ,$170.00 ,$140.00 ,$30.59 ,$190.00 ,$144.00 ,$146.00 ,$50.32 ,$170.00 ,$29.60 ,$50.32 ,$160.00 ,$146.00 ,$30.59 ,$29.60 ,$32.68 ,$200.00 ,$170.00 ,$66.60 ,$184.00 ,$140.00 ,$141.80 ,$152.31 ,$121.80 ,$141.80 ,$138.20 ,$140.00 ,$29.90 ,$144.00 ,$32.43 ,$35.52 ,$35.52 ,$29.60 ,$35.52 ,$29.60 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30100213,82308,HC CALCITONIN,301,1 ,$140.00 ,$70.00 ,$26.79 ,$140.00 ,$90.44 ,$27.68 ,$104.20 ,$89.31 ,$26.79 ,$84.00 ,$119.00 ,$98.00 ,$27.68 ,$133.00 ,$100.80 ,$102.20 ,$45.54 ,$119.00 ,$26.79 ,$45.54 ,$112.00 ,$102.20 ,$27.68 ,$26.79 ,$29.58 ,$140.00 ,$119.00 ,$60.28 ,$128.80 ,$98.00 ,$128.26 ,$137.76 ,$85.26 ,$128.26 ,$96.74 ,$98.00 ,$27.06 ,$100.80 ,$29.34 ,$32.15 ,$32.15 ,$26.79 ,$32.15 ,$26.79 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30100214,82310,HC CALCIUM,301,1 ,$34.00 ,$17.00 ,$5.16 ,$34.00 ,$21.96 ,$5.33 ,$20.06 ,$17.19 ,$5.16 ,$20.40 ,$28.90 ,$23.80 ,$5.33 ,$32.30 ,$24.48 ,$24.82 ,$8.77 ,$28.90 ,$5.16 ,$8.77 ,$27.20 ,$24.82 ,$5.33 ,$5.16 ,$5.70 ,$34.00 ,$28.90 ,$11.61 ,$31.28 ,$23.80 ,$24.71 ,$26.54 ,$20.71 ,$24.71 ,$23.49 ,$23.80 ,$5.21 ,$24.48 ,$5.65 ,$6.19 ,$6.19 ,$5.16 ,$6.19 ,$5.16 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30100215,82330,HC CALCIUM IONIZED,301,1 ,$90.00 ,$45.00 ,$13.68 ,$90.00 ,$58.14 ,$14.14 ,$53.20 ,$45.60 ,$13.68 ,$54.00 ,$76.50 ,$63.00 ,$14.14 ,$85.50 ,$64.80 ,$65.70 ,$23.26 ,$76.50 ,$13.68 ,$23.26 ,$72.00 ,$65.70 ,$14.14 ,$13.68 ,$15.11 ,$90.00 ,$76.50 ,$30.78 ,$82.80 ,$63.00 ,$65.46 ,$70.31 ,$54.81 ,$65.46 ,$62.19 ,$63.00 ,$13.82 ,$64.80 ,$14.99 ,$16.42 ,$16.42 ,$13.68 ,$16.42 ,$13.68 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100216,82340,HC CALCIUM URINE QN TIMED,301,1 ,$41.00 ,$20.50 ,$6.03 ,$41.00 ,$26.49 ,$6.23 ,$23.45 ,$20.10 ,$6.03 ,$24.60 ,$34.85 ,$28.70 ,$6.23 ,$38.95 ,$29.52 ,$29.93 ,$10.25 ,$34.85 ,$6.03 ,$10.25 ,$32.80 ,$29.93 ,$6.23 ,$6.03 ,$6.66 ,$41.00 ,$34.85 ,$13.57 ,$37.72 ,$28.70 ,$28.89 ,$31.03 ,$24.97 ,$28.89 ,$28.33 ,$28.70 ,$6.09 ,$29.52 ,$6.60 ,$7.24 ,$7.24 ,$6.03 ,$7.24 ,$6.03 ,$29.52 ,$25.42 ,$29.52 ,$29.52 ,$24.60 ST VINCENT HOSPITAL - ACUTE,30100217,82360,HC CALCULUS ANALYSIS QN,301,1 ,$90.00 ,$45.00 ,$12.87 ,$90.00 ,$58.14 ,$13.30 ,$50.05 ,$42.90 ,$12.87 ,$54.00 ,$76.50 ,$63.00 ,$13.30 ,$85.50 ,$64.80 ,$65.70 ,$21.88 ,$76.50 ,$12.87 ,$21.88 ,$72.00 ,$65.70 ,$13.30 ,$12.87 ,$14.21 ,$90.00 ,$76.50 ,$28.96 ,$82.80 ,$63.00 ,$61.64 ,$66.20 ,$54.81 ,$61.64 ,$62.19 ,$63.00 ,$13.00 ,$64.80 ,$14.10 ,$15.44 ,$15.44 ,$12.87 ,$15.44 ,$12.87 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100218,82365,HC CALCULUS ANLYS (SA) INFRARED,301,1 ,$105.00 ,$52.50 ,$12.90 ,$105.00 ,$67.83 ,$13.33 ,$50.16 ,$42.99 ,$12.90 ,$63.00 ,$89.25 ,$73.50 ,$13.33 ,$99.75 ,$75.60 ,$76.65 ,$21.93 ,$89.25 ,$12.90 ,$21.93 ,$84.00 ,$76.65 ,$13.33 ,$12.90 ,$14.24 ,$105.00 ,$89.25 ,$29.03 ,$96.60 ,$73.50 ,$61.74 ,$66.31 ,$63.95 ,$61.74 ,$72.56 ,$73.50 ,$13.03 ,$75.60 ,$14.13 ,$15.48 ,$15.48 ,$12.90 ,$15.48 ,$12.90 ,$75.60 ,$65.10 ,$75.60 ,$75.60 ,$63.00 ST VINCENT HOSPITAL - ACUTE,30100221,82373,HC CARBOHY DEFICIENT TRANSFER,301,1 ,$462.00 ,$231.00 ,$10.38 ,$462.00 ,$298.45 ,$10.38 ,$70.21 ,$60.18 ,$18.06 ,$277.20 ,$392.70 ,$323.40 ,$10.38 ,$438.90 ,$332.64 ,$337.26 ,$30.70 ,$392.70 ,$18.06 ,$30.70 ,$369.60 ,$337.26 ,$10.38 ,$18.06 ,$19.94 ,$462.00 ,$392.70 ,$40.64 ,$425.04 ,$323.40 ,$86.45 ,$92.86 ,$281.36 ,$86.45 ,$319.24 ,$323.40 ,$18.24 ,$332.64 ,$11.00 ,$21.67 ,$21.67 ,$18.06 ,$21.67 ,$18.06 ,$332.64 ,$286.44 ,$332.64 ,$332.64 ,$277.20 ST VINCENT HOSPITAL - ACUTE,30100222,82374,HC BICARBONATE,301,1 ,$90.00 ,$45.00 ,$4.88 ,$90.00 ,$58.14 ,$5.04 ,$19.01 ,$16.29 ,$4.88 ,$54.00 ,$76.50 ,$63.00 ,$5.04 ,$85.50 ,$64.80 ,$65.70 ,$8.30 ,$76.50 ,$4.88 ,$8.30 ,$72.00 ,$65.70 ,$5.04 ,$4.88 ,$5.39 ,$90.00 ,$76.50 ,$10.98 ,$82.80 ,$63.00 ,$23.41 ,$25.15 ,$54.81 ,$23.41 ,$62.19 ,$63.00 ,$4.93 ,$64.80 ,$5.34 ,$5.86 ,$5.86 ,$4.88 ,$5.86 ,$4.88 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100223,82374,HC CO2,301,1 ,$38.00 ,$19.00 ,$4.88 ,$38.00 ,$24.55 ,$5.04 ,$19.01 ,$16.29 ,$4.88 ,$22.80 ,$32.30 ,$26.60 ,$5.04 ,$36.10 ,$27.36 ,$27.74 ,$8.30 ,$32.30 ,$4.88 ,$8.30 ,$30.40 ,$27.74 ,$5.04 ,$4.88 ,$5.39 ,$38.00 ,$32.30 ,$10.98 ,$34.96 ,$26.60 ,$23.41 ,$25.15 ,$23.14 ,$23.41 ,$26.26 ,$26.60 ,$4.93 ,$27.36 ,$5.34 ,$5.86 ,$5.86 ,$4.88 ,$5.86 ,$4.88 ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,30100224,82375,HC CARBON MONOXIDE,301,1 ,$150.00 ,$75.00 ,$12.32 ,$150.00 ,$96.90 ,$12.73 ,$47.92 ,$41.07 ,$12.32 ,$90.00 ,$127.50 ,$105.00 ,$12.73 ,$142.50 ,$108.00 ,$109.50 ,$20.94 ,$127.50 ,$12.32 ,$20.94 ,$120.00 ,$109.50 ,$12.73 ,$12.32 ,$13.60 ,$150.00 ,$127.50 ,$27.72 ,$138.00 ,$105.00 ,$59.00 ,$63.37 ,$91.35 ,$59.00 ,$103.65 ,$105.00 ,$12.44 ,$108.00 ,$13.49 ,$14.78 ,$14.78 ,$12.32 ,$14.78 ,$12.32 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100225,82375,HC CARBOXYHEMOGLOBIN,301,1 ,$150.00 ,$75.00 ,$12.32 ,$150.00 ,$96.90 ,$12.73 ,$47.92 ,$41.07 ,$12.32 ,$90.00 ,$127.50 ,$105.00 ,$12.73 ,$142.50 ,$108.00 ,$109.50 ,$20.94 ,$127.50 ,$12.32 ,$20.94 ,$120.00 ,$109.50 ,$12.73 ,$12.32 ,$13.60 ,$150.00 ,$127.50 ,$27.72 ,$138.00 ,$105.00 ,$59.00 ,$63.37 ,$91.35 ,$59.00 ,$103.65 ,$105.00 ,$12.44 ,$108.00 ,$13.49 ,$14.78 ,$14.78 ,$12.32 ,$14.78 ,$12.32 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100226,82378,HC CARBINOEMBRYONIC AG (CEA),301,1 ,$130.00 ,$65.00 ,$18.96 ,$130.00 ,$83.98 ,$19.59 ,$73.75 ,$63.21 ,$18.96 ,$78.00 ,$110.50 ,$91.00 ,$19.59 ,$123.50 ,$93.60 ,$94.90 ,$32.23 ,$110.50 ,$18.96 ,$32.23 ,$104.00 ,$94.90 ,$19.59 ,$18.96 ,$20.94 ,$130.00 ,$110.50 ,$42.66 ,$119.60 ,$91.00 ,$90.84 ,$97.57 ,$79.17 ,$90.84 ,$89.83 ,$91.00 ,$19.15 ,$93.60 ,$20.77 ,$22.75 ,$22.75 ,$18.96 ,$22.75 ,$18.96 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100227,82378,HC CEA BODY FLUID,301,1 ,$210.00 ,$105.00 ,$18.96 ,$210.00 ,$135.66 ,$19.59 ,$73.75 ,$63.21 ,$18.96 ,$126.00 ,$178.50 ,$147.00 ,$19.59 ,$199.50 ,$151.20 ,$153.30 ,$32.23 ,$178.50 ,$18.96 ,$32.23 ,$168.00 ,$153.30 ,$19.59 ,$18.96 ,$20.94 ,$210.00 ,$178.50 ,$42.66 ,$193.20 ,$147.00 ,$90.84 ,$97.57 ,$127.89 ,$90.84 ,$145.11 ,$147.00 ,$19.15 ,$151.20 ,$20.77 ,$22.75 ,$22.75 ,$18.96 ,$22.75 ,$18.96 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,30100228,82379,HC CARNITINE URINE,301,1 ,$502.00 ,$251.00 ,$16.87 ,$502.00 ,$324.29 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$301.20 ,$426.70 ,$351.40 ,$17.43 ,$476.90 ,$361.44 ,$366.46 ,$28.68 ,$426.70 ,$16.87 ,$28.68 ,$401.60 ,$366.46 ,$17.43 ,$16.87 ,$18.63 ,$502.00 ,$426.70 ,$37.96 ,$461.84 ,$351.40 ,$69.01 ,$74.12 ,$305.72 ,$69.01 ,$346.88 ,$351.40 ,$17.04 ,$361.44 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$361.44 ,$311.24 ,$361.44 ,$361.44 ,$301.20 ST VINCENT HOSPITAL - ACUTE,30100229,82379,HC CARNITINE SERUM,301,1 ,$463.00 ,$231.50 ,$16.87 ,$463.00 ,$299.10 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$277.80 ,$393.55 ,$324.10 ,$17.43 ,$439.85 ,$333.36 ,$337.99 ,$28.68 ,$393.55 ,$16.87 ,$28.68 ,$370.40 ,$337.99 ,$17.43 ,$16.87 ,$18.63 ,$463.00 ,$393.55 ,$37.96 ,$425.96 ,$324.10 ,$69.01 ,$74.12 ,$281.97 ,$69.01 ,$319.93 ,$324.10 ,$17.04 ,$333.36 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$333.36 ,$287.06 ,$333.36 ,$333.36 ,$277.80 ST VINCENT HOSPITAL - ACUTE,30100230,82379,HC CARNITINE,301,1 ,$380.00 ,$190.00 ,$16.87 ,$380.00 ,$245.48 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$228.00 ,$323.00 ,$266.00 ,$17.43 ,$361.00 ,$273.60 ,$277.40 ,$28.68 ,$323.00 ,$16.87 ,$28.68 ,$304.00 ,$277.40 ,$17.43 ,$16.87 ,$18.63 ,$380.00 ,$323.00 ,$37.96 ,$349.60 ,$266.00 ,$69.01 ,$74.12 ,$231.42 ,$69.01 ,$262.58 ,$266.00 ,$17.04 ,$273.60 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,30100231,82380,HC CAROTENE,301,1 ,$51.00 ,$25.50 ,$9.22 ,$51.00 ,$32.95 ,$9.53 ,$35.88 ,$30.75 ,$9.22 ,$30.60 ,$43.35 ,$35.70 ,$9.53 ,$48.45 ,$36.72 ,$37.23 ,$15.67 ,$43.35 ,$9.22 ,$15.67 ,$40.80 ,$37.23 ,$9.53 ,$9.22 ,$10.18 ,$51.00 ,$43.35 ,$20.75 ,$46.92 ,$35.70 ,$44.16 ,$47.43 ,$31.06 ,$44.16 ,$35.24 ,$35.70 ,$9.31 ,$36.72 ,$10.10 ,$11.06 ,$11.06 ,$9.22 ,$11.06 ,$9.22 ,$36.72 ,$31.62 ,$36.72 ,$36.72 ,$30.60 ST VINCENT HOSPITAL - ACUTE,30100232,82384,HC CATECHOLAMINE FRACTION,301,1 ,$170.00 ,$85.00 ,$25.25 ,$170.00 ,$109.82 ,$26.09 ,$98.21 ,$84.18 ,$25.25 ,$102.00 ,$144.50 ,$119.00 ,$26.09 ,$161.50 ,$122.40 ,$124.10 ,$42.93 ,$144.50 ,$25.25 ,$42.93 ,$136.00 ,$124.10 ,$26.09 ,$25.25 ,$27.88 ,$170.00 ,$144.50 ,$56.81 ,$156.40 ,$119.00 ,$120.92 ,$129.88 ,$103.53 ,$120.92 ,$117.47 ,$119.00 ,$25.50 ,$122.40 ,$27.66 ,$30.30 ,$30.30 ,$25.25 ,$30.30 ,$25.25 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100233,82384,HC CATECHOLAMINE RNDM URINE,301,1 ,$170.00 ,$85.00 ,$25.25 ,$170.00 ,$109.82 ,$26.09 ,$98.21 ,$84.18 ,$25.25 ,$102.00 ,$144.50 ,$119.00 ,$26.09 ,$161.50 ,$122.40 ,$124.10 ,$42.93 ,$144.50 ,$25.25 ,$42.93 ,$136.00 ,$124.10 ,$26.09 ,$25.25 ,$27.88 ,$170.00 ,$144.50 ,$56.81 ,$156.40 ,$119.00 ,$120.92 ,$129.88 ,$103.53 ,$120.92 ,$117.47 ,$119.00 ,$25.50 ,$122.40 ,$27.66 ,$30.30 ,$30.30 ,$25.25 ,$30.30 ,$25.25 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100234,82384,HC CATECHOLAMINE PLASMA,301,1 ,$75.00 ,$37.50 ,$25.25 ,$75.00 ,$48.45 ,$26.09 ,$75.00 ,$75.00 ,$25.25 ,$45.00 ,$63.75 ,$52.50 ,$26.09 ,$71.25 ,$54.00 ,$54.75 ,$42.93 ,$63.75 ,$25.25 ,$42.93 ,$60.00 ,$54.75 ,$26.09 ,$25.25 ,$27.88 ,$75.00 ,$63.75 ,$56.81 ,$69.00 ,$52.50 ,$75.00 ,$75.00 ,$45.68 ,$75.00 ,$51.83 ,$52.50 ,$25.50 ,$54.00 ,$27.66 ,$30.30 ,$30.30 ,$25.25 ,$30.30 ,$25.25 ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,30100235,82390,HC CERULOPLASMIN,301,1 ,$70.00 ,$35.00 ,$10.74 ,$70.00 ,$45.22 ,$11.10 ,$41.76 ,$35.79 ,$10.74 ,$42.00 ,$59.50 ,$49.00 ,$11.10 ,$66.50 ,$50.40 ,$51.10 ,$18.26 ,$59.50 ,$10.74 ,$18.26 ,$56.00 ,$51.10 ,$11.10 ,$10.74 ,$11.86 ,$70.00 ,$59.50 ,$24.17 ,$64.40 ,$49.00 ,$51.42 ,$55.23 ,$42.63 ,$51.42 ,$48.37 ,$49.00 ,$10.85 ,$50.40 ,$11.77 ,$12.89 ,$12.89 ,$10.74 ,$12.89 ,$10.74 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100236,82397,HC CHEMILUMINESCENT ASSAY,301,1 ,$100.00 ,$50.00 ,$14.12 ,$100.00 ,$64.60 ,$14.59 ,$54.92 ,$47.07 ,$14.12 ,$60.00 ,$85.00 ,$70.00 ,$14.59 ,$95.00 ,$72.00 ,$73.00 ,$24.00 ,$85.00 ,$14.12 ,$24.00 ,$80.00 ,$73.00 ,$14.59 ,$14.12 ,$15.59 ,$100.00 ,$85.00 ,$31.77 ,$92.00 ,$70.00 ,$67.64 ,$72.65 ,$60.90 ,$67.64 ,$69.10 ,$70.00 ,$14.26 ,$72.00 ,$15.47 ,$16.94 ,$16.94 ,$14.12 ,$16.94 ,$14.12 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100237,82435,HC CHLORIDE,301,1 ,$60.00 ,$30.00 ,$4.60 ,$60.00 ,$38.76 ,$4.75 ,$17.89 ,$15.33 ,$4.60 ,$36.00 ,$51.00 ,$42.00 ,$4.75 ,$57.00 ,$43.20 ,$43.80 ,$7.82 ,$51.00 ,$4.60 ,$7.82 ,$48.00 ,$43.80 ,$4.75 ,$4.60 ,$5.08 ,$60.00 ,$51.00 ,$10.35 ,$55.20 ,$42.00 ,$22.01 ,$23.64 ,$36.54 ,$22.01 ,$41.46 ,$42.00 ,$4.65 ,$43.20 ,$5.04 ,$5.52 ,$5.52 ,$4.60 ,$5.52 ,$4.60 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100238,82436,HC CHLORIDE URINE,301,1 ,$43.00 ,$21.50 ,$5.75 ,$43.00 ,$27.78 ,$5.94 ,$20.13 ,$17.25 ,$5.75 ,$25.80 ,$36.55 ,$30.10 ,$5.94 ,$40.85 ,$30.96 ,$31.39 ,$9.78 ,$36.55 ,$5.75 ,$9.78 ,$34.40 ,$31.39 ,$5.94 ,$5.75 ,$6.35 ,$43.00 ,$36.55 ,$12.94 ,$39.56 ,$30.10 ,$24.08 ,$25.86 ,$26.19 ,$24.08 ,$29.71 ,$30.10 ,$5.81 ,$30.96 ,$6.30 ,$6.90 ,$6.90 ,$5.75 ,$6.90 ,$5.75 ,$30.96 ,$26.66 ,$30.96 ,$30.96 ,$25.80 ST VINCENT HOSPITAL - ACUTE,30100240,82438,HC CHLORIDE OTHER SOURCE,301,1 ,$68.00 ,$34.00 ,$5.00 ,$68.00 ,$43.93 ,$5.17 ,$19.01 ,$16.29 ,$5.00 ,$40.80 ,$57.80 ,$47.60 ,$5.17 ,$64.60 ,$48.96 ,$49.64 ,$8.50 ,$57.80 ,$5.00 ,$8.50 ,$54.40 ,$49.64 ,$5.17 ,$5.00 ,$5.52 ,$68.00 ,$57.80 ,$11.25 ,$62.56 ,$47.60 ,$23.41 ,$25.15 ,$41.41 ,$23.41 ,$46.99 ,$47.60 ,$5.05 ,$48.96 ,$5.48 ,$6.00 ,$6.00 ,$5.00 ,$6.00 ,$5.00 ,$48.96 ,$42.16 ,$48.96 ,$48.96 ,$40.80 ST VINCENT HOSPITAL - ACUTE,30100241,82465,HC CHOLESTEROL,301,1 ,$50.00 ,$25.00 ,$4.35 ,$50.00 ,$32.30 ,$4.49 ,$16.94 ,$14.52 ,$4.35 ,$30.00 ,$42.50 ,$35.00 ,$4.49 ,$47.50 ,$36.00 ,$36.50 ,$7.40 ,$42.50 ,$4.35 ,$7.40 ,$40.00 ,$36.50 ,$4.49 ,$4.35 ,$4.80 ,$50.00 ,$42.50 ,$9.79 ,$46.00 ,$35.00 ,$20.81 ,$22.36 ,$30.45 ,$20.81 ,$34.55 ,$35.00 ,$4.39 ,$36.00 ,$4.76 ,$5.22 ,$5.22 ,$4.35 ,$5.22 ,$4.35 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30100242,82542,HC CHROMATO QN SGL COLUMN,301,1 ,$140.00 ,$70.00 ,$24.09 ,$140.00 ,$90.44 ,$24.89 ,$84.32 ,$72.27 ,$24.09 ,$84.00 ,$119.00 ,$98.00 ,$24.89 ,$133.00 ,$100.80 ,$102.20 ,$40.95 ,$119.00 ,$24.09 ,$40.95 ,$112.00 ,$102.20 ,$24.89 ,$24.09 ,$26.60 ,$140.00 ,$119.00 ,$54.20 ,$128.80 ,$98.00 ,$86.45 ,$92.86 ,$85.26 ,$86.45 ,$96.74 ,$98.00 ,$24.33 ,$100.80 ,$26.38 ,$28.91 ,$28.91 ,$24.09 ,$28.91 ,$24.09 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30100243,80299,HC CHROMATO QN MLT COLUMN,301,1 ,$170.00 ,$85.00 ,$18.64 ,$170.00 ,$109.82 ,$19.26 ,$65.24 ,$55.92 ,$18.64 ,$102.00 ,$144.50 ,$119.00 ,$19.26 ,$161.50 ,$122.40 ,$124.10 ,$31.69 ,$144.50 ,$18.64 ,$31.69 ,$136.00 ,$124.10 ,$19.26 ,$18.64 ,$20.58 ,$170.00 ,$144.50 ,$41.94 ,$156.40 ,$119.00 ,$65.57 ,$70.42 ,$103.53 ,$65.57 ,$117.47 ,$119.00 ,$18.83 ,$122.40 ,$20.42 ,$22.37 ,$22.37 ,$18.64 ,$22.37 ,$18.64 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100244,82495,HC CHROMIUM (MAYO) SERUM,301,1 ,$239.00 ,$119.50 ,$10.23 ,$239.00 ,$154.39 ,$10.23 ,$78.86 ,$67.59 ,$20.28 ,$143.40 ,$203.15 ,$167.30 ,$10.23 ,$227.05 ,$172.08 ,$174.47 ,$34.48 ,$203.15 ,$20.28 ,$34.48 ,$191.20 ,$174.47 ,$10.23 ,$20.28 ,$22.39 ,$239.00 ,$203.15 ,$45.63 ,$219.88 ,$167.30 ,$34.82 ,$37.40 ,$145.55 ,$34.82 ,$165.15 ,$167.30 ,$20.48 ,$172.08 ,$10.84 ,$24.34 ,$24.34 ,$20.28 ,$24.34 ,$20.28 ,$172.08 ,$148.18 ,$172.08 ,$172.08 ,$143.40 ST VINCENT HOSPITAL - ACUTE,30100245,82495,HC CHROMIUM SERUM,301,1 ,$110.00 ,$55.00 ,$10.23 ,$110.00 ,$71.06 ,$10.23 ,$78.86 ,$67.59 ,$20.28 ,$66.00 ,$93.50 ,$77.00 ,$10.23 ,$104.50 ,$79.20 ,$80.30 ,$34.48 ,$93.50 ,$20.28 ,$34.48 ,$88.00 ,$80.30 ,$10.23 ,$20.28 ,$22.39 ,$110.00 ,$93.50 ,$45.63 ,$101.20 ,$77.00 ,$34.82 ,$37.40 ,$66.99 ,$34.82 ,$76.01 ,$77.00 ,$20.48 ,$79.20 ,$10.84 ,$24.34 ,$24.34 ,$20.28 ,$24.34 ,$20.28 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100246,82507,HC CITRATE,301,1 ,$184.00 ,$92.00 ,$27.80 ,$184.00 ,$118.86 ,$28.73 ,$108.12 ,$92.67 ,$27.80 ,$110.40 ,$156.40 ,$128.80 ,$28.73 ,$174.80 ,$132.48 ,$134.32 ,$47.26 ,$156.40 ,$27.80 ,$47.26 ,$147.20 ,$134.32 ,$28.73 ,$27.80 ,$30.70 ,$184.00 ,$156.40 ,$62.55 ,$169.28 ,$128.80 ,$133.13 ,$143.00 ,$112.06 ,$133.13 ,$127.14 ,$128.80 ,$28.08 ,$132.48 ,$30.45 ,$33.36 ,$33.36 ,$27.80 ,$33.36 ,$27.80 ,$132.48 ,$114.08 ,$132.48 ,$132.48 ,$110.40 ST VINCENT HOSPITAL - ACUTE,30100247,80343,HC COCAINE QN,301,1 ,$36.00 ,$18.00 ,$9.39 ,$36.00 ,$23.26 ,$9.39 ,$23.29 ,$23.29 , N/A ,$21.60 ,$30.60 ,$25.20 ,$9.39 ,$34.20 ,$25.92 ,$26.28 ,$36.00 ,$30.60 , N/A ,$36.00 ,$28.80 ,$26.28 ,$9.39 , N/A ,$35.70 ,$36.00 ,$30.60 , N/A ,$33.12 ,$25.20 ,$18.00 ,$21.60 ,$21.92 ,$18.00 ,$24.88 ,$25.20 , N/A ,$25.92 ,$9.95 , N/A , N/A , N/A , N/A , N/A ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,30100248,82525,HC COPPER (MAYO) SERUM,301,1 ,$137.00 ,$68.50 ,$12.41 ,$137.00 ,$88.50 ,$12.82 ,$48.27 ,$41.37 ,$12.41 ,$82.20 ,$116.45 ,$95.90 ,$12.82 ,$130.15 ,$98.64 ,$100.01 ,$21.10 ,$116.45 ,$12.41 ,$21.10 ,$109.60 ,$100.01 ,$12.82 ,$12.41 ,$13.70 ,$137.00 ,$116.45 ,$27.92 ,$126.04 ,$95.90 ,$49.18 ,$52.82 ,$83.43 ,$49.18 ,$94.67 ,$95.90 ,$12.53 ,$98.64 ,$13.59 ,$14.89 ,$14.89 ,$12.41 ,$14.89 ,$12.41 ,$98.64 ,$84.94 ,$98.64 ,$98.64 ,$82.20 ST VINCENT HOSPITAL - ACUTE,30100249,82525,HC COPPER URINE,301,1 ,$62.00 ,$31.00 ,$12.41 ,$62.00 ,$40.05 ,$12.82 ,$48.27 ,$41.37 ,$12.41 ,$37.20 ,$52.70 ,$43.40 ,$12.82 ,$58.90 ,$44.64 ,$45.26 ,$21.10 ,$52.70 ,$12.41 ,$21.10 ,$49.60 ,$45.26 ,$12.82 ,$12.41 ,$13.70 ,$62.00 ,$52.70 ,$27.92 ,$57.04 ,$43.40 ,$49.18 ,$52.82 ,$37.76 ,$49.18 ,$42.84 ,$43.40 ,$12.53 ,$44.64 ,$13.59 ,$14.89 ,$14.89 ,$12.41 ,$14.89 ,$12.41 ,$44.64 ,$38.44 ,$44.64 ,$44.64 ,$37.20 ST VINCENT HOSPITAL - ACUTE,30100250,82525,HC COPPER SERUM QCOP,301,1 ,$80.00 ,$40.00 ,$12.41 ,$80.00 ,$51.68 ,$12.82 ,$48.27 ,$41.37 ,$12.41 ,$48.00 ,$68.00 ,$56.00 ,$12.82 ,$76.00 ,$57.60 ,$58.40 ,$21.10 ,$68.00 ,$12.41 ,$21.10 ,$64.00 ,$58.40 ,$12.82 ,$12.41 ,$13.70 ,$80.00 ,$68.00 ,$27.92 ,$73.60 ,$56.00 ,$49.18 ,$52.82 ,$48.72 ,$49.18 ,$55.28 ,$56.00 ,$12.53 ,$57.60 ,$13.59 ,$14.89 ,$14.89 ,$12.41 ,$14.89 ,$12.41 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100251,82525,HC COPPER PLASMA,301,1 ,$107.00 ,$53.50 ,$12.41 ,$107.00 ,$69.12 ,$12.82 ,$48.27 ,$41.37 ,$12.41 ,$64.20 ,$90.95 ,$74.90 ,$12.82 ,$101.65 ,$77.04 ,$78.11 ,$21.10 ,$90.95 ,$12.41 ,$21.10 ,$85.60 ,$78.11 ,$12.82 ,$12.41 ,$13.70 ,$107.00 ,$90.95 ,$27.92 ,$98.44 ,$74.90 ,$49.18 ,$52.82 ,$65.16 ,$49.18 ,$73.94 ,$74.90 ,$12.53 ,$77.04 ,$13.59 ,$14.89 ,$14.89 ,$12.41 ,$14.89 ,$12.41 ,$77.04 ,$66.34 ,$77.04 ,$77.04 ,$64.20 ST VINCENT HOSPITAL - ACUTE,30100252,82525,HC COPPER,301,1 ,$60.00 ,$30.00 ,$12.41 ,$60.00 ,$38.76 ,$12.82 ,$48.27 ,$41.37 ,$12.41 ,$36.00 ,$51.00 ,$42.00 ,$12.82 ,$57.00 ,$43.20 ,$43.80 ,$21.10 ,$51.00 ,$12.41 ,$21.10 ,$48.00 ,$43.80 ,$12.82 ,$12.41 ,$13.70 ,$60.00 ,$51.00 ,$27.92 ,$55.20 ,$42.00 ,$49.18 ,$52.82 ,$36.54 ,$49.18 ,$41.46 ,$42.00 ,$12.53 ,$43.20 ,$13.59 ,$14.89 ,$14.89 ,$12.41 ,$14.89 ,$12.41 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100253,82530,HC CORTISOL FREE,301,1 ,$110.00 ,$55.00 ,$16.71 ,$110.00 ,$71.06 ,$17.27 ,$65.00 ,$55.71 ,$16.71 ,$66.00 ,$93.50 ,$77.00 ,$17.27 ,$104.50 ,$79.20 ,$80.30 ,$28.41 ,$93.50 ,$16.71 ,$28.41 ,$88.00 ,$80.30 ,$17.27 ,$16.71 ,$18.45 ,$110.00 ,$93.50 ,$37.60 ,$101.20 ,$77.00 ,$80.03 ,$85.96 ,$66.99 ,$80.03 ,$76.01 ,$77.00 ,$16.88 ,$79.20 ,$18.31 ,$20.05 ,$20.05 ,$16.71 ,$20.05 ,$16.71 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100254,82533,HC CORTISOL TOTAL,301,1 ,$110.00 ,$55.00 ,$16.30 ,$110.00 ,$71.06 ,$16.84 ,$63.39 ,$54.33 ,$16.30 ,$66.00 ,$93.50 ,$77.00 ,$16.84 ,$104.50 ,$79.20 ,$80.30 ,$27.71 ,$93.50 ,$16.30 ,$27.71 ,$88.00 ,$80.30 ,$16.84 ,$16.30 ,$18.00 ,$110.00 ,$93.50 ,$36.68 ,$101.20 ,$77.00 ,$78.06 ,$83.84 ,$66.99 ,$78.06 ,$76.01 ,$77.00 ,$16.46 ,$79.20 ,$17.85 ,$19.56 ,$19.56 ,$16.30 ,$19.56 ,$16.30 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100255,G0480,HC RISPERIDONE,301,1 ,$128.00 ,$64.00 ,$63.95 ,$257.47 ,$82.69 ,$63.95 ,$128.00 ,$128.00 ,$114.43 ,$76.80 ,$108.80 ,$89.60 ,$63.95 ,$121.60 ,$92.16 ,$93.44 ,$128.00 ,$108.80 ,$114.43 ,$128.00 ,$102.40 ,$93.44 ,$63.95 ,$114.43 ,$126.35 ,$128.00 ,$108.80 ,$257.47 ,$117.76 ,$89.60 ,$128.00 ,$128.00 ,$77.95 ,$128.00 ,$88.45 ,$89.60 ,$115.57 ,$92.16 ,$67.79 ,$128.00 ,$128.00 ,$114.43 ,$128.00 ,$114.43 ,$92.16 ,$79.36 ,$92.16 ,$92.16 ,$76.80 ST VINCENT HOSPITAL - ACUTE,30100256,G0480,HC THC CONFIRMATION,301,1 ,$100.00 ,$50.00 ,$50.00 ,$225.00 ,$64.60 ,$63.95 ,$100.00 ,$100.00 ,$100.00 ,$60.00 ,$85.00 ,$70.00 ,$63.95 ,$95.00 ,$72.00 ,$73.00 ,$100.00 ,$85.00 ,$100.00 ,$100.00 ,$80.00 ,$73.00 ,$63.95 ,$100.00 ,$100.00 ,$100.00 ,$85.00 ,$225.00 ,$92.00 ,$70.00 ,$100.00 ,$100.00 ,$60.90 ,$100.00 ,$69.10 ,$70.00 ,$101.00 ,$72.00 ,$67.79 ,$100.00 ,$100.00 ,$100.00 ,$100.00 ,$100.00 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100257,82542,HC ACYLGYLCINES QD,301,1 ,$669.00 ,$334.50 ,$24.09 ,$669.00 ,$432.17 ,$24.89 ,$84.32 ,$72.27 ,$24.09 ,$401.40 ,$568.65 ,$468.30 ,$24.89 ,$635.55 ,$481.68 ,$488.37 ,$40.95 ,$568.65 ,$24.09 ,$40.95 ,$535.20 ,$488.37 ,$24.89 ,$24.09 ,$26.60 ,$669.00 ,$568.65 ,$54.20 ,$615.48 ,$468.30 ,$86.45 ,$92.86 ,$407.42 ,$86.45 ,$462.28 ,$468.30 ,$24.33 ,$481.68 ,$26.38 ,$28.91 ,$28.91 ,$24.09 ,$28.91 ,$24.09 ,$481.68 ,$414.78 ,$481.68 ,$481.68 ,$401.40 ST VINCENT HOSPITAL - ACUTE,30100258,82542,HC ACYLGYLCINES (MAYO) URINE,301,1 ,$572.00 ,$286.00 ,$24.09 ,$572.00 ,$369.51 ,$24.89 ,$84.32 ,$72.27 ,$24.09 ,$343.20 ,$486.20 ,$400.40 ,$24.89 ,$543.40 ,$411.84 ,$417.56 ,$40.95 ,$486.20 ,$24.09 ,$40.95 ,$457.60 ,$417.56 ,$24.89 ,$24.09 ,$26.60 ,$572.00 ,$486.20 ,$54.20 ,$526.24 ,$400.40 ,$86.45 ,$92.86 ,$348.35 ,$86.45 ,$395.25 ,$400.40 ,$24.33 ,$411.84 ,$26.38 ,$28.91 ,$28.91 ,$24.09 ,$28.91 ,$24.09 ,$411.84 ,$354.64 ,$411.84 ,$411.84 ,$343.20 ST VINCENT HOSPITAL - ACUTE,30100259,82550,HC CREATINE KINASE (CPK) TOTAL,301,1 ,$46.00 ,$23.00 ,$6.51 ,$46.00 ,$29.72 ,$6.73 ,$25.31 ,$21.69 ,$6.51 ,$27.60 ,$39.10 ,$32.20 ,$6.73 ,$43.70 ,$33.12 ,$33.58 ,$11.07 ,$39.10 ,$6.51 ,$11.07 ,$36.80 ,$33.58 ,$6.73 ,$6.51 ,$7.19 ,$46.00 ,$39.10 ,$14.65 ,$42.32 ,$32.20 ,$31.17 ,$33.48 ,$28.01 ,$31.17 ,$31.79 ,$32.20 ,$6.58 ,$33.12 ,$7.13 ,$7.81 ,$7.81 ,$6.51 ,$7.81 ,$6.51 ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,30100260,82552,HC CREATINE KINASE (CPK) ISO,301,1 ,$82.00 ,$41.00 ,$13.39 ,$82.00 ,$52.97 ,$13.84 ,$52.08 ,$44.64 ,$13.39 ,$49.20 ,$69.70 ,$57.40 ,$13.84 ,$77.90 ,$59.04 ,$59.86 ,$22.76 ,$69.70 ,$13.39 ,$22.76 ,$65.60 ,$59.86 ,$13.84 ,$13.39 ,$14.79 ,$82.00 ,$69.70 ,$30.13 ,$75.44 ,$57.40 ,$64.16 ,$68.92 ,$49.94 ,$64.16 ,$56.66 ,$57.40 ,$13.52 ,$59.04 ,$14.67 ,$16.07 ,$16.07 ,$13.39 ,$16.07 ,$13.39 ,$59.04 ,$50.84 ,$59.04 ,$59.04 ,$49.20 ST VINCENT HOSPITAL - ACUTE,30100261,82553,HC CREATINE KINASE MB FRAC,301,1 ,$60.00 ,$30.00 ,$8.66 ,$60.00 ,$38.76 ,$8.66 ,$44.91 ,$38.49 ,$11.55 ,$36.00 ,$51.00 ,$42.00 ,$8.66 ,$57.00 ,$43.20 ,$43.80 ,$19.64 ,$51.00 ,$11.55 ,$19.64 ,$48.00 ,$43.80 ,$8.66 ,$11.55 ,$12.75 ,$60.00 ,$51.00 ,$25.99 ,$55.20 ,$42.00 ,$29.48 ,$31.67 ,$36.54 ,$29.48 ,$41.46 ,$42.00 ,$11.67 ,$43.20 ,$9.18 ,$13.86 ,$13.86 ,$11.55 ,$13.86 ,$11.55 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100262,82565,HC CREATININE,301,1 ,$35.00 ,$17.50 ,$5.12 ,$35.00 ,$22.61 ,$5.29 ,$19.92 ,$17.07 ,$5.12 ,$21.00 ,$29.75 ,$24.50 ,$5.29 ,$33.25 ,$25.20 ,$25.55 ,$8.70 ,$29.75 ,$5.12 ,$8.70 ,$28.00 ,$25.55 ,$5.29 ,$5.12 ,$5.65 ,$35.00 ,$29.75 ,$11.52 ,$32.20 ,$24.50 ,$24.53 ,$26.35 ,$21.32 ,$24.53 ,$24.19 ,$24.50 ,$5.17 ,$25.20 ,$5.61 ,$6.14 ,$6.14 ,$5.12 ,$6.14 ,$5.12 ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,30100263,82570,HC CREATININE BODY FLUID,301,1 ,$35.00 ,$17.50 ,$5.18 ,$35.00 ,$22.61 ,$5.35 ,$20.13 ,$17.25 ,$5.18 ,$21.00 ,$29.75 ,$24.50 ,$5.35 ,$33.25 ,$25.20 ,$25.55 ,$8.81 ,$29.75 ,$5.18 ,$8.81 ,$28.00 ,$25.55 ,$5.35 ,$5.18 ,$5.72 ,$35.00 ,$29.75 ,$11.66 ,$32.20 ,$24.50 ,$24.78 ,$26.62 ,$21.32 ,$24.78 ,$24.19 ,$24.50 ,$5.23 ,$25.20 ,$5.67 ,$6.22 ,$6.22 ,$5.18 ,$6.22 ,$5.18 ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,30100264,82570,HC CREATININE OTH SOURCE,301,1 ,$35.00 ,$17.50 ,$5.18 ,$35.00 ,$22.61 ,$5.35 ,$20.13 ,$17.25 ,$5.18 ,$21.00 ,$29.75 ,$24.50 ,$5.35 ,$33.25 ,$25.20 ,$25.55 ,$8.81 ,$29.75 ,$5.18 ,$8.81 ,$28.00 ,$25.55 ,$5.35 ,$5.18 ,$5.72 ,$35.00 ,$29.75 ,$11.66 ,$32.20 ,$24.50 ,$24.78 ,$26.62 ,$21.32 ,$24.78 ,$24.19 ,$24.50 ,$5.23 ,$25.20 ,$5.67 ,$6.22 ,$6.22 ,$5.18 ,$6.22 ,$5.18 ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,30100265,82570,HC CREATININE STONE,301,1 ,$35.00 ,$17.50 ,$5.18 ,$35.00 ,$22.61 ,$5.35 ,$20.13 ,$17.25 ,$5.18 ,$21.00 ,$29.75 ,$24.50 ,$5.35 ,$33.25 ,$25.20 ,$25.55 ,$8.81 ,$29.75 ,$5.18 ,$8.81 ,$28.00 ,$25.55 ,$5.35 ,$5.18 ,$5.72 ,$35.00 ,$29.75 ,$11.66 ,$32.20 ,$24.50 ,$24.78 ,$26.62 ,$21.32 ,$24.78 ,$24.19 ,$24.50 ,$5.23 ,$25.20 ,$5.67 ,$6.22 ,$6.22 ,$5.18 ,$6.22 ,$5.18 ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,30100266,82575,HC CREATININE CLEARANCE,301,1 ,$80.00 ,$40.00 ,$9.46 ,$80.00 ,$51.68 ,$9.78 ,$36.79 ,$31.53 ,$9.46 ,$48.00 ,$68.00 ,$56.00 ,$9.78 ,$76.00 ,$57.60 ,$58.40 ,$16.08 ,$68.00 ,$9.46 ,$16.08 ,$64.00 ,$58.40 ,$9.78 ,$9.46 ,$10.45 ,$80.00 ,$68.00 ,$21.29 ,$73.60 ,$56.00 ,$45.24 ,$48.60 ,$48.72 ,$45.24 ,$55.28 ,$56.00 ,$9.55 ,$57.60 ,$10.37 ,$11.35 ,$11.35 ,$9.46 ,$11.35 ,$9.46 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100267,82585,HC CRYOFIBRINOGEN,301,1 ,$46.00 ,$23.00 ,$9.02 ,$46.00 ,$29.72 ,$9.02 ,$46.00 ,$42.42 ,$14.14 ,$27.60 ,$39.10 ,$32.20 ,$9.02 ,$43.70 ,$33.12 ,$33.58 ,$24.04 ,$39.10 ,$14.14 ,$24.04 ,$36.80 ,$33.58 ,$9.02 ,$14.14 ,$15.61 ,$46.00 ,$39.10 ,$31.82 ,$42.32 ,$32.20 ,$30.71 ,$32.99 ,$28.01 ,$30.71 ,$31.79 ,$32.20 ,$14.28 ,$33.12 ,$9.56 ,$16.97 ,$16.97 ,$14.14 ,$16.97 ,$14.14 ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,30100268,82595,HC CRYOGLOBULIN,301,1 ,$150.00 ,$75.00 ,$6.47 ,$150.00 ,$96.90 ,$6.69 ,$25.13 ,$21.54 ,$6.47 ,$90.00 ,$127.50 ,$105.00 ,$6.69 ,$142.50 ,$108.00 ,$109.50 ,$11.00 ,$127.50 ,$6.47 ,$11.00 ,$120.00 ,$109.50 ,$6.69 ,$6.47 ,$7.14 ,$150.00 ,$127.50 ,$14.56 ,$138.00 ,$105.00 ,$30.99 ,$33.29 ,$91.35 ,$30.99 ,$103.65 ,$105.00 ,$6.53 ,$108.00 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100269,82607,HC VITAMIN B12,301,1 ,$100.00 ,$50.00 ,$15.08 ,$100.00 ,$64.60 ,$15.58 ,$58.63 ,$50.25 ,$15.08 ,$60.00 ,$85.00 ,$70.00 ,$15.58 ,$95.00 ,$72.00 ,$73.00 ,$25.64 ,$85.00 ,$15.08 ,$25.64 ,$80.00 ,$73.00 ,$15.58 ,$15.08 ,$16.65 ,$100.00 ,$85.00 ,$33.93 ,$92.00 ,$70.00 ,$72.17 ,$77.51 ,$60.90 ,$72.17 ,$69.10 ,$70.00 ,$15.23 ,$72.00 ,$16.51 ,$18.10 ,$18.10 ,$15.08 ,$18.10 ,$15.08 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100270,82626,HC DHEA,301,1 ,$170.00 ,$85.00 ,$25.27 ,$170.00 ,$109.82 ,$26.11 ,$98.28 ,$84.24 ,$25.27 ,$102.00 ,$144.50 ,$119.00 ,$26.11 ,$161.50 ,$122.40 ,$124.10 ,$42.96 ,$144.50 ,$25.27 ,$42.96 ,$136.00 ,$124.10 ,$26.11 ,$25.27 ,$27.90 ,$170.00 ,$144.50 ,$56.86 ,$156.40 ,$119.00 ,$121.02 ,$129.99 ,$103.53 ,$121.02 ,$117.47 ,$119.00 ,$25.52 ,$122.40 ,$27.68 ,$30.32 ,$30.32 ,$25.27 ,$30.32 ,$25.27 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100271,82627,HC DHEA SULFATE,301,1 ,$150.00 ,$75.00 ,$22.23 ,$150.00 ,$96.90 ,$22.97 ,$86.49 ,$74.13 ,$22.23 ,$90.00 ,$127.50 ,$105.00 ,$22.97 ,$142.50 ,$108.00 ,$109.50 ,$37.79 ,$127.50 ,$22.23 ,$37.79 ,$120.00 ,$109.50 ,$22.97 ,$22.23 ,$24.55 ,$150.00 ,$127.50 ,$50.02 ,$138.00 ,$105.00 ,$106.46 ,$114.34 ,$91.35 ,$106.46 ,$103.65 ,$105.00 ,$22.45 ,$108.00 ,$24.35 ,$26.68 ,$26.68 ,$22.23 ,$26.68 ,$22.23 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100272,82652,HC VITAMIN D (1 25 DIHYDROXY),301,1 ,$260.00 ,$130.00 ,$38.50 ,$260.00 ,$167.96 ,$39.78 ,$149.73 ,$128.34 ,$38.50 ,$156.00 ,$221.00 ,$182.00 ,$39.78 ,$247.00 ,$187.20 ,$189.80 ,$65.45 ,$221.00 ,$38.50 ,$65.45 ,$208.00 ,$189.80 ,$39.78 ,$38.50 ,$42.51 ,$260.00 ,$221.00 ,$86.63 ,$239.20 ,$182.00 ,$184.38 ,$198.04 ,$158.34 ,$184.38 ,$179.66 ,$182.00 ,$38.89 ,$187.20 ,$42.17 ,$46.20 ,$46.20 ,$38.50 ,$46.20 ,$38.50 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30100273,82657,HC ENZYME ACT NONRAD SUBS,301,1 ,$230.00 ,$115.00 ,$22.17 ,$230.00 ,$148.58 ,$22.91 ,$77.60 ,$66.51 ,$22.17 ,$138.00 ,$195.50 ,$161.00 ,$22.91 ,$218.50 ,$165.60 ,$167.90 ,$37.69 ,$195.50 ,$22.17 ,$37.69 ,$184.00 ,$167.90 ,$22.91 ,$22.17 ,$24.48 ,$230.00 ,$195.50 ,$49.88 ,$211.60 ,$161.00 ,$86.45 ,$92.86 ,$140.07 ,$86.45 ,$158.93 ,$161.00 ,$22.39 ,$165.60 ,$24.28 ,$26.60 ,$26.60 ,$22.17 ,$26.60 ,$22.17 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,30100274,82664,HC ELECTROPHORETIC TEST,301,1 ,$200.00 ,$100.00 ,$48.31 ,$200.00 ,$129.20 ,$48.31 ,$200.00 ,$184.50 ,$61.50 ,$120.00 ,$170.00 ,$140.00 ,$48.31 ,$190.00 ,$144.00 ,$146.00 ,$104.55 ,$170.00 ,$61.50 ,$104.55 ,$160.00 ,$146.00 ,$48.31 ,$61.50 ,$67.91 ,$200.00 ,$170.00 ,$138.38 ,$184.00 ,$140.00 ,$164.51 ,$176.70 ,$121.80 ,$164.51 ,$138.20 ,$140.00 ,$62.12 ,$144.00 ,$51.21 ,$73.80 ,$73.80 ,$61.50 ,$73.80 ,$61.50 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30100275,82668,HC ERYTHROPOIETIN,301,1 ,$90.00 ,$45.00 ,$18.79 ,$90.00 ,$58.14 ,$19.42 ,$73.08 ,$62.64 ,$18.79 ,$54.00 ,$76.50 ,$63.00 ,$19.42 ,$85.50 ,$64.80 ,$65.70 ,$31.94 ,$76.50 ,$18.79 ,$31.94 ,$72.00 ,$65.70 ,$19.42 ,$18.79 ,$20.75 ,$90.00 ,$76.50 ,$42.28 ,$82.80 ,$63.00 ,$90.00 ,$90.00 ,$54.81 ,$90.00 ,$62.19 ,$63.00 ,$18.98 ,$64.80 ,$20.59 ,$22.55 ,$22.55 ,$18.79 ,$22.55 ,$18.79 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100276,82670,HC ESTRADIOL,301,1 ,$190.00 ,$95.00 ,$27.94 ,$190.00 ,$122.74 ,$28.87 ,$108.64 ,$93.12 ,$27.94 ,$114.00 ,$161.50 ,$133.00 ,$28.87 ,$180.50 ,$136.80 ,$138.70 ,$47.50 ,$161.50 ,$27.94 ,$47.50 ,$152.00 ,$138.70 ,$28.87 ,$27.94 ,$30.85 ,$190.00 ,$161.50 ,$62.87 ,$174.80 ,$133.00 ,$133.80 ,$143.71 ,$115.71 ,$133.80 ,$131.29 ,$133.00 ,$28.22 ,$136.80 ,$30.60 ,$33.53 ,$33.53 ,$27.94 ,$33.53 ,$27.94 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30100277,82670,HC ESTRADIOL SERUM,301,1 ,$190.00 ,$95.00 ,$27.94 ,$190.00 ,$122.74 ,$28.87 ,$108.64 ,$93.12 ,$27.94 ,$114.00 ,$161.50 ,$133.00 ,$28.87 ,$180.50 ,$136.80 ,$138.70 ,$47.50 ,$161.50 ,$27.94 ,$47.50 ,$152.00 ,$138.70 ,$28.87 ,$27.94 ,$30.85 ,$190.00 ,$161.50 ,$62.87 ,$174.80 ,$133.00 ,$133.80 ,$143.71 ,$115.71 ,$133.80 ,$131.29 ,$133.00 ,$28.22 ,$136.80 ,$30.60 ,$33.53 ,$33.53 ,$27.94 ,$33.53 ,$27.94 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30100278,82672,HC ESTROGEN TOTAL,301,1 ,$150.00 ,$75.00 ,$21.70 ,$150.00 ,$96.90 ,$22.42 ,$84.39 ,$72.33 ,$21.70 ,$90.00 ,$127.50 ,$105.00 ,$22.42 ,$142.50 ,$108.00 ,$109.50 ,$36.89 ,$127.50 ,$21.70 ,$36.89 ,$120.00 ,$109.50 ,$22.42 ,$21.70 ,$23.96 ,$150.00 ,$127.50 ,$48.83 ,$138.00 ,$105.00 ,$103.90 ,$111.59 ,$91.35 ,$103.90 ,$103.65 ,$105.00 ,$21.92 ,$108.00 ,$23.77 ,$26.04 ,$26.04 ,$21.70 ,$26.04 ,$21.70 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100279,82672,HC ESTROGEN 24HR URINE,301,1 ,$167.00 ,$83.50 ,$21.70 ,$167.00 ,$107.88 ,$22.42 ,$84.39 ,$72.33 ,$21.70 ,$100.20 ,$141.95 ,$116.90 ,$22.42 ,$158.65 ,$120.24 ,$121.91 ,$36.89 ,$141.95 ,$21.70 ,$36.89 ,$133.60 ,$121.91 ,$22.42 ,$21.70 ,$23.96 ,$167.00 ,$141.95 ,$48.83 ,$153.64 ,$116.90 ,$103.90 ,$111.59 ,$101.70 ,$103.90 ,$115.40 ,$116.90 ,$21.92 ,$120.24 ,$23.77 ,$26.04 ,$26.04 ,$21.70 ,$26.04 ,$21.70 ,$120.24 ,$103.54 ,$120.24 ,$120.24 ,$100.20 ST VINCENT HOSPITAL - ACUTE,30100280,82677,HC ESTRIOL,301,1 ,$180.00 ,$90.00 ,$24.18 ,$180.00 ,$116.28 ,$24.99 ,$94.05 ,$80.61 ,$24.18 ,$108.00 ,$153.00 ,$126.00 ,$24.99 ,$171.00 ,$129.60 ,$131.40 ,$41.11 ,$153.00 ,$24.18 ,$41.11 ,$144.00 ,$131.40 ,$24.99 ,$24.18 ,$26.70 ,$180.00 ,$153.00 ,$54.41 ,$165.60 ,$126.00 ,$115.79 ,$124.37 ,$109.62 ,$115.79 ,$124.38 ,$126.00 ,$24.42 ,$129.60 ,$26.49 ,$29.02 ,$29.02 ,$24.18 ,$29.02 ,$24.18 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30100281,82677,HC ESTRIOL QUAD,301,1 ,$101.00 ,$50.50 ,$24.18 ,$101.00 ,$65.25 ,$24.99 ,$94.05 ,$80.61 ,$24.18 ,$60.60 ,$85.85 ,$70.70 ,$24.99 ,$95.95 ,$72.72 ,$73.73 ,$41.11 ,$85.85 ,$24.18 ,$41.11 ,$80.80 ,$73.73 ,$24.99 ,$24.18 ,$26.70 ,$101.00 ,$85.85 ,$54.41 ,$92.92 ,$70.70 ,$101.00 ,$101.00 ,$61.51 ,$101.00 ,$69.79 ,$70.70 ,$24.42 ,$72.72 ,$26.49 ,$29.02 ,$29.02 ,$24.18 ,$29.02 ,$24.18 ,$72.72 ,$62.62 ,$72.72 ,$72.72 ,$60.60 ST VINCENT HOSPITAL - ACUTE,30100283,82677,HC ESTRIOL URINE,301,1 ,$210.00 ,$105.00 ,$24.18 ,$210.00 ,$135.66 ,$24.99 ,$94.05 ,$80.61 ,$24.18 ,$126.00 ,$178.50 ,$147.00 ,$24.99 ,$199.50 ,$151.20 ,$153.30 ,$41.11 ,$178.50 ,$24.18 ,$41.11 ,$168.00 ,$153.30 ,$24.99 ,$24.18 ,$26.70 ,$210.00 ,$178.50 ,$54.41 ,$193.20 ,$147.00 ,$115.79 ,$124.37 ,$127.89 ,$115.79 ,$145.11 ,$147.00 ,$24.42 ,$151.20 ,$26.49 ,$29.02 ,$29.02 ,$24.18 ,$29.02 ,$24.18 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,30100284,82677,HC ESTRIOL ASSAY,301,1 ,$127.00 ,$63.50 ,$24.18 ,$127.00 ,$82.04 ,$24.99 ,$94.05 ,$80.61 ,$24.18 ,$76.20 ,$107.95 ,$88.90 ,$24.99 ,$120.65 ,$91.44 ,$92.71 ,$41.11 ,$107.95 ,$24.18 ,$41.11 ,$101.60 ,$92.71 ,$24.99 ,$24.18 ,$26.70 ,$127.00 ,$107.95 ,$54.41 ,$116.84 ,$88.90 ,$115.79 ,$124.37 ,$77.34 ,$115.79 ,$87.76 ,$88.90 ,$24.42 ,$91.44 ,$26.49 ,$29.02 ,$29.02 ,$24.18 ,$29.02 ,$24.18 ,$91.44 ,$78.74 ,$91.44 ,$91.44 ,$76.20 ST VINCENT HOSPITAL - ACUTE,30100285,82679,HC ESTRONE,301,1 ,$163.00 ,$81.50 ,$24.95 ,$163.00 ,$105.30 ,$25.78 ,$97.06 ,$83.19 ,$24.95 ,$97.80 ,$138.55 ,$114.10 ,$25.78 ,$154.85 ,$117.36 ,$118.99 ,$42.42 ,$138.55 ,$24.95 ,$42.42 ,$130.40 ,$118.99 ,$25.78 ,$24.95 ,$27.55 ,$163.00 ,$138.55 ,$56.14 ,$149.96 ,$114.10 ,$119.52 ,$128.37 ,$99.27 ,$119.52 ,$112.63 ,$114.10 ,$25.20 ,$117.36 ,$27.33 ,$29.94 ,$29.94 ,$24.95 ,$29.94 ,$24.95 ,$117.36 ,$101.06 ,$117.36 ,$117.36 ,$97.80 ST VINCENT HOSPITAL - ACUTE,30100286,82693,HC ETHYLENE GLYCOL,301,1 ,$357.00 ,$178.50 ,$7.95 ,$357.00 ,$230.62 ,$7.95 ,$57.96 ,$49.68 ,$14.90 ,$214.20 ,$303.45 ,$249.90 ,$7.95 ,$339.15 ,$257.04 ,$260.61 ,$25.33 ,$303.45 ,$14.90 ,$25.33 ,$285.60 ,$260.61 ,$7.95 ,$14.90 ,$16.45 ,$357.00 ,$303.45 ,$33.53 ,$328.44 ,$249.90 ,$27.06 ,$29.07 ,$217.41 ,$27.06 ,$246.69 ,$249.90 ,$15.05 ,$257.04 ,$8.43 ,$17.88 ,$17.88 ,$14.90 ,$17.88 ,$14.90 ,$257.04 ,$221.34 ,$257.04 ,$257.04 ,$214.20 ST VINCENT HOSPITAL - ACUTE,30100287,82710,HC FECAL FAT QN,301,1 ,$250.00 ,$125.00 ,$16.80 ,$250.00 ,$161.50 ,$17.36 ,$65.35 ,$56.01 ,$16.80 ,$150.00 ,$212.50 ,$175.00 ,$17.36 ,$237.50 ,$180.00 ,$182.50 ,$28.56 ,$212.50 ,$16.80 ,$28.56 ,$200.00 ,$182.50 ,$17.36 ,$16.80 ,$18.55 ,$250.00 ,$212.50 ,$37.80 ,$230.00 ,$175.00 ,$80.48 ,$86.45 ,$152.25 ,$80.48 ,$172.75 ,$175.00 ,$16.97 ,$180.00 ,$18.40 ,$20.16 ,$20.16 ,$16.80 ,$20.16 ,$16.80 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,30100288,82725,HC FATTY ACIDS NONESTERIFIED,301,1 ,$140.00 ,$70.00 ,$18.72 ,$140.00 ,$90.44 ,$18.72 ,$65.70 ,$56.31 ,$18.77 ,$84.00 ,$119.00 ,$98.00 ,$18.72 ,$133.00 ,$100.80 ,$102.20 ,$31.91 ,$119.00 ,$18.77 ,$31.91 ,$112.00 ,$102.20 ,$18.72 ,$18.77 ,$20.73 ,$140.00 ,$119.00 ,$42.23 ,$128.80 ,$98.00 ,$63.74 ,$68.46 ,$85.26 ,$63.74 ,$96.74 ,$98.00 ,$18.96 ,$100.80 ,$19.84 ,$22.52 ,$22.52 ,$18.77 ,$22.52 ,$18.77 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30100289,82726,HC VLFC FATTY ACIDS,301,1 ,$250.00 ,$125.00 ,$19.75 ,$250.00 ,$161.50 ,$20.41 ,$70.21 ,$60.18 ,$19.75 ,$150.00 ,$212.50 ,$175.00 ,$20.41 ,$237.50 ,$180.00 ,$182.50 ,$33.58 ,$212.50 ,$19.75 ,$33.58 ,$200.00 ,$182.50 ,$20.41 ,$19.75 ,$21.81 ,$250.00 ,$212.50 ,$44.44 ,$230.00 ,$175.00 ,$86.45 ,$92.86 ,$152.25 ,$86.45 ,$172.75 ,$175.00 ,$19.95 ,$180.00 ,$21.63 ,$23.70 ,$23.70 ,$19.75 ,$23.70 ,$19.75 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,30100290,82728,HC FERRITIN,301,1 ,$90.00 ,$45.00 ,$13.63 ,$90.00 ,$58.14 ,$14.08 ,$53.03 ,$45.45 ,$13.63 ,$54.00 ,$76.50 ,$63.00 ,$14.08 ,$85.50 ,$64.80 ,$65.70 ,$23.17 ,$76.50 ,$13.63 ,$23.17 ,$72.00 ,$65.70 ,$14.08 ,$13.63 ,$15.05 ,$90.00 ,$76.50 ,$30.67 ,$82.80 ,$63.00 ,$65.25 ,$70.08 ,$54.81 ,$65.25 ,$62.19 ,$63.00 ,$13.77 ,$64.80 ,$14.92 ,$16.36 ,$16.36 ,$13.63 ,$16.36 ,$13.63 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100291,82731,HC FETAL FIBRONECTIN,301,1 ,$440.00 ,$220.00 ,$64.41 ,$440.00 ,$284.24 ,$66.55 ,$250.50 ,$214.71 ,$64.41 ,$264.00 ,$374.00 ,$308.00 ,$66.55 ,$418.00 ,$316.80 ,$321.20 ,$109.50 ,$374.00 ,$64.41 ,$109.50 ,$352.00 ,$321.20 ,$66.55 ,$64.41 ,$71.12 ,$440.00 ,$374.00 ,$144.92 ,$404.80 ,$308.00 ,$308.46 ,$331.31 ,$267.96 ,$308.46 ,$304.04 ,$308.00 ,$65.05 ,$316.80 ,$70.54 ,$77.29 ,$77.29 ,$64.41 ,$77.29 ,$64.41 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,30100292,82746,HC FOLIC ACID SERUM,301,1 ,$100.00 ,$50.00 ,$14.70 ,$100.00 ,$64.60 ,$15.19 ,$57.19 ,$49.02 ,$14.70 ,$60.00 ,$85.00 ,$70.00 ,$15.19 ,$95.00 ,$72.00 ,$73.00 ,$24.99 ,$85.00 ,$14.70 ,$24.99 ,$80.00 ,$73.00 ,$15.19 ,$14.70 ,$16.23 ,$100.00 ,$85.00 ,$33.08 ,$92.00 ,$70.00 ,$70.41 ,$75.63 ,$60.90 ,$70.41 ,$69.10 ,$70.00 ,$14.85 ,$72.00 ,$16.10 ,$17.64 ,$17.64 ,$14.70 ,$17.64 ,$14.70 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100293,82747,HC FOLIC ACID RBC,301,1 ,$80.00 ,$40.00 ,$16.37 ,$80.00 ,$51.68 ,$16.37 ,$67.38 ,$57.75 ,$17.65 ,$48.00 ,$68.00 ,$56.00 ,$16.37 ,$76.00 ,$57.60 ,$58.40 ,$30.01 ,$68.00 ,$17.65 ,$30.01 ,$64.00 ,$58.40 ,$16.37 ,$17.65 ,$19.49 ,$80.00 ,$68.00 ,$39.71 ,$73.60 ,$56.00 ,$55.74 ,$59.87 ,$48.72 ,$55.74 ,$55.28 ,$56.00 ,$17.83 ,$57.60 ,$17.35 ,$21.18 ,$21.18 ,$17.65 ,$21.18 ,$17.65 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100295,82784,HC GAMMAGLOBULIN,301,1 ,$60.00 ,$30.00 ,$9.30 ,$60.00 ,$38.76 ,$9.61 ,$36.19 ,$31.02 ,$9.30 ,$36.00 ,$51.00 ,$42.00 ,$9.61 ,$57.00 ,$43.20 ,$43.80 ,$15.81 ,$51.00 ,$9.30 ,$15.81 ,$48.00 ,$43.80 ,$9.61 ,$9.30 ,$10.27 ,$60.00 ,$51.00 ,$20.93 ,$55.20 ,$42.00 ,$44.51 ,$47.80 ,$36.54 ,$44.51 ,$41.46 ,$42.00 ,$9.39 ,$43.20 ,$10.19 ,$11.16 ,$11.16 ,$9.30 ,$11.16 ,$9.30 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100296,82784,HC IGA (TISSUE TRNSGLT),301,1 ,$32.00 ,$16.00 ,$9.30 ,$32.00 ,$20.67 ,$9.61 ,$32.00 ,$31.02 ,$9.30 ,$19.20 ,$27.20 ,$22.40 ,$9.61 ,$30.40 ,$23.04 ,$23.36 ,$15.81 ,$27.20 ,$9.30 ,$15.81 ,$25.60 ,$23.36 ,$9.61 ,$9.30 ,$10.27 ,$32.00 ,$27.20 ,$20.93 ,$29.44 ,$22.40 ,$32.00 ,$32.00 ,$19.49 ,$32.00 ,$22.11 ,$22.40 ,$9.39 ,$23.04 ,$10.19 ,$11.16 ,$11.16 ,$9.30 ,$11.16 ,$9.30 ,$23.04 ,$19.84 ,$23.04 ,$23.04 ,$19.20 ST VINCENT HOSPITAL - ACUTE,30100297,82784,HC IGA (CELIAC SCRN),301,1 ,$60.00 ,$30.00 ,$9.30 ,$60.00 ,$38.76 ,$9.61 ,$36.19 ,$31.02 ,$9.30 ,$36.00 ,$51.00 ,$42.00 ,$9.61 ,$57.00 ,$43.20 ,$43.80 ,$15.81 ,$51.00 ,$9.30 ,$15.81 ,$48.00 ,$43.80 ,$9.61 ,$9.30 ,$10.27 ,$60.00 ,$51.00 ,$20.93 ,$55.20 ,$42.00 ,$44.51 ,$47.80 ,$36.54 ,$44.51 ,$41.46 ,$42.00 ,$9.39 ,$43.20 ,$10.19 ,$11.16 ,$11.16 ,$9.30 ,$11.16 ,$9.30 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100298,82784,HC GAMMAGLOBULIN TOTAL,301,1 ,$60.00 ,$30.00 ,$9.30 ,$60.00 ,$38.76 ,$9.61 ,$36.19 ,$31.02 ,$9.30 ,$36.00 ,$51.00 ,$42.00 ,$9.61 ,$57.00 ,$43.20 ,$43.80 ,$15.81 ,$51.00 ,$9.30 ,$15.81 ,$48.00 ,$43.80 ,$9.61 ,$9.30 ,$10.27 ,$60.00 ,$51.00 ,$20.93 ,$55.20 ,$42.00 ,$44.51 ,$47.80 ,$36.54 ,$44.51 ,$41.46 ,$42.00 ,$9.39 ,$43.20 ,$10.19 ,$11.16 ,$11.16 ,$9.30 ,$11.16 ,$9.30 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100299,82784,HC CP IGA,301,1 ,$60.00 ,$30.00 ,$9.30 ,$60.00 ,$38.76 ,$9.61 ,$36.19 ,$31.02 ,$9.30 ,$36.00 ,$51.00 ,$42.00 ,$9.61 ,$57.00 ,$43.20 ,$43.80 ,$15.81 ,$51.00 ,$9.30 ,$15.81 ,$48.00 ,$43.80 ,$9.61 ,$9.30 ,$10.27 ,$60.00 ,$51.00 ,$20.93 ,$55.20 ,$42.00 ,$44.51 ,$47.80 ,$36.54 ,$44.51 ,$41.46 ,$42.00 ,$9.39 ,$43.20 ,$10.19 ,$11.16 ,$11.16 ,$9.30 ,$11.16 ,$9.30 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100300,82784,HC IGD SERUM,301,1 ,$63.00 ,$31.50 ,$9.30 ,$63.00 ,$40.70 ,$9.61 ,$36.19 ,$31.02 ,$9.30 ,$37.80 ,$53.55 ,$44.10 ,$9.61 ,$59.85 ,$45.36 ,$45.99 ,$15.81 ,$53.55 ,$9.30 ,$15.81 ,$50.40 ,$45.99 ,$9.61 ,$9.30 ,$10.27 ,$63.00 ,$53.55 ,$20.93 ,$57.96 ,$44.10 ,$44.51 ,$47.80 ,$38.37 ,$44.51 ,$43.53 ,$44.10 ,$9.39 ,$45.36 ,$10.19 ,$11.16 ,$11.16 ,$9.30 ,$11.16 ,$9.30 ,$45.36 ,$39.06 ,$45.36 ,$45.36 ,$37.80 ST VINCENT HOSPITAL - ACUTE,30100301,82784,HC GAMMAGLOBULIN CSF/SERUM,301,1 ,$63.00 ,$31.50 ,$9.30 ,$63.00 ,$40.70 ,$9.61 ,$36.19 ,$31.02 ,$9.30 ,$37.80 ,$53.55 ,$44.10 ,$9.61 ,$59.85 ,$45.36 ,$45.99 ,$15.81 ,$53.55 ,$9.30 ,$15.81 ,$50.40 ,$45.99 ,$9.61 ,$9.30 ,$10.27 ,$63.00 ,$53.55 ,$20.93 ,$57.96 ,$44.10 ,$44.51 ,$47.80 ,$38.37 ,$44.51 ,$43.53 ,$44.10 ,$9.39 ,$45.36 ,$10.19 ,$11.16 ,$11.16 ,$9.30 ,$11.16 ,$9.30 ,$45.36 ,$39.06 ,$45.36 ,$45.36 ,$37.80 ST VINCENT HOSPITAL - ACUTE,30100302,82785,HC GAMMAGLOBULIN IGE,301,1 ,$110.00 ,$55.00 ,$16.46 ,$110.00 ,$71.06 ,$17.01 ,$64.02 ,$54.87 ,$16.46 ,$66.00 ,$93.50 ,$77.00 ,$17.01 ,$104.50 ,$79.20 ,$80.30 ,$27.98 ,$93.50 ,$16.46 ,$27.98 ,$88.00 ,$80.30 ,$17.01 ,$16.46 ,$18.18 ,$110.00 ,$93.50 ,$37.04 ,$101.20 ,$77.00 ,$78.87 ,$84.71 ,$66.99 ,$78.87 ,$76.01 ,$77.00 ,$16.62 ,$79.20 ,$18.03 ,$19.75 ,$19.75 ,$16.46 ,$19.75 ,$16.46 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100303,82787,HC IGG SUBCLASS1-3,301,1 ,$37.00 ,$18.50 ,$5.90 ,$37.00 ,$23.90 ,$5.90 ,$31.19 ,$26.73 ,$8.02 ,$22.20 ,$31.45 ,$25.90 ,$5.90 ,$35.15 ,$26.64 ,$27.01 ,$13.63 ,$31.45 ,$8.02 ,$13.63 ,$29.60 ,$27.01 ,$5.90 ,$8.02 ,$8.86 ,$37.00 ,$31.45 ,$18.05 ,$34.04 ,$25.90 ,$20.08 ,$21.56 ,$22.53 ,$20.08 ,$25.57 ,$25.90 ,$8.10 ,$26.64 ,$6.25 ,$9.62 ,$9.62 ,$8.02 ,$9.62 ,$8.02 ,$26.64 ,$22.94 ,$26.64 ,$26.64 ,$22.20 ST VINCENT HOSPITAL - ACUTE,30100304,82787,HC IGG SUBCLASS 4,301,1 ,$37.00 ,$18.50 ,$5.90 ,$37.00 ,$23.90 ,$5.90 ,$31.19 ,$26.73 ,$8.02 ,$22.20 ,$31.45 ,$25.90 ,$5.90 ,$35.15 ,$26.64 ,$27.01 ,$13.63 ,$31.45 ,$8.02 ,$13.63 ,$29.60 ,$27.01 ,$5.90 ,$8.02 ,$8.86 ,$37.00 ,$31.45 ,$18.05 ,$34.04 ,$25.90 ,$20.08 ,$21.56 ,$22.53 ,$20.08 ,$25.57 ,$25.90 ,$8.10 ,$26.64 ,$6.25 ,$9.62 ,$9.62 ,$8.02 ,$9.62 ,$8.02 ,$26.64 ,$22.94 ,$26.64 ,$26.64 ,$22.20 ST VINCENT HOSPITAL - ACUTE,30100305,82800,HC BLOOD GAS PH,301,1 ,$75.00 ,$37.50 ,$11.00 ,$75.00 ,$48.45 ,$11.37 ,$38.50 ,$33.00 ,$11.00 ,$45.00 ,$63.75 ,$52.50 ,$11.37 ,$71.25 ,$54.00 ,$54.75 ,$18.70 ,$63.75 ,$11.00 ,$18.70 ,$60.00 ,$54.75 ,$11.37 ,$11.00 ,$12.15 ,$75.00 ,$63.75 ,$24.75 ,$69.00 ,$52.50 ,$40.51 ,$43.51 ,$45.68 ,$40.51 ,$51.83 ,$52.50 ,$11.11 ,$54.00 ,$12.05 ,$13.20 ,$13.20 ,$11.00 ,$13.20 ,$11.00 ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,30100306,82803,HC BLOOD GAS PH PO2 AND /OR PCO2,301,1 ,$130.00 ,$65.00 ,$26.07 ,$130.00 ,$83.98 ,$26.94 ,$91.25 ,$78.21 ,$26.07 ,$78.00 ,$110.50 ,$91.00 ,$26.94 ,$123.50 ,$93.60 ,$94.90 ,$44.32 ,$110.50 ,$26.07 ,$44.32 ,$104.00 ,$94.90 ,$26.94 ,$26.07 ,$28.79 ,$130.00 ,$110.50 ,$58.66 ,$119.60 ,$91.00 ,$92.66 ,$99.53 ,$79.17 ,$92.66 ,$89.83 ,$91.00 ,$26.33 ,$93.60 ,$28.56 ,$31.28 ,$31.28 ,$26.07 ,$31.28 ,$26.07 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100307,82805,HC BLOOD GASES W/O2 SAT,301,1 ,$190.00 ,$95.00 ,$39.91 ,$190.00 ,$122.74 ,$39.91 ,$190.00 ,$190.00 ,$78.77 ,$114.00 ,$161.50 ,$133.00 ,$39.91 ,$180.50 ,$136.80 ,$138.70 ,$133.91 ,$161.50 ,$78.77 ,$133.91 ,$152.00 ,$138.70 ,$39.91 ,$78.77 ,$86.98 ,$190.00 ,$161.50 ,$177.23 ,$174.80 ,$133.00 ,$135.87 ,$145.94 ,$115.71 ,$135.87 ,$131.29 ,$133.00 ,$79.56 ,$136.80 ,$42.30 ,$94.52 ,$94.52 ,$78.77 ,$94.52 ,$78.77 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30100308,82810,HC BLOOD GAS O2 SAT ONLY,301,1 ,$135.00 ,$67.50 ,$9.77 ,$135.00 ,$87.21 ,$10.10 ,$34.20 ,$29.31 ,$9.77 ,$81.00 ,$114.75 ,$94.50 ,$10.10 ,$128.25 ,$97.20 ,$98.55 ,$16.61 ,$114.75 ,$9.77 ,$16.61 ,$108.00 ,$98.55 ,$10.10 ,$9.77 ,$10.79 ,$135.00 ,$114.75 ,$21.98 ,$124.20 ,$94.50 ,$41.80 ,$44.90 ,$82.22 ,$41.80 ,$93.29 ,$94.50 ,$9.87 ,$97.20 ,$10.71 ,$11.72 ,$11.72 ,$9.77 ,$11.72 ,$9.77 ,$97.20 ,$83.70 ,$97.20 ,$97.20 ,$81.00 ST VINCENT HOSPITAL - ACUTE,30100309,82941,HC GASTRIN,301,1 ,$90.00 ,$45.00 ,$17.63 ,$90.00 ,$58.14 ,$18.22 ,$68.57 ,$58.77 ,$17.63 ,$54.00 ,$76.50 ,$63.00 ,$18.22 ,$85.50 ,$64.80 ,$65.70 ,$29.97 ,$76.50 ,$17.63 ,$29.97 ,$72.00 ,$65.70 ,$18.22 ,$17.63 ,$19.47 ,$90.00 ,$76.50 ,$39.67 ,$82.80 ,$63.00 ,$84.45 ,$90.00 ,$54.81 ,$84.45 ,$62.19 ,$63.00 ,$17.81 ,$64.80 ,$19.31 ,$21.16 ,$21.16 ,$17.63 ,$21.16 ,$17.63 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100310,82943,HC GLUCAGON PLASMA,301,1 ,$55.00 ,$27.50 ,$13.88 ,$55.00 ,$35.53 ,$13.88 ,$55.00 ,$47.64 ,$14.29 ,$33.00 ,$46.75 ,$38.50 ,$13.88 ,$52.25 ,$39.60 ,$40.15 ,$24.29 ,$46.75 ,$14.29 ,$24.29 ,$44.00 ,$40.15 ,$13.88 ,$14.29 ,$15.78 ,$55.00 ,$46.75 ,$32.15 ,$50.60 ,$38.50 ,$47.24 ,$50.74 ,$33.50 ,$47.24 ,$38.01 ,$38.50 ,$14.43 ,$39.60 ,$14.71 ,$17.15 ,$17.15 ,$14.29 ,$17.15 ,$14.29 ,$39.60 ,$34.10 ,$39.60 ,$39.60 ,$33.00 ST VINCENT HOSPITAL - ACUTE,30100311,82945,HC GLUCOSE BODY FLUID,301,1 ,$48.00 ,$24.00 ,$3.93 ,$48.00 ,$31.01 ,$4.06 ,$15.30 ,$13.11 ,$3.93 ,$28.80 ,$40.80 ,$33.60 ,$4.06 ,$45.60 ,$34.56 ,$35.04 ,$6.68 ,$40.80 ,$3.93 ,$6.68 ,$38.40 ,$35.04 ,$4.06 ,$3.93 ,$4.34 ,$48.00 ,$40.80 ,$8.84 ,$44.16 ,$33.60 ,$18.81 ,$20.21 ,$29.23 ,$18.81 ,$33.17 ,$33.60 ,$3.97 ,$34.56 ,$4.30 ,$4.72 ,$4.72 ,$3.93 ,$4.72 ,$3.93 ,$34.56 ,$29.76 ,$34.56 ,$34.56 ,$28.80 ST VINCENT HOSPITAL - ACUTE,30100312,82947,HC GLUCOSE,301,1 ,$27.00 ,$13.50 ,$3.93 ,$27.00 ,$17.44 ,$4.06 ,$15.30 ,$13.11 ,$3.93 ,$16.20 ,$22.95 ,$18.90 ,$4.06 ,$25.65 ,$19.44 ,$19.71 ,$6.68 ,$22.95 ,$3.93 ,$6.68 ,$21.60 ,$19.71 ,$4.06 ,$3.93 ,$4.34 ,$27.00 ,$22.95 ,$8.84 ,$24.84 ,$18.90 ,$18.81 ,$20.21 ,$16.44 ,$18.81 ,$18.66 ,$18.90 ,$3.97 ,$19.44 ,$4.30 ,$4.72 ,$4.72 ,$3.93 ,$4.72 ,$3.93 ,$19.44 ,$16.74 ,$19.44 ,$19.44 ,$16.20 ST VINCENT HOSPITAL - ACUTE,30100313,82950,HC GLUCOSE SCREEN,301,1 ,$80.00 ,$40.00 ,$4.75 ,$80.00 ,$51.68 ,$4.91 ,$18.45 ,$15.81 ,$4.75 ,$48.00 ,$68.00 ,$56.00 ,$4.91 ,$76.00 ,$57.60 ,$58.40 ,$8.08 ,$68.00 ,$4.75 ,$8.08 ,$64.00 ,$58.40 ,$4.91 ,$4.75 ,$5.25 ,$80.00 ,$68.00 ,$10.69 ,$73.60 ,$56.00 ,$22.74 ,$24.43 ,$48.72 ,$22.74 ,$55.28 ,$56.00 ,$4.80 ,$57.60 ,$5.20 ,$5.70 ,$5.70 ,$4.75 ,$5.70 ,$4.75 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100314,82951,HC GLUCOSE TOLERANCE,301,1 ,$100.00 ,$50.00 ,$12.87 ,$100.00 ,$64.60 ,$13.30 ,$50.05 ,$42.90 ,$12.87 ,$60.00 ,$85.00 ,$70.00 ,$13.30 ,$95.00 ,$72.00 ,$73.00 ,$21.88 ,$85.00 ,$12.87 ,$21.88 ,$80.00 ,$73.00 ,$13.30 ,$12.87 ,$14.21 ,$100.00 ,$85.00 ,$28.96 ,$92.00 ,$70.00 ,$61.64 ,$66.20 ,$60.90 ,$61.64 ,$69.10 ,$70.00 ,$13.00 ,$72.00 ,$14.10 ,$15.44 ,$15.44 ,$12.87 ,$15.44 ,$12.87 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100315,82952,HC GLUCOSE TOLERANCE ADDL SPEC,301,1 ,$28.00 ,$14.00 ,$3.92 ,$28.00 ,$18.09 ,$4.05 ,$15.26 ,$13.08 ,$3.92 ,$16.80 ,$23.80 ,$19.60 ,$4.05 ,$26.60 ,$20.16 ,$20.44 ,$6.66 ,$23.80 ,$3.92 ,$6.66 ,$22.40 ,$20.44 ,$4.05 ,$3.92 ,$4.33 ,$28.00 ,$23.80 ,$8.82 ,$25.76 ,$19.60 ,$18.78 ,$20.17 ,$17.05 ,$18.78 ,$19.35 ,$19.60 ,$3.96 ,$20.16 ,$4.29 ,$4.70 ,$4.70 ,$3.92 ,$4.70 ,$3.92 ,$20.16 ,$17.36 ,$20.16 ,$20.16 ,$16.80 ST VINCENT HOSPITAL - ACUTE,30100316,82955,HC G6PD ENZYME QN,301,1 ,$385.00 ,$192.50 ,$9.70 ,$385.00 ,$248.71 ,$10.02 ,$37.70 ,$32.31 ,$9.70 ,$231.00 ,$327.25 ,$269.50 ,$10.02 ,$365.75 ,$277.20 ,$281.05 ,$16.49 ,$327.25 ,$9.70 ,$16.49 ,$308.00 ,$281.05 ,$10.02 ,$9.70 ,$10.71 ,$385.00 ,$327.25 ,$21.83 ,$354.20 ,$269.50 ,$46.40 ,$49.84 ,$234.47 ,$46.40 ,$266.04 ,$269.50 ,$9.80 ,$277.20 ,$10.62 ,$11.64 ,$11.64 ,$9.70 ,$11.64 ,$9.70 ,$277.20 ,$238.70 ,$277.20 ,$277.20 ,$231.00 ST VINCENT HOSPITAL - ACUTE,30100317,82955,HC GLUCOSE 6 PHOS DEHYDROGN,301,1 ,$70.00 ,$35.00 ,$9.70 ,$70.00 ,$45.22 ,$10.02 ,$37.70 ,$32.31 ,$9.70 ,$42.00 ,$59.50 ,$49.00 ,$10.02 ,$66.50 ,$50.40 ,$51.10 ,$16.49 ,$59.50 ,$9.70 ,$16.49 ,$56.00 ,$51.10 ,$10.02 ,$9.70 ,$10.71 ,$70.00 ,$59.50 ,$21.83 ,$64.40 ,$49.00 ,$46.40 ,$49.84 ,$42.63 ,$46.40 ,$48.37 ,$49.00 ,$9.80 ,$50.40 ,$10.62 ,$11.64 ,$11.64 ,$9.70 ,$11.64 ,$9.70 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100318,82962,HC GLUCOSE BY DEVICE,301,1 ,$17.00 ,$8.50 ,$3.28 ,$17.00 ,$10.98 ,$3.30 ,$11.48 ,$9.84 ,$3.28 ,$10.20 ,$14.45 ,$11.90 ,$3.30 ,$16.15 ,$12.24 ,$12.41 ,$5.58 ,$14.45 ,$3.28 ,$5.58 ,$13.60 ,$12.41 ,$3.30 ,$3.28 ,$3.62 ,$17.00 ,$14.45 ,$7.38 ,$15.64 ,$11.90 ,$11.23 ,$12.06 ,$10.35 ,$11.23 ,$11.75 ,$11.90 ,$3.31 ,$12.24 ,$3.50 ,$3.94 ,$3.94 ,$3.28 ,$3.94 ,$3.28 ,$12.24 ,$10.54 ,$12.24 ,$12.24 ,$10.20 ST VINCENT HOSPITAL - ACUTE,30100319,82977,HC GGT/GGTP,301,1 ,$49.00 ,$24.50 ,$7.20 ,$49.00 ,$31.65 ,$7.44 ,$28.00 ,$24.00 ,$7.20 ,$29.40 ,$41.65 ,$34.30 ,$7.44 ,$46.55 ,$35.28 ,$35.77 ,$12.24 ,$41.65 ,$7.20 ,$12.24 ,$39.20 ,$35.77 ,$7.44 ,$7.20 ,$7.95 ,$49.00 ,$41.65 ,$16.20 ,$45.08 ,$34.30 ,$34.47 ,$37.02 ,$29.84 ,$34.47 ,$33.86 ,$34.30 ,$7.27 ,$35.28 ,$7.89 ,$8.64 ,$8.64 ,$7.20 ,$8.64 ,$7.20 ,$35.28 ,$30.38 ,$35.28 ,$35.28 ,$29.40 ST VINCENT HOSPITAL - ACUTE,30100320,82978,HC GLUTATHIONE,301,1 ,$232.00 ,$116.00 ,$15.45 ,$232.00 ,$149.87 ,$15.96 ,$55.44 ,$47.52 ,$15.45 ,$139.20 ,$197.20 ,$162.40 ,$15.96 ,$220.40 ,$167.04 ,$169.36 ,$26.27 ,$197.20 ,$15.45 ,$26.27 ,$185.60 ,$169.36 ,$15.96 ,$15.45 ,$17.06 ,$232.00 ,$197.20 ,$34.76 ,$213.44 ,$162.40 ,$68.27 ,$73.33 ,$141.29 ,$68.27 ,$160.31 ,$162.40 ,$15.60 ,$167.04 ,$16.92 ,$18.54 ,$18.54 ,$15.45 ,$18.54 ,$15.45 ,$167.04 ,$143.84 ,$167.04 ,$167.04 ,$139.20 ST VINCENT HOSPITAL - ACUTE,30100321,82985,HC FRUCTOSAMINE,301,1 ,$80.00 ,$40.00 ,$16.62 ,$80.00 ,$51.68 ,$16.62 ,$58.66 ,$50.28 ,$16.76 ,$48.00 ,$68.00 ,$56.00 ,$16.62 ,$76.00 ,$57.60 ,$58.40 ,$28.49 ,$68.00 ,$16.76 ,$28.49 ,$64.00 ,$58.40 ,$16.62 ,$16.76 ,$18.51 ,$80.00 ,$68.00 ,$37.71 ,$73.60 ,$56.00 ,$56.58 ,$60.77 ,$48.72 ,$56.58 ,$55.28 ,$56.00 ,$16.93 ,$57.60 ,$17.62 ,$20.11 ,$20.11 ,$16.76 ,$20.11 ,$16.76 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100323,83001,HC FSH,301,1 ,$130.00 ,$65.00 ,$18.58 ,$130.00 ,$83.98 ,$19.20 ,$72.28 ,$61.95 ,$18.58 ,$78.00 ,$110.50 ,$91.00 ,$19.20 ,$123.50 ,$93.60 ,$94.90 ,$31.59 ,$110.50 ,$18.58 ,$31.59 ,$104.00 ,$94.90 ,$19.20 ,$18.58 ,$20.52 ,$130.00 ,$110.50 ,$41.81 ,$119.60 ,$91.00 ,$88.98 ,$95.57 ,$79.17 ,$88.98 ,$89.83 ,$91.00 ,$18.77 ,$93.60 ,$20.35 ,$22.30 ,$22.30 ,$18.58 ,$22.30 ,$18.58 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100325,83002,HC LUTEINIZING HORMONE (LH),301,1 ,$130.00 ,$65.00 ,$18.52 ,$130.00 ,$83.98 ,$19.14 ,$72.00 ,$61.71 ,$18.52 ,$78.00 ,$110.50 ,$91.00 ,$19.14 ,$123.50 ,$93.60 ,$94.90 ,$31.48 ,$110.50 ,$18.52 ,$31.48 ,$104.00 ,$94.90 ,$19.14 ,$18.52 ,$20.45 ,$130.00 ,$110.50 ,$41.67 ,$119.60 ,$91.00 ,$88.66 ,$95.23 ,$79.17 ,$88.66 ,$89.83 ,$91.00 ,$18.71 ,$93.60 ,$20.29 ,$22.22 ,$22.22 ,$18.52 ,$22.22 ,$18.52 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100326,83003,HC GROWTH HORMONE,301,1 ,$90.00 ,$45.00 ,$16.67 ,$90.00 ,$58.14 ,$17.23 ,$64.82 ,$55.56 ,$16.67 ,$54.00 ,$76.50 ,$63.00 ,$17.23 ,$85.50 ,$64.80 ,$65.70 ,$28.34 ,$76.50 ,$16.67 ,$28.34 ,$72.00 ,$65.70 ,$17.23 ,$16.67 ,$18.41 ,$90.00 ,$76.50 ,$37.51 ,$82.80 ,$63.00 ,$79.89 ,$85.81 ,$54.81 ,$79.89 ,$62.19 ,$63.00 ,$16.84 ,$64.80 ,$18.26 ,$20.00 ,$20.00 ,$16.67 ,$20.00 ,$16.67 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100327,83010,HC HAPTOGLOBIN,301,1 ,$90.00 ,$45.00 ,$12.58 ,$90.00 ,$58.14 ,$13.00 ,$48.90 ,$41.91 ,$12.58 ,$54.00 ,$76.50 ,$63.00 ,$13.00 ,$85.50 ,$64.80 ,$65.70 ,$21.39 ,$76.50 ,$12.58 ,$21.39 ,$72.00 ,$65.70 ,$13.00 ,$12.58 ,$13.89 ,$90.00 ,$76.50 ,$28.31 ,$82.80 ,$63.00 ,$60.23 ,$64.69 ,$54.81 ,$60.23 ,$62.19 ,$63.00 ,$12.71 ,$64.80 ,$13.78 ,$15.10 ,$15.10 ,$12.58 ,$15.10 ,$12.58 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100328,83018,HC HEAVY METAL EACH,301,1 ,$110.00 ,$55.00 ,$21.96 ,$110.00 ,$71.06 ,$22.69 ,$85.44 ,$73.23 ,$21.96 ,$66.00 ,$93.50 ,$77.00 ,$22.69 ,$104.50 ,$79.20 ,$80.30 ,$37.33 ,$93.50 ,$21.96 ,$37.33 ,$88.00 ,$80.30 ,$22.69 ,$21.96 ,$24.25 ,$110.00 ,$93.50 ,$49.41 ,$101.20 ,$77.00 ,$105.16 ,$110.00 ,$66.99 ,$105.16 ,$76.01 ,$77.00 ,$22.18 ,$79.20 ,$24.05 ,$26.35 ,$26.35 ,$21.96 ,$26.35 ,$21.96 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100329,83018,HC HEAVY METAL 24HR EACH,301,1 ,$110.00 ,$55.00 ,$21.96 ,$110.00 ,$71.06 ,$22.69 ,$85.44 ,$73.23 ,$21.96 ,$66.00 ,$93.50 ,$77.00 ,$22.69 ,$104.50 ,$79.20 ,$80.30 ,$37.33 ,$93.50 ,$21.96 ,$37.33 ,$88.00 ,$80.30 ,$22.69 ,$21.96 ,$24.25 ,$110.00 ,$93.50 ,$49.41 ,$101.20 ,$77.00 ,$105.16 ,$110.00 ,$66.99 ,$105.16 ,$76.01 ,$77.00 ,$22.18 ,$79.20 ,$24.05 ,$26.35 ,$26.35 ,$21.96 ,$26.35 ,$21.96 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100330,83020,HC HGB ELECTROPHORESIS,301,1 ,$114.00 ,$57.00 ,$6.41 ,$114.00 ,$73.64 ,$6.41 ,$50.05 ,$42.90 ,$12.87 ,$68.40 ,$96.90 ,$79.80 ,$6.41 ,$108.30 ,$82.08 ,$83.22 ,$21.88 ,$96.90 ,$12.87 ,$21.88 ,$91.20 ,$83.22 ,$6.41 ,$12.87 ,$14.21 ,$114.00 ,$96.90 ,$28.96 ,$104.88 ,$79.80 ,$21.83 ,$23.45 ,$69.43 ,$21.83 ,$78.77 ,$79.80 ,$13.00 ,$82.08 ,$6.79 ,$15.44 ,$15.44 ,$12.87 ,$15.44 ,$12.87 ,$82.08 ,$70.68 ,$82.08 ,$82.08 ,$68.40 ST VINCENT HOSPITAL - ACUTE,30100331,83020,HC HGB ELECTROPHORESIS (MAYO),301,1 ,$88.00 ,$44.00 ,$6.41 ,$88.00 ,$56.85 ,$6.41 ,$50.05 ,$42.90 ,$12.87 ,$52.80 ,$74.80 ,$61.60 ,$6.41 ,$83.60 ,$63.36 ,$64.24 ,$21.88 ,$74.80 ,$12.87 ,$21.88 ,$70.40 ,$64.24 ,$6.41 ,$12.87 ,$14.21 ,$88.00 ,$74.80 ,$28.96 ,$80.96 ,$61.60 ,$21.83 ,$23.45 ,$53.59 ,$21.83 ,$60.81 ,$61.60 ,$13.00 ,$63.36 ,$6.79 ,$15.44 ,$15.44 ,$12.87 ,$15.44 ,$12.87 ,$63.36 ,$54.56 ,$63.36 ,$63.36 ,$52.80 ST VINCENT HOSPITAL - ACUTE,30100332,83020,HC HGB ELECTORPHORESIS (QHBCV),301,1 ,$117.00 ,$58.50 ,$6.41 ,$117.00 ,$75.58 ,$6.41 ,$50.05 ,$42.90 ,$12.87 ,$70.20 ,$99.45 ,$81.90 ,$6.41 ,$111.15 ,$84.24 ,$85.41 ,$21.88 ,$99.45 ,$12.87 ,$21.88 ,$93.60 ,$85.41 ,$6.41 ,$12.87 ,$14.21 ,$117.00 ,$99.45 ,$28.96 ,$107.64 ,$81.90 ,$21.83 ,$23.45 ,$71.25 ,$21.83 ,$80.85 ,$81.90 ,$13.00 ,$84.24 ,$6.79 ,$15.44 ,$15.44 ,$12.87 ,$15.44 ,$12.87 ,$84.24 ,$72.54 ,$84.24 ,$84.24 ,$70.20 ST VINCENT HOSPITAL - ACUTE,30100334,83021,HC HEMOGLOBIN FRACT QN,301,1 ,$170.00 ,$85.00 ,$18.06 ,$170.00 ,$109.82 ,$18.66 ,$70.21 ,$60.18 ,$18.06 ,$102.00 ,$144.50 ,$119.00 ,$18.66 ,$161.50 ,$122.40 ,$124.10 ,$30.70 ,$144.50 ,$18.06 ,$30.70 ,$136.00 ,$124.10 ,$18.66 ,$18.06 ,$19.94 ,$170.00 ,$144.50 ,$40.64 ,$156.40 ,$119.00 ,$86.45 ,$92.86 ,$103.53 ,$86.45 ,$117.47 ,$119.00 ,$18.24 ,$122.40 ,$19.78 ,$21.67 ,$21.67 ,$18.06 ,$21.67 ,$18.06 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100335,83021,HC HEMOGLOBIN FRACT QN HPLC,301,1 ,$170.00 ,$85.00 ,$18.06 ,$170.00 ,$109.82 ,$18.66 ,$70.21 ,$60.18 ,$18.06 ,$102.00 ,$144.50 ,$119.00 ,$18.66 ,$161.50 ,$122.40 ,$124.10 ,$30.70 ,$144.50 ,$18.06 ,$30.70 ,$136.00 ,$124.10 ,$18.66 ,$18.06 ,$19.94 ,$170.00 ,$144.50 ,$40.64 ,$156.40 ,$119.00 ,$86.45 ,$92.86 ,$103.53 ,$86.45 ,$117.47 ,$119.00 ,$18.24 ,$122.40 ,$19.78 ,$21.67 ,$21.67 ,$18.06 ,$21.67 ,$18.06 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100336,83021,HC HEMOGLOBIN VARIANTS,301,1 ,$170.00 ,$85.00 ,$18.06 ,$170.00 ,$109.82 ,$18.66 ,$70.21 ,$60.18 ,$18.06 ,$102.00 ,$144.50 ,$119.00 ,$18.66 ,$161.50 ,$122.40 ,$124.10 ,$30.70 ,$144.50 ,$18.06 ,$30.70 ,$136.00 ,$124.10 ,$18.66 ,$18.06 ,$19.94 ,$170.00 ,$144.50 ,$40.64 ,$156.40 ,$119.00 ,$86.45 ,$92.86 ,$103.53 ,$86.45 ,$117.47 ,$119.00 ,$18.24 ,$122.40 ,$19.78 ,$21.67 ,$21.67 ,$18.06 ,$21.67 ,$18.06 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100337,83036,HC GLYCOSYLATED HGB,301,1 ,$70.00 ,$35.00 ,$9.71 ,$70.00 ,$45.22 ,$10.03 ,$37.77 ,$32.37 ,$9.71 ,$42.00 ,$59.50 ,$49.00 ,$10.03 ,$66.50 ,$50.40 ,$51.10 ,$16.51 ,$59.50 ,$9.71 ,$16.51 ,$56.00 ,$51.10 ,$10.03 ,$9.71 ,$10.72 ,$70.00 ,$59.50 ,$21.85 ,$64.40 ,$49.00 ,$46.47 ,$49.91 ,$42.63 ,$46.47 ,$48.37 ,$49.00 ,$9.81 ,$50.40 ,$10.63 ,$11.65 ,$11.65 ,$9.71 ,$11.65 ,$9.71 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100338,83050,HC METHEMOGLOBIN,301,1 ,$60.00 ,$30.00 ,$4.12 ,$60.00 ,$38.76 ,$4.12 ,$28.70 ,$24.60 ,$8.20 ,$36.00 ,$51.00 ,$42.00 ,$4.12 ,$57.00 ,$43.20 ,$43.80 ,$13.94 ,$51.00 ,$8.20 ,$13.94 ,$48.00 ,$43.80 ,$4.12 ,$8.20 ,$9.05 ,$60.00 ,$51.00 ,$18.45 ,$55.20 ,$42.00 ,$14.04 ,$15.08 ,$36.54 ,$14.04 ,$41.46 ,$42.00 ,$8.28 ,$43.20 ,$4.37 ,$9.84 ,$9.84 ,$8.20 ,$9.84 ,$8.20 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100339,83051,HC HEMOGLOBIN PLASMA,301,1 ,$22.00 ,$11.00 ,$4.90 ,$22.00 ,$14.21 ,$4.90 ,$22.00 ,$22.00 ,$7.31 ,$13.20 ,$18.70 ,$15.40 ,$4.90 ,$20.90 ,$15.84 ,$16.06 ,$12.43 ,$18.70 ,$7.31 ,$12.43 ,$17.60 ,$16.06 ,$4.90 ,$7.31 ,$8.07 ,$22.00 ,$18.70 ,$16.45 ,$20.24 ,$15.40 ,$16.67 ,$17.91 ,$13.40 ,$16.67 ,$15.20 ,$15.40 ,$7.38 ,$15.84 ,$5.19 ,$8.77 ,$8.77 ,$7.31 ,$8.77 ,$7.31 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30100341,83051,HC HEMOGLOBIN PLASMA,301,1 ,$22.00 ,$11.00 ,$4.90 ,$22.00 ,$14.21 ,$4.90 ,$22.00 ,$22.00 ,$7.31 ,$13.20 ,$18.70 ,$15.40 ,$4.90 ,$20.90 ,$15.84 ,$16.06 ,$12.43 ,$18.70 ,$7.31 ,$12.43 ,$17.60 ,$16.06 ,$4.90 ,$7.31 ,$8.07 ,$22.00 ,$18.70 ,$16.45 ,$20.24 ,$15.40 ,$16.67 ,$17.91 ,$13.40 ,$16.67 ,$15.20 ,$15.40 ,$7.38 ,$15.84 ,$5.19 ,$8.77 ,$8.77 ,$7.31 ,$8.77 ,$7.31 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30100342,83051,HC HEMOGLOBIN (MAYO),301,1 ,$90.00 ,$45.00 ,$4.90 ,$90.00 ,$58.14 ,$4.90 ,$28.42 ,$24.36 ,$7.31 ,$54.00 ,$76.50 ,$63.00 ,$4.90 ,$85.50 ,$64.80 ,$65.70 ,$12.43 ,$76.50 ,$7.31 ,$12.43 ,$72.00 ,$65.70 ,$4.90 ,$7.31 ,$8.07 ,$90.00 ,$76.50 ,$16.45 ,$82.80 ,$63.00 ,$16.67 ,$17.91 ,$54.81 ,$16.67 ,$62.19 ,$63.00 ,$7.38 ,$64.80 ,$5.19 ,$8.77 ,$8.77 ,$7.31 ,$8.77 ,$7.31 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100343,83068,HC HEMOGLOBIN UNSTABLE,301,1 ,$108.00 ,$54.00 ,$9.47 ,$108.00 ,$69.77 ,$9.79 ,$33.15 ,$28.41 ,$9.47 ,$64.80 ,$91.80 ,$75.60 ,$9.79 ,$102.60 ,$77.76 ,$78.84 ,$16.10 ,$91.80 ,$9.47 ,$16.10 ,$86.40 ,$78.84 ,$9.79 ,$9.47 ,$10.46 ,$108.00 ,$91.80 ,$21.31 ,$99.36 ,$75.60 ,$40.51 ,$43.51 ,$65.77 ,$40.51 ,$74.63 ,$75.60 ,$9.56 ,$77.76 ,$10.38 ,$11.36 ,$11.36 ,$9.47 ,$11.36 ,$9.47 ,$77.76 ,$66.96 ,$77.76 ,$77.76 ,$64.80 ST VINCENT HOSPITAL - ACUTE,30100344,83070,HC HEMOSIDERIN,301,1 ,$50.00 ,$25.00 ,$4.75 ,$50.00 ,$32.30 ,$4.91 ,$18.45 ,$15.81 ,$4.75 ,$30.00 ,$42.50 ,$35.00 ,$4.91 ,$47.50 ,$36.00 ,$36.50 ,$8.08 ,$42.50 ,$4.75 ,$8.08 ,$40.00 ,$36.50 ,$4.91 ,$4.75 ,$5.25 ,$50.00 ,$42.50 ,$10.69 ,$46.00 ,$35.00 ,$22.74 ,$24.43 ,$30.45 ,$22.74 ,$34.55 ,$35.00 ,$4.80 ,$36.00 ,$5.20 ,$5.70 ,$5.70 ,$4.75 ,$5.70 ,$4.75 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30100345,83088,HC HISTAMINE,301,1 ,$190.00 ,$95.00 ,$29.53 ,$190.00 ,$122.74 ,$30.51 ,$114.84 ,$98.43 ,$29.53 ,$114.00 ,$161.50 ,$133.00 ,$30.51 ,$180.50 ,$136.80 ,$138.70 ,$50.20 ,$161.50 ,$29.53 ,$50.20 ,$152.00 ,$138.70 ,$30.51 ,$29.53 ,$32.61 ,$190.00 ,$161.50 ,$66.44 ,$174.80 ,$133.00 ,$141.42 ,$151.89 ,$115.71 ,$141.42 ,$131.29 ,$133.00 ,$29.83 ,$136.80 ,$32.34 ,$35.44 ,$35.44 ,$29.53 ,$35.44 ,$29.53 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30100346,83090,HC HOMOCYSTEINE,301,1 ,$120.00 ,$60.00 ,$17.92 ,$120.00 ,$77.52 ,$18.52 ,$65.59 ,$56.22 ,$17.92 ,$72.00 ,$102.00 ,$84.00 ,$18.52 ,$114.00 ,$86.40 ,$87.60 ,$30.46 ,$102.00 ,$17.92 ,$30.46 ,$96.00 ,$87.60 ,$18.52 ,$17.92 ,$19.79 ,$120.00 ,$102.00 ,$40.32 ,$110.40 ,$84.00 ,$80.77 ,$86.75 ,$73.08 ,$80.77 ,$82.92 ,$84.00 ,$18.10 ,$86.40 ,$19.63 ,$21.50 ,$21.50 ,$17.92 ,$21.50 ,$17.92 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100347,83150,HC HOMOVANILLIC ACID (HVA24),301,1 ,$100.00 ,$50.00 ,$19.62 ,$100.00 ,$64.60 ,$19.62 ,$78.44 ,$67.23 ,$22.41 ,$60.00 ,$85.00 ,$70.00 ,$19.62 ,$95.00 ,$72.00 ,$73.00 ,$38.10 ,$85.00 ,$22.41 ,$38.10 ,$80.00 ,$73.00 ,$19.62 ,$22.41 ,$24.75 ,$100.00 ,$85.00 ,$50.42 ,$92.00 ,$70.00 ,$66.83 ,$71.78 ,$60.90 ,$66.83 ,$69.10 ,$70.00 ,$22.63 ,$72.00 ,$20.80 ,$26.89 ,$26.89 ,$22.41 ,$26.89 ,$22.41 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100348,83150,HC HOMOVANILLIC ACID,301,1 ,$100.00 ,$50.00 ,$19.62 ,$100.00 ,$64.60 ,$19.62 ,$78.44 ,$67.23 ,$22.41 ,$60.00 ,$85.00 ,$70.00 ,$19.62 ,$95.00 ,$72.00 ,$73.00 ,$38.10 ,$85.00 ,$22.41 ,$38.10 ,$80.00 ,$73.00 ,$19.62 ,$22.41 ,$24.75 ,$100.00 ,$85.00 ,$50.42 ,$92.00 ,$70.00 ,$66.83 ,$71.78 ,$60.90 ,$66.83 ,$69.10 ,$70.00 ,$22.63 ,$72.00 ,$20.80 ,$26.89 ,$26.89 ,$22.41 ,$26.89 ,$22.41 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100349,83491,HC CORTICOSTEROIDS 17D,301,1 ,$112.00 ,$56.00 ,$17.90 ,$112.00 ,$72.35 ,$18.50 ,$68.15 ,$58.41 ,$17.90 ,$67.20 ,$95.20 ,$78.40 ,$18.50 ,$106.40 ,$80.64 ,$81.76 ,$30.43 ,$95.20 ,$17.90 ,$30.43 ,$89.60 ,$81.76 ,$18.50 ,$17.90 ,$19.77 ,$112.00 ,$95.20 ,$40.28 ,$103.04 ,$78.40 ,$83.89 ,$90.10 ,$68.21 ,$83.89 ,$77.39 ,$78.40 ,$18.08 ,$80.64 ,$19.61 ,$21.48 ,$21.48 ,$17.90 ,$21.48 ,$17.90 ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,30100350,83497,HC HYDROXYINDOLACET 5 (HIAA),301,1 ,$90.00 ,$45.00 ,$12.90 ,$90.00 ,$58.14 ,$13.33 ,$50.16 ,$42.99 ,$12.90 ,$54.00 ,$76.50 ,$63.00 ,$13.33 ,$85.50 ,$64.80 ,$65.70 ,$21.93 ,$76.50 ,$12.90 ,$21.93 ,$72.00 ,$65.70 ,$13.33 ,$12.90 ,$14.24 ,$90.00 ,$76.50 ,$29.03 ,$82.80 ,$63.00 ,$61.74 ,$66.31 ,$54.81 ,$61.74 ,$62.19 ,$63.00 ,$13.03 ,$64.80 ,$14.13 ,$15.48 ,$15.48 ,$12.90 ,$15.48 ,$12.90 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100351,83497,HC HYDROXYINDOLACET 5 URINE,301,1 ,$42.00 ,$21.00 ,$12.90 ,$42.00 ,$27.13 ,$13.33 ,$42.00 ,$42.00 ,$12.90 ,$25.20 ,$35.70 ,$29.40 ,$13.33 ,$39.90 ,$30.24 ,$30.66 ,$21.93 ,$35.70 ,$12.90 ,$21.93 ,$33.60 ,$30.66 ,$13.33 ,$12.90 ,$14.24 ,$42.00 ,$35.70 ,$29.03 ,$38.64 ,$29.40 ,$42.00 ,$42.00 ,$25.58 ,$42.00 ,$29.02 ,$29.40 ,$13.03 ,$30.24 ,$14.13 ,$15.48 ,$15.48 ,$12.90 ,$15.48 ,$12.90 ,$30.24 ,$26.04 ,$30.24 ,$30.24 ,$25.20 ST VINCENT HOSPITAL - ACUTE,30100352,83498,HC HYDROXYPROGESTERONE 17D,301,1 ,$190.00 ,$95.00 ,$27.17 ,$190.00 ,$122.74 ,$28.07 ,$105.67 ,$90.57 ,$27.17 ,$114.00 ,$161.50 ,$133.00 ,$28.07 ,$180.50 ,$136.80 ,$138.70 ,$46.19 ,$161.50 ,$27.17 ,$46.19 ,$152.00 ,$138.70 ,$28.07 ,$27.17 ,$30.00 ,$190.00 ,$161.50 ,$61.13 ,$174.80 ,$133.00 ,$130.12 ,$139.75 ,$115.71 ,$130.12 ,$131.29 ,$133.00 ,$27.44 ,$136.80 ,$29.75 ,$32.60 ,$32.60 ,$27.17 ,$32.60 ,$27.17 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30100354,83505,HC HYDROXYPROLIN,301,1 ,$161.00 ,$80.50 ,$24.30 ,$161.00 ,$104.01 ,$25.11 ,$94.54 ,$81.03 ,$24.30 ,$96.60 ,$136.85 ,$112.70 ,$25.11 ,$152.95 ,$115.92 ,$117.53 ,$41.31 ,$136.85 ,$24.30 ,$41.31 ,$128.80 ,$117.53 ,$25.11 ,$24.30 ,$26.83 ,$161.00 ,$136.85 ,$54.68 ,$148.12 ,$112.70 ,$116.43 ,$125.05 ,$98.05 ,$116.43 ,$111.25 ,$112.70 ,$24.54 ,$115.92 ,$26.62 ,$29.16 ,$29.16 ,$24.30 ,$29.16 ,$24.30 ,$115.92 ,$99.82 ,$115.92 ,$115.92 ,$96.60 ST VINCENT HOSPITAL - ACUTE,30100355,83516,HC IMMUNO QL/SQ MLT,301,1 ,$80.00 ,$40.00 ,$11.53 ,$80.00 ,$51.68 ,$11.91 ,$44.84 ,$38.43 ,$11.53 ,$48.00 ,$68.00 ,$56.00 ,$11.91 ,$76.00 ,$57.60 ,$58.40 ,$19.60 ,$68.00 ,$11.53 ,$19.60 ,$64.00 ,$58.40 ,$11.91 ,$11.53 ,$12.73 ,$80.00 ,$68.00 ,$25.94 ,$73.60 ,$56.00 ,$55.25 ,$59.34 ,$48.72 ,$55.25 ,$55.28 ,$56.00 ,$11.65 ,$57.60 ,$12.62 ,$13.84 ,$13.84 ,$11.53 ,$13.84 ,$11.53 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100356,83516,HC ANTICARDIOPLIPIN SCREEN,301,1 ,$99.00 ,$49.50 ,$11.53 ,$99.00 ,$63.95 ,$11.91 ,$44.84 ,$38.43 ,$11.53 ,$59.40 ,$84.15 ,$69.30 ,$11.91 ,$94.05 ,$71.28 ,$72.27 ,$19.60 ,$84.15 ,$11.53 ,$19.60 ,$79.20 ,$72.27 ,$11.91 ,$11.53 ,$12.73 ,$99.00 ,$84.15 ,$25.94 ,$91.08 ,$69.30 ,$55.25 ,$59.34 ,$60.29 ,$55.25 ,$68.41 ,$69.30 ,$11.65 ,$71.28 ,$12.62 ,$13.84 ,$13.84 ,$11.53 ,$13.84 ,$11.53 ,$71.28 ,$61.38 ,$71.28 ,$71.28 ,$59.40 ST VINCENT HOSPITAL - ACUTE,30100357,83516,HC HISTONE ANTIBODY,301,1 ,$90.00 ,$45.00 ,$11.53 ,$90.00 ,$58.14 ,$11.91 ,$44.84 ,$38.43 ,$11.53 ,$54.00 ,$76.50 ,$63.00 ,$11.91 ,$85.50 ,$64.80 ,$65.70 ,$19.60 ,$76.50 ,$11.53 ,$19.60 ,$72.00 ,$65.70 ,$11.91 ,$11.53 ,$12.73 ,$90.00 ,$76.50 ,$25.94 ,$82.80 ,$63.00 ,$55.25 ,$59.34 ,$54.81 ,$55.25 ,$62.19 ,$63.00 ,$11.65 ,$64.80 ,$12.62 ,$13.84 ,$13.84 ,$11.53 ,$13.84 ,$11.53 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100358,83516,HC ACTIN AB,301,1 ,$71.00 ,$35.50 ,$11.53 ,$71.00 ,$45.87 ,$11.91 ,$44.84 ,$38.43 ,$11.53 ,$42.60 ,$60.35 ,$49.70 ,$11.91 ,$67.45 ,$51.12 ,$51.83 ,$19.60 ,$60.35 ,$11.53 ,$19.60 ,$56.80 ,$51.83 ,$11.91 ,$11.53 ,$12.73 ,$71.00 ,$60.35 ,$25.94 ,$65.32 ,$49.70 ,$55.25 ,$59.34 ,$43.24 ,$55.25 ,$49.06 ,$49.70 ,$11.65 ,$51.12 ,$12.62 ,$13.84 ,$13.84 ,$11.53 ,$13.84 ,$11.53 ,$51.12 ,$44.02 ,$51.12 ,$51.12 ,$42.60 ST VINCENT HOSPITAL - ACUTE,30100359,83516,HC IMMUNO QL/SQ MLT (2),301,1 ,$74.00 ,$37.00 ,$11.53 ,$74.00 ,$47.80 ,$11.91 ,$44.84 ,$38.43 ,$11.53 ,$44.40 ,$62.90 ,$51.80 ,$11.91 ,$70.30 ,$53.28 ,$54.02 ,$19.60 ,$62.90 ,$11.53 ,$19.60 ,$59.20 ,$54.02 ,$11.91 ,$11.53 ,$12.73 ,$74.00 ,$62.90 ,$25.94 ,$68.08 ,$51.80 ,$55.25 ,$59.34 ,$45.07 ,$55.25 ,$51.13 ,$51.80 ,$11.65 ,$53.28 ,$12.62 ,$13.84 ,$13.84 ,$11.53 ,$13.84 ,$11.53 ,$53.28 ,$45.88 ,$53.28 ,$53.28 ,$44.40 ST VINCENT HOSPITAL - ACUTE,30100360,83516,HC SMOOTH MUSCLE AB,301,1 ,$80.00 ,$40.00 ,$11.53 ,$80.00 ,$51.68 ,$11.91 ,$44.84 ,$38.43 ,$11.53 ,$48.00 ,$68.00 ,$56.00 ,$11.91 ,$76.00 ,$57.60 ,$58.40 ,$19.60 ,$68.00 ,$11.53 ,$19.60 ,$64.00 ,$58.40 ,$11.91 ,$11.53 ,$12.73 ,$80.00 ,$68.00 ,$25.94 ,$73.60 ,$56.00 ,$55.25 ,$59.34 ,$48.72 ,$55.25 ,$55.28 ,$56.00 ,$11.65 ,$57.60 ,$12.62 ,$13.84 ,$13.84 ,$11.53 ,$13.84 ,$11.53 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100361,83516,HC IMMUNO QL/SQ MLT (3),301,1 ,$90.00 ,$45.00 ,$11.53 ,$90.00 ,$58.14 ,$11.91 ,$44.84 ,$38.43 ,$11.53 ,$54.00 ,$76.50 ,$63.00 ,$11.91 ,$85.50 ,$64.80 ,$65.70 ,$19.60 ,$76.50 ,$11.53 ,$19.60 ,$72.00 ,$65.70 ,$11.91 ,$11.53 ,$12.73 ,$90.00 ,$76.50 ,$25.94 ,$82.80 ,$63.00 ,$55.25 ,$59.34 ,$54.81 ,$55.25 ,$62.19 ,$63.00 ,$11.65 ,$64.80 ,$12.62 ,$13.84 ,$13.84 ,$11.53 ,$13.84 ,$11.53 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100363,83519,HC ACETYLCHOLINE RECEPTR AB,301,1 ,$90.00 ,$45.00 ,$18.40 ,$90.00 ,$58.14 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$54.00 ,$76.50 ,$63.00 ,$19.00 ,$85.50 ,$64.80 ,$65.70 ,$31.28 ,$76.50 ,$18.40 ,$31.28 ,$72.00 ,$65.70 ,$19.00 ,$18.40 ,$20.32 ,$90.00 ,$76.50 ,$41.40 ,$82.80 ,$63.00 ,$64.69 ,$69.48 ,$54.81 ,$64.69 ,$62.19 ,$63.00 ,$18.58 ,$64.80 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100364,83519,HC ADI LEMS AUTO AB,301,1 ,$431.00 ,$215.50 ,$18.40 ,$431.00 ,$278.43 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$258.60 ,$366.35 ,$301.70 ,$19.00 ,$409.45 ,$310.32 ,$314.63 ,$31.28 ,$366.35 ,$18.40 ,$31.28 ,$344.80 ,$314.63 ,$19.00 ,$18.40 ,$20.32 ,$431.00 ,$366.35 ,$41.40 ,$396.52 ,$301.70 ,$64.69 ,$69.48 ,$262.48 ,$64.69 ,$297.82 ,$301.70 ,$18.58 ,$310.32 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$310.32 ,$267.22 ,$310.32 ,$310.32 ,$258.60 ST VINCENT HOSPITAL - ACUTE,30100365,83519,HC GAD 65 AB,301,1 ,$92.00 ,$46.00 ,$18.40 ,$92.00 ,$59.43 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$55.20 ,$78.20 ,$64.40 ,$19.00 ,$87.40 ,$66.24 ,$67.16 ,$31.28 ,$78.20 ,$18.40 ,$31.28 ,$73.60 ,$67.16 ,$19.00 ,$18.40 ,$20.32 ,$92.00 ,$78.20 ,$41.40 ,$84.64 ,$64.40 ,$64.69 ,$69.48 ,$56.03 ,$64.69 ,$63.57 ,$64.40 ,$18.58 ,$66.24 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$66.24 ,$57.04 ,$66.24 ,$66.24 ,$55.20 ST VINCENT HOSPITAL - ACUTE,30100366,86341,HC ISLET CELL AUTO AB,301,1 ,$230.00 ,$115.00 ,$19.88 ,$230.00 ,$148.58 ,$19.88 ,$82.50 ,$70.71 ,$23.57 ,$138.00 ,$195.50 ,$161.00 ,$19.88 ,$218.50 ,$165.60 ,$167.90 ,$40.07 ,$195.50 ,$23.57 ,$40.07 ,$184.00 ,$167.90 ,$19.88 ,$23.57 ,$26.03 ,$230.00 ,$195.50 ,$53.03 ,$211.60 ,$161.00 ,$67.71 ,$72.72 ,$140.07 ,$67.71 ,$158.93 ,$161.00 ,$23.81 ,$165.60 ,$21.07 ,$28.28 ,$28.28 ,$23.57 ,$28.28 ,$23.57 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,30100367,83519,HC PTH RELATED PROTEIN,301,1 ,$90.00 ,$45.00 ,$18.40 ,$90.00 ,$58.14 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$54.00 ,$76.50 ,$63.00 ,$19.00 ,$85.50 ,$64.80 ,$65.70 ,$31.28 ,$76.50 ,$18.40 ,$31.28 ,$72.00 ,$65.70 ,$19.00 ,$18.40 ,$20.32 ,$90.00 ,$76.50 ,$41.40 ,$82.80 ,$63.00 ,$64.69 ,$69.48 ,$54.81 ,$64.69 ,$62.19 ,$63.00 ,$18.58 ,$64.80 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100368,83519,HC NEOPTERIN,301,1 ,$90.00 ,$45.00 ,$18.40 ,$90.00 ,$58.14 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$54.00 ,$76.50 ,$63.00 ,$19.00 ,$85.50 ,$64.80 ,$65.70 ,$31.28 ,$76.50 ,$18.40 ,$31.28 ,$72.00 ,$65.70 ,$19.00 ,$18.40 ,$20.32 ,$90.00 ,$76.50 ,$41.40 ,$82.80 ,$63.00 ,$64.69 ,$69.48 ,$54.81 ,$64.69 ,$62.19 ,$63.00 ,$18.58 ,$64.80 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100369,83519,HC IGF BINDING PROTEIN,301,1 ,$90.00 ,$45.00 ,$18.40 ,$90.00 ,$58.14 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$54.00 ,$76.50 ,$63.00 ,$19.00 ,$85.50 ,$64.80 ,$65.70 ,$31.28 ,$76.50 ,$18.40 ,$31.28 ,$72.00 ,$65.70 ,$19.00 ,$18.40 ,$20.32 ,$90.00 ,$76.50 ,$41.40 ,$82.80 ,$63.00 ,$64.69 ,$69.48 ,$54.81 ,$64.69 ,$62.19 ,$63.00 ,$18.58 ,$64.80 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100370,83519,HC ACHR BINDING AB,301,1 ,$151.00 ,$75.50 ,$18.40 ,$151.00 ,$97.55 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$90.60 ,$128.35 ,$105.70 ,$19.00 ,$143.45 ,$108.72 ,$110.23 ,$31.28 ,$128.35 ,$18.40 ,$31.28 ,$120.80 ,$110.23 ,$19.00 ,$18.40 ,$20.32 ,$151.00 ,$128.35 ,$41.40 ,$138.92 ,$105.70 ,$64.69 ,$69.48 ,$91.96 ,$64.69 ,$104.34 ,$105.70 ,$18.58 ,$108.72 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$108.72 ,$93.62 ,$108.72 ,$108.72 ,$90.60 ST VINCENT HOSPITAL - ACUTE,30100371,83519,HC MUSK ANTIBODY,301,1 ,$500.00 ,$250.00 ,$18.40 ,$500.00 ,$323.00 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$300.00 ,$425.00 ,$350.00 ,$19.00 ,$475.00 ,$360.00 ,$365.00 ,$31.28 ,$425.00 ,$18.40 ,$31.28 ,$400.00 ,$365.00 ,$19.00 ,$18.40 ,$20.32 ,$500.00 ,$425.00 ,$41.40 ,$460.00 ,$350.00 ,$64.69 ,$69.48 ,$304.50 ,$64.69 ,$345.50 ,$350.00 ,$18.58 ,$360.00 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,30100372,83519,HC ACEYTLCHOLINE RECPT AB (BK),301,1 ,$90.00 ,$45.00 ,$18.40 ,$90.00 ,$58.14 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$54.00 ,$76.50 ,$63.00 ,$19.00 ,$85.50 ,$64.80 ,$65.70 ,$31.28 ,$76.50 ,$18.40 ,$31.28 ,$72.00 ,$65.70 ,$19.00 ,$18.40 ,$20.32 ,$90.00 ,$76.50 ,$41.40 ,$82.80 ,$63.00 ,$64.69 ,$69.48 ,$54.81 ,$64.69 ,$62.19 ,$63.00 ,$18.58 ,$64.80 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100373,83519,HC ACEYTLCHOLINE RECPT AB (MD),301,1 ,$90.00 ,$45.00 ,$18.40 ,$90.00 ,$58.14 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$54.00 ,$76.50 ,$63.00 ,$19.00 ,$85.50 ,$64.80 ,$65.70 ,$31.28 ,$76.50 ,$18.40 ,$31.28 ,$72.00 ,$65.70 ,$19.00 ,$18.40 ,$20.32 ,$90.00 ,$76.50 ,$41.40 ,$82.80 ,$63.00 ,$64.69 ,$69.48 ,$54.81 ,$64.69 ,$62.19 ,$63.00 ,$18.58 ,$64.80 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100374,83519,HC IGF BINDING PROTEIN 3,301,1 ,$214.00 ,$107.00 ,$18.40 ,$214.00 ,$138.24 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$128.40 ,$181.90 ,$149.80 ,$19.00 ,$203.30 ,$154.08 ,$156.22 ,$31.28 ,$181.90 ,$18.40 ,$31.28 ,$171.20 ,$156.22 ,$19.00 ,$18.40 ,$20.32 ,$214.00 ,$181.90 ,$41.40 ,$196.88 ,$149.80 ,$64.69 ,$69.48 ,$130.33 ,$64.69 ,$147.87 ,$149.80 ,$18.58 ,$154.08 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$154.08 ,$132.68 ,$154.08 ,$154.08 ,$128.40 ST VINCENT HOSPITAL - ACUTE,30100375,80155,HC CAFFEINE,301,1 ,$180.00 ,$90.00 ,$15.44 ,$180.00 ,$116.28 ,$15.44 ,$135.00 ,$115.71 ,$38.57 ,$108.00 ,$153.00 ,$126.00 ,$15.44 ,$171.00 ,$129.60 ,$131.40 ,$65.57 ,$153.00 ,$38.57 ,$65.57 ,$144.00 ,$131.40 ,$15.44 ,$38.57 ,$42.59 ,$180.00 ,$153.00 ,$86.78 ,$165.60 ,$126.00 ,$67.74 ,$72.76 ,$109.62 ,$67.74 ,$124.38 ,$126.00 ,$38.96 ,$129.60 ,$16.37 ,$46.28 ,$46.28 ,$38.57 ,$46.28 ,$38.57 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30100376,83520,HC METHOTREXATE,301,1 ,$300.00 ,$150.00 ,$17.27 ,$300.00 ,$193.80 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$180.00 ,$255.00 ,$210.00 ,$17.85 ,$285.00 ,$216.00 ,$219.00 ,$29.36 ,$255.00 ,$17.27 ,$29.36 ,$240.00 ,$219.00 ,$17.85 ,$17.27 ,$19.07 ,$300.00 ,$255.00 ,$38.86 ,$276.00 ,$210.00 ,$61.99 ,$66.58 ,$182.70 ,$61.99 ,$207.30 ,$210.00 ,$17.44 ,$216.00 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,30100377,83520,HC GLOMERULAR BS MEM IGG,301,1 ,$126.00 ,$63.00 ,$17.27 ,$126.00 ,$81.40 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$75.60 ,$107.10 ,$88.20 ,$17.85 ,$119.70 ,$90.72 ,$91.98 ,$29.36 ,$107.10 ,$17.27 ,$29.36 ,$100.80 ,$91.98 ,$17.85 ,$17.27 ,$19.07 ,$126.00 ,$107.10 ,$38.86 ,$115.92 ,$88.20 ,$61.99 ,$66.58 ,$76.73 ,$61.99 ,$87.07 ,$88.20 ,$17.44 ,$90.72 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$90.72 ,$78.12 ,$90.72 ,$90.72 ,$75.60 ST VINCENT HOSPITAL - ACUTE,30100378,83520,HC C1 ESTERASE IHHIB FUNCTN,301,1 ,$90.00 ,$45.00 ,$17.27 ,$90.00 ,$58.14 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$54.00 ,$76.50 ,$63.00 ,$17.85 ,$85.50 ,$64.80 ,$65.70 ,$29.36 ,$76.50 ,$17.27 ,$29.36 ,$72.00 ,$65.70 ,$17.85 ,$17.27 ,$19.07 ,$90.00 ,$76.50 ,$38.86 ,$82.80 ,$63.00 ,$61.99 ,$66.58 ,$54.81 ,$61.99 ,$62.19 ,$63.00 ,$17.44 ,$64.80 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100379,83520,HC IMMUNOASSAY QN PROTEIN,301,1 ,$90.00 ,$45.00 ,$17.27 ,$90.00 ,$58.14 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$54.00 ,$76.50 ,$63.00 ,$17.85 ,$85.50 ,$64.80 ,$65.70 ,$29.36 ,$76.50 ,$17.27 ,$29.36 ,$72.00 ,$65.70 ,$17.85 ,$17.27 ,$19.07 ,$90.00 ,$76.50 ,$38.86 ,$82.80 ,$63.00 ,$61.99 ,$66.58 ,$54.81 ,$61.99 ,$62.19 ,$63.00 ,$17.44 ,$64.80 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100380,83520,HC GASTRIC PARIETAL AB,301,1 ,$88.00 ,$44.00 ,$17.27 ,$88.00 ,$56.85 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$52.80 ,$74.80 ,$61.60 ,$17.85 ,$83.60 ,$63.36 ,$64.24 ,$29.36 ,$74.80 ,$17.27 ,$29.36 ,$70.40 ,$64.24 ,$17.85 ,$17.27 ,$19.07 ,$88.00 ,$74.80 ,$38.86 ,$80.96 ,$61.60 ,$61.99 ,$66.58 ,$53.59 ,$61.99 ,$60.81 ,$61.60 ,$17.44 ,$63.36 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$63.36 ,$54.56 ,$63.36 ,$63.36 ,$52.80 ST VINCENT HOSPITAL - ACUTE,30100381,83520,HC C3 A,301,1 ,$90.00 ,$45.00 ,$17.27 ,$90.00 ,$58.14 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$54.00 ,$76.50 ,$63.00 ,$17.85 ,$85.50 ,$64.80 ,$65.70 ,$29.36 ,$76.50 ,$17.27 ,$29.36 ,$72.00 ,$65.70 ,$17.85 ,$17.27 ,$19.07 ,$90.00 ,$76.50 ,$38.86 ,$82.80 ,$63.00 ,$61.99 ,$66.58 ,$54.81 ,$61.99 ,$62.19 ,$63.00 ,$17.44 ,$64.80 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100382,83520,HC ANTI GBM,301,1 ,$90.00 ,$45.00 ,$17.27 ,$90.00 ,$58.14 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$54.00 ,$76.50 ,$63.00 ,$17.85 ,$85.50 ,$64.80 ,$65.70 ,$29.36 ,$76.50 ,$17.27 ,$29.36 ,$72.00 ,$65.70 ,$17.85 ,$17.27 ,$19.07 ,$90.00 ,$76.50 ,$38.86 ,$82.80 ,$63.00 ,$61.99 ,$66.58 ,$54.81 ,$61.99 ,$62.19 ,$63.00 ,$17.44 ,$64.80 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100383,83520,HC CITRULLINE PEPTIDE ANTIBODY,301,1 ,$143.00 ,$71.50 ,$17.27 ,$143.00 ,$92.38 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$85.80 ,$121.55 ,$100.10 ,$17.85 ,$135.85 ,$102.96 ,$104.39 ,$29.36 ,$121.55 ,$17.27 ,$29.36 ,$114.40 ,$104.39 ,$17.85 ,$17.27 ,$19.07 ,$143.00 ,$121.55 ,$38.86 ,$131.56 ,$100.10 ,$61.99 ,$66.58 ,$87.09 ,$61.99 ,$98.81 ,$100.10 ,$17.44 ,$102.96 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$102.96 ,$88.66 ,$102.96 ,$102.96 ,$85.80 ST VINCENT HOSPITAL - ACUTE,30100384,83520,HC IMMUNOASSAY QN OTHER,301,1 ,$90.00 ,$45.00 ,$17.27 ,$90.00 ,$58.14 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$54.00 ,$76.50 ,$63.00 ,$17.85 ,$85.50 ,$64.80 ,$65.70 ,$29.36 ,$76.50 ,$17.27 ,$29.36 ,$72.00 ,$65.70 ,$17.85 ,$17.27 ,$19.07 ,$90.00 ,$76.50 ,$38.86 ,$82.80 ,$63.00 ,$61.99 ,$66.58 ,$54.81 ,$61.99 ,$62.19 ,$63.00 ,$17.44 ,$64.80 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100385,83520,HC CD ANTI GLIADIN,301,1 ,$88.00 ,$44.00 ,$17.27 ,$88.00 ,$56.85 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$52.80 ,$74.80 ,$61.60 ,$17.85 ,$83.60 ,$63.36 ,$64.24 ,$29.36 ,$74.80 ,$17.27 ,$29.36 ,$70.40 ,$64.24 ,$17.85 ,$17.27 ,$19.07 ,$88.00 ,$74.80 ,$38.86 ,$80.96 ,$61.60 ,$61.99 ,$66.58 ,$53.59 ,$61.99 ,$60.81 ,$61.60 ,$17.44 ,$63.36 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$63.36 ,$54.56 ,$63.36 ,$63.36 ,$52.80 ST VINCENT HOSPITAL - ACUTE,30100386,83520,HC FIBROSPECT TIMP 1,301,1 ,$88.00 ,$44.00 ,$17.27 ,$88.00 ,$56.85 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$52.80 ,$74.80 ,$61.60 ,$17.85 ,$83.60 ,$63.36 ,$64.24 ,$29.36 ,$74.80 ,$17.27 ,$29.36 ,$70.40 ,$64.24 ,$17.85 ,$17.27 ,$19.07 ,$88.00 ,$74.80 ,$38.86 ,$80.96 ,$61.60 ,$61.99 ,$66.58 ,$53.59 ,$61.99 ,$60.81 ,$61.60 ,$17.44 ,$63.36 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$63.36 ,$54.56 ,$63.36 ,$63.36 ,$52.80 ST VINCENT HOSPITAL - ACUTE,30100388,83520,HC CD ANTI HU TGG IGA,301,1 ,$88.00 ,$44.00 ,$17.27 ,$88.00 ,$56.85 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$52.80 ,$74.80 ,$61.60 ,$17.85 ,$83.60 ,$63.36 ,$64.24 ,$29.36 ,$74.80 ,$17.27 ,$29.36 ,$70.40 ,$64.24 ,$17.85 ,$17.27 ,$19.07 ,$88.00 ,$74.80 ,$38.86 ,$80.96 ,$61.60 ,$61.99 ,$66.58 ,$53.59 ,$61.99 ,$60.81 ,$61.60 ,$17.44 ,$63.36 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$63.36 ,$54.56 ,$63.36 ,$63.36 ,$52.80 ST VINCENT HOSPITAL - ACUTE,30100389,83520,HC TRYPTASE,301,1 ,$90.00 ,$45.00 ,$17.27 ,$90.00 ,$58.14 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$54.00 ,$76.50 ,$63.00 ,$17.85 ,$85.50 ,$64.80 ,$65.70 ,$29.36 ,$76.50 ,$17.27 ,$29.36 ,$72.00 ,$65.70 ,$17.85 ,$17.27 ,$19.07 ,$90.00 ,$76.50 ,$38.86 ,$82.80 ,$63.00 ,$61.99 ,$66.58 ,$54.81 ,$61.99 ,$62.19 ,$63.00 ,$17.44 ,$64.80 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100390,82397,HC INHIBIN B,301,1 ,$200.00 ,$100.00 ,$14.12 ,$200.00 ,$129.20 ,$14.59 ,$54.92 ,$47.07 ,$14.12 ,$120.00 ,$170.00 ,$140.00 ,$14.59 ,$190.00 ,$144.00 ,$146.00 ,$24.00 ,$170.00 ,$14.12 ,$24.00 ,$160.00 ,$146.00 ,$14.59 ,$14.12 ,$15.59 ,$200.00 ,$170.00 ,$31.77 ,$184.00 ,$140.00 ,$67.64 ,$72.65 ,$121.80 ,$67.64 ,$138.20 ,$140.00 ,$14.26 ,$144.00 ,$15.47 ,$16.94 ,$16.94 ,$14.12 ,$16.94 ,$14.12 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30100392,83525,HC INSULIN TOTAL,301,1 ,$70.00 ,$35.00 ,$11.43 ,$70.00 ,$45.22 ,$11.81 ,$44.45 ,$38.10 ,$11.43 ,$42.00 ,$59.50 ,$49.00 ,$11.81 ,$66.50 ,$50.40 ,$51.10 ,$19.43 ,$59.50 ,$11.43 ,$19.43 ,$56.00 ,$51.10 ,$11.81 ,$11.43 ,$12.62 ,$70.00 ,$59.50 ,$25.72 ,$64.40 ,$49.00 ,$54.72 ,$58.77 ,$42.63 ,$54.72 ,$48.37 ,$49.00 ,$11.54 ,$50.40 ,$12.52 ,$13.72 ,$13.72 ,$11.43 ,$13.72 ,$11.43 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100393,83540,HC IRON TOTAL,301,1 ,$44.00 ,$22.00 ,$6.47 ,$44.00 ,$28.42 ,$6.69 ,$25.17 ,$21.57 ,$6.47 ,$26.40 ,$37.40 ,$30.80 ,$6.69 ,$41.80 ,$31.68 ,$32.12 ,$11.00 ,$37.40 ,$6.47 ,$11.00 ,$35.20 ,$32.12 ,$6.69 ,$6.47 ,$7.14 ,$44.00 ,$37.40 ,$14.56 ,$40.48 ,$30.80 ,$30.99 ,$33.29 ,$26.80 ,$30.99 ,$30.40 ,$30.80 ,$6.53 ,$31.68 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$31.68 ,$27.28 ,$31.68 ,$31.68 ,$26.40 ST VINCENT HOSPITAL - ACUTE,30100394,83550,HC IRON BINDING CAPACITY,301,1 ,$60.00 ,$30.00 ,$8.74 ,$60.00 ,$38.76 ,$9.03 ,$33.99 ,$29.13 ,$8.74 ,$36.00 ,$51.00 ,$42.00 ,$9.03 ,$57.00 ,$43.20 ,$43.80 ,$14.86 ,$51.00 ,$8.74 ,$14.86 ,$48.00 ,$43.80 ,$9.03 ,$8.74 ,$9.65 ,$60.00 ,$51.00 ,$19.67 ,$55.20 ,$42.00 ,$41.87 ,$44.98 ,$36.54 ,$41.87 ,$41.46 ,$42.00 ,$8.83 ,$43.20 ,$9.57 ,$10.49 ,$10.49 ,$8.74 ,$10.49 ,$8.74 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100395,83586,HC KETOSTEROIDS (17-KS),301,1 ,$82.00 ,$41.00 ,$12.80 ,$82.00 ,$52.97 ,$13.23 ,$49.77 ,$42.66 ,$12.80 ,$49.20 ,$69.70 ,$57.40 ,$13.23 ,$77.90 ,$59.04 ,$59.86 ,$21.76 ,$69.70 ,$12.80 ,$21.76 ,$65.60 ,$59.86 ,$13.23 ,$12.80 ,$14.13 ,$82.00 ,$69.70 ,$28.80 ,$75.44 ,$57.40 ,$61.32 ,$65.86 ,$49.94 ,$61.32 ,$56.66 ,$57.40 ,$12.93 ,$59.04 ,$14.02 ,$15.36 ,$15.36 ,$12.80 ,$15.36 ,$12.80 ,$59.04 ,$50.84 ,$59.04 ,$59.04 ,$49.20 ST VINCENT HOSPITAL - ACUTE,30100396,83605,HC LACTATE/LACTIC ACID,301,1 ,$80.00 ,$40.00 ,$11.57 ,$80.00 ,$51.68 ,$11.96 ,$41.55 ,$35.61 ,$11.57 ,$48.00 ,$68.00 ,$56.00 ,$11.96 ,$76.00 ,$57.60 ,$58.40 ,$19.67 ,$68.00 ,$11.57 ,$19.67 ,$64.00 ,$58.40 ,$11.96 ,$11.57 ,$12.78 ,$80.00 ,$68.00 ,$26.03 ,$73.60 ,$56.00 ,$51.14 ,$54.93 ,$48.72 ,$51.14 ,$55.28 ,$56.00 ,$11.69 ,$57.60 ,$12.68 ,$13.88 ,$13.88 ,$11.57 ,$13.88 ,$11.57 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100397,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$44.00 ,$22.00 ,$6.04 ,$44.00 ,$28.42 ,$6.24 ,$23.49 ,$20.13 ,$6.04 ,$26.40 ,$37.40 ,$30.80 ,$6.24 ,$41.80 ,$31.68 ,$32.12 ,$10.27 ,$37.40 ,$6.04 ,$10.27 ,$35.20 ,$32.12 ,$6.24 ,$6.04 ,$6.67 ,$44.00 ,$37.40 ,$13.59 ,$40.48 ,$30.80 ,$28.89 ,$31.03 ,$26.80 ,$28.89 ,$30.40 ,$30.80 ,$6.10 ,$31.68 ,$6.61 ,$7.25 ,$7.25 ,$6.04 ,$7.25 ,$6.04 ,$31.68 ,$27.28 ,$31.68 ,$31.68 ,$26.40 ST VINCENT HOSPITAL - ACUTE,30100399,83625,HC LDH ISOENZYMES,301,1 ,$70.00 ,$35.00 ,$12.79 ,$70.00 ,$45.22 ,$13.22 ,$49.77 ,$42.66 ,$12.79 ,$42.00 ,$59.50 ,$49.00 ,$13.22 ,$66.50 ,$50.40 ,$51.10 ,$21.74 ,$59.50 ,$12.79 ,$21.74 ,$56.00 ,$51.10 ,$13.22 ,$12.79 ,$14.12 ,$70.00 ,$59.50 ,$28.78 ,$64.40 ,$49.00 ,$61.28 ,$65.82 ,$42.63 ,$61.28 ,$48.37 ,$49.00 ,$12.92 ,$50.40 ,$14.01 ,$15.35 ,$15.35 ,$12.79 ,$15.35 ,$12.79 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100401,83655,HC LEAD,301,1 ,$80.00 ,$40.00 ,$12.11 ,$80.00 ,$51.68 ,$12.51 ,$47.08 ,$40.35 ,$12.11 ,$48.00 ,$68.00 ,$56.00 ,$12.51 ,$76.00 ,$57.60 ,$58.40 ,$20.59 ,$68.00 ,$12.11 ,$20.59 ,$64.00 ,$58.40 ,$12.51 ,$12.11 ,$13.37 ,$80.00 ,$68.00 ,$27.25 ,$73.60 ,$56.00 ,$57.99 ,$62.28 ,$48.72 ,$57.99 ,$55.28 ,$56.00 ,$12.23 ,$57.60 ,$13.26 ,$14.53 ,$14.53 ,$12.11 ,$14.53 ,$12.11 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100403,83655,HC LEAD BLOOD PT DEMO,301,1 ,$80.00 ,$40.00 ,$12.11 ,$80.00 ,$51.68 ,$12.51 ,$47.08 ,$40.35 ,$12.11 ,$48.00 ,$68.00 ,$56.00 ,$12.51 ,$76.00 ,$57.60 ,$58.40 ,$20.59 ,$68.00 ,$12.11 ,$20.59 ,$64.00 ,$58.40 ,$12.51 ,$12.11 ,$13.37 ,$80.00 ,$68.00 ,$27.25 ,$73.60 ,$56.00 ,$57.99 ,$62.28 ,$48.72 ,$57.99 ,$55.28 ,$56.00 ,$12.23 ,$57.60 ,$13.26 ,$14.53 ,$14.53 ,$12.11 ,$14.53 ,$12.11 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100404,83655,HC LEAD URINE,301,1 ,$80.00 ,$40.00 ,$12.11 ,$80.00 ,$51.68 ,$12.51 ,$47.08 ,$40.35 ,$12.11 ,$48.00 ,$68.00 ,$56.00 ,$12.51 ,$76.00 ,$57.60 ,$58.40 ,$20.59 ,$68.00 ,$12.11 ,$20.59 ,$64.00 ,$58.40 ,$12.51 ,$12.11 ,$13.37 ,$80.00 ,$68.00 ,$27.25 ,$73.60 ,$56.00 ,$57.99 ,$62.28 ,$48.72 ,$57.99 ,$55.28 ,$56.00 ,$12.23 ,$57.60 ,$13.26 ,$14.53 ,$14.53 ,$12.11 ,$14.53 ,$12.11 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100405,83655,HC LEAD URINE UPB,301,1 ,$80.00 ,$40.00 ,$12.11 ,$80.00 ,$51.68 ,$12.51 ,$47.08 ,$40.35 ,$12.11 ,$48.00 ,$68.00 ,$56.00 ,$12.51 ,$76.00 ,$57.60 ,$58.40 ,$20.59 ,$68.00 ,$12.11 ,$20.59 ,$64.00 ,$58.40 ,$12.51 ,$12.11 ,$13.37 ,$80.00 ,$68.00 ,$27.25 ,$73.60 ,$56.00 ,$57.99 ,$62.28 ,$48.72 ,$57.99 ,$55.28 ,$56.00 ,$12.23 ,$57.60 ,$13.26 ,$14.53 ,$14.53 ,$12.11 ,$14.53 ,$12.11 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100406,83655,HC LEAD 24HR URINE,301,1 ,$80.00 ,$40.00 ,$12.11 ,$80.00 ,$51.68 ,$12.51 ,$47.08 ,$40.35 ,$12.11 ,$48.00 ,$68.00 ,$56.00 ,$12.51 ,$76.00 ,$57.60 ,$58.40 ,$20.59 ,$68.00 ,$12.11 ,$20.59 ,$64.00 ,$58.40 ,$12.51 ,$12.11 ,$13.37 ,$80.00 ,$68.00 ,$27.25 ,$73.60 ,$56.00 ,$57.99 ,$62.28 ,$48.72 ,$57.99 ,$55.28 ,$56.00 ,$12.23 ,$57.60 ,$13.26 ,$14.53 ,$14.53 ,$12.11 ,$14.53 ,$12.11 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100407,83655,HC LEAD (2),301,1 ,$80.00 ,$40.00 ,$12.11 ,$80.00 ,$51.68 ,$12.51 ,$47.08 ,$40.35 ,$12.11 ,$48.00 ,$68.00 ,$56.00 ,$12.51 ,$76.00 ,$57.60 ,$58.40 ,$20.59 ,$68.00 ,$12.11 ,$20.59 ,$64.00 ,$58.40 ,$12.51 ,$12.11 ,$13.37 ,$80.00 ,$68.00 ,$27.25 ,$73.60 ,$56.00 ,$57.99 ,$62.28 ,$48.72 ,$57.99 ,$55.28 ,$56.00 ,$12.23 ,$57.60 ,$13.26 ,$14.53 ,$14.53 ,$12.11 ,$14.53 ,$12.11 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100408,83663,HC FETAL LUNG MATURITY,301,1 ,$483.00 ,$241.50 ,$13.65 ,$483.00 ,$312.02 ,$13.65 ,$73.54 ,$63.03 ,$18.91 ,$289.80 ,$410.55 ,$338.10 ,$13.65 ,$458.85 ,$347.76 ,$352.59 ,$32.15 ,$410.55 ,$18.91 ,$32.15 ,$386.40 ,$352.59 ,$13.65 ,$18.91 ,$20.88 ,$483.00 ,$410.55 ,$42.55 ,$444.36 ,$338.10 ,$90.59 ,$97.30 ,$294.15 ,$90.59 ,$333.75 ,$338.10 ,$19.10 ,$347.76 ,$14.47 ,$22.69 ,$22.69 ,$18.91 ,$22.69 ,$18.91 ,$347.76 ,$299.46 ,$347.76 ,$347.76 ,$289.80 ST VINCENT HOSPITAL - ACUTE,30100409,83690,HC LIPASE,301,1 ,$70.00 ,$35.00 ,$6.89 ,$70.00 ,$45.22 ,$7.12 ,$26.78 ,$22.95 ,$6.89 ,$42.00 ,$59.50 ,$49.00 ,$7.12 ,$66.50 ,$50.40 ,$51.10 ,$11.71 ,$59.50 ,$6.89 ,$11.71 ,$56.00 ,$51.10 ,$7.12 ,$6.89 ,$7.61 ,$70.00 ,$59.50 ,$15.50 ,$64.40 ,$49.00 ,$32.99 ,$35.44 ,$42.63 ,$32.99 ,$48.37 ,$49.00 ,$6.96 ,$50.40 ,$7.55 ,$8.27 ,$8.27 ,$6.89 ,$8.27 ,$6.89 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100410,83695,HC LIPOPROTEIN,301,1 ,$70.00 ,$35.00 ,$14.32 ,$70.00 ,$45.22 ,$14.80 ,$50.37 ,$43.17 ,$14.32 ,$42.00 ,$59.50 ,$49.00 ,$14.80 ,$66.50 ,$50.40 ,$51.10 ,$24.34 ,$59.50 ,$14.32 ,$24.34 ,$56.00 ,$51.10 ,$14.80 ,$14.32 ,$15.81 ,$70.00 ,$59.50 ,$32.22 ,$64.40 ,$49.00 ,$61.99 ,$66.58 ,$42.63 ,$61.99 ,$48.37 ,$49.00 ,$14.46 ,$50.40 ,$15.69 ,$17.18 ,$17.18 ,$14.32 ,$17.18 ,$14.32 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100411,83701,HC VLDL,301,1 ,$164.00 ,$82.00 ,$32.56 ,$164.00 ,$105.94 ,$32.56 ,$118.51 ,$101.58 ,$33.86 ,$98.40 ,$139.40 ,$114.80 ,$32.56 ,$155.80 ,$118.08 ,$119.72 ,$57.56 ,$139.40 ,$33.86 ,$57.56 ,$131.20 ,$119.72 ,$32.56 ,$33.86 ,$37.39 ,$164.00 ,$139.40 ,$76.19 ,$150.88 ,$114.80 ,$118.85 ,$127.65 ,$99.88 ,$118.85 ,$113.32 ,$114.80 ,$34.20 ,$118.08 ,$34.51 ,$40.63 ,$40.63 ,$33.86 ,$40.63 ,$33.86 ,$118.08 ,$101.68 ,$118.08 ,$118.08 ,$98.40 ST VINCENT HOSPITAL - ACUTE,30100413,83704,HC LP FRACTN ION MOBILITY,301,1 ,$220.00 ,$110.00 ,$34.19 ,$220.00 ,$142.12 ,$35.33 ,$122.71 ,$105.18 ,$34.19 ,$132.00 ,$187.00 ,$154.00 ,$35.33 ,$209.00 ,$158.40 ,$160.60 ,$58.12 ,$187.00 ,$34.19 ,$58.12 ,$176.00 ,$160.60 ,$35.33 ,$34.19 ,$37.75 ,$220.00 ,$187.00 ,$76.93 ,$202.40 ,$154.00 ,$151.07 ,$162.26 ,$133.98 ,$151.07 ,$152.02 ,$154.00 ,$34.53 ,$158.40 ,$37.45 ,$41.03 ,$41.03 ,$34.19 ,$41.03 ,$34.19 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,30100414,83704,HC NMR LIPOPROFILE LIP,301,1 ,$115.00 ,$57.50 ,$34.19 ,$115.00 ,$74.29 ,$35.33 ,$115.00 ,$105.18 ,$34.19 ,$69.00 ,$97.75 ,$80.50 ,$35.33 ,$109.25 ,$82.80 ,$83.95 ,$58.12 ,$97.75 ,$34.19 ,$58.12 ,$92.00 ,$83.95 ,$35.33 ,$34.19 ,$37.75 ,$115.00 ,$97.75 ,$76.93 ,$105.80 ,$80.50 ,$115.00 ,$115.00 ,$70.04 ,$115.00 ,$79.47 ,$80.50 ,$34.53 ,$82.80 ,$37.45 ,$41.03 ,$41.03 ,$34.19 ,$41.03 ,$34.19 ,$82.80 ,$71.30 ,$82.80 ,$82.80 ,$69.00 ST VINCENT HOSPITAL - ACUTE,30100415,83718,HC CHOLESTEROL HDL,301,1 ,$60.00 ,$30.00 ,$8.19 ,$60.00 ,$38.76 ,$8.46 ,$31.85 ,$27.30 ,$8.19 ,$36.00 ,$51.00 ,$42.00 ,$8.46 ,$57.00 ,$43.20 ,$43.80 ,$13.92 ,$51.00 ,$8.19 ,$13.92 ,$48.00 ,$43.80 ,$8.46 ,$8.19 ,$9.04 ,$60.00 ,$51.00 ,$18.43 ,$55.20 ,$42.00 ,$39.21 ,$42.11 ,$36.54 ,$39.21 ,$41.46 ,$42.00 ,$8.27 ,$43.20 ,$8.97 ,$9.83 ,$9.83 ,$8.19 ,$9.83 ,$8.19 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100416,83721,HC CHOLESTEROL LDL,301,1 ,$70.00 ,$35.00 ,$10.50 ,$70.00 ,$45.22 ,$10.85 ,$37.10 ,$31.80 ,$10.50 ,$42.00 ,$59.50 ,$49.00 ,$10.85 ,$66.50 ,$50.40 ,$51.10 ,$17.85 ,$59.50 ,$10.50 ,$17.85 ,$56.00 ,$51.10 ,$10.85 ,$10.50 ,$11.59 ,$70.00 ,$59.50 ,$23.63 ,$64.40 ,$49.00 ,$45.70 ,$49.09 ,$42.63 ,$45.70 ,$48.37 ,$49.00 ,$10.61 ,$50.40 ,$11.50 ,$12.60 ,$12.60 ,$10.50 ,$12.60 ,$10.50 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100417,83735,HC MAGNESIUM,301,1 ,$46.00 ,$23.00 ,$6.70 ,$46.00 ,$29.72 ,$6.92 ,$26.04 ,$22.32 ,$6.70 ,$27.60 ,$39.10 ,$32.20 ,$6.92 ,$43.70 ,$33.12 ,$33.58 ,$11.39 ,$39.10 ,$6.70 ,$11.39 ,$36.80 ,$33.58 ,$6.92 ,$6.70 ,$7.40 ,$46.00 ,$39.10 ,$15.08 ,$42.32 ,$32.20 ,$32.08 ,$34.46 ,$28.01 ,$32.08 ,$31.79 ,$32.20 ,$6.77 ,$33.12 ,$7.34 ,$8.04 ,$8.04 ,$6.70 ,$8.04 ,$6.70 ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,30100418,83785,HC MANGANESE (MAYO),301,1 ,$140.00 ,$70.00 ,$26.65 ,$140.00 ,$90.44 ,$27.54 ,$95.66 ,$81.99 ,$26.65 ,$84.00 ,$119.00 ,$98.00 ,$27.54 ,$133.00 ,$100.80 ,$102.20 ,$45.31 ,$119.00 ,$26.65 ,$45.31 ,$112.00 ,$102.20 ,$27.54 ,$26.65 ,$29.43 ,$140.00 ,$119.00 ,$59.96 ,$128.80 ,$98.00 ,$117.76 ,$126.48 ,$85.26 ,$117.76 ,$96.74 ,$98.00 ,$26.92 ,$100.80 ,$29.19 ,$31.98 ,$31.98 ,$26.65 ,$31.98 ,$26.65 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30100419,83785,HC MANGANESE,301,1 ,$140.00 ,$70.00 ,$26.65 ,$140.00 ,$90.44 ,$27.54 ,$95.66 ,$81.99 ,$26.65 ,$84.00 ,$119.00 ,$98.00 ,$27.54 ,$133.00 ,$100.80 ,$102.20 ,$45.31 ,$119.00 ,$26.65 ,$45.31 ,$112.00 ,$102.20 ,$27.54 ,$26.65 ,$29.43 ,$140.00 ,$119.00 ,$59.96 ,$128.80 ,$98.00 ,$117.76 ,$126.48 ,$85.26 ,$117.76 ,$96.74 ,$98.00 ,$26.92 ,$100.80 ,$29.19 ,$31.98 ,$31.98 ,$26.65 ,$31.98 ,$26.65 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30100421,82542,HC BILE ACIDS,301,1 ,$280.00 ,$140.00 ,$24.09 ,$280.00 ,$180.88 ,$24.89 ,$84.32 ,$72.27 ,$24.09 ,$168.00 ,$238.00 ,$196.00 ,$24.89 ,$266.00 ,$201.60 ,$204.40 ,$40.95 ,$238.00 ,$24.09 ,$40.95 ,$224.00 ,$204.40 ,$24.89 ,$24.09 ,$26.60 ,$280.00 ,$238.00 ,$54.20 ,$257.60 ,$196.00 ,$86.45 ,$92.86 ,$170.52 ,$86.45 ,$193.48 ,$196.00 ,$24.33 ,$201.60 ,$26.38 ,$28.91 ,$28.91 ,$24.09 ,$28.91 ,$24.09 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,30100422,83789,HC CLOMIPRAMINE,301,1 ,$180.00 ,$90.00 ,$24.11 ,$180.00 ,$116.28 ,$24.91 ,$84.39 ,$72.33 ,$24.11 ,$108.00 ,$153.00 ,$126.00 ,$24.91 ,$171.00 ,$129.60 ,$131.40 ,$40.99 ,$153.00 ,$24.11 ,$40.99 ,$144.00 ,$131.40 ,$24.91 ,$24.11 ,$26.62 ,$180.00 ,$153.00 ,$54.25 ,$165.60 ,$126.00 ,$86.45 ,$92.86 ,$109.62 ,$86.45 ,$124.38 ,$126.00 ,$24.35 ,$129.60 ,$26.40 ,$28.93 ,$28.93 ,$24.11 ,$28.93 ,$24.11 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30100423,G0480,HC ETHYL GLUCUR/SULFATE,301,1 ,$180.00 ,$90.00 ,$63.95 ,$257.47 ,$116.28 ,$63.95 ,$180.00 ,$180.00 ,$114.43 ,$108.00 ,$153.00 ,$126.00 ,$63.95 ,$171.00 ,$129.60 ,$131.40 ,$180.00 ,$153.00 ,$114.43 ,$180.00 ,$144.00 ,$131.40 ,$63.95 ,$114.43 ,$126.35 ,$180.00 ,$153.00 ,$257.47 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$115.57 ,$129.60 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30100424,80183,HC TRILEPTAL,301,1 ,$100.00 ,$50.00 ,$13.25 ,$100.00 ,$64.60 ,$13.69 ,$51.56 ,$44.19 ,$13.25 ,$60.00 ,$85.00 ,$70.00 ,$13.69 ,$95.00 ,$72.00 ,$73.00 ,$22.53 ,$85.00 ,$13.25 ,$22.53 ,$80.00 ,$73.00 ,$13.69 ,$13.25 ,$14.63 ,$100.00 ,$85.00 ,$29.81 ,$92.00 ,$70.00 ,$63.50 ,$68.20 ,$60.90 ,$63.50 ,$69.10 ,$70.00 ,$13.38 ,$72.00 ,$14.51 ,$15.90 ,$15.90 ,$13.25 ,$15.90 ,$13.25 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100425,G0480,HC MEPROBAMATE,301,1 ,$160.00 ,$80.00 ,$63.95 ,$257.47 ,$103.36 ,$63.95 ,$160.00 ,$160.00 ,$114.43 ,$96.00 ,$136.00 ,$112.00 ,$63.95 ,$152.00 ,$115.20 ,$116.80 ,$160.00 ,$136.00 ,$114.43 ,$160.00 ,$128.00 ,$116.80 ,$63.95 ,$114.43 ,$126.35 ,$160.00 ,$136.00 ,$257.47 ,$147.20 ,$112.00 ,$160.00 ,$160.00 ,$97.44 ,$160.00 ,$110.56 ,$112.00 ,$115.57 ,$115.20 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30100426,83825,HC MERCURY,301,1 ,$90.00 ,$45.00 ,$16.26 ,$90.00 ,$58.14 ,$16.80 ,$63.21 ,$54.18 ,$16.26 ,$54.00 ,$76.50 ,$63.00 ,$16.80 ,$85.50 ,$64.80 ,$65.70 ,$27.64 ,$76.50 ,$16.26 ,$27.64 ,$72.00 ,$65.70 ,$16.80 ,$16.26 ,$17.95 ,$90.00 ,$76.50 ,$36.59 ,$82.80 ,$63.00 ,$77.85 ,$83.62 ,$54.81 ,$77.85 ,$62.19 ,$63.00 ,$16.42 ,$64.80 ,$17.81 ,$19.51 ,$19.51 ,$16.26 ,$19.51 ,$16.26 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100427,83825,HC MERCURY URINE,301,1 ,$90.00 ,$45.00 ,$16.26 ,$90.00 ,$58.14 ,$16.80 ,$63.21 ,$54.18 ,$16.26 ,$54.00 ,$76.50 ,$63.00 ,$16.80 ,$85.50 ,$64.80 ,$65.70 ,$27.64 ,$76.50 ,$16.26 ,$27.64 ,$72.00 ,$65.70 ,$16.80 ,$16.26 ,$17.95 ,$90.00 ,$76.50 ,$36.59 ,$82.80 ,$63.00 ,$77.85 ,$83.62 ,$54.81 ,$77.85 ,$62.19 ,$63.00 ,$16.42 ,$64.80 ,$17.81 ,$19.51 ,$19.51 ,$16.26 ,$19.51 ,$16.26 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100428,83825,HC MERCURY BLOOD,301,1 ,$90.00 ,$45.00 ,$16.26 ,$90.00 ,$58.14 ,$16.80 ,$63.21 ,$54.18 ,$16.26 ,$54.00 ,$76.50 ,$63.00 ,$16.80 ,$85.50 ,$64.80 ,$65.70 ,$27.64 ,$76.50 ,$16.26 ,$27.64 ,$72.00 ,$65.70 ,$16.80 ,$16.26 ,$17.95 ,$90.00 ,$76.50 ,$36.59 ,$82.80 ,$63.00 ,$77.85 ,$83.62 ,$54.81 ,$77.85 ,$62.19 ,$63.00 ,$16.42 ,$64.80 ,$17.81 ,$19.51 ,$19.51 ,$16.26 ,$19.51 ,$16.26 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100429,83825,HC MERCURY 24HR URINE,301,1 ,$90.00 ,$45.00 ,$16.26 ,$90.00 ,$58.14 ,$16.80 ,$63.21 ,$54.18 ,$16.26 ,$54.00 ,$76.50 ,$63.00 ,$16.80 ,$85.50 ,$64.80 ,$65.70 ,$27.64 ,$76.50 ,$16.26 ,$27.64 ,$72.00 ,$65.70 ,$16.80 ,$16.26 ,$17.95 ,$90.00 ,$76.50 ,$36.59 ,$82.80 ,$63.00 ,$77.85 ,$83.62 ,$54.81 ,$77.85 ,$62.19 ,$63.00 ,$16.42 ,$64.80 ,$17.81 ,$19.51 ,$19.51 ,$16.26 ,$19.51 ,$16.26 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100430,83835,HC METANEPHRINES,301,1 ,$120.00 ,$60.00 ,$16.94 ,$120.00 ,$77.52 ,$17.50 ,$65.87 ,$56.46 ,$16.94 ,$72.00 ,$102.00 ,$84.00 ,$17.50 ,$114.00 ,$86.40 ,$87.60 ,$28.80 ,$102.00 ,$16.94 ,$28.80 ,$96.00 ,$87.60 ,$17.50 ,$16.94 ,$18.71 ,$120.00 ,$102.00 ,$38.12 ,$110.40 ,$84.00 ,$81.12 ,$87.12 ,$73.08 ,$81.12 ,$82.92 ,$84.00 ,$17.11 ,$86.40 ,$18.55 ,$20.33 ,$20.33 ,$16.94 ,$20.33 ,$16.94 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100431,83835,HC METANEPHRINES PLASMA,301,1 ,$120.00 ,$60.00 ,$16.94 ,$120.00 ,$77.52 ,$17.50 ,$65.87 ,$56.46 ,$16.94 ,$72.00 ,$102.00 ,$84.00 ,$17.50 ,$114.00 ,$86.40 ,$87.60 ,$28.80 ,$102.00 ,$16.94 ,$28.80 ,$96.00 ,$87.60 ,$17.50 ,$16.94 ,$18.71 ,$120.00 ,$102.00 ,$38.12 ,$110.40 ,$84.00 ,$81.12 ,$87.12 ,$73.08 ,$81.12 ,$82.92 ,$84.00 ,$17.11 ,$86.40 ,$18.55 ,$20.33 ,$20.33 ,$16.94 ,$20.33 ,$16.94 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100432,83835,HC METANEPHRINES RANDM URINE,301,1 ,$120.00 ,$60.00 ,$16.94 ,$120.00 ,$77.52 ,$17.50 ,$65.87 ,$56.46 ,$16.94 ,$72.00 ,$102.00 ,$84.00 ,$17.50 ,$114.00 ,$86.40 ,$87.60 ,$28.80 ,$102.00 ,$16.94 ,$28.80 ,$96.00 ,$87.60 ,$17.50 ,$16.94 ,$18.71 ,$120.00 ,$102.00 ,$38.12 ,$110.40 ,$84.00 ,$81.12 ,$87.12 ,$73.08 ,$81.12 ,$82.92 ,$84.00 ,$17.11 ,$86.40 ,$18.55 ,$20.33 ,$20.33 ,$16.94 ,$20.33 ,$16.94 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100433,80358,HC METHADONE,301,1 ,$210.00 ,$105.00 ,$1.42 ,$210.00 ,$135.66 ,$1.42 ,$80.88 ,$69.32 , N/A ,$126.00 ,$178.50 ,$147.00 ,$1.42 ,$199.50 ,$151.20 ,$153.30 ,$38.56 ,$178.50 , N/A ,$38.56 ,$168.00 ,$153.30 ,$1.42 , N/A ,$14.49 ,$210.00 ,$178.50 , N/A ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 , N/A ,$151.20 ,$1.51 , N/A , N/A , N/A , N/A , N/A ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,30100434,83873,HC MYELIN BASIC PROTEIN,301,1 ,$100.00 ,$50.00 ,$17.20 ,$100.00 ,$64.60 ,$17.77 ,$66.92 ,$57.36 ,$17.20 ,$60.00 ,$85.00 ,$70.00 ,$17.77 ,$95.00 ,$72.00 ,$73.00 ,$29.24 ,$85.00 ,$17.20 ,$29.24 ,$80.00 ,$73.00 ,$17.77 ,$17.20 ,$18.99 ,$100.00 ,$85.00 ,$38.70 ,$92.00 ,$70.00 ,$82.38 ,$88.48 ,$60.90 ,$82.38 ,$69.10 ,$70.00 ,$17.37 ,$72.00 ,$18.84 ,$20.64 ,$20.64 ,$17.20 ,$20.64 ,$17.20 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100435,83874,HC MYOGLOBIN,301,1 ,$100.00 ,$50.00 ,$12.92 ,$100.00 ,$64.60 ,$13.35 ,$50.23 ,$43.05 ,$12.92 ,$60.00 ,$85.00 ,$70.00 ,$13.35 ,$95.00 ,$72.00 ,$73.00 ,$21.96 ,$85.00 ,$12.92 ,$21.96 ,$80.00 ,$73.00 ,$13.35 ,$12.92 ,$14.27 ,$100.00 ,$85.00 ,$29.07 ,$92.00 ,$70.00 ,$61.85 ,$66.43 ,$60.90 ,$61.85 ,$69.10 ,$70.00 ,$13.05 ,$72.00 ,$14.15 ,$15.50 ,$15.50 ,$12.92 ,$15.50 ,$12.92 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100436,83874,HC MYOGLOBIN URINE,301,1 ,$100.00 ,$50.00 ,$12.92 ,$100.00 ,$64.60 ,$13.35 ,$50.23 ,$43.05 ,$12.92 ,$60.00 ,$85.00 ,$70.00 ,$13.35 ,$95.00 ,$72.00 ,$73.00 ,$21.96 ,$85.00 ,$12.92 ,$21.96 ,$80.00 ,$73.00 ,$13.35 ,$12.92 ,$14.27 ,$100.00 ,$85.00 ,$29.07 ,$92.00 ,$70.00 ,$61.85 ,$66.43 ,$60.90 ,$61.85 ,$69.10 ,$70.00 ,$13.05 ,$72.00 ,$14.15 ,$15.50 ,$15.50 ,$12.92 ,$15.50 ,$12.92 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100437,83874,HC MYOGLOBIN URINE 2,301,1 ,$100.00 ,$50.00 ,$12.92 ,$100.00 ,$64.60 ,$13.35 ,$50.23 ,$43.05 ,$12.92 ,$60.00 ,$85.00 ,$70.00 ,$13.35 ,$95.00 ,$72.00 ,$73.00 ,$21.96 ,$85.00 ,$12.92 ,$21.96 ,$80.00 ,$73.00 ,$13.35 ,$12.92 ,$14.27 ,$100.00 ,$85.00 ,$29.07 ,$92.00 ,$70.00 ,$61.85 ,$66.43 ,$60.90 ,$61.85 ,$69.10 ,$70.00 ,$13.05 ,$72.00 ,$14.15 ,$15.50 ,$15.50 ,$12.92 ,$15.50 ,$12.92 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100438,83880,HC BNP NATRIURETIC PEPTIDE,301,1 ,$230.00 ,$115.00 ,$39.26 ,$230.00 ,$148.58 ,$40.57 ,$137.41 ,$117.78 ,$39.26 ,$138.00 ,$195.50 ,$161.00 ,$40.57 ,$218.50 ,$165.60 ,$167.90 ,$66.74 ,$195.50 ,$39.26 ,$66.74 ,$184.00 ,$167.90 ,$40.57 ,$39.26 ,$43.35 ,$230.00 ,$195.50 ,$88.34 ,$211.60 ,$161.00 ,$162.55 ,$174.59 ,$140.07 ,$162.55 ,$158.93 ,$161.00 ,$39.65 ,$165.60 ,$43.00 ,$47.11 ,$47.11 ,$39.26 ,$47.11 ,$39.26 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,30100439,83883,HC NEPHELOMETRY EA ANALYTE,301,1 ,$90.00 ,$45.00 ,$13.60 ,$90.00 ,$58.14 ,$14.05 ,$52.89 ,$45.33 ,$13.60 ,$54.00 ,$76.50 ,$63.00 ,$14.05 ,$85.50 ,$64.80 ,$65.70 ,$23.12 ,$76.50 ,$13.60 ,$23.12 ,$72.00 ,$65.70 ,$14.05 ,$13.60 ,$15.02 ,$90.00 ,$76.50 ,$30.60 ,$82.80 ,$63.00 ,$65.08 ,$69.90 ,$54.81 ,$65.08 ,$62.19 ,$63.00 ,$13.74 ,$64.80 ,$14.89 ,$16.32 ,$16.32 ,$13.60 ,$16.32 ,$13.60 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100440,83883,HC NEPHELOMETRY EA AN (MAYO),301,1 ,$90.00 ,$45.00 ,$13.60 ,$90.00 ,$58.14 ,$14.05 ,$52.89 ,$45.33 ,$13.60 ,$54.00 ,$76.50 ,$63.00 ,$14.05 ,$85.50 ,$64.80 ,$65.70 ,$23.12 ,$76.50 ,$13.60 ,$23.12 ,$72.00 ,$65.70 ,$14.05 ,$13.60 ,$15.02 ,$90.00 ,$76.50 ,$30.60 ,$82.80 ,$63.00 ,$65.08 ,$69.90 ,$54.81 ,$65.08 ,$62.19 ,$63.00 ,$13.74 ,$64.80 ,$14.89 ,$16.32 ,$16.32 ,$13.60 ,$16.32 ,$13.60 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100441,86160,HC C1 ESTERASE INHIB PRO QU,301,1 ,$80.00 ,$40.00 ,$12.00 ,$80.00 ,$51.68 ,$12.40 ,$46.66 ,$39.99 ,$12.00 ,$48.00 ,$68.00 ,$56.00 ,$12.40 ,$76.00 ,$57.60 ,$58.40 ,$20.40 ,$68.00 ,$12.00 ,$20.40 ,$64.00 ,$58.40 ,$12.40 ,$12.00 ,$13.25 ,$80.00 ,$68.00 ,$27.00 ,$73.60 ,$56.00 ,$57.49 ,$61.75 ,$48.72 ,$57.49 ,$55.28 ,$56.00 ,$12.12 ,$57.60 ,$13.14 ,$14.40 ,$14.40 ,$12.00 ,$14.40 ,$12.00 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100442,83883,HC NEPHELOMETRY EA AN (FREE),301,1 ,$113.00 ,$56.50 ,$13.60 ,$113.00 ,$73.00 ,$14.05 ,$52.89 ,$45.33 ,$13.60 ,$67.80 ,$96.05 ,$79.10 ,$14.05 ,$107.35 ,$81.36 ,$82.49 ,$23.12 ,$96.05 ,$13.60 ,$23.12 ,$90.40 ,$82.49 ,$14.05 ,$13.60 ,$15.02 ,$113.00 ,$96.05 ,$30.60 ,$103.96 ,$79.10 ,$65.08 ,$69.90 ,$68.82 ,$65.08 ,$78.08 ,$79.10 ,$13.74 ,$81.36 ,$14.89 ,$16.32 ,$16.32 ,$13.60 ,$16.32 ,$13.60 ,$81.36 ,$70.06 ,$81.36 ,$81.36 ,$67.80 ST VINCENT HOSPITAL - ACUTE,30100443,83883,HC NEPHELOMETRY EA AN 2,301,1 ,$80.00 ,$40.00 ,$13.60 ,$80.00 ,$51.68 ,$14.05 ,$52.89 ,$45.33 ,$13.60 ,$48.00 ,$68.00 ,$56.00 ,$14.05 ,$76.00 ,$57.60 ,$58.40 ,$23.12 ,$68.00 ,$13.60 ,$23.12 ,$64.00 ,$58.40 ,$14.05 ,$13.60 ,$15.02 ,$80.00 ,$68.00 ,$30.60 ,$73.60 ,$56.00 ,$65.08 ,$69.90 ,$48.72 ,$65.08 ,$55.28 ,$56.00 ,$13.74 ,$57.60 ,$14.89 ,$16.32 ,$16.32 ,$13.60 ,$16.32 ,$13.60 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100444,G0480,HC NICOTINE,301,1 ,$63.00 ,$31.50 ,$31.50 ,$141.75 ,$40.70 ,$63.00 ,$63.00 ,$63.00 ,$63.00 ,$37.80 ,$53.55 ,$44.10 ,$63.00 ,$59.85 ,$45.36 ,$45.99 ,$63.00 ,$53.55 ,$63.00 ,$63.00 ,$50.40 ,$45.99 ,$63.00 ,$63.00 ,$63.00 ,$63.00 ,$53.55 ,$141.75 ,$57.96 ,$44.10 ,$63.00 ,$63.00 ,$38.37 ,$63.00 ,$43.53 ,$44.10 ,$63.63 ,$45.36 ,$66.78 ,$63.00 ,$63.00 ,$63.00 ,$63.00 ,$63.00 ,$45.36 ,$39.06 ,$45.36 ,$45.36 ,$37.80 ST VINCENT HOSPITAL - ACUTE,30100445,G0480,HC NICOTINE W/METABOLITE,301,1 ,$120.00 ,$60.00 ,$60.00 ,$257.47 ,$77.52 ,$63.95 ,$120.00 ,$120.00 ,$114.43 ,$72.00 ,$102.00 ,$84.00 ,$63.95 ,$114.00 ,$86.40 ,$87.60 ,$120.00 ,$102.00 ,$114.43 ,$120.00 ,$96.00 ,$87.60 ,$63.95 ,$114.43 ,$120.00 ,$120.00 ,$102.00 ,$257.47 ,$110.40 ,$84.00 ,$120.00 ,$120.00 ,$73.08 ,$120.00 ,$82.92 ,$84.00 ,$115.57 ,$86.40 ,$67.79 ,$120.00 ,$120.00 ,$114.43 ,$120.00 ,$114.43 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100460,84311,HC FUNGITELL (1-3)-B-D-GLUCAN,301,1 ,$320.00 ,$160.00 ,$8.10 ,$320.00 ,$206.72 ,$8.37 ,$28.35 ,$24.30 ,$8.10 ,$192.00 ,$272.00 ,$224.00 ,$8.37 ,$304.00 ,$230.40 ,$233.60 ,$13.77 ,$272.00 ,$8.10 ,$13.77 ,$256.00 ,$233.60 ,$8.37 ,$8.10 ,$8.94 ,$320.00 ,$272.00 ,$18.23 ,$294.40 ,$224.00 ,$33.49 ,$35.97 ,$194.88 ,$33.49 ,$221.12 ,$224.00 ,$8.18 ,$230.40 ,$8.87 ,$9.72 ,$9.72 ,$8.10 ,$9.72 ,$8.10 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,30100480,82261,HC BIOTINIDASE SERUM,301,1 ,$113.00 ,$56.50 ,$16.87 ,$113.00 ,$73.00 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$67.80 ,$96.05 ,$79.10 ,$17.43 ,$107.35 ,$81.36 ,$82.49 ,$28.68 ,$96.05 ,$16.87 ,$28.68 ,$90.40 ,$82.49 ,$17.43 ,$16.87 ,$18.63 ,$113.00 ,$96.05 ,$37.96 ,$103.96 ,$79.10 ,$69.01 ,$74.12 ,$68.82 ,$69.01 ,$78.08 ,$79.10 ,$17.04 ,$81.36 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$81.36 ,$70.06 ,$81.36 ,$81.36 ,$67.80 ST VINCENT HOSPITAL - ACUTE,30100481,82373,HC CDG SERUM,301,1 ,$163.00 ,$81.50 ,$10.38 ,$163.00 ,$105.30 ,$10.38 ,$70.21 ,$60.18 ,$18.06 ,$97.80 ,$138.55 ,$114.10 ,$10.38 ,$154.85 ,$117.36 ,$118.99 ,$30.70 ,$138.55 ,$18.06 ,$30.70 ,$130.40 ,$118.99 ,$10.38 ,$18.06 ,$19.94 ,$163.00 ,$138.55 ,$40.64 ,$149.96 ,$114.10 ,$86.45 ,$92.86 ,$99.27 ,$86.45 ,$112.63 ,$114.10 ,$18.24 ,$117.36 ,$11.00 ,$21.67 ,$21.67 ,$18.06 ,$21.67 ,$18.06 ,$117.36 ,$101.06 ,$117.36 ,$117.36 ,$97.80 ST VINCENT HOSPITAL - ACUTE,30100482,82139,HC AMINO ACID QN CSF,301,1 ,$459.00 ,$229.50 ,$16.87 ,$459.00 ,$296.51 ,$17.43 ,$65.59 ,$56.22 ,$16.87 ,$275.40 ,$390.15 ,$321.30 ,$17.43 ,$436.05 ,$330.48 ,$335.07 ,$28.68 ,$390.15 ,$16.87 ,$28.68 ,$367.20 ,$335.07 ,$17.43 ,$16.87 ,$18.63 ,$459.00 ,$390.15 ,$37.96 ,$422.28 ,$321.30 ,$69.01 ,$74.12 ,$279.53 ,$69.01 ,$317.17 ,$321.30 ,$17.04 ,$330.48 ,$18.48 ,$20.24 ,$20.24 ,$16.87 ,$20.24 ,$16.87 ,$330.48 ,$284.58 ,$330.48 ,$330.48 ,$275.40 ST VINCENT HOSPITAL - ACUTE,30100483,84210,HC PYRUVIC ACID CSF,301,1 ,$92.00 ,$46.00 ,$14.48 ,$92.00 ,$59.43 ,$14.96 ,$50.68 ,$43.44 ,$14.48 ,$55.20 ,$78.20 ,$64.40 ,$14.96 ,$87.40 ,$66.24 ,$67.16 ,$24.62 ,$78.20 ,$14.48 ,$24.62 ,$73.60 ,$67.16 ,$14.96 ,$14.48 ,$15.99 ,$92.00 ,$78.20 ,$32.58 ,$84.64 ,$64.40 ,$51.98 ,$55.83 ,$56.03 ,$51.98 ,$63.57 ,$64.40 ,$14.62 ,$66.24 ,$15.86 ,$17.38 ,$17.38 ,$14.48 ,$17.38 ,$14.48 ,$66.24 ,$57.04 ,$66.24 ,$66.24 ,$55.20 ST VINCENT HOSPITAL - ACUTE,30100484,83605,HC LACTIC ACID CSF,301,1 ,$120.00 ,$60.00 ,$11.57 ,$120.00 ,$77.52 ,$11.96 ,$41.55 ,$35.61 ,$11.57 ,$72.00 ,$102.00 ,$84.00 ,$11.96 ,$114.00 ,$86.40 ,$87.60 ,$19.67 ,$102.00 ,$11.57 ,$19.67 ,$96.00 ,$87.60 ,$11.96 ,$11.57 ,$12.78 ,$120.00 ,$102.00 ,$26.03 ,$110.40 ,$84.00 ,$51.14 ,$54.93 ,$73.08 ,$51.14 ,$82.92 ,$84.00 ,$11.69 ,$86.40 ,$12.68 ,$13.88 ,$13.88 ,$11.57 ,$13.88 ,$11.57 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100485,83605,HC LACTIC ACID SPINAL FLUID,301,1 ,$120.00 ,$60.00 ,$11.57 ,$120.00 ,$77.52 ,$11.96 ,$41.55 ,$35.61 ,$11.57 ,$72.00 ,$102.00 ,$84.00 ,$11.96 ,$114.00 ,$86.40 ,$87.60 ,$19.67 ,$102.00 ,$11.57 ,$19.67 ,$96.00 ,$87.60 ,$11.96 ,$11.57 ,$12.78 ,$120.00 ,$102.00 ,$26.03 ,$110.40 ,$84.00 ,$51.14 ,$54.93 ,$73.08 ,$51.14 ,$82.92 ,$84.00 ,$11.69 ,$86.40 ,$12.68 ,$13.88 ,$13.88 ,$11.57 ,$13.88 ,$11.57 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100486,80165,HC VALPROIC ACID FREE,301,1 ,$67.00 ,$33.50 ,$13.54 ,$67.00 ,$43.28 ,$13.99 ,$52.68 ,$45.15 ,$13.54 ,$40.20 ,$56.95 ,$46.90 ,$13.99 ,$63.65 ,$48.24 ,$48.91 ,$23.02 ,$56.95 ,$13.54 ,$23.02 ,$53.60 ,$48.91 ,$13.99 ,$13.54 ,$14.95 ,$67.00 ,$56.95 ,$30.47 ,$61.64 ,$46.90 ,$64.72 ,$67.00 ,$40.80 ,$64.72 ,$46.30 ,$46.90 ,$13.68 ,$48.24 ,$14.83 ,$16.25 ,$16.25 ,$13.54 ,$16.25 ,$13.54 ,$48.24 ,$41.54 ,$48.24 ,$48.24 ,$40.20 ST VINCENT HOSPITAL - ACUTE,30100515,82542,HC CHROMATO QN SGL 6TGN 6MMPN RBC,301,1 ,$260.00 ,$130.00 ,$24.09 ,$260.00 ,$167.96 ,$24.89 ,$84.32 ,$72.27 ,$24.09 ,$156.00 ,$221.00 ,$182.00 ,$24.89 ,$247.00 ,$187.20 ,$189.80 ,$40.95 ,$221.00 ,$24.09 ,$40.95 ,$208.00 ,$189.80 ,$24.89 ,$24.09 ,$26.60 ,$260.00 ,$221.00 ,$54.20 ,$239.20 ,$182.00 ,$86.45 ,$92.86 ,$158.34 ,$86.45 ,$179.66 ,$182.00 ,$24.33 ,$187.20 ,$26.38 ,$28.91 ,$28.91 ,$24.09 ,$28.91 ,$24.09 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30100660,83915,HC NUCLEOTIDASE,301,1 ,$130.00 ,$65.00 ,$11.15 ,$130.00 ,$83.98 ,$11.52 ,$43.37 ,$37.17 ,$11.15 ,$78.00 ,$110.50 ,$91.00 ,$11.52 ,$123.50 ,$93.60 ,$94.90 ,$18.96 ,$110.50 ,$11.15 ,$18.96 ,$104.00 ,$94.90 ,$11.52 ,$11.15 ,$12.31 ,$130.00 ,$110.50 ,$25.09 ,$119.60 ,$91.00 ,$53.39 ,$57.34 ,$79.17 ,$53.39 ,$89.83 ,$91.00 ,$11.26 ,$93.60 ,$12.21 ,$13.38 ,$13.38 ,$11.15 ,$13.38 ,$11.15 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100661,83916,HC OLIGOCLONAL BANDS,301,1 ,$130.00 ,$65.00 ,$27.39 ,$130.00 ,$83.98 ,$28.28 ,$95.87 ,$82.17 ,$27.39 ,$78.00 ,$110.50 ,$91.00 ,$28.28 ,$123.50 ,$93.60 ,$94.90 ,$46.56 ,$110.50 ,$27.39 ,$46.56 ,$104.00 ,$94.90 ,$28.28 ,$27.39 ,$30.24 ,$130.00 ,$110.50 ,$61.63 ,$119.60 ,$91.00 ,$96.28 ,$103.41 ,$79.17 ,$96.28 ,$89.83 ,$91.00 ,$27.66 ,$93.60 ,$29.98 ,$32.87 ,$32.87 ,$27.39 ,$32.87 ,$27.39 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100662,83918,HC ORGANIC ACIDS QD,301,1 ,$590.00 ,$295.00 ,$23.14 ,$590.00 ,$381.14 ,$23.14 ,$82.60 ,$70.80 ,$23.60 ,$354.00 ,$501.50 ,$413.00 ,$23.14 ,$560.50 ,$424.80 ,$430.70 ,$40.12 ,$501.50 ,$23.60 ,$40.12 ,$472.00 ,$430.70 ,$23.14 ,$23.60 ,$26.06 ,$590.00 ,$501.50 ,$53.10 ,$542.80 ,$413.00 ,$78.80 ,$84.64 ,$359.31 ,$78.80 ,$407.69 ,$413.00 ,$23.84 ,$424.80 ,$24.53 ,$28.32 ,$28.32 ,$23.60 ,$28.32 ,$23.60 ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,30100663,83918,HC ORGANIC ACIDS QN,301,1 ,"$1,020.00 ",$510.00 ,$23.14 ,"$1,020.00 ",$658.92 ,$23.14 ,$82.60 ,$70.80 ,$23.60 ,$612.00 ,$867.00 ,$714.00 ,$23.14 ,$969.00 ,$734.40 ,$744.60 ,$40.12 ,$867.00 ,$23.60 ,$40.12 ,$816.00 ,$744.60 ,$23.14 ,$23.60 ,$26.06 ,"$1,020.00 ",$867.00 ,$53.10 ,$938.40 ,$714.00 ,$78.80 ,$84.64 ,$621.18 ,$78.80 ,$704.82 ,$714.00 ,$23.84 ,$734.40 ,$24.53 ,$28.32 ,$28.32 ,$23.60 ,$28.32 ,$23.60 ,$734.40 ,$632.40 ,$734.40 ,$734.40 ,$612.00 ST VINCENT HOSPITAL - ACUTE,30100664,83918,HC ORGANIC ACIDS URINE,301,1 ,"$1,058.00 ",$529.00 ,$23.14 ,"$1,058.00 ",$683.47 ,$23.14 ,$82.60 ,$70.80 ,$23.60 ,$634.80 ,$899.30 ,$740.60 ,$23.14 ,"$1,005.10 ",$761.76 ,$772.34 ,$40.12 ,$899.30 ,$23.60 ,$40.12 ,$846.40 ,$772.34 ,$23.14 ,$23.60 ,$26.06 ,"$1,058.00 ",$899.30 ,$53.10 ,$973.36 ,$740.60 ,$78.80 ,$84.64 ,$644.32 ,$78.80 ,$731.08 ,$740.60 ,$23.84 ,$761.76 ,$24.53 ,$28.32 ,$28.32 ,$23.60 ,$28.32 ,$23.60 ,$761.76 ,$655.96 ,$761.76 ,$761.76 ,$634.80 ST VINCENT HOSPITAL - ACUTE,30100665,83918,HC ACYLGLYCINE,301,1 ,$856.00 ,$428.00 ,$23.14 ,$856.00 ,$552.98 ,$23.14 ,$82.60 ,$70.80 ,$23.60 ,$513.60 ,$727.60 ,$599.20 ,$23.14 ,$813.20 ,$616.32 ,$624.88 ,$40.12 ,$727.60 ,$23.60 ,$40.12 ,$684.80 ,$624.88 ,$23.14 ,$23.60 ,$26.06 ,$856.00 ,$727.60 ,$53.10 ,$787.52 ,$599.20 ,$78.80 ,$84.64 ,$521.30 ,$78.80 ,$591.50 ,$599.20 ,$23.84 ,$616.32 ,$24.53 ,$28.32 ,$28.32 ,$23.60 ,$28.32 ,$23.60 ,$616.32 ,$530.72 ,$616.32 ,$616.32 ,$513.60 ST VINCENT HOSPITAL - ACUTE,30100666,83921,HC ORGANIC ACID SNG QN (MEHTYL),301,1 ,$110.00 ,$55.00 ,$21.21 ,$110.00 ,$71.06 ,$21.92 ,$74.24 ,$63.63 ,$21.21 ,$66.00 ,$93.50 ,$77.00 ,$21.92 ,$104.50 ,$79.20 ,$80.30 ,$36.06 ,$93.50 ,$21.21 ,$36.06 ,$88.00 ,$80.30 ,$21.92 ,$21.21 ,$23.42 ,$110.00 ,$93.50 ,$47.72 ,$101.20 ,$77.00 ,$78.80 ,$84.64 ,$66.99 ,$78.80 ,$76.01 ,$77.00 ,$21.42 ,$79.20 ,$23.24 ,$25.45 ,$25.45 ,$21.21 ,$25.45 ,$21.21 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100667,80364,HC OPIATES EXP,301,1 ,$37.00 ,$18.50 ,$1.42 ,$37.00 ,$23.90 ,$1.42 ,$23.94 ,$23.94 , N/A ,$22.20 ,$31.45 ,$25.90 ,$1.42 ,$35.15 ,$26.64 ,$27.01 ,$27.08 ,$31.45 , N/A ,$27.08 ,$29.60 ,$27.01 ,$1.42 , N/A ,$17.59 ,$37.00 ,$31.45 , N/A ,$34.04 ,$25.90 ,$18.50 ,$22.20 ,$22.53 ,$18.50 ,$25.57 ,$25.90 , N/A ,$26.64 ,$1.51 , N/A , N/A , N/A , N/A , N/A ,$26.64 ,$22.94 ,$26.64 ,$26.64 ,$22.20 ST VINCENT HOSPITAL - ACUTE,30100668,83930,HC OSMOLALITY BLOOD,301,1 ,$45.00 ,$22.50 ,$6.61 ,$45.00 ,$29.07 ,$6.83 ,$25.73 ,$22.05 ,$6.61 ,$27.00 ,$38.25 ,$31.50 ,$6.83 ,$42.75 ,$32.40 ,$32.85 ,$11.24 ,$38.25 ,$6.61 ,$11.24 ,$36.00 ,$32.85 ,$6.83 ,$6.61 ,$7.30 ,$45.00 ,$38.25 ,$14.87 ,$41.40 ,$31.50 ,$31.66 ,$34.01 ,$27.41 ,$31.66 ,$31.10 ,$31.50 ,$6.68 ,$32.40 ,$7.24 ,$7.93 ,$7.93 ,$6.61 ,$7.93 ,$6.61 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,30100669,83935,HC OSMOLALITY URINE,301,1 ,$47.00 ,$23.50 ,$6.82 ,$47.00 ,$30.36 ,$7.05 ,$26.50 ,$22.71 ,$6.82 ,$28.20 ,$39.95 ,$32.90 ,$7.05 ,$44.65 ,$33.84 ,$34.31 ,$11.59 ,$39.95 ,$6.82 ,$11.59 ,$37.60 ,$34.31 ,$7.05 ,$6.82 ,$7.53 ,$47.00 ,$39.95 ,$15.35 ,$43.24 ,$32.90 ,$32.64 ,$35.06 ,$28.62 ,$32.64 ,$32.48 ,$32.90 ,$6.89 ,$33.84 ,$7.47 ,$8.18 ,$8.18 ,$6.82 ,$8.18 ,$6.82 ,$33.84 ,$29.14 ,$33.84 ,$33.84 ,$28.20 ST VINCENT HOSPITAL - ACUTE,30100670,83945,HC OXALATE,301,1 ,$54.00 ,$27.00 ,$14.45 ,$54.00 ,$34.88 ,$14.93 ,$50.58 ,$43.35 ,$14.45 ,$32.40 ,$45.90 ,$37.80 ,$14.93 ,$51.30 ,$38.88 ,$39.42 ,$24.57 ,$45.90 ,$14.45 ,$24.57 ,$43.20 ,$39.42 ,$14.93 ,$14.45 ,$15.96 ,$54.00 ,$45.90 ,$32.51 ,$49.68 ,$37.80 ,$54.00 ,$54.00 ,$32.89 ,$54.00 ,$37.31 ,$37.80 ,$14.59 ,$38.88 ,$15.83 ,$17.34 ,$17.34 ,$14.45 ,$17.34 ,$14.45 ,$38.88 ,$33.48 ,$38.88 ,$38.88 ,$32.40 ST VINCENT HOSPITAL - ACUTE,30100671,83945,HC OXALATE 24 HR URINE,301,1 ,$112.00 ,$56.00 ,$14.45 ,$112.00 ,$72.35 ,$14.93 ,$50.58 ,$43.35 ,$14.45 ,$67.20 ,$95.20 ,$78.40 ,$14.93 ,$106.40 ,$80.64 ,$81.76 ,$24.57 ,$95.20 ,$14.45 ,$24.57 ,$89.60 ,$81.76 ,$14.93 ,$14.45 ,$15.96 ,$112.00 ,$95.20 ,$32.51 ,$103.04 ,$78.40 ,$61.64 ,$66.20 ,$68.21 ,$61.64 ,$77.39 ,$78.40 ,$14.59 ,$80.64 ,$15.83 ,$17.34 ,$17.34 ,$14.45 ,$17.34 ,$14.45 ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,30100672,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$280.00 ,$140.00 ,$41.28 ,$280.00 ,$180.88 ,$42.65 ,$160.51 ,$137.58 ,$41.28 ,$168.00 ,$238.00 ,$196.00 ,$42.65 ,$266.00 ,$201.60 ,$204.40 ,$70.18 ,$238.00 ,$41.28 ,$70.18 ,$224.00 ,$204.40 ,$42.65 ,$41.28 ,$45.58 ,$280.00 ,$238.00 ,$92.88 ,$257.60 ,$196.00 ,$197.65 ,$212.29 ,$170.52 ,$197.65 ,$193.48 ,$196.00 ,$41.69 ,$201.60 ,$45.21 ,$49.54 ,$49.54 ,$41.28 ,$49.54 ,$41.28 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,30100673,83986,HC PH BODY FLUID,301,1 ,$24.00 ,$12.00 ,$3.58 ,$24.00 ,$15.50 ,$3.70 ,$13.93 ,$11.94 ,$3.58 ,$14.40 ,$20.40 ,$16.80 ,$3.70 ,$22.80 ,$17.28 ,$17.52 ,$6.09 ,$20.40 ,$3.58 ,$6.09 ,$19.20 ,$17.52 ,$3.70 ,$3.58 ,$3.95 ,$24.00 ,$20.40 ,$8.06 ,$22.08 ,$16.80 ,$17.13 ,$18.40 ,$14.62 ,$17.13 ,$16.58 ,$16.80 ,$3.62 ,$17.28 ,$3.92 ,$4.30 ,$4.30 ,$3.58 ,$4.30 ,$3.58 ,$17.28 ,$14.88 ,$17.28 ,$17.28 ,$14.40 ST VINCENT HOSPITAL - ACUTE,30100674,83986,HC PH BODY FLUID (FECES),301,1 ,$24.00 ,$12.00 ,$3.58 ,$24.00 ,$15.50 ,$3.70 ,$13.93 ,$11.94 ,$3.58 ,$14.40 ,$20.40 ,$16.80 ,$3.70 ,$22.80 ,$17.28 ,$17.52 ,$6.09 ,$20.40 ,$3.58 ,$6.09 ,$19.20 ,$17.52 ,$3.70 ,$3.58 ,$3.95 ,$24.00 ,$20.40 ,$8.06 ,$22.08 ,$16.80 ,$17.13 ,$18.40 ,$14.62 ,$17.13 ,$16.58 ,$16.80 ,$3.62 ,$17.28 ,$3.92 ,$4.30 ,$4.30 ,$3.58 ,$4.30 ,$3.58 ,$17.28 ,$14.88 ,$17.28 ,$17.28 ,$14.40 ST VINCENT HOSPITAL - ACUTE,30100675,83992,HC PHENCYCLIDINE (PCP),301,1 ,$100.00 ,$50.00 ,$18.55 ,$100.00 ,$64.60 ,$20.67 ,$100.00 ,$100.00 , N/A ,$60.00 ,$85.00 ,$70.00 ,$20.67 ,$95.00 ,$72.00 ,$73.00 ,$66.49 ,$85.00 , N/A ,$66.49 ,$80.00 ,$73.00 ,$20.67 , N/A ,$18.55 ,$100.00 ,$85.00 , N/A ,$92.00 ,$70.00 ,$70.38 ,$75.59 ,$60.90 ,$70.38 ,$69.10 ,$70.00 , N/A ,$72.00 ,$21.91 ,$51.97 ,$51.97 , N/A ,$51.97 , N/A ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100676,84030,HC NEWBORN SCREEN PKU,301,1 ,$190.00 ,$95.00 ,$5.50 ,$190.00 ,$122.74 ,$5.68 ,$21.39 ,$18.33 ,$5.50 ,$114.00 ,$161.50 ,$133.00 ,$5.68 ,$180.50 ,$136.80 ,$138.70 ,$9.35 ,$161.50 ,$5.50 ,$9.35 ,$152.00 ,$138.70 ,$5.68 ,$5.50 ,$6.07 ,$190.00 ,$161.50 ,$12.38 ,$174.80 ,$133.00 ,$26.33 ,$28.28 ,$115.71 ,$26.33 ,$131.29 ,$133.00 ,$5.56 ,$136.80 ,$6.02 ,$6.60 ,$6.60 ,$5.50 ,$6.60 ,$5.50 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30100677,84060,HC ACID PHOSPHATASE,301,1 ,$93.00 ,$46.50 ,$7.64 ,$93.00 ,$60.08 ,$7.89 ,$28.74 ,$24.63 ,$7.64 ,$55.80 ,$79.05 ,$65.10 ,$7.89 ,$88.35 ,$66.96 ,$67.89 ,$12.99 ,$79.05 ,$7.64 ,$12.99 ,$74.40 ,$67.89 ,$7.89 ,$7.64 ,$8.44 ,$93.00 ,$79.05 ,$17.19 ,$85.56 ,$65.10 ,$35.38 ,$38.00 ,$56.64 ,$35.38 ,$64.26 ,$65.10 ,$7.72 ,$66.96 ,$8.36 ,$9.17 ,$9.17 ,$7.64 ,$9.17 ,$7.64 ,$66.96 ,$57.66 ,$66.96 ,$66.96 ,$55.80 ST VINCENT HOSPITAL - ACUTE,30100678,84066,HC PHOSPHATASE ACID PROSTATIC,301,1 ,$100.00 ,$50.00 ,$9.66 ,$100.00 ,$64.60 ,$9.98 ,$37.56 ,$32.19 ,$9.66 ,$60.00 ,$85.00 ,$70.00 ,$9.98 ,$95.00 ,$72.00 ,$73.00 ,$16.42 ,$85.00 ,$9.66 ,$16.42 ,$80.00 ,$73.00 ,$9.98 ,$9.66 ,$10.67 ,$100.00 ,$85.00 ,$21.74 ,$92.00 ,$70.00 ,$46.26 ,$49.69 ,$60.90 ,$46.26 ,$69.10 ,$70.00 ,$9.76 ,$72.00 ,$10.58 ,$11.59 ,$11.59 ,$9.66 ,$11.59 ,$9.66 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100679,84075,HC ALKALINE PHOSPHATASE,301,1 ,$25.00 ,$12.50 ,$5.18 ,$25.00 ,$16.15 ,$5.35 ,$20.13 ,$17.25 ,$5.18 ,$15.00 ,$21.25 ,$17.50 ,$5.35 ,$23.75 ,$18.00 ,$18.25 ,$8.81 ,$21.25 ,$5.18 ,$8.81 ,$20.00 ,$18.25 ,$5.35 ,$5.18 ,$5.72 ,$25.00 ,$21.25 ,$11.66 ,$23.00 ,$17.50 ,$24.78 ,$25.00 ,$15.23 ,$24.78 ,$17.28 ,$17.50 ,$5.23 ,$18.00 ,$5.67 ,$6.22 ,$6.22 ,$5.18 ,$6.22 ,$5.18 ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,30100680,84075,HC ALKALINE PHOSPHATASE TOT,301,1 ,$36.00 ,$18.00 ,$5.18 ,$36.00 ,$23.26 ,$5.35 ,$20.13 ,$17.25 ,$5.18 ,$21.60 ,$30.60 ,$25.20 ,$5.35 ,$34.20 ,$25.92 ,$26.28 ,$8.81 ,$30.60 ,$5.18 ,$8.81 ,$28.80 ,$26.28 ,$5.35 ,$5.18 ,$5.72 ,$36.00 ,$30.60 ,$11.66 ,$33.12 ,$25.20 ,$24.78 ,$26.62 ,$21.92 ,$24.78 ,$24.88 ,$25.20 ,$5.23 ,$25.92 ,$5.67 ,$6.22 ,$6.22 ,$5.18 ,$6.22 ,$5.18 ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,30100681,84080,HC ALK PHOS ISOENZ,301,1 ,$100.00 ,$50.00 ,$14.78 ,$100.00 ,$64.60 ,$15.27 ,$57.51 ,$49.29 ,$14.78 ,$60.00 ,$85.00 ,$70.00 ,$15.27 ,$95.00 ,$72.00 ,$73.00 ,$25.13 ,$85.00 ,$14.78 ,$25.13 ,$80.00 ,$73.00 ,$15.27 ,$14.78 ,$16.32 ,$100.00 ,$85.00 ,$33.26 ,$92.00 ,$70.00 ,$70.80 ,$76.04 ,$60.90 ,$70.80 ,$69.10 ,$70.00 ,$14.93 ,$72.00 ,$16.19 ,$17.74 ,$17.74 ,$14.78 ,$17.74 ,$14.78 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100682,84081,HC PHOSPHATIDYLYCEROL (PG),301,1 ,$389.00 ,$194.50 ,$16.52 ,$389.00 ,$251.29 ,$17.07 ,$64.23 ,$55.05 ,$16.52 ,$233.40 ,$330.65 ,$272.30 ,$17.07 ,$369.55 ,$280.08 ,$283.97 ,$28.08 ,$330.65 ,$16.52 ,$28.08 ,$311.20 ,$283.97 ,$17.07 ,$16.52 ,$18.24 ,$389.00 ,$330.65 ,$37.17 ,$357.88 ,$272.30 ,$79.12 ,$84.98 ,$236.90 ,$79.12 ,$268.80 ,$272.30 ,$16.69 ,$280.08 ,$18.09 ,$19.82 ,$19.82 ,$16.52 ,$19.82 ,$16.52 ,$280.08 ,$241.18 ,$280.08 ,$280.08 ,$233.40 ST VINCENT HOSPITAL - ACUTE,30100683,84087,HC PHOSPHATIDYLYCEROL (PG),301,1 ,$385.00 ,$192.50 ,$10.73 ,$385.00 ,$248.71 ,$11.09 ,$40.15 ,$34.41 ,$10.73 ,$231.00 ,$327.25 ,$269.50 ,$11.09 ,$365.75 ,$277.20 ,$281.05 ,$18.24 ,$327.25 ,$10.73 ,$18.24 ,$308.00 ,$281.05 ,$11.09 ,$10.73 ,$11.85 ,$385.00 ,$327.25 ,$24.14 ,$354.20 ,$269.50 ,$49.46 ,$53.12 ,$234.47 ,$49.46 ,$266.04 ,$269.50 ,$10.84 ,$277.20 ,$11.76 ,$12.88 ,$12.88 ,$10.73 ,$12.88 ,$10.73 ,$277.20 ,$238.70 ,$277.20 ,$277.20 ,$231.00 ST VINCENT HOSPITAL - ACUTE,30100684,84100,HC PHOSPHORUS,301,1 ,$32.00 ,$16.00 ,$4.74 ,$32.00 ,$20.67 ,$4.90 ,$18.45 ,$15.81 ,$4.74 ,$19.20 ,$27.20 ,$22.40 ,$4.90 ,$30.40 ,$23.04 ,$23.36 ,$8.06 ,$27.20 ,$4.74 ,$8.06 ,$25.60 ,$23.36 ,$4.90 ,$4.74 ,$5.23 ,$32.00 ,$27.20 ,$10.67 ,$29.44 ,$22.40 ,$22.67 ,$24.35 ,$19.49 ,$22.67 ,$22.11 ,$22.40 ,$4.79 ,$23.04 ,$5.19 ,$5.69 ,$5.69 ,$4.74 ,$5.69 ,$4.74 ,$23.04 ,$19.84 ,$23.04 ,$23.04 ,$19.20 ST VINCENT HOSPITAL - ACUTE,30100685,84105,HC PHOSPHORUS URINE,301,1 ,$35.00 ,$17.50 ,$5.78 ,$35.00 ,$22.61 ,$5.97 ,$20.23 ,$17.34 ,$5.78 ,$21.00 ,$29.75 ,$24.50 ,$5.97 ,$33.25 ,$25.20 ,$25.55 ,$9.83 ,$29.75 ,$5.78 ,$9.83 ,$28.00 ,$25.55 ,$5.97 ,$5.78 ,$6.38 ,$35.00 ,$29.75 ,$13.01 ,$32.20 ,$24.50 ,$24.78 ,$26.62 ,$21.32 ,$24.78 ,$24.19 ,$24.50 ,$5.84 ,$25.20 ,$6.33 ,$6.94 ,$6.94 ,$5.78 ,$6.94 ,$5.78 ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,30100686,84110,HC PORPHOBILINOGEN QN,301,1 ,$55.00 ,$27.50 ,$8.44 ,$55.00 ,$35.53 ,$8.72 ,$32.83 ,$28.14 ,$8.44 ,$33.00 ,$46.75 ,$38.50 ,$8.72 ,$52.25 ,$39.60 ,$40.15 ,$14.35 ,$46.75 ,$8.44 ,$14.35 ,$44.00 ,$40.15 ,$8.72 ,$8.44 ,$9.32 ,$55.00 ,$46.75 ,$18.99 ,$50.60 ,$38.50 ,$40.40 ,$43.39 ,$33.50 ,$40.40 ,$38.01 ,$38.50 ,$8.52 ,$39.60 ,$9.24 ,$10.13 ,$10.13 ,$8.44 ,$10.13 ,$8.44 ,$39.60 ,$34.10 ,$39.60 ,$39.60 ,$33.00 ST VINCENT HOSPITAL - ACUTE,30100687,84110,HC PORPHOBILINOGEN QN (24),301,1 ,$60.00 ,$30.00 ,$8.44 ,$60.00 ,$38.76 ,$8.72 ,$32.83 ,$28.14 ,$8.44 ,$36.00 ,$51.00 ,$42.00 ,$8.72 ,$57.00 ,$43.20 ,$43.80 ,$14.35 ,$51.00 ,$8.44 ,$14.35 ,$48.00 ,$43.80 ,$8.72 ,$8.44 ,$9.32 ,$60.00 ,$51.00 ,$18.99 ,$55.20 ,$42.00 ,$40.40 ,$43.39 ,$36.54 ,$40.40 ,$41.46 ,$42.00 ,$8.52 ,$43.20 ,$9.24 ,$10.13 ,$10.13 ,$8.44 ,$10.13 ,$8.44 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100688,84112,HC PLACENTAL ALPHA MICROGLOBULIN,301,1 ,$440.00 ,$220.00 ,$90.57 ,$440.00 ,$284.24 ,$90.57 ,$343.39 ,$294.33 ,$98.11 ,$264.00 ,$374.00 ,$308.00 ,$90.57 ,$418.00 ,$316.80 ,$321.20 ,$166.79 ,$374.00 ,$98.11 ,$166.79 ,$352.00 ,$321.20 ,$90.57 ,$98.11 ,$108.33 ,$440.00 ,$374.00 ,$220.75 ,$404.80 ,$308.00 ,$308.46 ,$331.31 ,$267.96 ,$308.46 ,$304.04 ,$308.00 ,$99.09 ,$316.80 ,$96.00 ,$117.73 ,$117.73 ,$98.11 ,$117.73 ,$98.11 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,30100689,84120,HC PORPHYRINS QN FRACT,301,1 ,$120.00 ,$60.00 ,$14.71 ,$120.00 ,$77.52 ,$15.20 ,$57.23 ,$49.05 ,$14.71 ,$72.00 ,$102.00 ,$84.00 ,$15.20 ,$114.00 ,$86.40 ,$87.60 ,$25.01 ,$102.00 ,$14.71 ,$25.01 ,$96.00 ,$87.60 ,$15.20 ,$14.71 ,$16.24 ,$120.00 ,$102.00 ,$33.10 ,$110.40 ,$84.00 ,$70.45 ,$75.66 ,$73.08 ,$70.45 ,$82.92 ,$84.00 ,$14.86 ,$86.40 ,$16.11 ,$17.65 ,$17.65 ,$14.71 ,$17.65 ,$14.71 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100690,84120,HC PORPHYRINS QN FRACT RNDM,301,1 ,$150.00 ,$75.00 ,$14.71 ,$150.00 ,$96.90 ,$15.20 ,$57.23 ,$49.05 ,$14.71 ,$90.00 ,$127.50 ,$105.00 ,$15.20 ,$142.50 ,$108.00 ,$109.50 ,$25.01 ,$127.50 ,$14.71 ,$25.01 ,$120.00 ,$109.50 ,$15.20 ,$14.71 ,$16.24 ,$150.00 ,$127.50 ,$33.10 ,$138.00 ,$105.00 ,$70.45 ,$75.66 ,$91.35 ,$70.45 ,$103.65 ,$105.00 ,$14.86 ,$108.00 ,$16.11 ,$17.65 ,$17.65 ,$14.71 ,$17.65 ,$14.71 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100691,84132,HC POTASSIUM,301,1 ,$31.00 ,$15.50 ,$4.76 ,$31.00 ,$20.03 ,$4.92 ,$17.89 ,$15.33 ,$4.76 ,$18.60 ,$26.35 ,$21.70 ,$4.92 ,$29.45 ,$22.32 ,$22.63 ,$8.09 ,$26.35 ,$4.76 ,$8.09 ,$24.80 ,$22.63 ,$4.92 ,$4.76 ,$5.26 ,$31.00 ,$26.35 ,$10.71 ,$28.52 ,$21.70 ,$22.01 ,$23.64 ,$18.88 ,$22.01 ,$21.42 ,$21.70 ,$4.81 ,$22.32 ,$5.22 ,$5.71 ,$5.71 ,$4.76 ,$5.71 ,$4.76 ,$22.32 ,$19.22 ,$22.32 ,$22.32 ,$18.60 ST VINCENT HOSPITAL - ACUTE,30100692,84132,HC POTASSIUM ABG,301,1 ,$31.00 ,$15.50 ,$4.76 ,$31.00 ,$20.03 ,$4.92 ,$17.89 ,$15.33 ,$4.76 ,$18.60 ,$26.35 ,$21.70 ,$4.92 ,$29.45 ,$22.32 ,$22.63 ,$8.09 ,$26.35 ,$4.76 ,$8.09 ,$24.80 ,$22.63 ,$4.92 ,$4.76 ,$5.26 ,$31.00 ,$26.35 ,$10.71 ,$28.52 ,$21.70 ,$22.01 ,$23.64 ,$18.88 ,$22.01 ,$21.42 ,$21.70 ,$4.81 ,$22.32 ,$5.22 ,$5.71 ,$5.71 ,$4.76 ,$5.71 ,$4.76 ,$22.32 ,$19.22 ,$22.32 ,$22.32 ,$18.60 ST VINCENT HOSPITAL - ACUTE,30100693,84132,HC POTASSIUM ISTAT,301,1 ,$31.00 ,$15.50 ,$4.76 ,$31.00 ,$20.03 ,$4.92 ,$17.89 ,$15.33 ,$4.76 ,$18.60 ,$26.35 ,$21.70 ,$4.92 ,$29.45 ,$22.32 ,$22.63 ,$8.09 ,$26.35 ,$4.76 ,$8.09 ,$24.80 ,$22.63 ,$4.92 ,$4.76 ,$5.26 ,$31.00 ,$26.35 ,$10.71 ,$28.52 ,$21.70 ,$22.01 ,$23.64 ,$18.88 ,$22.01 ,$21.42 ,$21.70 ,$4.81 ,$22.32 ,$5.22 ,$5.71 ,$5.71 ,$4.76 ,$5.71 ,$4.76 ,$22.32 ,$19.22 ,$22.32 ,$22.32 ,$18.60 ST VINCENT HOSPITAL - ACUTE,30100694,84133,HC POTASSIUM URINE,301,1 ,$29.00 ,$14.50 ,$4.73 ,$29.00 ,$18.73 ,$4.89 ,$16.77 ,$14.37 ,$4.73 ,$17.40 ,$24.65 ,$20.30 ,$4.89 ,$27.55 ,$20.88 ,$21.17 ,$8.04 ,$24.65 ,$4.73 ,$8.04 ,$23.20 ,$21.17 ,$4.89 ,$4.73 ,$5.22 ,$29.00 ,$24.65 ,$10.64 ,$26.68 ,$20.30 ,$20.60 ,$22.13 ,$17.66 ,$20.60 ,$20.04 ,$20.30 ,$4.78 ,$20.88 ,$5.18 ,$5.68 ,$5.68 ,$4.73 ,$5.68 ,$4.73 ,$20.88 ,$17.98 ,$20.88 ,$20.88 ,$17.40 ST VINCENT HOSPITAL - ACUTE,30100695,84134,HC PREALBUMIN,301,1 ,$45.00 ,$22.50 ,$7.85 ,$45.00 ,$29.07 ,$7.85 ,$45.00 ,$45.00 ,$14.59 ,$27.00 ,$38.25 ,$31.50 ,$7.85 ,$42.75 ,$32.40 ,$32.85 ,$24.80 ,$38.25 ,$14.59 ,$24.80 ,$36.00 ,$32.85 ,$7.85 ,$14.59 ,$16.11 ,$45.00 ,$38.25 ,$32.83 ,$41.40 ,$31.50 ,$26.75 ,$28.73 ,$27.41 ,$26.75 ,$31.10 ,$31.50 ,$14.74 ,$32.40 ,$8.32 ,$17.51 ,$17.51 ,$14.59 ,$17.51 ,$14.59 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,30100696,84144,HC PROGESTERONE,301,1 ,$130.00 ,$65.00 ,$20.86 ,$130.00 ,$83.98 ,$21.55 ,$81.13 ,$69.54 ,$20.86 ,$78.00 ,$110.50 ,$91.00 ,$21.55 ,$123.50 ,$93.60 ,$94.90 ,$35.46 ,$110.50 ,$20.86 ,$35.46 ,$104.00 ,$94.90 ,$21.55 ,$20.86 ,$23.03 ,$130.00 ,$110.50 ,$46.94 ,$119.60 ,$91.00 ,$89.08 ,$95.68 ,$79.17 ,$89.08 ,$89.83 ,$91.00 ,$21.07 ,$93.60 ,$22.84 ,$25.03 ,$25.03 ,$20.86 ,$25.03 ,$20.86 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100697,84146,HC PROLACTIN,301,1 ,$130.00 ,$65.00 ,$19.38 ,$130.00 ,$83.98 ,$20.03 ,$75.36 ,$64.59 ,$19.38 ,$78.00 ,$110.50 ,$91.00 ,$20.03 ,$123.50 ,$93.60 ,$94.90 ,$32.95 ,$110.50 ,$19.38 ,$32.95 ,$104.00 ,$94.90 ,$20.03 ,$19.38 ,$21.40 ,$130.00 ,$110.50 ,$43.61 ,$119.60 ,$91.00 ,$92.80 ,$99.68 ,$79.17 ,$92.80 ,$89.83 ,$91.00 ,$19.57 ,$93.60 ,$21.23 ,$23.26 ,$23.26 ,$19.38 ,$23.26 ,$19.38 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100698,84153,HC PSA TOTAL,301,1 ,$130.00 ,$65.00 ,$18.39 ,$130.00 ,$83.98 ,$19.00 ,$71.54 ,$61.32 ,$18.39 ,$78.00 ,$110.50 ,$91.00 ,$19.00 ,$123.50 ,$93.60 ,$94.90 ,$31.26 ,$110.50 ,$18.39 ,$31.26 ,$104.00 ,$94.90 ,$19.00 ,$18.39 ,$20.31 ,$130.00 ,$110.50 ,$41.38 ,$119.60 ,$91.00 ,$88.07 ,$94.59 ,$79.17 ,$88.07 ,$89.83 ,$91.00 ,$18.57 ,$93.60 ,$20.14 ,$22.07 ,$22.07 ,$18.39 ,$22.07 ,$18.39 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100699,84154,HC PSA FREE,301,1 ,$130.00 ,$65.00 ,$18.39 ,$130.00 ,$83.98 ,$19.00 ,$71.54 ,$61.32 ,$18.39 ,$78.00 ,$110.50 ,$91.00 ,$19.00 ,$123.50 ,$93.60 ,$94.90 ,$31.26 ,$110.50 ,$18.39 ,$31.26 ,$104.00 ,$94.90 ,$19.00 ,$18.39 ,$20.31 ,$130.00 ,$110.50 ,$41.38 ,$119.60 ,$91.00 ,$88.07 ,$94.59 ,$79.17 ,$88.07 ,$89.83 ,$91.00 ,$18.57 ,$93.60 ,$20.14 ,$22.07 ,$22.07 ,$18.39 ,$22.07 ,$18.39 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100700,84155,HC PROTEIN TOTAL,301,1 ,$26.00 ,$13.00 ,$3.67 ,$26.00 ,$16.80 ,$3.79 ,$14.25 ,$12.21 ,$3.67 ,$15.60 ,$22.10 ,$18.20 ,$3.79 ,$24.70 ,$18.72 ,$18.98 ,$6.24 ,$22.10 ,$3.67 ,$6.24 ,$20.80 ,$18.98 ,$3.79 ,$3.67 ,$4.05 ,$26.00 ,$22.10 ,$8.26 ,$23.92 ,$18.20 ,$17.55 ,$18.85 ,$15.83 ,$17.55 ,$17.97 ,$18.20 ,$3.71 ,$18.72 ,$4.02 ,$4.40 ,$4.40 ,$3.67 ,$4.40 ,$3.67 ,$18.72 ,$16.12 ,$18.72 ,$18.72 ,$15.60 ST VINCENT HOSPITAL - ACUTE,30100701,84156,HC PROTEIN TOTAL URINE,301,1 ,$31.00 ,$15.50 ,$3.67 ,$31.00 ,$20.03 ,$3.79 ,$14.25 ,$12.21 ,$3.67 ,$18.60 ,$26.35 ,$21.70 ,$3.79 ,$29.45 ,$22.32 ,$22.63 ,$6.24 ,$26.35 ,$3.67 ,$6.24 ,$24.80 ,$22.63 ,$3.79 ,$3.67 ,$4.05 ,$31.00 ,$26.35 ,$8.26 ,$28.52 ,$21.70 ,$17.55 ,$18.85 ,$18.88 ,$17.55 ,$21.42 ,$21.70 ,$3.71 ,$22.32 ,$4.02 ,$4.40 ,$4.40 ,$3.67 ,$4.40 ,$3.67 ,$22.32 ,$19.22 ,$22.32 ,$22.32 ,$18.60 ST VINCENT HOSPITAL - ACUTE,30100702,84156,HC PROTEIN TOTAL 24HR URINE,301,1 ,$25.00 ,$12.50 ,$3.67 ,$25.00 ,$16.15 ,$3.79 ,$14.25 ,$12.21 ,$3.67 ,$15.00 ,$21.25 ,$17.50 ,$3.79 ,$23.75 ,$18.00 ,$18.25 ,$6.24 ,$21.25 ,$3.67 ,$6.24 ,$20.00 ,$18.25 ,$3.79 ,$3.67 ,$4.05 ,$25.00 ,$21.25 ,$8.26 ,$23.00 ,$17.50 ,$17.55 ,$18.85 ,$15.23 ,$17.55 ,$17.28 ,$17.50 ,$3.71 ,$18.00 ,$4.02 ,$4.40 ,$4.40 ,$3.67 ,$4.40 ,$3.67 ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,30100703,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$47.00 ,$23.50 ,$4.00 ,$47.00 ,$30.36 ,$4.13 ,$14.25 ,$12.21 ,$4.00 ,$28.20 ,$39.95 ,$32.90 ,$4.13 ,$44.65 ,$33.84 ,$34.31 ,$6.80 ,$39.95 ,$4.00 ,$6.80 ,$37.60 ,$34.31 ,$4.13 ,$4.00 ,$4.42 ,$47.00 ,$39.95 ,$9.00 ,$43.24 ,$32.90 ,$17.55 ,$18.85 ,$28.62 ,$17.55 ,$32.48 ,$32.90 ,$4.04 ,$33.84 ,$4.38 ,$4.80 ,$4.80 ,$4.00 ,$4.80 ,$4.00 ,$33.84 ,$29.14 ,$33.84 ,$33.84 ,$28.20 ST VINCENT HOSPITAL - ACUTE,30100704,84157,HC PROTEIN TOTAL SPINAL FLUID,301,1 ,$47.00 ,$23.50 ,$4.00 ,$47.00 ,$30.36 ,$4.13 ,$14.25 ,$12.21 ,$4.00 ,$28.20 ,$39.95 ,$32.90 ,$4.13 ,$44.65 ,$33.84 ,$34.31 ,$6.80 ,$39.95 ,$4.00 ,$6.80 ,$37.60 ,$34.31 ,$4.13 ,$4.00 ,$4.42 ,$47.00 ,$39.95 ,$9.00 ,$43.24 ,$32.90 ,$17.55 ,$18.85 ,$28.62 ,$17.55 ,$32.48 ,$32.90 ,$4.04 ,$33.84 ,$4.38 ,$4.80 ,$4.80 ,$4.00 ,$4.80 ,$4.00 ,$33.84 ,$29.14 ,$33.84 ,$33.84 ,$28.20 ST VINCENT HOSPITAL - ACUTE,30100705,84165,HC PROTEIN ELECTROPHORESIS,301,1 ,$70.00 ,$35.00 ,$10.74 ,$70.00 ,$45.22 ,$11.10 ,$41.76 ,$35.79 ,$10.74 ,$42.00 ,$59.50 ,$49.00 ,$11.10 ,$66.50 ,$50.40 ,$51.10 ,$18.26 ,$59.50 ,$10.74 ,$18.26 ,$56.00 ,$51.10 ,$11.10 ,$10.74 ,$11.86 ,$70.00 ,$59.50 ,$24.17 ,$64.40 ,$49.00 ,$51.42 ,$55.23 ,$42.63 ,$51.42 ,$48.37 ,$49.00 ,$10.85 ,$50.40 ,$11.77 ,$12.89 ,$12.89 ,$10.74 ,$12.89 ,$10.74 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100706,84166,HC PROTEIN EP OTH FLUID,301,1 ,$120.00 ,$60.00 ,$17.83 ,$120.00 ,$77.52 ,$18.42 ,$69.34 ,$59.43 ,$17.83 ,$72.00 ,$102.00 ,$84.00 ,$18.42 ,$114.00 ,$86.40 ,$87.60 ,$30.31 ,$102.00 ,$17.83 ,$30.31 ,$96.00 ,$87.60 ,$18.42 ,$17.83 ,$19.69 ,$120.00 ,$102.00 ,$40.12 ,$110.40 ,$84.00 ,$85.40 ,$91.72 ,$73.08 ,$85.40 ,$82.92 ,$84.00 ,$18.01 ,$86.40 ,$19.53 ,$21.40 ,$21.40 ,$17.83 ,$21.40 ,$17.83 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100707,84166,HC PROTEIN EP OTH FLUID SF,301,1 ,$120.00 ,$60.00 ,$17.83 ,$120.00 ,$77.52 ,$18.42 ,$69.34 ,$59.43 ,$17.83 ,$72.00 ,$102.00 ,$84.00 ,$18.42 ,$114.00 ,$86.40 ,$87.60 ,$30.31 ,$102.00 ,$17.83 ,$30.31 ,$96.00 ,$87.60 ,$18.42 ,$17.83 ,$19.69 ,$120.00 ,$102.00 ,$40.12 ,$110.40 ,$84.00 ,$85.40 ,$91.72 ,$73.08 ,$85.40 ,$82.92 ,$84.00 ,$18.01 ,$86.40 ,$19.53 ,$21.40 ,$21.40 ,$17.83 ,$21.40 ,$17.83 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100708,84181,HC PROTEIN WESTERN BLOT,301,1 ,$142.00 ,$71.00 ,$17.03 ,$142.00 ,$91.73 ,$17.60 ,$66.22 ,$56.76 ,$17.03 ,$85.20 ,$120.70 ,$99.40 ,$17.60 ,$134.90 ,$102.24 ,$103.66 ,$28.95 ,$120.70 ,$17.03 ,$28.95 ,$113.60 ,$103.66 ,$17.60 ,$17.03 ,$18.80 ,$142.00 ,$120.70 ,$38.32 ,$130.64 ,$99.40 ,$81.57 ,$87.61 ,$86.48 ,$81.57 ,$98.12 ,$99.40 ,$17.20 ,$102.24 ,$18.66 ,$20.44 ,$20.44 ,$17.03 ,$20.44 ,$17.03 ,$102.24 ,$88.04 ,$102.24 ,$102.24 ,$85.20 ST VINCENT HOSPITAL - ACUTE,30100709,84202,HC PROTOPORPHYRIN,301,1 ,$80.00 ,$40.00 ,$14.35 ,$80.00 ,$51.68 ,$14.83 ,$55.79 ,$47.82 ,$14.35 ,$48.00 ,$68.00 ,$56.00 ,$14.83 ,$76.00 ,$57.60 ,$58.40 ,$24.40 ,$68.00 ,$14.35 ,$24.40 ,$64.00 ,$58.40 ,$14.83 ,$14.35 ,$15.85 ,$80.00 ,$68.00 ,$32.29 ,$73.60 ,$56.00 ,$68.69 ,$73.78 ,$48.72 ,$68.69 ,$55.28 ,$56.00 ,$14.49 ,$57.60 ,$15.72 ,$17.22 ,$17.22 ,$14.35 ,$17.22 ,$14.35 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100710,84206,HC PROINSULIN,301,1 ,$260.00 ,$130.00 ,$25.05 ,$260.00 ,$167.96 ,$25.05 ,$93.42 ,$80.07 ,$26.69 ,$156.00 ,$221.00 ,$182.00 ,$25.05 ,$247.00 ,$187.20 ,$189.80 ,$45.37 ,$221.00 ,$26.69 ,$45.37 ,$208.00 ,$189.80 ,$25.05 ,$26.69 ,$29.47 ,$260.00 ,$221.00 ,$60.05 ,$239.20 ,$182.00 ,$85.29 ,$91.61 ,$158.34 ,$85.29 ,$179.66 ,$182.00 ,$26.96 ,$187.20 ,$26.55 ,$32.03 ,$32.03 ,$26.69 ,$32.03 ,$26.69 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30100711,84207,HC VITAMIN B6,301,1 ,$190.00 ,$95.00 ,$28.10 ,$190.00 ,$122.74 ,$29.04 ,$109.27 ,$93.66 ,$28.10 ,$114.00 ,$161.50 ,$133.00 ,$29.04 ,$180.50 ,$136.80 ,$138.70 ,$47.77 ,$161.50 ,$28.10 ,$47.77 ,$152.00 ,$138.70 ,$29.04 ,$28.10 ,$31.03 ,$190.00 ,$161.50 ,$63.23 ,$174.80 ,$133.00 ,$134.54 ,$144.50 ,$115.71 ,$134.54 ,$131.29 ,$133.00 ,$28.38 ,$136.80 ,$30.78 ,$33.72 ,$33.72 ,$28.10 ,$33.72 ,$28.10 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30100712,84210,HC PYRUVATE,301,1 ,$100.00 ,$50.00 ,$14.48 ,$100.00 ,$64.60 ,$14.96 ,$50.68 ,$43.44 ,$14.48 ,$60.00 ,$85.00 ,$70.00 ,$14.96 ,$95.00 ,$72.00 ,$73.00 ,$24.62 ,$85.00 ,$14.48 ,$24.62 ,$80.00 ,$73.00 ,$14.96 ,$14.48 ,$15.99 ,$100.00 ,$85.00 ,$32.58 ,$92.00 ,$70.00 ,$51.98 ,$55.83 ,$60.90 ,$51.98 ,$69.10 ,$70.00 ,$14.62 ,$72.00 ,$15.86 ,$17.38 ,$17.38 ,$14.48 ,$17.38 ,$14.48 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100713,84220,HC PYRUVATE KINASE,301,1 ,$203.00 ,$101.50 ,$9.44 ,$203.00 ,$131.14 ,$9.75 ,$36.72 ,$31.47 ,$9.44 ,$121.80 ,$172.55 ,$142.10 ,$9.75 ,$192.85 ,$146.16 ,$148.19 ,$16.05 ,$172.55 ,$9.44 ,$16.05 ,$162.40 ,$148.19 ,$9.75 ,$9.44 ,$10.42 ,$203.00 ,$172.55 ,$21.24 ,$186.76 ,$142.10 ,$45.21 ,$48.56 ,$123.63 ,$45.21 ,$140.27 ,$142.10 ,$9.53 ,$146.16 ,$10.34 ,$11.33 ,$11.33 ,$9.44 ,$11.33 ,$9.44 ,$146.16 ,$125.86 ,$146.16 ,$146.16 ,$121.80 ST VINCENT HOSPITAL - ACUTE,30100714,84238,HC RECEPTOR ASSAY NON ENDO,301,1 ,$260.00 ,$130.00 ,$36.57 ,$260.00 ,$167.96 ,$37.79 ,$142.21 ,$121.89 ,$36.57 ,$156.00 ,$221.00 ,$182.00 ,$37.79 ,$247.00 ,$187.20 ,$189.80 ,$62.17 ,$221.00 ,$36.57 ,$62.17 ,$208.00 ,$189.80 ,$37.79 ,$36.57 ,$40.38 ,$260.00 ,$221.00 ,$82.28 ,$239.20 ,$182.00 ,$175.11 ,$188.09 ,$158.34 ,$175.11 ,$179.66 ,$182.00 ,$36.94 ,$187.20 ,$40.06 ,$43.88 ,$43.88 ,$36.57 ,$43.88 ,$36.57 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30100715,84244,HC RENIN,301,1 ,$150.00 ,$75.00 ,$21.99 ,$150.00 ,$96.90 ,$22.72 ,$85.54 ,$73.32 ,$21.99 ,$90.00 ,$127.50 ,$105.00 ,$22.72 ,$142.50 ,$108.00 ,$109.50 ,$37.38 ,$127.50 ,$21.99 ,$37.38 ,$120.00 ,$109.50 ,$22.72 ,$21.99 ,$24.28 ,$150.00 ,$127.50 ,$49.48 ,$138.00 ,$105.00 ,$105.34 ,$113.14 ,$91.35 ,$105.34 ,$103.65 ,$105.00 ,$22.21 ,$108.00 ,$24.08 ,$26.39 ,$26.39 ,$21.99 ,$26.39 ,$21.99 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100716,84255,HC SELENIUM (MAYO),301,1 ,$255.00 ,$127.50 ,$25.53 ,$255.00 ,$164.73 ,$26.38 ,$99.30 ,$85.11 ,$25.53 ,$153.00 ,$216.75 ,$178.50 ,$26.38 ,$242.25 ,$183.60 ,$186.15 ,$43.40 ,$216.75 ,$25.53 ,$43.40 ,$204.00 ,$186.15 ,$26.38 ,$25.53 ,$28.19 ,$255.00 ,$216.75 ,$57.44 ,$234.60 ,$178.50 ,$122.25 ,$131.31 ,$155.30 ,$122.25 ,$176.21 ,$178.50 ,$25.79 ,$183.60 ,$27.96 ,$30.64 ,$30.64 ,$25.53 ,$30.64 ,$25.53 ,$183.60 ,$158.10 ,$183.60 ,$183.60 ,$153.00 ST VINCENT HOSPITAL - ACUTE,30100717,84255,HC SELENIUM,301,1 ,$170.00 ,$85.00 ,$25.53 ,$170.00 ,$109.82 ,$26.38 ,$99.30 ,$85.11 ,$25.53 ,$102.00 ,$144.50 ,$119.00 ,$26.38 ,$161.50 ,$122.40 ,$124.10 ,$43.40 ,$144.50 ,$25.53 ,$43.40 ,$136.00 ,$124.10 ,$26.38 ,$25.53 ,$28.19 ,$170.00 ,$144.50 ,$57.44 ,$156.40 ,$119.00 ,$122.25 ,$131.31 ,$103.53 ,$122.25 ,$117.47 ,$119.00 ,$25.79 ,$122.40 ,$27.96 ,$30.64 ,$30.64 ,$25.53 ,$30.64 ,$25.53 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100718,84260,HC SEROTONIN,301,1 ,$170.00 ,$85.00 ,$30.98 ,$170.00 ,$109.82 ,$32.01 ,$120.51 ,$103.29 ,$30.98 ,$102.00 ,$144.50 ,$119.00 ,$32.01 ,$161.50 ,$122.40 ,$124.10 ,$52.67 ,$144.50 ,$30.98 ,$52.67 ,$136.00 ,$124.10 ,$32.01 ,$30.98 ,$34.21 ,$170.00 ,$144.50 ,$69.71 ,$156.40 ,$119.00 ,$148.33 ,$159.32 ,$103.53 ,$148.33 ,$117.47 ,$119.00 ,$31.29 ,$122.40 ,$33.93 ,$37.18 ,$37.18 ,$30.98 ,$37.18 ,$30.98 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100719,84260,HC SEROTONIN WHOLE BLOOD,301,1 ,$204.00 ,$102.00 ,$30.98 ,$204.00 ,$131.78 ,$32.01 ,$120.51 ,$103.29 ,$30.98 ,$122.40 ,$173.40 ,$142.80 ,$32.01 ,$193.80 ,$146.88 ,$148.92 ,$52.67 ,$173.40 ,$30.98 ,$52.67 ,$163.20 ,$148.92 ,$32.01 ,$30.98 ,$34.21 ,$204.00 ,$173.40 ,$69.71 ,$187.68 ,$142.80 ,$148.33 ,$159.32 ,$124.24 ,$148.33 ,$140.96 ,$142.80 ,$31.29 ,$146.88 ,$33.93 ,$37.18 ,$37.18 ,$30.98 ,$37.18 ,$30.98 ,$146.88 ,$126.48 ,$146.88 ,$146.88 ,$122.40 ST VINCENT HOSPITAL - ACUTE,30100720,84270,HC SEX HORMONE BIND GLOB,301,1 ,$150.00 ,$75.00 ,$21.73 ,$150.00 ,$96.90 ,$22.45 ,$84.53 ,$72.45 ,$21.73 ,$90.00 ,$127.50 ,$105.00 ,$22.45 ,$142.50 ,$108.00 ,$109.50 ,$36.94 ,$127.50 ,$21.73 ,$36.94 ,$120.00 ,$109.50 ,$22.45 ,$21.73 ,$23.99 ,$150.00 ,$127.50 ,$48.89 ,$138.00 ,$105.00 ,$104.07 ,$111.78 ,$91.35 ,$104.07 ,$103.65 ,$105.00 ,$21.95 ,$108.00 ,$23.80 ,$26.08 ,$26.08 ,$21.73 ,$26.08 ,$21.73 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100721,84295,HC SODIUM,301,1 ,$21.00 ,$10.50 ,$4.81 ,$21.00 ,$13.57 ,$4.97 ,$18.73 ,$16.05 ,$4.81 ,$12.60 ,$17.85 ,$14.70 ,$4.97 ,$19.95 ,$15.12 ,$15.33 ,$8.18 ,$17.85 ,$4.81 ,$8.18 ,$16.80 ,$15.33 ,$4.97 ,$4.81 ,$5.31 ,$21.00 ,$17.85 ,$10.82 ,$19.32 ,$14.70 ,$21.00 ,$21.00 ,$12.79 ,$21.00 ,$14.51 ,$14.70 ,$4.86 ,$15.12 ,$5.27 ,$5.77 ,$5.77 ,$4.81 ,$5.77 ,$4.81 ,$15.12 ,$13.02 ,$15.12 ,$15.12 ,$12.60 ST VINCENT HOSPITAL - ACUTE,30100722,84295,HC SODIUM SERUM/PLSM/WB,301,1 ,$13.00 ,$6.50 ,$4.81 ,$13.00 ,$8.40 ,$4.97 ,$13.00 ,$13.00 ,$4.81 ,$7.80 ,$11.05 ,$9.10 ,$4.97 ,$12.35 ,$9.36 ,$9.49 ,$8.18 ,$11.05 ,$4.81 ,$8.18 ,$10.40 ,$9.49 ,$4.97 ,$4.81 ,$5.31 ,$13.00 ,$11.05 ,$10.82 ,$11.96 ,$9.10 ,$13.00 ,$13.00 ,$7.92 ,$13.00 ,$8.98 ,$9.10 ,$4.86 ,$9.36 ,$5.27 ,$5.77 ,$5.77 ,$4.81 ,$5.77 ,$4.81 ,$9.36 ,$8.06 ,$9.36 ,$9.36 ,$7.80 ST VINCENT HOSPITAL - ACUTE,30100723,84295,HC SODIUM ISTAT,301,1 ,$21.00 ,$10.50 ,$4.81 ,$21.00 ,$13.57 ,$4.97 ,$18.73 ,$16.05 ,$4.81 ,$12.60 ,$17.85 ,$14.70 ,$4.97 ,$19.95 ,$15.12 ,$15.33 ,$8.18 ,$17.85 ,$4.81 ,$8.18 ,$16.80 ,$15.33 ,$4.97 ,$4.81 ,$5.31 ,$21.00 ,$17.85 ,$10.82 ,$19.32 ,$14.70 ,$21.00 ,$21.00 ,$12.79 ,$21.00 ,$14.51 ,$14.70 ,$4.86 ,$15.12 ,$5.27 ,$5.77 ,$5.77 ,$4.81 ,$5.77 ,$4.81 ,$15.12 ,$13.02 ,$15.12 ,$15.12 ,$12.60 ST VINCENT HOSPITAL - ACUTE,30100724,84300,HC SODIUM URINE,301,1 ,$33.00 ,$16.50 ,$5.06 ,$33.00 ,$21.32 ,$5.23 ,$18.90 ,$16.20 ,$5.06 ,$19.80 ,$28.05 ,$23.10 ,$5.23 ,$31.35 ,$23.76 ,$24.09 ,$8.60 ,$28.05 ,$5.06 ,$8.60 ,$26.40 ,$24.09 ,$5.23 ,$5.06 ,$5.59 ,$33.00 ,$28.05 ,$11.39 ,$30.36 ,$23.10 ,$23.31 ,$25.03 ,$20.10 ,$23.31 ,$22.80 ,$23.10 ,$5.11 ,$23.76 ,$5.54 ,$6.07 ,$6.07 ,$5.06 ,$6.07 ,$5.06 ,$23.76 ,$20.46 ,$23.76 ,$23.76 ,$19.80 ST VINCENT HOSPITAL - ACUTE,30100725,84302,HC SODIUM OTHER FLUID,301,1 ,$33.00 ,$16.50 ,$4.86 ,$33.00 ,$21.32 ,$5.02 ,$18.90 ,$16.20 ,$4.86 ,$19.80 ,$28.05 ,$23.10 ,$5.02 ,$31.35 ,$23.76 ,$24.09 ,$8.26 ,$28.05 ,$4.86 ,$8.26 ,$26.40 ,$24.09 ,$5.02 ,$4.86 ,$5.37 ,$33.00 ,$28.05 ,$10.94 ,$30.36 ,$23.10 ,$23.31 ,$25.03 ,$20.10 ,$23.31 ,$22.80 ,$23.10 ,$4.91 ,$23.76 ,$5.32 ,$5.83 ,$5.83 ,$4.86 ,$5.83 ,$4.86 ,$23.76 ,$20.46 ,$23.76 ,$23.76 ,$19.80 ST VINCENT HOSPITAL - ACUTE,30100726,84305,HC SOMATOMEDINC,301,1 ,$150.00 ,$75.00 ,$21.26 ,$150.00 ,$96.90 ,$21.97 ,$82.71 ,$70.89 ,$21.26 ,$90.00 ,$127.50 ,$105.00 ,$21.97 ,$142.50 ,$108.00 ,$109.50 ,$36.14 ,$127.50 ,$21.26 ,$36.14 ,$120.00 ,$109.50 ,$21.97 ,$21.26 ,$23.48 ,$150.00 ,$127.50 ,$47.84 ,$138.00 ,$105.00 ,$101.79 ,$109.33 ,$91.35 ,$101.79 ,$103.65 ,$105.00 ,$21.47 ,$108.00 ,$23.29 ,$25.51 ,$25.51 ,$21.26 ,$25.51 ,$21.26 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30100727,84311,HC SPECTROPHOTOMETRY,301,1 ,$190.00 ,$95.00 ,$8.10 ,$190.00 ,$122.74 ,$8.37 ,$28.35 ,$24.30 ,$8.10 ,$114.00 ,$161.50 ,$133.00 ,$8.37 ,$180.50 ,$136.80 ,$138.70 ,$13.77 ,$161.50 ,$8.10 ,$13.77 ,$152.00 ,$138.70 ,$8.37 ,$8.10 ,$8.94 ,$190.00 ,$161.50 ,$18.23 ,$174.80 ,$133.00 ,$33.49 ,$35.97 ,$115.71 ,$33.49 ,$131.29 ,$133.00 ,$8.18 ,$136.80 ,$8.87 ,$9.72 ,$9.72 ,$8.10 ,$9.72 ,$8.10 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30100728,84376,HC SUGARS SINGLE QL,301,1 ,$60.00 ,$30.00 ,$5.50 ,$60.00 ,$38.76 ,$5.68 ,$21.39 ,$18.33 ,$5.50 ,$36.00 ,$51.00 ,$42.00 ,$5.68 ,$57.00 ,$43.20 ,$43.80 ,$9.35 ,$51.00 ,$5.50 ,$9.35 ,$48.00 ,$43.80 ,$5.68 ,$5.50 ,$6.07 ,$60.00 ,$51.00 ,$12.38 ,$55.20 ,$42.00 ,$26.33 ,$28.28 ,$36.54 ,$26.33 ,$41.46 ,$42.00 ,$5.56 ,$43.20 ,$6.02 ,$6.60 ,$6.60 ,$5.50 ,$6.60 ,$5.50 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100729,84376,HC SUGARS SINGLE (ACID HYDRO) QL,301,1 ,$62.00 ,$31.00 ,$5.50 ,$62.00 ,$40.05 ,$5.68 ,$21.39 ,$18.33 ,$5.50 ,$37.20 ,$52.70 ,$43.40 ,$5.68 ,$58.90 ,$44.64 ,$45.26 ,$9.35 ,$52.70 ,$5.50 ,$9.35 ,$49.60 ,$45.26 ,$5.68 ,$5.50 ,$6.07 ,$62.00 ,$52.70 ,$12.38 ,$57.04 ,$43.40 ,$26.33 ,$28.28 ,$37.76 ,$26.33 ,$42.84 ,$43.40 ,$5.56 ,$44.64 ,$6.02 ,$6.60 ,$6.60 ,$5.50 ,$6.60 ,$5.50 ,$44.64 ,$38.44 ,$44.64 ,$44.64 ,$37.20 ST VINCENT HOSPITAL - ACUTE,30100730,84315,HC SPEC GRAVITY NON UR,301,1 ,$14.00 ,$7.00 ,$3.28 ,$14.00 ,$9.04 ,$3.39 ,$11.48 ,$9.84 ,$3.28 ,$8.40 ,$11.90 ,$9.80 ,$3.39 ,$13.30 ,$10.08 ,$10.22 ,$5.58 ,$11.90 ,$3.28 ,$5.58 ,$11.20 ,$10.22 ,$3.39 ,$3.28 ,$3.62 ,$14.00 ,$11.90 ,$7.38 ,$12.88 ,$9.80 ,$12.04 ,$12.93 ,$8.53 ,$12.04 ,$9.67 ,$9.80 ,$3.31 ,$10.08 ,$3.59 ,$3.94 ,$3.94 ,$3.28 ,$3.94 ,$3.28 ,$10.08 ,$8.68 ,$10.08 ,$10.08 ,$8.40 ST VINCENT HOSPITAL - ACUTE,30100731,84392,HC SULFATE URINE,301,1 ,$32.00 ,$16.00 ,$5.49 ,$32.00 ,$20.67 ,$5.67 ,$19.22 ,$16.47 ,$5.49 ,$19.20 ,$27.20 ,$22.40 ,$5.67 ,$30.40 ,$23.04 ,$23.36 ,$9.33 ,$27.20 ,$5.49 ,$9.33 ,$25.60 ,$23.36 ,$5.67 ,$5.49 ,$6.06 ,$32.00 ,$27.20 ,$12.35 ,$29.44 ,$22.40 ,$22.74 ,$24.43 ,$19.49 ,$22.74 ,$22.11 ,$22.40 ,$5.54 ,$23.04 ,$6.01 ,$6.59 ,$6.59 ,$5.49 ,$6.59 ,$5.49 ,$23.04 ,$19.84 ,$23.04 ,$23.04 ,$19.20 ST VINCENT HOSPITAL - ACUTE,30100732,84402,HC TESTOSTERONE FREE,301,1 ,$170.00 ,$85.00 ,$25.47 ,$170.00 ,$109.82 ,$26.32 ,$99.05 ,$84.90 ,$25.47 ,$102.00 ,$144.50 ,$119.00 ,$26.32 ,$161.50 ,$122.40 ,$124.10 ,$43.30 ,$144.50 ,$25.47 ,$43.30 ,$136.00 ,$124.10 ,$26.32 ,$25.47 ,$28.12 ,$170.00 ,$144.50 ,$57.31 ,$156.40 ,$119.00 ,$121.94 ,$130.97 ,$103.53 ,$121.94 ,$117.47 ,$119.00 ,$25.72 ,$122.40 ,$27.90 ,$30.56 ,$30.56 ,$25.47 ,$30.56 ,$25.47 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100733,84403,HC TESTOSTERONE TOTAL,301,1 ,$170.00 ,$85.00 ,$25.81 ,$170.00 ,$109.82 ,$26.67 ,$100.38 ,$86.04 ,$25.81 ,$102.00 ,$144.50 ,$119.00 ,$26.67 ,$161.50 ,$122.40 ,$124.10 ,$43.88 ,$144.50 ,$25.81 ,$43.88 ,$136.00 ,$124.10 ,$26.67 ,$25.81 ,$28.50 ,$170.00 ,$144.50 ,$58.07 ,$156.40 ,$119.00 ,$120.71 ,$129.65 ,$103.53 ,$120.71 ,$117.47 ,$119.00 ,$26.07 ,$122.40 ,$28.27 ,$30.97 ,$30.97 ,$25.81 ,$30.97 ,$25.81 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100734,84402,HC TESTOSTERONE FREE ASSAY,301,1 ,$170.00 ,$85.00 ,$25.47 ,$170.00 ,$109.82 ,$26.32 ,$99.05 ,$84.90 ,$25.47 ,$102.00 ,$144.50 ,$119.00 ,$26.32 ,$161.50 ,$122.40 ,$124.10 ,$43.30 ,$144.50 ,$25.47 ,$43.30 ,$136.00 ,$124.10 ,$26.32 ,$25.47 ,$28.12 ,$170.00 ,$144.50 ,$57.31 ,$156.40 ,$119.00 ,$121.94 ,$130.97 ,$103.53 ,$121.94 ,$117.47 ,$119.00 ,$25.72 ,$122.40 ,$27.90 ,$30.56 ,$30.56 ,$25.47 ,$30.56 ,$25.47 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100735,84425,HC VITAMIN B1,301,1 ,$120.00 ,$60.00 ,$21.23 ,$120.00 ,$77.52 ,$21.94 ,$82.57 ,$70.77 ,$21.23 ,$72.00 ,$102.00 ,$84.00 ,$21.94 ,$114.00 ,$86.40 ,$87.60 ,$36.09 ,$102.00 ,$21.23 ,$36.09 ,$96.00 ,$87.60 ,$21.94 ,$21.23 ,$23.44 ,$120.00 ,$102.00 ,$47.77 ,$110.40 ,$84.00 ,$101.65 ,$109.18 ,$73.08 ,$101.65 ,$82.92 ,$84.00 ,$21.44 ,$86.40 ,$23.26 ,$25.48 ,$25.48 ,$21.23 ,$25.48 ,$21.23 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30100736,84425,HC VITAMIN B1 PLASMA,301,1 ,$197.00 ,$98.50 ,$21.23 ,$197.00 ,$127.26 ,$21.94 ,$82.57 ,$70.77 ,$21.23 ,$118.20 ,$167.45 ,$137.90 ,$21.94 ,$187.15 ,$141.84 ,$143.81 ,$36.09 ,$167.45 ,$21.23 ,$36.09 ,$157.60 ,$143.81 ,$21.94 ,$21.23 ,$23.44 ,$197.00 ,$167.45 ,$47.77 ,$181.24 ,$137.90 ,$101.65 ,$109.18 ,$119.97 ,$101.65 ,$136.13 ,$137.90 ,$21.44 ,$141.84 ,$23.26 ,$25.48 ,$25.48 ,$21.23 ,$25.48 ,$21.23 ,$141.84 ,$122.14 ,$141.84 ,$141.84 ,$118.20 ST VINCENT HOSPITAL - ACUTE,30100737,84432,HC THYROGLOBULIN,301,1 ,$110.00 ,$55.00 ,$16.06 ,$110.00 ,$71.06 ,$16.59 ,$62.44 ,$53.52 ,$16.06 ,$66.00 ,$93.50 ,$77.00 ,$16.59 ,$104.50 ,$79.20 ,$80.30 ,$27.30 ,$93.50 ,$16.06 ,$27.30 ,$88.00 ,$80.30 ,$16.59 ,$16.06 ,$17.73 ,$110.00 ,$93.50 ,$36.14 ,$101.20 ,$77.00 ,$76.90 ,$82.60 ,$66.99 ,$76.90 ,$76.01 ,$77.00 ,$16.22 ,$79.20 ,$17.59 ,$19.27 ,$19.27 ,$16.06 ,$19.27 ,$16.06 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100738,84432,HC THYROGLOBULIN 2,301,1 ,$320.00 ,$160.00 ,$16.06 ,$320.00 ,$206.72 ,$16.59 ,$62.44 ,$53.52 ,$16.06 ,$192.00 ,$272.00 ,$224.00 ,$16.59 ,$304.00 ,$230.40 ,$233.60 ,$27.30 ,$272.00 ,$16.06 ,$27.30 ,$256.00 ,$233.60 ,$16.59 ,$16.06 ,$17.73 ,$320.00 ,$272.00 ,$36.14 ,$294.40 ,$224.00 ,$76.90 ,$82.60 ,$194.88 ,$76.90 ,$221.12 ,$224.00 ,$16.22 ,$230.40 ,$17.59 ,$19.27 ,$19.27 ,$16.06 ,$19.27 ,$16.06 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,30100739,84436,HC THYROXINE (T-4) TOTAL,301,1 ,$35.00 ,$17.50 ,$6.87 ,$35.00 ,$22.61 ,$7.10 ,$26.71 ,$22.89 ,$6.87 ,$21.00 ,$29.75 ,$24.50 ,$7.10 ,$33.25 ,$25.20 ,$25.55 ,$11.68 ,$29.75 ,$6.87 ,$11.68 ,$28.00 ,$25.55 ,$7.10 ,$6.87 ,$7.59 ,$35.00 ,$29.75 ,$15.46 ,$32.20 ,$24.50 ,$32.89 ,$35.00 ,$21.32 ,$32.89 ,$24.19 ,$24.50 ,$6.94 ,$25.20 ,$7.53 ,$8.24 ,$8.24 ,$6.87 ,$8.24 ,$6.87 ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,30100740,84439,HC T4 FREE,301,1 ,$60.00 ,$30.00 ,$9.02 ,$60.00 ,$38.76 ,$9.32 ,$35.07 ,$30.06 ,$9.02 ,$36.00 ,$51.00 ,$42.00 ,$9.32 ,$57.00 ,$43.20 ,$43.80 ,$15.33 ,$51.00 ,$9.02 ,$15.33 ,$48.00 ,$43.80 ,$9.32 ,$9.02 ,$9.96 ,$60.00 ,$51.00 ,$20.30 ,$55.20 ,$42.00 ,$43.17 ,$46.37 ,$36.54 ,$43.17 ,$41.46 ,$42.00 ,$9.11 ,$43.20 ,$9.88 ,$10.82 ,$10.82 ,$9.02 ,$10.82 ,$9.02 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100741,84439,HC T4/T4 FREE,301,1 ,$110.00 ,$55.00 ,$9.02 ,$110.00 ,$71.06 ,$9.32 ,$35.07 ,$30.06 ,$9.02 ,$66.00 ,$93.50 ,$77.00 ,$9.32 ,$104.50 ,$79.20 ,$80.30 ,$15.33 ,$93.50 ,$9.02 ,$15.33 ,$88.00 ,$80.30 ,$9.32 ,$9.02 ,$9.96 ,$110.00 ,$93.50 ,$20.30 ,$101.20 ,$77.00 ,$43.17 ,$46.37 ,$66.99 ,$43.17 ,$76.01 ,$77.00 ,$9.11 ,$79.20 ,$9.88 ,$10.82 ,$10.82 ,$9.02 ,$10.82 ,$9.02 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100742,84442,HC THYROXINE BIND GLOB,301,1 ,$72.00 ,$36.00 ,$14.78 ,$72.00 ,$46.51 ,$15.27 ,$57.51 ,$49.29 ,$14.78 ,$43.20 ,$61.20 ,$50.40 ,$15.27 ,$68.40 ,$51.84 ,$52.56 ,$25.13 ,$61.20 ,$14.78 ,$25.13 ,$57.60 ,$52.56 ,$15.27 ,$14.78 ,$16.32 ,$72.00 ,$61.20 ,$33.26 ,$66.24 ,$50.40 ,$70.80 ,$72.00 ,$43.85 ,$70.80 ,$49.75 ,$50.40 ,$14.93 ,$51.84 ,$16.19 ,$17.74 ,$17.74 ,$14.78 ,$17.74 ,$14.78 ,$51.84 ,$44.64 ,$51.84 ,$51.84 ,$43.20 ST VINCENT HOSPITAL - ACUTE,30100743,84443,HC THYROID STIMULATING HORM,301,1 ,$110.00 ,$55.00 ,$16.80 ,$110.00 ,$71.06 ,$17.36 ,$65.35 ,$56.01 ,$16.80 ,$66.00 ,$93.50 ,$77.00 ,$17.36 ,$104.50 ,$79.20 ,$80.30 ,$28.56 ,$93.50 ,$16.80 ,$28.56 ,$88.00 ,$80.30 ,$17.36 ,$16.80 ,$18.55 ,$110.00 ,$93.50 ,$37.80 ,$101.20 ,$77.00 ,$80.48 ,$86.45 ,$66.99 ,$80.48 ,$76.01 ,$77.00 ,$16.97 ,$79.20 ,$18.40 ,$20.16 ,$20.16 ,$16.80 ,$20.16 ,$16.80 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100744,84445,HC THYROID STIM IMMUNO GLOB,301,1 ,$260.00 ,$130.00 ,$32.70 ,$260.00 ,$167.96 ,$32.70 ,$197.79 ,$169.53 ,$50.86 ,$156.00 ,$221.00 ,$182.00 ,$32.70 ,$247.00 ,$187.20 ,$189.80 ,$86.46 ,$221.00 ,$50.86 ,$86.46 ,$208.00 ,$189.80 ,$32.70 ,$50.86 ,$56.16 ,$260.00 ,$221.00 ,$114.44 ,$239.20 ,$182.00 ,$111.37 ,$119.62 ,$158.34 ,$111.37 ,$179.66 ,$182.00 ,$51.37 ,$187.20 ,$34.66 ,$61.03 ,$61.03 ,$50.86 ,$61.03 ,$50.86 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30100745,84446,HC VITAMIN E,301,1 ,$100.00 ,$50.00 ,$14.18 ,$100.00 ,$64.60 ,$14.65 ,$55.13 ,$47.25 ,$14.18 ,$60.00 ,$85.00 ,$70.00 ,$14.65 ,$95.00 ,$72.00 ,$73.00 ,$24.11 ,$85.00 ,$14.18 ,$24.11 ,$80.00 ,$73.00 ,$14.65 ,$14.18 ,$15.66 ,$100.00 ,$85.00 ,$31.91 ,$92.00 ,$70.00 ,$67.88 ,$72.91 ,$60.90 ,$67.88 ,$69.10 ,$70.00 ,$14.32 ,$72.00 ,$15.53 ,$17.02 ,$17.02 ,$14.18 ,$17.02 ,$14.18 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100746,84450,HC AST,301,1 ,$35.00 ,$17.50 ,$5.18 ,$35.00 ,$22.61 ,$5.35 ,$20.13 ,$17.25 ,$5.18 ,$21.00 ,$29.75 ,$24.50 ,$5.35 ,$33.25 ,$25.20 ,$25.55 ,$8.81 ,$29.75 ,$5.18 ,$8.81 ,$28.00 ,$25.55 ,$5.35 ,$5.18 ,$5.72 ,$35.00 ,$29.75 ,$11.66 ,$32.20 ,$24.50 ,$24.78 ,$26.62 ,$21.32 ,$24.78 ,$24.19 ,$24.50 ,$5.23 ,$25.20 ,$5.67 ,$6.22 ,$6.22 ,$5.18 ,$6.22 ,$5.18 ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,30100747,84460,HC ALT,301,1 ,$36.00 ,$18.00 ,$5.30 ,$36.00 ,$23.26 ,$5.48 ,$20.62 ,$17.67 ,$5.30 ,$21.60 ,$30.60 ,$25.20 ,$5.48 ,$34.20 ,$25.92 ,$26.28 ,$9.01 ,$30.60 ,$5.30 ,$9.01 ,$28.80 ,$26.28 ,$5.48 ,$5.30 ,$5.85 ,$36.00 ,$30.60 ,$11.93 ,$33.12 ,$25.20 ,$25.34 ,$27.22 ,$21.92 ,$25.34 ,$24.88 ,$25.20 ,$5.35 ,$25.92 ,$5.81 ,$6.36 ,$6.36 ,$5.30 ,$6.36 ,$5.30 ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,30100748,84466,HC TRANSFERRIN,301,1 ,$48.00 ,$24.00 ,$12.76 ,$48.00 ,$31.01 ,$13.18 ,$48.00 ,$42.54 ,$12.76 ,$28.80 ,$40.80 ,$33.60 ,$13.18 ,$45.60 ,$34.56 ,$35.04 ,$21.69 ,$40.80 ,$12.76 ,$21.69 ,$38.40 ,$35.04 ,$13.18 ,$12.76 ,$14.09 ,$48.00 ,$40.80 ,$28.71 ,$44.16 ,$33.60 ,$48.00 ,$48.00 ,$29.23 ,$48.00 ,$33.17 ,$33.60 ,$12.89 ,$34.56 ,$13.97 ,$15.31 ,$15.31 ,$12.76 ,$15.31 ,$12.76 ,$34.56 ,$29.76 ,$34.56 ,$34.56 ,$28.80 ST VINCENT HOSPITAL - ACUTE,30100749,84466,HC TRANSFERRIN SERUM/IRON,301,1 ,$100.00 ,$50.00 ,$12.76 ,$100.00 ,$64.60 ,$13.18 ,$49.63 ,$42.54 ,$12.76 ,$60.00 ,$85.00 ,$70.00 ,$13.18 ,$95.00 ,$72.00 ,$73.00 ,$21.69 ,$85.00 ,$12.76 ,$21.69 ,$80.00 ,$73.00 ,$13.18 ,$12.76 ,$14.09 ,$100.00 ,$85.00 ,$28.71 ,$92.00 ,$70.00 ,$61.14 ,$65.67 ,$60.90 ,$61.14 ,$69.10 ,$70.00 ,$12.89 ,$72.00 ,$13.97 ,$15.31 ,$15.31 ,$12.76 ,$15.31 ,$12.76 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100750,84478,HC TRIGLYCERIDES,301,1 ,$39.00 ,$19.50 ,$5.74 ,$39.00 ,$25.19 ,$5.93 ,$22.33 ,$19.14 ,$5.74 ,$23.40 ,$33.15 ,$27.30 ,$5.93 ,$37.05 ,$28.08 ,$28.47 ,$9.76 ,$33.15 ,$5.74 ,$9.76 ,$31.20 ,$28.47 ,$5.93 ,$5.74 ,$6.34 ,$39.00 ,$33.15 ,$12.92 ,$35.88 ,$27.30 ,$27.52 ,$29.56 ,$23.75 ,$27.52 ,$26.95 ,$27.30 ,$5.80 ,$28.08 ,$6.29 ,$6.89 ,$6.89 ,$5.74 ,$6.89 ,$5.74 ,$28.08 ,$24.18 ,$28.08 ,$28.08 ,$23.40 ST VINCENT HOSPITAL - ACUTE,30100751,84478,HC TRIGLYCERIDES (VAP),301,1 ,$39.00 ,$19.50 ,$5.74 ,$39.00 ,$25.19 ,$5.93 ,$22.33 ,$19.14 ,$5.74 ,$23.40 ,$33.15 ,$27.30 ,$5.93 ,$37.05 ,$28.08 ,$28.47 ,$9.76 ,$33.15 ,$5.74 ,$9.76 ,$31.20 ,$28.47 ,$5.93 ,$5.74 ,$6.34 ,$39.00 ,$33.15 ,$12.92 ,$35.88 ,$27.30 ,$27.52 ,$29.56 ,$23.75 ,$27.52 ,$26.95 ,$27.30 ,$5.80 ,$28.08 ,$6.29 ,$6.89 ,$6.89 ,$5.74 ,$6.89 ,$5.74 ,$28.08 ,$24.18 ,$28.08 ,$28.08 ,$23.40 ST VINCENT HOSPITAL - ACUTE,30100752,84478,HC TRICGLYCERIDES BODY FLUID,301,1 ,$39.00 ,$19.50 ,$5.74 ,$39.00 ,$25.19 ,$5.93 ,$22.33 ,$19.14 ,$5.74 ,$23.40 ,$33.15 ,$27.30 ,$5.93 ,$37.05 ,$28.08 ,$28.47 ,$9.76 ,$33.15 ,$5.74 ,$9.76 ,$31.20 ,$28.47 ,$5.93 ,$5.74 ,$6.34 ,$39.00 ,$33.15 ,$12.92 ,$35.88 ,$27.30 ,$27.52 ,$29.56 ,$23.75 ,$27.52 ,$26.95 ,$27.30 ,$5.80 ,$28.08 ,$6.29 ,$6.89 ,$6.89 ,$5.74 ,$6.89 ,$5.74 ,$28.08 ,$24.18 ,$28.08 ,$28.08 ,$23.40 ST VINCENT HOSPITAL - ACUTE,30100753,84479,HC T3 UPTAKE,301,1 ,$60.00 ,$30.00 ,$6.47 ,$60.00 ,$38.76 ,$6.69 ,$25.13 ,$21.54 ,$6.47 ,$36.00 ,$51.00 ,$42.00 ,$6.69 ,$57.00 ,$43.20 ,$43.80 ,$11.00 ,$51.00 ,$6.47 ,$11.00 ,$48.00 ,$43.80 ,$6.69 ,$6.47 ,$7.14 ,$60.00 ,$51.00 ,$14.56 ,$55.20 ,$42.00 ,$30.99 ,$33.29 ,$36.54 ,$30.99 ,$41.46 ,$42.00 ,$6.53 ,$43.20 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100754,84480,HC T3 TOTAL,301,1 ,$100.00 ,$50.00 ,$14.18 ,$100.00 ,$64.60 ,$14.65 ,$55.13 ,$47.25 ,$14.18 ,$60.00 ,$85.00 ,$70.00 ,$14.65 ,$95.00 ,$72.00 ,$73.00 ,$24.11 ,$85.00 ,$14.18 ,$24.11 ,$80.00 ,$73.00 ,$14.65 ,$14.18 ,$15.66 ,$100.00 ,$85.00 ,$31.91 ,$92.00 ,$70.00 ,$67.88 ,$72.91 ,$60.90 ,$67.88 ,$69.10 ,$70.00 ,$14.32 ,$72.00 ,$15.53 ,$17.02 ,$17.02 ,$14.18 ,$17.02 ,$14.18 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100755,84481,HC T3 FREE,301,1 ,$80.00 ,$40.00 ,$16.62 ,$80.00 ,$51.68 ,$16.62 ,$65.87 ,$56.46 ,$16.94 ,$48.00 ,$68.00 ,$56.00 ,$16.62 ,$76.00 ,$57.60 ,$58.40 ,$28.80 ,$68.00 ,$16.94 ,$28.80 ,$64.00 ,$58.40 ,$16.62 ,$16.94 ,$18.71 ,$80.00 ,$68.00 ,$38.12 ,$73.60 ,$56.00 ,$56.58 ,$60.77 ,$48.72 ,$56.58 ,$55.28 ,$56.00 ,$17.11 ,$57.60 ,$17.62 ,$20.33 ,$20.33 ,$16.94 ,$20.33 ,$16.94 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100756,84481,HC TRIIODOTHYRONINE T3 FREE,301,1 ,$159.00 ,$79.50 ,$16.62 ,$159.00 ,$102.71 ,$16.62 ,$65.87 ,$56.46 ,$16.94 ,$95.40 ,$135.15 ,$111.30 ,$16.62 ,$151.05 ,$114.48 ,$116.07 ,$28.80 ,$135.15 ,$16.94 ,$28.80 ,$127.20 ,$116.07 ,$16.62 ,$16.94 ,$18.71 ,$159.00 ,$135.15 ,$38.12 ,$146.28 ,$111.30 ,$56.58 ,$60.77 ,$96.83 ,$56.58 ,$109.87 ,$111.30 ,$17.11 ,$114.48 ,$17.62 ,$20.33 ,$20.33 ,$16.94 ,$20.33 ,$16.94 ,$114.48 ,$98.58 ,$114.48 ,$114.48 ,$95.40 ST VINCENT HOSPITAL - ACUTE,30100757,84482,HC T3 REVERSE,301,1 ,$60.00 ,$30.00 ,$10.82 ,$60.00 ,$38.76 ,$10.82 ,$60.00 ,$52.53 ,$15.76 ,$36.00 ,$51.00 ,$42.00 ,$10.82 ,$57.00 ,$43.20 ,$43.80 ,$26.79 ,$51.00 ,$15.76 ,$26.79 ,$48.00 ,$43.80 ,$10.82 ,$15.76 ,$17.40 ,$60.00 ,$51.00 ,$35.46 ,$55.20 ,$42.00 ,$36.86 ,$39.59 ,$36.54 ,$36.86 ,$41.46 ,$42.00 ,$15.92 ,$43.20 ,$11.47 ,$18.91 ,$18.91 ,$15.76 ,$18.91 ,$15.76 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100758,84484,HC TROPONIN QN,301,1 ,$90.00 ,$45.00 ,$12.47 ,$90.00 ,$58.14 ,$12.89 ,$43.65 ,$37.41 ,$12.47 ,$54.00 ,$76.50 ,$63.00 ,$12.89 ,$85.50 ,$64.80 ,$65.70 ,$21.20 ,$76.50 ,$12.47 ,$21.20 ,$72.00 ,$65.70 ,$12.89 ,$12.47 ,$13.77 ,$90.00 ,$76.50 ,$28.06 ,$82.80 ,$63.00 ,$47.10 ,$50.59 ,$54.81 ,$47.10 ,$62.19 ,$63.00 ,$12.59 ,$64.80 ,$13.66 ,$14.96 ,$14.96 ,$12.47 ,$14.96 ,$12.47 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100759,84488,HC TRYPSIN FECES QL,301,1 ,$83.00 ,$41.50 ,$7.30 ,$83.00 ,$53.62 ,$7.54 ,$28.39 ,$24.33 ,$7.30 ,$49.80 ,$70.55 ,$58.10 ,$7.54 ,$78.85 ,$59.76 ,$60.59 ,$12.41 ,$70.55 ,$7.30 ,$12.41 ,$66.40 ,$60.59 ,$7.54 ,$7.30 ,$8.06 ,$83.00 ,$70.55 ,$16.43 ,$76.36 ,$58.10 ,$34.96 ,$37.55 ,$50.55 ,$34.96 ,$57.35 ,$58.10 ,$7.37 ,$59.76 ,$7.99 ,$8.76 ,$8.76 ,$7.30 ,$8.76 ,$7.30 ,$59.76 ,$51.46 ,$59.76 ,$59.76 ,$49.80 ST VINCENT HOSPITAL - ACUTE,30100761,84520,HC BUN,301,1 ,$27.00 ,$13.50 ,$3.95 ,$27.00 ,$17.44 ,$4.08 ,$15.37 ,$13.17 ,$3.95 ,$16.20 ,$22.95 ,$18.90 ,$4.08 ,$25.65 ,$19.44 ,$19.71 ,$6.72 ,$22.95 ,$3.95 ,$6.72 ,$21.60 ,$19.71 ,$4.08 ,$3.95 ,$4.36 ,$27.00 ,$22.95 ,$8.89 ,$24.84 ,$18.90 ,$18.92 ,$20.32 ,$16.44 ,$18.92 ,$18.66 ,$18.90 ,$3.99 ,$19.44 ,$4.32 ,$4.74 ,$4.74 ,$3.95 ,$4.74 ,$3.95 ,$19.44 ,$16.74 ,$19.44 ,$19.44 ,$16.20 ST VINCENT HOSPITAL - ACUTE,30100762,84520,HC BUN BODY FLUID,301,1 ,$34.00 ,$17.00 ,$3.95 ,$34.00 ,$21.96 ,$4.08 ,$15.37 ,$13.17 ,$3.95 ,$20.40 ,$28.90 ,$23.80 ,$4.08 ,$32.30 ,$24.48 ,$24.82 ,$6.72 ,$28.90 ,$3.95 ,$6.72 ,$27.20 ,$24.82 ,$4.08 ,$3.95 ,$4.36 ,$34.00 ,$28.90 ,$8.89 ,$31.28 ,$23.80 ,$18.92 ,$20.32 ,$20.71 ,$18.92 ,$23.49 ,$23.80 ,$3.99 ,$24.48 ,$4.32 ,$4.74 ,$4.74 ,$3.95 ,$4.74 ,$3.95 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30100763,84520,HC BUN ISTAT,301,1 ,$34.00 ,$17.00 ,$3.95 ,$34.00 ,$21.96 ,$4.08 ,$15.37 ,$13.17 ,$3.95 ,$20.40 ,$28.90 ,$23.80 ,$4.08 ,$32.30 ,$24.48 ,$24.82 ,$6.72 ,$28.90 ,$3.95 ,$6.72 ,$27.20 ,$24.82 ,$4.08 ,$3.95 ,$4.36 ,$34.00 ,$28.90 ,$8.89 ,$31.28 ,$23.80 ,$18.92 ,$20.32 ,$20.71 ,$18.92 ,$23.49 ,$23.80 ,$3.99 ,$24.48 ,$4.32 ,$4.74 ,$4.74 ,$3.95 ,$4.74 ,$3.95 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30100764,84540,HC UREA URINE,301,1 ,$60.00 ,$30.00 ,$5.56 ,$60.00 ,$38.76 ,$5.75 ,$19.46 ,$16.68 ,$5.56 ,$36.00 ,$51.00 ,$42.00 ,$5.75 ,$57.00 ,$43.20 ,$43.80 ,$9.45 ,$51.00 ,$5.56 ,$9.45 ,$48.00 ,$43.80 ,$5.75 ,$5.56 ,$6.14 ,$60.00 ,$51.00 ,$12.51 ,$55.20 ,$42.00 ,$22.74 ,$24.43 ,$36.54 ,$22.74 ,$41.46 ,$42.00 ,$5.62 ,$43.20 ,$6.10 ,$6.67 ,$6.67 ,$5.56 ,$6.67 ,$5.56 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100765,84550,HC URIC ACID,301,1 ,$34.00 ,$17.00 ,$4.52 ,$34.00 ,$21.96 ,$4.67 ,$17.57 ,$15.06 ,$4.52 ,$20.40 ,$28.90 ,$23.80 ,$4.67 ,$32.30 ,$24.48 ,$24.82 ,$7.68 ,$28.90 ,$4.52 ,$7.68 ,$27.20 ,$24.82 ,$4.67 ,$4.52 ,$4.99 ,$34.00 ,$28.90 ,$10.17 ,$31.28 ,$23.80 ,$21.62 ,$23.22 ,$20.71 ,$21.62 ,$23.49 ,$23.80 ,$4.57 ,$24.48 ,$4.95 ,$5.42 ,$5.42 ,$4.52 ,$5.42 ,$4.52 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30100766,84560,HC URIC ACID OTH SRC,301,1 ,$32.00 ,$16.00 ,$5.08 ,$32.00 ,$20.67 ,$5.25 ,$18.45 ,$15.81 ,$5.08 ,$19.20 ,$27.20 ,$22.40 ,$5.25 ,$30.40 ,$23.04 ,$23.36 ,$8.64 ,$27.20 ,$5.08 ,$8.64 ,$25.60 ,$23.36 ,$5.25 ,$5.08 ,$5.61 ,$32.00 ,$27.20 ,$11.43 ,$29.44 ,$22.40 ,$22.74 ,$24.43 ,$19.49 ,$22.74 ,$22.11 ,$22.40 ,$5.13 ,$23.04 ,$5.57 ,$6.10 ,$6.10 ,$5.08 ,$6.10 ,$5.08 ,$23.04 ,$19.84 ,$23.04 ,$23.04 ,$19.20 ST VINCENT HOSPITAL - ACUTE,30100767,84578,HC UROBILINOGEN,301,1 ,$22.00 ,$11.00 ,$4.47 ,$22.00 ,$14.21 ,$4.58 ,$15.65 ,$13.41 ,$4.47 ,$13.20 ,$18.70 ,$15.40 ,$4.58 ,$20.90 ,$15.84 ,$16.06 ,$7.60 ,$18.70 ,$4.47 ,$7.60 ,$17.60 ,$16.06 ,$4.58 ,$4.47 ,$4.94 ,$22.00 ,$18.70 ,$10.06 ,$20.24 ,$15.40 ,$15.55 ,$16.70 ,$13.40 ,$15.55 ,$15.20 ,$15.40 ,$4.51 ,$15.84 ,$4.85 ,$5.36 ,$5.36 ,$4.47 ,$5.36 ,$4.47 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30100768,84585,HC VANILLYLMAND AC (VMA),301,1 ,$100.00 ,$50.00 ,$15.50 ,$100.00 ,$64.60 ,$16.02 ,$60.27 ,$51.66 ,$15.50 ,$60.00 ,$85.00 ,$70.00 ,$16.02 ,$95.00 ,$72.00 ,$73.00 ,$26.35 ,$85.00 ,$15.50 ,$26.35 ,$80.00 ,$73.00 ,$16.02 ,$15.50 ,$17.12 ,$100.00 ,$85.00 ,$34.88 ,$92.00 ,$70.00 ,$74.20 ,$79.70 ,$60.90 ,$74.20 ,$69.10 ,$70.00 ,$15.66 ,$72.00 ,$16.98 ,$18.60 ,$18.60 ,$15.50 ,$18.60 ,$15.50 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100769,84586,HC VASOACTIVE INTEST PEPTIDE,301,1 ,$170.00 ,$85.00 ,$17.93 ,$170.00 ,$109.82 ,$17.93 ,$137.41 ,$117.78 ,$35.33 ,$102.00 ,$144.50 ,$119.00 ,$17.93 ,$161.50 ,$122.40 ,$124.10 ,$60.06 ,$144.50 ,$35.33 ,$60.06 ,$136.00 ,$124.10 ,$17.93 ,$35.33 ,$39.01 ,$170.00 ,$144.50 ,$79.49 ,$156.40 ,$119.00 ,$61.04 ,$65.56 ,$103.53 ,$61.04 ,$117.47 ,$119.00 ,$35.68 ,$122.40 ,$19.01 ,$42.40 ,$42.40 ,$35.33 ,$42.40 ,$35.33 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30100770,84588,HC VASOPRESSIN (ADH),301,1 ,$230.00 ,$115.00 ,$33.94 ,$230.00 ,$148.58 ,$35.07 ,$131.99 ,$113.13 ,$33.94 ,$138.00 ,$195.50 ,$161.00 ,$35.07 ,$218.50 ,$165.60 ,$167.90 ,$57.70 ,$195.50 ,$33.94 ,$57.70 ,$184.00 ,$167.90 ,$35.07 ,$33.94 ,$37.48 ,$230.00 ,$195.50 ,$76.37 ,$211.60 ,$161.00 ,$162.55 ,$174.59 ,$140.07 ,$162.55 ,$158.93 ,$161.00 ,$34.28 ,$165.60 ,$37.17 ,$40.73 ,$40.73 ,$33.94 ,$40.73 ,$33.94 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,30100771,84590,HC VITAMIN A,301,1 ,$80.00 ,$40.00 ,$11.61 ,$80.00 ,$51.68 ,$12.00 ,$45.15 ,$38.70 ,$11.61 ,$48.00 ,$68.00 ,$56.00 ,$12.00 ,$76.00 ,$57.60 ,$58.40 ,$19.74 ,$68.00 ,$11.61 ,$19.74 ,$64.00 ,$58.40 ,$12.00 ,$11.61 ,$12.82 ,$80.00 ,$68.00 ,$26.12 ,$73.60 ,$56.00 ,$55.56 ,$59.68 ,$48.72 ,$55.56 ,$55.28 ,$56.00 ,$11.73 ,$57.60 ,$12.72 ,$13.93 ,$13.93 ,$11.61 ,$13.93 ,$11.61 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100772,84597,HC VITAMIN K,301,1 ,$350.00 ,$175.00 ,$13.72 ,$350.00 ,$226.10 ,$14.18 ,$53.34 ,$45.72 ,$13.72 ,$210.00 ,$297.50 ,$245.00 ,$14.18 ,$332.50 ,$252.00 ,$255.50 ,$23.32 ,$297.50 ,$13.72 ,$23.32 ,$280.00 ,$255.50 ,$14.18 ,$13.72 ,$15.15 ,$350.00 ,$297.50 ,$30.87 ,$322.00 ,$245.00 ,$65.67 ,$70.54 ,$213.15 ,$65.67 ,$241.85 ,$245.00 ,$13.86 ,$252.00 ,$15.03 ,$16.46 ,$16.46 ,$13.72 ,$16.46 ,$13.72 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,30100773,80320,HC VOLATILES,301,1 ,$250.00 ,$125.00 ,$3.23 ,$250.00 ,$161.50 ,$3.23 ,$80.88 ,$69.32 , N/A ,$150.00 ,$212.50 ,$175.00 ,$3.23 ,$237.50 ,$180.00 ,$182.50 ,$38.56 ,$212.50 , N/A ,$38.56 ,$200.00 ,$182.50 ,$3.23 , N/A ,$12.38 ,$250.00 ,$212.50 , N/A ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 , N/A ,$180.00 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,30100774,G0480,HC VOLATILES (STAT),301,1 ,$247.00 ,$123.50 ,$63.95 ,$257.47 ,$159.56 ,$63.95 ,$247.00 ,$247.00 ,$114.43 ,$148.20 ,$209.95 ,$172.90 ,$63.95 ,$234.65 ,$177.84 ,$180.31 ,$194.53 ,$209.95 ,$114.43 ,$194.53 ,$197.60 ,$180.31 ,$63.95 ,$114.43 ,$126.35 ,$247.00 ,$209.95 ,$257.47 ,$227.24 ,$172.90 ,$247.00 ,$247.00 ,$150.42 ,$247.00 ,$170.68 ,$172.90 ,$115.57 ,$177.84 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$177.84 ,$153.14 ,$177.84 ,$177.84 ,$148.20 ST VINCENT HOSPITAL - ACUTE,30100775,84166,HC ELECTRPHRTC FRAC/QUNT,301,1 ,$49.00 ,$24.50 ,$17.83 ,$49.00 ,$31.65 ,$18.42 ,$49.00 ,$49.00 ,$17.83 ,$29.40 ,$41.65 ,$34.30 ,$18.42 ,$46.55 ,$35.28 ,$35.77 ,$30.31 ,$41.65 ,$17.83 ,$30.31 ,$39.20 ,$35.77 ,$18.42 ,$17.83 ,$19.69 ,$49.00 ,$41.65 ,$40.12 ,$45.08 ,$34.30 ,$49.00 ,$49.00 ,$29.84 ,$49.00 ,$33.86 ,$34.30 ,$18.01 ,$35.28 ,$19.53 ,$21.40 ,$21.40 ,$17.83 ,$21.40 ,$17.83 ,$35.28 ,$30.38 ,$35.28 ,$35.28 ,$29.40 ST VINCENT HOSPITAL - ACUTE,30100776,84630,HC ZINC,301,1 ,$70.00 ,$35.00 ,$11.39 ,$70.00 ,$45.22 ,$11.77 ,$44.28 ,$37.95 ,$11.39 ,$42.00 ,$59.50 ,$49.00 ,$11.77 ,$66.50 ,$50.40 ,$51.10 ,$19.36 ,$59.50 ,$11.39 ,$19.36 ,$56.00 ,$51.10 ,$11.77 ,$11.39 ,$12.58 ,$70.00 ,$59.50 ,$25.63 ,$64.40 ,$49.00 ,$49.63 ,$53.31 ,$42.63 ,$49.63 ,$48.37 ,$49.00 ,$11.50 ,$50.40 ,$12.48 ,$13.67 ,$13.67 ,$11.39 ,$13.67 ,$11.39 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30100777,84630,HC ZINC (MAYO),301,1 ,$152.00 ,$76.00 ,$11.39 ,$152.00 ,$98.19 ,$11.77 ,$44.28 ,$37.95 ,$11.39 ,$91.20 ,$129.20 ,$106.40 ,$11.77 ,$144.40 ,$109.44 ,$110.96 ,$19.36 ,$129.20 ,$11.39 ,$19.36 ,$121.60 ,$110.96 ,$11.77 ,$11.39 ,$12.58 ,$152.00 ,$129.20 ,$25.63 ,$139.84 ,$106.40 ,$49.63 ,$53.31 ,$92.57 ,$49.63 ,$105.03 ,$106.40 ,$11.50 ,$109.44 ,$12.48 ,$13.67 ,$13.67 ,$11.39 ,$13.67 ,$11.39 ,$109.44 ,$94.24 ,$109.44 ,$109.44 ,$91.20 ST VINCENT HOSPITAL - ACUTE,30100778,84630,HC ZINC PLASMA,301,1 ,$30.00 ,$15.00 ,$11.39 ,$30.00 ,$19.38 ,$11.77 ,$30.00 ,$30.00 ,$11.39 ,$18.00 ,$25.50 ,$21.00 ,$11.77 ,$28.50 ,$21.60 ,$21.90 ,$19.36 ,$25.50 ,$11.39 ,$19.36 ,$24.00 ,$21.90 ,$11.77 ,$11.39 ,$12.58 ,$30.00 ,$25.50 ,$25.63 ,$27.60 ,$21.00 ,$30.00 ,$30.00 ,$18.27 ,$30.00 ,$20.73 ,$21.00 ,$11.50 ,$21.60 ,$12.48 ,$13.67 ,$13.67 ,$11.39 ,$13.67 ,$11.39 ,$21.60 ,$18.60 ,$21.60 ,$21.60 ,$18.00 ST VINCENT HOSPITAL - ACUTE,30100780,82465,HC CHOLESTEROL (LMP),301,1 ,$78.00 ,$39.00 ,$4.35 ,$78.00 ,$50.39 ,$4.49 ,$16.94 ,$14.52 ,$4.35 ,$46.80 ,$66.30 ,$54.60 ,$4.49 ,$74.10 ,$56.16 ,$56.94 ,$7.40 ,$66.30 ,$4.35 ,$7.40 ,$62.40 ,$56.94 ,$4.49 ,$4.35 ,$4.80 ,$78.00 ,$66.30 ,$9.79 ,$71.76 ,$54.60 ,$20.81 ,$22.36 ,$47.50 ,$20.81 ,$53.90 ,$54.60 ,$4.39 ,$56.16 ,$4.76 ,$5.22 ,$5.22 ,$4.35 ,$5.22 ,$4.35 ,$56.16 ,$48.36 ,$56.16 ,$56.16 ,$46.80 ST VINCENT HOSPITAL - ACUTE,30100781,82542,HC ZIPRASIDONE,301,1 ,$115.00 ,$57.50 ,$24.09 ,$115.00 ,$74.29 ,$24.89 ,$84.32 ,$72.27 ,$24.09 ,$69.00 ,$97.75 ,$80.50 ,$24.89 ,$109.25 ,$82.80 ,$83.95 ,$40.95 ,$97.75 ,$24.09 ,$40.95 ,$92.00 ,$83.95 ,$24.89 ,$24.09 ,$26.60 ,$115.00 ,$97.75 ,$54.20 ,$105.80 ,$80.50 ,$86.45 ,$92.86 ,$70.04 ,$86.45 ,$79.47 ,$80.50 ,$24.33 ,$82.80 ,$26.38 ,$28.91 ,$28.91 ,$24.09 ,$28.91 ,$24.09 ,$82.80 ,$71.30 ,$82.80 ,$82.80 ,$69.00 ST VINCENT HOSPITAL - ACUTE,30100782,82664,HC CHOLESTEROL (LMP LPA),301,1 ,$202.00 ,$101.00 ,$48.31 ,$202.00 ,$130.49 ,$48.31 ,$202.00 ,$184.50 ,$61.50 ,$121.20 ,$171.70 ,$141.40 ,$48.31 ,$191.90 ,$145.44 ,$147.46 ,$104.55 ,$171.70 ,$61.50 ,$104.55 ,$161.60 ,$147.46 ,$48.31 ,$61.50 ,$67.91 ,$202.00 ,$171.70 ,$138.38 ,$185.84 ,$141.40 ,$164.51 ,$176.70 ,$123.02 ,$164.51 ,$139.58 ,$141.40 ,$62.12 ,$145.44 ,$51.21 ,$73.80 ,$73.80 ,$61.50 ,$73.80 ,$61.50 ,$145.44 ,$125.24 ,$145.44 ,$145.44 ,$121.20 ST VINCENT HOSPITAL - ACUTE,30100800,84478,HC TRIGLYCERIDES (LMP),301,1 ,$89.00 ,$44.50 ,$5.74 ,$89.00 ,$57.49 ,$5.93 ,$22.33 ,$19.14 ,$5.74 ,$53.40 ,$75.65 ,$62.30 ,$5.93 ,$84.55 ,$64.08 ,$64.97 ,$9.76 ,$75.65 ,$5.74 ,$9.76 ,$71.20 ,$64.97 ,$5.93 ,$5.74 ,$6.34 ,$89.00 ,$75.65 ,$12.92 ,$81.88 ,$62.30 ,$27.52 ,$29.56 ,$54.20 ,$27.52 ,$61.50 ,$62.30 ,$5.80 ,$64.08 ,$6.29 ,$6.89 ,$6.89 ,$5.74 ,$6.89 ,$5.74 ,$64.08 ,$55.18 ,$64.08 ,$64.08 ,$53.40 ST VINCENT HOSPITAL - ACUTE,30100801,84681,HC C PEPTIDE,301,1 ,$90.00 ,$45.00 ,$7.34 ,$90.00 ,$58.14 ,$7.34 ,$80.96 ,$69.39 ,$20.81 ,$54.00 ,$76.50 ,$63.00 ,$7.34 ,$85.50 ,$64.80 ,$65.70 ,$35.38 ,$76.50 ,$20.81 ,$35.38 ,$72.00 ,$65.70 ,$7.34 ,$20.81 ,$22.98 ,$90.00 ,$76.50 ,$46.82 ,$82.80 ,$63.00 ,$24.99 ,$26.84 ,$54.81 ,$24.99 ,$62.19 ,$63.00 ,$21.02 ,$64.80 ,$7.78 ,$24.97 ,$24.97 ,$20.81 ,$24.97 ,$20.81 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100802,84702,HC HCG QN,301,1 ,$100.00 ,$50.00 ,$15.05 ,$100.00 ,$64.60 ,$15.55 ,$58.56 ,$50.19 ,$15.05 ,$60.00 ,$85.00 ,$70.00 ,$15.55 ,$95.00 ,$72.00 ,$73.00 ,$25.59 ,$85.00 ,$15.05 ,$25.59 ,$80.00 ,$73.00 ,$15.55 ,$15.05 ,$16.62 ,$100.00 ,$85.00 ,$33.86 ,$92.00 ,$70.00 ,$72.10 ,$77.44 ,$60.90 ,$72.10 ,$69.10 ,$70.00 ,$15.20 ,$72.00 ,$16.48 ,$18.06 ,$18.06 ,$15.05 ,$18.06 ,$15.05 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100803,84702,HC HCG QN (SUBUNIT),301,1 ,$18.00 ,$9.00 ,$9.00 ,$33.86 ,$11.63 ,$15.55 ,$18.00 ,$18.00 ,$15.05 ,$10.80 ,$15.30 ,$12.60 ,$15.55 ,$17.10 ,$12.96 ,$13.14 ,$18.00 ,$15.30 ,$15.05 ,$18.00 ,$14.40 ,$13.14 ,$15.55 ,$15.05 ,$16.62 ,$18.00 ,$15.30 ,$33.86 ,$16.56 ,$12.60 ,$18.00 ,$18.00 ,$10.96 ,$18.00 ,$12.44 ,$12.60 ,$15.20 ,$12.96 ,$16.48 ,$18.00 ,$18.00 ,$15.05 ,$18.00 ,$15.05 ,$12.96 ,$11.16 ,$12.96 ,$12.96 ,$10.80 ST VINCENT HOSPITAL - ACUTE,30100807,84702,HC HCG QN (BETA SUBUNIT),301,1 ,$36.00 ,$18.00 ,$15.05 ,$36.00 ,$23.26 ,$15.55 ,$36.00 ,$36.00 ,$15.05 ,$21.60 ,$30.60 ,$25.20 ,$15.55 ,$34.20 ,$25.92 ,$26.28 ,$25.59 ,$30.60 ,$15.05 ,$25.59 ,$28.80 ,$26.28 ,$15.55 ,$15.05 ,$16.62 ,$36.00 ,$30.60 ,$33.86 ,$33.12 ,$25.20 ,$36.00 ,$36.00 ,$21.92 ,$36.00 ,$24.88 ,$25.20 ,$15.20 ,$25.92 ,$16.48 ,$18.06 ,$18.06 ,$15.05 ,$18.06 ,$15.05 ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,30100808,84703,HC HCG QL,301,1 ,$60.00 ,$30.00 ,$7.52 ,$60.00 ,$38.76 ,$7.77 ,$29.26 ,$25.08 ,$7.52 ,$36.00 ,$51.00 ,$42.00 ,$7.77 ,$57.00 ,$43.20 ,$43.80 ,$12.78 ,$51.00 ,$7.52 ,$12.78 ,$48.00 ,$43.80 ,$7.77 ,$7.52 ,$8.30 ,$60.00 ,$51.00 ,$16.92 ,$55.20 ,$42.00 ,$36.01 ,$38.68 ,$36.54 ,$36.01 ,$41.46 ,$42.00 ,$7.60 ,$43.20 ,$8.24 ,$9.02 ,$9.02 ,$7.52 ,$9.02 ,$7.52 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100809,84999,HC CHEMISTRY UNLISTED,301,1 ,$17.00 ,$8.50 ,$3.23 ,$17.00 ,$10.98 ,$3.23 ,$11.00 ,$11.00 , N/A ,$10.20 ,$14.45 ,$11.90 ,$3.23 ,$16.15 ,$12.24 ,$12.41 , N/A ,$14.45 , N/A , N/A ,$13.60 ,$12.41 ,$3.23 , N/A ,$7.14 ,$17.00 ,$14.45 ,$10.20 ,$15.64 ,$11.90 ,$8.50 ,$10.20 ,$10.35 ,$8.50 ,$11.75 ,$11.90 , N/A ,$12.24 ,$3.42 ,$8.50 ,$8.50 , N/A ,$8.50 , N/A ,$12.24 ,$10.54 ,$12.24 ,$12.24 ,$10.20 ST VINCENT HOSPITAL - ACUTE,30100810,88720,HC BILICHECK TEST,301,1 ,$34.00 ,$17.00 ,$3.63 ,$34.00 ,$21.96 ,$3.63 ,$19.50 ,$16.71 ,$5.02 ,$20.40 ,$28.90 ,$23.80 ,$3.63 ,$32.30 ,$24.48 ,$24.82 ,$8.53 ,$28.90 ,$5.02 ,$8.53 ,$27.20 ,$24.82 ,$3.63 ,$5.02 ,$5.54 ,$34.00 ,$28.90 ,$11.30 ,$31.28 ,$23.80 ,$24.01 ,$25.79 ,$20.71 ,$24.01 ,$23.49 ,$23.80 ,$5.07 ,$24.48 ,$3.85 ,$6.02 ,$6.02 ,$5.02 ,$6.02 ,$5.02 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30100813,G0103,HC PSA ANNUAL SCREENING,301,1 ,$130.00 ,$65.00 ,$19.31 ,$130.00 ,$83.98 ,$19.95 ,$71.54 ,$61.32 ,$19.31 ,$78.00 ,$110.50 ,$91.00 ,$19.95 ,$123.50 ,$93.60 ,$94.90 ,$32.83 ,$110.50 ,$19.31 ,$32.83 ,$104.00 ,$94.90 ,$19.95 ,$19.31 ,$21.32 ,$130.00 ,$110.50 ,$43.45 ,$119.60 ,$91.00 ,$88.07 ,$94.59 ,$79.17 ,$88.07 ,$89.83 ,$91.00 ,$19.50 ,$93.60 ,$21.15 ,$23.17 ,$23.17 ,$19.31 ,$23.17 ,$19.31 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30100815,G0123,HC PAP SMEAR THIN PREP SCREEN,311,1 ,$140.00 ,$70.00 ,$20.26 ,$140.00 ,$90.44 ,$20.93 ,$78.79 ,$67.53 ,$20.26 ,$84.00 ,$119.00 ,$98.00 ,$20.93 ,$133.00 ,$100.80 ,$102.20 ,$34.44 ,$119.00 ,$20.26 ,$34.44 ,$112.00 ,$102.20 ,$20.93 ,$20.26 ,$22.37 ,$140.00 ,$119.00 ,$45.59 ,$128.80 ,$98.00 ,$97.02 ,$104.20 ,$85.26 ,$97.02 ,$96.74 ,$98.00 ,$20.46 ,$100.80 ,$22.19 ,$24.31 ,$24.31 ,$20.26 ,$24.31 ,$20.26 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30100818,84182,HC PROTEIN WEST BLOT BAND ID,301,1 ,$402.00 ,$201.00 ,$25.31 ,$402.00 ,$259.69 ,$25.31 ,$102.24 ,$87.63 ,$29.21 ,$241.20 ,$341.70 ,$281.40 ,$25.31 ,$381.90 ,$289.44 ,$293.46 ,$49.66 ,$341.70 ,$29.21 ,$49.66 ,$321.60 ,$293.46 ,$25.31 ,$29.21 ,$32.25 ,$402.00 ,$341.70 ,$65.72 ,$369.84 ,$281.40 ,$86.17 ,$92.55 ,$244.82 ,$86.17 ,$277.78 ,$281.40 ,$29.50 ,$289.44 ,$26.83 ,$35.05 ,$35.05 ,$29.21 ,$35.05 ,$29.21 ,$289.44 ,$249.24 ,$289.44 ,$289.44 ,$241.20 ST VINCENT HOSPITAL - ACUTE,30100820,83664,HC LAMELLAR BODY CT,301,1 ,$146.00 ,$73.00 ,$6.82 ,$146.00 ,$94.32 ,$6.82 ,$73.54 ,$63.03 ,$19.32 ,$87.60 ,$124.10 ,$102.20 ,$6.82 ,$138.70 ,$105.12 ,$106.58 ,$32.84 ,$124.10 ,$19.32 ,$32.84 ,$116.80 ,$106.58 ,$6.82 ,$19.32 ,$21.33 ,$146.00 ,$124.10 ,$43.47 ,$134.32 ,$102.20 ,$90.59 ,$97.30 ,$88.91 ,$90.59 ,$100.89 ,$102.20 ,$19.51 ,$105.12 ,$7.23 ,$23.18 ,$23.18 ,$19.32 ,$23.18 ,$19.32 ,$105.12 ,$90.52 ,$105.12 ,$105.12 ,$87.60 ST VINCENT HOSPITAL - ACUTE,30100821,80159,HC CLOZAPINE,301,1 ,$100.00 ,$50.00 ,$20.15 ,$100.00 ,$64.60 ,$20.18 ,$71.93 ,$61.65 ,$20.15 ,$60.00 ,$85.00 ,$70.00 ,$20.18 ,$95.00 ,$72.00 ,$73.00 ,$34.26 ,$85.00 ,$20.15 ,$34.26 ,$80.00 ,$73.00 ,$20.18 ,$20.15 ,$22.25 ,$100.00 ,$85.00 ,$45.34 ,$92.00 ,$70.00 ,$88.56 ,$95.12 ,$60.90 ,$88.56 ,$69.10 ,$70.00 ,$20.35 ,$72.00 ,$21.39 ,$24.18 ,$24.18 ,$20.15 ,$24.18 ,$20.15 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100822,83701,HC VAP HRF LIPOPROTEINS,301,1 ,$164.00 ,$82.00 ,$32.56 ,$164.00 ,$105.94 ,$32.56 ,$118.51 ,$101.58 ,$33.86 ,$98.40 ,$139.40 ,$114.80 ,$32.56 ,$155.80 ,$118.08 ,$119.72 ,$57.56 ,$139.40 ,$33.86 ,$57.56 ,$131.20 ,$119.72 ,$32.56 ,$33.86 ,$37.39 ,$164.00 ,$139.40 ,$76.19 ,$150.88 ,$114.80 ,$118.85 ,$127.65 ,$99.88 ,$118.85 ,$113.32 ,$114.80 ,$34.20 ,$118.08 ,$34.51 ,$40.63 ,$40.63 ,$33.86 ,$40.63 ,$33.86 ,$118.08 ,$101.68 ,$118.08 ,$118.08 ,$98.40 ST VINCENT HOSPITAL - ACUTE,30100826,84403,HC TESTOSTERONE TOTAL ASSAY,301,1 ,$168.00 ,$84.00 ,$25.81 ,$168.00 ,$108.53 ,$26.67 ,$100.38 ,$86.04 ,$25.81 ,$100.80 ,$142.80 ,$117.60 ,$26.67 ,$159.60 ,$120.96 ,$122.64 ,$43.88 ,$142.80 ,$25.81 ,$43.88 ,$134.40 ,$122.64 ,$26.67 ,$25.81 ,$28.50 ,$168.00 ,$142.80 ,$58.07 ,$154.56 ,$117.60 ,$120.71 ,$129.65 ,$102.31 ,$120.71 ,$116.09 ,$117.60 ,$26.07 ,$120.96 ,$28.27 ,$30.97 ,$30.97 ,$25.81 ,$30.97 ,$25.81 ,$120.96 ,$104.16 ,$120.96 ,$120.96 ,$100.80 ST VINCENT HOSPITAL - ACUTE,30100827,80081,HC OB PANEL WITH HIV,301,1 ,$360.00 ,$180.00 ,$74.86 ,$360.00 ,$232.56 ,$77.35 ,$291.13 ,$249.54 ,$74.86 ,$216.00 ,$306.00 ,$252.00 ,$77.35 ,$342.00 ,$259.20 ,$262.80 ,$127.26 ,$306.00 ,$74.86 ,$127.26 ,$288.00 ,$262.80 ,$77.35 ,$74.86 ,$82.66 ,$360.00 ,$306.00 ,$168.44 ,$331.20 ,$252.00 ,$357.91 ,$360.00 ,$219.24 ,$357.91 ,$248.76 ,$252.00 ,$75.61 ,$259.20 ,$81.99 ,$89.83 ,$89.83 ,$74.86 ,$89.83 ,$74.86 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,30100830,83986,HC NITRAZINE CHECK,301,1 ,$24.00 ,$12.00 ,$3.58 ,$24.00 ,$15.50 ,$3.70 ,$13.93 ,$11.94 ,$3.58 ,$14.40 ,$20.40 ,$16.80 ,$3.70 ,$22.80 ,$17.28 ,$17.52 ,$6.09 ,$20.40 ,$3.58 ,$6.09 ,$19.20 ,$17.52 ,$3.70 ,$3.58 ,$3.95 ,$24.00 ,$20.40 ,$8.06 ,$22.08 ,$16.80 ,$17.13 ,$18.40 ,$14.62 ,$17.13 ,$16.58 ,$16.80 ,$3.62 ,$17.28 ,$3.92 ,$4.30 ,$4.30 ,$3.58 ,$4.30 ,$3.58 ,$17.28 ,$14.88 ,$17.28 ,$17.28 ,$14.40 ST VINCENT HOSPITAL - ACUTE,30100835,84481,HC T3 TOTAL/T3 FREE,301,1 ,$160.00 ,$80.00 ,$16.62 ,$160.00 ,$103.36 ,$16.62 ,$65.87 ,$56.46 ,$16.94 ,$96.00 ,$136.00 ,$112.00 ,$16.62 ,$152.00 ,$115.20 ,$116.80 ,$28.80 ,$136.00 ,$16.94 ,$28.80 ,$128.00 ,$116.80 ,$16.62 ,$16.94 ,$18.71 ,$160.00 ,$136.00 ,$38.12 ,$147.20 ,$112.00 ,$56.58 ,$60.77 ,$97.44 ,$56.58 ,$110.56 ,$112.00 ,$17.11 ,$115.20 ,$17.62 ,$20.33 ,$20.33 ,$16.94 ,$20.33 ,$16.94 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30100838,83033,HC FETAL HGB QI,301,1 ,$49.00 ,$24.50 ,$8.00 ,$49.00 ,$31.65 ,$8.27 ,$28.00 ,$24.00 ,$8.00 ,$29.40 ,$41.65 ,$34.30 ,$8.27 ,$46.55 ,$35.28 ,$35.77 ,$13.60 ,$41.65 ,$8.00 ,$13.60 ,$39.20 ,$35.77 ,$8.27 ,$8.00 ,$8.83 ,$49.00 ,$41.65 ,$18.00 ,$45.08 ,$34.30 ,$28.54 ,$30.65 ,$29.84 ,$28.54 ,$33.86 ,$34.30 ,$8.08 ,$35.28 ,$8.77 ,$9.60 ,$9.60 ,$8.00 ,$9.60 ,$8.00 ,$35.28 ,$30.38 ,$35.28 ,$35.28 ,$29.40 ST VINCENT HOSPITAL - ACUTE,30100840,82306,HC VITAMIN D 25 TOTAL,301,1 ,$204.00 ,$102.00 ,$29.60 ,$204.00 ,$131.78 ,$30.59 ,$115.12 ,$98.67 ,$29.60 ,$122.40 ,$173.40 ,$142.80 ,$30.59 ,$193.80 ,$146.88 ,$148.92 ,$50.32 ,$173.40 ,$29.60 ,$50.32 ,$163.20 ,$148.92 ,$30.59 ,$29.60 ,$32.68 ,$204.00 ,$173.40 ,$66.60 ,$187.68 ,$142.80 ,$141.80 ,$152.31 ,$124.24 ,$141.80 ,$140.96 ,$142.80 ,$29.90 ,$146.88 ,$32.43 ,$35.52 ,$35.52 ,$29.60 ,$35.52 ,$29.60 ,$146.88 ,$126.48 ,$146.88 ,$146.88 ,$122.40 ST VINCENT HOSPITAL - ACUTE,30100845,82948,HC GLUCOSE BLOOD REAGENT STRIP,301,1 ,$16.00 ,$8.00 ,$4.45 ,$16.00 ,$10.34 ,$4.45 ,$16.00 ,$15.12 ,$5.04 ,$9.60 ,$13.60 ,$11.20 ,$4.45 ,$15.20 ,$11.52 ,$11.68 ,$8.57 ,$13.60 ,$5.04 ,$8.57 ,$12.80 ,$11.68 ,$4.45 ,$5.04 ,$5.57 ,$16.00 ,$13.60 ,$11.34 ,$14.72 ,$11.20 ,$15.16 ,$16.00 ,$9.74 ,$15.16 ,$11.06 ,$11.20 ,$5.09 ,$11.52 ,$4.72 ,$6.05 ,$6.05 ,$5.04 ,$6.05 ,$5.04 ,$11.52 ,$9.92 ,$11.52 ,$11.52 ,$9.60 ST VINCENT HOSPITAL - ACUTE,30100860,84145,HC PROCALCITONIN,301,1 ,$180.00 ,$90.00 ,$27.22 ,$180.00 ,$116.28 ,$28.13 ,$104.20 ,$89.31 ,$27.22 ,$108.00 ,$153.00 ,$126.00 ,$28.13 ,$171.00 ,$129.60 ,$131.40 ,$46.27 ,$153.00 ,$27.22 ,$46.27 ,$144.00 ,$131.40 ,$28.13 ,$27.22 ,$30.06 ,$180.00 ,$153.00 ,$61.25 ,$165.60 ,$126.00 ,$128.26 ,$137.76 ,$109.62 ,$128.26 ,$124.38 ,$126.00 ,$27.49 ,$129.60 ,$29.82 ,$32.66 ,$32.66 ,$27.22 ,$32.66 ,$27.22 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30100950,G0328,HC OCCULT BLOOD FECAL SCRN - AMB,301,1 ,$112.00 ,$56.00 ,$3.23 ,$112.00 ,$72.35 ,$3.23 ,$63.18 ,$54.15 ,$18.05 ,$67.20 ,$95.20 ,$78.40 ,$3.23 ,$106.40 ,$80.64 ,$81.76 ,$30.69 ,$95.20 ,$18.05 ,$30.69 ,$89.60 ,$81.76 ,$3.23 ,$18.05 ,$19.93 ,$112.00 ,$95.20 ,$40.61 ,$103.04 ,$78.40 ,$76.17 ,$81.81 ,$68.21 ,$76.17 ,$77.39 ,$78.40 ,$18.23 ,$80.64 ,$3.42 ,$21.66 ,$21.66 ,$18.05 ,$21.66 ,$18.05 ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,30100951,82140,HC AMMONIA-STONE,301,1 ,$99.00 ,$49.50 ,$14.57 ,$99.00 ,$63.95 ,$15.06 ,$56.67 ,$48.57 ,$14.57 ,$59.40 ,$84.15 ,$69.30 ,$15.06 ,$94.05 ,$71.28 ,$72.27 ,$24.77 ,$84.15 ,$14.57 ,$24.77 ,$79.20 ,$72.27 ,$15.06 ,$14.57 ,$16.09 ,$99.00 ,$84.15 ,$32.78 ,$91.08 ,$69.30 ,$69.78 ,$74.95 ,$60.29 ,$69.78 ,$68.41 ,$69.30 ,$14.72 ,$71.28 ,$15.96 ,$17.48 ,$17.48 ,$14.57 ,$17.48 ,$14.57 ,$71.28 ,$61.38 ,$71.28 ,$71.28 ,$59.40 ST VINCENT HOSPITAL - ACUTE,30100952,82340,HC CALCIUM URINE QN TIMED-STONE,301,1 ,$41.00 ,$20.50 ,$6.03 ,$41.00 ,$26.49 ,$6.23 ,$23.45 ,$20.10 ,$6.03 ,$24.60 ,$34.85 ,$28.70 ,$6.23 ,$38.95 ,$29.52 ,$29.93 ,$10.25 ,$34.85 ,$6.03 ,$10.25 ,$32.80 ,$29.93 ,$6.23 ,$6.03 ,$6.66 ,$41.00 ,$34.85 ,$13.57 ,$37.72 ,$28.70 ,$28.89 ,$31.03 ,$24.97 ,$28.89 ,$28.33 ,$28.70 ,$6.09 ,$29.52 ,$6.60 ,$7.24 ,$7.24 ,$6.03 ,$7.24 ,$6.03 ,$29.52 ,$25.42 ,$29.52 ,$29.52 ,$24.60 ST VINCENT HOSPITAL - ACUTE,30100953,82507,HC CITRATE-STONE,301,1 ,$180.00 ,$90.00 ,$27.80 ,$180.00 ,$116.28 ,$28.73 ,$108.12 ,$92.67 ,$27.80 ,$108.00 ,$153.00 ,$126.00 ,$28.73 ,$171.00 ,$129.60 ,$131.40 ,$47.26 ,$153.00 ,$27.80 ,$47.26 ,$144.00 ,$131.40 ,$28.73 ,$27.80 ,$30.70 ,$180.00 ,$153.00 ,$62.55 ,$165.60 ,$126.00 ,$133.13 ,$143.00 ,$109.62 ,$133.13 ,$124.38 ,$126.00 ,$28.08 ,$129.60 ,$30.45 ,$33.36 ,$33.36 ,$27.80 ,$33.36 ,$27.80 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30100954,83735,HC MAGNESIUM-STONE,301,1 ,$46.00 ,$23.00 ,$6.70 ,$46.00 ,$29.72 ,$6.92 ,$26.04 ,$22.32 ,$6.70 ,$27.60 ,$39.10 ,$32.20 ,$6.92 ,$43.70 ,$33.12 ,$33.58 ,$11.39 ,$39.10 ,$6.70 ,$11.39 ,$36.80 ,$33.58 ,$6.92 ,$6.70 ,$7.40 ,$46.00 ,$39.10 ,$15.08 ,$42.32 ,$32.20 ,$32.08 ,$34.46 ,$28.01 ,$32.08 ,$31.79 ,$32.20 ,$6.77 ,$33.12 ,$7.34 ,$8.04 ,$8.04 ,$6.70 ,$8.04 ,$6.70 ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,30100955,83945,HC OXALATE-STONE,301,1 ,$88.00 ,$44.00 ,$14.45 ,$88.00 ,$56.85 ,$14.93 ,$50.58 ,$43.35 ,$14.45 ,$52.80 ,$74.80 ,$61.60 ,$14.93 ,$83.60 ,$63.36 ,$64.24 ,$24.57 ,$74.80 ,$14.45 ,$24.57 ,$70.40 ,$64.24 ,$14.93 ,$14.45 ,$15.96 ,$88.00 ,$74.80 ,$32.51 ,$80.96 ,$61.60 ,$61.64 ,$66.20 ,$53.59 ,$61.64 ,$60.81 ,$61.60 ,$14.59 ,$63.36 ,$15.83 ,$17.34 ,$17.34 ,$14.45 ,$17.34 ,$14.45 ,$63.36 ,$54.56 ,$63.36 ,$63.36 ,$52.80 ST VINCENT HOSPITAL - ACUTE,30100956,83986,HC PH BODY FLUID-STONE,301,1 ,$24.00 ,$12.00 ,$3.58 ,$24.00 ,$15.50 ,$3.70 ,$13.93 ,$11.94 ,$3.58 ,$14.40 ,$20.40 ,$16.80 ,$3.70 ,$22.80 ,$17.28 ,$17.52 ,$6.09 ,$20.40 ,$3.58 ,$6.09 ,$19.20 ,$17.52 ,$3.70 ,$3.58 ,$3.95 ,$24.00 ,$20.40 ,$8.06 ,$22.08 ,$16.80 ,$17.13 ,$18.40 ,$14.62 ,$17.13 ,$16.58 ,$16.80 ,$3.62 ,$17.28 ,$3.92 ,$4.30 ,$4.30 ,$3.58 ,$4.30 ,$3.58 ,$17.28 ,$14.88 ,$17.28 ,$17.28 ,$14.40 ST VINCENT HOSPITAL - ACUTE,30100957,84105,HC PHOSPHORUS URINE-STONE,301,1 ,$35.00 ,$17.50 ,$5.78 ,$35.00 ,$22.61 ,$5.97 ,$20.23 ,$17.34 ,$5.78 ,$21.00 ,$29.75 ,$24.50 ,$5.97 ,$33.25 ,$25.20 ,$25.55 ,$9.83 ,$29.75 ,$5.78 ,$9.83 ,$28.00 ,$25.55 ,$5.97 ,$5.78 ,$6.38 ,$35.00 ,$29.75 ,$13.01 ,$32.20 ,$24.50 ,$24.78 ,$26.62 ,$21.32 ,$24.78 ,$24.19 ,$24.50 ,$5.84 ,$25.20 ,$6.33 ,$6.94 ,$6.94 ,$5.78 ,$6.94 ,$5.78 ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,30100958,84133,HC POTASSIUM URINE-STONE,301,1 ,$29.00 ,$14.50 ,$4.73 ,$29.00 ,$18.73 ,$4.89 ,$16.77 ,$14.37 ,$4.73 ,$17.40 ,$24.65 ,$20.30 ,$4.89 ,$27.55 ,$20.88 ,$21.17 ,$8.04 ,$24.65 ,$4.73 ,$8.04 ,$23.20 ,$21.17 ,$4.89 ,$4.73 ,$5.22 ,$29.00 ,$24.65 ,$10.64 ,$26.68 ,$20.30 ,$20.60 ,$22.13 ,$17.66 ,$20.60 ,$20.04 ,$20.30 ,$4.78 ,$20.88 ,$5.18 ,$5.68 ,$5.68 ,$4.73 ,$5.68 ,$4.73 ,$20.88 ,$17.98 ,$20.88 ,$20.88 ,$17.40 ST VINCENT HOSPITAL - ACUTE,30100959,84300,HC SODIUM URINE-STONE,301,1 ,$33.00 ,$16.50 ,$5.06 ,$33.00 ,$21.32 ,$5.23 ,$18.90 ,$16.20 ,$5.06 ,$19.80 ,$28.05 ,$23.10 ,$5.23 ,$31.35 ,$23.76 ,$24.09 ,$8.60 ,$28.05 ,$5.06 ,$8.60 ,$26.40 ,$24.09 ,$5.23 ,$5.06 ,$5.59 ,$33.00 ,$28.05 ,$11.39 ,$30.36 ,$23.10 ,$23.31 ,$25.03 ,$20.10 ,$23.31 ,$22.80 ,$23.10 ,$5.11 ,$23.76 ,$5.54 ,$6.07 ,$6.07 ,$5.06 ,$6.07 ,$5.06 ,$23.76 ,$20.46 ,$23.76 ,$23.76 ,$19.80 ST VINCENT HOSPITAL - ACUTE,30100960,84560,HC URIC ACID OTH SOURCE-STONE,301,1 ,$32.00 ,$16.00 ,$5.08 ,$32.00 ,$20.67 ,$5.25 ,$18.45 ,$15.81 ,$5.08 ,$19.20 ,$27.20 ,$22.40 ,$5.25 ,$30.40 ,$23.04 ,$23.36 ,$8.64 ,$27.20 ,$5.08 ,$8.64 ,$25.60 ,$23.36 ,$5.25 ,$5.08 ,$5.61 ,$32.00 ,$27.20 ,$11.43 ,$29.44 ,$22.40 ,$22.74 ,$24.43 ,$19.49 ,$22.74 ,$22.11 ,$22.40 ,$5.13 ,$23.04 ,$5.57 ,$6.10 ,$6.10 ,$5.08 ,$6.10 ,$5.08 ,$23.04 ,$19.84 ,$23.04 ,$23.04 ,$19.20 ST VINCENT HOSPITAL - ACUTE,30100961,83993,HC CALPROTECTIN STOOL,301,1 ,$140.00 ,$70.00 ,$19.63 ,$140.00 ,$90.44 ,$20.28 ,$76.34 ,$65.43 ,$19.63 ,$84.00 ,$119.00 ,$98.00 ,$20.28 ,$133.00 ,$100.80 ,$102.20 ,$33.37 ,$119.00 ,$19.63 ,$33.37 ,$112.00 ,$102.20 ,$20.28 ,$19.63 ,$21.68 ,$140.00 ,$119.00 ,$44.17 ,$128.80 ,$98.00 ,$94.00 ,$100.96 ,$85.26 ,$94.00 ,$96.74 ,$98.00 ,$19.83 ,$100.80 ,$21.50 ,$23.56 ,$23.56 ,$19.63 ,$23.56 ,$19.63 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30100962,82656,"HC ELASTASE,PANCREATIC EL1 FECAL QT",301,1 ,$190.00 ,$95.00 ,$11.53 ,$190.00 ,$122.74 ,$11.91 ,$44.84 ,$38.43 ,$11.53 ,$114.00 ,$161.50 ,$133.00 ,$11.91 ,$180.50 ,$136.80 ,$138.70 ,$19.60 ,$161.50 ,$11.53 ,$19.60 ,$152.00 ,$138.70 ,$11.91 ,$11.53 ,$12.73 ,$190.00 ,$161.50 ,$25.94 ,$174.80 ,$133.00 ,$55.25 ,$59.34 ,$115.71 ,$55.25 ,$131.29 ,$133.00 ,$11.65 ,$136.80 ,$12.62 ,$13.84 ,$13.84 ,$11.53 ,$13.84 ,$11.53 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30100965,80361,HC DIHYDROCODEINONE,301,1 ,$172.00 ,$86.00 ,$9.39 ,$172.00 ,$111.11 ,$9.39 ,$80.88 ,$69.32 , N/A ,$103.20 ,$146.20 ,$120.40 ,$9.39 ,$163.40 ,$123.84 ,$125.56 ,$38.56 ,$146.20 , N/A ,$38.56 ,$137.60 ,$125.56 ,$9.39 , N/A ,$18.77 ,$172.00 ,$146.20 , N/A ,$158.24 ,$120.40 ,$86.00 ,$103.20 ,$104.75 ,$86.00 ,$118.85 ,$120.40 , N/A ,$123.84 ,$9.95 , N/A , N/A , N/A , N/A , N/A ,$123.84 ,$106.64 ,$123.84 ,$123.84 ,$103.20 ST VINCENT HOSPITAL - ACUTE,30100966,80324,"HC AMPHETAMINE CONFIRM GC/MS,UR",301,1 ,$90.00 ,$45.00 ,$3.23 ,$90.00 ,$58.14 ,$3.23 ,$80.88 ,$69.32 , N/A ,$54.00 ,$76.50 ,$63.00 ,$3.23 ,$85.50 ,$64.80 ,$65.70 ,$38.56 ,$76.50 , N/A ,$38.56 ,$72.00 ,$65.70 ,$3.23 , N/A ,$16.74 ,$90.00 ,$76.50 , N/A ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 , N/A ,$64.80 ,$3.42 , N/A , N/A , N/A , N/A , N/A ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100968,83018,HC COBALT BLOOD,301,1 ,$100.00 ,$50.00 ,$21.96 ,$100.00 ,$64.60 ,$22.69 ,$85.44 ,$73.23 ,$21.96 ,$60.00 ,$85.00 ,$70.00 ,$22.69 ,$95.00 ,$72.00 ,$73.00 ,$37.33 ,$85.00 ,$21.96 ,$37.33 ,$80.00 ,$73.00 ,$22.69 ,$21.96 ,$24.25 ,$100.00 ,$85.00 ,$49.41 ,$92.00 ,$70.00 ,$100.00 ,$100.00 ,$60.90 ,$100.00 ,$69.10 ,$70.00 ,$22.18 ,$72.00 ,$24.05 ,$26.35 ,$26.35 ,$21.96 ,$26.35 ,$21.96 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30100969,82705,HC FECAL FAT QUALITATIVE,301,1 ,$31.00 ,$15.50 ,$5.10 ,$31.00 ,$20.03 ,$5.27 ,$19.81 ,$16.98 ,$5.10 ,$18.60 ,$26.35 ,$21.70 ,$5.27 ,$29.45 ,$22.32 ,$22.63 ,$8.67 ,$26.35 ,$5.10 ,$8.67 ,$24.80 ,$22.63 ,$5.27 ,$5.10 ,$5.63 ,$31.00 ,$26.35 ,$11.48 ,$28.52 ,$21.70 ,$24.36 ,$26.16 ,$18.88 ,$24.36 ,$21.42 ,$21.70 ,$5.15 ,$22.32 ,$5.59 ,$6.12 ,$6.12 ,$5.10 ,$6.12 ,$5.10 ,$22.32 ,$19.22 ,$22.32 ,$22.32 ,$18.60 ST VINCENT HOSPITAL - ACUTE,30100970,80180,HC MYCOPHENOLIC ACID,301,1 ,$90.00 ,$45.00 ,$18.05 ,$90.00 ,$58.14 ,$18.65 ,$70.21 ,$60.18 ,$18.05 ,$54.00 ,$76.50 ,$63.00 ,$18.65 ,$85.50 ,$64.80 ,$65.70 ,$30.69 ,$76.50 ,$18.05 ,$30.69 ,$72.00 ,$65.70 ,$18.65 ,$18.05 ,$19.93 ,$90.00 ,$76.50 ,$40.61 ,$82.80 ,$63.00 ,$86.45 ,$90.00 ,$54.81 ,$86.45 ,$62.19 ,$63.00 ,$18.23 ,$64.80 ,$19.77 ,$21.66 ,$21.66 ,$18.05 ,$21.66 ,$18.05 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100971,80361,HC PAIN MGMT OPIATES QN URINE,301,1 ,$25.00 ,$12.50 ,$9.39 ,$25.00 ,$16.15 ,$9.39 ,$25.00 ,$25.00 , N/A ,$15.00 ,$21.25 ,$17.50 ,$9.39 ,$23.75 ,$18.00 ,$18.25 ,$25.00 ,$21.25 , N/A ,$25.00 ,$20.00 ,$18.25 ,$9.39 , N/A ,$18.77 ,$25.00 ,$21.25 , N/A ,$23.00 ,$17.50 ,$12.50 ,$15.00 ,$15.23 ,$12.50 ,$17.28 ,$17.50 , N/A ,$18.00 ,$9.95 , N/A , N/A , N/A , N/A , N/A ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,30100972,G0480,HC OPIATES 1 OR MORE,301,1 ,$160.00 ,$80.00 ,$63.95 ,$257.47 ,$103.36 ,$63.95 ,$160.00 ,$160.00 ,$114.43 ,$96.00 ,$136.00 ,$112.00 ,$63.95 ,$152.00 ,$115.20 ,$116.80 ,$160.00 ,$136.00 ,$114.43 ,$160.00 ,$128.00 ,$116.80 ,$63.95 ,$114.43 ,$126.35 ,$160.00 ,$136.00 ,$257.47 ,$147.20 ,$112.00 ,$160.00 ,$160.00 ,$97.44 ,$160.00 ,$110.56 ,$112.00 ,$115.57 ,$115.20 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30100973,G0480,HC PAIN MGMT BENZO QN URINE,301,1 ,$160.00 ,$80.00 ,$63.95 ,$257.47 ,$103.36 ,$63.95 ,$160.00 ,$160.00 ,$114.43 ,$96.00 ,$136.00 ,$112.00 ,$63.95 ,$152.00 ,$115.20 ,$116.80 ,$160.00 ,$136.00 ,$114.43 ,$160.00 ,$128.00 ,$116.80 ,$63.95 ,$114.43 ,$126.35 ,$160.00 ,$136.00 ,$257.47 ,$147.20 ,$112.00 ,$160.00 ,$160.00 ,$97.44 ,$160.00 ,$110.56 ,$112.00 ,$115.57 ,$115.20 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30100974,83516,HC TISSUE TRANGLUTAMINASE IGG AB,301,1 ,$53.00 ,$26.50 ,$11.53 ,$53.00 ,$34.24 ,$11.91 ,$44.84 ,$38.43 ,$11.53 ,$31.80 ,$45.05 ,$37.10 ,$11.91 ,$50.35 ,$38.16 ,$38.69 ,$19.60 ,$45.05 ,$11.53 ,$19.60 ,$42.40 ,$38.69 ,$11.91 ,$11.53 ,$12.73 ,$53.00 ,$45.05 ,$25.94 ,$48.76 ,$37.10 ,$53.00 ,$53.00 ,$32.28 ,$53.00 ,$36.62 ,$37.10 ,$11.65 ,$38.16 ,$12.62 ,$13.84 ,$13.84 ,$11.53 ,$13.84 ,$11.53 ,$38.16 ,$32.86 ,$38.16 ,$38.16 ,$31.80 ST VINCENT HOSPITAL - ACUTE,30100975,82784,HC TOTAL SERUM IGA BY NEPHELP,301,1 ,$63.00 ,$31.50 ,$9.30 ,$63.00 ,$40.70 ,$9.61 ,$36.19 ,$31.02 ,$9.30 ,$37.80 ,$53.55 ,$44.10 ,$9.61 ,$59.85 ,$45.36 ,$45.99 ,$15.81 ,$53.55 ,$9.30 ,$15.81 ,$50.40 ,$45.99 ,$9.61 ,$9.30 ,$10.27 ,$63.00 ,$53.55 ,$20.93 ,$57.96 ,$44.10 ,$44.51 ,$47.80 ,$38.37 ,$44.51 ,$43.53 ,$44.10 ,$9.39 ,$45.36 ,$10.19 ,$11.16 ,$11.16 ,$9.30 ,$11.16 ,$9.30 ,$45.36 ,$39.06 ,$45.36 ,$45.36 ,$37.80 ST VINCENT HOSPITAL - ACUTE,30100976,84075,HC ALKALINE PHOSPHATASE BONE SPECIFIC,301,1 ,$28.00 ,$14.00 ,$5.18 ,$28.00 ,$18.09 ,$5.35 ,$20.13 ,$17.25 ,$5.18 ,$16.80 ,$23.80 ,$19.60 ,$5.35 ,$26.60 ,$20.16 ,$20.44 ,$8.81 ,$23.80 ,$5.18 ,$8.81 ,$22.40 ,$20.44 ,$5.35 ,$5.18 ,$5.72 ,$28.00 ,$23.80 ,$11.66 ,$25.76 ,$19.60 ,$24.78 ,$26.62 ,$17.05 ,$24.78 ,$19.35 ,$19.60 ,$5.23 ,$20.16 ,$5.67 ,$6.22 ,$6.22 ,$5.18 ,$6.22 ,$5.18 ,$20.16 ,$17.36 ,$20.16 ,$20.16 ,$16.80 ST VINCENT HOSPITAL - ACUTE,30100977,84181,HC FLUOR AB TITER,301,1 ,$54.00 ,$27.00 ,$17.03 ,$54.00 ,$34.88 ,$17.60 ,$54.00 ,$54.00 ,$17.03 ,$32.40 ,$45.90 ,$37.80 ,$17.60 ,$51.30 ,$38.88 ,$39.42 ,$28.95 ,$45.90 ,$17.03 ,$28.95 ,$43.20 ,$39.42 ,$17.60 ,$17.03 ,$18.80 ,$54.00 ,$45.90 ,$38.32 ,$49.68 ,$37.80 ,$54.00 ,$54.00 ,$32.89 ,$54.00 ,$37.31 ,$37.80 ,$17.20 ,$38.88 ,$18.66 ,$20.44 ,$20.44 ,$17.03 ,$20.44 ,$17.03 ,$38.88 ,$33.48 ,$38.88 ,$38.88 ,$32.40 ST VINCENT HOSPITAL - ACUTE,30100978,83520,HC ANTI-MULLERIAN HORMONE,301,1 ,$90.00 ,$45.00 ,$17.27 ,$90.00 ,$58.14 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$54.00 ,$76.50 ,$63.00 ,$17.85 ,$85.50 ,$64.80 ,$65.70 ,$29.36 ,$76.50 ,$17.27 ,$29.36 ,$72.00 ,$65.70 ,$17.85 ,$17.27 ,$19.07 ,$90.00 ,$76.50 ,$38.86 ,$82.80 ,$63.00 ,$61.99 ,$66.58 ,$54.81 ,$61.99 ,$62.19 ,$63.00 ,$17.44 ,$64.80 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100979,G0480,HC TRAMADOL,301,1 ,$160.00 ,$80.00 ,$63.95 ,$257.47 ,$103.36 ,$63.95 ,$160.00 ,$160.00 ,$114.43 ,$96.00 ,$136.00 ,$112.00 ,$63.95 ,$152.00 ,$115.20 ,$116.80 ,$160.00 ,$136.00 ,$114.43 ,$160.00 ,$128.00 ,$116.80 ,$63.95 ,$114.43 ,$126.35 ,$160.00 ,$136.00 ,$257.47 ,$147.20 ,$112.00 ,$160.00 ,$160.00 ,$97.44 ,$160.00 ,$110.56 ,$112.00 ,$115.57 ,$115.20 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30100980,83498,HC 17 OH PROGESTERONE RESP TO ACTH,301,1 ,$178.00 ,$89.00 ,$27.17 ,$178.00 ,$114.99 ,$28.07 ,$105.67 ,$90.57 ,$27.17 ,$106.80 ,$151.30 ,$124.60 ,$28.07 ,$169.10 ,$128.16 ,$129.94 ,$46.19 ,$151.30 ,$27.17 ,$46.19 ,$142.40 ,$129.94 ,$28.07 ,$27.17 ,$30.00 ,$178.00 ,$151.30 ,$61.13 ,$163.76 ,$124.60 ,$130.12 ,$139.75 ,$108.40 ,$130.12 ,$123.00 ,$124.60 ,$27.44 ,$128.16 ,$29.75 ,$32.60 ,$32.60 ,$27.17 ,$32.60 ,$27.17 ,$128.16 ,$110.36 ,$128.16 ,$128.16 ,$106.80 ST VINCENT HOSPITAL - ACUTE,30100981,82397,HC ALPHA SUBUNIT,301,1 ,$110.00 ,$55.00 ,$14.12 ,$110.00 ,$71.06 ,$14.59 ,$54.92 ,$47.07 ,$14.12 ,$66.00 ,$93.50 ,$77.00 ,$14.59 ,$104.50 ,$79.20 ,$80.30 ,$24.00 ,$93.50 ,$14.12 ,$24.00 ,$88.00 ,$80.30 ,$14.59 ,$14.12 ,$15.59 ,$110.00 ,$93.50 ,$31.77 ,$101.20 ,$77.00 ,$67.64 ,$72.65 ,$66.99 ,$67.64 ,$76.01 ,$77.00 ,$14.26 ,$79.20 ,$15.47 ,$16.94 ,$16.94 ,$14.12 ,$16.94 ,$14.12 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100982,82530,HC CORTISOL SALIVA 2 SAMPLES,301,1 ,$110.00 ,$55.00 ,$16.71 ,$110.00 ,$71.06 ,$17.27 ,$65.00 ,$55.71 ,$16.71 ,$66.00 ,$93.50 ,$77.00 ,$17.27 ,$104.50 ,$79.20 ,$80.30 ,$28.41 ,$93.50 ,$16.71 ,$28.41 ,$88.00 ,$80.30 ,$17.27 ,$16.71 ,$18.45 ,$110.00 ,$93.50 ,$37.60 ,$101.20 ,$77.00 ,$80.03 ,$85.96 ,$66.99 ,$80.03 ,$76.01 ,$77.00 ,$16.88 ,$79.20 ,$18.31 ,$20.05 ,$20.05 ,$16.71 ,$20.05 ,$16.71 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100983,80299,HC DEXAMETHASONE,301,1 ,$140.00 ,$70.00 ,$18.64 ,$140.00 ,$90.44 ,$19.26 ,$65.24 ,$55.92 ,$18.64 ,$84.00 ,$119.00 ,$98.00 ,$19.26 ,$133.00 ,$100.80 ,$102.20 ,$31.69 ,$119.00 ,$18.64 ,$31.69 ,$112.00 ,$102.20 ,$19.26 ,$18.64 ,$20.58 ,$140.00 ,$119.00 ,$41.94 ,$128.80 ,$98.00 ,$65.57 ,$70.42 ,$85.26 ,$65.57 ,$96.74 ,$98.00 ,$18.83 ,$100.80 ,$20.42 ,$22.37 ,$22.37 ,$18.64 ,$22.37 ,$18.64 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30100984,83789,HC IODINE 24 HOUR URINE,301,1 ,$80.00 ,$40.00 ,$24.11 ,$80.00 ,$51.68 ,$24.91 ,$80.00 ,$72.33 ,$24.11 ,$48.00 ,$68.00 ,$56.00 ,$24.91 ,$76.00 ,$57.60 ,$58.40 ,$40.99 ,$68.00 ,$24.11 ,$40.99 ,$64.00 ,$58.40 ,$24.91 ,$24.11 ,$26.62 ,$80.00 ,$68.00 ,$54.25 ,$73.60 ,$56.00 ,$80.00 ,$80.00 ,$48.72 ,$80.00 ,$55.28 ,$56.00 ,$24.35 ,$57.60 ,$26.40 ,$28.93 ,$28.93 ,$24.11 ,$28.93 ,$24.11 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100985,83789,HC IODINE RANDOM URINE,301,1 ,$80.00 ,$40.00 ,$24.11 ,$80.00 ,$51.68 ,$24.91 ,$80.00 ,$72.33 ,$24.11 ,$48.00 ,$68.00 ,$56.00 ,$24.91 ,$76.00 ,$57.60 ,$58.40 ,$40.99 ,$68.00 ,$24.11 ,$40.99 ,$64.00 ,$58.40 ,$24.91 ,$24.11 ,$26.62 ,$80.00 ,$68.00 ,$54.25 ,$73.60 ,$56.00 ,$80.00 ,$80.00 ,$48.72 ,$80.00 ,$55.28 ,$56.00 ,$24.35 ,$57.60 ,$26.40 ,$28.93 ,$28.93 ,$24.11 ,$28.93 ,$24.11 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30100986,82533,HC ACTH STIM 3 SPECIMENS,301,1 ,$110.00 ,$55.00 ,$16.30 ,$110.00 ,$71.06 ,$16.84 ,$63.39 ,$54.33 ,$16.30 ,$66.00 ,$93.50 ,$77.00 ,$16.84 ,$104.50 ,$79.20 ,$80.30 ,$27.71 ,$93.50 ,$16.30 ,$27.71 ,$88.00 ,$80.30 ,$16.84 ,$16.30 ,$18.00 ,$110.00 ,$93.50 ,$36.68 ,$101.20 ,$77.00 ,$78.06 ,$83.84 ,$66.99 ,$78.06 ,$76.01 ,$77.00 ,$16.46 ,$79.20 ,$17.85 ,$19.56 ,$19.56 ,$16.30 ,$19.56 ,$16.30 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100987,82523,HC COLLAGEN CROSS LINKED 24 HR URINE,301,1 ,$110.00 ,$55.00 ,$14.65 ,$110.00 ,$71.06 ,$14.65 ,$72.66 ,$62.28 ,$18.68 ,$66.00 ,$93.50 ,$77.00 ,$14.65 ,$104.50 ,$79.20 ,$80.30 ,$31.76 ,$93.50 ,$18.68 ,$31.76 ,$88.00 ,$80.30 ,$14.65 ,$18.68 ,$20.63 ,$110.00 ,$93.50 ,$42.03 ,$101.20 ,$77.00 ,$49.91 ,$53.61 ,$66.99 ,$49.91 ,$76.01 ,$77.00 ,$18.87 ,$79.20 ,$15.53 ,$22.42 ,$22.42 ,$18.68 ,$22.42 ,$18.68 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100988,84439,HC T4 FREE DIRECT DIALYSIS,301,1 ,$60.00 ,$30.00 ,$9.02 ,$60.00 ,$38.76 ,$9.32 ,$35.07 ,$30.06 ,$9.02 ,$36.00 ,$51.00 ,$42.00 ,$9.32 ,$57.00 ,$43.20 ,$43.80 ,$15.33 ,$51.00 ,$9.02 ,$15.33 ,$48.00 ,$43.80 ,$9.32 ,$9.02 ,$9.96 ,$60.00 ,$51.00 ,$20.30 ,$55.20 ,$42.00 ,$43.17 ,$46.37 ,$36.54 ,$43.17 ,$41.46 ,$42.00 ,$9.11 ,$43.20 ,$9.88 ,$10.82 ,$10.82 ,$9.02 ,$10.82 ,$9.02 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30100989,84443,HC TSH WITH HAMA TREATMENT,301,1 ,$110.00 ,$55.00 ,$16.80 ,$110.00 ,$71.06 ,$17.36 ,$65.35 ,$56.01 ,$16.80 ,$66.00 ,$93.50 ,$77.00 ,$17.36 ,$104.50 ,$79.20 ,$80.30 ,$28.56 ,$93.50 ,$16.80 ,$28.56 ,$88.00 ,$80.30 ,$17.36 ,$16.80 ,$18.55 ,$110.00 ,$93.50 ,$37.80 ,$101.20 ,$77.00 ,$80.48 ,$86.45 ,$66.99 ,$80.48 ,$76.01 ,$77.00 ,$16.97 ,$79.20 ,$18.40 ,$20.16 ,$20.16 ,$16.80 ,$20.16 ,$16.80 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30100990,82523,HC C TELOPEPTIDE CTX,301,1 ,$90.00 ,$45.00 ,$14.65 ,$90.00 ,$58.14 ,$14.65 ,$72.66 ,$62.28 ,$18.68 ,$54.00 ,$76.50 ,$63.00 ,$14.65 ,$85.50 ,$64.80 ,$65.70 ,$31.76 ,$76.50 ,$18.68 ,$31.76 ,$72.00 ,$65.70 ,$14.65 ,$18.68 ,$20.63 ,$90.00 ,$76.50 ,$42.03 ,$82.80 ,$63.00 ,$49.91 ,$53.61 ,$54.81 ,$49.91 ,$62.19 ,$63.00 ,$18.87 ,$64.80 ,$15.53 ,$22.42 ,$22.42 ,$18.68 ,$22.42 ,$18.68 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100991,83519,HC THYROTROPIN BINDING INHIBITORY IG,301,1 ,$90.00 ,$45.00 ,$18.40 ,$90.00 ,$58.14 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$54.00 ,$76.50 ,$63.00 ,$19.00 ,$85.50 ,$64.80 ,$65.70 ,$31.28 ,$76.50 ,$18.40 ,$31.28 ,$72.00 ,$65.70 ,$19.00 ,$18.40 ,$20.32 ,$90.00 ,$76.50 ,$41.40 ,$82.80 ,$63.00 ,$64.69 ,$69.48 ,$54.81 ,$64.69 ,$62.19 ,$63.00 ,$18.58 ,$64.80 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30100992,83519,HC TSH ANTIBODY,301,1 ,$90.00 ,$45.00 ,$18.40 ,$90.00 ,$58.14 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$54.00 ,$76.50 ,$63.00 ,$19.00 ,$85.50 ,$64.80 ,$65.70 ,$31.28 ,$76.50 ,$18.40 ,$31.28 ,$72.00 ,$65.70 ,$19.00 ,$18.40 ,$20.32 ,$90.00 ,$76.50 ,$41.40 ,$82.80 ,$63.00 ,$64.69 ,$69.48 ,$54.81 ,$64.69 ,$62.19 ,$63.00 ,$18.58 ,$64.80 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30101003,82523,HC COLLAGEN CROSS LINKS ANY METHOD,301,1 ,$144.00 ,$72.00 ,$14.65 ,$144.00 ,$93.02 ,$14.65 ,$72.66 ,$62.28 ,$18.68 ,$86.40 ,$122.40 ,$100.80 ,$14.65 ,$136.80 ,$103.68 ,$105.12 ,$31.76 ,$122.40 ,$18.68 ,$31.76 ,$115.20 ,$105.12 ,$14.65 ,$18.68 ,$20.63 ,$144.00 ,$122.40 ,$42.03 ,$132.48 ,$100.80 ,$49.91 ,$53.61 ,$87.70 ,$49.91 ,$99.50 ,$100.80 ,$18.87 ,$103.68 ,$15.53 ,$22.42 ,$22.42 ,$18.68 ,$22.42 ,$18.68 ,$103.68 ,$89.28 ,$103.68 ,$103.68 ,$86.40 ST VINCENT HOSPITAL - ACUTE,30101006,82787,HC IMMUNOGLOBULIN SUBCLASSES,301,1 ,$56.00 ,$28.00 ,$5.90 ,$56.00 ,$36.18 ,$5.90 ,$31.19 ,$26.73 ,$8.02 ,$33.60 ,$47.60 ,$39.20 ,$5.90 ,$53.20 ,$40.32 ,$40.88 ,$13.63 ,$47.60 ,$8.02 ,$13.63 ,$44.80 ,$40.88 ,$5.90 ,$8.02 ,$8.86 ,$56.00 ,$47.60 ,$18.05 ,$51.52 ,$39.20 ,$20.08 ,$21.56 ,$34.10 ,$20.08 ,$38.70 ,$39.20 ,$8.10 ,$40.32 ,$6.25 ,$9.62 ,$9.62 ,$8.02 ,$9.62 ,$8.02 ,$40.32 ,$34.72 ,$40.32 ,$40.32 ,$33.60 ST VINCENT HOSPITAL - ACUTE,30101010,83520,HC IMMUNOASSAY QN OTHER,301,1 ,$140.00 ,$70.00 ,$17.27 ,$140.00 ,$90.44 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$84.00 ,$119.00 ,$98.00 ,$17.85 ,$133.00 ,$100.80 ,$102.20 ,$29.36 ,$119.00 ,$17.27 ,$29.36 ,$112.00 ,$102.20 ,$17.85 ,$17.27 ,$19.07 ,$140.00 ,$119.00 ,$38.86 ,$128.80 ,$98.00 ,$61.99 ,$66.58 ,$85.26 ,$61.99 ,$96.74 ,$98.00 ,$17.44 ,$100.80 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30101024,G0480,HC DRUG CONFIRMATION EA PROC 1-7 CLASSES,301,1 ,$160.00 ,$80.00 ,$63.95 ,$257.47 ,$103.36 ,$63.95 ,$160.00 ,$160.00 ,$114.43 ,$96.00 ,$136.00 ,$112.00 ,$63.95 ,$152.00 ,$115.20 ,$116.80 ,$160.00 ,$136.00 ,$114.43 ,$160.00 ,$128.00 ,$116.80 ,$63.95 ,$114.43 ,$126.35 ,$160.00 ,$136.00 ,$257.47 ,$147.20 ,$112.00 ,$160.00 ,$160.00 ,$97.44 ,$160.00 ,$110.56 ,$112.00 ,$115.57 ,$115.20 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30101030,80169,HC EVEROLIMUS,301,1 ,$190.00 ,$95.00 ,$13.73 ,$190.00 ,$122.74 ,$14.19 ,$53.41 ,$45.78 ,$13.73 ,$114.00 ,$161.50 ,$133.00 ,$14.19 ,$180.50 ,$136.80 ,$138.70 ,$23.34 ,$161.50 ,$13.73 ,$23.34 ,$152.00 ,$138.70 ,$14.19 ,$13.73 ,$15.16 ,$190.00 ,$161.50 ,$30.89 ,$174.80 ,$133.00 ,$65.74 ,$70.61 ,$115.71 ,$65.74 ,$131.29 ,$133.00 ,$13.87 ,$136.80 ,$15.04 ,$16.48 ,$16.48 ,$13.73 ,$16.48 ,$13.73 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30101045,80299,HC POSACONAZOLE,301,1 ,$200.00 ,$100.00 ,$18.64 ,$200.00 ,$129.20 ,$19.26 ,$65.24 ,$55.92 ,$18.64 ,$120.00 ,$170.00 ,$140.00 ,$19.26 ,$190.00 ,$144.00 ,$146.00 ,$31.69 ,$170.00 ,$18.64 ,$31.69 ,$160.00 ,$146.00 ,$19.26 ,$18.64 ,$20.58 ,$200.00 ,$170.00 ,$41.94 ,$184.00 ,$140.00 ,$65.57 ,$70.42 ,$121.80 ,$65.57 ,$138.20 ,$140.00 ,$18.83 ,$144.00 ,$20.42 ,$22.37 ,$22.37 ,$18.64 ,$22.37 ,$18.64 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30101049,82565,HC CREATININE W/GFR POC,301,1 ,$35.00 ,$17.50 ,$5.12 ,$35.00 ,$22.61 ,$5.29 ,$19.92 ,$17.07 ,$5.12 ,$21.00 ,$29.75 ,$24.50 ,$5.29 ,$33.25 ,$25.20 ,$25.55 ,$8.70 ,$29.75 ,$5.12 ,$8.70 ,$28.00 ,$25.55 ,$5.29 ,$5.12 ,$5.65 ,$35.00 ,$29.75 ,$11.52 ,$32.20 ,$24.50 ,$24.53 ,$26.35 ,$21.32 ,$24.53 ,$24.19 ,$24.50 ,$5.17 ,$25.20 ,$5.61 ,$6.14 ,$6.14 ,$5.12 ,$6.14 ,$5.12 ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,30101050,82610,HC CYSTATIN C,301,1 ,$110.00 ,$55.00 ,$18.52 ,$110.00 ,$71.06 ,$19.00 ,$64.82 ,$55.56 ,$18.52 ,$66.00 ,$93.50 ,$77.00 ,$19.00 ,$104.50 ,$79.20 ,$80.30 ,$31.48 ,$93.50 ,$18.52 ,$31.48 ,$88.00 ,$80.30 ,$19.00 ,$18.52 ,$20.45 ,$110.00 ,$93.50 ,$41.67 ,$101.20 ,$77.00 ,$65.08 ,$69.90 ,$66.99 ,$65.08 ,$76.01 ,$77.00 ,$18.71 ,$79.20 ,$20.14 ,$22.22 ,$22.22 ,$18.52 ,$22.22 ,$18.52 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30101051,83789,HC MASS/TANDEM SPEC TPMT ACTIVITY EACH SPECIMEN,301,1 ,$310.00 ,$155.00 ,$24.11 ,$310.00 ,$200.26 ,$24.91 ,$84.39 ,$72.33 ,$24.11 ,$186.00 ,$263.50 ,$217.00 ,$24.91 ,$294.50 ,$223.20 ,$226.30 ,$40.99 ,$263.50 ,$24.11 ,$40.99 ,$248.00 ,$226.30 ,$24.91 ,$24.11 ,$26.62 ,$310.00 ,$263.50 ,$54.25 ,$285.20 ,$217.00 ,$86.45 ,$92.86 ,$188.79 ,$86.45 ,$214.21 ,$217.00 ,$24.35 ,$223.20 ,$26.40 ,$28.93 ,$28.93 ,$24.11 ,$28.93 ,$24.11 ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,30101052,82642,HC DRUG CONFIRMATION DIHYDROTESTOSTERONE LC/MS/MS,301,1 ,$160.00 ,$80.00 ,$29.28 ,$160.00 ,$103.36 ,$30.26 ,$113.86 ,$97.59 ,$29.28 ,$96.00 ,$136.00 ,$112.00 ,$30.26 ,$152.00 ,$115.20 ,$116.80 ,$49.78 ,$136.00 ,$29.28 ,$49.78 ,$128.00 ,$116.80 ,$30.26 ,$29.28 ,$32.33 ,$160.00 ,$136.00 ,$65.88 ,$147.20 ,$112.00 ,$125.24 ,$134.51 ,$97.44 ,$125.24 ,$110.56 ,$112.00 ,$29.57 ,$115.20 ,$32.08 ,$35.14 ,$35.14 ,$29.28 ,$35.14 ,$29.28 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30101053,80235,HC LACOSAMIDE LC/MS/MS,301,1 ,$110.00 ,$55.00 ,$21.69 ,$110.00 ,$71.06 ,$21.69 ,$94.89 ,$81.33 ,$27.11 ,$66.00 ,$93.50 ,$77.00 ,$21.69 ,$104.50 ,$79.20 ,$80.30 ,$46.09 ,$93.50 ,$27.11 ,$46.09 ,$88.00 ,$80.30 ,$21.69 ,$27.11 ,$29.93 ,$110.00 ,$93.50 ,$61.00 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$27.38 ,$79.20 ,$22.99 ,$32.53 ,$32.53 ,$27.11 ,$32.53 ,$27.11 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30101054,83520,HC GANGLIOSIDE GQ1B AB IGG EIA,301,1 ,$90.00 ,$45.00 ,$17.27 ,$90.00 ,$58.14 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$54.00 ,$76.50 ,$63.00 ,$17.85 ,$85.50 ,$64.80 ,$65.70 ,$29.36 ,$76.50 ,$17.27 ,$29.36 ,$72.00 ,$65.70 ,$17.85 ,$17.27 ,$19.07 ,$90.00 ,$76.50 ,$38.86 ,$82.80 ,$63.00 ,$61.99 ,$66.58 ,$54.81 ,$61.99 ,$62.19 ,$63.00 ,$17.44 ,$64.80 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30101055,83519,HC CALCIUM CHAN AB VOLTAGE-GATED,301,1 ,$90.00 ,$45.00 ,$18.40 ,$90.00 ,$58.14 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$54.00 ,$76.50 ,$63.00 ,$19.00 ,$85.50 ,$64.80 ,$65.70 ,$31.28 ,$76.50 ,$18.40 ,$31.28 ,$72.00 ,$65.70 ,$19.00 ,$18.40 ,$20.32 ,$90.00 ,$76.50 ,$41.40 ,$82.80 ,$63.00 ,$64.69 ,$69.48 ,$54.81 ,$64.69 ,$62.19 ,$63.00 ,$18.58 ,$64.80 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30101057,84140,HC PREGNENOLONE,301,1 ,$95.00 ,$47.50 ,$20.67 ,$95.00 ,$61.37 ,$21.36 ,$80.40 ,$68.91 ,$20.67 ,$57.00 ,$80.75 ,$66.50 ,$21.36 ,$90.25 ,$68.40 ,$69.35 ,$35.14 ,$80.75 ,$20.67 ,$35.14 ,$76.00 ,$69.35 ,$21.36 ,$20.67 ,$22.82 ,$95.00 ,$80.75 ,$46.51 ,$87.40 ,$66.50 ,$95.00 ,$95.00 ,$57.86 ,$95.00 ,$65.65 ,$66.50 ,$20.88 ,$68.40 ,$22.64 ,$24.80 ,$24.80 ,$20.67 ,$24.80 ,$20.67 ,$68.40 ,$58.90 ,$68.40 ,$68.40 ,$57.00 ST VINCENT HOSPITAL - ACUTE,30101058,82679,HC ESTRONE LC/MS/MS,301,1 ,$89.00 ,$44.50 ,$24.95 ,$89.00 ,$57.49 ,$25.78 ,$89.00 ,$83.19 ,$24.95 ,$53.40 ,$75.65 ,$62.30 ,$25.78 ,$84.55 ,$64.08 ,$64.97 ,$42.42 ,$75.65 ,$24.95 ,$42.42 ,$71.20 ,$64.97 ,$25.78 ,$24.95 ,$27.55 ,$89.00 ,$75.65 ,$56.14 ,$81.88 ,$62.30 ,$89.00 ,$89.00 ,$54.20 ,$89.00 ,$61.50 ,$62.30 ,$25.20 ,$64.08 ,$27.33 ,$29.94 ,$29.94 ,$24.95 ,$29.94 ,$24.95 ,$64.08 ,$55.18 ,$64.08 ,$64.08 ,$53.40 ST VINCENT HOSPITAL - ACUTE,30101066,G0480,HC IF PREGABALIN,301,1 ,$282.00 ,$141.00 ,$63.95 ,$282.00 ,$182.17 ,$63.95 ,$282.00 ,$282.00 ,$114.43 ,$169.20 ,$239.70 ,$197.40 ,$63.95 ,$267.90 ,$203.04 ,$205.86 ,$194.53 ,$239.70 ,$114.43 ,$194.53 ,$225.60 ,$205.86 ,$63.95 ,$114.43 ,$126.35 ,$282.00 ,$239.70 ,$257.47 ,$259.44 ,$197.40 ,$280.59 ,$282.00 ,$171.74 ,$280.59 ,$194.86 ,$197.40 ,$115.57 ,$203.04 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$203.04 ,$174.84 ,$203.04 ,$203.04 ,$169.20 ST VINCENT HOSPITAL - ACUTE,30101067,G0480,HC IF MARIJUANA GC/MS URINE,301,1 ,$160.00 ,$80.00 ,$63.95 ,$257.47 ,$103.36 ,$63.95 ,$160.00 ,$160.00 ,$114.43 ,$96.00 ,$136.00 ,$112.00 ,$63.95 ,$152.00 ,$115.20 ,$116.80 ,$160.00 ,$136.00 ,$114.43 ,$160.00 ,$128.00 ,$116.80 ,$63.95 ,$114.43 ,$126.35 ,$160.00 ,$136.00 ,$257.47 ,$147.20 ,$112.00 ,$160.00 ,$160.00 ,$97.44 ,$160.00 ,$110.56 ,$112.00 ,$115.57 ,$115.20 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30101068,84630,HC ZINC RBC,301,1 ,$71.00 ,$35.50 ,$11.39 ,$71.00 ,$45.87 ,$11.77 ,$44.28 ,$37.95 ,$11.39 ,$42.60 ,$60.35 ,$49.70 ,$11.77 ,$67.45 ,$51.12 ,$51.83 ,$19.36 ,$60.35 ,$11.39 ,$19.36 ,$56.80 ,$51.83 ,$11.77 ,$11.39 ,$12.58 ,$71.00 ,$60.35 ,$25.63 ,$65.32 ,$49.70 ,$49.63 ,$53.31 ,$43.24 ,$49.63 ,$49.06 ,$49.70 ,$11.50 ,$51.12 ,$12.48 ,$13.67 ,$13.67 ,$11.39 ,$13.67 ,$11.39 ,$51.12 ,$44.02 ,$51.12 ,$51.12 ,$42.60 ST VINCENT HOSPITAL - ACUTE,30101071,84432,HC THYROGLOBULIN MASS SPEC,301,1 ,$290.00 ,$145.00 ,$16.06 ,$290.00 ,$187.34 ,$16.59 ,$62.44 ,$53.52 ,$16.06 ,$174.00 ,$246.50 ,$203.00 ,$16.59 ,$275.50 ,$208.80 ,$211.70 ,$27.30 ,$246.50 ,$16.06 ,$27.30 ,$232.00 ,$211.70 ,$16.59 ,$16.06 ,$17.73 ,$290.00 ,$246.50 ,$36.14 ,$266.80 ,$203.00 ,$76.90 ,$82.60 ,$176.61 ,$76.90 ,$200.39 ,$203.00 ,$16.22 ,$208.80 ,$17.59 ,$19.27 ,$19.27 ,$16.06 ,$19.27 ,$16.06 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,30101127,80299,HC THERAPEUTIC DRUG OTHER,301,1 ,$153.00 ,$76.50 ,$18.64 ,$153.00 ,$98.84 ,$19.26 ,$65.24 ,$55.92 ,$18.64 ,$91.80 ,$130.05 ,$107.10 ,$19.26 ,$145.35 ,$110.16 ,$111.69 ,$31.69 ,$130.05 ,$18.64 ,$31.69 ,$122.40 ,$111.69 ,$19.26 ,$18.64 ,$20.58 ,$153.00 ,$130.05 ,$41.94 ,$140.76 ,$107.10 ,$65.57 ,$70.42 ,$93.18 ,$65.57 ,$105.72 ,$107.10 ,$18.83 ,$110.16 ,$20.42 ,$22.37 ,$22.37 ,$18.64 ,$22.37 ,$18.64 ,$110.16 ,$94.86 ,$110.16 ,$110.16 ,$91.80 ST VINCENT HOSPITAL - ACUTE,30101466,82600,HC CYANIDE BLOOD,301,1 ,$130.00 ,$65.00 ,$19.40 ,$130.00 ,$83.98 ,$20.05 ,$75.43 ,$64.65 ,$19.40 ,$78.00 ,$110.50 ,$91.00 ,$20.05 ,$123.50 ,$93.60 ,$94.90 ,$32.98 ,$110.50 ,$19.40 ,$32.98 ,$104.00 ,$94.90 ,$20.05 ,$19.40 ,$21.42 ,$130.00 ,$110.50 ,$43.65 ,$119.60 ,$91.00 ,$92.87 ,$99.75 ,$79.17 ,$92.87 ,$89.83 ,$91.00 ,$19.59 ,$93.60 ,$21.25 ,$23.28 ,$23.28 ,$19.40 ,$23.28 ,$19.40 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30101467,84238,HC RECEPTOR ASSAY TRASFERRIN,301,1 ,$200.00 ,$100.00 ,$36.57 ,$200.00 ,$129.20 ,$37.79 ,$142.21 ,$121.89 ,$36.57 ,$120.00 ,$170.00 ,$140.00 ,$37.79 ,$190.00 ,$144.00 ,$146.00 ,$62.17 ,$170.00 ,$36.57 ,$62.17 ,$160.00 ,$146.00 ,$37.79 ,$36.57 ,$40.38 ,$200.00 ,$170.00 ,$82.28 ,$184.00 ,$140.00 ,$175.11 ,$188.09 ,$121.80 ,$175.11 ,$138.20 ,$140.00 ,$36.94 ,$144.00 ,$40.06 ,$43.88 ,$43.88 ,$36.57 ,$43.88 ,$36.57 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30101468,83013,HC H PYLORI BREATH TEST,301,1 ,$245.00 ,$122.50 ,$67.36 ,$245.00 ,$158.27 ,$69.60 ,$245.00 ,$224.52 ,$67.36 ,$147.00 ,$208.25 ,$171.50 ,$69.60 ,$232.75 ,$176.40 ,$178.85 ,$114.51 ,$208.25 ,$67.36 ,$114.51 ,$196.00 ,$178.85 ,$69.60 ,$67.36 ,$74.38 ,$245.00 ,$208.25 ,$151.56 ,$225.40 ,$171.50 ,$245.00 ,$245.00 ,$149.21 ,$245.00 ,$169.30 ,$171.50 ,$68.03 ,$176.40 ,$73.78 ,$80.83 ,$80.83 ,$67.36 ,$80.83 ,$67.36 ,$176.40 ,$151.90 ,$176.40 ,$176.40 ,$147.00 ST VINCENT HOSPITAL - ACUTE,30101469,G0481,HC DRUG SCREEN DEFINITIVE 8-14 CLASSES,301,1 ,$270.00 ,$135.00 ,$98.39 ,$352.33 ,$174.42 ,$98.39 ,$270.00 ,$270.00 ,$156.59 ,$162.00 ,$229.50 ,$189.00 ,$98.39 ,$256.50 ,$194.40 ,$197.10 ,$266.20 ,$229.50 ,$156.59 ,$266.20 ,$216.00 ,$197.10 ,$98.39 ,$156.59 ,$172.91 ,$270.00 ,$229.50 ,$352.33 ,$248.40 ,$189.00 ,$270.00 ,$270.00 ,$164.43 ,$270.00 ,$186.57 ,$189.00 ,$158.16 ,$194.40 ,$104.29 ,$187.91 ,$187.91 ,$156.59 ,$187.91 ,$156.59 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,30101470,G0482,HC DRUG SCREEN DEFINITIVE 15-21 CLASSES,301,1 ,$350.00 ,$175.00 ,$132.80 ,$447.17 ,$226.10 ,$132.80 ,$350.00 ,$350.00 ,$198.74 ,$210.00 ,$297.50 ,$245.00 ,$132.80 ,$332.50 ,$252.00 ,$255.50 ,$337.86 ,$297.50 ,$198.74 ,$337.86 ,$280.00 ,$255.50 ,$132.80 ,$198.74 ,$219.45 ,$350.00 ,$297.50 ,$447.17 ,$322.00 ,$245.00 ,$350.00 ,$350.00 ,$213.15 ,$350.00 ,$241.85 ,$245.00 ,$200.73 ,$252.00 ,$140.77 ,$238.49 ,$238.49 ,$198.74 ,$238.49 ,$198.74 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,30101471,G0483,HC DRUG SCREEN DEFINITIVE 22+ CLASSES,301,1 ,$515.00 ,$257.50 ,$172.18 ,$555.57 ,$332.69 ,$172.18 ,$515.00 ,$515.00 ,$246.92 ,$309.00 ,$437.75 ,$360.50 ,$172.18 ,$489.25 ,$370.80 ,$375.95 ,$419.76 ,$437.75 ,$246.92 ,$419.76 ,$412.00 ,$375.95 ,$172.18 ,$246.92 ,$272.65 ,$515.00 ,$437.75 ,$555.57 ,$473.80 ,$360.50 ,$515.00 ,$515.00 ,$313.64 ,$515.00 ,$355.87 ,$360.50 ,$249.39 ,$370.80 ,$182.51 ,$296.30 ,$296.30 ,$246.92 ,$296.30 ,$246.92 ,$370.80 ,$319.30 ,$370.80 ,$370.80 ,$309.00 ST VINCENT HOSPITAL - ACUTE,30101501,84999,HC OSMOLALITY FECAL,301,1 ,$115.00 ,$57.50 ,$3.23 ,$115.00 ,$74.29 ,$3.23 ,$74.39 ,$74.39 , N/A ,$69.00 ,$97.75 ,$80.50 ,$3.23 ,$109.25 ,$82.80 ,$83.95 , N/A ,$97.75 , N/A , N/A ,$92.00 ,$83.95 ,$3.23 , N/A ,$48.30 ,$115.00 ,$97.75 ,$69.00 ,$105.80 ,$80.50 ,$57.50 ,$69.00 ,$70.04 ,$57.50 ,$79.47 ,$80.50 , N/A ,$82.80 ,$3.42 ,$57.50 ,$57.50 , N/A ,$57.50 , N/A ,$82.80 ,$71.30 ,$82.80 ,$82.80 ,$69.00 ST VINCENT HOSPITAL - ACUTE,30101502,83520,HC IMMUNOASSAY QN MYELIN ASSOC GLYCOPROTEIN,301,1 ,$138.00 ,$69.00 ,$17.27 ,$138.00 ,$89.15 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$82.80 ,$117.30 ,$96.60 ,$17.85 ,$131.10 ,$99.36 ,$100.74 ,$29.36 ,$117.30 ,$17.27 ,$29.36 ,$110.40 ,$100.74 ,$17.85 ,$17.27 ,$19.07 ,$138.00 ,$117.30 ,$38.86 ,$126.96 ,$96.60 ,$61.99 ,$66.58 ,$84.04 ,$61.99 ,$95.36 ,$96.60 ,$17.44 ,$99.36 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$99.36 ,$85.56 ,$99.36 ,$99.36 ,$82.80 ST VINCENT HOSPITAL - ACUTE,30101504,80285,HC VORICONAZOLE,301,1 ,$140.00 ,$70.00 ,$21.69 ,$140.00 ,$90.44 ,$21.69 ,$94.89 ,$81.33 ,$27.11 ,$84.00 ,$119.00 ,$98.00 ,$21.69 ,$133.00 ,$100.80 ,$102.20 ,$46.09 ,$119.00 ,$27.11 ,$46.09 ,$112.00 ,$102.20 ,$21.69 ,$27.11 ,$29.93 ,$140.00 ,$119.00 ,$61.00 ,$128.80 ,$98.00 ,$95.16 ,$102.20 ,$85.26 ,$95.16 ,$96.74 ,$98.00 ,$27.38 ,$100.80 ,$22.99 ,$32.53 ,$32.53 ,$27.11 ,$32.53 ,$27.11 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30101506,G0483,HC DRUG SCREEN DEFINITIVE TOXICOLOGY URINE,301,1 ,"$1,000.00 ",$500.00 ,$172.18 ,"$1,000.00 ",$646.00 ,$172.18 ,$864.22 ,$740.76 ,$246.92 ,$600.00 ,$850.00 ,$700.00 ,$172.18 ,$950.00 ,$720.00 ,$730.00 ,$419.76 ,$850.00 ,$246.92 ,$419.76 ,$800.00 ,$730.00 ,$172.18 ,$246.92 ,$272.65 ,"$1,000.00 ",$850.00 ,$555.57 ,$920.00 ,$700.00 ,$755.46 ,$811.42 ,$609.00 ,$755.46 ,$691.00 ,$700.00 ,$249.39 ,$720.00 ,$182.51 ,$296.30 ,$296.30 ,$246.92 ,$296.30 ,$246.92 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,30101507,80307,HC DRUG SCREEN MONITOR 1 FLUID ORAL,301,1 ,$370.00 ,$185.00 ,$62.14 ,$370.00 ,$239.02 ,$63.40 ,$226.28 ,$193.95 ,$62.14 ,$222.00 ,$314.50 ,$259.00 ,$63.40 ,$351.50 ,$266.40 ,$270.10 ,$105.64 ,$314.50 ,$62.14 ,$105.64 ,$296.00 ,$270.10 ,$63.40 ,$62.14 ,$68.62 ,$370.00 ,$314.50 ,$139.82 ,$340.40 ,$259.00 ,$226.92 ,$243.73 ,$225.33 ,$226.92 ,$255.67 ,$259.00 ,$62.76 ,$266.40 ,$67.20 ,$74.57 ,$74.57 ,$62.14 ,$74.57 ,$62.14 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,30101508,G0480,HC TRICYCLIC QN URINE,301,1 ,$99.00 ,$49.50 ,$49.50 ,$222.75 ,$63.95 ,$63.95 ,$99.00 ,$99.00 ,$99.00 ,$59.40 ,$84.15 ,$69.30 ,$63.95 ,$94.05 ,$71.28 ,$72.27 ,$99.00 ,$84.15 ,$99.00 ,$99.00 ,$79.20 ,$72.27 ,$63.95 ,$99.00 ,$99.00 ,$99.00 ,$84.15 ,$222.75 ,$91.08 ,$69.30 ,$99.00 ,$99.00 ,$60.29 ,$99.00 ,$68.41 ,$69.30 ,$99.99 ,$71.28 ,$67.79 ,$99.00 ,$99.00 ,$99.00 ,$99.00 ,$99.00 ,$71.28 ,$61.38 ,$71.28 ,$71.28 ,$59.40 ST VINCENT HOSPITAL - ACUTE,30101519,83520,HC POLYMERASE III RNA ANTIBODY,301,1 ,$88.00 ,$44.00 ,$17.27 ,$88.00 ,$56.85 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$52.80 ,$74.80 ,$61.60 ,$17.85 ,$83.60 ,$63.36 ,$64.24 ,$29.36 ,$74.80 ,$17.27 ,$29.36 ,$70.40 ,$64.24 ,$17.85 ,$17.27 ,$19.07 ,$88.00 ,$74.80 ,$38.86 ,$80.96 ,$61.60 ,$61.99 ,$66.58 ,$53.59 ,$61.99 ,$60.81 ,$61.60 ,$17.44 ,$63.36 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$63.36 ,$54.56 ,$63.36 ,$63.36 ,$52.80 ST VINCENT HOSPITAL - ACUTE,30101523,84181,HC NEURONAL NUCLEAR AB/WB,301,1 ,$176.00 ,$88.00 ,$17.03 ,$176.00 ,$113.70 ,$17.60 ,$66.22 ,$56.76 ,$17.03 ,$105.60 ,$149.60 ,$123.20 ,$17.60 ,$167.20 ,$126.72 ,$128.48 ,$28.95 ,$149.60 ,$17.03 ,$28.95 ,$140.80 ,$128.48 ,$17.60 ,$17.03 ,$18.80 ,$176.00 ,$149.60 ,$38.32 ,$161.92 ,$123.20 ,$81.57 ,$87.61 ,$107.18 ,$81.57 ,$121.62 ,$123.20 ,$17.20 ,$126.72 ,$18.66 ,$20.44 ,$20.44 ,$17.03 ,$20.44 ,$17.03 ,$126.72 ,$109.12 ,$126.72 ,$126.72 ,$105.60 ST VINCENT HOSPITAL - ACUTE,30101528,82657,HC ENZYME ACT NONRAD SUBS DISACCHARIDASE,301,1 ,$240.00 ,$120.00 ,$22.17 ,$240.00 ,$155.04 ,$22.91 ,$77.60 ,$66.51 ,$22.17 ,$144.00 ,$204.00 ,$168.00 ,$22.91 ,$228.00 ,$172.80 ,$175.20 ,$37.69 ,$204.00 ,$22.17 ,$37.69 ,$192.00 ,$175.20 ,$22.91 ,$22.17 ,$24.48 ,$240.00 ,$204.00 ,$49.88 ,$220.80 ,$168.00 ,$86.45 ,$92.86 ,$146.16 ,$86.45 ,$165.84 ,$168.00 ,$22.39 ,$172.80 ,$24.28 ,$26.60 ,$26.60 ,$22.17 ,$26.60 ,$22.17 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30101594,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$75.00 ,$37.50 ,$6.04 ,$75.00 ,$48.45 ,$6.24 ,$23.49 ,$20.13 ,$6.04 ,$45.00 ,$63.75 ,$52.50 ,$6.24 ,$71.25 ,$54.00 ,$54.75 ,$10.27 ,$63.75 ,$6.04 ,$10.27 ,$60.00 ,$54.75 ,$6.24 ,$6.04 ,$6.67 ,$75.00 ,$63.75 ,$13.59 ,$69.00 ,$52.50 ,$28.89 ,$31.03 ,$45.68 ,$28.89 ,$51.83 ,$52.50 ,$6.10 ,$54.00 ,$6.61 ,$7.25 ,$7.25 ,$6.04 ,$7.25 ,$6.04 ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,30101595,83690,HC LIPASE,301,1 ,$160.00 ,$80.00 ,$6.89 ,$160.00 ,$103.36 ,$7.12 ,$26.78 ,$22.95 ,$6.89 ,$96.00 ,$136.00 ,$112.00 ,$7.12 ,$152.00 ,$115.20 ,$116.80 ,$11.71 ,$136.00 ,$6.89 ,$11.71 ,$128.00 ,$116.80 ,$7.12 ,$6.89 ,$7.61 ,$160.00 ,$136.00 ,$15.50 ,$147.20 ,$112.00 ,$32.99 ,$35.44 ,$97.44 ,$32.99 ,$110.56 ,$112.00 ,$6.96 ,$115.20 ,$7.55 ,$8.27 ,$8.27 ,$6.89 ,$8.27 ,$6.89 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30101654,82642,HC DIHYDROTESTOSTERONE,301,1 ,$160.00 ,$80.00 ,$29.28 ,$160.00 ,$103.36 ,$30.26 ,$113.86 ,$97.59 ,$29.28 ,$96.00 ,$136.00 ,$112.00 ,$30.26 ,$152.00 ,$115.20 ,$116.80 ,$49.78 ,$136.00 ,$29.28 ,$49.78 ,$128.00 ,$116.80 ,$30.26 ,$29.28 ,$32.33 ,$160.00 ,$136.00 ,$65.88 ,$147.20 ,$112.00 ,$125.24 ,$134.51 ,$97.44 ,$125.24 ,$110.56 ,$112.00 ,$29.57 ,$115.20 ,$32.08 ,$35.14 ,$35.14 ,$29.28 ,$35.14 ,$29.28 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30101666,84252,HC VITAMIN B-2 (RIBOFLAVIN),301,1 ,$134.00 ,$67.00 ,$20.24 ,$134.00 ,$86.56 ,$20.91 ,$78.72 ,$67.47 ,$20.24 ,$80.40 ,$113.90 ,$93.80 ,$20.91 ,$127.30 ,$96.48 ,$97.82 ,$34.41 ,$113.90 ,$20.24 ,$34.41 ,$107.20 ,$97.82 ,$20.91 ,$20.24 ,$22.35 ,$134.00 ,$113.90 ,$45.54 ,$123.28 ,$93.80 ,$96.91 ,$104.09 ,$81.61 ,$96.91 ,$92.59 ,$93.80 ,$20.44 ,$96.48 ,$22.16 ,$24.29 ,$24.29 ,$20.24 ,$24.29 ,$20.24 ,$96.48 ,$83.08 ,$96.48 ,$96.48 ,$80.40 ST VINCENT HOSPITAL - ACUTE,30101672,84591,HC VITAMIN OTHER,301,1 ,$122.00 ,$61.00 ,$16.32 ,$122.00 ,$78.81 ,$16.32 ,$59.71 ,$51.18 ,$17.06 ,$73.20 ,$103.70 ,$85.40 ,$16.32 ,$115.90 ,$87.84 ,$89.06 ,$29.00 ,$103.70 ,$17.06 ,$29.00 ,$97.60 ,$89.06 ,$16.32 ,$17.06 ,$18.84 ,$122.00 ,$103.70 ,$38.39 ,$112.24 ,$85.40 ,$55.56 ,$59.68 ,$74.30 ,$55.56 ,$84.30 ,$85.40 ,$17.23 ,$87.84 ,$17.30 ,$20.47 ,$20.47 ,$17.06 ,$20.47 ,$17.06 ,$87.84 ,$75.64 ,$87.84 ,$87.84 ,$73.20 ST VINCENT HOSPITAL - ACUTE,30101680,83520,HC IMMUNOASSAY PROTEIN QN CSF (PRION),301,1 ,$744.00 ,$372.00 ,$17.27 ,$744.00 ,$480.62 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$446.40 ,$632.40 ,$520.80 ,$17.85 ,$706.80 ,$535.68 ,$543.12 ,$29.36 ,$632.40 ,$17.27 ,$29.36 ,$595.20 ,$543.12 ,$17.85 ,$17.27 ,$19.07 ,$744.00 ,$632.40 ,$38.86 ,$684.48 ,$520.80 ,$61.99 ,$66.58 ,$453.10 ,$61.99 ,$514.10 ,$520.80 ,$17.44 ,$535.68 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$535.68 ,$461.28 ,$535.68 ,$535.68 ,$446.40 ST VINCENT HOSPITAL - ACUTE,30101683,83519,HC IMMUNOASSAY QN CHANNEL/NEURONAL AB,301,1 ,$188.00 ,$94.00 ,$18.40 ,$188.00 ,$121.45 ,$19.00 ,$64.40 ,$55.20 ,$18.40 ,$112.80 ,$159.80 ,$131.60 ,$19.00 ,$178.60 ,$135.36 ,$137.24 ,$31.28 ,$159.80 ,$18.40 ,$31.28 ,$150.40 ,$137.24 ,$19.00 ,$18.40 ,$20.32 ,$188.00 ,$159.80 ,$41.40 ,$172.96 ,$131.60 ,$64.69 ,$69.48 ,$114.49 ,$64.69 ,$129.91 ,$131.60 ,$18.58 ,$135.36 ,$20.14 ,$22.08 ,$22.08 ,$18.40 ,$22.08 ,$18.40 ,$135.36 ,$116.56 ,$135.36 ,$135.36 ,$112.80 ST VINCENT HOSPITAL - ACUTE,30101684,83520,HC IMMUNOASSAY QN STRIATIONAL AB,301,1 ,$151.00 ,$75.50 ,$17.27 ,$151.00 ,$97.55 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$90.60 ,$128.35 ,$105.70 ,$17.85 ,$143.45 ,$108.72 ,$110.23 ,$29.36 ,$128.35 ,$17.27 ,$29.36 ,$120.80 ,$110.23 ,$17.85 ,$17.27 ,$19.07 ,$151.00 ,$128.35 ,$38.86 ,$138.92 ,$105.70 ,$61.99 ,$66.58 ,$91.96 ,$61.99 ,$104.34 ,$105.70 ,$17.44 ,$108.72 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$108.72 ,$93.62 ,$108.72 ,$108.72 ,$90.60 ST VINCENT HOSPITAL - ACUTE,30101707,82542,"HC IODINE, SERUM/PLASMA",301,1 ,$179.00 ,$89.50 ,$24.09 ,$179.00 ,$115.63 ,$24.89 ,$84.32 ,$72.27 ,$24.09 ,$107.40 ,$152.15 ,$125.30 ,$24.89 ,$170.05 ,$128.88 ,$130.67 ,$40.95 ,$152.15 ,$24.09 ,$40.95 ,$143.20 ,$130.67 ,$24.89 ,$24.09 ,$26.60 ,$179.00 ,$152.15 ,$54.20 ,$164.68 ,$125.30 ,$86.45 ,$92.86 ,$109.01 ,$86.45 ,$123.69 ,$125.30 ,$24.33 ,$128.88 ,$26.38 ,$28.91 ,$28.91 ,$24.09 ,$28.91 ,$24.09 ,$128.88 ,$110.98 ,$128.88 ,$128.88 ,$107.40 ST VINCENT HOSPITAL - ACUTE,30101708,G0480,HC ALCOHOL METAB WITH CONFIRM,301,1 ,$219.00 ,$109.50 ,$63.95 ,$257.47 ,$141.47 ,$63.95 ,$219.00 ,$219.00 ,$114.43 ,$131.40 ,$186.15 ,$153.30 ,$63.95 ,$208.05 ,$157.68 ,$159.87 ,$194.53 ,$186.15 ,$114.43 ,$194.53 ,$175.20 ,$159.87 ,$63.95 ,$114.43 ,$126.35 ,$219.00 ,$186.15 ,$257.47 ,$201.48 ,$153.30 ,$219.00 ,$219.00 ,$133.37 ,$219.00 ,$151.33 ,$153.30 ,$115.57 ,$157.68 ,$67.79 ,$137.32 ,$137.32 ,$114.43 ,$137.32 ,$114.43 ,$157.68 ,$135.78 ,$157.68 ,$157.68 ,$131.40 ST VINCENT HOSPITAL - ACUTE,30101721,83520,HC TSH RECEPTOR BINDING AB,301,1 ,$151.00 ,$75.50 ,$17.27 ,$151.00 ,$97.55 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$90.60 ,$128.35 ,$105.70 ,$17.85 ,$143.45 ,$108.72 ,$110.23 ,$29.36 ,$128.35 ,$17.27 ,$29.36 ,$120.80 ,$110.23 ,$17.85 ,$17.27 ,$19.07 ,$151.00 ,$128.35 ,$38.86 ,$138.92 ,$105.70 ,$61.99 ,$66.58 ,$91.96 ,$61.99 ,$104.34 ,$105.70 ,$17.44 ,$108.72 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$108.72 ,$93.62 ,$108.72 ,$108.72 ,$90.60 ST VINCENT HOSPITAL - ACUTE,30180175,82105,HC ALPHA FETOPROTEIN SERUM GBO,301,1 ,$110.00 ,$55.00 ,$16.77 ,$110.00 ,$71.06 ,$17.33 ,$65.24 ,$55.92 ,$16.77 ,$66.00 ,$93.50 ,$77.00 ,$17.33 ,$104.50 ,$79.20 ,$80.30 ,$28.51 ,$93.50 ,$16.77 ,$28.51 ,$88.00 ,$80.30 ,$17.33 ,$16.77 ,$18.52 ,$110.00 ,$93.50 ,$37.73 ,$101.20 ,$77.00 ,$80.34 ,$86.30 ,$66.99 ,$80.34 ,$76.01 ,$77.00 ,$16.94 ,$79.20 ,$18.37 ,$20.12 ,$20.12 ,$16.77 ,$20.12 ,$16.77 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30180208,82274,HC OCCULT BLOOD FECAL HGB GBO,301,1 ,$110.00 ,$55.00 ,$15.92 ,$110.00 ,$71.06 ,$16.45 ,$61.85 ,$53.01 ,$15.92 ,$66.00 ,$93.50 ,$77.00 ,$16.45 ,$104.50 ,$79.20 ,$80.30 ,$27.06 ,$93.50 ,$15.92 ,$27.06 ,$88.00 ,$80.30 ,$16.45 ,$15.92 ,$17.58 ,$110.00 ,$93.50 ,$35.82 ,$101.20 ,$77.00 ,$76.17 ,$81.81 ,$66.99 ,$76.17 ,$76.01 ,$77.00 ,$16.08 ,$79.20 ,$17.44 ,$19.10 ,$19.10 ,$15.92 ,$19.10 ,$15.92 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30180226,82378,HC CARBINOEMBRYONIC AG (CEA) GBO,301,1 ,$130.00 ,$65.00 ,$18.96 ,$130.00 ,$83.98 ,$19.59 ,$73.75 ,$63.21 ,$18.96 ,$78.00 ,$110.50 ,$91.00 ,$19.59 ,$123.50 ,$93.60 ,$94.90 ,$32.23 ,$110.50 ,$18.96 ,$32.23 ,$104.00 ,$94.90 ,$19.59 ,$18.96 ,$20.94 ,$130.00 ,$110.50 ,$42.66 ,$119.60 ,$91.00 ,$90.84 ,$97.57 ,$79.17 ,$90.84 ,$89.83 ,$91.00 ,$19.15 ,$93.60 ,$20.77 ,$22.75 ,$22.75 ,$18.96 ,$22.75 ,$18.96 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30180269,82607,HC VITAMIN B12 GBO,301,1 ,$100.00 ,$50.00 ,$15.08 ,$100.00 ,$64.60 ,$15.58 ,$58.63 ,$50.25 ,$15.08 ,$60.00 ,$85.00 ,$70.00 ,$15.58 ,$95.00 ,$72.00 ,$73.00 ,$25.64 ,$85.00 ,$15.08 ,$25.64 ,$80.00 ,$73.00 ,$15.58 ,$15.08 ,$16.65 ,$100.00 ,$85.00 ,$33.93 ,$92.00 ,$70.00 ,$72.17 ,$77.51 ,$60.90 ,$72.17 ,$69.10 ,$70.00 ,$15.23 ,$72.00 ,$16.51 ,$18.10 ,$18.10 ,$15.08 ,$18.10 ,$15.08 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30180290,82728,HC FERRITIN GBO,301,1 ,$90.00 ,$45.00 ,$13.63 ,$90.00 ,$58.14 ,$14.08 ,$53.03 ,$45.45 ,$13.63 ,$54.00 ,$76.50 ,$63.00 ,$14.08 ,$85.50 ,$64.80 ,$65.70 ,$23.17 ,$76.50 ,$13.63 ,$23.17 ,$72.00 ,$65.70 ,$14.08 ,$13.63 ,$15.05 ,$90.00 ,$76.50 ,$30.67 ,$82.80 ,$63.00 ,$65.25 ,$70.08 ,$54.81 ,$65.25 ,$62.19 ,$63.00 ,$13.77 ,$64.80 ,$14.92 ,$16.36 ,$16.36 ,$13.63 ,$16.36 ,$13.63 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30180802,84702,HC HCG QN GBO,301,1 ,$100.00 ,$50.00 ,$15.05 ,$100.00 ,$64.60 ,$15.55 ,$58.56 ,$50.19 ,$15.05 ,$60.00 ,$85.00 ,$70.00 ,$15.55 ,$95.00 ,$72.00 ,$73.00 ,$25.59 ,$85.00 ,$15.05 ,$25.59 ,$80.00 ,$73.00 ,$15.55 ,$15.05 ,$16.62 ,$100.00 ,$85.00 ,$33.86 ,$92.00 ,$70.00 ,$72.10 ,$77.44 ,$60.90 ,$72.10 ,$69.10 ,$70.00 ,$15.20 ,$72.00 ,$16.48 ,$18.06 ,$18.06 ,$15.05 ,$18.06 ,$15.05 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30180845,82948,HC GLUCOSE BLOOD REAGENT STRIP GBO,301,1 ,$15.00 ,$7.50 ,$4.45 ,$15.00 ,$9.69 ,$4.45 ,$15.00 ,$15.00 ,$5.04 ,$9.00 ,$12.75 ,$10.50 ,$4.45 ,$14.25 ,$10.80 ,$10.95 ,$8.57 ,$12.75 ,$5.04 ,$8.57 ,$12.00 ,$10.95 ,$4.45 ,$5.04 ,$5.57 ,$15.00 ,$12.75 ,$11.34 ,$13.80 ,$10.50 ,$15.00 ,$15.00 ,$9.14 ,$15.00 ,$10.37 ,$10.50 ,$5.09 ,$10.80 ,$4.72 ,$6.05 ,$6.05 ,$5.04 ,$6.05 ,$5.04 ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,30182005,83520,HC INTERLEUKIN 6 (IL-6),301,1 ,$151.00 ,$75.50 ,$17.27 ,$151.00 ,$97.55 ,$17.85 ,$60.45 ,$51.81 ,$17.27 ,$90.60 ,$128.35 ,$105.70 ,$17.85 ,$143.45 ,$108.72 ,$110.23 ,$29.36 ,$128.35 ,$17.27 ,$29.36 ,$120.80 ,$110.23 ,$17.85 ,$17.27 ,$19.07 ,$151.00 ,$128.35 ,$38.86 ,$138.92 ,$105.70 ,$61.99 ,$66.58 ,$91.96 ,$61.99 ,$104.34 ,$105.70 ,$17.44 ,$108.72 ,$18.92 ,$20.72 ,$20.72 ,$17.27 ,$20.72 ,$17.27 ,$108.72 ,$93.62 ,$108.72 ,$108.72 ,$90.60 ST VINCENT HOSPITAL - ACUTE,30200101,86003,HC ALLERGEN IGE QN EA (LATEX/IGE),302,1 ,$22.00 ,$11.00 ,$4.57 ,$22.00 ,$14.21 ,$4.57 ,$20.30 ,$17.40 ,$5.22 ,$13.20 ,$18.70 ,$15.40 ,$4.57 ,$20.90 ,$15.84 ,$16.06 ,$8.87 ,$18.70 ,$5.22 ,$8.87 ,$17.60 ,$16.06 ,$4.57 ,$5.22 ,$5.76 ,$22.00 ,$18.70 ,$11.75 ,$20.24 ,$15.40 ,$15.55 ,$16.70 ,$13.40 ,$15.55 ,$15.20 ,$15.40 ,$5.27 ,$15.84 ,$4.84 ,$6.26 ,$6.26 ,$5.22 ,$6.26 ,$5.22 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30200102,86003,HC ALLERGEN IGE QN EA,302,1 ,$22.00 ,$11.00 ,$4.57 ,$22.00 ,$14.21 ,$4.57 ,$20.30 ,$17.40 ,$5.22 ,$13.20 ,$18.70 ,$15.40 ,$4.57 ,$20.90 ,$15.84 ,$16.06 ,$8.87 ,$18.70 ,$5.22 ,$8.87 ,$17.60 ,$16.06 ,$4.57 ,$5.22 ,$5.76 ,$22.00 ,$18.70 ,$11.75 ,$20.24 ,$15.40 ,$15.55 ,$16.70 ,$13.40 ,$15.55 ,$15.20 ,$15.40 ,$5.27 ,$15.84 ,$4.84 ,$6.26 ,$6.26 ,$5.22 ,$6.26 ,$5.22 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30200103,86021,HC LEUKO AB ID,302,1 ,$110.00 ,$55.00 ,$15.05 ,$110.00 ,$71.06 ,$15.55 ,$58.56 ,$50.19 ,$15.05 ,$66.00 ,$93.50 ,$77.00 ,$15.55 ,$104.50 ,$79.20 ,$80.30 ,$25.59 ,$93.50 ,$15.05 ,$25.59 ,$88.00 ,$80.30 ,$15.55 ,$15.05 ,$16.62 ,$110.00 ,$93.50 ,$33.86 ,$101.20 ,$77.00 ,$72.10 ,$77.44 ,$66.99 ,$72.10 ,$76.01 ,$77.00 ,$15.20 ,$79.20 ,$16.48 ,$18.06 ,$18.06 ,$15.05 ,$18.06 ,$15.05 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30200105,86021,HC LEUKO AB ID (ANCA),302,1 ,$70.00 ,$35.00 ,$15.05 ,$70.00 ,$45.22 ,$15.55 ,$58.56 ,$50.19 ,$15.05 ,$42.00 ,$59.50 ,$49.00 ,$15.55 ,$66.50 ,$50.40 ,$51.10 ,$25.59 ,$59.50 ,$15.05 ,$25.59 ,$56.00 ,$51.10 ,$15.55 ,$15.05 ,$16.62 ,$70.00 ,$59.50 ,$33.86 ,$64.40 ,$49.00 ,$70.00 ,$70.00 ,$42.63 ,$70.00 ,$48.37 ,$49.00 ,$15.20 ,$50.40 ,$16.48 ,$18.06 ,$18.06 ,$15.05 ,$18.06 ,$15.05 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200106,86021,HC LEUKO AB ID (MYELO),302,1 ,$90.00 ,$45.00 ,$15.05 ,$90.00 ,$58.14 ,$15.55 ,$58.56 ,$50.19 ,$15.05 ,$54.00 ,$76.50 ,$63.00 ,$15.55 ,$85.50 ,$64.80 ,$65.70 ,$25.59 ,$76.50 ,$15.05 ,$25.59 ,$72.00 ,$65.70 ,$15.55 ,$15.05 ,$16.62 ,$90.00 ,$76.50 ,$33.86 ,$82.80 ,$63.00 ,$72.10 ,$77.44 ,$54.81 ,$72.10 ,$62.19 ,$63.00 ,$15.20 ,$64.80 ,$16.48 ,$18.06 ,$18.06 ,$15.05 ,$18.06 ,$15.05 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200107,86021,HC LEUKO AB ID (PROTEIN),302,1 ,$90.00 ,$45.00 ,$15.05 ,$90.00 ,$58.14 ,$15.55 ,$58.56 ,$50.19 ,$15.05 ,$54.00 ,$76.50 ,$63.00 ,$15.55 ,$85.50 ,$64.80 ,$65.70 ,$25.59 ,$76.50 ,$15.05 ,$25.59 ,$72.00 ,$65.70 ,$15.55 ,$15.05 ,$16.62 ,$90.00 ,$76.50 ,$33.86 ,$82.80 ,$63.00 ,$72.10 ,$77.44 ,$54.81 ,$72.10 ,$62.19 ,$63.00 ,$15.20 ,$64.80 ,$16.48 ,$18.06 ,$18.06 ,$15.05 ,$18.06 ,$15.05 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200108,86022,HC PLATELET AB ID (HIT),302,1 ,$180.00 ,$90.00 ,$18.37 ,$180.00 ,$116.28 ,$18.98 ,$71.44 ,$61.23 ,$18.37 ,$108.00 ,$153.00 ,$126.00 ,$18.98 ,$171.00 ,$129.60 ,$131.40 ,$31.23 ,$153.00 ,$18.37 ,$31.23 ,$144.00 ,$131.40 ,$18.98 ,$18.37 ,$20.28 ,$180.00 ,$153.00 ,$41.33 ,$165.60 ,$126.00 ,$87.96 ,$94.48 ,$109.62 ,$87.96 ,$124.38 ,$126.00 ,$18.55 ,$129.60 ,$20.12 ,$22.04 ,$22.04 ,$18.37 ,$22.04 ,$18.37 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30200109,86022,HC PLATELET AB ID (HEPARIN),302,1 ,$190.00 ,$95.00 ,$18.37 ,$190.00 ,$122.74 ,$18.98 ,$71.44 ,$61.23 ,$18.37 ,$114.00 ,$161.50 ,$133.00 ,$18.98 ,$180.50 ,$136.80 ,$138.70 ,$31.23 ,$161.50 ,$18.37 ,$31.23 ,$152.00 ,$138.70 ,$18.98 ,$18.37 ,$20.28 ,$190.00 ,$161.50 ,$41.33 ,$174.80 ,$133.00 ,$87.96 ,$94.48 ,$115.71 ,$87.96 ,$131.29 ,$133.00 ,$18.55 ,$136.80 ,$20.12 ,$22.04 ,$22.04 ,$18.37 ,$22.04 ,$18.37 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30200111,86022,HC PLATELET AB ID (SEROTONIN),302,1 ,$390.00 ,$195.00 ,$18.37 ,$390.00 ,$251.94 ,$18.98 ,$71.44 ,$61.23 ,$18.37 ,$234.00 ,$331.50 ,$273.00 ,$18.98 ,$370.50 ,$280.80 ,$284.70 ,$31.23 ,$331.50 ,$18.37 ,$31.23 ,$312.00 ,$284.70 ,$18.98 ,$18.37 ,$20.28 ,$390.00 ,$331.50 ,$41.33 ,$358.80 ,$273.00 ,$87.96 ,$94.48 ,$237.51 ,$87.96 ,$269.49 ,$273.00 ,$18.55 ,$280.80 ,$20.12 ,$22.04 ,$22.04 ,$18.37 ,$22.04 ,$18.37 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,30200113,86022,HC PLATELET AB-ID,302,1 ,$180.00 ,$90.00 ,$18.37 ,$180.00 ,$116.28 ,$18.98 ,$71.44 ,$61.23 ,$18.37 ,$108.00 ,$153.00 ,$126.00 ,$18.98 ,$171.00 ,$129.60 ,$131.40 ,$31.23 ,$153.00 ,$18.37 ,$31.23 ,$144.00 ,$131.40 ,$18.98 ,$18.37 ,$20.28 ,$180.00 ,$153.00 ,$41.33 ,$165.60 ,$126.00 ,$87.96 ,$94.48 ,$109.62 ,$87.96 ,$124.38 ,$126.00 ,$18.55 ,$129.60 ,$20.12 ,$22.04 ,$22.04 ,$18.37 ,$22.04 ,$18.37 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30200116,86022,HC PLATELET AB ID (NAT),302,1 ,$52.00 ,$26.00 ,$18.37 ,$52.00 ,$33.59 ,$18.98 ,$52.00 ,$52.00 ,$18.37 ,$31.20 ,$44.20 ,$36.40 ,$18.98 ,$49.40 ,$37.44 ,$37.96 ,$31.23 ,$44.20 ,$18.37 ,$31.23 ,$41.60 ,$37.96 ,$18.98 ,$18.37 ,$20.28 ,$52.00 ,$44.20 ,$41.33 ,$47.84 ,$36.40 ,$52.00 ,$52.00 ,$31.67 ,$52.00 ,$35.93 ,$36.40 ,$18.55 ,$37.44 ,$20.12 ,$22.04 ,$22.04 ,$18.37 ,$22.04 ,$18.37 ,$37.44 ,$32.24 ,$37.44 ,$37.44 ,$31.20 ST VINCENT HOSPITAL - ACUTE,30200117,86022,HC PLATELET AB ID (HIT2),302,1 ,$180.00 ,$90.00 ,$18.37 ,$180.00 ,$116.28 ,$18.98 ,$71.44 ,$61.23 ,$18.37 ,$108.00 ,$153.00 ,$126.00 ,$18.98 ,$171.00 ,$129.60 ,$131.40 ,$31.23 ,$153.00 ,$18.37 ,$31.23 ,$144.00 ,$131.40 ,$18.98 ,$18.37 ,$20.28 ,$180.00 ,$153.00 ,$41.33 ,$165.60 ,$126.00 ,$87.96 ,$94.48 ,$109.62 ,$87.96 ,$124.38 ,$126.00 ,$18.55 ,$129.60 ,$20.12 ,$22.04 ,$22.04 ,$18.37 ,$22.04 ,$18.37 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30200118,86023,HC PLATELET ASSOC AB ID IGG,302,1 ,$90.00 ,$45.00 ,$12.46 ,$90.00 ,$58.14 ,$12.87 ,$48.44 ,$41.52 ,$12.46 ,$54.00 ,$76.50 ,$63.00 ,$12.87 ,$85.50 ,$64.80 ,$65.70 ,$21.18 ,$76.50 ,$12.46 ,$21.18 ,$72.00 ,$65.70 ,$12.87 ,$12.46 ,$13.76 ,$90.00 ,$76.50 ,$28.04 ,$82.80 ,$63.00 ,$59.67 ,$64.09 ,$54.81 ,$59.67 ,$62.19 ,$63.00 ,$12.58 ,$64.80 ,$13.64 ,$14.95 ,$14.95 ,$12.46 ,$14.95 ,$12.46 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200119,86038,HC ANA SCREEN,302,1 ,$70.00 ,$35.00 ,$12.09 ,$70.00 ,$45.22 ,$12.49 ,$47.01 ,$40.29 ,$12.09 ,$42.00 ,$59.50 ,$49.00 ,$12.49 ,$66.50 ,$50.40 ,$51.10 ,$20.55 ,$59.50 ,$12.09 ,$20.55 ,$56.00 ,$51.10 ,$12.49 ,$12.09 ,$13.35 ,$70.00 ,$59.50 ,$27.20 ,$64.40 ,$49.00 ,$49.91 ,$53.61 ,$42.63 ,$49.91 ,$48.37 ,$49.00 ,$12.21 ,$50.40 ,$13.24 ,$14.51 ,$14.51 ,$12.09 ,$14.51 ,$12.09 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200120,86039,HC ANA TITER,302,1 ,$80.00 ,$40.00 ,$11.16 ,$80.00 ,$51.68 ,$11.53 ,$43.40 ,$37.20 ,$11.16 ,$48.00 ,$68.00 ,$56.00 ,$11.53 ,$76.00 ,$57.60 ,$58.40 ,$18.97 ,$68.00 ,$11.16 ,$18.97 ,$64.00 ,$58.40 ,$11.53 ,$11.16 ,$12.32 ,$80.00 ,$68.00 ,$25.11 ,$73.60 ,$56.00 ,$53.46 ,$57.42 ,$48.72 ,$53.46 ,$55.28 ,$56.00 ,$11.27 ,$57.60 ,$12.22 ,$13.39 ,$13.39 ,$11.16 ,$13.39 ,$11.16 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200121,86060,HC ASO,302,1 ,$110.00 ,$55.00 ,$7.30 ,$110.00 ,$71.06 ,$7.54 ,$28.39 ,$24.33 ,$7.30 ,$66.00 ,$93.50 ,$77.00 ,$7.54 ,$104.50 ,$79.20 ,$80.30 ,$12.41 ,$93.50 ,$7.30 ,$12.41 ,$88.00 ,$80.30 ,$7.54 ,$7.30 ,$8.06 ,$110.00 ,$93.50 ,$16.43 ,$101.20 ,$77.00 ,$34.96 ,$37.55 ,$66.99 ,$34.96 ,$76.01 ,$77.00 ,$7.37 ,$79.20 ,$7.99 ,$8.76 ,$8.76 ,$7.30 ,$8.76 ,$7.30 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30200122,86063,HC ASO SCREEN,302,1 ,$94.00 ,$47.00 ,$5.77 ,$94.00 ,$60.72 ,$5.96 ,$22.44 ,$19.23 ,$5.77 ,$56.40 ,$79.90 ,$65.80 ,$5.96 ,$89.30 ,$67.68 ,$68.62 ,$9.81 ,$79.90 ,$5.77 ,$9.81 ,$75.20 ,$68.62 ,$5.96 ,$5.77 ,$6.37 ,$94.00 ,$79.90 ,$12.98 ,$86.48 ,$65.80 ,$27.62 ,$29.67 ,$57.25 ,$27.62 ,$64.95 ,$65.80 ,$5.83 ,$67.68 ,$6.32 ,$6.92 ,$6.92 ,$5.77 ,$6.92 ,$5.77 ,$67.68 ,$58.28 ,$67.68 ,$67.68 ,$56.40 ST VINCENT HOSPITAL - ACUTE,30200123,86140,HC C-REACTIVE PROTEIN,302,1 ,$40.00 ,$20.00 ,$5.18 ,$40.00 ,$25.84 ,$5.35 ,$20.13 ,$17.25 ,$5.18 ,$24.00 ,$34.00 ,$28.00 ,$5.35 ,$38.00 ,$28.80 ,$29.20 ,$8.81 ,$34.00 ,$5.18 ,$8.81 ,$32.00 ,$29.20 ,$5.35 ,$5.18 ,$5.72 ,$40.00 ,$34.00 ,$11.66 ,$36.80 ,$28.00 ,$24.78 ,$26.62 ,$24.36 ,$24.78 ,$27.64 ,$28.00 ,$5.23 ,$28.80 ,$5.67 ,$6.22 ,$6.22 ,$5.18 ,$6.22 ,$5.18 ,$28.80 ,$24.80 ,$28.80 ,$28.80 ,$24.00 ST VINCENT HOSPITAL - ACUTE,30200124,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$150.00 ,$75.00 ,$12.95 ,$150.00 ,$96.90 ,$13.38 ,$50.37 ,$43.17 ,$12.95 ,$90.00 ,$127.50 ,$105.00 ,$13.38 ,$142.50 ,$108.00 ,$109.50 ,$22.02 ,$127.50 ,$12.95 ,$22.02 ,$120.00 ,$109.50 ,$13.38 ,$12.95 ,$14.30 ,$150.00 ,$127.50 ,$29.14 ,$138.00 ,$105.00 ,$61.99 ,$66.58 ,$91.35 ,$61.99 ,$103.65 ,$105.00 ,$13.08 ,$108.00 ,$14.18 ,$15.54 ,$15.54 ,$12.95 ,$15.54 ,$12.95 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30200125,86146,HC BETA 2 GLYCO AB,302,1 ,$70.00 ,$35.00 ,$8.17 ,$70.00 ,$45.22 ,$8.17 ,$70.00 ,$70.00 ,$25.45 ,$42.00 ,$59.50 ,$49.00 ,$8.17 ,$66.50 ,$50.40 ,$51.10 ,$43.27 ,$59.50 ,$25.45 ,$43.27 ,$56.00 ,$51.10 ,$8.17 ,$25.45 ,$28.10 ,$70.00 ,$59.50 ,$57.26 ,$64.40 ,$49.00 ,$27.83 ,$29.90 ,$42.63 ,$27.83 ,$48.37 ,$49.00 ,$25.70 ,$50.40 ,$8.66 ,$30.54 ,$30.54 ,$25.45 ,$30.54 ,$25.45 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200126,86147,HC CARDIOLIPIN AB EA,302,1 ,$60.00 ,$30.00 ,$8.17 ,$60.00 ,$38.76 ,$8.17 ,$60.00 ,$60.00 ,$25.45 ,$36.00 ,$51.00 ,$42.00 ,$8.17 ,$57.00 ,$43.20 ,$43.80 ,$43.27 ,$51.00 ,$25.45 ,$43.27 ,$48.00 ,$43.80 ,$8.17 ,$25.45 ,$28.10 ,$60.00 ,$51.00 ,$57.26 ,$55.20 ,$42.00 ,$27.83 ,$29.90 ,$36.54 ,$27.83 ,$41.46 ,$42.00 ,$25.70 ,$43.20 ,$8.66 ,$30.54 ,$30.54 ,$25.45 ,$30.54 ,$25.45 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200127,86147,HC CARDIOLIPIN AB EA (ANTI),302,1 ,$68.00 ,$34.00 ,$8.17 ,$68.00 ,$43.93 ,$8.17 ,$68.00 ,$68.00 ,$25.45 ,$40.80 ,$57.80 ,$47.60 ,$8.17 ,$64.60 ,$48.96 ,$49.64 ,$43.27 ,$57.80 ,$25.45 ,$43.27 ,$54.40 ,$49.64 ,$8.17 ,$25.45 ,$28.10 ,$68.00 ,$57.80 ,$57.26 ,$62.56 ,$47.60 ,$27.83 ,$29.90 ,$41.41 ,$27.83 ,$46.99 ,$47.60 ,$25.70 ,$48.96 ,$8.66 ,$30.54 ,$30.54 ,$25.45 ,$30.54 ,$25.45 ,$48.96 ,$42.16 ,$48.96 ,$48.96 ,$40.80 ST VINCENT HOSPITAL - ACUTE,30200128,86147,HC CARDIOLIPIN AB EA (PHOSPH),302,1 ,$68.00 ,$34.00 ,$8.17 ,$68.00 ,$43.93 ,$8.17 ,$68.00 ,$68.00 ,$25.45 ,$40.80 ,$57.80 ,$47.60 ,$8.17 ,$64.60 ,$48.96 ,$49.64 ,$43.27 ,$57.80 ,$25.45 ,$43.27 ,$54.40 ,$49.64 ,$8.17 ,$25.45 ,$28.10 ,$68.00 ,$57.80 ,$57.26 ,$62.56 ,$47.60 ,$27.83 ,$29.90 ,$41.41 ,$27.83 ,$46.99 ,$47.60 ,$25.70 ,$48.96 ,$8.66 ,$30.54 ,$30.54 ,$25.45 ,$30.54 ,$25.45 ,$48.96 ,$42.16 ,$48.96 ,$48.96 ,$40.80 ST VINCENT HOSPITAL - ACUTE,30200129,86157,HC COLD AGGLUTININ TITER,302,1 ,$80.00 ,$40.00 ,$8.06 ,$80.00 ,$51.68 ,$8.17 ,$31.36 ,$26.88 ,$8.06 ,$48.00 ,$68.00 ,$56.00 ,$8.17 ,$76.00 ,$57.60 ,$58.40 ,$13.70 ,$68.00 ,$8.06 ,$13.70 ,$64.00 ,$58.40 ,$8.17 ,$8.06 ,$8.90 ,$80.00 ,$68.00 ,$18.14 ,$73.60 ,$56.00 ,$27.83 ,$29.90 ,$48.72 ,$27.83 ,$55.28 ,$56.00 ,$8.14 ,$57.60 ,$8.66 ,$9.67 ,$9.67 ,$8.06 ,$9.67 ,$8.06 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200130,86160,HC COMPLEMENT AG EA (C3),302,1 ,$80.00 ,$40.00 ,$12.00 ,$80.00 ,$51.68 ,$12.40 ,$46.66 ,$39.99 ,$12.00 ,$48.00 ,$68.00 ,$56.00 ,$12.40 ,$76.00 ,$57.60 ,$58.40 ,$20.40 ,$68.00 ,$12.00 ,$20.40 ,$64.00 ,$58.40 ,$12.40 ,$12.00 ,$13.25 ,$80.00 ,$68.00 ,$27.00 ,$73.60 ,$56.00 ,$57.49 ,$61.75 ,$48.72 ,$57.49 ,$55.28 ,$56.00 ,$12.12 ,$57.60 ,$13.14 ,$14.40 ,$14.40 ,$12.00 ,$14.40 ,$12.00 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200131,86160,HC COMPLEMENT AG EA (C4),302,1 ,$80.00 ,$40.00 ,$12.00 ,$80.00 ,$51.68 ,$12.40 ,$46.66 ,$39.99 ,$12.00 ,$48.00 ,$68.00 ,$56.00 ,$12.40 ,$76.00 ,$57.60 ,$58.40 ,$20.40 ,$68.00 ,$12.00 ,$20.40 ,$64.00 ,$58.40 ,$12.40 ,$12.00 ,$13.25 ,$80.00 ,$68.00 ,$27.00 ,$73.60 ,$56.00 ,$57.49 ,$61.75 ,$48.72 ,$57.49 ,$55.28 ,$56.00 ,$12.12 ,$57.60 ,$13.14 ,$14.40 ,$14.40 ,$12.00 ,$14.40 ,$12.00 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200132,86160,HC COMPLEMENT AG EA,302,1 ,$160.00 ,$80.00 ,$12.00 ,$160.00 ,$103.36 ,$12.40 ,$46.66 ,$39.99 ,$12.00 ,$96.00 ,$136.00 ,$112.00 ,$12.40 ,$152.00 ,$115.20 ,$116.80 ,$20.40 ,$136.00 ,$12.00 ,$20.40 ,$128.00 ,$116.80 ,$12.40 ,$12.00 ,$13.25 ,$160.00 ,$136.00 ,$27.00 ,$147.20 ,$112.00 ,$57.49 ,$61.75 ,$97.44 ,$57.49 ,$110.56 ,$112.00 ,$12.12 ,$115.20 ,$13.14 ,$14.40 ,$14.40 ,$12.00 ,$14.40 ,$12.00 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30200133,86161,HC C1 ESTERASE INHIBITOR,302,1 ,$77.00 ,$38.50 ,$12.00 ,$77.00 ,$49.74 ,$12.40 ,$46.66 ,$39.99 ,$12.00 ,$46.20 ,$65.45 ,$53.90 ,$12.40 ,$73.15 ,$55.44 ,$56.21 ,$20.40 ,$65.45 ,$12.00 ,$20.40 ,$61.60 ,$56.21 ,$12.40 ,$12.00 ,$13.25 ,$77.00 ,$65.45 ,$27.00 ,$70.84 ,$53.90 ,$57.49 ,$61.75 ,$46.89 ,$57.49 ,$53.21 ,$53.90 ,$12.12 ,$55.44 ,$13.14 ,$14.40 ,$14.40 ,$12.00 ,$14.40 ,$12.00 ,$55.44 ,$47.74 ,$55.44 ,$55.44 ,$46.20 ST VINCENT HOSPITAL - ACUTE,30200134,86162,HC COMPLEMENT TOTAL,302,1 ,$130.00 ,$65.00 ,$20.32 ,$130.00 ,$83.98 ,$21.00 ,$79.03 ,$67.74 ,$20.32 ,$78.00 ,$110.50 ,$91.00 ,$21.00 ,$123.50 ,$93.60 ,$94.90 ,$34.54 ,$110.50 ,$20.32 ,$34.54 ,$104.00 ,$94.90 ,$21.00 ,$20.32 ,$22.44 ,$130.00 ,$110.50 ,$45.72 ,$119.60 ,$91.00 ,$90.59 ,$97.30 ,$79.17 ,$90.59 ,$89.83 ,$91.00 ,$20.52 ,$93.60 ,$22.26 ,$24.38 ,$24.38 ,$20.32 ,$24.38 ,$20.32 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30200135,86200,HC CCP AB,302,1 ,$90.00 ,$45.00 ,$12.95 ,$90.00 ,$58.14 ,$13.38 ,$50.37 ,$43.17 ,$12.95 ,$54.00 ,$76.50 ,$63.00 ,$13.38 ,$85.50 ,$64.80 ,$65.70 ,$22.02 ,$76.50 ,$12.95 ,$22.02 ,$72.00 ,$65.70 ,$13.38 ,$12.95 ,$14.30 ,$90.00 ,$76.50 ,$29.14 ,$82.80 ,$63.00 ,$61.99 ,$66.58 ,$54.81 ,$61.99 ,$62.19 ,$63.00 ,$13.08 ,$64.80 ,$14.18 ,$15.54 ,$15.54 ,$12.95 ,$15.54 ,$12.95 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200136,86215,HC DEOXYRIBONUCLEASE AB,302,1 ,$70.00 ,$35.00 ,$13.25 ,$70.00 ,$45.22 ,$13.69 ,$51.52 ,$44.16 ,$13.25 ,$42.00 ,$59.50 ,$49.00 ,$13.69 ,$66.50 ,$50.40 ,$51.10 ,$22.53 ,$59.50 ,$13.25 ,$22.53 ,$56.00 ,$51.10 ,$13.69 ,$13.25 ,$14.63 ,$70.00 ,$59.50 ,$29.81 ,$64.40 ,$49.00 ,$60.16 ,$64.62 ,$42.63 ,$60.16 ,$48.37 ,$49.00 ,$13.38 ,$50.40 ,$14.51 ,$15.90 ,$15.90 ,$13.25 ,$15.90 ,$13.25 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200137,86225,HC DNA DOUBLE STRAND AB,302,1 ,$90.00 ,$45.00 ,$13.74 ,$90.00 ,$58.14 ,$14.20 ,$53.45 ,$45.81 ,$13.74 ,$54.00 ,$76.50 ,$63.00 ,$14.20 ,$85.50 ,$64.80 ,$65.70 ,$23.36 ,$76.50 ,$13.74 ,$23.36 ,$72.00 ,$65.70 ,$14.20 ,$13.74 ,$15.17 ,$90.00 ,$76.50 ,$30.92 ,$82.80 ,$63.00 ,$65.78 ,$70.65 ,$54.81 ,$65.78 ,$62.19 ,$63.00 ,$13.88 ,$64.80 ,$15.05 ,$16.49 ,$16.49 ,$13.74 ,$16.49 ,$13.74 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200138,86235,HC ENA AB,302,1 ,$120.00 ,$60.00 ,$17.93 ,$120.00 ,$77.52 ,$18.53 ,$69.76 ,$59.79 ,$17.93 ,$72.00 ,$102.00 ,$84.00 ,$18.53 ,$114.00 ,$86.40 ,$87.60 ,$30.48 ,$102.00 ,$17.93 ,$30.48 ,$96.00 ,$87.60 ,$18.53 ,$17.93 ,$19.80 ,$120.00 ,$102.00 ,$40.34 ,$110.40 ,$84.00 ,$85.85 ,$92.21 ,$73.08 ,$85.85 ,$82.92 ,$84.00 ,$18.11 ,$86.40 ,$19.64 ,$21.52 ,$21.52 ,$17.93 ,$21.52 ,$17.93 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30200139,86235,HC ENA AB (SCL70),302,1 ,$120.00 ,$60.00 ,$17.93 ,$120.00 ,$77.52 ,$18.53 ,$69.76 ,$59.79 ,$17.93 ,$72.00 ,$102.00 ,$84.00 ,$18.53 ,$114.00 ,$86.40 ,$87.60 ,$30.48 ,$102.00 ,$17.93 ,$30.48 ,$96.00 ,$87.60 ,$18.53 ,$17.93 ,$19.80 ,$120.00 ,$102.00 ,$40.34 ,$110.40 ,$84.00 ,$85.85 ,$92.21 ,$73.08 ,$85.85 ,$82.92 ,$84.00 ,$18.11 ,$86.40 ,$19.64 ,$21.52 ,$21.52 ,$17.93 ,$21.52 ,$17.93 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30200140,86235,HC ENA AB (JO1),302,1 ,$120.00 ,$60.00 ,$17.93 ,$120.00 ,$77.52 ,$18.53 ,$69.76 ,$59.79 ,$17.93 ,$72.00 ,$102.00 ,$84.00 ,$18.53 ,$114.00 ,$86.40 ,$87.60 ,$30.48 ,$102.00 ,$17.93 ,$30.48 ,$96.00 ,$87.60 ,$18.53 ,$17.93 ,$19.80 ,$120.00 ,$102.00 ,$40.34 ,$110.40 ,$84.00 ,$85.85 ,$92.21 ,$73.08 ,$85.85 ,$82.92 ,$84.00 ,$18.11 ,$86.40 ,$19.64 ,$21.52 ,$21.52 ,$17.93 ,$21.52 ,$17.93 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30200141,86235,HC ENA AB (SSA/SSB),302,1 ,$120.00 ,$60.00 ,$17.93 ,$120.00 ,$77.52 ,$18.53 ,$69.76 ,$59.79 ,$17.93 ,$72.00 ,$102.00 ,$84.00 ,$18.53 ,$114.00 ,$86.40 ,$87.60 ,$30.48 ,$102.00 ,$17.93 ,$30.48 ,$96.00 ,$87.60 ,$18.53 ,$17.93 ,$19.80 ,$120.00 ,$102.00 ,$40.34 ,$110.40 ,$84.00 ,$85.85 ,$92.21 ,$73.08 ,$85.85 ,$82.92 ,$84.00 ,$18.11 ,$86.40 ,$19.64 ,$21.52 ,$21.52 ,$17.93 ,$21.52 ,$17.93 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30200142,86255,HC FLUOR AB SCR (MITOCHONDRIAL),302,1 ,$50.00 ,$25.00 ,$12.05 ,$50.00 ,$32.30 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$30.00 ,$42.50 ,$35.00 ,$12.45 ,$47.50 ,$36.00 ,$36.50 ,$20.49 ,$42.50 ,$12.05 ,$20.49 ,$40.00 ,$36.50 ,$12.45 ,$12.05 ,$13.31 ,$50.00 ,$42.50 ,$27.11 ,$46.00 ,$35.00 ,$50.00 ,$50.00 ,$30.45 ,$50.00 ,$34.55 ,$35.00 ,$12.17 ,$36.00 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30200143,86255,HC FLUOR AB SCR (MUSCLE),302,1 ,$37.00 ,$18.50 ,$12.05 ,$37.00 ,$23.90 ,$12.45 ,$37.00 ,$37.00 ,$12.05 ,$22.20 ,$31.45 ,$25.90 ,$12.45 ,$35.15 ,$26.64 ,$27.01 ,$20.49 ,$31.45 ,$12.05 ,$20.49 ,$29.60 ,$27.01 ,$12.45 ,$12.05 ,$13.31 ,$37.00 ,$31.45 ,$27.11 ,$34.04 ,$25.90 ,$37.00 ,$37.00 ,$22.53 ,$37.00 ,$25.57 ,$25.90 ,$12.17 ,$26.64 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$26.64 ,$22.94 ,$26.64 ,$26.64 ,$22.20 ST VINCENT HOSPITAL - ACUTE,30200144,86255,HC FLUOR AB SCR (RETICULIN),302,1 ,$116.00 ,$58.00 ,$12.05 ,$116.00 ,$74.94 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$69.60 ,$98.60 ,$81.20 ,$12.45 ,$110.20 ,$83.52 ,$84.68 ,$20.49 ,$98.60 ,$12.05 ,$20.49 ,$92.80 ,$84.68 ,$12.45 ,$12.05 ,$13.31 ,$116.00 ,$98.60 ,$27.11 ,$106.72 ,$81.20 ,$57.70 ,$61.98 ,$70.64 ,$57.70 ,$80.16 ,$81.20 ,$12.17 ,$83.52 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$83.52 ,$71.92 ,$83.52 ,$83.52 ,$69.60 ST VINCENT HOSPITAL - ACUTE,30200145,86255,HC FLUOR AB SCR (MAYO),302,1 ,$149.00 ,$74.50 ,$12.05 ,$149.00 ,$96.25 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$89.40 ,$126.65 ,$104.30 ,$12.45 ,$141.55 ,$107.28 ,$108.77 ,$20.49 ,$126.65 ,$12.05 ,$20.49 ,$119.20 ,$108.77 ,$12.45 ,$12.05 ,$13.31 ,$149.00 ,$126.65 ,$27.11 ,$137.08 ,$104.30 ,$57.70 ,$61.98 ,$90.74 ,$57.70 ,$102.96 ,$104.30 ,$12.17 ,$107.28 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$107.28 ,$92.38 ,$107.28 ,$107.28 ,$89.40 ST VINCENT HOSPITAL - ACUTE,30200146,86255,HC FLUOR AB SCR (ENDOMYSIAL),302,1 ,$100.00 ,$50.00 ,$12.05 ,$100.00 ,$64.60 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$60.00 ,$85.00 ,$70.00 ,$12.45 ,$95.00 ,$72.00 ,$73.00 ,$20.49 ,$85.00 ,$12.05 ,$20.49 ,$80.00 ,$73.00 ,$12.45 ,$12.05 ,$13.31 ,$100.00 ,$85.00 ,$27.11 ,$92.00 ,$70.00 ,$57.70 ,$61.98 ,$60.90 ,$57.70 ,$69.10 ,$70.00 ,$12.17 ,$72.00 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200147,86255,HC FLUOR AB SCR (HU AB IFA),302,1 ,$140.00 ,$70.00 ,$12.05 ,$140.00 ,$90.44 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$84.00 ,$119.00 ,$98.00 ,$12.45 ,$133.00 ,$100.80 ,$102.20 ,$20.49 ,$119.00 ,$12.05 ,$20.49 ,$112.00 ,$102.20 ,$12.45 ,$12.05 ,$13.31 ,$140.00 ,$119.00 ,$27.11 ,$128.80 ,$98.00 ,$57.70 ,$61.98 ,$85.26 ,$57.70 ,$96.74 ,$98.00 ,$12.17 ,$100.80 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200148,86255,HC FLUOR AB SCR (PURKINJE),302,1 ,$140.00 ,$70.00 ,$12.05 ,$140.00 ,$90.44 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$84.00 ,$119.00 ,$98.00 ,$12.45 ,$133.00 ,$100.80 ,$102.20 ,$20.49 ,$119.00 ,$12.05 ,$20.49 ,$112.00 ,$102.20 ,$12.45 ,$12.05 ,$13.31 ,$140.00 ,$119.00 ,$27.11 ,$128.80 ,$98.00 ,$57.70 ,$61.98 ,$85.26 ,$57.70 ,$96.74 ,$98.00 ,$12.17 ,$100.80 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200149,86225,HC YO AB IFA,302,1 ,$90.00 ,$45.00 ,$13.74 ,$90.00 ,$58.14 ,$14.20 ,$53.45 ,$45.81 ,$13.74 ,$54.00 ,$76.50 ,$63.00 ,$14.20 ,$85.50 ,$64.80 ,$65.70 ,$23.36 ,$76.50 ,$13.74 ,$23.36 ,$72.00 ,$65.70 ,$14.20 ,$13.74 ,$15.17 ,$90.00 ,$76.50 ,$30.92 ,$82.80 ,$63.00 ,$65.78 ,$70.65 ,$54.81 ,$65.78 ,$62.19 ,$63.00 ,$13.88 ,$64.80 ,$15.05 ,$16.49 ,$16.49 ,$13.74 ,$16.49 ,$13.74 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200150,86256,HC FLUOR AB TITER (C ANCA),302,1 ,$80.00 ,$40.00 ,$12.05 ,$80.00 ,$51.68 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$48.00 ,$68.00 ,$56.00 ,$12.45 ,$76.00 ,$57.60 ,$58.40 ,$20.49 ,$68.00 ,$12.05 ,$20.49 ,$64.00 ,$58.40 ,$12.45 ,$12.05 ,$13.31 ,$80.00 ,$68.00 ,$27.11 ,$73.60 ,$56.00 ,$57.70 ,$61.98 ,$48.72 ,$57.70 ,$55.28 ,$56.00 ,$12.17 ,$57.60 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200151,86256,HC FLUOR AB TITER (P ANCA),302,1 ,$80.00 ,$40.00 ,$12.05 ,$80.00 ,$51.68 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$48.00 ,$68.00 ,$56.00 ,$12.45 ,$76.00 ,$57.60 ,$58.40 ,$20.49 ,$68.00 ,$12.05 ,$20.49 ,$64.00 ,$58.40 ,$12.45 ,$12.05 ,$13.31 ,$80.00 ,$68.00 ,$27.11 ,$73.60 ,$56.00 ,$57.70 ,$61.98 ,$48.72 ,$57.70 ,$55.28 ,$56.00 ,$12.17 ,$57.60 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200152,86256,HC FLUOR AB TITER (CAT SCRATCH),302,1 ,$58.00 ,$29.00 ,$12.05 ,$58.00 ,$37.47 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$34.80 ,$49.30 ,$40.60 ,$12.45 ,$55.10 ,$41.76 ,$42.34 ,$20.49 ,$49.30 ,$12.05 ,$20.49 ,$46.40 ,$42.34 ,$12.45 ,$12.05 ,$13.31 ,$58.00 ,$49.30 ,$27.11 ,$53.36 ,$40.60 ,$57.70 ,$58.00 ,$35.32 ,$57.70 ,$40.08 ,$40.60 ,$12.17 ,$41.76 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$41.76 ,$35.96 ,$41.76 ,$41.76 ,$34.80 ST VINCENT HOSPITAL - ACUTE,30200153,86256,HC FLUOR AB TITER (MITOCHONDRIAL),302,1 ,$82.00 ,$41.00 ,$12.05 ,$82.00 ,$52.97 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$49.20 ,$69.70 ,$57.40 ,$12.45 ,$77.90 ,$59.04 ,$59.86 ,$20.49 ,$69.70 ,$12.05 ,$20.49 ,$65.60 ,$59.86 ,$12.45 ,$12.05 ,$13.31 ,$82.00 ,$69.70 ,$27.11 ,$75.44 ,$57.40 ,$57.70 ,$61.98 ,$49.94 ,$57.70 ,$56.66 ,$57.40 ,$12.17 ,$59.04 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$59.04 ,$50.84 ,$59.04 ,$59.04 ,$49.20 ST VINCENT HOSPITAL - ACUTE,30200154,86256,HC FLUOR AB TITER (ENDOMYSIAL),302,1 ,$300.00 ,$150.00 ,$12.05 ,$300.00 ,$193.80 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$180.00 ,$255.00 ,$210.00 ,$12.45 ,$285.00 ,$216.00 ,$219.00 ,$20.49 ,$255.00 ,$12.05 ,$20.49 ,$240.00 ,$219.00 ,$12.45 ,$12.05 ,$13.31 ,$300.00 ,$255.00 ,$27.11 ,$276.00 ,$210.00 ,$57.70 ,$61.98 ,$182.70 ,$57.70 ,$207.30 ,$210.00 ,$12.17 ,$216.00 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,30200155,86256,HC FLUOR AB TITER (RETICULAN),302,1 ,$54.00 ,$27.00 ,$12.05 ,$54.00 ,$34.88 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$32.40 ,$45.90 ,$37.80 ,$12.45 ,$51.30 ,$38.88 ,$39.42 ,$20.49 ,$45.90 ,$12.05 ,$20.49 ,$43.20 ,$39.42 ,$12.45 ,$12.05 ,$13.31 ,$54.00 ,$45.90 ,$27.11 ,$49.68 ,$37.80 ,$54.00 ,$54.00 ,$32.89 ,$54.00 ,$37.31 ,$37.80 ,$12.17 ,$38.88 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$38.88 ,$33.48 ,$38.88 ,$38.88 ,$32.40 ST VINCENT HOSPITAL - ACUTE,30200156,86256,HC FLUOR AB TITER (MUSCLE),302,1 ,$92.00 ,$46.00 ,$12.05 ,$92.00 ,$59.43 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$55.20 ,$78.20 ,$64.40 ,$12.45 ,$87.40 ,$66.24 ,$67.16 ,$20.49 ,$78.20 ,$12.05 ,$20.49 ,$73.60 ,$67.16 ,$12.45 ,$12.05 ,$13.31 ,$92.00 ,$78.20 ,$27.11 ,$84.64 ,$64.40 ,$57.70 ,$61.98 ,$56.03 ,$57.70 ,$63.57 ,$64.40 ,$12.17 ,$66.24 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$66.24 ,$57.04 ,$66.24 ,$66.24 ,$55.20 ST VINCENT HOSPITAL - ACUTE,30200157,82677,HC ESTRIOL SERUM,302,1 ,$102.00 ,$51.00 ,$24.18 ,$102.00 ,$65.89 ,$24.99 ,$94.05 ,$80.61 ,$24.18 ,$61.20 ,$86.70 ,$71.40 ,$24.99 ,$96.90 ,$73.44 ,$74.46 ,$41.11 ,$86.70 ,$24.18 ,$41.11 ,$81.60 ,$74.46 ,$24.99 ,$24.18 ,$26.70 ,$102.00 ,$86.70 ,$54.41 ,$93.84 ,$71.40 ,$102.00 ,$102.00 ,$62.12 ,$102.00 ,$70.48 ,$71.40 ,$24.42 ,$73.44 ,$26.49 ,$29.02 ,$29.02 ,$24.18 ,$29.02 ,$24.18 ,$73.44 ,$63.24 ,$73.44 ,$73.44 ,$61.20 ST VINCENT HOSPITAL - ACUTE,30200158,86300,HC TUMOR AG CA 15-3 (27.29),302,1 ,$140.00 ,$70.00 ,$20.81 ,$140.00 ,$90.44 ,$21.50 ,$80.96 ,$69.39 ,$20.81 ,$84.00 ,$119.00 ,$98.00 ,$21.50 ,$133.00 ,$100.80 ,$102.20 ,$35.38 ,$119.00 ,$20.81 ,$35.38 ,$112.00 ,$102.20 ,$21.50 ,$20.81 ,$22.98 ,$140.00 ,$119.00 ,$46.82 ,$128.80 ,$98.00 ,$99.65 ,$107.03 ,$85.26 ,$99.65 ,$96.74 ,$98.00 ,$21.02 ,$100.80 ,$22.79 ,$24.97 ,$24.97 ,$20.81 ,$24.97 ,$20.81 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200159,86300,HC TUMOR AG CA 15-3 (27.29) 2,302,1 ,$117.00 ,$58.50 ,$20.81 ,$117.00 ,$75.58 ,$21.50 ,$80.96 ,$69.39 ,$20.81 ,$70.20 ,$99.45 ,$81.90 ,$21.50 ,$111.15 ,$84.24 ,$85.41 ,$35.38 ,$99.45 ,$20.81 ,$35.38 ,$93.60 ,$85.41 ,$21.50 ,$20.81 ,$22.98 ,$117.00 ,$99.45 ,$46.82 ,$107.64 ,$81.90 ,$99.65 ,$107.03 ,$71.25 ,$99.65 ,$80.85 ,$81.90 ,$21.02 ,$84.24 ,$22.79 ,$24.97 ,$24.97 ,$20.81 ,$24.97 ,$20.81 ,$84.24 ,$72.54 ,$84.24 ,$84.24 ,$70.20 ST VINCENT HOSPITAL - ACUTE,30200160,86301,HC TUMOR AG CA 19-9,302,1 ,$140.00 ,$70.00 ,$20.81 ,$140.00 ,$90.44 ,$21.50 ,$80.96 ,$69.39 ,$20.81 ,$84.00 ,$119.00 ,$98.00 ,$21.50 ,$133.00 ,$100.80 ,$102.20 ,$35.38 ,$119.00 ,$20.81 ,$35.38 ,$112.00 ,$102.20 ,$21.50 ,$20.81 ,$22.98 ,$140.00 ,$119.00 ,$46.82 ,$128.80 ,$98.00 ,$99.65 ,$107.03 ,$85.26 ,$99.65 ,$96.74 ,$98.00 ,$21.02 ,$100.80 ,$22.79 ,$24.97 ,$24.97 ,$20.81 ,$24.97 ,$20.81 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200161,86301,HC TUMOR AG CA 19-9 BODY FLUID,302,1 ,$140.00 ,$70.00 ,$20.81 ,$140.00 ,$90.44 ,$21.50 ,$80.96 ,$69.39 ,$20.81 ,$84.00 ,$119.00 ,$98.00 ,$21.50 ,$133.00 ,$100.80 ,$102.20 ,$35.38 ,$119.00 ,$20.81 ,$35.38 ,$112.00 ,$102.20 ,$21.50 ,$20.81 ,$22.98 ,$140.00 ,$119.00 ,$46.82 ,$128.80 ,$98.00 ,$99.65 ,$107.03 ,$85.26 ,$99.65 ,$96.74 ,$98.00 ,$21.02 ,$100.80 ,$22.79 ,$24.97 ,$24.97 ,$20.81 ,$24.97 ,$20.81 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200162,86304,HC TUMOR AG CA 125,302,1 ,$140.00 ,$70.00 ,$20.81 ,$140.00 ,$90.44 ,$21.50 ,$80.96 ,$69.39 ,$20.81 ,$84.00 ,$119.00 ,$98.00 ,$21.50 ,$133.00 ,$100.80 ,$102.20 ,$35.38 ,$119.00 ,$20.81 ,$35.38 ,$112.00 ,$102.20 ,$21.50 ,$20.81 ,$22.98 ,$140.00 ,$119.00 ,$46.82 ,$128.80 ,$98.00 ,$99.65 ,$107.03 ,$85.26 ,$99.65 ,$96.74 ,$98.00 ,$21.02 ,$100.80 ,$22.79 ,$24.97 ,$24.97 ,$20.81 ,$24.97 ,$20.81 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200163,86308,HC HETEROPHILE SCR MONO,302,1 ,$70.00 ,$35.00 ,$5.18 ,$70.00 ,$45.22 ,$5.35 ,$20.13 ,$17.25 ,$5.18 ,$42.00 ,$59.50 ,$49.00 ,$5.35 ,$66.50 ,$50.40 ,$51.10 ,$8.81 ,$59.50 ,$5.18 ,$8.81 ,$56.00 ,$51.10 ,$5.35 ,$5.18 ,$5.72 ,$70.00 ,$59.50 ,$11.66 ,$64.40 ,$49.00 ,$24.78 ,$26.62 ,$42.63 ,$24.78 ,$48.37 ,$49.00 ,$5.23 ,$50.40 ,$5.67 ,$6.22 ,$6.22 ,$5.18 ,$6.22 ,$5.18 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200164,86316,HC TUMOR AG OTHER AG QN,302,1 ,$150.00 ,$75.00 ,$20.81 ,$150.00 ,$96.90 ,$21.50 ,$80.96 ,$69.39 ,$20.81 ,$90.00 ,$127.50 ,$105.00 ,$21.50 ,$142.50 ,$108.00 ,$109.50 ,$35.38 ,$127.50 ,$20.81 ,$35.38 ,$120.00 ,$109.50 ,$21.50 ,$20.81 ,$22.98 ,$150.00 ,$127.50 ,$46.82 ,$138.00 ,$105.00 ,$99.65 ,$107.03 ,$91.35 ,$99.65 ,$103.65 ,$105.00 ,$21.02 ,$108.00 ,$22.79 ,$24.97 ,$24.97 ,$20.81 ,$24.97 ,$20.81 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30200165,86317,HC INFECTIOUS AB QN,302,1 ,$100.00 ,$50.00 ,$14.99 ,$100.00 ,$64.60 ,$15.49 ,$58.28 ,$49.95 ,$14.99 ,$60.00 ,$85.00 ,$70.00 ,$15.49 ,$95.00 ,$72.00 ,$73.00 ,$25.48 ,$85.00 ,$14.99 ,$25.48 ,$80.00 ,$73.00 ,$15.49 ,$14.99 ,$16.55 ,$100.00 ,$85.00 ,$33.73 ,$92.00 ,$70.00 ,$71.78 ,$77.10 ,$60.90 ,$71.78 ,$69.10 ,$70.00 ,$15.14 ,$72.00 ,$16.42 ,$17.99 ,$17.99 ,$14.99 ,$17.99 ,$14.99 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200166,86318,HC INFECTIOUS AB QL,302,1 ,$120.00 ,$60.00 ,$18.09 ,$120.00 ,$77.52 ,$18.21 ,$63.32 ,$54.27 ,$18.09 ,$72.00 ,$102.00 ,$84.00 ,$18.21 ,$114.00 ,$86.40 ,$87.60 ,$30.75 ,$102.00 ,$18.09 ,$30.75 ,$96.00 ,$87.60 ,$18.21 ,$18.09 ,$19.98 ,$120.00 ,$102.00 ,$40.70 ,$110.40 ,$84.00 ,$61.99 ,$66.58 ,$73.08 ,$61.99 ,$82.92 ,$84.00 ,$18.27 ,$86.40 ,$19.30 ,$21.71 ,$21.71 ,$18.09 ,$21.71 ,$18.09 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30200167,86331,HC IMMUNODIFF EL EA AG AB QL,302,1 ,$43.00 ,$21.50 ,$11.98 ,$43.00 ,$27.78 ,$12.38 ,$43.00 ,$39.93 ,$11.98 ,$25.80 ,$36.55 ,$30.10 ,$12.38 ,$40.85 ,$30.96 ,$31.39 ,$20.37 ,$36.55 ,$11.98 ,$20.37 ,$34.40 ,$31.39 ,$12.38 ,$11.98 ,$13.23 ,$43.00 ,$36.55 ,$26.96 ,$39.56 ,$30.10 ,$43.00 ,$43.00 ,$26.19 ,$43.00 ,$29.71 ,$30.10 ,$12.10 ,$30.96 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$30.96 ,$26.66 ,$30.96 ,$30.96 ,$25.80 ST VINCENT HOSPITAL - ACUTE,30200168,86331,HC IMMUNODIFF EL EA AG AB QL (TEICH),302,1 ,$43.00 ,$21.50 ,$11.98 ,$43.00 ,$27.78 ,$12.38 ,$43.00 ,$39.93 ,$11.98 ,$25.80 ,$36.55 ,$30.10 ,$12.38 ,$40.85 ,$30.96 ,$31.39 ,$20.37 ,$36.55 ,$11.98 ,$20.37 ,$34.40 ,$31.39 ,$12.38 ,$11.98 ,$13.23 ,$43.00 ,$36.55 ,$26.96 ,$39.56 ,$30.10 ,$43.00 ,$43.00 ,$26.19 ,$43.00 ,$29.71 ,$30.10 ,$12.10 ,$30.96 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$30.96 ,$26.66 ,$30.96 ,$30.96 ,$25.80 ST VINCENT HOSPITAL - ACUTE,30200169,86334,HC IMMUNOFIX ELECTRO SERUM,302,1 ,$150.00 ,$75.00 ,$22.34 ,$150.00 ,$96.90 ,$23.08 ,$86.91 ,$74.49 ,$22.34 ,$90.00 ,$127.50 ,$105.00 ,$23.08 ,$142.50 ,$108.00 ,$109.50 ,$37.98 ,$127.50 ,$22.34 ,$37.98 ,$120.00 ,$109.50 ,$23.08 ,$22.34 ,$24.67 ,$150.00 ,$127.50 ,$50.27 ,$138.00 ,$105.00 ,$106.98 ,$114.91 ,$91.35 ,$106.98 ,$103.65 ,$105.00 ,$22.56 ,$108.00 ,$24.46 ,$26.81 ,$26.81 ,$22.34 ,$26.81 ,$22.34 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30200170,86334,HC IMMUNOFIX ELECTRO REFLEX,302,1 ,$210.00 ,$105.00 ,$22.34 ,$210.00 ,$135.66 ,$23.08 ,$86.91 ,$74.49 ,$22.34 ,$126.00 ,$178.50 ,$147.00 ,$23.08 ,$199.50 ,$151.20 ,$153.30 ,$37.98 ,$178.50 ,$22.34 ,$37.98 ,$168.00 ,$153.30 ,$23.08 ,$22.34 ,$24.67 ,$210.00 ,$178.50 ,$50.27 ,$193.20 ,$147.00 ,$106.98 ,$114.91 ,$127.89 ,$106.98 ,$145.11 ,$147.00 ,$22.56 ,$151.20 ,$24.46 ,$26.81 ,$26.81 ,$22.34 ,$26.81 ,$22.34 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,30200171,86335,HC IMMUNOFIX ELECTRO OTH,302,1 ,$200.00 ,$100.00 ,$29.35 ,$200.00 ,$129.20 ,$30.33 ,$114.14 ,$97.83 ,$29.35 ,$120.00 ,$170.00 ,$140.00 ,$30.33 ,$190.00 ,$144.00 ,$146.00 ,$49.90 ,$170.00 ,$29.35 ,$49.90 ,$160.00 ,$146.00 ,$30.33 ,$29.35 ,$32.41 ,$200.00 ,$170.00 ,$66.04 ,$184.00 ,$140.00 ,$140.54 ,$150.95 ,$121.80 ,$140.54 ,$138.20 ,$140.00 ,$29.64 ,$144.00 ,$32.15 ,$35.22 ,$35.22 ,$29.35 ,$35.22 ,$29.35 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30200172,86335,HC IMMUNOFIX ELECTRO OTH (TRANS),302,1 ,$200.00 ,$100.00 ,$29.35 ,$200.00 ,$129.20 ,$30.33 ,$114.14 ,$97.83 ,$29.35 ,$120.00 ,$170.00 ,$140.00 ,$30.33 ,$190.00 ,$144.00 ,$146.00 ,$49.90 ,$170.00 ,$29.35 ,$49.90 ,$160.00 ,$146.00 ,$30.33 ,$29.35 ,$32.41 ,$200.00 ,$170.00 ,$66.04 ,$184.00 ,$140.00 ,$140.54 ,$150.95 ,$121.80 ,$140.54 ,$138.20 ,$140.00 ,$29.64 ,$144.00 ,$32.15 ,$35.22 ,$35.22 ,$29.35 ,$35.22 ,$29.35 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30200173,86336,HC INHIBIN A,302,1 ,$110.00 ,$55.00 ,$15.59 ,$110.00 ,$71.06 ,$16.11 ,$60.62 ,$51.96 ,$15.59 ,$66.00 ,$93.50 ,$77.00 ,$16.11 ,$104.50 ,$79.20 ,$80.30 ,$26.50 ,$93.50 ,$15.59 ,$26.50 ,$88.00 ,$80.30 ,$16.11 ,$15.59 ,$17.21 ,$110.00 ,$93.50 ,$35.08 ,$101.20 ,$77.00 ,$74.62 ,$80.15 ,$66.99 ,$74.62 ,$76.01 ,$77.00 ,$15.75 ,$79.20 ,$17.08 ,$18.71 ,$18.71 ,$15.59 ,$18.71 ,$15.59 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30200174,86336,HC INHIBIN A (QUAD),302,1 ,$157.00 ,$78.50 ,$15.59 ,$157.00 ,$101.42 ,$16.11 ,$60.62 ,$51.96 ,$15.59 ,$94.20 ,$133.45 ,$109.90 ,$16.11 ,$149.15 ,$113.04 ,$114.61 ,$26.50 ,$133.45 ,$15.59 ,$26.50 ,$125.60 ,$114.61 ,$16.11 ,$15.59 ,$17.21 ,$157.00 ,$133.45 ,$35.08 ,$144.44 ,$109.90 ,$74.62 ,$80.15 ,$95.61 ,$74.62 ,$108.49 ,$109.90 ,$15.75 ,$113.04 ,$17.08 ,$18.71 ,$18.71 ,$15.59 ,$18.71 ,$15.59 ,$113.04 ,$97.34 ,$113.04 ,$113.04 ,$94.20 ST VINCENT HOSPITAL - ACUTE,30200175,86337,HC INSULIN AB (HS),302,1 ,$228.00 ,$114.00 ,$21.41 ,$228.00 ,$147.29 ,$22.12 ,$83.27 ,$71.37 ,$21.41 ,$136.80 ,$193.80 ,$159.60 ,$22.12 ,$216.60 ,$164.16 ,$166.44 ,$36.40 ,$193.80 ,$21.41 ,$36.40 ,$182.40 ,$166.44 ,$22.12 ,$21.41 ,$23.64 ,$228.00 ,$193.80 ,$48.17 ,$209.76 ,$159.60 ,$102.53 ,$110.12 ,$138.85 ,$102.53 ,$157.55 ,$159.60 ,$21.62 ,$164.16 ,$23.45 ,$25.69 ,$25.69 ,$21.41 ,$25.69 ,$21.41 ,$164.16 ,$141.36 ,$164.16 ,$164.16 ,$136.80 ST VINCENT HOSPITAL - ACUTE,30200176,86337,HC INSULIN AB,302,1 ,$210.00 ,$105.00 ,$21.41 ,$210.00 ,$135.66 ,$22.12 ,$83.27 ,$71.37 ,$21.41 ,$126.00 ,$178.50 ,$147.00 ,$22.12 ,$199.50 ,$151.20 ,$153.30 ,$36.40 ,$178.50 ,$21.41 ,$36.40 ,$168.00 ,$153.30 ,$22.12 ,$21.41 ,$23.64 ,$210.00 ,$178.50 ,$48.17 ,$193.20 ,$147.00 ,$102.53 ,$110.12 ,$127.89 ,$102.53 ,$145.11 ,$147.00 ,$21.62 ,$151.20 ,$23.45 ,$25.69 ,$25.69 ,$21.41 ,$25.69 ,$21.41 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,30200177,86340,HC INTRINSIC FACTOR AB,302,1 ,$100.00 ,$50.00 ,$14.28 ,$100.00 ,$64.60 ,$14.28 ,$58.63 ,$50.25 ,$15.08 ,$60.00 ,$85.00 ,$70.00 ,$14.28 ,$95.00 ,$72.00 ,$73.00 ,$25.64 ,$85.00 ,$15.08 ,$25.64 ,$80.00 ,$73.00 ,$14.28 ,$15.08 ,$16.65 ,$100.00 ,$85.00 ,$33.93 ,$92.00 ,$70.00 ,$48.61 ,$52.21 ,$60.90 ,$48.61 ,$69.10 ,$70.00 ,$15.23 ,$72.00 ,$15.14 ,$18.10 ,$18.10 ,$15.08 ,$18.10 ,$15.08 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200178,86341,HC ISLET CELL AB,302,1 ,$90.00 ,$45.00 ,$19.88 ,$90.00 ,$58.14 ,$19.88 ,$82.50 ,$70.71 ,$23.57 ,$54.00 ,$76.50 ,$63.00 ,$19.88 ,$85.50 ,$64.80 ,$65.70 ,$40.07 ,$76.50 ,$23.57 ,$40.07 ,$72.00 ,$65.70 ,$19.88 ,$23.57 ,$26.03 ,$90.00 ,$76.50 ,$53.03 ,$82.80 ,$63.00 ,$67.71 ,$72.72 ,$54.81 ,$67.71 ,$62.19 ,$63.00 ,$23.81 ,$64.80 ,$21.07 ,$28.28 ,$28.28 ,$23.57 ,$28.28 ,$23.57 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200179,86355,HC B CELLS TOTAL COUNT (CD19),302,1 ,$225.00 ,$112.50 ,$37.73 ,$225.00 ,$145.35 ,$38.99 ,$146.72 ,$125.76 ,$37.73 ,$135.00 ,$191.25 ,$157.50 ,$38.99 ,$213.75 ,$162.00 ,$164.25 ,$64.14 ,$191.25 ,$37.73 ,$64.14 ,$180.00 ,$164.25 ,$38.99 ,$37.73 ,$41.66 ,$225.00 ,$191.25 ,$84.89 ,$207.00 ,$157.50 ,$180.62 ,$194.00 ,$137.03 ,$180.62 ,$155.48 ,$157.50 ,$38.11 ,$162.00 ,$41.33 ,$45.28 ,$45.28 ,$37.73 ,$45.28 ,$37.73 ,$162.00 ,$139.50 ,$162.00 ,$162.00 ,$135.00 ST VINCENT HOSPITAL - ACUTE,30200180,86355,HC B CELLS TOTAL COUNT (CD20),302,1 ,$225.00 ,$112.50 ,$37.73 ,$225.00 ,$145.35 ,$38.99 ,$146.72 ,$125.76 ,$37.73 ,$135.00 ,$191.25 ,$157.50 ,$38.99 ,$213.75 ,$162.00 ,$164.25 ,$64.14 ,$191.25 ,$37.73 ,$64.14 ,$180.00 ,$164.25 ,$38.99 ,$37.73 ,$41.66 ,$225.00 ,$191.25 ,$84.89 ,$207.00 ,$157.50 ,$180.62 ,$194.00 ,$137.03 ,$180.62 ,$155.48 ,$157.50 ,$38.11 ,$162.00 ,$41.33 ,$45.28 ,$45.28 ,$37.73 ,$45.28 ,$37.73 ,$162.00 ,$139.50 ,$162.00 ,$162.00 ,$135.00 ST VINCENT HOSPITAL - ACUTE,30200181,86355,HC B CELLS TOTAL COUNT,302,1 ,$260.00 ,$130.00 ,$37.73 ,$260.00 ,$167.96 ,$38.99 ,$146.72 ,$125.76 ,$37.73 ,$156.00 ,$221.00 ,$182.00 ,$38.99 ,$247.00 ,$187.20 ,$189.80 ,$64.14 ,$221.00 ,$37.73 ,$64.14 ,$208.00 ,$189.80 ,$38.99 ,$37.73 ,$41.66 ,$260.00 ,$221.00 ,$84.89 ,$239.20 ,$182.00 ,$180.62 ,$194.00 ,$158.34 ,$180.62 ,$179.66 ,$182.00 ,$38.11 ,$187.20 ,$41.33 ,$45.28 ,$45.28 ,$37.73 ,$45.28 ,$37.73 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30200182,86357,HC CD8 TOTAL COUNT,302,1 ,$260.00 ,$130.00 ,$37.73 ,$260.00 ,$167.96 ,$38.99 ,$146.72 ,$125.76 ,$37.73 ,$156.00 ,$221.00 ,$182.00 ,$38.99 ,$247.00 ,$187.20 ,$189.80 ,$64.14 ,$221.00 ,$37.73 ,$64.14 ,$208.00 ,$189.80 ,$38.99 ,$37.73 ,$41.66 ,$260.00 ,$221.00 ,$84.89 ,$239.20 ,$182.00 ,$180.62 ,$194.00 ,$158.34 ,$180.62 ,$179.66 ,$182.00 ,$38.11 ,$187.20 ,$41.33 ,$45.28 ,$45.28 ,$37.73 ,$45.28 ,$37.73 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30200184,86360,HC ABS T CELLS CD4 CD8 RATIO,302,1 ,$320.00 ,$160.00 ,$46.98 ,$320.00 ,$206.72 ,$48.54 ,$182.70 ,$156.60 ,$46.98 ,$192.00 ,$272.00 ,$224.00 ,$48.54 ,$304.00 ,$230.40 ,$233.60 ,$79.87 ,$272.00 ,$46.98 ,$79.87 ,$256.00 ,$233.60 ,$48.54 ,$46.98 ,$51.88 ,$320.00 ,$272.00 ,$105.71 ,$294.40 ,$224.00 ,$224.99 ,$241.66 ,$194.88 ,$224.99 ,$221.12 ,$224.00 ,$47.45 ,$230.40 ,$51.45 ,$56.38 ,$56.38 ,$46.98 ,$56.38 ,$46.98 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,30200185,86360,HC ABS T CELLS CD4 CD8 RATIO (MARKER),302,1 ,$320.00 ,$160.00 ,$46.98 ,$320.00 ,$206.72 ,$48.54 ,$182.70 ,$156.60 ,$46.98 ,$192.00 ,$272.00 ,$224.00 ,$48.54 ,$304.00 ,$230.40 ,$233.60 ,$79.87 ,$272.00 ,$46.98 ,$79.87 ,$256.00 ,$233.60 ,$48.54 ,$46.98 ,$51.88 ,$320.00 ,$272.00 ,$105.71 ,$294.40 ,$224.00 ,$224.99 ,$241.66 ,$194.88 ,$224.99 ,$221.12 ,$224.00 ,$47.45 ,$230.40 ,$51.45 ,$56.38 ,$56.38 ,$46.98 ,$56.38 ,$46.98 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,30200186,86360,HC ABS T CELLS CD4 CD8 RATIO (CD3),302,1 ,$320.00 ,$160.00 ,$46.98 ,$320.00 ,$206.72 ,$48.54 ,$182.70 ,$156.60 ,$46.98 ,$192.00 ,$272.00 ,$224.00 ,$48.54 ,$304.00 ,$230.40 ,$233.60 ,$79.87 ,$272.00 ,$46.98 ,$79.87 ,$256.00 ,$233.60 ,$48.54 ,$46.98 ,$51.88 ,$320.00 ,$272.00 ,$105.71 ,$294.40 ,$224.00 ,$224.99 ,$241.66 ,$194.88 ,$224.99 ,$221.12 ,$224.00 ,$47.45 ,$230.40 ,$51.45 ,$56.38 ,$56.38 ,$46.98 ,$56.38 ,$46.98 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,30200187,86361,HC T CELLS CD4 COUNT,302,1 ,$175.00 ,$87.50 ,$26.78 ,$175.00 ,$113.05 ,$27.67 ,$104.13 ,$89.25 ,$26.78 ,$105.00 ,$148.75 ,$122.50 ,$27.67 ,$166.25 ,$126.00 ,$127.75 ,$45.53 ,$148.75 ,$26.78 ,$45.53 ,$140.00 ,$127.75 ,$27.67 ,$26.78 ,$29.57 ,$175.00 ,$148.75 ,$60.26 ,$161.00 ,$122.50 ,$128.22 ,$137.72 ,$106.58 ,$128.22 ,$120.93 ,$122.50 ,$27.05 ,$126.00 ,$29.33 ,$32.14 ,$32.14 ,$26.78 ,$32.14 ,$26.78 ,$126.00 ,$108.50 ,$126.00 ,$126.00 ,$105.00 ST VINCENT HOSPITAL - ACUTE,30200188,86376,HC MICROSOMAL AB (TPO),302,1 ,$100.00 ,$50.00 ,$14.55 ,$100.00 ,$64.60 ,$15.03 ,$56.60 ,$48.51 ,$14.55 ,$60.00 ,$85.00 ,$70.00 ,$15.03 ,$95.00 ,$72.00 ,$73.00 ,$24.74 ,$85.00 ,$14.55 ,$24.74 ,$80.00 ,$73.00 ,$15.03 ,$14.55 ,$16.07 ,$100.00 ,$85.00 ,$32.74 ,$92.00 ,$70.00 ,$69.67 ,$74.83 ,$60.90 ,$69.67 ,$69.10 ,$70.00 ,$14.70 ,$72.00 ,$15.93 ,$17.46 ,$17.46 ,$14.55 ,$17.46 ,$14.55 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200189,86376,HC MICROSOMAL AB,302,1 ,$100.00 ,$50.00 ,$14.55 ,$100.00 ,$64.60 ,$15.03 ,$56.60 ,$48.51 ,$14.55 ,$60.00 ,$85.00 ,$70.00 ,$15.03 ,$95.00 ,$72.00 ,$73.00 ,$24.74 ,$85.00 ,$14.55 ,$24.74 ,$80.00 ,$73.00 ,$15.03 ,$14.55 ,$16.07 ,$100.00 ,$85.00 ,$32.74 ,$92.00 ,$70.00 ,$69.67 ,$74.83 ,$60.90 ,$69.67 ,$69.10 ,$70.00 ,$14.70 ,$72.00 ,$15.93 ,$17.46 ,$17.46 ,$14.55 ,$17.46 ,$14.55 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200190,86376,HC MICROSOMAL AB (LIV/KID),302,1 ,$100.00 ,$50.00 ,$14.55 ,$100.00 ,$64.60 ,$15.03 ,$56.60 ,$48.51 ,$14.55 ,$60.00 ,$85.00 ,$70.00 ,$15.03 ,$95.00 ,$72.00 ,$73.00 ,$24.74 ,$85.00 ,$14.55 ,$24.74 ,$80.00 ,$73.00 ,$15.03 ,$14.55 ,$16.07 ,$100.00 ,$85.00 ,$32.74 ,$92.00 ,$70.00 ,$69.67 ,$74.83 ,$60.90 ,$69.67 ,$69.10 ,$70.00 ,$14.70 ,$72.00 ,$15.93 ,$17.46 ,$17.46 ,$14.55 ,$17.46 ,$14.55 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200191,86403,HC PARTICLE AGG SCREEN,302,1 ,$92.00 ,$46.00 ,$11.54 ,$92.00 ,$59.43 ,$11.92 ,$40.39 ,$34.62 ,$11.54 ,$55.20 ,$78.20 ,$64.40 ,$11.92 ,$87.40 ,$66.24 ,$67.16 ,$19.62 ,$78.20 ,$11.54 ,$19.62 ,$73.60 ,$67.16 ,$11.92 ,$11.54 ,$12.74 ,$92.00 ,$78.20 ,$25.97 ,$84.64 ,$64.40 ,$48.79 ,$52.40 ,$56.03 ,$48.79 ,$63.57 ,$64.40 ,$11.66 ,$66.24 ,$12.64 ,$13.85 ,$13.85 ,$11.54 ,$13.85 ,$11.54 ,$66.24 ,$57.04 ,$66.24 ,$66.24 ,$55.20 ST VINCENT HOSPITAL - ACUTE,30200192,86403,HC CRYPTOCOCAL ANTIGEN,302,1 ,$60.00 ,$30.00 ,$11.54 ,$60.00 ,$38.76 ,$11.92 ,$40.39 ,$34.62 ,$11.54 ,$36.00 ,$51.00 ,$42.00 ,$11.92 ,$57.00 ,$43.20 ,$43.80 ,$19.62 ,$51.00 ,$11.54 ,$19.62 ,$48.00 ,$43.80 ,$11.92 ,$11.54 ,$12.74 ,$60.00 ,$51.00 ,$25.97 ,$55.20 ,$42.00 ,$48.79 ,$52.40 ,$36.54 ,$48.79 ,$41.46 ,$42.00 ,$11.66 ,$43.20 ,$12.64 ,$13.85 ,$13.85 ,$11.54 ,$13.85 ,$11.54 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200193,86403,HC STREPTOZYME,302,1 ,$51.00 ,$25.50 ,$11.54 ,$51.00 ,$32.95 ,$11.92 ,$40.39 ,$34.62 ,$11.54 ,$30.60 ,$43.35 ,$35.70 ,$11.92 ,$48.45 ,$36.72 ,$37.23 ,$19.62 ,$43.35 ,$11.54 ,$19.62 ,$40.80 ,$37.23 ,$11.92 ,$11.54 ,$12.74 ,$51.00 ,$43.35 ,$25.97 ,$46.92 ,$35.70 ,$48.79 ,$51.00 ,$31.06 ,$48.79 ,$35.24 ,$35.70 ,$11.66 ,$36.72 ,$12.64 ,$13.85 ,$13.85 ,$11.54 ,$13.85 ,$11.54 ,$36.72 ,$31.62 ,$36.72 ,$36.72 ,$30.60 ST VINCENT HOSPITAL - ACUTE,30200194,86403,HC CRYPTOCOCCUS AB,302,1 ,$81.00 ,$40.50 ,$11.54 ,$81.00 ,$52.33 ,$11.92 ,$40.39 ,$34.62 ,$11.54 ,$48.60 ,$68.85 ,$56.70 ,$11.92 ,$76.95 ,$58.32 ,$59.13 ,$19.62 ,$68.85 ,$11.54 ,$19.62 ,$64.80 ,$59.13 ,$11.92 ,$11.54 ,$12.74 ,$81.00 ,$68.85 ,$25.97 ,$74.52 ,$56.70 ,$48.79 ,$52.40 ,$49.33 ,$48.79 ,$55.97 ,$56.70 ,$11.66 ,$58.32 ,$12.64 ,$13.85 ,$13.85 ,$11.54 ,$13.85 ,$11.54 ,$58.32 ,$50.22 ,$58.32 ,$58.32 ,$48.60 ST VINCENT HOSPITAL - ACUTE,30200195,86403,HC MAYO CRYPTOCOCCUS AG,302,1 ,$143.00 ,$71.50 ,$11.54 ,$143.00 ,$92.38 ,$11.92 ,$40.39 ,$34.62 ,$11.54 ,$85.80 ,$121.55 ,$100.10 ,$11.92 ,$135.85 ,$102.96 ,$104.39 ,$19.62 ,$121.55 ,$11.54 ,$19.62 ,$114.40 ,$104.39 ,$11.92 ,$11.54 ,$12.74 ,$143.00 ,$121.55 ,$25.97 ,$131.56 ,$100.10 ,$48.79 ,$52.40 ,$87.09 ,$48.79 ,$98.81 ,$100.10 ,$11.66 ,$102.96 ,$12.64 ,$13.85 ,$13.85 ,$11.54 ,$13.85 ,$11.54 ,$102.96 ,$88.66 ,$102.96 ,$102.96 ,$85.80 ST VINCENT HOSPITAL - ACUTE,30200196,86406,HC PARTICLE AGGLUT TITER,302,1 ,$71.00 ,$35.50 ,$9.85 ,$71.00 ,$45.87 ,$9.85 ,$41.37 ,$35.46 ,$10.64 ,$42.60 ,$60.35 ,$49.70 ,$9.85 ,$67.45 ,$51.12 ,$51.83 ,$18.09 ,$60.35 ,$10.64 ,$18.09 ,$56.80 ,$51.83 ,$9.85 ,$10.64 ,$11.75 ,$71.00 ,$60.35 ,$23.94 ,$65.32 ,$49.70 ,$33.52 ,$36.00 ,$43.24 ,$33.52 ,$49.06 ,$49.70 ,$10.75 ,$51.12 ,$10.44 ,$12.77 ,$12.77 ,$10.64 ,$12.77 ,$10.64 ,$51.12 ,$44.02 ,$51.12 ,$51.12 ,$42.60 ST VINCENT HOSPITAL - ACUTE,30200197,86430,HC RHEUMATOID FACTOR,302,1 ,$42.00 ,$21.00 ,$6.14 ,$42.00 ,$27.13 ,$6.34 ,$22.05 ,$18.90 ,$6.14 ,$25.20 ,$35.70 ,$29.40 ,$6.34 ,$39.90 ,$30.24 ,$30.66 ,$10.44 ,$35.70 ,$6.14 ,$10.44 ,$33.60 ,$30.66 ,$6.34 ,$6.14 ,$6.78 ,$42.00 ,$35.70 ,$13.82 ,$38.64 ,$29.40 ,$27.17 ,$29.18 ,$25.58 ,$27.17 ,$29.02 ,$29.40 ,$6.20 ,$30.24 ,$6.72 ,$7.37 ,$7.37 ,$6.14 ,$7.37 ,$6.14 ,$30.24 ,$26.04 ,$30.24 ,$30.24 ,$25.20 ST VINCENT HOSPITAL - ACUTE,30200198,86431,HC RHEUMATOID FACTOR QN,302,1 ,$39.00 ,$19.50 ,$5.67 ,$39.00 ,$25.19 ,$5.86 ,$22.05 ,$18.90 ,$5.67 ,$23.40 ,$33.15 ,$27.30 ,$5.86 ,$37.05 ,$28.08 ,$28.47 ,$9.64 ,$33.15 ,$5.67 ,$9.64 ,$31.20 ,$28.47 ,$5.86 ,$5.67 ,$6.26 ,$39.00 ,$33.15 ,$12.76 ,$35.88 ,$27.30 ,$27.17 ,$29.18 ,$23.75 ,$27.17 ,$26.95 ,$27.30 ,$5.73 ,$28.08 ,$6.21 ,$6.80 ,$6.80 ,$5.67 ,$6.80 ,$5.67 ,$28.08 ,$24.18 ,$28.08 ,$28.08 ,$23.40 ST VINCENT HOSPITAL - ACUTE,30200200,86580,HC SKIN TEST TB INTRADERMAL,302,1 ,$60.00 ,$30.00 ,$3.18 ,$60.00 ,$38.76 ,$3.18 ,$28.20 ,$24.17 ,$23.89 ,$36.00 ,$51.00 ,$42.00 ,$3.18 ,$57.00 ,$43.20 ,$43.80 ,$15.83 ,$51.00 ,$23.89 ,$15.83 ,$48.00 ,$43.80 ,$3.18 ,$23.89 ,$25.20 ,$60.00 ,$51.00 ,$53.76 ,$55.20 ,$42.00 ,$47.35 ,$50.86 ,$36.54 ,$47.35 ,$41.46 ,$42.00 ,$24.13 ,$43.20 ,$3.37 ,$27.59 ,$27.59 ,$23.89 ,$27.59 ,$23.89 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200201,86592,HC SYPHILIS VDRL RPR QL,302,1 ,$29.00 ,$14.50 ,$4.27 ,$29.00 ,$18.73 ,$4.41 ,$16.63 ,$14.25 ,$4.27 ,$17.40 ,$24.65 ,$20.30 ,$4.41 ,$27.55 ,$20.88 ,$21.17 ,$7.26 ,$24.65 ,$4.27 ,$7.26 ,$23.20 ,$21.17 ,$4.41 ,$4.27 ,$4.71 ,$29.00 ,$24.65 ,$9.61 ,$26.68 ,$20.30 ,$20.43 ,$21.94 ,$17.66 ,$20.43 ,$20.04 ,$20.30 ,$4.31 ,$20.88 ,$4.67 ,$5.12 ,$5.12 ,$4.27 ,$5.12 ,$4.27 ,$20.88 ,$17.98 ,$20.88 ,$20.88 ,$17.40 ST VINCENT HOSPITAL - ACUTE,30200203,86592,HC SYPHILIS VDRL RPR QL (CSF),302,1 ,$58.00 ,$29.00 ,$4.27 ,$58.00 ,$37.47 ,$4.41 ,$16.63 ,$14.25 ,$4.27 ,$34.80 ,$49.30 ,$40.60 ,$4.41 ,$55.10 ,$41.76 ,$42.34 ,$7.26 ,$49.30 ,$4.27 ,$7.26 ,$46.40 ,$42.34 ,$4.41 ,$4.27 ,$4.71 ,$58.00 ,$49.30 ,$9.61 ,$53.36 ,$40.60 ,$20.43 ,$21.94 ,$35.32 ,$20.43 ,$40.08 ,$40.60 ,$4.31 ,$41.76 ,$4.67 ,$5.12 ,$5.12 ,$4.27 ,$5.12 ,$4.27 ,$41.76 ,$35.96 ,$41.76 ,$41.76 ,$34.80 ST VINCENT HOSPITAL - ACUTE,30200205,86602,HC ACTINOMYCES AB,302,1 ,$92.00 ,$46.00 ,$8.17 ,$92.00 ,$59.43 ,$8.17 ,$39.59 ,$33.93 ,$10.18 ,$55.20 ,$78.20 ,$64.40 ,$8.17 ,$87.40 ,$66.24 ,$67.16 ,$17.31 ,$78.20 ,$10.18 ,$17.31 ,$73.60 ,$67.16 ,$8.17 ,$10.18 ,$11.24 ,$92.00 ,$78.20 ,$22.91 ,$84.64 ,$64.40 ,$27.83 ,$29.90 ,$56.03 ,$27.83 ,$63.57 ,$64.40 ,$10.28 ,$66.24 ,$8.66 ,$12.22 ,$12.22 ,$10.18 ,$12.22 ,$10.18 ,$66.24 ,$57.04 ,$66.24 ,$66.24 ,$55.20 ST VINCENT HOSPITAL - ACUTE,30200206,86603,HC ADENOVIRUS AB,302,1 ,$53.00 ,$26.50 ,$8.17 ,$53.00 ,$34.24 ,$8.17 ,$50.05 ,$42.90 ,$12.87 ,$31.80 ,$45.05 ,$37.10 ,$8.17 ,$50.35 ,$38.16 ,$38.69 ,$21.88 ,$45.05 ,$12.87 ,$21.88 ,$42.40 ,$38.69 ,$8.17 ,$12.87 ,$14.21 ,$53.00 ,$45.05 ,$28.96 ,$48.76 ,$37.10 ,$27.83 ,$29.90 ,$32.28 ,$27.83 ,$36.62 ,$37.10 ,$13.00 ,$38.16 ,$8.66 ,$15.44 ,$15.44 ,$12.87 ,$15.44 ,$12.87 ,$38.16 ,$32.86 ,$38.16 ,$38.16 ,$31.80 ST VINCENT HOSPITAL - ACUTE,30200207,86606,HC ASPERGILLUS AB,302,1 ,$61.00 ,$30.50 ,$8.17 ,$61.00 ,$39.41 ,$8.17 ,$58.56 ,$50.19 ,$15.05 ,$36.60 ,$51.85 ,$42.70 ,$8.17 ,$57.95 ,$43.92 ,$44.53 ,$25.59 ,$51.85 ,$15.05 ,$25.59 ,$48.80 ,$44.53 ,$8.17 ,$15.05 ,$16.62 ,$61.00 ,$51.85 ,$33.86 ,$56.12 ,$42.70 ,$27.83 ,$29.90 ,$37.15 ,$27.83 ,$42.15 ,$42.70 ,$15.20 ,$43.92 ,$8.66 ,$18.06 ,$18.06 ,$15.05 ,$18.06 ,$15.05 ,$43.92 ,$37.82 ,$43.92 ,$43.92 ,$36.60 ST VINCENT HOSPITAL - ACUTE,30200208,86606,HC ASPERGILLUS AB (ASPER),302,1 ,$50.00 ,$25.00 ,$8.17 ,$50.00 ,$32.30 ,$8.17 ,$50.00 ,$50.00 ,$15.05 ,$30.00 ,$42.50 ,$35.00 ,$8.17 ,$47.50 ,$36.00 ,$36.50 ,$25.59 ,$42.50 ,$15.05 ,$25.59 ,$40.00 ,$36.50 ,$8.17 ,$15.05 ,$16.62 ,$50.00 ,$42.50 ,$33.86 ,$46.00 ,$35.00 ,$27.83 ,$29.90 ,$30.45 ,$27.83 ,$34.55 ,$35.00 ,$15.20 ,$36.00 ,$8.66 ,$18.06 ,$18.06 ,$15.05 ,$18.06 ,$15.05 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30200209,86606,HC ASPERGILLUS AB (FLAV/FUM/NIGER),302,1 ,$11.00 ,$5.50 ,$5.50 ,$24.75 ,$7.11 ,$8.17 ,$11.00 ,$11.00 ,$11.00 ,$6.60 ,$9.35 ,$7.70 ,$8.17 ,$10.45 ,$7.92 ,$8.03 ,$11.00 ,$9.35 ,$11.00 ,$11.00 ,$8.80 ,$8.03 ,$8.17 ,$11.00 ,$11.00 ,$11.00 ,$9.35 ,$24.75 ,$10.12 ,$7.70 ,$11.00 ,$11.00 ,$6.70 ,$11.00 ,$7.60 ,$7.70 ,$11.11 ,$7.92 ,$8.66 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$7.92 ,$6.82 ,$7.92 ,$7.92 ,$6.60 ST VINCENT HOSPITAL - ACUTE,30200210,86606,HC ASPERGILLIS AB (HS PNEUMO),302,1 ,$27.00 ,$13.50 ,$8.17 ,$33.86 ,$17.44 ,$8.17 ,$27.00 ,$27.00 ,$15.05 ,$16.20 ,$22.95 ,$18.90 ,$8.17 ,$25.65 ,$19.44 ,$19.71 ,$25.59 ,$22.95 ,$15.05 ,$25.59 ,$21.60 ,$19.71 ,$8.17 ,$15.05 ,$16.62 ,$27.00 ,$22.95 ,$33.86 ,$24.84 ,$18.90 ,$27.00 ,$27.00 ,$16.44 ,$27.00 ,$18.66 ,$18.90 ,$15.20 ,$19.44 ,$8.66 ,$18.06 ,$18.06 ,$15.05 ,$18.06 ,$15.05 ,$19.44 ,$16.74 ,$19.44 ,$19.44 ,$16.20 ST VINCENT HOSPITAL - ACUTE,30200211,86609,HC BACTERIUM AB NOS,302,1 ,$31.00 ,$15.50 ,$8.17 ,$31.00 ,$20.03 ,$8.17 ,$31.00 ,$31.00 ,$12.88 ,$18.60 ,$26.35 ,$21.70 ,$8.17 ,$29.45 ,$22.32 ,$22.63 ,$21.90 ,$26.35 ,$12.88 ,$21.90 ,$24.80 ,$22.63 ,$8.17 ,$12.88 ,$14.22 ,$31.00 ,$26.35 ,$28.98 ,$28.52 ,$21.70 ,$27.83 ,$29.90 ,$18.88 ,$27.83 ,$21.42 ,$21.70 ,$13.01 ,$22.32 ,$8.66 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$22.32 ,$19.22 ,$22.32 ,$22.32 ,$18.60 ST VINCENT HOSPITAL - ACUTE,30200212,86611,HC BARTONELLA SCREEN AB,302,1 ,$51.00 ,$25.50 ,$8.17 ,$51.00 ,$32.95 ,$8.17 ,$39.59 ,$33.93 ,$10.18 ,$30.60 ,$43.35 ,$35.70 ,$8.17 ,$48.45 ,$36.72 ,$37.23 ,$17.31 ,$43.35 ,$10.18 ,$17.31 ,$40.80 ,$37.23 ,$8.17 ,$10.18 ,$11.24 ,$51.00 ,$43.35 ,$22.91 ,$46.92 ,$35.70 ,$27.83 ,$29.90 ,$31.06 ,$27.83 ,$35.24 ,$35.70 ,$10.28 ,$36.72 ,$8.66 ,$12.22 ,$12.22 ,$10.18 ,$12.22 ,$10.18 ,$36.72 ,$31.62 ,$36.72 ,$36.72 ,$30.60 ST VINCENT HOSPITAL - ACUTE,30200213,86612,HC BLASTOMYCES AB,302,1 ,$70.00 ,$35.00 ,$8.17 ,$70.00 ,$45.22 ,$8.17 ,$50.19 ,$43.02 ,$12.90 ,$42.00 ,$59.50 ,$49.00 ,$8.17 ,$66.50 ,$50.40 ,$51.10 ,$21.93 ,$59.50 ,$12.90 ,$21.93 ,$56.00 ,$51.10 ,$8.17 ,$12.90 ,$14.24 ,$70.00 ,$59.50 ,$29.03 ,$64.40 ,$49.00 ,$27.83 ,$29.90 ,$42.63 ,$27.83 ,$48.37 ,$49.00 ,$13.03 ,$50.40 ,$8.66 ,$15.48 ,$15.48 ,$12.90 ,$15.48 ,$12.90 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200214,86612,HC BLASTOMYCES AB (CF/ID),302,1 ,$70.00 ,$35.00 ,$8.17 ,$70.00 ,$45.22 ,$8.17 ,$50.19 ,$43.02 ,$12.90 ,$42.00 ,$59.50 ,$49.00 ,$8.17 ,$66.50 ,$50.40 ,$51.10 ,$21.93 ,$59.50 ,$12.90 ,$21.93 ,$56.00 ,$51.10 ,$8.17 ,$12.90 ,$14.24 ,$70.00 ,$59.50 ,$29.03 ,$64.40 ,$49.00 ,$27.83 ,$29.90 ,$42.63 ,$27.83 ,$48.37 ,$49.00 ,$13.03 ,$50.40 ,$8.66 ,$15.48 ,$15.48 ,$12.90 ,$15.48 ,$12.90 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200215,86612,HC BLASTO AB ID,302,1 ,$11.00 ,$5.50 ,$5.50 ,$24.75 ,$7.11 ,$8.17 ,$11.00 ,$11.00 ,$11.00 ,$6.60 ,$9.35 ,$7.70 ,$8.17 ,$10.45 ,$7.92 ,$8.03 ,$11.00 ,$9.35 ,$11.00 ,$11.00 ,$8.80 ,$8.03 ,$8.17 ,$11.00 ,$11.00 ,$11.00 ,$9.35 ,$24.75 ,$10.12 ,$7.70 ,$11.00 ,$11.00 ,$6.70 ,$11.00 ,$7.60 ,$7.70 ,$11.11 ,$7.92 ,$8.66 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$7.92 ,$6.82 ,$7.92 ,$7.92 ,$6.60 ST VINCENT HOSPITAL - ACUTE,30200216,86612,HC BLASTOMYCES AB (MAYO),302,1 ,$70.00 ,$35.00 ,$8.17 ,$70.00 ,$45.22 ,$8.17 ,$50.19 ,$43.02 ,$12.90 ,$42.00 ,$59.50 ,$49.00 ,$8.17 ,$66.50 ,$50.40 ,$51.10 ,$21.93 ,$59.50 ,$12.90 ,$21.93 ,$56.00 ,$51.10 ,$8.17 ,$12.90 ,$14.24 ,$70.00 ,$59.50 ,$29.03 ,$64.40 ,$49.00 ,$27.83 ,$29.90 ,$42.63 ,$27.83 ,$48.37 ,$49.00 ,$13.03 ,$50.40 ,$8.66 ,$15.48 ,$15.48 ,$12.90 ,$15.48 ,$12.90 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200217,86617,HC LYME DISEASE AB CONFIRM (IGG),302,1 ,$110.00 ,$55.00 ,$15.49 ,$110.00 ,$71.06 ,$16.01 ,$60.24 ,$51.63 ,$15.49 ,$66.00 ,$93.50 ,$77.00 ,$16.01 ,$104.50 ,$79.20 ,$80.30 ,$26.33 ,$93.50 ,$15.49 ,$26.33 ,$88.00 ,$80.30 ,$16.01 ,$15.49 ,$17.10 ,$110.00 ,$93.50 ,$34.85 ,$101.20 ,$77.00 ,$74.17 ,$79.66 ,$66.99 ,$74.17 ,$76.01 ,$77.00 ,$15.64 ,$79.20 ,$16.97 ,$18.59 ,$18.59 ,$15.49 ,$18.59 ,$15.49 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30200218,86617,HC LYME DISEASE AB CONFIRM (IGM),302,1 ,$110.00 ,$55.00 ,$15.49 ,$110.00 ,$71.06 ,$16.01 ,$60.24 ,$51.63 ,$15.49 ,$66.00 ,$93.50 ,$77.00 ,$16.01 ,$104.50 ,$79.20 ,$80.30 ,$26.33 ,$93.50 ,$15.49 ,$26.33 ,$88.00 ,$80.30 ,$16.01 ,$15.49 ,$17.10 ,$110.00 ,$93.50 ,$34.85 ,$101.20 ,$77.00 ,$74.17 ,$79.66 ,$66.99 ,$74.17 ,$76.01 ,$77.00 ,$15.64 ,$79.20 ,$16.97 ,$18.59 ,$18.59 ,$15.49 ,$18.59 ,$15.49 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30200219,86618,HC LYME AB,302,1 ,$120.00 ,$60.00 ,$17.03 ,$120.00 ,$77.52 ,$17.60 ,$66.22 ,$56.76 ,$17.03 ,$72.00 ,$102.00 ,$84.00 ,$17.60 ,$114.00 ,$86.40 ,$87.60 ,$28.95 ,$102.00 ,$17.03 ,$28.95 ,$96.00 ,$87.60 ,$17.60 ,$17.03 ,$18.80 ,$120.00 ,$102.00 ,$38.32 ,$110.40 ,$84.00 ,$81.57 ,$87.61 ,$73.08 ,$81.57 ,$82.92 ,$84.00 ,$17.20 ,$86.40 ,$18.66 ,$20.44 ,$20.44 ,$17.03 ,$20.44 ,$17.03 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30200220,86622,HC BRUCELLA AB (IGG/IGM),302,1 ,$60.00 ,$30.00 ,$8.17 ,$60.00 ,$38.76 ,$8.17 ,$34.72 ,$29.76 ,$8.93 ,$36.00 ,$51.00 ,$42.00 ,$8.17 ,$57.00 ,$43.20 ,$43.80 ,$15.18 ,$51.00 ,$8.93 ,$15.18 ,$48.00 ,$43.80 ,$8.17 ,$8.93 ,$9.86 ,$60.00 ,$51.00 ,$20.09 ,$55.20 ,$42.00 ,$27.83 ,$29.90 ,$36.54 ,$27.83 ,$41.46 ,$42.00 ,$9.02 ,$43.20 ,$8.66 ,$10.72 ,$10.72 ,$8.93 ,$10.72 ,$8.93 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200221,86622,HC BRUCELLA AB,302,1 ,$54.00 ,$27.00 ,$8.17 ,$54.00 ,$34.88 ,$8.17 ,$34.72 ,$29.76 ,$8.93 ,$32.40 ,$45.90 ,$37.80 ,$8.17 ,$51.30 ,$38.88 ,$39.42 ,$15.18 ,$45.90 ,$8.93 ,$15.18 ,$43.20 ,$39.42 ,$8.17 ,$8.93 ,$9.86 ,$54.00 ,$45.90 ,$20.09 ,$49.68 ,$37.80 ,$27.83 ,$29.90 ,$32.89 ,$27.83 ,$37.31 ,$37.80 ,$9.02 ,$38.88 ,$8.66 ,$10.72 ,$10.72 ,$8.93 ,$10.72 ,$8.93 ,$38.88 ,$33.48 ,$38.88 ,$38.88 ,$32.40 ST VINCENT HOSPITAL - ACUTE,30200222,86628,HC CANDIDA AB,302,1 ,$55.00 ,$27.50 ,$8.17 ,$55.00 ,$35.53 ,$8.17 ,$46.69 ,$40.02 ,$12.01 ,$33.00 ,$46.75 ,$38.50 ,$8.17 ,$52.25 ,$39.60 ,$40.15 ,$20.42 ,$46.75 ,$12.01 ,$20.42 ,$44.00 ,$40.15 ,$8.17 ,$12.01 ,$13.26 ,$55.00 ,$46.75 ,$27.02 ,$50.60 ,$38.50 ,$27.83 ,$29.90 ,$33.50 ,$27.83 ,$38.01 ,$38.50 ,$12.13 ,$39.60 ,$8.66 ,$14.41 ,$14.41 ,$12.01 ,$14.41 ,$12.01 ,$39.60 ,$34.10 ,$39.60 ,$39.60 ,$33.00 ST VINCENT HOSPITAL - ACUTE,30200223,86631,HC CHLAMYDIA AB,302,1 ,$54.00 ,$27.00 ,$8.17 ,$54.00 ,$34.88 ,$8.17 ,$45.99 ,$39.42 ,$11.82 ,$32.40 ,$45.90 ,$37.80 ,$8.17 ,$51.30 ,$38.88 ,$39.42 ,$20.09 ,$45.90 ,$11.82 ,$20.09 ,$43.20 ,$39.42 ,$8.17 ,$11.82 ,$13.05 ,$54.00 ,$45.90 ,$26.60 ,$49.68 ,$37.80 ,$27.83 ,$29.90 ,$32.89 ,$27.83 ,$37.31 ,$37.80 ,$11.94 ,$38.88 ,$8.66 ,$14.18 ,$14.18 ,$11.82 ,$14.18 ,$11.82 ,$38.88 ,$33.48 ,$38.88 ,$38.88 ,$32.40 ST VINCENT HOSPITAL - ACUTE,30200224,86631,HC CHLAMYDIA AB IGG,302,1 ,$43.00 ,$21.50 ,$8.17 ,$43.00 ,$27.78 ,$8.17 ,$43.00 ,$39.42 ,$11.82 ,$25.80 ,$36.55 ,$30.10 ,$8.17 ,$40.85 ,$30.96 ,$31.39 ,$20.09 ,$36.55 ,$11.82 ,$20.09 ,$34.40 ,$31.39 ,$8.17 ,$11.82 ,$13.05 ,$43.00 ,$36.55 ,$26.60 ,$39.56 ,$30.10 ,$27.83 ,$29.90 ,$26.19 ,$27.83 ,$29.71 ,$30.10 ,$11.94 ,$30.96 ,$8.66 ,$14.18 ,$14.18 ,$11.82 ,$14.18 ,$11.82 ,$30.96 ,$26.66 ,$30.96 ,$30.96 ,$25.80 ST VINCENT HOSPITAL - ACUTE,30200225,86631,HC CHLAMYDIA AB (GRP AB),302,1 ,$130.00 ,$65.00 ,$8.17 ,$130.00 ,$83.98 ,$8.17 ,$45.99 ,$39.42 ,$11.82 ,$78.00 ,$110.50 ,$91.00 ,$8.17 ,$123.50 ,$93.60 ,$94.90 ,$20.09 ,$110.50 ,$11.82 ,$20.09 ,$104.00 ,$94.90 ,$8.17 ,$11.82 ,$13.05 ,$130.00 ,$110.50 ,$26.60 ,$119.60 ,$91.00 ,$27.83 ,$29.90 ,$79.17 ,$27.83 ,$89.83 ,$91.00 ,$11.94 ,$93.60 ,$8.66 ,$14.18 ,$14.18 ,$11.82 ,$14.18 ,$11.82 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30200226,86631,HC CHLAMYDIA AB (PSITT IGG/IGA),302,1 ,$15.00 ,$7.50 ,$7.50 ,$26.60 ,$9.69 ,$8.17 ,$15.00 ,$15.00 ,$11.82 ,$9.00 ,$12.75 ,$10.50 ,$8.17 ,$14.25 ,$10.80 ,$10.95 ,$15.00 ,$12.75 ,$11.82 ,$15.00 ,$12.00 ,$10.95 ,$8.17 ,$11.82 ,$13.05 ,$15.00 ,$12.75 ,$26.60 ,$13.80 ,$10.50 ,$15.00 ,$15.00 ,$9.14 ,$15.00 ,$10.37 ,$10.50 ,$11.94 ,$10.80 ,$8.66 ,$14.18 ,$14.18 ,$11.82 ,$14.18 ,$11.82 ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,30200227,86631,HC CHLAMYDIA AB IGG 2,302,1 ,$50.00 ,$25.00 ,$8.17 ,$50.00 ,$32.30 ,$8.17 ,$45.99 ,$39.42 ,$11.82 ,$30.00 ,$42.50 ,$35.00 ,$8.17 ,$47.50 ,$36.00 ,$36.50 ,$20.09 ,$42.50 ,$11.82 ,$20.09 ,$40.00 ,$36.50 ,$8.17 ,$11.82 ,$13.05 ,$50.00 ,$42.50 ,$26.60 ,$46.00 ,$35.00 ,$27.83 ,$29.90 ,$30.45 ,$27.83 ,$34.55 ,$35.00 ,$11.94 ,$36.00 ,$8.66 ,$14.18 ,$14.18 ,$11.82 ,$14.18 ,$11.82 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30200228,86632,HC CHLAMYDIA AB IGM SEROLOGY,302,1 ,$54.00 ,$27.00 ,$8.17 ,$54.00 ,$34.88 ,$8.17 ,$49.32 ,$42.27 ,$12.68 ,$32.40 ,$45.90 ,$37.80 ,$8.17 ,$51.30 ,$38.88 ,$39.42 ,$21.56 ,$45.90 ,$12.68 ,$21.56 ,$43.20 ,$39.42 ,$8.17 ,$12.68 ,$14.00 ,$54.00 ,$45.90 ,$28.53 ,$49.68 ,$37.80 ,$27.83 ,$29.90 ,$32.89 ,$27.83 ,$37.31 ,$37.80 ,$12.81 ,$38.88 ,$8.66 ,$15.22 ,$15.22 ,$12.68 ,$15.22 ,$12.68 ,$38.88 ,$33.48 ,$38.88 ,$38.88 ,$32.40 ST VINCENT HOSPITAL - ACUTE,30200229,86632,HC CHLAMYDIA AB IGM PSITTACI,302,1 ,$15.00 ,$7.50 ,$7.50 ,$28.53 ,$9.69 ,$8.17 ,$15.00 ,$15.00 ,$12.68 ,$9.00 ,$12.75 ,$10.50 ,$8.17 ,$14.25 ,$10.80 ,$10.95 ,$15.00 ,$12.75 ,$12.68 ,$15.00 ,$12.00 ,$10.95 ,$8.17 ,$12.68 ,$14.00 ,$15.00 ,$12.75 ,$28.53 ,$13.80 ,$10.50 ,$15.00 ,$15.00 ,$9.14 ,$15.00 ,$10.37 ,$10.50 ,$12.81 ,$10.80 ,$8.66 ,$15.00 ,$15.00 ,$12.68 ,$15.00 ,$12.68 ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,30200230,86632,HC CHLAMYDIA AB IGM,302,1 ,$49.00 ,$24.50 ,$8.17 ,$49.00 ,$31.65 ,$8.17 ,$49.00 ,$42.27 ,$12.68 ,$29.40 ,$41.65 ,$34.30 ,$8.17 ,$46.55 ,$35.28 ,$35.77 ,$21.56 ,$41.65 ,$12.68 ,$21.56 ,$39.20 ,$35.77 ,$8.17 ,$12.68 ,$14.00 ,$49.00 ,$41.65 ,$28.53 ,$45.08 ,$34.30 ,$27.83 ,$29.90 ,$29.84 ,$27.83 ,$33.86 ,$34.30 ,$12.81 ,$35.28 ,$8.66 ,$15.22 ,$15.22 ,$12.68 ,$15.22 ,$12.68 ,$35.28 ,$30.38 ,$35.28 ,$35.28 ,$29.40 ST VINCENT HOSPITAL - ACUTE,30200231,86635,HC COCCIDIOIDES AB,302,1 ,$50.00 ,$25.00 ,$8.17 ,$50.00 ,$32.30 ,$8.17 ,$44.63 ,$38.25 ,$11.47 ,$30.00 ,$42.50 ,$35.00 ,$8.17 ,$47.50 ,$36.00 ,$36.50 ,$19.50 ,$42.50 ,$11.47 ,$19.50 ,$40.00 ,$36.50 ,$8.17 ,$11.47 ,$12.67 ,$50.00 ,$42.50 ,$25.81 ,$46.00 ,$35.00 ,$27.83 ,$29.90 ,$30.45 ,$27.83 ,$34.55 ,$35.00 ,$11.58 ,$36.00 ,$8.66 ,$13.76 ,$13.76 ,$11.47 ,$13.76 ,$11.47 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30200232,86635,HC COCCID AB,302,1 ,$70.00 ,$35.00 ,$8.17 ,$70.00 ,$45.22 ,$8.17 ,$44.63 ,$38.25 ,$11.47 ,$42.00 ,$59.50 ,$49.00 ,$8.17 ,$66.50 ,$50.40 ,$51.10 ,$19.50 ,$59.50 ,$11.47 ,$19.50 ,$56.00 ,$51.10 ,$8.17 ,$11.47 ,$12.67 ,$70.00 ,$59.50 ,$25.81 ,$64.40 ,$49.00 ,$27.83 ,$29.90 ,$42.63 ,$27.83 ,$48.37 ,$49.00 ,$11.58 ,$50.40 ,$8.66 ,$13.76 ,$13.76 ,$11.47 ,$13.76 ,$11.47 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200233,86638,HC Q FEVER AB IGG,302,1 ,$64.00 ,$32.00 ,$8.17 ,$64.00 ,$41.34 ,$8.17 ,$47.15 ,$40.41 ,$12.12 ,$38.40 ,$54.40 ,$44.80 ,$8.17 ,$60.80 ,$46.08 ,$46.72 ,$20.60 ,$54.40 ,$12.12 ,$20.60 ,$51.20 ,$46.72 ,$8.17 ,$12.12 ,$13.38 ,$64.00 ,$54.40 ,$27.27 ,$58.88 ,$44.80 ,$27.83 ,$29.90 ,$38.98 ,$27.83 ,$44.22 ,$44.80 ,$12.24 ,$46.08 ,$8.66 ,$14.54 ,$14.54 ,$12.12 ,$14.54 ,$12.12 ,$46.08 ,$39.68 ,$46.08 ,$46.08 ,$38.40 ST VINCENT HOSPITAL - ACUTE,30200234,86638,HC Q FEVER AB IGM,302,1 ,$64.00 ,$32.00 ,$8.17 ,$64.00 ,$41.34 ,$8.17 ,$47.15 ,$40.41 ,$12.12 ,$38.40 ,$54.40 ,$44.80 ,$8.17 ,$60.80 ,$46.08 ,$46.72 ,$20.60 ,$54.40 ,$12.12 ,$20.60 ,$51.20 ,$46.72 ,$8.17 ,$12.12 ,$13.38 ,$64.00 ,$54.40 ,$27.27 ,$58.88 ,$44.80 ,$27.83 ,$29.90 ,$38.98 ,$27.83 ,$44.22 ,$44.80 ,$12.24 ,$46.08 ,$8.66 ,$14.54 ,$14.54 ,$12.12 ,$14.54 ,$12.12 ,$46.08 ,$39.68 ,$46.08 ,$46.08 ,$38.40 ST VINCENT HOSPITAL - ACUTE,30200235,86645,HC CMV AB IGM,302,1 ,$90.00 ,$45.00 ,$8.17 ,$90.00 ,$58.14 ,$8.17 ,$65.52 ,$56.16 ,$16.85 ,$54.00 ,$76.50 ,$63.00 ,$8.17 ,$85.50 ,$64.80 ,$65.70 ,$28.65 ,$76.50 ,$16.85 ,$28.65 ,$72.00 ,$65.70 ,$8.17 ,$16.85 ,$18.61 ,$90.00 ,$76.50 ,$37.91 ,$82.80 ,$63.00 ,$27.83 ,$29.90 ,$54.81 ,$27.83 ,$62.19 ,$63.00 ,$17.02 ,$64.80 ,$8.66 ,$20.22 ,$20.22 ,$16.85 ,$20.22 ,$16.85 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200236,86651,HC ENCEPHALITIS CALIFORNIA AB,302,1 ,$50.00 ,$25.00 ,$8.17 ,$50.00 ,$32.30 ,$8.17 ,$50.00 ,$43.95 ,$13.19 ,$30.00 ,$42.50 ,$35.00 ,$8.17 ,$47.50 ,$36.00 ,$36.50 ,$22.42 ,$42.50 ,$13.19 ,$22.42 ,$40.00 ,$36.50 ,$8.17 ,$13.19 ,$14.56 ,$50.00 ,$42.50 ,$29.68 ,$46.00 ,$35.00 ,$27.83 ,$29.90 ,$30.45 ,$27.83 ,$34.55 ,$35.00 ,$13.32 ,$36.00 ,$8.66 ,$15.83 ,$15.83 ,$13.19 ,$15.83 ,$13.19 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30200237,86652,HC ENCEPHALITIS EQUINE AB,302,1 ,$61.00 ,$30.50 ,$8.17 ,$61.00 ,$39.41 ,$8.17 ,$51.28 ,$43.95 ,$13.19 ,$36.60 ,$51.85 ,$42.70 ,$8.17 ,$57.95 ,$43.92 ,$44.53 ,$22.42 ,$51.85 ,$13.19 ,$22.42 ,$48.80 ,$44.53 ,$8.17 ,$13.19 ,$14.56 ,$61.00 ,$51.85 ,$29.68 ,$56.12 ,$42.70 ,$27.83 ,$29.90 ,$37.15 ,$27.83 ,$42.15 ,$42.70 ,$13.32 ,$43.92 ,$8.66 ,$15.83 ,$15.83 ,$13.19 ,$15.83 ,$13.19 ,$43.92 ,$37.82 ,$43.92 ,$43.92 ,$36.60 ST VINCENT HOSPITAL - ACUTE,30200238,86653,HC ENCEPHALITIS ST LOUIS AB,302,1 ,$62.00 ,$31.00 ,$8.17 ,$62.00 ,$40.05 ,$8.17 ,$51.28 ,$43.95 ,$13.19 ,$37.20 ,$52.70 ,$43.40 ,$8.17 ,$58.90 ,$44.64 ,$45.26 ,$22.42 ,$52.70 ,$13.19 ,$22.42 ,$49.60 ,$45.26 ,$8.17 ,$13.19 ,$14.56 ,$62.00 ,$52.70 ,$29.68 ,$57.04 ,$43.40 ,$27.83 ,$29.90 ,$37.76 ,$27.83 ,$42.84 ,$43.40 ,$13.32 ,$44.64 ,$8.66 ,$15.83 ,$15.83 ,$13.19 ,$15.83 ,$13.19 ,$44.64 ,$38.44 ,$44.64 ,$44.64 ,$37.20 ST VINCENT HOSPITAL - ACUTE,30200239,86654,HC ENCEPHALITIS WEST EQUINE AB,302,1 ,$61.00 ,$30.50 ,$8.17 ,$61.00 ,$39.41 ,$8.17 ,$51.28 ,$43.95 ,$13.19 ,$36.60 ,$51.85 ,$42.70 ,$8.17 ,$57.95 ,$43.92 ,$44.53 ,$22.42 ,$51.85 ,$13.19 ,$22.42 ,$48.80 ,$44.53 ,$8.17 ,$13.19 ,$14.56 ,$61.00 ,$51.85 ,$29.68 ,$56.12 ,$42.70 ,$27.83 ,$29.90 ,$37.15 ,$27.83 ,$42.15 ,$42.70 ,$13.32 ,$43.92 ,$8.66 ,$15.83 ,$15.83 ,$13.19 ,$15.83 ,$13.19 ,$43.92 ,$37.82 ,$43.92 ,$43.92 ,$36.60 ST VINCENT HOSPITAL - ACUTE,30200240,86658,HC ENTEROVIRUS A COXSACKIE,302,1 ,$60.00 ,$30.00 ,$8.17 ,$60.00 ,$38.76 ,$8.17 ,$50.65 ,$43.41 ,$13.03 ,$36.00 ,$51.00 ,$42.00 ,$8.17 ,$57.00 ,$43.20 ,$43.80 ,$22.15 ,$51.00 ,$13.03 ,$22.15 ,$48.00 ,$43.80 ,$8.17 ,$13.03 ,$14.39 ,$60.00 ,$51.00 ,$29.32 ,$55.20 ,$42.00 ,$27.83 ,$29.90 ,$36.54 ,$27.83 ,$41.46 ,$42.00 ,$13.16 ,$43.20 ,$8.66 ,$15.64 ,$15.64 ,$13.03 ,$15.64 ,$13.03 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200241,86658,HC ENTEROVIRUS (POLIO TYP 1),302,1 ,$130.00 ,$65.00 ,$8.17 ,$130.00 ,$83.98 ,$8.17 ,$50.65 ,$43.41 ,$13.03 ,$78.00 ,$110.50 ,$91.00 ,$8.17 ,$123.50 ,$93.60 ,$94.90 ,$22.15 ,$110.50 ,$13.03 ,$22.15 ,$104.00 ,$94.90 ,$8.17 ,$13.03 ,$14.39 ,$130.00 ,$110.50 ,$29.32 ,$119.60 ,$91.00 ,$27.83 ,$29.90 ,$79.17 ,$27.83 ,$89.83 ,$91.00 ,$13.16 ,$93.60 ,$8.66 ,$15.64 ,$15.64 ,$13.03 ,$15.64 ,$13.03 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30200242,86658,HC ENTEROVIRUS (POLIO TYP 2),302,1 ,$42.00 ,$21.00 ,$8.17 ,$42.00 ,$27.13 ,$8.17 ,$42.00 ,$42.00 ,$13.03 ,$25.20 ,$35.70 ,$29.40 ,$8.17 ,$39.90 ,$30.24 ,$30.66 ,$22.15 ,$35.70 ,$13.03 ,$22.15 ,$33.60 ,$30.66 ,$8.17 ,$13.03 ,$14.39 ,$42.00 ,$35.70 ,$29.32 ,$38.64 ,$29.40 ,$27.83 ,$29.90 ,$25.58 ,$27.83 ,$29.02 ,$29.40 ,$13.16 ,$30.24 ,$8.66 ,$15.64 ,$15.64 ,$13.03 ,$15.64 ,$13.03 ,$30.24 ,$26.04 ,$30.24 ,$30.24 ,$25.20 ST VINCENT HOSPITAL - ACUTE,30200243,86658,HC ENTEROVIRUS (POLIO TYP 3),302,1 ,$42.00 ,$21.00 ,$8.17 ,$42.00 ,$27.13 ,$8.17 ,$42.00 ,$42.00 ,$13.03 ,$25.20 ,$35.70 ,$29.40 ,$8.17 ,$39.90 ,$30.24 ,$30.66 ,$22.15 ,$35.70 ,$13.03 ,$22.15 ,$33.60 ,$30.66 ,$8.17 ,$13.03 ,$14.39 ,$42.00 ,$35.70 ,$29.32 ,$38.64 ,$29.40 ,$27.83 ,$29.90 ,$25.58 ,$27.83 ,$29.02 ,$29.40 ,$13.16 ,$30.24 ,$8.66 ,$15.64 ,$15.64 ,$13.03 ,$15.64 ,$13.03 ,$30.24 ,$26.04 ,$30.24 ,$30.24 ,$25.20 ST VINCENT HOSPITAL - ACUTE,30200244,86663,HC EBV EARLY AG,302,1 ,$90.00 ,$45.00 ,$13.12 ,$90.00 ,$58.14 ,$13.56 ,$51.03 ,$43.74 ,$13.12 ,$54.00 ,$76.50 ,$63.00 ,$13.56 ,$85.50 ,$64.80 ,$65.70 ,$22.30 ,$76.50 ,$13.12 ,$22.30 ,$72.00 ,$65.70 ,$13.56 ,$13.12 ,$14.49 ,$90.00 ,$76.50 ,$29.52 ,$82.80 ,$63.00 ,$62.83 ,$67.48 ,$54.81 ,$62.83 ,$62.19 ,$63.00 ,$13.25 ,$64.80 ,$14.37 ,$15.74 ,$15.74 ,$13.12 ,$15.74 ,$13.12 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200245,86664,HC EBV NUCLEAR AG,302,1 ,$100.00 ,$50.00 ,$15.29 ,$100.00 ,$64.60 ,$15.80 ,$59.47 ,$50.97 ,$15.29 ,$60.00 ,$85.00 ,$70.00 ,$15.80 ,$95.00 ,$72.00 ,$73.00 ,$25.99 ,$85.00 ,$15.29 ,$25.99 ,$80.00 ,$73.00 ,$15.80 ,$15.29 ,$16.88 ,$100.00 ,$85.00 ,$34.40 ,$92.00 ,$70.00 ,$73.25 ,$78.68 ,$60.90 ,$73.25 ,$69.10 ,$70.00 ,$15.44 ,$72.00 ,$16.75 ,$18.35 ,$18.35 ,$15.29 ,$18.35 ,$15.29 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200246,86665,HC EBV VIRAL CAP,302,1 ,$120.00 ,$60.00 ,$18.14 ,$120.00 ,$77.52 ,$18.74 ,$70.56 ,$60.48 ,$18.14 ,$72.00 ,$102.00 ,$84.00 ,$18.74 ,$114.00 ,$86.40 ,$87.60 ,$30.84 ,$102.00 ,$18.14 ,$30.84 ,$96.00 ,$87.60 ,$18.74 ,$18.14 ,$20.03 ,$120.00 ,$102.00 ,$40.82 ,$110.40 ,$84.00 ,$86.87 ,$93.31 ,$73.08 ,$86.87 ,$82.92 ,$84.00 ,$18.32 ,$86.40 ,$19.86 ,$21.77 ,$21.77 ,$18.14 ,$21.77 ,$18.14 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30200247,86666,HC EHRICHIA AB,302,1 ,$35.00 ,$17.50 ,$8.17 ,$35.00 ,$22.61 ,$8.17 ,$35.00 ,$33.93 ,$10.18 ,$21.00 ,$29.75 ,$24.50 ,$8.17 ,$33.25 ,$25.20 ,$25.55 ,$17.31 ,$29.75 ,$10.18 ,$17.31 ,$28.00 ,$25.55 ,$8.17 ,$10.18 ,$11.24 ,$35.00 ,$29.75 ,$22.91 ,$32.20 ,$24.50 ,$27.83 ,$29.90 ,$21.32 ,$27.83 ,$24.19 ,$24.50 ,$10.28 ,$25.20 ,$8.66 ,$12.22 ,$12.22 ,$10.18 ,$12.22 ,$10.18 ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,30200248,86666,HC EHRICHIA AB (ANAPLASMA),302,1 ,$45.00 ,$22.50 ,$8.17 ,$45.00 ,$29.07 ,$8.17 ,$39.59 ,$33.93 ,$10.18 ,$27.00 ,$38.25 ,$31.50 ,$8.17 ,$42.75 ,$32.40 ,$32.85 ,$17.31 ,$38.25 ,$10.18 ,$17.31 ,$36.00 ,$32.85 ,$8.17 ,$10.18 ,$11.24 ,$45.00 ,$38.25 ,$22.91 ,$41.40 ,$31.50 ,$27.83 ,$29.90 ,$27.41 ,$27.83 ,$31.10 ,$31.50 ,$10.28 ,$32.40 ,$8.66 ,$12.22 ,$12.22 ,$10.18 ,$12.22 ,$10.18 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,30200249,86668,HC FRANCISELLA AB,302,1 ,$60.00 ,$30.00 ,$14.16 ,$60.00 ,$38.76 ,$14.63 ,$49.56 ,$42.48 ,$14.16 ,$36.00 ,$51.00 ,$42.00 ,$14.63 ,$57.00 ,$43.20 ,$43.80 ,$24.07 ,$51.00 ,$14.16 ,$24.07 ,$48.00 ,$43.80 ,$14.63 ,$14.16 ,$15.64 ,$60.00 ,$51.00 ,$31.86 ,$55.20 ,$42.00 ,$49.81 ,$53.50 ,$36.54 ,$49.81 ,$41.46 ,$42.00 ,$14.30 ,$43.20 ,$15.51 ,$16.99 ,$16.99 ,$14.16 ,$16.99 ,$14.16 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200250,86671,HC FUNGUS AB NOS,302,1 ,$46.00 ,$23.00 ,$7.15 ,$46.00 ,$29.72 ,$7.15 ,$46.00 ,$40.86 ,$12.25 ,$27.60 ,$39.10 ,$32.20 ,$7.15 ,$43.70 ,$33.12 ,$33.58 ,$20.83 ,$39.10 ,$12.25 ,$20.83 ,$36.80 ,$33.58 ,$7.15 ,$12.25 ,$13.53 ,$46.00 ,$39.10 ,$27.56 ,$42.32 ,$32.20 ,$24.36 ,$26.16 ,$28.01 ,$24.36 ,$31.79 ,$32.20 ,$12.37 ,$33.12 ,$7.58 ,$14.70 ,$14.70 ,$12.25 ,$14.70 ,$12.25 ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,30200251,86677,HC H PYLORI AB,302,1 ,$80.00 ,$40.00 ,$8.17 ,$80.00 ,$51.68 ,$8.17 ,$58.98 ,$50.55 ,$16.85 ,$48.00 ,$68.00 ,$56.00 ,$8.17 ,$76.00 ,$57.60 ,$58.40 ,$28.65 ,$68.00 ,$16.85 ,$28.65 ,$64.00 ,$58.40 ,$8.17 ,$16.85 ,$18.61 ,$80.00 ,$68.00 ,$37.91 ,$73.60 ,$56.00 ,$27.83 ,$29.90 ,$48.72 ,$27.83 ,$55.28 ,$56.00 ,$17.02 ,$57.60 ,$8.66 ,$20.22 ,$20.22 ,$16.85 ,$20.22 ,$16.85 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200252,86684,HC HAEMOPHILUS INFLUENZA AB,302,1 ,$140.00 ,$70.00 ,$15.84 ,$140.00 ,$90.44 ,$16.37 ,$61.60 ,$52.80 ,$15.84 ,$84.00 ,$119.00 ,$98.00 ,$16.37 ,$133.00 ,$100.80 ,$102.20 ,$26.93 ,$119.00 ,$15.84 ,$26.93 ,$112.00 ,$102.20 ,$16.37 ,$15.84 ,$17.49 ,$140.00 ,$119.00 ,$35.64 ,$128.80 ,$98.00 ,$75.85 ,$81.47 ,$85.26 ,$75.85 ,$96.74 ,$98.00 ,$16.00 ,$100.80 ,$17.35 ,$19.01 ,$19.01 ,$15.84 ,$19.01 ,$15.84 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200253,86689,HC HIV WESTERN BLOT,302,1 ,$315.00 ,$157.50 ,$19.35 ,$315.00 ,$203.49 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$189.00 ,$267.75 ,$220.50 ,$19.99 ,$299.25 ,$226.80 ,$229.95 ,$32.90 ,$267.75 ,$19.35 ,$32.90 ,$252.00 ,$229.95 ,$19.99 ,$19.35 ,$21.37 ,$315.00 ,$267.75 ,$43.54 ,$289.80 ,$220.50 ,$92.66 ,$99.53 ,$191.84 ,$92.66 ,$217.67 ,$220.50 ,$19.54 ,$226.80 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$226.80 ,$195.30 ,$226.80 ,$226.80 ,$189.00 ST VINCENT HOSPITAL - ACUTE,30200254,86689,HC HIV REF WB,302,1 ,$62.00 ,$31.00 ,$19.35 ,$62.00 ,$40.05 ,$19.99 ,$62.00 ,$62.00 ,$19.35 ,$37.20 ,$52.70 ,$43.40 ,$19.99 ,$58.90 ,$44.64 ,$45.26 ,$32.90 ,$52.70 ,$19.35 ,$32.90 ,$49.60 ,$45.26 ,$19.99 ,$19.35 ,$21.37 ,$62.00 ,$52.70 ,$43.54 ,$57.04 ,$43.40 ,$62.00 ,$62.00 ,$37.76 ,$62.00 ,$42.84 ,$43.40 ,$19.54 ,$44.64 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$44.64 ,$38.44 ,$44.64 ,$44.64 ,$37.20 ST VINCENT HOSPITAL - ACUTE,30200255,86689,HC HTLV AB WESTERN BLOT,302,1 ,$114.00 ,$57.00 ,$19.35 ,$114.00 ,$73.64 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$68.40 ,$96.90 ,$79.80 ,$19.99 ,$108.30 ,$82.08 ,$83.22 ,$32.90 ,$96.90 ,$19.35 ,$32.90 ,$91.20 ,$83.22 ,$19.99 ,$19.35 ,$21.37 ,$114.00 ,$96.90 ,$43.54 ,$104.88 ,$79.80 ,$92.66 ,$99.53 ,$69.43 ,$92.66 ,$78.77 ,$79.80 ,$19.54 ,$82.08 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$82.08 ,$70.68 ,$82.08 ,$82.08 ,$68.40 ST VINCENT HOSPITAL - ACUTE,30200256,86689,HC HIV1 WESTERN BLOT,302,1 ,$126.00 ,$63.00 ,$19.35 ,$126.00 ,$81.40 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$75.60 ,$107.10 ,$88.20 ,$19.99 ,$119.70 ,$90.72 ,$91.98 ,$32.90 ,$107.10 ,$19.35 ,$32.90 ,$100.80 ,$91.98 ,$19.99 ,$19.35 ,$21.37 ,$126.00 ,$107.10 ,$43.54 ,$115.92 ,$88.20 ,$92.66 ,$99.53 ,$76.73 ,$92.66 ,$87.07 ,$88.20 ,$19.54 ,$90.72 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$90.72 ,$78.12 ,$90.72 ,$90.72 ,$75.60 ST VINCENT HOSPITAL - ACUTE,30200257,86689,HC HIV2 WESTERN BLOT,302,1 ,$126.00 ,$63.00 ,$19.35 ,$126.00 ,$81.40 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$75.60 ,$107.10 ,$88.20 ,$19.99 ,$119.70 ,$90.72 ,$91.98 ,$32.90 ,$107.10 ,$19.35 ,$32.90 ,$100.80 ,$91.98 ,$19.99 ,$19.35 ,$21.37 ,$126.00 ,$107.10 ,$43.54 ,$115.92 ,$88.20 ,$92.66 ,$99.53 ,$76.73 ,$92.66 ,$87.07 ,$88.20 ,$19.54 ,$90.72 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$90.72 ,$78.12 ,$90.72 ,$90.72 ,$75.60 ST VINCENT HOSPITAL - ACUTE,30200258,86692,HC HEPATITIS D AB,302,1 ,$118.00 ,$59.00 ,$17.16 ,$118.00 ,$76.23 ,$17.73 ,$66.75 ,$57.21 ,$17.16 ,$70.80 ,$100.30 ,$82.60 ,$17.73 ,$112.10 ,$84.96 ,$86.14 ,$29.17 ,$100.30 ,$17.16 ,$29.17 ,$94.40 ,$86.14 ,$17.73 ,$17.16 ,$18.95 ,$118.00 ,$100.30 ,$38.61 ,$108.56 ,$82.60 ,$82.17 ,$88.26 ,$71.86 ,$82.17 ,$81.54 ,$82.60 ,$17.33 ,$84.96 ,$18.79 ,$20.59 ,$20.59 ,$17.16 ,$20.59 ,$17.16 ,$84.96 ,$73.16 ,$84.96 ,$84.96 ,$70.80 ST VINCENT HOSPITAL - ACUTE,30200259,86694,HC HERPES SIMPLEX AB,302,1 ,$99.00 ,$49.50 ,$14.39 ,$99.00 ,$63.95 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$59.40 ,$84.15 ,$69.30 ,$14.87 ,$94.05 ,$71.28 ,$72.27 ,$24.46 ,$84.15 ,$14.39 ,$24.46 ,$79.20 ,$72.27 ,$14.87 ,$14.39 ,$15.89 ,$99.00 ,$84.15 ,$32.38 ,$91.08 ,$69.30 ,$68.94 ,$74.04 ,$60.29 ,$68.94 ,$68.41 ,$69.30 ,$14.53 ,$71.28 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$71.28 ,$61.38 ,$71.28 ,$71.28 ,$59.40 ST VINCENT HOSPITAL - ACUTE,30200260,86694,HC HERPES SIMPLEX AB (IGG),302,1 ,$99.00 ,$49.50 ,$14.39 ,$99.00 ,$63.95 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$59.40 ,$84.15 ,$69.30 ,$14.87 ,$94.05 ,$71.28 ,$72.27 ,$24.46 ,$84.15 ,$14.39 ,$24.46 ,$79.20 ,$72.27 ,$14.87 ,$14.39 ,$15.89 ,$99.00 ,$84.15 ,$32.38 ,$91.08 ,$69.30 ,$68.94 ,$74.04 ,$60.29 ,$68.94 ,$68.41 ,$69.30 ,$14.53 ,$71.28 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$71.28 ,$61.38 ,$71.28 ,$71.28 ,$59.40 ST VINCENT HOSPITAL - ACUTE,30200261,86695,HC HERPES SIMPLEX AB I,302,1 ,$90.00 ,$45.00 ,$13.19 ,$90.00 ,$58.14 ,$13.63 ,$51.28 ,$43.95 ,$13.19 ,$54.00 ,$76.50 ,$63.00 ,$13.63 ,$85.50 ,$64.80 ,$65.70 ,$22.42 ,$76.50 ,$13.19 ,$22.42 ,$72.00 ,$65.70 ,$13.63 ,$13.19 ,$14.56 ,$90.00 ,$76.50 ,$29.68 ,$82.80 ,$63.00 ,$63.18 ,$67.86 ,$54.81 ,$63.18 ,$62.19 ,$63.00 ,$13.32 ,$64.80 ,$14.45 ,$15.83 ,$15.83 ,$13.19 ,$15.83 ,$13.19 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200262,86695,HC HERPES SIMPLEX IGG I,302,1 ,$86.00 ,$43.00 ,$13.19 ,$86.00 ,$55.56 ,$13.63 ,$51.28 ,$43.95 ,$13.19 ,$51.60 ,$73.10 ,$60.20 ,$13.63 ,$81.70 ,$61.92 ,$62.78 ,$22.42 ,$73.10 ,$13.19 ,$22.42 ,$68.80 ,$62.78 ,$13.63 ,$13.19 ,$14.56 ,$86.00 ,$73.10 ,$29.68 ,$79.12 ,$60.20 ,$63.18 ,$67.86 ,$52.37 ,$63.18 ,$59.43 ,$60.20 ,$13.32 ,$61.92 ,$14.45 ,$15.83 ,$15.83 ,$13.19 ,$15.83 ,$13.19 ,$61.92 ,$53.32 ,$61.92 ,$61.92 ,$51.60 ST VINCENT HOSPITAL - ACUTE,30200263,86696,HC HERPES SIMPLEX AB II,302,1 ,$130.00 ,$65.00 ,$19.35 ,$130.00 ,$83.98 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$78.00 ,$110.50 ,$91.00 ,$19.99 ,$123.50 ,$93.60 ,$94.90 ,$32.90 ,$110.50 ,$19.35 ,$32.90 ,$104.00 ,$94.90 ,$19.99 ,$19.35 ,$21.37 ,$130.00 ,$110.50 ,$43.54 ,$119.60 ,$91.00 ,$92.66 ,$99.53 ,$79.17 ,$92.66 ,$89.83 ,$91.00 ,$19.54 ,$93.60 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30200264,86696,HC HERPES SIMPLEX IGG II,302,1 ,$130.00 ,$65.00 ,$19.35 ,$130.00 ,$83.98 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$78.00 ,$110.50 ,$91.00 ,$19.99 ,$123.50 ,$93.60 ,$94.90 ,$32.90 ,$110.50 ,$19.35 ,$32.90 ,$104.00 ,$94.90 ,$19.99 ,$19.35 ,$21.37 ,$130.00 ,$110.50 ,$43.54 ,$119.60 ,$91.00 ,$92.66 ,$99.53 ,$79.17 ,$92.66 ,$89.83 ,$91.00 ,$19.54 ,$93.60 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30200265,86698,HC HISTOPLASMA AB,302,1 ,$70.00 ,$35.00 ,$13.79 ,$70.00 ,$45.22 ,$14.25 ,$48.58 ,$41.64 ,$13.79 ,$42.00 ,$59.50 ,$49.00 ,$14.25 ,$66.50 ,$50.40 ,$51.10 ,$23.44 ,$59.50 ,$13.79 ,$23.44 ,$56.00 ,$51.10 ,$14.25 ,$13.79 ,$15.23 ,$70.00 ,$59.50 ,$31.03 ,$64.40 ,$49.00 ,$53.74 ,$57.72 ,$42.63 ,$53.74 ,$48.37 ,$49.00 ,$13.93 ,$50.40 ,$15.11 ,$16.55 ,$16.55 ,$13.79 ,$16.55 ,$13.79 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200266,86698,HC HISTOPLASMA AB (MAYO SCR),302,1 ,$70.00 ,$35.00 ,$13.79 ,$70.00 ,$45.22 ,$14.25 ,$48.58 ,$41.64 ,$13.79 ,$42.00 ,$59.50 ,$49.00 ,$14.25 ,$66.50 ,$50.40 ,$51.10 ,$23.44 ,$59.50 ,$13.79 ,$23.44 ,$56.00 ,$51.10 ,$14.25 ,$13.79 ,$15.23 ,$70.00 ,$59.50 ,$31.03 ,$64.40 ,$49.00 ,$53.74 ,$57.72 ,$42.63 ,$53.74 ,$48.37 ,$49.00 ,$13.93 ,$50.40 ,$15.11 ,$16.55 ,$16.55 ,$13.79 ,$16.55 ,$13.79 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200267,86698,HC HISTOPLASMA AB (MAYO),302,1 ,$150.00 ,$75.00 ,$13.79 ,$150.00 ,$96.90 ,$14.25 ,$48.58 ,$41.64 ,$13.79 ,$90.00 ,$127.50 ,$105.00 ,$14.25 ,$142.50 ,$108.00 ,$109.50 ,$23.44 ,$127.50 ,$13.79 ,$23.44 ,$120.00 ,$109.50 ,$14.25 ,$13.79 ,$15.23 ,$150.00 ,$127.50 ,$31.03 ,$138.00 ,$105.00 ,$53.74 ,$57.72 ,$91.35 ,$53.74 ,$103.65 ,$105.00 ,$13.93 ,$108.00 ,$15.11 ,$16.55 ,$16.55 ,$13.79 ,$16.55 ,$13.79 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30200268,86698,HC HISTOPLASMA AB (MYC),302,1 ,$11.00 ,$5.50 ,$5.50 ,$24.75 ,$7.11 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$6.60 ,$9.35 ,$7.70 ,$11.00 ,$10.45 ,$7.92 ,$8.03 ,$11.00 ,$9.35 ,$11.00 ,$11.00 ,$8.80 ,$8.03 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$9.35 ,$24.75 ,$10.12 ,$7.70 ,$11.00 ,$11.00 ,$6.70 ,$11.00 ,$7.60 ,$7.70 ,$11.11 ,$7.92 ,$11.66 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$7.92 ,$6.82 ,$7.92 ,$7.92 ,$6.60 ST VINCENT HOSPITAL - ACUTE,30200269,86698,HC HISTOPLASMA AB (YEAST),302,1 ,$11.00 ,$5.50 ,$5.50 ,$24.75 ,$7.11 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$6.60 ,$9.35 ,$7.70 ,$11.00 ,$10.45 ,$7.92 ,$8.03 ,$11.00 ,$9.35 ,$11.00 ,$11.00 ,$8.80 ,$8.03 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$9.35 ,$24.75 ,$10.12 ,$7.70 ,$11.00 ,$11.00 ,$6.70 ,$11.00 ,$7.60 ,$7.70 ,$11.11 ,$7.92 ,$11.66 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$11.00 ,$7.92 ,$6.82 ,$7.92 ,$7.92 ,$6.60 ST VINCENT HOSPITAL - ACUTE,30200270,86703,HC HIV 1 HIV 2 AB SGL ASSAY,302,1 ,$90.00 ,$45.00 ,$13.71 ,$90.00 ,$58.14 ,$14.17 ,$53.31 ,$45.69 ,$13.71 ,$54.00 ,$76.50 ,$63.00 ,$14.17 ,$85.50 ,$64.80 ,$65.70 ,$23.31 ,$76.50 ,$13.71 ,$23.31 ,$72.00 ,$65.70 ,$14.17 ,$13.71 ,$15.14 ,$90.00 ,$76.50 ,$30.85 ,$82.80 ,$63.00 ,$65.64 ,$70.50 ,$54.81 ,$65.64 ,$62.19 ,$63.00 ,$13.85 ,$64.80 ,$15.02 ,$16.45 ,$16.45 ,$13.71 ,$16.45 ,$13.71 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200271,86704,HC HEP CORE AB,302,1 ,$80.00 ,$40.00 ,$12.05 ,$80.00 ,$51.68 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$48.00 ,$68.00 ,$56.00 ,$12.45 ,$76.00 ,$57.60 ,$58.40 ,$20.49 ,$68.00 ,$12.05 ,$20.49 ,$64.00 ,$58.40 ,$12.45 ,$12.05 ,$13.31 ,$80.00 ,$68.00 ,$27.11 ,$73.60 ,$56.00 ,$57.70 ,$61.98 ,$48.72 ,$57.70 ,$55.28 ,$56.00 ,$12.17 ,$57.60 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200272,86704,HC HEP CORE AB (ATB),302,1 ,$96.00 ,$48.00 ,$12.05 ,$96.00 ,$62.02 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$57.60 ,$81.60 ,$67.20 ,$12.45 ,$91.20 ,$69.12 ,$70.08 ,$20.49 ,$81.60 ,$12.05 ,$20.49 ,$76.80 ,$70.08 ,$12.45 ,$12.05 ,$13.31 ,$96.00 ,$81.60 ,$27.11 ,$88.32 ,$67.20 ,$57.70 ,$61.98 ,$58.46 ,$57.70 ,$66.34 ,$67.20 ,$12.17 ,$69.12 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$69.12 ,$59.52 ,$69.12 ,$69.12 ,$57.60 ST VINCENT HOSPITAL - ACUTE,30200273,86706,HC HEP B SURFACE AB,302,1 ,$70.00 ,$35.00 ,$10.74 ,$70.00 ,$45.22 ,$11.10 ,$41.76 ,$35.79 ,$10.74 ,$42.00 ,$59.50 ,$49.00 ,$11.10 ,$66.50 ,$50.40 ,$51.10 ,$18.26 ,$59.50 ,$10.74 ,$18.26 ,$56.00 ,$51.10 ,$11.10 ,$10.74 ,$11.86 ,$70.00 ,$59.50 ,$24.17 ,$64.40 ,$49.00 ,$51.42 ,$55.23 ,$42.63 ,$51.42 ,$48.37 ,$49.00 ,$10.85 ,$50.40 ,$11.77 ,$12.89 ,$12.89 ,$10.74 ,$12.89 ,$10.74 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200274,86706,HC HEP B SURFACE AB (ATB),302,1 ,$53.00 ,$26.50 ,$10.74 ,$53.00 ,$34.24 ,$11.10 ,$41.76 ,$35.79 ,$10.74 ,$31.80 ,$45.05 ,$37.10 ,$11.10 ,$50.35 ,$38.16 ,$38.69 ,$18.26 ,$45.05 ,$10.74 ,$18.26 ,$42.40 ,$38.69 ,$11.10 ,$10.74 ,$11.86 ,$53.00 ,$45.05 ,$24.17 ,$48.76 ,$37.10 ,$51.42 ,$53.00 ,$32.28 ,$51.42 ,$36.62 ,$37.10 ,$10.85 ,$38.16 ,$11.77 ,$12.89 ,$12.89 ,$10.74 ,$12.89 ,$10.74 ,$38.16 ,$32.86 ,$38.16 ,$38.16 ,$31.80 ST VINCENT HOSPITAL - ACUTE,30200275,86707,HC HEP B E AB,302,1 ,$60.00 ,$30.00 ,$11.57 ,$60.00 ,$38.76 ,$11.96 ,$44.98 ,$38.55 ,$11.57 ,$36.00 ,$51.00 ,$42.00 ,$11.96 ,$57.00 ,$43.20 ,$43.80 ,$19.67 ,$51.00 ,$11.57 ,$19.67 ,$48.00 ,$43.80 ,$11.96 ,$11.57 ,$12.78 ,$60.00 ,$51.00 ,$26.03 ,$55.20 ,$42.00 ,$55.39 ,$59.49 ,$36.54 ,$55.39 ,$41.46 ,$42.00 ,$11.69 ,$43.20 ,$12.68 ,$13.88 ,$13.88 ,$11.57 ,$13.88 ,$11.57 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200276,86708,HC HEP A AB TOTAL,302,1 ,$70.00 ,$35.00 ,$12.39 ,$70.00 ,$45.22 ,$12.80 ,$48.16 ,$41.28 ,$12.39 ,$42.00 ,$59.50 ,$49.00 ,$12.80 ,$66.50 ,$50.40 ,$51.10 ,$21.06 ,$59.50 ,$12.39 ,$21.06 ,$56.00 ,$51.10 ,$12.80 ,$12.39 ,$13.68 ,$70.00 ,$59.50 ,$27.88 ,$64.40 ,$49.00 ,$59.32 ,$63.71 ,$42.63 ,$59.32 ,$48.37 ,$49.00 ,$12.51 ,$50.40 ,$13.57 ,$14.87 ,$14.87 ,$12.39 ,$14.87 ,$12.39 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200277,86709,HC HEP A AB IGM,302,1 ,$140.00 ,$70.00 ,$11.26 ,$140.00 ,$90.44 ,$11.63 ,$43.79 ,$37.53 ,$11.26 ,$84.00 ,$119.00 ,$98.00 ,$11.63 ,$133.00 ,$100.80 ,$102.20 ,$19.14 ,$119.00 ,$11.26 ,$19.14 ,$112.00 ,$102.20 ,$11.63 ,$11.26 ,$12.43 ,$140.00 ,$119.00 ,$25.34 ,$128.80 ,$98.00 ,$53.91 ,$57.91 ,$85.26 ,$53.91 ,$96.74 ,$98.00 ,$11.37 ,$100.80 ,$12.33 ,$13.51 ,$13.51 ,$11.26 ,$13.51 ,$11.26 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200279,86713,HC LEGIONELLA AB (PNEUM),302,1 ,$90.00 ,$45.00 ,$15.30 ,$90.00 ,$58.14 ,$15.81 ,$59.50 ,$51.00 ,$15.30 ,$54.00 ,$76.50 ,$63.00 ,$15.81 ,$85.50 ,$64.80 ,$65.70 ,$26.01 ,$76.50 ,$15.30 ,$26.01 ,$72.00 ,$65.70 ,$15.81 ,$15.30 ,$16.89 ,$90.00 ,$76.50 ,$34.43 ,$82.80 ,$63.00 ,$73.29 ,$78.72 ,$54.81 ,$73.29 ,$62.19 ,$63.00 ,$15.45 ,$64.80 ,$16.76 ,$18.36 ,$18.36 ,$15.30 ,$18.36 ,$15.30 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200280,86713,HC LEGIONELLA AB (IGM),302,1 ,$90.00 ,$45.00 ,$15.30 ,$90.00 ,$58.14 ,$15.81 ,$59.50 ,$51.00 ,$15.30 ,$54.00 ,$76.50 ,$63.00 ,$15.81 ,$85.50 ,$64.80 ,$65.70 ,$26.01 ,$76.50 ,$15.30 ,$26.01 ,$72.00 ,$65.70 ,$15.81 ,$15.30 ,$16.89 ,$90.00 ,$76.50 ,$34.43 ,$82.80 ,$63.00 ,$73.29 ,$78.72 ,$54.81 ,$73.29 ,$62.19 ,$63.00 ,$15.45 ,$64.80 ,$16.76 ,$18.36 ,$18.36 ,$15.30 ,$18.36 ,$15.30 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200281,86720,HC LEPTOSPIRA AB,302,1 ,$88.00 ,$44.00 ,$8.17 ,$88.00 ,$56.85 ,$8.17 ,$56.70 ,$48.60 ,$16.20 ,$52.80 ,$74.80 ,$61.60 ,$8.17 ,$83.60 ,$63.36 ,$64.24 ,$27.54 ,$74.80 ,$16.20 ,$27.54 ,$70.40 ,$64.24 ,$8.17 ,$16.20 ,$17.89 ,$88.00 ,$74.80 ,$36.45 ,$80.96 ,$61.60 ,$27.83 ,$29.90 ,$53.59 ,$27.83 ,$60.81 ,$61.60 ,$16.36 ,$63.36 ,$8.66 ,$19.44 ,$19.44 ,$16.20 ,$19.44 ,$16.20 ,$63.36 ,$54.56 ,$63.36 ,$63.36 ,$52.80 ST VINCENT HOSPITAL - ACUTE,30200282,86735,HC MUMPS AB,302,1 ,$110.00 ,$55.00 ,$13.05 ,$110.00 ,$71.06 ,$13.48 ,$50.75 ,$43.50 ,$13.05 ,$66.00 ,$93.50 ,$77.00 ,$13.48 ,$104.50 ,$79.20 ,$80.30 ,$22.19 ,$93.50 ,$13.05 ,$22.19 ,$88.00 ,$80.30 ,$13.48 ,$13.05 ,$14.41 ,$110.00 ,$93.50 ,$29.36 ,$101.20 ,$77.00 ,$62.48 ,$67.11 ,$66.99 ,$62.48 ,$76.01 ,$77.00 ,$13.18 ,$79.20 ,$14.29 ,$15.66 ,$15.66 ,$13.05 ,$15.66 ,$13.05 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30200283,86735,HC MUMPS QN,302,1 ,$40.00 ,$20.00 ,$13.05 ,$40.00 ,$25.84 ,$13.48 ,$40.00 ,$40.00 ,$13.05 ,$24.00 ,$34.00 ,$28.00 ,$13.48 ,$38.00 ,$28.80 ,$29.20 ,$22.19 ,$34.00 ,$13.05 ,$22.19 ,$32.00 ,$29.20 ,$13.48 ,$13.05 ,$14.41 ,$40.00 ,$34.00 ,$29.36 ,$36.80 ,$28.00 ,$40.00 ,$40.00 ,$24.36 ,$40.00 ,$27.64 ,$28.00 ,$13.18 ,$28.80 ,$14.29 ,$15.66 ,$15.66 ,$13.05 ,$15.66 ,$13.05 ,$28.80 ,$24.80 ,$28.80 ,$28.80 ,$24.00 ST VINCENT HOSPITAL - ACUTE,30200284,86738,HC MYCOPLASMA AB,302,1 ,$70.00 ,$35.00 ,$13.24 ,$70.00 ,$45.22 ,$13.68 ,$51.49 ,$44.13 ,$13.24 ,$42.00 ,$59.50 ,$49.00 ,$13.68 ,$66.50 ,$50.40 ,$51.10 ,$22.51 ,$59.50 ,$13.24 ,$22.51 ,$56.00 ,$51.10 ,$13.68 ,$13.24 ,$14.62 ,$70.00 ,$59.50 ,$29.79 ,$64.40 ,$49.00 ,$63.43 ,$68.12 ,$42.63 ,$63.43 ,$48.37 ,$49.00 ,$13.37 ,$50.40 ,$14.50 ,$15.89 ,$15.89 ,$13.24 ,$15.89 ,$13.24 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200285,86744,HC NOCARDIA AB,302,1 ,$37.00 ,$18.50 ,$8.17 ,$37.00 ,$23.90 ,$8.17 ,$37.00 ,$37.00 ,$15.99 ,$22.20 ,$31.45 ,$25.90 ,$8.17 ,$35.15 ,$26.64 ,$27.01 ,$27.18 ,$31.45 ,$15.99 ,$27.18 ,$29.60 ,$27.01 ,$8.17 ,$15.99 ,$17.66 ,$37.00 ,$31.45 ,$35.98 ,$34.04 ,$25.90 ,$27.83 ,$29.90 ,$22.53 ,$27.83 ,$25.57 ,$25.90 ,$16.15 ,$26.64 ,$8.66 ,$19.19 ,$19.19 ,$15.99 ,$19.19 ,$15.99 ,$26.64 ,$22.94 ,$26.64 ,$26.64 ,$22.20 ST VINCENT HOSPITAL - ACUTE,30200286,86747,HC PARVOVIRUS AB,302,1 ,$80.00 ,$40.00 ,$15.03 ,$80.00 ,$51.68 ,$15.53 ,$58.45 ,$50.10 ,$15.03 ,$48.00 ,$68.00 ,$56.00 ,$15.53 ,$76.00 ,$57.60 ,$58.40 ,$25.55 ,$68.00 ,$15.03 ,$25.55 ,$64.00 ,$58.40 ,$15.53 ,$15.03 ,$16.60 ,$80.00 ,$68.00 ,$33.82 ,$73.60 ,$56.00 ,$71.99 ,$77.32 ,$48.72 ,$71.99 ,$55.28 ,$56.00 ,$15.18 ,$57.60 ,$16.46 ,$18.04 ,$18.04 ,$15.03 ,$18.04 ,$15.03 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200287,86753,HC PROTOZOA AB,302,1 ,$43.00 ,$21.50 ,$8.17 ,$43.00 ,$27.78 ,$8.17 ,$43.00 ,$41.28 ,$12.39 ,$25.80 ,$36.55 ,$30.10 ,$8.17 ,$40.85 ,$30.96 ,$31.39 ,$21.06 ,$36.55 ,$12.39 ,$21.06 ,$34.40 ,$31.39 ,$8.17 ,$12.39 ,$13.68 ,$43.00 ,$36.55 ,$27.88 ,$39.56 ,$30.10 ,$27.83 ,$29.90 ,$26.19 ,$27.83 ,$29.71 ,$30.10 ,$12.51 ,$30.96 ,$8.66 ,$14.87 ,$14.87 ,$12.39 ,$14.87 ,$12.39 ,$30.96 ,$26.66 ,$30.96 ,$30.96 ,$25.80 ST VINCENT HOSPITAL - ACUTE,30200288,86762,HC RUBELLA AB,302,1 ,$100.00 ,$50.00 ,$14.39 ,$100.00 ,$64.60 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$60.00 ,$85.00 ,$70.00 ,$14.87 ,$95.00 ,$72.00 ,$73.00 ,$24.46 ,$85.00 ,$14.39 ,$24.46 ,$80.00 ,$73.00 ,$14.87 ,$14.39 ,$15.89 ,$100.00 ,$85.00 ,$32.38 ,$92.00 ,$70.00 ,$68.94 ,$74.04 ,$60.90 ,$68.94 ,$69.10 ,$70.00 ,$14.53 ,$72.00 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200289,86762,HC RUBELLA AB QN,302,1 ,$100.00 ,$50.00 ,$14.39 ,$100.00 ,$64.60 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$60.00 ,$85.00 ,$70.00 ,$14.87 ,$95.00 ,$72.00 ,$73.00 ,$24.46 ,$85.00 ,$14.39 ,$24.46 ,$80.00 ,$73.00 ,$14.87 ,$14.39 ,$15.89 ,$100.00 ,$85.00 ,$32.38 ,$92.00 ,$70.00 ,$68.94 ,$74.04 ,$60.90 ,$68.94 ,$69.10 ,$70.00 ,$14.53 ,$72.00 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200290,86762,HC RUBELLA AB IGG/IGM,302,1 ,$104.00 ,$52.00 ,$14.39 ,$104.00 ,$67.18 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$62.40 ,$88.40 ,$72.80 ,$14.87 ,$98.80 ,$74.88 ,$75.92 ,$24.46 ,$88.40 ,$14.39 ,$24.46 ,$83.20 ,$75.92 ,$14.87 ,$14.39 ,$15.89 ,$104.00 ,$88.40 ,$32.38 ,$95.68 ,$72.80 ,$68.94 ,$74.04 ,$63.34 ,$68.94 ,$71.86 ,$72.80 ,$14.53 ,$74.88 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$74.88 ,$64.48 ,$74.88 ,$74.88 ,$62.40 ST VINCENT HOSPITAL - ACUTE,30200291,86765,HC RUBEOLA AB,302,1 ,$90.00 ,$45.00 ,$12.88 ,$90.00 ,$58.14 ,$13.31 ,$50.09 ,$42.93 ,$12.88 ,$54.00 ,$76.50 ,$63.00 ,$13.31 ,$85.50 ,$64.80 ,$65.70 ,$21.90 ,$76.50 ,$12.88 ,$21.90 ,$72.00 ,$65.70 ,$13.31 ,$12.88 ,$14.22 ,$90.00 ,$76.50 ,$28.98 ,$82.80 ,$63.00 ,$61.71 ,$66.28 ,$54.81 ,$61.71 ,$62.19 ,$63.00 ,$13.01 ,$64.80 ,$14.11 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200292,86765,HC RUBEOLA AB QN,302,1 ,$90.00 ,$45.00 ,$12.88 ,$90.00 ,$58.14 ,$13.31 ,$50.09 ,$42.93 ,$12.88 ,$54.00 ,$76.50 ,$63.00 ,$13.31 ,$85.50 ,$64.80 ,$65.70 ,$21.90 ,$76.50 ,$12.88 ,$21.90 ,$72.00 ,$65.70 ,$13.31 ,$12.88 ,$14.22 ,$90.00 ,$76.50 ,$28.98 ,$82.80 ,$63.00 ,$61.71 ,$66.28 ,$54.81 ,$61.71 ,$62.19 ,$63.00 ,$13.01 ,$64.80 ,$14.11 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200293,86765,HC RUBEOLA AB IGM,302,1 ,$127.00 ,$63.50 ,$12.88 ,$127.00 ,$82.04 ,$13.31 ,$50.09 ,$42.93 ,$12.88 ,$76.20 ,$107.95 ,$88.90 ,$13.31 ,$120.65 ,$91.44 ,$92.71 ,$21.90 ,$107.95 ,$12.88 ,$21.90 ,$101.60 ,$92.71 ,$13.31 ,$12.88 ,$14.22 ,$127.00 ,$107.95 ,$28.98 ,$116.84 ,$88.90 ,$61.71 ,$66.28 ,$77.34 ,$61.71 ,$87.76 ,$88.90 ,$13.01 ,$91.44 ,$14.11 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$91.44 ,$78.74 ,$91.44 ,$91.44 ,$76.20 ST VINCENT HOSPITAL - ACUTE,30200294,86768,HC SALMONELLA,302,1 ,$67.00 ,$33.50 ,$11.50 ,$67.00 ,$43.28 ,$11.50 ,$51.28 ,$43.95 ,$13.19 ,$40.20 ,$56.95 ,$46.90 ,$11.50 ,$63.65 ,$48.24 ,$48.91 ,$22.42 ,$56.95 ,$13.19 ,$22.42 ,$53.60 ,$48.91 ,$11.50 ,$13.19 ,$14.56 ,$67.00 ,$56.95 ,$29.68 ,$61.64 ,$46.90 ,$39.17 ,$42.07 ,$40.80 ,$39.17 ,$46.30 ,$46.90 ,$13.32 ,$48.24 ,$12.19 ,$15.83 ,$15.83 ,$13.19 ,$15.83 ,$13.19 ,$48.24 ,$41.54 ,$48.24 ,$48.24 ,$40.20 ST VINCENT HOSPITAL - ACUTE,30200295,86774,HC TETANUS AB,302,1 ,$100.00 ,$50.00 ,$14.80 ,$100.00 ,$64.60 ,$15.29 ,$57.54 ,$49.32 ,$14.80 ,$60.00 ,$85.00 ,$70.00 ,$15.29 ,$95.00 ,$72.00 ,$73.00 ,$25.16 ,$85.00 ,$14.80 ,$25.16 ,$80.00 ,$73.00 ,$15.29 ,$14.80 ,$16.34 ,$100.00 ,$85.00 ,$33.30 ,$92.00 ,$70.00 ,$70.87 ,$76.12 ,$60.90 ,$70.87 ,$69.10 ,$70.00 ,$14.95 ,$72.00 ,$16.21 ,$17.76 ,$17.76 ,$14.80 ,$17.76 ,$14.80 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200296,86777,HC TOXOPLASMA AB,302,1 ,$100.00 ,$50.00 ,$14.39 ,$100.00 ,$64.60 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$60.00 ,$85.00 ,$70.00 ,$14.87 ,$95.00 ,$72.00 ,$73.00 ,$24.46 ,$85.00 ,$14.39 ,$24.46 ,$80.00 ,$73.00 ,$14.87 ,$14.39 ,$15.89 ,$100.00 ,$85.00 ,$32.38 ,$92.00 ,$70.00 ,$68.94 ,$74.04 ,$60.90 ,$68.94 ,$69.10 ,$70.00 ,$14.53 ,$72.00 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200297,86778,HC TOXOPLASMA AB IGM,302,1 ,$90.00 ,$45.00 ,$14.41 ,$90.00 ,$58.14 ,$14.89 ,$56.04 ,$48.03 ,$14.41 ,$54.00 ,$76.50 ,$63.00 ,$14.89 ,$85.50 ,$64.80 ,$65.70 ,$24.50 ,$76.50 ,$14.41 ,$24.50 ,$72.00 ,$65.70 ,$14.89 ,$14.41 ,$15.91 ,$90.00 ,$76.50 ,$32.42 ,$82.80 ,$63.00 ,$61.18 ,$65.71 ,$54.81 ,$61.18 ,$62.19 ,$63.00 ,$14.55 ,$64.80 ,$15.78 ,$17.29 ,$17.29 ,$14.41 ,$17.29 ,$14.41 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200298,86780,HC TREPONEMA P AB CONFIRM,302,1 ,$38.00 ,$19.00 ,$11.13 ,$38.00 ,$24.55 ,$11.13 ,$38.00 ,$38.00 ,$13.24 ,$22.80 ,$32.30 ,$26.60 ,$11.13 ,$36.10 ,$27.36 ,$27.74 ,$22.51 ,$32.30 ,$13.24 ,$22.51 ,$30.40 ,$27.74 ,$11.13 ,$13.24 ,$14.62 ,$38.00 ,$32.30 ,$29.79 ,$34.96 ,$26.60 ,$37.91 ,$38.00 ,$23.14 ,$37.91 ,$26.26 ,$26.60 ,$13.37 ,$27.36 ,$11.80 ,$15.89 ,$15.89 ,$13.24 ,$15.89 ,$13.24 ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,30200299,86787,HC VARICELLA ZOSTER ATB,302,1 ,$70.00 ,$35.00 ,$8.17 ,$70.00 ,$45.22 ,$8.17 ,$50.09 ,$42.93 ,$12.88 ,$42.00 ,$59.50 ,$49.00 ,$8.17 ,$66.50 ,$50.40 ,$51.10 ,$21.90 ,$59.50 ,$12.88 ,$21.90 ,$56.00 ,$51.10 ,$8.17 ,$12.88 ,$14.22 ,$70.00 ,$59.50 ,$28.98 ,$64.40 ,$49.00 ,$27.83 ,$29.90 ,$42.63 ,$27.83 ,$48.37 ,$49.00 ,$13.01 ,$50.40 ,$8.66 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200300,86787,HC VARICELLA ZOSTER IGM,302,1 ,$50.00 ,$25.00 ,$8.17 ,$50.00 ,$32.30 ,$8.17 ,$50.00 ,$42.93 ,$12.88 ,$30.00 ,$42.50 ,$35.00 ,$8.17 ,$47.50 ,$36.00 ,$36.50 ,$21.90 ,$42.50 ,$12.88 ,$21.90 ,$40.00 ,$36.50 ,$8.17 ,$12.88 ,$14.22 ,$50.00 ,$42.50 ,$28.98 ,$46.00 ,$35.00 ,$27.83 ,$29.90 ,$30.45 ,$27.83 ,$34.55 ,$35.00 ,$13.01 ,$36.00 ,$8.66 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30200301,86787,HC VARICELLA ZOSTER QN,302,1 ,$40.00 ,$20.00 ,$8.17 ,$40.00 ,$25.84 ,$8.17 ,$40.00 ,$40.00 ,$12.88 ,$24.00 ,$34.00 ,$28.00 ,$8.17 ,$38.00 ,$28.80 ,$29.20 ,$21.90 ,$34.00 ,$12.88 ,$21.90 ,$32.00 ,$29.20 ,$8.17 ,$12.88 ,$14.22 ,$40.00 ,$34.00 ,$28.98 ,$36.80 ,$28.00 ,$27.83 ,$29.90 ,$24.36 ,$27.83 ,$27.64 ,$28.00 ,$13.01 ,$28.80 ,$8.66 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$28.80 ,$24.80 ,$28.80 ,$28.80 ,$24.00 ST VINCENT HOSPITAL - ACUTE,30200302,86787,HC VARICELLA ZOSTER IGG,302,1 ,$45.00 ,$22.50 ,$8.17 ,$45.00 ,$29.07 ,$8.17 ,$45.00 ,$42.93 ,$12.88 ,$27.00 ,$38.25 ,$31.50 ,$8.17 ,$42.75 ,$32.40 ,$32.85 ,$21.90 ,$38.25 ,$12.88 ,$21.90 ,$36.00 ,$32.85 ,$8.17 ,$12.88 ,$14.22 ,$45.00 ,$38.25 ,$28.98 ,$41.40 ,$31.50 ,$27.83 ,$29.90 ,$27.41 ,$27.83 ,$31.10 ,$31.50 ,$13.01 ,$32.40 ,$8.66 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,30200303,86788,HC WEST NILE VIRUS AB IGM,302,1 ,$70.00 ,$35.00 ,$8.17 ,$70.00 ,$45.22 ,$8.17 ,$65.52 ,$56.16 ,$16.85 ,$42.00 ,$59.50 ,$49.00 ,$8.17 ,$66.50 ,$50.40 ,$51.10 ,$28.65 ,$59.50 ,$16.85 ,$28.65 ,$56.00 ,$51.10 ,$8.17 ,$16.85 ,$18.61 ,$70.00 ,$59.50 ,$37.91 ,$64.40 ,$49.00 ,$27.83 ,$29.90 ,$42.63 ,$27.83 ,$48.37 ,$49.00 ,$17.02 ,$50.40 ,$8.66 ,$20.22 ,$20.22 ,$16.85 ,$20.22 ,$16.85 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200304,86789,HC WEST NILE AB,302,1 ,$80.00 ,$40.00 ,$14.39 ,$80.00 ,$51.68 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$48.00 ,$68.00 ,$56.00 ,$14.87 ,$76.00 ,$57.60 ,$58.40 ,$24.46 ,$68.00 ,$14.39 ,$24.46 ,$64.00 ,$58.40 ,$14.87 ,$14.39 ,$15.89 ,$80.00 ,$68.00 ,$32.38 ,$73.60 ,$56.00 ,$68.94 ,$74.04 ,$48.72 ,$68.94 ,$55.28 ,$56.00 ,$14.53 ,$57.60 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200305,86790,HC HTLV I/II AB,302,1 ,$70.00 ,$35.00 ,$3.18 ,$70.00 ,$45.22 ,$3.18 ,$50.09 ,$42.93 ,$12.88 ,$42.00 ,$59.50 ,$49.00 ,$3.18 ,$66.50 ,$50.40 ,$51.10 ,$21.90 ,$59.50 ,$12.88 ,$21.90 ,$56.00 ,$51.10 ,$3.18 ,$12.88 ,$14.22 ,$70.00 ,$59.50 ,$28.98 ,$64.40 ,$49.00 ,$27.83 ,$29.90 ,$42.63 ,$27.83 ,$48.37 ,$49.00 ,$13.01 ,$50.40 ,$3.37 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200306,86790,HC HHV6 IGM/IGG,302,1 ,$70.00 ,$35.00 ,$3.18 ,$70.00 ,$45.22 ,$3.18 ,$50.09 ,$42.93 ,$12.88 ,$42.00 ,$59.50 ,$49.00 ,$3.18 ,$66.50 ,$50.40 ,$51.10 ,$21.90 ,$59.50 ,$12.88 ,$21.90 ,$56.00 ,$51.10 ,$3.18 ,$12.88 ,$14.22 ,$70.00 ,$59.50 ,$28.98 ,$64.40 ,$49.00 ,$27.83 ,$29.90 ,$42.63 ,$27.83 ,$48.37 ,$49.00 ,$13.01 ,$50.40 ,$3.37 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200307,86790,HC HERPES VIRUS 7 IGM/IGG,302,1 ,$70.00 ,$35.00 ,$3.18 ,$70.00 ,$45.22 ,$3.18 ,$50.09 ,$42.93 ,$12.88 ,$42.00 ,$59.50 ,$49.00 ,$3.18 ,$66.50 ,$50.40 ,$51.10 ,$21.90 ,$59.50 ,$12.88 ,$21.90 ,$56.00 ,$51.10 ,$3.18 ,$12.88 ,$14.22 ,$70.00 ,$59.50 ,$28.98 ,$64.40 ,$49.00 ,$27.83 ,$29.90 ,$42.63 ,$27.83 ,$48.37 ,$49.00 ,$13.01 ,$50.40 ,$3.37 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200308,86790,HC HERPES VIRUS 8 IGM,302,1 ,$116.00 ,$58.00 ,$3.18 ,$116.00 ,$74.94 ,$3.18 ,$50.09 ,$42.93 ,$12.88 ,$69.60 ,$98.60 ,$81.20 ,$3.18 ,$110.20 ,$83.52 ,$84.68 ,$21.90 ,$98.60 ,$12.88 ,$21.90 ,$92.80 ,$84.68 ,$3.18 ,$12.88 ,$14.22 ,$116.00 ,$98.60 ,$28.98 ,$106.72 ,$81.20 ,$27.83 ,$29.90 ,$70.64 ,$27.83 ,$80.16 ,$81.20 ,$13.01 ,$83.52 ,$3.37 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$83.52 ,$71.92 ,$83.52 ,$83.52 ,$69.60 ST VINCENT HOSPITAL - ACUTE,30200309,86790,HC RABIES AB,302,1 ,$79.00 ,$39.50 ,$3.18 ,$79.00 ,$51.03 ,$3.18 ,$50.09 ,$42.93 ,$12.88 ,$47.40 ,$67.15 ,$55.30 ,$3.18 ,$75.05 ,$56.88 ,$57.67 ,$21.90 ,$67.15 ,$12.88 ,$21.90 ,$63.20 ,$57.67 ,$3.18 ,$12.88 ,$14.22 ,$79.00 ,$67.15 ,$28.98 ,$72.68 ,$55.30 ,$27.83 ,$29.90 ,$48.11 ,$27.83 ,$54.59 ,$55.30 ,$13.01 ,$56.88 ,$3.37 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$56.88 ,$48.98 ,$56.88 ,$56.88 ,$47.40 ST VINCENT HOSPITAL - ACUTE,30200310,86694,HC HSV IGM,302,1 ,$100.00 ,$50.00 ,$14.39 ,$100.00 ,$64.60 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$60.00 ,$85.00 ,$70.00 ,$14.87 ,$95.00 ,$72.00 ,$73.00 ,$24.46 ,$85.00 ,$14.39 ,$24.46 ,$80.00 ,$73.00 ,$14.87 ,$14.39 ,$15.89 ,$100.00 ,$85.00 ,$32.38 ,$92.00 ,$70.00 ,$68.94 ,$74.04 ,$60.90 ,$68.94 ,$69.10 ,$70.00 ,$14.53 ,$72.00 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200312,86800,HC THYROGLOBULIN AB,302,1 ,$110.00 ,$55.00 ,$15.91 ,$110.00 ,$71.06 ,$16.44 ,$61.85 ,$53.01 ,$15.91 ,$66.00 ,$93.50 ,$77.00 ,$16.44 ,$104.50 ,$79.20 ,$80.30 ,$27.05 ,$93.50 ,$15.91 ,$27.05 ,$88.00 ,$80.30 ,$16.44 ,$15.91 ,$17.57 ,$110.00 ,$93.50 ,$35.80 ,$101.20 ,$77.00 ,$76.17 ,$81.81 ,$66.99 ,$76.17 ,$76.01 ,$77.00 ,$16.07 ,$79.20 ,$17.43 ,$19.09 ,$19.09 ,$15.91 ,$19.09 ,$15.91 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30200313,86800,HC THYROGLOBULIN ANTIBODY,302,1 ,$110.00 ,$55.00 ,$15.91 ,$110.00 ,$71.06 ,$16.44 ,$61.85 ,$53.01 ,$15.91 ,$66.00 ,$93.50 ,$77.00 ,$16.44 ,$104.50 ,$79.20 ,$80.30 ,$27.05 ,$93.50 ,$15.91 ,$27.05 ,$88.00 ,$80.30 ,$16.44 ,$15.91 ,$17.57 ,$110.00 ,$93.50 ,$35.80 ,$101.20 ,$77.00 ,$76.17 ,$81.81 ,$66.99 ,$76.17 ,$76.01 ,$77.00 ,$16.07 ,$79.20 ,$17.43 ,$19.09 ,$19.09 ,$15.91 ,$19.09 ,$15.91 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30200314,86803,HC HEP C AB,302,1 ,$100.00 ,$50.00 ,$14.27 ,$100.00 ,$64.60 ,$14.75 ,$55.48 ,$47.55 ,$14.27 ,$60.00 ,$85.00 ,$70.00 ,$14.75 ,$95.00 ,$72.00 ,$73.00 ,$24.26 ,$85.00 ,$14.27 ,$24.26 ,$80.00 ,$73.00 ,$14.75 ,$14.27 ,$15.76 ,$100.00 ,$85.00 ,$32.11 ,$92.00 ,$70.00 ,$68.34 ,$73.40 ,$60.90 ,$68.34 ,$69.10 ,$70.00 ,$14.41 ,$72.00 ,$15.64 ,$17.12 ,$17.12 ,$14.27 ,$17.12 ,$14.27 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200316,86804,HC HEP C AB CONFIRM,302,1 ,$146.00 ,$73.00 ,$15.49 ,$146.00 ,$94.32 ,$16.01 ,$60.24 ,$51.63 ,$15.49 ,$87.60 ,$124.10 ,$102.20 ,$16.01 ,$138.70 ,$105.12 ,$106.58 ,$26.33 ,$124.10 ,$15.49 ,$26.33 ,$116.80 ,$106.58 ,$16.01 ,$15.49 ,$17.10 ,$146.00 ,$124.10 ,$34.85 ,$134.32 ,$102.20 ,$74.17 ,$79.66 ,$88.91 ,$74.17 ,$100.89 ,$102.20 ,$15.64 ,$105.12 ,$16.97 ,$18.59 ,$18.59 ,$15.49 ,$18.59 ,$15.49 ,$105.12 ,$90.52 ,$105.12 ,$105.12 ,$87.60 ST VINCENT HOSPITAL - ACUTE,30200317,86807,HC CYTOTOXIC PRA STND,302,1 ,$77.00 ,$38.50 ,$38.50 ,$173.25 ,$49.74 ,$55.65 ,$77.00 ,$77.00 ,$77.00 ,$46.20 ,$65.45 ,$53.90 ,$55.65 ,$73.15 ,$55.44 ,$56.21 ,$77.00 ,$65.45 ,$77.00 ,$77.00 ,$61.60 ,$56.21 ,$55.65 ,$77.00 ,$77.00 ,$77.00 ,$65.45 ,$173.25 ,$70.84 ,$53.90 ,$77.00 ,$77.00 ,$46.89 ,$77.00 ,$53.21 ,$53.90 ,$77.77 ,$55.44 ,$58.99 ,$77.00 ,$77.00 ,$77.00 ,$77.00 ,$77.00 ,$55.44 ,$47.74 ,$55.44 ,$55.44 ,$46.20 ST VINCENT HOSPITAL - ACUTE,30200318,86807,HC CYTOTOXIC PRA STND SCR,302,1 ,$362.00 ,$181.00 ,$55.65 ,$362.00 ,$233.85 ,$55.65 ,$275.28 ,$235.95 ,$78.65 ,$217.20 ,$307.70 ,$253.40 ,$55.65 ,$343.90 ,$260.64 ,$264.26 ,$133.71 ,$307.70 ,$78.65 ,$133.71 ,$289.60 ,$264.26 ,$55.65 ,$78.65 ,$86.85 ,$362.00 ,$307.70 ,$176.96 ,$333.04 ,$253.40 ,$189.50 ,$203.54 ,$220.46 ,$189.50 ,$250.14 ,$253.40 ,$79.44 ,$260.64 ,$58.99 ,$94.38 ,$94.38 ,$78.65 ,$94.38 ,$78.65 ,$260.64 ,$224.44 ,$260.64 ,$260.64 ,$217.20 ST VINCENT HOSPITAL - ACUTE,30200319,86808,HC CYTOTOXIC PRA QUICK SCR,302,1 ,$55.00 ,$27.50 ,$27.50 ,$66.78 ,$35.53 ,$30.67 ,$55.00 ,$55.00 ,$29.68 ,$33.00 ,$46.75 ,$38.50 ,$30.67 ,$52.25 ,$39.60 ,$40.15 ,$50.46 ,$46.75 ,$29.68 ,$50.46 ,$44.00 ,$40.15 ,$30.67 ,$29.68 ,$32.77 ,$55.00 ,$46.75 ,$66.78 ,$50.60 ,$38.50 ,$55.00 ,$55.00 ,$33.50 ,$55.00 ,$38.01 ,$38.50 ,$29.98 ,$39.60 ,$32.51 ,$35.62 ,$35.62 ,$29.68 ,$35.62 ,$29.68 ,$39.60 ,$34.10 ,$39.60 ,$39.60 ,$33.00 ST VINCENT HOSPITAL - ACUTE,30200320,86808,HC CYTOTOXIC PRA QUICK (MTHD 1/2),302,1 ,$235.00 ,$117.50 ,$29.68 ,$235.00 ,$151.81 ,$30.67 ,$115.43 ,$98.94 ,$29.68 ,$141.00 ,$199.75 ,$164.50 ,$30.67 ,$223.25 ,$169.20 ,$171.55 ,$50.46 ,$199.75 ,$29.68 ,$50.46 ,$188.00 ,$171.55 ,$30.67 ,$29.68 ,$32.77 ,$235.00 ,$199.75 ,$66.78 ,$216.20 ,$164.50 ,$142.12 ,$152.65 ,$143.12 ,$142.12 ,$162.39 ,$164.50 ,$29.98 ,$169.20 ,$32.51 ,$35.62 ,$35.62 ,$29.68 ,$35.62 ,$29.68 ,$169.20 ,$145.70 ,$169.20 ,$169.20 ,$141.00 ST VINCENT HOSPITAL - ACUTE,30200321,86808,HC CYTOTOXIC PRA QUICK,302,1 ,$77.00 ,$38.50 ,$29.68 ,$77.00 ,$49.74 ,$30.67 ,$77.00 ,$77.00 ,$29.68 ,$46.20 ,$65.45 ,$53.90 ,$30.67 ,$73.15 ,$55.44 ,$56.21 ,$50.46 ,$65.45 ,$29.68 ,$50.46 ,$61.60 ,$56.21 ,$30.67 ,$29.68 ,$32.77 ,$77.00 ,$65.45 ,$66.78 ,$70.84 ,$53.90 ,$77.00 ,$77.00 ,$46.89 ,$77.00 ,$53.21 ,$53.90 ,$29.98 ,$55.44 ,$32.51 ,$35.62 ,$35.62 ,$29.68 ,$35.62 ,$29.68 ,$55.44 ,$47.74 ,$55.44 ,$55.44 ,$46.20 ST VINCENT HOSPITAL - ACUTE,30200322,86812,HC HLA TYPING SINGLE A/B/C,302,1 ,$210.00 ,$105.00 ,$25.81 ,$210.00 ,$135.66 ,$26.67 ,$100.35 ,$86.01 ,$25.81 ,$126.00 ,$178.50 ,$147.00 ,$26.67 ,$199.50 ,$151.20 ,$153.30 ,$43.88 ,$178.50 ,$25.81 ,$43.88 ,$168.00 ,$153.30 ,$26.67 ,$25.81 ,$28.50 ,$210.00 ,$178.50 ,$58.07 ,$193.20 ,$147.00 ,$123.59 ,$132.74 ,$127.89 ,$123.59 ,$145.11 ,$147.00 ,$26.07 ,$151.20 ,$28.27 ,$30.97 ,$30.97 ,$25.81 ,$30.97 ,$25.81 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,30200323,86813,HC HLA TYPING MULTI A/B/C,302,1 ,$527.00 ,$263.50 ,$58.00 ,$527.00 ,$340.44 ,$59.93 ,$225.54 ,$193.32 ,$58.00 ,$316.20 ,$447.95 ,$368.90 ,$59.93 ,$500.65 ,$379.44 ,$384.71 ,$98.60 ,$447.95 ,$58.00 ,$98.60 ,$421.60 ,$384.71 ,$59.93 ,$58.00 ,$64.04 ,$527.00 ,$447.95 ,$130.50 ,$484.84 ,$368.90 ,$277.71 ,$298.28 ,$320.94 ,$277.71 ,$364.16 ,$368.90 ,$58.58 ,$379.44 ,$63.53 ,$69.60 ,$69.60 ,$58.00 ,$69.60 ,$58.00 ,$379.44 ,$326.74 ,$379.44 ,$379.44 ,$316.20 ST VINCENT HOSPITAL - ACUTE,30200324,86849,HC IMMUNOASSAY UNLISTED (LEUKO),302,1 ,$55.00 ,$27.50 ,$3.18 ,$55.00 ,$35.53 ,$3.18 ,$35.58 ,$35.58 , N/A ,$33.00 ,$46.75 ,$38.50 ,$3.18 ,$52.25 ,$39.60 ,$40.15 , N/A ,$46.75 , N/A , N/A ,$44.00 ,$40.15 ,$3.18 , N/A ,$23.10 ,$55.00 ,$46.75 ,$33.00 ,$50.60 ,$38.50 ,$27.50 ,$33.00 ,$33.50 ,$27.50 ,$38.01 ,$38.50 , N/A ,$39.60 ,$3.37 ,$27.50 ,$27.50 , N/A ,$27.50 , N/A ,$39.60 ,$34.10 ,$39.60 ,$39.60 ,$33.00 ST VINCENT HOSPITAL - ACUTE,30200325,86849,HC IMMUNOASSAY UNLISTED (ABID),302,1 ,$77.00 ,$38.50 ,$3.18 ,$77.00 ,$49.74 ,$3.18 ,$49.81 ,$49.81 , N/A ,$46.20 ,$65.45 ,$53.90 ,$3.18 ,$73.15 ,$55.44 ,$56.21 , N/A ,$65.45 , N/A , N/A ,$61.60 ,$56.21 ,$3.18 , N/A ,$32.34 ,$77.00 ,$65.45 ,$46.20 ,$70.84 ,$53.90 ,$38.50 ,$46.20 ,$46.89 ,$38.50 ,$53.21 ,$53.90 , N/A ,$55.44 ,$3.37 ,$38.50 ,$38.50 , N/A ,$38.50 , N/A ,$55.44 ,$47.74 ,$55.44 ,$55.44 ,$46.20 ST VINCENT HOSPITAL - ACUTE,30200326,86849,HC IMMUNOASSAY UNLISTED,302,1 ,$144.00 ,$72.00 ,$3.18 ,$144.00 ,$93.02 ,$3.18 ,$93.15 ,$93.15 , N/A ,$86.40 ,$122.40 ,$100.80 ,$3.18 ,$136.80 ,$103.68 ,$105.12 , N/A ,$122.40 , N/A , N/A ,$115.20 ,$105.12 ,$3.18 , N/A ,$60.48 ,$144.00 ,$122.40 ,$86.40 ,$132.48 ,$100.80 ,$72.00 ,$86.40 ,$87.70 ,$72.00 ,$99.50 ,$100.80 , N/A ,$103.68 ,$3.37 ,$72.00 ,$72.00 , N/A ,$72.00 , N/A ,$103.68 ,$89.28 ,$103.68 ,$103.68 ,$86.40 ST VINCENT HOSPITAL - ACUTE,30200327,86850,HC AB SCREEN,302,1 ,$80.00 ,$40.00 ,$5.38 ,$108.43 ,$51.68 ,$5.38 ,$34.20 ,$29.31 ,$48.19 ,$48.00 ,$68.00 ,$56.00 ,$5.38 ,$76.00 ,$57.60 ,$58.40 ,$16.61 ,$68.00 ,$48.19 ,$16.61 ,$64.00 ,$58.40 ,$5.38 ,$48.19 ,$10.79 ,$80.00 ,$68.00 ,$108.43 ,$73.60 ,$56.00 ,$45.91 ,$49.31 ,$48.72 ,$45.91 ,$55.28 ,$56.00 ,$48.67 ,$57.60 ,$5.70 ,$11.72 ,$11.72 ,$48.19 ,$11.72 ,$48.19 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200329,86860,HC ELUTION,302,1 ,$130.00 ,$65.00 ,$4.14 ,$325.04 ,$83.98 ,$4.14 ,$109.85 ,$94.16 ,$144.46 ,$78.00 ,$110.50 ,$91.00 ,$4.14 ,$123.50 ,$93.60 ,$94.90 ,$52.53 ,$110.50 ,$144.46 ,$52.53 ,$104.00 ,$94.90 ,$4.14 ,$144.46 ,$54.60 ,$130.00 ,$110.50 ,$325.04 ,$119.60 ,$91.00 ,$130.00 ,$130.00 ,$79.17 ,$130.00 ,$89.83 ,$91.00 ,$145.90 ,$93.60 ,$4.39 ,$130.00 ,$130.00 ,$144.46 ,$130.00 ,$144.46 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30200331,86870,HC RBC AB ID PANEL,302,1 ,$240.00 ,$120.00 ,$4.14 ,$634.69 ,$155.04 ,$4.14 ,$150.89 ,$129.34 ,$282.09 ,$144.00 ,$204.00 ,$168.00 ,$4.14 ,$228.00 ,$172.80 ,$175.20 ,$71.52 ,$204.00 ,$282.09 ,$71.52 ,$192.00 ,$175.20 ,$4.14 ,$282.09 ,$100.80 ,$240.00 ,$204.00 ,$634.69 ,$220.80 ,$168.00 ,$119.55 ,$128.41 ,$146.16 ,$119.55 ,$165.84 ,$168.00 ,$284.91 ,$172.80 ,$4.39 ,$240.00 ,$240.00 ,$282.09 ,$240.00 ,$282.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30200334,86880,HC COOMBS DIRECT,302,1 ,$50.00 ,$25.00 ,$5.57 ,$121.29 ,$32.30 ,$5.57 ,$20.97 ,$17.97 ,$53.91 ,$30.00 ,$42.50 ,$35.00 ,$5.57 ,$47.50 ,$36.00 ,$36.50 ,$9.16 ,$42.50 ,$53.91 ,$9.16 ,$40.00 ,$36.50 ,$5.57 ,$53.91 ,$5.95 ,$50.00 ,$42.50 ,$121.29 ,$46.00 ,$35.00 ,$20.57 ,$22.09 ,$30.45 ,$20.57 ,$34.55 ,$35.00 ,$54.45 ,$36.00 ,$5.90 ,$6.47 ,$6.47 ,$53.91 ,$6.47 ,$53.91 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30200336,86880,HC ANTIHUMAN GLOBULIN TEST,302,1 ,$47.00 ,$23.50 ,$5.57 ,$121.29 ,$30.36 ,$5.57 ,$20.97 ,$17.97 ,$53.91 ,$28.20 ,$39.95 ,$32.90 ,$5.57 ,$44.65 ,$33.84 ,$34.31 ,$9.16 ,$39.95 ,$53.91 ,$9.16 ,$37.60 ,$34.31 ,$5.57 ,$53.91 ,$5.95 ,$47.00 ,$39.95 ,$121.29 ,$43.24 ,$32.90 ,$20.57 ,$22.09 ,$28.62 ,$20.57 ,$32.48 ,$32.90 ,$54.45 ,$33.84 ,$5.90 ,$6.47 ,$6.47 ,$53.91 ,$6.47 ,$53.91 ,$33.84 ,$29.14 ,$33.84 ,$33.84 ,$28.20 ST VINCENT HOSPITAL - ACUTE,30200338,86885,HC INDIRECT COOMBS,302,1 ,$71.00 ,$35.50 ,$5.91 ,$325.04 ,$45.87 ,$5.91 ,$22.26 ,$19.08 ,$144.46 ,$42.60 ,$60.35 ,$49.70 ,$5.91 ,$67.45 ,$51.12 ,$51.83 ,$9.72 ,$60.35 ,$144.46 ,$9.72 ,$56.80 ,$51.83 ,$5.91 ,$144.46 ,$6.32 ,$71.00 ,$60.35 ,$325.04 ,$65.32 ,$49.70 ,$27.41 ,$29.44 ,$43.24 ,$27.41 ,$49.06 ,$49.70 ,$145.90 ,$51.12 ,$6.26 ,$6.86 ,$6.86 ,$144.46 ,$6.86 ,$144.46 ,$51.12 ,$44.02 ,$51.12 ,$51.12 ,$42.60 ST VINCENT HOSPITAL - ACUTE,30200339,86885,HC INDIRECT COOMBS (ABID),302,1 ,$10.00 ,$5.00 ,$5.00 ,$325.04 ,$6.46 ,$5.91 ,$10.00 ,$10.00 ,$144.46 ,$6.00 ,$8.50 ,$7.00 ,$5.91 ,$9.50 ,$7.20 ,$7.30 ,$9.72 ,$8.50 ,$144.46 ,$9.72 ,$8.00 ,$7.30 ,$5.91 ,$144.46 ,$6.32 ,$10.00 ,$8.50 ,$325.04 ,$9.20 ,$7.00 ,$10.00 ,$10.00 ,$6.09 ,$10.00 ,$6.91 ,$7.00 ,$145.90 ,$7.20 ,$6.26 ,$6.86 ,$6.86 ,$144.46 ,$6.86 ,$144.46 ,$7.20 ,$6.20 ,$7.20 ,$7.20 ,$6.00 ST VINCENT HOSPITAL - ACUTE,30200340,86886,HC INDIRECT TITER,302,1 ,$60.00 ,$30.00 ,$5.35 ,$325.04 ,$38.76 ,$5.35 ,$20.13 ,$17.25 ,$144.46 ,$36.00 ,$51.00 ,$42.00 ,$5.35 ,$57.00 ,$43.20 ,$43.80 ,$8.81 ,$51.00 ,$144.46 ,$8.81 ,$48.00 ,$43.80 ,$5.35 ,$144.46 ,$5.72 ,$60.00 ,$51.00 ,$325.04 ,$55.20 ,$42.00 ,$24.78 ,$26.62 ,$36.54 ,$24.78 ,$41.46 ,$42.00 ,$145.90 ,$43.20 ,$5.67 ,$6.22 ,$6.22 ,$144.46 ,$6.22 ,$144.46 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200342,86890,HC AUTOLOGOUS PROCESSING FEE,302,1 ,$340.00 ,$170.00 ,$8.01 ,$340.00 ,$219.64 ,$8.01 ,$340.00 ,$296.95 ,$144.46 ,$204.00 ,$289.00 ,$238.00 ,$8.01 ,$323.00 ,$244.80 ,$248.20 ,$164.83 ,$289.00 ,$144.46 ,$164.83 ,$272.00 ,$248.20 ,$8.01 ,$144.46 ,$142.80 ,$340.00 ,$289.00 ,$325.04 ,$312.80 ,$238.00 ,$228.96 ,$245.92 ,$207.06 ,$228.96 ,$234.94 ,$238.00 ,$145.90 ,$244.80 ,$8.49 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,30200343,86891,HC BLOOD SALVAGE AUTOLOOUS INTRA,302,1 ,$450.00 ,$225.00 ,$8.01 ,"$1,429.83 ",$290.70 ,$8.01 ,$450.00 ,$420.08 ,$635.48 ,$270.00 ,$382.50 ,$315.00 ,$8.01 ,$427.50 ,$324.00 ,$328.50 ,$232.46 ,$382.50 ,$635.48 ,$232.46 ,$360.00 ,$328.50 ,$8.01 ,$635.48 ,$189.00 ,$450.00 ,$382.50 ,"$1,429.83 ",$414.00 ,$315.00 ,$228.96 ,$245.92 ,$274.05 ,$228.96 ,$310.95 ,$315.00 ,$641.83 ,$324.00 ,$8.49 ,$450.00 ,$450.00 ,$635.48 ,$450.00 ,$635.48 ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,30200344,86900,HC BLOOD TYPING ABO,302,1 ,$36.00 ,$18.00 ,$3.09 ,$243.95 ,$23.26 ,$3.09 ,$11.62 ,$9.96 ,$108.42 ,$21.60 ,$30.60 ,$25.20 ,$3.09 ,$34.20 ,$25.92 ,$26.28 ,$5.08 ,$30.60 ,$108.42 ,$5.08 ,$28.80 ,$26.28 ,$3.09 ,$108.42 ,$3.30 ,$36.00 ,$30.60 ,$243.95 ,$33.12 ,$25.20 ,$13.13 ,$14.10 ,$21.92 ,$13.13 ,$24.88 ,$25.20 ,$109.50 ,$25.92 ,$3.28 ,$3.59 ,$3.59 ,$108.42 ,$3.59 ,$108.42 ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,30200346,86901,HC BLOOD TYPING RH,302,1 ,$39.00 ,$19.50 ,$3.09 ,$73.74 ,$25.19 ,$3.09 ,$11.62 ,$9.96 ,$32.77 ,$23.40 ,$33.15 ,$27.30 ,$3.09 ,$37.05 ,$28.08 ,$28.47 ,$5.08 ,$33.15 ,$32.77 ,$5.08 ,$31.20 ,$28.47 ,$3.09 ,$32.77 ,$3.30 ,$39.00 ,$33.15 ,$73.74 ,$35.88 ,$27.30 ,$13.13 ,$14.10 ,$23.75 ,$13.13 ,$26.95 ,$27.30 ,$33.10 ,$28.08 ,$3.28 ,$3.59 ,$3.59 ,$32.77 ,$3.59 ,$32.77 ,$28.08 ,$24.18 ,$28.08 ,$28.08 ,$23.40 ST VINCENT HOSPITAL - ACUTE,30200347,86901,HC BLOOD TYPING RH (CLINIC),302,1 ,$21.00 ,$10.50 ,$3.09 ,$73.74 ,$13.57 ,$3.09 ,$11.62 ,$9.96 ,$32.77 ,$12.60 ,$17.85 ,$14.70 ,$3.09 ,$19.95 ,$15.12 ,$15.33 ,$5.08 ,$17.85 ,$32.77 ,$5.08 ,$16.80 ,$15.33 ,$3.09 ,$32.77 ,$3.30 ,$21.00 ,$17.85 ,$73.74 ,$19.32 ,$14.70 ,$13.13 ,$14.10 ,$12.79 ,$13.13 ,$14.51 ,$14.70 ,$33.10 ,$15.12 ,$3.28 ,$3.59 ,$3.59 ,$32.77 ,$3.59 ,$32.77 ,$15.12 ,$13.02 ,$15.12 ,$15.12 ,$12.60 ST VINCENT HOSPITAL - ACUTE,30200349,86902,HC RBC AG SCR RGT SERUM,302,1 ,$70.00 ,$35.00 ,$5.37 ,$634.69 ,$45.22 ,$5.37 ,$22.23 ,$19.05 ,$282.09 ,$42.00 ,$59.50 ,$49.00 ,$5.37 ,$66.50 ,$50.40 ,$51.10 ,$10.80 ,$59.50 ,$282.09 ,$10.80 ,$56.00 ,$51.10 ,$5.37 ,$282.09 ,$7.01 ,$70.00 ,$59.50 ,$634.69 ,$64.40 ,$49.00 ,$18.32 ,$19.68 ,$42.63 ,$18.32 ,$48.37 ,$49.00 ,$284.91 ,$50.40 ,$5.69 ,$7.62 ,$7.62 ,$282.09 ,$7.62 ,$282.09 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200351,86902,HC RBC AG SCR RGT SERUM TYPE UNIT,302,1 ,$60.00 ,$30.00 ,$5.37 ,$634.69 ,$38.76 ,$5.37 ,$22.23 ,$19.05 ,$282.09 ,$36.00 ,$51.00 ,$42.00 ,$5.37 ,$57.00 ,$43.20 ,$43.80 ,$10.80 ,$51.00 ,$282.09 ,$10.80 ,$48.00 ,$43.80 ,$5.37 ,$282.09 ,$7.01 ,$60.00 ,$51.00 ,$634.69 ,$55.20 ,$42.00 ,$18.32 ,$19.68 ,$36.54 ,$18.32 ,$41.46 ,$42.00 ,$284.91 ,$43.20 ,$5.69 ,$7.62 ,$7.62 ,$282.09 ,$7.62 ,$282.09 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200352,86904,HC RBC AG SCR PAT SERUM,302,1 ,$77.00 ,$38.50 ,$13.37 ,$77.00 ,$49.74 ,$13.37 ,$57.19 ,$49.02 ,$32.77 ,$46.20 ,$65.45 ,$53.90 ,$13.37 ,$73.15 ,$55.44 ,$56.21 ,$27.78 ,$65.45 ,$32.77 ,$27.78 ,$61.60 ,$56.21 ,$13.37 ,$32.77 ,$18.04 ,$77.00 ,$65.45 ,$73.74 ,$70.84 ,$53.90 ,$45.52 ,$48.90 ,$46.89 ,$45.52 ,$53.21 ,$53.90 ,$33.10 ,$55.44 ,$14.17 ,$19.61 ,$19.61 ,$32.77 ,$19.61 ,$32.77 ,$55.44 ,$47.74 ,$55.44 ,$55.44 ,$46.20 ST VINCENT HOSPITAL - ACUTE,30200354,86905,HC ANTIGEN ID ONLY,302,1 ,$60.00 ,$30.00 ,$3.96 ,$634.69 ,$38.76 ,$3.96 ,$14.88 ,$12.75 ,$282.09 ,$36.00 ,$51.00 ,$42.00 ,$3.96 ,$57.00 ,$43.20 ,$43.80 ,$6.51 ,$51.00 ,$282.09 ,$6.51 ,$48.00 ,$43.80 ,$3.96 ,$282.09 ,$4.23 ,$60.00 ,$51.00 ,$634.69 ,$55.20 ,$42.00 ,$18.32 ,$19.68 ,$36.54 ,$18.32 ,$41.46 ,$42.00 ,$284.91 ,$43.20 ,$4.20 ,$4.60 ,$4.60 ,$282.09 ,$4.60 ,$282.09 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200356,86920,HC CROSSMATCH IMMEDIATE SPIN,302,1 ,$140.00 ,$70.00 ,$4.14 ,$325.04 ,$90.44 ,$4.14 ,$121.92 ,$104.50 ,$144.46 ,$84.00 ,$119.00 ,$98.00 ,$4.14 ,$133.00 ,$100.80 ,$102.20 ,$58.11 ,$119.00 ,$144.46 ,$58.11 ,$112.00 ,$102.20 ,$4.14 ,$144.46 ,$58.80 ,$140.00 ,$119.00 ,$325.04 ,$128.80 ,$98.00 ,$119.55 ,$128.41 ,$85.26 ,$119.55 ,$96.74 ,$98.00 ,$145.90 ,$100.80 ,$4.39 ,$140.00 ,$140.00 ,$144.46 ,$140.00 ,$144.46 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200358,86921,HC CROSSMATCH INCUBATION,302,1 ,$110.00 ,$55.00 ,$4.14 ,$325.04 ,$71.06 ,$4.14 ,$109.85 ,$94.16 ,$144.46 ,$66.00 ,$93.50 ,$77.00 ,$4.14 ,$104.50 ,$79.20 ,$80.30 ,$52.53 ,$93.50 ,$144.46 ,$52.53 ,$88.00 ,$80.30 ,$4.14 ,$144.46 ,$46.20 ,$110.00 ,$93.50 ,$325.04 ,$101.20 ,$77.00 ,$45.91 ,$49.31 ,$66.99 ,$45.91 ,$76.01 ,$77.00 ,$145.90 ,$79.20 ,$4.39 ,$110.00 ,$110.00 ,$144.46 ,$110.00 ,$144.46 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30200360,86922,HC CROSSMATCH AHG,302,1 ,$140.00 ,$70.00 ,$4.14 ,$325.04 ,$90.44 ,$4.14 ,$130.37 ,$111.75 ,$144.46 ,$84.00 ,$119.00 ,$98.00 ,$4.14 ,$133.00 ,$100.80 ,$102.20 ,$62.02 ,$119.00 ,$144.46 ,$62.02 ,$112.00 ,$102.20 ,$4.14 ,$144.46 ,$58.80 ,$140.00 ,$119.00 ,$325.04 ,$128.80 ,$98.00 ,$119.55 ,$128.41 ,$85.26 ,$119.55 ,$96.74 ,$98.00 ,$145.90 ,$100.80 ,$4.39 ,$140.00 ,$140.00 ,$144.46 ,$140.00 ,$144.46 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200362,86923,HC CROSSMATCH ELECTRONIC,302,1 ,$140.00 ,$70.00 ,$4.14 ,$325.04 ,$90.44 ,$4.14 ,$97.78 ,$83.81 ,$144.46 ,$84.00 ,$119.00 ,$98.00 ,$4.14 ,$133.00 ,$100.80 ,$102.20 ,$46.38 ,$119.00 ,$144.46 ,$46.38 ,$112.00 ,$102.20 ,$4.14 ,$144.46 ,$58.80 ,$140.00 ,$119.00 ,$325.04 ,$128.80 ,$98.00 ,$119.55 ,$128.41 ,$85.26 ,$119.55 ,$96.74 ,$98.00 ,$145.90 ,$100.80 ,$4.39 ,$140.00 ,$140.00 ,$144.46 ,$140.00 ,$144.46 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200363,86927,HC FFP THAWING EACH UNIT,302,1 ,$150.00 ,$75.00 ,$8.01 ,$325.04 ,$96.90 ,$8.01 ,$68.81 ,$58.98 ,$144.46 ,$90.00 ,$127.50 ,$105.00 ,$8.01 ,$142.50 ,$108.00 ,$109.50 ,$32.96 ,$127.50 ,$144.46 ,$32.96 ,$120.00 ,$109.50 ,$8.01 ,$144.46 ,$63.00 ,$150.00 ,$127.50 ,$325.04 ,$138.00 ,$105.00 ,$150.00 ,$150.00 ,$91.35 ,$150.00 ,$103.65 ,$105.00 ,$145.90 ,$108.00 ,$8.49 ,$150.00 ,$150.00 ,$144.46 ,$150.00 ,$144.46 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30200365,86945,HC BLOOD PRODUCT IRRADIATION,302,1 ,$103.00 ,$51.50 ,$8.01 ,$103.00 ,$66.54 ,$8.01 ,$102.61 ,$87.95 ,$32.77 ,$61.80 ,$87.55 ,$72.10 ,$8.01 ,$97.85 ,$74.16 ,$75.19 ,$48.62 ,$87.55 ,$32.77 ,$48.62 ,$82.40 ,$75.19 ,$8.01 ,$32.77 ,$43.26 ,$103.00 ,$87.55 ,$73.74 ,$94.76 ,$72.10 ,$45.91 ,$49.31 ,$62.73 ,$45.91 ,$71.17 ,$72.10 ,$33.10 ,$74.16 ,$8.49 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$74.16 ,$63.86 ,$74.16 ,$74.16 ,$61.80 ST VINCENT HOSPITAL - ACUTE,30200366,86950,HC WBC CONC CMV NEG,302,1 ,"$1,540.00 ",$770.00 ,$8.01 ,"$1,540.00 ",$994.84 ,$8.01 ,$265.57 ,$227.63 ,$144.46 ,$924.00 ,"$1,309.00 ","$1,078.00 ",$8.01 ,"$1,463.00 ","$1,108.80 ","$1,124.20 ",$126.28 ,"$1,309.00 ",$144.46 ,$126.28 ,"$1,232.00 ","$1,124.20 ",$8.01 ,$144.46 ,$646.80 ,"$1,540.00 ","$1,309.00 ",$325.04 ,"$1,416.80 ","$1,078.00 ",$45.91 ,$49.31 ,$937.86 ,$45.91 ,"$1,064.14 ","$1,078.00 ",$145.90 ,"$1,108.80 ",$8.49 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,"$1,108.80 ",$954.80 ,"$1,108.80 ","$1,108.80 ",$924.00 ST VINCENT HOSPITAL - ACUTE,30200367,86950,HC WBC CONC CMV NEG (RC),302,1 ,"$1,516.00 ",$758.00 ,$8.01 ,"$1,516.00 ",$979.34 ,$8.01 ,$265.57 ,$227.63 ,$144.46 ,$909.60 ,"$1,288.60 ","$1,061.20 ",$8.01 ,"$1,440.20 ","$1,091.52 ","$1,106.68 ",$126.28 ,"$1,288.60 ",$144.46 ,$126.28 ,"$1,212.80 ","$1,106.68 ",$8.01 ,$144.46 ,$636.72 ,"$1,516.00 ","$1,288.60 ",$325.04 ,"$1,394.72 ","$1,061.20 ",$45.91 ,$49.31 ,$923.24 ,$45.91 ,"$1,047.56 ","$1,061.20 ",$145.90 ,"$1,091.52 ",$8.49 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,"$1,091.52 ",$939.92 ,"$1,091.52 ","$1,091.52 ",$909.60 ST VINCENT HOSPITAL - ACUTE,30200368,86965,HC BLOOD PRODUCT POOL,302,1 ,$113.00 ,$56.50 ,$8.01 ,$325.04 ,$73.00 ,$8.01 ,$113.00 ,$98.29 ,$144.46 ,$67.80 ,$96.05 ,$79.10 ,$8.01 ,$107.35 ,$81.36 ,$82.49 ,$54.20 ,$96.05 ,$144.46 ,$54.20 ,$90.40 ,$82.49 ,$8.01 ,$144.46 ,$47.46 ,$113.00 ,$96.05 ,$325.04 ,$103.96 ,$79.10 ,$113.00 ,$113.00 ,$68.82 ,$113.00 ,$78.08 ,$79.10 ,$145.90 ,$81.36 ,$8.49 ,$113.00 ,$113.00 ,$144.46 ,$113.00 ,$144.46 ,$81.36 ,$70.06 ,$81.36 ,$81.36 ,$67.80 ST VINCENT HOSPITAL - ACUTE,30200369,86970,HC RBC PRETREAT CHEM,302,1 ,$103.00 ,$51.50 ,$8.01 ,$103.00 ,$66.54 ,$8.01 ,$102.61 ,$87.95 ,$32.77 ,$61.80 ,$87.55 ,$72.10 ,$8.01 ,$97.85 ,$74.16 ,$75.19 ,$48.62 ,$87.55 ,$32.77 ,$48.62 ,$82.40 ,$75.19 ,$8.01 ,$32.77 ,$43.26 ,$103.00 ,$87.55 ,$73.74 ,$94.76 ,$72.10 ,$103.00 ,$103.00 ,$62.73 ,$103.00 ,$71.17 ,$72.10 ,$33.10 ,$74.16 ,$8.49 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$74.16 ,$63.86 ,$74.16 ,$74.16 ,$61.80 ST VINCENT HOSPITAL - ACUTE,30200373,86403,HC PARTICLE AGG SCREEN (HAEMOPHILUS OR NEISSERIA),302,1 ,$103.00 ,$51.50 ,$11.54 ,$103.00 ,$66.54 ,$11.92 ,$40.39 ,$34.62 ,$11.54 ,$61.80 ,$87.55 ,$72.10 ,$11.92 ,$97.85 ,$74.16 ,$75.19 ,$19.62 ,$87.55 ,$11.54 ,$19.62 ,$82.40 ,$75.19 ,$11.92 ,$11.54 ,$12.74 ,$103.00 ,$87.55 ,$25.97 ,$94.76 ,$72.10 ,$48.79 ,$52.40 ,$62.73 ,$48.79 ,$71.17 ,$72.10 ,$11.66 ,$74.16 ,$12.64 ,$13.85 ,$13.85 ,$11.54 ,$13.85 ,$11.54 ,$74.16 ,$63.86 ,$74.16 ,$74.16 ,$61.80 ST VINCENT HOSPITAL - ACUTE,30200375,86880,HC C3 DIRECT COOMBS,302,1 ,$46.00 ,$23.00 ,$5.57 ,$121.29 ,$29.72 ,$5.57 ,$20.97 ,$17.97 ,$53.91 ,$27.60 ,$39.10 ,$32.20 ,$5.57 ,$43.70 ,$33.12 ,$33.58 ,$9.16 ,$39.10 ,$53.91 ,$9.16 ,$36.80 ,$33.58 ,$5.57 ,$53.91 ,$5.95 ,$46.00 ,$39.10 ,$121.29 ,$42.32 ,$32.20 ,$20.57 ,$22.09 ,$28.01 ,$20.57 ,$31.79 ,$32.20 ,$54.45 ,$33.12 ,$5.90 ,$6.47 ,$6.47 ,$53.91 ,$6.47 ,$53.91 ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,30200376,86832,HC HLA AB ID CLASS I HIGH RES,302,1 ,$810.00 ,$405.00 ,$139.23 ,$810.00 ,$523.26 ,$139.23 ,$810.00 ,$810.00 ,$323.75 ,$486.00 ,$688.50 ,$567.00 ,$139.23 ,$769.50 ,$583.20 ,$591.30 ,$550.38 ,$688.50 ,$323.75 ,$550.38 ,$648.00 ,$591.30 ,$139.23 ,$323.75 ,$357.48 ,$810.00 ,$688.50 ,$728.44 ,$745.20 ,$567.00 ,$607.55 ,$652.55 ,$493.29 ,$607.55 ,$559.71 ,$567.00 ,$326.99 ,$583.20 ,$147.58 ,$388.50 ,$388.50 ,$323.75 ,$388.50 ,$323.75 ,$583.20 ,$502.20 ,$583.20 ,$583.20 ,$486.00 ST VINCENT HOSPITAL - ACUTE,30200380,86658,HC ENTEROVIRUS B COXSACKIE,302,1 ,$38.00 ,$19.00 ,$8.17 ,$38.00 ,$24.55 ,$8.17 ,$38.00 ,$38.00 ,$13.03 ,$22.80 ,$32.30 ,$26.60 ,$8.17 ,$36.10 ,$27.36 ,$27.74 ,$22.15 ,$32.30 ,$13.03 ,$22.15 ,$30.40 ,$27.74 ,$8.17 ,$13.03 ,$14.39 ,$38.00 ,$32.30 ,$29.32 ,$34.96 ,$26.60 ,$27.83 ,$29.90 ,$23.14 ,$27.83 ,$26.26 ,$26.60 ,$13.16 ,$27.36 ,$8.66 ,$15.64 ,$15.64 ,$13.03 ,$15.64 ,$13.03 ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,30200400,86235,HC ENA AB QUEST,302,1 ,$110.00 ,$55.00 ,$17.93 ,$110.00 ,$71.06 ,$18.53 ,$69.76 ,$59.79 ,$17.93 ,$66.00 ,$93.50 ,$77.00 ,$18.53 ,$104.50 ,$79.20 ,$80.30 ,$30.48 ,$93.50 ,$17.93 ,$30.48 ,$88.00 ,$80.30 ,$18.53 ,$17.93 ,$19.80 ,$110.00 ,$93.50 ,$40.34 ,$101.20 ,$77.00 ,$85.85 ,$92.21 ,$66.99 ,$85.85 ,$76.01 ,$77.00 ,$18.11 ,$79.20 ,$19.64 ,$21.52 ,$21.52 ,$17.93 ,$21.52 ,$17.93 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30200448,86757,HC RICKETTSIA IGG,302,1 ,$100.00 ,$50.00 ,$19.35 ,$100.00 ,$64.60 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$60.00 ,$85.00 ,$70.00 ,$19.99 ,$95.00 ,$72.00 ,$73.00 ,$32.90 ,$85.00 ,$19.35 ,$32.90 ,$80.00 ,$73.00 ,$19.99 ,$19.35 ,$21.37 ,$100.00 ,$85.00 ,$43.54 ,$92.00 ,$70.00 ,$92.66 ,$99.53 ,$60.90 ,$92.66 ,$69.10 ,$70.00 ,$19.54 ,$72.00 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200449,86757,HC RICKETTSIA IGM,302,1 ,$100.00 ,$50.00 ,$19.35 ,$100.00 ,$64.60 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$60.00 ,$85.00 ,$70.00 ,$19.99 ,$95.00 ,$72.00 ,$73.00 ,$32.90 ,$85.00 ,$19.35 ,$32.90 ,$80.00 ,$73.00 ,$19.99 ,$19.35 ,$21.37 ,$100.00 ,$85.00 ,$43.54 ,$92.00 ,$70.00 ,$92.66 ,$99.53 ,$60.90 ,$92.66 ,$69.10 ,$70.00 ,$19.54 ,$72.00 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200450,86635,HC COCCID AB IGG/IGM,302,1 ,$122.00 ,$61.00 ,$8.17 ,$122.00 ,$78.81 ,$8.17 ,$44.63 ,$38.25 ,$11.47 ,$73.20 ,$103.70 ,$85.40 ,$8.17 ,$115.90 ,$87.84 ,$89.06 ,$19.50 ,$103.70 ,$11.47 ,$19.50 ,$97.60 ,$89.06 ,$8.17 ,$11.47 ,$12.67 ,$122.00 ,$103.70 ,$25.81 ,$112.24 ,$85.40 ,$27.83 ,$29.90 ,$74.30 ,$27.83 ,$84.30 ,$85.40 ,$11.58 ,$87.84 ,$8.66 ,$13.76 ,$13.76 ,$11.47 ,$13.76 ,$11.47 ,$87.84 ,$75.64 ,$87.84 ,$87.84 ,$73.20 ST VINCENT HOSPITAL - ACUTE,30200460,86038,HC ANA CENTROMERE B AB,302,1 ,$70.00 ,$35.00 ,$12.09 ,$70.00 ,$45.22 ,$12.49 ,$47.01 ,$40.29 ,$12.09 ,$42.00 ,$59.50 ,$49.00 ,$12.49 ,$66.50 ,$50.40 ,$51.10 ,$20.55 ,$59.50 ,$12.09 ,$20.55 ,$56.00 ,$51.10 ,$12.49 ,$12.09 ,$13.35 ,$70.00 ,$59.50 ,$27.20 ,$64.40 ,$49.00 ,$49.91 ,$53.61 ,$42.63 ,$49.91 ,$48.37 ,$49.00 ,$12.21 ,$50.40 ,$13.24 ,$14.51 ,$14.51 ,$12.09 ,$14.51 ,$12.09 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30200476,86985,HC SPLITTING BLOOD PRODUCT EA,302,1 ,$75.00 ,$37.50 ,$8.01 ,$325.04 ,$48.45 ,$8.01 ,$75.00 ,$75.00 ,$144.46 ,$45.00 ,$63.75 ,$52.50 ,$8.01 ,$71.25 ,$54.00 ,$54.75 ,$42.47 ,$63.75 ,$144.46 ,$42.47 ,$60.00 ,$54.75 ,$8.01 ,$144.46 ,$31.50 ,$75.00 ,$63.75 ,$325.04 ,$69.00 ,$52.50 ,$75.00 ,$75.00 ,$45.68 ,$75.00 ,$51.83 ,$52.50 ,$145.90 ,$54.00 ,$8.49 ,$75.00 ,$75.00 ,$144.46 ,$75.00 ,$144.46 ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,30200477,86695,HC HSV IGM TITER TYPE I,302,1 ,$90.00 ,$45.00 ,$13.19 ,$90.00 ,$58.14 ,$13.63 ,$51.28 ,$43.95 ,$13.19 ,$54.00 ,$76.50 ,$63.00 ,$13.63 ,$85.50 ,$64.80 ,$65.70 ,$22.42 ,$76.50 ,$13.19 ,$22.42 ,$72.00 ,$65.70 ,$13.63 ,$13.19 ,$14.56 ,$90.00 ,$76.50 ,$29.68 ,$82.80 ,$63.00 ,$63.18 ,$67.86 ,$54.81 ,$63.18 ,$62.19 ,$63.00 ,$13.32 ,$64.80 ,$14.45 ,$15.83 ,$15.83 ,$13.19 ,$15.83 ,$13.19 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200478,86696,HC HSV IGM TITER TYPE 2,302,1 ,$130.00 ,$65.00 ,$19.35 ,$130.00 ,$83.98 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$78.00 ,$110.50 ,$91.00 ,$19.99 ,$123.50 ,$93.60 ,$94.90 ,$32.90 ,$110.50 ,$19.35 ,$32.90 ,$104.00 ,$94.90 ,$19.99 ,$19.35 ,$21.37 ,$130.00 ,$110.50 ,$43.54 ,$119.60 ,$91.00 ,$92.66 ,$99.53 ,$79.17 ,$92.66 ,$89.83 ,$91.00 ,$19.54 ,$93.60 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30200480,86696,HC HSV TYPE 2 AB IGG,302,1 ,$130.00 ,$65.00 ,$19.35 ,$130.00 ,$83.98 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$78.00 ,$110.50 ,$91.00 ,$19.99 ,$123.50 ,$93.60 ,$94.90 ,$32.90 ,$110.50 ,$19.35 ,$32.90 ,$104.00 ,$94.90 ,$19.99 ,$19.35 ,$21.37 ,$130.00 ,$110.50 ,$43.54 ,$119.60 ,$91.00 ,$92.66 ,$99.53 ,$79.17 ,$92.66 ,$89.83 ,$91.00 ,$19.54 ,$93.60 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30200481,86695,HC HSV TYPE 1 AB IGG,302,1 ,$90.00 ,$45.00 ,$13.19 ,$90.00 ,$58.14 ,$13.63 ,$51.28 ,$43.95 ,$13.19 ,$54.00 ,$76.50 ,$63.00 ,$13.63 ,$85.50 ,$64.80 ,$65.70 ,$22.42 ,$76.50 ,$13.19 ,$22.42 ,$72.00 ,$65.70 ,$13.63 ,$13.19 ,$14.56 ,$90.00 ,$76.50 ,$29.68 ,$82.80 ,$63.00 ,$63.18 ,$67.86 ,$54.81 ,$63.18 ,$62.19 ,$63.00 ,$13.32 ,$64.80 ,$14.45 ,$15.83 ,$15.83 ,$13.19 ,$15.83 ,$13.19 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30200482,86777,HC TOXOPLASMA AB IGG,302,1 ,$95.00 ,$47.50 ,$14.39 ,$95.00 ,$61.37 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$57.00 ,$80.75 ,$66.50 ,$14.87 ,$90.25 ,$68.40 ,$69.35 ,$24.46 ,$80.75 ,$14.39 ,$24.46 ,$76.00 ,$69.35 ,$14.87 ,$14.39 ,$15.89 ,$95.00 ,$80.75 ,$32.38 ,$87.40 ,$66.50 ,$68.94 ,$74.04 ,$57.86 ,$68.94 ,$65.65 ,$66.50 ,$14.53 ,$68.40 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$68.40 ,$58.90 ,$68.40 ,$68.40 ,$57.00 ST VINCENT HOSPITAL - ACUTE,30200483,86762,HC RUBELLA AB IGG MAYO,302,1 ,$104.00 ,$52.00 ,$14.39 ,$104.00 ,$67.18 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$62.40 ,$88.40 ,$72.80 ,$14.87 ,$98.80 ,$74.88 ,$75.92 ,$24.46 ,$88.40 ,$14.39 ,$24.46 ,$83.20 ,$75.92 ,$14.87 ,$14.39 ,$15.89 ,$104.00 ,$88.40 ,$32.38 ,$95.68 ,$72.80 ,$68.94 ,$74.04 ,$63.34 ,$68.94 ,$71.86 ,$72.80 ,$14.53 ,$74.88 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$74.88 ,$64.48 ,$74.88 ,$74.88 ,$62.40 ST VINCENT HOSPITAL - ACUTE,30200484,86644,HC CMV AB IGG,302,1 ,$98.00 ,$49.00 ,$14.39 ,$98.00 ,$63.31 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$58.80 ,$83.30 ,$68.60 ,$14.87 ,$93.10 ,$70.56 ,$71.54 ,$24.46 ,$83.30 ,$14.39 ,$24.46 ,$78.40 ,$71.54 ,$14.87 ,$14.39 ,$15.89 ,$98.00 ,$83.30 ,$32.38 ,$90.16 ,$68.60 ,$68.94 ,$74.04 ,$59.68 ,$68.94 ,$67.72 ,$68.60 ,$14.53 ,$70.56 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$70.56 ,$60.76 ,$70.56 ,$70.56 ,$58.80 ST VINCENT HOSPITAL - ACUTE,30200511,86226,HC DNA SINGLE STRAND AB,302,1 ,$103.00 ,$51.50 ,$12.11 ,$103.00 ,$66.54 ,$12.51 ,$47.08 ,$40.35 ,$12.11 ,$61.80 ,$87.55 ,$72.10 ,$12.51 ,$97.85 ,$74.16 ,$75.19 ,$20.59 ,$87.55 ,$12.11 ,$20.59 ,$82.40 ,$75.19 ,$12.51 ,$12.11 ,$13.37 ,$103.00 ,$87.55 ,$27.25 ,$94.76 ,$72.10 ,$57.99 ,$62.28 ,$62.73 ,$57.99 ,$71.17 ,$72.10 ,$12.23 ,$74.16 ,$13.26 ,$14.53 ,$14.53 ,$12.11 ,$14.53 ,$12.11 ,$74.16 ,$63.86 ,$74.16 ,$74.16 ,$61.80 ST VINCENT HOSPITAL - ACUTE,30200513,86256,HC FLUOR AB TITER,302,1 ,$77.00 ,$38.50 ,$12.05 ,$77.00 ,$49.74 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$46.20 ,$65.45 ,$53.90 ,$12.45 ,$73.15 ,$55.44 ,$56.21 ,$20.49 ,$65.45 ,$12.05 ,$20.49 ,$61.60 ,$56.21 ,$12.45 ,$12.05 ,$13.31 ,$77.00 ,$65.45 ,$27.11 ,$70.84 ,$53.90 ,$57.70 ,$61.98 ,$46.89 ,$57.70 ,$53.21 ,$53.90 ,$12.17 ,$55.44 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$55.44 ,$47.74 ,$55.44 ,$55.44 ,$46.20 ST VINCENT HOSPITAL - ACUTE,30200540,86701,HC HIV-1 AB,302,1 ,$80.00 ,$40.00 ,$8.89 ,$80.00 ,$51.68 ,$9.19 ,$34.55 ,$29.61 ,$8.89 ,$48.00 ,$68.00 ,$56.00 ,$9.19 ,$76.00 ,$57.60 ,$58.40 ,$15.11 ,$68.00 ,$8.89 ,$15.11 ,$64.00 ,$58.40 ,$9.19 ,$8.89 ,$9.82 ,$80.00 ,$68.00 ,$20.00 ,$73.60 ,$56.00 ,$42.54 ,$45.69 ,$48.72 ,$42.54 ,$55.28 ,$56.00 ,$8.98 ,$57.60 ,$9.74 ,$10.67 ,$10.67 ,$8.89 ,$10.67 ,$8.89 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200541,86702,HC HIV-2 AB,302,1 ,$80.00 ,$40.00 ,$13.52 ,$80.00 ,$51.68 ,$13.97 ,$52.57 ,$45.06 ,$13.52 ,$48.00 ,$68.00 ,$56.00 ,$13.97 ,$76.00 ,$57.60 ,$58.40 ,$22.98 ,$68.00 ,$13.52 ,$22.98 ,$64.00 ,$58.40 ,$13.97 ,$13.52 ,$14.93 ,$80.00 ,$68.00 ,$30.42 ,$73.60 ,$56.00 ,$64.72 ,$69.52 ,$48.72 ,$64.72 ,$55.28 ,$56.00 ,$13.66 ,$57.60 ,$14.81 ,$16.22 ,$16.22 ,$13.52 ,$16.22 ,$13.52 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200577,86481,HC TB ANTIGEN RESPONSE GAMMA INTER T-CELL SUSP,302,1 ,$420.00 ,$210.00 ,$90.12 ,$420.00 ,$271.32 ,$90.12 ,$350.00 ,$300.00 ,$100.00 ,$252.00 ,$357.00 ,$294.00 ,$90.12 ,$399.00 ,$302.40 ,$306.60 ,$170.00 ,$357.00 ,$100.00 ,$170.00 ,$336.00 ,$306.60 ,$90.12 ,$100.00 ,$110.42 ,$420.00 ,$357.00 ,$225.00 ,$386.40 ,$294.00 ,$358.79 ,$385.37 ,$255.78 ,$358.79 ,$290.22 ,$294.00 ,$101.00 ,$302.40 ,$95.53 ,$120.00 ,$120.00 ,$100.00 ,$120.00 ,$100.00 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,30200582,86382,HC RABIES VACCINE RESPONSE TTR,302,1 ,$140.00 ,$70.00 ,$16.91 ,$140.00 ,$90.44 ,$17.47 ,$65.77 ,$56.37 ,$16.91 ,$84.00 ,$119.00 ,$98.00 ,$17.47 ,$133.00 ,$100.80 ,$102.20 ,$28.75 ,$119.00 ,$16.91 ,$28.75 ,$112.00 ,$102.20 ,$17.47 ,$16.91 ,$18.67 ,$140.00 ,$119.00 ,$38.05 ,$128.80 ,$98.00 ,$80.98 ,$86.97 ,$85.26 ,$80.98 ,$96.74 ,$98.00 ,$17.08 ,$100.80 ,$18.52 ,$20.29 ,$20.29 ,$16.91 ,$20.29 ,$16.91 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30200583,86382,HC POLIOVIRUS AB NEUTRALIZATION,302,1 ,$39.00 ,$19.50 ,$16.91 ,$39.00 ,$25.19 ,$17.47 ,$39.00 ,$39.00 ,$16.91 ,$23.40 ,$33.15 ,$27.30 ,$17.47 ,$37.05 ,$28.08 ,$28.47 ,$28.75 ,$33.15 ,$16.91 ,$28.75 ,$31.20 ,$28.47 ,$17.47 ,$16.91 ,$18.67 ,$39.00 ,$33.15 ,$38.05 ,$35.88 ,$27.30 ,$39.00 ,$39.00 ,$23.75 ,$39.00 ,$26.95 ,$27.30 ,$17.08 ,$28.08 ,$18.52 ,$20.29 ,$20.29 ,$16.91 ,$20.29 ,$16.91 ,$28.08 ,$24.18 ,$28.08 ,$28.08 ,$23.40 ST VINCENT HOSPITAL - ACUTE,30200584,86658,HC ENTEROVIRUS PANEL CF SERUM,302,1 ,$130.00 ,$65.00 ,$8.17 ,$130.00 ,$83.98 ,$8.17 ,$50.65 ,$43.41 ,$13.03 ,$78.00 ,$110.50 ,$91.00 ,$8.17 ,$123.50 ,$93.60 ,$94.90 ,$22.15 ,$110.50 ,$13.03 ,$22.15 ,$104.00 ,$94.90 ,$8.17 ,$13.03 ,$14.39 ,$130.00 ,$110.50 ,$29.32 ,$119.60 ,$91.00 ,$27.83 ,$29.90 ,$79.17 ,$27.83 ,$89.83 ,$91.00 ,$13.16 ,$93.60 ,$8.66 ,$15.64 ,$15.64 ,$13.03 ,$15.64 ,$13.03 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30200585,86800,HC THYROGLOBULIN AB CANCER MONITORING,302,1 ,$45.00 ,$22.50 ,$15.91 ,$45.00 ,$29.07 ,$16.44 ,$45.00 ,$45.00 ,$15.91 ,$27.00 ,$38.25 ,$31.50 ,$16.44 ,$42.75 ,$32.40 ,$32.85 ,$27.05 ,$38.25 ,$15.91 ,$27.05 ,$36.00 ,$32.85 ,$16.44 ,$15.91 ,$17.57 ,$45.00 ,$38.25 ,$35.80 ,$41.40 ,$31.50 ,$45.00 ,$45.00 ,$27.41 ,$45.00 ,$31.10 ,$31.50 ,$16.07 ,$32.40 ,$17.43 ,$19.09 ,$19.09 ,$15.91 ,$19.09 ,$15.91 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,30200586,86790,HC VIRUS AB DENGUE FEVER IGG/IGMA,302,1 ,$100.00 ,$50.00 ,$3.18 ,$100.00 ,$64.60 ,$3.18 ,$50.09 ,$42.93 ,$12.88 ,$60.00 ,$85.00 ,$70.00 ,$3.18 ,$95.00 ,$72.00 ,$73.00 ,$21.90 ,$85.00 ,$12.88 ,$21.90 ,$80.00 ,$73.00 ,$3.18 ,$12.88 ,$14.22 ,$100.00 ,$85.00 ,$28.98 ,$92.00 ,$70.00 ,$27.83 ,$29.90 ,$60.90 ,$27.83 ,$69.10 ,$70.00 ,$13.01 ,$72.00 ,$3.37 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200587,86753,HC PROTOZOA AB ENTAMOEBA HISTOLYTICA IGG,302,1 ,$85.00 ,$42.50 ,$8.17 ,$85.00 ,$54.91 ,$8.17 ,$48.16 ,$41.28 ,$12.39 ,$51.00 ,$72.25 ,$59.50 ,$8.17 ,$80.75 ,$61.20 ,$62.05 ,$21.06 ,$72.25 ,$12.39 ,$21.06 ,$68.00 ,$62.05 ,$8.17 ,$12.39 ,$13.68 ,$85.00 ,$72.25 ,$27.88 ,$78.20 ,$59.50 ,$27.83 ,$29.90 ,$51.77 ,$27.83 ,$58.74 ,$59.50 ,$12.51 ,$61.20 ,$8.66 ,$14.87 ,$14.87 ,$12.39 ,$14.87 ,$12.39 ,$61.20 ,$52.70 ,$61.20 ,$61.20 ,$51.00 ST VINCENT HOSPITAL - ACUTE,30200822,86705,HC HEP B CORE IGM,302,1 ,$150.00 ,$75.00 ,$11.77 ,$150.00 ,$96.90 ,$12.16 ,$45.78 ,$39.24 ,$11.77 ,$90.00 ,$127.50 ,$105.00 ,$12.16 ,$142.50 ,$108.00 ,$109.50 ,$20.01 ,$127.50 ,$11.77 ,$20.01 ,$120.00 ,$109.50 ,$12.16 ,$11.77 ,$13.00 ,$150.00 ,$127.50 ,$26.48 ,$138.00 ,$105.00 ,$56.41 ,$60.58 ,$91.35 ,$56.41 ,$103.65 ,$105.00 ,$11.89 ,$108.00 ,$12.89 ,$14.12 ,$14.12 ,$11.77 ,$14.12 ,$11.77 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30200824,86644,HC CMV AB,302,1 ,$100.00 ,$50.00 ,$14.39 ,$100.00 ,$64.60 ,$14.87 ,$55.97 ,$47.97 ,$14.39 ,$60.00 ,$85.00 ,$70.00 ,$14.87 ,$95.00 ,$72.00 ,$73.00 ,$24.46 ,$85.00 ,$14.39 ,$24.46 ,$80.00 ,$73.00 ,$14.87 ,$14.39 ,$15.89 ,$100.00 ,$85.00 ,$32.38 ,$92.00 ,$70.00 ,$68.94 ,$74.04 ,$60.90 ,$68.94 ,$69.10 ,$70.00 ,$14.53 ,$72.00 ,$15.76 ,$17.27 ,$17.27 ,$14.39 ,$17.27 ,$14.39 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30200825,86671,HC FUNGUS AB NOS 2-REF,302,1 ,$46.00 ,$23.00 ,$7.15 ,$46.00 ,$29.72 ,$7.15 ,$46.00 ,$40.86 ,$12.25 ,$27.60 ,$39.10 ,$32.20 ,$7.15 ,$43.70 ,$33.12 ,$33.58 ,$20.83 ,$39.10 ,$12.25 ,$20.83 ,$36.80 ,$33.58 ,$7.15 ,$12.25 ,$13.53 ,$46.00 ,$39.10 ,$27.56 ,$42.32 ,$32.20 ,$24.36 ,$26.16 ,$28.01 ,$24.36 ,$31.79 ,$32.20 ,$12.37 ,$33.12 ,$7.58 ,$14.70 ,$14.70 ,$12.25 ,$14.70 ,$12.25 ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,30200826,86735,HC MUMPS AB (DIAG),302,1 ,$60.00 ,$30.00 ,$13.05 ,$60.00 ,$38.76 ,$13.48 ,$50.75 ,$43.50 ,$13.05 ,$36.00 ,$51.00 ,$42.00 ,$13.48 ,$57.00 ,$43.20 ,$43.80 ,$22.19 ,$51.00 ,$13.05 ,$22.19 ,$48.00 ,$43.80 ,$13.48 ,$13.05 ,$14.41 ,$60.00 ,$51.00 ,$29.36 ,$55.20 ,$42.00 ,$60.00 ,$60.00 ,$36.54 ,$60.00 ,$41.46 ,$42.00 ,$13.18 ,$43.20 ,$14.29 ,$15.66 ,$15.66 ,$13.05 ,$15.66 ,$13.05 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30200830,87801,HC INFECT MLT ORG AMP,302,1 ,$480.00 ,$240.00 ,$50.62 ,$480.00 ,$310.08 ,$50.62 ,$272.97 ,$233.97 ,$70.20 ,$288.00 ,$408.00 ,$336.00 ,$50.62 ,$456.00 ,$345.60 ,$350.40 ,$119.34 ,$408.00 ,$70.20 ,$119.34 ,$384.00 ,$350.40 ,$50.62 ,$70.20 ,$77.51 ,$480.00 ,$408.00 ,$157.95 ,$441.60 ,$336.00 ,$336.12 ,$361.02 ,$292.32 ,$336.12 ,$331.68 ,$336.00 ,$70.90 ,$345.60 ,$53.66 ,$84.24 ,$84.24 ,$70.20 ,$84.24 ,$70.20 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,30200831,86832,HC HLA HIGH DEFINITION QL PANEL,302,1 ,$728.00 ,$364.00 ,$139.23 ,$728.44 ,$470.29 ,$139.23 ,$728.00 ,$728.00 ,$323.75 ,$436.80 ,$618.80 ,$509.60 ,$139.23 ,$691.60 ,$524.16 ,$531.44 ,$550.38 ,$618.80 ,$323.75 ,$550.38 ,$582.40 ,$531.44 ,$139.23 ,$323.75 ,$357.48 ,$728.00 ,$618.80 ,$728.44 ,$669.76 ,$509.60 ,$607.55 ,$652.55 ,$443.35 ,$607.55 ,$503.05 ,$509.60 ,$326.99 ,$524.16 ,$147.58 ,$388.50 ,$388.50 ,$323.75 ,$388.50 ,$323.75 ,$524.16 ,$451.36 ,$524.16 ,$524.16 ,$436.80 ST VINCENT HOSPITAL - ACUTE,30200832,86611,HC BARTONELLA TITER,302,1 ,$56.00 ,$28.00 ,$8.17 ,$56.00 ,$36.18 ,$8.17 ,$39.59 ,$33.93 ,$10.18 ,$33.60 ,$47.60 ,$39.20 ,$8.17 ,$53.20 ,$40.32 ,$40.88 ,$17.31 ,$47.60 ,$10.18 ,$17.31 ,$44.80 ,$40.88 ,$8.17 ,$10.18 ,$11.24 ,$56.00 ,$47.60 ,$22.91 ,$51.52 ,$39.20 ,$27.83 ,$29.90 ,$34.10 ,$27.83 ,$38.70 ,$39.20 ,$10.28 ,$40.32 ,$8.66 ,$12.22 ,$12.22 ,$10.18 ,$12.22 ,$10.18 ,$40.32 ,$34.72 ,$40.32 ,$40.32 ,$33.60 ST VINCENT HOSPITAL - ACUTE,30200833,86406,HC STREPTOZYME TITER,302,1 ,$69.00 ,$34.50 ,$9.85 ,$69.00 ,$44.57 ,$9.85 ,$41.37 ,$35.46 ,$10.64 ,$41.40 ,$58.65 ,$48.30 ,$9.85 ,$65.55 ,$49.68 ,$50.37 ,$18.09 ,$58.65 ,$10.64 ,$18.09 ,$55.20 ,$50.37 ,$9.85 ,$10.64 ,$11.75 ,$69.00 ,$58.65 ,$23.94 ,$63.48 ,$48.30 ,$33.52 ,$36.00 ,$42.02 ,$33.52 ,$47.68 ,$48.30 ,$10.75 ,$49.68 ,$10.44 ,$12.77 ,$12.77 ,$10.64 ,$12.77 ,$10.64 ,$49.68 ,$42.78 ,$49.68 ,$49.68 ,$41.40 ST VINCENT HOSPITAL - ACUTE,30200834,86648,HC DIPTHERIA,302,1 ,$80.00 ,$40.00 ,$8.17 ,$80.00 ,$51.68 ,$8.17 ,$59.15 ,$50.70 ,$15.21 ,$48.00 ,$68.00 ,$56.00 ,$8.17 ,$76.00 ,$57.60 ,$58.40 ,$25.86 ,$68.00 ,$15.21 ,$25.86 ,$64.00 ,$58.40 ,$8.17 ,$15.21 ,$16.79 ,$80.00 ,$68.00 ,$34.22 ,$73.60 ,$56.00 ,$27.83 ,$29.90 ,$48.72 ,$27.83 ,$55.28 ,$56.00 ,$15.36 ,$57.60 ,$8.66 ,$18.25 ,$18.25 ,$15.21 ,$18.25 ,$15.21 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30200835,86790,HC HANTAVIRUS (SIN NOMBRE) ELISA,302,1 ,$61.00 ,$30.50 ,$3.18 ,$61.00 ,$39.41 ,$3.18 ,$50.09 ,$42.93 ,$12.88 ,$36.60 ,$51.85 ,$42.70 ,$3.18 ,$57.95 ,$43.92 ,$44.53 ,$21.90 ,$51.85 ,$12.88 ,$21.90 ,$48.80 ,$44.53 ,$3.18 ,$12.88 ,$14.22 ,$61.00 ,$51.85 ,$28.98 ,$56.12 ,$42.70 ,$27.83 ,$29.90 ,$37.15 ,$27.83 ,$42.15 ,$42.70 ,$13.01 ,$43.92 ,$3.37 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$43.92 ,$37.82 ,$43.92 ,$43.92 ,$36.60 ST VINCENT HOSPITAL - ACUTE,30200836,86790,HC HANTAVIRUS (SIN NOMBRE) IGG,302,1 ,$107.00 ,$53.50 ,$3.18 ,$107.00 ,$69.12 ,$3.18 ,$50.09 ,$42.93 ,$12.88 ,$64.20 ,$90.95 ,$74.90 ,$3.18 ,$101.65 ,$77.04 ,$78.11 ,$21.90 ,$90.95 ,$12.88 ,$21.90 ,$85.60 ,$78.11 ,$3.18 ,$12.88 ,$14.22 ,$107.00 ,$90.95 ,$28.98 ,$98.44 ,$74.90 ,$27.83 ,$29.90 ,$65.16 ,$27.83 ,$73.94 ,$74.90 ,$13.01 ,$77.04 ,$3.37 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$77.04 ,$66.34 ,$77.04 ,$77.04 ,$64.20 ST VINCENT HOSPITAL - ACUTE,30200837,86790,HC HANTAVIRUS (SIN NOMBRE) IGM,302,1 ,$61.00 ,$30.50 ,$3.18 ,$61.00 ,$39.41 ,$3.18 ,$50.09 ,$42.93 ,$12.88 ,$36.60 ,$51.85 ,$42.70 ,$3.18 ,$57.95 ,$43.92 ,$44.53 ,$21.90 ,$51.85 ,$12.88 ,$21.90 ,$48.80 ,$44.53 ,$3.18 ,$12.88 ,$14.22 ,$61.00 ,$51.85 ,$28.98 ,$56.12 ,$42.70 ,$27.83 ,$29.90 ,$37.15 ,$27.83 ,$42.15 ,$42.70 ,$13.01 ,$43.92 ,$3.37 ,$15.46 ,$15.46 ,$12.88 ,$15.46 ,$12.88 ,$43.92 ,$37.82 ,$43.92 ,$43.92 ,$36.60 ST VINCENT HOSPITAL - ACUTE,30200841,86671,HC FUNGUS AB SACC CEREVISIAE,302,1 ,$131.00 ,$65.50 ,$7.15 ,$131.00 ,$84.63 ,$7.15 ,$47.67 ,$40.86 ,$12.25 ,$78.60 ,$111.35 ,$91.70 ,$7.15 ,$124.45 ,$94.32 ,$95.63 ,$20.83 ,$111.35 ,$12.25 ,$20.83 ,$104.80 ,$95.63 ,$7.15 ,$12.25 ,$13.53 ,$131.00 ,$111.35 ,$27.56 ,$120.52 ,$91.70 ,$24.36 ,$26.16 ,$79.78 ,$24.36 ,$90.52 ,$91.70 ,$12.37 ,$94.32 ,$7.58 ,$14.70 ,$14.70 ,$12.25 ,$14.70 ,$12.25 ,$94.32 ,$81.22 ,$94.32 ,$94.32 ,$78.60 ST VINCENT HOSPITAL - ACUTE,30201069,86711,HC AB JOHN CUNNINGHAM VIRUS,302,1 ,"$1,600.00 ",$800.00 ,$15.79 ,"$1,600.00 ","$1,033.60 ",$15.79 ,$59.12 ,$50.67 ,$16.89 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$15.79 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ",$28.71 ,"$1,360.00 ",$16.89 ,$28.71 ,"$1,280.00 ","$1,168.00 ",$15.79 ,$16.89 ,$18.65 ,"$1,600.00 ","$1,360.00 ",$38.00 ,"$1,472.00 ","$1,120.00 ",$68.94 ,$74.04 ,$974.40 ,$68.94 ,"$1,105.60 ","$1,120.00 ",$17.06 ,"$1,152.00 ",$16.74 ,$20.27 ,$20.27 ,$16.89 ,$20.27 ,$16.89 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,30201070,86711,HC AB JOHN CUNNINGHAM VIRUS INHIBITION ASSAY,302,1 ,$627.00 ,$313.50 ,$15.79 ,$627.00 ,$405.04 ,$15.79 ,$59.12 ,$50.67 ,$16.89 ,$376.20 ,$532.95 ,$438.90 ,$15.79 ,$595.65 ,$451.44 ,$457.71 ,$28.71 ,$532.95 ,$16.89 ,$28.71 ,$501.60 ,$457.71 ,$15.79 ,$16.89 ,$18.65 ,$627.00 ,$532.95 ,$38.00 ,$576.84 ,$438.90 ,$68.94 ,$74.04 ,$381.84 ,$68.94 ,$433.26 ,$438.90 ,$17.06 ,$451.44 ,$16.74 ,$20.27 ,$20.27 ,$16.89 ,$20.27 ,$16.89 ,$451.44 ,$388.74 ,$451.44 ,$451.44 ,$376.20 ST VINCENT HOSPITAL - ACUTE,30201080,G0472,HC HEPATITIS C SCREEN HIGH RISK,302,1 ,$100.00 ,$50.00 ,$9.39 ,$104.29 ,$64.60 ,$9.39 ,$100.00 ,$100.00 ,$46.35 ,$60.00 ,$85.00 ,$70.00 ,$9.39 ,$95.00 ,$72.00 ,$73.00 ,$78.80 ,$85.00 ,$46.35 ,$78.80 ,$80.00 ,$73.00 ,$9.39 ,$46.35 ,$51.18 ,$100.00 ,$85.00 ,$104.29 ,$92.00 ,$70.00 ,$68.23 ,$73.29 ,$60.90 ,$68.23 ,$69.10 ,$70.00 ,$46.81 ,$72.00 ,$9.95 ,$55.62 ,$55.62 ,$46.35 ,$55.62 ,$46.35 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30201081,86695,HC HERPES SIMPLEX IGM I,302,1 ,$90.00 ,$45.00 ,$13.19 ,$90.00 ,$58.14 ,$13.63 ,$51.28 ,$43.95 ,$13.19 ,$54.00 ,$76.50 ,$63.00 ,$13.63 ,$85.50 ,$64.80 ,$65.70 ,$22.42 ,$76.50 ,$13.19 ,$22.42 ,$72.00 ,$65.70 ,$13.63 ,$13.19 ,$14.56 ,$90.00 ,$76.50 ,$29.68 ,$82.80 ,$63.00 ,$63.18 ,$67.86 ,$54.81 ,$63.18 ,$62.19 ,$63.00 ,$13.32 ,$64.80 ,$14.45 ,$15.83 ,$15.83 ,$13.19 ,$15.83 ,$13.19 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30201082,86696,HC HERPES SIMPLEX IGM II,302,1 ,$130.00 ,$65.00 ,$19.35 ,$130.00 ,$83.98 ,$19.99 ,$75.29 ,$64.53 ,$19.35 ,$78.00 ,$110.50 ,$91.00 ,$19.99 ,$123.50 ,$93.60 ,$94.90 ,$32.90 ,$110.50 ,$19.35 ,$32.90 ,$104.00 ,$94.90 ,$19.99 ,$19.35 ,$21.37 ,$130.00 ,$110.50 ,$43.54 ,$119.60 ,$91.00 ,$92.66 ,$99.53 ,$79.17 ,$92.66 ,$89.83 ,$91.00 ,$19.54 ,$93.60 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30201084,86008,HC ALLERGEN IGE QN/SEMI-QN RECOMB/COMP EA,302,1 ,$33.00 ,$16.50 ,$16.50 ,$40.34 ,$21.32 ,$17.71 ,$33.00 ,$33.00 ,$17.93 ,$19.80 ,$28.05 ,$23.10 ,$17.71 ,$31.35 ,$23.76 ,$24.09 ,$30.48 ,$28.05 ,$17.93 ,$30.48 ,$26.40 ,$24.09 ,$17.71 ,$17.93 ,$19.80 ,$33.00 ,$28.05 ,$40.34 ,$30.36 ,$23.10 ,$33.00 ,$33.00 ,$20.10 ,$33.00 ,$22.80 ,$23.10 ,$18.11 ,$23.76 ,$18.77 ,$21.52 ,$21.52 ,$17.93 ,$21.52 ,$17.93 ,$23.76 ,$20.46 ,$23.76 ,$23.76 ,$19.80 ST VINCENT HOSPITAL - ACUTE,30201085,86481,HC TSPOT TB AG RESPONSE GAMMA INTER T-CELL SUSP,302,1 ,$260.00 ,$130.00 ,$90.12 ,$260.00 ,$167.96 ,$90.12 ,$260.00 ,$260.00 ,$100.00 ,$156.00 ,$221.00 ,$182.00 ,$90.12 ,$247.00 ,$187.20 ,$189.80 ,$170.00 ,$221.00 ,$100.00 ,$170.00 ,$208.00 ,$189.80 ,$90.12 ,$100.00 ,$110.42 ,$260.00 ,$221.00 ,$225.00 ,$239.20 ,$182.00 ,$260.00 ,$260.00 ,$158.34 ,$260.00 ,$179.66 ,$182.00 ,$101.00 ,$187.20 ,$95.53 ,$120.00 ,$120.00 ,$100.00 ,$120.00 ,$100.00 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30201087,86317,HC INFECTIOUS STREPTOCOCCUS PNEUMONIAE EA AB,302,1 ,$80.00 ,$40.00 ,$14.99 ,$80.00 ,$51.68 ,$15.49 ,$58.28 ,$49.95 ,$14.99 ,$48.00 ,$68.00 ,$56.00 ,$15.49 ,$76.00 ,$57.60 ,$58.40 ,$25.48 ,$68.00 ,$14.99 ,$25.48 ,$64.00 ,$58.40 ,$15.49 ,$14.99 ,$16.55 ,$80.00 ,$68.00 ,$33.73 ,$73.60 ,$56.00 ,$71.78 ,$77.10 ,$48.72 ,$71.78 ,$55.28 ,$56.00 ,$15.14 ,$57.60 ,$16.42 ,$17.99 ,$17.99 ,$14.99 ,$17.99 ,$14.99 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30201090,86780,HC TREPONEMA P AB SCREEN,302,1 ,$38.00 ,$19.00 ,$11.13 ,$38.00 ,$24.55 ,$11.13 ,$38.00 ,$38.00 ,$13.24 ,$22.80 ,$32.30 ,$26.60 ,$11.13 ,$36.10 ,$27.36 ,$27.74 ,$22.51 ,$32.30 ,$13.24 ,$22.51 ,$30.40 ,$27.74 ,$11.13 ,$13.24 ,$14.62 ,$38.00 ,$32.30 ,$29.79 ,$34.96 ,$26.60 ,$37.91 ,$38.00 ,$23.14 ,$37.91 ,$26.26 ,$26.60 ,$13.37 ,$27.36 ,$11.80 ,$15.89 ,$15.89 ,$13.24 ,$15.89 ,$13.24 ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,30201158,86255,HC FLUOR AB SCR CYTOP/NEURONAL AB,302,1 ,$125.00 ,$62.50 ,$12.05 ,$125.00 ,$80.75 ,$12.45 ,$46.87 ,$40.17 ,$12.05 ,$75.00 ,$106.25 ,$87.50 ,$12.45 ,$118.75 ,$90.00 ,$91.25 ,$20.49 ,$106.25 ,$12.05 ,$20.49 ,$100.00 ,$91.25 ,$12.45 ,$12.05 ,$13.31 ,$125.00 ,$106.25 ,$27.11 ,$115.00 ,$87.50 ,$57.70 ,$61.98 ,$76.13 ,$57.70 ,$86.38 ,$87.50 ,$12.17 ,$90.00 ,$13.20 ,$14.46 ,$14.46 ,$12.05 ,$14.46 ,$12.05 ,$90.00 ,$77.50 ,$90.00 ,$90.00 ,$75.00 ST VINCENT HOSPITAL - ACUTE,30201159,87801,HC INFECT MLT ORG AMP BRD RAGNE BACT PCR,302,1 ,$480.00 ,$240.00 ,$50.62 ,$480.00 ,$310.08 ,$50.62 ,$272.97 ,$233.97 ,$70.20 ,$288.00 ,$408.00 ,$336.00 ,$50.62 ,$456.00 ,$345.60 ,$350.40 ,$119.34 ,$408.00 ,$70.20 ,$119.34 ,$384.00 ,$350.40 ,$50.62 ,$70.20 ,$77.51 ,$480.00 ,$408.00 ,$157.95 ,$441.60 ,$336.00 ,$336.12 ,$361.02 ,$292.32 ,$336.12 ,$331.68 ,$336.00 ,$70.90 ,$345.60 ,$53.66 ,$84.24 ,$84.24 ,$70.20 ,$84.24 ,$70.20 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,30280158,86300,HC TUMOR AG CA 15-3 (27.29) GBO,302,1 ,$140.00 ,$70.00 ,$20.81 ,$140.00 ,$90.44 ,$21.50 ,$80.96 ,$69.39 ,$20.81 ,$84.00 ,$119.00 ,$98.00 ,$21.50 ,$133.00 ,$100.80 ,$102.20 ,$35.38 ,$119.00 ,$20.81 ,$35.38 ,$112.00 ,$102.20 ,$21.50 ,$20.81 ,$22.98 ,$140.00 ,$119.00 ,$46.82 ,$128.80 ,$98.00 ,$99.65 ,$107.03 ,$85.26 ,$99.65 ,$96.74 ,$98.00 ,$21.02 ,$100.80 ,$22.79 ,$24.97 ,$24.97 ,$20.81 ,$24.97 ,$20.81 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30280160,86301,HC TUMOR AG CA 19-9 GBO,302,1 ,$140.00 ,$70.00 ,$20.81 ,$140.00 ,$90.44 ,$21.50 ,$80.96 ,$69.39 ,$20.81 ,$84.00 ,$119.00 ,$98.00 ,$21.50 ,$133.00 ,$100.80 ,$102.20 ,$35.38 ,$119.00 ,$20.81 ,$35.38 ,$112.00 ,$102.20 ,$21.50 ,$20.81 ,$22.98 ,$140.00 ,$119.00 ,$46.82 ,$128.80 ,$98.00 ,$99.65 ,$107.03 ,$85.26 ,$99.65 ,$96.74 ,$98.00 ,$21.02 ,$100.80 ,$22.79 ,$24.97 ,$24.97 ,$20.81 ,$24.97 ,$20.81 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30280162,86304,HC TUMOR AG CA 125 GBO,302,1 ,$140.00 ,$70.00 ,$20.81 ,$140.00 ,$90.44 ,$21.50 ,$80.96 ,$69.39 ,$20.81 ,$84.00 ,$119.00 ,$98.00 ,$21.50 ,$133.00 ,$100.80 ,$102.20 ,$35.38 ,$119.00 ,$20.81 ,$35.38 ,$112.00 ,$102.20 ,$21.50 ,$20.81 ,$22.98 ,$140.00 ,$119.00 ,$46.82 ,$128.80 ,$98.00 ,$99.65 ,$107.03 ,$85.26 ,$99.65 ,$96.74 ,$98.00 ,$21.02 ,$100.80 ,$22.79 ,$24.97 ,$24.97 ,$20.81 ,$24.97 ,$20.81 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30500098,85421,HC PLASMINOGEN ANTIGENIC,305,1 ,$128.00 ,$64.00 ,$10.18 ,$128.00 ,$82.69 ,$10.52 ,$39.62 ,$33.96 ,$10.18 ,$76.80 ,$108.80 ,$89.60 ,$10.52 ,$121.60 ,$92.16 ,$93.44 ,$17.31 ,$108.80 ,$10.18 ,$17.31 ,$102.40 ,$93.44 ,$10.52 ,$10.18 ,$11.24 ,$128.00 ,$108.80 ,$22.91 ,$117.76 ,$89.60 ,$48.79 ,$52.40 ,$77.95 ,$48.79 ,$88.45 ,$89.60 ,$10.28 ,$92.16 ,$11.15 ,$12.22 ,$12.22 ,$10.18 ,$12.22 ,$10.18 ,$92.16 ,$79.36 ,$92.16 ,$92.16 ,$76.80 ST VINCENT HOSPITAL - ACUTE,30500101,85002,HC BLEEDING TIME,305,1 ,$115.00 ,$57.50 ,$4.77 ,$115.00 ,$74.29 ,$4.77 ,$17.54 ,$15.03 ,$4.82 ,$69.00 ,$97.75 ,$80.50 ,$4.77 ,$109.25 ,$82.80 ,$83.95 ,$8.19 ,$97.75 ,$4.82 ,$8.19 ,$92.00 ,$83.95 ,$4.77 ,$4.82 ,$5.32 ,$115.00 ,$97.75 ,$10.85 ,$105.80 ,$80.50 ,$16.25 ,$17.46 ,$70.04 ,$16.25 ,$79.47 ,$80.50 ,$4.87 ,$82.80 ,$5.06 ,$5.78 ,$5.78 ,$4.82 ,$5.78 ,$4.82 ,$82.80 ,$71.30 ,$82.80 ,$82.80 ,$69.00 ST VINCENT HOSPITAL - ACUTE,30500102,85004,HC WBC W/AUTO DIFFERENTIAL,305,1 ,$38.00 ,$19.00 ,$6.47 ,$38.00 ,$24.55 ,$6.69 ,$25.13 ,$21.54 ,$6.47 ,$22.80 ,$32.30 ,$26.60 ,$6.69 ,$36.10 ,$27.36 ,$27.74 ,$11.00 ,$32.30 ,$6.47 ,$11.00 ,$30.40 ,$27.74 ,$6.69 ,$6.47 ,$7.14 ,$38.00 ,$32.30 ,$14.56 ,$34.96 ,$26.60 ,$30.99 ,$33.29 ,$23.14 ,$30.99 ,$26.26 ,$26.60 ,$6.53 ,$27.36 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,30500103,85007,HC BLOOD COUNT MAN DIFF WBC,305,1 ,$31.00 ,$15.50 ,$3.80 ,$31.00 ,$20.03 ,$3.93 ,$13.37 ,$11.46 ,$3.80 ,$18.60 ,$26.35 ,$21.70 ,$3.93 ,$29.45 ,$22.32 ,$22.63 ,$6.46 ,$26.35 ,$3.80 ,$6.46 ,$24.80 ,$22.63 ,$3.93 ,$3.80 ,$4.20 ,$31.00 ,$26.35 ,$8.55 ,$28.52 ,$21.70 ,$16.46 ,$17.68 ,$18.88 ,$16.46 ,$21.42 ,$21.70 ,$3.84 ,$22.32 ,$4.17 ,$4.56 ,$4.56 ,$3.80 ,$4.56 ,$3.80 ,$22.32 ,$19.22 ,$22.32 ,$22.32 ,$18.60 ST VINCENT HOSPITAL - ACUTE,30500104,85014,HC HEMATOCRIT,305,1 ,$16.00 ,$8.00 ,$2.37 ,$16.00 ,$10.34 ,$2.45 ,$9.21 ,$7.89 ,$2.37 ,$9.60 ,$13.60 ,$11.20 ,$2.45 ,$15.20 ,$11.52 ,$11.68 ,$4.03 ,$13.60 ,$2.37 ,$4.03 ,$12.80 ,$11.68 ,$2.45 ,$2.37 ,$2.62 ,$16.00 ,$13.60 ,$5.33 ,$14.72 ,$11.20 ,$11.34 ,$12.18 ,$9.74 ,$11.34 ,$11.06 ,$11.20 ,$2.39 ,$11.52 ,$2.60 ,$2.84 ,$2.84 ,$2.37 ,$2.84 ,$2.37 ,$11.52 ,$9.92 ,$11.52 ,$11.52 ,$9.60 ST VINCENT HOSPITAL - ACUTE,30500106,85018,HC HGB,305,1 ,$17.00 ,$8.50 ,$2.37 ,$17.00 ,$10.98 ,$2.45 ,$9.21 ,$7.89 ,$2.37 ,$10.20 ,$14.45 ,$11.90 ,$2.45 ,$16.15 ,$12.24 ,$12.41 ,$4.03 ,$14.45 ,$2.37 ,$4.03 ,$13.60 ,$12.41 ,$2.45 ,$2.37 ,$2.62 ,$17.00 ,$14.45 ,$5.33 ,$15.64 ,$11.90 ,$11.34 ,$12.18 ,$10.35 ,$11.34 ,$11.75 ,$11.90 ,$2.39 ,$12.24 ,$2.60 ,$2.84 ,$2.84 ,$2.37 ,$2.84 ,$2.37 ,$12.24 ,$10.54 ,$12.24 ,$12.24 ,$10.20 ST VINCENT HOSPITAL - ACUTE,30500107,85025,HC CBC AUTO W/AUTO DIFF,305,1 ,$60.00 ,$30.00 ,$7.77 ,$60.00 ,$38.76 ,$8.03 ,$30.21 ,$25.89 ,$7.77 ,$36.00 ,$51.00 ,$42.00 ,$8.03 ,$57.00 ,$43.20 ,$43.80 ,$13.21 ,$51.00 ,$7.77 ,$13.21 ,$48.00 ,$43.80 ,$8.03 ,$7.77 ,$8.58 ,$60.00 ,$51.00 ,$17.48 ,$55.20 ,$42.00 ,$37.24 ,$40.00 ,$36.54 ,$37.24 ,$41.46 ,$42.00 ,$7.85 ,$43.20 ,$8.51 ,$9.32 ,$9.32 ,$7.77 ,$9.32 ,$7.77 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30500108,85027,HC CBC W/O DIFF,305,1 ,$44.00 ,$22.00 ,$6.47 ,$44.00 ,$28.42 ,$6.69 ,$25.13 ,$21.54 ,$6.47 ,$26.40 ,$37.40 ,$30.80 ,$6.69 ,$41.80 ,$31.68 ,$32.12 ,$11.00 ,$37.40 ,$6.47 ,$11.00 ,$35.20 ,$32.12 ,$6.69 ,$6.47 ,$7.14 ,$44.00 ,$37.40 ,$14.56 ,$40.48 ,$30.80 ,$30.99 ,$33.29 ,$26.80 ,$30.99 ,$30.40 ,$30.80 ,$6.53 ,$31.68 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$31.68 ,$27.28 ,$31.68 ,$31.68 ,$26.40 ST VINCENT HOSPITAL - ACUTE,30500109,85027,HC HISTOGRAM,305,1 ,$44.00 ,$22.00 ,$6.47 ,$44.00 ,$28.42 ,$6.69 ,$25.13 ,$21.54 ,$6.47 ,$26.40 ,$37.40 ,$30.80 ,$6.69 ,$41.80 ,$31.68 ,$32.12 ,$11.00 ,$37.40 ,$6.47 ,$11.00 ,$35.20 ,$32.12 ,$6.69 ,$6.47 ,$7.14 ,$44.00 ,$37.40 ,$14.56 ,$40.48 ,$30.80 ,$30.99 ,$33.29 ,$26.80 ,$30.99 ,$30.40 ,$30.80 ,$6.53 ,$31.68 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$31.68 ,$27.28 ,$31.68 ,$31.68 ,$26.40 ST VINCENT HOSPITAL - ACUTE,30500110,85044,HC RETIC COUNT MANUAL,305,1 ,$130.00 ,$65.00 ,$4.31 ,$130.00 ,$83.98 ,$4.45 ,$16.77 ,$14.37 ,$4.31 ,$78.00 ,$110.50 ,$91.00 ,$4.45 ,$123.50 ,$93.60 ,$94.90 ,$7.33 ,$110.50 ,$4.31 ,$7.33 ,$104.00 ,$94.90 ,$4.45 ,$4.31 ,$4.76 ,$130.00 ,$110.50 ,$9.70 ,$119.60 ,$91.00 ,$20.60 ,$22.13 ,$79.17 ,$20.60 ,$89.83 ,$91.00 ,$4.35 ,$93.60 ,$4.72 ,$5.17 ,$5.17 ,$4.31 ,$5.17 ,$4.31 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30500111,85045,HC RETIC COUNT AUTO,305,1 ,$30.00 ,$15.00 ,$3.99 ,$30.00 ,$19.38 ,$4.12 ,$15.54 ,$13.32 ,$3.99 ,$18.00 ,$25.50 ,$21.00 ,$4.12 ,$28.50 ,$21.60 ,$21.90 ,$6.78 ,$25.50 ,$3.99 ,$6.78 ,$24.00 ,$21.90 ,$4.12 ,$3.99 ,$4.41 ,$30.00 ,$25.50 ,$8.98 ,$27.60 ,$21.00 ,$19.13 ,$20.55 ,$18.27 ,$19.13 ,$20.73 ,$21.00 ,$4.03 ,$21.60 ,$4.37 ,$4.79 ,$4.79 ,$3.99 ,$4.79 ,$3.99 ,$21.60 ,$18.60 ,$21.60 ,$21.60 ,$18.00 ST VINCENT HOSPITAL - ACUTE,30500112,85048,HC BLOOD COUNT LEUKO AUTO,305,1 ,$17.00 ,$8.50 ,$2.54 ,$17.00 ,$10.98 ,$2.62 ,$9.87 ,$8.46 ,$2.54 ,$10.20 ,$14.45 ,$11.90 ,$2.62 ,$16.15 ,$12.24 ,$12.41 ,$4.32 ,$14.45 ,$2.54 ,$4.32 ,$13.60 ,$12.41 ,$2.62 ,$2.54 ,$2.80 ,$17.00 ,$14.45 ,$5.72 ,$15.64 ,$11.90 ,$12.14 ,$13.04 ,$10.35 ,$12.14 ,$11.75 ,$11.90 ,$2.57 ,$12.24 ,$2.78 ,$3.05 ,$3.05 ,$2.54 ,$3.05 ,$2.54 ,$12.24 ,$10.54 ,$12.24 ,$12.24 ,$10.20 ST VINCENT HOSPITAL - ACUTE,30500113,85049,HC PLATELET COUNT AUTO,305,1 ,$34.00 ,$17.00 ,$4.48 ,$34.00 ,$21.96 ,$4.63 ,$17.40 ,$14.91 ,$4.48 ,$20.40 ,$28.90 ,$23.80 ,$4.63 ,$32.30 ,$24.48 ,$24.82 ,$7.62 ,$28.90 ,$4.48 ,$7.62 ,$27.20 ,$24.82 ,$4.63 ,$4.48 ,$4.95 ,$34.00 ,$28.90 ,$10.08 ,$31.28 ,$23.80 ,$21.45 ,$23.03 ,$20.71 ,$21.45 ,$23.49 ,$23.80 ,$4.52 ,$24.48 ,$4.91 ,$5.38 ,$5.38 ,$4.48 ,$5.38 ,$4.48 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30500116,85097,HC BONE MARROW SMEAR INTERP,305,1 ,$408.00 ,$204.00 ,$11.38 ,"$1,429.83 ",$263.57 ,$11.38 ,$172.66 ,$148.00 ,$635.48 ,$244.80 ,$346.80 ,$285.60 ,$11.38 ,$387.60 ,$293.76 ,$297.84 ,$113.07 ,$346.80 ,$635.48 ,$113.07 ,$326.40 ,$297.84 ,$11.38 ,$635.48 ,$171.36 ,$408.00 ,$346.80 ,"$1,429.83 ",$375.36 ,$285.60 ,$138.36 ,$148.61 ,$248.47 ,$138.36 ,$281.93 ,$285.60 ,$641.83 ,$293.76 ,$12.06 ,$408.00 ,$408.00 ,$635.48 ,$408.00 ,$635.48 ,$293.76 ,$252.96 ,$293.76 ,$293.76 ,$244.80 ST VINCENT HOSPITAL - ACUTE,30500117,85097,HC BONE MARROW SMEAR INTERP (MAYO),305,1 ,$408.00 ,$204.00 ,$11.38 ,"$1,429.83 ",$263.57 ,$11.38 ,$172.66 ,$148.00 ,$635.48 ,$244.80 ,$346.80 ,$285.60 ,$11.38 ,$387.60 ,$293.76 ,$297.84 ,$113.07 ,$346.80 ,$635.48 ,$113.07 ,$326.40 ,$297.84 ,$11.38 ,$635.48 ,$171.36 ,$408.00 ,$346.80 ,"$1,429.83 ",$375.36 ,$285.60 ,$138.36 ,$148.61 ,$248.47 ,$138.36 ,$281.93 ,$285.60 ,$641.83 ,$293.76 ,$12.06 ,$408.00 ,$408.00 ,$635.48 ,$408.00 ,$635.48 ,$293.76 ,$252.96 ,$293.76 ,$293.76 ,$244.80 ST VINCENT HOSPITAL - ACUTE,30500119,85175,HC CLOT LYSIS TIME,305,1 ,$70.00 ,$35.00 ,$6.40 ,$70.00 ,$45.22 ,$6.40 ,$70.00 ,$61.11 ,$20.37 ,$42.00 ,$59.50 ,$49.00 ,$6.40 ,$66.50 ,$50.40 ,$51.10 ,$34.63 ,$59.50 ,$20.37 ,$34.63 ,$56.00 ,$51.10 ,$6.40 ,$20.37 ,$22.49 ,$70.00 ,$59.50 ,$45.83 ,$64.40 ,$49.00 ,$21.80 ,$23.41 ,$42.63 ,$21.80 ,$48.37 ,$49.00 ,$20.57 ,$50.40 ,$6.78 ,$24.44 ,$24.44 ,$20.37 ,$24.44 ,$20.37 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30500120,85018,HC HGB ANESTH,305,1 ,$145.00 ,$72.50 ,$2.37 ,$145.00 ,$93.67 ,$2.45 ,$9.21 ,$7.89 ,$2.37 ,$87.00 ,$123.25 ,$101.50 ,$2.45 ,$137.75 ,$104.40 ,$105.85 ,$4.03 ,$123.25 ,$2.37 ,$4.03 ,$116.00 ,$105.85 ,$2.45 ,$2.37 ,$2.62 ,$145.00 ,$123.25 ,$5.33 ,$133.40 ,$101.50 ,$11.34 ,$12.18 ,$88.31 ,$11.34 ,$100.20 ,$101.50 ,$2.39 ,$104.40 ,$2.60 ,$2.84 ,$2.84 ,$2.37 ,$2.84 ,$2.37 ,$104.40 ,$89.90 ,$104.40 ,$104.40 ,$87.00 ST VINCENT HOSPITAL - ACUTE,30500121,85210,HC FACTOR II,305,1 ,$90.00 ,$45.00 ,$8.17 ,$90.00 ,$58.14 ,$8.17 ,$50.51 ,$43.29 ,$12.98 ,$54.00 ,$76.50 ,$63.00 ,$8.17 ,$85.50 ,$64.80 ,$65.70 ,$22.07 ,$76.50 ,$12.98 ,$22.07 ,$72.00 ,$65.70 ,$8.17 ,$12.98 ,$14.33 ,$90.00 ,$76.50 ,$29.21 ,$82.80 ,$63.00 ,$27.83 ,$29.90 ,$54.81 ,$27.83 ,$62.19 ,$63.00 ,$13.11 ,$64.80 ,$8.66 ,$15.58 ,$15.58 ,$12.98 ,$15.58 ,$12.98 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30500123,85220,HC FACTOR V,305,1 ,$150.00 ,$75.00 ,$17.65 ,$150.00 ,$96.90 ,$18.24 ,$68.64 ,$58.83 ,$17.65 ,$90.00 ,$127.50 ,$105.00 ,$18.24 ,$142.50 ,$108.00 ,$109.50 ,$30.01 ,$127.50 ,$17.65 ,$30.01 ,$120.00 ,$109.50 ,$18.24 ,$17.65 ,$19.49 ,$150.00 ,$127.50 ,$39.71 ,$138.00 ,$105.00 ,$84.49 ,$90.74 ,$91.35 ,$84.49 ,$103.65 ,$105.00 ,$17.83 ,$108.00 ,$19.33 ,$21.18 ,$21.18 ,$17.65 ,$21.18 ,$17.65 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30500125,85230,HC FACTOR VII,305,1 ,$150.00 ,$75.00 ,$17.90 ,$150.00 ,$96.90 ,$18.50 ,$69.62 ,$59.67 ,$17.90 ,$90.00 ,$127.50 ,$105.00 ,$18.50 ,$142.50 ,$108.00 ,$109.50 ,$30.43 ,$127.50 ,$17.90 ,$30.43 ,$120.00 ,$109.50 ,$18.50 ,$17.90 ,$19.77 ,$150.00 ,$127.50 ,$40.28 ,$138.00 ,$105.00 ,$85.75 ,$92.10 ,$91.35 ,$85.75 ,$103.65 ,$105.00 ,$18.08 ,$108.00 ,$19.61 ,$21.48 ,$21.48 ,$17.90 ,$21.48 ,$17.90 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30500126,85240,HC FACTOR VIII AHG,305,1 ,$90.00 ,$45.00 ,$9.84 ,$90.00 ,$58.14 ,$9.84 ,$69.62 ,$59.67 ,$17.90 ,$54.00 ,$76.50 ,$63.00 ,$9.84 ,$85.50 ,$64.80 ,$65.70 ,$30.43 ,$76.50 ,$17.90 ,$30.43 ,$72.00 ,$65.70 ,$9.84 ,$17.90 ,$19.77 ,$90.00 ,$76.50 ,$40.28 ,$82.80 ,$63.00 ,$33.49 ,$35.97 ,$54.81 ,$33.49 ,$62.19 ,$63.00 ,$18.08 ,$64.80 ,$10.43 ,$21.48 ,$21.48 ,$17.90 ,$21.48 ,$17.90 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30500128,85240,HC FACTOR VIII AHG (ASSAY),305,1 ,$163.00 ,$81.50 ,$9.84 ,$163.00 ,$105.30 ,$9.84 ,$69.62 ,$59.67 ,$17.90 ,$97.80 ,$138.55 ,$114.10 ,$9.84 ,$154.85 ,$117.36 ,$118.99 ,$30.43 ,$138.55 ,$17.90 ,$30.43 ,$130.40 ,$118.99 ,$9.84 ,$17.90 ,$19.77 ,$163.00 ,$138.55 ,$40.28 ,$149.96 ,$114.10 ,$33.49 ,$35.97 ,$99.27 ,$33.49 ,$112.63 ,$114.10 ,$18.08 ,$117.36 ,$10.43 ,$21.48 ,$21.48 ,$17.90 ,$21.48 ,$17.90 ,$117.36 ,$101.06 ,$117.36 ,$117.36 ,$97.80 ST VINCENT HOSPITAL - ACUTE,30500130,85245,HC FACTOR VIII VW RISTO,305,1 ,$166.00 ,$83.00 ,$22.94 ,$166.00 ,$107.24 ,$23.70 ,$89.22 ,$76.47 ,$22.94 ,$99.60 ,$141.10 ,$116.20 ,$23.70 ,$157.70 ,$119.52 ,$121.18 ,$39.00 ,$141.10 ,$22.94 ,$39.00 ,$132.80 ,$121.18 ,$23.70 ,$22.94 ,$25.33 ,$166.00 ,$141.10 ,$51.62 ,$152.72 ,$116.20 ,$109.86 ,$118.00 ,$101.09 ,$109.86 ,$114.71 ,$116.20 ,$23.17 ,$119.52 ,$25.12 ,$27.53 ,$27.53 ,$22.94 ,$27.53 ,$22.94 ,$119.52 ,$102.92 ,$119.52 ,$119.52 ,$99.60 ST VINCENT HOSPITAL - ACUTE,30500131,85245,HC FACTOR VIII VW RISTO (VW),305,1 ,$160.00 ,$80.00 ,$22.94 ,$160.00 ,$103.36 ,$23.70 ,$89.22 ,$76.47 ,$22.94 ,$96.00 ,$136.00 ,$112.00 ,$23.70 ,$152.00 ,$115.20 ,$116.80 ,$39.00 ,$136.00 ,$22.94 ,$39.00 ,$128.00 ,$116.80 ,$23.70 ,$22.94 ,$25.33 ,$160.00 ,$136.00 ,$51.62 ,$147.20 ,$112.00 ,$109.86 ,$118.00 ,$97.44 ,$109.86 ,$110.56 ,$112.00 ,$23.17 ,$115.20 ,$25.12 ,$27.53 ,$27.53 ,$22.94 ,$27.53 ,$22.94 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30500132,85246,HC FACTOR VIII VW AG,305,1 ,$140.00 ,$70.00 ,$22.94 ,$140.00 ,$90.44 ,$23.70 ,$89.22 ,$76.47 ,$22.94 ,$84.00 ,$119.00 ,$98.00 ,$23.70 ,$133.00 ,$100.80 ,$102.20 ,$39.00 ,$119.00 ,$22.94 ,$39.00 ,$112.00 ,$102.20 ,$23.70 ,$22.94 ,$25.33 ,$140.00 ,$119.00 ,$51.62 ,$128.80 ,$98.00 ,$109.86 ,$118.00 ,$85.26 ,$109.86 ,$96.74 ,$98.00 ,$23.17 ,$100.80 ,$25.12 ,$27.53 ,$27.53 ,$22.94 ,$27.53 ,$22.94 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30500135,85246,HC FACTOR VIII VW AG (MAYO),305,1 ,$173.00 ,$86.50 ,$22.94 ,$173.00 ,$111.76 ,$23.70 ,$89.22 ,$76.47 ,$22.94 ,$103.80 ,$147.05 ,$121.10 ,$23.70 ,$164.35 ,$124.56 ,$126.29 ,$39.00 ,$147.05 ,$22.94 ,$39.00 ,$138.40 ,$126.29 ,$23.70 ,$22.94 ,$25.33 ,$173.00 ,$147.05 ,$51.62 ,$159.16 ,$121.10 ,$109.86 ,$118.00 ,$105.36 ,$109.86 ,$119.54 ,$121.10 ,$23.17 ,$124.56 ,$25.12 ,$27.53 ,$27.53 ,$22.94 ,$27.53 ,$22.94 ,$124.56 ,$107.26 ,$124.56 ,$124.56 ,$103.80 ST VINCENT HOSPITAL - ACUTE,30500136,85247,HC FACTOR VW MULTIM ANALY,305,1 ,$190.00 ,$95.00 ,$22.94 ,$190.00 ,$122.74 ,$23.70 ,$89.22 ,$76.47 ,$22.94 ,$114.00 ,$161.50 ,$133.00 ,$23.70 ,$180.50 ,$136.80 ,$138.70 ,$39.00 ,$161.50 ,$22.94 ,$39.00 ,$152.00 ,$138.70 ,$23.70 ,$22.94 ,$25.33 ,$190.00 ,$161.50 ,$51.62 ,$174.80 ,$133.00 ,$109.86 ,$118.00 ,$115.71 ,$109.86 ,$131.29 ,$133.00 ,$23.17 ,$136.80 ,$25.12 ,$27.53 ,$27.53 ,$22.94 ,$27.53 ,$22.94 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30500138,85250,HC FACTOR IX,305,1 ,$200.00 ,$100.00 ,$19.04 ,$200.00 ,$129.20 ,$19.67 ,$74.06 ,$63.48 ,$19.04 ,$120.00 ,$170.00 ,$140.00 ,$19.67 ,$190.00 ,$144.00 ,$146.00 ,$32.37 ,$170.00 ,$19.04 ,$32.37 ,$160.00 ,$146.00 ,$19.67 ,$19.04 ,$21.02 ,$200.00 ,$170.00 ,$42.84 ,$184.00 ,$140.00 ,$91.15 ,$97.91 ,$121.80 ,$91.15 ,$138.20 ,$140.00 ,$19.23 ,$144.00 ,$20.85 ,$22.85 ,$22.85 ,$19.04 ,$22.85 ,$19.04 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30500140,85250,HC FACTOR IX (ASSAY),305,1 ,$198.00 ,$99.00 ,$19.04 ,$198.00 ,$127.91 ,$19.67 ,$74.06 ,$63.48 ,$19.04 ,$118.80 ,$168.30 ,$138.60 ,$19.67 ,$188.10 ,$142.56 ,$144.54 ,$32.37 ,$168.30 ,$19.04 ,$32.37 ,$158.40 ,$144.54 ,$19.67 ,$19.04 ,$21.02 ,$198.00 ,$168.30 ,$42.84 ,$182.16 ,$138.60 ,$91.15 ,$97.91 ,$120.58 ,$91.15 ,$136.82 ,$138.60 ,$19.23 ,$142.56 ,$20.85 ,$22.85 ,$22.85 ,$19.04 ,$22.85 ,$19.04 ,$142.56 ,$122.76 ,$142.56 ,$142.56 ,$118.80 ST VINCENT HOSPITAL - ACUTE,30500142,85260,HC FACTOR X,305,1 ,$140.00 ,$70.00 ,$17.90 ,$140.00 ,$90.44 ,$18.50 ,$69.62 ,$59.67 ,$17.90 ,$84.00 ,$119.00 ,$98.00 ,$18.50 ,$133.00 ,$100.80 ,$102.20 ,$30.43 ,$119.00 ,$17.90 ,$30.43 ,$112.00 ,$102.20 ,$18.50 ,$17.90 ,$19.77 ,$140.00 ,$119.00 ,$40.28 ,$128.80 ,$98.00 ,$85.75 ,$92.10 ,$85.26 ,$85.75 ,$96.74 ,$98.00 ,$18.08 ,$100.80 ,$19.61 ,$21.48 ,$21.48 ,$17.90 ,$21.48 ,$17.90 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30500144,85270,HC FACTOR XI,305,1 ,$150.00 ,$75.00 ,$17.90 ,$150.00 ,$96.90 ,$18.50 ,$69.62 ,$59.67 ,$17.90 ,$90.00 ,$127.50 ,$105.00 ,$18.50 ,$142.50 ,$108.00 ,$109.50 ,$30.43 ,$127.50 ,$17.90 ,$30.43 ,$120.00 ,$109.50 ,$18.50 ,$17.90 ,$19.77 ,$150.00 ,$127.50 ,$40.28 ,$138.00 ,$105.00 ,$85.75 ,$92.10 ,$91.35 ,$85.75 ,$103.65 ,$105.00 ,$18.08 ,$108.00 ,$19.61 ,$21.48 ,$21.48 ,$17.90 ,$21.48 ,$17.90 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30500146,85280,HC FACTOR XII,305,1 ,$110.00 ,$55.00 ,$19.35 ,$110.00 ,$71.06 ,$19.99 ,$75.25 ,$64.50 ,$19.35 ,$66.00 ,$93.50 ,$77.00 ,$19.99 ,$104.50 ,$79.20 ,$80.30 ,$32.90 ,$93.50 ,$19.35 ,$32.90 ,$88.00 ,$80.30 ,$19.99 ,$19.35 ,$21.37 ,$110.00 ,$93.50 ,$43.54 ,$101.20 ,$77.00 ,$92.66 ,$99.53 ,$66.99 ,$92.66 ,$76.01 ,$77.00 ,$19.54 ,$79.20 ,$21.19 ,$23.22 ,$23.22 ,$19.35 ,$23.22 ,$19.35 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30500147,85291,HC FACTOR XIII SOL SCR,305,1 ,$50.00 ,$25.00 ,$9.11 ,$50.00 ,$32.30 ,$9.41 ,$34.58 ,$29.64 ,$9.11 ,$30.00 ,$42.50 ,$35.00 ,$9.41 ,$47.50 ,$36.00 ,$36.50 ,$15.49 ,$42.50 ,$9.11 ,$15.49 ,$40.00 ,$36.50 ,$9.41 ,$9.11 ,$10.06 ,$50.00 ,$42.50 ,$20.50 ,$46.00 ,$35.00 ,$42.61 ,$45.77 ,$30.45 ,$42.61 ,$34.55 ,$35.00 ,$9.20 ,$36.00 ,$9.97 ,$10.93 ,$10.93 ,$9.11 ,$10.93 ,$9.11 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30500150,85300,HC ANTITHROMBIN III,305,1 ,$130.00 ,$65.00 ,$11.85 ,$130.00 ,$83.98 ,$12.24 ,$46.10 ,$39.51 ,$11.85 ,$78.00 ,$110.50 ,$91.00 ,$12.24 ,$123.50 ,$93.60 ,$94.90 ,$20.15 ,$110.50 ,$11.85 ,$20.15 ,$104.00 ,$94.90 ,$12.24 ,$11.85 ,$13.08 ,$130.00 ,$110.50 ,$26.66 ,$119.60 ,$91.00 ,$56.76 ,$60.96 ,$79.17 ,$56.76 ,$89.83 ,$91.00 ,$11.97 ,$93.60 ,$12.97 ,$14.22 ,$14.22 ,$11.85 ,$14.22 ,$11.85 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30500151,85301,HC ANTITHROMBIN III AG,305,1 ,$90.00 ,$45.00 ,$10.81 ,$90.00 ,$58.14 ,$11.17 ,$42.04 ,$36.03 ,$10.81 ,$54.00 ,$76.50 ,$63.00 ,$11.17 ,$85.50 ,$64.80 ,$65.70 ,$18.38 ,$76.50 ,$10.81 ,$18.38 ,$72.00 ,$65.70 ,$11.17 ,$10.81 ,$11.94 ,$90.00 ,$76.50 ,$24.32 ,$82.80 ,$63.00 ,$51.77 ,$55.61 ,$54.81 ,$51.77 ,$62.19 ,$63.00 ,$10.92 ,$64.80 ,$11.84 ,$12.97 ,$12.97 ,$10.81 ,$12.97 ,$10.81 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30500153,85302,HC PROTEIN C AG,305,1 ,$130.00 ,$65.00 ,$12.01 ,$130.00 ,$83.98 ,$12.41 ,$46.73 ,$40.05 ,$12.01 ,$78.00 ,$110.50 ,$91.00 ,$12.41 ,$123.50 ,$93.60 ,$94.90 ,$20.42 ,$110.50 ,$12.01 ,$20.42 ,$104.00 ,$94.90 ,$12.41 ,$12.01 ,$13.26 ,$130.00 ,$110.50 ,$27.02 ,$119.60 ,$91.00 ,$57.56 ,$61.83 ,$79.17 ,$57.56 ,$89.83 ,$91.00 ,$12.13 ,$93.60 ,$13.15 ,$14.41 ,$14.41 ,$12.01 ,$14.41 ,$12.01 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30500154,85303,HC PROTEIN C ACTIVITY,305,1 ,$110.00 ,$55.00 ,$13.84 ,$110.00 ,$71.06 ,$14.30 ,$53.80 ,$46.11 ,$13.84 ,$66.00 ,$93.50 ,$77.00 ,$14.30 ,$104.50 ,$79.20 ,$80.30 ,$23.53 ,$93.50 ,$13.84 ,$23.53 ,$88.00 ,$80.30 ,$14.30 ,$13.84 ,$15.28 ,$110.00 ,$93.50 ,$31.14 ,$101.20 ,$77.00 ,$66.23 ,$71.14 ,$66.99 ,$66.23 ,$76.01 ,$77.00 ,$13.98 ,$79.20 ,$15.16 ,$16.61 ,$16.61 ,$13.84 ,$16.61 ,$13.84 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30500155,85303,HC PROTEIN C ACTIVITY (2),305,1 ,$78.00 ,$39.00 ,$13.84 ,$78.00 ,$50.39 ,$14.30 ,$53.80 ,$46.11 ,$13.84 ,$46.80 ,$66.30 ,$54.60 ,$14.30 ,$74.10 ,$56.16 ,$56.94 ,$23.53 ,$66.30 ,$13.84 ,$23.53 ,$62.40 ,$56.94 ,$14.30 ,$13.84 ,$15.28 ,$78.00 ,$66.30 ,$31.14 ,$71.76 ,$54.60 ,$66.23 ,$71.14 ,$47.50 ,$66.23 ,$53.90 ,$54.60 ,$13.98 ,$56.16 ,$15.16 ,$16.61 ,$16.61 ,$13.84 ,$16.61 ,$13.84 ,$56.16 ,$48.36 ,$56.16 ,$56.16 ,$46.80 ST VINCENT HOSPITAL - ACUTE,30500156,85305,HC PROTEIN S TOTAL,305,1 ,$130.00 ,$65.00 ,$11.61 ,$130.00 ,$83.98 ,$12.00 ,$45.15 ,$38.70 ,$11.61 ,$78.00 ,$110.50 ,$91.00 ,$12.00 ,$123.50 ,$93.60 ,$94.90 ,$19.74 ,$110.50 ,$11.61 ,$19.74 ,$104.00 ,$94.90 ,$12.00 ,$11.61 ,$12.82 ,$130.00 ,$110.50 ,$26.12 ,$119.60 ,$91.00 ,$55.56 ,$59.68 ,$79.17 ,$55.56 ,$89.83 ,$91.00 ,$11.73 ,$93.60 ,$12.72 ,$13.93 ,$13.93 ,$11.61 ,$13.93 ,$11.61 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30500158,85306,HC PROTEIN S FREE (2),305,1 ,$120.00 ,$60.00 ,$15.32 ,$120.00 ,$77.52 ,$15.83 ,$59.61 ,$51.09 ,$15.32 ,$72.00 ,$102.00 ,$84.00 ,$15.83 ,$114.00 ,$86.40 ,$87.60 ,$26.04 ,$102.00 ,$15.32 ,$26.04 ,$96.00 ,$87.60 ,$15.83 ,$15.32 ,$16.92 ,$120.00 ,$102.00 ,$34.47 ,$110.40 ,$84.00 ,$68.41 ,$73.48 ,$73.08 ,$68.41 ,$82.92 ,$84.00 ,$15.47 ,$86.40 ,$16.78 ,$18.38 ,$18.38 ,$15.32 ,$18.38 ,$15.32 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30500159,85306,HC PROTEIN S FREE,305,1 ,$130.00 ,$65.00 ,$15.32 ,$130.00 ,$83.98 ,$15.83 ,$59.61 ,$51.09 ,$15.32 ,$78.00 ,$110.50 ,$91.00 ,$15.83 ,$123.50 ,$93.60 ,$94.90 ,$26.04 ,$110.50 ,$15.32 ,$26.04 ,$104.00 ,$94.90 ,$15.83 ,$15.32 ,$16.92 ,$130.00 ,$110.50 ,$34.47 ,$119.60 ,$91.00 ,$68.41 ,$73.48 ,$79.17 ,$68.41 ,$89.83 ,$91.00 ,$15.47 ,$93.60 ,$16.78 ,$18.38 ,$18.38 ,$15.32 ,$18.38 ,$15.32 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30500161,85306,HC PROTEIN S FREE ACT,305,1 ,$153.00 ,$76.50 ,$15.32 ,$153.00 ,$98.84 ,$15.83 ,$59.61 ,$51.09 ,$15.32 ,$91.80 ,$130.05 ,$107.10 ,$15.83 ,$145.35 ,$110.16 ,$111.69 ,$26.04 ,$130.05 ,$15.32 ,$26.04 ,$122.40 ,$111.69 ,$15.83 ,$15.32 ,$16.92 ,$153.00 ,$130.05 ,$34.47 ,$140.76 ,$107.10 ,$68.41 ,$73.48 ,$93.18 ,$68.41 ,$105.72 ,$107.10 ,$15.47 ,$110.16 ,$16.78 ,$18.38 ,$18.38 ,$15.32 ,$18.38 ,$15.32 ,$110.16 ,$94.86 ,$110.16 ,$110.16 ,$91.80 ST VINCENT HOSPITAL - ACUTE,30500163,85306,HC PROTEIN S FREE QD,305,1 ,$159.00 ,$79.50 ,$15.32 ,$159.00 ,$102.71 ,$15.83 ,$59.61 ,$51.09 ,$15.32 ,$95.40 ,$135.15 ,$111.30 ,$15.83 ,$151.05 ,$114.48 ,$116.07 ,$26.04 ,$135.15 ,$15.32 ,$26.04 ,$127.20 ,$116.07 ,$15.83 ,$15.32 ,$16.92 ,$159.00 ,$135.15 ,$34.47 ,$146.28 ,$111.30 ,$68.41 ,$73.48 ,$96.83 ,$68.41 ,$109.87 ,$111.30 ,$15.47 ,$114.48 ,$16.78 ,$18.38 ,$18.38 ,$15.32 ,$18.38 ,$15.32 ,$114.48 ,$98.58 ,$114.48 ,$114.48 ,$95.40 ST VINCENT HOSPITAL - ACUTE,30500164,85307,HC ACTIV PROTEIN C RESIST,305,1 ,$120.00 ,$60.00 ,$15.32 ,$120.00 ,$77.52 ,$15.83 ,$59.61 ,$51.09 ,$15.32 ,$72.00 ,$102.00 ,$84.00 ,$15.83 ,$114.00 ,$86.40 ,$87.60 ,$26.04 ,$102.00 ,$15.32 ,$26.04 ,$96.00 ,$87.60 ,$15.83 ,$15.32 ,$16.92 ,$120.00 ,$102.00 ,$34.47 ,$110.40 ,$84.00 ,$68.41 ,$73.48 ,$73.08 ,$68.41 ,$82.92 ,$84.00 ,$15.47 ,$86.40 ,$16.78 ,$18.38 ,$18.38 ,$15.32 ,$18.38 ,$15.32 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30500165,85335,HC FACTOR VIII INHIB,305,1 ,$200.00 ,$100.00 ,$12.87 ,$200.00 ,$129.20 ,$13.30 ,$50.05 ,$42.90 ,$12.87 ,$120.00 ,$170.00 ,$140.00 ,$13.30 ,$190.00 ,$144.00 ,$146.00 ,$21.88 ,$170.00 ,$12.87 ,$21.88 ,$160.00 ,$146.00 ,$13.30 ,$12.87 ,$14.21 ,$200.00 ,$170.00 ,$28.96 ,$184.00 ,$140.00 ,$61.64 ,$66.20 ,$121.80 ,$61.64 ,$138.20 ,$140.00 ,$13.00 ,$144.00 ,$14.10 ,$15.44 ,$15.44 ,$12.87 ,$15.44 ,$12.87 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30500166,85335,HC FACTOR IX INHIB,305,1 ,$204.00 ,$102.00 ,$12.87 ,$204.00 ,$131.78 ,$13.30 ,$50.05 ,$42.90 ,$12.87 ,$122.40 ,$173.40 ,$142.80 ,$13.30 ,$193.80 ,$146.88 ,$148.92 ,$21.88 ,$173.40 ,$12.87 ,$21.88 ,$163.20 ,$148.92 ,$13.30 ,$12.87 ,$14.21 ,$204.00 ,$173.40 ,$28.96 ,$187.68 ,$142.80 ,$61.64 ,$66.20 ,$124.24 ,$61.64 ,$140.96 ,$142.80 ,$13.00 ,$146.88 ,$14.10 ,$15.44 ,$15.44 ,$12.87 ,$15.44 ,$12.87 ,$146.88 ,$126.48 ,$146.88 ,$146.88 ,$122.40 ST VINCENT HOSPITAL - ACUTE,30500167,85335,HC FACTOR XIII INHIB,305,1 ,$235.00 ,$117.50 ,$12.87 ,$235.00 ,$151.81 ,$13.30 ,$50.05 ,$42.90 ,$12.87 ,$141.00 ,$199.75 ,$164.50 ,$13.30 ,$223.25 ,$169.20 ,$171.55 ,$21.88 ,$199.75 ,$12.87 ,$21.88 ,$188.00 ,$171.55 ,$13.30 ,$12.87 ,$14.21 ,$235.00 ,$199.75 ,$28.96 ,$216.20 ,$164.50 ,$61.64 ,$66.20 ,$143.12 ,$61.64 ,$162.39 ,$164.50 ,$13.00 ,$169.20 ,$14.10 ,$15.44 ,$15.44 ,$12.87 ,$15.44 ,$12.87 ,$169.20 ,$145.70 ,$169.20 ,$169.20 ,$141.00 ST VINCENT HOSPITAL - ACUTE,30500168,85347,HC ACTIVATED CLOTTING TIME,305,1 ,$94.00 ,$47.00 ,$4.28 ,$94.00 ,$60.72 ,$4.42 ,$16.56 ,$14.19 ,$4.28 ,$56.40 ,$79.90 ,$65.80 ,$4.42 ,$89.30 ,$67.68 ,$68.62 ,$7.28 ,$79.90 ,$4.28 ,$7.28 ,$75.20 ,$68.62 ,$4.42 ,$4.28 ,$4.73 ,$94.00 ,$79.90 ,$9.63 ,$86.48 ,$65.80 ,$20.39 ,$21.90 ,$57.25 ,$20.39 ,$64.95 ,$65.80 ,$4.32 ,$67.68 ,$4.69 ,$5.14 ,$5.14 ,$4.28 ,$5.14 ,$4.28 ,$67.68 ,$58.28 ,$67.68 ,$67.68 ,$56.40 ST VINCENT HOSPITAL - ACUTE,30500169,85347,HC ACTIVATED CLOTTING TIME (TEG),305,1 ,$70.00 ,$35.00 ,$4.28 ,$70.00 ,$45.22 ,$4.42 ,$16.56 ,$14.19 ,$4.28 ,$42.00 ,$59.50 ,$49.00 ,$4.42 ,$66.50 ,$50.40 ,$51.10 ,$7.28 ,$59.50 ,$4.28 ,$7.28 ,$56.00 ,$51.10 ,$4.42 ,$4.28 ,$4.73 ,$70.00 ,$59.50 ,$9.63 ,$64.40 ,$49.00 ,$20.39 ,$21.90 ,$42.63 ,$20.39 ,$48.37 ,$49.00 ,$4.32 ,$50.40 ,$4.69 ,$5.14 ,$5.14 ,$4.28 ,$5.14 ,$4.28 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30500171,85347,HC ACTIVATED CLOTTING TIME (IACT),305,1 ,$60.00 ,$30.00 ,$4.28 ,$60.00 ,$38.76 ,$4.42 ,$16.56 ,$14.19 ,$4.28 ,$36.00 ,$51.00 ,$42.00 ,$4.42 ,$57.00 ,$43.20 ,$43.80 ,$7.28 ,$51.00 ,$4.28 ,$7.28 ,$48.00 ,$43.80 ,$4.42 ,$4.28 ,$4.73 ,$60.00 ,$51.00 ,$9.63 ,$55.20 ,$42.00 ,$20.39 ,$21.90 ,$36.54 ,$20.39 ,$41.46 ,$42.00 ,$4.32 ,$43.20 ,$4.69 ,$5.14 ,$5.14 ,$4.28 ,$5.14 ,$4.28 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30500172,85347,HC ACTIVATED CLOTTING TIME (HRACT),305,1 ,$24.00 ,$12.00 ,$4.28 ,$24.00 ,$15.50 ,$4.42 ,$16.56 ,$14.19 ,$4.28 ,$14.40 ,$20.40 ,$16.80 ,$4.42 ,$22.80 ,$17.28 ,$17.52 ,$7.28 ,$20.40 ,$4.28 ,$7.28 ,$19.20 ,$17.52 ,$4.42 ,$4.28 ,$4.73 ,$24.00 ,$20.40 ,$9.63 ,$22.08 ,$16.80 ,$20.39 ,$21.90 ,$14.62 ,$20.39 ,$16.58 ,$16.80 ,$4.32 ,$17.28 ,$4.69 ,$5.14 ,$5.14 ,$4.28 ,$5.14 ,$4.28 ,$17.28 ,$14.88 ,$17.28 ,$17.28 ,$14.40 ST VINCENT HOSPITAL - ACUTE,30500173,85347,HC ACTIVATED CLOTTING TIME (HDR),305,1 ,$20.00 ,$10.00 ,$4.28 ,$20.00 ,$12.92 ,$4.42 ,$16.56 ,$14.19 ,$4.28 ,$12.00 ,$17.00 ,$14.00 ,$4.42 ,$19.00 ,$14.40 ,$14.60 ,$7.28 ,$17.00 ,$4.28 ,$7.28 ,$16.00 ,$14.60 ,$4.42 ,$4.28 ,$4.73 ,$20.00 ,$17.00 ,$9.63 ,$18.40 ,$14.00 ,$20.00 ,$20.00 ,$12.18 ,$20.00 ,$13.82 ,$14.00 ,$4.32 ,$14.40 ,$4.69 ,$5.14 ,$5.14 ,$4.28 ,$5.14 ,$4.28 ,$14.40 ,$12.40 ,$14.40 ,$14.40 ,$12.00 ST VINCENT HOSPITAL - ACUTE,30500174,85362,HC FDP/FSP AGGLUT SQ,305,1 ,$47.00 ,$23.50 ,$6.89 ,$47.00 ,$30.36 ,$7.12 ,$26.78 ,$22.95 ,$6.89 ,$28.20 ,$39.95 ,$32.90 ,$7.12 ,$44.65 ,$33.84 ,$34.31 ,$11.71 ,$39.95 ,$6.89 ,$11.71 ,$37.60 ,$34.31 ,$7.12 ,$6.89 ,$7.61 ,$47.00 ,$39.95 ,$15.50 ,$43.24 ,$32.90 ,$32.99 ,$35.44 ,$28.62 ,$32.99 ,$32.48 ,$32.90 ,$6.96 ,$33.84 ,$7.55 ,$8.27 ,$8.27 ,$6.89 ,$8.27 ,$6.89 ,$33.84 ,$29.14 ,$33.84 ,$33.84 ,$28.20 ST VINCENT HOSPITAL - ACUTE,30500175,85379,HC D DIMER QN,305,1 ,$70.00 ,$35.00 ,$10.18 ,$70.00 ,$45.22 ,$10.52 ,$39.59 ,$33.93 ,$10.18 ,$42.00 ,$59.50 ,$49.00 ,$10.52 ,$66.50 ,$50.40 ,$51.10 ,$17.31 ,$59.50 ,$10.18 ,$17.31 ,$56.00 ,$51.10 ,$10.52 ,$10.18 ,$11.24 ,$70.00 ,$59.50 ,$22.91 ,$64.40 ,$49.00 ,$38.82 ,$41.70 ,$42.63 ,$38.82 ,$48.37 ,$49.00 ,$10.28 ,$50.40 ,$11.15 ,$12.22 ,$12.22 ,$10.18 ,$12.22 ,$10.18 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30500176,85384,HC FIBRINOGEN,305,1 ,$70.00 ,$35.00 ,$9.72 ,$70.00 ,$45.22 ,$10.04 ,$34.02 ,$29.16 ,$9.72 ,$42.00 ,$59.50 ,$49.00 ,$10.04 ,$66.50 ,$50.40 ,$51.10 ,$16.52 ,$59.50 ,$9.72 ,$16.52 ,$56.00 ,$51.10 ,$10.04 ,$9.72 ,$10.73 ,$70.00 ,$59.50 ,$21.87 ,$64.40 ,$49.00 ,$40.65 ,$43.66 ,$42.63 ,$40.65 ,$48.37 ,$49.00 ,$9.82 ,$50.40 ,$10.64 ,$11.66 ,$11.66 ,$9.72 ,$11.66 ,$9.72 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30500177,85384,HC FIBRINOGEN (TEG),305,1 ,$60.00 ,$30.00 ,$9.72 ,$60.00 ,$38.76 ,$10.04 ,$34.02 ,$29.16 ,$9.72 ,$36.00 ,$51.00 ,$42.00 ,$10.04 ,$57.00 ,$43.20 ,$43.80 ,$16.52 ,$51.00 ,$9.72 ,$16.52 ,$48.00 ,$43.80 ,$10.04 ,$9.72 ,$10.73 ,$60.00 ,$51.00 ,$21.87 ,$55.20 ,$42.00 ,$40.65 ,$43.66 ,$36.54 ,$40.65 ,$41.46 ,$42.00 ,$9.82 ,$43.20 ,$10.64 ,$11.66 ,$11.66 ,$9.72 ,$11.66 ,$9.72 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30500179,85385,HC FIBRINOGEN AG,305,1 ,$60.00 ,$30.00 ,$11.94 ,$60.00 ,$38.76 ,$11.94 ,$50.61 ,$43.38 ,$14.46 ,$36.00 ,$51.00 ,$42.00 ,$11.94 ,$57.00 ,$43.20 ,$43.80 ,$24.58 ,$51.00 ,$14.46 ,$24.58 ,$48.00 ,$43.80 ,$11.94 ,$14.46 ,$15.97 ,$60.00 ,$51.00 ,$32.54 ,$55.20 ,$42.00 ,$40.65 ,$43.66 ,$36.54 ,$40.65 ,$41.46 ,$42.00 ,$14.60 ,$43.20 ,$12.66 ,$17.35 ,$17.35 ,$14.46 ,$17.35 ,$14.46 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30500181,85410,HC ALPHA 2 ANTIPLASMIN,305,1 ,$180.00 ,$90.00 ,$7.71 ,$180.00 ,$116.28 ,$7.97 ,$29.96 ,$25.68 ,$7.71 ,$108.00 ,$153.00 ,$126.00 ,$7.97 ,$171.00 ,$129.60 ,$131.40 ,$13.11 ,$153.00 ,$7.71 ,$13.11 ,$144.00 ,$131.40 ,$7.97 ,$7.71 ,$8.51 ,$180.00 ,$153.00 ,$17.35 ,$165.60 ,$126.00 ,$36.93 ,$39.66 ,$109.62 ,$36.93 ,$124.38 ,$126.00 ,$7.79 ,$129.60 ,$8.45 ,$9.25 ,$9.25 ,$7.71 ,$9.25 ,$7.71 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30500182,85415,HC PLASMINGEN ACTIV INHIB,305,1 ,$223.00 ,$111.50 ,$17.19 ,$223.00 ,$144.06 ,$17.76 ,$66.85 ,$57.30 ,$17.19 ,$133.80 ,$189.55 ,$156.10 ,$17.76 ,$211.85 ,$160.56 ,$162.79 ,$29.22 ,$189.55 ,$17.19 ,$29.22 ,$178.40 ,$162.79 ,$17.76 ,$17.19 ,$18.98 ,$223.00 ,$189.55 ,$38.68 ,$205.16 ,$156.10 ,$82.34 ,$88.44 ,$135.81 ,$82.34 ,$154.09 ,$156.10 ,$17.36 ,$160.56 ,$18.83 ,$20.63 ,$20.63 ,$17.19 ,$20.63 ,$17.19 ,$160.56 ,$138.26 ,$160.56 ,$160.56 ,$133.80 ST VINCENT HOSPITAL - ACUTE,30500184,85420,HC PLASMINOGEN ACTIVITY,305,1 ,$210.00 ,$105.00 ,$6.53 ,$210.00 ,$135.66 ,$6.75 ,$25.41 ,$21.78 ,$6.53 ,$126.00 ,$178.50 ,$147.00 ,$6.75 ,$199.50 ,$151.20 ,$153.30 ,$11.10 ,$178.50 ,$6.53 ,$11.10 ,$168.00 ,$153.30 ,$6.75 ,$6.53 ,$7.21 ,$210.00 ,$178.50 ,$14.69 ,$193.20 ,$147.00 ,$31.31 ,$33.63 ,$127.89 ,$31.31 ,$145.11 ,$147.00 ,$6.60 ,$151.20 ,$7.16 ,$7.84 ,$7.84 ,$6.53 ,$7.84 ,$6.53 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,30500185,85460,HC FETAL HGB KLEIHAUER BETKE,305,1 ,$150.00 ,$75.00 ,$7.73 ,$150.00 ,$96.90 ,$7.99 ,$30.07 ,$25.77 ,$7.73 ,$90.00 ,$127.50 ,$105.00 ,$7.99 ,$142.50 ,$108.00 ,$109.50 ,$13.14 ,$127.50 ,$7.73 ,$13.14 ,$120.00 ,$109.50 ,$7.99 ,$7.73 ,$8.54 ,$150.00 ,$127.50 ,$17.39 ,$138.00 ,$105.00 ,$37.07 ,$39.81 ,$91.35 ,$37.07 ,$103.65 ,$105.00 ,$7.81 ,$108.00 ,$8.47 ,$9.28 ,$9.28 ,$7.73 ,$9.28 ,$7.73 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30500186,85461,HC FETAL HGB ROSETTE,305,1 ,$60.00 ,$30.00 ,$9.33 ,$60.00 ,$38.76 ,$9.33 ,$32.76 ,$28.08 ,$9.36 ,$36.00 ,$51.00 ,$42.00 ,$9.33 ,$57.00 ,$43.20 ,$43.80 ,$15.91 ,$51.00 ,$9.36 ,$15.91 ,$48.00 ,$43.80 ,$9.33 ,$9.36 ,$10.34 ,$60.00 ,$51.00 ,$21.06 ,$55.20 ,$42.00 ,$31.77 ,$34.12 ,$36.54 ,$31.77 ,$41.46 ,$42.00 ,$9.45 ,$43.20 ,$9.89 ,$11.23 ,$11.23 ,$9.36 ,$11.23 ,$9.36 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30500187,85520,HC HEPARIN ASSAY,305,1 ,$170.00 ,$85.00 ,$13.09 ,$170.00 ,$109.82 ,$13.53 ,$50.93 ,$43.65 ,$13.09 ,$102.00 ,$144.50 ,$119.00 ,$13.53 ,$161.50 ,$122.40 ,$124.10 ,$22.25 ,$144.50 ,$13.09 ,$22.25 ,$136.00 ,$124.10 ,$13.53 ,$13.09 ,$14.45 ,$170.00 ,$144.50 ,$29.45 ,$156.40 ,$119.00 ,$53.49 ,$57.45 ,$103.53 ,$53.49 ,$117.47 ,$119.00 ,$13.22 ,$122.40 ,$14.34 ,$15.71 ,$15.71 ,$13.09 ,$15.71 ,$13.09 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30500188,85520,HC HEPARIN ASSAY (LOW MOLE),305,1 ,$170.00 ,$85.00 ,$13.09 ,$170.00 ,$109.82 ,$13.53 ,$50.93 ,$43.65 ,$13.09 ,$102.00 ,$144.50 ,$119.00 ,$13.53 ,$161.50 ,$122.40 ,$124.10 ,$22.25 ,$144.50 ,$13.09 ,$22.25 ,$136.00 ,$124.10 ,$13.53 ,$13.09 ,$14.45 ,$170.00 ,$144.50 ,$29.45 ,$156.40 ,$119.00 ,$53.49 ,$57.45 ,$103.53 ,$53.49 ,$117.47 ,$119.00 ,$13.22 ,$122.40 ,$14.34 ,$15.71 ,$15.71 ,$13.09 ,$15.71 ,$13.09 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30500189,85520,HC HPT,305,1 ,$53.00 ,$26.50 ,$13.09 ,$53.00 ,$34.24 ,$13.53 ,$50.93 ,$43.65 ,$13.09 ,$31.80 ,$45.05 ,$37.10 ,$13.53 ,$50.35 ,$38.16 ,$38.69 ,$22.25 ,$45.05 ,$13.09 ,$22.25 ,$42.40 ,$38.69 ,$13.53 ,$13.09 ,$14.45 ,$53.00 ,$45.05 ,$29.45 ,$48.76 ,$37.10 ,$53.00 ,$53.00 ,$32.28 ,$53.00 ,$36.62 ,$37.10 ,$13.22 ,$38.16 ,$14.34 ,$15.71 ,$15.71 ,$13.09 ,$15.71 ,$13.09 ,$38.16 ,$32.86 ,$38.16 ,$38.16 ,$31.80 ST VINCENT HOSPITAL - ACUTE,30500190,85540,HC LEUKOCYTE ALK PHOS,305,1 ,$125.00 ,$62.50 ,$8.60 ,$125.00 ,$80.75 ,$8.89 ,$33.46 ,$28.68 ,$8.60 ,$75.00 ,$106.25 ,$87.50 ,$8.89 ,$118.75 ,$90.00 ,$91.25 ,$14.62 ,$106.25 ,$8.60 ,$14.62 ,$100.00 ,$91.25 ,$8.89 ,$8.60 ,$9.50 ,$125.00 ,$106.25 ,$19.35 ,$115.00 ,$87.50 ,$41.21 ,$44.26 ,$76.13 ,$41.21 ,$86.38 ,$87.50 ,$8.69 ,$90.00 ,$9.42 ,$10.32 ,$10.32 ,$8.60 ,$10.32 ,$8.60 ,$90.00 ,$77.50 ,$90.00 ,$90.00 ,$75.00 ST VINCENT HOSPITAL - ACUTE,30500191,85557,HC OSMOTIC FRAG RBC INCUB,305,1 ,$231.00 ,$115.50 ,$13.36 ,$231.00 ,$149.23 ,$13.80 ,$51.94 ,$44.52 ,$13.36 ,$138.60 ,$196.35 ,$161.70 ,$13.80 ,$219.45 ,$166.32 ,$168.63 ,$22.71 ,$196.35 ,$13.36 ,$22.71 ,$184.80 ,$168.63 ,$13.80 ,$13.36 ,$14.75 ,$231.00 ,$196.35 ,$30.06 ,$212.52 ,$161.70 ,$63.99 ,$68.73 ,$140.68 ,$63.99 ,$159.62 ,$161.70 ,$13.49 ,$166.32 ,$14.63 ,$16.03 ,$16.03 ,$13.36 ,$16.03 ,$13.36 ,$166.32 ,$143.22 ,$166.32 ,$166.32 ,$138.60 ST VINCENT HOSPITAL - ACUTE,30500192,85576,HC PLATELET AGGREGATION EA,305,1 ,$190.00 ,$95.00 ,$24.91 ,$190.00 ,$122.74 ,$25.74 ,$87.19 ,$74.73 ,$24.91 ,$114.00 ,$161.50 ,$133.00 ,$25.74 ,$180.50 ,$136.80 ,$138.70 ,$42.35 ,$161.50 ,$24.91 ,$42.35 ,$152.00 ,$138.70 ,$25.74 ,$24.91 ,$27.51 ,$190.00 ,$161.50 ,$56.05 ,$174.80 ,$133.00 ,$102.88 ,$110.50 ,$115.71 ,$102.88 ,$131.29 ,$133.00 ,$25.16 ,$136.80 ,$27.28 ,$29.89 ,$29.89 ,$24.91 ,$29.89 ,$24.91 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,30500193,85576,HC PLATELET AGGREGATION EA (TEG),305,1 ,$70.00 ,$35.00 ,$24.91 ,$70.00 ,$45.22 ,$25.74 ,$70.00 ,$70.00 ,$24.91 ,$42.00 ,$59.50 ,$49.00 ,$25.74 ,$66.50 ,$50.40 ,$51.10 ,$42.35 ,$59.50 ,$24.91 ,$42.35 ,$56.00 ,$51.10 ,$25.74 ,$24.91 ,$27.51 ,$70.00 ,$59.50 ,$56.05 ,$64.40 ,$49.00 ,$70.00 ,$70.00 ,$42.63 ,$70.00 ,$48.37 ,$49.00 ,$25.16 ,$50.40 ,$27.28 ,$29.89 ,$29.89 ,$24.91 ,$29.89 ,$24.91 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30500195,85576,HC PLATELET AGGREGATION EA (ASSAY),305,1 ,$92.00 ,$46.00 ,$24.91 ,$92.00 ,$59.43 ,$25.74 ,$87.19 ,$74.73 ,$24.91 ,$55.20 ,$78.20 ,$64.40 ,$25.74 ,$87.40 ,$66.24 ,$67.16 ,$42.35 ,$78.20 ,$24.91 ,$42.35 ,$73.60 ,$67.16 ,$25.74 ,$24.91 ,$27.51 ,$92.00 ,$78.20 ,$56.05 ,$84.64 ,$64.40 ,$92.00 ,$92.00 ,$56.03 ,$92.00 ,$63.57 ,$64.40 ,$25.16 ,$66.24 ,$27.28 ,$29.89 ,$29.89 ,$24.91 ,$29.89 ,$24.91 ,$66.24 ,$57.04 ,$66.24 ,$66.24 ,$55.20 ST VINCENT HOSPITAL - ACUTE,30500196,85610,HC PROTHROMBIN TIME (PT),305,1 ,$32.00 ,$16.00 ,$4.29 ,$32.00 ,$20.67 ,$4.43 ,$15.30 ,$13.11 ,$4.29 ,$19.20 ,$27.20 ,$22.40 ,$4.43 ,$30.40 ,$23.04 ,$23.36 ,$7.29 ,$27.20 ,$4.29 ,$7.29 ,$25.60 ,$23.36 ,$4.43 ,$4.29 ,$4.74 ,$32.00 ,$27.20 ,$9.65 ,$29.44 ,$22.40 ,$18.85 ,$20.24 ,$19.49 ,$18.85 ,$22.11 ,$22.40 ,$4.33 ,$23.04 ,$4.70 ,$5.15 ,$5.15 ,$4.29 ,$5.15 ,$4.29 ,$23.04 ,$19.84 ,$23.04 ,$23.04 ,$19.20 ST VINCENT HOSPITAL - ACUTE,30500197,85611,HC PT MIX STUDY,305,1 ,$43.00 ,$21.50 ,$3.94 ,$43.00 ,$27.78 ,$4.07 ,$15.33 ,$13.14 ,$3.94 ,$25.80 ,$36.55 ,$30.10 ,$4.07 ,$40.85 ,$30.96 ,$31.39 ,$6.70 ,$36.55 ,$3.94 ,$6.70 ,$34.40 ,$31.39 ,$4.07 ,$3.94 ,$4.35 ,$43.00 ,$36.55 ,$8.87 ,$39.56 ,$30.10 ,$18.88 ,$20.28 ,$26.19 ,$18.88 ,$29.71 ,$30.10 ,$3.98 ,$30.96 ,$4.31 ,$4.73 ,$4.73 ,$3.94 ,$4.73 ,$3.94 ,$30.96 ,$26.66 ,$30.96 ,$30.96 ,$25.80 ST VINCENT HOSPITAL - ACUTE,30500198,85613,HC RUSSELL VIPER VENOM SCR,305,1 ,$70.00 ,$35.00 ,$9.58 ,$70.00 ,$45.22 ,$9.90 ,$37.24 ,$31.92 ,$9.58 ,$42.00 ,$59.50 ,$49.00 ,$9.90 ,$66.50 ,$50.40 ,$51.10 ,$16.29 ,$59.50 ,$9.58 ,$16.29 ,$56.00 ,$51.10 ,$9.90 ,$9.58 ,$10.58 ,$70.00 ,$59.50 ,$21.56 ,$64.40 ,$49.00 ,$45.84 ,$49.24 ,$42.63 ,$45.84 ,$48.37 ,$49.00 ,$9.68 ,$50.40 ,$10.49 ,$11.50 ,$11.50 ,$9.58 ,$11.50 ,$9.58 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30500200,85613,HC RUSSELL VIPER VENOM CONF,305,1 ,$70.00 ,$35.00 ,$9.58 ,$70.00 ,$45.22 ,$9.90 ,$37.24 ,$31.92 ,$9.58 ,$42.00 ,$59.50 ,$49.00 ,$9.90 ,$66.50 ,$50.40 ,$51.10 ,$16.29 ,$59.50 ,$9.58 ,$16.29 ,$56.00 ,$51.10 ,$9.90 ,$9.58 ,$10.58 ,$70.00 ,$59.50 ,$21.56 ,$64.40 ,$49.00 ,$45.84 ,$49.24 ,$42.63 ,$45.84 ,$48.37 ,$49.00 ,$9.68 ,$50.40 ,$10.49 ,$11.50 ,$11.50 ,$9.58 ,$11.50 ,$9.58 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30500201,85613,HC RUSSELL VIPER VENOM DIL (DRVVT),305,1 ,$70.00 ,$35.00 ,$9.58 ,$70.00 ,$45.22 ,$9.90 ,$37.24 ,$31.92 ,$9.58 ,$42.00 ,$59.50 ,$49.00 ,$9.90 ,$66.50 ,$50.40 ,$51.10 ,$16.29 ,$59.50 ,$9.58 ,$16.29 ,$56.00 ,$51.10 ,$9.90 ,$9.58 ,$10.58 ,$70.00 ,$59.50 ,$21.56 ,$64.40 ,$49.00 ,$45.84 ,$49.24 ,$42.63 ,$45.84 ,$48.37 ,$49.00 ,$9.68 ,$50.40 ,$10.49 ,$11.50 ,$11.50 ,$9.58 ,$11.50 ,$9.58 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30500202,85613,HC RUSSELL VIPER VENOM DIL,305,1 ,$122.00 ,$61.00 ,$9.58 ,$122.00 ,$78.81 ,$9.90 ,$37.24 ,$31.92 ,$9.58 ,$73.20 ,$103.70 ,$85.40 ,$9.90 ,$115.90 ,$87.84 ,$89.06 ,$16.29 ,$103.70 ,$9.58 ,$16.29 ,$97.60 ,$89.06 ,$9.90 ,$9.58 ,$10.58 ,$122.00 ,$103.70 ,$21.56 ,$112.24 ,$85.40 ,$45.84 ,$49.24 ,$74.30 ,$45.84 ,$84.30 ,$85.40 ,$9.68 ,$87.84 ,$10.49 ,$11.50 ,$11.50 ,$9.58 ,$11.50 ,$9.58 ,$87.84 ,$75.64 ,$87.84 ,$87.84 ,$73.20 ST VINCENT HOSPITAL - ACUTE,30500204,85651,HC SED RATE RBC NON AUTO,305,1 ,$41.00 ,$20.50 ,$4.01 ,$41.00 ,$26.49 ,$4.01 ,$14.95 ,$12.81 ,$4.27 ,$24.60 ,$34.85 ,$28.70 ,$4.01 ,$38.95 ,$29.52 ,$29.93 ,$7.26 ,$34.85 ,$4.27 ,$7.26 ,$32.80 ,$29.93 ,$4.01 ,$4.27 ,$4.71 ,$41.00 ,$34.85 ,$9.61 ,$37.72 ,$28.70 ,$16.99 ,$18.25 ,$24.97 ,$16.99 ,$28.33 ,$28.70 ,$4.31 ,$29.52 ,$4.25 ,$5.12 ,$5.12 ,$4.27 ,$5.12 ,$4.27 ,$29.52 ,$25.42 ,$29.52 ,$29.52 ,$24.60 ST VINCENT HOSPITAL - ACUTE,30500205,85652,HC SED RATE AUTO,305,1 ,$36.00 ,$18.00 ,$2.70 ,$36.00 ,$23.26 ,$2.79 ,$10.50 ,$9.00 ,$2.70 ,$21.60 ,$30.60 ,$25.20 ,$2.79 ,$34.20 ,$25.92 ,$26.28 ,$4.59 ,$30.60 ,$2.70 ,$4.59 ,$28.80 ,$26.28 ,$2.79 ,$2.70 ,$2.98 ,$36.00 ,$30.60 ,$6.08 ,$33.12 ,$25.20 ,$12.95 ,$13.91 ,$21.92 ,$12.95 ,$24.88 ,$25.20 ,$2.73 ,$25.92 ,$2.96 ,$3.24 ,$3.24 ,$2.70 ,$3.24 ,$2.70 ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,30500206,85660,HC SICKLE CELL RBC,305,1 ,$60.00 ,$30.00 ,$5.51 ,$60.00 ,$38.76 ,$5.69 ,$21.42 ,$18.36 ,$5.51 ,$36.00 ,$51.00 ,$42.00 ,$5.69 ,$57.00 ,$43.20 ,$43.80 ,$9.37 ,$51.00 ,$5.51 ,$9.37 ,$48.00 ,$43.80 ,$5.69 ,$5.51 ,$6.08 ,$60.00 ,$51.00 ,$12.40 ,$55.20 ,$42.00 ,$26.43 ,$28.39 ,$36.54 ,$26.43 ,$41.46 ,$42.00 ,$5.57 ,$43.20 ,$6.03 ,$6.61 ,$6.61 ,$5.51 ,$6.61 ,$5.51 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30500207,85670,HC THROMBIN TIME PLASMA,305,1 ,$90.00 ,$45.00 ,$1.21 ,$90.00 ,$58.14 ,$1.21 ,$22.44 ,$19.23 ,$5.77 ,$54.00 ,$76.50 ,$63.00 ,$1.21 ,$85.50 ,$64.80 ,$65.70 ,$9.81 ,$76.50 ,$5.77 ,$9.81 ,$72.00 ,$65.70 ,$1.21 ,$5.77 ,$6.37 ,$90.00 ,$76.50 ,$12.98 ,$82.80 ,$63.00 ,$27.62 ,$29.67 ,$54.81 ,$27.62 ,$62.19 ,$63.00 ,$5.83 ,$64.80 ,$1.28 ,$6.92 ,$6.92 ,$5.77 ,$6.92 ,$5.77 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30500208,85705,HC HEX PHOSPHOLIPID NEUT,305,1 ,$50.00 ,$25.00 ,$8.17 ,$50.00 ,$32.30 ,$8.17 ,$37.45 ,$32.10 ,$9.63 ,$30.00 ,$42.50 ,$35.00 ,$8.17 ,$47.50 ,$36.00 ,$36.50 ,$16.37 ,$42.50 ,$9.63 ,$16.37 ,$40.00 ,$36.50 ,$8.17 ,$9.63 ,$10.63 ,$50.00 ,$42.50 ,$21.67 ,$46.00 ,$35.00 ,$27.83 ,$29.90 ,$30.45 ,$27.83 ,$34.55 ,$35.00 ,$9.73 ,$36.00 ,$8.66 ,$11.56 ,$11.56 ,$9.63 ,$11.56 ,$9.63 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30500209,85730,HC PTT (LUPUS),305,1 ,$46.00 ,$23.00 ,$6.01 ,$46.00 ,$29.72 ,$6.21 ,$23.35 ,$20.01 ,$6.01 ,$27.60 ,$39.10 ,$32.20 ,$6.21 ,$43.70 ,$33.12 ,$33.58 ,$10.22 ,$39.10 ,$6.01 ,$10.22 ,$36.80 ,$33.58 ,$6.21 ,$6.01 ,$6.64 ,$46.00 ,$39.10 ,$13.52 ,$42.32 ,$32.20 ,$28.75 ,$30.88 ,$28.01 ,$28.75 ,$31.79 ,$32.20 ,$6.07 ,$33.12 ,$6.58 ,$7.21 ,$7.21 ,$6.01 ,$7.21 ,$6.01 ,$33.12 ,$28.52 ,$33.12 ,$33.12 ,$27.60 ST VINCENT HOSPITAL - ACUTE,30500210,85730,HC PTT (LUPUS ANTI),305,1 ,$78.00 ,$39.00 ,$6.01 ,$78.00 ,$50.39 ,$6.21 ,$23.35 ,$20.01 ,$6.01 ,$46.80 ,$66.30 ,$54.60 ,$6.21 ,$74.10 ,$56.16 ,$56.94 ,$10.22 ,$66.30 ,$6.01 ,$10.22 ,$62.40 ,$56.94 ,$6.21 ,$6.01 ,$6.64 ,$78.00 ,$66.30 ,$13.52 ,$71.76 ,$54.60 ,$28.75 ,$30.88 ,$47.50 ,$28.75 ,$53.90 ,$54.60 ,$6.07 ,$56.16 ,$6.58 ,$7.21 ,$7.21 ,$6.01 ,$7.21 ,$6.01 ,$56.16 ,$48.36 ,$56.16 ,$56.16 ,$46.80 ST VINCENT HOSPITAL - ACUTE,30500211,85730,HC PTT,305,1 ,$50.00 ,$25.00 ,$6.01 ,$50.00 ,$32.30 ,$6.21 ,$23.35 ,$20.01 ,$6.01 ,$30.00 ,$42.50 ,$35.00 ,$6.21 ,$47.50 ,$36.00 ,$36.50 ,$10.22 ,$42.50 ,$6.01 ,$10.22 ,$40.00 ,$36.50 ,$6.21 ,$6.01 ,$6.64 ,$50.00 ,$42.50 ,$13.52 ,$46.00 ,$35.00 ,$28.75 ,$30.88 ,$30.45 ,$28.75 ,$34.55 ,$35.00 ,$6.07 ,$36.00 ,$6.58 ,$7.21 ,$7.21 ,$6.01 ,$7.21 ,$6.01 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30500212,85730,HC APTT,305,1 ,$92.00 ,$46.00 ,$6.01 ,$92.00 ,$59.43 ,$6.21 ,$23.35 ,$20.01 ,$6.01 ,$55.20 ,$78.20 ,$64.40 ,$6.21 ,$87.40 ,$66.24 ,$67.16 ,$10.22 ,$78.20 ,$6.01 ,$10.22 ,$73.60 ,$67.16 ,$6.21 ,$6.01 ,$6.64 ,$92.00 ,$78.20 ,$13.52 ,$84.64 ,$64.40 ,$28.75 ,$30.88 ,$56.03 ,$28.75 ,$63.57 ,$64.40 ,$6.07 ,$66.24 ,$6.58 ,$7.21 ,$7.21 ,$6.01 ,$7.21 ,$6.01 ,$66.24 ,$57.04 ,$66.24 ,$66.24 ,$55.20 ST VINCENT HOSPITAL - ACUTE,30500213,85732,HC PTT MIXING STUDY,305,1 ,$70.00 ,$35.00 ,$6.47 ,$70.00 ,$45.22 ,$6.69 ,$25.13 ,$21.54 ,$6.47 ,$42.00 ,$59.50 ,$49.00 ,$6.69 ,$66.50 ,$50.40 ,$51.10 ,$11.00 ,$59.50 ,$6.47 ,$11.00 ,$56.00 ,$51.10 ,$6.69 ,$6.47 ,$7.14 ,$70.00 ,$59.50 ,$14.56 ,$64.40 ,$49.00 ,$30.99 ,$33.29 ,$42.63 ,$30.99 ,$48.37 ,$49.00 ,$6.53 ,$50.40 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30500214,85732,HC PTT MIXING STUDY (LUPUS),305,1 ,$23.00 ,$11.50 ,$6.47 ,$23.00 ,$14.86 ,$6.69 ,$23.00 ,$21.54 ,$6.47 ,$13.80 ,$19.55 ,$16.10 ,$6.69 ,$21.85 ,$16.56 ,$16.79 ,$11.00 ,$19.55 ,$6.47 ,$11.00 ,$18.40 ,$16.79 ,$6.69 ,$6.47 ,$7.14 ,$23.00 ,$19.55 ,$14.56 ,$21.16 ,$16.10 ,$23.00 ,$23.00 ,$14.01 ,$23.00 ,$15.89 ,$16.10 ,$6.53 ,$16.56 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$16.56 ,$14.26 ,$16.56 ,$16.56 ,$13.80 ST VINCENT HOSPITAL - ACUTE,30500215,85732,HC PTT MIXING STUDY (24) HR,305,1 ,$58.00 ,$29.00 ,$6.47 ,$58.00 ,$37.47 ,$6.69 ,$25.13 ,$21.54 ,$6.47 ,$34.80 ,$49.30 ,$40.60 ,$6.69 ,$55.10 ,$41.76 ,$42.34 ,$11.00 ,$49.30 ,$6.47 ,$11.00 ,$46.40 ,$42.34 ,$6.69 ,$6.47 ,$7.14 ,$58.00 ,$49.30 ,$14.56 ,$53.36 ,$40.60 ,$30.99 ,$33.29 ,$35.32 ,$30.99 ,$40.08 ,$40.60 ,$6.53 ,$41.76 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$41.76 ,$35.96 ,$41.76 ,$41.76 ,$34.80 ST VINCENT HOSPITAL - ACUTE,30500216,85732,HC PTT MIXING STUDY (PLASMA),305,1 ,$140.00 ,$70.00 ,$6.47 ,$140.00 ,$90.44 ,$6.69 ,$25.13 ,$21.54 ,$6.47 ,$84.00 ,$119.00 ,$98.00 ,$6.69 ,$133.00 ,$100.80 ,$102.20 ,$11.00 ,$119.00 ,$6.47 ,$11.00 ,$112.00 ,$102.20 ,$6.69 ,$6.47 ,$7.14 ,$140.00 ,$119.00 ,$14.56 ,$128.80 ,$98.00 ,$30.99 ,$33.29 ,$85.26 ,$30.99 ,$96.74 ,$98.00 ,$6.53 ,$100.80 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30500217,85810,HC VISCOSITY,305,1 ,$80.00 ,$40.00 ,$11.67 ,$80.00 ,$51.68 ,$12.06 ,$45.40 ,$38.91 ,$11.67 ,$48.00 ,$68.00 ,$56.00 ,$12.06 ,$76.00 ,$57.60 ,$58.40 ,$19.84 ,$68.00 ,$11.67 ,$19.84 ,$64.00 ,$58.40 ,$12.06 ,$11.67 ,$12.89 ,$80.00 ,$68.00 ,$26.26 ,$73.60 ,$56.00 ,$55.88 ,$60.02 ,$48.72 ,$55.88 ,$55.28 ,$56.00 ,$11.79 ,$57.60 ,$12.78 ,$14.00 ,$14.00 ,$11.67 ,$14.00 ,$11.67 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30500220,85576,HC PLTMAP ADP 85576,305,1 ,$90.00 ,$45.00 ,$24.91 ,$90.00 ,$58.14 ,$25.74 ,$87.19 ,$74.73 ,$24.91 ,$54.00 ,$76.50 ,$63.00 ,$25.74 ,$85.50 ,$64.80 ,$65.70 ,$42.35 ,$76.50 ,$24.91 ,$42.35 ,$72.00 ,$65.70 ,$25.74 ,$24.91 ,$27.51 ,$90.00 ,$76.50 ,$56.05 ,$82.80 ,$63.00 ,$90.00 ,$90.00 ,$54.81 ,$90.00 ,$62.19 ,$63.00 ,$25.16 ,$64.80 ,$27.28 ,$29.89 ,$29.89 ,$24.91 ,$29.89 ,$24.91 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30500221,85576,HC PLTMAP AA 85576,305,1 ,$90.00 ,$45.00 ,$24.91 ,$90.00 ,$58.14 ,$25.74 ,$87.19 ,$74.73 ,$24.91 ,$54.00 ,$76.50 ,$63.00 ,$25.74 ,$85.50 ,$64.80 ,$65.70 ,$42.35 ,$76.50 ,$24.91 ,$42.35 ,$72.00 ,$65.70 ,$25.74 ,$24.91 ,$27.51 ,$90.00 ,$76.50 ,$56.05 ,$82.80 ,$63.00 ,$90.00 ,$90.00 ,$54.81 ,$90.00 ,$62.19 ,$63.00 ,$25.16 ,$64.80 ,$27.28 ,$29.89 ,$29.89 ,$24.91 ,$29.89 ,$24.91 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30500222,85576,HC PLT MAP TEG 85576,305,1 ,$90.00 ,$45.00 ,$24.91 ,$90.00 ,$58.14 ,$25.74 ,$87.19 ,$74.73 ,$24.91 ,$54.00 ,$76.50 ,$63.00 ,$25.74 ,$85.50 ,$64.80 ,$65.70 ,$42.35 ,$76.50 ,$24.91 ,$42.35 ,$72.00 ,$65.70 ,$25.74 ,$24.91 ,$27.51 ,$90.00 ,$76.50 ,$56.05 ,$82.80 ,$63.00 ,$90.00 ,$90.00 ,$54.81 ,$90.00 ,$62.19 ,$63.00 ,$25.16 ,$64.80 ,$27.28 ,$29.89 ,$29.89 ,$24.91 ,$29.89 ,$24.91 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30500223,85576,HC PLTINHIB ADP 85576,305,1 ,$130.00 ,$65.00 ,$24.91 ,$130.00 ,$83.98 ,$25.74 ,$87.19 ,$74.73 ,$24.91 ,$78.00 ,$110.50 ,$91.00 ,$25.74 ,$123.50 ,$93.60 ,$94.90 ,$42.35 ,$110.50 ,$24.91 ,$42.35 ,$104.00 ,$94.90 ,$25.74 ,$24.91 ,$27.51 ,$130.00 ,$110.50 ,$56.05 ,$119.60 ,$91.00 ,$102.88 ,$110.50 ,$79.17 ,$102.88 ,$89.83 ,$91.00 ,$25.16 ,$93.60 ,$27.28 ,$29.89 ,$29.89 ,$24.91 ,$29.89 ,$24.91 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30500224,85576,HC PLTINHIB TEG 85576,305,1 ,$130.00 ,$65.00 ,$24.91 ,$130.00 ,$83.98 ,$25.74 ,$87.19 ,$74.73 ,$24.91 ,$78.00 ,$110.50 ,$91.00 ,$25.74 ,$123.50 ,$93.60 ,$94.90 ,$42.35 ,$110.50 ,$24.91 ,$42.35 ,$104.00 ,$94.90 ,$25.74 ,$24.91 ,$27.51 ,$130.00 ,$110.50 ,$56.05 ,$119.60 ,$91.00 ,$102.88 ,$110.50 ,$79.17 ,$102.88 ,$89.83 ,$91.00 ,$25.16 ,$93.60 ,$27.28 ,$29.89 ,$29.89 ,$24.91 ,$29.89 ,$24.91 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30500225,85245,HC RISTOCETIN COFACT MAYO,305,1 ,$97.00 ,$48.50 ,$22.94 ,$97.00 ,$62.66 ,$23.70 ,$89.22 ,$76.47 ,$22.94 ,$58.20 ,$82.45 ,$67.90 ,$23.70 ,$92.15 ,$69.84 ,$70.81 ,$39.00 ,$82.45 ,$22.94 ,$39.00 ,$77.60 ,$70.81 ,$23.70 ,$22.94 ,$25.33 ,$97.00 ,$82.45 ,$51.62 ,$89.24 ,$67.90 ,$97.00 ,$97.00 ,$59.07 ,$97.00 ,$67.03 ,$67.90 ,$23.17 ,$69.84 ,$25.12 ,$27.53 ,$27.53 ,$22.94 ,$27.53 ,$22.94 ,$69.84 ,$60.14 ,$69.84 ,$69.84 ,$58.20 ST VINCENT HOSPITAL - ACUTE,30500226,85246,HC VW FACTOR ANTIGEN MAYO,305,1 ,$257.00 ,$128.50 ,$22.94 ,$257.00 ,$166.02 ,$23.70 ,$89.22 ,$76.47 ,$22.94 ,$154.20 ,$218.45 ,$179.90 ,$23.70 ,$244.15 ,$185.04 ,$187.61 ,$39.00 ,$218.45 ,$22.94 ,$39.00 ,$205.60 ,$187.61 ,$23.70 ,$22.94 ,$25.33 ,$257.00 ,$218.45 ,$51.62 ,$236.44 ,$179.90 ,$109.86 ,$118.00 ,$156.51 ,$109.86 ,$177.59 ,$179.90 ,$23.17 ,$185.04 ,$25.12 ,$27.53 ,$27.53 ,$22.94 ,$27.53 ,$22.94 ,$185.04 ,$159.34 ,$185.04 ,$185.04 ,$154.20 ST VINCENT HOSPITAL - ACUTE,30500227,85240,HC FACTOR VIII ASSAY MAYO,305,1 ,$197.00 ,$98.50 ,$9.84 ,$197.00 ,$127.26 ,$9.84 ,$69.62 ,$59.67 ,$17.90 ,$118.20 ,$167.45 ,$137.90 ,$9.84 ,$187.15 ,$141.84 ,$143.81 ,$30.43 ,$167.45 ,$17.90 ,$30.43 ,$157.60 ,$143.81 ,$9.84 ,$17.90 ,$19.77 ,$197.00 ,$167.45 ,$40.28 ,$181.24 ,$137.90 ,$33.49 ,$35.97 ,$119.97 ,$33.49 ,$136.13 ,$137.90 ,$18.08 ,$141.84 ,$10.43 ,$21.48 ,$21.48 ,$17.90 ,$21.48 ,$17.90 ,$141.84 ,$122.14 ,$141.84 ,$141.84 ,$118.20 ST VINCENT HOSPITAL - ACUTE,30500228,85397,HC VW FACTOR ACTIVITY MAYO,305,1 ,$257.00 ,$128.50 ,$30.86 ,$257.00 ,$166.02 ,$31.89 ,$108.01 ,$92.58 ,$30.86 ,$154.20 ,$218.45 ,$179.90 ,$31.89 ,$244.15 ,$185.04 ,$187.61 ,$52.46 ,$218.45 ,$30.86 ,$52.46 ,$205.60 ,$187.61 ,$31.89 ,$30.86 ,$34.08 ,$257.00 ,$218.45 ,$69.44 ,$236.44 ,$179.90 ,$109.86 ,$118.00 ,$156.51 ,$109.86 ,$177.59 ,$179.90 ,$31.17 ,$185.04 ,$33.80 ,$37.03 ,$37.03 ,$30.86 ,$37.03 ,$30.86 ,$185.04 ,$159.34 ,$185.04 ,$185.04 ,$154.20 ST VINCENT HOSPITAL - ACUTE,30500230,85055,HC IMMATURE PLATELET FRACTION,305,1 ,$180.00 ,$90.00 ,$18.97 ,$180.00 ,$116.28 ,$18.97 ,$125.09 ,$107.22 ,$35.74 ,$108.00 ,$153.00 ,$126.00 ,$18.97 ,$171.00 ,$129.60 ,$131.40 ,$60.76 ,$153.00 ,$35.74 ,$60.76 ,$144.00 ,$131.40 ,$18.97 ,$35.74 ,$39.46 ,$180.00 ,$153.00 ,$80.42 ,$165.60 ,$126.00 ,$128.22 ,$137.72 ,$109.62 ,$128.22 ,$124.38 ,$126.00 ,$36.10 ,$129.60 ,$20.11 ,$42.89 ,$42.89 ,$35.74 ,$42.89 ,$35.74 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30500231,85260,HC FACTOR X CHROMOGENIC,305,1 ,$170.00 ,$85.00 ,$17.90 ,$170.00 ,$109.82 ,$18.50 ,$69.62 ,$59.67 ,$17.90 ,$102.00 ,$144.50 ,$119.00 ,$18.50 ,$161.50 ,$122.40 ,$124.10 ,$30.43 ,$144.50 ,$17.90 ,$30.43 ,$136.00 ,$124.10 ,$18.50 ,$17.90 ,$19.77 ,$170.00 ,$144.50 ,$40.28 ,$156.40 ,$119.00 ,$85.75 ,$92.10 ,$103.53 ,$85.75 ,$117.47 ,$119.00 ,$18.08 ,$122.40 ,$19.61 ,$21.48 ,$21.48 ,$17.90 ,$21.48 ,$17.90 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,30500320,85048,HC BLOOD COUNT LEUKO AUTO WITH NEUTROPHIL,305,1 ,$34.00 ,$17.00 ,$2.54 ,$34.00 ,$21.96 ,$2.62 ,$9.87 ,$8.46 ,$2.54 ,$20.40 ,$28.90 ,$23.80 ,$2.62 ,$32.30 ,$24.48 ,$24.82 ,$4.32 ,$28.90 ,$2.54 ,$4.32 ,$27.20 ,$24.82 ,$2.62 ,$2.54 ,$2.80 ,$34.00 ,$28.90 ,$5.72 ,$31.28 ,$23.80 ,$12.14 ,$13.04 ,$20.71 ,$12.14 ,$23.49 ,$23.80 ,$2.57 ,$24.48 ,$2.78 ,$3.05 ,$3.05 ,$2.54 ,$3.05 ,$2.54 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30500321,85660,HC SICKLE CELL RBC (RC),305,1 ,$42.00 ,$21.00 ,$5.51 ,$42.00 ,$27.13 ,$5.69 ,$21.42 ,$18.36 ,$5.51 ,$25.20 ,$35.70 ,$29.40 ,$5.69 ,$39.90 ,$30.24 ,$30.66 ,$9.37 ,$35.70 ,$5.51 ,$9.37 ,$33.60 ,$30.66 ,$5.69 ,$5.51 ,$6.08 ,$42.00 ,$35.70 ,$12.40 ,$38.64 ,$29.40 ,$26.43 ,$28.39 ,$25.58 ,$26.43 ,$29.02 ,$29.40 ,$5.57 ,$30.24 ,$6.03 ,$6.61 ,$6.61 ,$5.51 ,$6.61 ,$5.51 ,$30.24 ,$26.04 ,$30.24 ,$30.24 ,$25.20 ST VINCENT HOSPITAL - ACUTE,30500343,85549,HC MURAMIDASE,305,1 ,$79.00 ,$39.50 ,$18.75 ,$79.00 ,$51.03 ,$19.37 ,$72.91 ,$62.49 ,$18.75 ,$47.40 ,$67.15 ,$55.30 ,$19.37 ,$75.05 ,$56.88 ,$57.67 ,$31.88 ,$67.15 ,$18.75 ,$31.88 ,$63.20 ,$57.67 ,$19.37 ,$18.75 ,$20.70 ,$79.00 ,$67.15 ,$42.19 ,$72.68 ,$55.30 ,$79.00 ,$79.00 ,$48.11 ,$79.00 ,$54.59 ,$55.30 ,$18.94 ,$56.88 ,$20.53 ,$22.50 ,$22.50 ,$18.75 ,$22.50 ,$18.75 ,$56.88 ,$48.98 ,$56.88 ,$56.88 ,$47.40 ST VINCENT HOSPITAL - ACUTE,30500827,85611,HC PT MIX STUDY (PLASMA),305,1 ,$107.00 ,$53.50 ,$3.94 ,$107.00 ,$69.12 ,$4.07 ,$15.33 ,$13.14 ,$3.94 ,$64.20 ,$90.95 ,$74.90 ,$4.07 ,$101.65 ,$77.04 ,$78.11 ,$6.70 ,$90.95 ,$3.94 ,$6.70 ,$85.60 ,$78.11 ,$4.07 ,$3.94 ,$4.35 ,$107.00 ,$90.95 ,$8.87 ,$98.44 ,$74.90 ,$18.88 ,$20.28 ,$65.16 ,$18.88 ,$73.94 ,$74.90 ,$3.98 ,$77.04 ,$4.31 ,$4.73 ,$4.73 ,$3.94 ,$4.73 ,$3.94 ,$77.04 ,$66.34 ,$77.04 ,$77.04 ,$64.20 ST VINCENT HOSPITAL - ACUTE,30580103,85007,HC BLOOD COUNT MAN DIFF WBC GBO,305,1 ,$31.00 ,$15.50 ,$3.80 ,$31.00 ,$20.03 ,$3.93 ,$13.37 ,$11.46 ,$3.80 ,$18.60 ,$26.35 ,$21.70 ,$3.93 ,$29.45 ,$22.32 ,$22.63 ,$6.46 ,$26.35 ,$3.80 ,$6.46 ,$24.80 ,$22.63 ,$3.93 ,$3.80 ,$4.20 ,$31.00 ,$26.35 ,$8.55 ,$28.52 ,$21.70 ,$16.46 ,$17.68 ,$18.88 ,$16.46 ,$21.42 ,$21.70 ,$3.84 ,$22.32 ,$4.17 ,$4.56 ,$4.56 ,$3.80 ,$4.56 ,$3.80 ,$22.32 ,$19.22 ,$22.32 ,$22.32 ,$18.60 ST VINCENT HOSPITAL - ACUTE,30580107,85025,HC CBC AUTO W/AUTO DIFF GBO,305,1 ,$60.00 ,$30.00 ,$7.77 ,$60.00 ,$38.76 ,$8.03 ,$30.21 ,$25.89 ,$7.77 ,$36.00 ,$51.00 ,$42.00 ,$8.03 ,$57.00 ,$43.20 ,$43.80 ,$13.21 ,$51.00 ,$7.77 ,$13.21 ,$48.00 ,$43.80 ,$8.03 ,$7.77 ,$8.58 ,$60.00 ,$51.00 ,$17.48 ,$55.20 ,$42.00 ,$37.24 ,$40.00 ,$36.54 ,$37.24 ,$41.46 ,$42.00 ,$7.85 ,$43.20 ,$8.51 ,$9.32 ,$9.32 ,$7.77 ,$9.32 ,$7.77 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30580108,85027,HC CBC W/O DIFF GBO,305,1 ,$44.00 ,$22.00 ,$6.47 ,$44.00 ,$28.42 ,$6.69 ,$25.13 ,$21.54 ,$6.47 ,$26.40 ,$37.40 ,$30.80 ,$6.69 ,$41.80 ,$31.68 ,$32.12 ,$11.00 ,$37.40 ,$6.47 ,$11.00 ,$35.20 ,$32.12 ,$6.69 ,$6.47 ,$7.14 ,$44.00 ,$37.40 ,$14.56 ,$40.48 ,$30.80 ,$30.99 ,$33.29 ,$26.80 ,$30.99 ,$30.40 ,$30.80 ,$6.53 ,$31.68 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$31.68 ,$27.28 ,$31.68 ,$31.68 ,$26.40 ST VINCENT HOSPITAL - ACUTE,30580196,85610,HC PROTHROMBIN TIME (PT) GBO,305,1 ,$32.00 ,$16.00 ,$4.29 ,$32.00 ,$20.67 ,$4.43 ,$15.30 ,$13.11 ,$4.29 ,$19.20 ,$27.20 ,$22.40 ,$4.43 ,$30.40 ,$23.04 ,$23.36 ,$7.29 ,$27.20 ,$4.29 ,$7.29 ,$25.60 ,$23.36 ,$4.43 ,$4.29 ,$4.74 ,$32.00 ,$27.20 ,$9.65 ,$29.44 ,$22.40 ,$18.85 ,$20.24 ,$19.49 ,$18.85 ,$22.11 ,$22.40 ,$4.33 ,$23.04 ,$4.70 ,$5.15 ,$5.15 ,$4.29 ,$5.15 ,$4.29 ,$23.04 ,$19.84 ,$23.04 ,$23.04 ,$19.20 ST VINCENT HOSPITAL - ACUTE,30600096,87480,HC CANDIDA SPECIES DNA SCREEN,306,1 ,$140.00 ,$70.00 ,$20.05 ,$140.00 ,$90.44 ,$20.72 ,$77.98 ,$66.84 ,$20.05 ,$84.00 ,$119.00 ,$98.00 ,$20.72 ,$133.00 ,$100.80 ,$102.20 ,$34.09 ,$119.00 ,$20.05 ,$34.09 ,$112.00 ,$102.20 ,$20.72 ,$20.05 ,$22.14 ,$140.00 ,$119.00 ,$45.11 ,$128.80 ,$98.00 ,$96.03 ,$103.15 ,$85.26 ,$96.03 ,$96.74 ,$98.00 ,$20.25 ,$100.80 ,$21.96 ,$24.06 ,$24.06 ,$20.05 ,$24.06 ,$20.05 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30600097,87660,HC TRICHOMONAS DNA SCREEN,306,1 ,$140.00 ,$70.00 ,$20.05 ,$140.00 ,$90.44 ,$20.72 ,$77.98 ,$66.84 ,$20.05 ,$84.00 ,$119.00 ,$98.00 ,$20.72 ,$133.00 ,$100.80 ,$102.20 ,$34.09 ,$119.00 ,$20.05 ,$34.09 ,$112.00 ,$102.20 ,$20.72 ,$20.05 ,$22.14 ,$140.00 ,$119.00 ,$45.11 ,$128.80 ,$98.00 ,$96.03 ,$103.15 ,$85.26 ,$96.03 ,$96.74 ,$98.00 ,$20.25 ,$100.80 ,$21.96 ,$24.06 ,$24.06 ,$20.05 ,$24.06 ,$20.05 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30600098,87510,HC G VAGINALIS DNA SCREEN,306,1 ,$140.00 ,$70.00 ,$20.05 ,$140.00 ,$90.44 ,$20.72 ,$77.98 ,$66.84 ,$20.05 ,$84.00 ,$119.00 ,$98.00 ,$20.72 ,$133.00 ,$100.80 ,$102.20 ,$34.09 ,$119.00 ,$20.05 ,$34.09 ,$112.00 ,$102.20 ,$20.72 ,$20.05 ,$22.14 ,$140.00 ,$119.00 ,$45.11 ,$128.80 ,$98.00 ,$96.03 ,$103.15 ,$85.26 ,$96.03 ,$96.74 ,$98.00 ,$20.25 ,$100.80 ,$21.96 ,$24.06 ,$24.06 ,$20.05 ,$24.06 ,$20.05 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30600099,87496,HC CMV DNA QUAL PCR,306,1 ,$260.00 ,$130.00 ,$35.09 ,$260.00 ,$167.96 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$156.00 ,$221.00 ,$182.00 ,$36.26 ,$247.00 ,$187.20 ,$189.80 ,$59.65 ,$221.00 ,$35.09 ,$59.65 ,$208.00 ,$189.80 ,$36.26 ,$35.09 ,$38.75 ,$260.00 ,$221.00 ,$78.95 ,$239.20 ,$182.00 ,$168.02 ,$180.47 ,$158.34 ,$168.02 ,$179.66 ,$182.00 ,$35.44 ,$187.20 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,30600101,87015,HC CONCENTRATION INFECTIOUS AGENT,306,1 ,$36.00 ,$18.00 ,$5.25 ,$36.00 ,$23.26 ,$5.25 ,$25.97 ,$22.26 ,$6.68 ,$21.60 ,$30.60 ,$25.20 ,$5.25 ,$34.20 ,$25.92 ,$26.28 ,$11.36 ,$30.60 ,$6.68 ,$11.36 ,$28.80 ,$26.28 ,$5.25 ,$6.68 ,$7.38 ,$36.00 ,$30.60 ,$15.03 ,$33.12 ,$25.20 ,$17.87 ,$19.19 ,$21.92 ,$17.87 ,$24.88 ,$25.20 ,$6.75 ,$25.92 ,$5.57 ,$8.02 ,$8.02 ,$6.68 ,$8.02 ,$6.68 ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,30600102,87040,HC BLOOD CULTURE,306,1 ,$100.00 ,$50.00 ,$10.32 ,$100.00 ,$64.60 ,$10.66 ,$40.15 ,$34.41 ,$10.32 ,$60.00 ,$85.00 ,$70.00 ,$10.66 ,$95.00 ,$72.00 ,$73.00 ,$17.54 ,$85.00 ,$10.32 ,$17.54 ,$80.00 ,$73.00 ,$10.66 ,$10.32 ,$11.40 ,$100.00 ,$85.00 ,$23.22 ,$92.00 ,$70.00 ,$49.46 ,$53.12 ,$60.90 ,$49.46 ,$69.10 ,$70.00 ,$10.42 ,$72.00 ,$11.30 ,$12.38 ,$12.38 ,$10.32 ,$12.38 ,$10.32 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30600103,87045,HC STOOL CULTURE,306,1 ,$70.00 ,$35.00 ,$9.44 ,$70.00 ,$45.22 ,$9.75 ,$36.72 ,$31.47 ,$9.44 ,$42.00 ,$59.50 ,$49.00 ,$9.75 ,$66.50 ,$50.40 ,$51.10 ,$16.05 ,$59.50 ,$9.44 ,$16.05 ,$56.00 ,$51.10 ,$9.75 ,$9.44 ,$10.42 ,$70.00 ,$59.50 ,$21.24 ,$64.40 ,$49.00 ,$45.21 ,$48.56 ,$42.63 ,$45.21 ,$48.37 ,$49.00 ,$9.53 ,$50.40 ,$10.34 ,$11.33 ,$11.33 ,$9.44 ,$11.33 ,$9.44 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600104,87046,HC STOOL CULTURE ADD ISO,306,1 ,$60.00 ,$30.00 ,$3.40 ,$60.00 ,$38.76 ,$3.40 ,$36.72 ,$31.47 ,$9.44 ,$36.00 ,$51.00 ,$42.00 ,$3.40 ,$57.00 ,$43.20 ,$43.80 ,$16.05 ,$51.00 ,$9.44 ,$16.05 ,$48.00 ,$43.80 ,$3.40 ,$9.44 ,$10.42 ,$60.00 ,$51.00 ,$21.24 ,$55.20 ,$42.00 ,$45.21 ,$48.56 ,$36.54 ,$45.21 ,$41.46 ,$42.00 ,$9.53 ,$43.20 ,$3.60 ,$11.33 ,$11.33 ,$9.44 ,$11.33 ,$9.44 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600105,87070,HC BODY FLUID CULTURE (ENVIRO),306,1 ,$32.00 ,$16.00 ,$8.62 ,$32.00 ,$20.67 ,$8.91 ,$32.00 ,$28.71 ,$8.62 ,$19.20 ,$27.20 ,$22.40 ,$8.91 ,$30.40 ,$23.04 ,$23.36 ,$14.65 ,$27.20 ,$8.62 ,$14.65 ,$25.60 ,$23.36 ,$8.91 ,$8.62 ,$9.52 ,$32.00 ,$27.20 ,$19.40 ,$29.44 ,$22.40 ,$32.00 ,$32.00 ,$19.49 ,$32.00 ,$22.11 ,$22.40 ,$8.71 ,$23.04 ,$9.44 ,$10.34 ,$10.34 ,$8.62 ,$10.34 ,$8.62 ,$23.04 ,$19.84 ,$23.04 ,$23.04 ,$19.20 ST VINCENT HOSPITAL - ACUTE,30600106,87070,HC BODY FLUID CULTURE (THROAT),306,1 ,$59.00 ,$29.50 ,$8.62 ,$59.00 ,$38.11 ,$8.91 ,$33.50 ,$28.71 ,$8.62 ,$35.40 ,$50.15 ,$41.30 ,$8.91 ,$56.05 ,$42.48 ,$43.07 ,$14.65 ,$50.15 ,$8.62 ,$14.65 ,$47.20 ,$43.07 ,$8.91 ,$8.62 ,$9.52 ,$59.00 ,$50.15 ,$19.40 ,$54.28 ,$41.30 ,$41.24 ,$44.30 ,$35.93 ,$41.24 ,$40.77 ,$41.30 ,$8.71 ,$42.48 ,$9.44 ,$10.34 ,$10.34 ,$8.62 ,$10.34 ,$8.62 ,$42.48 ,$36.58 ,$42.48 ,$42.48 ,$35.40 ST VINCENT HOSPITAL - ACUTE,30600107,87070,HC BODY FLUID CULTURE (MISC),306,1 ,$102.00 ,$51.00 ,$8.62 ,$102.00 ,$65.89 ,$8.91 ,$33.50 ,$28.71 ,$8.62 ,$61.20 ,$86.70 ,$71.40 ,$8.91 ,$96.90 ,$73.44 ,$74.46 ,$14.65 ,$86.70 ,$8.62 ,$14.65 ,$81.60 ,$74.46 ,$8.91 ,$8.62 ,$9.52 ,$102.00 ,$86.70 ,$19.40 ,$93.84 ,$71.40 ,$41.24 ,$44.30 ,$62.12 ,$41.24 ,$70.48 ,$71.40 ,$8.71 ,$73.44 ,$9.44 ,$10.34 ,$10.34 ,$8.62 ,$10.34 ,$8.62 ,$73.44 ,$63.24 ,$73.44 ,$73.44 ,$61.20 ST VINCENT HOSPITAL - ACUTE,30600108,87081,HC BODY FLUID CULTURE (MRSA),306,1 ,$96.00 ,$48.00 ,$6.63 ,$96.00 ,$62.02 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$57.60 ,$81.60 ,$67.20 ,$6.85 ,$91.20 ,$69.12 ,$70.08 ,$11.27 ,$81.60 ,$6.63 ,$11.27 ,$76.80 ,$70.08 ,$6.85 ,$6.63 ,$7.32 ,$96.00 ,$81.60 ,$14.92 ,$88.32 ,$67.20 ,$31.77 ,$34.12 ,$58.46 ,$31.77 ,$66.34 ,$67.20 ,$6.70 ,$69.12 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$69.12 ,$59.52 ,$69.12 ,$69.12 ,$57.60 ST VINCENT HOSPITAL - ACUTE,30600109,87070,HC BODY FLUID CULTURE,306,1 ,$90.00 ,$45.00 ,$8.62 ,$90.00 ,$58.14 ,$8.91 ,$33.50 ,$28.71 ,$8.62 ,$54.00 ,$76.50 ,$63.00 ,$8.91 ,$85.50 ,$64.80 ,$65.70 ,$14.65 ,$76.50 ,$8.62 ,$14.65 ,$72.00 ,$65.70 ,$8.91 ,$8.62 ,$9.52 ,$90.00 ,$76.50 ,$19.40 ,$82.80 ,$63.00 ,$41.24 ,$44.30 ,$54.81 ,$41.24 ,$62.19 ,$63.00 ,$8.71 ,$64.80 ,$9.44 ,$10.34 ,$10.34 ,$8.62 ,$10.34 ,$8.62 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30600110,87070,HC WATER CULTURE,306,1 ,$12.00 ,$6.00 ,$6.00 ,$19.40 ,$7.75 ,$8.91 ,$12.00 ,$12.00 ,$8.62 ,$7.20 ,$10.20 ,$8.40 ,$8.91 ,$11.40 ,$8.64 ,$8.76 ,$12.00 ,$10.20 ,$8.62 ,$12.00 ,$9.60 ,$8.76 ,$8.91 ,$8.62 ,$9.52 ,$12.00 ,$10.20 ,$19.40 ,$11.04 ,$8.40 ,$12.00 ,$12.00 ,$7.31 ,$12.00 ,$8.29 ,$8.40 ,$8.71 ,$8.64 ,$9.44 ,$10.34 ,$10.34 ,$8.62 ,$10.34 ,$8.62 ,$8.64 ,$7.44 ,$8.64 ,$8.64 ,$7.20 ST VINCENT HOSPITAL - ACUTE,30600111,87070,"HC BODY FLUID CULTURE (CSF, WOUND,MISC)",306,1 ,$153.00 ,$76.50 ,$8.62 ,$153.00 ,$98.84 ,$8.91 ,$33.50 ,$28.71 ,$8.62 ,$91.80 ,$130.05 ,$107.10 ,$8.91 ,$145.35 ,$110.16 ,$111.69 ,$14.65 ,$130.05 ,$8.62 ,$14.65 ,$122.40 ,$111.69 ,$8.91 ,$8.62 ,$9.52 ,$153.00 ,$130.05 ,$19.40 ,$140.76 ,$107.10 ,$41.24 ,$44.30 ,$93.18 ,$41.24 ,$105.72 ,$107.10 ,$8.71 ,$110.16 ,$9.44 ,$10.34 ,$10.34 ,$8.62 ,$10.34 ,$8.62 ,$110.16 ,$94.86 ,$110.16 ,$110.16 ,$91.80 ST VINCENT HOSPITAL - ACUTE,30600115,87070,HC BODY FLUID CULTURE (CF),306,1 ,$240.00 ,$120.00 ,$8.62 ,$240.00 ,$155.04 ,$8.91 ,$33.50 ,$28.71 ,$8.62 ,$144.00 ,$204.00 ,$168.00 ,$8.91 ,$228.00 ,$172.80 ,$175.20 ,$14.65 ,$204.00 ,$8.62 ,$14.65 ,$192.00 ,$175.20 ,$8.91 ,$8.62 ,$9.52 ,$240.00 ,$204.00 ,$19.40 ,$220.80 ,$168.00 ,$41.24 ,$44.30 ,$146.16 ,$41.24 ,$165.84 ,$168.00 ,$8.71 ,$172.80 ,$9.44 ,$10.34 ,$10.34 ,$8.62 ,$10.34 ,$8.62 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600120,87075,HC CULTURE ANAEROBIC,306,1 ,$90.00 ,$45.00 ,$9.47 ,$90.00 ,$58.14 ,$9.79 ,$36.82 ,$31.56 ,$9.47 ,$54.00 ,$76.50 ,$63.00 ,$9.79 ,$85.50 ,$64.80 ,$65.70 ,$16.10 ,$76.50 ,$9.47 ,$16.10 ,$72.00 ,$65.70 ,$9.79 ,$9.47 ,$10.46 ,$90.00 ,$76.50 ,$21.31 ,$82.80 ,$63.00 ,$45.31 ,$48.67 ,$54.81 ,$45.31 ,$62.19 ,$63.00 ,$9.56 ,$64.80 ,$10.38 ,$11.36 ,$11.36 ,$9.47 ,$11.36 ,$9.47 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30600121,87076,HC CULTURE ANAEROBIC ID,306,1 ,$60.00 ,$30.00 ,$8.08 ,$60.00 ,$38.76 ,$8.35 ,$31.40 ,$26.91 ,$8.08 ,$36.00 ,$51.00 ,$42.00 ,$8.35 ,$57.00 ,$43.20 ,$43.80 ,$13.74 ,$51.00 ,$8.08 ,$13.74 ,$48.00 ,$43.80 ,$8.35 ,$8.08 ,$8.92 ,$60.00 ,$51.00 ,$18.18 ,$55.20 ,$42.00 ,$38.72 ,$41.58 ,$36.54 ,$38.72 ,$41.46 ,$42.00 ,$8.16 ,$43.20 ,$8.85 ,$9.70 ,$9.70 ,$8.08 ,$9.70 ,$8.08 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600122,87076,HC CULTURE ANAEROBIC ID (ORGANISM),306,1 ,$60.00 ,$30.00 ,$8.08 ,$60.00 ,$38.76 ,$8.35 ,$31.40 ,$26.91 ,$8.08 ,$36.00 ,$51.00 ,$42.00 ,$8.35 ,$57.00 ,$43.20 ,$43.80 ,$13.74 ,$51.00 ,$8.08 ,$13.74 ,$48.00 ,$43.80 ,$8.35 ,$8.08 ,$8.92 ,$60.00 ,$51.00 ,$18.18 ,$55.20 ,$42.00 ,$38.72 ,$41.58 ,$36.54 ,$38.72 ,$41.46 ,$42.00 ,$8.16 ,$43.20 ,$8.85 ,$9.70 ,$9.70 ,$8.08 ,$9.70 ,$8.08 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600123,87077,HC CULTURE AEROBIC ID ADDL,306,1 ,$60.00 ,$30.00 ,$8.08 ,$60.00 ,$38.76 ,$8.35 ,$31.40 ,$26.91 ,$8.08 ,$36.00 ,$51.00 ,$42.00 ,$8.35 ,$57.00 ,$43.20 ,$43.80 ,$13.74 ,$51.00 ,$8.08 ,$13.74 ,$48.00 ,$43.80 ,$8.35 ,$8.08 ,$8.92 ,$60.00 ,$51.00 ,$18.18 ,$55.20 ,$42.00 ,$38.72 ,$41.58 ,$36.54 ,$38.72 ,$41.46 ,$42.00 ,$8.16 ,$43.20 ,$8.85 ,$9.70 ,$9.70 ,$8.08 ,$9.70 ,$8.08 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600124,87081,HC CULTURE SCR (MRSA),306,1 ,$50.00 ,$25.00 ,$6.63 ,$50.00 ,$32.30 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$30.00 ,$42.50 ,$35.00 ,$6.85 ,$47.50 ,$36.00 ,$36.50 ,$11.27 ,$42.50 ,$6.63 ,$11.27 ,$40.00 ,$36.50 ,$6.85 ,$6.63 ,$7.32 ,$50.00 ,$42.50 ,$14.92 ,$46.00 ,$35.00 ,$31.77 ,$34.12 ,$30.45 ,$31.77 ,$34.55 ,$35.00 ,$6.70 ,$36.00 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30600125,87081,HC CULTURE SCR (GRP B STREP),306,1 ,$66.00 ,$33.00 ,$6.63 ,$66.00 ,$42.64 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$39.60 ,$56.10 ,$46.20 ,$6.85 ,$62.70 ,$47.52 ,$48.18 ,$11.27 ,$56.10 ,$6.63 ,$11.27 ,$52.80 ,$48.18 ,$6.85 ,$6.63 ,$7.32 ,$66.00 ,$56.10 ,$14.92 ,$60.72 ,$46.20 ,$31.77 ,$34.12 ,$40.19 ,$31.77 ,$45.61 ,$46.20 ,$6.70 ,$47.52 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$47.52 ,$40.92 ,$47.52 ,$47.52 ,$39.60 ST VINCENT HOSPITAL - ACUTE,30600126,87081,HC CULTURE SCR (GC ONLY),306,1 ,$45.00 ,$22.50 ,$6.63 ,$45.00 ,$29.07 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$27.00 ,$38.25 ,$31.50 ,$6.85 ,$42.75 ,$32.40 ,$32.85 ,$11.27 ,$38.25 ,$6.63 ,$11.27 ,$36.00 ,$32.85 ,$6.85 ,$6.63 ,$7.32 ,$45.00 ,$38.25 ,$14.92 ,$41.40 ,$31.50 ,$31.77 ,$34.12 ,$27.41 ,$31.77 ,$31.10 ,$31.50 ,$6.70 ,$32.40 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,30600127,87081,HC CULTURE SCR (LEGIONELLA),306,1 ,$45.00 ,$22.50 ,$6.63 ,$45.00 ,$29.07 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$27.00 ,$38.25 ,$31.50 ,$6.85 ,$42.75 ,$32.40 ,$32.85 ,$11.27 ,$38.25 ,$6.63 ,$11.27 ,$36.00 ,$32.85 ,$6.85 ,$6.63 ,$7.32 ,$45.00 ,$38.25 ,$14.92 ,$41.40 ,$31.50 ,$31.77 ,$34.12 ,$27.41 ,$31.77 ,$31.10 ,$31.50 ,$6.70 ,$32.40 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,30600128,87081,HC CULTURE SCR (PERTUSSIS),306,1 ,$72.00 ,$36.00 ,$6.63 ,$72.00 ,$46.51 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$43.20 ,$61.20 ,$50.40 ,$6.85 ,$68.40 ,$51.84 ,$52.56 ,$11.27 ,$61.20 ,$6.63 ,$11.27 ,$57.60 ,$52.56 ,$6.85 ,$6.63 ,$7.32 ,$72.00 ,$61.20 ,$14.92 ,$66.24 ,$50.40 ,$31.77 ,$34.12 ,$43.85 ,$31.77 ,$49.75 ,$50.40 ,$6.70 ,$51.84 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$51.84 ,$44.64 ,$51.84 ,$51.84 ,$43.20 ST VINCENT HOSPITAL - ACUTE,30600129,87081,HC CULTURE SCR (GRP A STREP),306,1 ,$45.00 ,$22.50 ,$6.63 ,$45.00 ,$29.07 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$27.00 ,$38.25 ,$31.50 ,$6.85 ,$42.75 ,$32.40 ,$32.85 ,$11.27 ,$38.25 ,$6.63 ,$11.27 ,$36.00 ,$32.85 ,$6.85 ,$6.63 ,$7.32 ,$45.00 ,$38.25 ,$14.92 ,$41.40 ,$31.50 ,$31.77 ,$34.12 ,$27.41 ,$31.77 ,$31.10 ,$31.50 ,$6.70 ,$32.40 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,30600130,87081,HC CULTURE SCR (VRE),306,1 ,$104.00 ,$52.00 ,$6.63 ,$104.00 ,$67.18 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$62.40 ,$88.40 ,$72.80 ,$6.85 ,$98.80 ,$74.88 ,$75.92 ,$11.27 ,$88.40 ,$6.63 ,$11.27 ,$83.20 ,$75.92 ,$6.85 ,$6.63 ,$7.32 ,$104.00 ,$88.40 ,$14.92 ,$95.68 ,$72.80 ,$31.77 ,$34.12 ,$63.34 ,$31.77 ,$71.86 ,$72.80 ,$6.70 ,$74.88 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$74.88 ,$64.48 ,$74.88 ,$74.88 ,$62.40 ST VINCENT HOSPITAL - ACUTE,30600131,87081,HC CULTURE (MRSA),306,1 ,$50.00 ,$25.00 ,$6.63 ,$50.00 ,$32.30 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$30.00 ,$42.50 ,$35.00 ,$6.85 ,$47.50 ,$36.00 ,$36.50 ,$11.27 ,$42.50 ,$6.63 ,$11.27 ,$40.00 ,$36.50 ,$6.85 ,$6.63 ,$7.32 ,$50.00 ,$42.50 ,$14.92 ,$46.00 ,$35.00 ,$31.77 ,$34.12 ,$30.45 ,$31.77 ,$34.55 ,$35.00 ,$6.70 ,$36.00 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30600132,87081,HC CULTURE (CLO TEST),306,1 ,$45.00 ,$22.50 ,$6.63 ,$45.00 ,$29.07 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$27.00 ,$38.25 ,$31.50 ,$6.85 ,$42.75 ,$32.40 ,$32.85 ,$11.27 ,$38.25 ,$6.63 ,$11.27 ,$36.00 ,$32.85 ,$6.85 ,$6.63 ,$7.32 ,$45.00 ,$38.25 ,$14.92 ,$41.40 ,$31.50 ,$31.77 ,$34.12 ,$27.41 ,$31.77 ,$31.10 ,$31.50 ,$6.70 ,$32.40 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,30600133,87081,HC CULTURE SCR (BRUCELLA),306,1 ,$57.00 ,$28.50 ,$6.63 ,$57.00 ,$36.82 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$34.20 ,$48.45 ,$39.90 ,$6.85 ,$54.15 ,$41.04 ,$41.61 ,$11.27 ,$48.45 ,$6.63 ,$11.27 ,$45.60 ,$41.61 ,$6.85 ,$6.63 ,$7.32 ,$57.00 ,$48.45 ,$14.92 ,$52.44 ,$39.90 ,$31.77 ,$34.12 ,$34.71 ,$31.77 ,$39.39 ,$39.90 ,$6.70 ,$41.04 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$41.04 ,$35.34 ,$41.04 ,$41.04 ,$34.20 ST VINCENT HOSPITAL - ACUTE,30600134,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$60.00 ,$30.00 ,$8.07 ,$60.00 ,$38.76 ,$8.34 ,$31.40 ,$26.91 ,$8.07 ,$36.00 ,$51.00 ,$42.00 ,$8.34 ,$57.00 ,$43.20 ,$43.80 ,$13.72 ,$51.00 ,$8.07 ,$13.72 ,$48.00 ,$43.80 ,$8.34 ,$8.07 ,$8.91 ,$60.00 ,$51.00 ,$18.16 ,$55.20 ,$42.00 ,$38.65 ,$41.51 ,$36.54 ,$38.65 ,$41.46 ,$42.00 ,$8.15 ,$43.20 ,$8.84 ,$9.68 ,$9.68 ,$8.07 ,$9.68 ,$8.07 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600135,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$60.00 ,$30.00 ,$8.09 ,$60.00 ,$38.76 ,$8.36 ,$31.47 ,$26.97 ,$8.09 ,$36.00 ,$51.00 ,$42.00 ,$8.36 ,$57.00 ,$43.20 ,$43.80 ,$13.75 ,$51.00 ,$8.09 ,$13.75 ,$48.00 ,$43.80 ,$8.36 ,$8.09 ,$8.93 ,$60.00 ,$51.00 ,$18.20 ,$55.20 ,$42.00 ,$38.79 ,$41.66 ,$36.54 ,$38.79 ,$41.46 ,$42.00 ,$8.17 ,$43.20 ,$8.86 ,$9.71 ,$9.71 ,$8.09 ,$9.71 ,$8.09 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600136,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL,306,1 ,$120.00 ,$60.00 ,$7.71 ,$120.00 ,$77.52 ,$7.97 ,$29.96 ,$25.68 ,$7.71 ,$72.00 ,$102.00 ,$84.00 ,$7.97 ,$114.00 ,$86.40 ,$87.60 ,$13.11 ,$102.00 ,$7.71 ,$13.11 ,$96.00 ,$87.60 ,$7.97 ,$7.71 ,$8.51 ,$120.00 ,$102.00 ,$17.35 ,$110.40 ,$84.00 ,$36.93 ,$39.66 ,$73.08 ,$36.93 ,$82.92 ,$84.00 ,$7.79 ,$86.40 ,$8.45 ,$9.25 ,$9.25 ,$7.71 ,$9.25 ,$7.71 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30600137,87101,HC CULTURE YEAST SKIN/HAIR/NAIL,306,1 ,$56.00 ,$28.00 ,$7.71 ,$56.00 ,$36.18 ,$7.97 ,$29.96 ,$25.68 ,$7.71 ,$33.60 ,$47.60 ,$39.20 ,$7.97 ,$53.20 ,$40.32 ,$40.88 ,$13.11 ,$47.60 ,$7.71 ,$13.11 ,$44.80 ,$40.88 ,$7.97 ,$7.71 ,$8.51 ,$56.00 ,$47.60 ,$17.35 ,$51.52 ,$39.20 ,$36.93 ,$39.66 ,$34.10 ,$36.93 ,$38.70 ,$39.20 ,$7.79 ,$40.32 ,$8.45 ,$9.25 ,$9.25 ,$7.71 ,$9.25 ,$7.71 ,$40.32 ,$34.72 ,$40.32 ,$40.32 ,$33.60 ST VINCENT HOSPITAL - ACUTE,30600138,87102,HC CULTURE FUNGUS OTHER,306,1 ,$70.00 ,$35.00 ,$8.41 ,$70.00 ,$45.22 ,$8.69 ,$32.69 ,$28.02 ,$8.41 ,$42.00 ,$59.50 ,$49.00 ,$8.69 ,$66.50 ,$50.40 ,$51.10 ,$14.30 ,$59.50 ,$8.41 ,$14.30 ,$56.00 ,$51.10 ,$8.69 ,$8.41 ,$9.29 ,$70.00 ,$59.50 ,$18.92 ,$64.40 ,$49.00 ,$40.22 ,$43.20 ,$42.63 ,$40.22 ,$48.37 ,$49.00 ,$8.49 ,$50.40 ,$9.21 ,$10.09 ,$10.09 ,$8.41 ,$10.09 ,$8.41 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600139,87102,HC CULTURE YEAST OTHER,306,1 ,$60.00 ,$30.00 ,$8.41 ,$60.00 ,$38.76 ,$8.69 ,$32.69 ,$28.02 ,$8.41 ,$36.00 ,$51.00 ,$42.00 ,$8.69 ,$57.00 ,$43.20 ,$43.80 ,$14.30 ,$51.00 ,$8.41 ,$14.30 ,$48.00 ,$43.80 ,$8.69 ,$8.41 ,$9.29 ,$60.00 ,$51.00 ,$18.92 ,$55.20 ,$42.00 ,$40.22 ,$43.20 ,$36.54 ,$40.22 ,$41.46 ,$42.00 ,$8.49 ,$43.20 ,$9.21 ,$10.09 ,$10.09 ,$8.41 ,$10.09 ,$8.41 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600140,87103,HC CULTURE FUNGUS BLOOD,306,1 ,$150.00 ,$75.00 ,$12.68 ,$150.00 ,$96.90 ,$12.68 ,$71.61 ,$61.38 ,$20.46 ,$90.00 ,$127.50 ,$105.00 ,$12.68 ,$142.50 ,$108.00 ,$109.50 ,$34.78 ,$127.50 ,$20.46 ,$34.78 ,$120.00 ,$109.50 ,$12.68 ,$20.46 ,$22.59 ,$150.00 ,$127.50 ,$46.04 ,$138.00 ,$105.00 ,$43.17 ,$46.37 ,$91.35 ,$43.17 ,$103.65 ,$105.00 ,$20.66 ,$108.00 ,$13.44 ,$24.55 ,$24.55 ,$20.46 ,$24.55 ,$20.46 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,30600142,87106,HC CULTURE FUNGUS ID,306,1 ,$86.00 ,$43.00 ,$10.32 ,$86.00 ,$55.56 ,$10.66 ,$40.15 ,$34.41 ,$10.32 ,$51.60 ,$73.10 ,$60.20 ,$10.66 ,$81.70 ,$61.92 ,$62.78 ,$17.54 ,$73.10 ,$10.32 ,$17.54 ,$68.80 ,$62.78 ,$10.66 ,$10.32 ,$11.40 ,$86.00 ,$73.10 ,$23.22 ,$79.12 ,$60.20 ,$49.46 ,$53.12 ,$52.37 ,$49.46 ,$59.43 ,$60.20 ,$10.42 ,$61.92 ,$11.30 ,$12.38 ,$12.38 ,$10.32 ,$12.38 ,$10.32 ,$61.92 ,$53.32 ,$61.92 ,$61.92 ,$51.60 ST VINCENT HOSPITAL - ACUTE,30600143,87106,HC CULTURE FUNGUS ID,306,1 ,$47.00 ,$23.50 ,$10.32 ,$47.00 ,$30.36 ,$10.66 ,$40.15 ,$34.41 ,$10.32 ,$28.20 ,$39.95 ,$32.90 ,$10.66 ,$44.65 ,$33.84 ,$34.31 ,$17.54 ,$39.95 ,$10.32 ,$17.54 ,$37.60 ,$34.31 ,$10.66 ,$10.32 ,$11.40 ,$47.00 ,$39.95 ,$23.22 ,$43.24 ,$32.90 ,$47.00 ,$47.00 ,$28.62 ,$47.00 ,$32.48 ,$32.90 ,$10.42 ,$33.84 ,$11.30 ,$12.38 ,$12.38 ,$10.32 ,$12.38 ,$10.32 ,$33.84 ,$29.14 ,$33.84 ,$33.84 ,$28.20 ST VINCENT HOSPITAL - ACUTE,30600144,87106,HC CULTURE FUNGUS ID (MOLD),306,1 ,$119.00 ,$59.50 ,$10.32 ,$119.00 ,$76.87 ,$10.66 ,$40.15 ,$34.41 ,$10.32 ,$71.40 ,$101.15 ,$83.30 ,$10.66 ,$113.05 ,$85.68 ,$86.87 ,$17.54 ,$101.15 ,$10.32 ,$17.54 ,$95.20 ,$86.87 ,$10.66 ,$10.32 ,$11.40 ,$119.00 ,$101.15 ,$23.22 ,$109.48 ,$83.30 ,$49.46 ,$53.12 ,$72.47 ,$49.46 ,$82.23 ,$83.30 ,$10.42 ,$85.68 ,$11.30 ,$12.38 ,$12.38 ,$10.32 ,$12.38 ,$10.32 ,$85.68 ,$73.78 ,$85.68 ,$85.68 ,$71.40 ST VINCENT HOSPITAL - ACUTE,30600145,87107,HC CULTURE FUNGUS ID MOLD,306,1 ,$70.00 ,$35.00 ,$10.32 ,$70.00 ,$45.22 ,$10.66 ,$40.15 ,$34.41 ,$10.32 ,$42.00 ,$59.50 ,$49.00 ,$10.66 ,$66.50 ,$50.40 ,$51.10 ,$17.54 ,$59.50 ,$10.32 ,$17.54 ,$56.00 ,$51.10 ,$10.66 ,$10.32 ,$11.40 ,$70.00 ,$59.50 ,$23.22 ,$64.40 ,$49.00 ,$49.46 ,$53.12 ,$42.63 ,$49.46 ,$48.37 ,$49.00 ,$10.42 ,$50.40 ,$11.30 ,$12.38 ,$12.38 ,$10.32 ,$12.38 ,$10.32 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600146,87109,HC CULTURE MYCOPLASMA,306,1 ,$80.00 ,$40.00 ,$14.01 ,$80.00 ,$51.68 ,$14.01 ,$59.85 ,$51.30 ,$15.39 ,$48.00 ,$68.00 ,$56.00 ,$14.01 ,$76.00 ,$57.60 ,$58.40 ,$26.16 ,$68.00 ,$15.39 ,$26.16 ,$64.00 ,$58.40 ,$14.01 ,$15.39 ,$16.99 ,$80.00 ,$68.00 ,$34.63 ,$73.60 ,$56.00 ,$47.70 ,$51.23 ,$48.72 ,$47.70 ,$55.28 ,$56.00 ,$15.54 ,$57.60 ,$14.85 ,$18.47 ,$18.47 ,$15.39 ,$18.47 ,$15.39 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30600147,87110,HC CULTURE CHLAMYDIA,306,1 ,$133.00 ,$66.50 ,$19.60 ,$133.00 ,$85.92 ,$20.25 ,$76.20 ,$65.31 ,$19.60 ,$79.80 ,$113.05 ,$93.10 ,$20.25 ,$126.35 ,$95.76 ,$97.09 ,$33.32 ,$113.05 ,$19.60 ,$33.32 ,$106.40 ,$97.09 ,$20.25 ,$19.60 ,$21.64 ,$133.00 ,$113.05 ,$44.10 ,$122.36 ,$93.10 ,$93.82 ,$100.77 ,$81.00 ,$93.82 ,$91.90 ,$93.10 ,$19.80 ,$95.76 ,$21.47 ,$23.52 ,$23.52 ,$19.60 ,$23.52 ,$19.60 ,$95.76 ,$82.46 ,$95.76 ,$95.76 ,$79.80 ST VINCENT HOSPITAL - ACUTE,30600148,87116,HC CULTURE AFB/TB/MYCOBACT,306,1 ,$70.00 ,$35.00 ,$10.80 ,$70.00 ,$45.22 ,$11.16 ,$42.00 ,$36.00 ,$10.80 ,$42.00 ,$59.50 ,$49.00 ,$11.16 ,$66.50 ,$50.40 ,$51.10 ,$18.36 ,$59.50 ,$10.80 ,$18.36 ,$56.00 ,$51.10 ,$11.16 ,$10.80 ,$11.93 ,$70.00 ,$59.50 ,$24.30 ,$64.40 ,$49.00 ,$51.74 ,$55.57 ,$42.63 ,$51.74 ,$48.37 ,$49.00 ,$10.91 ,$50.40 ,$11.83 ,$12.96 ,$12.96 ,$10.80 ,$12.96 ,$10.80 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600149,87116,HC CULTURE AFB/TB/MYCOBACT (BLOOD),306,1 ,$145.00 ,$72.50 ,$10.80 ,$145.00 ,$93.67 ,$11.16 ,$42.00 ,$36.00 ,$10.80 ,$87.00 ,$123.25 ,$101.50 ,$11.16 ,$137.75 ,$104.40 ,$105.85 ,$18.36 ,$123.25 ,$10.80 ,$18.36 ,$116.00 ,$105.85 ,$11.16 ,$10.80 ,$11.93 ,$145.00 ,$123.25 ,$24.30 ,$133.40 ,$101.50 ,$51.74 ,$55.57 ,$88.31 ,$51.74 ,$100.20 ,$101.50 ,$10.91 ,$104.40 ,$11.83 ,$12.96 ,$12.96 ,$10.80 ,$12.96 ,$10.80 ,$104.40 ,$89.90 ,$104.40 ,$104.40 ,$87.00 ST VINCENT HOSPITAL - ACUTE,30600150,87116,HC CULTURE AFB/TB/MYCOBACT (SMEAR),306,1 ,$76.00 ,$38.00 ,$10.80 ,$76.00 ,$49.10 ,$11.16 ,$42.00 ,$36.00 ,$10.80 ,$45.60 ,$64.60 ,$53.20 ,$11.16 ,$72.20 ,$54.72 ,$55.48 ,$18.36 ,$64.60 ,$10.80 ,$18.36 ,$60.80 ,$55.48 ,$11.16 ,$10.80 ,$11.93 ,$76.00 ,$64.60 ,$24.30 ,$69.92 ,$53.20 ,$51.74 ,$55.57 ,$46.28 ,$51.74 ,$52.52 ,$53.20 ,$10.91 ,$54.72 ,$11.83 ,$12.96 ,$12.96 ,$10.80 ,$12.96 ,$10.80 ,$54.72 ,$47.12 ,$54.72 ,$54.72 ,$45.60 ST VINCENT HOSPITAL - ACUTE,30600151,87118,HC MYCOBACTERIA ID BY HPLC,306,1 ,$140.00 ,$70.00 ,$14.61 ,$140.00 ,$90.44 ,$15.10 ,$51.14 ,$43.83 ,$14.61 ,$84.00 ,$119.00 ,$98.00 ,$15.10 ,$133.00 ,$100.80 ,$102.20 ,$24.84 ,$119.00 ,$14.61 ,$24.84 ,$112.00 ,$102.20 ,$15.10 ,$14.61 ,$16.13 ,$140.00 ,$119.00 ,$32.87 ,$128.80 ,$98.00 ,$52.40 ,$56.29 ,$85.26 ,$52.40 ,$96.74 ,$98.00 ,$14.76 ,$100.80 ,$16.01 ,$17.53 ,$17.53 ,$14.61 ,$17.53 ,$14.61 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30600152,87140,HC CLT TYP IF EA ANTISER (RESP),306,1 ,$17.00 ,$8.50 ,$5.57 ,$17.00 ,$10.98 ,$5.76 ,$17.00 ,$17.00 ,$5.57 ,$10.20 ,$14.45 ,$11.90 ,$5.76 ,$16.15 ,$12.24 ,$12.41 ,$9.47 ,$14.45 ,$5.57 ,$9.47 ,$13.60 ,$12.41 ,$5.76 ,$5.57 ,$6.15 ,$17.00 ,$14.45 ,$12.53 ,$15.64 ,$11.90 ,$17.00 ,$17.00 ,$10.35 ,$17.00 ,$11.75 ,$11.90 ,$5.63 ,$12.24 ,$6.11 ,$6.68 ,$6.68 ,$5.57 ,$6.68 ,$5.57 ,$12.24 ,$10.54 ,$12.24 ,$12.24 ,$10.20 ST VINCENT HOSPITAL - ACUTE,30600153,87140,HC CLT TYP IF EA ANTISER (CHLAM PNEUMO 1),306,1 ,$34.00 ,$17.00 ,$5.57 ,$34.00 ,$21.96 ,$5.76 ,$21.67 ,$18.57 ,$5.57 ,$20.40 ,$28.90 ,$23.80 ,$5.76 ,$32.30 ,$24.48 ,$24.82 ,$9.47 ,$28.90 ,$5.57 ,$9.47 ,$27.20 ,$24.82 ,$5.76 ,$5.57 ,$6.15 ,$34.00 ,$28.90 ,$12.53 ,$31.28 ,$23.80 ,$21.83 ,$23.45 ,$20.71 ,$21.83 ,$23.49 ,$23.80 ,$5.63 ,$24.48 ,$6.11 ,$6.68 ,$6.68 ,$5.57 ,$6.68 ,$5.57 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30600154,87140,HC CLT TYP IF EA ANTISER (CHLAM PNEUMO 2),306,1 ,$34.00 ,$17.00 ,$5.57 ,$34.00 ,$21.96 ,$5.76 ,$21.67 ,$18.57 ,$5.57 ,$20.40 ,$28.90 ,$23.80 ,$5.76 ,$32.30 ,$24.48 ,$24.82 ,$9.47 ,$28.90 ,$5.57 ,$9.47 ,$27.20 ,$24.82 ,$5.76 ,$5.57 ,$6.15 ,$34.00 ,$28.90 ,$12.53 ,$31.28 ,$23.80 ,$21.83 ,$23.45 ,$20.71 ,$21.83 ,$23.49 ,$23.80 ,$5.63 ,$24.48 ,$6.11 ,$6.68 ,$6.68 ,$5.57 ,$6.68 ,$5.57 ,$24.48 ,$21.08 ,$24.48 ,$24.48 ,$20.40 ST VINCENT HOSPITAL - ACUTE,30600155,87140,HC CLT TYP IF EA ANTISER (CHLAM TRACH),306,1 ,$50.00 ,$25.00 ,$5.57 ,$50.00 ,$32.30 ,$5.76 ,$21.67 ,$18.57 ,$5.57 ,$30.00 ,$42.50 ,$35.00 ,$5.76 ,$47.50 ,$36.00 ,$36.50 ,$9.47 ,$42.50 ,$5.57 ,$9.47 ,$40.00 ,$36.50 ,$5.76 ,$5.57 ,$6.15 ,$50.00 ,$42.50 ,$12.53 ,$46.00 ,$35.00 ,$21.83 ,$23.45 ,$30.45 ,$21.83 ,$34.55 ,$35.00 ,$5.63 ,$36.00 ,$6.11 ,$6.68 ,$6.68 ,$5.57 ,$6.68 ,$5.57 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30600156,87140,HC FLU CONFIRM,306,1 ,$19.00 ,$9.50 ,$5.57 ,$19.00 ,$12.27 ,$5.76 ,$19.00 ,$18.57 ,$5.57 ,$11.40 ,$16.15 ,$13.30 ,$5.76 ,$18.05 ,$13.68 ,$13.87 ,$9.47 ,$16.15 ,$5.57 ,$9.47 ,$15.20 ,$13.87 ,$5.76 ,$5.57 ,$6.15 ,$19.00 ,$16.15 ,$12.53 ,$17.48 ,$13.30 ,$19.00 ,$19.00 ,$11.57 ,$19.00 ,$13.13 ,$13.30 ,$5.63 ,$13.68 ,$6.11 ,$6.68 ,$6.68 ,$5.57 ,$6.68 ,$5.57 ,$13.68 ,$11.78 ,$13.68 ,$13.68 ,$11.40 ST VINCENT HOSPITAL - ACUTE,30600157,87140,HC CLT TYP IF EA ANTISER (ADENO/ENTERO),306,1 ,$19.00 ,$9.50 ,$5.57 ,$19.00 ,$12.27 ,$5.76 ,$19.00 ,$18.57 ,$5.57 ,$11.40 ,$16.15 ,$13.30 ,$5.76 ,$18.05 ,$13.68 ,$13.87 ,$9.47 ,$16.15 ,$5.57 ,$9.47 ,$15.20 ,$13.87 ,$5.76 ,$5.57 ,$6.15 ,$19.00 ,$16.15 ,$12.53 ,$17.48 ,$13.30 ,$19.00 ,$19.00 ,$11.57 ,$19.00 ,$13.13 ,$13.30 ,$5.63 ,$13.68 ,$6.11 ,$6.68 ,$6.68 ,$5.57 ,$6.68 ,$5.57 ,$13.68 ,$11.78 ,$13.68 ,$13.68 ,$11.40 ST VINCENT HOSPITAL - ACUTE,30600158,87143,HC CULTURE TYPE GLC OR HPLC,306,1 ,$99.00 ,$49.50 ,$12.52 ,$99.00 ,$63.95 ,$12.94 ,$48.72 ,$41.76 ,$12.52 ,$59.40 ,$84.15 ,$69.30 ,$12.94 ,$94.05 ,$71.28 ,$72.27 ,$21.28 ,$84.15 ,$12.52 ,$21.28 ,$79.20 ,$72.27 ,$12.94 ,$12.52 ,$13.82 ,$99.00 ,$84.15 ,$28.17 ,$91.08 ,$69.30 ,$59.99 ,$64.43 ,$60.29 ,$59.99 ,$68.41 ,$69.30 ,$12.65 ,$71.28 ,$13.72 ,$15.02 ,$15.02 ,$12.52 ,$15.02 ,$12.52 ,$71.28 ,$61.38 ,$71.28 ,$71.28 ,$59.40 ST VINCENT HOSPITAL - ACUTE,30600159,87147,HC CULTURE TYPE SEROLOGIC,306,1 ,$119.00 ,$59.50 ,$5.18 ,$119.00 ,$76.87 ,$5.35 ,$20.13 ,$17.25 ,$5.18 ,$71.40 ,$101.15 ,$83.30 ,$5.35 ,$113.05 ,$85.68 ,$86.87 ,$8.81 ,$101.15 ,$5.18 ,$8.81 ,$95.20 ,$86.87 ,$5.35 ,$5.18 ,$5.72 ,$119.00 ,$101.15 ,$11.66 ,$109.48 ,$83.30 ,$24.78 ,$26.62 ,$72.47 ,$24.78 ,$82.23 ,$83.30 ,$5.23 ,$85.68 ,$5.67 ,$6.22 ,$6.22 ,$5.18 ,$6.22 ,$5.18 ,$85.68 ,$73.78 ,$85.68 ,$85.68 ,$71.40 ST VINCENT HOSPITAL - ACUTE,30600160,87150,HC ID NUCLEAR ACID PROBE,306,1 ,$222.00 ,$111.00 ,$35.09 ,$222.00 ,$143.41 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$133.20 ,$188.70 ,$155.40 ,$36.26 ,$210.90 ,$159.84 ,$162.06 ,$59.65 ,$188.70 ,$35.09 ,$59.65 ,$177.60 ,$162.06 ,$36.26 ,$35.09 ,$38.75 ,$222.00 ,$188.70 ,$78.95 ,$204.24 ,$155.40 ,$168.02 ,$180.47 ,$135.20 ,$168.02 ,$153.40 ,$155.40 ,$35.44 ,$159.84 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$159.84 ,$137.64 ,$159.84 ,$159.84 ,$133.20 ST VINCENT HOSPITAL - ACUTE,30600161,87168,HC EXAM ARTHROPOD,306,1 ,$70.00 ,$35.00 ,$4.27 ,$70.00 ,$45.22 ,$4.41 ,$16.63 ,$14.25 ,$4.27 ,$42.00 ,$59.50 ,$49.00 ,$4.41 ,$66.50 ,$50.40 ,$51.10 ,$7.26 ,$59.50 ,$4.27 ,$7.26 ,$56.00 ,$51.10 ,$4.41 ,$4.27 ,$4.71 ,$70.00 ,$59.50 ,$9.61 ,$64.40 ,$49.00 ,$20.43 ,$21.94 ,$42.63 ,$20.43 ,$48.37 ,$49.00 ,$4.31 ,$50.40 ,$4.67 ,$5.12 ,$5.12 ,$4.27 ,$5.12 ,$4.27 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600162,87169,HC PARASITE ID,306,1 ,$70.00 ,$35.00 ,$4.31 ,$70.00 ,$45.22 ,$4.45 ,$16.63 ,$14.25 ,$4.31 ,$42.00 ,$59.50 ,$49.00 ,$4.45 ,$66.50 ,$50.40 ,$51.10 ,$7.33 ,$59.50 ,$4.31 ,$7.33 ,$56.00 ,$51.10 ,$4.45 ,$4.31 ,$4.76 ,$70.00 ,$59.50 ,$9.70 ,$64.40 ,$49.00 ,$20.43 ,$21.94 ,$42.63 ,$20.43 ,$48.37 ,$49.00 ,$4.35 ,$50.40 ,$4.72 ,$5.17 ,$5.17 ,$4.31 ,$5.17 ,$4.31 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600163,87172,HC PINWORM EXAM,306,1 ,$24.00 ,$12.00 ,$4.27 ,$24.00 ,$15.50 ,$4.41 ,$16.63 ,$14.25 ,$4.27 ,$14.40 ,$20.40 ,$16.80 ,$4.41 ,$22.80 ,$17.28 ,$17.52 ,$7.26 ,$20.40 ,$4.27 ,$7.26 ,$19.20 ,$17.52 ,$4.41 ,$4.27 ,$4.71 ,$24.00 ,$20.40 ,$9.61 ,$22.08 ,$16.80 ,$20.43 ,$21.94 ,$14.62 ,$20.43 ,$16.58 ,$16.80 ,$4.31 ,$17.28 ,$4.67 ,$5.12 ,$5.12 ,$4.27 ,$5.12 ,$4.27 ,$17.28 ,$14.88 ,$17.28 ,$17.28 ,$14.40 ST VINCENT HOSPITAL - ACUTE,30600164,87177,HC SMEAR OVA PARASITE CONC/ID,306,1 ,$60.00 ,$30.00 ,$8.90 ,$60.00 ,$38.76 ,$9.20 ,$34.62 ,$29.67 ,$8.90 ,$36.00 ,$51.00 ,$42.00 ,$9.20 ,$57.00 ,$43.20 ,$43.80 ,$15.13 ,$51.00 ,$8.90 ,$15.13 ,$48.00 ,$43.80 ,$9.20 ,$8.90 ,$9.83 ,$60.00 ,$51.00 ,$20.03 ,$55.20 ,$42.00 ,$42.61 ,$45.77 ,$36.54 ,$42.61 ,$41.46 ,$42.00 ,$8.99 ,$43.20 ,$9.75 ,$10.68 ,$10.68 ,$8.90 ,$10.68 ,$8.90 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600166,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$70.00 ,$35.00 ,$4.75 ,$70.00 ,$45.22 ,$4.91 ,$18.45 ,$15.81 ,$4.75 ,$42.00 ,$59.50 ,$49.00 ,$4.91 ,$66.50 ,$50.40 ,$51.10 ,$8.08 ,$59.50 ,$4.75 ,$8.08 ,$56.00 ,$51.10 ,$4.91 ,$4.75 ,$5.25 ,$70.00 ,$59.50 ,$10.69 ,$64.40 ,$49.00 ,$22.74 ,$24.43 ,$42.63 ,$22.74 ,$48.37 ,$49.00 ,$4.80 ,$50.40 ,$5.20 ,$5.70 ,$5.70 ,$4.75 ,$5.70 ,$4.75 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600167,87181,HC SENSITIVITY STUDY AGAR (GRADIENT),306,1 ,$137.00 ,$68.50 ,$4.75 ,$137.00 ,$88.50 ,$4.91 ,$18.45 ,$15.81 ,$4.75 ,$82.20 ,$116.45 ,$95.90 ,$4.91 ,$130.15 ,$98.64 ,$100.01 ,$8.08 ,$116.45 ,$4.75 ,$8.08 ,$109.60 ,$100.01 ,$4.91 ,$4.75 ,$5.25 ,$137.00 ,$116.45 ,$10.69 ,$126.04 ,$95.90 ,$22.74 ,$24.43 ,$83.43 ,$22.74 ,$94.67 ,$95.90 ,$4.80 ,$98.64 ,$5.20 ,$5.70 ,$5.70 ,$4.75 ,$5.70 ,$4.75 ,$98.64 ,$84.94 ,$98.64 ,$98.64 ,$82.20 ST VINCENT HOSPITAL - ACUTE,30600168,87184,HC SENSITIVITY DISK KB (HAEMOPHILUS),306,1 ,$50.00 ,$25.00 ,$7.48 ,$50.00 ,$32.30 ,$7.73 ,$26.81 ,$22.98 ,$7.48 ,$30.00 ,$42.50 ,$35.00 ,$7.73 ,$47.50 ,$36.00 ,$36.50 ,$12.72 ,$42.50 ,$7.48 ,$12.72 ,$40.00 ,$36.50 ,$7.73 ,$7.48 ,$8.26 ,$50.00 ,$42.50 ,$16.83 ,$46.00 ,$35.00 ,$33.03 ,$35.48 ,$30.45 ,$33.03 ,$34.55 ,$35.00 ,$7.55 ,$36.00 ,$8.19 ,$8.98 ,$8.98 ,$7.48 ,$8.98 ,$7.48 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30600169,87184,HC SENSITIVITY DISK KB,306,1 ,$68.00 ,$34.00 ,$7.48 ,$68.00 ,$43.93 ,$7.73 ,$26.81 ,$22.98 ,$7.48 ,$40.80 ,$57.80 ,$47.60 ,$7.73 ,$64.60 ,$48.96 ,$49.64 ,$12.72 ,$57.80 ,$7.48 ,$12.72 ,$54.40 ,$49.64 ,$7.73 ,$7.48 ,$8.26 ,$68.00 ,$57.80 ,$16.83 ,$62.56 ,$47.60 ,$33.03 ,$35.48 ,$41.41 ,$33.03 ,$46.99 ,$47.60 ,$7.55 ,$48.96 ,$8.19 ,$8.98 ,$8.98 ,$7.48 ,$8.98 ,$7.48 ,$48.96 ,$42.16 ,$48.96 ,$48.96 ,$40.80 ST VINCENT HOSPITAL - ACUTE,30600171,87185,HC BETA LACTAMASE,306,1 ,$50.00 ,$25.00 ,$4.75 ,$50.00 ,$32.30 ,$4.91 ,$18.45 ,$15.81 ,$4.75 ,$30.00 ,$42.50 ,$35.00 ,$4.91 ,$47.50 ,$36.00 ,$36.50 ,$8.08 ,$42.50 ,$4.75 ,$8.08 ,$40.00 ,$36.50 ,$4.91 ,$4.75 ,$5.25 ,$50.00 ,$42.50 ,$10.69 ,$46.00 ,$35.00 ,$22.74 ,$24.43 ,$30.45 ,$22.74 ,$34.55 ,$35.00 ,$4.80 ,$36.00 ,$5.20 ,$5.70 ,$5.70 ,$4.75 ,$5.70 ,$4.75 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,30600172,87186,HC SENSITIVITY MIC,306,1 ,$60.00 ,$30.00 ,$8.65 ,$60.00 ,$38.76 ,$8.94 ,$33.64 ,$28.83 ,$8.65 ,$36.00 ,$51.00 ,$42.00 ,$8.94 ,$57.00 ,$43.20 ,$43.80 ,$14.71 ,$51.00 ,$8.65 ,$14.71 ,$48.00 ,$43.80 ,$8.94 ,$8.65 ,$9.55 ,$60.00 ,$51.00 ,$19.46 ,$55.20 ,$42.00 ,$41.42 ,$44.49 ,$36.54 ,$41.42 ,$41.46 ,$42.00 ,$8.74 ,$43.20 ,$9.48 ,$10.38 ,$10.38 ,$8.65 ,$10.38 ,$8.65 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600173,87186,HC SENSITIVITY MIC (SUSCEPT),306,1 ,$100.00 ,$50.00 ,$8.65 ,$100.00 ,$64.60 ,$8.94 ,$33.64 ,$28.83 ,$8.65 ,$60.00 ,$85.00 ,$70.00 ,$8.94 ,$95.00 ,$72.00 ,$73.00 ,$14.71 ,$85.00 ,$8.65 ,$14.71 ,$80.00 ,$73.00 ,$8.94 ,$8.65 ,$9.55 ,$100.00 ,$85.00 ,$19.46 ,$92.00 ,$70.00 ,$41.42 ,$44.49 ,$60.90 ,$41.42 ,$69.10 ,$70.00 ,$8.74 ,$72.00 ,$9.48 ,$10.38 ,$10.38 ,$8.65 ,$10.38 ,$8.65 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30600174,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$40.00 ,$20.00 ,$4.27 ,$40.00 ,$25.84 ,$4.41 ,$16.63 ,$14.25 ,$4.27 ,$24.00 ,$34.00 ,$28.00 ,$4.41 ,$38.00 ,$28.80 ,$29.20 ,$7.26 ,$34.00 ,$4.27 ,$7.26 ,$32.00 ,$29.20 ,$4.41 ,$4.27 ,$4.71 ,$40.00 ,$34.00 ,$9.61 ,$36.80 ,$28.00 ,$20.43 ,$21.94 ,$24.36 ,$20.43 ,$27.64 ,$28.00 ,$4.31 ,$28.80 ,$4.67 ,$5.12 ,$5.12 ,$4.27 ,$5.12 ,$4.27 ,$28.80 ,$24.80 ,$28.80 ,$28.80 ,$24.00 ST VINCENT HOSPITAL - ACUTE,30600175,87205,HC URINE FOR EOSINOPHILS,306,1 ,$66.00 ,$33.00 ,$4.27 ,$66.00 ,$42.64 ,$4.41 ,$16.63 ,$14.25 ,$4.27 ,$39.60 ,$56.10 ,$46.20 ,$4.41 ,$62.70 ,$47.52 ,$48.18 ,$7.26 ,$56.10 ,$4.27 ,$7.26 ,$52.80 ,$48.18 ,$4.41 ,$4.27 ,$4.71 ,$66.00 ,$56.10 ,$9.61 ,$60.72 ,$46.20 ,$20.43 ,$21.94 ,$40.19 ,$20.43 ,$45.61 ,$46.20 ,$4.31 ,$47.52 ,$4.67 ,$5.12 ,$5.12 ,$4.27 ,$5.12 ,$4.27 ,$47.52 ,$40.92 ,$47.52 ,$47.52 ,$39.60 ST VINCENT HOSPITAL - ACUTE,30600176,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$41.00 ,$20.50 ,$5.39 ,$41.00 ,$26.49 ,$5.57 ,$20.97 ,$17.97 ,$5.39 ,$24.60 ,$34.85 ,$28.70 ,$5.57 ,$38.95 ,$29.52 ,$29.93 ,$9.16 ,$34.85 ,$5.39 ,$9.16 ,$32.80 ,$29.93 ,$5.57 ,$5.39 ,$5.95 ,$41.00 ,$34.85 ,$12.13 ,$37.72 ,$28.70 ,$25.76 ,$27.67 ,$24.97 ,$25.76 ,$28.33 ,$28.70 ,$5.44 ,$29.52 ,$5.90 ,$6.47 ,$6.47 ,$5.39 ,$6.47 ,$5.39 ,$29.52 ,$25.42 ,$29.52 ,$29.52 ,$24.60 ST VINCENT HOSPITAL - ACUTE,30600177,87206,HC SMEAR ACID FAST/FLUOR (FUNGUS),306,1 ,$120.00 ,$60.00 ,$5.39 ,$120.00 ,$77.52 ,$5.57 ,$20.97 ,$17.97 ,$5.39 ,$72.00 ,$102.00 ,$84.00 ,$5.57 ,$114.00 ,$86.40 ,$87.60 ,$9.16 ,$102.00 ,$5.39 ,$9.16 ,$96.00 ,$87.60 ,$5.57 ,$5.39 ,$5.95 ,$120.00 ,$102.00 ,$12.13 ,$110.40 ,$84.00 ,$25.76 ,$27.67 ,$73.08 ,$25.76 ,$82.92 ,$84.00 ,$5.44 ,$86.40 ,$5.90 ,$6.47 ,$6.47 ,$5.39 ,$6.47 ,$5.39 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30600178,87206,HC SMEAR ACID FAST/FLUOR (CRYPTO),306,1 ,$71.00 ,$35.50 ,$5.39 ,$71.00 ,$45.87 ,$5.57 ,$20.97 ,$17.97 ,$5.39 ,$42.60 ,$60.35 ,$49.70 ,$5.57 ,$67.45 ,$51.12 ,$51.83 ,$9.16 ,$60.35 ,$5.39 ,$9.16 ,$56.80 ,$51.83 ,$5.57 ,$5.39 ,$5.95 ,$71.00 ,$60.35 ,$12.13 ,$65.32 ,$49.70 ,$25.76 ,$27.67 ,$43.24 ,$25.76 ,$49.06 ,$49.70 ,$5.44 ,$51.12 ,$5.90 ,$6.47 ,$6.47 ,$5.39 ,$6.47 ,$5.39 ,$51.12 ,$44.02 ,$51.12 ,$51.12 ,$42.60 ST VINCENT HOSPITAL - ACUTE,30600179,87207,HC SPECIAL STAIN (MALARIA),306,1 ,$130.00 ,$65.00 ,$5.99 ,$130.00 ,$83.98 ,$6.19 ,$23.31 ,$19.98 ,$5.99 ,$78.00 ,$110.50 ,$91.00 ,$6.19 ,$123.50 ,$93.60 ,$94.90 ,$10.18 ,$110.50 ,$5.99 ,$10.18 ,$104.00 ,$94.90 ,$6.19 ,$5.99 ,$6.61 ,$130.00 ,$110.50 ,$13.48 ,$119.60 ,$91.00 ,$28.71 ,$30.84 ,$79.17 ,$28.71 ,$89.83 ,$91.00 ,$6.05 ,$93.60 ,$6.56 ,$7.19 ,$7.19 ,$5.99 ,$7.19 ,$5.99 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30600180,87207,HC SPECIAL STAIN (TZANCK EVAL),306,1 ,$66.00 ,$33.00 ,$5.99 ,$66.00 ,$42.64 ,$6.19 ,$23.31 ,$19.98 ,$5.99 ,$39.60 ,$56.10 ,$46.20 ,$6.19 ,$62.70 ,$47.52 ,$48.18 ,$10.18 ,$56.10 ,$5.99 ,$10.18 ,$52.80 ,$48.18 ,$6.19 ,$5.99 ,$6.61 ,$66.00 ,$56.10 ,$13.48 ,$60.72 ,$46.20 ,$28.71 ,$30.84 ,$40.19 ,$28.71 ,$45.61 ,$46.20 ,$6.05 ,$47.52 ,$6.56 ,$7.19 ,$7.19 ,$5.99 ,$7.19 ,$5.99 ,$47.52 ,$40.92 ,$47.52 ,$47.52 ,$39.60 ST VINCENT HOSPITAL - ACUTE,30600181,87207,HC SPECIAL STAIN (HERPES),306,1 ,$72.00 ,$36.00 ,$5.99 ,$72.00 ,$46.51 ,$6.19 ,$23.31 ,$19.98 ,$5.99 ,$43.20 ,$61.20 ,$50.40 ,$6.19 ,$68.40 ,$51.84 ,$52.56 ,$10.18 ,$61.20 ,$5.99 ,$10.18 ,$57.60 ,$52.56 ,$6.19 ,$5.99 ,$6.61 ,$72.00 ,$61.20 ,$13.48 ,$66.24 ,$50.40 ,$28.71 ,$30.84 ,$43.85 ,$28.71 ,$49.75 ,$50.40 ,$6.05 ,$51.84 ,$6.56 ,$7.19 ,$7.19 ,$5.99 ,$7.19 ,$5.99 ,$51.84 ,$44.64 ,$51.84 ,$51.84 ,$43.20 ST VINCENT HOSPITAL - ACUTE,30600182,87209,HC OVA AND PARASITE W/STAIN,306,1 ,$80.00 ,$40.00 ,$17.98 ,$80.00 ,$51.68 ,$18.58 ,$69.90 ,$59.91 ,$17.98 ,$48.00 ,$68.00 ,$56.00 ,$18.58 ,$76.00 ,$57.60 ,$58.40 ,$30.57 ,$68.00 ,$17.98 ,$30.57 ,$64.00 ,$58.40 ,$18.58 ,$17.98 ,$19.85 ,$80.00 ,$68.00 ,$40.46 ,$73.60 ,$56.00 ,$80.00 ,$80.00 ,$48.72 ,$80.00 ,$55.28 ,$56.00 ,$18.16 ,$57.60 ,$19.69 ,$21.58 ,$21.58 ,$17.98 ,$21.58 ,$17.98 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30600183,87210,HC SMEAR WET MOUNT,306,1 ,$29.00 ,$14.50 ,$5.82 ,$29.00 ,$18.73 ,$6.00 ,$20.37 ,$17.46 ,$5.82 ,$17.40 ,$24.65 ,$20.30 ,$6.00 ,$27.55 ,$20.88 ,$21.17 ,$9.89 ,$24.65 ,$5.82 ,$9.89 ,$23.20 ,$21.17 ,$6.00 ,$5.82 ,$6.43 ,$29.00 ,$24.65 ,$13.10 ,$26.68 ,$20.30 ,$20.43 ,$21.94 ,$17.66 ,$20.43 ,$20.04 ,$20.30 ,$5.88 ,$20.88 ,$6.36 ,$6.98 ,$6.98 ,$5.82 ,$6.98 ,$5.82 ,$20.88 ,$17.98 ,$20.88 ,$20.88 ,$17.40 ST VINCENT HOSPITAL - ACUTE,30600184,87210,HC SMEAR WET MOUNT (FUNGUS),306,1 ,$40.00 ,$20.00 ,$5.82 ,$40.00 ,$25.84 ,$6.00 ,$20.37 ,$17.46 ,$5.82 ,$24.00 ,$34.00 ,$28.00 ,$6.00 ,$38.00 ,$28.80 ,$29.20 ,$9.89 ,$34.00 ,$5.82 ,$9.89 ,$32.00 ,$29.20 ,$6.00 ,$5.82 ,$6.43 ,$40.00 ,$34.00 ,$13.10 ,$36.80 ,$28.00 ,$20.43 ,$21.94 ,$24.36 ,$20.43 ,$27.64 ,$28.00 ,$5.88 ,$28.80 ,$6.36 ,$6.98 ,$6.98 ,$5.82 ,$6.98 ,$5.82 ,$28.80 ,$24.80 ,$28.80 ,$28.80 ,$24.00 ST VINCENT HOSPITAL - ACUTE,30600185,87220,HC TISSUE KOH PREP,306,1 ,$47.00 ,$23.50 ,$4.27 ,$47.00 ,$30.36 ,$4.41 ,$16.63 ,$14.25 ,$4.27 ,$28.20 ,$39.95 ,$32.90 ,$4.41 ,$44.65 ,$33.84 ,$34.31 ,$7.26 ,$39.95 ,$4.27 ,$7.26 ,$37.60 ,$34.31 ,$4.41 ,$4.27 ,$4.71 ,$47.00 ,$39.95 ,$9.61 ,$43.24 ,$32.90 ,$20.43 ,$21.94 ,$28.62 ,$20.43 ,$32.48 ,$32.90 ,$4.31 ,$33.84 ,$4.67 ,$5.12 ,$5.12 ,$4.27 ,$5.12 ,$4.27 ,$33.84 ,$29.14 ,$33.84 ,$33.84 ,$28.20 ST VINCENT HOSPITAL - ACUTE,30600186,87230,HC TOXIN ANTITOXIN ASSAY,306,1 ,$117.00 ,$58.50 ,$19.74 ,$117.00 ,$75.58 ,$20.40 ,$76.76 ,$65.79 ,$19.74 ,$70.20 ,$99.45 ,$81.90 ,$20.40 ,$111.15 ,$84.24 ,$85.41 ,$33.56 ,$99.45 ,$19.74 ,$33.56 ,$93.60 ,$85.41 ,$20.40 ,$19.74 ,$21.80 ,$117.00 ,$99.45 ,$44.42 ,$107.64 ,$81.90 ,$94.56 ,$101.56 ,$71.25 ,$94.56 ,$80.85 ,$81.90 ,$19.94 ,$84.24 ,$21.62 ,$23.69 ,$23.69 ,$19.74 ,$23.69 ,$19.74 ,$84.24 ,$72.54 ,$84.24 ,$84.24 ,$70.20 ST VINCENT HOSPITAL - ACUTE,30600187,87252,HC CULTURE VIRUS ID TISS (CMV),306,1 ,$180.00 ,$90.00 ,$26.07 ,$180.00 ,$116.28 ,$26.94 ,$101.40 ,$86.91 ,$26.07 ,$108.00 ,$153.00 ,$126.00 ,$26.94 ,$171.00 ,$129.60 ,$131.40 ,$44.32 ,$153.00 ,$26.07 ,$44.32 ,$144.00 ,$131.40 ,$26.94 ,$26.07 ,$28.79 ,$180.00 ,$153.00 ,$58.66 ,$165.60 ,$126.00 ,$124.82 ,$134.06 ,$109.62 ,$124.82 ,$124.38 ,$126.00 ,$26.33 ,$129.60 ,$28.56 ,$31.28 ,$31.28 ,$26.07 ,$31.28 ,$26.07 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30600188,87252,HC CULTURE VIRUS ID TISS (HERPES),306,1 ,$180.00 ,$90.00 ,$26.07 ,$180.00 ,$116.28 ,$26.94 ,$101.40 ,$86.91 ,$26.07 ,$108.00 ,$153.00 ,$126.00 ,$26.94 ,$171.00 ,$129.60 ,$131.40 ,$44.32 ,$153.00 ,$26.07 ,$44.32 ,$144.00 ,$131.40 ,$26.94 ,$26.07 ,$28.79 ,$180.00 ,$153.00 ,$58.66 ,$165.60 ,$126.00 ,$124.82 ,$134.06 ,$109.62 ,$124.82 ,$124.38 ,$126.00 ,$26.33 ,$129.60 ,$28.56 ,$31.28 ,$31.28 ,$26.07 ,$31.28 ,$26.07 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30600189,87252,HC CULTURE VIRUS ID TISS (RESP),306,1 ,$102.00 ,$51.00 ,$26.07 ,$102.00 ,$65.89 ,$26.94 ,$101.40 ,$86.91 ,$26.07 ,$61.20 ,$86.70 ,$71.40 ,$26.94 ,$96.90 ,$73.44 ,$74.46 ,$44.32 ,$86.70 ,$26.07 ,$44.32 ,$81.60 ,$74.46 ,$26.94 ,$26.07 ,$28.79 ,$102.00 ,$86.70 ,$58.66 ,$93.84 ,$71.40 ,$102.00 ,$102.00 ,$62.12 ,$102.00 ,$70.48 ,$71.40 ,$26.33 ,$73.44 ,$28.56 ,$31.28 ,$31.28 ,$26.07 ,$31.28 ,$26.07 ,$73.44 ,$63.24 ,$73.44 ,$73.44 ,$61.20 ST VINCENT HOSPITAL - ACUTE,30600190,87252,HC CULTURE VIRUS ID TISS (ADENO/ENTER),306,1 ,$112.00 ,$56.00 ,$26.07 ,$112.00 ,$72.35 ,$26.94 ,$101.40 ,$86.91 ,$26.07 ,$67.20 ,$95.20 ,$78.40 ,$26.94 ,$106.40 ,$80.64 ,$81.76 ,$44.32 ,$95.20 ,$26.07 ,$44.32 ,$89.60 ,$81.76 ,$26.94 ,$26.07 ,$28.79 ,$112.00 ,$95.20 ,$58.66 ,$103.04 ,$78.40 ,$112.00 ,$112.00 ,$68.21 ,$112.00 ,$77.39 ,$78.40 ,$26.33 ,$80.64 ,$28.56 ,$31.28 ,$31.28 ,$26.07 ,$31.28 ,$26.07 ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,30600193,87254,HC VIRUS ISOL SHELL ID (CMV),306,1 ,$130.00 ,$65.00 ,$7.06 ,$130.00 ,$83.98 ,$7.06 ,$76.06 ,$65.19 ,$19.56 ,$78.00 ,$110.50 ,$91.00 ,$7.06 ,$123.50 ,$93.60 ,$94.90 ,$33.25 ,$110.50 ,$19.56 ,$33.25 ,$104.00 ,$94.90 ,$7.06 ,$19.56 ,$21.60 ,$130.00 ,$110.50 ,$44.01 ,$119.60 ,$91.00 ,$93.65 ,$100.58 ,$79.17 ,$93.65 ,$89.83 ,$91.00 ,$19.76 ,$93.60 ,$7.48 ,$23.47 ,$23.47 ,$19.56 ,$23.47 ,$19.56 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30600194,87254,HC VIRUS ISOL SHELL ID (RESP),306,1 ,$82.00 ,$41.00 ,$7.06 ,$82.00 ,$52.97 ,$7.06 ,$76.06 ,$65.19 ,$19.56 ,$49.20 ,$69.70 ,$57.40 ,$7.06 ,$77.90 ,$59.04 ,$59.86 ,$33.25 ,$69.70 ,$19.56 ,$33.25 ,$65.60 ,$59.86 ,$7.06 ,$19.56 ,$21.60 ,$82.00 ,$69.70 ,$44.01 ,$75.44 ,$57.40 ,$82.00 ,$82.00 ,$49.94 ,$82.00 ,$56.66 ,$57.40 ,$19.76 ,$59.04 ,$7.48 ,$23.47 ,$23.47 ,$19.56 ,$23.47 ,$19.56 ,$59.04 ,$50.84 ,$59.04 ,$59.04 ,$49.20 ST VINCENT HOSPITAL - ACUTE,30600195,87254,HC VIRUS ISOL SHELL ID (VARI),306,1 ,$130.00 ,$65.00 ,$7.06 ,$130.00 ,$83.98 ,$7.06 ,$76.06 ,$65.19 ,$19.56 ,$78.00 ,$110.50 ,$91.00 ,$7.06 ,$123.50 ,$93.60 ,$94.90 ,$33.25 ,$110.50 ,$19.56 ,$33.25 ,$104.00 ,$94.90 ,$7.06 ,$19.56 ,$21.60 ,$130.00 ,$110.50 ,$44.01 ,$119.60 ,$91.00 ,$93.65 ,$100.58 ,$79.17 ,$93.65 ,$89.83 ,$91.00 ,$19.76 ,$93.60 ,$7.48 ,$23.47 ,$23.47 ,$19.56 ,$23.47 ,$19.56 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30600196,87254,HC VIRUS ISOL SHELL ID (CHLAM PNEUMO 1),306,1 ,$130.00 ,$65.00 ,$7.06 ,$130.00 ,$83.98 ,$7.06 ,$76.06 ,$65.19 ,$19.56 ,$78.00 ,$110.50 ,$91.00 ,$7.06 ,$123.50 ,$93.60 ,$94.90 ,$33.25 ,$110.50 ,$19.56 ,$33.25 ,$104.00 ,$94.90 ,$7.06 ,$19.56 ,$21.60 ,$130.00 ,$110.50 ,$44.01 ,$119.60 ,$91.00 ,$93.65 ,$100.58 ,$79.17 ,$93.65 ,$89.83 ,$91.00 ,$19.76 ,$93.60 ,$7.48 ,$23.47 ,$23.47 ,$19.56 ,$23.47 ,$19.56 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30600197,87254,HC VIRUS ISOL SHELL ID (CHLAM PNEUMO 2),306,1 ,$130.00 ,$65.00 ,$7.06 ,$130.00 ,$83.98 ,$7.06 ,$76.06 ,$65.19 ,$19.56 ,$78.00 ,$110.50 ,$91.00 ,$7.06 ,$123.50 ,$93.60 ,$94.90 ,$33.25 ,$110.50 ,$19.56 ,$33.25 ,$104.00 ,$94.90 ,$7.06 ,$19.56 ,$21.60 ,$130.00 ,$110.50 ,$44.01 ,$119.60 ,$91.00 ,$93.65 ,$100.58 ,$79.17 ,$93.65 ,$89.83 ,$91.00 ,$19.76 ,$93.60 ,$7.48 ,$23.47 ,$23.47 ,$19.56 ,$23.47 ,$19.56 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30600198,87254,HC VIRUS ISOL SHELL ID (CHLAM TRACH),306,1 ,$130.00 ,$65.00 ,$7.06 ,$130.00 ,$83.98 ,$7.06 ,$76.06 ,$65.19 ,$19.56 ,$78.00 ,$110.50 ,$91.00 ,$7.06 ,$123.50 ,$93.60 ,$94.90 ,$33.25 ,$110.50 ,$19.56 ,$33.25 ,$104.00 ,$94.90 ,$7.06 ,$19.56 ,$21.60 ,$130.00 ,$110.50 ,$44.01 ,$119.60 ,$91.00 ,$93.65 ,$100.58 ,$79.17 ,$93.65 ,$89.83 ,$91.00 ,$19.76 ,$93.60 ,$7.48 ,$23.47 ,$23.47 ,$19.56 ,$23.47 ,$19.56 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30600200,87260,HC IF ADENOVIRUS AG,306,1 ,$76.00 ,$38.00 ,$14.43 ,$76.00 ,$49.10 ,$14.91 ,$50.51 ,$43.29 ,$14.43 ,$45.60 ,$64.60 ,$53.20 ,$14.91 ,$72.20 ,$54.72 ,$55.48 ,$24.53 ,$64.60 ,$14.43 ,$24.53 ,$60.80 ,$55.48 ,$14.91 ,$14.43 ,$15.93 ,$76.00 ,$64.60 ,$32.47 ,$69.92 ,$53.20 ,$57.42 ,$61.68 ,$46.28 ,$57.42 ,$52.52 ,$53.20 ,$14.57 ,$54.72 ,$15.80 ,$17.32 ,$17.32 ,$14.43 ,$17.32 ,$14.43 ,$54.72 ,$47.12 ,$54.72 ,$54.72 ,$45.60 ST VINCENT HOSPITAL - ACUTE,30600201,87270,HC IF CHLAMYDIA AG,306,1 ,$97.00 ,$48.50 ,$11.98 ,$97.00 ,$62.66 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$58.20 ,$82.45 ,$67.90 ,$12.38 ,$92.15 ,$69.84 ,$70.81 ,$20.37 ,$82.45 ,$11.98 ,$20.37 ,$77.60 ,$70.81 ,$12.38 ,$11.98 ,$13.23 ,$97.00 ,$82.45 ,$26.96 ,$89.24 ,$67.90 ,$57.42 ,$61.68 ,$59.07 ,$57.42 ,$67.03 ,$67.90 ,$12.10 ,$69.84 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$69.84 ,$60.14 ,$69.84 ,$69.84 ,$58.20 ST VINCENT HOSPITAL - ACUTE,30600202,87273,HC IF HERPES SIMPLEX 2 AG,306,1 ,$76.00 ,$38.00 ,$11.98 ,$76.00 ,$49.10 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$45.60 ,$64.60 ,$53.20 ,$12.38 ,$72.20 ,$54.72 ,$55.48 ,$20.37 ,$64.60 ,$11.98 ,$20.37 ,$60.80 ,$55.48 ,$12.38 ,$11.98 ,$13.23 ,$76.00 ,$64.60 ,$26.96 ,$69.92 ,$53.20 ,$57.42 ,$61.68 ,$46.28 ,$57.42 ,$52.52 ,$53.20 ,$12.10 ,$54.72 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$54.72 ,$47.12 ,$54.72 ,$54.72 ,$45.60 ST VINCENT HOSPITAL - ACUTE,30600203,87274,HC IF HERPES SIMPLEX 1 AG,306,1 ,$76.00 ,$38.00 ,$11.98 ,$76.00 ,$49.10 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$45.60 ,$64.60 ,$53.20 ,$12.38 ,$72.20 ,$54.72 ,$55.48 ,$20.37 ,$64.60 ,$11.98 ,$20.37 ,$60.80 ,$55.48 ,$12.38 ,$11.98 ,$13.23 ,$76.00 ,$64.60 ,$26.96 ,$69.92 ,$53.20 ,$57.42 ,$61.68 ,$46.28 ,$57.42 ,$52.52 ,$53.20 ,$12.10 ,$54.72 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$54.72 ,$47.12 ,$54.72 ,$54.72 ,$45.60 ST VINCENT HOSPITAL - ACUTE,30600204,87275,HC IF INFLUENZA B AG,306,1 ,$97.00 ,$48.50 ,$12.25 ,$97.00 ,$62.66 ,$12.66 ,$46.62 ,$39.96 ,$12.25 ,$58.20 ,$82.45 ,$67.90 ,$12.66 ,$92.15 ,$69.84 ,$70.81 ,$20.83 ,$82.45 ,$12.25 ,$20.83 ,$77.60 ,$70.81 ,$12.66 ,$12.25 ,$13.53 ,$97.00 ,$82.45 ,$27.56 ,$89.24 ,$67.90 ,$57.42 ,$61.68 ,$59.07 ,$57.42 ,$67.03 ,$67.90 ,$12.37 ,$69.84 ,$13.42 ,$14.70 ,$14.70 ,$12.25 ,$14.70 ,$12.25 ,$69.84 ,$60.14 ,$69.84 ,$69.84 ,$58.20 ST VINCENT HOSPITAL - ACUTE,30600205,87276,HC IF INFLUENZA A AG,306,1 ,$97.00 ,$48.50 ,$16.07 ,$97.00 ,$62.66 ,$16.61 ,$56.25 ,$48.21 ,$16.07 ,$58.20 ,$82.45 ,$67.90 ,$16.61 ,$92.15 ,$69.84 ,$70.81 ,$27.32 ,$82.45 ,$16.07 ,$27.32 ,$77.60 ,$70.81 ,$16.61 ,$16.07 ,$17.74 ,$97.00 ,$82.45 ,$36.16 ,$89.24 ,$67.90 ,$57.42 ,$61.68 ,$59.07 ,$57.42 ,$67.03 ,$67.90 ,$16.23 ,$69.84 ,$17.61 ,$19.28 ,$19.28 ,$16.07 ,$19.28 ,$16.07 ,$69.84 ,$60.14 ,$69.84 ,$69.84 ,$58.20 ST VINCENT HOSPITAL - ACUTE,30600206,87278,HC IF LEGIONELLA AG,306,1 ,$60.00 ,$30.00 ,$15.60 ,$60.00 ,$38.76 ,$16.12 ,$54.60 ,$46.80 ,$15.60 ,$36.00 ,$51.00 ,$42.00 ,$16.12 ,$57.00 ,$43.20 ,$43.80 ,$26.52 ,$51.00 ,$15.60 ,$26.52 ,$48.00 ,$43.80 ,$16.12 ,$15.60 ,$17.23 ,$60.00 ,$51.00 ,$35.10 ,$55.20 ,$42.00 ,$57.42 ,$60.00 ,$36.54 ,$57.42 ,$41.46 ,$42.00 ,$15.76 ,$43.20 ,$17.09 ,$18.72 ,$18.72 ,$15.60 ,$18.72 ,$15.60 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600207,87279,HC IF PARAFLUENZA AG,306,1 ,$76.00 ,$38.00 ,$16.43 ,$76.00 ,$49.10 ,$16.86 ,$57.51 ,$49.29 ,$16.43 ,$45.60 ,$64.60 ,$53.20 ,$16.86 ,$72.20 ,$54.72 ,$55.48 ,$27.93 ,$64.60 ,$16.43 ,$27.93 ,$60.80 ,$55.48 ,$16.86 ,$16.43 ,$18.14 ,$76.00 ,$64.60 ,$36.97 ,$69.92 ,$53.20 ,$57.42 ,$61.68 ,$46.28 ,$57.42 ,$52.52 ,$53.20 ,$16.59 ,$54.72 ,$17.87 ,$19.72 ,$19.72 ,$16.43 ,$19.72 ,$16.43 ,$54.72 ,$47.12 ,$54.72 ,$54.72 ,$45.60 ST VINCENT HOSPITAL - ACUTE,30600208,87280,HC IF RSV AG,306,1 ,$100.00 ,$50.00 ,$13.42 ,$100.00 ,$64.60 ,$13.87 ,$46.97 ,$40.26 ,$13.42 ,$60.00 ,$85.00 ,$70.00 ,$13.87 ,$95.00 ,$72.00 ,$73.00 ,$22.81 ,$85.00 ,$13.42 ,$22.81 ,$80.00 ,$73.00 ,$13.87 ,$13.42 ,$14.82 ,$100.00 ,$85.00 ,$30.20 ,$92.00 ,$70.00 ,$57.42 ,$61.68 ,$60.90 ,$57.42 ,$69.10 ,$70.00 ,$13.55 ,$72.00 ,$14.70 ,$16.10 ,$16.10 ,$13.42 ,$16.10 ,$13.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30600209,87281,HC IF PNEUMOCYST CARINII AG,306,1 ,$100.00 ,$50.00 ,$11.98 ,$100.00 ,$64.60 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$60.00 ,$85.00 ,$70.00 ,$12.38 ,$95.00 ,$72.00 ,$73.00 ,$20.37 ,$85.00 ,$11.98 ,$20.37 ,$80.00 ,$73.00 ,$12.38 ,$11.98 ,$13.23 ,$100.00 ,$85.00 ,$26.96 ,$92.00 ,$70.00 ,$57.42 ,$61.68 ,$60.90 ,$57.42 ,$69.10 ,$70.00 ,$12.10 ,$72.00 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30600210,87290,HC IF VARICELLA ZOETER AG,306,1 ,$97.00 ,$48.50 ,$13.42 ,$97.00 ,$62.66 ,$13.87 ,$46.97 ,$40.26 ,$13.42 ,$58.20 ,$82.45 ,$67.90 ,$13.87 ,$92.15 ,$69.84 ,$70.81 ,$22.81 ,$82.45 ,$13.42 ,$22.81 ,$77.60 ,$70.81 ,$13.87 ,$13.42 ,$14.82 ,$97.00 ,$82.45 ,$30.20 ,$89.24 ,$67.90 ,$57.42 ,$61.68 ,$59.07 ,$57.42 ,$67.03 ,$67.90 ,$13.55 ,$69.84 ,$14.70 ,$16.10 ,$16.10 ,$13.42 ,$16.10 ,$13.42 ,$69.84 ,$60.14 ,$69.84 ,$69.84 ,$58.20 ST VINCENT HOSPITAL - ACUTE,30600211,87300,HC IF POLYVALENT MLT ORG AG,306,1 ,$76.00 ,$38.00 ,$8.66 ,$76.00 ,$49.10 ,$8.66 ,$46.62 ,$39.96 ,$11.98 ,$45.60 ,$64.60 ,$53.20 ,$8.66 ,$72.20 ,$54.72 ,$55.48 ,$20.37 ,$64.60 ,$11.98 ,$20.37 ,$60.80 ,$55.48 ,$8.66 ,$11.98 ,$13.23 ,$76.00 ,$64.60 ,$26.96 ,$69.92 ,$53.20 ,$57.42 ,$61.68 ,$46.28 ,$57.42 ,$52.52 ,$53.20 ,$12.10 ,$54.72 ,$9.18 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$54.72 ,$47.12 ,$54.72 ,$54.72 ,$45.60 ST VINCENT HOSPITAL - ACUTE,30600212,87305,HC EIA QL ASPERGILLUS AG,306,1 ,$120.00 ,$60.00 ,$11.98 ,$120.00 ,$77.52 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$72.00 ,$102.00 ,$84.00 ,$12.38 ,$114.00 ,$86.40 ,$87.60 ,$20.37 ,$102.00 ,$11.98 ,$20.37 ,$96.00 ,$87.60 ,$12.38 ,$11.98 ,$13.23 ,$120.00 ,$102.00 ,$26.96 ,$110.40 ,$84.00 ,$57.42 ,$61.68 ,$73.08 ,$57.42 ,$82.92 ,$84.00 ,$12.10 ,$86.40 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30600213,87324,HC EIA QL CLOS DIFF TOXIN AG,306,1 ,$97.00 ,$48.50 ,$11.98 ,$97.00 ,$62.66 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$58.20 ,$82.45 ,$67.90 ,$12.38 ,$92.15 ,$69.84 ,$70.81 ,$20.37 ,$82.45 ,$11.98 ,$20.37 ,$77.60 ,$70.81 ,$12.38 ,$11.98 ,$13.23 ,$97.00 ,$82.45 ,$26.96 ,$89.24 ,$67.90 ,$57.42 ,$61.68 ,$59.07 ,$57.42 ,$67.03 ,$67.90 ,$12.10 ,$69.84 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$69.84 ,$60.14 ,$69.84 ,$69.84 ,$58.20 ST VINCENT HOSPITAL - ACUTE,30600214,87327,HC EIA QL CRYPTOCOCCUS AG,306,1 ,$97.00 ,$48.50 ,$13.42 ,$97.00 ,$62.66 ,$13.87 ,$46.97 ,$40.26 ,$13.42 ,$58.20 ,$82.45 ,$67.90 ,$13.87 ,$92.15 ,$69.84 ,$70.81 ,$22.81 ,$82.45 ,$13.42 ,$22.81 ,$77.60 ,$70.81 ,$13.87 ,$13.42 ,$14.82 ,$97.00 ,$82.45 ,$30.20 ,$89.24 ,$67.90 ,$57.42 ,$61.68 ,$59.07 ,$57.42 ,$67.03 ,$67.90 ,$13.55 ,$69.84 ,$14.70 ,$16.10 ,$16.10 ,$13.42 ,$16.10 ,$13.42 ,$69.84 ,$60.14 ,$69.84 ,$69.84 ,$58.20 ST VINCENT HOSPITAL - ACUTE,30600215,87328,HC EIA QL CRYPTOSPORIDIUM AG,306,1 ,$43.00 ,$21.50 ,$13.82 ,$43.00 ,$27.78 ,$14.28 ,$43.00 ,$41.46 ,$13.82 ,$25.80 ,$36.55 ,$30.10 ,$14.28 ,$40.85 ,$30.96 ,$31.39 ,$23.49 ,$36.55 ,$13.82 ,$23.49 ,$34.40 ,$31.39 ,$14.28 ,$13.82 ,$15.26 ,$43.00 ,$36.55 ,$31.10 ,$39.56 ,$30.10 ,$43.00 ,$43.00 ,$26.19 ,$43.00 ,$29.71 ,$30.10 ,$13.96 ,$30.96 ,$15.14 ,$16.58 ,$16.58 ,$13.82 ,$16.58 ,$13.82 ,$30.96 ,$26.66 ,$30.96 ,$30.96 ,$25.80 ST VINCENT HOSPITAL - ACUTE,30600216,87329,HC EIA QL GIARDIA AG,306,1 ,$60.00 ,$30.00 ,$11.98 ,$60.00 ,$38.76 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$36.00 ,$51.00 ,$42.00 ,$12.38 ,$57.00 ,$43.20 ,$43.80 ,$20.37 ,$51.00 ,$11.98 ,$20.37 ,$48.00 ,$43.80 ,$12.38 ,$11.98 ,$13.23 ,$60.00 ,$51.00 ,$26.96 ,$55.20 ,$42.00 ,$57.42 ,$60.00 ,$36.54 ,$57.42 ,$41.46 ,$42.00 ,$12.10 ,$43.20 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600217,87338,HC EIA QL H PYLORI AG STOOL,306,1 ,$120.00 ,$60.00 ,$14.38 ,$120.00 ,$77.52 ,$14.86 ,$55.93 ,$47.94 ,$14.38 ,$72.00 ,$102.00 ,$84.00 ,$14.86 ,$114.00 ,$86.40 ,$87.60 ,$24.45 ,$102.00 ,$14.38 ,$24.45 ,$96.00 ,$87.60 ,$14.86 ,$14.38 ,$15.88 ,$120.00 ,$102.00 ,$32.36 ,$110.40 ,$84.00 ,$68.87 ,$73.97 ,$73.08 ,$68.87 ,$82.92 ,$84.00 ,$14.52 ,$86.40 ,$15.75 ,$17.26 ,$17.26 ,$14.38 ,$17.26 ,$14.38 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30600218,87340,HC EIA QL HEPATITIS B AG,306,1 ,$70.00 ,$35.00 ,$10.33 ,$70.00 ,$45.22 ,$10.67 ,$40.18 ,$34.44 ,$10.33 ,$42.00 ,$59.50 ,$49.00 ,$10.67 ,$66.50 ,$50.40 ,$51.10 ,$17.56 ,$59.50 ,$10.33 ,$17.56 ,$56.00 ,$51.10 ,$10.67 ,$10.33 ,$11.41 ,$70.00 ,$59.50 ,$23.24 ,$64.40 ,$49.00 ,$49.49 ,$53.16 ,$42.63 ,$49.49 ,$48.37 ,$49.00 ,$10.43 ,$50.40 ,$11.31 ,$12.40 ,$12.40 ,$10.33 ,$12.40 ,$10.33 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600220,87341,HC EIA QL HEPATITIS B AG NEUT,306,1 ,$70.00 ,$35.00 ,$10.33 ,$70.00 ,$45.22 ,$10.67 ,$40.18 ,$34.44 ,$10.33 ,$42.00 ,$59.50 ,$49.00 ,$10.67 ,$66.50 ,$50.40 ,$51.10 ,$17.56 ,$59.50 ,$10.33 ,$17.56 ,$56.00 ,$51.10 ,$10.67 ,$10.33 ,$11.41 ,$70.00 ,$59.50 ,$23.24 ,$64.40 ,$49.00 ,$49.49 ,$53.16 ,$42.63 ,$49.49 ,$48.37 ,$49.00 ,$10.43 ,$50.40 ,$11.31 ,$12.40 ,$12.40 ,$10.33 ,$12.40 ,$10.33 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600221,87350,HC HEPATITIS BE AG QL,306,1 ,$60.00 ,$30.00 ,$11.53 ,$60.00 ,$38.76 ,$11.91 ,$44.84 ,$38.43 ,$11.53 ,$36.00 ,$51.00 ,$42.00 ,$11.91 ,$57.00 ,$43.20 ,$43.80 ,$19.60 ,$51.00 ,$11.53 ,$19.60 ,$48.00 ,$43.80 ,$11.91 ,$11.53 ,$12.73 ,$60.00 ,$51.00 ,$25.94 ,$55.20 ,$42.00 ,$55.21 ,$59.30 ,$36.54 ,$55.21 ,$41.46 ,$42.00 ,$11.65 ,$43.20 ,$12.62 ,$13.84 ,$13.84 ,$11.53 ,$13.84 ,$11.53 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600222,87385,HC EIA QL HISTOPLASMA AG,306,1 ,$140.00 ,$70.00 ,$13.25 ,$140.00 ,$90.44 ,$13.69 ,$46.62 ,$39.96 ,$13.25 ,$84.00 ,$119.00 ,$98.00 ,$13.69 ,$133.00 ,$100.80 ,$102.20 ,$22.53 ,$119.00 ,$13.25 ,$22.53 ,$112.00 ,$102.20 ,$13.69 ,$13.25 ,$14.63 ,$140.00 ,$119.00 ,$29.81 ,$128.80 ,$98.00 ,$57.42 ,$61.68 ,$85.26 ,$57.42 ,$96.74 ,$98.00 ,$13.38 ,$100.80 ,$14.51 ,$15.90 ,$15.90 ,$13.25 ,$15.90 ,$13.25 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30600223,87385,HC EIA QL HISTOPLASMA AG (URINE),306,1 ,$130.00 ,$65.00 ,$13.25 ,$130.00 ,$83.98 ,$13.69 ,$46.62 ,$39.96 ,$13.25 ,$78.00 ,$110.50 ,$91.00 ,$13.69 ,$123.50 ,$93.60 ,$94.90 ,$22.53 ,$110.50 ,$13.25 ,$22.53 ,$104.00 ,$94.90 ,$13.69 ,$13.25 ,$14.63 ,$130.00 ,$110.50 ,$29.81 ,$119.60 ,$91.00 ,$57.42 ,$61.68 ,$79.17 ,$57.42 ,$89.83 ,$91.00 ,$13.38 ,$93.60 ,$14.51 ,$15.90 ,$15.90 ,$13.25 ,$15.90 ,$13.25 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30600224,87390,HC HIV 1 AG QL,306,1 ,$126.00 ,$63.00 ,$24.06 ,$126.00 ,$81.40 ,$24.81 ,$84.21 ,$72.18 ,$24.06 ,$75.60 ,$107.10 ,$88.20 ,$24.81 ,$119.70 ,$90.72 ,$91.98 ,$40.90 ,$107.10 ,$24.06 ,$40.90 ,$100.80 ,$91.98 ,$24.81 ,$24.06 ,$26.57 ,$126.00 ,$107.10 ,$54.14 ,$115.92 ,$88.20 ,$84.45 ,$90.71 ,$76.73 ,$84.45 ,$87.07 ,$88.20 ,$24.30 ,$90.72 ,$26.30 ,$28.87 ,$28.87 ,$24.06 ,$28.87 ,$24.06 ,$90.72 ,$78.12 ,$90.72 ,$90.72 ,$75.60 ST VINCENT HOSPITAL - ACUTE,30600225,87400,HC EIA QL INFLUENZA A/B AG,306,1 ,$72.00 ,$36.00 ,$8.66 ,$72.00 ,$46.51 ,$8.66 ,$49.46 ,$42.39 ,$14.13 ,$43.20 ,$61.20 ,$50.40 ,$8.66 ,$68.40 ,$51.84 ,$52.56 ,$24.02 ,$61.20 ,$14.13 ,$24.02 ,$57.60 ,$52.56 ,$8.66 ,$14.13 ,$15.60 ,$72.00 ,$61.20 ,$31.79 ,$66.24 ,$50.40 ,$57.42 ,$61.68 ,$43.85 ,$57.42 ,$49.75 ,$50.40 ,$14.27 ,$51.84 ,$9.18 ,$16.96 ,$16.96 ,$14.13 ,$16.96 ,$14.13 ,$51.84 ,$44.64 ,$51.84 ,$51.84 ,$43.20 ST VINCENT HOSPITAL - ACUTE,30600226,87420,HC RSV AG QL,306,1 ,$100.00 ,$50.00 ,$13.91 ,$100.00 ,$64.60 ,$14.37 ,$48.69 ,$41.73 ,$13.91 ,$60.00 ,$85.00 ,$70.00 ,$14.37 ,$95.00 ,$72.00 ,$73.00 ,$23.65 ,$85.00 ,$13.91 ,$23.65 ,$80.00 ,$73.00 ,$14.37 ,$13.91 ,$15.36 ,$100.00 ,$85.00 ,$31.30 ,$92.00 ,$70.00 ,$57.42 ,$61.68 ,$60.90 ,$57.42 ,$69.10 ,$70.00 ,$14.05 ,$72.00 ,$15.23 ,$16.69 ,$16.69 ,$13.91 ,$16.69 ,$13.91 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30600227,87425,HC EIA QL ROTAVIRUS AG,306,1 ,$60.00 ,$30.00 ,$11.98 ,$60.00 ,$38.76 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$36.00 ,$51.00 ,$42.00 ,$12.38 ,$57.00 ,$43.20 ,$43.80 ,$20.37 ,$51.00 ,$11.98 ,$20.37 ,$48.00 ,$43.80 ,$12.38 ,$11.98 ,$13.23 ,$60.00 ,$51.00 ,$26.96 ,$55.20 ,$42.00 ,$57.42 ,$60.00 ,$36.54 ,$57.42 ,$41.46 ,$42.00 ,$12.10 ,$43.20 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600228,87430,HC RAPID STREP,306,1 ,$80.00 ,$40.00 ,$16.81 ,$80.00 ,$51.68 ,$16.86 ,$58.84 ,$50.43 ,$16.81 ,$48.00 ,$68.00 ,$56.00 ,$16.86 ,$76.00 ,$57.60 ,$58.40 ,$28.58 ,$68.00 ,$16.81 ,$28.58 ,$64.00 ,$58.40 ,$16.86 ,$16.81 ,$18.56 ,$80.00 ,$68.00 ,$37.82 ,$73.60 ,$56.00 ,$57.42 ,$61.68 ,$48.72 ,$57.42 ,$55.28 ,$56.00 ,$16.98 ,$57.60 ,$17.87 ,$20.17 ,$20.17 ,$16.81 ,$20.17 ,$16.81 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30600229,87449,HC EIA QL MLT AG INF (RPD GRP B),306,1 ,$114.00 ,$57.00 ,$11.98 ,$114.00 ,$73.64 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$68.40 ,$96.90 ,$79.80 ,$12.38 ,$108.30 ,$82.08 ,$83.22 ,$20.37 ,$96.90 ,$11.98 ,$20.37 ,$91.20 ,$83.22 ,$12.38 ,$11.98 ,$13.23 ,$114.00 ,$96.90 ,$26.96 ,$104.88 ,$79.80 ,$57.42 ,$61.68 ,$69.43 ,$57.42 ,$78.77 ,$79.80 ,$12.10 ,$82.08 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$82.08 ,$70.68 ,$82.08 ,$82.08 ,$68.40 ST VINCENT HOSPITAL - ACUTE,30600230,87449,HC EIA QL MLT AG INF (LEGION),306,1 ,$60.00 ,$30.00 ,$11.98 ,$60.00 ,$38.76 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$36.00 ,$51.00 ,$42.00 ,$12.38 ,$57.00 ,$43.20 ,$43.80 ,$20.37 ,$51.00 ,$11.98 ,$20.37 ,$48.00 ,$43.80 ,$12.38 ,$11.98 ,$13.23 ,$60.00 ,$51.00 ,$26.96 ,$55.20 ,$42.00 ,$57.42 ,$60.00 ,$36.54 ,$57.42 ,$41.46 ,$42.00 ,$12.10 ,$43.20 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600231,87449,HC EIA QL MLT AG INF (S. PNEUMO),306,1 ,$60.00 ,$30.00 ,$11.98 ,$60.00 ,$38.76 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$36.00 ,$51.00 ,$42.00 ,$12.38 ,$57.00 ,$43.20 ,$43.80 ,$20.37 ,$51.00 ,$11.98 ,$20.37 ,$48.00 ,$43.80 ,$12.38 ,$11.98 ,$13.23 ,$60.00 ,$51.00 ,$26.96 ,$55.20 ,$42.00 ,$57.42 ,$60.00 ,$36.54 ,$57.42 ,$41.46 ,$42.00 ,$12.10 ,$43.20 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600232,87449,HC EIA QL MLT AG INF (NOROVIRUS),306,1 ,$60.00 ,$30.00 ,$11.98 ,$60.00 ,$38.76 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$36.00 ,$51.00 ,$42.00 ,$12.38 ,$57.00 ,$43.20 ,$43.80 ,$20.37 ,$51.00 ,$11.98 ,$20.37 ,$48.00 ,$43.80 ,$12.38 ,$11.98 ,$13.23 ,$60.00 ,$51.00 ,$26.96 ,$55.20 ,$42.00 ,$57.42 ,$60.00 ,$36.54 ,$57.42 ,$41.46 ,$42.00 ,$12.10 ,$43.20 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600233,87449,HC EIA QL MLT AG INF (BLASTO),306,1 ,$60.00 ,$30.00 ,$11.98 ,$60.00 ,$38.76 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$36.00 ,$51.00 ,$42.00 ,$12.38 ,$57.00 ,$43.20 ,$43.80 ,$20.37 ,$51.00 ,$11.98 ,$20.37 ,$48.00 ,$43.80 ,$12.38 ,$11.98 ,$13.23 ,$60.00 ,$51.00 ,$26.96 ,$55.20 ,$42.00 ,$57.42 ,$60.00 ,$36.54 ,$57.42 ,$41.46 ,$42.00 ,$12.10 ,$43.20 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600234,87449,HC EIA QL MLT AG INF (RPD FLU),306,1 ,$70.00 ,$35.00 ,$11.98 ,$70.00 ,$45.22 ,$12.38 ,$46.62 ,$39.96 ,$11.98 ,$42.00 ,$59.50 ,$49.00 ,$12.38 ,$66.50 ,$50.40 ,$51.10 ,$20.37 ,$59.50 ,$11.98 ,$20.37 ,$56.00 ,$51.10 ,$12.38 ,$11.98 ,$13.23 ,$70.00 ,$59.50 ,$26.96 ,$64.40 ,$49.00 ,$57.42 ,$61.68 ,$42.63 ,$57.42 ,$48.37 ,$49.00 ,$12.10 ,$50.40 ,$13.12 ,$14.38 ,$14.38 ,$11.98 ,$14.38 ,$11.98 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600235,87476,HC LYMES DNA DETECT PCR,306,1 ,$316.00 ,$158.00 ,$35.09 ,$316.00 ,$204.14 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$189.60 ,$268.60 ,$221.20 ,$36.26 ,$300.20 ,$227.52 ,$230.68 ,$59.65 ,$268.60 ,$35.09 ,$59.65 ,$252.80 ,$230.68 ,$36.26 ,$35.09 ,$38.75 ,$316.00 ,$268.60 ,$78.95 ,$290.72 ,$221.20 ,$168.02 ,$180.47 ,$192.44 ,$168.02 ,$218.36 ,$221.20 ,$35.44 ,$227.52 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$227.52 ,$195.92 ,$227.52 ,$227.52 ,$189.60 ST VINCENT HOSPITAL - ACUTE,30600236,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600237,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$240.00 ,$120.00 ,$37.27 ,$240.00 ,$155.04 ,$38.51 ,$136.47 ,$116.97 ,$37.27 ,$144.00 ,$204.00 ,$168.00 ,$38.51 ,$228.00 ,$172.80 ,$175.20 ,$63.36 ,$204.00 ,$37.27 ,$63.36 ,$192.00 ,$175.20 ,$38.51 ,$37.27 ,$41.15 ,$240.00 ,$204.00 ,$83.86 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$37.64 ,$172.80 ,$40.82 ,$44.72 ,$44.72 ,$37.27 ,$44.72 ,$37.27 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600238,87497,HC CMV QN,306,1 ,$230.00 ,$115.00 ,$42.84 ,$230.00 ,$148.58 ,$44.27 ,$166.60 ,$142.80 ,$42.84 ,$138.00 ,$195.50 ,$161.00 ,$44.27 ,$218.50 ,$165.60 ,$167.90 ,$72.83 ,$195.50 ,$42.84 ,$72.83 ,$184.00 ,$167.90 ,$44.27 ,$42.84 ,$47.30 ,$230.00 ,$195.50 ,$96.39 ,$211.60 ,$161.00 ,$205.12 ,$220.32 ,$140.07 ,$205.12 ,$158.93 ,$161.00 ,$43.27 ,$165.60 ,$46.93 ,$51.41 ,$51.41 ,$42.84 ,$51.41 ,$42.84 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,30600239,87498,HC ENTEROVIRUS AMP PROBE,306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600240,87517,HC HEPATITIS B QN,306,1 ,$175.00 ,$87.50 ,$42.84 ,$175.00 ,$113.05 ,$44.27 ,$166.60 ,$142.80 ,$42.84 ,$105.00 ,$148.75 ,$122.50 ,$44.27 ,$166.25 ,$126.00 ,$127.75 ,$72.83 ,$148.75 ,$42.84 ,$72.83 ,$140.00 ,$127.75 ,$44.27 ,$42.84 ,$47.30 ,$175.00 ,$148.75 ,$96.39 ,$161.00 ,$122.50 ,$175.00 ,$175.00 ,$106.58 ,$175.00 ,$120.93 ,$122.50 ,$43.27 ,$126.00 ,$46.93 ,$51.41 ,$51.41 ,$42.84 ,$51.41 ,$42.84 ,$126.00 ,$108.50 ,$126.00 ,$126.00 ,$105.00 ST VINCENT HOSPITAL - ACUTE,30600241,87517,HC HEPATITIS B QN (PCR),306,1 ,$330.00 ,$165.00 ,$42.84 ,$330.00 ,$213.18 ,$44.27 ,$166.60 ,$142.80 ,$42.84 ,$198.00 ,$280.50 ,$231.00 ,$44.27 ,$313.50 ,$237.60 ,$240.90 ,$72.83 ,$280.50 ,$42.84 ,$72.83 ,$264.00 ,$240.90 ,$44.27 ,$42.84 ,$47.30 ,$330.00 ,$280.50 ,$96.39 ,$303.60 ,$231.00 ,$205.12 ,$220.32 ,$200.97 ,$205.12 ,$228.03 ,$231.00 ,$43.27 ,$237.60 ,$46.93 ,$51.41 ,$51.41 ,$42.84 ,$51.41 ,$42.84 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,30600242,87522,HC HEPATITIS C QN,306,1 ,$290.00 ,$145.00 ,$42.84 ,$290.00 ,$187.34 ,$44.27 ,$166.60 ,$142.80 ,$42.84 ,$174.00 ,$246.50 ,$203.00 ,$44.27 ,$275.50 ,$208.80 ,$211.70 ,$72.83 ,$246.50 ,$42.84 ,$72.83 ,$232.00 ,$211.70 ,$44.27 ,$42.84 ,$47.30 ,$290.00 ,$246.50 ,$96.39 ,$266.80 ,$203.00 ,$205.12 ,$220.32 ,$176.61 ,$205.12 ,$200.39 ,$203.00 ,$43.27 ,$208.80 ,$46.93 ,$51.41 ,$51.41 ,$42.84 ,$51.41 ,$42.84 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,30600243,87522,HC HEPATITIS C QN (BDNA),306,1 ,$220.00 ,$110.00 ,$42.84 ,$220.00 ,$142.12 ,$44.27 ,$166.60 ,$142.80 ,$42.84 ,$132.00 ,$187.00 ,$154.00 ,$44.27 ,$209.00 ,$158.40 ,$160.60 ,$72.83 ,$187.00 ,$42.84 ,$72.83 ,$176.00 ,$160.60 ,$44.27 ,$42.84 ,$47.30 ,$220.00 ,$187.00 ,$96.39 ,$202.40 ,$154.00 ,$205.12 ,$220.00 ,$133.98 ,$205.12 ,$152.02 ,$154.00 ,$43.27 ,$158.40 ,$46.93 ,$51.41 ,$51.41 ,$42.84 ,$51.41 ,$42.84 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,30600244,87529,HC HERPES SIMPLEX AMP,306,1 ,$160.00 ,$80.00 ,$35.09 ,$160.00 ,$103.36 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$96.00 ,$136.00 ,$112.00 ,$36.26 ,$152.00 ,$115.20 ,$116.80 ,$59.65 ,$136.00 ,$35.09 ,$59.65 ,$128.00 ,$116.80 ,$36.26 ,$35.09 ,$38.75 ,$160.00 ,$136.00 ,$78.95 ,$147.20 ,$112.00 ,$160.00 ,$160.00 ,$97.44 ,$160.00 ,$110.56 ,$112.00 ,$35.44 ,$115.20 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,30600245,87535,HC PROBE HIV-1 AMP,306,1 ,$290.00 ,$145.00 ,$35.09 ,$290.00 ,$187.34 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$174.00 ,$246.50 ,$203.00 ,$36.26 ,$275.50 ,$208.80 ,$211.70 ,$59.65 ,$246.50 ,$35.09 ,$59.65 ,$232.00 ,$211.70 ,$36.26 ,$35.09 ,$38.75 ,$290.00 ,$246.50 ,$78.95 ,$266.80 ,$203.00 ,$168.02 ,$180.47 ,$176.61 ,$168.02 ,$200.39 ,$203.00 ,$35.44 ,$208.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,30600246,87536,HC HIV-1 QN,306,1 ,$290.00 ,$145.00 ,$85.10 ,$290.00 ,$187.34 ,$87.93 ,$290.00 ,$283.65 ,$85.10 ,$174.00 ,$246.50 ,$203.00 ,$87.93 ,$275.50 ,$208.80 ,$211.70 ,$144.67 ,$246.50 ,$85.10 ,$144.67 ,$232.00 ,$211.70 ,$87.93 ,$85.10 ,$93.97 ,$290.00 ,$246.50 ,$191.48 ,$266.80 ,$203.00 ,$290.00 ,$290.00 ,$176.61 ,$290.00 ,$200.39 ,$203.00 ,$85.95 ,$208.80 ,$93.21 ,$102.12 ,$102.12 ,$85.10 ,$102.12 ,$85.10 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,30600247,87536,HC HIV-1 QN (2ND GEN),306,1 ,$290.00 ,$145.00 ,$85.10 ,$290.00 ,$187.34 ,$87.93 ,$290.00 ,$283.65 ,$85.10 ,$174.00 ,$246.50 ,$203.00 ,$87.93 ,$275.50 ,$208.80 ,$211.70 ,$144.67 ,$246.50 ,$85.10 ,$144.67 ,$232.00 ,$211.70 ,$87.93 ,$85.10 ,$93.97 ,$290.00 ,$246.50 ,$191.48 ,$266.80 ,$203.00 ,$290.00 ,$290.00 ,$176.61 ,$290.00 ,$200.39 ,$203.00 ,$85.95 ,$208.80 ,$93.21 ,$102.12 ,$102.12 ,$85.10 ,$102.12 ,$85.10 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,30600248,87556,HC MTB COMPLEX PCR,306,1 ,$200.00 ,$100.00 ,$41.68 ,$200.00 ,$129.20 ,$43.07 ,$145.88 ,$125.04 ,$41.68 ,$120.00 ,$170.00 ,$140.00 ,$43.07 ,$190.00 ,$144.00 ,$146.00 ,$70.86 ,$170.00 ,$41.68 ,$70.86 ,$160.00 ,$146.00 ,$43.07 ,$41.68 ,$46.02 ,$200.00 ,$170.00 ,$93.78 ,$184.00 ,$140.00 ,$168.02 ,$180.47 ,$121.80 ,$168.02 ,$138.20 ,$140.00 ,$42.10 ,$144.00 ,$45.65 ,$50.02 ,$50.02 ,$41.68 ,$50.02 ,$41.68 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30600249,87591,HC NEISSERIA AMP,306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600250,87624,HC HPV AMP,306,1 ,$126.00 ,$63.00 ,$35.09 ,$126.00 ,$81.40 ,$36.26 ,$126.00 ,$116.97 ,$35.09 ,$75.60 ,$107.10 ,$88.20 ,$36.26 ,$119.70 ,$90.72 ,$91.98 ,$59.65 ,$107.10 ,$35.09 ,$59.65 ,$100.80 ,$91.98 ,$36.26 ,$35.09 ,$38.75 ,$126.00 ,$107.10 ,$78.95 ,$115.92 ,$88.20 ,$126.00 ,$126.00 ,$76.73 ,$126.00 ,$87.07 ,$88.20 ,$35.44 ,$90.72 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$90.72 ,$78.12 ,$90.72 ,$90.72 ,$75.60 ST VINCENT HOSPITAL - ACUTE,30600252,87624,HC HPV AMP,306,1 ,$118.00 ,$59.00 ,$35.09 ,$118.00 ,$76.23 ,$36.26 ,$118.00 ,$116.97 ,$35.09 ,$70.80 ,$100.30 ,$82.60 ,$36.26 ,$112.10 ,$84.96 ,$86.14 ,$59.65 ,$100.30 ,$35.09 ,$59.65 ,$94.40 ,$86.14 ,$36.26 ,$35.09 ,$38.75 ,$118.00 ,$100.30 ,$78.95 ,$108.56 ,$82.60 ,$118.00 ,$118.00 ,$71.86 ,$118.00 ,$81.54 ,$82.60 ,$35.44 ,$84.96 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$84.96 ,$73.16 ,$84.96 ,$84.96 ,$70.80 ST VINCENT HOSPITAL - ACUTE,30600253,87624,HC HPV AMP (DNA),306,1 ,$126.00 ,$63.00 ,$35.09 ,$126.00 ,$81.40 ,$36.26 ,$126.00 ,$116.97 ,$35.09 ,$75.60 ,$107.10 ,$88.20 ,$36.26 ,$119.70 ,$90.72 ,$91.98 ,$59.65 ,$107.10 ,$35.09 ,$59.65 ,$100.80 ,$91.98 ,$36.26 ,$35.09 ,$38.75 ,$126.00 ,$107.10 ,$78.95 ,$115.92 ,$88.20 ,$126.00 ,$126.00 ,$76.73 ,$126.00 ,$87.07 ,$88.20 ,$35.44 ,$90.72 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$90.72 ,$78.12 ,$90.72 ,$90.72 ,$75.60 ST VINCENT HOSPITAL - ACUTE,30600254,87640,HC STAPH AURE AMP PROBE,306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600255,87641,HC MRSA AMP,306,1 ,$110.00 ,$55.00 ,$35.09 ,$110.00 ,$71.06 ,$36.26 ,$110.00 ,$110.00 ,$35.09 ,$66.00 ,$93.50 ,$77.00 ,$36.26 ,$104.50 ,$79.20 ,$80.30 ,$59.65 ,$93.50 ,$35.09 ,$59.65 ,$88.00 ,$80.30 ,$36.26 ,$35.09 ,$38.75 ,$110.00 ,$93.50 ,$78.95 ,$101.20 ,$77.00 ,$110.00 ,$110.00 ,$66.99 ,$110.00 ,$76.01 ,$77.00 ,$35.44 ,$79.20 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,30600256,87798,HC INFECT AMP (BORDETELLA),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600257,87653,HC INFECT AMP (GRP B STREP),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600258,87798,HC INFECT AMP (PNEUMO),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600259,87798,HC INFECT AMP (WEST NILE),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600260,87798,HC INFECT AMP (PARVOVIRUS),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600261,87798,HC INFECT AMP (E CHAFF),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600262,87798,HC INFECT AMP (A PHAGO),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600263,87798,HC INFECT AMP (RSV),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600264,87798,HC INFECT AMP (INFLU),306,1 ,$55.00 ,$27.50 ,$27.50 ,$78.95 ,$35.53 ,$36.26 ,$55.00 ,$55.00 ,$35.09 ,$33.00 ,$46.75 ,$38.50 ,$36.26 ,$52.25 ,$39.60 ,$40.15 ,$55.00 ,$46.75 ,$35.09 ,$55.00 ,$44.00 ,$40.15 ,$36.26 ,$35.09 ,$38.75 ,$55.00 ,$46.75 ,$78.95 ,$50.60 ,$38.50 ,$55.00 ,$55.00 ,$33.50 ,$55.00 ,$38.01 ,$38.50 ,$35.44 ,$39.60 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$39.60 ,$34.10 ,$39.60 ,$39.60 ,$33.00 ST VINCENT HOSPITAL - ACUTE,30600265,87798,HC INFECT AMP (ENTEROVIRUS),306,1 ,$217.00 ,$108.50 ,$35.09 ,$217.00 ,$140.18 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$130.20 ,$184.45 ,$151.90 ,$36.26 ,$206.15 ,$156.24 ,$158.41 ,$59.65 ,$184.45 ,$35.09 ,$59.65 ,$173.60 ,$158.41 ,$36.26 ,$35.09 ,$38.75 ,$217.00 ,$184.45 ,$78.95 ,$199.64 ,$151.90 ,$168.02 ,$180.47 ,$132.15 ,$168.02 ,$149.95 ,$151.90 ,$35.44 ,$156.24 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$156.24 ,$134.54 ,$156.24 ,$156.24 ,$130.20 ST VINCENT HOSPITAL - ACUTE,30600267,87799,HC INFECT AGENT QN,306,1 ,$290.00 ,$145.00 ,$42.84 ,$290.00 ,$187.34 ,$44.27 ,$166.60 ,$142.80 ,$42.84 ,$174.00 ,$246.50 ,$203.00 ,$44.27 ,$275.50 ,$208.80 ,$211.70 ,$72.83 ,$246.50 ,$42.84 ,$72.83 ,$232.00 ,$211.70 ,$44.27 ,$42.84 ,$47.30 ,$290.00 ,$246.50 ,$96.39 ,$266.80 ,$203.00 ,$205.12 ,$220.32 ,$176.61 ,$205.12 ,$200.39 ,$203.00 ,$43.27 ,$208.80 ,$46.93 ,$51.41 ,$51.41 ,$42.84 ,$51.41 ,$42.84 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,30600268,87802,HC OPTICAL STREP B,306,1 ,$118.00 ,$59.00 ,$12.73 ,$118.00 ,$76.23 ,$13.15 ,$46.62 ,$39.96 ,$12.73 ,$70.80 ,$100.30 ,$82.60 ,$13.15 ,$112.10 ,$84.96 ,$86.14 ,$21.64 ,$100.30 ,$12.73 ,$21.64 ,$94.40 ,$86.14 ,$13.15 ,$12.73 ,$14.06 ,$118.00 ,$100.30 ,$28.64 ,$108.56 ,$82.60 ,$57.42 ,$61.68 ,$71.86 ,$57.42 ,$81.54 ,$82.60 ,$12.86 ,$84.96 ,$13.94 ,$15.28 ,$15.28 ,$12.73 ,$15.28 ,$12.73 ,$84.96 ,$73.16 ,$84.96 ,$84.96 ,$70.80 ST VINCENT HOSPITAL - ACUTE,30600269,87807,HC QL RSV,306,1 ,$100.00 ,$50.00 ,$13.10 ,$100.00 ,$64.60 ,$13.54 ,$46.62 ,$39.96 ,$13.10 ,$60.00 ,$85.00 ,$70.00 ,$13.54 ,$95.00 ,$72.00 ,$73.00 ,$22.27 ,$85.00 ,$13.10 ,$22.27 ,$80.00 ,$73.00 ,$13.54 ,$13.10 ,$14.47 ,$100.00 ,$85.00 ,$29.48 ,$92.00 ,$70.00 ,$57.42 ,$61.68 ,$60.90 ,$57.42 ,$69.10 ,$70.00 ,$13.23 ,$72.00 ,$14.35 ,$15.72 ,$15.72 ,$13.10 ,$15.72 ,$13.10 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30600270,87880,HC OPTICAL STREP,306,1 ,$80.00 ,$40.00 ,$16.53 ,$80.00 ,$51.68 ,$16.86 ,$57.86 ,$49.59 ,$16.53 ,$48.00 ,$68.00 ,$56.00 ,$16.86 ,$76.00 ,$57.60 ,$58.40 ,$28.10 ,$68.00 ,$16.53 ,$28.10 ,$64.00 ,$58.40 ,$16.86 ,$16.53 ,$18.25 ,$80.00 ,$68.00 ,$37.19 ,$73.60 ,$56.00 ,$57.42 ,$61.68 ,$48.72 ,$57.42 ,$55.28 ,$56.00 ,$16.70 ,$57.60 ,$17.87 ,$19.84 ,$19.84 ,$16.53 ,$19.84 ,$16.53 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,30600271,87899,HC INFECT AGENT DETECT OPTICAL,306,1 ,$60.00 ,$30.00 ,$16.07 ,$60.00 ,$38.76 ,$16.61 ,$56.25 ,$48.21 ,$16.07 ,$36.00 ,$51.00 ,$42.00 ,$16.61 ,$57.00 ,$43.20 ,$43.80 ,$27.32 ,$51.00 ,$16.07 ,$27.32 ,$48.00 ,$43.80 ,$16.61 ,$16.07 ,$17.74 ,$60.00 ,$51.00 ,$36.16 ,$55.20 ,$42.00 ,$57.42 ,$60.00 ,$36.54 ,$57.42 ,$41.46 ,$42.00 ,$16.23 ,$43.20 ,$17.61 ,$19.28 ,$19.28 ,$16.07 ,$19.28 ,$16.07 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600272,87902,HC GENTOYPE HEP C,306,1 ,"$1,400.00 ",$700.00 ,$257.45 ,"$1,400.00 ",$904.40 ,$266.02 ,"$1,001.18 ",$858.15 ,$257.45 ,$840.00 ,"$1,190.00 ",$980.00 ,$266.02 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$437.67 ,"$1,190.00 ",$257.45 ,$437.67 ,"$1,120.00 ","$1,022.00 ",$266.02 ,$257.45 ,$284.28 ,"$1,400.00 ","$1,190.00 ",$579.26 ,"$1,288.00 ",$980.00 ,"$1,232.78 ","$1,324.10 ",$852.60 ,"$1,232.78 ",$967.40 ,$980.00 ,$260.02 ,"$1,008.00 ",$281.98 ,$308.94 ,$308.94 ,$257.45 ,$308.94 ,$257.45 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,30600273,87801,HC INFECT MLT ORG AMP STAPH,306,1 ,$480.00 ,$240.00 ,$50.62 ,$480.00 ,$310.08 ,$50.62 ,$272.97 ,$233.97 ,$70.20 ,$288.00 ,$408.00 ,$336.00 ,$50.62 ,$456.00 ,$345.60 ,$350.40 ,$119.34 ,$408.00 ,$70.20 ,$119.34 ,$384.00 ,$350.40 ,$50.62 ,$70.20 ,$77.51 ,$480.00 ,$408.00 ,$157.95 ,$441.60 ,$336.00 ,$336.12 ,$361.02 ,$292.32 ,$336.12 ,$331.68 ,$336.00 ,$70.90 ,$345.60 ,$53.66 ,$84.24 ,$84.24 ,$70.20 ,$84.24 ,$70.20 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,30600275,87153,HC MYCOBACTERIA ID BY DNA SEQUENCING,306,1 ,$600.00 ,$300.00 ,$115.36 ,$600.00 ,$387.60 ,$119.20 ,$448.60 ,$384.51 ,$115.36 ,$360.00 ,$510.00 ,$420.00 ,$119.20 ,$570.00 ,$432.00 ,$438.00 ,$196.11 ,$510.00 ,$115.36 ,$196.11 ,$480.00 ,$438.00 ,$119.20 ,$115.36 ,$127.38 ,$600.00 ,$510.00 ,$259.56 ,$552.00 ,$420.00 ,$552.40 ,$593.32 ,$365.40 ,$552.40 ,$414.60 ,$420.00 ,$116.51 ,$432.00 ,$126.35 ,$138.43 ,$138.43 ,$115.36 ,$138.43 ,$115.36 ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,30600280,87491,HC C TACH RNA TMA,306,1 ,$220.00 ,$110.00 ,$35.09 ,$220.00 ,$142.12 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$132.00 ,$187.00 ,$154.00 ,$36.26 ,$209.00 ,$158.40 ,$160.60 ,$59.65 ,$187.00 ,$35.09 ,$59.65 ,$176.00 ,$160.60 ,$36.26 ,$35.09 ,$38.75 ,$220.00 ,$187.00 ,$78.95 ,$202.40 ,$154.00 ,$168.02 ,$180.47 ,$133.98 ,$168.02 ,$152.02 ,$154.00 ,$35.44 ,$158.40 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,30600281,87591,HC N GONOR RNA TMA,306,1 ,$220.00 ,$110.00 ,$35.09 ,$220.00 ,$142.12 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$132.00 ,$187.00 ,$154.00 ,$36.26 ,$209.00 ,$158.40 ,$160.60 ,$59.65 ,$187.00 ,$35.09 ,$59.65 ,$176.00 ,$160.60 ,$36.26 ,$35.09 ,$38.75 ,$220.00 ,$187.00 ,$78.95 ,$202.40 ,$154.00 ,$168.02 ,$180.47 ,$133.98 ,$168.02 ,$152.02 ,$154.00 ,$35.44 ,$158.40 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,30600282,87899,HC INFECT AGENT DETECT OPT (SHIGA),306,1 ,$60.00 ,$30.00 ,$16.07 ,$60.00 ,$38.76 ,$16.61 ,$56.25 ,$48.21 ,$16.07 ,$36.00 ,$51.00 ,$42.00 ,$16.61 ,$57.00 ,$43.20 ,$43.80 ,$27.32 ,$51.00 ,$16.07 ,$27.32 ,$48.00 ,$43.80 ,$16.61 ,$16.07 ,$17.74 ,$60.00 ,$51.00 ,$36.16 ,$55.20 ,$42.00 ,$57.42 ,$60.00 ,$36.54 ,$57.42 ,$41.46 ,$42.00 ,$16.23 ,$43.20 ,$17.61 ,$19.28 ,$19.28 ,$16.07 ,$19.28 ,$16.07 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600283,87804,HC QL INFLUENZA A/B,306,1 ,$90.00 ,$45.00 ,$16.55 ,$90.00 ,$58.14 ,$16.86 ,$57.93 ,$49.65 ,$16.55 ,$54.00 ,$76.50 ,$63.00 ,$16.86 ,$85.50 ,$64.80 ,$65.70 ,$28.14 ,$76.50 ,$16.55 ,$28.14 ,$72.00 ,$65.70 ,$16.86 ,$16.55 ,$18.27 ,$90.00 ,$76.50 ,$37.24 ,$82.80 ,$63.00 ,$57.42 ,$61.68 ,$54.81 ,$57.42 ,$62.19 ,$63.00 ,$16.72 ,$64.80 ,$17.87 ,$19.86 ,$19.86 ,$16.55 ,$19.86 ,$16.55 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,30600285,87624,HC HPV HR GENOTYPES,306,1 ,$140.00 ,$70.00 ,$35.09 ,$140.00 ,$90.44 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$84.00 ,$119.00 ,$98.00 ,$36.26 ,$133.00 ,$100.80 ,$102.20 ,$59.65 ,$119.00 ,$35.09 ,$59.65 ,$112.00 ,$102.20 ,$36.26 ,$35.09 ,$38.75 ,$140.00 ,$119.00 ,$78.95 ,$128.80 ,$98.00 ,$140.00 ,$140.00 ,$85.26 ,$140.00 ,$96.74 ,$98.00 ,$35.44 ,$100.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30600286,87625,HC HPV GENOTYPE 16 18/45,306,1 ,$140.00 ,$70.00 ,$38.30 ,$140.00 ,$90.44 ,$38.30 ,$140.00 ,$121.65 ,$40.55 ,$84.00 ,$119.00 ,$98.00 ,$38.30 ,$133.00 ,$100.80 ,$102.20 ,$68.94 ,$119.00 ,$40.55 ,$68.94 ,$112.00 ,$102.20 ,$38.30 ,$40.55 ,$44.78 ,$140.00 ,$119.00 ,$91.24 ,$128.80 ,$98.00 ,$140.00 ,$140.00 ,$85.26 ,$140.00 ,$96.74 ,$98.00 ,$40.96 ,$100.80 ,$40.60 ,$48.66 ,$48.66 ,$40.55 ,$48.66 ,$40.55 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,30600288,87633,HC RESP VIRUS MAP-TECH 17 TARGETS,306,1 ,$800.00 ,$400.00 ,$400.00 ,$937.76 ,$516.80 ,$430.66 ,$800.00 ,$800.00 ,$416.78 ,$480.00 ,$680.00 ,$560.00 ,$430.66 ,$760.00 ,$576.00 ,$584.00 ,$708.53 ,$680.00 ,$416.78 ,$708.53 ,$640.00 ,$584.00 ,$430.66 ,$416.78 ,$460.21 ,$800.00 ,$680.00 ,$937.76 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$420.95 ,$576.00 ,$456.50 ,$500.14 ,$500.14 ,$416.78 ,$500.14 ,$416.78 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,30600289,87798,HC B. PERTUSSIS AP-TECH,306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600290,87486,HC C PNEUMONIAE AP-TECH,306,1 ,$200.00 ,$100.00 ,$35.09 ,$200.00 ,$129.20 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$120.00 ,$170.00 ,$140.00 ,$36.26 ,$190.00 ,$144.00 ,$146.00 ,$59.65 ,$170.00 ,$35.09 ,$59.65 ,$160.00 ,$146.00 ,$36.26 ,$35.09 ,$38.75 ,$200.00 ,$170.00 ,$78.95 ,$184.00 ,$140.00 ,$168.02 ,$180.47 ,$121.80 ,$168.02 ,$138.20 ,$140.00 ,$35.44 ,$144.00 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30600291,87581,HC M PNEUMONIAS AP-TECH,306,1 ,$200.00 ,$100.00 ,$35.09 ,$200.00 ,$129.20 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$120.00 ,$170.00 ,$140.00 ,$36.26 ,$190.00 ,$144.00 ,$146.00 ,$59.65 ,$170.00 ,$35.09 ,$59.65 ,$160.00 ,$146.00 ,$36.26 ,$35.09 ,$38.75 ,$200.00 ,$170.00 ,$78.95 ,$184.00 ,$140.00 ,$168.02 ,$180.47 ,$121.80 ,$168.02 ,$138.20 ,$140.00 ,$35.44 ,$144.00 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,30600292,87798,HC INFECT AMP (EA ORG) MENI,306,1 ,$184.00 ,$92.00 ,$35.09 ,$184.00 ,$118.86 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$110.40 ,$156.40 ,$128.80 ,$36.26 ,$174.80 ,$132.48 ,$134.32 ,$59.65 ,$156.40 ,$35.09 ,$59.65 ,$147.20 ,$134.32 ,$36.26 ,$35.09 ,$38.75 ,$184.00 ,$156.40 ,$78.95 ,$169.28 ,$128.80 ,$168.02 ,$180.47 ,$112.06 ,$168.02 ,$127.14 ,$128.80 ,$35.44 ,$132.48 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$132.48 ,$114.08 ,$132.48 ,$132.48 ,$110.40 ST VINCENT HOSPITAL - ACUTE,30600293,87653,HC INFECT AMP (STREP B) MENI,306,1 ,$184.00 ,$92.00 ,$35.09 ,$184.00 ,$118.86 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$110.40 ,$156.40 ,$128.80 ,$36.26 ,$174.80 ,$132.48 ,$134.32 ,$59.65 ,$156.40 ,$35.09 ,$59.65 ,$147.20 ,$134.32 ,$36.26 ,$35.09 ,$38.75 ,$184.00 ,$156.40 ,$78.95 ,$169.28 ,$128.80 ,$168.02 ,$180.47 ,$112.06 ,$168.02 ,$127.14 ,$128.80 ,$35.44 ,$132.48 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$132.48 ,$114.08 ,$132.48 ,$132.48 ,$110.40 ST VINCENT HOSPITAL - ACUTE,30600294,87496,HC INFECT AMP (CMV) MENI,306,1 ,$142.00 ,$71.00 ,$35.09 ,$142.00 ,$91.73 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$85.20 ,$120.70 ,$99.40 ,$36.26 ,$134.90 ,$102.24 ,$103.66 ,$59.65 ,$120.70 ,$35.09 ,$59.65 ,$113.60 ,$103.66 ,$36.26 ,$35.09 ,$38.75 ,$142.00 ,$120.70 ,$78.95 ,$130.64 ,$99.40 ,$142.00 ,$142.00 ,$86.48 ,$142.00 ,$98.12 ,$99.40 ,$35.44 ,$102.24 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$102.24 ,$88.04 ,$102.24 ,$102.24 ,$85.20 ST VINCENT HOSPITAL - ACUTE,30600295,87532,HC INFECT AMP (HHSV6) MENI,306,1 ,$142.00 ,$71.00 ,$35.09 ,$142.00 ,$91.73 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$85.20 ,$120.70 ,$99.40 ,$36.26 ,$134.90 ,$102.24 ,$103.66 ,$59.65 ,$120.70 ,$35.09 ,$59.65 ,$113.60 ,$103.66 ,$36.26 ,$35.09 ,$38.75 ,$142.00 ,$120.70 ,$78.95 ,$130.64 ,$99.40 ,$142.00 ,$142.00 ,$86.48 ,$142.00 ,$98.12 ,$99.40 ,$35.44 ,$102.24 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$102.24 ,$88.04 ,$102.24 ,$102.24 ,$85.20 ST VINCENT HOSPITAL - ACUTE,30600296,87529,HC INFECT AMP (HSV 1 OR 2) MENI,306,1 ,$142.00 ,$71.00 ,$35.09 ,$142.00 ,$91.73 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$85.20 ,$120.70 ,$99.40 ,$36.26 ,$134.90 ,$102.24 ,$103.66 ,$59.65 ,$120.70 ,$35.09 ,$59.65 ,$113.60 ,$103.66 ,$36.26 ,$35.09 ,$38.75 ,$142.00 ,$120.70 ,$78.95 ,$130.64 ,$99.40 ,$142.00 ,$142.00 ,$86.48 ,$142.00 ,$98.12 ,$99.40 ,$35.44 ,$102.24 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$102.24 ,$88.04 ,$102.24 ,$102.24 ,$85.20 ST VINCENT HOSPITAL - ACUTE,30600297,87798,HC BABESIA SPECIES PCR B,306,1 ,$70.00 ,$35.00 ,$35.00 ,$78.95 ,$45.22 ,$36.26 ,$70.00 ,$70.00 ,$35.09 ,$42.00 ,$59.50 ,$49.00 ,$36.26 ,$66.50 ,$50.40 ,$51.10 ,$59.65 ,$59.50 ,$35.09 ,$59.65 ,$56.00 ,$51.10 ,$36.26 ,$35.09 ,$38.75 ,$70.00 ,$59.50 ,$78.95 ,$64.40 ,$49.00 ,$70.00 ,$70.00 ,$42.63 ,$70.00 ,$48.37 ,$49.00 ,$35.44 ,$50.40 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600298,87798,HC DETECT AGENT NOS DNA AMP,306,1 ,$70.00 ,$35.00 ,$35.00 ,$78.95 ,$45.22 ,$36.26 ,$70.00 ,$70.00 ,$35.09 ,$42.00 ,$59.50 ,$49.00 ,$36.26 ,$66.50 ,$50.40 ,$51.10 ,$59.65 ,$59.50 ,$35.09 ,$59.65 ,$56.00 ,$51.10 ,$36.26 ,$35.09 ,$38.75 ,$70.00 ,$59.50 ,$78.95 ,$64.40 ,$49.00 ,$70.00 ,$70.00 ,$42.63 ,$70.00 ,$48.37 ,$49.00 ,$35.44 ,$50.40 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,30600306,87207,HC SPECIAL STAIN INCL BODIES/PARASITES,306,1 ,$60.00 ,$30.00 ,$5.99 ,$60.00 ,$38.76 ,$6.19 ,$23.31 ,$19.98 ,$5.99 ,$36.00 ,$51.00 ,$42.00 ,$6.19 ,$57.00 ,$43.20 ,$43.80 ,$10.18 ,$51.00 ,$5.99 ,$10.18 ,$48.00 ,$43.80 ,$6.19 ,$5.99 ,$6.61 ,$60.00 ,$51.00 ,$13.48 ,$55.20 ,$42.00 ,$28.71 ,$30.84 ,$36.54 ,$28.71 ,$41.46 ,$42.00 ,$6.05 ,$43.20 ,$6.56 ,$7.19 ,$7.19 ,$5.99 ,$7.19 ,$5.99 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600316,87389,HC HIV-1 AG W/HIV-1 AND HIV-2 AB,306,1 ,$100.00 ,$50.00 ,$24.08 ,$100.00 ,$64.60 ,$24.88 ,$93.63 ,$80.25 ,$24.08 ,$60.00 ,$85.00 ,$70.00 ,$24.88 ,$95.00 ,$72.00 ,$73.00 ,$40.94 ,$85.00 ,$24.08 ,$40.94 ,$80.00 ,$73.00 ,$24.88 ,$24.08 ,$26.59 ,$100.00 ,$85.00 ,$54.18 ,$92.00 ,$70.00 ,$100.00 ,$100.00 ,$60.90 ,$100.00 ,$69.10 ,$70.00 ,$24.32 ,$72.00 ,$26.37 ,$28.90 ,$28.90 ,$24.08 ,$28.90 ,$24.08 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,30600335,87799,HC INFECT AGENT QN BK VIRUS DNA,306,1 ,$290.00 ,$145.00 ,$42.84 ,$290.00 ,$187.34 ,$44.27 ,$166.60 ,$142.80 ,$42.84 ,$174.00 ,$246.50 ,$203.00 ,$44.27 ,$275.50 ,$208.80 ,$211.70 ,$72.83 ,$246.50 ,$42.84 ,$72.83 ,$232.00 ,$211.70 ,$44.27 ,$42.84 ,$47.30 ,$290.00 ,$246.50 ,$96.39 ,$266.80 ,$203.00 ,$205.12 ,$220.32 ,$176.61 ,$205.12 ,$200.39 ,$203.00 ,$43.27 ,$208.80 ,$46.93 ,$51.41 ,$51.41 ,$42.84 ,$51.41 ,$42.84 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,30600336,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS,306,1 ,$841.00 ,$420.50 ,$416.78 ,$937.76 ,$543.29 ,$430.66 ,$841.00 ,$841.00 ,$416.78 ,$504.60 ,$714.85 ,$588.70 ,$430.66 ,$798.95 ,$605.52 ,$613.93 ,$708.53 ,$714.85 ,$416.78 ,$708.53 ,$672.80 ,$613.93 ,$430.66 ,$416.78 ,$460.21 ,$841.00 ,$714.85 ,$937.76 ,$773.72 ,$588.70 ,$841.00 ,$841.00 ,$512.17 ,$841.00 ,$581.13 ,$588.70 ,$420.95 ,$605.52 ,$456.50 ,$500.14 ,$500.14 ,$416.78 ,$500.14 ,$416.78 ,$605.52 ,$521.42 ,$605.52 ,$605.52 ,$504.60 ST VINCENT HOSPITAL - ACUTE,30600339,87633,HC IF AG RESP VIRUS MAP 12-25 TARGETS,306,1 ,$800.00 ,$400.00 ,$400.00 ,$937.76 ,$516.80 ,$430.66 ,$800.00 ,$800.00 ,$416.78 ,$480.00 ,$680.00 ,$560.00 ,$430.66 ,$760.00 ,$576.00 ,$584.00 ,$708.53 ,$680.00 ,$416.78 ,$708.53 ,$640.00 ,$584.00 ,$430.66 ,$416.78 ,$460.21 ,$800.00 ,$680.00 ,$937.76 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$420.95 ,$576.00 ,$456.50 ,$500.14 ,$500.14 ,$416.78 ,$500.14 ,$416.78 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,30600341,87798,HC INFECT AMP (VZV VIRUS DNA QL RT PCR),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600343,87798,HC INFECT AMP (NOROVIRUS RNA QL RT PCR),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600344,87530,HC HSV QUANT TYPE 1 AND 2 DNA QN RT PCR,306,1 ,$180.00 ,$90.00 ,$42.84 ,$180.00 ,$116.28 ,$44.27 ,$166.60 ,$142.80 ,$42.84 ,$108.00 ,$153.00 ,$126.00 ,$44.27 ,$171.00 ,$129.60 ,$131.40 ,$72.83 ,$153.00 ,$42.84 ,$72.83 ,$144.00 ,$131.40 ,$44.27 ,$42.84 ,$47.30 ,$180.00 ,$153.00 ,$96.39 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$43.27 ,$129.60 ,$46.93 ,$51.41 ,$51.41 ,$42.84 ,$51.41 ,$42.84 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,30600345,87799,HC INFECT AGENT QN BK VIRUS DNA RT PCR URINE,306,1 ,$290.00 ,$145.00 ,$42.84 ,$290.00 ,$187.34 ,$44.27 ,$166.60 ,$142.80 ,$42.84 ,$174.00 ,$246.50 ,$203.00 ,$44.27 ,$275.50 ,$208.80 ,$211.70 ,$72.83 ,$246.50 ,$42.84 ,$72.83 ,$232.00 ,$211.70 ,$44.27 ,$42.84 ,$47.30 ,$290.00 ,$246.50 ,$96.39 ,$266.80 ,$203.00 ,$205.12 ,$220.32 ,$176.61 ,$205.12 ,$200.39 ,$203.00 ,$43.27 ,$208.80 ,$46.93 ,$51.41 ,$51.41 ,$42.84 ,$51.41 ,$42.84 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,30600346,87798,HC INFECT AMP (B PERTUSSIS/PARA DNA QL RTPCR),306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600347,87505,HC GI ENTERIC PATHOGEN PANEL 3-5 TARGETS,306,1 ,$390.00 ,$195.00 ,$128.29 ,$390.00 ,$251.94 ,$132.56 ,$390.00 ,$390.00 ,$128.29 ,$234.00 ,$331.50 ,$273.00 ,$132.56 ,$370.50 ,$280.80 ,$284.70 ,$218.09 ,$331.50 ,$128.29 ,$218.09 ,$312.00 ,$284.70 ,$132.56 ,$128.29 ,$141.66 ,$390.00 ,$331.50 ,$288.65 ,$358.80 ,$273.00 ,$390.00 ,$390.00 ,$237.51 ,$390.00 ,$269.49 ,$273.00 ,$129.57 ,$280.80 ,$140.51 ,$153.95 ,$153.95 ,$128.29 ,$153.95 ,$128.29 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,30600348,87483,HC INFECT AMP CNS DNA/RNA 14 TARGETS,306,1 ,"$1,700.00 ",$850.00 ,$333.42 ,"$1,700.00 ","$1,098.20 ",$333.42 ,"$1,620.82 ","$1,389.27 ",$416.78 ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$333.42 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ",$708.53 ,"$1,445.00 ",$416.78 ,$708.53 ,"$1,360.00 ","$1,241.00 ",$333.42 ,$416.78 ,$460.21 ,"$1,700.00 ","$1,445.00 ",$937.76 ,"$1,564.00 ","$1,190.00 ","$1,625.45 ","$1,700.00 ","$1,035.30 ","$1,625.45 ","$1,174.70 ","$1,190.00 ",$420.95 ,"$1,224.00 ",$353.43 ,$500.14 ,$500.14 ,$416.78 ,$500.14 ,$416.78 ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,30600349,87798,HC INFECT AMP (ZIKA PCR SERUM),306,1 ,$292.00 ,$146.00 ,$35.09 ,$292.00 ,$188.63 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$175.20 ,$248.20 ,$204.40 ,$36.26 ,$277.40 ,$210.24 ,$213.16 ,$59.65 ,$248.20 ,$35.09 ,$59.65 ,$233.60 ,$213.16 ,$36.26 ,$35.09 ,$38.75 ,$292.00 ,$248.20 ,$78.95 ,$268.64 ,$204.40 ,$168.02 ,$180.47 ,$177.83 ,$168.02 ,$201.77 ,$204.40 ,$35.44 ,$210.24 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$210.24 ,$181.04 ,$210.24 ,$210.24 ,$175.20 ST VINCENT HOSPITAL - ACUTE,30600350,87798,HC INFECT AMP (ZIKA VIRUS REAL TIME PCR RNA QL),306,1 ,$500.00 ,$250.00 ,$35.09 ,$500.00 ,$323.00 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$300.00 ,$425.00 ,$350.00 ,$36.26 ,$475.00 ,$360.00 ,$365.00 ,$59.65 ,$425.00 ,$35.09 ,$59.65 ,$400.00 ,$365.00 ,$36.26 ,$35.09 ,$38.75 ,$500.00 ,$425.00 ,$78.95 ,$460.00 ,$350.00 ,$168.02 ,$180.47 ,$304.50 ,$168.02 ,$345.50 ,$350.00 ,$35.44 ,$360.00 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,30600351,86628,HC CANDIDA AB IGA IGG IBM,306,1 ,$37.00 ,$18.50 ,$8.17 ,$37.00 ,$23.90 ,$8.17 ,$37.00 ,$37.00 ,$12.01 ,$22.20 ,$31.45 ,$25.90 ,$8.17 ,$35.15 ,$26.64 ,$27.01 ,$20.42 ,$31.45 ,$12.01 ,$20.42 ,$29.60 ,$27.01 ,$8.17 ,$12.01 ,$13.26 ,$37.00 ,$31.45 ,$27.02 ,$34.04 ,$25.90 ,$27.83 ,$29.90 ,$22.53 ,$27.83 ,$25.57 ,$25.90 ,$12.13 ,$26.64 ,$8.66 ,$14.41 ,$14.41 ,$12.01 ,$14.41 ,$12.01 ,$26.64 ,$22.94 ,$26.64 ,$26.64 ,$22.20 ST VINCENT HOSPITAL - ACUTE,30600352,87563,"HC INFECT AMP (MYCOPLASMA/UREAPLASMA PNL, PCR)",306,1 ,$240.00 ,$120.00 ,$28.07 ,$240.00 ,$155.04 ,$28.07 ,$122.82 ,$105.27 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$28.07 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$28.07 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$123.17 ,$132.29 ,$146.16 ,$123.17 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$29.75 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600406,87254,HC VIRUS ISOL SHELL ID,306,1 ,$111.95 ,$55.98 ,$7.06 ,$111.95 ,$72.32 ,$7.06 ,$76.06 ,$65.19 ,$19.56 ,$67.17 ,$95.16 ,$78.37 ,$7.06 ,$106.35 ,$80.60 ,$81.72 ,$33.25 ,$95.16 ,$19.56 ,$33.25 ,$89.56 ,$81.72 ,$7.06 ,$19.56 ,$21.60 ,$111.95 ,$95.16 ,$44.01 ,$102.99 ,$78.37 ,$93.65 ,$100.58 ,$68.18 ,$93.65 ,$77.36 ,$78.37 ,$19.76 ,$80.60 ,$7.48 ,$23.47 ,$23.47 ,$19.56 ,$23.47 ,$19.56 ,$80.60 ,$69.41 ,$80.60 ,$80.60 ,$67.17 ST VINCENT HOSPITAL - ACUTE,30600498,87506,HC GI ENTERIC PATHOGEN PANEL 6-8 TARGETS,306,1 ,$470.00 ,$235.00 ,$232.94 ,$591.73 ,$303.62 ,$232.94 ,$470.00 ,$470.00 ,$262.99 ,$282.00 ,$399.50 ,$329.00 ,$232.94 ,$446.50 ,$338.40 ,$343.10 ,$447.08 ,$399.50 ,$262.99 ,$447.08 ,$376.00 ,$343.10 ,$232.94 ,$262.99 ,$290.39 ,$470.00 ,$399.50 ,$591.73 ,$432.40 ,$329.00 ,$470.00 ,$470.00 ,$286.23 ,$470.00 ,$324.77 ,$329.00 ,$265.62 ,$338.40 ,$246.92 ,$315.59 ,$315.59 ,$262.99 ,$315.59 ,$262.99 ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,30600499,87506,HC GI ENTERIC PATHOGEN PANEL 9-11 TARGETS,306,1 ,$540.00 ,$270.00 ,$232.94 ,$591.73 ,$348.84 ,$232.94 ,$540.00 ,$540.00 ,$262.99 ,$324.00 ,$459.00 ,$378.00 ,$232.94 ,$513.00 ,$388.80 ,$394.20 ,$447.08 ,$459.00 ,$262.99 ,$447.08 ,$432.00 ,$394.20 ,$232.94 ,$262.99 ,$290.39 ,$540.00 ,$459.00 ,$591.73 ,$496.80 ,$378.00 ,$540.00 ,$540.00 ,$328.86 ,$540.00 ,$373.14 ,$378.00 ,$265.62 ,$388.80 ,$246.92 ,$315.59 ,$315.59 ,$262.99 ,$315.59 ,$262.99 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,30600500,87254,HC VIRUS ISOL SHELL RESP RAPID CULTURE W/REFLEX,306,1 ,$130.00 ,$65.00 ,$7.06 ,$130.00 ,$83.98 ,$7.06 ,$76.06 ,$65.19 ,$19.56 ,$78.00 ,$110.50 ,$91.00 ,$7.06 ,$123.50 ,$93.60 ,$94.90 ,$33.25 ,$110.50 ,$19.56 ,$33.25 ,$104.00 ,$94.90 ,$7.06 ,$19.56 ,$21.60 ,$130.00 ,$110.50 ,$44.01 ,$119.60 ,$91.00 ,$93.65 ,$100.58 ,$79.17 ,$93.65 ,$89.83 ,$91.00 ,$19.76 ,$93.60 ,$7.48 ,$23.47 ,$23.47 ,$19.56 ,$23.47 ,$19.56 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,30600501,87140,HC CLT TYP IF EA VIRAL RESP RAPID CULTURE REFLEX,306,1 ,$63.00 ,$31.50 ,$5.57 ,$63.00 ,$40.70 ,$5.76 ,$21.67 ,$18.57 ,$5.57 ,$37.80 ,$53.55 ,$44.10 ,$5.76 ,$59.85 ,$45.36 ,$45.99 ,$9.47 ,$53.55 ,$5.57 ,$9.47 ,$50.40 ,$45.99 ,$5.76 ,$5.57 ,$6.15 ,$63.00 ,$53.55 ,$12.53 ,$57.96 ,$44.10 ,$21.83 ,$23.45 ,$38.37 ,$21.83 ,$43.53 ,$44.10 ,$5.63 ,$45.36 ,$6.11 ,$6.68 ,$6.68 ,$5.57 ,$6.68 ,$5.57 ,$45.36 ,$39.06 ,$45.36 ,$45.36 ,$37.80 ST VINCENT HOSPITAL - ACUTE,30600540,87798,HC IF AGENT PARAPERTUSSIS DNA DETECTION METHOD,306,1 ,$320.00 ,$160.00 ,$35.09 ,$320.00 ,$206.72 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$192.00 ,$272.00 ,$224.00 ,$36.26 ,$304.00 ,$230.40 ,$233.60 ,$59.65 ,$272.00 ,$35.09 ,$59.65 ,$256.00 ,$233.60 ,$36.26 ,$35.09 ,$38.75 ,$320.00 ,$272.00 ,$78.95 ,$294.40 ,$224.00 ,$168.02 ,$180.47 ,$194.88 ,$168.02 ,$221.12 ,$224.00 ,$35.44 ,$230.40 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,30600594,87150,HC CULTURE TYPING ID AMP PROBE TECH,306,1 ,$60.00 ,$30.00 ,$30.00 ,$78.95 ,$38.76 ,$36.26 ,$60.00 ,$60.00 ,$35.09 ,$36.00 ,$51.00 ,$42.00 ,$36.26 ,$57.00 ,$43.20 ,$43.80 ,$59.65 ,$51.00 ,$35.09 ,$59.65 ,$48.00 ,$43.80 ,$36.26 ,$35.09 ,$38.75 ,$60.00 ,$51.00 ,$78.95 ,$55.20 ,$42.00 ,$60.00 ,$60.00 ,$36.54 ,$60.00 ,$41.46 ,$42.00 ,$35.44 ,$43.20 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30600595,87798,HC INFECT AMP (TICK BORNE PCR PNL CHAIN REACTION),306,1 ,$178.00 ,$89.00 ,$35.09 ,$178.00 ,$114.99 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$106.80 ,$151.30 ,$124.60 ,$36.26 ,$169.10 ,$128.16 ,$129.94 ,$59.65 ,$151.30 ,$35.09 ,$59.65 ,$142.40 ,$129.94 ,$36.26 ,$35.09 ,$38.75 ,$178.00 ,$151.30 ,$78.95 ,$163.76 ,$124.60 ,$168.02 ,$178.00 ,$108.40 ,$168.02 ,$123.00 ,$124.60 ,$35.44 ,$128.16 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$128.16 ,$110.36 ,$128.16 ,$128.16 ,$106.80 ST VINCENT HOSPITAL - ACUTE,30600596,87801,HC INFECT MLT ORG AMP TICK,306,1 ,$346.00 ,$173.00 ,$50.62 ,$346.00 ,$223.52 ,$50.62 ,$272.97 ,$233.97 ,$70.20 ,$207.60 ,$294.10 ,$242.20 ,$50.62 ,$328.70 ,$249.12 ,$252.58 ,$119.34 ,$294.10 ,$70.20 ,$119.34 ,$276.80 ,$252.58 ,$50.62 ,$70.20 ,$77.51 ,$346.00 ,$294.10 ,$157.95 ,$318.32 ,$242.20 ,$336.12 ,$346.00 ,$210.71 ,$336.12 ,$239.09 ,$242.20 ,$70.90 ,$249.12 ,$53.66 ,$84.24 ,$84.24 ,$70.20 ,$84.24 ,$70.20 ,$249.12 ,$214.52 ,$249.12 ,$249.12 ,$207.60 ST VINCENT HOSPITAL - ACUTE,30600597,87186,HC SENSITIVITY MIC FUNGUS,306,1 ,$360.00 ,$180.00 ,$8.65 ,$360.00 ,$232.56 ,$8.94 ,$33.64 ,$28.83 ,$8.65 ,$216.00 ,$306.00 ,$252.00 ,$8.94 ,$342.00 ,$259.20 ,$262.80 ,$14.71 ,$306.00 ,$8.65 ,$14.71 ,$288.00 ,$262.80 ,$8.94 ,$8.65 ,$9.55 ,$360.00 ,$306.00 ,$19.46 ,$331.20 ,$252.00 ,$41.42 ,$44.49 ,$219.24 ,$41.42 ,$248.76 ,$252.00 ,$8.74 ,$259.20 ,$9.48 ,$10.38 ,$10.38 ,$8.65 ,$10.38 ,$8.65 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,30600616,87798,HC MYCOPL GENIT AMP PROBE,306,1 ,$240.00 ,$120.00 ,$35.09 ,$240.00 ,$155.04 ,$36.26 ,$136.47 ,$116.97 ,$35.09 ,$144.00 ,$204.00 ,$168.00 ,$36.26 ,$228.00 ,$172.80 ,$175.20 ,$59.65 ,$204.00 ,$35.09 ,$59.65 ,$192.00 ,$175.20 ,$36.26 ,$35.09 ,$38.75 ,$240.00 ,$204.00 ,$78.95 ,$220.80 ,$168.00 ,$168.02 ,$180.47 ,$146.16 ,$168.02 ,$165.84 ,$168.00 ,$35.44 ,$172.80 ,$38.44 ,$42.11 ,$42.11 ,$35.09 ,$42.11 ,$35.09 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,30600622,87081,HC CULTURE (H PYLORI),306,1 ,$120.00 ,$60.00 ,$6.63 ,$120.00 ,$77.52 ,$6.85 ,$25.76 ,$22.08 ,$6.63 ,$72.00 ,$102.00 ,$84.00 ,$6.85 ,$114.00 ,$86.40 ,$87.60 ,$11.27 ,$102.00 ,$6.63 ,$11.27 ,$96.00 ,$87.60 ,$6.85 ,$6.63 ,$7.32 ,$120.00 ,$102.00 ,$14.92 ,$110.40 ,$84.00 ,$31.77 ,$34.12 ,$73.08 ,$31.77 ,$82.92 ,$84.00 ,$6.70 ,$86.40 ,$7.26 ,$7.96 ,$7.96 ,$6.63 ,$7.96 ,$6.63 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,30682011,87635,HC COVID-19 LAB TEST NON-CDC,306,1 ,$108.00 ,$54.00 ,$51.31 ,$115.45 ,$69.77 ,$51.31 ,$108.00 ,$108.00 ,$51.31 ,$64.80 ,$91.80 ,$75.60 ,$51.31 ,$102.60 ,$77.76 ,$78.84 ,$87.23 ,$91.80 ,$51.31 ,$87.23 ,$86.40 ,$78.84 ,$51.31 ,$51.31 ,$56.66 ,$108.00 ,$91.80 ,$115.45 ,$99.36 ,$75.60 ,$108.00 ,$108.00 ,$65.77 ,$108.00 ,$74.63 ,$75.60 ,$51.82 ,$77.76 ,$54.39 ,$61.50 ,$61.50 ,$51.31 ,$61.50 ,$51.31 ,$77.76 ,$66.96 ,$77.76 ,$77.76 ,$64.80 ST VINCENT HOSPITAL - ACUTE,30682013,87635,HC COVID-19 LAB TEST,306,1 ,$108.00 ,$54.00 ,$51.31 ,$115.45 ,$69.77 ,$51.31 ,$108.00 ,$108.00 ,$51.31 ,$64.80 ,$91.80 ,$75.60 ,$51.31 ,$102.60 ,$77.76 ,$78.84 ,$87.23 ,$91.80 ,$51.31 ,$87.23 ,$86.40 ,$78.84 ,$51.31 ,$51.31 ,$56.66 ,$108.00 ,$91.80 ,$115.45 ,$99.36 ,$75.60 ,$108.00 ,$108.00 ,$65.77 ,$108.00 ,$74.63 ,$75.60 ,$51.82 ,$77.76 ,$54.39 ,$61.50 ,$61.50 ,$51.31 ,$61.50 ,$51.31 ,$77.76 ,$66.96 ,$77.76 ,$77.76 ,$64.80 ST VINCENT HOSPITAL - ACUTE,30682014,86769,HC SARS-COV-2 COVID-19 ANTIBODY,306,1 ,$78.00 ,$39.00 ,$19.06 ,$94.79 ,$50.39 ,$42.13 ,$78.00 ,$78.00 ,$42.13 ,$46.80 ,$66.30 ,$54.60 ,$42.13 ,$74.10 ,$56.16 ,$56.94 ,$71.62 ,$66.30 ,$42.13 ,$71.62 ,$62.40 ,$56.94 ,$42.13 ,$42.13 ,$46.52 ,$78.00 ,$66.30 ,$94.79 ,$71.76 ,$54.60 ,$69.60 ,$74.76 ,$47.50 ,$69.60 ,$53.90 ,$54.60 ,$42.55 ,$56.16 ,$44.66 ,$19.06 ,$19.06 ,$42.13 ,$19.06 ,$42.13 ,$56.16 ,$48.36 ,$56.16 ,$56.16 ,$46.80 ST VINCENT HOSPITAL - ACUTE,30682021,86769,HC SARS-COV-2 COVID-19 ANTIBODY IN-HOUSE,306,1 ,$78.00 ,$39.00 ,$19.06 ,$94.79 ,$50.39 ,$42.13 ,$78.00 ,$78.00 ,$42.13 ,$46.80 ,$66.30 ,$54.60 ,$42.13 ,$74.10 ,$56.16 ,$56.94 ,$71.62 ,$66.30 ,$42.13 ,$71.62 ,$62.40 ,$56.94 ,$42.13 ,$42.13 ,$46.52 ,$78.00 ,$66.30 ,$94.79 ,$71.76 ,$54.60 ,$69.60 ,$74.76 ,$47.50 ,$69.60 ,$53.90 ,$54.60 ,$42.55 ,$56.16 ,$44.66 ,$19.06 ,$19.06 ,$42.13 ,$19.06 ,$42.13 ,$56.16 ,$48.36 ,$56.16 ,$56.16 ,$46.80 ST VINCENT HOSPITAL - ACUTE,30682023,87426,HC SARS COVID ANTIGEN TEST,306,1 ,$75.00 ,$37.50 ,$35.33 ,$79.49 ,$48.45 ,$35.33 ,$75.00 ,$75.00 ,$35.33 ,$45.00 ,$63.75 ,$52.50 ,$35.33 ,$71.25 ,$54.00 ,$54.75 ,$75.00 ,$63.75 ,$35.33 ,$75.00 ,$60.00 ,$54.75 ,$35.33 ,$35.33 ,$39.01 ,$75.00 ,$63.75 ,$79.49 ,$69.00 ,$52.50 ,$75.00 ,$75.00 ,$45.68 ,$75.00 ,$51.83 ,$52.50 ,$35.68 ,$54.00 ,$37.45 ,$54.44 ,$54.44 ,$35.33 ,$54.44 ,$35.33 ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,30700101,81001,HC URINALYSIS AUTO W/MICRO,307,1 ,$38.00 ,$19.00 ,$3.17 ,$38.00 ,$24.55 ,$3.28 ,$12.32 ,$10.56 ,$3.17 ,$22.80 ,$32.30 ,$26.60 ,$3.28 ,$36.10 ,$27.36 ,$27.74 ,$5.39 ,$32.30 ,$3.17 ,$5.39 ,$30.40 ,$27.74 ,$3.28 ,$3.17 ,$3.50 ,$38.00 ,$32.30 ,$7.13 ,$34.96 ,$26.60 ,$15.16 ,$16.29 ,$23.14 ,$15.16 ,$26.26 ,$26.60 ,$3.20 ,$27.36 ,$3.48 ,$3.80 ,$3.80 ,$3.17 ,$3.80 ,$3.17 ,$27.36 ,$23.56 ,$27.36 ,$27.36 ,$22.80 ST VINCENT HOSPITAL - ACUTE,30700102,81003,HC URINALYSIS DIP STICK,307,1 ,$23.00 ,$11.50 ,$2.25 ,$23.00 ,$14.86 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$13.80 ,$19.55 ,$16.10 ,$2.32 ,$21.85 ,$16.56 ,$16.79 ,$3.83 ,$19.55 ,$2.25 ,$3.83 ,$18.40 ,$16.79 ,$2.32 ,$2.25 ,$2.48 ,$23.00 ,$19.55 ,$5.06 ,$21.16 ,$16.10 ,$10.74 ,$11.54 ,$14.01 ,$10.74 ,$15.89 ,$16.10 ,$2.27 ,$16.56 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$16.56 ,$14.26 ,$16.56 ,$16.56 ,$13.80 ST VINCENT HOSPITAL - ACUTE,30700104,81003,HC URINALYSIS AUTO W/O MICRO,307,1 ,$28.00 ,$14.00 ,$2.25 ,$28.00 ,$18.09 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$16.80 ,$23.80 ,$19.60 ,$2.32 ,$26.60 ,$20.16 ,$20.44 ,$3.83 ,$23.80 ,$2.25 ,$3.83 ,$22.40 ,$20.44 ,$2.32 ,$2.25 ,$2.48 ,$28.00 ,$23.80 ,$5.06 ,$25.76 ,$19.60 ,$10.74 ,$11.54 ,$17.05 ,$10.74 ,$19.35 ,$19.60 ,$2.27 ,$20.16 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$20.16 ,$17.36 ,$20.16 ,$20.16 ,$16.80 ST VINCENT HOSPITAL - ACUTE,30700105,81003,HC URINE ONE TEST ONLY,307,1 ,$19.00 ,$9.50 ,$2.25 ,$19.00 ,$12.27 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$11.40 ,$16.15 ,$13.30 ,$2.32 ,$18.05 ,$13.68 ,$13.87 ,$3.83 ,$16.15 ,$2.25 ,$3.83 ,$15.20 ,$13.87 ,$2.32 ,$2.25 ,$2.48 ,$19.00 ,$16.15 ,$5.06 ,$17.48 ,$13.30 ,$10.74 ,$11.54 ,$11.57 ,$10.74 ,$13.13 ,$13.30 ,$2.27 ,$13.68 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$13.68 ,$11.78 ,$13.68 ,$13.68 ,$11.40 ST VINCENT HOSPITAL - ACUTE,30700106,81003,HC URINALYSIS BLOOD,307,1 ,$36.00 ,$18.00 ,$2.25 ,$36.00 ,$23.26 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$21.60 ,$30.60 ,$25.20 ,$2.32 ,$34.20 ,$25.92 ,$26.28 ,$3.83 ,$30.60 ,$2.25 ,$3.83 ,$28.80 ,$26.28 ,$2.32 ,$2.25 ,$2.48 ,$36.00 ,$30.60 ,$5.06 ,$33.12 ,$25.20 ,$10.74 ,$11.54 ,$21.92 ,$10.74 ,$24.88 ,$25.20 ,$2.27 ,$25.92 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,30700107,81003,HC URINALYSIS GLUCOSE,307,1 ,$15.00 ,$7.50 ,$2.25 ,$15.00 ,$9.69 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$9.00 ,$12.75 ,$10.50 ,$2.32 ,$14.25 ,$10.80 ,$10.95 ,$3.83 ,$12.75 ,$2.25 ,$3.83 ,$12.00 ,$10.95 ,$2.32 ,$2.25 ,$2.48 ,$15.00 ,$12.75 ,$5.06 ,$13.80 ,$10.50 ,$10.74 ,$11.54 ,$9.14 ,$10.74 ,$10.37 ,$10.50 ,$2.27 ,$10.80 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,30700108,81003,HC URINALYSIS ACETONE OR PH,307,1 ,$22.00 ,$11.00 ,$2.25 ,$22.00 ,$14.21 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$13.20 ,$18.70 ,$15.40 ,$2.32 ,$20.90 ,$15.84 ,$16.06 ,$3.83 ,$18.70 ,$2.25 ,$3.83 ,$17.60 ,$16.06 ,$2.32 ,$2.25 ,$2.48 ,$22.00 ,$18.70 ,$5.06 ,$20.24 ,$15.40 ,$10.74 ,$11.54 ,$13.40 ,$10.74 ,$15.20 ,$15.40 ,$2.27 ,$15.84 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30700109,81003,HC URINALYSIS PROTEIN,307,1 ,$22.00 ,$11.00 ,$2.25 ,$22.00 ,$14.21 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$13.20 ,$18.70 ,$15.40 ,$2.32 ,$20.90 ,$15.84 ,$16.06 ,$3.83 ,$18.70 ,$2.25 ,$3.83 ,$17.60 ,$16.06 ,$2.32 ,$2.25 ,$2.48 ,$22.00 ,$18.70 ,$5.06 ,$20.24 ,$15.40 ,$10.74 ,$11.54 ,$13.40 ,$10.74 ,$15.20 ,$15.40 ,$2.27 ,$15.84 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30700110,81003,HC URINALYSIS KETONE,307,1 ,$22.00 ,$11.00 ,$2.25 ,$22.00 ,$14.21 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$13.20 ,$18.70 ,$15.40 ,$2.32 ,$20.90 ,$15.84 ,$16.06 ,$3.83 ,$18.70 ,$2.25 ,$3.83 ,$17.60 ,$16.06 ,$2.32 ,$2.25 ,$2.48 ,$22.00 ,$18.70 ,$5.06 ,$20.24 ,$15.40 ,$10.74 ,$11.54 ,$13.40 ,$10.74 ,$15.20 ,$15.40 ,$2.27 ,$15.84 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30700111,81003,HC URINALYSIS SPECIFIC GRAVITY,307,1 ,$15.00 ,$7.50 ,$2.25 ,$15.00 ,$9.69 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$9.00 ,$12.75 ,$10.50 ,$2.32 ,$14.25 ,$10.80 ,$10.95 ,$3.83 ,$12.75 ,$2.25 ,$3.83 ,$12.00 ,$10.95 ,$2.32 ,$2.25 ,$2.48 ,$15.00 ,$12.75 ,$5.06 ,$13.80 ,$10.50 ,$10.74 ,$11.54 ,$9.14 ,$10.74 ,$10.37 ,$10.50 ,$2.27 ,$10.80 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,30700113,81005,HC REDUCING SUBSTANCES,307,1 ,$63.00 ,$31.50 ,$2.17 ,$63.00 ,$40.70 ,$2.24 ,$8.44 ,$7.23 ,$2.17 ,$37.80 ,$53.55 ,$44.10 ,$2.24 ,$59.85 ,$45.36 ,$45.99 ,$3.69 ,$53.55 ,$2.17 ,$3.69 ,$50.40 ,$45.99 ,$2.24 ,$2.17 ,$2.40 ,$63.00 ,$53.55 ,$4.88 ,$57.96 ,$44.10 ,$10.39 ,$11.16 ,$38.37 ,$10.39 ,$43.53 ,$44.10 ,$2.19 ,$45.36 ,$2.37 ,$2.60 ,$2.60 ,$2.17 ,$2.60 ,$2.17 ,$45.36 ,$39.06 ,$45.36 ,$45.36 ,$37.80 ST VINCENT HOSPITAL - ACUTE,30700114,81005,HC QUALITATIVE SUGARS SCREEN,307,1 ,$65.00 ,$32.50 ,$2.17 ,$65.00 ,$41.99 ,$2.24 ,$8.44 ,$7.23 ,$2.17 ,$39.00 ,$55.25 ,$45.50 ,$2.24 ,$61.75 ,$46.80 ,$47.45 ,$3.69 ,$55.25 ,$2.17 ,$3.69 ,$52.00 ,$47.45 ,$2.24 ,$2.17 ,$2.40 ,$65.00 ,$55.25 ,$4.88 ,$59.80 ,$45.50 ,$10.39 ,$11.16 ,$39.59 ,$10.39 ,$44.92 ,$45.50 ,$2.19 ,$46.80 ,$2.37 ,$2.60 ,$2.60 ,$2.17 ,$2.60 ,$2.17 ,$46.80 ,$40.30 ,$46.80 ,$46.80 ,$39.00 ST VINCENT HOSPITAL - ACUTE,30700115,81015,HC URINALYSIS MICRO ONLY,307,1 ,$21.00 ,$10.50 ,$3.05 ,$21.00 ,$13.57 ,$3.15 ,$11.87 ,$10.17 ,$3.05 ,$12.60 ,$17.85 ,$14.70 ,$3.15 ,$19.95 ,$15.12 ,$15.33 ,$5.19 ,$17.85 ,$3.05 ,$5.19 ,$16.80 ,$15.33 ,$3.15 ,$3.05 ,$3.37 ,$21.00 ,$17.85 ,$6.86 ,$19.32 ,$14.70 ,$14.57 ,$15.65 ,$12.79 ,$14.57 ,$14.51 ,$14.70 ,$3.08 ,$15.12 ,$3.34 ,$3.66 ,$3.66 ,$3.05 ,$3.66 ,$3.05 ,$15.12 ,$13.02 ,$15.12 ,$15.12 ,$12.60 ST VINCENT HOSPITAL - ACUTE,30700116,81025,HC URINE PREGNANCY TEST,307,1 ,$60.00 ,$30.00 ,$8.61 ,$60.00 ,$38.76 ,$8.90 ,$30.14 ,$25.83 ,$8.61 ,$36.00 ,$51.00 ,$42.00 ,$8.90 ,$57.00 ,$43.20 ,$43.80 ,$14.64 ,$51.00 ,$8.61 ,$14.64 ,$48.00 ,$43.80 ,$8.90 ,$8.61 ,$9.51 ,$60.00 ,$51.00 ,$19.37 ,$55.20 ,$42.00 ,$30.29 ,$32.54 ,$36.54 ,$30.29 ,$41.46 ,$42.00 ,$8.70 ,$43.20 ,$9.43 ,$10.33 ,$10.33 ,$8.61 ,$10.33 ,$8.61 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,30700117,81050,HC VOLUME MEASUREMENT URINE,307,1 ,$22.00 ,$11.00 ,$3.64 ,$22.00 ,$14.21 ,$3.76 ,$12.74 ,$10.92 ,$3.64 ,$13.20 ,$18.70 ,$15.40 ,$3.76 ,$20.90 ,$15.84 ,$16.06 ,$6.19 ,$18.70 ,$3.64 ,$6.19 ,$17.60 ,$16.06 ,$3.76 ,$3.64 ,$4.02 ,$22.00 ,$18.70 ,$8.19 ,$20.24 ,$15.40 ,$14.36 ,$15.42 ,$13.40 ,$14.36 ,$15.20 ,$15.40 ,$3.68 ,$15.84 ,$3.99 ,$4.37 ,$4.37 ,$3.64 ,$4.37 ,$3.64 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30700135,81015,HC URINALYSIS MICRO ONLY PREVEA 72HR,307,1 ,$21.00 ,$10.50 ,$3.05 ,$21.00 ,$13.57 ,$3.15 ,$11.87 ,$10.17 ,$3.05 ,$12.60 ,$17.85 ,$14.70 ,$3.15 ,$19.95 ,$15.12 ,$15.33 ,$5.19 ,$17.85 ,$3.05 ,$5.19 ,$16.80 ,$15.33 ,$3.15 ,$3.05 ,$3.37 ,$21.00 ,$17.85 ,$6.86 ,$19.32 ,$14.70 ,$14.57 ,$15.65 ,$12.79 ,$14.57 ,$14.51 ,$14.70 ,$3.08 ,$15.12 ,$3.34 ,$3.66 ,$3.66 ,$3.05 ,$3.66 ,$3.05 ,$15.12 ,$13.02 ,$15.12 ,$15.12 ,$12.60 ST VINCENT HOSPITAL - ACUTE,30780106,81003,HC URINALYSIS BLOOD GBO,307,1 ,$36.00 ,$18.00 ,$2.25 ,$36.00 ,$23.26 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$21.60 ,$30.60 ,$25.20 ,$2.32 ,$34.20 ,$25.92 ,$26.28 ,$3.83 ,$30.60 ,$2.25 ,$3.83 ,$28.80 ,$26.28 ,$2.32 ,$2.25 ,$2.48 ,$36.00 ,$30.60 ,$5.06 ,$33.12 ,$25.20 ,$10.74 ,$11.54 ,$21.92 ,$10.74 ,$24.88 ,$25.20 ,$2.27 ,$25.92 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,30780109,81003,HC URINALYSIS PROTEIN GBO,307,1 ,$22.00 ,$11.00 ,$2.25 ,$22.00 ,$14.21 ,$2.32 ,$8.72 ,$7.47 ,$2.25 ,$13.20 ,$18.70 ,$15.40 ,$2.32 ,$20.90 ,$15.84 ,$16.06 ,$3.83 ,$18.70 ,$2.25 ,$3.83 ,$17.60 ,$16.06 ,$2.32 ,$2.25 ,$2.48 ,$22.00 ,$18.70 ,$5.06 ,$20.24 ,$15.40 ,$10.74 ,$11.54 ,$13.40 ,$10.74 ,$15.20 ,$15.40 ,$2.27 ,$15.84 ,$2.46 ,$2.70 ,$2.70 ,$2.25 ,$2.70 ,$2.25 ,$15.84 ,$13.64 ,$15.84 ,$15.84 ,$13.20 ST VINCENT HOSPITAL - ACUTE,30900001,N/A,HC SLIDE PROCESSING FEE,309,1 ,$10.00 ,$5.00 ,$4.20 ,$10.00 ,$6.46 , N/A ,$6.47 ,$6.47 , N/A ,$6.00 ,$8.50 ,$7.00 , N/A ,$9.50 ,$7.20 ,$7.30 , N/A ,$8.50 , N/A , N/A ,$8.00 ,$7.30 , N/A , N/A ,$4.20 ,$10.00 ,$8.50 , N/A ,$9.20 ,$7.00 ,$5.00 ,$6.00 ,$6.09 ,$5.00 ,$6.91 ,$7.00 , N/A ,$7.20 , N/A ,$5.00 ,$5.00 , N/A ,$5.00 , N/A ,$7.20 ,$6.20 ,$7.20 ,$7.20 ,$6.00 ST VINCENT HOSPITAL - ACUTE,30900002,89300,HC POST VASECTOMY SEMEN ANALYSIS,309,1 ,$77.00 ,$38.50 ,$9.84 ,$77.00 ,$49.74 ,$10.17 ,$34.72 ,$29.76 ,$9.84 ,$46.20 ,$65.45 ,$53.90 ,$10.17 ,$73.15 ,$55.44 ,$56.21 ,$16.73 ,$65.45 ,$9.84 ,$16.73 ,$61.60 ,$56.21 ,$10.17 ,$9.84 ,$10.87 ,$77.00 ,$65.45 ,$22.14 ,$70.84 ,$53.90 ,$42.72 ,$45.88 ,$46.89 ,$42.72 ,$53.21 ,$53.90 ,$9.94 ,$55.44 ,$10.78 ,$11.81 ,$11.81 ,$9.84 ,$11.81 ,$9.84 ,$55.44 ,$47.74 ,$55.44 ,$55.44 ,$46.20 ST VINCENT HOSPITAL - ACUTE,30900199,87254,HC VIRUS ISOL SHELL ID,309,1 ,$124.00 ,$62.00 ,$7.06 ,$124.00 ,$80.10 ,$7.06 ,$76.06 ,$65.19 ,$19.56 ,$74.40 ,$105.40 ,$86.80 ,$7.06 ,$117.80 ,$89.28 ,$90.52 ,$33.25 ,$105.40 ,$19.56 ,$33.25 ,$99.20 ,$90.52 ,$7.06 ,$19.56 ,$21.60 ,$124.00 ,$105.40 ,$44.01 ,$114.08 ,$86.80 ,$93.65 ,$100.58 ,$75.52 ,$93.65 ,$85.68 ,$86.80 ,$19.76 ,$89.28 ,$7.48 ,$23.47 ,$23.47 ,$19.56 ,$23.47 ,$19.56 ,$89.28 ,$76.88 ,$89.28 ,$89.28 ,$74.40 ST VINCENT HOSPITAL - ACUTE,31000001,N/A,HC AUTOPSY PER BLOCK-CLINICS,310,1 ,$15.00 ,$7.50 ,$6.30 ,$15.00 ,$9.69 , N/A ,$9.70 ,$9.70 , N/A ,$9.00 ,$12.75 ,$10.50 , N/A ,$14.25 ,$10.80 ,$10.95 , N/A ,$12.75 , N/A , N/A ,$12.00 ,$10.95 , N/A , N/A ,$6.30 ,$15.00 ,$12.75 , N/A ,$13.80 ,$10.50 ,$7.50 ,$9.00 ,$9.14 ,$7.50 ,$10.37 ,$10.50 , N/A ,$10.80 , N/A ,$7.50 ,$7.50 , N/A ,$7.50 , N/A ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,31000002,N/A,HC AUTOPSY PER BLOCK-IN HOUSE,310,1 ,$33.00 ,$16.50 ,$13.86 ,$33.00 ,$21.32 , N/A ,$21.35 ,$21.35 , N/A ,$19.80 ,$28.05 ,$23.10 , N/A ,$31.35 ,$23.76 ,$24.09 , N/A ,$28.05 , N/A , N/A ,$26.40 ,$24.09 , N/A , N/A ,$13.86 ,$33.00 ,$28.05 , N/A ,$30.36 ,$23.10 ,$16.50 ,$19.80 ,$20.10 ,$16.50 ,$22.80 ,$23.10 , N/A ,$23.76 , N/A ,$16.50 ,$16.50 , N/A ,$16.50 , N/A ,$23.76 ,$20.46 ,$23.76 ,$23.76 ,$19.80 ST VINCENT HOSPITAL - ACUTE,31000003,N/A,HC MORGUE USE,310,1 ,$200.00 ,$100.00 ,$84.00 ,$200.00 ,$129.20 , N/A ,$129.38 ,$129.38 , N/A ,$120.00 ,$170.00 ,$140.00 , N/A ,$190.00 ,$144.00 ,$146.00 , N/A ,$170.00 , N/A , N/A ,$160.00 ,$146.00 , N/A , N/A ,$84.00 ,$200.00 ,$170.00 , N/A ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 , N/A ,$144.00 , N/A ,$100.00 ,$100.00 , N/A ,$100.00 , N/A ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,31000006,88312,HC AUTOPSY SPECIAL STAIN LEVEL I,310,1 ,$25.00 ,$12.50 ,$10.50 ,$108.43 ,$16.15 ,$11.38 ,$25.00 ,$25.00 ,$48.19 ,$15.00 ,$21.25 ,$17.50 ,$11.38 ,$23.75 ,$18.00 ,$18.25 ,$25.00 ,$21.25 ,$48.19 ,$25.00 ,$20.00 ,$18.25 ,$11.38 ,$48.19 ,$10.50 ,$25.00 ,$21.25 ,$108.43 ,$23.00 ,$17.50 ,$25.00 ,$25.00 ,$15.23 ,$25.00 ,$17.28 ,$17.50 ,$48.67 ,$18.00 ,$12.06 ,$25.00 ,$25.00 ,$48.19 ,$25.00 ,$48.19 ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,31000007,88312,HC AUTOPSY SPECIAL STAIN LEVEL II,310,1 ,$30.00 ,$15.00 ,$11.38 ,$108.43 ,$19.38 ,$11.38 ,$30.00 ,$30.00 ,$48.19 ,$18.00 ,$25.50 ,$21.00 ,$11.38 ,$28.50 ,$21.60 ,$21.90 ,$30.00 ,$25.50 ,$48.19 ,$30.00 ,$24.00 ,$21.90 ,$11.38 ,$48.19 ,$12.60 ,$30.00 ,$25.50 ,$108.43 ,$27.60 ,$21.00 ,$30.00 ,$30.00 ,$18.27 ,$30.00 ,$20.73 ,$21.00 ,$48.67 ,$21.60 ,$12.06 ,$30.00 ,$30.00 ,$48.19 ,$30.00 ,$48.19 ,$21.60 ,$18.60 ,$21.60 ,$21.60 ,$18.00 ST VINCENT HOSPITAL - ACUTE,31000008,88341,HC AUTOPSY IMMUNOPEROXIDASE QL,310,1 ,$44.00 ,$22.00 ,$11.95 ,$44.00 ,$28.42 ,$11.95 ,$44.00 ,$44.00 , N/A ,$26.40 ,$37.40 ,$30.80 ,$11.95 ,$41.80 ,$31.68 ,$32.12 ,$44.00 ,$37.40 , N/A ,$44.00 ,$35.20 ,$32.12 ,$11.95 , N/A ,$18.48 ,$44.00 ,$37.40 , N/A ,$40.48 ,$30.80 ,$22.00 ,$26.40 ,$26.80 ,$22.00 ,$30.40 ,$30.80 , N/A ,$31.68 ,$12.67 ,$44.00 ,$44.00 , N/A ,$44.00 , N/A ,$31.68 ,$27.28 ,$31.68 ,$31.68 ,$26.40 ST VINCENT HOSPITAL - ACUTE,31000009,88360,HC AUTOPSY IMMUNOPEROXIDASE QN,310,1 ,$50.00 ,$25.00 ,$11.95 ,$325.04 ,$32.30 ,$11.95 ,$50.00 ,$50.00 ,$144.46 ,$30.00 ,$42.50 ,$35.00 ,$11.95 ,$47.50 ,$36.00 ,$36.50 ,$50.00 ,$42.50 ,$144.46 ,$50.00 ,$40.00 ,$36.50 ,$11.95 ,$144.46 ,$21.00 ,$50.00 ,$42.50 ,$325.04 ,$46.00 ,$35.00 ,$50.00 ,$50.00 ,$30.45 ,$50.00 ,$34.55 ,$35.00 ,$145.90 ,$36.00 ,$12.67 ,$50.00 ,$50.00 ,$144.46 ,$50.00 ,$144.46 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,31000010,81206,HC BCR/ABL1 GENE MAJOR BP,310,1 ,$760.00 ,$380.00 ,$163.96 ,$760.00 ,$490.96 ,$169.42 ,$637.63 ,$546.54 ,$163.96 ,$456.00 ,$646.00 ,$532.00 ,$169.42 ,$722.00 ,$547.20 ,$554.80 ,$278.73 ,$646.00 ,$163.96 ,$278.73 ,$608.00 ,$554.80 ,$169.42 ,$163.96 ,$181.04 ,$760.00 ,$646.00 ,$368.91 ,$699.20 ,$532.00 ,$760.00 ,$760.00 ,$462.84 ,$760.00 ,$525.16 ,$532.00 ,$165.60 ,$547.20 ,$179.59 ,$196.75 ,$196.75 ,$163.96 ,$196.75 ,$163.96 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,31000011,81206,HC BCR/ABL1 GENE MAJOR BP QUEST,310,1 ,$420.00 ,$210.00 ,$163.96 ,$420.00 ,$271.32 ,$169.42 ,$420.00 ,$420.00 ,$163.96 ,$252.00 ,$357.00 ,$294.00 ,$169.42 ,$399.00 ,$302.40 ,$306.60 ,$278.73 ,$357.00 ,$163.96 ,$278.73 ,$336.00 ,$306.60 ,$169.42 ,$163.96 ,$181.04 ,$420.00 ,$357.00 ,$368.91 ,$386.40 ,$294.00 ,$420.00 ,$420.00 ,$255.78 ,$420.00 ,$290.22 ,$294.00 ,$165.60 ,$302.40 ,$179.59 ,$196.75 ,$196.75 ,$163.96 ,$196.75 ,$163.96 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,31000012,81207,HC BCR/ABL1 GENE MINOR BP,310,1 ,$920.00 ,$460.00 ,$144.84 ,$920.00 ,$594.32 ,$149.66 ,$563.26 ,$482.79 ,$144.84 ,$552.00 ,$782.00 ,$644.00 ,$149.66 ,$874.00 ,$662.40 ,$671.60 ,$246.23 ,$782.00 ,$144.84 ,$246.23 ,$736.00 ,$671.60 ,$149.66 ,$144.84 ,$159.93 ,$920.00 ,$782.00 ,$325.89 ,$846.40 ,$644.00 ,$693.54 ,$744.91 ,$560.28 ,$693.54 ,$635.72 ,$644.00 ,$146.29 ,$662.40 ,$158.64 ,$173.81 ,$173.81 ,$144.84 ,$173.81 ,$144.84 ,$662.40 ,$570.40 ,$662.40 ,$662.40 ,$552.00 ST VINCENT HOSPITAL - ACUTE,31000013,81226,HC CYP2D6 GENE COM VARIANTS,310,1 ,"$1,600.00 ",$800.00 ,$119.53 ,"$1,600.00 ","$1,033.60 ",$119.53 ,"$1,578.19 ","$1,352.73 ",$450.91 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$119.53 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ",$766.55 ,"$1,360.00 ",$450.91 ,$766.55 ,"$1,280.00 ","$1,168.00 ",$119.53 ,$450.91 ,$497.89 ,"$1,600.00 ","$1,360.00 ","$1,014.55 ","$1,472.00 ","$1,120.00 ","$1,585.08 ","$1,600.00 ",$974.40 ,"$1,585.08 ","$1,105.60 ","$1,120.00 ",$455.42 ,"$1,152.00 ",$126.70 ,$541.09 ,$541.09 ,$450.91 ,$541.09 ,$450.91 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,31000014,81228,HC CYTOGEN MICRARRAY COPY NO,310,1 ,"$2,020.00 ","$1,010.00 ",$516.91 ,"$2,025.00 ","$1,304.92 ",$516.91 ,"$2,020.00 ","$2,020.00 ",$900.00 ,"$1,212.00 ","$1,717.00 ","$1,414.00 ",$516.91 ,"$1,919.00 ","$1,454.40 ","$1,474.60 ","$1,530.00 ","$1,717.00 ",$900.00 ,"$1,530.00 ","$1,616.00 ","$1,474.60 ",$516.91 ,$900.00 ,$993.78 ,"$2,020.00 ","$1,717.00 ","$2,025.00 ","$1,858.40 ","$1,414.00 ","$2,020.00 ","$2,020.00 ","$1,230.18 ","$2,020.00 ","$1,395.82 ","$1,414.00 ",$909.00 ,"$1,454.40 ",$547.92 ,"$1,080.00 ","$1,080.00 ",$900.00 ,"$1,080.00 ",$900.00 ,"$1,454.40 ","$1,252.40 ","$1,454.40 ","$1,454.40 ","$1,212.00 " ST VINCENT HOSPITAL - ACUTE,31000015,81240,HC F2 GENE ANAL 20210G A VAR,310,1 ,$240.00 ,$120.00 ,$53.70 ,$240.00 ,$155.04 ,$53.70 ,$229.92 ,$197.07 ,$65.69 ,$144.00 ,$204.00 ,$168.00 ,$53.70 ,$228.00 ,$172.80 ,$175.20 ,$111.67 ,$204.00 ,$65.69 ,$111.67 ,$192.00 ,$175.20 ,$53.70 ,$65.69 ,$72.53 ,$240.00 ,$204.00 ,$147.80 ,$220.80 ,$168.00 ,$235.63 ,$240.00 ,$146.16 ,$235.63 ,$165.84 ,$168.00 ,$66.35 ,$172.80 ,$56.92 ,$78.83 ,$78.83 ,$65.69 ,$78.83 ,$65.69 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,31000016,81241,HC F5 GENE ANAL LEIDEN VAR,310,1 ,$240.00 ,$120.00 ,$66.70 ,$240.00 ,$155.04 ,$66.70 ,$240.00 ,$220.11 ,$73.37 ,$144.00 ,$204.00 ,$168.00 ,$66.70 ,$228.00 ,$172.80 ,$175.20 ,$124.73 ,$204.00 ,$73.37 ,$124.73 ,$192.00 ,$175.20 ,$66.70 ,$73.37 ,$81.02 ,$240.00 ,$204.00 ,$165.08 ,$220.80 ,$168.00 ,$240.00 ,$240.00 ,$146.16 ,$240.00 ,$165.84 ,$168.00 ,$74.10 ,$172.80 ,$70.70 ,$88.04 ,$88.04 ,$73.37 ,$88.04 ,$73.37 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,31000017,81243,HC FMR1 GENE CHARACTERZTN,310,1 ,$240.00 ,$120.00 ,$54.46 ,$240.00 ,$155.04 ,$54.46 ,$199.64 ,$171.12 , N/A ,$144.00 ,$204.00 ,$168.00 ,$54.46 ,$228.00 ,$172.80 ,$175.20 ,$96.97 ,$204.00 , N/A ,$96.97 ,$192.00 ,$175.20 ,$54.46 , N/A ,$62.98 ,$240.00 ,$204.00 ,$144.00 ,$220.80 ,$168.00 ,$200.21 ,$215.04 ,$146.16 ,$200.21 ,$165.84 ,$168.00 , N/A ,$172.80 ,$57.73 ,$68.45 ,$68.45 , N/A ,$68.45 , N/A ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,31000018,81256,HC HFE GENE,310,1 ,$430.00 ,$215.00 ,$65.36 ,$430.00 ,$277.78 ,$67.54 ,$254.17 ,$217.86 ,$65.36 ,$258.00 ,$365.50 ,$301.00 ,$67.54 ,$408.50 ,$309.60 ,$313.90 ,$111.11 ,$365.50 ,$65.36 ,$111.11 ,$344.00 ,$313.90 ,$67.54 ,$65.36 ,$72.17 ,$430.00 ,$365.50 ,$147.06 ,$395.60 ,$301.00 ,$312.99 ,$336.17 ,$261.87 ,$312.99 ,$297.13 ,$301.00 ,$66.01 ,$309.60 ,$71.59 ,$78.43 ,$78.43 ,$65.36 ,$78.43 ,$65.36 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,31000019,81261,HC IGH GENE REARRNG AMP METH,310,1 ,"$1,619.00 ",$809.50 ,$197.99 ,"$1,619.00 ","$1,045.87 ",$204.58 ,$769.97 ,$659.97 ,$197.99 ,$971.40 ,"$1,376.15 ","$1,133.30 ",$204.58 ,"$1,538.05 ","$1,165.68 ","$1,181.87 ",$336.58 ,"$1,376.15 ",$197.99 ,$336.58 ,"$1,295.20 ","$1,181.87 ",$204.58 ,$197.99 ,$218.62 ,"$1,619.00 ","$1,376.15 ",$445.48 ,"$1,489.48 ","$1,133.30 ",$948.09 ,"$1,018.31 ",$985.97 ,$948.09 ,"$1,118.73 ","$1,133.30 ",$199.97 ,"$1,165.68 ",$216.85 ,$237.59 ,$237.59 ,$197.99 ,$237.59 ,$197.99 ,"$1,165.68 ","$1,003.78 ","$1,165.68 ","$1,165.68 ",$971.40 ST VINCENT HOSPITAL - ACUTE,31000020,81264,HC IGK REARRANGE CLONAL POP,310,1 ,"$1,619.00 ",$809.50 ,$162.98 ,"$1,619.00 ","$1,045.87 ",$162.98 ,$604.56 ,$518.19 ,$172.73 ,$971.40 ,"$1,376.15 ","$1,133.30 ",$162.98 ,"$1,538.05 ","$1,165.68 ","$1,181.87 ",$293.64 ,"$1,376.15 ",$172.73 ,$293.64 ,"$1,295.20 ","$1,181.87 ",$162.98 ,$172.73 ,$190.73 ,"$1,619.00 ","$1,376.15 ",$388.64 ,"$1,489.48 ","$1,133.30 ",$715.06 ,$768.02 ,$985.97 ,$715.06 ,"$1,118.73 ","$1,133.30 ",$174.46 ,"$1,165.68 ",$172.76 ,$207.28 ,$207.28 ,$172.73 ,$207.28 ,$172.73 ,"$1,165.68 ","$1,003.78 ","$1,165.68 ","$1,165.68 ",$971.40 ST VINCENT HOSPITAL - ACUTE,31000021,81275,HC KRAS GENE,310,1 ,$940.00 ,$470.00 ,$157.98 ,$940.00 ,$607.24 ,$157.98 ,$676.38 ,$579.75 ,$193.25 ,$564.00 ,$799.00 ,$658.00 ,$157.98 ,$893.00 ,$676.80 ,$686.20 ,$328.53 ,$799.00 ,$193.25 ,$328.53 ,$752.00 ,$686.20 ,$157.98 ,$193.25 ,$213.39 ,$940.00 ,$799.00 ,$434.81 ,$864.80 ,$658.00 ,$693.15 ,$744.50 ,$572.46 ,$693.15 ,$649.54 ,$658.00 ,$195.18 ,$676.80 ,$167.46 ,$231.90 ,$231.90 ,$193.25 ,$231.90 ,$193.25 ,$676.80 ,$582.80 ,$676.80 ,$676.80 ,$564.00 ST VINCENT HOSPITAL - ACUTE,31000022,81291,HC MTHFR ISOLATION,310,1 ,$280.00 ,$140.00 ,$10.83 ,$280.00 ,$180.88 ,$10.83 ,$228.69 ,$196.02 ,$65.34 ,$168.00 ,$238.00 ,$196.00 ,$10.83 ,$266.00 ,$201.60 ,$204.40 ,$111.08 ,$238.00 ,$65.34 ,$111.08 ,$224.00 ,$204.40 ,$10.83 ,$65.34 ,$72.15 ,$280.00 ,$238.00 ,$147.02 ,$257.60 ,$196.00 ,$209.02 ,$224.50 ,$170.52 ,$209.02 ,$193.48 ,$196.00 ,$65.99 ,$201.60 ,$11.48 ,$78.41 ,$78.41 ,$65.34 ,$78.41 ,$65.34 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,31000023,81301,HC MSI MICROSAT INSTAB,310,1 ,$705.00 ,$352.50 ,$316.03 ,$784.26 ,$455.43 ,$316.03 ,$705.00 ,$705.00 ,$348.56 ,$423.00 ,$599.25 ,$493.50 ,$316.03 ,$669.75 ,$507.60 ,$514.65 ,$592.55 ,$599.25 ,$348.56 ,$592.55 ,$564.00 ,$514.65 ,$316.03 ,$348.56 ,$384.88 ,$705.00 ,$599.25 ,$784.26 ,$648.60 ,$493.50 ,$705.00 ,$705.00 ,$429.35 ,$705.00 ,$487.16 ,$493.50 ,$352.05 ,$507.60 ,$334.99 ,$418.27 ,$418.27 ,$348.56 ,$418.27 ,$348.56 ,$507.60 ,$437.10 ,$507.60 ,$507.60 ,$423.00 ST VINCENT HOSPITAL - ACUTE,31000024,81291,HC MTHFR GENE BC,310,1 ,$300.00 ,$150.00 ,$10.83 ,$300.00 ,$193.80 ,$10.83 ,$228.69 ,$196.02 ,$65.34 ,$180.00 ,$255.00 ,$210.00 ,$10.83 ,$285.00 ,$216.00 ,$219.00 ,$111.08 ,$255.00 ,$65.34 ,$111.08 ,$240.00 ,$219.00 ,$10.83 ,$65.34 ,$72.15 ,$300.00 ,$255.00 ,$147.02 ,$276.00 ,$210.00 ,$209.02 ,$224.50 ,$182.70 ,$209.02 ,$207.30 ,$210.00 ,$65.99 ,$216.00 ,$11.48 ,$78.41 ,$78.41 ,$65.34 ,$78.41 ,$65.34 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,31000025,81301,HC HNCP MICROSATL INSTABLTY,310,1 ,$522.00 ,$261.00 ,$261.00 ,$784.26 ,$337.21 ,$316.03 ,$522.00 ,$522.00 ,$348.56 ,$313.20 ,$443.70 ,$365.40 ,$316.03 ,$495.90 ,$375.84 ,$381.06 ,$522.00 ,$443.70 ,$348.56 ,$522.00 ,$417.60 ,$381.06 ,$316.03 ,$348.56 ,$384.88 ,$522.00 ,$443.70 ,$784.26 ,$480.24 ,$365.40 ,$522.00 ,$522.00 ,$317.90 ,$522.00 ,$360.70 ,$365.40 ,$352.05 ,$375.84 ,$334.99 ,$418.27 ,$418.27 ,$348.56 ,$418.27 ,$348.56 ,$375.84 ,$323.64 ,$375.84 ,$375.84 ,$313.20 ST VINCENT HOSPITAL - ACUTE,31000026,81315,HC PML/RARAL COM BRKPNTS,310,1 ,$870.00 ,$435.00 ,$207.31 ,$870.00 ,$562.02 ,$214.21 ,$806.23 ,$691.05 ,$207.31 ,$522.00 ,$739.50 ,$609.00 ,$214.21 ,$826.50 ,$626.40 ,$635.10 ,$352.43 ,$739.50 ,$207.31 ,$352.43 ,$696.00 ,$635.10 ,$214.21 ,$207.31 ,$228.91 ,$870.00 ,$739.50 ,$466.45 ,$800.40 ,$609.00 ,$870.00 ,$870.00 ,$529.83 ,$870.00 ,$601.17 ,$609.00 ,$209.38 ,$626.40 ,$227.06 ,$248.77 ,$248.77 ,$207.31 ,$248.77 ,$207.31 ,$626.40 ,$539.40 ,$626.40 ,$626.40 ,$522.00 ST VINCENT HOSPITAL - ACUTE,31000027,81331,HC SNRPN/UBE3A GENE,310,1 ,$330.00 ,$165.00 ,$51.07 ,$330.00 ,$213.18 ,$52.77 ,$178.75 ,$153.21 ,$51.07 ,$198.00 ,$280.50 ,$231.00 ,$52.77 ,$313.50 ,$237.60 ,$240.90 ,$86.82 ,$280.50 ,$51.07 ,$86.82 ,$264.00 ,$240.90 ,$52.77 ,$51.07 ,$56.39 ,$330.00 ,$280.50 ,$114.91 ,$303.60 ,$231.00 ,$179.26 ,$192.53 ,$200.97 ,$179.26 ,$228.03 ,$231.00 ,$51.58 ,$237.60 ,$55.94 ,$61.28 ,$61.28 ,$51.07 ,$61.28 ,$51.07 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,31000028,81332,HC SERPINA1 GENE,310,1 ,$948.00 ,$474.00 ,$10.83 ,$948.00 ,$612.41 ,$10.83 ,$169.75 ,$145.50 ,$43.65 ,$568.80 ,$805.80 ,$663.60 ,$10.83 ,$900.60 ,$682.56 ,$692.04 ,$74.21 ,$805.80 ,$43.65 ,$74.21 ,$758.40 ,$692.04 ,$10.83 ,$43.65 ,$48.20 ,$948.00 ,$805.80 ,$98.21 ,$872.16 ,$663.60 ,$209.02 ,$224.50 ,$577.33 ,$209.02 ,$655.07 ,$663.60 ,$44.09 ,$682.56 ,$11.48 ,$52.38 ,$52.38 ,$43.65 ,$52.38 ,$43.65 ,$682.56 ,$587.76 ,$682.56 ,$682.56 ,$568.80 ST VINCENT HOSPITAL - ACUTE,31000029,81383,HC HLA II TYPING ALLELE HR,310,1 ,$636.00 ,$318.00 ,$109.13 ,$636.00 ,$410.86 ,$112.76 ,$424.41 ,$363.78 ,$109.13 ,$381.60 ,$540.60 ,$445.20 ,$112.76 ,$604.20 ,$457.92 ,$464.28 ,$185.52 ,$540.60 ,$109.13 ,$185.52 ,$508.80 ,$464.28 ,$112.76 ,$109.13 ,$120.50 ,$636.00 ,$540.60 ,$245.54 ,$585.12 ,$445.20 ,$522.57 ,$561.28 ,$387.32 ,$522.57 ,$439.48 ,$445.20 ,$110.22 ,$457.92 ,$119.53 ,$130.96 ,$130.96 ,$109.13 ,$130.96 ,$109.13 ,$457.92 ,$394.32 ,$457.92 ,$457.92 ,$381.60 ST VINCENT HOSPITAL - ACUTE,31000030,81400,HC DPD MOPATH PROCEDURE L1,310,1 ,$375.00 ,$187.50 ,$51.17 ,$375.00 ,$242.25 ,$51.17 ,$223.86 ,$191.88 ,$63.96 ,$225.00 ,$318.75 ,$262.50 ,$51.17 ,$356.25 ,$270.00 ,$273.75 ,$108.73 ,$318.75 ,$63.96 ,$108.73 ,$300.00 ,$273.75 ,$51.17 ,$63.96 ,$70.62 ,$375.00 ,$318.75 ,$143.91 ,$345.00 ,$262.50 ,$224.50 ,$241.13 ,$228.38 ,$224.50 ,$259.13 ,$262.50 ,$64.60 ,$270.00 ,$54.24 ,$76.75 ,$76.75 ,$63.96 ,$76.75 ,$63.96 ,$270.00 ,$232.50 ,$270.00 ,$270.00 ,$225.00 ST VINCENT HOSPITAL - ACUTE,31000031,81401,HC HUNT MOPATH PROCEDURE L2,310,1 ,$400.00 ,$200.00 ,$109.60 ,$400.00 ,$258.40 ,$109.60 ,$400.00 ,$400.00 , N/A ,$240.00 ,$340.00 ,$280.00 ,$109.60 ,$380.00 ,$288.00 ,$292.00 ,$232.90 ,$340.00 , N/A ,$232.90 ,$320.00 ,$292.00 ,$109.60 , N/A ,$151.28 ,$400.00 ,$340.00 ,$240.00 ,$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 , N/A ,$288.00 ,$116.18 ,$164.40 ,$164.40 , N/A ,$164.40 , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,31000032,81402,HC TCR MOPATH PROCED L3,310,1 ,$525.00 ,$262.50 ,$120.26 ,$525.00 ,$339.15 ,$120.26 ,$525.00 ,$450.99 , N/A ,$315.00 ,$446.25 ,$367.50 ,$120.26 ,$498.75 ,$378.00 ,$383.25 ,$255.56 ,$446.25 , N/A ,$255.56 ,$420.00 ,$383.25 ,$120.26 , N/A ,$165.99 ,$525.00 ,$446.25 ,$315.00 ,$483.00 ,$367.50 ,$525.00 ,$525.00 ,$319.73 ,$525.00 ,$362.78 ,$367.50 , N/A ,$378.00 ,$127.48 ,$180.40 ,$180.40 , N/A ,$180.40 , N/A ,$378.00 ,$325.50 ,$378.00 ,$378.00 ,$315.00 ST VINCENT HOSPITAL - ACUTE,31000033,81270,HC JAK2 GENE,310,1 ,$500.00 ,$250.00 ,$91.66 ,$500.00 ,$323.00 ,$94.71 ,$356.48 ,$305.55 ,$91.66 ,$300.00 ,$425.00 ,$350.00 ,$94.71 ,$475.00 ,$360.00 ,$365.00 ,$155.82 ,$425.00 ,$91.66 ,$155.82 ,$400.00 ,$365.00 ,$94.71 ,$91.66 ,$101.21 ,$500.00 ,$425.00 ,$206.24 ,$460.00 ,$350.00 ,$438.96 ,$471.48 ,$304.50 ,$438.96 ,$345.50 ,$350.00 ,$92.58 ,$360.00 ,$100.39 ,$109.99 ,$109.99 ,$91.66 ,$109.99 ,$91.66 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,31000050,81241,HC FACTOR V GENE ANALYSIS (HR2),310,1 ,$371.00 ,$185.50 ,$66.70 ,$371.00 ,$239.67 ,$66.70 ,$256.80 ,$220.11 ,$73.37 ,$222.60 ,$315.35 ,$259.70 ,$66.70 ,$352.45 ,$267.12 ,$270.83 ,$124.73 ,$315.35 ,$73.37 ,$124.73 ,$296.80 ,$270.83 ,$66.70 ,$73.37 ,$81.02 ,$371.00 ,$315.35 ,$165.08 ,$341.32 ,$259.70 ,$292.63 ,$314.30 ,$225.94 ,$292.63 ,$256.36 ,$259.70 ,$74.10 ,$267.12 ,$70.70 ,$88.04 ,$88.04 ,$73.37 ,$88.04 ,$73.37 ,$267.12 ,$230.02 ,$267.12 ,$267.12 ,$222.60 ST VINCENT HOSPITAL - ACUTE,31000051,81220,HC CFTR GENE ANALYSIS,310,1 ,$730.00 ,$365.00 ,$210.00 ,"$1,252.35 ",$471.58 ,$210.00 ,$730.00 ,$730.00 ,$556.60 ,$438.00 ,$620.50 ,$511.00 ,$210.00 ,$693.50 ,$525.60 ,$532.90 ,$730.00 ,$620.50 ,$556.60 ,$730.00 ,$584.00 ,$532.90 ,$210.00 ,$556.60 ,$614.60 ,$730.00 ,$620.50 ,"$1,252.35 ",$671.60 ,$511.00 ,$730.00 ,$730.00 ,$444.57 ,$730.00 ,$504.43 ,$511.00 ,$562.17 ,$525.60 ,$222.60 ,$667.92 ,$667.92 ,$556.60 ,$667.92 ,$556.60 ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,31000052,81332,HC SERPINA1 GENE ANALYSIS (AAT),310,1 ,$670.00 ,$335.00 ,$10.83 ,$670.00 ,$432.82 ,$10.83 ,$169.75 ,$145.50 ,$43.65 ,$402.00 ,$569.50 ,$469.00 ,$10.83 ,$636.50 ,$482.40 ,$489.10 ,$74.21 ,$569.50 ,$43.65 ,$74.21 ,$536.00 ,$489.10 ,$10.83 ,$43.65 ,$48.20 ,$670.00 ,$569.50 ,$98.21 ,$616.40 ,$469.00 ,$209.02 ,$224.50 ,$408.03 ,$209.02 ,$462.97 ,$469.00 ,$44.09 ,$482.40 ,$11.48 ,$52.38 ,$52.38 ,$43.65 ,$52.38 ,$43.65 ,$482.40 ,$415.40 ,$482.40 ,$482.40 ,$402.00 ST VINCENT HOSPITAL - ACUTE,31000053,81342,HC TRG GENE ARRANGEMENT ANALYSIS,310,1 ,"$1,172.00 ",$586.00 ,$201.50 ,"$1,172.00 ",$757.11 ,$208.21 ,$783.58 ,$671.64 ,$201.50 ,$703.20 ,$996.20 ,$820.40 ,$208.21 ,"$1,113.40 ",$843.84 ,$855.56 ,$342.55 ,$996.20 ,$201.50 ,$342.55 ,$937.60 ,$855.56 ,$208.21 ,$201.50 ,$222.50 ,"$1,172.00 ",$996.20 ,$453.38 ,"$1,078.24 ",$820.40 ,$964.90 ,"$1,036.37 ",$713.75 ,$964.90 ,$809.85 ,$820.40 ,$203.52 ,$843.84 ,$220.70 ,$241.80 ,$241.80 ,$201.50 ,$241.80 ,$201.50 ,$843.84 ,$726.64 ,$843.84 ,$843.84 ,$703.20 ST VINCENT HOSPITAL - ACUTE,31000054,81261,HC AMPLIFIED METH IG GRA,310,1 ,$440.00 ,$220.00 ,$197.99 ,$445.48 ,$284.24 ,$204.58 ,$440.00 ,$440.00 ,$197.99 ,$264.00 ,$374.00 ,$308.00 ,$204.58 ,$418.00 ,$316.80 ,$321.20 ,$336.58 ,$374.00 ,$197.99 ,$336.58 ,$352.00 ,$321.20 ,$204.58 ,$197.99 ,$218.62 ,$440.00 ,$374.00 ,$445.48 ,$404.80 ,$308.00 ,$440.00 ,$440.00 ,$267.96 ,$440.00 ,$304.04 ,$308.00 ,$199.97 ,$316.80 ,$216.85 ,$237.59 ,$237.59 ,$197.99 ,$237.59 ,$197.99 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,31000055,81264,HC EVAL CLONAL POP IG GRA,310,1 ,$440.00 ,$220.00 ,$162.98 ,$440.00 ,$284.24 ,$162.98 ,$440.00 ,$440.00 ,$172.73 ,$264.00 ,$374.00 ,$308.00 ,$162.98 ,$418.00 ,$316.80 ,$321.20 ,$293.64 ,$374.00 ,$172.73 ,$293.64 ,$352.00 ,$321.20 ,$162.98 ,$172.73 ,$190.73 ,$440.00 ,$374.00 ,$388.64 ,$404.80 ,$308.00 ,$440.00 ,$440.00 ,$267.96 ,$440.00 ,$304.04 ,$308.00 ,$174.46 ,$316.80 ,$172.76 ,$207.28 ,$207.28 ,$172.73 ,$207.28 ,$172.73 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,31000060,81241,HC F5 GENE ANAL LEIDEN VAR,310,1 ,$333.00 ,$166.50 ,$66.70 ,$333.00 ,$215.12 ,$66.70 ,$256.80 ,$220.11 ,$73.37 ,$199.80 ,$283.05 ,$233.10 ,$66.70 ,$316.35 ,$239.76 ,$243.09 ,$124.73 ,$283.05 ,$73.37 ,$124.73 ,$266.40 ,$243.09 ,$66.70 ,$73.37 ,$81.02 ,$333.00 ,$283.05 ,$165.08 ,$306.36 ,$233.10 ,$292.63 ,$314.30 ,$202.80 ,$292.63 ,$230.10 ,$233.10 ,$74.10 ,$239.76 ,$70.70 ,$88.04 ,$88.04 ,$73.37 ,$88.04 ,$73.37 ,$239.76 ,$206.46 ,$239.76 ,$239.76 ,$199.80 ST VINCENT HOSPITAL - ACUTE,31000061,81256,HC HFE GENE ANALYSIS,310,1 ,$82.00 ,$41.00 ,$41.00 ,$147.06 ,$52.97 ,$67.54 ,$82.00 ,$82.00 ,$65.36 ,$49.20 ,$69.70 ,$57.40 ,$67.54 ,$77.90 ,$59.04 ,$59.86 ,$82.00 ,$69.70 ,$65.36 ,$82.00 ,$65.60 ,$59.86 ,$67.54 ,$65.36 ,$72.17 ,$82.00 ,$69.70 ,$147.06 ,$75.44 ,$57.40 ,$82.00 ,$82.00 ,$49.94 ,$82.00 ,$56.66 ,$57.40 ,$66.01 ,$59.04 ,$71.59 ,$78.43 ,$78.43 ,$65.36 ,$78.43 ,$65.36 ,$59.04 ,$50.84 ,$59.04 ,$59.04 ,$49.20 ST VINCENT HOSPITAL - ACUTE,31000062,81270,HC JAK2 GENE ANALYSIS,310,1 ,"$1,080.00 ",$540.00 ,$91.66 ,"$1,080.00 ",$697.68 ,$94.71 ,$356.48 ,$305.55 ,$91.66 ,$648.00 ,$918.00 ,$756.00 ,$94.71 ,"$1,026.00 ",$777.60 ,$788.40 ,$155.82 ,$918.00 ,$91.66 ,$155.82 ,$864.00 ,$788.40 ,$94.71 ,$91.66 ,$101.21 ,"$1,080.00 ",$918.00 ,$206.24 ,$993.60 ,$756.00 ,$438.96 ,$471.48 ,$657.72 ,$438.96 ,$746.28 ,$756.00 ,$92.58 ,$777.60 ,$100.39 ,$109.99 ,$109.99 ,$91.66 ,$109.99 ,$91.66 ,$777.60 ,$669.60 ,$777.60 ,$777.60 ,$648.00 ST VINCENT HOSPITAL - ACUTE,31000073,81207,HC BCR/ABL1 GENE MINOR BP QUEST,310,1 ,$300.00 ,$150.00 ,$144.84 ,$325.89 ,$193.80 ,$149.66 ,$300.00 ,$300.00 ,$144.84 ,$180.00 ,$255.00 ,$210.00 ,$149.66 ,$285.00 ,$216.00 ,$219.00 ,$246.23 ,$255.00 ,$144.84 ,$246.23 ,$240.00 ,$219.00 ,$149.66 ,$144.84 ,$159.93 ,$300.00 ,$255.00 ,$325.89 ,$276.00 ,$210.00 ,$300.00 ,$300.00 ,$182.70 ,$300.00 ,$207.30 ,$210.00 ,$146.29 ,$216.00 ,$158.64 ,$173.81 ,$173.81 ,$144.84 ,$173.81 ,$144.84 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,31000101,83540,HC IRON LIVER TISSUE,310,1 ,$100.00 ,$50.00 ,$6.47 ,$100.00 ,$64.60 ,$6.69 ,$25.17 ,$21.57 ,$6.47 ,$60.00 ,$85.00 ,$70.00 ,$6.69 ,$95.00 ,$72.00 ,$73.00 ,$11.00 ,$85.00 ,$6.47 ,$11.00 ,$80.00 ,$73.00 ,$6.69 ,$6.47 ,$7.14 ,$100.00 ,$85.00 ,$14.56 ,$92.00 ,$70.00 ,$30.99 ,$33.29 ,$60.90 ,$30.99 ,$69.10 ,$70.00 ,$6.53 ,$72.00 ,$7.09 ,$7.76 ,$7.76 ,$6.47 ,$7.76 ,$6.47 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31000102,80500,HC CLINAL PATH CONSULT LTD,310,1 ,$137.00 ,$68.50 ,$5.22 ,$137.00 ,$88.50 ,$5.22 ,$68.07 ,$58.34 ,$48.19 ,$82.20 ,$116.45 ,$95.90 ,$5.22 ,$130.15 ,$98.64 ,$100.01 ,$36.26 ,$116.45 ,$48.19 ,$36.26 ,$109.60 ,$100.01 ,$5.22 ,$48.19 ,$57.54 ,$137.00 ,$116.45 ,$108.43 ,$126.04 ,$95.90 ,$137.00 ,$137.00 ,$83.43 ,$137.00 ,$94.67 ,$95.90 ,$48.67 ,$98.64 ,$5.53 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$98.64 ,$84.94 ,$98.64 ,$98.64 ,$82.20 ST VINCENT HOSPITAL - ACUTE,31000105,81313,HC PROSTATE CANCER ANTIGEN 3,310,1 ,"$1,200.00 ",$600.00 ,$31.17 ,"$1,200.00 ",$775.20 ,$31.17 ,$892.68 ,$765.15 ,$255.05 ,$720.00 ,"$1,020.00 ",$840.00 ,$31.17 ,"$1,140.00 ",$864.00 ,$876.00 ,$433.59 ,"$1,020.00 ",$255.05 ,$433.59 ,$960.00 ,$876.00 ,$31.17 ,$255.05 ,$281.63 ,"$1,200.00 ","$1,020.00 ",$573.86 ,"$1,104.00 ",$840.00 ,$913.51 ,$981.18 ,$730.80 ,$913.51 ,$829.20 ,$840.00 ,$257.60 ,$864.00 ,$33.04 ,$306.06 ,$306.06 ,$255.05 ,$306.06 ,$255.05 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,31000106,81401,HC MOPATH PROC L2,310,1 ,$410.00 ,$205.00 ,$109.60 ,$410.00 ,$264.86 ,$109.60 ,$410.00 ,$410.00 , N/A ,$246.00 ,$348.50 ,$287.00 ,$109.60 ,$389.50 ,$295.20 ,$299.30 ,$232.90 ,$348.50 , N/A ,$232.90 ,$328.00 ,$299.30 ,$109.60 , N/A ,$151.28 ,$410.00 ,$348.50 ,$246.00 ,$377.20 ,$287.00 ,$410.00 ,$410.00 ,$249.69 ,$410.00 ,$283.31 ,$287.00 , N/A ,$295.20 ,$116.18 ,$164.40 ,$164.40 , N/A ,$164.40 , N/A ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,31000109,81170,HC ABL1 GENE ANALYSIS KINASE DOMAIN,310,1 ,$420.00 ,$210.00 ,$195.07 ,$675.00 ,$271.32 ,$195.07 ,$420.00 ,$420.00 ,$300.00 ,$252.00 ,$357.00 ,$294.00 ,$195.07 ,$399.00 ,$302.40 ,$306.60 ,$420.00 ,$357.00 ,$300.00 ,$420.00 ,$336.00 ,$306.60 ,$195.07 ,$300.00 ,$331.26 ,$420.00 ,$357.00 ,$675.00 ,$386.40 ,$294.00 ,$420.00 ,$420.00 ,$255.78 ,$420.00 ,$290.22 ,$294.00 ,$303.00 ,$302.40 ,$206.77 ,$360.00 ,$360.00 ,$300.00 ,$360.00 ,$300.00 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,31000110,81218,HC CEBPA GENE ANALYSIS FULL SEQUENCE,310,1 ,$420.00 ,$210.00 ,$195.07 ,$544.28 ,$271.32 ,$195.07 ,$420.00 ,$420.00 ,$241.90 ,$252.00 ,$357.00 ,$294.00 ,$195.07 ,$399.00 ,$302.40 ,$306.60 ,$411.23 ,$357.00 ,$241.90 ,$411.23 ,$336.00 ,$306.60 ,$195.07 ,$241.90 ,$267.11 ,$420.00 ,$357.00 ,$544.28 ,$386.40 ,$294.00 ,$420.00 ,$420.00 ,$255.78 ,$420.00 ,$290.22 ,$294.00 ,$244.32 ,$302.40 ,$206.77 ,$290.28 ,$290.28 ,$241.90 ,$290.28 ,$241.90 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,31000111,81219,HC CALR GENE ANALYSIS EXON 9,310,1 ,$420.00 ,$210.00 ,$98.08 ,$420.00 ,$271.32 ,$98.08 ,$420.00 ,$405.42 ,$121.63 ,$252.00 ,$357.00 ,$294.00 ,$98.08 ,$399.00 ,$302.40 ,$306.60 ,$206.77 ,$357.00 ,$121.63 ,$206.77 ,$336.00 ,$306.60 ,$98.08 ,$121.63 ,$134.30 ,$420.00 ,$357.00 ,$273.67 ,$386.40 ,$294.00 ,$420.00 ,$420.00 ,$255.78 ,$420.00 ,$290.22 ,$294.00 ,$122.85 ,$302.40 ,$103.96 ,$145.96 ,$145.96 ,$121.63 ,$145.96 ,$121.63 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,31000112,81226,HC CYP2D6 GENE ANALYSIS COMMON VARIANTS,310,1 ,$540.00 ,$270.00 ,$119.53 ,"$1,014.55 ",$348.84 ,$119.53 ,$540.00 ,$540.00 ,$450.91 ,$324.00 ,$459.00 ,$378.00 ,$119.53 ,$513.00 ,$388.80 ,$394.20 ,$540.00 ,$459.00 ,$450.91 ,$540.00 ,$432.00 ,$394.20 ,$119.53 ,$450.91 ,$497.89 ,$540.00 ,$459.00 ,"$1,014.55 ",$496.80 ,$378.00 ,$540.00 ,$540.00 ,$328.86 ,$540.00 ,$373.14 ,$378.00 ,$455.42 ,$388.80 ,$126.70 ,$540.00 ,$540.00 ,$450.91 ,$540.00 ,$450.91 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,31000113,81245,HC FLT3 GENE ANALYSIS INT TANDEM DUP VARIANTS,310,1 ,$250.00 ,$125.00 ,$125.00 ,$372.40 ,$161.50 ,$132.74 ,$250.00 ,$250.00 ,$165.51 ,$150.00 ,$212.50 ,$175.00 ,$132.74 ,$237.50 ,$180.00 ,$182.50 ,$250.00 ,$212.50 ,$165.51 ,$250.00 ,$200.00 ,$182.50 ,$132.74 ,$165.51 ,$182.76 ,$250.00 ,$212.50 ,$372.40 ,$230.00 ,$175.00 ,$250.00 ,$250.00 ,$152.25 ,$250.00 ,$172.75 ,$175.00 ,$167.17 ,$180.00 ,$140.70 ,$198.61 ,$198.61 ,$165.51 ,$198.61 ,$165.51 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,31000114,81246,HC FL53 GENE ANALYSIS TYROSINE KINASE VARIANTS,310,1 ,$210.00 ,$105.00 ,$83.00 ,$210.00 ,$135.66 ,$85.76 ,$210.00 ,$210.00 ,$83.00 ,$126.00 ,$178.50 ,$147.00 ,$85.76 ,$199.50 ,$151.20 ,$153.30 ,$141.10 ,$178.50 ,$83.00 ,$141.10 ,$168.00 ,$153.30 ,$85.76 ,$83.00 ,$91.65 ,$210.00 ,$178.50 ,$186.75 ,$193.20 ,$147.00 ,$210.00 ,$210.00 ,$127.89 ,$210.00 ,$145.11 ,$147.00 ,$83.83 ,$151.20 ,$90.91 ,$99.60 ,$99.60 ,$83.00 ,$99.60 ,$83.00 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,31000115,81257,HC HBA1/HBA2 GENE ANALYSIS COM DELETE OR VARIANTS,310,1 ,$560.00 ,$280.00 ,$105.67 ,$560.00 ,$361.76 ,$105.67 ,$357.91 ,$306.78 , N/A ,$336.00 ,$476.00 ,$392.00 ,$105.67 ,$532.00 ,$403.20 ,$408.80 ,$173.84 ,$476.00 , N/A ,$173.84 ,$448.00 ,$408.80 ,$105.67 , N/A ,$112.92 ,$560.00 ,$476.00 ,$336.00 ,$515.20 ,$392.00 ,$358.93 ,$385.52 ,$341.04 ,$358.93 ,$386.96 ,$392.00 , N/A ,$403.20 ,$112.01 ,$122.71 ,$122.71 , N/A ,$122.71 , N/A ,$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,31000116,81261,HC IGH GENE ANALYSIS REARRANGEMENT AMP,310,1 ,$531.00 ,$265.50 ,$197.99 ,$531.00 ,$343.03 ,$204.58 ,$531.00 ,$531.00 ,$197.99 ,$318.60 ,$451.35 ,$371.70 ,$204.58 ,$504.45 ,$382.32 ,$387.63 ,$336.58 ,$451.35 ,$197.99 ,$336.58 ,$424.80 ,$387.63 ,$204.58 ,$197.99 ,$218.62 ,$531.00 ,$451.35 ,$445.48 ,$488.52 ,$371.70 ,$531.00 ,$531.00 ,$323.38 ,$531.00 ,$366.92 ,$371.70 ,$199.97 ,$382.32 ,$216.85 ,$237.59 ,$237.59 ,$197.99 ,$237.59 ,$197.99 ,$382.32 ,$329.22 ,$382.32 ,$382.32 ,$318.60 ST VINCENT HOSPITAL - ACUTE,31000117,81263,HC IGH VAR REG SOMATIC MUTATION ANALYSIS,310,1 ,$690.00 ,$345.00 ,$294.52 ,$690.00 ,$445.74 ,$304.33 ,$690.00 ,$690.00 ,$294.52 ,$414.00 ,$586.50 ,$483.00 ,$304.33 ,$655.50 ,$496.80 ,$503.70 ,$500.68 ,$586.50 ,$294.52 ,$500.68 ,$552.00 ,$503.70 ,$304.33 ,$294.52 ,$325.21 ,$690.00 ,$586.50 ,$662.67 ,$634.80 ,$483.00 ,$690.00 ,$690.00 ,$420.21 ,$690.00 ,$476.79 ,$483.00 ,$297.47 ,$496.80 ,$322.59 ,$353.42 ,$353.42 ,$294.52 ,$353.42 ,$294.52 ,$496.80 ,$427.80 ,$496.80 ,$496.80 ,$414.00 ST VINCENT HOSPITAL - ACUTE,31000118,81272,HC V KIT GENE ANALYSIS TARGETED SEQ,310,1 ,$500.00 ,$250.00 ,$195.07 ,$741.40 ,$323.00 ,$195.07 ,$500.00 ,$500.00 ,$329.51 ,$300.00 ,$425.00 ,$350.00 ,$195.07 ,$475.00 ,$360.00 ,$365.00 ,$500.00 ,$425.00 ,$329.51 ,$500.00 ,$400.00 ,$365.00 ,$195.07 ,$329.51 ,$363.84 ,$500.00 ,$425.00 ,$741.40 ,$460.00 ,$350.00 ,$500.00 ,$500.00 ,$304.50 ,$500.00 ,$345.50 ,$350.00 ,$332.81 ,$360.00 ,$206.77 ,$395.41 ,$395.41 ,$329.51 ,$395.41 ,$329.51 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,31000119,81315,HC PML/RARALPHA ANALYSIS COMMON BRKPNTS QL/QN,310,1 ,$510.00 ,$255.00 ,$207.31 ,$510.00 ,$329.46 ,$214.21 ,$510.00 ,$510.00 ,$207.31 ,$306.00 ,$433.50 ,$357.00 ,$214.21 ,$484.50 ,$367.20 ,$372.30 ,$352.43 ,$433.50 ,$207.31 ,$352.43 ,$408.00 ,$372.30 ,$214.21 ,$207.31 ,$228.91 ,$510.00 ,$433.50 ,$466.45 ,$469.20 ,$357.00 ,$510.00 ,$510.00 ,$310.59 ,$510.00 ,$352.41 ,$357.00 ,$209.38 ,$367.20 ,$227.06 ,$248.77 ,$248.77 ,$207.31 ,$248.77 ,$207.31 ,$367.20 ,$316.20 ,$367.20 ,$367.20 ,$306.00 ST VINCENT HOSPITAL - ACUTE,31000120,81350,HC UGT1A1 GENE ANALYSIS COM VARIANTS,310,1 ,$625.00 ,$312.50 ,$234.00 ,$625.00 ,$403.75 ,$234.00 ,$625.00 ,$625.00 ,$234.00 ,$375.00 ,$531.25 ,$437.50 ,$234.00 ,$593.75 ,$450.00 ,$456.25 ,$397.80 ,$531.25 ,$234.00 ,$397.80 ,$500.00 ,$456.25 ,$234.00 ,$234.00 ,$258.38 ,$625.00 ,$531.25 ,$526.50 ,$575.00 ,$437.50 ,$625.00 ,$625.00 ,$380.63 ,$625.00 ,$431.88 ,$437.50 ,$236.34 ,$450.00 ,$248.04 ,$280.80 ,$280.80 ,$234.00 ,$280.80 ,$234.00 ,$450.00 ,$387.50 ,$450.00 ,$450.00 ,$375.00 ST VINCENT HOSPITAL - ACUTE,31000121,81401,HC MOPATH PROC (ABL),310,1 ,$500.00 ,$250.00 ,$109.60 ,$500.00 ,$323.00 ,$109.60 ,$479.50 ,$411.00 , N/A ,$300.00 ,$425.00 ,$350.00 ,$109.60 ,$475.00 ,$360.00 ,$365.00 ,$232.90 ,$425.00 , N/A ,$232.90 ,$400.00 ,$365.00 ,$109.60 , N/A ,$151.28 ,$500.00 ,$425.00 ,$300.00 ,$460.00 ,$350.00 ,$480.87 ,$500.00 ,$304.50 ,$480.87 ,$345.50 ,$350.00 , N/A ,$360.00 ,$116.18 ,$164.40 ,$164.40 , N/A ,$164.40 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,31000123,81401,HC MOPATH PROC (CBFB),310,1 ,$500.00 ,$250.00 ,$109.60 ,$500.00 ,$323.00 ,$109.60 ,$479.50 ,$411.00 , N/A ,$300.00 ,$425.00 ,$350.00 ,$109.60 ,$475.00 ,$360.00 ,$365.00 ,$232.90 ,$425.00 , N/A ,$232.90 ,$400.00 ,$365.00 ,$109.60 , N/A ,$151.28 ,$500.00 ,$425.00 ,$300.00 ,$460.00 ,$350.00 ,$480.87 ,$500.00 ,$304.50 ,$480.87 ,$345.50 ,$350.00 , N/A ,$360.00 ,$116.18 ,$164.40 ,$164.40 , N/A ,$164.40 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,31000124,81402,HC MOPATH PROC (BCL2) L3,310,1 ,$500.00 ,$250.00 ,$120.26 ,$500.00 ,$323.00 ,$120.26 ,$500.00 ,$450.99 , N/A ,$300.00 ,$425.00 ,$350.00 ,$120.26 ,$475.00 ,$360.00 ,$365.00 ,$255.56 ,$425.00 , N/A ,$255.56 ,$400.00 ,$365.00 ,$120.26 , N/A ,$165.99 ,$500.00 ,$425.00 ,$300.00 ,$460.00 ,$350.00 ,$500.00 ,$500.00 ,$304.50 ,$500.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$127.48 ,$180.40 ,$180.40 , N/A ,$180.40 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,31000202,81229,HC CYTOGENOMIC MICROARRAY ASSAY,310,1 ,"$1,900.00 ",$950.00 ,$608.00 ,"$2,610.00 ","$1,227.40 ",$608.00 ,"$1,900.00 ","$1,900.00 ","$1,160.00 ","$1,140.00 ","$1,615.00 ","$1,330.00 ",$608.00 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,900.00 ","$1,615.00 ","$1,160.00 ","$1,900.00 ","$1,520.00 ","$1,387.00 ",$608.00 ,"$1,160.00 ","$1,280.87 ","$1,900.00 ","$1,615.00 ","$2,610.00 ","$1,748.00 ","$1,330.00 ","$1,900.00 ","$1,900.00 ","$1,157.10 ","$1,900.00 ","$1,312.90 ","$1,330.00 ","$1,171.60 ","$1,368.00 ",$644.48 ,"$1,392.00 ","$1,392.00 ","$1,160.00 ","$1,392.00 ","$1,160.00 ","$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,31000210,81235,HC EGFR GENE COM VARIANTS 29 PANEL,310,1 ,"$1,200.00 ",$600.00 ,$264.01 ,"$1,200.00 ",$775.20 ,$264.01 ,"$1,136.03 ",$973.74 ,$324.58 ,$720.00 ,"$1,020.00 ",$840.00 ,$264.01 ,"$1,140.00 ",$864.00 ,$876.00 ,$551.79 ,"$1,020.00 ",$324.58 ,$551.79 ,$960.00 ,$876.00 ,$264.01 ,$324.58 ,$358.40 ,"$1,200.00 ","$1,020.00 ",$730.31 ,"$1,104.00 ",$840.00 ,"$1,158.34 ","$1,200.00 ",$730.80 ,"$1,158.34 ",$829.20 ,$840.00 ,$327.83 ,$864.00 ,$279.85 ,$389.50 ,$389.50 ,$324.58 ,$389.50 ,$324.58 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,31000211,81210,HC BRAF GENE ANALYS V600E VAR,310,1 ,$480.00 ,$240.00 ,$143.40 ,$480.00 ,$310.08 ,$143.40 ,$480.00 ,$480.00 ,$175.40 ,$288.00 ,$408.00 ,$336.00 ,$143.40 ,$456.00 ,$345.60 ,$350.40 ,$298.18 ,$408.00 ,$175.40 ,$298.18 ,$384.00 ,$350.40 ,$143.40 ,$175.40 ,$193.68 ,$480.00 ,$408.00 ,$394.65 ,$441.60 ,$336.00 ,$480.00 ,$480.00 ,$292.32 ,$480.00 ,$331.68 ,$336.00 ,$177.15 ,$345.60 ,$152.00 ,$210.48 ,$210.48 ,$175.40 ,$210.48 ,$175.40 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,31000212,81445,HC GENE SEQ SOLID ORGAN NEOPLASM 5-50 GENES,310,1 ,"$2,000.00 ","$1,000.00 ",$478.33 ,"$2,000.00 ","$1,292.00 ",$478.33 ,"$2,000.00 ","$1,793.73 ",$597.91 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$478.33 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,016.45 ","$1,700.00 ",$597.91 ,"$1,016.45 ","$1,600.00 ","$1,460.00 ",$478.33 ,$597.91 ,$660.21 ,"$2,000.00 ","$1,700.00 ","$1,345.30 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ",$603.89 ,"$1,440.00 ",$507.03 ,$717.49 ,$717.49 ,$597.91 ,$717.49 ,$597.91 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,31000231,81229,HC CHROMOSOMAL MICROARRAY,310,1 ,"$2,400.00 ","$1,200.00 ",$608.00 ,"$2,610.00 ","$1,550.40 ",$608.00 ,"$2,400.00 ","$2,400.00 ","$1,160.00 ","$1,440.00 ","$2,040.00 ","$1,680.00 ",$608.00 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$1,972.00 ","$2,040.00 ","$1,160.00 ","$1,972.00 ","$1,920.00 ","$1,752.00 ",$608.00 ,"$1,160.00 ","$1,280.87 ","$2,400.00 ","$2,040.00 ","$2,610.00 ","$2,208.00 ","$1,680.00 ","$2,400.00 ","$2,400.00 ","$1,461.60 ","$2,400.00 ","$1,658.40 ","$1,680.00 ","$1,171.60 ","$1,728.00 ",$644.48 ,"$1,392.00 ","$1,392.00 ","$1,160.00 ","$1,392.00 ","$1,160.00 ","$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,31000235,81219,HC MUTATION ANALYSIS CALRETICULIN,310,1 ,$525.00 ,$262.50 ,$98.08 ,$525.00 ,$339.15 ,$98.08 ,$472.99 ,$405.42 ,$121.63 ,$315.00 ,$446.25 ,$367.50 ,$98.08 ,$498.75 ,$378.00 ,$383.25 ,$206.77 ,$446.25 ,$121.63 ,$206.77 ,$420.00 ,$383.25 ,$98.08 ,$121.63 ,$134.30 ,$525.00 ,$446.25 ,$273.67 ,$483.00 ,$367.50 ,$430.33 ,$462.20 ,$319.73 ,$430.33 ,$362.78 ,$367.50 ,$122.85 ,$378.00 ,$103.96 ,$145.96 ,$145.96 ,$121.63 ,$145.96 ,$121.63 ,$378.00 ,$325.50 ,$378.00 ,$378.00 ,$315.00 ST VINCENT HOSPITAL - ACUTE,31000236,81403,HC MOLECULAR PATH MUTATION ANALYSIS EXON 12,310,1 ,$400.00 ,$200.00 ,$148.16 ,$400.00 ,$258.40 ,$148.16 ,$400.00 ,$400.00 , N/A ,$240.00 ,$340.00 ,$280.00 ,$148.16 ,$380.00 ,$288.00 ,$292.00 ,$314.84 ,$340.00 , N/A ,$314.84 ,$320.00 ,$292.00 ,$148.16 , N/A ,$204.50 ,$400.00 ,$340.00 ,$240.00 ,$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 , N/A ,$288.00 ,$157.05 ,$222.24 ,$222.24 , N/A ,$222.24 , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,31000237,81402,HC MOLECULAR PATH MUTATION ANALYSIS MPL,310,1 ,$375.00 ,$187.50 ,$120.26 ,$375.00 ,$242.25 ,$120.26 ,$375.00 ,$375.00 , N/A ,$225.00 ,$318.75 ,$262.50 ,$120.26 ,$356.25 ,$270.00 ,$273.75 ,$255.56 ,$318.75 , N/A ,$255.56 ,$300.00 ,$273.75 ,$120.26 , N/A ,$165.99 ,$375.00 ,$318.75 ,$225.00 ,$345.00 ,$262.50 ,$375.00 ,$375.00 ,$228.38 ,$375.00 ,$259.13 ,$262.50 , N/A ,$270.00 ,$127.48 ,$180.40 ,$180.40 , N/A ,$180.40 , N/A ,$270.00 ,$232.50 ,$270.00 ,$270.00 ,$225.00 ST VINCENT HOSPITAL - ACUTE,31000238,81479,HC MUTATION ANALYSIS CSF3R,310,1 ,$300.00 ,$150.00 ,$10.83 ,$300.00 ,$193.80 ,$10.83 ,$194.07 ,$194.07 , N/A ,$180.00 ,$255.00 ,$210.00 ,$10.83 ,$285.00 ,$216.00 ,$219.00 , N/A ,$255.00 , N/A , N/A ,$240.00 ,$219.00 ,$10.83 , N/A ,$126.00 ,$300.00 ,$255.00 ,$180.00 ,$276.00 ,$210.00 ,$150.00 ,$180.00 ,$182.70 ,$150.00 ,$207.30 ,$210.00 , N/A ,$216.00 ,$11.48 ,$150.00 ,$150.00 , N/A ,$150.00 , N/A ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,31000239,81270,HC JAK2 MUTATION ANALYSIS,310,1 ,$360.00 ,$180.00 ,$91.66 ,$360.00 ,$232.56 ,$94.71 ,$356.48 ,$305.55 ,$91.66 ,$216.00 ,$306.00 ,$252.00 ,$94.71 ,$342.00 ,$259.20 ,$262.80 ,$155.82 ,$306.00 ,$91.66 ,$155.82 ,$288.00 ,$262.80 ,$94.71 ,$91.66 ,$101.21 ,$360.00 ,$306.00 ,$206.24 ,$331.20 ,$252.00 ,$360.00 ,$360.00 ,$219.24 ,$360.00 ,$248.76 ,$252.00 ,$92.58 ,$259.20 ,$100.39 ,$109.99 ,$109.99 ,$91.66 ,$109.99 ,$91.66 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,31000244,81271,HC HTT GENE ANALYSIS DETECT ABNORMAL ALLELES,310,1 ,$395.00 ,$197.50 ,$109.60 ,$395.00 ,$255.17 ,$109.60 ,$395.00 ,$395.00 ,$137.00 ,$237.00 ,$335.75 ,$276.50 ,$109.60 ,$375.25 ,$284.40 ,$288.35 ,$232.90 ,$335.75 ,$137.00 ,$232.90 ,$316.00 ,$288.35 ,$109.60 ,$137.00 ,$151.28 ,$395.00 ,$335.75 ,$308.25 ,$363.40 ,$276.50 ,$395.00 ,$395.00 ,$240.56 ,$395.00 ,$272.95 ,$276.50 ,$138.37 ,$284.40 ,$116.18 ,$164.40 ,$164.40 ,$137.00 ,$164.40 ,$137.00 ,$284.40 ,$244.90 ,$284.40 ,$284.40 ,$237.00 ST VINCENT HOSPITAL - ACUTE,31000252,81309,HC MOLECULAR MUTATION ANALYSIS PIK3CA,310,1 ,$370.00 ,$185.00 ,$185.00 ,$618.37 ,$239.02 ,$219.86 ,$370.00 ,$370.00 ,$274.83 ,$222.00 ,$314.50 ,$259.00 ,$219.86 ,$351.50 ,$266.40 ,$270.10 ,$370.00 ,$314.50 ,$274.83 ,$370.00 ,$296.00 ,$270.10 ,$219.86 ,$274.83 ,$303.47 ,$370.00 ,$314.50 ,$618.37 ,$340.40 ,$259.00 ,$370.00 ,$370.00 ,$225.33 ,$370.00 ,$255.67 ,$259.00 ,$277.58 ,$266.40 ,$233.05 ,$329.80 ,$329.80 ,$274.83 ,$329.80 ,$274.83 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,31000265,81445,HC GENE SEQ NEOPLASM 5-50 GENES LUNG W/REARRANG TUMOR,310,1 ,"$3,000.00 ","$1,500.00 ",$478.33 ,"$3,000.00 ","$1,938.00 ",$478.33 ,"$2,092.69 ","$1,793.73 ",$597.91 ,"$1,800.00 ","$2,550.00 ","$2,100.00 ",$478.33 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ","$1,016.45 ","$2,550.00 ",$597.91 ,"$1,016.45 ","$2,400.00 ","$2,190.00 ",$478.33 ,$597.91 ,$660.21 ,"$3,000.00 ","$2,550.00 ","$1,345.30 ","$2,760.00 ","$2,100.00 ","$2,098.66 ","$2,254.12 ","$1,827.00 ","$2,098.66 ","$2,073.00 ","$2,100.00 ",$603.89 ,"$2,160.00 ",$507.03 ,$717.49 ,$717.49 ,$597.91 ,$717.49 ,$597.91 ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,31000273,81270,HC JAK2 V617F MUTATION DETECTION B/BM,310,1 ,$381.00 ,$190.50 ,$91.66 ,$381.00 ,$246.13 ,$94.71 ,$356.48 ,$305.55 ,$91.66 ,$228.60 ,$323.85 ,$266.70 ,$94.71 ,$361.95 ,$274.32 ,$278.13 ,$155.82 ,$323.85 ,$91.66 ,$155.82 ,$304.80 ,$278.13 ,$94.71 ,$91.66 ,$101.21 ,$381.00 ,$323.85 ,$206.24 ,$350.52 ,$266.70 ,$381.00 ,$381.00 ,$232.03 ,$381.00 ,$263.27 ,$266.70 ,$92.58 ,$274.32 ,$100.39 ,$109.99 ,$109.99 ,$91.66 ,$109.99 ,$91.66 ,$274.32 ,$236.22 ,$274.32 ,$274.32 ,$228.60 ST VINCENT HOSPITAL - ACUTE,31000274,81305,HC MYD88 L265P GENE MUTATION ANALYSIS,310,1 ,$686.00 ,$343.00 ,$140.32 ,$686.00 ,$443.16 ,$140.32 ,$613.90 ,$526.20 ,$175.40 ,$411.60 ,$583.10 ,$480.20 ,$140.32 ,$651.70 ,$493.92 ,$500.78 ,$298.18 ,$583.10 ,$175.40 ,$298.18 ,$548.80 ,$500.78 ,$140.32 ,$175.40 ,$193.68 ,$686.00 ,$583.10 ,$394.65 ,$631.12 ,$480.20 ,$675.25 ,$686.00 ,$417.77 ,$675.25 ,$474.03 ,$480.20 ,$177.15 ,$493.92 ,$148.74 ,$210.48 ,$210.48 ,$175.40 ,$210.48 ,$175.40 ,$493.92 ,$425.32 ,$493.92 ,$493.92 ,$411.60 ST VINCENT HOSPITAL - ACUTE,31040107,81311,HC NRAS GENE VARIANTS EXON 2 AND 3,310,1 ,$680.00 ,$340.00 ,$175.10 ,$680.00 ,$439.28 ,$175.10 ,$680.00 ,$680.00 ,$295.79 ,$408.00 ,$578.00 ,$476.00 ,$175.10 ,$646.00 ,$489.60 ,$496.40 ,$502.84 ,$578.00 ,$295.79 ,$502.84 ,$544.00 ,$496.40 ,$175.10 ,$295.79 ,$326.61 ,$680.00 ,$578.00 ,$665.53 ,$625.60 ,$476.00 ,$680.00 ,$680.00 ,$414.12 ,$680.00 ,$469.88 ,$476.00 ,$298.75 ,$489.60 ,$185.61 ,$354.95 ,$354.95 ,$295.79 ,$354.95 ,$295.79 ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,31040108,81404,HC MOLECULAR PATH PROC LEVEL 5,310,1 ,$400.00 ,$200.00 ,$200.00 ,$400.00 ,$258.40 ,$219.86 ,$400.00 ,$400.00 , N/A ,$240.00 ,$340.00 ,$280.00 ,$219.86 ,$380.00 ,$288.00 ,$292.00 ,$400.00 ,$340.00 , N/A ,$400.00 ,$320.00 ,$292.00 ,$219.86 , N/A ,$303.47 ,$400.00 ,$340.00 ,$240.00 ,$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 , N/A ,$288.00 ,$233.05 ,$329.80 ,$329.80 , N/A ,$329.80 , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,31100101,88104,HC CYTOPATH FLD SMEAR,311,1 ,$150.00 ,$75.00 ,$5.22 ,$150.00 ,$96.90 ,$5.22 ,$139.26 ,$119.36 ,$32.77 ,$90.00 ,$127.50 ,$105.00 ,$5.22 ,$142.50 ,$108.00 ,$109.50 ,$109.00 ,$127.50 ,$32.77 ,$109.00 ,$120.00 ,$109.50 ,$5.22 ,$32.77 ,$63.00 ,$150.00 ,$127.50 ,$73.74 ,$138.00 ,$105.00 ,$75.15 ,$80.72 ,$91.35 ,$75.15 ,$103.65 ,$105.00 ,$33.10 ,$108.00 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,31100102,88108,HC CYTOPATH CONCENTRATION,311,1 ,$210.00 ,$105.00 ,$5.22 ,$210.00 ,$135.66 ,$5.22 ,$127.19 ,$109.02 ,$32.77 ,$126.00 ,$178.50 ,$147.00 ,$5.22 ,$199.50 ,$151.20 ,$153.30 ,$103.00 ,$178.50 ,$32.77 ,$103.00 ,$168.00 ,$153.30 ,$5.22 ,$32.77 ,$88.20 ,$210.00 ,$178.50 ,$73.74 ,$193.20 ,$147.00 ,$75.15 ,$80.72 ,$127.89 ,$75.15 ,$145.11 ,$147.00 ,$33.10 ,$151.20 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,31100103,88108,HC CYTOPATH CONCENTRATION (BF),311,1 ,$194.00 ,$97.00 ,$5.22 ,$194.00 ,$125.32 ,$5.22 ,$127.19 ,$109.02 ,$32.77 ,$116.40 ,$164.90 ,$135.80 ,$5.22 ,$184.30 ,$139.68 ,$141.62 ,$103.00 ,$164.90 ,$32.77 ,$103.00 ,$155.20 ,$141.62 ,$5.22 ,$32.77 ,$81.48 ,$194.00 ,$164.90 ,$73.74 ,$178.48 ,$135.80 ,$75.15 ,$80.72 ,$118.15 ,$75.15 ,$134.05 ,$135.80 ,$33.10 ,$139.68 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$139.68 ,$120.28 ,$139.68 ,$139.68 ,$116.40 ST VINCENT HOSPITAL - ACUTE,31100104,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$170.00 ,$85.00 ,$11.38 ,$170.00 ,$109.82 ,$11.38 ,$130.81 ,$112.12 ,$48.19 ,$102.00 ,$144.50 ,$119.00 ,$11.38 ,$161.50 ,$122.40 ,$124.10 ,$109.57 ,$144.50 ,$48.19 ,$109.57 ,$136.00 ,$124.10 ,$11.38 ,$48.19 ,$71.40 ,$170.00 ,$144.50 ,$108.43 ,$156.40 ,$119.00 ,$138.36 ,$148.61 ,$103.53 ,$138.36 ,$117.47 ,$119.00 ,$48.67 ,$122.40 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,31100107,88142,HC THINPREP PAP,311,1 ,$140.00 ,$70.00 ,$20.26 ,$140.00 ,$90.44 ,$20.93 ,$78.79 ,$67.53 ,$20.26 ,$84.00 ,$119.00 ,$98.00 ,$20.93 ,$133.00 ,$100.80 ,$102.20 ,$34.44 ,$119.00 ,$20.26 ,$34.44 ,$112.00 ,$102.20 ,$20.93 ,$20.26 ,$22.37 ,$140.00 ,$119.00 ,$45.59 ,$128.80 ,$98.00 ,$97.02 ,$104.20 ,$85.26 ,$97.02 ,$96.74 ,$98.00 ,$20.46 ,$100.80 ,$22.19 ,$24.31 ,$24.31 ,$20.26 ,$24.31 ,$20.26 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,31100108,88150,HC PAP SMEAR DIAG UP TO 3 SLIDES,311,1 ,$72.00 ,$36.00 ,$14.86 ,$72.00 ,$46.51 ,$14.86 ,$52.47 ,$44.97 ,$15.15 ,$43.20 ,$61.20 ,$50.40 ,$14.86 ,$68.40 ,$51.84 ,$52.56 ,$25.76 ,$61.20 ,$15.15 ,$25.76 ,$57.60 ,$52.56 ,$14.86 ,$15.15 ,$16.73 ,$72.00 ,$61.20 ,$34.09 ,$66.24 ,$50.40 ,$50.61 ,$54.36 ,$43.85 ,$50.61 ,$49.75 ,$50.40 ,$15.30 ,$51.84 ,$15.75 ,$18.14 ,$18.14 ,$15.15 ,$18.14 ,$15.15 ,$51.84 ,$44.64 ,$51.84 ,$51.84 ,$43.20 ST VINCENT HOSPITAL - ACUTE,31100109,88155,HC CYTOPATH MATURATION INDEX,311,1 ,$40.00 ,$20.00 ,$8.42 ,$40.00 ,$25.84 ,$8.42 ,$40.00 ,$40.00 ,$14.65 ,$24.00 ,$34.00 ,$28.00 ,$8.42 ,$38.00 ,$28.80 ,$29.20 ,$24.91 ,$34.00 ,$14.65 ,$24.91 ,$32.00 ,$29.20 ,$8.42 ,$14.65 ,$16.18 ,$40.00 ,$34.00 ,$32.96 ,$36.80 ,$28.00 ,$28.71 ,$30.84 ,$24.36 ,$28.71 ,$27.64 ,$28.00 ,$14.80 ,$28.80 ,$8.93 ,$17.58 ,$17.58 ,$14.65 ,$17.58 ,$14.65 ,$28.80 ,$24.80 ,$28.80 ,$28.80 ,$24.00 ST VINCENT HOSPITAL - ACUTE,31100110,88160,HC CYTOPATH SMEAR NON GYN,311,1 ,$170.00 ,$85.00 ,$5.22 ,$170.00 ,$109.82 ,$5.22 ,$151.33 ,$129.71 ,$23.89 ,$102.00 ,$144.50 ,$119.00 ,$5.22 ,$161.50 ,$122.40 ,$124.10 ,$116.06 ,$144.50 ,$23.89 ,$116.06 ,$136.00 ,$124.10 ,$5.22 ,$23.89 ,$71.40 ,$170.00 ,$144.50 ,$53.76 ,$156.40 ,$119.00 ,$75.15 ,$80.72 ,$103.53 ,$75.15 ,$117.47 ,$119.00 ,$24.13 ,$122.40 ,$5.53 ,$27.59 ,$27.59 ,$23.89 ,$27.59 ,$23.89 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,31100111,88160,HC CYTOPATH SMEAR NON GYN (TZANK),311,1 ,$170.00 ,$85.00 ,$5.22 ,$170.00 ,$109.82 ,$5.22 ,$151.33 ,$129.71 ,$23.89 ,$102.00 ,$144.50 ,$119.00 ,$5.22 ,$161.50 ,$122.40 ,$124.10 ,$116.06 ,$144.50 ,$23.89 ,$116.06 ,$136.00 ,$124.10 ,$5.22 ,$23.89 ,$71.40 ,$170.00 ,$144.50 ,$53.76 ,$156.40 ,$119.00 ,$75.15 ,$80.72 ,$103.53 ,$75.15 ,$117.47 ,$119.00 ,$24.13 ,$122.40 ,$5.53 ,$27.59 ,$27.59 ,$23.89 ,$27.59 ,$23.89 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,31100112,88162,HC CYTOPATH SMEAR OVER 5 SLIDES,311,1 ,$250.00 ,$125.00 ,$11.38 ,$250.00 ,$161.50 ,$11.38 ,$190.39 ,$163.20 ,$48.19 ,$150.00 ,$212.50 ,$175.00 ,$11.38 ,$237.50 ,$180.00 ,$182.50 ,$168.54 ,$212.50 ,$48.19 ,$168.54 ,$200.00 ,$182.50 ,$11.38 ,$48.19 ,$105.00 ,$250.00 ,$212.50 ,$108.43 ,$230.00 ,$175.00 ,$75.15 ,$80.72 ,$152.25 ,$75.15 ,$172.75 ,$175.00 ,$48.67 ,$180.00 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,31100113,88164,HC CYTOPATH SCR BETHESDA,311,1 ,$62.00 ,$31.00 ,$14.86 ,$62.00 ,$40.05 ,$14.86 ,$52.47 ,$44.97 ,$15.15 ,$37.20 ,$52.70 ,$43.40 ,$14.86 ,$58.90 ,$44.64 ,$45.26 ,$25.76 ,$52.70 ,$15.15 ,$25.76 ,$49.60 ,$45.26 ,$14.86 ,$15.15 ,$16.73 ,$62.00 ,$52.70 ,$34.09 ,$57.04 ,$43.40 ,$50.61 ,$54.36 ,$37.76 ,$50.61 ,$42.84 ,$43.40 ,$15.30 ,$44.64 ,$15.75 ,$18.14 ,$18.14 ,$15.15 ,$18.14 ,$15.15 ,$44.64 ,$38.44 ,$44.64 ,$44.64 ,$37.20 ST VINCENT HOSPITAL - ACUTE,31100114,88172,HC FINE NEEDLE EVAL,311,1 ,$126.00 ,$63.00 ,$11.38 ,$325.04 ,$81.40 ,$11.38 ,$65.62 ,$56.25 ,$144.46 ,$75.60 ,$107.10 ,$88.20 ,$11.38 ,$119.70 ,$90.72 ,$91.98 ,$91.02 ,$107.10 ,$144.46 ,$91.02 ,$100.80 ,$91.98 ,$11.38 ,$144.46 ,$52.92 ,$126.00 ,$107.10 ,$325.04 ,$115.92 ,$88.20 ,$75.15 ,$80.72 ,$76.73 ,$75.15 ,$87.07 ,$88.20 ,$145.90 ,$90.72 ,$12.06 ,$126.00 ,$126.00 ,$144.46 ,$126.00 ,$144.46 ,$90.72 ,$78.12 ,$90.72 ,$90.72 ,$75.60 ST VINCENT HOSPITAL - ACUTE,31100115,88173,HC FINE NEEDLE INTERP,311,1 ,$360.00 ,$180.00 ,$11.38 ,$360.00 ,$232.56 ,$11.38 ,$272.48 ,$233.55 ,$48.19 ,$216.00 ,$306.00 ,$252.00 ,$11.38 ,$342.00 ,$259.20 ,$262.80 ,$253.37 ,$306.00 ,$48.19 ,$253.37 ,$288.00 ,$262.80 ,$11.38 ,$48.19 ,$151.20 ,$360.00 ,$306.00 ,$108.43 ,$331.20 ,$252.00 ,$138.36 ,$148.61 ,$219.24 ,$138.36 ,$248.76 ,$252.00 ,$48.67 ,$259.20 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,31100116,88177,HC FINE NEEDLE EVAL ADDL,311,1 ,$90.00 ,$45.00 ,$8.66 ,$90.00 ,$58.14 ,$11.38 ,$24.14 ,$20.69 , N/A ,$54.00 ,$76.50 ,$63.00 ,$11.38 ,$85.50 ,$64.80 ,$65.70 ,$47.99 ,$76.50 , N/A ,$47.99 ,$72.00 ,$65.70 ,$11.38 , N/A ,$37.80 ,$90.00 ,$76.50 , N/A ,$82.80 ,$63.00 ,$41.70 ,$44.79 ,$54.81 ,$41.70 ,$62.19 ,$63.00 , N/A ,$64.80 ,$12.06 ,$8.66 ,$8.66 , N/A ,$8.66 , N/A ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,31100117,88182,HC T AND B CELL QN FLOWCYT,311,1 ,$135.00 ,$67.50 ,$11.38 ,$135.00 ,$87.21 ,$11.38 ,$135.00 ,$135.00 ,$48.19 ,$81.00 ,$114.75 ,$94.50 ,$11.38 ,$128.25 ,$97.20 ,$98.55 ,$135.00 ,$114.75 ,$48.19 ,$135.00 ,$108.00 ,$98.55 ,$11.38 ,$48.19 ,$56.70 ,$135.00 ,$114.75 ,$108.43 ,$124.20 ,$94.50 ,$135.00 ,$135.00 ,$82.22 ,$135.00 ,$93.29 ,$94.50 ,$48.67 ,$97.20 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$97.20 ,$83.70 ,$97.20 ,$97.20 ,$81.00 ST VINCENT HOSPITAL - ACUTE,31100118,88182,HC T AND B CELL QN FLOWCYT (DNA CELL CYCLE),311,1 ,$550.00 ,$275.00 ,$11.38 ,$550.00 ,$355.30 ,$11.38 ,$320.00 ,$274.28 ,$48.19 ,$330.00 ,$467.50 ,$385.00 ,$11.38 ,$522.50 ,$396.00 ,$401.50 ,$225.91 ,$467.50 ,$48.19 ,$225.91 ,$440.00 ,$401.50 ,$11.38 ,$48.19 ,$231.00 ,$550.00 ,$467.50 ,$108.43 ,$506.00 ,$385.00 ,$138.36 ,$148.61 ,$334.95 ,$138.36 ,$380.05 ,$385.00 ,$48.67 ,$396.00 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,31100119,88184,HC FLOW CYTO 1ST MARKER (CD4),311,1 ,$28.00 ,$14.00 ,$11.38 ,$634.69 ,$18.09 ,$11.38 ,$28.00 ,$28.00 ,$282.09 ,$16.80 ,$23.80 ,$19.60 ,$11.38 ,$26.60 ,$20.16 ,$20.44 ,$28.00 ,$23.80 ,$282.09 ,$28.00 ,$22.40 ,$20.44 ,$11.38 ,$282.09 ,$11.76 ,$28.00 ,$23.80 ,$634.69 ,$25.76 ,$19.60 ,$28.00 ,$28.00 ,$17.05 ,$28.00 ,$19.35 ,$19.60 ,$284.91 ,$20.16 ,$12.06 ,$28.00 ,$28.00 ,$282.09 ,$28.00 ,$282.09 ,$20.16 ,$17.36 ,$20.16 ,$20.16 ,$16.80 ST VINCENT HOSPITAL - ACUTE,31100120,88184,HC FLOW CYTO 1ST MARKER (PCLI),311,1 ,$69.00 ,$34.50 ,$11.38 ,$634.69 ,$44.57 ,$11.38 ,$69.00 ,$69.00 ,$282.09 ,$41.40 ,$58.65 ,$48.30 ,$11.38 ,$65.55 ,$49.68 ,$50.37 ,$69.00 ,$58.65 ,$282.09 ,$69.00 ,$55.20 ,$50.37 ,$11.38 ,$282.09 ,$28.98 ,$69.00 ,$58.65 ,$634.69 ,$63.48 ,$48.30 ,$69.00 ,$69.00 ,$42.02 ,$69.00 ,$47.68 ,$48.30 ,$284.91 ,$49.68 ,$12.06 ,$69.00 ,$69.00 ,$282.09 ,$69.00 ,$282.09 ,$49.68 ,$42.78 ,$49.68 ,$49.68 ,$41.40 ST VINCENT HOSPITAL - ACUTE,31100121,88184,HC FLOW CYTO 1ST MARKER,311,1 ,$420.00 ,$210.00 ,$11.38 ,$634.69 ,$271.32 ,$11.38 ,$225.40 ,$193.20 ,$282.09 ,$252.00 ,$357.00 ,$294.00 ,$11.38 ,$399.00 ,$302.40 ,$306.60 ,$110.99 ,$357.00 ,$282.09 ,$110.99 ,$336.00 ,$306.60 ,$11.38 ,$282.09 ,$176.40 ,$420.00 ,$357.00 ,$634.69 ,$386.40 ,$294.00 ,$138.36 ,$148.61 ,$255.78 ,$138.36 ,$290.22 ,$294.00 ,$284.91 ,$302.40 ,$12.06 ,$340.09 ,$340.09 ,$282.09 ,$340.09 ,$282.09 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,31100122,88184,HC FLOW CYTO 1ST MARKER (MM),311,1 ,$136.00 ,$68.00 ,$11.38 ,$634.69 ,$87.86 ,$11.38 ,$136.00 ,$136.00 ,$282.09 ,$81.60 ,$115.60 ,$95.20 ,$11.38 ,$129.20 ,$97.92 ,$99.28 ,$110.99 ,$115.60 ,$282.09 ,$110.99 ,$108.80 ,$99.28 ,$11.38 ,$282.09 ,$57.12 ,$136.00 ,$115.60 ,$634.69 ,$125.12 ,$95.20 ,$136.00 ,$136.00 ,$82.82 ,$136.00 ,$93.98 ,$95.20 ,$284.91 ,$97.92 ,$12.06 ,$136.00 ,$136.00 ,$282.09 ,$136.00 ,$282.09 ,$97.92 ,$84.32 ,$97.92 ,$97.92 ,$81.60 ST VINCENT HOSPITAL - ACUTE,31100124,88185,HC FLOW CYTO EA ADD MARKER (PCLI),311,1 ,$69.00 ,$34.50 ,$11.95 ,$69.00 ,$44.57 ,$11.95 ,$69.00 ,$69.00 , N/A ,$41.40 ,$58.65 ,$48.30 ,$11.95 ,$65.55 ,$49.68 ,$50.37 ,$36.87 ,$58.65 , N/A ,$36.87 ,$55.20 ,$50.37 ,$11.95 , N/A ,$28.98 ,$69.00 ,$58.65 , N/A ,$63.48 ,$48.30 ,$64.44 ,$69.00 ,$42.02 ,$64.44 ,$47.68 ,$48.30 , N/A ,$49.68 ,$12.67 ,$26.86 ,$26.86 , N/A ,$26.86 , N/A ,$49.68 ,$42.78 ,$49.68 ,$49.68 ,$41.40 ST VINCENT HOSPITAL - ACUTE,31100125,88185,HC FLOW CYTO EA ADD MARKER (PNH),311,1 ,$70.00 ,$35.00 ,$11.95 ,$70.00 ,$45.22 ,$11.95 ,$70.00 ,$70.00 , N/A ,$42.00 ,$59.50 ,$49.00 ,$11.95 ,$66.50 ,$50.40 ,$51.10 ,$36.87 ,$59.50 , N/A ,$36.87 ,$56.00 ,$51.10 ,$11.95 , N/A ,$29.40 ,$70.00 ,$59.50 , N/A ,$64.40 ,$49.00 ,$64.44 ,$69.22 ,$42.63 ,$64.44 ,$48.37 ,$49.00 , N/A ,$50.40 ,$12.67 ,$26.86 ,$26.86 , N/A ,$26.86 , N/A ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,31100126,88185,HC FLOW CYTO EA ADD MARKER,311,1 ,$260.00 ,$130.00 ,$11.95 ,$260.00 ,$167.96 ,$11.95 ,$83.29 ,$71.39 , N/A ,$156.00 ,$221.00 ,$182.00 ,$11.95 ,$247.00 ,$187.20 ,$189.80 ,$36.87 ,$221.00 , N/A ,$36.87 ,$208.00 ,$189.80 ,$11.95 , N/A ,$109.20 ,$260.00 ,$221.00 , N/A ,$239.20 ,$182.00 ,$64.44 ,$69.22 ,$158.34 ,$64.44 ,$179.66 ,$182.00 , N/A ,$187.20 ,$12.67 ,$26.86 ,$26.86 , N/A ,$26.86 , N/A ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31100128,88185,HC T AND B MAKERS ADDL,311,1 ,$69.00 ,$34.50 ,$11.95 ,$69.00 ,$44.57 ,$11.95 ,$69.00 ,$69.00 , N/A ,$41.40 ,$58.65 ,$48.30 ,$11.95 ,$65.55 ,$49.68 ,$50.37 ,$36.87 ,$58.65 , N/A ,$36.87 ,$55.20 ,$50.37 ,$11.95 , N/A ,$28.98 ,$69.00 ,$58.65 , N/A ,$63.48 ,$48.30 ,$64.44 ,$69.00 ,$42.02 ,$64.44 ,$47.68 ,$48.30 , N/A ,$49.68 ,$12.67 ,$26.86 ,$26.86 , N/A ,$26.86 , N/A ,$49.68 ,$42.78 ,$49.68 ,$49.68 ,$41.40 ST VINCENT HOSPITAL - ACUTE,31100131,88230,HC TISSUE CLT NONNEO (CHROMO),311,1 ,$520.00 ,$260.00 ,$70.04 ,$520.00 ,$335.92 ,$70.04 ,$453.04 ,$388.32 ,$116.49 ,$312.00 ,$442.00 ,$364.00 ,$70.04 ,$494.00 ,$374.40 ,$379.60 ,$198.03 ,$442.00 ,$116.49 ,$198.03 ,$416.00 ,$379.60 ,$70.04 ,$116.49 ,$128.63 ,$520.00 ,$442.00 ,$262.10 ,$478.40 ,$364.00 ,$238.50 ,$256.17 ,$316.68 ,$238.50 ,$359.32 ,$364.00 ,$117.65 ,$374.40 ,$74.24 ,$139.79 ,$139.79 ,$116.49 ,$139.79 ,$116.49 ,$374.40 ,$322.40 ,$374.40 ,$374.40 ,$312.00 ST VINCENT HOSPITAL - ACUTE,31100132,88230,HC TISSUE CLT NONNEO (FRAG X),311,1 ,$146.00 ,$73.00 ,$70.04 ,$262.10 ,$94.32 ,$70.04 ,$146.00 ,$146.00 ,$116.49 ,$87.60 ,$124.10 ,$102.20 ,$70.04 ,$138.70 ,$105.12 ,$106.58 ,$146.00 ,$124.10 ,$116.49 ,$146.00 ,$116.80 ,$106.58 ,$70.04 ,$116.49 ,$128.63 ,$146.00 ,$124.10 ,$262.10 ,$134.32 ,$102.20 ,$146.00 ,$146.00 ,$88.91 ,$146.00 ,$100.89 ,$102.20 ,$117.65 ,$105.12 ,$74.24 ,$139.79 ,$139.79 ,$116.49 ,$139.79 ,$116.49 ,$105.12 ,$90.52 ,$105.12 ,$105.12 ,$87.60 ST VINCENT HOSPITAL - ACUTE,31100133,88230,HC TISSUE CLT NONNEO (HRS),311,1 ,$277.00 ,$138.50 ,$70.04 ,$277.00 ,$178.94 ,$70.04 ,$277.00 ,$277.00 ,$116.49 ,$166.20 ,$235.45 ,$193.90 ,$70.04 ,$263.15 ,$199.44 ,$202.21 ,$198.03 ,$235.45 ,$116.49 ,$198.03 ,$221.60 ,$202.21 ,$70.04 ,$116.49 ,$128.63 ,$277.00 ,$235.45 ,$262.10 ,$254.84 ,$193.90 ,$238.50 ,$256.17 ,$168.69 ,$238.50 ,$191.41 ,$193.90 ,$117.65 ,$199.44 ,$74.24 ,$139.79 ,$139.79 ,$116.49 ,$139.79 ,$116.49 ,$199.44 ,$171.74 ,$199.44 ,$199.44 ,$166.20 ST VINCENT HOSPITAL - ACUTE,31100134,88230,HC TISSUE CLT NONNEO (FXS),311,1 ,$109.00 ,$54.50 ,$54.50 ,$245.25 ,$70.41 ,$70.04 ,$109.00 ,$109.00 ,$109.00 ,$65.40 ,$92.65 ,$76.30 ,$70.04 ,$103.55 ,$78.48 ,$79.57 ,$109.00 ,$92.65 ,$109.00 ,$109.00 ,$87.20 ,$79.57 ,$70.04 ,$109.00 ,$109.00 ,$109.00 ,$92.65 ,$245.25 ,$100.28 ,$76.30 ,$109.00 ,$109.00 ,$66.38 ,$109.00 ,$75.32 ,$76.30 ,$110.09 ,$78.48 ,$74.24 ,$109.00 ,$109.00 ,$109.00 ,$109.00 ,$109.00 ,$78.48 ,$67.58 ,$78.48 ,$78.48 ,$65.40 ST VINCENT HOSPITAL - ACUTE,31100135,88230,HC TISSUE CLT NONNEO (MAYO),311,1 ,$518.00 ,$259.00 ,$70.04 ,$518.00 ,$334.63 ,$70.04 ,$453.04 ,$388.32 ,$116.49 ,$310.80 ,$440.30 ,$362.60 ,$70.04 ,$492.10 ,$372.96 ,$378.14 ,$198.03 ,$440.30 ,$116.49 ,$198.03 ,$414.40 ,$378.14 ,$70.04 ,$116.49 ,$128.63 ,$518.00 ,$440.30 ,$262.10 ,$476.56 ,$362.60 ,$238.50 ,$256.17 ,$315.46 ,$238.50 ,$357.94 ,$362.60 ,$117.65 ,$372.96 ,$74.24 ,$139.79 ,$139.79 ,$116.49 ,$139.79 ,$116.49 ,$372.96 ,$321.16 ,$372.96 ,$372.96 ,$310.80 ST VINCENT HOSPITAL - ACUTE,31100136,88230,HC TISSUE CLT NONNEO (LYMPHO),311,1 ,$420.00 ,$210.00 ,$70.04 ,$420.00 ,$271.32 ,$70.04 ,$420.00 ,$388.32 ,$116.49 ,$252.00 ,$357.00 ,$294.00 ,$70.04 ,$399.00 ,$302.40 ,$306.60 ,$198.03 ,$357.00 ,$116.49 ,$198.03 ,$336.00 ,$306.60 ,$70.04 ,$116.49 ,$128.63 ,$420.00 ,$357.00 ,$262.10 ,$386.40 ,$294.00 ,$238.50 ,$256.17 ,$255.78 ,$238.50 ,$290.22 ,$294.00 ,$117.65 ,$302.40 ,$74.24 ,$139.79 ,$139.79 ,$116.49 ,$139.79 ,$116.49 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,31100137,88233,HC TISSUE CULT SKIN/OTH SOLID,311,1 ,$370.00 ,$185.00 ,$70.04 ,$370.00 ,$239.02 ,$70.04 ,$370.00 ,$370.00 ,$140.73 ,$222.00 ,$314.50 ,$259.00 ,$70.04 ,$351.50 ,$266.40 ,$270.10 ,$239.24 ,$314.50 ,$140.73 ,$239.24 ,$296.00 ,$270.10 ,$70.04 ,$140.73 ,$155.39 ,$370.00 ,$314.50 ,$316.64 ,$340.40 ,$259.00 ,$238.50 ,$256.17 ,$225.33 ,$238.50 ,$255.67 ,$259.00 ,$142.14 ,$266.40 ,$74.24 ,$168.88 ,$168.88 ,$140.73 ,$168.88 ,$140.73 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,31100138,88233,HC TISSUE CULT SKIN/OTH SOLID (CHROMO),311,1 ,$847.00 ,$423.50 ,$70.04 ,$847.00 ,$547.16 ,$70.04 ,$547.26 ,$469.08 ,$140.73 ,$508.20 ,$719.95 ,$592.90 ,$70.04 ,$804.65 ,$609.84 ,$618.31 ,$239.24 ,$719.95 ,$140.73 ,$239.24 ,$677.60 ,$618.31 ,$70.04 ,$140.73 ,$155.39 ,$847.00 ,$719.95 ,$316.64 ,$779.24 ,$592.90 ,$238.50 ,$256.17 ,$515.82 ,$238.50 ,$585.28 ,$592.90 ,$142.14 ,$609.84 ,$74.24 ,$168.88 ,$168.88 ,$140.73 ,$168.88 ,$140.73 ,$609.84 ,$525.14 ,$609.84 ,$609.84 ,$508.20 ST VINCENT HOSPITAL - ACUTE,31100139,88235,HC TISSUE CULT AMNIO/CHORION,311,1 ,$558.00 ,$279.00 ,$70.04 ,$558.00 ,$360.47 ,$70.04 ,$558.00 ,$490.89 ,$150.30 ,$334.80 ,$474.30 ,$390.60 ,$70.04 ,$530.10 ,$401.76 ,$407.34 ,$255.51 ,$474.30 ,$150.30 ,$255.51 ,$446.40 ,$407.34 ,$70.04 ,$150.30 ,$165.96 ,$558.00 ,$474.30 ,$338.18 ,$513.36 ,$390.60 ,$238.50 ,$256.17 ,$339.82 ,$238.50 ,$385.58 ,$390.60 ,$151.80 ,$401.76 ,$74.24 ,$180.36 ,$180.36 ,$150.30 ,$180.36 ,$150.30 ,$401.76 ,$345.96 ,$401.76 ,$401.76 ,$334.80 ST VINCENT HOSPITAL - ACUTE,31100140,88237,HC TISSUE CULT BONE/BLD (CHROMO QD),311,1 ,$407.00 ,$203.50 ,$70.04 ,$407.00 ,$262.92 ,$70.04 ,$407.00 ,$407.00 ,$143.75 ,$244.20 ,$345.95 ,$284.90 ,$70.04 ,$386.65 ,$293.04 ,$297.11 ,$244.38 ,$345.95 ,$143.75 ,$244.38 ,$325.60 ,$297.11 ,$70.04 ,$143.75 ,$158.73 ,$407.00 ,$345.95 ,$323.44 ,$374.44 ,$284.90 ,$238.50 ,$256.17 ,$247.86 ,$238.50 ,$281.24 ,$284.90 ,$145.19 ,$293.04 ,$74.24 ,$172.50 ,$172.50 ,$143.75 ,$172.50 ,$143.75 ,$293.04 ,$252.34 ,$293.04 ,$293.04 ,$244.20 ST VINCENT HOSPITAL - ACUTE,31100142,88237,HC TISSUE CULT BONE/BLD (DC),311,1 ,$474.00 ,$237.00 ,$70.04 ,$474.00 ,$306.20 ,$70.04 ,$474.00 ,$431.25 ,$143.75 ,$284.40 ,$402.90 ,$331.80 ,$70.04 ,$450.30 ,$341.28 ,$346.02 ,$244.38 ,$402.90 ,$143.75 ,$244.38 ,$379.20 ,$346.02 ,$70.04 ,$143.75 ,$158.73 ,$474.00 ,$402.90 ,$323.44 ,$436.08 ,$331.80 ,$238.50 ,$256.17 ,$288.67 ,$238.50 ,$327.53 ,$331.80 ,$145.19 ,$341.28 ,$74.24 ,$172.50 ,$172.50 ,$143.75 ,$172.50 ,$143.75 ,$341.28 ,$293.88 ,$341.28 ,$341.28 ,$284.40 ST VINCENT HOSPITAL - ACUTE,31100143,88237,HC TISSUE CULT BONE/BLD (CHROMO),311,1 ,$340.00 ,$170.00 ,$70.04 ,$340.00 ,$219.64 ,$70.04 ,$340.00 ,$340.00 ,$143.75 ,$204.00 ,$289.00 ,$238.00 ,$70.04 ,$323.00 ,$244.80 ,$248.20 ,$244.38 ,$289.00 ,$143.75 ,$244.38 ,$272.00 ,$248.20 ,$70.04 ,$143.75 ,$158.73 ,$340.00 ,$289.00 ,$323.44 ,$312.80 ,$238.00 ,$238.50 ,$256.17 ,$207.06 ,$238.50 ,$234.94 ,$238.00 ,$145.19 ,$244.80 ,$74.24 ,$172.50 ,$172.50 ,$143.75 ,$172.50 ,$143.75 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,31100144,88237,HC TISSUE CULT BONE/BLD,311,1 ,$340.00 ,$170.00 ,$70.04 ,$340.00 ,$219.64 ,$70.04 ,$340.00 ,$340.00 ,$143.75 ,$204.00 ,$289.00 ,$238.00 ,$70.04 ,$323.00 ,$244.80 ,$248.20 ,$244.38 ,$289.00 ,$143.75 ,$244.38 ,$272.00 ,$248.20 ,$70.04 ,$143.75 ,$158.73 ,$340.00 ,$289.00 ,$323.44 ,$312.80 ,$238.00 ,$238.50 ,$256.17 ,$207.06 ,$238.50 ,$234.94 ,$238.00 ,$145.19 ,$244.80 ,$74.24 ,$172.50 ,$172.50 ,$143.75 ,$172.50 ,$143.75 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,31100145,88237,HC TISSUE CULT BONE/BLD (CHROMO 1),311,1 ,$340.00 ,$170.00 ,$70.04 ,$340.00 ,$219.64 ,$70.04 ,$340.00 ,$340.00 ,$143.75 ,$204.00 ,$289.00 ,$238.00 ,$70.04 ,$323.00 ,$244.80 ,$248.20 ,$244.38 ,$289.00 ,$143.75 ,$244.38 ,$272.00 ,$248.20 ,$70.04 ,$143.75 ,$158.73 ,$340.00 ,$289.00 ,$323.44 ,$312.80 ,$238.00 ,$238.50 ,$256.17 ,$207.06 ,$238.50 ,$234.94 ,$238.00 ,$145.19 ,$244.80 ,$74.24 ,$172.50 ,$172.50 ,$143.75 ,$172.50 ,$143.75 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,31100146,88237,HC TISSUE CULT BONE/BLD (CHROMO 2),311,1 ,$340.00 ,$170.00 ,$70.04 ,$340.00 ,$219.64 ,$70.04 ,$340.00 ,$340.00 ,$143.75 ,$204.00 ,$289.00 ,$238.00 ,$70.04 ,$323.00 ,$244.80 ,$248.20 ,$244.38 ,$289.00 ,$143.75 ,$244.38 ,$272.00 ,$248.20 ,$70.04 ,$143.75 ,$158.73 ,$340.00 ,$289.00 ,$323.44 ,$312.80 ,$238.00 ,$238.50 ,$256.17 ,$207.06 ,$238.50 ,$234.94 ,$238.00 ,$145.19 ,$244.80 ,$74.24 ,$172.50 ,$172.50 ,$143.75 ,$172.50 ,$143.75 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,31100148,88239,HC TISSUE CULT TUMOR,311,1 ,$460.00 ,$230.00 ,$70.04 ,$460.00 ,$297.16 ,$70.04 ,$460.00 ,$460.00 ,$147.52 ,$276.00 ,$391.00 ,$322.00 ,$70.04 ,$437.00 ,$331.20 ,$335.80 ,$250.78 ,$391.00 ,$147.52 ,$250.78 ,$368.00 ,$335.80 ,$70.04 ,$147.52 ,$162.89 ,$460.00 ,$391.00 ,$331.92 ,$423.20 ,$322.00 ,$238.50 ,$256.17 ,$280.14 ,$238.50 ,$317.86 ,$322.00 ,$149.00 ,$331.20 ,$74.24 ,$177.02 ,$177.02 ,$147.52 ,$177.02 ,$147.52 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,31100150,88239,HC TISSUE CULT TUMOR (LYM),311,1 ,$600.00 ,$300.00 ,$70.04 ,$600.00 ,$387.60 ,$70.04 ,$573.69 ,$491.73 ,$147.52 ,$360.00 ,$510.00 ,$420.00 ,$70.04 ,$570.00 ,$432.00 ,$438.00 ,$250.78 ,$510.00 ,$147.52 ,$250.78 ,$480.00 ,$438.00 ,$70.04 ,$147.52 ,$162.89 ,$600.00 ,$510.00 ,$331.92 ,$552.00 ,$420.00 ,$238.50 ,$256.17 ,$365.40 ,$238.50 ,$414.60 ,$420.00 ,$149.00 ,$432.00 ,$74.24 ,$177.02 ,$177.02 ,$147.52 ,$177.02 ,$147.52 ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,31100151,88240,HC CRYOPRESERVATION,311,1 ,$45.00 ,$22.50 ,$9.83 ,$45.00 ,$29.07 ,$9.83 ,$45.00 ,$39.21 ,$13.07 ,$27.00 ,$38.25 ,$31.50 ,$9.83 ,$42.75 ,$32.40 ,$32.85 ,$22.22 ,$38.25 ,$13.07 ,$22.22 ,$36.00 ,$32.85 ,$9.83 ,$13.07 ,$14.43 ,$45.00 ,$38.25 ,$29.41 ,$41.40 ,$31.50 ,$33.45 ,$35.93 ,$27.41 ,$33.45 ,$31.10 ,$31.50 ,$13.20 ,$32.40 ,$10.42 ,$15.68 ,$15.68 ,$13.07 ,$15.68 ,$13.07 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,31100152,88248,HC FXS CHROM ANALYSIS,311,1 ,$260.00 ,$130.00 ,$130.00 ,$389.63 ,$167.96 ,$178.94 ,$260.00 ,$260.00 ,$173.17 ,$156.00 ,$221.00 ,$182.00 ,$178.94 ,$247.00 ,$187.20 ,$189.80 ,$260.00 ,$221.00 ,$173.17 ,$260.00 ,$208.00 ,$189.80 ,$178.94 ,$173.17 ,$191.21 ,$260.00 ,$221.00 ,$389.63 ,$239.20 ,$182.00 ,$260.00 ,$260.00 ,$158.34 ,$260.00 ,$179.66 ,$182.00 ,$174.90 ,$187.20 ,$189.68 ,$207.80 ,$207.80 ,$173.17 ,$207.80 ,$173.17 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31100153,88262,HC CHROM COUNT 15-20/2 (QD),311,1 ,$650.00 ,$325.00 ,$125.49 ,$650.00 ,$419.90 ,$129.67 ,$484.72 ,$415.47 ,$125.49 ,$390.00 ,$552.50 ,$455.00 ,$129.67 ,$617.50 ,$468.00 ,$474.50 ,$213.33 ,$552.50 ,$125.49 ,$213.33 ,$520.00 ,$474.50 ,$129.67 ,$125.49 ,$138.57 ,$650.00 ,$552.50 ,$282.35 ,$598.00 ,$455.00 ,$596.84 ,$641.05 ,$395.85 ,$596.84 ,$449.15 ,$455.00 ,$126.74 ,$468.00 ,$137.45 ,$150.59 ,$150.59 ,$125.49 ,$150.59 ,$125.49 ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,31100154,88262,HC CHROM COUNT 15-20/2 (FRAG X),311,1 ,$145.00 ,$72.50 ,$72.50 ,$282.35 ,$93.67 ,$129.67 ,$145.00 ,$145.00 ,$125.49 ,$87.00 ,$123.25 ,$101.50 ,$129.67 ,$137.75 ,$104.40 ,$105.85 ,$145.00 ,$123.25 ,$125.49 ,$145.00 ,$116.00 ,$105.85 ,$129.67 ,$125.49 ,$138.57 ,$145.00 ,$123.25 ,$282.35 ,$133.40 ,$101.50 ,$145.00 ,$145.00 ,$88.31 ,$145.00 ,$100.20 ,$101.50 ,$126.74 ,$104.40 ,$137.45 ,$145.00 ,$145.00 ,$125.49 ,$145.00 ,$125.49 ,$104.40 ,$89.90 ,$104.40 ,$104.40 ,$87.00 ST VINCENT HOSPITAL - ACUTE,31100155,88299,HC CYTOGENIC STUDY (LYMPH),311,1 ,$430.00 ,$215.00 ,$10.83 ,$430.00 ,$277.78 ,$10.83 ,$278.17 ,$278.17 ,$48.19 ,$258.00 ,$365.50 ,$301.00 ,$10.83 ,$408.50 ,$309.60 ,$313.90 , N/A ,$365.50 ,$48.19 , N/A ,$344.00 ,$313.90 ,$10.83 ,$48.19 ,$180.60 ,$430.00 ,$365.50 ,$108.43 ,$395.60 ,$301.00 ,$75.15 ,$80.72 ,$261.87 ,$75.15 ,$297.13 ,$301.00 ,$48.67 ,$309.60 ,$11.48 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,31100156,88262,HC CHROM COUNT 15-20/2 (HRS),311,1 ,$275.00 ,$137.50 ,$125.49 ,$282.35 ,$177.65 ,$129.67 ,$275.00 ,$275.00 ,$125.49 ,$165.00 ,$233.75 ,$192.50 ,$129.67 ,$261.25 ,$198.00 ,$200.75 ,$213.33 ,$233.75 ,$125.49 ,$213.33 ,$220.00 ,$200.75 ,$129.67 ,$125.49 ,$138.57 ,$275.00 ,$233.75 ,$282.35 ,$253.00 ,$192.50 ,$275.00 ,$275.00 ,$167.48 ,$275.00 ,$190.03 ,$192.50 ,$126.74 ,$198.00 ,$137.45 ,$150.59 ,$150.59 ,$125.49 ,$150.59 ,$125.49 ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,31100157,88262,HC CHROM COUNT 15-20/2 (MAYO),311,1 ,$704.00 ,$352.00 ,$125.49 ,$704.00 ,$454.78 ,$129.67 ,$484.72 ,$415.47 ,$125.49 ,$422.40 ,$598.40 ,$492.80 ,$129.67 ,$668.80 ,$506.88 ,$513.92 ,$213.33 ,$598.40 ,$125.49 ,$213.33 ,$563.20 ,$513.92 ,$129.67 ,$125.49 ,$138.57 ,$704.00 ,$598.40 ,$282.35 ,$647.68 ,$492.80 ,$596.84 ,$641.05 ,$428.74 ,$596.84 ,$486.46 ,$492.80 ,$126.74 ,$506.88 ,$137.45 ,$150.59 ,$150.59 ,$125.49 ,$150.59 ,$125.49 ,$506.88 ,$436.48 ,$506.88 ,$506.88 ,$422.40 ST VINCENT HOSPITAL - ACUTE,31100160,88262,HC CHROM COUNT 15-20/2 (KARO),311,1 ,$461.00 ,$230.50 ,$125.49 ,$461.00 ,$297.81 ,$129.67 ,$461.00 ,$415.47 ,$125.49 ,$276.60 ,$391.85 ,$322.70 ,$129.67 ,$437.95 ,$331.92 ,$336.53 ,$213.33 ,$391.85 ,$125.49 ,$213.33 ,$368.80 ,$336.53 ,$129.67 ,$125.49 ,$138.57 ,$461.00 ,$391.85 ,$282.35 ,$424.12 ,$322.70 ,$461.00 ,$461.00 ,$280.75 ,$461.00 ,$318.55 ,$322.70 ,$126.74 ,$331.92 ,$137.45 ,$150.59 ,$150.59 ,$125.49 ,$150.59 ,$125.49 ,$331.92 ,$285.82 ,$331.92 ,$331.92 ,$276.60 ST VINCENT HOSPITAL - ACUTE,31100161,88262,HC CHROM COUNT 15-20/2,311,1 ,$450.00 ,$225.00 ,$125.49 ,$450.00 ,$290.70 ,$129.67 ,$450.00 ,$415.47 ,$125.49 ,$270.00 ,$382.50 ,$315.00 ,$129.67 ,$427.50 ,$324.00 ,$328.50 ,$213.33 ,$382.50 ,$125.49 ,$213.33 ,$360.00 ,$328.50 ,$129.67 ,$125.49 ,$138.57 ,$450.00 ,$382.50 ,$282.35 ,$414.00 ,$315.00 ,$450.00 ,$450.00 ,$274.05 ,$450.00 ,$310.95 ,$315.00 ,$126.74 ,$324.00 ,$137.45 ,$150.59 ,$150.59 ,$125.49 ,$150.59 ,$125.49 ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,31100162,88262,HC CHROM COUNT 15-20/2 (AUTOP),311,1 ,$470.00 ,$235.00 ,$125.49 ,$470.00 ,$303.62 ,$129.67 ,$470.00 ,$415.47 ,$125.49 ,$282.00 ,$399.50 ,$329.00 ,$129.67 ,$446.50 ,$338.40 ,$343.10 ,$213.33 ,$399.50 ,$125.49 ,$213.33 ,$376.00 ,$343.10 ,$129.67 ,$125.49 ,$138.57 ,$470.00 ,$399.50 ,$282.35 ,$432.40 ,$329.00 ,$470.00 ,$470.00 ,$286.23 ,$470.00 ,$324.77 ,$329.00 ,$126.74 ,$338.40 ,$137.45 ,$150.59 ,$150.59 ,$125.49 ,$150.59 ,$125.49 ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,31100163,88262,HC CHROM COUNT 15-20/2 (LYM),311,1 ,$673.00 ,$336.50 ,$125.49 ,$673.00 ,$434.76 ,$129.67 ,$484.72 ,$415.47 ,$125.49 ,$403.80 ,$572.05 ,$471.10 ,$129.67 ,$639.35 ,$484.56 ,$491.29 ,$213.33 ,$572.05 ,$125.49 ,$213.33 ,$538.40 ,$491.29 ,$129.67 ,$125.49 ,$138.57 ,$673.00 ,$572.05 ,$282.35 ,$619.16 ,$471.10 ,$596.84 ,$641.05 ,$409.86 ,$596.84 ,$465.04 ,$471.10 ,$126.74 ,$484.56 ,$137.45 ,$150.59 ,$150.59 ,$125.49 ,$150.59 ,$125.49 ,$484.56 ,$417.26 ,$484.56 ,$484.56 ,$403.80 ST VINCENT HOSPITAL - ACUTE,31100164,88299,HC CYTOGENIC STUDY (STLBRT1),311,1 ,$422.00 ,$211.00 ,$10.83 ,$422.00 ,$272.61 ,$10.83 ,$272.99 ,$272.99 ,$48.19 ,$253.20 ,$358.70 ,$295.40 ,$10.83 ,$400.90 ,$303.84 ,$308.06 , N/A ,$358.70 ,$48.19 , N/A ,$337.60 ,$308.06 ,$10.83 ,$48.19 ,$177.24 ,$422.00 ,$358.70 ,$108.43 ,$388.24 ,$295.40 ,$75.15 ,$80.72 ,$257.00 ,$75.15 ,$291.60 ,$295.40 ,$48.67 ,$303.84 ,$11.48 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$303.84 ,$261.64 ,$303.84 ,$303.84 ,$253.20 ST VINCENT HOSPITAL - ACUTE,31100165,88264,HC CYTOGENIC STUDY (HEMA BLD),311,1 ,$850.00 ,$425.00 ,$144.61 ,$850.00 ,$549.10 ,$149.43 ,$506.14 ,$433.83 ,$144.61 ,$510.00 ,$722.50 ,$595.00 ,$149.43 ,$807.50 ,$612.00 ,$620.50 ,$245.84 ,$722.50 ,$144.61 ,$245.84 ,$680.00 ,$620.50 ,$149.43 ,$144.61 ,$159.68 ,$850.00 ,$722.50 ,$325.37 ,$782.00 ,$595.00 ,$596.84 ,$641.05 ,$517.65 ,$596.84 ,$587.35 ,$595.00 ,$146.06 ,$612.00 ,$158.40 ,$173.53 ,$173.53 ,$144.61 ,$173.53 ,$144.61 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,31100166,88264,HC CHROM ANLYS ANALYZE 20,311,1 ,$850.00 ,$425.00 ,$144.61 ,$850.00 ,$549.10 ,$149.43 ,$506.14 ,$433.83 ,$144.61 ,$510.00 ,$722.50 ,$595.00 ,$149.43 ,$807.50 ,$612.00 ,$620.50 ,$245.84 ,$722.50 ,$144.61 ,$245.84 ,$680.00 ,$620.50 ,$149.43 ,$144.61 ,$159.68 ,$850.00 ,$722.50 ,$325.37 ,$782.00 ,$595.00 ,$596.84 ,$641.05 ,$517.65 ,$596.84 ,$587.35 ,$595.00 ,$146.06 ,$612.00 ,$158.40 ,$173.53 ,$173.53 ,$144.61 ,$173.53 ,$144.61 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,31100167,88264,HC CHROM ANLYS ANALZYE 20 (KARO),311,1 ,$850.00 ,$425.00 ,$144.61 ,$850.00 ,$549.10 ,$149.43 ,$506.14 ,$433.83 ,$144.61 ,$510.00 ,$722.50 ,$595.00 ,$149.43 ,$807.50 ,$612.00 ,$620.50 ,$245.84 ,$722.50 ,$144.61 ,$245.84 ,$680.00 ,$620.50 ,$149.43 ,$144.61 ,$159.68 ,$850.00 ,$722.50 ,$325.37 ,$782.00 ,$595.00 ,$596.84 ,$641.05 ,$517.65 ,$596.84 ,$587.35 ,$595.00 ,$146.06 ,$612.00 ,$158.40 ,$173.53 ,$173.53 ,$144.61 ,$173.53 ,$144.61 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,31100168,88264,HC CHROM ANLYS ANALZYE 20 (DC),311,1 ,$850.00 ,$425.00 ,$144.61 ,$850.00 ,$549.10 ,$149.43 ,$506.14 ,$433.83 ,$144.61 ,$510.00 ,$722.50 ,$595.00 ,$149.43 ,$807.50 ,$612.00 ,$620.50 ,$245.84 ,$722.50 ,$144.61 ,$245.84 ,$680.00 ,$620.50 ,$149.43 ,$144.61 ,$159.68 ,$850.00 ,$722.50 ,$325.37 ,$782.00 ,$595.00 ,$596.84 ,$641.05 ,$517.65 ,$596.84 ,$587.35 ,$595.00 ,$146.06 ,$612.00 ,$158.40 ,$173.53 ,$173.53 ,$144.61 ,$173.53 ,$144.61 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,31100169,88264,HC CYTOGENIC STUDY (BM),311,1 ,$850.00 ,$425.00 ,$144.61 ,$850.00 ,$549.10 ,$149.43 ,$506.14 ,$433.83 ,$144.61 ,$510.00 ,$722.50 ,$595.00 ,$149.43 ,$807.50 ,$612.00 ,$620.50 ,$245.84 ,$722.50 ,$144.61 ,$245.84 ,$680.00 ,$620.50 ,$149.43 ,$144.61 ,$159.68 ,$850.00 ,$722.50 ,$325.37 ,$782.00 ,$595.00 ,$596.84 ,$641.05 ,$517.65 ,$596.84 ,$587.35 ,$595.00 ,$146.06 ,$612.00 ,$158.40 ,$173.53 ,$173.53 ,$144.61 ,$173.53 ,$144.61 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,31100170,88299,HC CYTOGENIC STUDY (SOLID),311,1 ,$550.00 ,$275.00 ,$10.83 ,$550.00 ,$355.30 ,$10.83 ,$355.80 ,$355.80 ,$48.19 ,$330.00 ,$467.50 ,$385.00 ,$10.83 ,$522.50 ,$396.00 ,$401.50 , N/A ,$467.50 ,$48.19 , N/A ,$440.00 ,$401.50 ,$10.83 ,$48.19 ,$231.00 ,$550.00 ,$467.50 ,$108.43 ,$506.00 ,$385.00 ,$75.15 ,$80.72 ,$334.95 ,$75.15 ,$380.05 ,$385.00 ,$48.67 ,$396.00 ,$11.48 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,31100172,88271,HC MCG DNA PROBE (HER2),311,1 ,$230.00 ,$115.00 ,$20.36 ,$230.00 ,$148.58 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$138.00 ,$195.50 ,$161.00 ,$20.36 ,$218.50 ,$165.60 ,$167.90 ,$36.41 ,$195.50 ,$21.42 ,$36.41 ,$184.00 ,$167.90 ,$20.36 ,$21.42 ,$23.65 ,$230.00 ,$195.50 ,$48.20 ,$211.60 ,$161.00 ,$69.32 ,$74.46 ,$140.07 ,$69.32 ,$158.93 ,$161.00 ,$21.63 ,$165.60 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,31100173,88271,HC MCG DNA PROBE (PARDER WILLI),311,1 ,$400.00 ,$200.00 ,$20.36 ,$400.00 ,$258.40 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$240.00 ,$340.00 ,$280.00 ,$20.36 ,$380.00 ,$288.00 ,$292.00 ,$36.41 ,$340.00 ,$21.42 ,$36.41 ,$320.00 ,$292.00 ,$20.36 ,$21.42 ,$23.65 ,$400.00 ,$340.00 ,$48.20 ,$368.00 ,$280.00 ,$69.32 ,$74.46 ,$243.60 ,$69.32 ,$276.40 ,$280.00 ,$21.63 ,$288.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,31100174,88271,HC MCG DNA PROBE(FISH),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100175,88271,HC MCG DNA PROBE (FISH B CELL),311,1 ,$280.00 ,$140.00 ,$20.36 ,$280.00 ,$180.88 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$168.00 ,$238.00 ,$196.00 ,$20.36 ,$266.00 ,$201.60 ,$204.40 ,$36.41 ,$238.00 ,$21.42 ,$36.41 ,$224.00 ,$204.40 ,$20.36 ,$21.42 ,$23.65 ,$280.00 ,$238.00 ,$48.20 ,$257.60 ,$196.00 ,$69.32 ,$74.46 ,$170.52 ,$69.32 ,$193.48 ,$196.00 ,$21.63 ,$201.60 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,31100177,88271,HC MCG DNA PROBE (FISH DNA),311,1 ,$175.00 ,$87.50 ,$20.36 ,$175.00 ,$113.05 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$105.00 ,$148.75 ,$122.50 ,$20.36 ,$166.25 ,$126.00 ,$127.75 ,$36.41 ,$148.75 ,$21.42 ,$36.41 ,$140.00 ,$127.75 ,$20.36 ,$21.42 ,$23.65 ,$175.00 ,$148.75 ,$48.20 ,$161.00 ,$122.50 ,$69.32 ,$74.46 ,$106.58 ,$69.32 ,$120.93 ,$122.50 ,$21.63 ,$126.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$126.00 ,$108.50 ,$126.00 ,$126.00 ,$105.00 ST VINCENT HOSPITAL - ACUTE,31100178,88271,HC MCG DNA PROBE (T CELL),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100179,88271,HC MCG DNA PROBE (B CELL LYMPH),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100180,88271,HC MCG DNA PROBE (AML),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100181,88271,HC MCG DNA PROBE (MYCN),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100182,88271,HC MCG DNA PROBE (MDS),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100183,88271,HC MCG DNA PROBE (EACH),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100184,88271,HC MCG DNA PROBE (T CELL FISH),311,1 ,$175.00 ,$87.50 ,$20.36 ,$175.00 ,$113.05 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$105.00 ,$148.75 ,$122.50 ,$20.36 ,$166.25 ,$126.00 ,$127.75 ,$36.41 ,$148.75 ,$21.42 ,$36.41 ,$140.00 ,$127.75 ,$20.36 ,$21.42 ,$23.65 ,$175.00 ,$148.75 ,$48.20 ,$161.00 ,$122.50 ,$69.32 ,$74.46 ,$106.58 ,$69.32 ,$120.93 ,$122.50 ,$21.63 ,$126.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$126.00 ,$108.50 ,$126.00 ,$126.00 ,$105.00 ST VINCENT HOSPITAL - ACUTE,31100185,88271,HC MCG DNA PROBE (CLL),311,1 ,$200.00 ,$100.00 ,$20.36 ,$200.00 ,$129.20 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$120.00 ,$170.00 ,$140.00 ,$20.36 ,$190.00 ,$144.00 ,$146.00 ,$36.41 ,$170.00 ,$21.42 ,$36.41 ,$160.00 ,$146.00 ,$20.36 ,$21.42 ,$23.65 ,$200.00 ,$170.00 ,$48.20 ,$184.00 ,$140.00 ,$69.32 ,$74.46 ,$121.80 ,$69.32 ,$138.20 ,$140.00 ,$21.63 ,$144.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,31100186,88271,HC MCG DNA PROBE (BCR),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100187,88271,HC MCG DNA PROBE (B CELL ALL),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100188,88271,HC MCG DNA PROBE (B CELL ALL),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100189,88271,HC MCG DNA PROBE (T CELL LYMPH),311,1 ,$100.00 ,$50.00 ,$20.36 ,$100.00 ,$64.60 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$60.00 ,$85.00 ,$70.00 ,$20.36 ,$95.00 ,$72.00 ,$73.00 ,$36.41 ,$85.00 ,$21.42 ,$36.41 ,$80.00 ,$73.00 ,$20.36 ,$21.42 ,$23.65 ,$100.00 ,$85.00 ,$48.20 ,$92.00 ,$70.00 ,$69.32 ,$74.46 ,$60.90 ,$69.32 ,$69.10 ,$70.00 ,$21.63 ,$72.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100191,88273,HC MCG CHROM INSITU 10-30 (PARDER WILLI),311,1 ,$460.00 ,$230.00 ,$34.81 ,$460.00 ,$297.16 ,$35.97 ,$124.95 ,$107.10 ,$34.81 ,$276.00 ,$391.00 ,$322.00 ,$35.97 ,$437.00 ,$331.20 ,$335.80 ,$59.18 ,$391.00 ,$34.81 ,$59.18 ,$368.00 ,$335.80 ,$35.97 ,$34.81 ,$38.44 ,$460.00 ,$391.00 ,$78.32 ,$423.20 ,$322.00 ,$153.88 ,$165.28 ,$280.14 ,$153.88 ,$317.86 ,$322.00 ,$35.16 ,$331.20 ,$38.13 ,$41.77 ,$41.77 ,$34.81 ,$41.77 ,$34.81 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,31100192,88273,HC MCG CHROM INSITU 10-30,311,1 ,$175.00 ,$87.50 ,$34.81 ,$175.00 ,$113.05 ,$35.97 ,$124.95 ,$107.10 ,$34.81 ,$105.00 ,$148.75 ,$122.50 ,$35.97 ,$166.25 ,$126.00 ,$127.75 ,$59.18 ,$148.75 ,$34.81 ,$59.18 ,$140.00 ,$127.75 ,$35.97 ,$34.81 ,$38.44 ,$175.00 ,$148.75 ,$78.32 ,$161.00 ,$122.50 ,$153.88 ,$165.28 ,$106.58 ,$153.88 ,$120.93 ,$122.50 ,$35.16 ,$126.00 ,$38.13 ,$41.77 ,$41.77 ,$34.81 ,$41.77 ,$34.81 ,$126.00 ,$108.50 ,$126.00 ,$126.00 ,$105.00 ST VINCENT HOSPITAL - ACUTE,31100193,88274,HC MCG INTERPHASE INSITU 25 (HER2),311,1 ,$200.00 ,$100.00 ,$42.38 ,$200.00 ,$129.20 ,$43.79 ,$148.33 ,$127.14 ,$42.38 ,$120.00 ,$170.00 ,$140.00 ,$43.79 ,$190.00 ,$144.00 ,$146.00 ,$72.05 ,$170.00 ,$42.38 ,$72.05 ,$160.00 ,$146.00 ,$43.79 ,$42.38 ,$46.80 ,$200.00 ,$170.00 ,$95.36 ,$184.00 ,$140.00 ,$166.69 ,$179.04 ,$121.80 ,$166.69 ,$138.20 ,$140.00 ,$42.80 ,$144.00 ,$46.42 ,$50.86 ,$50.86 ,$42.38 ,$50.86 ,$42.38 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,31100194,88274,HC MCG INTERPHASE INSITU 25 (MYCN),311,1 ,$200.00 ,$100.00 ,$42.38 ,$200.00 ,$129.20 ,$43.79 ,$148.33 ,$127.14 ,$42.38 ,$120.00 ,$170.00 ,$140.00 ,$43.79 ,$190.00 ,$144.00 ,$146.00 ,$72.05 ,$170.00 ,$42.38 ,$72.05 ,$160.00 ,$146.00 ,$43.79 ,$42.38 ,$46.80 ,$200.00 ,$170.00 ,$95.36 ,$184.00 ,$140.00 ,$166.69 ,$179.04 ,$121.80 ,$166.69 ,$138.20 ,$140.00 ,$42.80 ,$144.00 ,$46.42 ,$50.86 ,$50.86 ,$42.38 ,$50.86 ,$42.38 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,31100195,88275,HC MCG INTERPH INSITU 100 (CML),311,1 ,$270.00 ,$135.00 ,$51.19 ,$270.00 ,$174.42 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$162.00 ,$229.50 ,$189.00 ,$52.89 ,$256.50 ,$194.40 ,$197.10 ,$87.02 ,$229.50 ,$51.19 ,$87.02 ,$216.00 ,$197.10 ,$52.89 ,$51.19 ,$56.52 ,$270.00 ,$229.50 ,$115.18 ,$248.40 ,$189.00 ,$192.31 ,$206.56 ,$164.43 ,$192.31 ,$186.57 ,$189.00 ,$51.70 ,$194.40 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,31100196,88275,HC MCG INTERPH INSITU 100 (B CELL FISH),311,1 ,$550.00 ,$275.00 ,$51.19 ,$550.00 ,$355.30 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$330.00 ,$467.50 ,$385.00 ,$52.89 ,$522.50 ,$396.00 ,$401.50 ,$87.02 ,$467.50 ,$51.19 ,$87.02 ,$440.00 ,$401.50 ,$52.89 ,$51.19 ,$56.52 ,$550.00 ,$467.50 ,$115.18 ,$506.00 ,$385.00 ,$192.31 ,$206.56 ,$334.95 ,$192.31 ,$380.05 ,$385.00 ,$51.70 ,$396.00 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,31100197,88275,HC MCG INTERPH INSITU 100 ADDITIONAL,311,1 ,$100.00 ,$50.00 ,$50.00 ,$115.18 ,$64.60 ,$52.89 ,$100.00 ,$100.00 ,$51.19 ,$60.00 ,$85.00 ,$70.00 ,$52.89 ,$95.00 ,$72.00 ,$73.00 ,$87.02 ,$85.00 ,$51.19 ,$87.02 ,$80.00 ,$73.00 ,$52.89 ,$51.19 ,$56.52 ,$100.00 ,$85.00 ,$115.18 ,$92.00 ,$70.00 ,$100.00 ,$100.00 ,$60.90 ,$100.00 ,$69.10 ,$70.00 ,$51.70 ,$72.00 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100198,88275,HC MCG INTERPH INSITU 100 (T CELL),311,1 ,$131.00 ,$65.50 ,$51.19 ,$131.00 ,$84.63 ,$52.89 ,$131.00 ,$131.00 ,$51.19 ,$78.60 ,$111.35 ,$91.70 ,$52.89 ,$124.45 ,$94.32 ,$95.63 ,$87.02 ,$111.35 ,$51.19 ,$87.02 ,$104.80 ,$95.63 ,$52.89 ,$51.19 ,$56.52 ,$131.00 ,$111.35 ,$115.18 ,$120.52 ,$91.70 ,$131.00 ,$131.00 ,$79.78 ,$131.00 ,$90.52 ,$91.70 ,$51.70 ,$94.32 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$94.32 ,$81.22 ,$94.32 ,$94.32 ,$78.60 ST VINCENT HOSPITAL - ACUTE,31100199,88275,HC MCG INTERPH INSITU 100 (B CELL LYMPH),311,1 ,$210.00 ,$105.00 ,$51.19 ,$210.00 ,$135.66 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$126.00 ,$178.50 ,$147.00 ,$52.89 ,$199.50 ,$151.20 ,$153.30 ,$87.02 ,$178.50 ,$51.19 ,$87.02 ,$168.00 ,$153.30 ,$52.89 ,$51.19 ,$56.52 ,$210.00 ,$178.50 ,$115.18 ,$193.20 ,$147.00 ,$192.31 ,$206.56 ,$127.89 ,$192.31 ,$145.11 ,$147.00 ,$51.70 ,$151.20 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,31100200,88275,HC MCG INTERPH INSITU 100 (AML),311,1 ,$210.00 ,$105.00 ,$51.19 ,$210.00 ,$135.66 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$126.00 ,$178.50 ,$147.00 ,$52.89 ,$199.50 ,$151.20 ,$153.30 ,$87.02 ,$178.50 ,$51.19 ,$87.02 ,$168.00 ,$153.30 ,$52.89 ,$51.19 ,$56.52 ,$210.00 ,$178.50 ,$115.18 ,$193.20 ,$147.00 ,$192.31 ,$206.56 ,$127.89 ,$192.31 ,$145.11 ,$147.00 ,$51.70 ,$151.20 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,31100201,88275,HC MCG INTERPH INSITU 100 (MDS),311,1 ,$300.00 ,$150.00 ,$51.19 ,$300.00 ,$193.80 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$180.00 ,$255.00 ,$210.00 ,$52.89 ,$285.00 ,$216.00 ,$219.00 ,$87.02 ,$255.00 ,$51.19 ,$87.02 ,$240.00 ,$219.00 ,$52.89 ,$51.19 ,$56.52 ,$300.00 ,$255.00 ,$115.18 ,$276.00 ,$210.00 ,$192.31 ,$206.56 ,$182.70 ,$192.31 ,$207.30 ,$210.00 ,$51.70 ,$216.00 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,31100202,88275,HC MCG INTERPH INSITU 100 (PCPD),311,1 ,$100.00 ,$50.00 ,$50.00 ,$115.18 ,$64.60 ,$52.89 ,$100.00 ,$100.00 ,$51.19 ,$60.00 ,$85.00 ,$70.00 ,$52.89 ,$95.00 ,$72.00 ,$73.00 ,$87.02 ,$85.00 ,$51.19 ,$87.02 ,$80.00 ,$73.00 ,$52.89 ,$51.19 ,$56.52 ,$100.00 ,$85.00 ,$115.18 ,$92.00 ,$70.00 ,$100.00 ,$100.00 ,$60.90 ,$100.00 ,$69.10 ,$70.00 ,$51.70 ,$72.00 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100203,88275,HC MCG INTERPH INSITU 100 (T CELL FISH),311,1 ,$175.00 ,$87.50 ,$51.19 ,$175.00 ,$113.05 ,$52.89 ,$175.00 ,$153.57 ,$51.19 ,$105.00 ,$148.75 ,$122.50 ,$52.89 ,$166.25 ,$126.00 ,$127.75 ,$87.02 ,$148.75 ,$51.19 ,$87.02 ,$140.00 ,$127.75 ,$52.89 ,$51.19 ,$56.52 ,$175.00 ,$148.75 ,$115.18 ,$161.00 ,$122.50 ,$175.00 ,$175.00 ,$106.58 ,$175.00 ,$120.93 ,$122.50 ,$51.70 ,$126.00 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$126.00 ,$108.50 ,$126.00 ,$126.00 ,$105.00 ST VINCENT HOSPITAL - ACUTE,31100204,88275,HC MCG INTERPH INSITU 100 (CLL),311,1 ,$100.00 ,$50.00 ,$50.00 ,$115.18 ,$64.60 ,$52.89 ,$100.00 ,$100.00 ,$51.19 ,$60.00 ,$85.00 ,$70.00 ,$52.89 ,$95.00 ,$72.00 ,$73.00 ,$87.02 ,$85.00 ,$51.19 ,$87.02 ,$80.00 ,$73.00 ,$52.89 ,$51.19 ,$56.52 ,$100.00 ,$85.00 ,$115.18 ,$92.00 ,$70.00 ,$100.00 ,$100.00 ,$60.90 ,$100.00 ,$69.10 ,$70.00 ,$51.70 ,$72.00 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100205,88275,HC MCG INTERPH INSITU 100 (BCR),311,1 ,$200.00 ,$100.00 ,$51.19 ,$200.00 ,$129.20 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$120.00 ,$170.00 ,$140.00 ,$52.89 ,$190.00 ,$144.00 ,$146.00 ,$87.02 ,$170.00 ,$51.19 ,$87.02 ,$160.00 ,$146.00 ,$52.89 ,$51.19 ,$56.52 ,$200.00 ,$170.00 ,$115.18 ,$184.00 ,$140.00 ,$192.31 ,$200.00 ,$121.80 ,$192.31 ,$138.20 ,$140.00 ,$51.70 ,$144.00 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,31100206,88275,HC MCG INTERPH INSITU 100 (B CELL),311,1 ,$226.00 ,$113.00 ,$51.19 ,$226.00 ,$146.00 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$135.60 ,$192.10 ,$158.20 ,$52.89 ,$214.70 ,$162.72 ,$164.98 ,$87.02 ,$192.10 ,$51.19 ,$87.02 ,$180.80 ,$164.98 ,$52.89 ,$51.19 ,$56.52 ,$226.00 ,$192.10 ,$115.18 ,$207.92 ,$158.20 ,$192.31 ,$206.56 ,$137.63 ,$192.31 ,$156.17 ,$158.20 ,$51.70 ,$162.72 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$162.72 ,$140.12 ,$162.72 ,$162.72 ,$135.60 ST VINCENT HOSPITAL - ACUTE,31100207,88275,HC MCG INTERPH INSITU 100 (B CELL ALL),311,1 ,$100.00 ,$50.00 ,$50.00 ,$115.18 ,$64.60 ,$52.89 ,$100.00 ,$100.00 ,$51.19 ,$60.00 ,$85.00 ,$70.00 ,$52.89 ,$95.00 ,$72.00 ,$73.00 ,$87.02 ,$85.00 ,$51.19 ,$87.02 ,$80.00 ,$73.00 ,$52.89 ,$51.19 ,$56.52 ,$100.00 ,$85.00 ,$115.18 ,$92.00 ,$70.00 ,$100.00 ,$100.00 ,$60.90 ,$100.00 ,$69.10 ,$70.00 ,$51.70 ,$72.00 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100208,88275,HC MCG INTERPH INSITU 100 (T CELL LYMPH),311,1 ,$100.00 ,$50.00 ,$50.00 ,$115.18 ,$64.60 ,$52.89 ,$100.00 ,$100.00 ,$51.19 ,$60.00 ,$85.00 ,$70.00 ,$52.89 ,$95.00 ,$72.00 ,$73.00 ,$87.02 ,$85.00 ,$51.19 ,$87.02 ,$80.00 ,$73.00 ,$52.89 ,$51.19 ,$56.52 ,$100.00 ,$85.00 ,$115.18 ,$92.00 ,$70.00 ,$100.00 ,$100.00 ,$60.90 ,$100.00 ,$69.10 ,$70.00 ,$51.70 ,$72.00 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,31100209,88275,HC MCG INTERPH INSITU 100 (T CELL LYMPHOMA),311,1 ,$175.00 ,$87.50 ,$51.19 ,$175.00 ,$113.05 ,$52.89 ,$175.00 ,$153.57 ,$51.19 ,$105.00 ,$148.75 ,$122.50 ,$52.89 ,$166.25 ,$126.00 ,$127.75 ,$87.02 ,$148.75 ,$51.19 ,$87.02 ,$140.00 ,$127.75 ,$52.89 ,$51.19 ,$56.52 ,$175.00 ,$148.75 ,$115.18 ,$161.00 ,$122.50 ,$175.00 ,$175.00 ,$106.58 ,$175.00 ,$120.93 ,$122.50 ,$51.70 ,$126.00 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$126.00 ,$108.50 ,$126.00 ,$126.00 ,$105.00 ST VINCENT HOSPITAL - ACUTE,31100210,88275,HC MCG INTERPH INSITU 100 (B CELL LYMPHOMA),311,1 ,$180.00 ,$90.00 ,$51.19 ,$180.00 ,$116.28 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$108.00 ,$153.00 ,$126.00 ,$52.89 ,$171.00 ,$129.60 ,$131.40 ,$87.02 ,$153.00 ,$51.19 ,$87.02 ,$144.00 ,$131.40 ,$52.89 ,$51.19 ,$56.52 ,$180.00 ,$153.00 ,$115.18 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$51.70 ,$129.60 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,31100211,88280,HC CHROM ADDL KARYO,311,1 ,$250.00 ,$125.00 ,$33.47 ,$250.00 ,$161.50 ,$34.58 ,$117.15 ,$100.41 ,$33.47 ,$150.00 ,$212.50 ,$175.00 ,$34.58 ,$237.50 ,$180.00 ,$182.50 ,$56.90 ,$212.50 ,$33.47 ,$56.90 ,$200.00 ,$182.50 ,$34.58 ,$33.47 ,$36.96 ,$250.00 ,$212.50 ,$75.31 ,$230.00 ,$175.00 ,$120.18 ,$129.08 ,$152.25 ,$120.18 ,$172.75 ,$175.00 ,$33.80 ,$180.00 ,$36.65 ,$40.16 ,$40.16 ,$33.47 ,$40.16 ,$33.47 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,31100212,88280,HC CHROM ADDL KARYO (T),311,1 ,$289.00 ,$144.50 ,$33.47 ,$289.00 ,$186.69 ,$34.58 ,$117.15 ,$100.41 ,$33.47 ,$173.40 ,$245.65 ,$202.30 ,$34.58 ,$274.55 ,$208.08 ,$210.97 ,$56.90 ,$245.65 ,$33.47 ,$56.90 ,$231.20 ,$210.97 ,$34.58 ,$33.47 ,$36.96 ,$289.00 ,$245.65 ,$75.31 ,$265.88 ,$202.30 ,$120.18 ,$129.08 ,$176.00 ,$120.18 ,$199.70 ,$202.30 ,$33.80 ,$208.08 ,$36.65 ,$40.16 ,$40.16 ,$33.47 ,$40.16 ,$33.47 ,$208.08 ,$179.18 ,$208.08 ,$208.08 ,$173.40 ST VINCENT HOSPITAL - ACUTE,31100213,88280,HC CHROM ADDL KARYO (L),311,1 ,$171.00 ,$85.50 ,$33.47 ,$171.00 ,$110.47 ,$34.58 ,$117.15 ,$100.41 ,$33.47 ,$102.60 ,$145.35 ,$119.70 ,$34.58 ,$162.45 ,$123.12 ,$124.83 ,$56.90 ,$145.35 ,$33.47 ,$56.90 ,$136.80 ,$124.83 ,$34.58 ,$33.47 ,$36.96 ,$171.00 ,$145.35 ,$75.31 ,$157.32 ,$119.70 ,$120.18 ,$129.08 ,$104.14 ,$120.18 ,$118.16 ,$119.70 ,$33.80 ,$123.12 ,$36.65 ,$40.16 ,$40.16 ,$33.47 ,$40.16 ,$33.47 ,$123.12 ,$106.02 ,$123.12 ,$123.12 ,$102.60 ST VINCENT HOSPITAL - ACUTE,31100214,88289,HC CHROM ADDL HIGH RES (HRS),311,1 ,$277.00 ,$138.50 ,$34.43 ,$277.00 ,$178.94 ,$35.58 ,$133.91 ,$114.78 ,$34.43 ,$166.20 ,$235.45 ,$193.90 ,$35.58 ,$263.15 ,$199.44 ,$202.21 ,$58.53 ,$235.45 ,$34.43 ,$58.53 ,$221.60 ,$202.21 ,$35.58 ,$34.43 ,$38.02 ,$277.00 ,$235.45 ,$77.47 ,$254.84 ,$193.90 ,$164.90 ,$177.11 ,$168.69 ,$164.90 ,$191.41 ,$193.90 ,$34.77 ,$199.44 ,$37.71 ,$41.32 ,$41.32 ,$34.43 ,$41.32 ,$34.43 ,$199.44 ,$171.74 ,$199.44 ,$199.44 ,$166.20 ST VINCENT HOSPITAL - ACUTE,31100215,88289,HC CHROM ADDL HIGH RES (FXS),311,1 ,$109.00 ,$54.50 ,$34.43 ,$109.00 ,$70.41 ,$35.58 ,$109.00 ,$109.00 ,$34.43 ,$65.40 ,$92.65 ,$76.30 ,$35.58 ,$103.55 ,$78.48 ,$79.57 ,$58.53 ,$92.65 ,$34.43 ,$58.53 ,$87.20 ,$79.57 ,$35.58 ,$34.43 ,$38.02 ,$109.00 ,$92.65 ,$77.47 ,$100.28 ,$76.30 ,$109.00 ,$109.00 ,$66.38 ,$109.00 ,$75.32 ,$76.30 ,$34.77 ,$78.48 ,$37.71 ,$41.32 ,$41.32 ,$34.43 ,$41.32 ,$34.43 ,$78.48 ,$67.58 ,$78.48 ,$78.48 ,$65.40 ST VINCENT HOSPITAL - ACUTE,31100218,P3000,HC PAP SMEAR SCREEN (UP TO 3),311,1 ,$61.00 ,$30.50 ,$14.86 ,$61.00 ,$39.41 ,$14.86 ,$52.47 ,$44.97 ,$15.15 ,$36.60 ,$51.85 ,$42.70 ,$14.86 ,$57.95 ,$43.92 ,$44.53 ,$25.76 ,$51.85 ,$15.15 ,$25.76 ,$48.80 ,$44.53 ,$14.86 ,$15.15 ,$16.73 ,$61.00 ,$51.85 ,$34.09 ,$56.12 ,$42.70 ,$50.61 ,$54.36 ,$37.15 ,$50.61 ,$42.15 ,$42.70 ,$15.30 ,$43.92 ,$15.75 ,$18.14 ,$18.14 ,$15.15 ,$18.14 ,$15.15 ,$43.92 ,$37.82 ,$43.92 ,$43.92 ,$36.60 ST VINCENT HOSPITAL - ACUTE,31100219,P3000,HC PAP SMEAR SLIDE SCREEN,311,1 ,$53.00 ,$26.50 ,$14.86 ,$53.00 ,$34.24 ,$14.86 ,$52.47 ,$44.97 ,$15.15 ,$31.80 ,$45.05 ,$37.10 ,$14.86 ,$50.35 ,$38.16 ,$38.69 ,$25.76 ,$45.05 ,$15.15 ,$25.76 ,$42.40 ,$38.69 ,$14.86 ,$15.15 ,$16.73 ,$53.00 ,$45.05 ,$34.09 ,$48.76 ,$37.10 ,$50.61 ,$53.00 ,$32.28 ,$50.61 ,$36.62 ,$37.10 ,$15.30 ,$38.16 ,$15.75 ,$18.14 ,$18.14 ,$15.15 ,$18.14 ,$15.15 ,$38.16 ,$32.86 ,$38.16 ,$38.16 ,$31.80 ST VINCENT HOSPITAL - ACUTE,31100220,88274,HC INTERPHASE 20-99 CELLS FISH,311,1 ,$120.00 ,$60.00 ,$42.38 ,$120.00 ,$77.52 ,$43.79 ,$120.00 ,$120.00 ,$42.38 ,$72.00 ,$102.00 ,$84.00 ,$43.79 ,$114.00 ,$86.40 ,$87.60 ,$72.05 ,$102.00 ,$42.38 ,$72.05 ,$96.00 ,$87.60 ,$43.79 ,$42.38 ,$46.80 ,$120.00 ,$102.00 ,$95.36 ,$110.40 ,$84.00 ,$120.00 ,$120.00 ,$73.08 ,$120.00 ,$82.92 ,$84.00 ,$42.80 ,$86.40 ,$46.42 ,$50.86 ,$50.86 ,$42.38 ,$50.86 ,$42.38 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,31100221,88271,HC MCG DNA PROBE (B CELL),311,1 ,$122.00 ,$61.00 ,$20.36 ,$122.00 ,$78.81 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$73.20 ,$103.70 ,$85.40 ,$20.36 ,$115.90 ,$87.84 ,$89.06 ,$36.41 ,$103.70 ,$21.42 ,$36.41 ,$97.60 ,$89.06 ,$20.36 ,$21.42 ,$23.65 ,$122.00 ,$103.70 ,$48.20 ,$112.24 ,$85.40 ,$69.32 ,$74.46 ,$74.30 ,$69.32 ,$84.30 ,$85.40 ,$21.63 ,$87.84 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$87.84 ,$75.64 ,$87.84 ,$87.84 ,$73.20 ST VINCENT HOSPITAL - ACUTE,31100222,88299,HC CYTOGENIC STUDY,311,1 ,$493.00 ,$246.50 ,$10.83 ,$493.00 ,$318.48 ,$10.83 ,$318.92 ,$318.92 ,$48.19 ,$295.80 ,$419.05 ,$345.10 ,$10.83 ,$468.35 ,$354.96 ,$359.89 , N/A ,$419.05 ,$48.19 , N/A ,$394.40 ,$359.89 ,$10.83 ,$48.19 ,$207.06 ,$493.00 ,$419.05 ,$108.43 ,$453.56 ,$345.10 ,$75.15 ,$80.72 ,$300.24 ,$75.15 ,$340.66 ,$345.10 ,$48.67 ,$354.96 ,$11.48 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$354.96 ,$305.66 ,$354.96 ,$354.96 ,$295.80 ST VINCENT HOSPITAL - ACUTE,31100223,88280,HC ADDITIONAL KARYO EACH (DC),311,1 ,$217.00 ,$108.50 ,$33.47 ,$217.00 ,$140.18 ,$34.58 ,$117.15 ,$100.41 ,$33.47 ,$130.20 ,$184.45 ,$151.90 ,$34.58 ,$206.15 ,$156.24 ,$158.41 ,$56.90 ,$184.45 ,$33.47 ,$56.90 ,$173.60 ,$158.41 ,$34.58 ,$33.47 ,$36.96 ,$217.00 ,$184.45 ,$75.31 ,$199.64 ,$151.90 ,$120.18 ,$129.08 ,$132.15 ,$120.18 ,$149.95 ,$151.90 ,$33.80 ,$156.24 ,$36.65 ,$40.16 ,$40.16 ,$33.47 ,$40.16 ,$33.47 ,$156.24 ,$134.54 ,$156.24 ,$156.24 ,$130.20 ST VINCENT HOSPITAL - ACUTE,31100232,88271,HC MCG DNA PROBE (QST EACH),311,1 ,$150.00 ,$75.00 ,$20.36 ,$150.00 ,$96.90 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$90.00 ,$127.50 ,$105.00 ,$20.36 ,$142.50 ,$108.00 ,$109.50 ,$36.41 ,$127.50 ,$21.42 ,$36.41 ,$120.00 ,$109.50 ,$20.36 ,$21.42 ,$23.65 ,$150.00 ,$127.50 ,$48.20 ,$138.00 ,$105.00 ,$69.32 ,$74.46 ,$91.35 ,$69.32 ,$103.65 ,$105.00 ,$21.63 ,$108.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,31100233,88275,HC MCG INTERPH INSITU 100 (FISH MDS MY),311,1 ,$224.00 ,$112.00 ,$51.19 ,$224.00 ,$144.70 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$134.40 ,$190.40 ,$156.80 ,$52.89 ,$212.80 ,$161.28 ,$163.52 ,$87.02 ,$190.40 ,$51.19 ,$87.02 ,$179.20 ,$163.52 ,$52.89 ,$51.19 ,$56.52 ,$224.00 ,$190.40 ,$115.18 ,$206.08 ,$156.80 ,$192.31 ,$206.56 ,$136.42 ,$192.31 ,$154.78 ,$156.80 ,$51.70 ,$161.28 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$161.28 ,$138.88 ,$161.28 ,$161.28 ,$134.40 ST VINCENT HOSPITAL - ACUTE,31100234,88275,HC MCG INTERPH INSITU 100 (FISH AMLM3/BURKITT),311,1 ,$224.00 ,$112.00 ,$51.19 ,$224.00 ,$144.70 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$134.40 ,$190.40 ,$156.80 ,$52.89 ,$212.80 ,$161.28 ,$163.52 ,$87.02 ,$190.40 ,$51.19 ,$87.02 ,$179.20 ,$163.52 ,$52.89 ,$51.19 ,$56.52 ,$224.00 ,$190.40 ,$115.18 ,$206.08 ,$156.80 ,$192.31 ,$206.56 ,$136.42 ,$192.31 ,$154.78 ,$156.80 ,$51.70 ,$161.28 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$161.28 ,$138.88 ,$161.28 ,$161.28 ,$134.40 ST VINCENT HOSPITAL - ACUTE,31100235,88275,HC MCG INTERPH INSITU 100 (FISH AML/HES/AMLETO/IGH),311,1 ,$224.00 ,$112.00 ,$51.19 ,$224.00 ,$144.70 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$134.40 ,$190.40 ,$156.80 ,$52.89 ,$212.80 ,$161.28 ,$163.52 ,$87.02 ,$190.40 ,$51.19 ,$87.02 ,$179.20 ,$163.52 ,$52.89 ,$51.19 ,$56.52 ,$224.00 ,$190.40 ,$115.18 ,$206.08 ,$156.80 ,$192.31 ,$206.56 ,$136.42 ,$192.31 ,$154.78 ,$156.80 ,$51.70 ,$161.28 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$161.28 ,$138.88 ,$161.28 ,$161.28 ,$134.40 ST VINCENT HOSPITAL - ACUTE,31100236,88275,HC MCG INTERPH INSITU 100 (FISH ESO),311,1 ,$234.00 ,$117.00 ,$51.19 ,$234.00 ,$151.16 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$140.40 ,$198.90 ,$163.80 ,$52.89 ,$222.30 ,$168.48 ,$170.82 ,$87.02 ,$198.90 ,$51.19 ,$87.02 ,$187.20 ,$170.82 ,$52.89 ,$51.19 ,$56.52 ,$234.00 ,$198.90 ,$115.18 ,$215.28 ,$163.80 ,$192.31 ,$206.56 ,$142.51 ,$192.31 ,$161.69 ,$163.80 ,$51.70 ,$168.48 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$168.48 ,$145.08 ,$168.48 ,$168.48 ,$140.40 ST VINCENT HOSPITAL - ACUTE,31100237,88275,HC MCG INTERPH INSITU 100 (FISH IGHBCL2/MCL),311,1 ,$260.00 ,$130.00 ,$51.19 ,$260.00 ,$167.96 ,$52.89 ,$179.17 ,$153.57 ,$51.19 ,$156.00 ,$221.00 ,$182.00 ,$52.89 ,$247.00 ,$187.20 ,$189.80 ,$87.02 ,$221.00 ,$51.19 ,$87.02 ,$208.00 ,$189.80 ,$52.89 ,$51.19 ,$56.52 ,$260.00 ,$221.00 ,$115.18 ,$239.20 ,$182.00 ,$192.31 ,$206.56 ,$158.34 ,$192.31 ,$179.66 ,$182.00 ,$51.70 ,$187.20 ,$56.06 ,$61.43 ,$61.43 ,$51.19 ,$61.43 ,$51.19 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31100285,88271,HC MCG DNA PROBE(FISH) LUNG CANCER ROS1,311,1 ,$790.00 ,$395.00 ,$20.36 ,$790.00 ,$510.34 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$474.00 ,$671.50 ,$553.00 ,$20.36 ,$750.50 ,$568.80 ,$576.70 ,$36.41 ,$671.50 ,$21.42 ,$36.41 ,$632.00 ,$576.70 ,$20.36 ,$21.42 ,$23.65 ,$790.00 ,$671.50 ,$48.20 ,$726.80 ,$553.00 ,$69.32 ,$74.46 ,$481.11 ,$69.32 ,$545.89 ,$553.00 ,$21.63 ,$568.80 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,31100286,88271,HC MCG DNA PROBE(FISH) LUNG CANCER ALK,311,1 ,$700.00 ,$350.00 ,$20.36 ,$700.00 ,$452.20 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$420.00 ,$595.00 ,$490.00 ,$20.36 ,$665.00 ,$504.00 ,$511.00 ,$36.41 ,$595.00 ,$21.42 ,$36.41 ,$560.00 ,$511.00 ,$20.36 ,$21.42 ,$23.65 ,$700.00 ,$595.00 ,$48.20 ,$644.00 ,$490.00 ,$69.32 ,$74.46 ,$426.30 ,$69.32 ,$483.70 ,$490.00 ,$21.63 ,$504.00 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,31100309,88121,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC COMP ASSIST,311,1 ,$526.00 ,$263.00 ,$11.95 ,$634.69 ,$339.80 ,$11.95 ,$526.00 ,$526.00 ,$282.09 ,$315.60 ,$447.10 ,$368.20 ,$11.95 ,$499.70 ,$378.72 ,$383.98 ,$526.00 ,$447.10 ,$282.09 ,$526.00 ,$420.80 ,$383.98 ,$11.95 ,$282.09 ,$220.92 ,$526.00 ,$447.10 ,$634.69 ,$483.92 ,$368.20 ,$526.00 ,$526.00 ,$320.33 ,$526.00 ,$363.47 ,$368.20 ,$284.91 ,$378.72 ,$12.67 ,$340.09 ,$340.09 ,$282.09 ,$340.09 ,$282.09 ,$378.72 ,$326.12 ,$378.72 ,$378.72 ,$315.60 ST VINCENT HOSPITAL - ACUTE,31100315,88271,HC PLASMA CELL PROLIF SORT FISH PROBE/REPORT,311,1 ,$411.00 ,$205.50 ,$20.36 ,$411.00 ,$265.51 ,$20.36 ,$83.30 ,$71.40 ,$21.42 ,$246.60 ,$349.35 ,$287.70 ,$20.36 ,$390.45 ,$295.92 ,$300.03 ,$36.41 ,$349.35 ,$21.42 ,$36.41 ,$328.80 ,$300.03 ,$20.36 ,$21.42 ,$23.65 ,$411.00 ,$349.35 ,$48.20 ,$378.12 ,$287.70 ,$69.32 ,$74.46 ,$250.30 ,$69.32 ,$284.00 ,$287.70 ,$21.63 ,$295.92 ,$21.58 ,$25.70 ,$25.70 ,$21.42 ,$25.70 ,$21.42 ,$295.92 ,$254.82 ,$295.92 ,$295.92 ,$246.60 ST VINCENT HOSPITAL - ACUTE,31100316,88184,HC PCPDS PRE ANAL CELL SORT BM 1 MARKER,311,1 ,$79.00 ,$39.50 ,$11.38 ,$634.69 ,$51.03 ,$11.38 ,$79.00 ,$79.00 ,$282.09 ,$47.40 ,$67.15 ,$55.30 ,$11.38 ,$75.05 ,$56.88 ,$57.67 ,$79.00 ,$67.15 ,$282.09 ,$79.00 ,$63.20 ,$57.67 ,$11.38 ,$282.09 ,$33.18 ,$79.00 ,$67.15 ,$634.69 ,$72.68 ,$55.30 ,$79.00 ,$79.00 ,$48.11 ,$79.00 ,$54.59 ,$55.30 ,$284.91 ,$56.88 ,$12.06 ,$79.00 ,$79.00 ,$282.09 ,$79.00 ,$282.09 ,$56.88 ,$48.98 ,$56.88 ,$56.88 ,$47.40 ST VINCENT HOSPITAL - ACUTE,31100317,88185,HC PCPDS PRE ANAL CELL SORT BM ADDNT MARKER,311,1 ,$26.00 ,$13.00 ,$10.92 ,$26.00 ,$16.80 ,$11.95 ,$26.00 ,$26.00 , N/A ,$15.60 ,$22.10 ,$18.20 ,$11.95 ,$24.70 ,$18.72 ,$18.98 ,$26.00 ,$22.10 , N/A ,$26.00 ,$20.80 ,$18.98 ,$11.95 , N/A ,$10.92 ,$26.00 ,$22.10 , N/A ,$23.92 ,$18.20 ,$26.00 ,$26.00 ,$15.83 ,$26.00 ,$17.97 ,$18.20 , N/A ,$18.72 ,$12.67 ,$26.00 ,$26.00 , N/A ,$26.00 , N/A ,$18.72 ,$16.12 ,$18.72 ,$18.72 ,$15.60 ST VINCENT HOSPITAL - ACUTE,31200101,88300,HC GROSS ONLY LEVEL I,312,1 ,$97.00 ,$48.50 ,$5.22 ,$97.00 ,$62.66 ,$5.22 ,$37.86 ,$32.45 ,$23.89 ,$58.20 ,$82.45 ,$67.90 ,$5.22 ,$92.15 ,$69.84 ,$70.81 ,$24.65 ,$82.45 ,$23.89 ,$24.65 ,$77.60 ,$70.81 ,$5.22 ,$23.89 ,$40.74 ,$97.00 ,$82.45 ,$53.76 ,$89.24 ,$67.90 ,$75.15 ,$80.72 ,$59.07 ,$75.15 ,$67.03 ,$67.90 ,$24.13 ,$69.84 ,$5.53 ,$27.59 ,$27.59 ,$23.89 ,$27.59 ,$23.89 ,$69.84 ,$60.14 ,$69.84 ,$69.84 ,$58.20 ST VINCENT HOSPITAL - ACUTE,31200102,88302,HC GROSS AND MICRO LEVEL II,312,1 ,$200.00 ,$100.00 ,$5.22 ,$200.00 ,$129.20 ,$5.22 ,$80.11 ,$68.66 ,$23.89 ,$120.00 ,$170.00 ,$140.00 ,$5.22 ,$190.00 ,$144.00 ,$146.00 ,$51.09 ,$170.00 ,$23.89 ,$51.09 ,$160.00 ,$146.00 ,$5.22 ,$23.89 ,$84.00 ,$200.00 ,$170.00 ,$53.76 ,$184.00 ,$140.00 ,$75.15 ,$80.72 ,$121.80 ,$75.15 ,$138.20 ,$140.00 ,$24.13 ,$144.00 ,$5.53 ,$27.59 ,$27.59 ,$23.89 ,$27.59 ,$23.89 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,31200103,88304,HC GROSS AND MICRO LEVEL III,312,1 ,$250.00 ,$125.00 ,$11.38 ,$250.00 ,$161.50 ,$11.38 ,$97.01 ,$83.15 ,$48.19 ,$150.00 ,$212.50 ,$175.00 ,$11.38 ,$237.50 ,$180.00 ,$182.50 ,$67.61 ,$212.50 ,$48.19 ,$67.61 ,$200.00 ,$182.50 ,$11.38 ,$48.19 ,$105.00 ,$250.00 ,$212.50 ,$108.43 ,$230.00 ,$175.00 ,$138.36 ,$148.61 ,$152.25 ,$138.36 ,$172.75 ,$175.00 ,$48.67 ,$180.00 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,31200105,88305,HC CELLIENT CELL BLOCK,312,1 ,$102.00 ,$51.00 ,$11.38 ,$108.43 ,$65.89 ,$11.38 ,$101.84 ,$87.29 ,$48.19 ,$61.20 ,$86.70 ,$71.40 ,$11.38 ,$96.90 ,$73.44 ,$74.46 ,$102.00 ,$86.70 ,$48.19 ,$102.00 ,$81.60 ,$74.46 ,$11.38 ,$48.19 ,$42.84 ,$102.00 ,$86.70 ,$108.43 ,$93.84 ,$71.40 ,$102.00 ,$102.00 ,$62.12 ,$102.00 ,$70.48 ,$71.40 ,$48.67 ,$73.44 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$73.44 ,$63.24 ,$73.44 ,$73.44 ,$61.20 ST VINCENT HOSPITAL - ACUTE,31200108,88305,HC GROSS AND MICRO LEVEL IV,312,1 ,$300.00 ,$150.00 ,$11.38 ,$300.00 ,$193.80 ,$11.38 ,$101.84 ,$87.29 ,$48.19 ,$180.00 ,$255.00 ,$210.00 ,$11.38 ,$285.00 ,$216.00 ,$219.00 ,$116.37 ,$255.00 ,$48.19 ,$116.37 ,$240.00 ,$219.00 ,$11.38 ,$48.19 ,$126.00 ,$300.00 ,$255.00 ,$108.43 ,$276.00 ,$210.00 ,$138.36 ,$148.61 ,$182.70 ,$138.36 ,$207.30 ,$210.00 ,$48.67 ,$216.00 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,31200109,88305,HC GROSS AND MICRO LEVEL IV (BM),312,1 ,$255.00 ,$127.50 ,$11.38 ,$255.00 ,$164.73 ,$11.38 ,$101.84 ,$87.29 ,$48.19 ,$153.00 ,$216.75 ,$178.50 ,$11.38 ,$242.25 ,$183.60 ,$186.15 ,$116.37 ,$216.75 ,$48.19 ,$116.37 ,$204.00 ,$186.15 ,$11.38 ,$48.19 ,$107.10 ,$255.00 ,$216.75 ,$108.43 ,$234.60 ,$178.50 ,$138.36 ,$148.61 ,$155.30 ,$138.36 ,$176.21 ,$178.50 ,$48.67 ,$183.60 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$183.60 ,$158.10 ,$183.60 ,$183.60 ,$153.00 ST VINCENT HOSPITAL - ACUTE,31200110,88307,HC GROSS AND MICRO LEVEL V,312,1 ,$980.00 ,$490.00 ,$11.95 ,$980.00 ,$633.08 ,$11.95 ,$623.75 ,$534.65 ,$282.09 ,$588.00 ,$833.00 ,$686.00 ,$11.95 ,$931.00 ,$705.60 ,$715.40 ,$467.31 ,$833.00 ,$282.09 ,$467.31 ,$784.00 ,$715.40 ,$11.95 ,$282.09 ,$411.60 ,$980.00 ,$833.00 ,$634.69 ,$901.60 ,$686.00 ,$232.78 ,$250.03 ,$596.82 ,$232.78 ,$677.18 ,$686.00 ,$284.91 ,$705.60 ,$12.67 ,$340.09 ,$340.09 ,$282.09 ,$340.09 ,$282.09 ,$705.60 ,$607.60 ,$705.60 ,$705.60 ,$588.00 ST VINCENT HOSPITAL - ACUTE,31200112,88307,HC GROSS AND MICRO LEVEL V ( >3),312,1 ,$980.00 ,$490.00 ,$11.95 ,$980.00 ,$633.08 ,$11.95 ,$623.75 ,$534.65 ,$282.09 ,$588.00 ,$833.00 ,$686.00 ,$11.95 ,$931.00 ,$705.60 ,$715.40 ,$467.31 ,$833.00 ,$282.09 ,$467.31 ,$784.00 ,$715.40 ,$11.95 ,$282.09 ,$411.60 ,$980.00 ,$833.00 ,$634.69 ,$901.60 ,$686.00 ,$232.78 ,$250.03 ,$596.82 ,$232.78 ,$677.18 ,$686.00 ,$284.91 ,$705.60 ,$12.67 ,$340.09 ,$340.09 ,$282.09 ,$340.09 ,$282.09 ,$705.60 ,$607.60 ,$705.60 ,$705.60 ,$588.00 ST VINCENT HOSPITAL - ACUTE,31200113,88309,HC GROSS AND MICRO LEVEL VI,312,1 ,"$1,400.00 ",$700.00 ,$11.95 ,"$1,429.83 ",$904.40 ,$11.95 ,$875.27 ,$750.24 ,$635.48 ,$840.00 ,"$1,190.00 ",$980.00 ,$11.95 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$713.59 ,"$1,190.00 ",$635.48 ,$713.59 ,"$1,120.00 ","$1,022.00 ",$11.95 ,$635.48 ,$588.00 ,"$1,400.00 ","$1,190.00 ","$1,429.83 ","$1,288.00 ",$980.00 ,$680.48 ,$730.89 ,$852.60 ,$680.48 ,$967.40 ,$980.00 ,$641.83 ,"$1,008.00 ",$12.67 ,$753.84 ,$753.84 ,$635.48 ,$753.84 ,$635.48 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,31200115,88309,HC GROSS AND MICRO LEVEL VI ( >5),312,1 ,"$1,400.00 ",$700.00 ,$11.95 ,"$1,429.83 ",$904.40 ,$11.95 ,$875.27 ,$750.24 ,$635.48 ,$840.00 ,"$1,190.00 ",$980.00 ,$11.95 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$713.59 ,"$1,190.00 ",$635.48 ,$713.59 ,"$1,120.00 ","$1,022.00 ",$11.95 ,$635.48 ,$588.00 ,"$1,400.00 ","$1,190.00 ","$1,429.83 ","$1,288.00 ",$980.00 ,$680.48 ,$730.89 ,$852.60 ,$680.48 ,$967.40 ,$980.00 ,$641.83 ,"$1,008.00 ",$12.67 ,$753.84 ,$753.84 ,$635.48 ,$753.84 ,$635.48 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,31200116,88311,HC DECALCIFICATION,312,1 ,$70.00 ,$35.00 ,$5.22 ,$70.00 ,$45.22 ,$5.22 ,$29.41 ,$25.21 , N/A ,$42.00 ,$59.50 ,$49.00 ,$5.22 ,$66.50 ,$50.40 ,$51.10 ,$34.15 ,$59.50 , N/A ,$34.15 ,$56.00 ,$51.10 ,$5.22 , N/A ,$29.40 ,$70.00 ,$59.50 , N/A ,$64.40 ,$49.00 ,$39.17 ,$42.07 ,$42.63 ,$39.17 ,$48.37 ,$49.00 , N/A ,$50.40 ,$5.53 ,$10.82 ,$10.82 , N/A ,$10.82 , N/A ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,31200119,88312,HC SPECIAL STAIN I (STEINER),312,1 ,$140.00 ,$70.00 ,$11.38 ,$140.00 ,$90.44 ,$11.38 ,$140.00 ,$140.00 ,$48.19 ,$84.00 ,$119.00 ,$98.00 ,$11.38 ,$133.00 ,$100.80 ,$102.20 ,$140.00 ,$119.00 ,$48.19 ,$140.00 ,$112.00 ,$102.20 ,$11.38 ,$48.19 ,$58.80 ,$140.00 ,$119.00 ,$108.43 ,$128.80 ,$98.00 ,$75.15 ,$80.72 ,$85.26 ,$75.15 ,$96.74 ,$98.00 ,$48.67 ,$100.80 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,31200120,88312,HC SPECIAL STAIN I (WARTHIN-STARRY),312,1 ,$126.00 ,$63.00 ,$11.38 ,$126.00 ,$81.40 ,$11.38 ,$126.00 ,$126.00 ,$48.19 ,$75.60 ,$107.10 ,$88.20 ,$11.38 ,$119.70 ,$90.72 ,$91.98 ,$126.00 ,$107.10 ,$48.19 ,$126.00 ,$100.80 ,$91.98 ,$11.38 ,$48.19 ,$52.92 ,$126.00 ,$107.10 ,$108.43 ,$115.92 ,$88.20 ,$75.15 ,$80.72 ,$76.73 ,$75.15 ,$87.07 ,$88.20 ,$48.67 ,$90.72 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$90.72 ,$78.12 ,$90.72 ,$90.72 ,$75.60 ST VINCENT HOSPITAL - ACUTE,31200122,88312,HC SPECIAL STAIN I (AFB),312,1 ,$143.00 ,$71.50 ,$11.38 ,$143.00 ,$92.38 ,$11.38 ,$143.00 ,$143.00 ,$48.19 ,$85.80 ,$121.55 ,$100.10 ,$11.38 ,$135.85 ,$102.96 ,$104.39 ,$143.00 ,$121.55 ,$48.19 ,$143.00 ,$114.40 ,$104.39 ,$11.38 ,$48.19 ,$60.06 ,$143.00 ,$121.55 ,$108.43 ,$131.56 ,$100.10 ,$75.15 ,$80.72 ,$87.09 ,$75.15 ,$98.81 ,$100.10 ,$48.67 ,$102.96 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$102.96 ,$88.66 ,$102.96 ,$102.96 ,$85.80 ST VINCENT HOSPITAL - ACUTE,31200123,88312,HC SPECIAL STAIN I,312,1 ,$320.00 ,$160.00 ,$11.38 ,$320.00 ,$206.72 ,$11.38 ,$247.90 ,$212.49 ,$48.19 ,$192.00 ,$272.00 ,$224.00 ,$11.38 ,$304.00 ,$230.40 ,$233.60 ,$182.14 ,$272.00 ,$48.19 ,$182.14 ,$256.00 ,$233.60 ,$11.38 ,$48.19 ,$134.40 ,$320.00 ,$272.00 ,$108.43 ,$294.40 ,$224.00 ,$75.15 ,$80.72 ,$194.88 ,$75.15 ,$221.12 ,$224.00 ,$48.67 ,$230.40 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,31200124,88312,HC SPECIAL STAIN I (GIEMSA OR PAS),312,1 ,$320.00 ,$160.00 ,$11.38 ,$320.00 ,$206.72 ,$11.38 ,$247.90 ,$212.49 ,$48.19 ,$192.00 ,$272.00 ,$224.00 ,$11.38 ,$304.00 ,$230.40 ,$233.60 ,$182.14 ,$272.00 ,$48.19 ,$182.14 ,$256.00 ,$233.60 ,$11.38 ,$48.19 ,$134.40 ,$320.00 ,$272.00 ,$108.43 ,$294.40 ,$224.00 ,$75.15 ,$80.72 ,$194.88 ,$75.15 ,$221.12 ,$224.00 ,$48.67 ,$230.40 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,31200125,88313,HC SPECIAL STAIN II,312,1 ,$260.00 ,$130.00 ,$5.22 ,$260.00 ,$167.96 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$156.00 ,$221.00 ,$182.00 ,$5.22 ,$247.00 ,$187.20 ,$189.80 ,$130.82 ,$221.00 ,$32.77 ,$130.82 ,$208.00 ,$189.80 ,$5.22 ,$32.77 ,$109.20 ,$260.00 ,$221.00 ,$73.74 ,$239.20 ,$182.00 ,$75.15 ,$80.72 ,$158.34 ,$75.15 ,$179.66 ,$182.00 ,$33.10 ,$187.20 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31200126,88313,HC SPECIAL STAIN II (OIL RED),312,1 ,$260.00 ,$130.00 ,$5.22 ,$260.00 ,$167.96 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$156.00 ,$221.00 ,$182.00 ,$5.22 ,$247.00 ,$187.20 ,$189.80 ,$130.82 ,$221.00 ,$32.77 ,$130.82 ,$208.00 ,$189.80 ,$5.22 ,$32.77 ,$109.20 ,$260.00 ,$221.00 ,$73.74 ,$239.20 ,$182.00 ,$75.15 ,$80.72 ,$158.34 ,$75.15 ,$179.66 ,$182.00 ,$33.10 ,$187.20 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31200127,88313,HC SPECIAL STAIN II (SUDAN BLACK),312,1 ,$260.00 ,$130.00 ,$5.22 ,$260.00 ,$167.96 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$156.00 ,$221.00 ,$182.00 ,$5.22 ,$247.00 ,$187.20 ,$189.80 ,$130.82 ,$221.00 ,$32.77 ,$130.82 ,$208.00 ,$189.80 ,$5.22 ,$32.77 ,$109.20 ,$260.00 ,$221.00 ,$73.74 ,$239.20 ,$182.00 ,$75.15 ,$80.72 ,$158.34 ,$75.15 ,$179.66 ,$182.00 ,$33.10 ,$187.20 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31200128,88313,HC SPECIAL STAIN II (MISC),312,1 ,$260.00 ,$130.00 ,$5.22 ,$260.00 ,$167.96 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$156.00 ,$221.00 ,$182.00 ,$5.22 ,$247.00 ,$187.20 ,$189.80 ,$130.82 ,$221.00 ,$32.77 ,$130.82 ,$208.00 ,$189.80 ,$5.22 ,$32.77 ,$109.20 ,$260.00 ,$221.00 ,$73.74 ,$239.20 ,$182.00 ,$75.15 ,$80.72 ,$158.34 ,$75.15 ,$179.66 ,$182.00 ,$33.10 ,$187.20 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31200129,88313,HC SPECIAL STAIN II (MAST CELL),312,1 ,$128.00 ,$64.00 ,$5.22 ,$128.00 ,$82.69 ,$5.22 ,$128.00 ,$128.00 ,$32.77 ,$76.80 ,$108.80 ,$89.60 ,$5.22 ,$121.60 ,$92.16 ,$93.44 ,$128.00 ,$108.80 ,$32.77 ,$128.00 ,$102.40 ,$93.44 ,$5.22 ,$32.77 ,$53.76 ,$128.00 ,$108.80 ,$73.74 ,$117.76 ,$89.60 ,$75.15 ,$80.72 ,$77.95 ,$75.15 ,$88.45 ,$89.60 ,$33.10 ,$92.16 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$92.16 ,$79.36 ,$92.16 ,$92.16 ,$76.80 ST VINCENT HOSPITAL - ACUTE,31200130,88313,HC SPECIAL STAIN II (CONGO RED),312,1 ,$143.00 ,$71.50 ,$5.22 ,$143.00 ,$92.38 ,$5.22 ,$143.00 ,$143.00 ,$32.77 ,$85.80 ,$121.55 ,$100.10 ,$5.22 ,$135.85 ,$102.96 ,$104.39 ,$130.82 ,$121.55 ,$32.77 ,$130.82 ,$114.40 ,$104.39 ,$5.22 ,$32.77 ,$60.06 ,$143.00 ,$121.55 ,$73.74 ,$131.56 ,$100.10 ,$75.15 ,$80.72 ,$87.09 ,$75.15 ,$98.81 ,$100.10 ,$33.10 ,$102.96 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$102.96 ,$88.66 ,$102.96 ,$102.96 ,$85.80 ST VINCENT HOSPITAL - ACUTE,31200131,88313,HC SPECIAL STAIN II (FE),312,1 ,$143.00 ,$71.50 ,$5.22 ,$143.00 ,$92.38 ,$5.22 ,$143.00 ,$143.00 ,$32.77 ,$85.80 ,$121.55 ,$100.10 ,$5.22 ,$135.85 ,$102.96 ,$104.39 ,$130.82 ,$121.55 ,$32.77 ,$130.82 ,$114.40 ,$104.39 ,$5.22 ,$32.77 ,$60.06 ,$143.00 ,$121.55 ,$73.74 ,$131.56 ,$100.10 ,$75.15 ,$80.72 ,$87.09 ,$75.15 ,$98.81 ,$100.10 ,$33.10 ,$102.96 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$102.96 ,$88.66 ,$102.96 ,$102.96 ,$85.80 ST VINCENT HOSPITAL - ACUTE,31200132,88313,HC SPECIAL STAIN II (PAS),312,1 ,$143.00 ,$71.50 ,$5.22 ,$143.00 ,$92.38 ,$5.22 ,$143.00 ,$143.00 ,$32.77 ,$85.80 ,$121.55 ,$100.10 ,$5.22 ,$135.85 ,$102.96 ,$104.39 ,$130.82 ,$121.55 ,$32.77 ,$130.82 ,$114.40 ,$104.39 ,$5.22 ,$32.77 ,$60.06 ,$143.00 ,$121.55 ,$73.74 ,$131.56 ,$100.10 ,$75.15 ,$80.72 ,$87.09 ,$75.15 ,$98.81 ,$100.10 ,$33.10 ,$102.96 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$102.96 ,$88.66 ,$102.96 ,$102.96 ,$85.80 ST VINCENT HOSPITAL - ACUTE,31200133,88313,HC SPECIAL STAIN II (ALCIAN BLUE/PAS),312,1 ,$245.00 ,$122.50 ,$5.22 ,$245.00 ,$158.27 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$147.00 ,$208.25 ,$171.50 ,$5.22 ,$232.75 ,$176.40 ,$178.85 ,$130.82 ,$208.25 ,$32.77 ,$130.82 ,$196.00 ,$178.85 ,$5.22 ,$32.77 ,$102.90 ,$245.00 ,$208.25 ,$73.74 ,$225.40 ,$171.50 ,$75.15 ,$80.72 ,$149.21 ,$75.15 ,$169.30 ,$171.50 ,$33.10 ,$176.40 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$176.40 ,$151.90 ,$176.40 ,$176.40 ,$147.00 ST VINCENT HOSPITAL - ACUTE,31200134,88313,HC SPECIAL STAIN II (ELASTIC),312,1 ,$224.00 ,$112.00 ,$5.22 ,$224.00 ,$144.70 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$134.40 ,$190.40 ,$156.80 ,$5.22 ,$212.80 ,$161.28 ,$163.52 ,$130.82 ,$190.40 ,$32.77 ,$130.82 ,$179.20 ,$163.52 ,$5.22 ,$32.77 ,$94.08 ,$224.00 ,$190.40 ,$73.74 ,$206.08 ,$156.80 ,$75.15 ,$80.72 ,$136.42 ,$75.15 ,$154.78 ,$156.80 ,$33.10 ,$161.28 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$161.28 ,$138.88 ,$161.28 ,$161.28 ,$134.40 ST VINCENT HOSPITAL - ACUTE,31200135,88313,HC SPECIAL STAIN II (HALE'S COLLOIDAL FE),312,1 ,$228.00 ,$114.00 ,$5.22 ,$228.00 ,$147.29 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$136.80 ,$193.80 ,$159.60 ,$5.22 ,$216.60 ,$164.16 ,$166.44 ,$130.82 ,$193.80 ,$32.77 ,$130.82 ,$182.40 ,$166.44 ,$5.22 ,$32.77 ,$95.76 ,$228.00 ,$193.80 ,$73.74 ,$209.76 ,$159.60 ,$75.15 ,$80.72 ,$138.85 ,$75.15 ,$157.55 ,$159.60 ,$33.10 ,$164.16 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$164.16 ,$141.36 ,$164.16 ,$164.16 ,$136.80 ST VINCENT HOSPITAL - ACUTE,31200136,88313,HC SPECIAL STAIN II (MUCICARMINE),312,1 ,$228.00 ,$114.00 ,$5.22 ,$228.00 ,$147.29 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$136.80 ,$193.80 ,$159.60 ,$5.22 ,$216.60 ,$164.16 ,$166.44 ,$130.82 ,$193.80 ,$32.77 ,$130.82 ,$182.40 ,$166.44 ,$5.22 ,$32.77 ,$95.76 ,$228.00 ,$193.80 ,$73.74 ,$209.76 ,$159.60 ,$75.15 ,$80.72 ,$138.85 ,$75.15 ,$157.55 ,$159.60 ,$33.10 ,$164.16 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$164.16 ,$141.36 ,$164.16 ,$164.16 ,$136.80 ST VINCENT HOSPITAL - ACUTE,31200137,88313,HC SPECIAL STAIN II (ALCIAN BL W/HYALUR),312,1 ,$228.00 ,$114.00 ,$5.22 ,$228.00 ,$147.29 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$136.80 ,$193.80 ,$159.60 ,$5.22 ,$216.60 ,$164.16 ,$166.44 ,$130.82 ,$193.80 ,$32.77 ,$130.82 ,$182.40 ,$166.44 ,$5.22 ,$32.77 ,$95.76 ,$228.00 ,$193.80 ,$73.74 ,$209.76 ,$159.60 ,$75.15 ,$80.72 ,$138.85 ,$75.15 ,$157.55 ,$159.60 ,$33.10 ,$164.16 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$164.16 ,$141.36 ,$164.16 ,$164.16 ,$136.80 ST VINCENT HOSPITAL - ACUTE,31200138,88313,HC SPECIAL STAIN II (ARGENTAFFIN),312,1 ,$228.00 ,$114.00 ,$5.22 ,$228.00 ,$147.29 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$136.80 ,$193.80 ,$159.60 ,$5.22 ,$216.60 ,$164.16 ,$166.44 ,$130.82 ,$193.80 ,$32.77 ,$130.82 ,$182.40 ,$166.44 ,$5.22 ,$32.77 ,$95.76 ,$228.00 ,$193.80 ,$73.74 ,$209.76 ,$159.60 ,$75.15 ,$80.72 ,$138.85 ,$75.15 ,$157.55 ,$159.60 ,$33.10 ,$164.16 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$164.16 ,$141.36 ,$164.16 ,$164.16 ,$136.80 ST VINCENT HOSPITAL - ACUTE,31200139,88313,HC SPECIAL STAIN II (BIELSCHOWSKY SILVER),312,1 ,$228.00 ,$114.00 ,$5.22 ,$228.00 ,$147.29 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$136.80 ,$193.80 ,$159.60 ,$5.22 ,$216.60 ,$164.16 ,$166.44 ,$130.82 ,$193.80 ,$32.77 ,$130.82 ,$182.40 ,$166.44 ,$5.22 ,$32.77 ,$95.76 ,$228.00 ,$193.80 ,$73.74 ,$209.76 ,$159.60 ,$75.15 ,$80.72 ,$138.85 ,$75.15 ,$157.55 ,$159.60 ,$33.10 ,$164.16 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$164.16 ,$141.36 ,$164.16 ,$164.16 ,$136.80 ST VINCENT HOSPITAL - ACUTE,31200140,88313,HC SPECIAL STAIN II (ALCIAN/PAS W DIASTASE),312,1 ,$228.00 ,$114.00 ,$5.22 ,$228.00 ,$147.29 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$136.80 ,$193.80 ,$159.60 ,$5.22 ,$216.60 ,$164.16 ,$166.44 ,$130.82 ,$193.80 ,$32.77 ,$130.82 ,$182.40 ,$166.44 ,$5.22 ,$32.77 ,$95.76 ,$228.00 ,$193.80 ,$73.74 ,$209.76 ,$159.60 ,$75.15 ,$80.72 ,$138.85 ,$75.15 ,$157.55 ,$159.60 ,$33.10 ,$164.16 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$164.16 ,$141.36 ,$164.16 ,$164.16 ,$136.80 ST VINCENT HOSPITAL - ACUTE,31200142,88313,HC SPECIAL STAIN II (RHODAMINE),312,1 ,$228.00 ,$114.00 ,$5.22 ,$228.00 ,$147.29 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$136.80 ,$193.80 ,$159.60 ,$5.22 ,$216.60 ,$164.16 ,$166.44 ,$130.82 ,$193.80 ,$32.77 ,$130.82 ,$182.40 ,$166.44 ,$5.22 ,$32.77 ,$95.76 ,$228.00 ,$193.80 ,$73.74 ,$209.76 ,$159.60 ,$75.15 ,$80.72 ,$138.85 ,$75.15 ,$157.55 ,$159.60 ,$33.10 ,$164.16 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$164.16 ,$141.36 ,$164.16 ,$164.16 ,$136.80 ST VINCENT HOSPITAL - ACUTE,31200143,88313,HC SPECIAL STAIN II (TRICHROME),312,1 ,$143.00 ,$71.50 ,$5.22 ,$143.00 ,$92.38 ,$5.22 ,$143.00 ,$143.00 ,$32.77 ,$85.80 ,$121.55 ,$100.10 ,$5.22 ,$135.85 ,$102.96 ,$104.39 ,$130.82 ,$121.55 ,$32.77 ,$130.82 ,$114.40 ,$104.39 ,$5.22 ,$32.77 ,$60.06 ,$143.00 ,$121.55 ,$73.74 ,$131.56 ,$100.10 ,$75.15 ,$80.72 ,$87.09 ,$75.15 ,$98.81 ,$100.10 ,$33.10 ,$102.96 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$102.96 ,$88.66 ,$102.96 ,$102.96 ,$85.80 ST VINCENT HOSPITAL - ACUTE,31200144,88313,HC SPECIAL STAIN II (RETICULUM),312,1 ,$224.00 ,$112.00 ,$5.22 ,$224.00 ,$144.70 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$134.40 ,$190.40 ,$156.80 ,$5.22 ,$212.80 ,$161.28 ,$163.52 ,$130.82 ,$190.40 ,$32.77 ,$130.82 ,$179.20 ,$163.52 ,$5.22 ,$32.77 ,$94.08 ,$224.00 ,$190.40 ,$73.74 ,$206.08 ,$156.80 ,$75.15 ,$80.72 ,$136.42 ,$75.15 ,$154.78 ,$156.80 ,$33.10 ,$161.28 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$161.28 ,$138.88 ,$161.28 ,$161.28 ,$134.40 ST VINCENT HOSPITAL - ACUTE,31200145,88313,HC SPECIAL STAIN II (ALCIAN BLUE),312,1 ,$245.00 ,$122.50 ,$5.22 ,$245.00 ,$158.27 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$147.00 ,$208.25 ,$171.50 ,$5.22 ,$232.75 ,$176.40 ,$178.85 ,$130.82 ,$208.25 ,$32.77 ,$130.82 ,$196.00 ,$178.85 ,$5.22 ,$32.77 ,$102.90 ,$245.00 ,$208.25 ,$73.74 ,$225.40 ,$171.50 ,$75.15 ,$80.72 ,$149.21 ,$75.15 ,$169.30 ,$171.50 ,$33.10 ,$176.40 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$176.40 ,$151.90 ,$176.40 ,$176.40 ,$147.00 ST VINCENT HOSPITAL - ACUTE,31200146,88313,HC SPECIAL STAIN II (PAS W/DIGEST),312,1 ,$245.00 ,$122.50 ,$5.22 ,$245.00 ,$158.27 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$147.00 ,$208.25 ,$171.50 ,$5.22 ,$232.75 ,$176.40 ,$178.85 ,$130.82 ,$208.25 ,$32.77 ,$130.82 ,$196.00 ,$178.85 ,$5.22 ,$32.77 ,$102.90 ,$245.00 ,$208.25 ,$73.74 ,$225.40 ,$171.50 ,$75.15 ,$80.72 ,$149.21 ,$75.15 ,$169.30 ,$171.50 ,$33.10 ,$176.40 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$176.40 ,$151.90 ,$176.40 ,$176.40 ,$147.00 ST VINCENT HOSPITAL - ACUTE,31200147,88313,HC SPECIAL STAIN II (RENAL BX LGHT MICRO),312,1 ,$825.00 ,$412.50 ,$5.22 ,$825.00 ,$532.95 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$495.00 ,$701.25 ,$577.50 ,$5.22 ,$783.75 ,$594.00 ,$602.25 ,$130.82 ,$701.25 ,$32.77 ,$130.82 ,$660.00 ,$602.25 ,$5.22 ,$32.77 ,$346.50 ,$825.00 ,$701.25 ,$73.74 ,$759.00 ,$577.50 ,$75.15 ,$80.72 ,$502.43 ,$75.15 ,$570.08 ,$577.50 ,$33.10 ,$594.00 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$594.00 ,$511.50 ,$594.00 ,$594.00 ,$495.00 ST VINCENT HOSPITAL - ACUTE,31200150,88313,HC SPECIAL STAIN II (WARTHIN STARRY),312,1 ,$130.00 ,$65.00 ,$5.22 ,$130.00 ,$83.98 ,$5.22 ,$130.00 ,$130.00 ,$32.77 ,$78.00 ,$110.50 ,$91.00 ,$5.22 ,$123.50 ,$93.60 ,$94.90 ,$130.00 ,$110.50 ,$32.77 ,$130.00 ,$104.00 ,$94.90 ,$5.22 ,$32.77 ,$54.60 ,$130.00 ,$110.50 ,$73.74 ,$119.60 ,$91.00 ,$75.15 ,$80.72 ,$79.17 ,$75.15 ,$89.83 ,$91.00 ,$33.10 ,$93.60 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,31200151,88313,HC SPECIAL STAIN II (ESTERASE MIX),312,1 ,$103.00 ,$51.50 ,$5.22 ,$103.00 ,$66.54 ,$5.22 ,$103.00 ,$103.00 ,$32.77 ,$61.80 ,$87.55 ,$72.10 ,$5.22 ,$97.85 ,$74.16 ,$75.19 ,$103.00 ,$87.55 ,$32.77 ,$103.00 ,$82.40 ,$75.19 ,$5.22 ,$32.77 ,$43.26 ,$103.00 ,$87.55 ,$73.74 ,$94.76 ,$72.10 ,$75.15 ,$80.72 ,$62.73 ,$75.15 ,$71.17 ,$72.10 ,$33.10 ,$74.16 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$74.16 ,$63.86 ,$74.16 ,$74.16 ,$61.80 ST VINCENT HOSPITAL - ACUTE,31200152,88313,HC SPECIAL STAIN II (ESTERASE SPEC),312,1 ,$153.00 ,$76.50 ,$5.22 ,$153.00 ,$98.84 ,$5.22 ,$153.00 ,$153.00 ,$32.77 ,$91.80 ,$130.05 ,$107.10 ,$5.22 ,$145.35 ,$110.16 ,$111.69 ,$130.82 ,$130.05 ,$32.77 ,$130.82 ,$122.40 ,$111.69 ,$5.22 ,$32.77 ,$64.26 ,$153.00 ,$130.05 ,$73.74 ,$140.76 ,$107.10 ,$75.15 ,$80.72 ,$93.18 ,$75.15 ,$105.72 ,$107.10 ,$33.10 ,$110.16 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$110.16 ,$94.86 ,$110.16 ,$110.16 ,$91.80 ST VINCENT HOSPITAL - ACUTE,31200153,88313,HC SPECIAL STAIN II (ESTERASE NONSPEC),312,1 ,$164.00 ,$82.00 ,$5.22 ,$164.00 ,$105.94 ,$5.22 ,$164.00 ,$164.00 ,$32.77 ,$98.40 ,$139.40 ,$114.80 ,$5.22 ,$155.80 ,$118.08 ,$119.72 ,$130.82 ,$139.40 ,$32.77 ,$130.82 ,$131.20 ,$119.72 ,$5.22 ,$32.77 ,$68.88 ,$164.00 ,$139.40 ,$73.74 ,$150.88 ,$114.80 ,$75.15 ,$80.72 ,$99.88 ,$75.15 ,$113.32 ,$114.80 ,$33.10 ,$118.08 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$118.08 ,$101.68 ,$118.08 ,$118.08 ,$98.40 ST VINCENT HOSPITAL - ACUTE,31200155,88313,HC HISTOCHEM CHEMICAL STAIN,312,1 ,$234.00 ,$117.00 ,$5.22 ,$234.00 ,$151.16 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$140.40 ,$198.90 ,$163.80 ,$5.22 ,$222.30 ,$168.48 ,$170.82 ,$130.82 ,$198.90 ,$32.77 ,$130.82 ,$187.20 ,$170.82 ,$5.22 ,$32.77 ,$98.28 ,$234.00 ,$198.90 ,$73.74 ,$215.28 ,$163.80 ,$75.15 ,$80.72 ,$142.51 ,$75.15 ,$161.69 ,$163.80 ,$33.10 ,$168.48 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$168.48 ,$145.08 ,$168.48 ,$168.48 ,$140.40 ST VINCENT HOSPITAL - ACUTE,31200156,88319,HC HISTOCHEM ENZYME STAIN,312,1 ,$220.00 ,$110.00 ,$11.95 ,"$1,429.83 ",$142.12 ,$11.95 ,$220.00 ,$203.17 ,$635.48 ,$132.00 ,$187.00 ,$154.00 ,$11.95 ,$209.00 ,$158.40 ,$160.60 ,$209.10 ,$187.00 ,$635.48 ,$209.10 ,$176.00 ,$160.60 ,$11.95 ,$635.48 ,$92.40 ,$220.00 ,$187.00 ,"$1,429.83 ",$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$641.83 ,$158.40 ,$12.67 ,$220.00 ,$220.00 ,$635.48 ,$220.00 ,$635.48 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,31200157,88319,HC HISTOCHEM ENZYME STAIN (LEUKO),312,1 ,$220.00 ,$110.00 ,$11.95 ,"$1,429.83 ",$142.12 ,$11.95 ,$220.00 ,$203.17 ,$635.48 ,$132.00 ,$187.00 ,$154.00 ,$11.95 ,$209.00 ,$158.40 ,$160.60 ,$209.10 ,$187.00 ,$635.48 ,$209.10 ,$176.00 ,$160.60 ,$11.95 ,$635.48 ,$92.40 ,$220.00 ,$187.00 ,"$1,429.83 ",$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$641.83 ,$158.40 ,$12.67 ,$220.00 ,$220.00 ,$635.48 ,$220.00 ,$635.48 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,31200159,88321,HC CONSULT REFERRED SLIDES,312,1 ,$222.00 ,$111.00 ,$5.22 ,$222.00 ,$143.41 ,$5.22 ,$222.00 ,$222.00 ,$32.77 ,$133.20 ,$188.70 ,$155.40 ,$5.22 ,$210.90 ,$159.84 ,$162.06 ,$160.85 ,$188.70 ,$32.77 ,$160.85 ,$177.60 ,$162.06 ,$5.22 ,$32.77 ,$93.24 ,$222.00 ,$188.70 ,$73.74 ,$204.24 ,$155.40 ,$75.15 ,$80.72 ,$135.20 ,$75.15 ,$153.40 ,$155.40 ,$33.10 ,$159.84 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$159.84 ,$137.64 ,$159.84 ,$159.84 ,$133.20 ST VINCENT HOSPITAL - ACUTE,31200162,88321,HC CONSULT REFERRED SLIDES (MUSCLE),312,1 ,$658.00 ,$329.00 ,$5.22 ,$658.00 ,$425.07 ,$5.22 ,$294.81 ,$252.69 ,$32.77 ,$394.80 ,$559.30 ,$460.60 ,$5.22 ,$625.10 ,$473.76 ,$480.34 ,$160.85 ,$559.30 ,$32.77 ,$160.85 ,$526.40 ,$480.34 ,$5.22 ,$32.77 ,$276.36 ,$658.00 ,$559.30 ,$73.74 ,$605.36 ,$460.60 ,$75.15 ,$80.72 ,$400.72 ,$75.15 ,$454.68 ,$460.60 ,$33.10 ,$473.76 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$473.76 ,$407.96 ,$473.76 ,$473.76 ,$394.80 ST VINCENT HOSPITAL - ACUTE,31200163,88321,HC CONSULT REFERRED SLIDES (MAYO),312,1 ,$460.00 ,$230.00 ,$5.22 ,$460.00 ,$297.16 ,$5.22 ,$294.81 ,$252.69 ,$32.77 ,$276.00 ,$391.00 ,$322.00 ,$5.22 ,$437.00 ,$331.20 ,$335.80 ,$160.85 ,$391.00 ,$32.77 ,$160.85 ,$368.00 ,$335.80 ,$5.22 ,$32.77 ,$193.20 ,$460.00 ,$391.00 ,$73.74 ,$423.20 ,$322.00 ,$75.15 ,$80.72 ,$280.14 ,$75.15 ,$317.86 ,$322.00 ,$33.10 ,$331.20 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,31200164,88323,HC CONSULT/SLIDE PREP,312,1 ,$370.00 ,$185.00 ,$11.38 ,$370.00 ,$239.02 ,$11.38 ,$89.77 ,$76.94 ,$48.19 ,$222.00 ,$314.50 ,$259.00 ,$11.38 ,$351.50 ,$266.40 ,$270.10 ,$188.99 ,$314.50 ,$48.19 ,$188.99 ,$296.00 ,$270.10 ,$11.38 ,$48.19 ,$155.40 ,$370.00 ,$314.50 ,$108.43 ,$340.40 ,$259.00 ,$138.36 ,$148.61 ,$225.33 ,$138.36 ,$255.67 ,$259.00 ,$48.67 ,$266.40 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,31200165,88323,HC CONSULT/SLIDE PREP (CUTAN),312,1 ,$66.00 ,$33.00 ,$11.38 ,$108.43 ,$42.64 ,$11.38 ,$66.00 ,$66.00 ,$48.19 ,$39.60 ,$56.10 ,$46.20 ,$11.38 ,$62.70 ,$47.52 ,$48.18 ,$66.00 ,$56.10 ,$48.19 ,$66.00 ,$52.80 ,$48.18 ,$11.38 ,$48.19 ,$27.72 ,$66.00 ,$56.10 ,$108.43 ,$60.72 ,$46.20 ,$66.00 ,$66.00 ,$40.19 ,$66.00 ,$45.61 ,$46.20 ,$48.67 ,$47.52 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$47.52 ,$40.92 ,$47.52 ,$47.52 ,$39.60 ST VINCENT HOSPITAL - ACUTE,31200167,88325,HC CONSULT PATH REV/REP (CYTO),312,1 ,"$1,000.00 ",$500.00 ,$11.38 ,"$1,000.00 ",$646.00 ,$11.38 ,$522.54 ,$447.90 ,$144.46 ,$600.00 ,$850.00 ,$700.00 ,$11.38 ,$950.00 ,$720.00 ,$730.00 ,$271.54 ,$850.00 ,$144.46 ,$271.54 ,$800.00 ,$730.00 ,$11.38 ,$144.46 ,$420.00 ,"$1,000.00 ",$850.00 ,$325.04 ,$920.00 ,$700.00 ,$232.78 ,$250.03 ,$609.00 ,$232.78 ,$691.00 ,$700.00 ,$145.90 ,$720.00 ,$12.06 ,$59.36 ,$59.36 ,$144.46 ,$59.36 ,$144.46 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,31200168,88325,HC CONSULT PATH REV/REP (PERI NERVE),312,1 ,"$1,000.00 ",$500.00 ,$11.38 ,"$1,000.00 ",$646.00 ,$11.38 ,$522.54 ,$447.90 ,$144.46 ,$600.00 ,$850.00 ,$700.00 ,$11.38 ,$950.00 ,$720.00 ,$730.00 ,$271.54 ,$850.00 ,$144.46 ,$271.54 ,$800.00 ,$730.00 ,$11.38 ,$144.46 ,$420.00 ,"$1,000.00 ",$850.00 ,$325.04 ,$920.00 ,$700.00 ,$232.78 ,$250.03 ,$609.00 ,$232.78 ,$691.00 ,$700.00 ,$145.90 ,$720.00 ,$12.06 ,$59.36 ,$59.36 ,$144.46 ,$59.36 ,$144.46 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,31200169,88325,HC CONSULT PATH REV/REP (HEMATOPATH),312,1 ,"$1,000.00 ",$500.00 ,$11.38 ,"$1,000.00 ",$646.00 ,$11.38 ,$522.54 ,$447.90 ,$144.46 ,$600.00 ,$850.00 ,$700.00 ,$11.38 ,$950.00 ,$720.00 ,$730.00 ,$271.54 ,$850.00 ,$144.46 ,$271.54 ,$800.00 ,$730.00 ,$11.38 ,$144.46 ,$420.00 ,"$1,000.00 ",$850.00 ,$325.04 ,$920.00 ,$700.00 ,$232.78 ,$250.03 ,$609.00 ,$232.78 ,$691.00 ,$700.00 ,$145.90 ,$720.00 ,$12.06 ,$59.36 ,$59.36 ,$144.46 ,$59.36 ,$144.46 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,31200170,88325,HC CONSULT PATH REV/REP (RENAL PATH),312,1 ,"$1,000.00 ",$500.00 ,$11.38 ,"$1,000.00 ",$646.00 ,$11.38 ,$522.54 ,$447.90 ,$144.46 ,$600.00 ,$850.00 ,$700.00 ,$11.38 ,$950.00 ,$720.00 ,$730.00 ,$271.54 ,$850.00 ,$144.46 ,$271.54 ,$800.00 ,$730.00 ,$11.38 ,$144.46 ,$420.00 ,"$1,000.00 ",$850.00 ,$325.04 ,$920.00 ,$700.00 ,$232.78 ,$250.03 ,$609.00 ,$232.78 ,$691.00 ,$700.00 ,$145.90 ,$720.00 ,$12.06 ,$59.36 ,$59.36 ,$144.46 ,$59.36 ,$144.46 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,31200171,88325,HC CONSULT PATH REV/REP,312,1 ,"$1,000.00 ",$500.00 ,$11.38 ,"$1,000.00 ",$646.00 ,$11.38 ,$522.54 ,$447.90 ,$144.46 ,$600.00 ,$850.00 ,$700.00 ,$11.38 ,$950.00 ,$720.00 ,$730.00 ,$271.54 ,$850.00 ,$144.46 ,$271.54 ,$800.00 ,$730.00 ,$11.38 ,$144.46 ,$420.00 ,"$1,000.00 ",$850.00 ,$325.04 ,$920.00 ,$700.00 ,$232.78 ,$250.03 ,$609.00 ,$232.78 ,$691.00 ,$700.00 ,$145.90 ,$720.00 ,$12.06 ,$59.36 ,$59.36 ,$144.46 ,$59.36 ,$144.46 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,31200173,88331,HC CONSULT PATH SURG W/FROZEN,312,1 ,$230.00 ,$115.00 ,$11.38 ,$325.04 ,$148.58 ,$11.38 ,$111.49 ,$95.57 ,$144.46 ,$138.00 ,$195.50 ,$161.00 ,$11.38 ,$218.50 ,$165.60 ,$167.90 ,$170.58 ,$195.50 ,$144.46 ,$170.58 ,$184.00 ,$167.90 ,$11.38 ,$144.46 ,$96.60 ,$230.00 ,$195.50 ,$325.04 ,$211.60 ,$161.00 ,$138.36 ,$148.61 ,$140.07 ,$138.36 ,$158.93 ,$161.00 ,$145.90 ,$165.60 ,$12.06 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,31200174,88332,HC CONSULT PATH SURG ADDL FROZEN,312,1 ,$170.00 ,$85.00 ,$11.38 ,$170.00 ,$109.82 ,$11.38 ,$72.87 ,$62.46 , N/A ,$102.00 ,$144.50 ,$119.00 ,$11.38 ,$161.50 ,$122.40 ,$124.10 ,$89.56 ,$144.50 , N/A ,$89.56 ,$136.00 ,$124.10 ,$11.38 , N/A ,$71.40 ,$170.00 ,$144.50 , N/A ,$156.40 ,$119.00 ,$64.44 ,$69.22 ,$103.53 ,$64.44 ,$117.47 ,$119.00 , N/A ,$122.40 ,$12.06 ,$27.72 ,$27.72 , N/A ,$27.72 , N/A ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,31200175,88333,HC CONSULT PATH SURG CYTO INIT,312,1 ,$110.00 ,$55.00 ,$11.38 ,"$1,429.83 ",$71.06 ,$11.38 ,$84.94 ,$72.80 ,$635.48 ,$66.00 ,$93.50 ,$77.00 ,$11.38 ,$104.50 ,$79.20 ,$80.30 ,$110.00 ,$93.50 ,$635.48 ,$110.00 ,$88.00 ,$80.30 ,$11.38 ,$635.48 ,$46.20 ,$110.00 ,$93.50 ,"$1,429.83 ",$101.20 ,$77.00 ,$110.00 ,$110.00 ,$66.99 ,$110.00 ,$76.01 ,$77.00 ,$641.83 ,$79.20 ,$12.06 ,$110.00 ,$110.00 ,$635.48 ,$110.00 ,$635.48 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,31200176,88334,HC CONSULT PATH SURG EA ADDL,312,1 ,$155.00 ,$77.50 ,$11.38 ,$155.00 ,$100.13 ,$11.38 ,$56.74 ,$48.63 , N/A ,$93.00 ,$131.75 ,$108.50 ,$11.38 ,$147.25 ,$111.60 ,$113.15 ,$93.77 ,$131.75 , N/A ,$93.77 ,$124.00 ,$113.15 ,$11.38 , N/A ,$65.10 ,$155.00 ,$131.75 , N/A ,$142.60 ,$108.50 ,$64.44 ,$69.22 ,$94.40 ,$64.44 ,$107.11 ,$108.50 , N/A ,$111.60 ,$12.06 ,$21.65 ,$21.65 , N/A ,$21.65 , N/A ,$111.60 ,$96.10 ,$111.60 ,$111.60 ,$93.00 ST VINCENT HOSPITAL - ACUTE,31200177,88341,HC IMMUNOHISTOCHEM EA AB,312,1 ,$90.00 ,$45.00 ,$11.95 ,$90.00 ,$58.14 ,$11.95 ,$90.00 ,$90.00 , N/A ,$54.00 ,$76.50 ,$63.00 ,$11.95 ,$85.50 ,$64.80 ,$65.70 ,$90.00 ,$76.50 , N/A ,$90.00 ,$72.00 ,$65.70 ,$11.95 , N/A ,$37.80 ,$90.00 ,$76.50 , N/A ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 , N/A ,$64.80 ,$12.67 ,$77.52 ,$77.52 , N/A ,$77.52 , N/A ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,31200182,88341,HC IMMUNOHISTOCHEM EA AB T2,312,1 ,$245.00 ,$122.50 ,$11.95 ,$245.00 ,$158.27 ,$11.95 ,$216.08 ,$185.21 , N/A ,$147.00 ,$208.25 ,$171.50 ,$11.95 ,$232.75 ,$176.40 ,$178.85 ,$151.86 ,$208.25 , N/A ,$151.86 ,$196.00 ,$178.85 ,$11.95 , N/A ,$102.90 ,$245.00 ,$208.25 , N/A ,$225.40 ,$171.50 ,$122.50 ,$147.00 ,$149.21 ,$122.50 ,$169.30 ,$171.50 , N/A ,$176.40 ,$12.67 ,$77.52 ,$77.52 , N/A ,$77.52 , N/A ,$176.40 ,$151.90 ,$176.40 ,$176.40 ,$147.00 ST VINCENT HOSPITAL - ACUTE,31200183,88341,HC IMMUNOHISTOCHEM EA AB T3,312,1 ,$305.00 ,$152.50 ,$11.95 ,$305.00 ,$197.03 ,$11.95 ,$216.08 ,$185.21 , N/A ,$183.00 ,$259.25 ,$213.50 ,$11.95 ,$289.75 ,$219.60 ,$222.65 ,$151.86 ,$259.25 , N/A ,$151.86 ,$244.00 ,$222.65 ,$11.95 , N/A ,$128.10 ,$305.00 ,$259.25 , N/A ,$280.60 ,$213.50 ,$152.50 ,$183.00 ,$185.75 ,$152.50 ,$210.76 ,$213.50 , N/A ,$219.60 ,$12.67 ,$77.52 ,$77.52 , N/A ,$77.52 , N/A ,$219.60 ,$189.10 ,$219.60 ,$219.60 ,$183.00 ST VINCENT HOSPITAL - ACUTE,31200184,88341,HC IMMUNOHISTOCHEM EA AB T4,312,1 ,$243.00 ,$121.50 ,$11.95 ,$243.00 ,$156.98 ,$11.95 ,$216.08 ,$185.21 , N/A ,$145.80 ,$206.55 ,$170.10 ,$11.95 ,$230.85 ,$174.96 ,$177.39 ,$151.86 ,$206.55 , N/A ,$151.86 ,$194.40 ,$177.39 ,$11.95 , N/A ,$102.06 ,$243.00 ,$206.55 , N/A ,$223.56 ,$170.10 ,$121.50 ,$145.80 ,$147.99 ,$121.50 ,$167.91 ,$170.10 , N/A ,$174.96 ,$12.67 ,$77.52 ,$77.52 , N/A ,$77.52 , N/A ,$174.96 ,$150.66 ,$174.96 ,$174.96 ,$145.80 ST VINCENT HOSPITAL - ACUTE,31200185,88341,HC IMMUNOHISTOCHEM EA AB T5,312,1 ,$327.00 ,$163.50 ,$11.95 ,$327.00 ,$211.24 ,$11.95 ,$216.08 ,$185.21 , N/A ,$196.20 ,$277.95 ,$228.90 ,$11.95 ,$310.65 ,$235.44 ,$238.71 ,$151.86 ,$277.95 , N/A ,$151.86 ,$261.60 ,$238.71 ,$11.95 , N/A ,$137.34 ,$327.00 ,$277.95 , N/A ,$300.84 ,$228.90 ,$163.50 ,$196.20 ,$199.14 ,$163.50 ,$225.96 ,$228.90 , N/A ,$235.44 ,$12.67 ,$77.52 ,$77.52 , N/A ,$77.52 , N/A ,$235.44 ,$202.74 ,$235.44 ,$235.44 ,$196.20 ST VINCENT HOSPITAL - ACUTE,31200186,88346,HC IF DIRECT,312,1 ,$90.00 ,$45.00 ,$11.38 ,$634.69 ,$58.14 ,$11.38 ,$90.00 ,$90.00 ,$282.09 ,$54.00 ,$76.50 ,$63.00 ,$11.38 ,$85.50 ,$64.80 ,$65.70 ,$90.00 ,$76.50 ,$282.09 ,$90.00 ,$72.00 ,$65.70 ,$11.38 ,$282.09 ,$37.80 ,$90.00 ,$76.50 ,$634.69 ,$82.80 ,$63.00 ,$90.00 ,$90.00 ,$54.81 ,$90.00 ,$62.19 ,$63.00 ,$284.91 ,$64.80 ,$12.06 ,$90.00 ,$90.00 ,$282.09 ,$90.00 ,$282.09 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,31200187,88346,HC IF DIRECT (RENAL BX),312,1 ,$90.00 ,$45.00 ,$11.38 ,$634.69 ,$58.14 ,$11.38 ,$90.00 ,$90.00 ,$282.09 ,$54.00 ,$76.50 ,$63.00 ,$11.38 ,$85.50 ,$64.80 ,$65.70 ,$90.00 ,$76.50 ,$282.09 ,$90.00 ,$72.00 ,$65.70 ,$11.38 ,$282.09 ,$37.80 ,$90.00 ,$76.50 ,$634.69 ,$82.80 ,$63.00 ,$90.00 ,$90.00 ,$54.81 ,$90.00 ,$62.19 ,$63.00 ,$284.91 ,$64.80 ,$12.06 ,$90.00 ,$90.00 ,$282.09 ,$90.00 ,$282.09 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,31200188,88346,HC IF DIRECT (CUTANEOUS),312,1 ,$90.00 ,$45.00 ,$11.38 ,$634.69 ,$58.14 ,$11.38 ,$90.00 ,$90.00 ,$282.09 ,$54.00 ,$76.50 ,$63.00 ,$11.38 ,$85.50 ,$64.80 ,$65.70 ,$90.00 ,$76.50 ,$282.09 ,$90.00 ,$72.00 ,$65.70 ,$11.38 ,$282.09 ,$37.80 ,$90.00 ,$76.50 ,$634.69 ,$82.80 ,$63.00 ,$90.00 ,$90.00 ,$54.81 ,$90.00 ,$62.19 ,$63.00 ,$284.91 ,$64.80 ,$12.06 ,$90.00 ,$90.00 ,$282.09 ,$90.00 ,$282.09 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,31200189,88348,HC ELECTRON MICRO DIAG,312,1 ,"$3,000.00 ","$1,500.00 ",$11.95 ,"$3,000.00 ","$1,938.00 ",$11.95 ,$954.61 ,$818.24 ,$635.48 ,"$1,800.00 ","$2,550.00 ","$2,100.00 ",$11.95 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ",$694.64 ,"$2,550.00 ",$635.48 ,$694.64 ,"$2,400.00 ","$2,190.00 ",$11.95 ,$635.48 ,"$1,260.00 ","$3,000.00 ","$2,550.00 ","$1,429.83 ","$2,760.00 ","$2,100.00 ",$680.48 ,$730.89 ,"$1,827.00 ",$680.48 ,"$2,073.00 ","$2,100.00 ",$641.83 ,"$2,160.00 ",$12.67 ,$753.84 ,$753.84 ,$635.48 ,$753.84 ,$635.48 ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,31200190,88348,HC ELECTRON MICRO DIAG MAYO,312,1 ,"$1,460.00 ",$730.00 ,$11.95 ,"$1,460.00 ",$943.16 ,$11.95 ,$954.61 ,$818.24 ,$635.48 ,$876.00 ,"$1,241.00 ","$1,022.00 ",$11.95 ,"$1,387.00 ","$1,051.20 ","$1,065.80 ",$694.64 ,"$1,241.00 ",$635.48 ,$694.64 ,"$1,168.00 ","$1,065.80 ",$11.95 ,$635.48 ,$613.20 ,"$1,460.00 ","$1,241.00 ","$1,429.83 ","$1,343.20 ","$1,022.00 ",$680.48 ,$730.89 ,$889.14 ,$680.48 ,"$1,008.86 ","$1,022.00 ",$641.83 ,"$1,051.20 ",$12.67 ,$753.84 ,$753.84 ,$635.48 ,$753.84 ,$635.48 ,"$1,051.20 ",$905.20 ,"$1,051.20 ","$1,051.20 ",$876.00 ST VINCENT HOSPITAL - ACUTE,31200191,88360,HC MORPHO ANLYS TUMOR MAN (PR),312,1 ,$360.00 ,$180.00 ,$11.95 ,$360.00 ,$232.56 ,$11.95 ,$285.32 ,$244.56 ,$144.46 ,$216.00 ,$306.00 ,$252.00 ,$11.95 ,$342.00 ,$259.20 ,$262.80 ,$202.20 ,$306.00 ,$144.46 ,$202.20 ,$288.00 ,$262.80 ,$11.95 ,$144.46 ,$151.20 ,$360.00 ,$306.00 ,$325.04 ,$331.20 ,$252.00 ,$138.36 ,$148.61 ,$219.24 ,$138.36 ,$248.76 ,$252.00 ,$145.90 ,$259.20 ,$12.67 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,31200192,88360,HC MORPHO ANLYS TUMOR MAN (ER),312,1 ,$360.00 ,$180.00 ,$11.95 ,$360.00 ,$232.56 ,$11.95 ,$285.32 ,$244.56 ,$144.46 ,$216.00 ,$306.00 ,$252.00 ,$11.95 ,$342.00 ,$259.20 ,$262.80 ,$202.20 ,$306.00 ,$144.46 ,$202.20 ,$288.00 ,$262.80 ,$11.95 ,$144.46 ,$151.20 ,$360.00 ,$306.00 ,$325.04 ,$331.20 ,$252.00 ,$138.36 ,$148.61 ,$219.24 ,$138.36 ,$248.76 ,$252.00 ,$145.90 ,$259.20 ,$12.67 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,31200193,88360,HC MORPHO ANLYS TUMOR MAN,312,1 ,$360.00 ,$180.00 ,$11.95 ,$360.00 ,$232.56 ,$11.95 ,$285.32 ,$244.56 ,$144.46 ,$216.00 ,$306.00 ,$252.00 ,$11.95 ,$342.00 ,$259.20 ,$262.80 ,$202.20 ,$306.00 ,$144.46 ,$202.20 ,$288.00 ,$262.80 ,$11.95 ,$144.46 ,$151.20 ,$360.00 ,$306.00 ,$325.04 ,$331.20 ,$252.00 ,$138.36 ,$148.61 ,$219.24 ,$138.36 ,$248.76 ,$252.00 ,$145.90 ,$259.20 ,$12.67 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,31200194,88360,HC MORPHO ANLYS TUMOR MAN (HER2),312,1 ,$360.00 ,$180.00 ,$11.95 ,$360.00 ,$232.56 ,$11.95 ,$285.32 ,$244.56 ,$144.46 ,$216.00 ,$306.00 ,$252.00 ,$11.95 ,$342.00 ,$259.20 ,$262.80 ,$202.20 ,$306.00 ,$144.46 ,$202.20 ,$288.00 ,$262.80 ,$11.95 ,$144.46 ,$151.20 ,$360.00 ,$306.00 ,$325.04 ,$331.20 ,$252.00 ,$138.36 ,$148.61 ,$219.24 ,$138.36 ,$248.76 ,$252.00 ,$145.90 ,$259.20 ,$12.67 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,31200201,88360,HC MORPHO ANLYS TUMOR MAN (DCMH),312,1 ,$285.00 ,$142.50 ,$11.95 ,$325.04 ,$184.11 ,$11.95 ,$285.00 ,$244.56 ,$144.46 ,$171.00 ,$242.25 ,$199.50 ,$11.95 ,$270.75 ,$205.20 ,$208.05 ,$202.20 ,$242.25 ,$144.46 ,$202.20 ,$228.00 ,$208.05 ,$11.95 ,$144.46 ,$119.70 ,$285.00 ,$242.25 ,$325.04 ,$262.20 ,$199.50 ,$138.36 ,$148.61 ,$173.57 ,$138.36 ,$196.94 ,$199.50 ,$145.90 ,$205.20 ,$12.67 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$205.20 ,$176.70 ,$205.20 ,$205.20 ,$171.00 ST VINCENT HOSPITAL - ACUTE,31200202,88361,HC MORPHO ANLYS COMP ASSIST,312,1 ,$428.00 ,$214.00 ,$11.95 ,$634.69 ,$276.49 ,$11.95 ,$288.94 ,$247.66 ,$282.09 ,$256.80 ,$363.80 ,$299.60 ,$11.95 ,$406.60 ,$308.16 ,$312.44 ,$201.43 ,$363.80 ,$282.09 ,$201.43 ,$342.40 ,$312.44 ,$11.95 ,$282.09 ,$179.76 ,$428.00 ,$363.80 ,$634.69 ,$393.76 ,$299.60 ,$138.36 ,$148.61 ,$260.65 ,$138.36 ,$295.75 ,$299.60 ,$284.91 ,$308.16 ,$12.67 ,$340.09 ,$340.09 ,$282.09 ,$340.09 ,$282.09 ,$308.16 ,$265.36 ,$308.16 ,$308.16 ,$256.80 ST VINCENT HOSPITAL - ACUTE,31200203,88363,HC EXAM ARCHIVE TISS MOL ANLYS,312,1 ,$112.00 ,$56.00 ,$5.22 ,$112.00 ,$72.35 ,$5.22 ,$69.27 ,$59.38 ,$23.89 ,$67.20 ,$95.20 ,$78.40 ,$5.22 ,$106.40 ,$80.64 ,$81.76 ,$37.94 ,$95.20 ,$23.89 ,$37.94 ,$89.60 ,$81.76 ,$5.22 ,$23.89 ,$47.04 ,$112.00 ,$95.20 ,$53.76 ,$103.04 ,$78.40 ,$75.15 ,$80.72 ,$68.21 ,$75.15 ,$77.39 ,$78.40 ,$24.13 ,$80.64 ,$5.53 ,$27.59 ,$27.59 ,$23.89 ,$27.59 ,$23.89 ,$80.64 ,$69.44 ,$80.64 ,$80.64 ,$67.20 ST VINCENT HOSPITAL - ACUTE,31200204,88365,HC IN SITU HYBRID (FISH),312,1 ,$497.00 ,$248.50 ,$11.95 ,$497.00 ,$321.06 ,$11.95 ,$448.28 ,$384.24 ,$144.46 ,$298.20 ,$422.45 ,$347.90 ,$11.95 ,$472.15 ,$357.84 ,$362.81 ,$299.32 ,$422.45 ,$144.46 ,$299.32 ,$397.60 ,$362.81 ,$11.95 ,$144.46 ,$208.74 ,$497.00 ,$422.45 ,$325.04 ,$457.24 ,$347.90 ,$138.36 ,$148.61 ,$302.67 ,$138.36 ,$343.43 ,$347.90 ,$145.90 ,$357.84 ,$12.67 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$357.84 ,$308.14 ,$357.84 ,$357.84 ,$298.20 ST VINCENT HOSPITAL - ACUTE,31200207,88365,HC IN SITU HYBRID (FISH) HER2,312,1 ,$497.00 ,$248.50 ,$11.95 ,$497.00 ,$321.06 ,$11.95 ,$448.28 ,$384.24 ,$144.46 ,$298.20 ,$422.45 ,$347.90 ,$11.95 ,$472.15 ,$357.84 ,$362.81 ,$299.32 ,$422.45 ,$144.46 ,$299.32 ,$397.60 ,$362.81 ,$11.95 ,$144.46 ,$208.74 ,$497.00 ,$422.45 ,$325.04 ,$457.24 ,$347.90 ,$138.36 ,$148.61 ,$302.67 ,$138.36 ,$343.43 ,$347.90 ,$145.90 ,$357.84 ,$12.67 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$357.84 ,$308.14 ,$357.84 ,$357.84 ,$298.20 ST VINCENT HOSPITAL - ACUTE,31200208,88368,HC MORPHO ANLYS IN SITU HYBRID,312,1 ,$370.00 ,$185.00 ,$11.95 ,$634.69 ,$239.02 ,$11.95 ,$286.53 ,$245.59 ,$282.09 ,$222.00 ,$314.50 ,$259.00 ,$11.95 ,$351.50 ,$266.40 ,$270.10 ,$221.48 ,$314.50 ,$282.09 ,$221.48 ,$296.00 ,$270.10 ,$11.95 ,$282.09 ,$155.40 ,$370.00 ,$314.50 ,$634.69 ,$340.40 ,$259.00 ,$138.36 ,$148.61 ,$225.33 ,$138.36 ,$255.67 ,$259.00 ,$284.91 ,$266.40 ,$12.67 ,$340.09 ,$340.09 ,$282.09 ,$340.09 ,$282.09 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,31200210,88399,HC ACGH ARRAY,312,1 ,"$1,835.00 ",$917.50 ,$5.22 ,"$1,835.00 ","$1,185.41 ",$5.22 ,"$1,187.06 ","$1,187.06 ",$48.19 ,"$1,101.00 ","$1,559.75 ","$1,284.50 ",$5.22 ,"$1,743.25 ","$1,321.20 ","$1,339.55 ", N/A ,"$1,559.75 ",$48.19 , N/A ,"$1,468.00 ","$1,339.55 ",$5.22 ,$48.19 ,$770.70 ,"$1,835.00 ","$1,559.75 ",$108.43 ,"$1,688.20 ","$1,284.50 ",$75.15 ,$80.72 ,"$1,117.52 ",$75.15 ,"$1,267.99 ","$1,284.50 ",$48.67 ,"$1,321.20 ",$5.53 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,"$1,321.20 ","$1,137.70 ","$1,321.20 ","$1,321.20 ","$1,101.00 " ST VINCENT HOSPITAL - ACUTE,31200212,G0416,HC PROSTATE NEEDLE BX SAMPLING 1-20 SPEC,312,1 ,$465.00 ,$232.50 ,$11.95 ,$634.69 ,$300.39 ,$11.95 ,$300.81 ,$300.81 ,$282.09 ,$279.00 ,$395.25 ,$325.50 ,$11.95 ,$441.75 ,$334.80 ,$339.45 ,$465.00 ,$395.25 ,$282.09 ,$465.00 ,$372.00 ,$339.45 ,$11.95 ,$282.09 ,$195.30 ,$465.00 ,$395.25 ,$634.69 ,$427.80 ,$325.50 ,$465.00 ,$465.00 ,$283.19 ,$465.00 ,$321.32 ,$325.50 ,$284.91 ,$334.80 ,$12.67 ,$340.09 ,$340.09 ,$282.09 ,$340.09 ,$282.09 ,$334.80 ,$288.30 ,$334.80 ,$334.80 ,$279.00 ST VINCENT HOSPITAL - ACUTE,31200213,88313,HC SPECIAL STAIN II (BM CLOT),312,1 ,$194.00 ,$97.00 ,$5.22 ,$194.00 ,$125.32 ,$5.22 ,$194.00 ,$175.24 ,$32.77 ,$116.40 ,$164.90 ,$135.80 ,$5.22 ,$184.30 ,$139.68 ,$141.62 ,$130.82 ,$164.90 ,$32.77 ,$130.82 ,$155.20 ,$141.62 ,$5.22 ,$32.77 ,$81.48 ,$194.00 ,$164.90 ,$73.74 ,$178.48 ,$135.80 ,$75.15 ,$80.72 ,$118.15 ,$75.15 ,$134.05 ,$135.80 ,$33.10 ,$139.68 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$139.68 ,$120.28 ,$139.68 ,$139.68 ,$116.40 ST VINCENT HOSPITAL - ACUTE,31200214,88348,HC ELECTROMICROSCOPE SCAN,312,1 ,"$1,000.00 ",$500.00 ,$11.95 ,"$1,429.83 ",$646.00 ,$11.95 ,$954.61 ,$818.24 ,$635.48 ,$600.00 ,$850.00 ,$700.00 ,$11.95 ,$950.00 ,$720.00 ,$730.00 ,$694.64 ,$850.00 ,$635.48 ,$694.64 ,$800.00 ,$730.00 ,$11.95 ,$635.48 ,$420.00 ,"$1,000.00 ",$850.00 ,"$1,429.83 ",$920.00 ,$700.00 ,$680.48 ,$730.89 ,$609.00 ,$680.48 ,$691.00 ,$700.00 ,$641.83 ,$720.00 ,$12.67 ,$753.84 ,$753.84 ,$635.48 ,$753.84 ,$635.48 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,31200215,88341,HC MLH-1 IMMUNOSTAIN,312,1 ,$330.00 ,$165.00 ,$11.95 ,$330.00 ,$213.18 ,$11.95 ,$216.08 ,$185.21 , N/A ,$198.00 ,$280.50 ,$231.00 ,$11.95 ,$313.50 ,$237.60 ,$240.90 ,$151.86 ,$280.50 , N/A ,$151.86 ,$264.00 ,$240.90 ,$11.95 , N/A ,$138.60 ,$330.00 ,$280.50 , N/A ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 , N/A ,$237.60 ,$12.67 ,$77.52 ,$77.52 , N/A ,$77.52 , N/A ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,31200216,88341,HC MSH-2 IMMUNOSTAIN,312,1 ,$330.00 ,$165.00 ,$11.95 ,$330.00 ,$213.18 ,$11.95 ,$216.08 ,$185.21 , N/A ,$198.00 ,$280.50 ,$231.00 ,$11.95 ,$313.50 ,$237.60 ,$240.90 ,$151.86 ,$280.50 , N/A ,$151.86 ,$264.00 ,$240.90 ,$11.95 , N/A ,$138.60 ,$330.00 ,$280.50 , N/A ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 , N/A ,$237.60 ,$12.67 ,$77.52 ,$77.52 , N/A ,$77.52 , N/A ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,31200217,88341,HC MSH-3 IMMUNOSTAIN,312,1 ,$330.00 ,$165.00 ,$11.95 ,$330.00 ,$213.18 ,$11.95 ,$216.08 ,$185.21 , N/A ,$198.00 ,$280.50 ,$231.00 ,$11.95 ,$313.50 ,$237.60 ,$240.90 ,$151.86 ,$280.50 , N/A ,$151.86 ,$264.00 ,$240.90 ,$11.95 , N/A ,$138.60 ,$330.00 ,$280.50 , N/A ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 , N/A ,$237.60 ,$12.67 ,$77.52 ,$77.52 , N/A ,$77.52 , N/A ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,31200218,88341,HC PMS-2 IMMUNOSTAIN,312,1 ,$330.00 ,$165.00 ,$11.95 ,$330.00 ,$213.18 ,$11.95 ,$216.08 ,$185.21 , N/A ,$198.00 ,$280.50 ,$231.00 ,$11.95 ,$313.50 ,$237.60 ,$240.90 ,$151.86 ,$280.50 , N/A ,$151.86 ,$264.00 ,$240.90 ,$11.95 , N/A ,$138.60 ,$330.00 ,$280.50 , N/A ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 , N/A ,$237.60 ,$12.67 ,$77.52 ,$77.52 , N/A ,$77.52 , N/A ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,31200220,88342,HC IMMUNOHISTOCHEM AB-INITIAL,312,1 ,$260.00 ,$130.00 ,$11.38 ,$325.04 ,$167.96 ,$11.38 ,$238.24 ,$204.21 ,$144.46 ,$156.00 ,$221.00 ,$182.00 ,$11.38 ,$247.00 ,$187.20 ,$189.80 ,$171.51 ,$221.00 ,$144.46 ,$171.51 ,$208.00 ,$189.80 ,$11.38 ,$144.46 ,$109.20 ,$260.00 ,$221.00 ,$325.04 ,$239.20 ,$182.00 ,$137.73 ,$147.93 ,$158.34 ,$137.73 ,$179.66 ,$182.00 ,$145.90 ,$187.20 ,$12.06 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31200221,88341,HC IP STAIN ADDITIONAL,312,1 ,$330.00 ,$165.00 ,$11.95 ,$330.00 ,$213.18 ,$11.95 ,$216.08 ,$185.21 , N/A ,$198.00 ,$280.50 ,$231.00 ,$11.95 ,$313.50 ,$237.60 ,$240.90 ,$151.86 ,$280.50 , N/A ,$151.86 ,$264.00 ,$240.90 ,$11.95 , N/A ,$138.60 ,$330.00 ,$280.50 , N/A ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 , N/A ,$237.60 ,$12.67 ,$77.52 ,$77.52 , N/A ,$77.52 , N/A ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,31200226,88323,HC CONSULT SLIDE PREP LV II,312,1 ,$400.00 ,$200.00 ,$11.38 ,$400.00 ,$258.40 ,$11.38 ,$89.77 ,$76.94 ,$48.19 ,$240.00 ,$340.00 ,$280.00 ,$11.38 ,$380.00 ,$288.00 ,$292.00 ,$188.99 ,$340.00 ,$48.19 ,$188.99 ,$320.00 ,$292.00 ,$11.38 ,$48.19 ,$168.00 ,$400.00 ,$340.00 ,$108.43 ,$368.00 ,$280.00 ,$138.36 ,$148.61 ,$243.60 ,$138.36 ,$276.40 ,$280.00 ,$48.67 ,$288.00 ,$12.06 ,$59.36 ,$59.36 ,$48.19 ,$59.36 ,$48.19 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,31200228,81479,HC IBD SCREEN-UNLISTED,312,1 ,$160.00 ,$80.00 ,$10.83 ,$160.00 ,$103.36 ,$10.83 ,$103.50 ,$103.50 , N/A ,$96.00 ,$136.00 ,$112.00 ,$10.83 ,$152.00 ,$115.20 ,$116.80 , N/A ,$136.00 , N/A , N/A ,$128.00 ,$116.80 ,$10.83 , N/A ,$67.20 ,$160.00 ,$136.00 ,$96.00 ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , N/A ,$115.20 ,$11.48 ,$80.00 ,$80.00 , N/A ,$80.00 , N/A ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,31200229,88368,HC I KAPPA ISH,312,1 ,$800.00 ,$400.00 ,$11.95 ,$800.00 ,$516.80 ,$11.95 ,$286.53 ,$245.59 ,$282.09 ,$480.00 ,$680.00 ,$560.00 ,$11.95 ,$760.00 ,$576.00 ,$584.00 ,$221.48 ,$680.00 ,$282.09 ,$221.48 ,$640.00 ,$584.00 ,$11.95 ,$282.09 ,$336.00 ,$800.00 ,$680.00 ,$634.69 ,$736.00 ,$560.00 ,$138.36 ,$148.61 ,$487.20 ,$138.36 ,$552.80 ,$560.00 ,$284.91 ,$576.00 ,$12.67 ,$340.09 ,$340.09 ,$282.09 ,$340.09 ,$282.09 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,31200230,88369,HC I LAMBDA ISH-ADDITIONAL,312,1 ,$360.00 ,$180.00 ,$11.38 ,$360.00 ,$232.56 ,$11.38 ,$264.80 ,$226.97 , N/A ,$216.00 ,$306.00 ,$252.00 ,$11.38 ,$342.00 ,$259.20 ,$262.80 ,$191.06 ,$306.00 , N/A ,$191.06 ,$288.00 ,$262.80 ,$11.38 , N/A ,$151.20 ,$360.00 ,$306.00 , N/A ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 , N/A ,$259.20 ,$12.06 ,$99.18 ,$99.18 , N/A ,$99.18 , N/A ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,31200231,88313,HC PERIODIC ACID SCHIFF STAIN II,312,1 ,$260.00 ,$130.00 ,$5.22 ,$260.00 ,$167.96 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$156.00 ,$221.00 ,$182.00 ,$5.22 ,$247.00 ,$187.20 ,$189.80 ,$130.82 ,$221.00 ,$32.77 ,$130.82 ,$208.00 ,$189.80 ,$5.22 ,$32.77 ,$109.20 ,$260.00 ,$221.00 ,$73.74 ,$239.20 ,$182.00 ,$75.15 ,$80.72 ,$158.34 ,$75.15 ,$179.66 ,$182.00 ,$33.10 ,$187.20 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31200232,88313,HC MASSONS TRICHROME STAIN II,312,1 ,$260.00 ,$130.00 ,$5.22 ,$260.00 ,$167.96 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$156.00 ,$221.00 ,$182.00 ,$5.22 ,$247.00 ,$187.20 ,$189.80 ,$130.82 ,$221.00 ,$32.77 ,$130.82 ,$208.00 ,$189.80 ,$5.22 ,$32.77 ,$109.20 ,$260.00 ,$221.00 ,$73.74 ,$239.20 ,$182.00 ,$75.15 ,$80.72 ,$158.34 ,$75.15 ,$179.66 ,$182.00 ,$33.10 ,$187.20 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31200233,88313,HC JONES METH SILVER STAIN II,312,1 ,$260.00 ,$130.00 ,$5.22 ,$260.00 ,$167.96 ,$5.22 ,$204.44 ,$175.24 ,$32.77 ,$156.00 ,$221.00 ,$182.00 ,$5.22 ,$247.00 ,$187.20 ,$189.80 ,$130.82 ,$221.00 ,$32.77 ,$130.82 ,$208.00 ,$189.80 ,$5.22 ,$32.77 ,$109.20 ,$260.00 ,$221.00 ,$73.74 ,$239.20 ,$182.00 ,$75.15 ,$80.72 ,$158.34 ,$75.15 ,$179.66 ,$182.00 ,$33.10 ,$187.20 ,$5.53 ,$40.12 ,$40.12 ,$32.77 ,$40.12 ,$32.77 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,31200234,88346,HC IGG1 IF,312,1 ,$137.00 ,$68.50 ,$11.38 ,$634.69 ,$88.50 ,$11.38 ,$137.00 ,$137.00 ,$282.09 ,$82.20 ,$116.45 ,$95.90 ,$11.38 ,$130.15 ,$98.64 ,$100.01 ,$137.00 ,$116.45 ,$282.09 ,$137.00 ,$109.60 ,$100.01 ,$11.38 ,$282.09 ,$57.54 ,$137.00 ,$116.45 ,$634.69 ,$126.04 ,$95.90 ,$137.00 ,$137.00 ,$83.43 ,$137.00 ,$94.67 ,$95.90 ,$284.91 ,$98.64 ,$12.06 ,$137.00 ,$137.00 ,$282.09 ,$137.00 ,$282.09 ,$98.64 ,$84.94 ,$98.64 ,$98.64 ,$82.20 ST VINCENT HOSPITAL - ACUTE,31200235,88381,HC MICRODISSECTION MANUAL,312,1 ,$250.00 ,$125.00 ,$11.38 ,$250.00 ,$161.50 ,$11.38 ,$250.00 ,$250.00 , N/A ,$150.00 ,$212.50 ,$175.00 ,$11.38 ,$237.50 ,$180.00 ,$182.50 ,$250.00 ,$212.50 , N/A ,$250.00 ,$200.00 ,$182.50 ,$11.38 , N/A ,$105.00 ,$250.00 ,$212.50 , N/A ,$230.00 ,$175.00 ,$250.00 ,$250.00 ,$152.25 ,$250.00 ,$172.75 ,$175.00 , N/A ,$180.00 ,$12.06 ,$188.39 ,$188.39 , N/A ,$188.39 , N/A ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,31200236,88346,HC IGG3 IF,312,1 ,$137.00 ,$68.50 ,$11.38 ,$634.69 ,$88.50 ,$11.38 ,$137.00 ,$137.00 ,$282.09 ,$82.20 ,$116.45 ,$95.90 ,$11.38 ,$130.15 ,$98.64 ,$100.01 ,$137.00 ,$116.45 ,$282.09 ,$137.00 ,$109.60 ,$100.01 ,$11.38 ,$282.09 ,$57.54 ,$137.00 ,$116.45 ,$634.69 ,$126.04 ,$95.90 ,$137.00 ,$137.00 ,$83.43 ,$137.00 ,$94.67 ,$95.90 ,$284.91 ,$98.64 ,$12.06 ,$137.00 ,$137.00 ,$282.09 ,$137.00 ,$282.09 ,$98.64 ,$84.94 ,$98.64 ,$98.64 ,$82.20 ST VINCENT HOSPITAL - ACUTE,31200237,88346,HC IGG4 IF,312,1 ,$137.00 ,$68.50 ,$11.38 ,$634.69 ,$88.50 ,$11.38 ,$137.00 ,$137.00 ,$282.09 ,$82.20 ,$116.45 ,$95.90 ,$11.38 ,$130.15 ,$98.64 ,$100.01 ,$137.00 ,$116.45 ,$282.09 ,$137.00 ,$109.60 ,$100.01 ,$11.38 ,$282.09 ,$57.54 ,$137.00 ,$116.45 ,$634.69 ,$126.04 ,$95.90 ,$137.00 ,$137.00 ,$83.43 ,$137.00 ,$94.67 ,$95.90 ,$284.91 ,$98.64 ,$12.06 ,$137.00 ,$137.00 ,$282.09 ,$137.00 ,$282.09 ,$98.64 ,$84.94 ,$98.64 ,$98.64 ,$82.20 ST VINCENT HOSPITAL - ACUTE,31200238,88346,HC IGG2 IF,312,1 ,$137.00 ,$68.50 ,$11.38 ,$634.69 ,$88.50 ,$11.38 ,$137.00 ,$137.00 ,$282.09 ,$82.20 ,$116.45 ,$95.90 ,$11.38 ,$130.15 ,$98.64 ,$100.01 ,$137.00 ,$116.45 ,$282.09 ,$137.00 ,$109.60 ,$100.01 ,$11.38 ,$282.09 ,$57.54 ,$137.00 ,$116.45 ,$634.69 ,$126.04 ,$95.90 ,$137.00 ,$137.00 ,$83.43 ,$137.00 ,$94.67 ,$95.90 ,$284.91 ,$98.64 ,$12.06 ,$137.00 ,$137.00 ,$282.09 ,$137.00 ,$282.09 ,$98.64 ,$84.94 ,$98.64 ,$98.64 ,$82.20 ST VINCENT HOSPITAL - ACUTE,31200239,88368,HC HER2 DUAL ISH,312,1 ,$800.00 ,$400.00 ,$11.95 ,$800.00 ,$516.80 ,$11.95 ,$286.53 ,$245.59 ,$282.09 ,$480.00 ,$680.00 ,$560.00 ,$11.95 ,$760.00 ,$576.00 ,$584.00 ,$221.48 ,$680.00 ,$282.09 ,$221.48 ,$640.00 ,$584.00 ,$11.95 ,$282.09 ,$336.00 ,$800.00 ,$680.00 ,$634.69 ,$736.00 ,$560.00 ,$138.36 ,$148.61 ,$487.20 ,$138.36 ,$552.80 ,$560.00 ,$284.91 ,$576.00 ,$12.67 ,$340.09 ,$340.09 ,$282.09 ,$340.09 ,$282.09 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,31200240,88365,HC EPSTEIN BARR ISH,312,1 ,$310.00 ,$155.00 ,$11.95 ,$325.04 ,$200.26 ,$11.95 ,$310.00 ,$310.00 ,$144.46 ,$186.00 ,$263.50 ,$217.00 ,$11.95 ,$294.50 ,$223.20 ,$226.30 ,$299.32 ,$263.50 ,$144.46 ,$299.32 ,$248.00 ,$226.30 ,$11.95 ,$144.46 ,$130.20 ,$310.00 ,$263.50 ,$325.04 ,$285.20 ,$217.00 ,$138.36 ,$148.61 ,$188.79 ,$138.36 ,$214.21 ,$217.00 ,$145.90 ,$223.20 ,$12.67 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,31200241,88369,HC HER2 DUAL ISH - ADDITIONAL,312,1 ,$360.00 ,$180.00 ,$11.38 ,$360.00 ,$232.56 ,$11.38 ,$264.80 ,$226.97 , N/A ,$216.00 ,$306.00 ,$252.00 ,$11.38 ,$342.00 ,$259.20 ,$262.80 ,$191.06 ,$306.00 , N/A ,$191.06 ,$288.00 ,$262.80 ,$11.38 , N/A ,$151.20 ,$360.00 ,$306.00 , N/A ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 , N/A ,$259.20 ,$12.06 ,$99.18 ,$99.18 , N/A ,$99.18 , N/A ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,31200242,88368,HC ISH,312,1 ,$278.00 ,$139.00 ,$11.95 ,$634.69 ,$179.59 ,$11.95 ,$278.00 ,$245.59 ,$282.09 ,$166.80 ,$236.30 ,$194.60 ,$11.95 ,$264.10 ,$200.16 ,$202.94 ,$221.48 ,$236.30 ,$282.09 ,$221.48 ,$222.40 ,$202.94 ,$11.95 ,$282.09 ,$116.76 ,$278.00 ,$236.30 ,$634.69 ,$255.76 ,$194.60 ,$138.36 ,$148.61 ,$169.30 ,$138.36 ,$192.10 ,$194.60 ,$284.91 ,$200.16 ,$12.67 ,$278.00 ,$278.00 ,$282.09 ,$278.00 ,$282.09 ,$200.16 ,$172.36 ,$200.16 ,$200.16 ,$166.80 ST VINCENT HOSPITAL - ACUTE,31200243,88369,HC ISH ADDITIONAL,312,1 ,$278.00 ,$139.00 ,$11.38 ,$278.00 ,$179.59 ,$11.38 ,$264.80 ,$226.97 , N/A ,$166.80 ,$236.30 ,$194.60 ,$11.38 ,$264.10 ,$200.16 ,$202.94 ,$191.06 ,$236.30 , N/A ,$191.06 ,$222.40 ,$202.94 ,$11.38 , N/A ,$116.76 ,$278.00 ,$236.30 , N/A ,$255.76 ,$194.60 ,$139.00 ,$166.80 ,$169.30 ,$139.00 ,$192.10 ,$194.60 , N/A ,$200.16 ,$12.06 ,$99.18 ,$99.18 , N/A ,$99.18 , N/A ,$200.16 ,$172.36 ,$200.16 ,$200.16 ,$166.80 ST VINCENT HOSPITAL - ACUTE,31200245,88350,HC IMMUNOFLUOR PER SPEC EA ADDN SINGLE STAIN,312,1 ,$210.00 ,$105.00 ,$11.95 ,$210.00 ,$135.66 ,$11.95 ,$162.96 ,$139.68 , N/A ,$126.00 ,$178.50 ,$147.00 ,$11.95 ,$199.50 ,$151.20 ,$153.30 ,$178.40 ,$178.50 , N/A ,$178.40 ,$168.00 ,$153.30 ,$11.95 , N/A ,$88.20 ,$210.00 ,$178.50 , N/A ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 , N/A ,$151.20 ,$12.67 ,$76.66 ,$76.66 , N/A ,$76.66 , N/A ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,31200251,88350,HC IMMUNOFLUOR PER SPEC EA ADDL STAIN (CUTANEOUS),312,1 ,$110.00 ,$55.00 ,$11.95 ,$110.00 ,$71.06 ,$11.95 ,$110.00 ,$110.00 , N/A ,$66.00 ,$93.50 ,$77.00 ,$11.95 ,$104.50 ,$79.20 ,$80.30 ,$110.00 ,$93.50 , N/A ,$110.00 ,$88.00 ,$80.30 ,$11.95 , N/A ,$46.20 ,$110.00 ,$93.50 , N/A ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 , N/A ,$79.20 ,$12.67 ,$76.66 ,$76.66 , N/A ,$76.66 , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,31200291,88360,HC MORPHO ANALYSIS TUMOR MANUAL PD-L1,312,1 ,$360.00 ,$180.00 ,$11.95 ,$360.00 ,$232.56 ,$11.95 ,$285.32 ,$244.56 ,$144.46 ,$216.00 ,$306.00 ,$252.00 ,$11.95 ,$342.00 ,$259.20 ,$262.80 ,$202.20 ,$306.00 ,$144.46 ,$202.20 ,$288.00 ,$262.80 ,$11.95 ,$144.46 ,$151.20 ,$360.00 ,$306.00 ,$325.04 ,$331.20 ,$252.00 ,$138.36 ,$148.61 ,$219.24 ,$138.36 ,$248.76 ,$252.00 ,$145.90 ,$259.20 ,$12.67 ,$172.20 ,$172.20 ,$144.46 ,$172.20 ,$144.46 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,31200318,88381,HC MICRODISSECTION MANUAL LUNG PANEL,312,1 ,$110.00 ,$55.00 ,$11.38 ,$110.00 ,$71.06 ,$11.38 ,$110.00 ,$110.00 , N/A ,$66.00 ,$93.50 ,$77.00 ,$11.38 ,$104.50 ,$79.20 ,$80.30 ,$110.00 ,$93.50 , N/A ,$110.00 ,$88.00 ,$80.30 ,$11.38 , N/A ,$46.20 ,$110.00 ,$93.50 , N/A ,$101.20 ,$77.00 ,$110.00 ,$110.00 ,$66.99 ,$110.00 ,$76.01 ,$77.00 , N/A ,$79.20 ,$12.06 ,$110.00 ,$110.00 , N/A ,$110.00 , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,32000002,21116,HC TMJ INJECTION,361,1 ,$522.00 ,$261.00 ,$86.58 ,$522.00 ,$337.21 ,$86.58 ,$522.00 ,$522.00 , N/A ,$313.20 ,$443.70 ,$365.40 ,$86.58 ,$495.90 ,$375.84 ,$381.06 ,$522.00 ,$443.70 , N/A ,$522.00 ,$417.60 ,$381.06 ,$86.58 , N/A ,$522.00 ,$522.00 ,$443.70 , N/A ,$480.24 ,$365.40 ,$522.00 ,$522.00 ,$317.90 ,$522.00 ,$360.70 ,$365.40 , N/A ,$375.84 ,$91.77 ,$522.00 ,$522.00 , N/A ,$522.00 , N/A ,$375.84 ,$323.64 ,$375.84 ,$375.84 ,$313.20 ST VINCENT HOSPITAL - ACUTE,32000003,22510,HC VERTEBROPLASTY INJ PERC THOR,320,1 ,"$5,500.00 ","$2,750.00 ",$415.00 ,"$7,821.36 ","$3,553.00 ","$1,424.58 ","$3,557.95 ","$3,557.95 ","$2,741.24 ","$3,300.00 ","$4,675.00 ","$3,850.00 ","$1,424.58 ","$5,225.00 ","$3,960.00 ","$4,015.00 ",$835.62 ,"$4,675.00 ","$2,741.24 ",$835.62 ,"$4,400.00 ","$4,015.00 ","$1,424.58 ","$2,741.24 ","$2,310.00 ","$5,500.00 ","$4,675.00 ","$6,167.80 ","$5,060.00 ","$3,850.00 ","$5,818.90 ","$7,821.36 ","$3,349.50 ","$7,273.62 ","$3,800.50 ","$3,850.00 ","$2,768.65 ","$3,960.00 ","$1,510.05 ",$415.00 ,$415.00 ,"$2,741.24 ",$415.00 ,"$2,741.24 ","$3,960.00 ","$3,410.00 ","$3,960.00 ","$3,960.00 ","$3,300.00 " ST VINCENT HOSPITAL - ACUTE,32000004,22511,HC VERTEBROPLASTY INJ PERC LUMBAR,320,1 ,"$5,500.00 ","$2,750.00 ",$415.00 ,"$7,821.36 ","$3,553.00 ","$1,424.58 ","$3,557.95 ","$3,557.95 ","$2,741.24 ","$3,300.00 ","$4,675.00 ","$3,850.00 ","$1,424.58 ","$5,225.00 ","$3,960.00 ","$4,015.00 ",$785.03 ,"$4,675.00 ","$2,741.24 ",$785.03 ,"$4,400.00 ","$4,015.00 ","$1,424.58 ","$2,741.24 ","$2,310.00 ","$5,500.00 ","$4,675.00 ","$6,167.80 ","$5,060.00 ","$3,850.00 ","$5,818.90 ","$7,821.36 ","$3,349.50 ","$7,273.62 ","$3,800.50 ","$3,850.00 ","$2,768.65 ","$3,960.00 ","$1,510.05 ",$415.00 ,$415.00 ,"$2,741.24 ",$415.00 ,"$2,741.24 ","$3,960.00 ","$3,410.00 ","$3,960.00 ","$3,960.00 ","$3,300.00 " ST VINCENT HOSPITAL - ACUTE,32000005,22512,HC VERTEBROPLASTY INJ PERC ADDL,320,1 ,"$5,500.00 ","$2,750.00 ",$394.73 ,"$7,821.36 ","$3,553.00 ","$1,424.58 ","$3,557.95 ","$3,557.95 ", N/A ,"$3,300.00 ","$4,675.00 ","$3,850.00 ","$1,424.58 ","$5,225.00 ","$3,960.00 ","$4,015.00 ",$394.73 ,"$4,675.00 ", N/A ,$394.73 ,"$4,400.00 ","$4,015.00 ","$1,424.58 ", N/A ,"$2,310.00 ","$5,500.00 ","$4,675.00 ", N/A ,"$5,060.00 ","$3,850.00 ","$5,818.90 ","$7,821.36 ","$3,349.50 ","$7,273.62 ","$3,800.50 ","$3,850.00 ", N/A ,"$3,960.00 ","$1,510.05 ",$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$3,960.00 ","$3,410.00 ","$3,960.00 ","$3,960.00 ","$3,300.00 " ST VINCENT HOSPITAL - ACUTE,32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$590.00 ,$295.00 ,$86.58 ,$590.00 ,$381.14 ,$86.58 ,$381.67 ,$381.67 , N/A ,$354.00 ,$501.50 ,$413.00 ,$86.58 ,$560.50 ,$424.80 ,$430.70 ,$98.36 ,$501.50 , N/A ,$98.36 ,$472.00 ,$430.70 ,$86.58 , N/A ,$247.80 ,$590.00 ,$501.50 , N/A ,$542.80 ,$413.00 ,$590.00 ,$590.00 ,$359.31 ,$590.00 ,$407.69 ,$413.00 , N/A ,$424.80 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$885.00 ,$442.50 ,$86.58 ,$885.00 ,$571.71 ,$86.58 ,$572.51 ,$572.51 , N/A ,$531.00 ,$752.25 ,$619.50 ,$86.58 ,$840.75 ,$637.20 ,$646.05 ,$98.36 ,$752.25 , N/A ,$98.36 ,$708.00 ,$646.05 ,$86.58 , N/A ,$371.70 ,$885.00 ,$752.25 , N/A ,$814.20 ,$619.50 ,$885.00 ,$885.00 ,$538.97 ,$885.00 ,$611.54 ,$619.50 , N/A ,$637.20 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$637.20 ,$548.70 ,$637.20 ,$637.20 ,$531.00 ST VINCENT HOSPITAL - ACUTE,32000010,24220,HC ARTHROGRAM INJ ELBOW,320,1 ,$590.00 ,$295.00 ,$86.58 ,$590.00 ,$381.14 ,$86.58 ,$381.67 ,$381.67 , N/A ,$354.00 ,$501.50 ,$413.00 ,$86.58 ,$560.50 ,$424.80 ,$430.70 ,$131.71 ,$501.50 , N/A ,$131.71 ,$472.00 ,$430.70 ,$86.58 , N/A ,$247.80 ,$590.00 ,$501.50 , N/A ,$542.80 ,$413.00 ,$590.00 ,$590.00 ,$359.31 ,$590.00 ,$407.69 ,$413.00 , N/A ,$424.80 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,32000011,25246,HC ARTHROGRAM INJ WRIST,320,1 ,$590.00 ,$295.00 ,$86.58 ,$590.00 ,$381.14 ,$86.58 ,$381.67 ,$381.67 , N/A ,$354.00 ,$501.50 ,$413.00 ,$86.58 ,$560.50 ,$424.80 ,$430.70 ,$145.10 ,$501.50 , N/A ,$145.10 ,$472.00 ,$430.70 ,$86.58 , N/A ,$247.80 ,$590.00 ,$501.50 , N/A ,$542.80 ,$413.00 ,$590.00 ,$590.00 ,$359.31 ,$590.00 ,$407.69 ,$413.00 , N/A ,$424.80 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,32000012,27093,HC INJ ARTHROGRAM HIP W/O,320,1 ,$590.00 ,$295.00 ,$86.58 ,$590.00 ,$381.14 ,$86.58 ,$381.67 ,$381.67 , N/A ,$354.00 ,$501.50 ,$413.00 ,$86.58 ,$560.50 ,$424.80 ,$430.70 ,$134.36 ,$501.50 , N/A ,$134.36 ,$472.00 ,$430.70 ,$86.58 , N/A ,$247.80 ,$590.00 ,$501.50 , N/A ,$542.80 ,$413.00 ,$590.00 ,$590.00 ,$359.31 ,$590.00 ,$407.69 ,$413.00 , N/A ,$424.80 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,32000013,27095,HC INJ ARTHROGRAPHY HIP,320,1 ,$590.00 ,$295.00 ,$86.58 ,$590.00 ,$381.14 ,$86.58 ,$381.67 ,$381.67 , N/A ,$354.00 ,$501.50 ,$413.00 ,$86.58 ,$560.50 ,$424.80 ,$430.70 ,$159.80 ,$501.50 , N/A ,$159.80 ,$472.00 ,$430.70 ,$86.58 , N/A ,$247.80 ,$590.00 ,$501.50 , N/A ,$542.80 ,$413.00 ,$590.00 ,$590.00 ,$359.31 ,$590.00 ,$407.69 ,$413.00 , N/A ,$424.80 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,32000014,27324,HC BX SOFT TX THIGH/KNEE DEEP,361,1 ,"$3,900.00 ","$1,950.00 ",$496.73 ,"$5,164.55 ","$2,519.40 ",$496.73 ,"$3,900.00 ","$3,900.00 ","$2,295.35 ","$2,340.00 ","$3,315.00 ","$2,730.00 ",$496.73 ,"$3,705.00 ","$2,808.00 ","$2,847.00 ","$2,717.00 ","$3,315.00 ","$2,295.35 ","$2,717.00 ","$3,120.00 ","$2,847.00 ",$496.73 ,"$2,295.35 ","$3,900.00 ","$3,900.00 ","$3,315.00 ","$5,164.55 ","$3,588.00 ","$2,730.00 ","$2,066.93 ","$2,778.48 ","$2,375.10 ","$2,583.66 ","$2,694.90 ","$2,730.00 ","$2,318.30 ","$2,808.00 ",$526.53 ,"$3,900.00 ","$3,900.00 ","$2,295.35 ","$3,900.00 ","$2,295.35 ","$2,808.00 ","$2,418.00 ","$2,808.00 ","$2,808.00 ","$2,340.00 " ST VINCENT HOSPITAL - ACUTE,32000015,27369,HC ARTHROGRAM INJ KNEE,320,1 ,$885.00 ,$442.50 ,$77.41 ,$885.00 ,$571.71 ,$86.58 ,$572.51 ,$572.51 , N/A ,$531.00 ,$752.25 ,$619.50 ,$86.58 ,$840.75 ,$637.20 ,$646.05 ,$77.41 ,$752.25 , N/A ,$77.41 ,$708.00 ,$646.05 ,$86.58 , N/A ,$371.70 ,$885.00 ,$752.25 , N/A ,$814.20 ,$619.50 ,$885.00 ,$885.00 ,$538.97 ,$885.00 ,$611.54 ,$619.50 , N/A ,$637.20 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$637.20 ,$548.70 ,$637.20 ,$637.20 ,$531.00 ST VINCENT HOSPITAL - ACUTE,32000015,27369,HC ARTHROGRAM INJ KNEE,320,1 ,$590.00 ,$295.00 ,$77.41 ,$590.00 ,$381.14 ,$86.58 ,$381.67 ,$381.67 , N/A ,$354.00 ,$501.50 ,$413.00 ,$86.58 ,$560.50 ,$424.80 ,$430.70 ,$77.41 ,$501.50 , N/A ,$77.41 ,$472.00 ,$430.70 ,$86.58 , N/A ,$247.80 ,$590.00 ,$501.50 , N/A ,$542.80 ,$413.00 ,$590.00 ,$590.00 ,$359.31 ,$590.00 ,$407.69 ,$413.00 , N/A ,$424.80 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,32000016,27648,HC ARTHROGRAM INJ ANKLE,320,1 ,$590.00 ,$295.00 ,$86.58 ,$590.00 ,$381.14 ,$86.58 ,$381.67 ,$381.67 , N/A ,$354.00 ,$501.50 ,$413.00 ,$86.58 ,$560.50 ,$424.80 ,$430.70 ,$100.61 ,$501.50 , N/A ,$100.61 ,$472.00 ,$430.70 ,$86.58 , N/A ,$247.80 ,$590.00 ,$501.50 , N/A ,$542.80 ,$413.00 ,$590.00 ,$590.00 ,$359.31 ,$590.00 ,$407.69 ,$413.00 , N/A ,$424.80 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,32000017,28899,HC UNLISTED PROCEDURE TOE OR FOOT,361,1 ,$590.00 ,$295.00 ,$193.84 ,$590.00 ,$381.14 ,$193.84 ,$590.00 ,$590.00 ,$199.70 ,$354.00 ,$501.50 ,$413.00 ,$193.84 ,$560.50 ,$424.80 ,$430.70 ,$590.00 ,$501.50 ,$199.70 ,$590.00 ,$472.00 ,$430.70 ,$193.84 ,$199.70 ,$590.00 ,$590.00 ,$501.50 ,$449.31 ,$542.80 ,$413.00 , N/A , N/A ,$359.31 , N/A ,$407.69 ,$413.00 ,$201.70 ,$424.80 ,$205.47 ,$590.00 ,$590.00 ,$199.70 ,$590.00 ,$199.70 ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,32000018,32550,HC INSERT CATH PLEURAL INDWELL W/,320,1 ,"$3,900.00 ","$1,950.00 ",$258.10 ,"$6,937.05 ","$2,519.40 ",$258.10 ,"$2,522.91 ","$2,522.91 ","$3,083.13 ","$2,340.00 ","$3,315.00 ","$2,730.00 ",$258.10 ,"$3,705.00 ","$2,808.00 ","$2,847.00 ",$395.38 ,"$3,315.00 ","$3,083.13 ",$395.38 ,"$3,120.00 ","$2,847.00 ",$258.10 ,"$3,083.13 ","$1,638.00 ","$3,900.00 ","$3,315.00 ","$6,937.05 ","$3,588.00 ","$2,730.00 ","$2,066.93 ","$2,778.48 ","$2,375.10 ","$2,583.66 ","$2,694.90 ","$2,730.00 ","$3,113.96 ","$2,808.00 ",$273.59 ,$415.00 ,$415.00 ,"$3,083.13 ",$415.00 ,"$3,083.13 ","$2,808.00 ","$2,418.00 ","$2,808.00 ","$2,808.00 ","$2,340.00 " ST VINCENT HOSPITAL - ACUTE,32000019,32551,HC CHEST TUBE INSERTION 32551,320,1 ,"$1,100.00 ",$550.00 ,$258.10 ,"$3,064.15 ",$710.60 ,$258.10 ,$711.59 ,$711.59 ,"$1,361.85 ",$660.00 ,$935.00 ,$770.00 ,$258.10 ,"$1,045.00 ",$792.00 ,$803.00 ,$296.51 ,$935.00 ,"$1,361.85 ",$296.51 ,$880.00 ,$803.00 ,$258.10 ,"$1,361.85 ",$462.00 ,"$1,100.00 ",$935.00 ,"$3,064.15 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,"$1,375.47 ",$792.00 ,$273.59 ,$415.00 ,$415.00 ,"$1,361.85 ",$415.00 ,"$1,361.85 ",$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,32000020,32552,HC REMOVAL TUNNELED PLEURAL CATH,320,1 ,"$1,300.00 ",$650.00 ,$258.10 ,"$1,300.00 ",$839.80 ,$258.10 ,$840.97 ,$840.97 ,$524.56 ,$780.00 ,"$1,105.00 ",$910.00 ,$258.10 ,"$1,235.00 ",$936.00 ,$949.00 ,$305.84 ,"$1,105.00 ",$524.56 ,$305.84 ,"$1,040.00 ",$949.00 ,$258.10 ,$524.56 ,$546.00 ,"$1,300.00 ","$1,105.00 ","$1,180.26 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,$529.81 ,$936.00 ,$273.59 ,$415.00 ,$415.00 ,$524.56 ,$415.00 ,$524.56 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000021,32561,HC INSTILL FIBRO CHEST TUBE INIT,320,1 ,$870.00 ,$435.00 ,$132.25 ,"$1,180.26 ",$562.02 ,$258.10 ,$562.80 ,$562.80 ,$524.56 ,$522.00 ,$739.50 ,$609.00 ,$258.10 ,$826.50 ,$626.40 ,$635.10 ,$132.25 ,$739.50 ,$524.56 ,$132.25 ,$696.00 ,$635.10 ,$258.10 ,$524.56 ,$365.40 ,$870.00 ,$739.50 ,"$1,180.26 ",$800.40 ,$609.00 ,$870.00 ,$870.00 ,$529.83 ,$870.00 ,$601.17 ,$609.00 ,$529.81 ,$626.40 ,$273.59 ,$415.00 ,$415.00 ,$524.56 ,$415.00 ,$524.56 ,$626.40 ,$539.40 ,$626.40 ,$626.40 ,$522.00 ST VINCENT HOSPITAL - ACUTE,32000022,32562,HC INSTILL FIBRO CHEST TUBE SUBSQ DAY,320,1 ,$870.00 ,$435.00 ,$117.94 ,"$1,180.26 ",$562.02 ,$258.10 ,$562.80 ,$562.80 ,$524.56 ,$522.00 ,$739.50 ,$609.00 ,$258.10 ,$826.50 ,$626.40 ,$635.10 ,$117.94 ,$739.50 ,$524.56 ,$117.94 ,$696.00 ,$635.10 ,$258.10 ,$524.56 ,$365.40 ,$870.00 ,$739.50 ,"$1,180.26 ",$800.40 ,$609.00 ,$870.00 ,$870.00 ,$529.83 ,$870.00 ,$601.17 ,$609.00 ,$529.81 ,$626.40 ,$273.59 ,$415.00 ,$415.00 ,$524.56 ,$415.00 ,$524.56 ,$626.40 ,$539.40 ,$626.40 ,$626.40 ,$522.00 ST VINCENT HOSPITAL - ACUTE,32000026,36000,HC IV START > 3YR OLD,320,1 ,$130.00 ,$65.00 ,$17.61 ,$130.00 ,$83.98 ,$17.61 ,$84.10 ,$84.10 , N/A ,$78.00 ,$110.50 ,$91.00 ,$17.61 ,$123.50 ,$93.60 ,$94.90 ,$17.79 ,$110.50 , N/A ,$17.79 ,$104.00 ,$94.90 ,$17.61 , N/A ,$54.60 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,$130.00 ,$130.00 ,$79.17 ,$130.00 ,$89.83 ,$91.00 , N/A ,$93.60 ,$18.67 ,$130.00 ,$130.00 , N/A ,$130.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,32000027,36002,HC INJ PSEUDOANEURYSM (THROMBIN),320,1 ,$670.00 ,$335.00 ,$198.69 ,"$1,180.26 ",$432.82 ,$265.78 ,$433.42 ,$433.42 ,$524.56 ,$402.00 ,$569.50 ,$469.00 ,$265.78 ,$636.50 ,$482.40 ,$489.10 ,$198.69 ,$569.50 ,$524.56 ,$198.69 ,$536.00 ,$489.10 ,$265.78 ,$524.56 ,$281.40 ,$670.00 ,$569.50 ,"$1,180.26 ",$616.40 ,$469.00 ,$670.00 ,$670.00 ,$408.03 ,$670.00 ,$462.97 ,$469.00 ,$529.81 ,$482.40 ,$281.73 ,$415.00 ,$415.00 ,$524.56 ,$415.00 ,$524.56 ,$482.40 ,$415.40 ,$482.40 ,$482.40 ,$402.00 ST VINCENT HOSPITAL - ACUTE,32000028,36005,HC VENOGRAM INJECTION 36005,320,1 ,$770.00 ,$385.00 ,$91.35 ,$770.00 ,$497.42 ,$202.63 ,$498.11 ,$498.11 , N/A ,$462.00 ,$654.50 ,$539.00 ,$202.63 ,$731.50 ,$554.40 ,$562.10 ,$91.35 ,$654.50 , N/A ,$91.35 ,$616.00 ,$562.10 ,$202.63 , N/A ,$323.40 ,$770.00 ,$654.50 , N/A ,$708.40 ,$539.00 ,$770.00 ,$770.00 ,$468.93 ,$770.00 ,$532.07 ,$539.00 , N/A ,$554.40 ,$214.79 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,32000029,36410,HC VENIPUNCTURE > AGE 3 REQUIR MD,320,1 ,$100.00 ,$50.00 ,$17.61 ,$100.00 ,$64.60 ,$17.61 ,$64.69 ,$64.69 , N/A ,$60.00 ,$85.00 ,$70.00 ,$17.61 ,$95.00 ,$72.00 ,$73.00 ,$18.02 ,$85.00 , N/A ,$18.02 ,$80.00 ,$73.00 ,$17.61 , N/A ,$42.00 ,$100.00 ,$85.00 , N/A ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 , N/A ,$72.00 ,$18.67 ,$100.00 ,$100.00 , N/A ,$100.00 , N/A ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,32000030,36598,HC CONTRAST INJ CV CATH W/FLUORO,320,1 ,$490.00 ,$245.00 ,$70.38 ,$490.00 ,$316.54 ,$86.58 ,$316.98 ,$316.98 ,$197.09 ,$294.00 ,$416.50 ,$343.00 ,$86.58 ,$465.50 ,$352.80 ,$357.70 ,$70.38 ,$416.50 ,$197.09 ,$70.38 ,$392.00 ,$357.70 ,$86.58 ,$197.09 ,$205.80 ,$490.00 ,$416.50 ,$443.45 ,$450.80 ,$343.00 ,$490.00 ,$490.00 ,$298.41 ,$490.00 ,$338.59 ,$343.00 ,$199.06 ,$352.80 ,$91.77 ,$415.00 ,$415.00 ,$197.09 ,$415.00 ,$197.09 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000032,42400,HC BX GLAND SALIVARY NEEDLE,320,1 ,"$1,100.00 ",$550.00 ,$102.85 ,"$1,355.35 ",$710.60 ,$280.78 ,$711.59 ,$711.59 ,$602.38 ,$660.00 ,$935.00 ,$770.00 ,$280.78 ,"$1,045.00 ",$792.00 ,$803.00 ,$102.85 ,$935.00 ,$602.38 ,$102.85 ,$880.00 ,$803.00 ,$280.78 ,$602.38 ,$462.00 ,"$1,100.00 ",$935.00 ,"$1,355.35 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$608.40 ,$792.00 ,$297.63 ,$415.00 ,$415.00 ,$602.38 ,$415.00 ,$602.38 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,32000033,42550,HC SIALOGRAM INJECTION,320,1 ,$382.00 ,$191.00 ,$86.58 ,$382.00 ,$246.77 ,$86.58 ,$247.12 ,$247.12 , N/A ,$229.20 ,$324.70 ,$267.40 ,$86.58 ,$362.90 ,$275.04 ,$278.86 ,$120.72 ,$324.70 , N/A ,$120.72 ,$305.60 ,$278.86 ,$86.58 , N/A ,$160.44 ,$382.00 ,$324.70 , N/A ,$351.44 ,$267.40 ,$382.00 ,$382.00 ,$232.64 ,$382.00 ,$263.96 ,$267.40 , N/A ,$275.04 ,$91.77 ,$382.00 ,$382.00 , N/A ,$382.00 , N/A ,$275.04 ,$236.84 ,$275.04 ,$275.04 ,$229.20 ST VINCENT HOSPITAL - ACUTE,32000034,43274,HC ERCP W/PLACE STENT,320,1 ,"$3,160.00 ","$1,580.00 ",$415.00 ,"$10,957.77 ","$2,041.36 ","$1,055.82 ","$2,044.20 ","$2,044.20 ","$4,870.12 ","$1,896.00 ","$2,686.00 ","$2,212.00 ","$1,055.82 ","$3,002.00 ","$2,275.20 ","$2,306.80 ",$900.30 ,"$2,686.00 ","$4,870.12 ",$900.30 ,"$2,528.00 ","$2,306.80 ","$1,055.82 ","$4,870.12 ","$1,327.20 ","$3,160.00 ","$2,686.00 ","$10,957.77 ","$2,907.20 ","$2,212.00 ","$2,331.31 ","$3,133.44 ","$1,924.44 ","$2,914.14 ","$2,183.56 ","$2,212.00 ","$4,918.82 ","$2,275.20 ","$1,119.17 ",$415.00 ,$415.00 ,"$4,870.12 ",$415.00 ,"$4,870.12 ","$2,275.20 ","$1,959.20 ","$2,275.20 ","$2,275.20 ","$1,896.00 " ST VINCENT HOSPITAL - ACUTE,32000035,43752,HC PLACE TUBE NASOGASTRIC,320,1 ,$400.00 ,$200.00 ,$78.72 ,$588.84 ,$258.40 ,$199.12 ,$258.76 ,$258.76 ,$261.71 ,$240.00 ,$340.00 ,$280.00 ,$199.12 ,$380.00 ,$288.00 ,$292.00 ,$78.72 ,$340.00 ,$261.71 ,$78.72 ,$320.00 ,$292.00 ,$199.12 ,$261.71 ,$168.00 ,$400.00 ,$340.00 ,$588.84 ,$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 ,$264.33 ,$288.00 ,$211.07 ,$400.00 ,$400.00 ,$261.71 ,$400.00 ,$261.71 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,32000036,43761,HC REPOSITION G-TUBE,320,1 ,$840.00 ,$420.00 ,$60.28 ,$840.00 ,$542.64 ,$60.28 ,$543.40 ,$543.40 ,$257.76 ,$504.00 ,$714.00 ,$588.00 ,$60.28 ,$798.00 ,$604.80 ,$613.20 ,$199.32 ,$714.00 ,$257.76 ,$199.32 ,$672.00 ,$613.20 ,$60.28 ,$257.76 ,$352.80 ,$840.00 ,$714.00 ,$579.95 ,$772.80 ,$588.00 ,$840.00 ,$840.00 ,$511.56 ,$840.00 ,$580.44 ,$588.00 ,$260.34 ,$604.80 ,$63.90 ,$415.00 ,$415.00 ,$257.76 ,$415.00 ,$257.76 ,$604.80 ,$520.80 ,$604.80 ,$604.80 ,$504.00 ST VINCENT HOSPITAL - ACUTE,32000038,44500,HC INTRO TUBE GI LONG,320,1 ,$525.00 ,$262.50 ,$38.17 ,"$1,764.22 ",$339.15 ,$199.12 ,$339.62 ,$339.62 ,$784.10 ,$315.00 ,$446.25 ,$367.50 ,$199.12 ,$498.75 ,$378.00 ,$383.25 ,$38.17 ,$446.25 ,$784.10 ,$38.17 ,$420.00 ,$383.25 ,$199.12 ,$784.10 ,$220.50 ,$525.00 ,$446.25 ,"$1,764.22 ",$483.00 ,$367.50 ,$525.00 ,$525.00 ,$319.73 ,$525.00 ,$362.78 ,$367.50 ,$791.94 ,$378.00 ,$211.07 ,$415.00 ,$415.00 ,$784.10 ,$415.00 ,$784.10 ,$378.00 ,$325.50 ,$378.00 ,$378.00 ,$315.00 ST VINCENT HOSPITAL - ACUTE,32000043,47536,HC CHG PERC BIL DRAIN CATH,320,1 ,"$2,500.00 ","$1,250.00 ",$256.25 ,"$6,937.05 ","$1,615.00 ",$703.19 ,"$1,617.25 ","$1,617.25 ","$3,083.13 ","$1,500.00 ","$2,125.00 ","$1,750.00 ",$703.19 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ",$256.25 ,"$2,125.00 ","$3,083.13 ",$256.25 ,"$2,000.00 ","$1,825.00 ",$703.19 ,"$3,083.13 ","$1,050.00 ","$2,500.00 ","$2,125.00 ","$6,937.05 ","$2,300.00 ","$1,750.00 ","$2,331.31 ","$2,500.00 ","$1,522.50 ","$2,500.00 ","$1,727.50 ","$1,750.00 ","$3,113.96 ","$1,800.00 ",$745.38 ,$415.00 ,$415.00 ,"$3,083.13 ",$415.00 ,"$3,083.13 ","$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,32000044,47535,HC REVISE/REINSERT TUBE TRNSHEPAT,320,1 ,"$3,590.00 ","$1,795.00 ",$380.71 ,"$6,937.05 ","$2,319.14 ",$703.19 ,"$2,322.37 ","$2,322.37 ","$3,083.13 ","$2,154.00 ","$3,051.50 ","$2,513.00 ",$703.19 ,"$3,410.50 ","$2,584.80 ","$2,620.70 ",$380.71 ,"$3,051.50 ","$3,083.13 ",$380.71 ,"$2,872.00 ","$2,620.70 ",$703.19 ,"$3,083.13 ","$1,507.80 ","$3,590.00 ","$3,051.50 ","$6,937.05 ","$3,302.80 ","$2,513.00 ","$2,331.31 ","$3,133.44 ","$2,186.31 ","$2,914.14 ","$2,480.69 ","$2,513.00 ","$3,113.96 ","$2,584.80 ",$745.38 ,$415.00 ,$415.00 ,"$3,083.13 ",$415.00 ,"$3,083.13 ","$2,584.80 ","$2,225.80 ","$2,584.80 ","$2,584.80 ","$2,154.00 " ST VINCENT HOSPITAL - ACUTE,32000045,47542,HC ENDO BILIARY W/DIL BILI DUCT,320,1 ,"$2,500.00 ","$1,250.00 ",$264.41 ,"$2,500.00 ","$1,615.00 ",$703.19 ,"$1,617.25 ","$1,617.25 ", N/A ,"$1,500.00 ","$2,125.00 ","$1,750.00 ",$703.19 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ",$264.41 ,"$2,125.00 ", N/A ,$264.41 ,"$2,000.00 ","$1,825.00 ",$703.19 , N/A ,"$1,050.00 ","$2,500.00 ","$2,125.00 ", N/A ,"$2,300.00 ","$1,750.00 ","$2,331.31 ","$2,500.00 ","$1,522.50 ","$2,500.00 ","$1,727.50 ","$1,750.00 ", N/A ,"$1,800.00 ",$745.38 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,32000046,47539,HC ENDO BILIARY DIL DUCT W/STENT,320,1 ,"$2,586.00 ","$1,293.00 ",$415.00 ,"$11,027.33 ","$1,670.56 ",$703.19 ,"$1,672.88 ","$1,672.88 ","$4,901.04 ","$1,551.60 ","$2,198.10 ","$1,810.20 ",$703.19 ,"$2,456.70 ","$1,861.92 ","$1,887.78 ",$815.08 ,"$2,198.10 ","$4,901.04 ",$815.08 ,"$2,068.80 ","$1,887.78 ",$703.19 ,"$4,901.04 ","$1,086.12 ","$2,586.00 ","$2,198.10 ","$11,027.33 ","$2,379.12 ","$1,810.20 ","$5,818.90 ","$7,821.36 ","$1,574.87 ","$7,273.62 ","$1,786.93 ","$1,810.20 ","$4,950.05 ","$1,861.92 ",$745.38 ,$415.00 ,$415.00 ,"$4,901.04 ",$415.00 ,"$4,901.04 ","$1,861.92 ","$1,603.32 ","$1,861.92 ","$1,861.92 ","$1,551.60 " ST VINCENT HOSPITAL - ACUTE,32000052,49400,HC INJ PERITONEAL CAVITY,361,1 ,$518.00 ,$259.00 ,$86.58 ,$518.00 ,$334.63 ,$86.58 ,$518.00 ,$518.00 , N/A ,$310.80 ,$440.30 ,$362.60 ,$86.58 ,$492.10 ,$372.96 ,$378.14 ,$518.00 ,$440.30 , N/A ,$518.00 ,$414.40 ,$378.14 ,$86.58 , N/A ,$518.00 ,$518.00 ,$440.30 , N/A ,$476.56 ,$362.60 ,$518.00 ,$518.00 ,$315.46 ,$518.00 ,$357.94 ,$362.60 , N/A ,$372.96 ,$91.77 ,$518.00 ,$518.00 , N/A ,$518.00 , N/A ,$372.96 ,$321.16 ,$372.96 ,$372.96 ,$310.80 ST VINCENT HOSPITAL - ACUTE,32000053,49423,HC EXCHG CATH ABSC/CYST DRAIN,320,1 ,"$2,000.00 ","$1,000.00 ",$138.19 ,"$3,541.12 ","$1,292.00 ",$202.63 ,"$1,293.80 ","$1,293.80 ","$1,573.83 ","$1,200.00 ","$1,700.00 ","$1,400.00 ",$202.63 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ",$138.19 ,"$1,700.00 ","$1,573.83 ",$138.19 ,"$1,600.00 ","$1,460.00 ",$202.63 ,"$1,573.83 ",$840.00 ,"$2,000.00 ","$1,700.00 ","$3,541.12 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ","$1,589.57 ","$1,440.00 ",$214.79 ,$415.00 ,$415.00 ,"$1,573.83 ",$415.00 ,"$1,573.83 ","$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,32000054,49424,HC INJ CONTRAST ABSC/CYST,320,1 ,$680.00 ,$340.00 ,$73.14 ,$680.00 ,$439.28 ,$86.58 ,$439.89 ,$439.89 , N/A ,$408.00 ,$578.00 ,$476.00 ,$86.58 ,$646.00 ,$489.60 ,$496.40 ,$73.14 ,$578.00 , N/A ,$73.14 ,$544.00 ,$496.40 ,$86.58 , N/A ,$285.60 ,$680.00 ,$578.00 , N/A ,$625.60 ,$476.00 ,$680.00 ,$680.00 ,$414.12 ,$680.00 ,$469.88 ,$476.00 , N/A ,$489.60 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,32000055,49427,HC INJ PREV PLACED SHUNT,320,1 ,$490.00 ,$245.00 ,$75.01 ,$490.00 ,$316.54 ,$86.58 ,$316.98 ,$316.98 , N/A ,$294.00 ,$416.50 ,$343.00 ,$86.58 ,$465.50 ,$352.80 ,$357.70 ,$75.01 ,$416.50 , N/A ,$75.01 ,$392.00 ,$357.70 ,$86.58 , N/A ,$205.80 ,$490.00 ,$416.50 , N/A ,$450.80 ,$343.00 ,$490.00 ,$490.00 ,$298.41 ,$490.00 ,$338.59 ,$343.00 , N/A ,$352.80 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000056,49440,HC INSERT GASTRO TUBE FLUORO,320,1 ,"$1,700.00 ",$850.00 ,$199.12 ,"$3,541.12 ","$1,098.20 ",$199.12 ,"$1,099.73 ","$1,099.73 ","$1,573.83 ","$1,020.00 ","$1,445.00 ","$1,190.00 ",$199.12 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ",$396.08 ,"$1,445.00 ","$1,573.83 ",$396.08 ,"$1,360.00 ","$1,241.00 ",$199.12 ,"$1,573.83 ",$714.00 ,"$1,700.00 ","$1,445.00 ","$3,541.12 ","$1,564.00 ","$1,190.00 ","$1,700.00 ","$1,700.00 ","$1,035.30 ","$1,700.00 ","$1,174.70 ","$1,190.00 ","$1,589.57 ","$1,224.00 ",$211.07 ,$415.00 ,$415.00 ,"$1,573.83 ",$415.00 ,"$1,573.83 ","$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,32000057,49441,HC INSERT DUODEN/JEJUN TBE FLUORO,320,1 ,"$2,960.00 ","$1,480.00 ",$199.12 ,"$3,541.12 ","$1,912.16 ",$199.12 ,"$1,914.82 ","$1,914.82 ","$1,573.83 ","$1,776.00 ","$2,516.00 ","$2,072.00 ",$199.12 ,"$2,812.00 ","$2,131.20 ","$2,160.80 ",$461.43 ,"$2,516.00 ","$1,573.83 ",$461.43 ,"$2,368.00 ","$2,160.80 ",$199.12 ,"$1,573.83 ","$1,243.20 ","$2,960.00 ","$2,516.00 ","$3,541.12 ","$2,723.20 ","$2,072.00 ","$2,331.31 ","$2,960.00 ","$1,802.64 ","$2,914.14 ","$2,045.36 ","$2,072.00 ","$1,589.57 ","$2,131.20 ",$211.07 ,$415.00 ,$415.00 ,"$1,573.83 ",$415.00 ,"$1,573.83 ","$2,131.20 ","$1,835.20 ","$2,131.20 ","$2,131.20 ","$1,776.00 " ST VINCENT HOSPITAL - ACUTE,32000058,49442,HC INSERT CECOS/OTHR TBE FLUORO,320,1 ,"$2,800.00 ","$1,400.00 ",$403.97 ,"$2,800.00 ","$1,808.80 ",$682.71 ,"$1,811.32 ","$1,811.32 ","$1,004.30 ","$1,680.00 ","$2,380.00 ","$1,960.00 ",$682.71 ,"$2,660.00 ","$2,016.00 ","$2,044.00 ",$403.97 ,"$2,380.00 ","$1,004.30 ",$403.97 ,"$2,240.00 ","$2,044.00 ",$682.71 ,"$1,004.30 ","$1,176.00 ","$2,800.00 ","$2,380.00 ","$2,259.67 ","$2,576.00 ","$1,960.00 ","$2,331.31 ","$2,800.00 ","$1,705.20 ","$2,800.00 ","$1,934.80 ","$1,960.00 ","$1,014.34 ","$2,016.00 ",$723.67 ,$415.00 ,$415.00 ,"$1,004.30 ",$415.00 ,"$1,004.30 ","$2,016.00 ","$1,736.00 ","$2,016.00 ","$2,016.00 ","$1,680.00 " ST VINCENT HOSPITAL - ACUTE,32000059,49446,HC CHG G-TB TO GJ-TB PERC FLUORO,320,1 ,"$1,900.00 ",$950.00 ,$199.12 ,"$3,541.12 ","$1,227.40 ",$199.12 ,"$1,229.11 ","$1,229.11 ","$1,573.83 ","$1,140.00 ","$1,615.00 ","$1,330.00 ",$199.12 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ",$287.06 ,"$1,615.00 ","$1,573.83 ",$287.06 ,"$1,520.00 ","$1,387.00 ",$199.12 ,"$1,573.83 ",$798.00 ,"$1,900.00 ","$1,615.00 ","$3,541.12 ","$1,748.00 ","$1,330.00 ","$1,900.00 ","$1,900.00 ","$1,157.10 ","$1,900.00 ","$1,312.90 ","$1,330.00 ","$1,589.57 ","$1,368.00 ",$211.07 ,$415.00 ,$415.00 ,"$1,573.83 ",$415.00 ,"$1,573.83 ","$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,32000060,49450,HC RPLC G/CEC/OTH TB UNDER FLUORO,320,1 ,"$1,000.00 ",$500.00 ,$128.33 ,"$1,764.22 ",$646.00 ,$199.12 ,$646.90 ,$646.90 ,$784.10 ,$600.00 ,$850.00 ,$700.00 ,$199.12 ,$950.00 ,$720.00 ,$730.00 ,$128.33 ,$850.00 ,$784.10 ,$128.33 ,$800.00 ,$730.00 ,$199.12 ,$784.10 ,$420.00 ,"$1,000.00 ",$850.00 ,"$1,764.22 ",$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$791.94 ,$720.00 ,$211.07 ,$415.00 ,$415.00 ,$784.10 ,$415.00 ,$784.10 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,32000061,49451,HC RPLC DUODEN/JEJUN TB FLUORO,320,1 ,"$1,200.00 ",$600.00 ,$172.96 ,"$1,764.22 ",$775.20 ,$199.12 ,$776.28 ,$776.28 ,$784.10 ,$720.00 ,"$1,020.00 ",$840.00 ,$199.12 ,"$1,140.00 ",$864.00 ,$876.00 ,$172.96 ,"$1,020.00 ",$784.10 ,$172.96 ,$960.00 ,$876.00 ,$199.12 ,$784.10 ,$504.00 ,"$1,200.00 ","$1,020.00 ","$1,764.22 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,$791.94 ,$864.00 ,$211.07 ,$415.00 ,$415.00 ,$784.10 ,$415.00 ,$784.10 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,32000062,49452,HC RPLC GASTRO-JEJUN TB FLUORO,361,1 ,"$1,100.00 ",$550.00 ,$199.12 ,"$1,764.22 ",$710.60 ,$199.12 ,"$1,100.00 ","$1,100.00 ",$784.10 ,$660.00 ,$935.00 ,$770.00 ,$199.12 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 ,$784.10 ,"$1,100.00 ",$880.00 ,$803.00 ,$199.12 ,$784.10 ,"$1,100.00 ","$1,100.00 ",$935.00 ,"$1,764.22 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$791.94 ,$792.00 ,$211.07 ,"$1,100.00 ","$1,100.00 ",$784.10 ,"$1,100.00 ",$784.10 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,32000063,49465,HC INJ CNTR W/FLUOR EVAL G/D/J TB,320,1 ,$440.00 ,$220.00 ,$37.66 ,$501.48 ,$284.24 ,$37.66 ,$284.64 ,$284.64 ,$222.88 ,$264.00 ,$374.00 ,$308.00 ,$37.66 ,$418.00 ,$316.80 ,$321.20 ,$60.23 ,$374.00 ,$222.88 ,$60.23 ,$352.00 ,$321.20 ,$37.66 ,$222.88 ,$184.80 ,$440.00 ,$374.00 ,$501.48 ,$404.80 ,$308.00 ,$440.00 ,$440.00 ,$267.96 ,$440.00 ,$304.04 ,$308.00 ,$225.11 ,$316.80 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,32000065,49999,HC ABD/PERITONEUM/OMNTM UNLSTD,320,1 ,"$2,400.00 ","$1,200.00 ",$415.00 ,"$2,400.00 ","$1,550.40 ",$538.40 ,"$1,552.56 ","$1,552.56 ",$784.10 ,"$1,440.00 ","$2,040.00 ","$1,680.00 ",$538.40 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ", N/A ,"$2,040.00 ",$784.10 , N/A ,"$1,920.00 ","$1,752.00 ",$538.40 ,$784.10 ,"$1,008.00 ","$2,400.00 ","$2,040.00 ","$1,764.22 ","$2,208.00 ","$1,680.00 ","$1,200.00 ","$1,440.00 ","$1,461.60 ","$1,200.00 ","$1,658.40 ","$1,680.00 ",$791.94 ,"$1,728.00 ",$570.70 ,$415.00 ,$415.00 ,$784.10 ,$415.00 ,$784.10 ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,32000066,49405,HC DRN ABSC PERIRENAL PERC,320,1 ,"$1,600.00 ",$800.00 ,$202.63 ,"$3,066.03 ","$1,033.60 ",$202.63 ,"$1,035.04 ","$1,035.04 ","$1,362.68 ",$960.00 ,"$1,360.00 ","$1,120.00 ",$202.63 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ",$382.26 ,"$1,360.00 ","$1,362.68 ",$382.26 ,"$1,280.00 ","$1,168.00 ",$202.63 ,"$1,362.68 ",$672.00 ,"$1,600.00 ","$1,360.00 ","$3,066.03 ","$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ","$1,376.31 ","$1,152.00 ",$214.79 ,$415.00 ,$415.00 ,"$1,362.68 ",$415.00 ,"$1,362.68 ","$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,32000067,50382,HC CHANGE URETERAL STENT PERCU,320,1 ,"$3,700.00 ","$1,850.00 ",$415.00 ,"$3,907.15 ","$2,390.20 ",$430.16 ,"$2,393.53 ","$2,393.53 ","$1,736.51 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$430.16 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ",$495.53 ,"$3,145.00 ","$1,736.51 ",$495.53 ,"$2,960.00 ","$2,701.00 ",$430.16 ,"$1,736.51 ","$1,554.00 ","$3,700.00 ","$3,145.00 ","$3,907.15 ","$3,404.00 ","$2,590.00 ","$2,066.93 ","$2,778.48 ","$2,253.30 ","$2,583.66 ","$2,556.70 ","$2,590.00 ","$1,753.88 ","$2,664.00 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,32000068,50384,HC REM URETERAL STENT PERCU,320,1 ,"$2,600.00 ","$1,300.00 ",$415.00 ,"$3,907.15 ","$1,679.60 ",$430.16 ,"$1,681.94 ","$1,681.94 ","$1,736.51 ","$1,560.00 ","$2,210.00 ","$1,820.00 ",$430.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ",$445.44 ,"$2,210.00 ","$1,736.51 ",$445.44 ,"$2,080.00 ","$1,898.00 ",$430.16 ,"$1,736.51 ","$1,092.00 ","$2,600.00 ","$2,210.00 ","$3,907.15 ","$2,392.00 ","$1,820.00 ","$2,066.93 ","$2,600.00 ","$1,583.40 ","$2,583.66 ","$1,796.60 ","$1,820.00 ","$1,753.88 ","$1,872.00 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,32000069,50385,HC URETERAL STENT CHNG USING SNARE,320,1 ,"$3,500.00 ","$1,750.00 ",$415.00 ,"$3,907.15 ","$2,261.00 ",$430.16 ,"$2,264.15 ","$2,264.15 ","$1,736.51 ","$2,100.00 ","$2,975.00 ","$2,450.00 ",$430.16 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ",$423.12 ,"$2,975.00 ","$1,736.51 ",$423.12 ,"$2,800.00 ","$2,555.00 ",$430.16 ,"$1,736.51 ","$1,470.00 ","$3,500.00 ","$2,975.00 ","$3,907.15 ","$3,220.00 ","$2,450.00 ","$2,066.93 ","$2,778.48 ","$2,131.50 ","$2,583.66 ","$2,418.50 ","$2,450.00 ","$1,753.88 ","$2,520.00 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,32000070,50386,HC URETERAL STENT REMOVAL USNG SNARE,320,1 ,"$1,500.00 ",$750.00 ,$312.30 ,"$3,907.15 ",$969.00 ,$430.16 ,$970.35 ,$970.35 ,"$1,736.51 ",$900.00 ,"$1,275.00 ","$1,050.00 ",$430.16 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$312.30 ,"$1,275.00 ","$1,736.51 ",$312.30 ,"$1,200.00 ","$1,095.00 ",$430.16 ,"$1,736.51 ",$630.00 ,"$1,500.00 ","$1,275.00 ","$3,907.15 ","$1,380.00 ","$1,050.00 ","$1,500.00 ","$1,500.00 ",$913.50 ,"$1,500.00 ","$1,036.50 ","$1,050.00 ","$1,753.88 ","$1,080.00 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,32000071,50387,HC CHANGE EXT/INT URET STENT,320,1 ,"$2,030.00 ","$1,015.00 ",$162.73 ,"$3,907.15 ","$1,311.38 ",$430.16 ,"$1,313.21 ","$1,313.21 ","$1,736.51 ","$1,218.00 ","$1,725.50 ","$1,421.00 ",$430.16 ,"$1,928.50 ","$1,461.60 ","$1,481.90 ",$162.73 ,"$1,725.50 ","$1,736.51 ",$162.73 ,"$1,624.00 ","$1,481.90 ",$430.16 ,"$1,736.51 ",$852.60 ,"$2,030.00 ","$1,725.50 ","$3,907.15 ","$1,867.60 ","$1,421.00 ","$2,030.00 ","$2,030.00 ","$1,236.27 ","$2,030.00 ","$1,402.73 ","$1,421.00 ","$1,753.88 ","$1,461.60 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$1,461.60 ","$1,258.60 ","$1,461.60 ","$1,461.60 ","$1,218.00 " ST VINCENT HOSPITAL - ACUTE,32000072,50389,HC REM NEPHRO TUBE FLUORO,320,1 ,"$1,000.00 ",$500.00 ,$104.39 ,"$1,252.50 ",$646.00 ,$125.13 ,$646.90 ,$646.90 ,$556.66 ,$600.00 ,$850.00 ,$700.00 ,$125.13 ,$950.00 ,$720.00 ,$730.00 ,$104.39 ,$850.00 ,$556.66 ,$104.39 ,$800.00 ,$730.00 ,$125.13 ,$556.66 ,$420.00 ,"$1,000.00 ",$850.00 ,"$1,252.50 ",$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$562.23 ,$720.00 ,$132.64 ,$415.00 ,$415.00 ,$556.66 ,$415.00 ,$556.66 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,32000077,50693,HC INTRO GUIDE RENAL PELVIS URET DIL,320,1 ,"$4,300.00 ","$2,150.00 ",$396.92 ,"$6,703.73 ","$2,777.80 ",$898.01 ,"$2,781.67 ","$2,781.67 ","$2,979.44 ","$2,580.00 ","$3,655.00 ","$3,010.00 ",$898.01 ,"$4,085.00 ","$3,096.00 ","$3,139.00 ",$396.92 ,"$3,655.00 ","$2,979.44 ",$396.92 ,"$3,440.00 ","$3,139.00 ",$898.01 ,"$2,979.44 ","$1,806.00 ","$4,300.00 ","$3,655.00 ","$6,703.73 ","$3,956.00 ","$3,010.00 ","$2,066.93 ","$2,778.48 ","$2,618.70 ","$2,583.66 ","$2,971.30 ","$3,010.00 ","$3,009.23 ","$3,096.00 ",$951.89 ,$415.00 ,$415.00 ,"$2,979.44 ",$415.00 ,"$2,979.44 ","$3,096.00 ","$2,666.00 ","$3,096.00 ","$3,096.00 ","$2,580.00 " ST VINCENT HOSPITAL - ACUTE,32000077,50693,HC INTRO GUIDE RENAL PELVIS URET DIL,320,1 ,"$2,800.00 ","$1,400.00 ",$396.92 ,"$6,703.73 ","$1,808.80 ",$898.01 ,"$1,811.32 ","$1,811.32 ","$2,979.44 ","$1,680.00 ","$2,380.00 ","$1,960.00 ",$898.01 ,"$2,660.00 ","$2,016.00 ","$2,044.00 ",$396.92 ,"$2,380.00 ","$2,979.44 ",$396.92 ,"$2,240.00 ","$2,044.00 ",$898.01 ,"$2,979.44 ","$1,176.00 ","$2,800.00 ","$2,380.00 ","$6,703.73 ","$2,576.00 ","$1,960.00 ","$2,066.93 ","$2,778.48 ","$1,705.20 ","$2,583.66 ","$1,934.80 ","$1,960.00 ","$3,009.23 ","$2,016.00 ",$951.89 ,$415.00 ,$415.00 ,"$2,979.44 ",$415.00 ,"$2,979.44 ","$2,016.00 ","$1,736.00 ","$2,016.00 ","$2,016.00 ","$1,680.00 " ST VINCENT HOSPITAL - ACUTE,32000078,50396,HC MANOMETRIC STUDIES-NEPHROSTOMY,320,1 ,$720.00 ,$360.00 ,$125.13 ,"$1,252.50 ",$465.12 ,$125.13 ,$465.77 ,$465.77 ,$556.66 ,$432.00 ,$612.00 ,$504.00 ,$125.13 ,$684.00 ,$518.40 ,$525.60 ,$227.02 ,$612.00 ,$556.66 ,$227.02 ,$576.00 ,$525.60 ,$125.13 ,$556.66 ,$302.40 ,$720.00 ,$612.00 ,"$1,252.50 ",$662.40 ,$504.00 ,$720.00 ,$720.00 ,$438.48 ,$720.00 ,$497.52 ,$504.00 ,$562.23 ,$518.40 ,$132.64 ,$415.00 ,$415.00 ,$556.66 ,$415.00 ,$556.66 ,$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,32000079,50435,HC CHANGE NEPHROSTOMY TUBE,320,1 ,"$3,900.00 ","$1,950.00 ",$193.34 ,"$3,907.15 ","$2,519.40 ",$430.16 ,"$2,522.91 ","$2,522.91 ","$1,736.51 ","$2,340.00 ","$3,315.00 ","$2,730.00 ",$430.16 ,"$3,705.00 ","$2,808.00 ","$2,847.00 ",$193.34 ,"$3,315.00 ","$1,736.51 ",$193.34 ,"$3,120.00 ","$2,847.00 ",$430.16 ,"$1,736.51 ","$1,638.00 ","$3,900.00 ","$3,315.00 ","$3,907.15 ","$3,588.00 ","$2,730.00 ","$2,066.93 ","$2,778.48 ","$2,375.10 ","$2,583.66 ","$2,694.90 ","$2,730.00 ","$1,753.88 ","$2,808.00 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$2,808.00 ","$2,418.00 ","$2,808.00 ","$2,808.00 ","$2,340.00 " ST VINCENT HOSPITAL - ACUTE,32000079,50435,HC CHANGE NEPHROSTOMY TUBE,320,1 ,"$2,600.00 ","$1,300.00 ",$193.34 ,"$3,907.15 ","$1,679.60 ",$430.16 ,"$1,681.94 ","$1,681.94 ","$1,736.51 ","$1,560.00 ","$2,210.00 ","$1,820.00 ",$430.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ",$193.34 ,"$2,210.00 ","$1,736.51 ",$193.34 ,"$2,080.00 ","$1,898.00 ",$430.16 ,"$1,736.51 ","$1,092.00 ","$2,600.00 ","$2,210.00 ","$3,907.15 ","$2,392.00 ","$1,820.00 ","$2,066.93 ","$2,600.00 ","$1,583.40 ","$2,583.66 ","$1,796.60 ","$1,820.00 ","$1,753.88 ","$1,872.00 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,32000080,50553,HC ENDO RENAL ESTAB W/CATH,320,1 ,"$3,375.00 ","$1,687.50 ",$415.00 ,"$9,618.44 ","$2,180.25 ",$898.01 ,"$2,183.29 ","$2,183.29 ","$4,274.86 ","$2,025.00 ","$2,868.75 ","$2,362.50 ",$898.01 ,"$3,206.25 ","$2,430.00 ","$2,463.75 ",$606.31 ,"$2,868.75 ","$4,274.86 ",$606.31 ,"$2,700.00 ","$2,463.75 ",$898.01 ,"$4,274.86 ","$1,417.50 ","$3,375.00 ","$2,868.75 ","$9,618.44 ","$3,105.00 ","$2,362.50 ","$2,066.93 ","$2,778.48 ","$2,055.38 ","$2,583.66 ","$2,332.13 ","$2,362.50 ","$4,317.61 ","$2,430.00 ",$951.89 ,$415.00 ,$415.00 ,"$4,274.86 ",$415.00 ,"$4,274.86 ","$2,430.00 ","$2,092.50 ","$2,430.00 ","$2,430.00 ","$2,025.00 " ST VINCENT HOSPITAL - ACUTE,32000082,50688,HC CHG TUBE URETEROSTOMY,320,1 ,"$2,600.00 ","$1,300.00 ",$150.16 ,"$3,907.15 ","$1,679.60 ",$430.16 ,"$1,681.94 ","$1,681.94 ","$1,736.51 ","$1,560.00 ","$2,210.00 ","$1,820.00 ",$430.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ",$150.16 ,"$2,210.00 ","$1,736.51 ",$150.16 ,"$2,080.00 ","$1,898.00 ",$430.16 ,"$1,736.51 ","$1,092.00 ","$2,600.00 ","$2,210.00 ","$3,907.15 ","$2,392.00 ","$1,820.00 ","$2,066.93 ","$2,600.00 ","$1,583.40 ","$2,583.66 ","$1,796.60 ","$1,820.00 ","$1,753.88 ","$1,872.00 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,32000082,50688,HC CHG TUBE URETEROSTOMY,320,1 ,"$3,900.00 ","$1,950.00 ",$150.16 ,"$3,907.15 ","$2,519.40 ",$430.16 ,"$2,522.91 ","$2,522.91 ","$1,736.51 ","$2,340.00 ","$3,315.00 ","$2,730.00 ",$430.16 ,"$3,705.00 ","$2,808.00 ","$2,847.00 ",$150.16 ,"$3,315.00 ","$1,736.51 ",$150.16 ,"$3,120.00 ","$2,847.00 ",$430.16 ,"$1,736.51 ","$1,638.00 ","$3,900.00 ","$3,315.00 ","$3,907.15 ","$3,588.00 ","$2,730.00 ","$2,066.93 ","$2,778.48 ","$2,375.10 ","$2,583.66 ","$2,694.90 ","$2,730.00 ","$1,753.88 ","$2,808.00 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$2,808.00 ","$2,418.00 ","$2,808.00 ","$2,808.00 ","$2,340.00 " ST VINCENT HOSPITAL - ACUTE,32000083,50690,HC INJ ILEAL CONDUIT,320,1 ,$550.00 ,$275.00 ,$86.58 ,$550.00 ,$355.30 ,$86.58 ,$355.80 ,$355.80 , N/A ,$330.00 ,$467.50 ,$385.00 ,$86.58 ,$522.50 ,$396.00 ,$401.50 ,$135.18 ,$467.50 , N/A ,$135.18 ,$440.00 ,$401.50 ,$86.58 , N/A ,$231.00 ,$550.00 ,$467.50 , N/A ,$506.00 ,$385.00 ,$550.00 ,$550.00 ,$334.95 ,$550.00 ,$380.05 ,$385.00 , N/A ,$396.00 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,32000085,51600,HC INJ CYSTOGRAM,320,1 ,$470.00 ,$235.00 ,$85.73 ,$470.00 ,$303.62 ,$86.58 ,$304.04 ,$304.04 , N/A ,$282.00 ,$399.50 ,$329.00 ,$86.58 ,$446.50 ,$338.40 ,$343.10 ,$85.73 ,$399.50 , N/A ,$85.73 ,$376.00 ,$343.10 ,$86.58 , N/A ,$197.40 ,$470.00 ,$399.50 , N/A ,$432.40 ,$329.00 ,$470.00 ,$470.00 ,$286.23 ,$470.00 ,$324.77 ,$329.00 , N/A ,$338.40 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,32000086,51610,HC INJ URETHROCYSTOGRAM RETRO,320,1 ,$510.00 ,$255.00 ,$86.58 ,$510.00 ,$329.46 ,$86.58 ,$329.92 ,$329.92 , N/A ,$306.00 ,$433.50 ,$357.00 ,$86.58 ,$484.50 ,$367.20 ,$372.30 ,$123.92 ,$433.50 , N/A ,$123.92 ,$408.00 ,$372.30 ,$86.58 , N/A ,$214.20 ,$510.00 ,$433.50 , N/A ,$469.20 ,$357.00 ,$510.00 ,$510.00 ,$310.59 ,$510.00 ,$352.41 ,$357.00 , N/A ,$367.20 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$367.20 ,$316.20 ,$367.20 ,$367.20 ,$306.00 ST VINCENT HOSPITAL - ACUTE,32000087,58340,HC CATH/INTRO SALINE/CONTRAST SIS,320,1 ,$510.00 ,$255.00 ,$86.58 ,$510.00 ,$329.46 ,$86.58 ,$329.92 ,$329.92 , N/A ,$306.00 ,$433.50 ,$357.00 ,$86.58 ,$484.50 ,$367.20 ,$372.30 ,$110.17 ,$433.50 , N/A ,$110.17 ,$408.00 ,$372.30 ,$86.58 , N/A ,$214.20 ,$510.00 ,$433.50 , N/A ,$469.20 ,$357.00 ,$510.00 ,$510.00 ,$310.59 ,$510.00 ,$352.41 ,$357.00 , N/A ,$367.20 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$367.20 ,$316.20 ,$367.20 ,$367.20 ,$306.00 ST VINCENT HOSPITAL - ACUTE,32000089,61070,HC PUNCT ASP/INJ SHUNT TUBE,320,1 ,$810.00 ,$405.00 ,$107.28 ,"$1,382.85 ",$523.26 ,$121.61 ,$523.99 ,$523.99 ,$614.60 ,$486.00 ,$688.50 ,$567.00 ,$121.61 ,$769.50 ,$583.20 ,$591.30 ,$107.28 ,$688.50 ,$614.60 ,$107.28 ,$648.00 ,$591.30 ,$121.61 ,$614.60 ,$340.20 ,$810.00 ,$688.50 ,"$1,382.85 ",$745.20 ,$567.00 ,$810.00 ,$810.00 ,$493.29 ,$810.00 ,$559.71 ,$567.00 ,$620.75 ,$583.20 ,$128.91 ,$415.00 ,$415.00 ,$614.60 ,$415.00 ,$614.60 ,$583.20 ,$502.20 ,$583.20 ,$583.20 ,$486.00 ST VINCENT HOSPITAL - ACUTE,32000090,62272,HC LUMBAR PUNCTURE DRAIN,320,1 ,$830.00 ,$415.00 ,$164.02 ,"$1,382.85 ",$536.18 ,$263.02 ,$536.93 ,$536.93 ,$614.60 ,$498.00 ,$705.50 ,$581.00 ,$263.02 ,$788.50 ,$597.60 ,$605.90 ,$164.02 ,$705.50 ,$614.60 ,$164.02 ,$664.00 ,$605.90 ,$263.02 ,$614.60 ,$348.60 ,$830.00 ,$705.50 ,"$1,382.85 ",$763.60 ,$581.00 ,$830.00 ,$830.00 ,$505.47 ,$830.00 ,$573.53 ,$581.00 ,$620.75 ,$597.60 ,$278.80 ,$415.00 ,$415.00 ,$614.60 ,$415.00 ,$614.60 ,$597.60 ,$514.60 ,$597.60 ,$597.60 ,$498.00 ST VINCENT HOSPITAL - ACUTE,32000091,62284,HC INJ MYELOGRAM,320,1 ,$830.00 ,$415.00 ,$86.58 ,$830.00 ,$536.18 ,$86.58 ,$536.93 ,$536.93 , N/A ,$498.00 ,$705.50 ,$581.00 ,$86.58 ,$788.50 ,$597.60 ,$605.90 ,$165.64 ,$705.50 , N/A ,$165.64 ,$664.00 ,$605.90 ,$86.58 , N/A ,$348.60 ,$830.00 ,$705.50 , N/A ,$763.60 ,$581.00 ,$830.00 ,$830.00 ,$505.47 ,$830.00 ,$573.53 ,$581.00 , N/A ,$597.60 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$597.60 ,$514.60 ,$597.60 ,$597.60 ,$498.00 ST VINCENT HOSPITAL - ACUTE,32000092,62287,HC DECOMP DISC LUMBAR PERC,320,1 ,"$7,200.00 ","$3,600.00 ",$415.00 ,"$7,821.36 ","$4,651.20 ","$1,424.58 ","$4,657.68 ","$4,657.68 ","$1,699.13 ","$4,320.00 ","$6,120.00 ","$5,040.00 ","$1,424.58 ","$6,840.00 ","$5,184.00 ","$5,256.00 ","$1,130.14 ","$6,120.00 ","$1,699.13 ","$1,130.14 ","$5,760.00 ","$5,256.00 ","$1,424.58 ","$1,699.13 ","$3,024.00 ","$7,200.00 ","$6,120.00 ","$3,823.04 ","$6,624.00 ","$5,040.00 ","$5,818.90 ","$7,821.36 ","$4,384.80 ","$7,273.62 ","$4,975.20 ","$5,040.00 ","$1,716.12 ","$5,184.00 ","$1,510.05 ",$415.00 ,$415.00 ,"$1,699.13 ",$415.00 ,"$1,699.13 ","$5,184.00 ","$4,464.00 ","$5,184.00 ","$5,184.00 ","$4,320.00 " ST VINCENT HOSPITAL - ACUTE,32000093,62290,HC INJ DISKOGRAM LUMBAR EA LEVEL,320,1 ,"$1,700.00 ",$850.00 ,$86.58 ,"$1,700.00 ","$1,098.20 ",$86.58 ,"$1,099.73 ","$1,099.73 ", N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$86.58 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ",$322.06 ,"$1,445.00 ", N/A ,$322.06 ,"$1,360.00 ","$1,241.00 ",$86.58 , N/A ,$714.00 ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ","$1,700.00 ","$1,700.00 ","$1,035.30 ","$1,700.00 ","$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ",$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,32000094,62291,HC INJ DISKOGRAM CERVICAL EA LVL,320,1 ,"$1,050.00 ",$525.00 ,$86.58 ,"$1,050.00 ",$678.30 ,$86.58 ,$679.25 ,$679.25 , N/A ,$630.00 ,$892.50 ,$735.00 ,$86.58 ,$997.50 ,$756.00 ,$766.50 ,$305.31 ,$892.50 , N/A ,$305.31 ,$840.00 ,$766.50 ,$86.58 , N/A ,$441.00 ,"$1,050.00 ",$892.50 , N/A ,$966.00 ,$735.00 ,"$1,050.00 ","$1,050.00 ",$639.45 ,"$1,050.00 ",$725.55 ,$735.00 , N/A ,$756.00 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$756.00 ,$651.00 ,$756.00 ,$756.00 ,$630.00 ST VINCENT HOSPITAL - ACUTE,32000098,70030,HC XRAY EYE (FOREIGN BODY),320,1 ,$250.00 ,$125.00 ,$17.72 ,$250.00 ,$161.50 ,$17.72 ,$90.58 ,$80.52 ,$78.35 ,$150.00 ,$212.50 ,$175.00 ,$17.72 ,$237.50 ,$180.00 ,$182.50 ,$45.37 ,$212.50 ,$78.35 ,$45.37 ,$200.00 ,$182.50 ,$17.72 ,$78.35 ,$105.00 ,$250.00 ,$212.50 ,$176.29 ,$230.00 ,$175.00 ,$193.07 ,$207.92 ,$152.25 ,$193.07 ,$172.75 ,$175.00 ,$79.13 ,$180.00 ,$18.78 ,$250.00 ,$250.00 ,$78.35 ,$250.00 ,$78.35 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,32000099,70030,HC FOREIGN BODY EYE BOTH,320,1 ,$250.00 ,$125.00 ,$17.72 ,$250.00 ,$161.50 ,$17.72 ,$90.58 ,$80.52 ,$78.35 ,$150.00 ,$212.50 ,$175.00 ,$17.72 ,$237.50 ,$180.00 ,$182.50 ,$45.37 ,$212.50 ,$78.35 ,$45.37 ,$200.00 ,$182.50 ,$17.72 ,$78.35 ,$105.00 ,$250.00 ,$212.50 ,$176.29 ,$230.00 ,$175.00 ,$193.07 ,$207.92 ,$152.25 ,$193.07 ,$172.75 ,$175.00 ,$79.13 ,$180.00 ,$18.78 ,$250.00 ,$250.00 ,$78.35 ,$250.00 ,$78.35 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,32000100,70110,HC MANDIBLE MIN 4 VIEWS,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$118.52 ,$105.35 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$61.54 ,$348.50 ,$105.54 ,$61.54 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$305.98 ,$329.52 ,$249.69 ,$305.98 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000101,70130,HC MASTOIDS MN 3VW PER SIDE,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$172.84 ,$153.63 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$90.51 ,$280.50 ,$105.54 ,$90.51 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000102,70134,HC INT AUD MEATI BILAT,320,1 ,$410.00 ,$205.00 ,$17.72 ,"$1,052.28 ",$264.86 ,$17.72 ,$155.77 ,$138.46 ,$467.68 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$83.09 ,$348.50 ,$467.68 ,$83.09 ,$328.00 ,$299.30 ,$17.72 ,$467.68 ,$172.20 ,$410.00 ,$348.50 ,"$1,052.28 ",$377.20 ,$287.00 ,$193.07 ,$207.92 ,$249.69 ,$193.07 ,$283.31 ,$287.00 ,$472.36 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$467.68 ,$410.00 ,$467.68 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000103,70140,HC FACIAL BONES < 3 VIEWS,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$87.48 ,$77.76 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$43.34 ,$280.50 ,$78.35 ,$43.34 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000104,70150,HC FACIAL BONES MIN 3 VIEWS,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$130.93 ,$116.38 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$67.61 ,$348.50 ,$105.54 ,$67.61 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$305.98 ,$329.52 ,$249.69 ,$305.98 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000105,70160,HC NASAL BONES MIN 3 VIEWS,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$110.76 ,$98.45 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$57.48 ,$280.50 ,$78.35 ,$57.48 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000106,70200,HC XRAY ORBITS (EYE) (MIN 4 V),320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$129.38 ,$115.01 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$67.59 ,$348.50 ,$105.54 ,$67.59 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$193.07 ,$207.92 ,$249.69 ,$193.07 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000107,70210,HC XRAY SINUS WATERS VIEW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$98.34 ,$87.41 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.02 ,$280.50 ,$78.35 ,$46.02 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000108,70220,HC SINUSES MIN 3 VIEWS,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$113.86 ,$101.21 ,$78.35 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$52.77 ,$348.50 ,$78.35 ,$52.77 ,$328.00 ,$299.30 ,$17.72 ,$78.35 ,$172.20 ,$410.00 ,$348.50 ,$176.29 ,$377.20 ,$287.00 ,$193.07 ,$207.92 ,$249.69 ,$193.07 ,$283.31 ,$287.00 ,$79.13 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$78.35 ,$410.00 ,$78.35 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000109,70240,HC SELLA TURCICA,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$93.68 ,$83.27 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.72 ,$280.50 ,$78.35 ,$46.72 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000110,70250,HC SKULL LESS THAN 4 VIEWS,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$109.20 ,$97.07 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$52.11 ,$280.50 ,$105.54 ,$52.11 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000111,70250,HC SKULL LESS THAN 4 VIEWS OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$109.20 ,$97.07 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$52.11 ,$280.50 ,$105.54 ,$52.11 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000112,70260,HC SKULL MIN 4 VIEWS,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$129.38 ,$115.01 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$60.84 ,$348.50 ,$105.54 ,$60.84 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$305.98 ,$329.52 ,$249.69 ,$305.98 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000113,70330,HC TEMPOROMANDIBULAR JOINTS BILAT,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$160.42 ,$142.60 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$81.73 ,$280.50 ,$78.35 ,$81.73 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000114,70336,HC MRI TMJ,320,1 ,"$3,200.00 ","$1,600.00 ",$76.81 ,"$3,200.00 ","$2,067.20 ",$76.81 ,"$1,048.74 ",$932.21 ,$222.88 ,"$1,920.00 ","$2,720.00 ","$2,240.00 ",$76.81 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ",$453.91 ,"$2,720.00 ",$222.88 ,$453.91 ,"$2,560.00 ","$2,336.00 ",$76.81 ,$222.88 ,"$1,344.00 ","$3,200.00 ","$2,720.00 ",$501.48 ,"$2,944.00 ","$2,240.00 ",$992.38 ,"$1,068.72 ","$1,948.80 ",$992.38 ,"$2,211.20 ","$2,240.00 ",$225.11 ,"$2,304.00 ",$81.42 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,"$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,32000115,70355,HC XRAY PAN MANDIBLE/MAXLA,320,1 ,$330.00 ,$165.00 ,$15.70 ,$330.00 ,$213.18 ,$17.72 ,$37.81 ,$33.61 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$15.70 ,$280.50 ,$78.35 ,$15.70 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$143.52 ,$154.56 ,$200.97 ,$143.52 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000116,70360,HC XRAY NECK SOFT TISSUE,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$93.68 ,$83.27 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$44.01 ,$280.50 ,$78.35 ,$44.01 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000117,70370,HC XRAY PHARYNX/LARYNX W/FLUORO,320,1 ,$660.00 ,$330.00 ,$17.72 ,$660.00 ,$426.36 ,$17.72 ,$286.14 ,$254.34 ,$78.35 ,$396.00 ,$561.00 ,$462.00 ,$17.72 ,$627.00 ,$475.20 ,$481.80 ,$161.25 ,$561.00 ,$78.35 ,$161.25 ,$528.00 ,$481.80 ,$17.72 ,$78.35 ,$277.20 ,$660.00 ,$561.00 ,$176.29 ,$607.20 ,$462.00 ,$527.44 ,$568.01 ,$401.94 ,$527.44 ,$456.06 ,$462.00 ,$79.13 ,$475.20 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$475.20 ,$409.20 ,$475.20 ,$475.20 ,$396.00 ST VINCENT HOSPITAL - ACUTE,32000118,74230,HC XRAY SPEECH EVAL W/CINE/VIDEO,320,1 ,$520.00 ,$260.00 ,$37.66 ,$520.00 ,$335.92 ,$37.66 ,$438.23 ,$389.54 ,$172.93 ,$312.00 ,$442.00 ,$364.00 ,$37.66 ,$494.00 ,$374.40 ,$379.60 ,$211.79 ,$442.00 ,$172.93 ,$211.79 ,$416.00 ,$379.60 ,$37.66 ,$172.93 ,$218.40 ,$520.00 ,$442.00 ,$389.08 ,$478.40 ,$364.00 ,$342.86 ,$369.23 ,$316.68 ,$342.86 ,$359.32 ,$364.00 ,$174.66 ,$374.40 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$374.40 ,$322.40 ,$374.40 ,$374.40 ,$312.00 ST VINCENT HOSPITAL - ACUTE,32000120,70390,HC XRAY SIALOGRAPHY,320,1 ,$555.00 ,$277.50 ,$37.66 ,$555.00 ,$358.53 ,$37.66 ,$365.29 ,$324.70 ,$222.88 ,$333.00 ,$471.75 ,$388.50 ,$37.66 ,$527.25 ,$399.60 ,$405.15 ,$199.65 ,$471.75 ,$222.88 ,$199.65 ,$444.00 ,$405.15 ,$37.66 ,$222.88 ,$233.10 ,$555.00 ,$471.75 ,$501.48 ,$510.60 ,$388.50 ,$555.00 ,$555.00 ,$338.00 ,$555.00 ,$383.51 ,$388.50 ,$225.11 ,$399.60 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$399.60 ,$344.10 ,$399.60 ,$399.60 ,$333.00 ST VINCENT HOSPITAL - ACUTE,32000121,71045,HC XR CHEST 1V,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$67.30 ,$59.82 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$32.57 ,$255.00 ,$78.35 ,$32.57 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$206.92 ,$222.84 ,$182.70 ,$206.92 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000122,71045,HC XR CHEST 1V OR,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$67.30 ,$59.82 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$32.57 ,$255.00 ,$78.35 ,$32.57 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$206.92 ,$222.84 ,$182.70 ,$206.92 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000123,71045,HC XR CHEST 1V POST OP,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$67.30 ,$59.82 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$32.57 ,$255.00 ,$78.35 ,$32.57 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$206.92 ,$222.84 ,$182.70 ,$206.92 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000124,71045,HC XR CHEST 1V EMPLOYEE,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$67.30 ,$59.82 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$32.57 ,$255.00 ,$78.35 ,$32.57 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$206.92 ,$222.84 ,$182.70 ,$206.92 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000125,71045,HC XR CHEST 1V PORTABLE,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$67.30 ,$59.82 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$32.57 ,$255.00 ,$78.35 ,$32.57 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$206.92 ,$222.84 ,$182.70 ,$206.92 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000126,71045,HC XR CHEST 1V INFANT,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$67.30 ,$59.82 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$32.57 ,$255.00 ,$78.35 ,$32.57 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$206.92 ,$222.84 ,$182.70 ,$206.92 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000127,71046,HC XR CHEST 2V,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$44.69 ,$255.00 ,$78.35 ,$44.69 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$206.92 ,$222.84 ,$182.70 ,$206.92 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000128,71046,HC XR CHEST 2V CORPORATE,320,1 ,$150.05 ,$75.03 ,$17.72 ,$176.29 ,$96.93 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$90.03 ,$127.54 ,$105.04 ,$17.72 ,$142.55 ,$108.04 ,$109.54 ,$44.69 ,$127.54 ,$78.35 ,$44.69 ,$120.04 ,$109.54 ,$17.72 ,$78.35 ,$63.02 ,$150.05 ,$127.54 ,$176.29 ,$138.05 ,$105.04 ,$150.05 ,$150.05 ,$91.38 ,$150.05 ,$103.68 ,$105.04 ,$79.13 ,$108.04 ,$18.78 ,$150.05 ,$150.05 ,$78.35 ,$150.05 ,$78.35 ,$108.04 ,$93.03 ,$108.04 ,$108.04 ,$90.03 ST VINCENT HOSPITAL - ACUTE,32000129,71046,HC XR CHEST 2V PORTABLE,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$44.69 ,$255.00 ,$78.35 ,$44.69 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$206.92 ,$222.84 ,$182.70 ,$206.92 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000130,71047,HC XR CHEST 2V W/LORDOTIC,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$110.76 ,$98.45 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$56.81 ,$255.00 ,$78.35 ,$56.81 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$206.92 ,$222.84 ,$182.70 ,$206.92 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000131,71048,HC XR CHEST PA/LAT W/OBLIQUES,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$115.41 ,$102.59 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$58.84 ,$348.50 ,$105.54 ,$58.84 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$395.55 ,$410.00 ,$249.69 ,$395.55 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000133,71048,HC XR CHEST 4+V,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$115.41 ,$102.59 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$58.84 ,$348.50 ,$105.54 ,$58.84 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$395.55 ,$410.00 ,$249.69 ,$395.55 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000135,71046,HC XR CHEST SPECIAL VIEWS,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$44.69 ,$255.00 ,$78.35 ,$44.69 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$206.92 ,$222.84 ,$182.70 ,$206.92 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000137,71100,HC XR RIBS 2V UNI,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$99.89 ,$88.79 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.06 ,$280.50 ,$78.35 ,$50.06 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000138,71101,HC XR RIBS W/CXR 3+V UNI,320,1 ,$500.00 ,$250.00 ,$17.72 ,$500.00 ,$323.00 ,$17.72 ,$110.76 ,$98.45 ,$105.54 ,$300.00 ,$425.00 ,$350.00 ,$17.72 ,$475.00 ,$360.00 ,$365.00 ,$56.81 ,$425.00 ,$105.54 ,$56.81 ,$400.00 ,$365.00 ,$17.72 ,$105.54 ,$210.00 ,$500.00 ,$425.00 ,$237.46 ,$460.00 ,$350.00 ,$305.98 ,$329.52 ,$304.50 ,$305.98 ,$345.50 ,$350.00 ,$106.60 ,$360.00 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,32000139,71110,HC XR RIBS 3 V BIL,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$113.86 ,$101.21 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$58.16 ,$348.50 ,$105.54 ,$58.16 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$305.98 ,$329.52 ,$249.69 ,$305.98 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000140,71111,HC XR RIBS W/CXR 4+V BI,320,1 ,$500.00 ,$250.00 ,$17.72 ,$500.00 ,$323.00 ,$17.72 ,$140.24 ,$124.66 ,$105.54 ,$300.00 ,$425.00 ,$350.00 ,$17.72 ,$475.00 ,$360.00 ,$365.00 ,$72.32 ,$425.00 ,$105.54 ,$72.32 ,$400.00 ,$365.00 ,$17.72 ,$105.54 ,$210.00 ,$500.00 ,$425.00 ,$237.46 ,$460.00 ,$350.00 ,$305.98 ,$329.52 ,$304.50 ,$305.98 ,$345.50 ,$350.00 ,$106.60 ,$360.00 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,32000141,71120,HC XR STERNUM 2+V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$90.58 ,$80.52 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.72 ,$280.50 ,$78.35 ,$46.72 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000142,71130,HC XR STERNOCLAVIC JT 3+V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$113.86 ,$101.21 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$60.19 ,$280.50 ,$78.35 ,$60.19 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000144,71250,HC CT CHEST W/O CONTRAST,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,32000146,71260,HC CT CHEST W/CONTRAST,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$172.93 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$389.08 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$174.66 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,32000148,71270,HC CT CHEST W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$90.16 ,"$2,600.00 ","$1,679.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$90.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$943.96 ,"$1,016.57 ","$1,583.40 ",$943.96 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,32000150,71275,HC CTA CHEST W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$99.42 ,"$2,600.00 ","$1,679.60 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$99.42 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$99.42 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$982.89 ,"$1,058.50 ","$1,583.40 ",$982.89 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,32000151,71550,HC MRI CHEST W/O CON,610,1 ,"$3,000.00 ","$1,500.00 ",$76.81 ,"$3,000.00 ","$1,938.00 ",$76.81 ,"$1,288.00 ","$1,288.00 ",$222.88 ,"$1,800.00 ","$2,550.00 ","$2,100.00 ",$76.81 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ","$2,118.00 ","$2,550.00 ",$222.88 ,"$2,118.00 ","$2,400.00 ","$2,190.00 ",$76.81 ,$222.88 ,"$1,387.49 ","$3,000.00 ","$2,550.00 ",$501.48 ,"$2,760.00 ","$2,100.00 ",$992.38 ,"$1,068.72 ","$1,827.00 ",$992.38 ,"$2,073.00 ","$2,100.00 ",$225.11 ,"$2,160.00 ",$81.42 ,"$1,311.00 ","$1,311.00 ",$222.88 ,"$1,311.00 ",$222.88 ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,32000152,71551,HC MRI CHEST W/CONTRAST,610,1 ,"$3,000.00 ","$1,500.00 ",$136.33 ,"$3,000.00 ","$1,938.00 ",$136.33 ,"$1,288.00 ","$1,288.00 ",$692.65 ,"$1,800.00 ","$2,550.00 ","$2,100.00 ",$136.33 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ","$2,118.00 ","$2,550.00 ",$692.65 ,"$2,118.00 ","$2,400.00 ","$2,190.00 ",$136.33 ,$692.65 ,"$1,387.49 ","$3,000.00 ","$2,550.00 ","$1,558.47 ","$2,760.00 ","$2,100.00 ","$1,435.79 ","$1,546.24 ","$1,827.00 ","$1,435.79 ","$2,073.00 ","$2,100.00 ",$699.58 ,"$2,160.00 ",$144.51 ,"$1,311.00 ","$1,311.00 ",$692.65 ,"$1,311.00 ",$692.65 ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,32000153,71552,HC MRI CHEST W AND W/O CONTRAST,610,1 ,"$3,000.00 ","$1,500.00 ",$136.33 ,"$3,000.00 ","$1,938.00 ",$136.33 ,"$1,288.00 ","$1,288.00 ",$356.52 ,"$1,800.00 ","$2,550.00 ","$2,100.00 ",$136.33 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ","$2,118.00 ","$2,550.00 ",$356.52 ,"$2,118.00 ","$2,400.00 ","$2,190.00 ",$136.33 ,$356.52 ,"$1,387.49 ","$3,000.00 ","$2,550.00 ",$802.18 ,"$2,760.00 ","$2,100.00 ","$1,659.43 ","$1,787.08 ","$1,827.00 ","$1,659.43 ","$2,073.00 ","$2,100.00 ",$360.09 ,"$2,160.00 ",$144.51 ,"$1,311.00 ","$1,311.00 ",$356.52 ,"$1,311.00 ",$356.52 ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,32000155,72020,HC XR SPINE 1V ANY LEVEL,320,1 ,$350.00 ,$175.00 ,$17.72 ,$350.00 ,$226.10 ,$17.72 ,$65.75 ,$58.44 ,$78.35 ,$210.00 ,$297.50 ,$245.00 ,$17.72 ,$332.50 ,$252.00 ,$255.50 ,$32.55 ,$297.50 ,$78.35 ,$32.55 ,$280.00 ,$255.50 ,$17.72 ,$78.35 ,$147.00 ,$350.00 ,$297.50 ,$176.29 ,$322.00 ,$245.00 ,$193.07 ,$207.92 ,$213.15 ,$193.07 ,$241.85 ,$245.00 ,$79.13 ,$252.00 ,$18.78 ,$350.00 ,$350.00 ,$78.35 ,$350.00 ,$78.35 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,32000156,72020,HC XR C-SPINE 1V,320,1 ,$350.00 ,$175.00 ,$17.72 ,$350.00 ,$226.10 ,$17.72 ,$65.75 ,$58.44 ,$78.35 ,$210.00 ,$297.50 ,$245.00 ,$17.72 ,$332.50 ,$252.00 ,$255.50 ,$32.55 ,$297.50 ,$78.35 ,$32.55 ,$280.00 ,$255.50 ,$17.72 ,$78.35 ,$147.00 ,$350.00 ,$297.50 ,$176.29 ,$322.00 ,$245.00 ,$193.07 ,$207.92 ,$213.15 ,$193.07 ,$241.85 ,$245.00 ,$79.13 ,$252.00 ,$18.78 ,$350.00 ,$350.00 ,$78.35 ,$350.00 ,$78.35 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,32000157,72020,HC XR SPINE 1V (L SPINE/ T SPINE) OR,320,1 ,$350.00 ,$175.00 ,$17.72 ,$350.00 ,$226.10 ,$17.72 ,$65.75 ,$58.44 ,$78.35 ,$210.00 ,$297.50 ,$245.00 ,$17.72 ,$332.50 ,$252.00 ,$255.50 ,$32.55 ,$297.50 ,$78.35 ,$32.55 ,$280.00 ,$255.50 ,$17.72 ,$78.35 ,$147.00 ,$350.00 ,$297.50 ,$176.29 ,$322.00 ,$245.00 ,$193.07 ,$207.92 ,$213.15 ,$193.07 ,$241.85 ,$245.00 ,$79.13 ,$252.00 ,$18.78 ,$350.00 ,$350.00 ,$78.35 ,$350.00 ,$78.35 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,32000158,72020,HC XR SPINE 1V (C SPINE/L SPINE),320,1 ,$350.00 ,$175.00 ,$17.72 ,$350.00 ,$226.10 ,$17.72 ,$65.75 ,$58.44 ,$78.35 ,$210.00 ,$297.50 ,$245.00 ,$17.72 ,$332.50 ,$252.00 ,$255.50 ,$32.55 ,$297.50 ,$78.35 ,$32.55 ,$280.00 ,$255.50 ,$17.72 ,$78.35 ,$147.00 ,$350.00 ,$297.50 ,$176.29 ,$322.00 ,$245.00 ,$193.07 ,$207.92 ,$213.15 ,$193.07 ,$241.85 ,$245.00 ,$79.13 ,$252.00 ,$18.78 ,$350.00 ,$350.00 ,$78.35 ,$350.00 ,$78.35 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,32000159,72020,HC XR SPINE 1V (T SPINE CLEAR LAT),320,1 ,$350.00 ,$175.00 ,$17.72 ,$350.00 ,$226.10 ,$17.72 ,$65.75 ,$58.44 ,$78.35 ,$210.00 ,$297.50 ,$245.00 ,$17.72 ,$332.50 ,$252.00 ,$255.50 ,$32.55 ,$297.50 ,$78.35 ,$32.55 ,$280.00 ,$255.50 ,$17.72 ,$78.35 ,$147.00 ,$350.00 ,$297.50 ,$176.29 ,$322.00 ,$245.00 ,$193.07 ,$207.92 ,$213.15 ,$193.07 ,$241.85 ,$245.00 ,$79.13 ,$252.00 ,$18.78 ,$350.00 ,$350.00 ,$78.35 ,$350.00 ,$78.35 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,32000160,72020,HC XR SPINE 1V (T SPINE),320,1 ,$350.00 ,$175.00 ,$17.72 ,$350.00 ,$226.10 ,$17.72 ,$65.75 ,$58.44 ,$78.35 ,$210.00 ,$297.50 ,$245.00 ,$17.72 ,$332.50 ,$252.00 ,$255.50 ,$32.55 ,$297.50 ,$78.35 ,$32.55 ,$280.00 ,$255.50 ,$17.72 ,$78.35 ,$147.00 ,$350.00 ,$297.50 ,$176.29 ,$322.00 ,$245.00 ,$193.07 ,$207.92 ,$213.15 ,$193.07 ,$241.85 ,$245.00 ,$79.13 ,$252.00 ,$18.78 ,$350.00 ,$350.00 ,$78.35 ,$350.00 ,$78.35 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,32000161,72020,HC XR L-SPINE 1V,320,1 ,$350.00 ,$175.00 ,$17.72 ,$350.00 ,$226.10 ,$17.72 ,$65.75 ,$58.44 ,$78.35 ,$210.00 ,$297.50 ,$245.00 ,$17.72 ,$332.50 ,$252.00 ,$255.50 ,$32.55 ,$297.50 ,$78.35 ,$32.55 ,$280.00 ,$255.50 ,$17.72 ,$78.35 ,$147.00 ,$350.00 ,$297.50 ,$176.29 ,$322.00 ,$245.00 ,$193.07 ,$207.92 ,$213.15 ,$193.07 ,$241.85 ,$245.00 ,$79.13 ,$252.00 ,$18.78 ,$350.00 ,$350.00 ,$78.35 ,$350.00 ,$78.35 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,32000162,72040,HC XR C-SPINE 2V,320,1 ,$440.00 ,$220.00 ,$17.72 ,$440.00 ,$284.24 ,$17.72 ,$109.20 ,$97.07 ,$78.35 ,$264.00 ,$374.00 ,$308.00 ,$17.72 ,$418.00 ,$316.80 ,$321.20 ,$55.45 ,$374.00 ,$78.35 ,$55.45 ,$352.00 ,$321.20 ,$17.72 ,$78.35 ,$184.80 ,$440.00 ,$374.00 ,$176.29 ,$404.80 ,$308.00 ,$193.07 ,$207.92 ,$267.96 ,$193.07 ,$304.04 ,$308.00 ,$79.13 ,$316.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,32000163,72040,HC XR C-SPINE 3V,320,1 ,$440.00 ,$220.00 ,$17.72 ,$440.00 ,$284.24 ,$17.72 ,$109.20 ,$97.07 ,$78.35 ,$264.00 ,$374.00 ,$308.00 ,$17.72 ,$418.00 ,$316.80 ,$321.20 ,$55.45 ,$374.00 ,$78.35 ,$55.45 ,$352.00 ,$321.20 ,$17.72 ,$78.35 ,$184.80 ,$440.00 ,$374.00 ,$176.29 ,$404.80 ,$308.00 ,$193.07 ,$207.92 ,$267.96 ,$193.07 ,$304.04 ,$308.00 ,$79.13 ,$316.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,32000164,72040,HC XR C-SPINE 2-3V,320,1 ,$440.00 ,$220.00 ,$17.72 ,$440.00 ,$284.24 ,$17.72 ,$109.20 ,$97.07 ,$78.35 ,$264.00 ,$374.00 ,$308.00 ,$17.72 ,$418.00 ,$316.80 ,$321.20 ,$55.45 ,$374.00 ,$78.35 ,$55.45 ,$352.00 ,$321.20 ,$17.72 ,$78.35 ,$184.80 ,$440.00 ,$374.00 ,$176.29 ,$404.80 ,$308.00 ,$193.07 ,$207.92 ,$267.96 ,$193.07 ,$304.04 ,$308.00 ,$79.13 ,$316.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,32000165,72040,HC XR C-SPINE CLEAR 3V,320,1 ,$440.00 ,$220.00 ,$17.72 ,$440.00 ,$284.24 ,$17.72 ,$109.20 ,$97.07 ,$78.35 ,$264.00 ,$374.00 ,$308.00 ,$17.72 ,$418.00 ,$316.80 ,$321.20 ,$55.45 ,$374.00 ,$78.35 ,$55.45 ,$352.00 ,$321.20 ,$17.72 ,$78.35 ,$184.80 ,$440.00 ,$374.00 ,$176.29 ,$404.80 ,$308.00 ,$193.07 ,$207.92 ,$267.96 ,$193.07 ,$304.04 ,$308.00 ,$79.13 ,$316.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,32000166,72040,HC XR C-SPINE 3V ROUTINE,320,1 ,$440.00 ,$220.00 ,$17.72 ,$440.00 ,$284.24 ,$17.72 ,$109.20 ,$97.07 ,$78.35 ,$264.00 ,$374.00 ,$308.00 ,$17.72 ,$418.00 ,$316.80 ,$321.20 ,$55.45 ,$374.00 ,$78.35 ,$55.45 ,$352.00 ,$321.20 ,$17.72 ,$78.35 ,$184.80 ,$440.00 ,$374.00 ,$176.29 ,$404.80 ,$308.00 ,$193.07 ,$207.92 ,$267.96 ,$193.07 ,$304.04 ,$308.00 ,$79.13 ,$316.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,32000167,72040,HC XR C-SPINE 2-3V OBLS,320,1 ,$440.00 ,$220.00 ,$17.72 ,$440.00 ,$284.24 ,$17.72 ,$109.20 ,$97.07 ,$78.35 ,$264.00 ,$374.00 ,$308.00 ,$17.72 ,$418.00 ,$316.80 ,$321.20 ,$55.45 ,$374.00 ,$78.35 ,$55.45 ,$352.00 ,$321.20 ,$17.72 ,$78.35 ,$184.80 ,$440.00 ,$374.00 ,$176.29 ,$404.80 ,$308.00 ,$193.07 ,$207.92 ,$267.96 ,$193.07 ,$304.04 ,$308.00 ,$79.13 ,$316.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,32000168,72050,HC XR C-SPINE 4-5 VIEW,320,1 ,$470.00 ,$235.00 ,$17.72 ,$470.00 ,$303.62 ,$17.72 ,$149.56 ,$132.94 ,$105.54 ,$282.00 ,$399.50 ,$329.00 ,$17.72 ,$446.50 ,$338.40 ,$343.10 ,$77.02 ,$399.50 ,$105.54 ,$77.02 ,$376.00 ,$343.10 ,$17.72 ,$105.54 ,$197.40 ,$470.00 ,$399.50 ,$237.46 ,$432.40 ,$329.00 ,$305.98 ,$329.52 ,$286.23 ,$305.98 ,$324.77 ,$329.00 ,$106.60 ,$338.40 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,32000170,72052,HC XR C-SPINE 6+ VIEWS,320,1 ,$610.00 ,$305.00 ,$17.72 ,$610.00 ,$394.06 ,$17.72 ,$180.60 ,$160.53 ,$105.54 ,$366.00 ,$518.50 ,$427.00 ,$17.72 ,$579.50 ,$439.20 ,$445.30 ,$93.19 ,$518.50 ,$105.54 ,$93.19 ,$488.00 ,$445.30 ,$17.72 ,$105.54 ,$256.20 ,$610.00 ,$518.50 ,$237.46 ,$561.20 ,$427.00 ,$305.98 ,$329.52 ,$371.49 ,$305.98 ,$421.51 ,$427.00 ,$106.60 ,$439.20 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,32000172,72070,HC XR T-SPINE 2V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$98.34 ,$87.41 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$44.01 ,$280.50 ,$105.54 ,$44.01 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000173,72070,HC XR T-SPINE 2V OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$98.34 ,$87.41 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$44.01 ,$280.50 ,$105.54 ,$44.01 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000174,72072,HC XR T-SPINE 3V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$109.20 ,$97.07 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$54.80 ,$280.50 ,$105.54 ,$54.80 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$305.98 ,$329.52 ,$200.97 ,$305.98 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000177,72100,HC XR L-SPINE 2 VIEW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$109.20 ,$97.07 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$56.13 ,$280.50 ,$105.54 ,$56.13 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000178,72100,HC XR L-SPINE 2-3V,320,1 ,$380.00 ,$190.00 ,$17.72 ,$380.00 ,$245.48 ,$17.72 ,$109.20 ,$97.07 ,$105.54 ,$228.00 ,$323.00 ,$266.00 ,$17.72 ,$361.00 ,$273.60 ,$277.40 ,$56.13 ,$323.00 ,$105.54 ,$56.13 ,$304.00 ,$277.40 ,$17.72 ,$105.54 ,$159.60 ,$380.00 ,$323.00 ,$237.46 ,$349.60 ,$266.00 ,$193.07 ,$207.92 ,$231.42 ,$193.07 ,$262.58 ,$266.00 ,$106.60 ,$273.60 ,$18.78 ,$380.00 ,$380.00 ,$105.54 ,$380.00 ,$105.54 ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,32000179,72100,HC XR L-SPINE 2-3V CORPORATE,320,1 ,$255.00 ,$127.50 ,$17.72 ,$255.00 ,$164.73 ,$17.72 ,$109.20 ,$97.07 ,$105.54 ,$153.00 ,$216.75 ,$178.50 ,$17.72 ,$242.25 ,$183.60 ,$186.15 ,$56.13 ,$216.75 ,$105.54 ,$56.13 ,$204.00 ,$186.15 ,$17.72 ,$105.54 ,$107.10 ,$255.00 ,$216.75 ,$237.46 ,$234.60 ,$178.50 ,$193.07 ,$207.92 ,$155.30 ,$193.07 ,$176.21 ,$178.50 ,$106.60 ,$183.60 ,$18.78 ,$255.00 ,$255.00 ,$105.54 ,$255.00 ,$105.54 ,$183.60 ,$158.10 ,$183.60 ,$183.60 ,$153.00 ST VINCENT HOSPITAL - ACUTE,32000180,72100,HC XR L-SPINE 2V OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$109.20 ,$97.07 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$56.13 ,$280.50 ,$105.54 ,$56.13 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000181,72110,HC XR L-SPINE 4+V,320,1 ,$610.00 ,$305.00 ,$17.72 ,$610.00 ,$394.06 ,$17.72 ,$152.66 ,$135.70 ,$105.54 ,$366.00 ,$518.50 ,$427.00 ,$17.72 ,$579.50 ,$439.20 ,$445.30 ,$74.33 ,$518.50 ,$105.54 ,$74.33 ,$488.00 ,$445.30 ,$17.72 ,$105.54 ,$256.20 ,$610.00 ,$518.50 ,$237.46 ,$561.20 ,$427.00 ,$305.98 ,$329.52 ,$371.49 ,$305.98 ,$421.51 ,$427.00 ,$106.60 ,$439.20 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,32000182,72110,HC XR L-SPINE 5V OBLIQUES,320,1 ,$610.00 ,$305.00 ,$17.72 ,$610.00 ,$394.06 ,$17.72 ,$152.66 ,$135.70 ,$105.54 ,$366.00 ,$518.50 ,$427.00 ,$17.72 ,$579.50 ,$439.20 ,$445.30 ,$74.33 ,$518.50 ,$105.54 ,$74.33 ,$488.00 ,$445.30 ,$17.72 ,$105.54 ,$256.20 ,$610.00 ,$518.50 ,$237.46 ,$561.20 ,$427.00 ,$305.98 ,$329.52 ,$371.49 ,$305.98 ,$421.51 ,$427.00 ,$106.60 ,$439.20 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,32000183,72120,HC XR L-SPINE BENDING ONLY MIN 4V,320,1 ,$610.00 ,$305.00 ,$17.72 ,$610.00 ,$394.06 ,$17.72 ,$137.14 ,$121.90 ,$105.54 ,$366.00 ,$518.50 ,$427.00 ,$17.72 ,$579.50 ,$439.20 ,$445.30 ,$58.16 ,$518.50 ,$105.54 ,$58.16 ,$488.00 ,$445.30 ,$17.72 ,$105.54 ,$256.20 ,$610.00 ,$518.50 ,$237.46 ,$561.20 ,$427.00 ,$305.98 ,$329.52 ,$371.49 ,$305.98 ,$421.51 ,$427.00 ,$106.60 ,$439.20 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,32000184,72114,HC XR L-SPINE CMPL W/BEND MIN 6 VIEW,320,1 ,$610.00 ,$305.00 ,$17.72 ,$610.00 ,$394.06 ,$17.72 ,$180.60 ,$160.53 ,$105.54 ,$366.00 ,$518.50 ,$427.00 ,$17.72 ,$579.50 ,$439.20 ,$445.30 ,$92.52 ,$518.50 ,$105.54 ,$92.52 ,$488.00 ,$445.30 ,$17.72 ,$105.54 ,$256.20 ,$610.00 ,$518.50 ,$237.46 ,$561.20 ,$427.00 ,$305.98 ,$329.52 ,$371.49 ,$305.98 ,$421.51 ,$427.00 ,$106.60 ,$439.20 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,32000186,72170,HC XR PELVIS 1-2V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$104.55 ,$92.93 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$37.27 ,$280.50 ,$105.54 ,$37.27 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000187,72170,HC XR PELVIS 1-2V OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$104.55 ,$92.93 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$37.27 ,$280.50 ,$105.54 ,$37.27 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000188,72170,HC XR PELVIS 1-2V FROG,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$104.55 ,$92.93 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$37.27 ,$280.50 ,$105.54 ,$37.27 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000189,72190,HC XR PELVIS CMPL 3+V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$124.72 ,$110.87 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$57.50 ,$280.50 ,$105.54 ,$57.50 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000190,72202,HC XR SACROILI JT 3+V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$109.20 ,$97.07 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$54.80 ,$280.50 ,$105.54 ,$54.80 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000191,72220,HC XR SACRUM/COCCYX 2+V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$93.68 ,$83.27 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.02 ,$280.50 ,$78.35 ,$46.02 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000192,72220,HC XR COCCYX 2+V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$93.68 ,$83.27 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.02 ,$280.50 ,$78.35 ,$46.02 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000193,72220,HC XR SACRUM 2+V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$93.68 ,$83.27 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.02 ,$280.50 ,$78.35 ,$46.02 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000194,62302,HC XR MYELOGRAM C-SPINE,320,1 ,"$2,100.00 ","$1,050.00 ",$193.81 ,"$2,100.00 ","$1,356.60 ",$193.81 ,"$1,358.49 ","$1,358.49 ",$692.65 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$193.81 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ",$235.42 ,"$1,785.00 ",$692.65 ,$235.42 ,"$1,680.00 ","$1,533.00 ",$193.81 ,$692.65 ,$882.00 ,"$2,100.00 ","$1,785.00 ","$1,558.47 ","$1,932.00 ","$1,470.00 ","$2,066.93 ","$2,100.00 ","$1,278.90 ","$2,100.00 ","$1,451.10 ","$1,470.00 ",$699.58 ,"$1,512.00 ",$205.44 ,$415.00 ,$415.00 ,$692.65 ,$415.00 ,$692.65 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,32000195,62303,HC XR MYELOGRAM T-SPINE,320,1 ,"$1,700.00 ",$850.00 ,$193.81 ,"$1,700.00 ","$1,098.20 ",$193.81 ,"$1,099.73 ","$1,099.73 ",$692.65 ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$193.81 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ",$235.42 ,"$1,445.00 ",$692.65 ,$235.42 ,"$1,360.00 ","$1,241.00 ",$193.81 ,$692.65 ,$714.00 ,"$1,700.00 ","$1,445.00 ","$1,558.47 ","$1,564.00 ","$1,190.00 ","$1,700.00 ","$1,700.00 ","$1,035.30 ","$1,700.00 ","$1,174.70 ","$1,190.00 ",$699.58 ,"$1,224.00 ",$205.44 ,$415.00 ,$415.00 ,$692.65 ,$415.00 ,$692.65 ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,32000196,62304,HC XR MYELOGRAM L-SPINE,320,1 ,"$1,700.00 ",$850.00 ,$193.81 ,"$1,700.00 ","$1,098.20 ",$193.81 ,"$1,099.73 ","$1,099.73 ",$692.65 ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$193.81 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ",$231.90 ,"$1,445.00 ",$692.65 ,$231.90 ,"$1,360.00 ","$1,241.00 ",$193.81 ,$692.65 ,$714.00 ,"$1,700.00 ","$1,445.00 ","$1,558.47 ","$1,564.00 ","$1,190.00 ","$1,700.00 ","$1,700.00 ","$1,035.30 ","$1,700.00 ","$1,174.70 ","$1,190.00 ",$699.58 ,"$1,224.00 ",$205.44 ,$415.00 ,$415.00 ,$692.65 ,$415.00 ,$692.65 ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,32000197,62305,HC XR MYELOGRAM >2 REGIONS,320,1 ,"$2,000.00 ","$1,000.00 ",$193.81 ,"$2,000.00 ","$1,292.00 ",$193.81 ,"$1,293.80 ","$1,293.80 ",$692.65 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$193.81 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ",$241.74 ,"$1,700.00 ",$692.65 ,$241.74 ,"$1,600.00 ","$1,460.00 ",$193.81 ,$692.65 ,$840.00 ,"$2,000.00 ","$1,700.00 ","$1,558.47 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ",$699.58 ,"$1,440.00 ",$205.44 ,$415.00 ,$415.00 ,$692.65 ,$415.00 ,$692.65 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,32000198,72285,HC XR DISKOGRAM C- OR T-SPINE,320,1 ,"$2,000.00 ","$1,000.00 ",$135.65 ,"$3,823.04 ","$1,292.00 ",$193.81 ,$251.99 ,$223.99 ,"$1,699.13 ","$1,200.00 ","$1,700.00 ","$1,400.00 ",$193.81 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ",$135.65 ,"$1,700.00 ","$1,699.13 ",$135.65 ,"$1,600.00 ","$1,460.00 ",$193.81 ,"$1,699.13 ",$840.00 ,"$2,000.00 ","$1,700.00 ","$3,823.04 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ","$1,716.12 ","$1,440.00 ",$205.44 ,$415.00 ,$415.00 ,"$1,699.13 ",$415.00 ,"$1,699.13 ","$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,32000200,72295,HC XR DISKOGRAM L-SPINE,320,1 ,"$2,600.00 ","$1,300.00 ",$140.36 ,"$3,823.04 ","$1,679.60 ",$193.81 ,$258.20 ,$229.51 ,"$1,699.13 ","$1,560.00 ","$2,210.00 ","$1,820.00 ",$193.81 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ",$140.36 ,"$2,210.00 ","$1,699.13 ",$140.36 ,"$2,080.00 ","$1,898.00 ",$193.81 ,"$1,699.13 ","$1,092.00 ","$2,600.00 ","$2,210.00 ","$3,823.04 ","$2,392.00 ","$1,820.00 ","$2,600.00 ","$2,600.00 ","$1,583.40 ","$2,600.00 ","$1,796.60 ","$1,820.00 ","$1,716.12 ","$1,872.00 ",$205.44 ,$415.00 ,$415.00 ,"$1,699.13 ",$415.00 ,"$1,699.13 ","$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,32000201,73000,HC XRAY CLAVICLE,320,1 ,$350.00 ,$175.00 ,$17.72 ,$350.00 ,$226.10 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$210.00 ,$297.50 ,$245.00 ,$17.72 ,$332.50 ,$252.00 ,$255.50 ,$46.70 ,$297.50 ,$78.35 ,$46.70 ,$280.00 ,$255.50 ,$17.72 ,$78.35 ,$147.00 ,$350.00 ,$297.50 ,$176.29 ,$322.00 ,$245.00 ,$193.07 ,$207.92 ,$213.15 ,$193.07 ,$241.85 ,$245.00 ,$79.13 ,$252.00 ,$18.78 ,$350.00 ,$350.00 ,$78.35 ,$350.00 ,$78.35 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,32000202,73000,HC XRAY CLAVICLE 2V OR,320,1 ,$525.00 ,$262.50 ,$17.72 ,$525.00 ,$339.15 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$315.00 ,$446.25 ,$367.50 ,$17.72 ,$498.75 ,$378.00 ,$383.25 ,$46.70 ,$446.25 ,$78.35 ,$46.70 ,$420.00 ,$383.25 ,$17.72 ,$78.35 ,$220.50 ,$525.00 ,$446.25 ,$176.29 ,$483.00 ,$367.50 ,$193.07 ,$207.92 ,$319.73 ,$193.07 ,$362.78 ,$367.50 ,$79.13 ,$378.00 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$378.00 ,$325.50 ,$378.00 ,$378.00 ,$315.00 ST VINCENT HOSPITAL - ACUTE,32000203,73000,HC XRAY CLAVICLE 1V OR,320,1 ,$350.00 ,$175.00 ,$17.72 ,$350.00 ,$226.10 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$210.00 ,$297.50 ,$245.00 ,$17.72 ,$332.50 ,$252.00 ,$255.50 ,$46.70 ,$297.50 ,$78.35 ,$46.70 ,$280.00 ,$255.50 ,$17.72 ,$78.35 ,$147.00 ,$350.00 ,$297.50 ,$176.29 ,$322.00 ,$245.00 ,$193.07 ,$207.92 ,$213.15 ,$193.07 ,$241.85 ,$245.00 ,$79.13 ,$252.00 ,$18.78 ,$350.00 ,$350.00 ,$78.35 ,$350.00 ,$78.35 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,32000204,73010,HC XRAY SCAPULA,320,1 ,$370.00 ,$185.00 ,$17.72 ,$370.00 ,$239.02 ,$17.72 ,$98.34 ,$87.41 ,$105.54 ,$222.00 ,$314.50 ,$259.00 ,$17.72 ,$351.50 ,$266.40 ,$270.10 ,$28.52 ,$314.50 ,$105.54 ,$28.52 ,$296.00 ,$270.10 ,$17.72 ,$105.54 ,$155.40 ,$370.00 ,$314.50 ,$237.46 ,$340.40 ,$259.00 ,$193.07 ,$207.92 ,$225.33 ,$193.07 ,$255.67 ,$259.00 ,$106.60 ,$266.40 ,$18.78 ,$370.00 ,$370.00 ,$105.54 ,$370.00 ,$105.54 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$67.30 ,$59.82 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$27.16 ,$280.50 ,$78.35 ,$27.16 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000207,73020,HC XRAY SHOULDER (1 V) OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$67.30 ,$59.82 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$27.16 ,$280.50 ,$78.35 ,$27.16 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$48.73 ,$416.50 ,$78.35 ,$48.73 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$48.73 ,$280.50 ,$78.35 ,$48.73 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000209,73030,HC XRAY SHOULDER TRAUMA (MIN 2V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$48.73 ,$280.50 ,$78.35 ,$48.73 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000211,73030,HC XRAY SHOULDER (MIN 2V) OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$48.73 ,$280.50 ,$78.35 ,$48.73 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000212,73040,HC XRAY SHOULDER ARTHRO,320,1 ,"$1,600.00 ",$800.00 ,$37.66 ,"$1,600.00 ","$1,033.60 ",$37.66 ,$362.18 ,$321.94 ,$356.52 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$37.66 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ",$204.36 ,"$1,360.00 ",$356.52 ,$204.36 ,"$1,280.00 ","$1,168.00 ",$37.66 ,$356.52 ,$672.00 ,"$1,600.00 ","$1,360.00 ",$802.18 ,"$1,472.00 ","$1,120.00 ","$1,142.36 ","$1,230.23 ",$974.40 ,"$1,142.36 ","$1,105.60 ","$1,120.00 ",$360.09 ,"$1,152.00 ",$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,32000212,73040,HC XRAY SHOULDER ARTHRO,320,1 ,"$2,400.00 ","$1,200.00 ",$37.66 ,"$2,400.00 ","$1,550.40 ",$37.66 ,$362.18 ,$321.94 ,$356.52 ,"$1,440.00 ","$2,040.00 ","$1,680.00 ",$37.66 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ",$204.36 ,"$2,040.00 ",$356.52 ,$204.36 ,"$1,920.00 ","$1,752.00 ",$37.66 ,$356.52 ,"$1,008.00 ","$2,400.00 ","$2,040.00 ",$802.18 ,"$2,208.00 ","$1,680.00 ","$1,142.36 ","$1,230.23 ","$1,461.60 ","$1,142.36 ","$1,658.40 ","$1,680.00 ",$360.09 ,"$1,728.00 ",$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,32000213,73050,HC XR AC JOINTS BI W/W/O WTS,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$115.41 ,$102.59 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$37.27 ,$280.50 ,$78.35 ,$37.27 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$93.68 ,$83.27 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$46.70 ,$416.50 ,$78.35 ,$46.70 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$93.68 ,$83.27 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.70 ,$280.50 ,$78.35 ,$46.70 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000216,73060,HC XRAY HUMERUS (2 V) OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$93.68 ,$83.27 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.70 ,$280.50 ,$78.35 ,$46.70 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$81.27 ,$72.24 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$40.63 ,$416.50 ,$78.35 ,$40.63 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$81.27 ,$72.24 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.63 ,$280.50 ,$78.35 ,$40.63 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000219,73070,HC XRAY ELBOW (2 V) OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$81.27 ,$72.24 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.63 ,$280.50 ,$78.35 ,$40.63 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$90.58 ,$80.52 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.02 ,$280.50 ,$78.35 ,$46.02 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$90.58 ,$80.52 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$46.02 ,$416.50 ,$78.35 ,$46.02 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000222,73085,HC XRAY ELBOW ARTHRO,320,1 ,$870.00 ,$435.00 ,$37.66 ,$870.00 ,$562.02 ,$37.66 ,$335.80 ,$298.49 ,$356.52 ,$522.00 ,$739.50 ,$609.00 ,$37.66 ,$826.50 ,$626.40 ,$635.10 ,$176.10 ,$739.50 ,$356.52 ,$176.10 ,$696.00 ,$635.10 ,$37.66 ,$356.52 ,$365.40 ,$870.00 ,$739.50 ,$802.18 ,$800.40 ,$609.00 ,$870.00 ,$870.00 ,$529.83 ,$870.00 ,$601.17 ,$609.00 ,$360.09 ,$626.40 ,$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,$626.40 ,$539.40 ,$626.40 ,$626.40 ,$522.00 ST VINCENT HOSPITAL - ACUTE,32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$84.37 ,$75.00 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$41.31 ,$416.50 ,$78.35 ,$41.31 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$84.37 ,$75.00 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$41.31 ,$280.50 ,$78.35 ,$41.31 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000225,73090,HC XRAY FOREARM (2 V) OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$84.37 ,$75.00 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$41.31 ,$280.50 ,$78.35 ,$41.31 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000226,73092,HC XRAY INFANT UP EXTRM MIN 2V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$89.03 ,$79.14 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.02 ,$280.50 ,$105.54 ,$46.02 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$305.98 ,$329.52 ,$200.97 ,$305.98 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000228,73100,HC XRAY WRIST 2 VIEWS NAVICULAR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$101.44 ,$90.17 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.06 ,$280.50 ,$78.35 ,$50.06 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$101.44 ,$90.17 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.06 ,$280.50 ,$78.35 ,$50.06 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$101.44 ,$90.17 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$50.06 ,$416.50 ,$78.35 ,$50.06 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000231,73100,HC XRAY WRIST 2 VIEWS NAVICULAR/CARP,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$101.44 ,$90.17 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$50.06 ,$416.50 ,$78.35 ,$50.06 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000231,73100,HC XRAY WRIST 2 VIEWS NAVICULAR/CARP,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$101.44 ,$90.17 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.06 ,$280.50 ,$78.35 ,$50.06 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000232,73100,HC XRAY WRIST 2 VIEWS OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$101.44 ,$90.17 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.06 ,$280.50 ,$78.35 ,$50.06 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$120.07 ,$106.73 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$62.20 ,$416.50 ,$78.35 ,$62.20 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$120.07 ,$106.73 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$62.20 ,$280.50 ,$78.35 ,$62.20 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000235,73110,HC XRAY WRIST COMP MIN 3 V + NAVIC,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$120.07 ,$106.73 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$62.20 ,$280.50 ,$78.35 ,$62.20 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000236,73115,HC XRAY WRIST ARTHRO,320,1 ,$870.00 ,$435.00 ,$37.66 ,$870.00 ,$562.02 ,$37.66 ,$390.12 ,$346.77 ,$356.52 ,$522.00 ,$739.50 ,$609.00 ,$37.66 ,$826.50 ,$626.40 ,$635.10 ,$215.15 ,$739.50 ,$356.52 ,$215.15 ,$696.00 ,$635.10 ,$37.66 ,$356.52 ,$365.40 ,$870.00 ,$739.50 ,$802.18 ,$800.40 ,$609.00 ,$870.00 ,$870.00 ,$529.83 ,$870.00 ,$601.17 ,$609.00 ,$360.09 ,$626.40 ,$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,$626.40 ,$539.40 ,$626.40 ,$626.40 ,$522.00 ST VINCENT HOSPITAL - ACUTE,32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$89.03 ,$79.14 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$44.67 ,$280.50 ,$105.54 ,$44.67 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$89.03 ,$79.14 ,$105.54 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$44.67 ,$416.50 ,$105.54 ,$44.67 ,$392.00 ,$357.70 ,$17.72 ,$105.54 ,$205.80 ,$490.00 ,$416.50 ,$237.46 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$106.60 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$106.10 ,$94.31 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$54.10 ,$416.50 ,$78.35 ,$54.10 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$106.10 ,$94.31 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$54.10 ,$280.50 ,$78.35 ,$54.10 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000241,73140,HC XRAY FINGER MIN 2 VIEWS,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$115.41 ,$102.59 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$59.51 ,$280.50 ,$78.35 ,$59.51 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000242,73140,HC XRAY FINGER MIN 2 VIEWS OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$115.41 ,$102.59 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$59.51 ,$280.50 ,$78.35 ,$59.51 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000243,73140,HC XRAY FINGER MIN 2 VIEWS MULTI,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$115.41 ,$102.59 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$59.51 ,$280.50 ,$78.35 ,$59.51 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000252,73525,HC XRAY HIP ARTHRGRPHY,320,1 ,"$1,600.00 ",$800.00 ,$37.66 ,"$1,600.00 ","$1,033.60 ",$37.66 ,$363.74 ,$323.32 ,$356.52 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$37.66 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ",$208.42 ,"$1,360.00 ",$356.52 ,$208.42 ,"$1,280.00 ","$1,168.00 ",$37.66 ,$356.52 ,$672.00 ,"$1,600.00 ","$1,360.00 ",$802.18 ,"$1,472.00 ","$1,120.00 ","$1,142.36 ","$1,230.23 ",$974.40 ,"$1,142.36 ","$1,105.60 ","$1,120.00 ",$360.09 ,"$1,152.00 ",$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,32000253,73525,HC XRAY HIP ARTHRGRPHY OR,320,1 ,"$1,600.00 ",$800.00 ,$37.66 ,"$1,600.00 ","$1,033.60 ",$37.66 ,$363.74 ,$323.32 ,$356.52 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$37.66 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ",$208.42 ,"$1,360.00 ",$356.52 ,$208.42 ,"$1,280.00 ","$1,168.00 ",$37.66 ,$356.52 ,$672.00 ,"$1,600.00 ","$1,360.00 ",$802.18 ,"$1,472.00 ","$1,120.00 ","$1,142.36 ","$1,230.23 ",$974.40 ,"$1,142.36 ","$1,105.60 ","$1,120.00 ",$360.09 ,"$1,152.00 ",$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$103.00 ,$91.55 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$50.74 ,$416.50 ,$78.35 ,$50.74 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$103.00 ,$91.55 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.74 ,$280.50 ,$78.35 ,$50.74 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000262,73560,HC XRAY KNEE (1 OR 2 V) OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$103.00 ,$91.55 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.74 ,$280.50 ,$78.35 ,$50.74 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000263,73562,HC XRAY KNEE (3 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$120.07 ,$106.73 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$60.86 ,$280.50 ,$78.35 ,$60.86 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000263,73562,HC XRAY KNEE (3 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$120.07 ,$106.73 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$60.86 ,$416.50 ,$78.35 ,$60.86 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$130.93 ,$116.38 ,$105.54 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$68.27 ,$416.50 ,$105.54 ,$68.27 ,$392.00 ,$357.70 ,$17.72 ,$105.54 ,$205.80 ,$490.00 ,$416.50 ,$237.46 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$106.60 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$130.93 ,$116.38 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$68.27 ,$280.50 ,$105.54 ,$68.27 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000267,73565,HC XR KNEE STAND,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$123.17 ,$109.49 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$62.87 ,$280.50 ,$78.35 ,$62.87 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000268,73580,HC XRAY KNEE ARTHRO,320,1 ,"$1,500.00 ",$750.00 ,$37.66 ,"$1,500.00 ",$969.00 ,$37.66 ,$428.92 ,$381.26 ,$356.52 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$37.66 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$232.68 ,"$1,275.00 ",$356.52 ,$232.68 ,"$1,200.00 ","$1,095.00 ",$37.66 ,$356.52 ,$630.00 ,"$1,500.00 ","$1,275.00 ",$802.18 ,"$1,380.00 ","$1,050.00 ","$1,142.36 ","$1,230.23 ",$913.50 ,"$1,142.36 ","$1,036.50 ","$1,050.00 ",$360.09 ,"$1,080.00 ",$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,32000268,73580,HC XRAY KNEE ARTHRO,320,1 ,"$1,000.00 ",$500.00 ,$37.66 ,"$1,000.00 ",$646.00 ,$37.66 ,$428.92 ,$381.26 ,$356.52 ,$600.00 ,$850.00 ,$700.00 ,$37.66 ,$950.00 ,$720.00 ,$730.00 ,$232.68 ,$850.00 ,$356.52 ,$232.68 ,$800.00 ,$730.00 ,$37.66 ,$356.52 ,$420.00 ,"$1,000.00 ",$850.00 ,$802.18 ,$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$360.09 ,$720.00 ,$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$92.13 ,$81.90 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$46.02 ,$416.50 ,$78.35 ,$46.02 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$92.13 ,$81.90 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.02 ,$280.50 ,$78.35 ,$46.02 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000271,73590,HC XRAY TIBIA/FIBULA 2 VIEW OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$92.13 ,$81.90 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.02 ,$280.50 ,$78.35 ,$46.02 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000272,73592,HC XRAY INFANT LO EXTRM MIN 2V,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$46.02 ,$416.50 ,$78.35 ,$46.02 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000272,73592,HC XRAY INFANT LO EXTRM MIN 2V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$89.03 ,$79.14 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$46.02 ,$280.50 ,$78.35 ,$46.02 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$96.79 ,$86.03 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$47.38 ,$416.50 ,$78.35 ,$47.38 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$96.79 ,$86.03 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$47.38 ,$280.50 ,$78.35 ,$47.38 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000275,73600,HC XRAY ANKLE (2 V) OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$96.79 ,$86.03 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$47.38 ,$280.50 ,$78.35 ,$47.38 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$106.10 ,$94.31 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$54.78 ,$280.50 ,$78.35 ,$54.78 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$106.10 ,$94.31 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$54.78 ,$416.50 ,$78.35 ,$54.78 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000278,73615,HC XRAY ARTHRO ANKLE,320,1 ,"$1,300.00 ",$650.00 ,$37.66 ,"$1,300.00 ",$839.80 ,$37.66 ,$388.57 ,$345.39 ,$356.52 ,$780.00 ,"$1,105.00 ",$910.00 ,$37.66 ,"$1,235.00 ",$936.00 ,$949.00 ,$214.47 ,"$1,105.00 ",$356.52 ,$214.47 ,"$1,040.00 ",$949.00 ,$37.66 ,$356.52 ,$546.00 ,"$1,300.00 ","$1,105.00 ",$802.18 ,"$1,196.00 ",$910.00 ,"$1,142.36 ","$1,230.23 ",$791.70 ,"$1,142.36 ",$898.30 ,$910.00 ,$360.09 ,$936.00 ,$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000279,73620,HC XRAY FOOT (2 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$82.82 ,$73.62 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$40.63 ,$416.50 ,$78.35 ,$40.63 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000279,73620,HC XRAY FOOT (2 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$82.82 ,$73.62 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.63 ,$280.50 ,$78.35 ,$40.63 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000280,73620,HC XRAY FOOT (2 V) OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$82.82 ,$73.62 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.63 ,$280.50 ,$78.35 ,$40.63 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$98.34 ,$87.41 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$50.74 ,$416.50 ,$78.35 ,$50.74 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$98.34 ,$87.41 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.74 ,$280.50 ,$78.35 ,$50.74 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$81.27 ,$72.24 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$40.63 ,$416.50 ,$78.35 ,$40.63 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$81.27 ,$72.24 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.63 ,$280.50 ,$78.35 ,$40.63 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000284,73650,HC XRAY OS CALCIS HEEL OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$81.27 ,$72.24 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.63 ,$280.50 ,$78.35 ,$40.63 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$95.24 ,$84.65 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$44.01 ,$416.50 ,$78.35 ,$44.01 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$193.07 ,$207.92 ,$298.41 ,$193.07 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$95.24 ,$84.65 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$44.01 ,$280.50 ,$78.35 ,$44.01 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000288,73660,HC XRAY TOE MIN 2 VIEW OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$95.24 ,$84.65 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$44.01 ,$280.50 ,$78.35 ,$44.01 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000289,74018,HC XRAY ABDOMEN 1V,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$82.82 ,$73.62 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.65 ,$280.50 ,$78.35 ,$40.65 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$206.92 ,$222.84 ,$200.97 ,$206.92 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000290,74018,HC XRAY ABDOMEN 1V OR,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$82.82 ,$73.62 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.65 ,$280.50 ,$78.35 ,$40.65 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$206.92 ,$222.84 ,$200.97 ,$206.92 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000291,74018,HC XRAY ABDOMEN 1V PORTABLE,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$82.82 ,$73.62 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.65 ,$280.50 ,$78.35 ,$40.65 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$206.92 ,$222.84 ,$200.97 ,$206.92 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000292,74018,HC XRAY ABDOMEN 1V SHUNTOGRAM,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$82.82 ,$73.62 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.65 ,$280.50 ,$78.35 ,$40.65 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$206.92 ,$222.84 ,$200.97 ,$206.92 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000293,74018,HC XRAY ABDOMEN 1V MATRN FETAL,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$82.82 ,$73.62 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.65 ,$280.50 ,$78.35 ,$40.65 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$206.92 ,$222.84 ,$200.97 ,$206.92 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000294,74019,HC XRAY ABDOMEN AP AND LAT (2 V OR 3 V),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$99.89 ,$88.79 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.06 ,$280.50 ,$105.54 ,$50.06 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$330.00 ,$330.00 ,$200.97 ,$330.00 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000295,74019,HC XRAY ABDOMEN AP AND LAT (2 V BABY PORT),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$99.89 ,$88.79 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.06 ,$280.50 ,$105.54 ,$50.06 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$330.00 ,$330.00 ,$200.97 ,$330.00 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000296,74019,HC XRAY ABDOMEN AP AND LAT (2 V BABY,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$99.89 ,$88.79 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.06 ,$280.50 ,$105.54 ,$50.06 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$330.00 ,$330.00 ,$200.97 ,$330.00 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000297,74019,HC XRAY ABDOMEN AP AND LAT (2 V OR 3 V)FLAT,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$99.89 ,$88.79 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$50.06 ,$280.50 ,$105.54 ,$50.06 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$330.00 ,$330.00 ,$200.97 ,$330.00 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000298,74022,HC XRAY ABDOMEN AP/DECUB/ERECT/CXR,320,1 ,$470.00 ,$235.00 ,$17.72 ,$470.00 ,$303.62 ,$17.72 ,$130.93 ,$116.38 ,$105.54 ,$282.00 ,$399.50 ,$329.00 ,$17.72 ,$446.50 ,$338.40 ,$343.10 ,$66.93 ,$399.50 ,$105.54 ,$66.93 ,$376.00 ,$343.10 ,$17.72 ,$105.54 ,$197.40 ,$470.00 ,$399.50 ,$237.46 ,$432.40 ,$329.00 ,$305.98 ,$329.52 ,$286.23 ,$305.98 ,$324.77 ,$329.00 ,$106.60 ,$338.40 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,32000299,74190,HC S AND I PERITONEOGRAM,320,1 ,$590.00 ,$295.00 ,$37.66 ,"$1,052.28 ",$381.14 ,$37.66 ,$381.67 ,$381.67 ,$467.68 ,$354.00 ,$501.50 ,$413.00 ,$37.66 ,$560.50 ,$424.80 ,$430.70 ,$108.24 ,$501.50 ,$467.68 ,$108.24 ,$472.00 ,$430.70 ,$37.66 ,$467.68 ,$247.80 ,$590.00 ,$501.50 ,"$1,052.28 ",$542.80 ,$413.00 ,$590.00 ,$590.00 ,$359.31 ,$590.00 ,$407.69 ,$413.00 ,$472.36 ,$424.80 ,$39.92 ,$415.00 ,$415.00 ,$467.68 ,$415.00 ,$467.68 ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,32000300,74220,HC XRAY ESOPHAGUS,320,1 ,$540.00 ,$270.00 ,$17.72 ,$540.00 ,$348.84 ,$17.72 ,$273.72 ,$243.31 ,$172.93 ,$324.00 ,$459.00 ,$378.00 ,$17.72 ,$513.00 ,$388.80 ,$394.20 ,$141.04 ,$459.00 ,$172.93 ,$141.04 ,$432.00 ,$394.20 ,$17.72 ,$172.93 ,$226.80 ,$540.00 ,$459.00 ,$389.08 ,$496.80 ,$378.00 ,$342.86 ,$369.23 ,$328.86 ,$342.86 ,$373.14 ,$378.00 ,$174.66 ,$388.80 ,$18.78 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,32000301,74230,HC VIDEO FLUORO SWALLOWING,320,1 ,$550.00 ,$275.00 ,$37.66 ,$550.00 ,$355.30 ,$37.66 ,$438.23 ,$389.54 ,$172.93 ,$330.00 ,$467.50 ,$385.00 ,$37.66 ,$522.50 ,$396.00 ,$401.50 ,$211.79 ,$467.50 ,$172.93 ,$211.79 ,$440.00 ,$401.50 ,$37.66 ,$172.93 ,$231.00 ,$550.00 ,$467.50 ,$389.08 ,$506.00 ,$385.00 ,$342.86 ,$369.23 ,$334.95 ,$342.86 ,$380.05 ,$385.00 ,$174.66 ,$396.00 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,32000302,74240,HC XRAY UPPER GI TRACT,320,1 ,$550.00 ,$275.00 ,$37.66 ,$550.00 ,$355.30 ,$37.66 ,$380.81 ,$338.50 ,$172.93 ,$330.00 ,$467.50 ,$385.00 ,$37.66 ,$522.50 ,$396.00 ,$401.50 ,$170.68 ,$467.50 ,$172.93 ,$170.68 ,$440.00 ,$401.50 ,$37.66 ,$172.93 ,$231.00 ,$550.00 ,$467.50 ,$389.08 ,$506.00 ,$385.00 ,$509.12 ,$548.28 ,$334.95 ,$509.12 ,$380.05 ,$385.00 ,$174.66 ,$396.00 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,32000306,74246,HC UPPER GI TRACT - NO KUB,320,1 ,$850.00 ,$425.00 ,$37.66 ,$850.00 ,$549.10 ,$37.66 ,$442.89 ,$393.68 ,$172.93 ,$510.00 ,$722.50 ,$595.00 ,$37.66 ,$807.50 ,$612.00 ,$620.50 ,$198.30 ,$722.50 ,$172.93 ,$198.30 ,$680.00 ,$620.50 ,$37.66 ,$172.93 ,$357.00 ,$850.00 ,$722.50 ,$389.08 ,$782.00 ,$595.00 ,$509.12 ,$548.28 ,$517.65 ,$509.12 ,$587.35 ,$595.00 ,$174.66 ,$612.00 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,32000307,74246,HC XRAY ESOPHAGUS/UGI W AIR,320,1 ,$850.00 ,$425.00 ,$37.66 ,$850.00 ,$549.10 ,$37.66 ,$442.89 ,$393.68 ,$172.93 ,$510.00 ,$722.50 ,$595.00 ,$37.66 ,$807.50 ,$612.00 ,$620.50 ,$198.30 ,$722.50 ,$172.93 ,$198.30 ,$680.00 ,$620.50 ,$37.66 ,$172.93 ,$357.00 ,$850.00 ,$722.50 ,$389.08 ,$782.00 ,$595.00 ,$509.12 ,$548.28 ,$517.65 ,$509.12 ,$587.35 ,$595.00 ,$174.66 ,$612.00 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,32000311,74250,HC XRAY SMALL BOWEL,320,1 ,$640.00 ,$320.00 ,$37.66 ,$640.00 ,$413.44 ,$37.66 ,$388.57 ,$345.39 ,$172.93 ,$384.00 ,$544.00 ,$448.00 ,$37.66 ,$608.00 ,$460.80 ,$467.20 ,$170.68 ,$544.00 ,$172.93 ,$170.68 ,$512.00 ,$467.20 ,$37.66 ,$172.93 ,$268.80 ,$640.00 ,$544.00 ,$389.08 ,$588.80 ,$448.00 ,$342.86 ,$369.23 ,$389.76 ,$342.86 ,$442.24 ,$448.00 ,$174.66 ,$460.80 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$460.80 ,$396.80 ,$460.80 ,$460.80 ,$384.00 ST VINCENT HOSPITAL - ACUTE,32000312,74018,HC SITZ MARKER STUDY,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$82.82 ,$73.62 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$40.65 ,$280.50 ,$78.35 ,$40.65 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$206.92 ,$222.84 ,$200.97 ,$206.92 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000314,74251,HC SMALL BOWEL VIA ENTEROCLY TUBE,320,1 ,$980.00 ,$490.00 ,$37.66 ,$980.00 ,$633.08 ,$37.66 ,$980.00 ,$980.00 ,$172.93 ,$588.00 ,$833.00 ,$686.00 ,$37.66 ,$931.00 ,$705.60 ,$715.40 ,$692.22 ,$833.00 ,$172.93 ,$692.22 ,$784.00 ,$715.40 ,$37.66 ,$172.93 ,$411.60 ,$980.00 ,$833.00 ,$389.08 ,$901.60 ,$686.00 ,$509.12 ,$548.28 ,$596.82 ,$509.12 ,$677.18 ,$686.00 ,$174.66 ,$705.60 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$705.60 ,$607.60 ,$705.60 ,$705.60 ,$588.00 ST VINCENT HOSPITAL - ACUTE,32000315,74270,HC XRAY COLON BARIUM,320,1 ,$680.00 ,$340.00 ,$37.66 ,$680.00 ,$439.28 ,$37.66 ,$551.53 ,$490.25 ,$172.93 ,$408.00 ,$578.00 ,$476.00 ,$37.66 ,$646.00 ,$489.60 ,$496.40 ,$215.15 ,$578.00 ,$172.93 ,$215.15 ,$544.00 ,$496.40 ,$37.66 ,$172.93 ,$285.60 ,$680.00 ,$578.00 ,$389.08 ,$625.60 ,$476.00 ,$509.12 ,$548.28 ,$414.12 ,$509.12 ,$469.88 ,$476.00 ,$174.66 ,$489.60 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,32000318,74270,HC XRAY BARM ENEMA/COLSTMY,320,1 ,$680.00 ,$340.00 ,$37.66 ,$680.00 ,$439.28 ,$37.66 ,$551.53 ,$490.25 ,$172.93 ,$408.00 ,$578.00 ,$476.00 ,$37.66 ,$646.00 ,$489.60 ,$496.40 ,$215.15 ,$578.00 ,$172.93 ,$215.15 ,$544.00 ,$496.40 ,$37.66 ,$172.93 ,$285.60 ,$680.00 ,$578.00 ,$389.08 ,$625.60 ,$476.00 ,$509.12 ,$548.28 ,$414.12 ,$509.12 ,$469.88 ,$476.00 ,$174.66 ,$489.60 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,32000319,74270,HC XRAY BARM ENEMA WATER SOL,320,1 ,$680.00 ,$340.00 ,$37.66 ,$680.00 ,$439.28 ,$37.66 ,$551.53 ,$490.25 ,$172.93 ,$408.00 ,$578.00 ,$476.00 ,$37.66 ,$646.00 ,$489.60 ,$496.40 ,$215.15 ,$578.00 ,$172.93 ,$215.15 ,$544.00 ,$496.40 ,$37.66 ,$172.93 ,$285.60 ,$680.00 ,$578.00 ,$389.08 ,$625.60 ,$476.00 ,$509.12 ,$548.28 ,$414.12 ,$509.12 ,$469.88 ,$476.00 ,$174.66 ,$489.60 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,32000320,74280,HC XRAY COLON BARIUM AIR CONTRAST,320,1 ,$980.00 ,$490.00 ,$37.66 ,$980.00 ,$633.08 ,$37.66 ,$775.02 ,$688.91 ,$172.93 ,$588.00 ,$833.00 ,$686.00 ,$37.66 ,$931.00 ,$705.60 ,$715.40 ,$334.44 ,$833.00 ,$172.93 ,$334.44 ,$784.00 ,$715.40 ,$37.66 ,$172.93 ,$411.60 ,$980.00 ,$833.00 ,$389.08 ,$901.60 ,$686.00 ,$509.12 ,$548.28 ,$596.82 ,$509.12 ,$677.18 ,$686.00 ,$174.66 ,$705.60 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$705.60 ,$607.60 ,$705.60 ,$705.60 ,$588.00 ST VINCENT HOSPITAL - ACUTE,32000322,74283,HC THERAPEUTIC COLON,320,1 ,$680.00 ,$340.00 ,$37.66 ,$680.00 ,$439.28 ,$37.66 ,$568.60 ,$505.43 ,$172.93 ,$408.00 ,$578.00 ,$476.00 ,$37.66 ,$646.00 ,$489.60 ,$496.40 ,$321.62 ,$578.00 ,$172.93 ,$321.62 ,$544.00 ,$496.40 ,$37.66 ,$172.93 ,$285.60 ,$680.00 ,$578.00 ,$389.08 ,$625.60 ,$476.00 ,$509.12 ,$548.28 ,$414.12 ,$509.12 ,$469.88 ,$476.00 ,$174.66 ,$489.60 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,32000323,74300,HC CHOLANGIOGRAPHY OPERATIVE,320,1 ,$690.00 ,$345.00 ,$53.35 ,$690.00 ,$445.74 ,$53.35 ,$145.60 ,$129.42 , N/A ,$414.00 ,$586.50 ,$483.00 ,$53.35 ,$655.50 ,$496.80 ,$503.70 ,$98.36 ,$586.50 , N/A ,$98.36 ,$552.00 ,$503.70 ,$53.35 , N/A ,$289.80 ,$690.00 ,$586.50 , N/A ,$634.80 ,$483.00 ,$345.00 ,$414.00 ,$420.21 ,$345.00 ,$476.79 ,$483.00 , N/A ,$496.80 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$496.80 ,$427.80 ,$496.80 ,$496.80 ,$414.00 ST VINCENT HOSPITAL - ACUTE,32000324,74301,HC CHOLANGIOGRAPHY OPERATIVE ADDL,320,1 ,$405.00 ,$202.50 ,$53.35 ,$405.00 ,$261.63 ,$53.35 ,$83.95 ,$74.62 , N/A ,$243.00 ,$344.25 ,$283.50 ,$53.35 ,$384.75 ,$291.60 ,$295.65 ,$87.29 ,$344.25 , N/A ,$87.29 ,$324.00 ,$295.65 ,$53.35 , N/A ,$170.10 ,$405.00 ,$344.25 , N/A ,$372.60 ,$283.50 ,$202.50 ,$243.00 ,$246.65 ,$202.50 ,$279.86 ,$283.50 , N/A ,$291.60 ,$56.55 ,$405.00 ,$405.00 , N/A ,$405.00 , N/A ,$291.60 ,$251.10 ,$291.60 ,$291.60 ,$243.00 ST VINCENT HOSPITAL - ACUTE,32000325,47531,HC XRAY CHOLANGIOGRAM THRU CATH,320,1 ,"$1,500.00 ",$750.00 ,$137.51 ,"$6,937.05 ",$969.00 ,$534.02 ,$970.35 ,$970.35 ,"$3,083.13 ",$900.00 ,"$1,275.00 ","$1,050.00 ",$534.02 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$137.51 ,"$1,275.00 ","$3,083.13 ",$137.51 ,"$1,200.00 ","$1,095.00 ",$534.02 ,"$3,083.13 ",$630.00 ,"$1,500.00 ","$1,275.00 ","$6,937.05 ","$1,380.00 ","$1,050.00 ","$1,500.00 ","$1,500.00 ",$913.50 ,"$1,500.00 ","$1,036.50 ","$1,050.00 ","$3,113.96 ","$1,080.00 ",$566.06 ,$415.00 ,$415.00 ,"$3,083.13 ",$415.00 ,"$3,083.13 ","$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,32000326,47532,HC PERCUTAN CHOLANGIOGRAM,320,1 ,"$1,900.00 ",$950.00 ,$413.30 ,"$6,937.05 ","$1,227.40 ",$534.02 ,"$1,229.11 ","$1,229.11 ","$3,083.13 ","$1,140.00 ","$1,615.00 ","$1,330.00 ",$534.02 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ",$413.30 ,"$1,615.00 ","$3,083.13 ",$413.30 ,"$1,520.00 ","$1,387.00 ",$534.02 ,"$3,083.13 ",$798.00 ,"$1,900.00 ","$1,615.00 ","$6,937.05 ","$1,748.00 ","$1,330.00 ","$1,900.00 ","$1,900.00 ","$1,157.10 ","$1,900.00 ","$1,312.90 ","$1,330.00 ","$3,113.96 ","$1,368.00 ",$566.06 ,$415.00 ,$415.00 ,"$3,083.13 ",$415.00 ,"$3,083.13 ","$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,32000327,47544,HC XRAY REM BILE DUCT STONE,320,1 ,"$3,180.00 ","$1,590.00 ",$303.65 ,"$3,180.00 ","$2,054.28 ",$703.19 ,"$2,057.14 ","$2,057.14 ", N/A ,"$1,908.00 ","$2,703.00 ","$2,226.00 ",$703.19 ,"$3,021.00 ","$2,289.60 ","$2,321.40 ",$303.65 ,"$2,703.00 ", N/A ,$303.65 ,"$2,544.00 ","$2,321.40 ",$703.19 , N/A ,"$1,335.60 ","$3,180.00 ","$2,703.00 ", N/A ,"$2,925.60 ","$2,226.00 ","$2,331.31 ","$3,133.44 ","$1,936.62 ","$2,914.14 ","$2,197.38 ","$2,226.00 ", N/A ,"$2,289.60 ",$745.38 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$2,289.60 ","$1,971.60 ","$2,289.60 ","$2,289.60 ","$1,908.00 " ST VINCENT HOSPITAL - ACUTE,32000328,74328,HC XRAY ERCP BILIARY ONLY,320,1 ,$990.00 ,$495.00 ,$53.35 ,$990.00 ,$639.54 ,$53.35 ,$354.41 ,$315.03 , N/A ,$594.00 ,$841.50 ,$693.00 ,$53.35 ,$940.50 ,$712.80 ,$722.70 ,$261.13 ,$841.50 , N/A ,$261.13 ,$792.00 ,$722.70 ,$53.35 , N/A ,$415.80 ,$990.00 ,$841.50 , N/A ,$910.80 ,$693.00 ,$495.00 ,$594.00 ,$602.91 ,$495.00 ,$684.09 ,$693.00 , N/A ,$712.80 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$712.80 ,$613.80 ,$712.80 ,$712.80 ,$594.00 ST VINCENT HOSPITAL - ACUTE,32000329,74329,HC ERCP PANCREATIC,320,1 ,$990.00 ,$495.00 ,$53.35 ,$990.00 ,$639.54 ,$53.35 ,$282.88 ,$251.45 , N/A ,$594.00 ,$841.50 ,$693.00 ,$53.35 ,$940.50 ,$712.80 ,$722.70 ,$261.13 ,$841.50 , N/A ,$261.13 ,$792.00 ,$722.70 ,$53.35 , N/A ,$415.80 ,$990.00 ,$841.50 , N/A ,$910.80 ,$693.00 ,$495.00 ,$594.00 ,$602.91 ,$495.00 ,$684.09 ,$693.00 , N/A ,$712.80 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$712.80 ,$613.80 ,$712.80 ,$712.80 ,$594.00 ST VINCENT HOSPITAL - ACUTE,32000330,74330,HC XRAY ERCP CATH BILIARY AND PANCREAS,320,1 ,"$1,300.00 ",$650.00 ,$53.35 ,"$1,300.00 ",$839.80 ,$53.35 ,$524.84 ,$466.52 , N/A ,$780.00 ,"$1,105.00 ",$910.00 ,$53.35 ,"$1,235.00 ",$936.00 ,$949.00 ,$261.13 ,"$1,105.00 ", N/A ,$261.13 ,"$1,040.00 ",$949.00 ,$53.35 , N/A ,$546.00 ,"$1,300.00 ","$1,105.00 ", N/A ,"$1,196.00 ",$910.00 ,$650.00 ,$780.00 ,$791.70 ,$650.00 ,$898.30 ,$910.00 , N/A ,$936.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000331,74340,HC INTRODUCTION LONG GI TUBE,320,1 ,$575.00 ,$287.50 ,$53.35 ,$575.00 ,$371.45 ,$53.35 ,$346.65 ,$308.13 , N/A ,$345.00 ,$488.75 ,$402.50 ,$53.35 ,$546.25 ,$414.00 ,$419.75 ,$217.22 ,$488.75 , N/A ,$217.22 ,$460.00 ,$419.75 ,$53.35 , N/A ,$241.50 ,$575.00 ,$488.75 , N/A ,$529.00 ,$402.50 ,$287.50 ,$345.00 ,$350.18 ,$287.50 ,$397.33 ,$402.50 , N/A ,$414.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$414.00 ,$356.50 ,$414.00 ,$414.00 ,$345.00 ST VINCENT HOSPITAL - ACUTE,32000333,74363,HC BILIARY DILITAT W OR W/O STENT,320,1 ,"$1,530.00 ",$765.00 ,$53.35 ,"$1,530.00 ",$988.38 ,$53.35 ,$341.43 ,$303.49 , N/A ,$918.00 ,"$1,300.50 ","$1,071.00 ",$53.35 ,"$1,453.50 ","$1,101.60 ","$1,116.90 ",$217.22 ,"$1,300.50 ", N/A ,$217.22 ,"$1,224.00 ","$1,116.90 ",$53.35 , N/A ,$642.60 ,"$1,530.00 ","$1,300.50 ", N/A ,"$1,407.60 ","$1,071.00 ",$765.00 ,$918.00 ,$931.77 ,$765.00 ,"$1,057.23 ","$1,071.00 ", N/A ,"$1,101.60 ",$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$1,101.60 ",$948.60 ,"$1,101.60 ","$1,101.60 ",$918.00 ST VINCENT HOSPITAL - ACUTE,32000335,74400,HC XRAY IVP W OR W/O TOMO,320,1 ,$800.00 ,$400.00 ,$37.66 ,$800.00 ,$516.80 ,$37.66 ,$411.85 ,$366.09 ,$172.93 ,$480.00 ,$680.00 ,$560.00 ,$37.66 ,$760.00 ,$576.00 ,$584.00 ,$221.91 ,$680.00 ,$172.93 ,$221.91 ,$640.00 ,$584.00 ,$37.66 ,$172.93 ,$336.00 ,$800.00 ,$680.00 ,$389.08 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$174.66 ,$576.00 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000336,74400,HC XRAY IVP W OR W/O TOMO,320,1 ,$800.00 ,$400.00 ,$37.66 ,$800.00 ,$516.80 ,$37.66 ,$411.85 ,$366.09 ,$172.93 ,$480.00 ,$680.00 ,$560.00 ,$37.66 ,$760.00 ,$576.00 ,$584.00 ,$221.91 ,$680.00 ,$172.93 ,$221.91 ,$640.00 ,$584.00 ,$37.66 ,$172.93 ,$336.00 ,$800.00 ,$680.00 ,$389.08 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$174.66 ,$576.00 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000337,74410,HC XRAY UROGRAM IVP DRIP TECH,320,1 ,$800.00 ,$400.00 ,$37.66 ,$800.00 ,$516.80 ,$37.66 ,$421.16 ,$374.37 ,$172.93 ,$480.00 ,$680.00 ,$560.00 ,$37.66 ,$760.00 ,$576.00 ,$584.00 ,$230.67 ,$680.00 ,$172.93 ,$230.67 ,$640.00 ,$584.00 ,$37.66 ,$172.93 ,$336.00 ,$800.00 ,$680.00 ,$389.08 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$174.66 ,$576.00 ,$39.92 ,$415.00 ,$415.00 ,$172.93 ,$415.00 ,$172.93 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000339,74420,HC XRAY UROGRAM RETROGRADE,320,1 ,$660.00 ,$330.00 ,$37.66 ,$802.18 ,$426.36 ,$37.66 ,$199.22 ,$177.09 ,$356.52 ,$396.00 ,$561.00 ,$462.00 ,$37.66 ,$627.00 ,$475.20 ,$481.80 ,$101.95 ,$561.00 ,$356.52 ,$101.95 ,$528.00 ,$481.80 ,$37.66 ,$356.52 ,$277.20 ,$660.00 ,$561.00 ,$802.18 ,$607.20 ,$462.00 ,$660.00 ,$660.00 ,$401.94 ,$660.00 ,$456.06 ,$462.00 ,$360.09 ,$475.20 ,$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,$475.20 ,$409.20 ,$475.20 ,$475.20 ,$396.00 ST VINCENT HOSPITAL - ACUTE,32000340,74425,HC XRAY UROGRAM ANTEGRADE,320,1 ,$660.00 ,$330.00 ,$37.66 ,$802.18 ,$426.36 ,$37.66 ,$426.95 ,$426.95 ,$356.52 ,$396.00 ,$561.00 ,$462.00 ,$37.66 ,$627.00 ,$475.20 ,$481.80 ,$225.93 ,$561.00 ,$356.52 ,$225.93 ,$528.00 ,$481.80 ,$37.66 ,$356.52 ,$277.20 ,$660.00 ,$561.00 ,$802.18 ,$607.20 ,$462.00 ,$660.00 ,$660.00 ,$401.94 ,$660.00 ,$456.06 ,$462.00 ,$360.09 ,$475.20 ,$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,$475.20 ,$409.20 ,$475.20 ,$475.20 ,$396.00 ST VINCENT HOSPITAL - ACUTE,32000341,50431,HC ANGIO NEPHROSTGRAM,320,1 ,$680.00 ,$340.00 ,$125.13 ,"$1,252.50 ",$439.28 ,$125.13 ,$439.89 ,$439.89 ,$556.66 ,$408.00 ,$578.00 ,$476.00 ,$125.13 ,$646.00 ,$489.60 ,$496.40 ,$127.31 ,$578.00 ,$556.66 ,$127.31 ,$544.00 ,$496.40 ,$125.13 ,$556.66 ,$285.60 ,$680.00 ,$578.00 ,"$1,252.50 ",$625.60 ,$476.00 ,$680.00 ,$680.00 ,$414.12 ,$680.00 ,$469.88 ,$476.00 ,$562.23 ,$489.60 ,$132.64 ,$415.00 ,$415.00 ,$556.66 ,$415.00 ,$556.66 ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,32000342,74425,HC XR UROGRAM ANTE (LOOPOGRAM SVG),320,1 ,$660.00 ,$330.00 ,$37.66 ,$802.18 ,$426.36 ,$37.66 ,$426.95 ,$426.95 ,$356.52 ,$396.00 ,$561.00 ,$462.00 ,$37.66 ,$627.00 ,$475.20 ,$481.80 ,$225.93 ,$561.00 ,$356.52 ,$225.93 ,$528.00 ,$481.80 ,$37.66 ,$356.52 ,$277.20 ,$660.00 ,$561.00 ,$802.18 ,$607.20 ,$462.00 ,$660.00 ,$660.00 ,$401.94 ,$660.00 ,$456.06 ,$462.00 ,$360.09 ,$475.20 ,$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,$475.20 ,$409.20 ,$475.20 ,$475.20 ,$396.00 ST VINCENT HOSPITAL - ACUTE,32000343,74430,HC CYSTOGRAM 3+ VIEWS,320,1 ,$840.00 ,$420.00 ,$37.66 ,$840.00 ,$542.64 ,$37.66 ,$99.89 ,$88.79 ,$356.52 ,$504.00 ,$714.00 ,$588.00 ,$37.66 ,$798.00 ,$604.80 ,$613.20 ,$50.08 ,$714.00 ,$356.52 ,$50.08 ,$672.00 ,$613.20 ,$37.66 ,$356.52 ,$352.80 ,$840.00 ,$714.00 ,$802.18 ,$772.80 ,$588.00 ,$840.00 ,$840.00 ,$511.56 ,$840.00 ,$580.44 ,$588.00 ,$360.09 ,$604.80 ,$39.92 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,$604.80 ,$520.80 ,$604.80 ,$604.80 ,$504.00 ST VINCENT HOSPITAL - ACUTE,32000344,74450,HC CYSTOURETHROGRAM RETROGRADE,320,1 ,$800.00 ,$400.00 ,$37.66 ,$800.00 ,$516.80 ,$37.66 ,$517.52 ,$517.52 ,$222.88 ,$480.00 ,$680.00 ,$560.00 ,$37.66 ,$760.00 ,$576.00 ,$584.00 ,$120.77 ,$680.00 ,$222.88 ,$120.77 ,$640.00 ,$584.00 ,$37.66 ,$222.88 ,$336.00 ,$800.00 ,$680.00 ,$501.48 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$225.11 ,$576.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000345,74450,HC CYSTOURETHROGRAM RETRO OR,320,1 ,$800.00 ,$400.00 ,$37.66 ,$800.00 ,$516.80 ,$37.66 ,$517.52 ,$517.52 ,$222.88 ,$480.00 ,$680.00 ,$560.00 ,$37.66 ,$760.00 ,$576.00 ,$584.00 ,$120.77 ,$680.00 ,$222.88 ,$120.77 ,$640.00 ,$584.00 ,$37.66 ,$222.88 ,$336.00 ,$800.00 ,$680.00 ,$501.48 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$225.11 ,$576.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000346,74455,HC XRAY VOID CYSTOURETHGRAM,320,1 ,$800.00 ,$400.00 ,$37.66 ,$800.00 ,$516.80 ,$37.66 ,$321.83 ,$286.07 ,$222.88 ,$480.00 ,$680.00 ,$560.00 ,$37.66 ,$760.00 ,$576.00 ,$584.00 ,$177.43 ,$680.00 ,$222.88 ,$177.43 ,$640.00 ,$584.00 ,$37.66 ,$222.88 ,$336.00 ,$800.00 ,$680.00 ,$501.48 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$225.11 ,$576.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000347,74455,HC XRAY VOID CYSTOURETH OR,320,1 ,$800.00 ,$400.00 ,$37.66 ,$800.00 ,$516.80 ,$37.66 ,$321.83 ,$286.07 ,$222.88 ,$480.00 ,$680.00 ,$560.00 ,$37.66 ,$760.00 ,$576.00 ,$584.00 ,$177.43 ,$680.00 ,$222.88 ,$177.43 ,$640.00 ,$584.00 ,$37.66 ,$222.88 ,$336.00 ,$800.00 ,$680.00 ,$501.48 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$225.11 ,$576.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000348,74470,HC RENAL CYST STUDY S AND I,320,1 ,$670.00 ,$335.00 ,$37.66 ,"$1,052.28 ",$432.82 ,$37.66 ,$433.42 ,$433.42 ,$467.68 ,$402.00 ,$569.50 ,$469.00 ,$37.66 ,$636.50 ,$482.40 ,$489.10 ,$103.46 ,$569.50 ,$467.68 ,$103.46 ,$536.00 ,$489.10 ,$37.66 ,$467.68 ,$281.40 ,$670.00 ,$569.50 ,"$1,052.28 ",$616.40 ,$469.00 ,$670.00 ,$670.00 ,$408.03 ,$670.00 ,$462.97 ,$469.00 ,$472.36 ,$482.40 ,$39.92 ,$415.00 ,$415.00 ,$467.68 ,$415.00 ,$467.68 ,$482.40 ,$415.40 ,$482.40 ,$482.40 ,$402.00 ST VINCENT HOSPITAL - ACUTE,32000349,50432,HC PERCUTANEOUS NEPHRO CATH PLCMT,320,1 ,"$4,100.00 ","$2,050.00 ",$399.11 ,"$4,100.00 ","$2,648.60 ",$430.16 ,"$2,652.29 ","$2,652.29 ","$1,736.51 ","$2,460.00 ","$3,485.00 ","$2,870.00 ",$430.16 ,"$3,895.00 ","$2,952.00 ","$2,993.00 ",$399.11 ,"$3,485.00 ","$1,736.51 ",$399.11 ,"$3,280.00 ","$2,993.00 ",$430.16 ,"$1,736.51 ","$1,722.00 ","$4,100.00 ","$3,485.00 ","$3,907.15 ","$3,772.00 ","$2,870.00 ","$2,331.31 ","$3,133.44 ","$2,496.90 ","$2,914.14 ","$2,833.10 ","$2,870.00 ","$1,753.88 ","$2,952.00 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$2,952.00 ","$2,542.00 ","$2,952.00 ","$2,952.00 ","$2,460.00 " ST VINCENT HOSPITAL - ACUTE,32000349,50432,HC PERCUTANEOUS NEPHRO CATH PLCMT,320,1 ,"$6,100.00 ","$3,050.00 ",$399.11 ,"$6,100.00 ","$3,940.60 ",$430.16 ,"$3,946.09 ","$3,946.09 ","$1,736.51 ","$3,660.00 ","$5,185.00 ","$4,270.00 ",$430.16 ,"$5,795.00 ","$4,392.00 ","$4,453.00 ",$399.11 ,"$5,185.00 ","$1,736.51 ",$399.11 ,"$4,880.00 ","$4,453.00 ",$430.16 ,"$1,736.51 ","$2,562.00 ","$6,100.00 ","$5,185.00 ","$3,907.15 ","$5,612.00 ","$4,270.00 ","$2,331.31 ","$3,133.44 ","$3,714.90 ","$2,914.14 ","$4,215.10 ","$4,270.00 ","$1,753.88 ","$4,392.00 ",$455.97 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$4,392.00 ","$3,782.00 ","$4,392.00 ","$4,392.00 ","$3,660.00 " ST VINCENT HOSPITAL - ACUTE,32000352,74485,"HC DILITATN NEPHRO,URETER,URETHRA",320,1 ,"$2,550.00 ","$1,275.00 ",$53.35 ,"$3,907.15 ","$1,647.30 ",$53.35 ,$290.79 ,$258.48 ,"$1,736.51 ","$1,530.00 ","$2,167.50 ","$1,785.00 ",$53.35 ,"$2,422.50 ","$1,836.00 ","$1,861.50 ",$158.57 ,"$2,167.50 ","$1,736.51 ",$158.57 ,"$2,040.00 ","$1,861.50 ",$53.35 ,"$1,736.51 ","$1,071.00 ","$2,550.00 ","$2,167.50 ","$3,907.15 ","$2,346.00 ","$1,785.00 ","$2,550.00 ","$2,550.00 ","$1,552.95 ","$2,550.00 ","$1,762.05 ","$1,785.00 ","$1,753.88 ","$1,836.00 ",$56.55 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$1,836.00 ","$1,581.00 ","$1,836.00 ","$1,836.00 ","$1,530.00 " ST VINCENT HOSPITAL - ACUTE,32000352,74485,"HC DILITATN NEPHRO,URETER,URETHRA",320,1 ,"$1,700.00 ",$850.00 ,$53.35 ,"$3,907.15 ","$1,098.20 ",$53.35 ,$290.79 ,$258.48 ,"$1,736.51 ","$1,020.00 ","$1,445.00 ","$1,190.00 ",$53.35 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ",$158.57 ,"$1,445.00 ","$1,736.51 ",$158.57 ,"$1,360.00 ","$1,241.00 ",$53.35 ,"$1,736.51 ",$714.00 ,"$1,700.00 ","$1,445.00 ","$3,907.15 ","$1,564.00 ","$1,190.00 ","$1,700.00 ","$1,700.00 ","$1,035.30 ","$1,700.00 ","$1,174.70 ","$1,190.00 ","$1,753.88 ","$1,224.00 ",$56.55 ,$415.00 ,$415.00 ,"$1,736.51 ",$415.00 ,"$1,736.51 ","$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,32000354,74740,HC XRAY HYSTEROSALPINGOGRAP,320,1 ,$670.00 ,$335.00 ,$37.66 ,$670.00 ,$432.82 ,$37.66 ,$275.27 ,$244.69 ,$222.88 ,$402.00 ,$569.50 ,$469.00 ,$37.66 ,$636.50 ,$482.40 ,$489.10 ,$155.86 ,$569.50 ,$222.88 ,$155.86 ,$536.00 ,$489.10 ,$37.66 ,$222.88 ,$281.40 ,$670.00 ,$569.50 ,$501.48 ,$616.40 ,$469.00 ,$670.00 ,$670.00 ,$408.03 ,$670.00 ,$462.97 ,$469.00 ,$225.11 ,$482.40 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$482.40 ,$415.40 ,$482.40 ,$482.40 ,$402.00 ST VINCENT HOSPITAL - ACUTE,32000355,75605,HC THORACIC AORTA,320,1 ,"$3,700.00 ","$1,850.00 ",$143.05 ,"$10,395.23 ","$2,390.20 ","$1,067.27 ",$340.46 ,$302.63 ,"$4,620.10 ","$2,220.00 ","$3,145.00 ","$2,590.00 ","$1,067.27 ","$3,515.00 ","$2,664.00 ","$2,701.00 ",$143.05 ,"$3,145.00 ","$4,620.10 ",$143.05 ,"$2,960.00 ","$2,701.00 ","$1,067.27 ","$4,620.10 ","$1,554.00 ","$3,700.00 ","$3,145.00 ","$10,395.23 ","$3,404.00 ","$2,590.00 ","$3,700.00 ","$3,700.00 ","$2,253.30 ","$3,700.00 ","$2,556.70 ","$2,590.00 ","$4,666.30 ","$2,664.00 ","$1,131.31 ",$415.00 ,$415.00 ,"$4,620.10 ",$415.00 ,"$4,620.10 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,32000356,75625,HC ABDOMINAL AORTAGRAM 75625,320,1 ,"$3,700.00 ","$1,850.00 ",$130.26 ,"$6,235.91 ","$2,390.20 ",$534.02 ,$332.70 ,$295.73 ,"$2,771.52 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$534.02 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ",$130.26 ,"$3,145.00 ","$2,771.52 ",$130.26 ,"$2,960.00 ","$2,701.00 ",$534.02 ,"$2,771.52 ","$1,554.00 ","$3,700.00 ","$3,145.00 ","$6,235.91 ","$3,404.00 ","$2,590.00 ","$3,700.00 ","$3,700.00 ","$2,253.30 ","$3,700.00 ","$2,556.70 ","$2,590.00 ","$2,799.24 ","$2,664.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,32000357,75630,HC AORTA WITH RUNOFF 75630,320,1 ,"$3,900.00 ","$1,950.00 ",$138.35 ,"$6,235.91 ","$2,519.40 ",$534.02 ,$338.90 ,$301.25 ,"$2,771.52 ","$2,340.00 ","$3,315.00 ","$2,730.00 ",$534.02 ,"$3,705.00 ","$2,808.00 ","$2,847.00 ",$138.35 ,"$3,315.00 ","$2,771.52 ",$138.35 ,"$3,120.00 ","$2,847.00 ",$534.02 ,"$2,771.52 ","$1,638.00 ","$3,900.00 ","$3,315.00 ","$6,235.91 ","$3,588.00 ","$2,730.00 ","$3,900.00 ","$3,900.00 ","$2,375.10 ","$3,900.00 ","$2,694.90 ","$2,730.00 ","$2,799.24 ","$2,808.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,808.00 ","$2,418.00 ","$2,808.00 ","$2,808.00 ","$2,340.00 " ST VINCENT HOSPITAL - ACUTE,32000370,75705,HC ANGIO SPINAL,320,1 ,"$2,000.00 ","$1,000.00 ",$264.57 ,"$10,395.23 ","$1,292.00 ","$1,067.27 ",$589.34 ,$523.86 ,"$4,620.10 ","$1,200.00 ","$1,700.00 ","$1,400.00 ","$1,067.27 ","$1,900.00 ","$1,440.00 ","$1,460.00 ",$264.57 ,"$1,700.00 ","$4,620.10 ",$264.57 ,"$1,600.00 ","$1,460.00 ","$1,067.27 ","$4,620.10 ",$840.00 ,"$2,000.00 ","$1,700.00 ","$10,395.23 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ","$4,666.30 ","$1,440.00 ","$1,131.31 ",$415.00 ,$415.00 ,"$4,620.10 ",$415.00 ,"$4,620.10 ","$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,32000371,75710,HC ANGIO EXTREMITY UNI 75710,320,1 ,"$1,600.00 ",$800.00 ,$147.78 ,"$6,235.91 ","$1,033.60 ",$534.02 ,$352.87 ,$313.66 ,"$2,771.52 ",$960.00 ,"$1,360.00 ","$1,120.00 ",$534.02 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ",$147.78 ,"$1,360.00 ","$2,771.52 ",$147.78 ,"$1,280.00 ","$1,168.00 ",$534.02 ,"$2,771.52 ",$672.00 ,"$1,600.00 ","$1,360.00 ","$6,235.91 ","$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ","$2,799.24 ","$1,152.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,32000372,75710,HC ANGIO EXTREMITY UNI OR,320,1 ,"$1,600.00 ",$800.00 ,$147.78 ,"$6,235.91 ","$1,033.60 ",$534.02 ,$352.87 ,$313.66 ,"$2,771.52 ",$960.00 ,"$1,360.00 ","$1,120.00 ",$534.02 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ",$147.78 ,"$1,360.00 ","$2,771.52 ",$147.78 ,"$1,280.00 ","$1,168.00 ",$534.02 ,"$2,771.52 ",$672.00 ,"$1,600.00 ","$1,360.00 ","$6,235.91 ","$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ","$2,799.24 ","$1,152.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,32000373,75716,HC ANGIO EXTREMITY BILAT 75716,320,1 ,"$2,400.00 ","$1,200.00 ",$151.35 ,"$6,235.91 ","$1,550.40 ",$534.02 ,$357.53 ,$317.80 ,"$2,771.52 ","$1,440.00 ","$2,040.00 ","$1,680.00 ",$534.02 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ",$151.35 ,"$2,040.00 ","$2,771.52 ",$151.35 ,"$1,920.00 ","$1,752.00 ",$534.02 ,"$2,771.52 ","$1,008.00 ","$2,400.00 ","$2,040.00 ","$6,235.91 ","$2,208.00 ","$1,680.00 ","$2,400.00 ","$2,400.00 ","$1,461.60 ","$2,400.00 ","$1,658.40 ","$1,680.00 ","$2,799.24 ","$1,728.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,32000375,36251,HC ANGIO SEL RENAL UNILA 36251,320,1 ,"$2,900.00 ","$1,450.00 ",$415.00 ,"$6,235.91 ","$1,873.40 ","$1,067.27 ","$1,876.01 ","$1,876.01 ","$2,771.52 ","$1,740.00 ","$2,465.00 ","$2,030.00 ","$1,067.27 ","$2,755.00 ","$2,088.00 ","$2,117.00 ",$484.76 ,"$2,465.00 ","$2,771.52 ",$484.76 ,"$2,320.00 ","$2,117.00 ","$1,067.27 ","$2,771.52 ","$1,218.00 ","$2,900.00 ","$2,465.00 ","$6,235.91 ","$2,668.00 ","$2,030.00 ","$2,066.93 ","$2,778.48 ","$1,766.10 ","$2,583.66 ","$2,003.90 ","$2,030.00 ","$2,799.24 ","$2,088.00 ","$1,131.31 ",$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,32000376,36252,HC ANGIO SEL RENAL BILAT 36252,320,1 ,"$2,900.00 ","$1,450.00 ",$415.00 ,"$6,235.91 ","$1,873.40 ","$1,067.27 ","$1,876.01 ","$1,876.01 ","$2,771.52 ","$1,740.00 ","$2,465.00 ","$2,030.00 ","$1,067.27 ","$2,755.00 ","$2,088.00 ","$2,117.00 ",$665.10 ,"$2,465.00 ","$2,771.52 ",$665.10 ,"$2,320.00 ","$2,117.00 ","$1,067.27 ","$2,771.52 ","$1,218.00 ","$2,900.00 ","$2,465.00 ","$6,235.91 ","$2,668.00 ","$2,030.00 ","$2,066.93 ","$2,778.48 ","$1,766.10 ","$2,583.66 ","$2,003.90 ","$2,030.00 ","$2,799.24 ","$2,088.00 ","$1,131.31 ",$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,32000378,75726,"HC ANGIO VISERAL, SEL, OR SUPRASEL 75726",320,1 ,"$2,000.00 ","$1,000.00 ",$163.49 ,"$10,395.23 ","$1,292.00 ","$1,067.27 ",$390.12 ,$346.77 ,"$4,620.10 ","$1,200.00 ","$1,700.00 ","$1,400.00 ","$1,067.27 ","$1,900.00 ","$1,440.00 ","$1,460.00 ",$163.49 ,"$1,700.00 ","$4,620.10 ",$163.49 ,"$1,600.00 ","$1,460.00 ","$1,067.27 ","$4,620.10 ",$840.00 ,"$2,000.00 ","$1,700.00 ","$10,395.23 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ","$4,666.30 ","$1,440.00 ","$1,131.31 ",$415.00 ,$415.00 ,"$4,620.10 ",$415.00 ,"$4,620.10 ","$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,32000382,75731,HC ANGIO ADRENAL UNILATERAL,320,1 ,"$2,600.00 ","$1,300.00 ",$201.23 ,"$6,235.91 ","$1,679.60 ",$534.02 ,$479.15 ,$425.91 ,"$2,771.52 ","$1,560.00 ","$2,210.00 ","$1,820.00 ",$534.02 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ",$201.23 ,"$2,210.00 ","$2,771.52 ",$201.23 ,"$2,080.00 ","$1,898.00 ",$534.02 ,"$2,771.52 ","$1,092.00 ","$2,600.00 ","$2,210.00 ","$6,235.91 ","$2,392.00 ","$1,820.00 ","$2,600.00 ","$2,600.00 ","$1,583.40 ","$2,600.00 ","$1,796.60 ","$1,820.00 ","$2,799.24 ","$1,872.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,32000383,75733,HC ANGIO ADRENAL BILATERAL,320,1 ,"$5,100.00 ","$2,550.00 ",$217.83 ,"$6,235.91 ","$3,294.60 ",$534.02 ,$506.10 ,$449.86 ,"$2,771.52 ","$3,060.00 ","$4,335.00 ","$3,570.00 ",$534.02 ,"$4,845.00 ","$3,672.00 ","$3,723.00 ",$217.83 ,"$4,335.00 ","$2,771.52 ",$217.83 ,"$4,080.00 ","$3,723.00 ",$534.02 ,"$2,771.52 ","$2,142.00 ","$5,100.00 ","$4,335.00 ","$6,235.91 ","$4,692.00 ","$3,570.00 ","$5,100.00 ","$5,100.00 ","$3,105.90 ","$5,100.00 ","$3,524.10 ","$3,570.00 ","$2,799.24 ","$3,672.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$3,672.00 ","$3,162.00 ","$3,672.00 ","$3,672.00 ","$3,060.00 " ST VINCENT HOSPITAL - ACUTE,32000384,75736,HC ANGIO PELVIC SELECT,320,1 ,"$2,000.00 ","$1,000.00 ",$183.02 ,"$10,395.23 ","$1,292.00 ","$1,067.27 ",$435.69 ,$387.28 ,"$4,620.10 ","$1,200.00 ","$1,700.00 ","$1,400.00 ","$1,067.27 ","$1,900.00 ","$1,440.00 ","$1,460.00 ",$183.02 ,"$1,700.00 ","$4,620.10 ",$183.02 ,"$1,600.00 ","$1,460.00 ","$1,067.27 ","$4,620.10 ",$840.00 ,"$2,000.00 ","$1,700.00 ","$10,395.23 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ","$4,666.30 ","$1,440.00 ","$1,131.31 ",$415.00 ,$415.00 ,"$4,620.10 ",$415.00 ,"$4,620.10 ","$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,32000385,75741,HC ANGIO PULMONARY UNILAT,320,1 ,"$3,000.00 ","$1,500.00 ",$150.47 ,"$6,235.91 ","$1,938.00 ",$534.02 ,$360.63 ,$320.56 ,"$2,771.52 ","$1,800.00 ","$2,550.00 ","$2,100.00 ",$534.02 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ",$150.47 ,"$2,550.00 ","$2,771.52 ",$150.47 ,"$2,400.00 ","$2,190.00 ",$534.02 ,"$2,771.52 ","$1,260.00 ","$3,000.00 ","$2,550.00 ","$6,235.91 ","$2,760.00 ","$2,100.00 ","$3,000.00 ","$3,000.00 ","$1,827.00 ","$3,000.00 ","$2,073.00 ","$2,100.00 ","$2,799.24 ","$2,160.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,32000386,75743,HC ANGIO PULMONARY BILAT,320,1 ,"$3,500.00 ","$1,750.00 ",$152.50 ,"$6,235.91 ","$2,261.00 ",$534.02 ,$365.29 ,$324.70 ,"$2,771.52 ","$2,100.00 ","$2,975.00 ","$2,450.00 ",$534.02 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ",$152.50 ,"$2,975.00 ","$2,771.52 ",$152.50 ,"$2,800.00 ","$2,555.00 ",$534.02 ,"$2,771.52 ","$1,470.00 ","$3,500.00 ","$2,975.00 ","$6,235.91 ","$3,220.00 ","$2,450.00 ","$3,500.00 ","$3,500.00 ","$2,131.50 ","$3,500.00 ","$2,418.50 ","$2,450.00 ","$2,799.24 ","$2,520.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,32000387,75746,HC ANGIO PULMONARY NONSELECT,320,1 ,"$2,400.00 ","$1,200.00 ",$169.56 ,"$6,235.91 ","$1,550.40 ",$534.02 ,$399.43 ,$355.05 ,"$2,771.52 ","$1,440.00 ","$2,040.00 ","$1,680.00 ",$534.02 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ",$169.56 ,"$2,040.00 ","$2,771.52 ",$169.56 ,"$1,920.00 ","$1,752.00 ",$534.02 ,"$2,771.52 ","$1,008.00 ","$2,400.00 ","$2,040.00 ","$6,235.91 ","$2,208.00 ","$1,680.00 ","$2,400.00 ","$2,400.00 ","$1,461.60 ","$2,400.00 ","$1,658.40 ","$1,680.00 ","$2,799.24 ","$1,728.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,32000388,75756,HC ANGIO INTERNAL MAMMARY,320,1 ,"$2,000.00 ","$1,000.00 ",$209.98 ,"$6,235.91 ","$1,292.00 ",$534.02 ,$490.01 ,$435.57 ,"$2,771.52 ","$1,200.00 ","$1,700.00 ","$1,400.00 ",$534.02 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ",$209.98 ,"$1,700.00 ","$2,771.52 ",$209.98 ,"$1,600.00 ","$1,460.00 ",$534.02 ,"$2,771.52 ",$840.00 ,"$2,000.00 ","$1,700.00 ","$6,235.91 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ","$2,799.24 ","$1,440.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,32000389,75774,HC ANGIO EA VESSEL ADDL 75774,320,1 ,"$1,000.00 ",$500.00 ,$112.05 ,"$1,131.31 ",$646.00 ,"$1,000.00 ",$284.58 ,$252.96 , N/A ,$600.00 ,$850.00 ,$700.00 ,"$1,067.27 ",$950.00 ,$720.00 ,$730.00 ,$112.05 ,$850.00 , N/A ,$112.05 ,$800.00 ,$730.00 ,"$1,067.27 ", N/A ,$420.00 ,"$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 ,"$1,131.31 ",$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,32000391,75803,HC LYMPHANGIOGRAPHY LEGS,320,1 ,"$2,000.00 ","$1,000.00 ",$265.78 ,"$3,064.15 ","$1,292.00 ",$265.78 ,"$1,293.80 ","$1,293.80 ","$1,361.85 ","$1,200.00 ","$1,700.00 ","$1,400.00 ",$265.78 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ",$448.56 ,"$1,700.00 ","$1,361.85 ",$448.56 ,"$1,600.00 ","$1,460.00 ",$265.78 ,"$1,361.85 ",$840.00 ,"$2,000.00 ","$1,700.00 ","$3,064.15 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ","$1,375.47 ","$1,440.00 ",$281.73 ,$415.00 ,$415.00 ,"$1,361.85 ",$415.00 ,"$1,361.85 ","$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,32000392,75807,HC LYMPHANGIOGRAPHY ABDOM,320,1 ,"$1,900.00 ",$950.00 ,$415.00 ,"$6,235.91 ","$1,227.40 ",$534.02 ,"$1,229.11 ","$1,229.11 ","$2,771.52 ","$1,140.00 ","$1,615.00 ","$1,330.00 ",$534.02 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ",$758.56 ,"$1,615.00 ","$2,771.52 ",$758.56 ,"$1,520.00 ","$1,387.00 ",$534.02 ,"$2,771.52 ",$798.00 ,"$1,900.00 ","$1,615.00 ","$6,235.91 ","$1,748.00 ","$1,330.00 ","$1,900.00 ","$1,900.00 ","$1,157.10 ","$1,900.00 ","$1,312.90 ","$1,330.00 ","$2,799.24 ","$1,368.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,32000393,75809,HC SHUNTOGRAM NONVASCULAR,320,1 ,$560.00 ,$280.00 ,$37.66 ,$560.00 ,$361.76 ,$37.66 ,$310.97 ,$276.42 ,$105.54 ,$336.00 ,$476.00 ,$392.00 ,$37.66 ,$532.00 ,$403.20 ,$408.80 ,$128.90 ,$476.00 ,$105.54 ,$128.90 ,$448.00 ,$408.80 ,$37.66 ,$105.54 ,$235.20 ,$560.00 ,$476.00 ,$237.46 ,$515.20 ,$392.00 ,$305.98 ,$329.52 ,$341.04 ,$305.98 ,$386.96 ,$392.00 ,$106.60 ,$403.20 ,$39.92 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,32000394,75810,HC SPLENOPORTOGRAPHY,320,1 ,"$3,200.00 ","$1,600.00 ",$265.78 ,"$6,235.91 ","$2,067.20 ",$265.78 ,"$2,070.08 ","$2,070.08 ","$2,771.52 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$265.78 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$1,042.38 ","$2,720.00 ","$2,771.52 ","$1,042.38 ","$2,560.00 ","$2,336.00 ",$265.78 ,"$2,771.52 ","$1,344.00 ","$3,200.00 ","$2,720.00 ","$6,235.91 ","$2,944.00 ","$2,240.00 ","$3,200.00 ","$3,200.00 ","$1,948.80 ","$3,200.00 ","$2,211.20 ","$2,240.00 ","$2,799.24 ","$2,304.00 ",$281.73 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,32000395,75820,HC VENOGRAM EXTREMITY UNI 75820,320,1 ,"$1,300.00 ",$650.00 ,$132.29 ,"$3,064.15 ",$839.80 ,$265.78 ,$334.25 ,$297.11 ,"$1,361.85 ",$780.00 ,"$1,105.00 ",$910.00 ,$265.78 ,"$1,235.00 ",$936.00 ,$949.00 ,$132.29 ,"$1,105.00 ","$1,361.85 ",$132.29 ,"$1,040.00 ",$949.00 ,$265.78 ,"$1,361.85 ",$546.00 ,"$1,300.00 ","$1,105.00 ","$3,064.15 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,"$1,375.47 ",$936.00 ,$281.73 ,$415.00 ,$415.00 ,"$1,361.85 ",$415.00 ,"$1,361.85 ",$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000397,75822,HC VENOGRAM EXTREMITY BILAT,320,1 ,"$1,600.00 ",$800.00 ,$140.36 ,"$3,064.15 ","$1,033.60 ",$265.78 ,$342.01 ,$304.01 ,"$1,361.85 ",$960.00 ,"$1,360.00 ","$1,120.00 ",$265.78 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ",$140.36 ,"$1,360.00 ","$1,361.85 ",$140.36 ,"$1,280.00 ","$1,168.00 ",$265.78 ,"$1,361.85 ",$672.00 ,"$1,600.00 ","$1,360.00 ","$3,064.15 ","$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ","$1,375.47 ","$1,152.00 ",$281.73 ,$415.00 ,$415.00 ,"$1,361.85 ",$415.00 ,"$1,361.85 ","$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,32000398,75825,HC VENOGRAPHY CAVAL INFERIOR,320,1 ,"$2,900.00 ","$1,450.00 ",$132.29 ,"$6,235.91 ","$1,873.40 ",$534.02 ,$324.94 ,$288.83 ,"$2,771.52 ","$1,740.00 ","$2,465.00 ","$2,030.00 ",$534.02 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ",$132.29 ,"$2,465.00 ","$2,771.52 ",$132.29 ,"$2,320.00 ","$2,117.00 ",$534.02 ,"$2,771.52 ","$1,218.00 ","$2,900.00 ","$2,465.00 ","$6,235.91 ","$2,668.00 ","$2,030.00 ","$2,900.00 ","$2,900.00 ","$1,766.10 ","$2,900.00 ","$2,003.90 ","$2,030.00 ","$2,799.24 ","$2,088.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,32000399,75827,HC VENOGRAPHY CAVAL SUPERIOR,320,1 ,"$2,300.00 ","$1,150.00 ",$142.39 ,"$3,064.15 ","$1,485.80 ",$265.78 ,$343.56 ,$305.39 ,"$1,361.85 ","$1,380.00 ","$1,955.00 ","$1,610.00 ",$265.78 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ",$142.39 ,"$1,955.00 ","$1,361.85 ",$142.39 ,"$1,840.00 ","$1,679.00 ",$265.78 ,"$1,361.85 ",$966.00 ,"$2,300.00 ","$1,955.00 ","$3,064.15 ","$2,116.00 ","$1,610.00 ","$2,300.00 ","$2,300.00 ","$1,400.70 ","$2,300.00 ","$1,589.30 ","$1,610.00 ","$1,375.47 ","$1,656.00 ",$281.73 ,$415.00 ,$415.00 ,"$1,361.85 ",$415.00 ,"$1,361.85 ","$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,32000400,75831,HC VENOGRAM RENAL UNILAT,320,1 ,"$2,700.00 ","$1,350.00 ",$144.40 ,"$6,235.91 ","$1,744.20 ",$534.02 ,$352.87 ,$313.66 ,"$2,771.52 ","$1,620.00 ","$2,295.00 ","$1,890.00 ",$534.02 ,"$2,565.00 ","$1,944.00 ","$1,971.00 ",$144.40 ,"$2,295.00 ","$2,771.52 ",$144.40 ,"$2,160.00 ","$1,971.00 ",$534.02 ,"$2,771.52 ","$1,134.00 ","$2,700.00 ","$2,295.00 ","$6,235.91 ","$2,484.00 ","$1,890.00 ","$2,700.00 ","$2,700.00 ","$1,644.30 ","$2,700.00 ","$1,865.70 ","$1,890.00 ","$2,799.24 ","$1,944.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,944.00 ","$1,674.00 ","$1,944.00 ","$1,944.00 ","$1,620.00 " ST VINCENT HOSPITAL - ACUTE,32000401,75833,HC VENOGRAM RENAL BILAT,320,1 ,"$3,000.00 ","$1,500.00 ",$160.78 ,"$6,235.91 ","$1,938.00 ",$534.02 ,$382.92 ,$340.38 ,"$2,771.52 ","$1,800.00 ","$2,550.00 ","$2,100.00 ",$534.02 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ",$160.78 ,"$2,550.00 ","$2,771.52 ",$160.78 ,"$2,400.00 ","$2,190.00 ",$534.02 ,"$2,771.52 ","$1,260.00 ","$3,000.00 ","$2,550.00 ","$6,235.91 ","$2,760.00 ","$2,100.00 ","$3,000.00 ","$3,000.00 ","$1,827.00 ","$3,000.00 ","$2,073.00 ","$2,100.00 ","$2,799.24 ","$2,160.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,32000402,75840,HC VENOGRAM ADRENAL UNILAT,320,1 ,"$2,400.00 ","$1,200.00 ",$158.57 ,"$6,235.91 ","$1,550.40 ",$534.02 ,$379.26 ,$337.12 ,"$2,771.52 ","$1,440.00 ","$2,040.00 ","$1,680.00 ",$534.02 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ",$158.57 ,"$2,040.00 ","$2,771.52 ",$158.57 ,"$1,920.00 ","$1,752.00 ",$534.02 ,"$2,771.52 ","$1,008.00 ","$2,400.00 ","$2,040.00 ","$6,235.91 ","$2,208.00 ","$1,680.00 ","$2,400.00 ","$2,400.00 ","$1,461.60 ","$2,400.00 ","$1,658.40 ","$1,680.00 ","$2,799.24 ","$1,728.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,32000403,75842,HC VENOGRAM ADRENAL BILAT,320,1 ,"$2,600.00 ","$1,300.00 ",$182.35 ,"$10,395.23 ","$1,679.60 ","$1,067.27 ",$435.69 ,$387.28 ,"$4,620.10 ","$1,560.00 ","$2,210.00 ","$1,820.00 ","$1,067.27 ","$2,470.00 ","$1,872.00 ","$1,898.00 ",$182.35 ,"$2,210.00 ","$4,620.10 ",$182.35 ,"$2,080.00 ","$1,898.00 ","$1,067.27 ","$4,620.10 ","$1,092.00 ","$2,600.00 ","$2,210.00 ","$10,395.23 ","$2,392.00 ","$1,820.00 ","$2,600.00 ","$2,600.00 ","$1,583.40 ","$2,600.00 ","$1,796.60 ","$1,820.00 ","$4,666.30 ","$1,872.00 ","$1,131.31 ",$415.00 ,$415.00 ,"$4,620.10 ",$415.00 ,"$4,620.10 ","$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,32000404,75860,HC VENOGRAPHY SINUS/ JUGULAR,320,1 ,"$1,900.00 ",$950.00 ,$155.86 ,"$6,235.91 ","$1,227.40 ",$534.02 ,$369.94 ,$328.84 ,"$2,771.52 ","$1,140.00 ","$1,615.00 ","$1,330.00 ",$534.02 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ",$155.86 ,"$1,615.00 ","$2,771.52 ",$155.86 ,"$1,520.00 ","$1,387.00 ",$534.02 ,"$2,771.52 ",$798.00 ,"$1,900.00 ","$1,615.00 ","$6,235.91 ","$1,748.00 ","$1,330.00 ","$1,900.00 ","$1,900.00 ","$1,157.10 ","$1,900.00 ","$1,312.90 ","$1,330.00 ","$2,799.24 ","$1,368.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,32000406,75870,HC VENOGRAM SUPERIOR SAGITTAL,320,1 ,"$1,800.00 ",$900.00 ,$220.54 ,"$6,235.91 ","$1,162.80 ",$265.78 ,$537.56 ,$477.83 ,"$2,771.52 ","$1,080.00 ","$1,530.00 ","$1,260.00 ",$265.78 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ",$220.54 ,"$1,530.00 ","$2,771.52 ",$220.54 ,"$1,440.00 ","$1,314.00 ",$265.78 ,"$2,771.52 ",$756.00 ,"$1,800.00 ","$1,530.00 ","$6,235.91 ","$1,656.00 ","$1,260.00 ","$1,070.25 ","$1,152.58 ","$1,096.20 ","$1,070.25 ","$1,243.80 ","$1,260.00 ","$2,799.24 ","$1,296.00 ",$281.73 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,32000407,75872,HC VENOGRAM EPIDURAL,320,1 ,"$2,100.00 ","$1,050.00 ",$158.57 ,"$2,100.00 ","$1,356.60 ",$265.78 ,$379.26 ,$337.12 ,$524.56 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$265.78 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ",$158.57 ,"$1,785.00 ",$524.56 ,$158.57 ,"$1,680.00 ","$1,533.00 ",$265.78 ,$524.56 ,$882.00 ,"$2,100.00 ","$1,785.00 ","$1,180.26 ","$1,932.00 ","$1,470.00 ","$2,100.00 ","$2,100.00 ","$1,278.90 ","$2,100.00 ","$1,451.10 ","$1,470.00 ",$529.81 ,"$1,512.00 ",$281.73 ,$415.00 ,$415.00 ,$524.56 ,$415.00 ,$524.56 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,32000408,75880,HC VENOGRAM ORBITAL,320,1 ,"$1,300.00 ",$650.00 ,$157.87 ,"$1,300.00 ",$839.80 ,$265.78 ,$377.70 ,$335.74 ,$524.56 ,$780.00 ,"$1,105.00 ",$910.00 ,$265.78 ,"$1,235.00 ",$936.00 ,$949.00 ,$157.87 ,"$1,105.00 ",$524.56 ,$157.87 ,"$1,040.00 ",$949.00 ,$265.78 ,$524.56 ,$546.00 ,"$1,300.00 ","$1,105.00 ","$1,180.26 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,$529.81 ,$936.00 ,$281.73 ,$415.00 ,$415.00 ,$524.56 ,$415.00 ,$524.56 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000409,75885,HC TRANSHEPATIC PORTOGRAPHY W/ HEMO,320,1 ,"$3,200.00 ","$1,600.00 ",$152.48 ,"$6,235.91 ","$2,067.20 ",$534.02 ,$366.84 ,$326.08 ,"$2,771.52 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$534.02 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ",$152.48 ,"$2,720.00 ","$2,771.52 ",$152.48 ,"$2,560.00 ","$2,336.00 ",$534.02 ,"$2,771.52 ","$1,344.00 ","$3,200.00 ","$2,720.00 ","$6,235.91 ","$2,944.00 ","$2,240.00 ","$3,200.00 ","$3,200.00 ","$1,948.80 ","$3,200.00 ","$2,211.20 ","$2,240.00 ","$2,799.24 ","$2,304.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,32000412,75891,HC VENOGRAM HEPATIC W/O HEMO,320,1 ,"$3,100.00 ","$1,550.00 ",$154.53 ,"$6,235.91 ","$2,002.60 ",$534.02 ,$373.05 ,$331.60 ,"$2,771.52 ","$1,860.00 ","$2,635.00 ","$2,170.00 ",$534.02 ,"$2,945.00 ","$2,232.00 ","$2,263.00 ",$154.53 ,"$2,635.00 ","$2,771.52 ",$154.53 ,"$2,480.00 ","$2,263.00 ",$534.02 ,"$2,771.52 ","$1,302.00 ","$3,100.00 ","$2,635.00 ","$6,235.91 ","$2,852.00 ","$2,170.00 ","$3,100.00 ","$3,100.00 ","$1,887.90 ","$3,100.00 ","$2,142.10 ","$2,170.00 ","$2,799.24 ","$2,232.00 ",$566.06 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ","$2,232.00 ","$1,922.00 ","$2,232.00 ","$2,232.00 ","$1,860.00 " ST VINCENT HOSPITAL - ACUTE,32000413,75893,HC VENOGRAM SAMPLING CATH,320,1 ,"$4,200.00 ","$2,100.00 ",$167.32 ,"$10,395.23 ","$2,713.20 ","$1,067.27 ",$394.78 ,$350.91 ,"$4,620.10 ","$2,520.00 ","$3,570.00 ","$2,940.00 ","$1,067.27 ","$3,990.00 ","$3,024.00 ","$3,066.00 ",$167.32 ,"$3,570.00 ","$4,620.10 ",$167.32 ,"$3,360.00 ","$3,066.00 ","$1,067.27 ","$4,620.10 ","$1,764.00 ","$4,200.00 ","$3,570.00 ","$10,395.23 ","$3,864.00 ","$2,940.00 ","$4,200.00 ","$4,200.00 ","$2,557.80 ","$4,200.00 ","$2,902.20 ","$2,940.00 ","$4,666.30 ","$3,024.00 ","$1,131.31 ",$415.00 ,$415.00 ,"$4,620.10 ",$415.00 ,"$4,620.10 ","$3,024.00 ","$2,604.00 ","$3,024.00 ","$3,024.00 ","$2,520.00 " ST VINCENT HOSPITAL - ACUTE,32000414,75894,HC TRANSCATH EMBOLIZATION 75894,320,1 ,"$4,200.00 ","$2,100.00 ",$53.35 ,"$4,200.00 ","$2,713.20 ",$53.35 ,"$4,112.36 ","$3,655.43 ", N/A ,"$2,520.00 ","$3,570.00 ","$2,940.00 ",$53.35 ,"$3,990.00 ","$3,024.00 ","$3,066.00 ","$1,997.46 ","$3,570.00 ", N/A ,"$1,997.46 ","$3,360.00 ","$3,066.00 ",$53.35 , N/A ,"$1,764.00 ","$4,200.00 ","$3,570.00 ", N/A ,"$3,864.00 ","$2,940.00 ","$2,100.00 ","$2,520.00 ","$2,557.80 ","$2,100.00 ","$2,902.20 ","$2,940.00 ", N/A ,"$3,024.00 ",$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$3,024.00 ","$2,604.00 ","$3,024.00 ","$3,024.00 ","$2,520.00 " ST VINCENT HOSPITAL - ACUTE,32000417,75898,HC TRANSCATH ANGIO EXIST 75898,320,1 ,"$1,000.00 ",$500.00 ,$86.98 ,"$6,235.91 ",$646.00 ,$265.78 ,$646.90 ,$646.90 ,"$2,771.52 ",$600.00 ,$850.00 ,$700.00 ,$265.78 ,$950.00 ,$720.00 ,$730.00 ,$86.98 ,$850.00 ,"$2,771.52 ",$86.98 ,$800.00 ,$730.00 ,$265.78 ,"$2,771.52 ",$420.00 ,"$1,000.00 ",$850.00 ,"$6,235.91 ",$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,"$2,799.24 ",$720.00 ,$281.73 ,$415.00 ,$415.00 ,"$2,771.52 ",$415.00 ,"$2,771.52 ",$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,32000421,75901,HC REMOVE PERICATH OBST CV CATH,320,1 ,$720.00 ,$360.00 ,$53.35 ,$720.00 ,$465.12 ,$53.35 ,$720.00 ,$682.01 , N/A ,$432.00 ,$612.00 ,$504.00 ,$53.35 ,$684.00 ,$518.40 ,$525.60 ,$422.92 ,$612.00 , N/A ,$422.92 ,$576.00 ,$525.60 ,$53.35 , N/A ,$302.40 ,$720.00 ,$612.00 , N/A ,$662.40 ,$504.00 ,$360.00 ,$432.00 ,$438.48 ,$360.00 ,$497.52 ,$504.00 , N/A ,$518.40 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,32000422,75902,HC REMOVE INTRALUMN OBST CV CATH,320,1 ,$600.00 ,$300.00 ,$53.35 ,$600.00 ,$387.60 ,$53.35 ,$259.75 ,$230.89 , N/A ,$360.00 ,$510.00 ,$420.00 ,$53.35 ,$570.00 ,$432.00 ,$438.00 ,$144.40 ,$510.00 , N/A ,$144.40 ,$480.00 ,$438.00 ,$53.35 , N/A ,$252.00 ,$600.00 ,$510.00 , N/A ,$552.00 ,$420.00 ,$300.00 ,$360.00 ,$365.40 ,$300.00 ,$414.60 ,$420.00 , N/A ,$432.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,32000423,37191,HC IVC FILTER PLACEMENT 37191,320,1 ,"$8,300.00 ","$4,150.00 ",$415.00 ,"$10,395.23 ","$5,361.80 ","$1,095.68 ","$5,369.27 ","$5,369.27 ","$4,620.10 ","$4,980.00 ","$7,055.00 ","$5,810.00 ","$1,095.68 ","$7,885.00 ","$5,976.00 ","$6,059.00 ",$424.92 ,"$7,055.00 ","$4,620.10 ",$424.92 ,"$6,640.00 ","$6,059.00 ","$1,095.68 ","$4,620.10 ","$3,486.00 ","$8,300.00 ","$7,055.00 ","$10,395.23 ","$7,636.00 ","$5,810.00 ","$5,818.90 ","$7,821.36 ","$5,054.70 ","$7,273.62 ","$5,735.30 ","$5,810.00 ","$4,666.30 ","$5,976.00 ","$1,161.42 ",$415.00 ,$415.00 ,"$4,620.10 ",$415.00 ,"$4,620.10 ","$5,976.00 ","$5,146.00 ","$5,976.00 ","$5,976.00 ","$4,980.00 " ST VINCENT HOSPITAL - ACUTE,32000435,75970,HC TRANSCATH BX,320,1 ,"$2,500.00 ","$1,250.00 ",$53.35 ,"$2,500.00 ","$1,615.00 ",$53.35 ,"$1,717.57 ","$1,526.73 ", N/A ,"$1,500.00 ","$2,125.00 ","$1,750.00 ",$53.35 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ",$954.50 ,"$2,125.00 ", N/A ,$954.50 ,"$2,000.00 ","$1,825.00 ",$53.35 , N/A ,"$1,050.00 ","$2,500.00 ","$2,125.00 ", N/A ,"$2,300.00 ","$1,750.00 ","$1,250.00 ","$1,500.00 ","$1,522.50 ","$1,250.00 ","$1,727.50 ","$1,750.00 ", N/A ,"$1,800.00 ",$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,32000436,75970,HC TRANSCATH BX TRNJUG LIVER,320,1 ,"$2,500.00 ","$1,250.00 ",$53.35 ,"$2,500.00 ","$1,615.00 ",$53.35 ,"$1,717.57 ","$1,526.73 ", N/A ,"$1,500.00 ","$2,125.00 ","$1,750.00 ",$53.35 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ",$954.50 ,"$2,125.00 ", N/A ,$954.50 ,"$2,000.00 ","$1,825.00 ",$53.35 , N/A ,"$1,050.00 ","$2,500.00 ","$2,125.00 ", N/A ,"$2,300.00 ","$1,750.00 ","$1,250.00 ","$1,500.00 ","$1,522.50 ","$1,250.00 ","$1,727.50 ","$1,750.00 ", N/A ,"$1,800.00 ",$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,32000438,47533,HC TRANSHEPATIC DRAINAGE,320,1 ,"$6,100.00 ","$3,050.00 ",$415.00 ,"$6,937.05 ","$3,940.60 ",$703.19 ,"$3,946.09 ","$3,946.09 ","$3,083.13 ","$3,660.00 ","$5,185.00 ","$4,270.00 ",$703.19 ,"$5,795.00 ","$4,392.00 ","$4,453.00 ",$515.62 ,"$5,185.00 ","$3,083.13 ",$515.62 ,"$4,880.00 ","$4,453.00 ",$703.19 ,"$3,083.13 ","$2,562.00 ","$6,100.00 ","$5,185.00 ","$6,937.05 ","$5,612.00 ","$4,270.00 ","$2,066.93 ","$2,778.48 ","$3,714.90 ","$2,583.66 ","$4,215.10 ","$4,270.00 ","$3,113.96 ","$4,392.00 ",$745.38 ,$415.00 ,$415.00 ,"$3,083.13 ",$415.00 ,"$3,083.13 ","$4,392.00 ","$3,782.00 ","$4,392.00 ","$4,392.00 ","$3,660.00 " ST VINCENT HOSPITAL - ACUTE,32000439,47534,HC PLACE BILIARY DRAINAGE CATH,320,1 ,"$6,400.00 ","$3,200.00 ",$415.00 ,"$7,821.36 ","$4,134.40 ",$703.19 ,"$4,140.16 ","$4,140.16 ","$3,083.13 ","$3,840.00 ","$5,440.00 ","$4,480.00 ",$703.19 ,"$6,080.00 ","$4,608.00 ","$4,672.00 ",$720.45 ,"$5,440.00 ","$3,083.13 ",$720.45 ,"$5,120.00 ","$4,672.00 ",$703.19 ,"$3,083.13 ","$2,688.00 ","$6,400.00 ","$5,440.00 ","$6,937.05 ","$5,888.00 ","$4,480.00 ","$5,818.90 ","$7,821.36 ","$3,897.60 ","$7,273.62 ","$4,422.40 ","$4,480.00 ","$3,113.96 ","$4,608.00 ",$745.38 ,$415.00 ,$415.00 ,"$3,083.13 ",$415.00 ,"$3,083.13 ","$4,608.00 ","$3,968.00 ","$4,608.00 ","$4,608.00 ","$3,840.00 " ST VINCENT HOSPITAL - ACUTE,32000440,75984,HC CHANGE PERC DRAINAGE TUBE OR CATH,320,1 ,$780.00 ,$390.00 ,$53.35 ,$780.00 ,$503.88 ,$53.35 ,$293.90 ,$261.24 , N/A ,$468.00 ,$663.00 ,$546.00 ,$53.35 ,$741.00 ,$561.60 ,$569.40 ,$130.26 ,$663.00 , N/A ,$130.26 ,$624.00 ,$569.40 ,$53.35 , N/A ,$327.60 ,$780.00 ,$663.00 , N/A ,$717.60 ,$546.00 ,$390.00 ,$468.00 ,$475.02 ,$390.00 ,$538.98 ,$546.00 , N/A ,$561.60 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$561.60 ,$483.60 ,$561.60 ,$561.60 ,$468.00 ST VINCENT HOSPITAL - ACUTE,32000440,75984,HC CHANGE PERC DRAINAGE TUBE OR CATH,320,1 ,"$1,300.00 ",$650.00 ,$53.35 ,"$1,300.00 ",$839.80 ,$53.35 ,$293.90 ,$261.24 , N/A ,$780.00 ,"$1,105.00 ",$910.00 ,$53.35 ,"$1,235.00 ",$936.00 ,$949.00 ,$130.26 ,"$1,105.00 ", N/A ,$130.26 ,"$1,040.00 ",$949.00 ,$53.35 , N/A ,$546.00 ,"$1,300.00 ","$1,105.00 ", N/A ,"$1,196.00 ",$910.00 ,$650.00 ,$780.00 ,$791.70 ,$650.00 ,$898.30 ,$910.00 , N/A ,$936.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000444,49406,HC PERC DRN ABSC/HEM/CYST PERIT/RETROPER,320,1 ,"$1,300.00 ",$650.00 ,$202.63 ,"$3,066.03 ",$839.80 ,$202.63 ,$840.97 ,$840.97 ,"$1,362.68 ",$780.00 ,"$1,105.00 ",$910.00 ,$202.63 ,"$1,235.00 ",$936.00 ,$949.00 ,$382.26 ,"$1,105.00 ","$1,362.68 ",$382.26 ,"$1,040.00 ",$949.00 ,$202.63 ,"$1,362.68 ",$546.00 ,"$1,300.00 ","$1,105.00 ","$3,066.03 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,"$1,376.31 ",$936.00 ,$214.79 ,$415.00 ,$415.00 ,"$1,362.68 ",$415.00 ,"$1,362.68 ",$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000445,75989,HC GUID FOR PERC DRAIN ABSCESS,320,1 ,"$1,300.00 ",$650.00 ,$53.35 ,"$1,300.00 ",$839.80 ,$53.35 ,$273.72 ,$243.31 , N/A ,$780.00 ,"$1,105.00 ",$910.00 ,$53.35 ,"$1,235.00 ",$936.00 ,$949.00 ,$124.21 ,"$1,105.00 ", N/A ,$124.21 ,"$1,040.00 ",$949.00 ,$53.35 , N/A ,$546.00 ,"$1,300.00 ","$1,105.00 ", N/A ,"$1,196.00 ",$910.00 ,$650.00 ,$780.00 ,$791.70 ,$650.00 ,$898.30 ,$910.00 , N/A ,$936.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000446,75989,HC GUID FOR PERC CHEST TUBE INSERTION,320,1 ,"$1,300.00 ",$650.00 ,$53.35 ,"$1,300.00 ",$839.80 ,$53.35 ,$273.72 ,$243.31 , N/A ,$780.00 ,"$1,105.00 ",$910.00 ,$53.35 ,"$1,235.00 ",$936.00 ,$949.00 ,$124.21 ,"$1,105.00 ", N/A ,$124.21 ,"$1,040.00 ",$949.00 ,$53.35 , N/A ,$546.00 ,"$1,300.00 ","$1,105.00 ", N/A ,"$1,196.00 ",$910.00 ,$650.00 ,$780.00 ,$791.70 ,$650.00 ,$898.30 ,$910.00 , N/A ,$936.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000447,76000,HC FLUOROSCOPY UP TO 1 HR 76000,320,1 ,$500.00 ,$250.00 ,$37.66 ,$501.48 ,$323.00 ,$37.66 ,$137.14 ,$121.90 ,$222.88 ,$300.00 ,$425.00 ,$350.00 ,$37.66 ,$475.00 ,$360.00 ,$365.00 ,$53.44 ,$425.00 ,$222.88 ,$53.44 ,$400.00 ,$365.00 ,$37.66 ,$222.88 ,$210.00 ,$500.00 ,$425.00 ,$501.48 ,$460.00 ,$350.00 ,$500.00 ,$500.00 ,$304.50 ,$500.00 ,$345.50 ,$350.00 ,$225.11 ,$360.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,32000449,76000,HC FLUOROSCOPY UP TO 1 HR GASTRIC,320,1 ,$500.00 ,$250.00 ,$37.66 ,$501.48 ,$323.00 ,$37.66 ,$137.14 ,$121.90 ,$222.88 ,$300.00 ,$425.00 ,$350.00 ,$37.66 ,$475.00 ,$360.00 ,$365.00 ,$53.44 ,$425.00 ,$222.88 ,$53.44 ,$400.00 ,$365.00 ,$37.66 ,$222.88 ,$210.00 ,$500.00 ,$425.00 ,$501.48 ,$460.00 ,$350.00 ,$500.00 ,$500.00 ,$304.50 ,$500.00 ,$345.50 ,$350.00 ,$225.11 ,$360.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,32000450,76000,HC FLUORO CARM < 1 HR,320,1 ,$500.00 ,$250.00 ,$37.66 ,$501.48 ,$323.00 ,$37.66 ,$137.14 ,$121.90 ,$222.88 ,$300.00 ,$425.00 ,$350.00 ,$37.66 ,$475.00 ,$360.00 ,$365.00 ,$53.44 ,$425.00 ,$222.88 ,$53.44 ,$400.00 ,$365.00 ,$37.66 ,$222.88 ,$210.00 ,$500.00 ,$425.00 ,$501.48 ,$460.00 ,$350.00 ,$500.00 ,$500.00 ,$304.50 ,$500.00 ,$345.50 ,$350.00 ,$225.11 ,$360.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,32000452,N/A,HC FLUORO OARM/CARM <1 HR OR,360,1 ,$940.00 ,$470.00 ,$470.00 ,$940.00 ,$607.24 , N/A , N/A , N/A , N/A ,$564.00 ,$799.00 ,$658.00 , N/A ,$893.00 ,$676.80 ,$686.20 , N/A ,$799.00 , N/A , N/A ,$752.00 ,$686.20 , N/A , N/A , N/A ,$940.00 ,$799.00 , N/A ,$864.80 ,$658.00 ,$470.00 ,$564.00 ,$572.46 ,$470.00 ,$649.54 ,$658.00 , N/A ,$676.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$676.80 ,$582.80 ,$676.80 ,$676.80 ,$564.00 ST VINCENT HOSPITAL - ACUTE,32000453,N/A,HC FLUOROSCOPY UP TO 1 HR SEED OR,360,1 ,$940.00 ,$470.00 ,$470.00 ,$940.00 ,$607.24 , N/A , N/A , N/A , N/A ,$564.00 ,$799.00 ,$658.00 , N/A ,$893.00 ,$676.80 ,$686.20 , N/A ,$799.00 , N/A , N/A ,$752.00 ,$686.20 , N/A , N/A , N/A ,$940.00 ,$799.00 , N/A ,$864.80 ,$658.00 ,$470.00 ,$564.00 ,$572.46 ,$470.00 ,$649.54 ,$658.00 , N/A ,$676.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$676.80 ,$582.80 ,$676.80 ,$676.80 ,$564.00 ST VINCENT HOSPITAL - ACUTE,32000455,N/A,HC FLUORO MINI CARM < 1 HR OR,360,1 ,$940.00 ,$470.00 ,$470.00 ,$940.00 ,$607.24 , N/A , N/A , N/A , N/A ,$564.00 ,$799.00 ,$658.00 , N/A ,$893.00 ,$676.80 ,$686.20 , N/A ,$799.00 , N/A , N/A ,$752.00 ,$686.20 , N/A , N/A , N/A ,$940.00 ,$799.00 , N/A ,$864.80 ,$658.00 ,$470.00 ,$564.00 ,$572.46 ,$470.00 ,$649.54 ,$658.00 , N/A ,$676.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$676.80 ,$582.80 ,$676.80 ,$676.80 ,$564.00 ST VINCENT HOSPITAL - ACUTE,32000456,N/A,HC CARM FLUORO > 1 HR OR,360,1 ,"$1,000.00 ",$500.00 ,$500.00 ,"$1,000.00 ",$646.00 , N/A , N/A , N/A , N/A ,$600.00 ,$850.00 ,$700.00 , N/A ,$950.00 ,$720.00 ,$730.00 , N/A ,$850.00 , N/A , N/A ,$800.00 ,$730.00 , N/A , N/A , N/A ,"$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,32000462,N/A,HC FLUORO IN CYSTO ROOM > 1 HR OR,360,1 ,"$1,000.00 ",$500.00 ,$500.00 ,"$1,000.00 ",$646.00 , N/A , N/A , N/A , N/A ,$600.00 ,$850.00 ,$700.00 , N/A ,$950.00 ,$720.00 ,$730.00 , N/A ,$850.00 , N/A , N/A ,$800.00 ,$730.00 , N/A , N/A , N/A ,"$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,32000464,76010,HC BABYGRAM,320,1 ,$300.00 ,$150.00 ,$17.72 ,$300.00 ,$193.80 ,$17.72 ,$78.16 ,$69.48 ,$78.35 ,$180.00 ,$255.00 ,$210.00 ,$17.72 ,$285.00 ,$216.00 ,$219.00 ,$40.65 ,$255.00 ,$78.35 ,$40.65 ,$240.00 ,$219.00 ,$17.72 ,$78.35 ,$126.00 ,$300.00 ,$255.00 ,$176.29 ,$276.00 ,$210.00 ,$193.07 ,$207.92 ,$182.70 ,$193.07 ,$207.30 ,$210.00 ,$79.13 ,$216.00 ,$18.78 ,$300.00 ,$300.00 ,$78.35 ,$300.00 ,$78.35 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,32000465,76080,HC ABSCESS FISTULA OR SINUS TRACT,320,1 ,$650.00 ,$325.00 ,$37.66 ,"$1,052.28 ",$419.90 ,$37.66 ,$134.04 ,$119.14 ,$467.68 ,$390.00 ,$552.50 ,$455.00 ,$37.66 ,$617.50 ,$468.00 ,$474.50 ,$68.94 ,$552.50 ,$467.68 ,$68.94 ,$520.00 ,$474.50 ,$37.66 ,$467.68 ,$273.00 ,$650.00 ,$552.50 ,"$1,052.28 ",$598.00 ,$455.00 ,$650.00 ,$650.00 ,$395.85 ,$650.00 ,$449.15 ,$455.00 ,$472.36 ,$468.00 ,$39.92 ,$415.00 ,$415.00 ,$467.68 ,$415.00 ,$467.68 ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,32000466,76080,HC ABSCESS FISTULA DRAINAGE CATH CHECK,320,1 ,$650.00 ,$325.00 ,$37.66 ,"$1,052.28 ",$419.90 ,$37.66 ,$134.04 ,$119.14 ,$467.68 ,$390.00 ,$552.50 ,$455.00 ,$37.66 ,$617.50 ,$468.00 ,$474.50 ,$68.94 ,$552.50 ,$467.68 ,$68.94 ,$520.00 ,$474.50 ,$37.66 ,$467.68 ,$273.00 ,$650.00 ,$552.50 ,"$1,052.28 ",$598.00 ,$455.00 ,$650.00 ,$650.00 ,$395.85 ,$650.00 ,$449.15 ,$455.00 ,$472.36 ,$468.00 ,$39.92 ,$415.00 ,$415.00 ,$467.68 ,$415.00 ,$467.68 ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,32000467,76098,HC RADIOLOGICAL EXAM SURG SPEC,320,1 ,$400.00 ,$200.00 ,$32.23 ,"$1,052.28 ",$258.40 ,$37.66 ,$36.26 ,$32.23 ,$467.68 ,$240.00 ,$340.00 ,$280.00 ,$37.66 ,$380.00 ,$288.00 ,$292.00 ,$52.09 ,$340.00 ,$467.68 ,$52.09 ,$320.00 ,$292.00 ,$37.66 ,$467.68 ,$168.00 ,$400.00 ,$340.00 ,"$1,052.28 ",$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 ,$472.36 ,$288.00 ,$39.92 ,$400.00 ,$400.00 ,$467.68 ,$400.00 ,$467.68 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,32000472,76101,HC RADIOLOGICAL EXAM COMPLEX UNI,320,1 ,$800.00 ,$400.00 ,$17.72 ,$800.00 ,$516.80 ,$17.72 ,$286.14 ,$254.34 ,$105.54 ,$480.00 ,$680.00 ,$560.00 ,$17.72 ,$760.00 ,$576.00 ,$584.00 ,$149.34 ,$680.00 ,$105.54 ,$149.34 ,$640.00 ,$584.00 ,$17.72 ,$105.54 ,$336.00 ,$800.00 ,$680.00 ,$237.46 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$106.60 ,$576.00 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000473,76496,HC UNLSTD FLUORO PROCEDURE,320,1 ,$680.00 ,$340.00 ,$17.72 ,$680.00 ,$439.28 ,$17.72 ,$275.73 ,$245.10 ,$78.35 ,$408.00 ,$578.00 ,$476.00 ,$17.72 ,$646.00 ,$489.60 ,$496.40 , N/A ,$578.00 ,$78.35 , N/A ,$544.00 ,$496.40 ,$17.72 ,$78.35 ,$285.60 ,$680.00 ,$578.00 ,$176.29 ,$625.60 ,$476.00 ,$527.44 ,$568.01 ,$414.12 ,$527.44 ,$469.88 ,$476.00 ,$79.13 ,$489.60 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,32000474,76499,HC SUPER D PLANNING RECON AND MAPPING,320,1 ,$250.00 ,$125.00 ,$17.72 ,$250.00 ,$161.50 ,$17.72 ,$161.73 ,$161.73 ,$78.35 ,$150.00 ,$212.50 ,$175.00 ,$17.72 ,$237.50 ,$180.00 ,$182.50 , N/A ,$212.50 ,$78.35 , N/A ,$200.00 ,$182.50 ,$17.72 ,$78.35 ,$105.00 ,$250.00 ,$212.50 ,$176.29 ,$230.00 ,$175.00 ,$193.07 ,$207.92 ,$152.25 ,$193.07 ,$172.75 ,$175.00 ,$79.13 ,$180.00 ,$18.78 ,$250.00 ,$250.00 ,$78.35 ,$250.00 ,$78.35 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,32000475,77001,HC FLUORO CV ACCESS PLACEMENT,320,1 ,$450.00 ,$225.00 ,$53.35 ,$450.00 ,$290.70 ,$53.35 ,$312.52 ,$277.80 , N/A ,$270.00 ,$382.50 ,$315.00 ,$53.35 ,$427.50 ,$324.00 ,$328.50 ,$165.97 ,$382.50 , N/A ,$165.97 ,$360.00 ,$328.50 ,$53.35 , N/A ,$189.00 ,$450.00 ,$382.50 , N/A ,$414.00 ,$315.00 ,$225.00 ,$270.00 ,$274.05 ,$225.00 ,$310.95 ,$315.00 , N/A ,$324.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,32000476,77002,HC FLUORO NEEDLE PLACEMENT,320,1 ,$500.00 ,$250.00 ,$53.35 ,$500.00 ,$323.00 ,$53.35 ,$320.28 ,$284.69 , N/A ,$300.00 ,$425.00 ,$350.00 ,$53.35 ,$475.00 ,$360.00 ,$365.00 ,$175.40 ,$425.00 , N/A ,$175.40 ,$400.00 ,$365.00 ,$53.35 , N/A ,$210.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,32000477,77002,HC FLUORO NEEDLE PLACEMENT BX ASP IN,320,1 ,$500.00 ,$250.00 ,$53.35 ,$500.00 ,$323.00 ,$53.35 ,$320.28 ,$284.69 , N/A ,$300.00 ,$425.00 ,$350.00 ,$53.35 ,$475.00 ,$360.00 ,$365.00 ,$175.40 ,$425.00 , N/A ,$175.40 ,$400.00 ,$365.00 ,$53.35 , N/A ,$210.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,32000478,77002,HC FLUORO NEEDLE PLACEMENT LOCAL,320,1 ,$500.00 ,$250.00 ,$53.35 ,$500.00 ,$323.00 ,$53.35 ,$320.28 ,$284.69 , N/A ,$300.00 ,$425.00 ,$350.00 ,$53.35 ,$475.00 ,$360.00 ,$365.00 ,$175.40 ,$425.00 , N/A ,$175.40 ,$400.00 ,$365.00 ,$53.35 , N/A ,$210.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,32000479,77002,HC FLUORO NEEDLE PLACEMENT HIP,320,1 ,$500.00 ,$250.00 ,$53.35 ,$500.00 ,$323.00 ,$53.35 ,$320.28 ,$284.69 , N/A ,$300.00 ,$425.00 ,$350.00 ,$53.35 ,$475.00 ,$360.00 ,$365.00 ,$175.40 ,$425.00 , N/A ,$175.40 ,$400.00 ,$365.00 ,$53.35 , N/A ,$210.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,32000481,77003,HC FLUORO NEEDLE LOCALIZATION,320,1 ,$550.00 ,$275.00 ,$53.35 ,$550.00 ,$355.30 ,$53.35 ,$295.45 ,$262.62 , N/A ,$330.00 ,$467.50 ,$385.00 ,$53.35 ,$522.50 ,$396.00 ,$401.50 ,$149.14 ,$467.50 , N/A ,$149.14 ,$440.00 ,$401.50 ,$53.35 , N/A ,$231.00 ,$550.00 ,$467.50 , N/A ,$506.00 ,$385.00 ,$275.00 ,$330.00 ,$334.95 ,$275.00 ,$380.05 ,$385.00 , N/A ,$396.00 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,32000483,19283,HC MAMM STER GUIDE BRST NDL PL,320,1 ,"$1,300.00 ",$650.00 ,$195.82 ,"$1,355.35 ",$839.80 ,$205.01 ,$840.97 ,$840.97 ,$602.38 ,$780.00 ,"$1,105.00 ",$910.00 ,$205.01 ,"$1,235.00 ",$936.00 ,$949.00 ,$195.82 ,"$1,105.00 ",$602.38 ,$195.82 ,"$1,040.00 ",$949.00 ,$205.01 ,$602.38 ,$546.00 ,"$1,300.00 ","$1,105.00 ","$1,355.35 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,$608.40 ,$936.00 ,$217.31 ,$415.00 ,$415.00 ,$602.38 ,$415.00 ,$602.38 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000484,19081,HC MAMM STER GUIDE BRST DISCON STEREO,320,1 ,"$1,300.00 ",$650.00 ,$322.30 ,"$3,066.03 ",$839.80 ,$405.89 ,$840.97 ,$840.97 ,"$1,362.68 ",$780.00 ,"$1,105.00 ",$910.00 ,$405.89 ,"$1,235.00 ",$936.00 ,$949.00 ,$322.30 ,"$1,105.00 ","$1,362.68 ",$322.30 ,"$1,040.00 ",$949.00 ,$405.89 ,"$1,362.68 ",$546.00 ,"$1,300.00 ","$1,105.00 ","$3,066.03 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,"$1,376.31 ",$936.00 ,$430.24 ,$415.00 ,$415.00 ,"$1,362.68 ",$415.00 ,"$1,362.68 ",$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000485,19281,HC MAMMO GUIDE BRST DISCON NDL LOC,320,1 ,"$1,300.00 ",$650.00 ,$194.96 ,"$1,355.35 ",$839.80 ,$205.01 ,$840.97 ,$840.97 ,$602.38 ,$780.00 ,"$1,105.00 ",$910.00 ,$205.01 ,"$1,235.00 ",$936.00 ,$949.00 ,$194.96 ,"$1,105.00 ",$602.38 ,$194.96 ,"$1,040.00 ",$949.00 ,$205.01 ,$602.38 ,$546.00 ,"$1,300.00 ","$1,105.00 ","$1,355.35 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,$608.40 ,$936.00 ,$217.31 ,$415.00 ,$415.00 ,$602.38 ,$415.00 ,$602.38 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000486,19283,HC MAMM STER GUIDE BRST STEREO CORE,320,1 ,"$1,300.00 ",$650.00 ,$195.82 ,"$1,355.35 ",$839.80 ,$205.01 ,$840.97 ,$840.97 ,$602.38 ,$780.00 ,"$1,105.00 ",$910.00 ,$205.01 ,"$1,235.00 ",$936.00 ,$949.00 ,$195.82 ,"$1,105.00 ",$602.38 ,$195.82 ,"$1,040.00 ",$949.00 ,$205.01 ,$602.38 ,$546.00 ,"$1,300.00 ","$1,105.00 ","$1,355.35 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,$608.40 ,$936.00 ,$217.31 ,$415.00 ,$415.00 ,$602.38 ,$415.00 ,$602.38 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,32000487,19081,HC MAMM STER GUIDE BRST MAMMT STEREO CORE,320,1 ,"$3,000.00 ","$1,500.00 ",$322.30 ,"$3,066.03 ","$1,938.00 ",$405.89 ,"$1,940.70 ","$1,940.70 ","$1,362.68 ","$1,800.00 ","$2,550.00 ","$2,100.00 ",$405.89 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ",$322.30 ,"$2,550.00 ","$1,362.68 ",$322.30 ,"$2,400.00 ","$2,190.00 ",$405.89 ,"$1,362.68 ","$1,260.00 ","$3,000.00 ","$2,550.00 ","$3,066.03 ","$2,760.00 ","$2,100.00 ","$2,331.31 ","$3,000.00 ","$1,827.00 ","$2,914.14 ","$2,073.00 ","$2,100.00 ","$1,376.31 ","$2,160.00 ",$430.24 ,$415.00 ,$415.00 ,"$1,362.68 ",$415.00 ,"$1,362.68 ","$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,32000487,19081,HC MAMM STER GUIDE BRST MAMMT STEREO CORE,320,1 ,"$4,500.00 ","$2,250.00 ",$322.30 ,"$4,500.00 ","$2,907.00 ",$405.89 ,"$2,911.05 ","$2,911.05 ","$1,362.68 ","$2,700.00 ","$3,825.00 ","$3,150.00 ",$405.89 ,"$4,275.00 ","$3,240.00 ","$3,285.00 ",$322.30 ,"$3,825.00 ","$1,362.68 ",$322.30 ,"$3,600.00 ","$3,285.00 ",$405.89 ,"$1,362.68 ","$1,890.00 ","$4,500.00 ","$3,825.00 ","$3,066.03 ","$4,140.00 ","$3,150.00 ","$2,331.31 ","$3,133.44 ","$2,740.50 ","$2,914.14 ","$3,109.50 ","$3,150.00 ","$1,376.31 ","$3,240.00 ",$430.24 ,$415.00 ,$415.00 ,"$1,362.68 ",$415.00 ,"$1,362.68 ","$3,240.00 ","$2,790.00 ","$3,240.00 ","$3,240.00 ","$2,700.00 " ST VINCENT HOSPITAL - ACUTE,32000488,19284,HC MAMM STER GUIDE BRST MAMMT STEREO CORE ADDN,361,1 ,$115.00 ,$57.50 ,$57.50 ,"$3,133.44 ",$74.29 ,$115.00 ,$115.00 ,$115.00 , N/A ,$69.00 ,$97.75 ,$80.50 ,$205.01 ,$109.25 ,$82.80 ,$83.95 ,$115.00 ,$97.75 , N/A ,$115.00 ,$92.00 ,$83.95 ,$205.01 , N/A ,$115.00 ,$115.00 ,$97.75 , N/A ,$105.80 ,$80.50 ,"$2,331.72 ","$3,133.44 ",$70.04 ,"$2,914.14 ",$79.47 ,$80.50 , N/A ,$82.80 ,$217.31 ,$115.00 ,$115.00 , N/A ,$115.00 , N/A ,$82.80 ,$71.30 ,$82.80 ,$82.80 ,$69.00 ST VINCENT HOSPITAL - ACUTE,32000489,19281,HC MAMM GUIDE NDL PLACEMENT,320,1 ,$740.00 ,$370.00 ,$194.96 ,"$1,355.35 ",$478.04 ,$205.01 ,$478.71 ,$478.71 ,$602.38 ,$444.00 ,$629.00 ,$518.00 ,$205.01 ,$703.00 ,$532.80 ,$540.20 ,$194.96 ,$629.00 ,$602.38 ,$194.96 ,$592.00 ,$540.20 ,$205.01 ,$602.38 ,$310.80 ,$740.00 ,$629.00 ,"$1,355.35 ",$680.80 ,$518.00 ,$740.00 ,$740.00 ,$450.66 ,$740.00 ,$511.34 ,$518.00 ,$608.40 ,$532.80 ,$217.31 ,$415.00 ,$415.00 ,$602.38 ,$415.00 ,$602.38 ,$532.80 ,$458.80 ,$532.80 ,$532.80 ,$444.00 ST VINCENT HOSPITAL - ACUTE,32000490,77053,HC GALACTOGRAM SINGLE DUCT,320,1 ,$800.00 ,$400.00 ,$37.66 ,$800.00 ,$516.80 ,$37.66 ,$171.29 ,$152.25 ,$222.88 ,$480.00 ,$680.00 ,$560.00 ,$37.66 ,$760.00 ,$576.00 ,$584.00 ,$74.33 ,$680.00 ,$222.88 ,$74.33 ,$640.00 ,$584.00 ,$37.66 ,$222.88 ,$336.00 ,$800.00 ,$680.00 ,$501.48 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$225.11 ,$576.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000491,77054,HC GALACTOGRAM MULTI DUCT,320,1 ,$800.00 ,$400.00 ,$37.66 ,$800.00 ,$516.80 ,$37.66 ,$227.16 ,$201.92 ,$222.88 ,$480.00 ,$680.00 ,$560.00 ,$37.66 ,$760.00 ,$576.00 ,$584.00 ,$98.58 ,$680.00 ,$222.88 ,$98.58 ,$640.00 ,$584.00 ,$37.66 ,$222.88 ,$336.00 ,$800.00 ,$680.00 ,$501.48 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$225.11 ,$576.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000492,77073,HC BONE LENGTH STUDIES,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$99.89 ,$88.79 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$62.22 ,$348.50 ,$105.54 ,$62.22 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$193.07 ,$207.92 ,$249.69 ,$193.07 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000493,77074,HC BONE SURVEY LIMITED,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$194.57 ,$172.95 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$85.79 ,$348.50 ,$105.54 ,$85.79 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$305.98 ,$329.52 ,$249.69 ,$305.98 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000494,77075,HC BONE SURVEY COMPLETE,320,1 ,$540.00 ,$270.00 ,$37.66 ,$540.00 ,$348.84 ,$37.66 ,$283.03 ,$251.58 ,$105.54 ,$324.00 ,$459.00 ,$378.00 ,$37.66 ,$513.00 ,$388.80 ,$394.20 ,$141.04 ,$459.00 ,$105.54 ,$141.04 ,$432.00 ,$394.20 ,$37.66 ,$105.54 ,$226.80 ,$540.00 ,$459.00 ,$237.46 ,$496.80 ,$378.00 ,$305.98 ,$329.52 ,$328.86 ,$305.98 ,$373.14 ,$378.00 ,$106.60 ,$388.80 ,$39.92 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,32000495,77076,HC OSSEOUS SURVEY INFANT,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$286.14 ,$254.34 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$142.37 ,$348.50 ,$105.54 ,$142.37 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$305.98 ,$329.52 ,$249.69 ,$305.98 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000496,77080,HC BONE DENSITY DXA,320,1 ,$620.00 ,$310.00 ,$28.36 ,$620.00 ,$400.52 ,$28.36 ,$130.93 ,$116.38 ,$105.54 ,$372.00 ,$527.00 ,$434.00 ,$28.36 ,$589.00 ,$446.40 ,$452.60 ,$55.47 ,$527.00 ,$105.54 ,$55.47 ,$496.00 ,$452.60 ,$28.36 ,$105.54 ,$260.40 ,$620.00 ,$527.00 ,$237.46 ,$570.40 ,$434.00 ,$303.54 ,$326.89 ,$377.58 ,$303.54 ,$428.42 ,$434.00 ,$106.60 ,$446.40 ,$30.06 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,32000497,77081,HC BONE DENSITY PERIPHERAL,320,1 ,$570.00 ,$285.00 ,$28.36 ,$570.00 ,$368.22 ,$28.36 ,$99.89 ,$88.79 ,$78.35 ,$342.00 ,$484.50 ,$399.00 ,$28.36 ,$541.50 ,$410.40 ,$416.10 ,$41.98 ,$484.50 ,$78.35 ,$41.98 ,$456.00 ,$416.10 ,$28.36 ,$78.35 ,$239.40 ,$570.00 ,$484.50 ,$176.29 ,$524.40 ,$399.00 ,$172.41 ,$185.67 ,$347.13 ,$172.41 ,$393.87 ,$399.00 ,$79.13 ,$410.40 ,$30.06 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$410.40 ,$353.40 ,$410.40 ,$410.40 ,$342.00 ST VINCENT HOSPITAL - ACUTE,32000499,0238T,HC TRNLUM PERIP ATHRC ILIAC ARTY 0238T,320,1 ,"$12,000.00 ","$6,000.00 ",$415.00 ,"$35,005.46 ","$7,752.00 ","$3,338.02 ","$7,762.80 ","$7,762.80 ","$15,557.98 ","$7,200.00 ","$10,200.00 ","$8,400.00 ","$3,338.02 ","$11,400.00 ","$8,640.00 ","$8,760.00 ","$12,000.00 ","$10,200.00 ","$15,557.98 ","$12,000.00 ","$9,600.00 ","$8,760.00 ","$3,338.02 ","$15,557.98 ","$5,040.00 ","$12,000.00 ","$10,200.00 ","$35,005.46 ","$11,040.00 ","$8,400.00 ","$2,066.93 ","$2,778.48 ","$7,308.00 ","$2,583.66 ","$8,292.00 ","$8,400.00 ","$15,713.56 ","$8,640.00 ","$3,538.30 ",$415.00 ,$415.00 ,"$15,557.98 ",$415.00 ,"$15,557.98 ","$8,640.00 ","$7,440.00 ","$8,640.00 ","$8,640.00 ","$7,200.00 " ST VINCENT HOSPITAL - ACUTE,32000500,76000,HC FLUOROSCOPY UP TO 1 HR SNIFF DIAPHRM,320,1 ,$500.00 ,$250.00 ,$37.66 ,$501.48 ,$323.00 ,$37.66 ,$137.14 ,$121.90 ,$222.88 ,$300.00 ,$425.00 ,$350.00 ,$37.66 ,$475.00 ,$360.00 ,$365.00 ,$53.44 ,$425.00 ,$222.88 ,$53.44 ,$400.00 ,$365.00 ,$37.66 ,$222.88 ,$210.00 ,$500.00 ,$425.00 ,$501.48 ,$460.00 ,$350.00 ,$500.00 ,$500.00 ,$304.50 ,$500.00 ,$345.50 ,$350.00 ,$225.11 ,$360.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,32000503,20501,HC INJ TRACT SINOGRAM DIAG,320,1 ,$420.00 ,$210.00 ,$73.14 ,$420.00 ,$271.32 ,$86.58 ,$271.70 ,$271.70 , N/A ,$252.00 ,$357.00 ,$294.00 ,$86.58 ,$399.00 ,$302.40 ,$306.60 ,$73.14 ,$357.00 , N/A ,$73.14 ,$336.00 ,$306.60 ,$86.58 , N/A ,$176.40 ,$420.00 ,$357.00 , N/A ,$386.40 ,$294.00 ,$420.00 ,$420.00 ,$255.78 ,$420.00 ,$290.22 ,$294.00 , N/A ,$302.40 ,$91.77 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,32000504,20550,HC INJ SINGLE TENDON/LIGAMENT,320,1 ,$120.00 ,$60.00 ,$50.40 ,$569.12 ,$77.52 ,$101.56 ,$77.63 ,$77.63 ,$252.94 ,$72.00 ,$102.00 ,$84.00 ,$101.56 ,$114.00 ,$86.40 ,$87.60 ,$75.77 ,$102.00 ,$252.94 ,$75.77 ,$96.00 ,$87.60 ,$101.56 ,$252.94 ,$50.40 ,$120.00 ,$102.00 ,$569.12 ,$110.40 ,$84.00 ,$120.00 ,$120.00 ,$73.08 ,$120.00 ,$82.92 ,$84.00 ,$255.47 ,$86.40 ,$107.65 ,$120.00 ,$120.00 ,$252.94 ,$120.00 ,$252.94 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,32000505,20552,HC INJ TRIGGER PT 1-2 MUSCLE(S),320,1 ,$360.00 ,$180.00 ,$73.37 ,$569.12 ,$232.56 ,$101.56 ,$232.88 ,$232.88 ,$252.94 ,$216.00 ,$306.00 ,$252.00 ,$101.56 ,$342.00 ,$259.20 ,$262.80 ,$73.37 ,$306.00 ,$252.94 ,$73.37 ,$288.00 ,$262.80 ,$101.56 ,$252.94 ,$151.20 ,$360.00 ,$306.00 ,$569.12 ,$331.20 ,$252.00 ,$360.00 ,$360.00 ,$219.24 ,$360.00 ,$248.76 ,$252.00 ,$255.47 ,$259.20 ,$107.65 ,$360.00 ,$360.00 ,$252.94 ,$360.00 ,$252.94 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,32000506,20553,HC INJ TRIGGER PT 3+ MUSC GROUP,320,1 ,$400.00 ,$200.00 ,$83.19 ,$569.12 ,$258.40 ,$101.56 ,$258.76 ,$258.76 ,$252.94 ,$240.00 ,$340.00 ,$280.00 ,$101.56 ,$380.00 ,$288.00 ,$292.00 ,$83.19 ,$340.00 ,$252.94 ,$83.19 ,$320.00 ,$292.00 ,$101.56 ,$252.94 ,$168.00 ,$400.00 ,$340.00 ,$569.12 ,$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 ,$255.47 ,$288.00 ,$107.65 ,$400.00 ,$400.00 ,$252.94 ,$400.00 ,$252.94 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,32000508,74775,HC VAGINOGRAM,320,1 ,$800.00 ,$400.00 ,$37.66 ,$800.00 ,$516.80 ,$37.66 ,$517.52 ,$517.52 ,$222.88 ,$480.00 ,$680.00 ,$560.00 ,$37.66 ,$760.00 ,$576.00 ,$584.00 ,$120.77 ,$680.00 ,$222.88 ,$120.77 ,$640.00 ,$584.00 ,$37.66 ,$222.88 ,$336.00 ,$800.00 ,$680.00 ,$501.48 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$225.11 ,$576.00 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,32000509,77072,HC BONE AGE STUDIES,320,1 ,$530.00 ,$265.00 ,$17.72 ,$530.00 ,$342.38 ,$17.72 ,$62.64 ,$55.68 ,$105.54 ,$318.00 ,$450.50 ,$371.00 ,$17.72 ,$503.50 ,$381.60 ,$386.90 ,$32.55 ,$450.50 ,$105.54 ,$32.55 ,$424.00 ,$386.90 ,$17.72 ,$105.54 ,$222.60 ,$530.00 ,$450.50 ,$237.46 ,$487.60 ,$371.00 ,$193.07 ,$207.92 ,$322.77 ,$193.07 ,$366.23 ,$371.00 ,$106.60 ,$381.60 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$381.60 ,$328.60 ,$381.60 ,$381.60 ,$318.00 ST VINCENT HOSPITAL - ACUTE,32000515,G0278,HC ILIAC ARTERY ANGIO W CATH G0278,320,1 ,$610.00 ,$305.00 ,$25.01 ,"$1,131.31 ",$394.06 ,$610.00 ,$394.61 ,$394.61 , N/A ,$366.00 ,$518.50 ,$427.00 ,"$1,067.27 ",$579.50 ,$439.20 ,$445.30 ,$25.01 ,$518.50 , N/A ,$25.01 ,$488.00 ,$445.30 ,"$1,067.27 ", N/A ,$256.20 ,$610.00 ,$518.50 , N/A ,$561.20 ,$427.00 ,$305.00 ,$366.00 ,$371.49 ,$305.00 ,$421.51 ,$427.00 , N/A ,$439.20 ,"$1,131.31 ",$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,32000523,72020,HC XR SPINE 1V (C SPINE CLEAR LAT),320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$65.75 ,$58.44 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$32.55 ,$280.50 ,$78.35 ,$32.55 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000525,N/A,HC CARM FLUORO <1 HR OR,360,1 ,$940.00 ,$470.00 ,$470.00 ,$940.00 ,$607.24 , N/A , N/A , N/A , N/A ,$564.00 ,$799.00 ,$658.00 , N/A ,$893.00 ,$676.80 ,$686.20 , N/A ,$799.00 , N/A , N/A ,$752.00 ,$686.20 , N/A , N/A , N/A ,$940.00 ,$799.00 , N/A ,$864.80 ,$658.00 ,$470.00 ,$564.00 ,$572.46 ,$470.00 ,$649.54 ,$658.00 , N/A ,$676.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$676.80 ,$582.80 ,$676.80 ,$676.80 ,$564.00 ST VINCENT HOSPITAL - ACUTE,32000528,47543,HC ENDO BILIARY PERC DX WITH SPECIMEN,320,1 ,"$3,000.00 ","$1,500.00 ",$280.07 ,"$3,000.00 ","$1,938.00 ",$703.19 ,"$1,940.70 ","$1,940.70 ", N/A ,"$1,800.00 ","$2,550.00 ","$2,100.00 ",$703.19 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ",$280.07 ,"$2,550.00 ", N/A ,$280.07 ,"$2,400.00 ","$2,190.00 ",$703.19 , N/A ,"$1,260.00 ","$3,000.00 ","$2,550.00 ", N/A ,"$2,760.00 ","$2,100.00 ","$2,331.31 ","$3,000.00 ","$1,827.00 ","$2,914.14 ","$2,073.00 ","$2,100.00 ", N/A ,"$2,160.00 ",$745.38 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,32000530,32554,HC THORACENTESIS W/O IMAGING 32554,320,1 ,"$1,100.00 ",$550.00 ,$174.64 ,"$1,180.26 ",$710.60 ,$258.10 ,$711.59 ,$711.59 ,$524.56 ,$660.00 ,$935.00 ,$770.00 ,$258.10 ,"$1,045.00 ",$792.00 ,$803.00 ,$174.64 ,$935.00 ,$524.56 ,$174.64 ,$880.00 ,$803.00 ,$258.10 ,$524.56 ,$462.00 ,"$1,100.00 ",$935.00 ,"$1,180.26 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$529.81 ,$792.00 ,$273.59 ,$415.00 ,$415.00 ,$524.56 ,$415.00 ,$524.56 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,32000531,32555,HC THORACENTESIS W IMAGING 32555,320,1 ,"$1,200.00 ",$600.00 ,$217.14 ,"$1,200.00 ",$775.20 ,$258.10 ,$776.28 ,$776.28 ,$524.56 ,$720.00 ,"$1,020.00 ",$840.00 ,$258.10 ,"$1,140.00 ",$864.00 ,$876.00 ,$217.14 ,"$1,020.00 ",$524.56 ,$217.14 ,$960.00 ,$876.00 ,$258.10 ,$524.56 ,$504.00 ,"$1,200.00 ","$1,020.00 ","$1,180.26 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,$529.81 ,$864.00 ,$273.59 ,$415.00 ,$415.00 ,$524.56 ,$415.00 ,$524.56 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,32000531,32555,HC THORACENTESIS W IMAGING 32555,320,1 ,"$1,800.00 ",$900.00 ,$217.14 ,"$1,800.00 ","$1,162.80 ",$258.10 ,"$1,164.42 ","$1,164.42 ",$524.56 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$258.10 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ",$217.14 ,"$1,530.00 ",$524.56 ,$217.14 ,"$1,440.00 ","$1,314.00 ",$258.10 ,$524.56 ,$756.00 ,"$1,800.00 ","$1,530.00 ","$1,180.26 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ",$529.81 ,"$1,296.00 ",$273.59 ,$415.00 ,$415.00 ,$524.56 ,$415.00 ,$524.56 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,32000532,32556,HC PLEURAL DRAINAGE W/O IMAGING 32556,450,1 ,"$1,100.00 ",$550.00 ,$258.10 ,"$3,541.12 ",$710.60 ,$258.10 ,$711.59 ,$711.59 ,"$1,573.83 ",$660.00 ,$935.00 ,$770.00 ,$258.10 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,"$1,573.83 ",$715.00 ,$880.00 ,$803.00 ,$258.10 ,"$1,573.83 ",$557.43 ,"$1,100.00 ",$935.00 ,"$3,541.12 ","$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,"$1,589.57 ",$792.00 ,$273.59 ,$669.00 ,$669.00 ,"$1,573.83 ",$669.00 ,"$1,573.83 ",$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,32000533,32557,HC PLEURAL DRAINAGE W/IMAGING 32557,320,1 ,"$1,800.00 ",$900.00 ,$258.10 ,"$3,064.15 ","$1,162.80 ",$258.10 ,"$1,164.42 ","$1,164.42 ","$1,361.85 ","$1,080.00 ","$1,530.00 ","$1,260.00 ",$258.10 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ",$294.71 ,"$1,530.00 ","$1,361.85 ",$294.71 ,"$1,440.00 ","$1,314.00 ",$258.10 ,"$1,361.85 ",$756.00 ,"$1,800.00 ","$1,530.00 ","$3,064.15 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ","$1,375.47 ","$1,296.00 ",$273.59 ,$415.00 ,$415.00 ,"$1,361.85 ",$415.00 ,"$1,361.85 ","$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,32000540,N/A,HC FLUORO OARM > 1 HR OR,360,1 ,"$1,000.00 ",$500.00 ,$500.00 ,"$1,000.00 ",$646.00 , N/A , N/A , N/A , N/A ,$600.00 ,$850.00 ,$700.00 , N/A ,$950.00 ,$720.00 ,$730.00 , N/A ,$850.00 , N/A , N/A ,$800.00 ,$730.00 , N/A , N/A , N/A ,"$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,32000542,20551,HC INJ TENDON ORIGIN,320,1 ,$400.00 ,$200.00 ,$76.44 ,$569.12 ,$258.40 ,$101.56 ,$258.76 ,$258.76 ,$252.94 ,$240.00 ,$340.00 ,$280.00 ,$101.56 ,$380.00 ,$288.00 ,$292.00 ,$76.44 ,$340.00 ,$252.94 ,$76.44 ,$320.00 ,$292.00 ,$101.56 ,$252.94 ,$168.00 ,$400.00 ,$340.00 ,$569.12 ,$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 ,$255.47 ,$288.00 ,$107.65 ,$400.00 ,$400.00 ,$252.94 ,$400.00 ,$252.94 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,32000548,51100,HC ASPIRATE BLADDER BY NEEDLE,320,1 ,$370.00 ,$185.00 ,$74.09 ,$579.95 ,$239.02 ,$125.13 ,$239.35 ,$239.35 ,$257.76 ,$222.00 ,$314.50 ,$259.00 ,$125.13 ,$351.50 ,$266.40 ,$270.10 ,$74.09 ,$314.50 ,$257.76 ,$74.09 ,$296.00 ,$270.10 ,$125.13 ,$257.76 ,$155.40 ,$370.00 ,$314.50 ,$579.95 ,$340.40 ,$259.00 ,$370.00 ,$370.00 ,$225.33 ,$370.00 ,$255.67 ,$259.00 ,$260.34 ,$266.40 ,$132.64 ,$370.00 ,$370.00 ,$257.76 ,$370.00 ,$257.76 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,32000560,49460,HC MECHAN REMOVAL OF OBSTRUCT MATERIAL FROM G/J/D TUBE FLUOR/CONT,320,1 ,"$1,100.00 ",$550.00 ,$94.59 ,"$1,764.22 ",$710.60 ,$199.12 ,$711.59 ,$711.59 ,$784.10 ,$660.00 ,$935.00 ,$770.00 ,$199.12 ,"$1,045.00 ",$792.00 ,$803.00 ,$94.59 ,$935.00 ,$784.10 ,$94.59 ,$880.00 ,$803.00 ,$199.12 ,$784.10 ,$462.00 ,"$1,100.00 ",$935.00 ,"$1,764.22 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$791.94 ,$792.00 ,$211.07 ,$415.00 ,$415.00 ,$784.10 ,$415.00 ,$784.10 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,32000561,49405,HC ABSCESS DRAIN KIDN/LIV/SPLN/LUNG VISERAL 49405,320,1 ,"$1,400.00 ",$700.00 ,$202.63 ,"$3,066.03 ",$904.40 ,$202.63 ,$905.66 ,$905.66 ,"$1,362.68 ",$840.00 ,"$1,190.00 ",$980.00 ,$202.63 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$382.26 ,"$1,190.00 ","$1,362.68 ",$382.26 ,"$1,120.00 ","$1,022.00 ",$202.63 ,"$1,362.68 ",$588.00 ,"$1,400.00 ","$1,190.00 ","$3,066.03 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,"$1,376.31 ","$1,008.00 ",$214.79 ,$415.00 ,$415.00 ,"$1,362.68 ",$415.00 ,"$1,362.68 ","$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,32000562,49406,HC ABSCESS DRAIN PERI/ RETROPER PERC 49406,320,1 ,"$1,400.00 ",$700.00 ,$202.63 ,"$3,066.03 ",$904.40 ,$202.63 ,$905.66 ,$905.66 ,"$1,362.68 ",$840.00 ,"$1,190.00 ",$980.00 ,$202.63 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$382.26 ,"$1,190.00 ","$1,362.68 ",$382.26 ,"$1,120.00 ","$1,022.00 ",$202.63 ,"$1,362.68 ",$588.00 ,"$1,400.00 ","$1,190.00 ","$3,066.03 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,"$1,376.31 ","$1,008.00 ",$214.79 ,$415.00 ,$415.00 ,"$1,362.68 ",$415.00 ,"$1,362.68 ","$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,32000563,49407,HC PERC DRN ABSC/HEM/CYST PERIT/RETROPER TV OR TR,320,1 ,"$1,400.00 ",$700.00 ,$202.63 ,"$3,066.03 ",$904.40 ,$202.63 ,$905.66 ,$905.66 ,"$1,362.68 ",$840.00 ,"$1,190.00 ",$980.00 ,$202.63 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$404.55 ,"$1,190.00 ","$1,362.68 ",$404.55 ,"$1,120.00 ","$1,022.00 ",$202.63 ,"$1,362.68 ",$588.00 ,"$1,400.00 ","$1,190.00 ","$3,066.03 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,"$1,376.31 ","$1,008.00 ",$214.79 ,$415.00 ,$415.00 ,"$1,362.68 ",$415.00 ,"$1,362.68 ","$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,32000564,0075T,HC STENT VERTEBRAL EXTRACRANIAL 0075T,320,1 ,"$7,700.00 ","$3,850.00 ",$415.00 ,"$7,821.36 ","$4,974.20 ","$1,802.28 ","$4,981.13 ","$4,981.13 ", N/A ,"$4,620.00 ","$6,545.00 ","$5,390.00 ","$1,802.28 ","$7,315.00 ","$5,544.00 ","$5,621.00 ","$2,589.23 ","$6,545.00 ", N/A ,"$2,589.23 ","$6,160.00 ","$5,621.00 ","$1,802.28 ", N/A ,"$3,234.00 ","$7,700.00 ","$6,545.00 ", N/A ,"$7,084.00 ","$5,390.00 ","$5,818.90 ","$7,821.36 ","$4,689.30 ","$7,273.62 ","$5,320.70 ","$5,390.00 ", N/A ,"$5,544.00 ","$1,910.42 ",$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$5,544.00 ","$4,774.00 ","$5,544.00 ","$5,544.00 ","$4,620.00 " ST VINCENT HOSPITAL - ACUTE,32000565,37218,HC STENT CAROTID INTRATHORACIC 37218,320,1 ,"$1,100.00 ",$550.00 ,$415.00 ,"$1,910.42 ",$710.60 ,"$1,100.00 ",$711.59 ,$711.59 , N/A ,$660.00 ,$935.00 ,$770.00 ,"$1,802.28 ","$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 , N/A ,"$1,100.00 ",$880.00 ,$803.00 ,"$1,802.28 ", N/A ,$462.00 ,"$1,100.00 ",$935.00 , N/A ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 , N/A ,$792.00 ,"$1,910.42 ",$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,32000567,70100,HC XR MANDIBLE 1-3 VIEW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$109.20 ,$97.07 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$57.50 ,$280.50 ,$78.35 ,$57.50 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000568,70190,HC XR EYE SOCKETS,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$110.76 ,$98.45 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$54.12 ,$280.50 ,$78.35 ,$54.12 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$193.07 ,$207.92 ,$200.97 ,$193.07 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000570,72081,HC XR SPINE/CERV SCOLIOSIS 1 VW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$115.41 ,$102.59 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$57.48 ,$280.50 ,$78.35 ,$57.48 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$189.70 ,$204.29 ,$200.97 ,$189.70 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000571,72082,HC XR SPINE/CERV SCOLIOSIS 2-3VW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$211.64 ,$188.12 ,$105.54 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$107.36 ,$280.50 ,$105.54 ,$107.36 ,$264.00 ,$240.90 ,$17.72 ,$105.54 ,$138.60 ,$330.00 ,$280.50 ,$237.46 ,$303.60 ,$231.00 ,$314.15 ,$330.00 ,$200.97 ,$314.15 ,$228.03 ,$231.00 ,$106.60 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$105.54 ,$330.00 ,$105.54 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000572,72083,HC XR SPINE/CERV SCOLIOSIS 4-5VW,320,1 ,$370.00 ,$185.00 ,$17.72 ,$370.00 ,$239.02 ,$17.72 ,$253.54 ,$225.37 ,$105.54 ,$222.00 ,$314.50 ,$259.00 ,$17.72 ,$351.50 ,$266.40 ,$270.10 ,$120.83 ,$314.50 ,$105.54 ,$120.83 ,$296.00 ,$270.10 ,$17.72 ,$105.54 ,$155.40 ,$370.00 ,$314.50 ,$237.46 ,$340.40 ,$259.00 ,$370.00 ,$370.00 ,$225.33 ,$370.00 ,$255.67 ,$259.00 ,$106.60 ,$266.40 ,$18.78 ,$370.00 ,$370.00 ,$105.54 ,$370.00 ,$105.54 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,32000573,72084,HC XR SPINE/CERV SCOLIOSIS 6+VW,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$297.00 ,$264.00 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$151.82 ,$348.50 ,$105.54 ,$151.82 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$410.00 ,$410.00 ,$249.69 ,$410.00 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000574,73501,HC XR HIP W/PELVIS UNI 1VIEW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$92.13 ,$81.90 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$44.69 ,$280.50 ,$78.35 ,$44.69 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$189.70 ,$204.29 ,$200.97 ,$189.70 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000575,73502,HC XR HIP W/PELVIS UNI 2-3VWS,320,1 ,$370.00 ,$185.00 ,$17.72 ,$370.00 ,$239.02 ,$17.72 ,$137.14 ,$121.90 ,$78.35 ,$222.00 ,$314.50 ,$259.00 ,$17.72 ,$351.50 ,$266.40 ,$270.10 ,$69.62 ,$314.50 ,$78.35 ,$69.62 ,$296.00 ,$270.10 ,$17.72 ,$78.35 ,$155.40 ,$370.00 ,$314.50 ,$176.29 ,$340.40 ,$259.00 ,$189.70 ,$204.29 ,$225.33 ,$189.70 ,$255.67 ,$259.00 ,$79.13 ,$266.40 ,$18.78 ,$370.00 ,$370.00 ,$78.35 ,$370.00 ,$78.35 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,32000576,73503,HC XR HIP W/PELVIS UNI 4+VWS,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$171.29 ,$152.25 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$88.48 ,$348.50 ,$105.54 ,$88.48 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$314.15 ,$338.32 ,$249.69 ,$314.15 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000577,73521,HC XR HIP W/PELVIS BIL 2 VIEWS,320,1 ,$410.00 ,$205.00 ,$17.72 ,$410.00 ,$264.86 ,$17.72 ,$116.96 ,$103.97 ,$105.54 ,$246.00 ,$348.50 ,$287.00 ,$17.72 ,$389.50 ,$295.20 ,$299.30 ,$58.84 ,$348.50 ,$105.54 ,$58.84 ,$328.00 ,$299.30 ,$17.72 ,$105.54 ,$172.20 ,$410.00 ,$348.50 ,$237.46 ,$377.20 ,$287.00 ,$314.15 ,$338.32 ,$249.69 ,$314.15 ,$283.31 ,$287.00 ,$106.60 ,$295.20 ,$18.78 ,$410.00 ,$410.00 ,$105.54 ,$410.00 ,$105.54 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,32000578,73522,HC XR HIP W/PELVIS BIL 3-4VIEWS,320,1 ,$450.00 ,$225.00 ,$17.72 ,$450.00 ,$290.70 ,$17.72 ,$151.11 ,$134.32 ,$105.54 ,$270.00 ,$382.50 ,$315.00 ,$17.72 ,$427.50 ,$324.00 ,$328.50 ,$76.34 ,$382.50 ,$105.54 ,$76.34 ,$360.00 ,$328.50 ,$17.72 ,$105.54 ,$189.00 ,$450.00 ,$382.50 ,$237.46 ,$414.00 ,$315.00 ,$314.15 ,$338.32 ,$274.05 ,$314.15 ,$310.95 ,$315.00 ,$106.60 ,$324.00 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,32000579,73523,HC XR HIP W/PELVIS BIL 5+VIEWS,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$183.70 ,$163.29 ,$105.54 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$90.51 ,$416.50 ,$105.54 ,$90.51 ,$392.00 ,$357.70 ,$17.72 ,$105.54 ,$205.80 ,$490.00 ,$416.50 ,$237.46 ,$450.80 ,$343.00 ,$490.00 ,$490.00 ,$298.41 ,$490.00 ,$338.59 ,$343.00 ,$106.60 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$105.54 ,$415.00 ,$105.54 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000580,73551,HC XR FEMUR 1VIEW,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$85.92 ,$76.38 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$41.31 ,$280.50 ,$78.35 ,$41.31 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$189.70 ,$204.29 ,$200.97 ,$189.70 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$330.00 ,$165.00 ,$17.72 ,$330.00 ,$213.18 ,$17.72 ,$104.55 ,$92.93 ,$78.35 ,$198.00 ,$280.50 ,$231.00 ,$17.72 ,$313.50 ,$237.60 ,$240.90 ,$51.43 ,$280.50 ,$78.35 ,$51.43 ,$264.00 ,$240.90 ,$17.72 ,$78.35 ,$138.60 ,$330.00 ,$280.50 ,$176.29 ,$303.60 ,$231.00 ,$189.70 ,$204.29 ,$200.97 ,$189.70 ,$228.03 ,$231.00 ,$79.13 ,$237.60 ,$18.78 ,$330.00 ,$330.00 ,$78.35 ,$330.00 ,$78.35 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$490.00 ,$245.00 ,$17.72 ,$490.00 ,$316.54 ,$17.72 ,$104.55 ,$92.93 ,$78.35 ,$294.00 ,$416.50 ,$343.00 ,$17.72 ,$465.50 ,$352.80 ,$357.70 ,$51.43 ,$416.50 ,$78.35 ,$51.43 ,$392.00 ,$357.70 ,$17.72 ,$78.35 ,$205.80 ,$490.00 ,$416.50 ,$176.29 ,$450.80 ,$343.00 ,$189.70 ,$204.29 ,$298.41 ,$189.70 ,$338.59 ,$343.00 ,$79.13 ,$352.80 ,$18.78 ,$415.00 ,$415.00 ,$78.35 ,$415.00 ,$78.35 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,32000591,75956,HC ENDOVASC REPR THOR AORTA W/SUBCL S AND I,320,1 ,"$3,700.00 ","$1,850.00 ",$53.35 ,"$3,700.00 ","$2,390.20 ",$53.35 ,"$1,448.25 ","$1,287.34 ", N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ",$53.35 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ",$53.35 , N/A ,"$1,554.00 ","$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ",$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,32000592,75957,HC ENDOVASC REPR THOR AORTA W/O SUBCL S AND I,320,1 ,"$3,700.00 ","$1,850.00 ",$53.35 ,"$3,700.00 ","$2,390.20 ",$53.35 ,"$1,241.38 ","$1,103.45 ", N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ",$53.35 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ",$53.35 , N/A ,"$1,554.00 ","$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ",$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,32000593,75958,HC PLACE PROX EXT PROSTH ENDOVASC THOR AORTA S AND I,320,1 ,"$3,700.00 ","$1,850.00 ",$53.35 ,"$3,700.00 ","$2,390.20 ",$53.35 ,$826.79 ,$734.92 , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ",$53.35 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ",$53.35 , N/A ,"$1,554.00 ","$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ",$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,32000594,75959,HC PLACE DISTAL EXT PROSTH POST RPR THOR AORTA S AND I,320,1 ,"$3,700.00 ","$1,850.00 ",$53.35 ,"$3,700.00 ","$2,390.20 ",$53.35 ,$721.45 ,$641.29 , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ",$53.35 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ",$53.35 , N/A ,"$1,554.00 ","$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ",$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,32000602,C9733,HC NON-OPHTHALMIC FVA,320,1 ,"$1,000.00 ",$500.00 ,$86.58 ,"$1,000.00 ",$646.00 ,$86.58 ,$646.90 ,$646.90 ,$356.52 ,$600.00 ,$850.00 ,$700.00 ,$86.58 ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 ,$356.52 ,$650.00 ,$800.00 ,$730.00 ,$86.58 ,$356.52 ,$420.00 ,"$1,000.00 ",$850.00 ,$802.18 ,$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$360.09 ,$720.00 ,$91.77 ,$415.00 ,$415.00 ,$356.52 ,$415.00 ,$356.52 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,32000603,74742,HC TRANSCERV CATH FALLOPIAN TUBE S AND I,320,1 ,$670.00 ,$335.00 ,$53.35 ,$670.00 ,$432.82 ,$53.35 ,$245.07 ,$217.84 , N/A ,$402.00 ,$569.50 ,$469.00 ,$53.35 ,$636.50 ,$482.40 ,$489.10 ,$113.92 ,$569.50 , N/A ,$113.92 ,$536.00 ,$489.10 ,$53.35 , N/A ,$281.40 ,$670.00 ,$569.50 , N/A ,$616.40 ,$469.00 ,$335.00 ,$402.00 ,$408.03 ,$335.00 ,$462.97 ,$469.00 , N/A ,$482.40 ,$56.55 ,$415.00 ,$415.00 , N/A ,$415.00 , N/A ,$482.40 ,$415.40 ,$482.40 ,$482.40 ,$402.00 ST VINCENT HOSPITAL - ACUTE,32000604,70371,HC SPEECH EVAL W/CINE/VIDEO RECORDING,320,1 ,$590.00 ,$295.00 ,$37.66 ,$590.00 ,$381.14 ,$37.66 ,$241.13 ,$214.33 ,$222.88 ,$354.00 ,$501.50 ,$413.00 ,$37.66 ,$560.50 ,$424.80 ,$430.70 ,$134.97 ,$501.50 ,$222.88 ,$134.97 ,$472.00 ,$430.70 ,$37.66 ,$222.88 ,$247.80 ,$590.00 ,$501.50 ,$501.48 ,$542.80 ,$413.00 ,$527.44 ,$568.01 ,$359.31 ,$527.44 ,$407.69 ,$413.00 ,$225.11 ,$424.80 ,$39.92 ,$415.00 ,$415.00 ,$222.88 ,$415.00 ,$222.88 ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,32000611,G1004,HC RAD AUC CDSM NATL DECISION SUPPORT COMPANY,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000612,74248,HC XRAY SMALL INTESTINE FOLLOW THRU STUDY,320,1 ,$150.00 ,$75.00 ,$37.66 ,$150.00 ,$96.90 ,$37.66 ,$150.00 ,$150.00 , N/A ,$90.00 ,$127.50 ,$105.00 ,$37.66 ,$142.50 ,$108.00 ,$109.50 ,$101.07 ,$127.50 , N/A ,$101.07 ,$120.00 ,$109.50 ,$37.66 , N/A ,$63.00 ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 , N/A ,$108.00 ,$39.92 ,$150.00 ,$150.00 , N/A ,$150.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,32000613,G1002,HC RAD AUC CDSM MEDCURRENT,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000614,G1003,HC RAD AUC CDSM MEDICALIS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000615,G1005,HC RAD AUC CDSM NATIONAL IMAGING ASSOCIATES,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000616,G1006,HC RAD AUC CDSM TEST APPROPRIATE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000617,G1007,HC RAD AUC CDSM AIM SPECIALTY HEALTH,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000618,G1008,HC RAD AUC CDSM CRANBERRY PEAK,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000619,G1009,HC RAD AUC CDSM SAGE HEALTH MGMT SOLUTIONS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000620,G1010,HC RAD AUC CDSM STANSON,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000621,G1011,HC RAD AUC CDSM QUALIFIED TOOL NOS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000622,G1000,HC RAD AUC CDSM APPLIED PATHWAYS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,32000623,G1001,HC RAD AUC CDSM EVICORE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ST VINCENT HOSPITAL - ACUTE,33300001,C1717,HC HDR BRACHYTX SOURCE IR192,333,1 ,$900.00 ,$450.00 ,$140.27 ,$900.00 ,$581.40 ,$140.27 ,$582.21 ,$582.21 ,$334.69 ,$540.00 ,$765.00 ,$630.00 ,$140.27 ,$855.00 ,$648.00 ,$657.00 ,$585.00 ,$765.00 ,$334.69 ,$585.00 ,$720.00 ,$657.00 ,$140.27 ,$334.69 ,$390.75 ,$900.00 ,$765.00 ,$753.05 ,$828.00 ,$630.00 ,$450.00 ,$540.00 ,$548.10 ,$450.00 ,$621.90 ,$630.00 ,$338.04 ,$648.00 ,$148.69 ,$900.00 ,$900.00 ,$334.69 ,$900.00 ,$334.69 ,$648.00 ,$558.00 ,$648.00 ,$648.00 ,$540.00 ST VINCENT HOSPITAL - ACUTE,33300003,20665,HC HALO REMOVAL,361,1 ,$220.00 ,$110.00 ,$52.41 ,$588.84 ,$142.12 ,$52.41 ,$220.00 ,$220.00 ,$261.71 ,$132.00 ,$187.00 ,$154.00 ,$52.41 ,$209.00 ,$158.40 ,$160.60 ,$220.00 ,$187.00 ,$261.71 ,$220.00 ,$176.00 ,$160.60 ,$52.41 ,$261.71 ,$220.00 ,$220.00 ,$187.00 ,$588.84 ,$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$264.33 ,$158.40 ,$55.55 ,$220.00 ,$220.00 ,$261.71 ,$220.00 ,$261.71 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,33300004,C1728,HC ENDO CATH BRACTHRPY SEED ADM,333,1 ,$190.00 ,$95.00 ,$95.00 ,$190.00 ,$122.74 , N/A ,$122.91 ,$122.91 , N/A ,$114.00 ,$161.50 ,$133.00 , N/A ,$180.50 ,$136.80 ,$138.70 ,$123.50 ,$161.50 , N/A ,$123.50 ,$152.00 ,$138.70 , N/A , N/A ,$190.00 ,$190.00 ,$161.50 , N/A ,$174.80 ,$133.00 ,$95.00 ,$114.00 ,$115.71 ,$95.00 ,$131.29 ,$133.00 , N/A ,$136.80 , N/A ,$190.00 ,$190.00 , N/A ,$190.00 , N/A ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,33300006,C2639,HC IODINE 125 PER SOURCE NON STRANDED,333,1 ,$105.00 ,$52.50 ,$34.10 ,$882.47 ,$67.83 ,$105.00 ,$67.92 ,$67.92 ,$34.10 ,$63.00 ,$89.25 ,$73.50 ,$832.52 ,$99.75 ,$75.60 ,$76.65 ,$68.25 ,$89.25 ,$34.10 ,$68.25 ,$84.00 ,$76.65 ,$832.52 ,$34.10 ,$105.00 ,$105.00 ,$89.25 ,$76.73 ,$96.60 ,$73.50 ,$52.50 ,$63.00 ,$63.95 ,$52.50 ,$72.56 ,$73.50 ,$34.44 ,$75.60 ,$882.47 ,$105.00 ,$105.00 ,$34.10 ,$105.00 ,$34.10 ,$75.60 ,$65.10 ,$75.60 ,$75.60 ,$63.00 ST VINCENT HOSPITAL - ACUTE,33300009,77285,HC SIMULATION INTERMED,333,1 ,"$1,400.00 ",$700.00 ,$60.87 ,"$1,400.00 ",$904.40 ,$60.87 ,"$1,400.00 ","$1,400.00 ",$328.01 ,$840.00 ,"$1,190.00 ",$980.00 ,$60.87 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$328.01 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$60.87 ,$328.01 ,$390.75 ,"$1,400.00 ","$1,190.00 ",$738.03 ,"$1,288.00 ",$980.00 ,"$1,048.23 ","$1,128.86 ",$852.60 ,"$1,048.23 ",$967.40 ,$980.00 ,$331.29 ,"$1,008.00 ",$64.52 ,"$1,400.00 ","$1,400.00 ",$328.01 ,"$1,400.00 ",$328.01 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,33300010,77290,HC SIMULATION COMPLEX,333,1 ,"$2,900.00 ","$1,450.00 ",$60.87 ,"$2,900.00 ","$1,873.40 ",$60.87 ,"$1,876.96 ","$1,668.41 ",$328.01 ,"$1,740.00 ","$2,465.00 ","$2,030.00 ",$60.87 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ","$1,885.00 ","$2,465.00 ",$328.01 ,"$1,885.00 ","$2,320.00 ","$2,117.00 ",$60.87 ,$328.01 ,$390.75 ,"$2,900.00 ","$2,465.00 ",$738.03 ,"$2,668.00 ","$2,030.00 ","$1,048.23 ","$1,128.86 ","$1,766.10 ","$1,048.23 ","$2,003.90 ","$2,030.00 ",$331.29 ,"$2,088.00 ",$64.52 ,"$1,838.00 ","$1,838.00 ",$328.01 ,"$1,838.00 ",$328.01 ,"$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,33300011,77295,HC SIMULATION 3-D,333,1 ,"$6,500.00 ","$3,250.00 ",$347.06 ,"$6,500.00 ","$4,199.00 ",$347.06 ,"$1,165.28 ","$1,035.80 ","$1,222.42 ","$3,900.00 ","$5,525.00 ","$4,550.00 ",$347.06 ,"$6,175.00 ","$4,680.00 ","$4,745.00 ","$4,225.00 ","$5,525.00 ","$1,222.42 ","$4,225.00 ","$5,200.00 ","$4,745.00 ",$347.06 ,"$1,222.42 ",$390.75 ,"$6,500.00 ","$5,525.00 ","$2,750.45 ","$5,980.00 ","$4,550.00 ","$3,489.03 ","$3,757.42 ","$3,958.50 ","$3,489.03 ","$4,491.50 ","$4,550.00 ","$1,234.64 ","$4,680.00 ",$367.88 ,"$1,838.00 ","$1,838.00 ","$1,222.42 ","$1,838.00 ","$1,222.42 ","$4,680.00 ","$4,030.00 ","$4,680.00 ","$4,680.00 ","$3,900.00 " ST VINCENT HOSPITAL - ACUTE,33300015,77300,HC DOSIMETRY CALCULATION BASIC,333,1 ,$780.00 ,$390.00 ,$60.87 ,$780.00 ,$503.88 ,$60.87 ,$148.01 ,$131.56 ,$122.87 ,$468.00 ,$663.00 ,$546.00 ,$60.87 ,$741.00 ,$561.60 ,$569.40 ,$507.00 ,$663.00 ,$122.87 ,$507.00 ,$624.00 ,$569.40 ,$60.87 ,$122.87 ,$390.75 ,$780.00 ,$663.00 ,$276.47 ,$717.60 ,$546.00 ,$385.98 ,$415.67 ,$475.02 ,$385.98 ,$538.98 ,$546.00 ,$124.10 ,$561.60 ,$64.52 ,$780.00 ,$780.00 ,$122.87 ,$780.00 ,$122.87 ,$561.60 ,$483.60 ,$561.60 ,$561.60 ,$468.00 ST VINCENT HOSPITAL - ACUTE,33300016,77300,HC DOSIMETRY CALCULATION,333,1 ,$780.00 ,$390.00 ,$60.87 ,$780.00 ,$503.88 ,$60.87 ,$148.01 ,$131.56 ,$122.87 ,$468.00 ,$663.00 ,$546.00 ,$60.87 ,$741.00 ,$561.60 ,$569.40 ,$507.00 ,$663.00 ,$122.87 ,$507.00 ,$624.00 ,$569.40 ,$60.87 ,$122.87 ,$390.75 ,$780.00 ,$663.00 ,$276.47 ,$717.60 ,$546.00 ,$385.98 ,$415.67 ,$475.02 ,$385.98 ,$538.98 ,$546.00 ,$124.10 ,$561.60 ,$64.52 ,$780.00 ,$780.00 ,$122.87 ,$780.00 ,$122.87 ,$561.60 ,$483.60 ,$561.60 ,$561.60 ,$468.00 ST VINCENT HOSPITAL - ACUTE,33300017,77301,HC IMRT TX PLAN,333,1 ,"$5,200.00 ","$2,600.00 ",$347.06 ,"$5,200.00 ","$3,359.20 ",$347.06 ,"$5,200.00 ","$5,200.00 ","$1,222.42 ","$3,120.00 ","$4,420.00 ","$3,640.00 ",$347.06 ,"$4,940.00 ","$3,744.00 ","$3,796.00 ","$3,380.00 ","$4,420.00 ","$1,222.42 ","$3,380.00 ","$4,160.00 ","$3,796.00 ",$347.06 ,"$1,222.42 ",$390.75 ,"$5,200.00 ","$4,420.00 ","$2,750.45 ","$4,784.00 ","$3,640.00 ","$3,489.03 ","$3,757.42 ","$3,166.80 ","$3,489.03 ","$3,593.20 ","$3,640.00 ","$1,234.64 ","$3,744.00 ",$367.88 ,"$1,838.00 ","$1,838.00 ","$1,222.42 ","$1,838.00 ","$1,222.42 ","$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,33300019,77306,HC ISODOSE PLAN SIMPLE COMPUTER PLAN,333,1 ,$770.00 ,$385.00 ,$39.10 ,$770.00 ,$497.42 ,$39.10 ,$333.26 ,$296.23 ,$328.01 ,$462.00 ,$654.50 ,$539.00 ,$39.10 ,$731.50 ,$554.40 ,$562.10 ,$500.50 ,$654.50 ,$328.01 ,$500.50 ,$616.00 ,$562.10 ,$39.10 ,$328.01 ,$390.75 ,$770.00 ,$654.50 ,$738.03 ,$708.40 ,$539.00 ,$374.40 ,$403.20 ,$468.93 ,$374.40 ,$532.07 ,$539.00 ,$331.29 ,$554.40 ,$41.45 ,$770.00 ,$770.00 ,$328.01 ,$770.00 ,$328.01 ,$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,33300023,77307,HC ISODOSE PLAN COMPLEX COMPUTER PLAN,333,1 ,"$2,900.00 ","$1,450.00 ",$60.87 ,"$2,900.00 ","$1,873.40 ",$60.87 ,$602.32 ,$535.40 ,$328.01 ,"$1,740.00 ","$2,465.00 ","$2,030.00 ",$60.87 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ","$1,885.00 ","$2,465.00 ",$328.01 ,"$1,885.00 ","$2,320.00 ","$2,117.00 ",$60.87 ,$328.01 ,$390.75 ,"$2,900.00 ","$2,465.00 ",$738.03 ,"$2,668.00 ","$2,030.00 ",$374.40 ,$403.20 ,"$1,766.10 ",$374.40 ,"$2,003.90 ","$2,030.00 ",$331.29 ,"$2,088.00 ",$64.52 ,"$1,838.00 ","$1,838.00 ",$328.01 ,"$1,838.00 ",$328.01 ,"$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,33300024,77321,HC PORT PLAN SPECIAL,333,1 ,"$1,800.00 ",$900.00 ,$60.87 ,"$1,800.00 ","$1,162.80 ",$60.87 ,$191.46 ,$170.19 ,$328.01 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$60.87 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,170.00 ","$1,530.00 ",$328.01 ,"$1,170.00 ","$1,440.00 ","$1,314.00 ",$60.87 ,$328.01 ,$390.75 ,"$1,800.00 ","$1,530.00 ",$738.03 ,"$1,656.00 ","$1,260.00 ","$1,048.23 ","$1,128.86 ","$1,096.20 ","$1,048.23 ","$1,243.80 ","$1,260.00 ",$331.29 ,"$1,296.00 ",$64.52 ,"$1,800.00 ","$1,800.00 ",$328.01 ,"$1,800.00 ",$328.01 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,33300025,77316,HC BRACHY ISODOSE CALC SIMPLE,333,1 ,$850.00 ,$425.00 ,$39.10 ,$850.00 ,$549.10 ,$39.10 ,$568.18 ,$505.05 ,$328.01 ,$510.00 ,$722.50 ,$595.00 ,$39.10 ,$807.50 ,$612.00 ,$620.50 ,$552.50 ,$722.50 ,$328.01 ,$552.50 ,$680.00 ,$620.50 ,$39.10 ,$328.01 ,$390.75 ,$850.00 ,$722.50 ,$738.03 ,$782.00 ,$595.00 ,$374.40 ,$403.20 ,$517.65 ,$374.40 ,$587.35 ,$595.00 ,$331.29 ,$612.00 ,$41.45 ,$850.00 ,$850.00 ,$328.01 ,$850.00 ,$328.01 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,33300026,77317,HC BRACHY ISODOSE CALC INTERMED,333,1 ,"$1,500.00 ",$750.00 ,$60.87 ,"$1,500.00 ",$969.00 ,$60.87 ,$747.22 ,$664.20 ,$328.01 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$60.87 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ",$328.01 ,$975.00 ,"$1,200.00 ","$1,095.00 ",$60.87 ,$328.01 ,$390.75 ,"$1,500.00 ","$1,275.00 ",$738.03 ,"$1,380.00 ","$1,050.00 ","$1,040.71 ","$1,120.76 ",$913.50 ,"$1,040.71 ","$1,036.50 ","$1,050.00 ",$331.29 ,"$1,080.00 ",$64.52 ,"$1,500.00 ","$1,500.00 ",$328.01 ,"$1,500.00 ",$328.01 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,33300027,77318,HC BRACHY ISODOSE PLAN COMPLEX,333,1 ,"$1,700.00 ",$850.00 ,$60.87 ,"$1,700.00 ","$1,098.20 ",$60.87 ,"$1,012.19 ",$899.73 ,$328.01 ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$60.87 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,105.00 ","$1,445.00 ",$328.01 ,"$1,105.00 ","$1,360.00 ","$1,241.00 ",$60.87 ,$328.01 ,$390.75 ,"$1,700.00 ","$1,445.00 ",$738.03 ,"$1,564.00 ","$1,190.00 ","$1,040.71 ","$1,120.76 ","$1,035.30 ","$1,040.71 ","$1,174.70 ","$1,190.00 ",$331.29 ,"$1,224.00 ",$64.52 ,"$1,700.00 ","$1,700.00 ",$328.01 ,"$1,700.00 ",$328.01 ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,33300029,77331,HC DOSIMETRY CALCULATION SPECIAL,333,1 ,$560.00 ,$280.00 ,$39.10 ,$560.00 ,$361.76 ,$39.10 ,$82.82 ,$73.62 ,$122.87 ,$336.00 ,$476.00 ,$392.00 ,$39.10 ,$532.00 ,$403.20 ,$408.80 ,$364.00 ,$476.00 ,$122.87 ,$364.00 ,$448.00 ,$408.80 ,$39.10 ,$122.87 ,$390.75 ,$560.00 ,$476.00 ,$276.47 ,$515.20 ,$392.00 ,$385.98 ,$415.67 ,$341.04 ,$385.98 ,$386.96 ,$392.00 ,$124.10 ,$403.20 ,$41.45 ,$560.00 ,$560.00 ,$122.87 ,$560.00 ,$122.87 ,$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,33300030,77332,HC TREATMENT DEVICE SIMPLE,333,1 ,$670.00 ,$335.00 ,$39.10 ,$670.00 ,$432.82 ,$39.10 ,$124.72 ,$110.87 ,$122.87 ,$402.00 ,$569.50 ,$469.00 ,$39.10 ,$636.50 ,$482.40 ,$489.10 ,$435.50 ,$569.50 ,$122.87 ,$435.50 ,$536.00 ,$489.10 ,$39.10 ,$122.87 ,$390.75 ,$670.00 ,$569.50 ,$276.47 ,$616.40 ,$469.00 ,$670.00 ,$670.00 ,$408.03 ,$670.00 ,$462.97 ,$469.00 ,$124.10 ,$482.40 ,$41.45 ,$670.00 ,$670.00 ,$122.87 ,$670.00 ,$122.87 ,$482.40 ,$415.40 ,$482.40 ,$482.40 ,$402.00 ST VINCENT HOSPITAL - ACUTE,33300031,77333,HC TREATMENT DEVICE INTERM,333,1 ,"$1,000.00 ",$500.00 ,$39.10 ,"$1,000.00 ",$646.00 ,$39.10 ,$306.31 ,$272.28 ,$122.87 ,$600.00 ,$850.00 ,$700.00 ,$39.10 ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 ,$122.87 ,$650.00 ,$800.00 ,$730.00 ,$39.10 ,$122.87 ,$390.75 ,"$1,000.00 ",$850.00 ,$276.47 ,$920.00 ,$700.00 ,$718.72 ,$774.01 ,$609.00 ,$718.72 ,$691.00 ,$700.00 ,$124.10 ,$720.00 ,$41.45 ,"$1,000.00 ","$1,000.00 ",$122.87 ,"$1,000.00 ",$122.87 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,33300032,77334,HC TREATMENT DEVICE COMPLEX,333,1 ,"$1,900.00 ",$950.00 ,$60.87 ,"$1,900.00 ","$1,227.40 ",$60.87 ,$297.00 ,$264.00 ,$328.01 ,"$1,140.00 ","$1,615.00 ","$1,330.00 ",$60.87 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,235.00 ","$1,615.00 ",$328.01 ,"$1,235.00 ","$1,520.00 ","$1,387.00 ",$60.87 ,$328.01 ,$390.75 ,"$1,900.00 ","$1,615.00 ",$738.03 ,"$1,748.00 ","$1,330.00 ",$718.72 ,$774.01 ,"$1,157.10 ",$718.72 ,"$1,312.90 ","$1,330.00 ",$331.29 ,"$1,368.00 ",$64.52 ,"$1,838.00 ","$1,838.00 ",$328.01 ,"$1,838.00 ",$328.01 ,"$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,33300033,77336,HC MEDICAL PHYSICS CONTINUING,333,1 ,$830.00 ,$415.00 ,$39.10 ,$830.00 ,$536.18 ,$39.10 ,$344.82 ,$306.51 ,$122.87 ,$498.00 ,$705.50 ,$581.00 ,$39.10 ,$788.50 ,$597.60 ,$605.90 ,$539.50 ,$705.50 ,$122.87 ,$539.50 ,$664.00 ,$605.90 ,$39.10 ,$122.87 ,$390.75 ,$830.00 ,$705.50 ,$276.47 ,$763.60 ,$581.00 ,$385.98 ,$415.67 ,$505.47 ,$385.98 ,$573.53 ,$581.00 ,$124.10 ,$597.60 ,$41.45 ,$830.00 ,$830.00 ,$122.87 ,$830.00 ,$122.87 ,$597.60 ,$514.60 ,$597.60 ,$597.60 ,$498.00 ST VINCENT HOSPITAL - ACUTE,33300034,77338,HC MLC DEVICE FOR IMRT,333,1 ,"$2,500.00 ","$1,250.00 ",$60.87 ,"$2,500.00 ","$1,615.00 ",$60.87 ,"$1,198.43 ","$1,065.28 ",$328.01 ,"$1,500.00 ","$2,125.00 ","$1,750.00 ",$60.87 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ","$1,625.00 ","$2,125.00 ",$328.01 ,"$1,625.00 ","$2,000.00 ","$1,825.00 ",$60.87 ,$328.01 ,$390.75 ,"$2,500.00 ","$2,125.00 ",$738.03 ,"$2,300.00 ","$1,750.00 ","$1,048.23 ","$1,128.86 ","$1,522.50 ","$1,048.23 ","$1,727.50 ","$1,750.00 ",$331.29 ,"$1,800.00 ",$64.52 ,"$1,838.00 ","$1,838.00 ",$328.01 ,"$1,838.00 ",$328.01 ,"$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,33300036,77370,HC SPECIAL MED PHYSICS CONSULT,333,1 ,"$1,400.00 ",$700.00 ,$39.10 ,"$1,400.00 ",$904.40 ,$39.10 ,$534.44 ,$475.06 ,$122.87 ,$840.00 ,"$1,190.00 ",$980.00 ,$39.10 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$122.87 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$39.10 ,$122.87 ,$390.75 ,"$1,400.00 ","$1,190.00 ",$276.47 ,"$1,288.00 ",$980.00 ,$385.98 ,$415.67 ,$852.60 ,$385.98 ,$967.40 ,$980.00 ,$124.10 ,"$1,008.00 ",$41.45 ,"$1,400.00 ","$1,400.00 ",$122.87 ,"$1,400.00 ",$122.87 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,33300037,77402,HC RAD THRPY SIMPLE >1MEV,333,1 ,"$1,100.00 ",$550.00 ,$58.54 ,"$1,100.00 ",$710.60 ,$58.54 ,$627.58 ,$557.85 ,$116.74 ,$660.00 ,$935.00 ,$770.00 ,$58.54 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$116.74 ,$715.00 ,$880.00 ,$803.00 ,$58.54 ,$116.74 ,$390.75 ,"$1,100.00 ",$935.00 ,$262.67 ,"$1,012.00 ",$770.00 ,$350.97 ,$377.97 ,$669.90 ,$350.97 ,$760.10 ,$770.00 ,$117.91 ,$792.00 ,$62.05 ,"$1,100.00 ","$1,100.00 ",$116.74 ,"$1,100.00 ",$116.74 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,33300041,77407,HC RAD THRPY INTERMEDIATE,333,1 ,"$1,000.00 ",$500.00 ,$58.54 ,"$1,000.00 ",$646.00 ,$58.54 ,$863.49 ,$767.54 ,$234.07 ,$600.00 ,$850.00 ,$700.00 ,$58.54 ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 ,$234.07 ,$650.00 ,$800.00 ,$730.00 ,$58.54 ,$234.07 ,$390.75 ,"$1,000.00 ",$850.00 ,$526.65 ,$920.00 ,$700.00 ,$350.97 ,$377.97 ,$609.00 ,$350.97 ,$691.00 ,$700.00 ,$236.41 ,$720.00 ,$62.05 ,"$1,000.00 ","$1,000.00 ",$234.07 ,"$1,000.00 ",$234.07 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,33300045,77412,HC RAD THRPY COMPLEX,333,1 ,"$1,400.00 ",$700.00 ,$58.54 ,"$1,400.00 ",$904.40 ,$58.54 ,"$1,155.27 ","$1,026.91 ",$234.07 ,$840.00 ,"$1,190.00 ",$980.00 ,$58.54 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$234.07 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$58.54 ,$234.07 ,$390.75 ,"$1,400.00 ","$1,190.00 ",$526.65 ,"$1,288.00 ",$980.00 ,$647.31 ,$697.10 ,$852.60 ,$647.31 ,$967.40 ,$980.00 ,$236.41 ,"$1,008.00 ",$62.05 ,"$1,400.00 ","$1,400.00 ",$234.07 ,"$1,400.00 ",$234.07 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,33300051,77386,HC IMRT TREATMENT COMPLEX,333,1 ,"$3,700.00 ","$1,850.00 ",$153.16 ,"$3,700.00 ","$2,390.20 ",$153.16 ,"$1,557.38 ","$1,384.34 ",$525.46 ,"$2,220.00 ","$3,145.00 ","$2,590.00 ",$153.16 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$2,405.00 ","$3,145.00 ",$525.46 ,"$2,405.00 ","$2,960.00 ","$2,701.00 ",$153.16 ,$525.46 ,$390.75 ,"$3,700.00 ","$3,145.00 ","$1,182.28 ","$3,404.00 ","$2,590.00 ","$1,679.90 ","$1,809.12 ","$2,253.30 ","$1,679.90 ","$2,556.70 ","$2,590.00 ",$530.71 ,"$2,664.00 ",$162.35 ,"$1,838.00 ","$1,838.00 ",$525.46 ,"$1,838.00 ",$525.46 ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,33300052,77417,HC PORT FILMS,333,1 ,$530.00 ,$265.00 ,$17.72 ,$530.00 ,$342.38 ,$17.72 ,$48.68 ,$43.27 , N/A ,$318.00 ,$450.50 ,$371.00 ,$17.72 ,$503.50 ,$381.60 ,$386.90 ,$344.50 ,$450.50 , N/A ,$344.50 ,$424.00 ,$386.90 ,$17.72 , N/A ,$390.75 ,$530.00 ,$450.50 , N/A ,$487.60 ,$371.00 ,$265.00 ,$318.00 ,$322.77 ,$265.00 ,$366.23 ,$371.00 , N/A ,$381.60 ,$18.78 ,$530.00 ,$530.00 , N/A ,$530.00 , N/A ,$381.60 ,$328.60 ,$381.60 ,$381.60 ,$318.00 ST VINCENT HOSPITAL - ACUTE,33300053,77417,HC PORT FILMS 5+ SRS SRT IMRT,333,1 ,$530.00 ,$265.00 ,$17.72 ,$530.00 ,$342.38 ,$17.72 ,$48.68 ,$43.27 , N/A ,$318.00 ,$450.50 ,$371.00 ,$17.72 ,$503.50 ,$381.60 ,$386.90 ,$344.50 ,$450.50 , N/A ,$344.50 ,$424.00 ,$386.90 ,$17.72 , N/A ,$390.75 ,$530.00 ,$450.50 , N/A ,$487.60 ,$371.00 ,$265.00 ,$318.00 ,$322.77 ,$265.00 ,$366.23 ,$371.00 , N/A ,$381.60 ,$18.78 ,$530.00 ,$530.00 , N/A ,$530.00 , N/A ,$381.60 ,$328.60 ,$381.60 ,$381.60 ,$318.00 ST VINCENT HOSPITAL - ACUTE,33300054,77385,HC IMRT TREATMENT SIMPLE,333,1 ,"$3,300.00 ","$1,650.00 ",$153.16 ,"$3,300.00 ","$2,131.80 ",$153.16 ,"$1,555.69 ","$1,382.84 ",$525.46 ,"$1,980.00 ","$2,805.00 ","$2,310.00 ",$153.16 ,"$3,135.00 ","$2,376.00 ","$2,409.00 ","$2,145.00 ","$2,805.00 ",$525.46 ,"$2,145.00 ","$2,640.00 ","$2,409.00 ",$153.16 ,$525.46 ,$390.75 ,"$3,300.00 ","$2,805.00 ","$1,182.28 ","$3,036.00 ","$2,310.00 ","$1,679.90 ","$1,809.12 ","$2,009.70 ","$1,679.90 ","$2,280.30 ","$2,310.00 ",$530.71 ,"$2,376.00 ",$162.35 ,"$1,838.00 ","$1,838.00 ",$525.46 ,"$1,838.00 ",$525.46 ,"$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,33300055,77387,HC STEREOSCOPIC X RAY GUIDANCE,333,1 ,$470.00 ,$235.00 ,$39.10 ,$470.00 ,$303.62 ,$39.10 ,$349.65 ,$310.80 , N/A ,$282.00 ,$399.50 ,$329.00 ,$39.10 ,$446.50 ,$338.40 ,$343.10 ,$305.50 ,$399.50 , N/A ,$305.50 ,$376.00 ,$343.10 ,$39.10 , N/A ,$390.75 ,$470.00 ,$399.50 , N/A ,$432.40 ,$329.00 ,$235.00 ,$282.00 ,$286.23 ,$235.00 ,$324.77 ,$329.00 , N/A ,$338.40 ,$41.45 ,$470.00 ,$470.00 , N/A ,$470.00 , N/A ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,33300057,77470,HC SPECIAL TREATMENT PROCEDURE,333,1 ,"$2,200.00 ","$1,100.00 ",$98.45 ,"$2,200.00 ","$1,421.20 ",$153.16 ,$110.76 ,$98.45 ,$525.46 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$153.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,430.00 ","$1,870.00 ",$525.46 ,"$1,430.00 ","$1,760.00 ","$1,606.00 ",$153.16 ,$525.46 ,$390.75 ,"$2,200.00 ","$1,870.00 ","$1,182.28 ","$2,024.00 ","$1,540.00 ","$1,391.11 ","$1,498.12 ","$1,339.80 ","$1,391.11 ","$1,520.20 ","$1,540.00 ",$530.71 ,"$1,584.00 ",$162.35 ,"$1,838.00 ","$1,838.00 ",$525.46 ,"$1,838.00 ",$525.46 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,33300058,77470,HC SPECIAL TREATMENT PROCEDURE IMRT HDT BID SRS,333,1 ,"$2,200.00 ","$1,100.00 ",$98.45 ,"$2,200.00 ","$1,421.20 ",$153.16 ,$110.76 ,$98.45 ,$525.46 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$153.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,430.00 ","$1,870.00 ",$525.46 ,"$1,430.00 ","$1,760.00 ","$1,606.00 ",$153.16 ,$525.46 ,$390.75 ,"$2,200.00 ","$1,870.00 ","$1,182.28 ","$2,024.00 ","$1,540.00 ","$1,391.11 ","$1,498.12 ","$1,339.80 ","$1,391.11 ","$1,520.20 ","$1,540.00 ",$530.71 ,"$1,584.00 ",$162.35 ,"$1,838.00 ","$1,838.00 ",$525.46 ,"$1,838.00 ",$525.46 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,33300060,77761,HC INTRACAVITARY APPL-SIMPL,333,1 ,"$1,600.00 ",$800.00 ,$153.16 ,"$1,600.00 ","$1,033.60 ",$153.16 ,$861.08 ,$765.41 ,$525.46 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$153.16 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$525.46 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$153.16 ,$525.46 ,$390.75 ,"$1,600.00 ","$1,360.00 ","$1,182.28 ","$1,472.00 ","$1,120.00 ","$1,216.30 ","$1,309.86 ",$974.40 ,"$1,216.30 ","$1,105.60 ","$1,120.00 ",$530.71 ,"$1,152.00 ",$162.35 ,"$1,600.00 ","$1,600.00 ",$525.46 ,"$1,600.00 ",$525.46 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,33300061,77762,HC INTRACAVITARY APPL-INTER,333,1 ,"$1,800.00 ",$900.00 ,$390.75 ,"$1,800.00 ","$1,162.80 ",$473.35 ,$985.81 ,$876.27 ,$525.46 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$473.35 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,170.00 ","$1,530.00 ",$525.46 ,"$1,170.00 ","$1,440.00 ","$1,314.00 ",$473.35 ,$525.46 ,$390.75 ,"$1,800.00 ","$1,530.00 ","$1,182.28 ","$1,656.00 ","$1,260.00 ","$1,216.30 ","$1,309.86 ","$1,096.20 ","$1,216.30 ","$1,243.80 ","$1,260.00 ",$530.71 ,"$1,296.00 ",$501.75 ,"$1,800.00 ","$1,800.00 ",$525.46 ,"$1,800.00 ",$525.46 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,33300062,77763,HC INTRACAVITARY APPL-COMPL,333,1 ,"$2,000.00 ","$1,000.00 ",$390.75 ,"$2,000.00 ","$1,292.00 ",$473.35 ,"$1,294.80 ","$1,150.93 ",$686.14 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$473.35 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,300.00 ","$1,700.00 ",$686.14 ,"$1,300.00 ","$1,600.00 ","$1,460.00 ",$473.35 ,$686.14 ,$390.75 ,"$2,000.00 ","$1,700.00 ","$1,543.82 ","$1,840.00 ","$1,400.00 ","$1,216.30 ","$1,309.86 ","$1,218.00 ","$1,216.30 ","$1,382.00 ","$1,400.00 ",$693.00 ,"$1,440.00 ",$501.75 ,"$1,838.00 ","$1,838.00 ",$686.14 ,"$1,838.00 ",$686.14 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,33300063,77799,HC INTERSTITIAL APPL-SIMPLE,333,1 ,"$1,600.00 ",$800.00 ,$58.54 ,"$1,600.00 ","$1,033.60 ",$58.54 ,"$1,035.04 ","$1,035.04 ",$116.74 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$58.54 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$116.74 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$58.54 ,$116.74 ,$390.75 ,"$1,600.00 ","$1,360.00 ",$262.67 ,"$1,472.00 ","$1,120.00 ","$1,216.30 ","$1,309.86 ",$974.40 ,"$1,216.30 ","$1,105.60 ","$1,120.00 ",$117.91 ,"$1,152.00 ",$62.05 ,"$1,600.00 ","$1,600.00 ",$116.74 ,"$1,600.00 ",$116.74 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,33300064,77799,HC INTERSTITIAL APPL-INTERM,333,1 ,"$1,800.00 ",$900.00 ,$58.54 ,"$1,800.00 ","$1,162.80 ",$58.54 ,"$1,164.42 ","$1,164.42 ",$116.74 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$58.54 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,170.00 ","$1,530.00 ",$116.74 ,"$1,170.00 ","$1,440.00 ","$1,314.00 ",$58.54 ,$116.74 ,$390.75 ,"$1,800.00 ","$1,530.00 ",$262.67 ,"$1,656.00 ","$1,260.00 ","$1,216.30 ","$1,309.86 ","$1,096.20 ","$1,216.30 ","$1,243.80 ","$1,260.00 ",$117.91 ,"$1,296.00 ",$62.05 ,"$1,800.00 ","$1,800.00 ",$116.74 ,"$1,800.00 ",$116.74 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,33300065,77778,HC INTERSTITIAL APPL-COMPLE,333,1 ,"$5,400.00 ","$2,700.00 ",$390.75 ,"$5,400.00 ","$3,488.40 ",$473.35 ,"$1,696.34 ","$1,507.86 ",$686.14 ,"$3,240.00 ","$4,590.00 ","$3,780.00 ",$473.35 ,"$5,130.00 ","$3,888.00 ","$3,942.00 ","$3,510.00 ","$4,590.00 ",$686.14 ,"$3,510.00 ","$4,320.00 ","$3,942.00 ",$473.35 ,$686.14 ,$390.75 ,"$5,400.00 ","$4,590.00 ","$1,543.82 ","$4,968.00 ","$3,780.00 ","$3,359.43 ","$3,617.85 ","$3,288.60 ","$3,359.43 ","$3,731.40 ","$3,780.00 ",$693.00 ,"$3,888.00 ",$501.75 ,"$1,838.00 ","$1,838.00 ",$686.14 ,"$1,838.00 ",$686.14 ,"$3,888.00 ","$3,348.00 ","$3,888.00 ","$3,888.00 ","$3,240.00 " ST VINCENT HOSPITAL - ACUTE,33300066,77770,HC HDR AFTERLOAD 1 CHANNEL,333,1 ,"$3,500.00 ","$1,750.00 ",$153.16 ,"$3,500.00 ","$2,261.00 ",$153.16 ,$998.65 ,$887.69 ,$686.14 ,"$2,100.00 ","$2,975.00 ","$2,450.00 ",$153.16 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ","$2,275.00 ","$2,975.00 ",$686.14 ,"$2,275.00 ","$2,800.00 ","$2,555.00 ",$153.16 ,$686.14 ,$390.75 ,"$3,500.00 ","$2,975.00 ","$1,543.82 ","$3,220.00 ","$2,450.00 ","$2,172.18 ","$2,339.27 ","$2,131.50 ","$2,172.18 ","$2,418.50 ","$2,450.00 ",$693.00 ,"$2,520.00 ",$162.35 ,"$1,838.00 ","$1,838.00 ",$686.14 ,"$1,838.00 ",$686.14 ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,33300067,77771,HC HDR AFTERLOAD 2-12 CHANNELS,333,1 ,"$3,800.00 ","$1,900.00 ",$390.75 ,"$3,800.00 ","$2,454.80 ",$473.35 ,"$1,762.38 ","$1,566.56 ",$686.14 ,"$2,280.00 ","$3,230.00 ","$2,660.00 ",$473.35 ,"$3,610.00 ","$2,736.00 ","$2,774.00 ","$2,470.00 ","$3,230.00 ",$686.14 ,"$2,470.00 ","$3,040.00 ","$2,774.00 ",$473.35 ,$686.14 ,$390.75 ,"$3,800.00 ","$3,230.00 ","$1,543.82 ","$3,496.00 ","$2,660.00 ","$2,172.18 ","$2,339.27 ","$2,314.20 ","$2,172.18 ","$2,625.80 ","$2,660.00 ",$693.00 ,"$2,736.00 ",$501.75 ,"$1,838.00 ","$1,838.00 ",$686.14 ,"$1,838.00 ",$686.14 ,"$2,736.00 ","$2,356.00 ","$2,736.00 ","$2,736.00 ","$2,280.00 " ST VINCENT HOSPITAL - ACUTE,33300068,77772,HC HDR AFTERLOAD > 12 CHANNELS,333,1 ,"$4,000.00 ","$2,000.00 ",$390.75 ,"$4,000.00 ","$2,584.00 ",$473.35 ,"$2,756.94 ","$2,450.61 ",$686.14 ,"$2,400.00 ","$3,400.00 ","$2,800.00 ",$473.35 ,"$3,800.00 ","$2,880.00 ","$2,920.00 ","$2,600.00 ","$3,400.00 ",$686.14 ,"$2,600.00 ","$3,200.00 ","$2,920.00 ",$473.35 ,$686.14 ,$390.75 ,"$4,000.00 ","$3,400.00 ","$1,543.82 ","$3,680.00 ","$2,800.00 ","$2,172.18 ","$2,339.27 ","$2,436.00 ","$2,172.18 ","$2,764.00 ","$2,800.00 ",$693.00 ,"$2,880.00 ",$501.75 ,"$1,838.00 ","$1,838.00 ",$686.14 ,"$1,838.00 ",$686.14 ,"$2,880.00 ","$2,480.00 ","$2,880.00 ","$2,880.00 ","$2,400.00 " ST VINCENT HOSPITAL - ACUTE,33300069,77789,HC STRONTIUM-90,333,1 ,$550.00 ,$275.00 ,$58.54 ,$550.00 ,$355.30 ,$58.54 ,$275.27 ,$244.69 ,$116.74 ,$330.00 ,$467.50 ,$385.00 ,$58.54 ,$522.50 ,$396.00 ,$401.50 ,$357.50 ,$467.50 ,$116.74 ,$357.50 ,$440.00 ,$401.50 ,$58.54 ,$116.74 ,$390.75 ,$550.00 ,$467.50 ,$262.67 ,$506.00 ,$385.00 ,$550.00 ,$550.00 ,$334.95 ,$550.00 ,$380.05 ,$385.00 ,$117.91 ,$396.00 ,$62.05 ,$550.00 ,$550.00 ,$116.74 ,$550.00 ,$116.74 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,33300070,C9728,HC PLCMNT FIDUCIAL MARKERS OTHER,333,1 ,"$1,500.00 ",$750.00 ,$347.06 ,"$2,750.45 ",$969.00 ,$347.06 ,$970.35 ,$970.35 ,"$1,222.42 ",$900.00 ,"$1,275.00 ","$1,050.00 ",$347.06 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ","$1,222.42 ",$975.00 ,"$1,200.00 ","$1,095.00 ",$347.06 ,"$1,222.42 ",$390.75 ,"$1,500.00 ","$1,275.00 ","$2,750.45 ","$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ","$1,234.64 ","$1,080.00 ",$367.88 ,"$1,500.00 ","$1,500.00 ","$1,222.42 ","$1,500.00 ","$1,222.42 ","$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,33300071,77372,HC SRS TREATMENT,333,1 ,"$6,600.00 ","$3,300.00 ","$1,496.39 ","$16,937.82 ","$4,263.60 ","$1,496.39 ","$4,677.49 ","$4,157.77 ","$7,527.92 ","$3,960.00 ","$5,610.00 ","$4,620.00 ","$1,496.39 ","$6,270.00 ","$4,752.00 ","$4,818.00 ","$4,290.00 ","$5,610.00 ","$7,527.92 ","$4,290.00 ","$5,280.00 ","$4,818.00 ","$1,496.39 ","$7,527.92 ","$6,600.00 ","$6,600.00 ","$5,610.00 ","$16,937.82 ","$6,072.00 ","$4,620.00 ","$6,600.00 ","$6,600.00 ","$4,019.40 ","$6,600.00 ","$4,560.60 ","$4,620.00 ","$7,603.20 ","$4,752.00 ","$1,586.17 ","$6,600.00 ","$6,600.00 ","$7,527.92 ","$6,600.00 ","$7,527.92 ","$4,752.00 ","$4,092.00 ","$4,752.00 ","$4,752.00 ","$3,960.00 " ST VINCENT HOSPITAL - ACUTE,33300072,77373,HC SRT TREATMENT,333,1 ,"$9,800.00 ","$4,900.00 ",$473.35 ,"$9,800.00 ","$6,330.80 ",$473.35 ,"$5,662.17 ","$5,033.04 ","$1,679.13 ","$5,880.00 ","$8,330.00 ","$6,860.00 ",$473.35 ,"$9,310.00 ","$7,056.00 ","$7,154.00 ","$6,370.00 ","$8,330.00 ","$1,679.13 ","$6,370.00 ","$7,840.00 ","$7,154.00 ",$473.35 ,"$1,679.13 ", N/A ,"$9,800.00 ","$8,330.00 ","$3,778.04 ","$9,016.00 ","$6,860.00 ","$6,468.10 ","$6,965.65 ","$5,968.20 ","$6,468.10 ","$6,771.80 ","$6,860.00 ","$1,695.92 ","$7,056.00 ",$501.75 ,"$3,772.00 ","$3,772.00 ","$1,679.13 ","$3,772.00 ","$1,679.13 ","$7,056.00 ","$6,076.00 ","$7,056.00 ","$7,056.00 ","$5,880.00 " ST VINCENT HOSPITAL - ACUTE,33300073,77770,HC HDR AFTERLOAD 1 CHANNEL BRST/VAG/LUNG,333,1 ,"$4,600.00 ","$2,300.00 ",$153.16 ,"$4,600.00 ","$2,971.60 ",$153.16 ,$998.65 ,$887.69 ,$686.14 ,"$2,760.00 ","$3,910.00 ","$3,220.00 ",$153.16 ,"$4,370.00 ","$3,312.00 ","$3,358.00 ","$2,990.00 ","$3,910.00 ",$686.14 ,"$2,990.00 ","$3,680.00 ","$3,358.00 ",$153.16 ,$686.14 ,$390.75 ,"$4,600.00 ","$3,910.00 ","$1,543.82 ","$4,232.00 ","$3,220.00 ","$2,172.18 ","$2,339.27 ","$2,801.40 ","$2,172.18 ","$3,178.60 ","$3,220.00 ",$693.00 ,"$3,312.00 ",$162.35 ,"$1,838.00 ","$1,838.00 ",$686.14 ,"$1,838.00 ",$686.14 ,"$3,312.00 ","$2,852.00 ","$3,312.00 ","$3,312.00 ","$2,760.00 " ST VINCENT HOSPITAL - ACUTE,33300074,77771,HC HDR AFTERLOAD 2-12 CHANNELS BRST/VAG/LUNG,333,1 ,"$5,200.00 ","$2,600.00 ",$390.75 ,"$5,200.00 ","$3,359.20 ",$473.35 ,"$1,762.38 ","$1,566.56 ",$686.14 ,"$3,120.00 ","$4,420.00 ","$3,640.00 ",$473.35 ,"$4,940.00 ","$3,744.00 ","$3,796.00 ","$3,380.00 ","$4,420.00 ",$686.14 ,"$3,380.00 ","$4,160.00 ","$3,796.00 ",$473.35 ,$686.14 ,$390.75 ,"$5,200.00 ","$4,420.00 ","$1,543.82 ","$4,784.00 ","$3,640.00 ","$2,172.18 ","$2,339.27 ","$3,166.80 ","$2,172.18 ","$3,593.20 ","$3,640.00 ",$693.00 ,"$3,744.00 ",$501.75 ,"$1,838.00 ","$1,838.00 ",$686.14 ,"$1,838.00 ",$686.14 ,"$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,33300075,77772,HC HDR AFTERLOAD > 12 CHANNELS BRST/VAG/LUNG,333,1 ,"$5,200.00 ","$2,600.00 ",$390.75 ,"$5,200.00 ","$3,359.20 ",$473.35 ,"$2,756.94 ","$2,450.61 ",$686.14 ,"$3,120.00 ","$4,420.00 ","$3,640.00 ",$473.35 ,"$4,940.00 ","$3,744.00 ","$3,796.00 ","$3,380.00 ","$4,420.00 ",$686.14 ,"$3,380.00 ","$4,160.00 ","$3,796.00 ",$473.35 ,$686.14 ,$390.75 ,"$5,200.00 ","$4,420.00 ","$1,543.82 ","$4,784.00 ","$3,640.00 ","$2,172.18 ","$2,339.27 ","$3,166.80 ","$2,172.18 ","$3,593.20 ","$3,640.00 ",$693.00 ,"$3,744.00 ",$501.75 ,"$1,838.00 ","$1,838.00 ",$686.14 ,"$1,838.00 ",$686.14 ,"$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,33300081,77332,HC TREATMENT DEVICE CAPRI SIMPLE,333,1 ,$575.00 ,$287.50 ,$39.10 ,$575.00 ,$371.45 ,$39.10 ,$124.72 ,$110.87 ,$122.87 ,$345.00 ,$488.75 ,$402.50 ,$39.10 ,$546.25 ,$414.00 ,$419.75 ,$373.75 ,$488.75 ,$122.87 ,$373.75 ,$460.00 ,$419.75 ,$39.10 ,$122.87 ,$390.75 ,$575.00 ,$488.75 ,$276.47 ,$529.00 ,$402.50 ,$575.00 ,$575.00 ,$350.18 ,$575.00 ,$397.33 ,$402.50 ,$124.10 ,$414.00 ,$41.45 ,$575.00 ,$575.00 ,$122.87 ,$575.00 ,$122.87 ,$414.00 ,$356.50 ,$414.00 ,$414.00 ,$345.00 ST VINCENT HOSPITAL - ACUTE,33300082,77334,HC HAM APPLICATOR COMPLX TRMT DEVICE,333,1 ,"$1,200.00 ",$600.00 ,$60.87 ,"$1,200.00 ",$775.20 ,$60.87 ,$297.00 ,$264.00 ,$328.01 ,$720.00 ,"$1,020.00 ",$840.00 ,$60.87 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$328.01 ,$780.00 ,$960.00 ,$876.00 ,$60.87 ,$328.01 ,$390.75 ,"$1,200.00 ","$1,020.00 ",$738.03 ,"$1,104.00 ",$840.00 ,$718.72 ,$774.01 ,$730.80 ,$718.72 ,$829.20 ,$840.00 ,$331.29 ,$864.00 ,$64.52 ,"$1,200.00 ","$1,200.00 ",$328.01 ,"$1,200.00 ",$328.01 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,33300083,77387,HC INTRA FRACTION LOCAL AND TRACK,333,1 ,$350.00 ,$175.00 ,$39.10 ,$350.00 ,$226.10 ,$39.10 ,$349.65 ,$310.80 , N/A ,$210.00 ,$297.50 ,$245.00 ,$39.10 ,$332.50 ,$252.00 ,$255.50 ,$227.50 ,$297.50 , N/A ,$227.50 ,$280.00 ,$255.50 ,$39.10 , N/A ,$350.00 ,$350.00 ,$297.50 , N/A ,$322.00 ,$245.00 ,$175.00 ,$210.00 ,$213.15 ,$175.00 ,$241.85 ,$245.00 , N/A ,$252.00 ,$41.45 ,$350.00 ,$350.00 , N/A ,$350.00 , N/A ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,33300084,77293,HC RESPIRATORY MOTION MGMT SIM,333,1 ,$530.00 ,$265.00 ,$39.10 ,$530.00 ,$342.38 ,$39.10 ,$530.00 ,$530.00 , N/A ,$318.00 ,$450.50 ,$371.00 ,$39.10 ,$503.50 ,$381.60 ,$386.90 ,$344.50 ,$450.50 , N/A ,$344.50 ,$424.00 ,$386.90 ,$39.10 , N/A ,$390.75 ,$530.00 ,$450.50 , N/A ,$487.60 ,$371.00 ,$265.00 ,$318.00 ,$322.77 ,$265.00 ,$366.23 ,$371.00 , N/A ,$381.60 ,$41.45 ,$530.00 ,$530.00 , N/A ,$530.00 , N/A ,$381.60 ,$328.60 ,$381.60 ,$381.60 ,$318.00 ST VINCENT HOSPITAL - ACUTE,33300088,77799,HC REMOVE CATHETER BREAST SAVI,333,1 ,$340.00 ,$170.00 ,$58.54 ,$340.00 ,$219.64 ,$58.54 ,$219.95 ,$219.95 ,$116.74 ,$204.00 ,$289.00 ,$238.00 ,$58.54 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$116.74 ,$221.00 ,$272.00 ,$248.20 ,$58.54 ,$116.74 ,$340.00 ,$340.00 ,$289.00 ,$262.67 ,$312.80 ,$238.00 ,$340.00 ,$340.00 ,$207.06 ,$340.00 ,$234.94 ,$238.00 ,$117.91 ,$244.80 ,$62.05 ,$340.00 ,$340.00 ,$116.74 ,$340.00 ,$116.74 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,33301000,C1728,HC HEAD NECK OR BRST BRACTHRPY SEED ADM,333,1 ,$190.00 ,$95.00 ,$95.00 ,$190.00 ,$122.74 , N/A ,$122.91 ,$122.91 , N/A ,$114.00 ,$161.50 ,$133.00 , N/A ,$180.50 ,$136.80 ,$138.70 ,$123.50 ,$161.50 , N/A ,$123.50 ,$152.00 ,$138.70 , N/A , N/A ,$190.00 ,$190.00 ,$161.50 , N/A ,$174.80 ,$133.00 ,$95.00 ,$114.00 ,$115.71 ,$95.00 ,$131.29 ,$133.00 , N/A ,$136.80 , N/A ,$190.00 ,$190.00 , N/A ,$190.00 , N/A ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,33301001,31575,HC LARYNGOSCOPY FLEX FIBEROPTC,333,1 ,$275.00 ,$137.50 ,$35.67 ,$358.23 ,$177.65 ,$35.67 ,$177.90 ,$177.90 ,$159.21 ,$165.00 ,$233.75 ,$192.50 ,$35.67 ,$261.25 ,$198.00 ,$200.75 ,$178.75 ,$233.75 ,$159.21 ,$178.75 ,$220.00 ,$200.75 ,$35.67 ,$159.21 ,$275.00 ,$275.00 ,$233.75 ,$358.23 ,$253.00 ,$192.50 ,$275.00 ,$275.00 ,$167.48 ,$275.00 ,$190.03 ,$192.50 ,$160.80 ,$198.00 ,$37.81 ,$275.00 ,$275.00 ,$159.21 ,$275.00 ,$159.21 ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,33301002,49411,HC PLCMT INSTST DEV ABD/PELV/RETR,333,1 ,"$3,300.00 ","$1,650.00 ",$390.75 ,"$3,300.00 ","$2,131.80 ",$555.45 ,"$2,134.77 ","$2,134.77 ","$1,222.42 ","$1,980.00 ","$2,805.00 ","$2,310.00 ",$555.45 ,"$3,135.00 ","$2,376.00 ","$2,409.00 ","$2,145.00 ","$2,805.00 ","$1,222.42 ","$2,145.00 ","$2,640.00 ","$2,409.00 ",$555.45 ,"$1,222.42 ",$390.75 ,"$3,300.00 ","$2,805.00 ","$2,750.45 ","$3,036.00 ","$2,310.00 ","$2,066.93 ","$2,778.48 ","$2,009.70 ","$2,583.66 ","$2,280.30 ","$2,310.00 ","$1,234.64 ","$2,376.00 ",$588.78 ,"$1,838.00 ","$1,838.00 ","$1,222.42 ","$1,838.00 ","$1,222.42 ","$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,33301004,57156,HC INSERTION OF VAG CLY BRACHY DEVICE,361,1 ,"$1,800.00 ",$900.00 ,$205.01 ,"$1,800.00 ","$1,162.80 ",$205.01 ,"$1,800.00 ","$1,800.00 ",$272.61 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$205.01 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ",$272.61 ,"$1,800.00 ","$1,440.00 ","$1,314.00 ",$205.01 ,$272.61 ,"$1,655.72 ","$1,800.00 ","$1,530.00 ",$613.38 ,"$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ",$275.34 ,"$1,296.00 ",$217.31 ,"$1,800.00 ","$1,800.00 ",$272.61 ,"$1,800.00 ",$272.61 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,33301005,77280,HC SIMULATION SMP,333,1 ,"$1,000.00 ",$500.00 ,$39.10 ,"$1,000.00 ",$646.00 ,$39.10 ,"$1,000.00 ",$934.47 ,$122.87 ,$600.00 ,$850.00 ,$700.00 ,$39.10 ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 ,$122.87 ,$650.00 ,$800.00 ,$730.00 ,$39.10 ,$122.87 ,$390.75 ,"$1,000.00 ",$850.00 ,$276.47 ,$920.00 ,$700.00 ,$385.98 ,$415.67 ,$609.00 ,$385.98 ,$691.00 ,$700.00 ,$124.10 ,$720.00 ,$41.45 ,"$1,000.00 ","$1,000.00 ",$122.87 ,"$1,000.00 ",$122.87 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,33301007,77790,HC RADIOELEMENT HANDLING/LOADING,333,1 ,$450.00 ,$225.00 ,$39.10 ,$450.00 ,$290.70 ,$39.10 ,$65.75 ,$58.44 , N/A ,$270.00 ,$382.50 ,$315.00 ,$39.10 ,$427.50 ,$324.00 ,$328.50 ,$292.50 ,$382.50 , N/A ,$292.50 ,$360.00 ,$328.50 ,$39.10 , N/A ,$390.75 ,$450.00 ,$382.50 , N/A ,$414.00 ,$315.00 ,$225.00 ,$270.00 ,$274.05 ,$225.00 ,$310.95 ,$315.00 , N/A ,$324.00 ,$41.45 ,$450.00 ,$450.00 , N/A ,$450.00 , N/A ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,33301008,77399,HC IMAGE FUSION DOSIMETRY,333,1 ,$260.00 ,$130.00 ,$39.10 ,$276.47 ,$167.96 ,$39.10 ,$168.19 ,$168.19 ,$122.87 ,$156.00 ,$221.00 ,$182.00 ,$39.10 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 ,$122.87 ,$169.00 ,$208.00 ,$189.80 ,$39.10 ,$122.87 ,$260.00 ,$260.00 ,$221.00 ,$276.47 ,$239.20 ,$182.00 ,$260.00 ,$260.00 ,$158.34 ,$260.00 ,$179.66 ,$182.00 ,$124.10 ,$187.20 ,$41.45 ,$260.00 ,$260.00 ,$122.87 ,$260.00 ,$122.87 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,33500002,96401,HC CHEMO SQ/IM NON ANTI-NEOPLAST,335,1 ,$320.00 ,$160.00 ,$14.00 ,$320.00 ,$206.72 ,$14.00 ,$207.01 ,$207.01 ,$60.02 ,$192.00 ,$272.00 ,$224.00 ,$14.00 ,$304.00 ,$230.40 ,$233.60 ,$208.00 ,$272.00 ,$60.02 ,$208.00 ,$256.00 ,$233.60 ,$14.00 ,$60.02 ,$272.64 ,$320.00 ,$272.00 ,$135.04 ,$294.40 ,$224.00 ,$160.00 ,$192.00 ,$194.88 ,$160.00 ,$221.12 ,$224.00 ,$60.62 ,$230.40 ,$14.84 ,$320.00 ,$320.00 ,$60.02 ,$320.00 ,$60.02 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,33500003,96409,HC CHEMO IV PUSH SINGLE/INIT,335,1 ,$540.00 ,$270.00 ,$14.00 ,$540.00 ,$348.84 ,$14.00 ,$349.33 ,$349.33 ,$197.09 ,$324.00 ,$459.00 ,$378.00 ,$14.00 ,$513.00 ,$388.80 ,$394.20 ,$351.00 ,$459.00 ,$197.09 ,$351.00 ,$432.00 ,$394.20 ,$14.00 ,$197.09 ,$272.64 ,$540.00 ,$459.00 ,$443.45 ,$496.80 ,$378.00 ,$270.00 ,$324.00 ,$328.86 ,$270.00 ,$373.14 ,$378.00 ,$199.06 ,$388.80 ,$14.84 ,$540.00 ,$540.00 ,$197.09 ,$540.00 ,$197.09 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,33500004,96411,HC CHEMO IV PUSH ADDL DRUG,335,1 ,$310.00 ,$155.00 ,$14.00 ,$310.00 ,$200.26 ,$14.00 ,$200.54 ,$200.54 ,$60.02 ,$186.00 ,$263.50 ,$217.00 ,$14.00 ,$294.50 ,$223.20 ,$226.30 ,$201.50 ,$263.50 ,$60.02 ,$201.50 ,$248.00 ,$226.30 ,$14.00 ,$60.02 ,$272.64 ,$310.00 ,$263.50 ,$135.04 ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 ,$60.62 ,$223.20 ,$14.84 ,$310.00 ,$310.00 ,$60.02 ,$310.00 ,$60.02 ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,33500005,96413,HC CHEMO IV INFUSION SGL/INIT<1H,335,1 ,$830.00 ,$415.00 ,$100.19 ,$830.00 ,$536.18 ,$100.19 ,$536.93 ,$536.93 ,$300.96 ,$498.00 ,$705.50 ,$581.00 ,$100.19 ,$788.50 ,$597.60 ,$605.90 ,$539.50 ,$705.50 ,$300.96 ,$539.50 ,$664.00 ,$605.90 ,$100.19 ,$300.96 ,$272.64 ,$830.00 ,$705.50 ,$677.16 ,$763.60 ,$581.00 ,$415.00 ,$498.00 ,$505.47 ,$415.00 ,$573.53 ,$581.00 ,$303.97 ,$597.60 ,$106.20 ,$830.00 ,$830.00 ,$300.96 ,$830.00 ,$300.96 ,$597.60 ,$514.60 ,$597.60 ,$597.60 ,$498.00 ST VINCENT HOSPITAL - ACUTE,33500006,96415,HC CHEMO IV INFUSION ADDL HR,335,1 ,$210.00 ,$105.00 ,$60.02 ,$210.00 ,$135.66 ,$145.88 ,$135.85 ,$135.85 ,$60.02 ,$126.00 ,$178.50 ,$147.00 ,$145.88 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$60.02 ,$136.50 ,$168.00 ,$153.30 ,$145.88 ,$60.02 ,$210.00 ,$210.00 ,$178.50 ,$135.04 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$60.62 ,$151.20 ,$154.63 ,$210.00 ,$210.00 ,$60.02 ,$210.00 ,$60.02 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,33500007,96416,HC CHEMO ADMIN INTRAV INFUS >8HR,335,1 ,$830.00 ,$415.00 ,$145.88 ,$830.00 ,$536.18 ,$145.88 ,$536.93 ,$536.93 ,$300.96 ,$498.00 ,$705.50 ,$581.00 ,$145.88 ,$788.50 ,$597.60 ,$605.90 ,$539.50 ,$705.50 ,$300.96 ,$539.50 ,$664.00 ,$605.90 ,$145.88 ,$300.96 ,$272.64 ,$830.00 ,$705.50 ,$677.16 ,$763.60 ,$581.00 ,$415.00 ,$498.00 ,$505.47 ,$415.00 ,$573.53 ,$581.00 ,$303.97 ,$597.60 ,$154.63 ,$830.00 ,$830.00 ,$300.96 ,$830.00 ,$300.96 ,$597.60 ,$514.60 ,$597.60 ,$597.60 ,$498.00 ST VINCENT HOSPITAL - ACUTE,33500008,96417,HC CHEMO IV INFUSION EA ADDL <1H,335,1 ,$300.00 ,$150.00 ,$60.02 ,$300.00 ,$193.80 ,$100.19 ,$194.07 ,$194.07 ,$60.02 ,$180.00 ,$255.00 ,$210.00 ,$100.19 ,$285.00 ,$216.00 ,$219.00 ,$195.00 ,$255.00 ,$60.02 ,$195.00 ,$240.00 ,$219.00 ,$100.19 ,$60.02 ,$272.64 ,$300.00 ,$255.00 ,$135.04 ,$276.00 ,$210.00 ,$150.00 ,$180.00 ,$182.70 ,$150.00 ,$207.30 ,$210.00 ,$60.62 ,$216.00 ,$106.20 ,$300.00 ,$300.00 ,$60.02 ,$300.00 ,$60.02 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,33500009,96422,HC CHEMO ADMIN INTRA-ARTR INFUS<1HR,335,1 ,$830.00 ,$415.00 ,$100.19 ,$830.00 ,$536.18 ,$100.19 ,$536.93 ,$536.93 ,$197.09 ,$498.00 ,$705.50 ,$581.00 ,$100.19 ,$788.50 ,$597.60 ,$605.90 ,$539.50 ,$705.50 ,$197.09 ,$539.50 ,$664.00 ,$605.90 ,$100.19 ,$197.09 ,$272.64 ,$830.00 ,$705.50 ,$443.45 ,$763.60 ,$581.00 ,$415.00 ,$498.00 ,$505.47 ,$415.00 ,$573.53 ,$581.00 ,$199.06 ,$597.60 ,$106.20 ,$830.00 ,$830.00 ,$197.09 ,$830.00 ,$197.09 ,$597.60 ,$514.60 ,$597.60 ,$597.60 ,$498.00 ST VINCENT HOSPITAL - ACUTE,33500010,96423,HC CHEMO ADMN INTR-ARTR EA ADD HR,335,1 ,$210.00 ,$105.00 ,$38.74 ,$210.00 ,$135.66 ,$145.88 ,$135.85 ,$135.85 ,$38.74 ,$126.00 ,$178.50 ,$147.00 ,$145.88 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$38.74 ,$136.50 ,$168.00 ,$153.30 ,$145.88 ,$38.74 ,$210.00 ,$210.00 ,$178.50 ,$87.17 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$39.13 ,$151.20 ,$154.63 ,$210.00 ,$210.00 ,$38.74 ,$210.00 ,$38.74 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,33500011,96446,HC CHEMO PERITONEAL CAVITY,335,1 ,$710.00 ,$355.00 ,$100.19 ,$710.00 ,$458.66 ,$100.19 ,$459.30 ,$459.30 ,$300.96 ,$426.00 ,$603.50 ,$497.00 ,$100.19 ,$674.50 ,$511.20 ,$518.30 ,$461.50 ,$603.50 ,$300.96 ,$461.50 ,$568.00 ,$518.30 ,$100.19 ,$300.96 ,$272.64 ,$710.00 ,$603.50 ,$677.16 ,$653.20 ,$497.00 ,$355.00 ,$426.00 ,$432.39 ,$355.00 ,$490.61 ,$497.00 ,$303.97 ,$511.20 ,$106.20 ,$710.00 ,$710.00 ,$300.96 ,$710.00 ,$300.96 ,$511.20 ,$440.20 ,$511.20 ,$511.20 ,$426.00 ST VINCENT HOSPITAL - ACUTE,33500012,96450,HC CHEMO CNS,335,1 ,$910.00 ,$455.00 ,$145.88 ,$910.00 ,$587.86 ,$145.88 ,$588.68 ,$588.68 ,$300.96 ,$546.00 ,$773.50 ,$637.00 ,$145.88 ,$864.50 ,$655.20 ,$664.30 ,$591.50 ,$773.50 ,$300.96 ,$591.50 ,$728.00 ,$664.30 ,$145.88 ,$300.96 ,$272.64 ,$910.00 ,$773.50 ,$677.16 ,$837.20 ,$637.00 ,$455.00 ,$546.00 ,$554.19 ,$455.00 ,$628.81 ,$637.00 ,$303.97 ,$655.20 ,$154.63 ,$910.00 ,$910.00 ,$300.96 ,$910.00 ,$300.96 ,$655.20 ,$564.20 ,$655.20 ,$655.20 ,$546.00 ST VINCENT HOSPITAL - ACUTE,33500013,96402,HC CHEMOTHERAPY INJECTION-HORMONAL ANTI-NEO,335,1 ,$210.00 ,$105.00 ,$14.00 ,$210.00 ,$135.66 ,$14.00 ,$135.85 ,$135.85 ,$60.02 ,$126.00 ,$178.50 ,$147.00 ,$14.00 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$60.02 ,$136.50 ,$168.00 ,$153.30 ,$14.00 ,$60.02 ,$210.00 ,$210.00 ,$178.50 ,$135.04 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$60.62 ,$151.20 ,$14.84 ,$210.00 ,$210.00 ,$60.02 ,$210.00 ,$60.02 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,33500014,96521,HC REFILLING/MAINTENANCE PORTABLE PUMP,335,1 ,$850.00 ,$425.00 ,$14.00 ,$850.00 ,$549.10 ,$14.00 ,$549.87 ,$549.87 ,$197.09 ,$510.00 ,$722.50 ,$595.00 ,$14.00 ,$807.50 ,$612.00 ,$620.50 ,$552.50 ,$722.50 ,$197.09 ,$552.50 ,$680.00 ,$620.50 ,$14.00 ,$197.09 ,$272.64 ,$850.00 ,$722.50 ,$443.45 ,$782.00 ,$595.00 ,$425.00 ,$510.00 ,$517.65 ,$425.00 ,$587.35 ,$595.00 ,$199.06 ,$612.00 ,$14.84 ,$850.00 ,$850.00 ,$197.09 ,$850.00 ,$197.09 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,33500023,G6004,HC DAILY TX SIMPLE 6-10MV/MEV G6004,333,1 ,$800.00 ,$400.00 ,$58.54 ,$800.00 ,$516.80 ,$58.54 ,$627.58 ,$557.85 , N/A ,$480.00 ,$680.00 ,$560.00 ,$58.54 ,$760.00 ,$576.00 ,$584.00 ,$520.00 ,$680.00 , N/A ,$520.00 ,$640.00 ,$584.00 ,$58.54 , N/A ,$390.75 ,$800.00 ,$680.00 , N/A ,$736.00 ,$560.00 ,$400.00 ,$480.00 ,$487.20 ,$400.00 ,$552.80 ,$560.00 , N/A ,$576.00 ,$62.05 ,$800.00 ,$800.00 , N/A ,$800.00 , N/A ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,33500025,96542,HC CHEMOTHERAPY INJECTION SUBARACHNOID OR INTRAVENTRICULAR,335,1 ,$540.00 ,$270.00 ,$14.00 ,$540.00 ,$348.84 ,$14.00 ,$349.33 ,$349.33 ,$197.09 ,$324.00 ,$459.00 ,$378.00 ,$14.00 ,$513.00 ,$388.80 ,$394.20 ,$351.00 ,$459.00 ,$197.09 ,$351.00 ,$432.00 ,$394.20 ,$14.00 ,$197.09 ,$272.64 ,$540.00 ,$459.00 ,$443.45 ,$496.80 ,$378.00 ,$270.00 ,$324.00 ,$328.86 ,$270.00 ,$373.14 ,$378.00 ,$199.06 ,$388.80 ,$14.84 ,$540.00 ,$540.00 ,$197.09 ,$540.00 ,$197.09 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,34000002,78012,HC THYROID UPTAKE SGL/MULT 78012,340,1 ,$490.00 ,$245.00 ,$117.70 ,$821.79 ,$316.54 ,$117.70 ,$319.29 ,$283.81 ,$365.24 ,$294.00 ,$416.50 ,$343.00 ,$117.70 ,$465.50 ,$352.80 ,$357.70 ,$318.50 ,$416.50 ,$365.24 ,$318.50 ,$392.00 ,$357.70 ,$117.70 ,$365.24 ,$490.00 ,$490.00 ,$416.50 ,$821.79 ,$450.80 ,$343.00 ,$472.62 ,$490.00 ,$298.41 ,$472.62 ,$338.59 ,$343.00 ,$368.89 ,$352.80 ,$124.76 ,$490.00 ,$490.00 ,$365.24 ,$490.00 ,$365.24 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,34000004,78014,HC NM THYROID IMAGING SGL OR MULT UPTAKE 78014,340,1 ,"$1,500.00 ",$750.00 ,$117.70 ,"$1,500.00 ",$969.00 ,$117.70 ,$967.05 ,$859.60 ,$365.24 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$117.70 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ",$365.24 ,$975.00 ,"$1,200.00 ","$1,095.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,500.00 ","$1,275.00 ",$821.79 ,"$1,380.00 ","$1,050.00 ",$965.98 ,"$1,040.29 ",$913.50 ,$965.98 ,"$1,036.50 ","$1,050.00 ",$368.89 ,"$1,080.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,34000006,78013,HC NM THYROID SCAN,340,1 ,$950.00 ,$475.00 ,$117.70 ,$950.00 ,$613.70 ,$117.70 ,$776.15 ,$689.91 ,$365.24 ,$570.00 ,$807.50 ,$665.00 ,$117.70 ,$902.50 ,$684.00 ,$693.50 ,$617.50 ,$807.50 ,$365.24 ,$617.50 ,$760.00 ,$693.50 ,$117.70 ,$365.24 ,$566.26 ,$950.00 ,$807.50 ,$821.79 ,$874.00 ,$665.00 ,$617.42 ,$664.91 ,$578.55 ,$617.42 ,$656.45 ,$665.00 ,$368.89 ,$684.00 ,$124.76 ,$950.00 ,$950.00 ,$365.24 ,$950.00 ,$365.24 ,$684.00 ,$589.00 ,$684.00 ,$684.00 ,$570.00 ST VINCENT HOSPITAL - ACUTE,34000007,78018,HC NM THYROID CA METS WHOLE BODY,340,1 ,"$2,000.00 ","$1,000.00 ",$117.70 ,"$2,000.00 ","$1,292.00 ",$117.70 ,"$1,215.93 ","$1,080.83 ",$473.98 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$117.70 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,300.00 ","$1,700.00 ",$473.98 ,"$1,300.00 ","$1,600.00 ","$1,460.00 ",$117.70 ,$473.98 ,$566.26 ,"$2,000.00 ","$1,700.00 ","$1,066.46 ","$1,840.00 ","$1,400.00 ","$1,288.59 ","$1,387.71 ","$1,218.00 ","$1,288.59 ","$1,382.00 ","$1,400.00 ",$478.72 ,"$1,440.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,34000008,78020,HC THYROID CARCINOMA METS UPTAKE,340,1 ,$500.00 ,$250.00 ,$117.70 ,$500.00 ,$323.00 ,$117.70 ,$249.45 ,$221.73 , N/A ,$300.00 ,$425.00 ,$350.00 ,$117.70 ,$475.00 ,$360.00 ,$365.00 ,$325.00 ,$425.00 , N/A ,$325.00 ,$400.00 ,$365.00 ,$117.70 , N/A ,$500.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$124.76 ,$500.00 ,$500.00 , N/A ,$500.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,34000009,78070,HC PARATHRYOID IMAGING 78070,340,1 ,"$1,600.00 ",$800.00 ,$289.73 ,"$1,600.00 ","$1,033.60 ",$289.73 ,"$1,161.05 ","$1,032.04 ",$365.24 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$289.73 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$365.24 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$289.73 ,$365.24 ,$566.26 ,"$1,600.00 ","$1,360.00 ",$821.79 ,"$1,472.00 ","$1,120.00 ",$965.98 ,"$1,040.29 ",$974.40 ,$965.98 ,"$1,105.60 ","$1,120.00 ",$368.89 ,"$1,152.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000010,78102,"HC BONE MARROW IMAGING, LTD",340,1 ,"$1,000.00 ",$500.00 ,$117.70 ,"$1,000.00 ",$646.00 ,$117.70 ,$639.57 ,$568.51 ,$365.24 ,$600.00 ,$850.00 ,$700.00 ,$117.70 ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 ,$365.24 ,$650.00 ,$800.00 ,$730.00 ,$117.70 ,$365.24 ,$566.26 ,"$1,000.00 ",$850.00 ,$821.79 ,$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$368.89 ,$720.00 ,$124.76 ,"$1,000.00 ","$1,000.00 ",$365.24 ,"$1,000.00 ",$365.24 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,34000011,78104,HC BONE MARROW IMAGING WHOLE BODY,340,1 ,"$1,300.00 ",$650.00 ,$117.70 ,"$1,300.00 ",$839.80 ,$117.70 ,$936.01 ,$832.01 ,$365.24 ,$780.00 ,"$1,105.00 ",$910.00 ,$117.70 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$365.24 ,$845.00 ,"$1,040.00 ",$949.00 ,$117.70 ,$365.24 ,$566.26 ,"$1,300.00 ","$1,105.00 ",$821.79 ,"$1,196.00 ",$910.00 ,"$1,165.98 ","$1,255.67 ",$791.70 ,"$1,165.98 ",$898.30 ,$910.00 ,$368.89 ,$936.00 ,$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,34000012,78135,HC RED CELL SURVIVAL/SEQUES,340,1 ,"$1,800.00 ",$900.00 ,$566.26 ,"$1,800.00 ","$1,162.80 ", N/A ,"$1,122.81 ",$998.06 , N/A ,"$1,080.00 ","$1,530.00 ","$1,260.00 ", N/A ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,170.00 ","$1,530.00 ", N/A ,"$1,170.00 ","$1,440.00 ","$1,314.00 ", N/A , N/A ,$566.26 ,"$1,800.00 ","$1,530.00 ", N/A ,"$1,656.00 ","$1,260.00 ",$900.00 ,"$1,080.00 ","$1,096.20 ",$900.00 ,"$1,243.80 ","$1,260.00 ", N/A ,"$1,296.00 ", N/A ,"$1,131.00 ","$1,131.00 ", N/A ,"$1,131.00 ", N/A ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,34000013,78191,HC PLATELET SURVIVAL,340,1 ,$800.00 ,$400.00 ,$117.70 ,$821.79 ,$516.80 ,$117.70 ,$436.82 ,$388.28 ,$365.24 ,$480.00 ,$680.00 ,$560.00 ,$117.70 ,$760.00 ,$576.00 ,$584.00 ,$520.00 ,$680.00 ,$365.24 ,$520.00 ,$640.00 ,$584.00 ,$117.70 ,$365.24 ,$566.26 ,$800.00 ,$680.00 ,$821.79 ,$736.00 ,$560.00 ,$800.00 ,$800.00 ,$487.20 ,$800.00 ,$552.80 ,$560.00 ,$368.89 ,$576.00 ,$124.76 ,$800.00 ,$800.00 ,$365.24 ,$800.00 ,$365.24 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,34000014,78195,HC LYMPH NODE IMAGING,340,1 ,"$2,000.00 ","$1,000.00 ",$289.73 ,"$2,000.00 ","$1,292.00 ",$289.73 ,"$1,330.78 ","$1,182.92 ",$473.98 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$289.73 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,300.00 ","$1,700.00 ",$473.98 ,"$1,300.00 ","$1,600.00 ","$1,460.00 ",$289.73 ,$473.98 ,$566.26 ,"$2,000.00 ","$1,700.00 ","$1,066.46 ","$1,840.00 ","$1,400.00 ","$1,165.98 ","$1,255.67 ","$1,218.00 ","$1,165.98 ","$1,382.00 ","$1,400.00 ",$478.72 ,"$1,440.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,34000015,78201,HC LIVER IMAGING STATIC,340,1 ,"$1,100.00 ",$550.00 ,$289.73 ,"$1,100.00 ",$710.60 ,$289.73 ,$755.97 ,$671.97 ,$473.98 ,$660.00 ,$935.00 ,$770.00 ,$289.73 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$473.98 ,$715.00 ,$880.00 ,$803.00 ,$289.73 ,$473.98 ,$566.26 ,"$1,100.00 ",$935.00 ,"$1,066.46 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$478.72 ,$792.00 ,$307.11 ,"$1,100.00 ","$1,100.00 ",$473.98 ,"$1,100.00 ",$473.98 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,34000016,78202,HC LIVER IMAGING STATIC FLOW,340,1 ,"$1,000.00 ",$500.00 ,$289.73 ,"$1,066.46 ",$646.00 ,$289.73 ,$796.32 ,$707.84 ,$473.98 ,$600.00 ,$850.00 ,$700.00 ,$289.73 ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 ,$473.98 ,$650.00 ,$800.00 ,$730.00 ,$289.73 ,$473.98 ,$566.26 ,"$1,000.00 ",$850.00 ,"$1,066.46 ",$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$478.72 ,$720.00 ,$307.11 ,"$1,000.00 ","$1,000.00 ",$473.98 ,"$1,000.00 ",$473.98 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,34000019,78215,HC LIVER SPLEEN STATIC,340,1 ,"$1,300.00 ",$650.00 ,$289.73 ,"$1,300.00 ",$839.80 ,$289.73 ,$760.63 ,$676.11 ,$365.24 ,$780.00 ,"$1,105.00 ",$910.00 ,$289.73 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$365.24 ,$845.00 ,"$1,040.00 ",$949.00 ,$289.73 ,$365.24 ,$566.26 ,"$1,300.00 ","$1,105.00 ",$821.79 ,"$1,196.00 ",$910.00 ,"$1,254.27 ","$1,300.00 ",$791.70 ,"$1,254.27 ",$898.30 ,$910.00 ,$368.89 ,$936.00 ,$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,34000020,78216,HC LIVER SPLEEN STATIC FLOW,340,1 ,"$1,700.00 ",$850.00 ,$289.73 ,"$1,700.00 ","$1,098.20 ",$289.73 ,$447.12 ,$397.44 ,$365.24 ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$289.73 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,105.00 ","$1,445.00 ",$365.24 ,"$1,105.00 ","$1,360.00 ","$1,241.00 ",$289.73 ,$365.24 ,$566.26 ,"$1,700.00 ","$1,445.00 ",$821.79 ,"$1,564.00 ","$1,190.00 ","$1,254.27 ","$1,350.75 ","$1,035.30 ","$1,254.27 ","$1,174.70 ","$1,190.00 ",$368.89 ,"$1,224.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,34000021,78216,HC RBC LIVER SCAN,340,1 ,"$1,700.00 ",$850.00 ,$289.73 ,"$1,700.00 ","$1,098.20 ",$289.73 ,$447.12 ,$397.44 ,$365.24 ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$289.73 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,105.00 ","$1,445.00 ",$365.24 ,"$1,105.00 ","$1,360.00 ","$1,241.00 ",$289.73 ,$365.24 ,$566.26 ,"$1,700.00 ","$1,445.00 ",$821.79 ,"$1,564.00 ","$1,190.00 ","$1,254.27 ","$1,350.75 ","$1,035.30 ","$1,254.27 ","$1,174.70 ","$1,190.00 ",$368.89 ,"$1,224.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,34000022,78226,HC HEPATOBILIARY SCAN,340,1 ,"$2,000.00 ","$1,000.00 ",$117.70 ,"$2,000.00 ","$1,292.00 ",$117.70 ,"$1,312.16 ","$1,166.36 ",$365.24 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$117.70 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,300.00 ","$1,700.00 ",$365.24 ,"$1,300.00 ","$1,600.00 ","$1,460.00 ",$117.70 ,$365.24 ,$566.26 ,"$2,000.00 ","$1,700.00 ",$821.79 ,"$1,840.00 ","$1,400.00 ","$1,254.27 ","$1,350.75 ","$1,218.00 ","$1,254.27 ","$1,382.00 ","$1,400.00 ",$368.89 ,"$1,440.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,34000023,78231,HC SALIVARY GLAND SCAN SERIAL,340,1 ,"$1,400.00 ",$700.00 ,$117.70 ,"$1,400.00 ",$904.40 ,$117.70 ,$363.31 ,$322.94 ,$365.24 ,$840.00 ,"$1,190.00 ",$980.00 ,$117.70 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$365.24 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,400.00 ","$1,190.00 ",$821.79 ,"$1,288.00 ",$980.00 ,"$1,090.00 ","$1,173.85 ",$852.60 ,"$1,090.00 ",$967.40 ,$980.00 ,$368.89 ,"$1,008.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,34000024,78261,HC GASTRIC MUCOSA IMAGING,340,1 ,"$1,000.00 ",$500.00 ,$117.70 ,"$1,000.00 ",$646.00 ,$117.70 ,$774.60 ,$688.53 ,$365.24 ,$600.00 ,$850.00 ,$700.00 ,$117.70 ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 ,$365.24 ,$650.00 ,$800.00 ,$730.00 ,$117.70 ,$365.24 ,$566.26 ,"$1,000.00 ",$850.00 ,$821.79 ,$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$368.89 ,$720.00 ,$124.76 ,"$1,000.00 ","$1,000.00 ",$365.24 ,"$1,000.00 ",$365.24 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,34000025,78262,HC GASTROESOPHAGEAL REFLUX,340,1 ,"$1,000.00 ",$500.00 ,$117.70 ,"$1,000.00 ",$646.00 ,$117.70 ,$929.80 ,$826.49 ,$365.24 ,$600.00 ,$850.00 ,$700.00 ,$117.70 ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 ,$365.24 ,$650.00 ,$800.00 ,$730.00 ,$117.70 ,$365.24 ,$566.26 ,"$1,000.00 ",$850.00 ,$821.79 ,$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$368.89 ,$720.00 ,$124.76 ,"$1,000.00 ","$1,000.00 ",$365.24 ,"$1,000.00 ",$365.24 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,34000026,78264,HC GASTRIC EMPTYING STUDY,340,1 ,"$1,600.00 ",$800.00 ,$117.70 ,"$1,600.00 ","$1,033.60 ",$117.70 ,"$1,323.02 ","$1,176.02 ",$365.24 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$117.70 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$365.24 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,600.00 ","$1,360.00 ",$821.79 ,"$1,472.00 ","$1,120.00 ","$1,090.00 ","$1,173.85 ",$974.40 ,"$1,090.00 ","$1,105.60 ","$1,120.00 ",$368.89 ,"$1,152.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000027,78278,HC GI BLEED SCAN,340,1 ,"$1,800.00 ",$900.00 ,$289.73 ,"$1,800.00 ","$1,162.80 ",$289.73 ,"$1,341.65 ","$1,192.58 ",$365.24 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$289.73 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,170.00 ","$1,530.00 ",$365.24 ,"$1,170.00 ","$1,440.00 ","$1,314.00 ",$289.73 ,$365.24 ,$566.26 ,"$1,800.00 ","$1,530.00 ",$821.79 ,"$1,656.00 ","$1,260.00 ","$1,090.00 ","$1,173.85 ","$1,096.20 ","$1,090.00 ","$1,243.80 ","$1,260.00 ",$368.89 ,"$1,296.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,34000028,78290,HC SM BOWEL MECKEL'S SCAN,340,1 ,"$1,700.00 ",$850.00 ,$117.70 ,"$1,700.00 ","$1,098.20 ",$117.70 ,"$1,327.68 ","$1,180.16 ",$365.24 ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$117.70 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,105.00 ","$1,445.00 ",$365.24 ,"$1,105.00 ","$1,360.00 ","$1,241.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,700.00 ","$1,445.00 ",$821.79 ,"$1,564.00 ","$1,190.00 ","$1,090.00 ","$1,173.85 ","$1,035.30 ","$1,090.00 ","$1,174.70 ","$1,190.00 ",$368.89 ,"$1,224.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,34000029,78300,HC BONE SCAN LIMITED,340,1 ,"$1,300.00 ",$650.00 ,$117.70 ,"$1,300.00 ",$839.80 ,$117.70 ,$890.44 ,$791.50 ,$365.24 ,$780.00 ,"$1,105.00 ",$910.00 ,$117.70 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$365.24 ,$845.00 ,"$1,040.00 ",$949.00 ,$117.70 ,$365.24 ,$566.26 ,"$1,300.00 ","$1,105.00 ",$821.79 ,"$1,196.00 ",$910.00 ,"$1,090.56 ","$1,174.45 ",$791.70 ,"$1,090.56 ",$898.30 ,$910.00 ,$368.89 ,$936.00 ,$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,34000030,78305,HC BONE SCAN MULTIPLE,340,1 ,"$1,600.00 ",$800.00 ,$117.70 ,"$1,600.00 ","$1,033.60 ",$117.70 ,"$1,069.48 ",$950.65 ,$365.24 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$117.70 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$365.24 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,600.00 ","$1,360.00 ",$821.79 ,"$1,472.00 ","$1,120.00 ","$1,090.56 ","$1,174.45 ",$974.40 ,"$1,090.56 ","$1,105.60 ","$1,120.00 ",$368.89 ,"$1,152.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000031,78306,HC BONE SCAN WHOLE BODY,340,1 ,"$1,900.00 ",$950.00 ,$117.70 ,"$1,900.00 ","$1,227.40 ",$117.70 ,"$1,162.60 ","$1,033.42 ",$365.24 ,"$1,140.00 ","$1,615.00 ","$1,330.00 ",$117.70 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,235.00 ","$1,615.00 ",$365.24 ,"$1,235.00 ","$1,520.00 ","$1,387.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,900.00 ","$1,615.00 ",$821.79 ,"$1,748.00 ","$1,330.00 ","$1,090.56 ","$1,174.45 ","$1,157.10 ","$1,090.56 ","$1,312.90 ","$1,330.00 ",$368.89 ,"$1,368.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,34000033,78315,HC BONE SCAN/3 PHASE,340,1 ,"$2,100.00 ","$1,050.00 ",$117.70 ,"$2,100.00 ","$1,356.60 ",$117.70 ,"$1,324.58 ","$1,177.40 ",$365.24 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$117.70 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$1,365.00 ","$1,785.00 ",$365.24 ,"$1,365.00 ","$1,680.00 ","$1,533.00 ",$117.70 ,$365.24 ,$566.26 ,"$2,100.00 ","$1,785.00 ",$821.79 ,"$1,932.00 ","$1,470.00 ","$1,090.56 ","$1,174.45 ","$1,278.90 ","$1,090.56 ","$1,451.10 ","$1,470.00 ",$368.89 ,"$1,512.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,34000035,78451,HC HT MUSCLE IMAGE SPECT SINGLE,340,1 ,"$4,200.00 ","$2,100.00 ",$289.73 ,"$4,200.00 ","$2,713.20 ",$289.73 ,"$1,215.93 ","$1,080.83 ","$1,264.80 ","$2,520.00 ","$3,570.00 ","$2,940.00 ",$289.73 ,"$3,990.00 ","$3,024.00 ","$3,066.00 ","$2,730.00 ","$3,570.00 ","$1,264.80 ","$2,730.00 ","$3,360.00 ","$3,066.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$4,200.00 ","$3,570.00 ","$2,845.81 ","$3,864.00 ","$2,940.00 ","$3,883.68 ","$4,182.43 ","$2,557.80 ","$3,883.68 ","$2,902.20 ","$2,940.00 ","$1,277.45 ","$3,024.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$3,024.00 ","$2,604.00 ","$3,024.00 ","$3,024.00 ","$2,520.00 " ST VINCENT HOSPITAL - ACUTE,34000036,78451,HC HT MUSCLE IMAGE SPECT SINGLE REST ONLY,340,1 ,"$4,200.00 ","$2,100.00 ",$289.73 ,"$4,200.00 ","$2,713.20 ",$289.73 ,"$1,215.93 ","$1,080.83 ","$1,264.80 ","$2,520.00 ","$3,570.00 ","$2,940.00 ",$289.73 ,"$3,990.00 ","$3,024.00 ","$3,066.00 ","$2,730.00 ","$3,570.00 ","$1,264.80 ","$2,730.00 ","$3,360.00 ","$3,066.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$4,200.00 ","$3,570.00 ","$2,845.81 ","$3,864.00 ","$2,940.00 ","$3,883.68 ","$4,182.43 ","$2,557.80 ","$3,883.68 ","$2,902.20 ","$2,940.00 ","$1,277.45 ","$3,024.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$3,024.00 ","$2,604.00 ","$3,024.00 ","$3,024.00 ","$2,520.00 " ST VINCENT HOSPITAL - ACUTE,34000037,78452,HC HT MUSCLE IMAGE SPECT MULTI,340,1 ,"$4,600.00 ","$2,300.00 ",$289.73 ,"$4,600.00 ","$2,971.60 ",$289.73 ,"$1,757.16 ","$1,561.92 ","$1,264.80 ","$2,760.00 ","$3,910.00 ","$3,220.00 ",$289.73 ,"$4,370.00 ","$3,312.00 ","$3,358.00 ","$2,990.00 ","$3,910.00 ","$1,264.80 ","$2,990.00 ","$3,680.00 ","$3,358.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$4,600.00 ","$3,910.00 ","$2,845.81 ","$4,232.00 ","$3,220.00 ","$3,883.68 ","$4,182.43 ","$2,801.40 ","$3,883.68 ","$3,178.60 ","$3,220.00 ","$1,277.45 ","$3,312.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$3,312.00 ","$2,852.00 ","$3,312.00 ","$3,312.00 ","$2,760.00 " ST VINCENT HOSPITAL - ACUTE,34000038,78452,HC STRESS/RST/REINJCT SPECT,340,1 ,"$4,300.00 ","$2,150.00 ",$289.73 ,"$4,300.00 ","$2,777.80 ",$289.73 ,"$1,757.16 ","$1,561.92 ","$1,264.80 ","$2,580.00 ","$3,655.00 ","$3,010.00 ",$289.73 ,"$4,085.00 ","$3,096.00 ","$3,139.00 ","$2,795.00 ","$3,655.00 ","$1,264.80 ","$2,795.00 ","$3,440.00 ","$3,139.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$4,300.00 ","$3,655.00 ","$2,845.81 ","$3,956.00 ","$3,010.00 ","$3,883.68 ","$4,182.43 ","$2,618.70 ","$3,883.68 ","$2,971.30 ","$3,010.00 ","$1,277.45 ","$3,096.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$3,096.00 ","$2,666.00 ","$3,096.00 ","$3,096.00 ","$2,580.00 " ST VINCENT HOSPITAL - ACUTE,34000039,78452,HC REST SPECT/24 HR REDISTR,340,1 ,"$4,300.00 ","$2,150.00 ",$289.73 ,"$4,300.00 ","$2,777.80 ",$289.73 ,"$1,757.16 ","$1,561.92 ","$1,264.80 ","$2,580.00 ","$3,655.00 ","$3,010.00 ",$289.73 ,"$4,085.00 ","$3,096.00 ","$3,139.00 ","$2,795.00 ","$3,655.00 ","$1,264.80 ","$2,795.00 ","$3,440.00 ","$3,139.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$4,300.00 ","$3,655.00 ","$2,845.81 ","$3,956.00 ","$3,010.00 ","$3,883.68 ","$4,182.43 ","$2,618.70 ","$3,883.68 ","$2,971.30 ","$3,010.00 ","$1,277.45 ","$3,096.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$3,096.00 ","$2,666.00 ","$3,096.00 ","$3,096.00 ","$2,580.00 " ST VINCENT HOSPITAL - ACUTE,34000040,78452,HC REDISTRIB TL SPECT ONLY,340,1 ,"$4,300.00 ","$2,150.00 ",$289.73 ,"$4,300.00 ","$2,777.80 ",$289.73 ,"$1,757.16 ","$1,561.92 ","$1,264.80 ","$2,580.00 ","$3,655.00 ","$3,010.00 ",$289.73 ,"$4,085.00 ","$3,096.00 ","$3,139.00 ","$2,795.00 ","$3,655.00 ","$1,264.80 ","$2,795.00 ","$3,440.00 ","$3,139.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$4,300.00 ","$3,655.00 ","$2,845.81 ","$3,956.00 ","$3,010.00 ","$3,883.68 ","$4,182.43 ","$2,618.70 ","$3,883.68 ","$2,971.30 ","$3,010.00 ","$1,277.45 ","$3,096.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$3,096.00 ","$2,666.00 ","$3,096.00 ","$3,096.00 ","$2,580.00 " ST VINCENT HOSPITAL - ACUTE,34000041,78452,HC PHARMACOLOGICAL TL-201 SCAN,340,1 ,"$4,300.00 ","$2,150.00 ",$289.73 ,"$4,300.00 ","$2,777.80 ",$289.73 ,"$1,757.16 ","$1,561.92 ","$1,264.80 ","$2,580.00 ","$3,655.00 ","$3,010.00 ",$289.73 ,"$4,085.00 ","$3,096.00 ","$3,139.00 ","$2,795.00 ","$3,655.00 ","$1,264.80 ","$2,795.00 ","$3,440.00 ","$3,139.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$4,300.00 ","$3,655.00 ","$2,845.81 ","$3,956.00 ","$3,010.00 ","$3,883.68 ","$4,182.43 ","$2,618.70 ","$3,883.68 ","$2,971.30 ","$3,010.00 ","$1,277.45 ","$3,096.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$3,096.00 ","$2,666.00 ","$3,096.00 ","$3,096.00 ","$2,580.00 " ST VINCENT HOSPITAL - ACUTE,34000042,78454,HC HT MUSC IMAGE PLANAR MULTI,340,1 ,"$3,400.00 ","$1,700.00 ",$289.73 ,"$3,400.00 ","$2,196.40 ",$289.73 ,"$1,651.06 ","$1,467.61 ","$1,264.80 ","$2,040.00 ","$2,890.00 ","$2,380.00 ",$289.73 ,"$3,230.00 ","$2,448.00 ","$2,482.00 ","$2,210.00 ","$2,890.00 ","$1,264.80 ","$2,210.00 ","$2,720.00 ","$2,482.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$3,400.00 ","$2,890.00 ","$2,845.81 ","$3,128.00 ","$2,380.00 ","$3,400.00 ","$3,400.00 ","$2,070.60 ","$3,400.00 ","$2,349.40 ","$2,380.00 ","$1,277.45 ","$2,448.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$2,448.00 ","$2,108.00 ","$2,448.00 ","$2,448.00 ","$2,040.00 " ST VINCENT HOSPITAL - ACUTE,34000043,78466,HC CARDIAC SCAN,340,1 ,"$1,300.00 ",$650.00 ,$117.70 ,"$1,300.00 ",$839.80 ,$117.70 ,$723.38 ,$643.00 ,$365.24 ,$780.00 ,"$1,105.00 ",$910.00 ,$117.70 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$365.24 ,$845.00 ,"$1,040.00 ",$949.00 ,$117.70 ,$365.24 ,$566.26 ,"$1,300.00 ","$1,105.00 ",$821.79 ,"$1,196.00 ",$910.00 ,"$1,289.75 ","$1,300.00 ",$791.70 ,"$1,289.75 ",$898.30 ,$910.00 ,$368.89 ,$936.00 ,$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,34000044,78472,HC MUGA RESTING SGL,340,1 ,"$2,100.00 ","$1,050.00 ",$117.70 ,"$2,100.00 ","$1,356.60 ",$117.70 ,$807.19 ,$717.50 ,$365.24 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$117.70 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$1,365.00 ","$1,785.00 ",$365.24 ,"$1,365.00 ","$1,680.00 ","$1,533.00 ",$117.70 ,$365.24 ,$566.26 ,"$2,100.00 ","$1,785.00 ",$821.79 ,"$1,932.00 ","$1,470.00 ","$1,289.75 ","$1,388.96 ","$1,278.90 ","$1,289.75 ","$1,451.10 ","$1,470.00 ",$368.89 ,"$1,512.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,34000045,78473,HC MUGA RESTING MULTI,340,1 ,"$2,200.00 ","$1,100.00 ",$117.70 ,"$2,200.00 ","$1,421.20 ",$117.70 ,$974.81 ,$866.50 ,$365.24 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$117.70 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,430.00 ","$1,870.00 ",$365.24 ,"$1,430.00 ","$1,760.00 ","$1,606.00 ",$117.70 ,$365.24 ,$566.26 ,"$2,200.00 ","$1,870.00 ",$821.79 ,"$2,024.00 ","$1,540.00 ","$1,289.75 ","$1,388.96 ","$1,339.80 ","$1,289.75 ","$1,520.20 ","$1,540.00 ",$368.89 ,"$1,584.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,34000046,78499,HC THALLIUM VIABILITY,340,1 ,"$1,300.00 ",$650.00 ,$117.70 ,"$1,300.00 ",$839.80 ,$117.70 ,$840.97 ,$840.97 ,$365.24 ,$780.00 ,"$1,105.00 ",$910.00 ,$117.70 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$365.24 ,$845.00 ,"$1,040.00 ",$949.00 ,$117.70 ,$365.24 ,$566.26 ,"$1,300.00 ","$1,105.00 ",$821.79 ,"$1,196.00 ",$910.00 ,"$1,289.75 ","$1,300.00 ",$791.70 ,"$1,289.75 ",$898.30 ,$910.00 ,$368.89 ,$936.00 ,$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,34000047,78580,HC LUNG PERFUS,340,1 ,"$1,500.00 ",$750.00 ,$289.73 ,"$1,500.00 ",$969.00 ,$289.73 ,$901.86 ,$801.66 ,$365.24 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$289.73 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ",$365.24 ,$975.00 ,"$1,200.00 ","$1,095.00 ",$289.73 ,$365.24 ,$566.26 ,"$1,500.00 ","$1,275.00 ",$821.79 ,"$1,380.00 ","$1,050.00 ","$1,030.19 ","$1,109.44 ",$913.50 ,"$1,030.19 ","$1,036.50 ","$1,050.00 ",$368.89 ,"$1,080.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,34000048,78582,HC LUNG SCAN-VENT/PERF,340,1 ,"$1,600.00 ",$800.00 ,$289.73 ,"$1,600.00 ","$1,033.60 ",$289.73 ,"$1,259.39 ","$1,119.46 ",$473.98 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$289.73 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$473.98 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$289.73 ,$473.98 ,$566.26 ,"$1,600.00 ","$1,360.00 ","$1,066.46 ","$1,472.00 ","$1,120.00 ","$1,450.52 ","$1,562.10 ",$974.40 ,"$1,450.52 ","$1,105.60 ","$1,120.00 ",$478.72 ,"$1,152.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000049,78582,HC LUNG PERFUS AND SCAN,340,1 ,"$1,600.00 ",$800.00 ,$289.73 ,"$1,600.00 ","$1,033.60 ",$289.73 ,"$1,259.39 ","$1,119.46 ",$473.98 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$289.73 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$473.98 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$289.73 ,$473.98 ,$566.26 ,"$1,600.00 ","$1,360.00 ","$1,066.46 ","$1,472.00 ","$1,120.00 ","$1,450.52 ","$1,562.10 ",$974.40 ,"$1,450.52 ","$1,105.60 ","$1,120.00 ",$478.72 ,"$1,152.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000050,78579,HC PULM VENT W/IMG,340,1 ,"$1,600.00 ",$800.00 ,$289.73 ,"$1,600.00 ","$1,033.60 ",$289.73 ,$724.37 ,$643.88 ,$365.24 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$289.73 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$365.24 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$289.73 ,$365.24 ,$566.26 ,"$1,600.00 ","$1,360.00 ",$821.79 ,"$1,472.00 ","$1,120.00 ","$1,030.19 ","$1,109.44 ",$974.40 ,"$1,030.19 ","$1,105.60 ","$1,120.00 ",$368.89 ,"$1,152.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000051,78582,HC PULM VENT AND PERF W/IMG L,340,1 ,"$1,600.00 ",$800.00 ,$289.73 ,"$1,600.00 ","$1,033.60 ",$289.73 ,"$1,259.39 ","$1,119.46 ",$473.98 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$289.73 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$473.98 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$289.73 ,$473.98 ,$566.26 ,"$1,600.00 ","$1,360.00 ","$1,066.46 ","$1,472.00 ","$1,120.00 ","$1,450.52 ","$1,562.10 ",$974.40 ,"$1,450.52 ","$1,105.60 ","$1,120.00 ",$478.72 ,"$1,152.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000052,78579,HC LUNG SCAN-VENTILATION,340,1 ,"$1,600.00 ",$800.00 ,$289.73 ,"$1,600.00 ","$1,033.60 ",$289.73 ,$724.37 ,$643.88 ,$365.24 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$289.73 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$365.24 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$289.73 ,$365.24 ,$566.26 ,"$1,600.00 ","$1,360.00 ",$821.79 ,"$1,472.00 ","$1,120.00 ","$1,030.19 ","$1,109.44 ",$974.40 ,"$1,030.19 ","$1,105.60 ","$1,120.00 ",$368.89 ,"$1,152.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000053,78601,HC BRAIN W/FLOW < 4 VIEWS STAT,340,1 ,"$2,100.00 ","$1,050.00 ",$117.70 ,"$2,100.00 ","$1,356.60 ",$117.70 ,$855.30 ,$760.27 ,$365.24 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$117.70 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$1,365.00 ","$1,785.00 ",$365.24 ,"$1,365.00 ","$1,680.00 ","$1,533.00 ",$117.70 ,$365.24 ,$566.26 ,"$2,100.00 ","$1,785.00 ",$821.79 ,"$1,932.00 ","$1,470.00 ","$1,794.97 ","$1,933.04 ","$1,278.90 ","$1,794.97 ","$1,451.10 ","$1,470.00 ",$368.89 ,"$1,512.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,34000054,78606,HC BRAIN SC W/VASCULAR FLOW > 4 VIEWS,340,1 ,"$2,500.00 ","$1,250.00 ",$117.70 ,"$2,500.00 ","$1,615.00 ",$117.70 ,"$1,332.34 ","$1,184.30 ",$473.98 ,"$1,500.00 ","$2,125.00 ","$1,750.00 ",$117.70 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ","$1,625.00 ","$2,125.00 ",$473.98 ,"$1,625.00 ","$2,000.00 ","$1,825.00 ",$117.70 ,$473.98 ,$566.26 ,"$2,500.00 ","$2,125.00 ","$1,066.46 ","$2,300.00 ","$1,750.00 ","$1,794.97 ","$1,933.04 ","$1,522.50 ","$1,794.97 ","$1,727.50 ","$1,750.00 ",$478.72 ,"$1,800.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,34000056,78630,HC CISTERNOGRAPHY,340,1 ,"$2,500.00 ","$1,250.00 ",$289.73 ,"$2,500.00 ","$1,615.00 ",$289.73 ,"$1,358.72 ","$1,207.75 ",$473.98 ,"$1,500.00 ","$2,125.00 ","$1,750.00 ",$289.73 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ","$1,625.00 ","$2,125.00 ",$473.98 ,"$1,625.00 ","$2,000.00 ","$1,825.00 ",$289.73 ,$473.98 ,$566.26 ,"$2,500.00 ","$2,125.00 ","$1,066.46 ","$2,300.00 ","$1,750.00 ","$1,794.97 ","$1,933.04 ","$1,522.50 ","$1,794.97 ","$1,727.50 ","$1,750.00 ",$478.72 ,"$1,800.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,34000057,78645,HC CSF SHUNT EVALUATION,340,1 ,"$1,300.00 ",$650.00 ,$289.73 ,"$1,300.00 ",$839.80 ,$289.73 ,"$1,300.00 ","$1,180.16 ",$473.98 ,$780.00 ,"$1,105.00 ",$910.00 ,$289.73 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$473.98 ,$845.00 ,"$1,040.00 ",$949.00 ,$289.73 ,$473.98 ,$566.26 ,"$1,300.00 ","$1,105.00 ","$1,066.46 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,$478.72 ,$936.00 ,$307.11 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,34000058,78650,HC CSF LEAK DETECTION,340,1 ,"$2,500.00 ","$1,250.00 ",$289.73 ,"$2,845.81 ","$1,615.00 ",$289.73 ,"$1,108.84 ",$985.64 ,"$1,264.80 ","$1,500.00 ","$2,125.00 ","$1,750.00 ",$289.73 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ","$1,625.00 ","$2,125.00 ","$1,264.80 ","$1,625.00 ","$2,000.00 ","$1,825.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$2,500.00 ","$2,125.00 ","$2,845.81 ","$2,300.00 ","$1,750.00 ","$1,794.97 ","$1,933.04 ","$1,522.50 ","$1,794.97 ","$1,727.50 ","$1,750.00 ","$1,277.45 ","$1,800.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,34000059,78660,HC TEAR DUCT SCAN,340,1 ,"$1,800.00 ",$900.00 ,$117.70 ,"$1,800.00 ","$1,162.80 ",$117.70 ,$696.99 ,$619.55 ,$365.24 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$117.70 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,170.00 ","$1,530.00 ",$365.24 ,"$1,170.00 ","$1,440.00 ","$1,314.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,800.00 ","$1,530.00 ",$821.79 ,"$1,656.00 ","$1,260.00 ",$547.65 ,$589.78 ,"$1,096.20 ",$547.65 ,"$1,243.80 ","$1,260.00 ",$368.89 ,"$1,296.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,34000060,78700,HC KIDNEY SCAN,340,1 ,"$1,600.00 ",$800.00 ,$117.70 ,"$1,600.00 ","$1,033.60 ",$117.70 ,$664.40 ,$590.58 ,$365.24 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$117.70 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$365.24 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,600.00 ","$1,360.00 ",$821.79 ,"$1,472.00 ","$1,120.00 ","$1,403.91 ","$1,511.90 ",$974.40 ,"$1,403.91 ","$1,105.60 ","$1,120.00 ",$368.89 ,"$1,152.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000061,78701,HC KIDNEY SCAN W/FLOW,340,1 ,"$1,600.00 ",$800.00 ,$117.70 ,"$1,600.00 ","$1,033.60 ",$117.70 ,$861.51 ,$765.79 ,$365.24 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$117.70 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$365.24 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,600.00 ","$1,360.00 ",$821.79 ,"$1,472.00 ","$1,120.00 ","$1,403.91 ","$1,511.90 ",$974.40 ,"$1,403.91 ","$1,105.60 ","$1,120.00 ",$368.89 ,"$1,152.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000062,78707,HC KIDNEY SCAN W/FLOW AND FUNCTION,340,1 ,"$2,300.00 ","$1,150.00 ",$117.70 ,"$2,300.00 ","$1,485.80 ",$117.70 ,$830.47 ,$738.19 ,$473.98 ,"$1,380.00 ","$1,955.00 ","$1,610.00 ",$117.70 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$1,495.00 ","$1,955.00 ",$473.98 ,"$1,495.00 ","$1,840.00 ","$1,679.00 ",$117.70 ,$473.98 ,$566.26 ,"$2,300.00 ","$1,955.00 ","$1,066.46 ","$2,116.00 ","$1,610.00 ","$1,403.91 ","$1,511.90 ","$1,400.70 ","$1,403.91 ","$1,589.30 ","$1,610.00 ",$478.72 ,"$1,656.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,34000063,78708,HC KIDNEY W/PHARMACLGCL INTER,340,1 ,"$2,300.00 ","$1,150.00 ",$117.70 ,"$2,300.00 ","$1,485.80 ",$117.70 ,$525.28 ,$466.92 ,$473.98 ,"$1,380.00 ","$1,955.00 ","$1,610.00 ",$117.70 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$1,495.00 ","$1,955.00 ",$473.98 ,"$1,495.00 ","$1,840.00 ","$1,679.00 ",$117.70 ,$473.98 ,$566.26 ,"$2,300.00 ","$1,955.00 ","$1,066.46 ","$2,116.00 ","$1,610.00 ","$1,403.91 ","$1,511.90 ","$1,400.70 ","$1,403.91 ","$1,589.30 ","$1,610.00 ",$478.72 ,"$1,656.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,34000065,78709,HC KIDNEY W AND W/O PHARM INTERVEN,340,1 ,"$2,300.00 ","$1,150.00 ",$117.70 ,"$2,300.00 ","$1,485.80 ",$117.70 ,"$1,340.10 ","$1,191.20 ",$473.98 ,"$1,380.00 ","$1,955.00 ","$1,610.00 ",$117.70 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$1,495.00 ","$1,955.00 ",$473.98 ,"$1,495.00 ","$1,840.00 ","$1,679.00 ",$117.70 ,$473.98 ,$566.26 ,"$2,300.00 ","$1,955.00 ","$1,066.46 ","$2,116.00 ","$1,610.00 ","$1,403.91 ","$1,511.90 ","$1,400.70 ","$1,403.91 ","$1,589.30 ","$1,610.00 ",$478.72 ,"$1,656.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,34000066,78740,HC URETERAL REFLUX STUDY,340,1 ,"$1,400.00 ",$700.00 ,$117.70 ,"$1,400.00 ",$904.40 ,$117.70 ,$852.20 ,$757.51 ,$365.24 ,$840.00 ,"$1,190.00 ",$980.00 ,$117.70 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$365.24 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,400.00 ","$1,190.00 ",$821.79 ,"$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,$368.89 ,"$1,008.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,34000067,78761,HC TESTICULAR IMAG W/FLOW,340,1 ,"$1,400.00 ",$700.00 ,$117.70 ,"$1,400.00 ",$904.40 ,$117.70 ,$783.91 ,$696.81 ,$365.24 ,$840.00 ,"$1,190.00 ",$980.00 ,$117.70 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$365.24 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$117.70 ,$365.24 ,$566.26 ,"$1,400.00 ","$1,190.00 ",$821.79 ,"$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,$368.89 ,"$1,008.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,34000068,78800,HC TUMOR LOCAL LIMITED,340,1 ,"$1,200.00 ",$600.00 ,$289.73 ,"$1,200.00 ",$775.20 ,$289.73 ,$717.17 ,$637.49 ,$365.24 ,$720.00 ,"$1,020.00 ",$840.00 ,$289.73 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$365.24 ,$780.00 ,$960.00 ,$876.00 ,$289.73 ,$365.24 ,$566.26 ,"$1,200.00 ","$1,020.00 ",$821.79 ,"$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,$368.89 ,$864.00 ,$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,34000069,78801,HC TUMOR LOCAL MULTIPLE,340,1 ,"$2,100.00 ","$1,050.00 ",$289.73 ,"$2,100.00 ","$1,356.60 ",$289.73 ,$974.81 ,$866.50 ,$365.24 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$289.73 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$1,365.00 ","$1,785.00 ",$365.24 ,"$1,365.00 ","$1,680.00 ","$1,533.00 ",$289.73 ,$365.24 ,$566.26 ,"$2,100.00 ","$1,785.00 ",$821.79 ,"$1,932.00 ","$1,470.00 ","$1,288.59 ","$1,387.71 ","$1,278.90 ","$1,288.59 ","$1,451.10 ","$1,470.00 ",$368.89 ,"$1,512.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,34000070,78802,HC TUMOR IMAGE-WHOLE BODY-1 DAY,340,1 ,"$2,000.00 ","$1,000.00 ",$289.73 ,"$2,845.81 ","$1,292.00 ",$289.73 ,"$1,254.73 ","$1,115.32 ","$1,264.80 ","$1,200.00 ","$1,700.00 ","$1,400.00 ",$289.73 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,300.00 ","$1,700.00 ","$1,264.80 ","$1,300.00 ","$1,600.00 ","$1,460.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$2,000.00 ","$1,700.00 ","$2,845.81 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ","$1,277.45 ","$1,440.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,34000071,78803,HC TUMOR IMAGING (SPECT),340,1 ,"$2,300.00 ","$1,150.00 ",$289.73 ,"$2,845.81 ","$1,485.80 ",$289.73 ,"$1,288.88 ","$1,145.67 ","$1,264.80 ","$1,380.00 ","$1,955.00 ","$1,610.00 ",$289.73 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$1,495.00 ","$1,955.00 ","$1,264.80 ","$1,495.00 ","$1,840.00 ","$1,679.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$2,300.00 ","$1,955.00 ","$2,845.81 ","$2,116.00 ","$1,610.00 ","$2,211.71 ","$2,300.00 ","$1,400.70 ","$2,211.71 ","$1,589.30 ","$1,610.00 ","$1,277.45 ","$1,656.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,34000072,78803,HC TUMOR IMAGING (SPECT) MIBG,340,1 ,"$2,300.00 ","$1,150.00 ",$289.73 ,"$2,845.81 ","$1,485.80 ",$289.73 ,"$1,288.88 ","$1,145.67 ","$1,264.80 ","$1,380.00 ","$1,955.00 ","$1,610.00 ",$289.73 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$1,495.00 ","$1,955.00 ","$1,264.80 ","$1,495.00 ","$1,840.00 ","$1,679.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$2,300.00 ","$1,955.00 ","$2,845.81 ","$2,116.00 ","$1,610.00 ","$2,211.71 ","$2,300.00 ","$1,400.70 ","$2,211.71 ","$1,589.30 ","$1,610.00 ","$1,277.45 ","$1,656.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,34000073,78803,HC TUMOR IMAGING (SPECT) GALLIUM,340,1 ,"$2,300.00 ","$1,150.00 ",$289.73 ,"$2,845.81 ","$1,485.80 ",$289.73 ,"$1,288.88 ","$1,145.67 ","$1,264.80 ","$1,380.00 ","$1,955.00 ","$1,610.00 ",$289.73 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$1,495.00 ","$1,955.00 ","$1,264.80 ","$1,495.00 ","$1,840.00 ","$1,679.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$2,300.00 ","$1,955.00 ","$2,845.81 ","$2,116.00 ","$1,610.00 ","$2,211.71 ","$2,300.00 ","$1,400.70 ","$2,211.71 ","$1,589.30 ","$1,610.00 ","$1,277.45 ","$1,656.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,34000074,78803,HC TUMOR IMAGING (SPECT) NON GATED,340,1 ,"$2,300.00 ","$1,150.00 ",$289.73 ,"$2,845.81 ","$1,485.80 ",$289.73 ,"$1,288.88 ","$1,145.67 ","$1,264.80 ","$1,380.00 ","$1,955.00 ","$1,610.00 ",$289.73 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$1,495.00 ","$1,955.00 ","$1,264.80 ","$1,495.00 ","$1,840.00 ","$1,679.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$2,300.00 ","$1,955.00 ","$2,845.81 ","$2,116.00 ","$1,610.00 ","$2,211.71 ","$2,300.00 ","$1,400.70 ","$2,211.71 ","$1,589.30 ","$1,610.00 ","$1,277.45 ","$1,656.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,34000075,78803,HC TUMOR IMAGING (SPECT) OCTREO,340,1 ,"$2,300.00 ","$1,150.00 ",$289.73 ,"$2,845.81 ","$1,485.80 ",$289.73 ,"$1,288.88 ","$1,145.67 ","$1,264.80 ","$1,380.00 ","$1,955.00 ","$1,610.00 ",$289.73 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$1,495.00 ","$1,955.00 ","$1,264.80 ","$1,495.00 ","$1,840.00 ","$1,679.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$2,300.00 ","$1,955.00 ","$2,845.81 ","$2,116.00 ","$1,610.00 ","$2,211.71 ","$2,300.00 ","$1,400.70 ","$2,211.71 ","$1,589.30 ","$1,610.00 ","$1,277.45 ","$1,656.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,34000076,78803,HC TUMOR IMAGING (SPECT) PARATHYROID,340,1 ,"$2,300.00 ","$1,150.00 ",$289.73 ,"$2,845.81 ","$1,485.80 ",$289.73 ,"$1,288.88 ","$1,145.67 ","$1,264.80 ","$1,380.00 ","$1,955.00 ","$1,610.00 ",$289.73 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$1,495.00 ","$1,955.00 ","$1,264.80 ","$1,495.00 ","$1,840.00 ","$1,679.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$2,300.00 ","$1,955.00 ","$2,845.81 ","$2,116.00 ","$1,610.00 ","$2,211.71 ","$2,300.00 ","$1,400.70 ","$2,211.71 ","$1,589.30 ","$1,610.00 ","$1,277.45 ","$1,656.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,34000077,78804,HC TUMOR/INF-WHOLE BODY-MULT DAY,340,1 ,"$4,600.00 ","$2,300.00 ",$289.73 ,"$4,600.00 ","$2,971.60 ",$289.73 ,"$2,305.59 ","$2,049.41 ","$1,264.80 ","$2,760.00 ","$3,910.00 ","$3,220.00 ",$289.73 ,"$4,370.00 ","$3,312.00 ","$3,358.00 ","$2,990.00 ","$3,910.00 ","$1,264.80 ","$2,990.00 ","$3,680.00 ","$3,358.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$4,600.00 ","$3,910.00 ","$2,845.81 ","$4,232.00 ","$3,220.00 ","$3,896.47 ","$4,196.20 ","$2,801.40 ","$3,896.47 ","$3,178.60 ","$3,220.00 ","$1,277.45 ","$3,312.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$3,312.00 ","$2,852.00 ","$3,312.00 ","$3,312.00 ","$2,760.00 " ST VINCENT HOSPITAL - ACUTE,34000078,78804,HC TUMOR IMAG-WHOLE BODY-DIAGNOSTIC,340,1 ,"$4,300.00 ","$2,150.00 ",$289.73 ,"$4,300.00 ","$2,777.80 ",$289.73 ,"$2,305.59 ","$2,049.41 ","$1,264.80 ","$2,580.00 ","$3,655.00 ","$3,010.00 ",$289.73 ,"$4,085.00 ","$3,096.00 ","$3,139.00 ","$2,795.00 ","$3,655.00 ","$1,264.80 ","$2,795.00 ","$3,440.00 ","$3,139.00 ",$289.73 ,"$1,264.80 ",$566.26 ,"$4,300.00 ","$3,655.00 ","$2,845.81 ","$3,956.00 ","$3,010.00 ","$3,896.47 ","$4,196.20 ","$2,618.70 ","$3,896.47 ","$2,971.30 ","$3,010.00 ","$1,277.45 ","$3,096.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$3,096.00 ","$2,666.00 ","$3,096.00 ","$3,096.00 ","$2,580.00 " ST VINCENT HOSPITAL - ACUTE,34000081,79005,HC NM RADIOPAHARM THRPY ORAL,340,1 ,"$1,300.00 ",$650.00 ,$82.66 ,"$1,300.00 ",$839.80 ,$82.66 ,$216.86 ,$192.76 ,$241.76 ,$780.00 ,"$1,105.00 ",$910.00 ,$82.66 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$241.76 ,$845.00 ,"$1,040.00 ",$949.00 ,$82.66 ,$241.76 ,$566.26 ,"$1,300.00 ","$1,105.00 ",$543.95 ,"$1,196.00 ",$910.00 ,$861.18 ,$927.43 ,$791.70 ,$861.18 ,$898.30 ,$910.00 ,$244.18 ,$936.00 ,$87.62 ,"$1,131.00 ","$1,131.00 ",$241.76 ,"$1,131.00 ",$241.76 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,34000082,79005,HC NM RADIOPAHARM THRPY HYPERTHYROID,340,1 ,"$1,300.00 ",$650.00 ,$82.66 ,"$1,300.00 ",$839.80 ,$82.66 ,$216.86 ,$192.76 ,$241.76 ,$780.00 ,"$1,105.00 ",$910.00 ,$82.66 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$241.76 ,$845.00 ,"$1,040.00 ",$949.00 ,$82.66 ,$241.76 ,$566.26 ,"$1,300.00 ","$1,105.00 ",$543.95 ,"$1,196.00 ",$910.00 ,$861.18 ,$927.43 ,$791.70 ,$861.18 ,$898.30 ,$910.00 ,$244.18 ,$936.00 ,$87.62 ,"$1,131.00 ","$1,131.00 ",$241.76 ,"$1,131.00 ",$241.76 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,34000083,79101,HC NM RADIOPAHARM THRPY IV,340,1 ,"$1,500.00 ",$750.00 ,$82.66 ,"$1,500.00 ",$969.00 ,$82.66 ,$216.29 ,$192.26 ,$241.76 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$82.66 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ",$241.76 ,$975.00 ,"$1,200.00 ","$1,095.00 ",$82.66 ,$241.76 ,$566.26 ,"$1,500.00 ","$1,275.00 ",$543.95 ,"$1,380.00 ","$1,050.00 ",$861.18 ,$927.43 ,$913.50 ,$861.18 ,"$1,036.50 ","$1,050.00 ",$244.18 ,"$1,080.00 ",$87.62 ,"$1,131.00 ","$1,131.00 ",$241.76 ,"$1,131.00 ",$241.76 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,34000084,79403,HC NM MONOCLONAL ANTIBODY THRPY,340,1 ,"$1,700.00 ",$850.00 ,$82.66 ,"$1,700.00 ","$1,098.20 ",$82.66 ,$358.65 ,$318.80 ,$241.76 ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$82.66 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,105.00 ","$1,445.00 ",$241.76 ,"$1,105.00 ","$1,360.00 ","$1,241.00 ",$82.66 ,$241.76 ,$566.26 ,"$1,700.00 ","$1,445.00 ",$543.95 ,"$1,564.00 ","$1,190.00 ","$1,200.76 ","$1,293.13 ","$1,035.30 ","$1,200.76 ","$1,174.70 ","$1,190.00 ",$244.18 ,"$1,224.00 ",$87.62 ,"$1,131.00 ","$1,131.00 ",$241.76 ,"$1,131.00 ",$241.76 ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,34000090,78597,HC PULM PERF DIFF W/IMG,340,1 ,"$1,150.00 ",$575.00 ,$289.73 ,"$1,150.00 ",$742.90 ,$289.73 ,$739.89 ,$657.68 ,$365.24 ,$690.00 ,$977.50 ,$805.00 ,$289.73 ,"$1,092.50 ",$828.00 ,$839.50 ,$747.50 ,$977.50 ,$365.24 ,$747.50 ,$920.00 ,$839.50 ,$289.73 ,$365.24 ,$566.26 ,"$1,150.00 ",$977.50 ,$821.79 ,"$1,058.00 ",$805.00 ,"$1,030.19 ","$1,109.44 ",$700.35 ,"$1,030.19 ",$794.65 ,$805.00 ,$368.89 ,$828.00 ,$307.11 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,$828.00 ,$713.00 ,$828.00 ,$828.00 ,$690.00 ST VINCENT HOSPITAL - ACUTE,34000091,78598,HC NM PULM VENT AND PERF DIFF W/IMG,340,1 ,"$1,600.00 ",$800.00 ,$289.73 ,"$1,600.00 ","$1,033.60 ",$289.73 ,"$1,180.24 ","$1,049.10 ",$473.98 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$289.73 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$473.98 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$289.73 ,$473.98 ,$566.26 ,"$1,600.00 ","$1,360.00 ","$1,066.46 ","$1,472.00 ","$1,120.00 ","$1,450.52 ","$1,562.10 ",$974.40 ,"$1,450.52 ","$1,105.60 ","$1,120.00 ",$478.72 ,"$1,152.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,34000092,78227,HC NM HEPATOBILIARY DUCTS W/PHARM,340,1 ,"$2,100.00 ","$1,050.00 ",$117.70 ,"$2,100.00 ","$1,356.60 ",$117.70 ,"$1,795.40 ","$1,595.91 ",$473.98 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$117.70 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$1,365.00 ","$1,785.00 ",$473.98 ,"$1,365.00 ","$1,680.00 ","$1,533.00 ",$117.70 ,$473.98 ,$566.26 ,"$2,100.00 ","$1,785.00 ","$1,066.46 ","$1,932.00 ","$1,470.00 ","$1,254.27 ","$1,350.75 ","$1,278.90 ","$1,254.27 ","$1,451.10 ","$1,470.00 ",$478.72 ,"$1,512.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,34000093,78071,HC PARATHYROID IMG W/SPECT 78071,340,1 ,"$2,200.00 ","$1,100.00 ",$117.70 ,"$2,200.00 ","$1,421.20 ",$117.70 ,"$1,330.78 ","$1,182.92 ",$365.24 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$117.70 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,430.00 ","$1,870.00 ",$365.24 ,"$1,430.00 ","$1,760.00 ","$1,606.00 ",$117.70 ,$365.24 ,$566.26 ,"$2,200.00 ","$1,870.00 ",$821.79 ,"$2,024.00 ","$1,540.00 ","$2,200.00 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ",$368.89 ,"$1,584.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$365.24 ,"$1,131.00 ",$365.24 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,34000094,78072,HC PARATHYROID IMG W/SPECT AND CT 78072,340,1 ,"$2,400.00 ","$1,200.00 ",$117.70 ,"$2,400.00 ","$1,550.40 ",$117.70 ,"$1,395.97 ","$1,240.86 ",$473.98 ,"$1,440.00 ","$2,040.00 ","$1,680.00 ",$117.70 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$1,560.00 ","$2,040.00 ",$473.98 ,"$1,560.00 ","$1,920.00 ","$1,752.00 ",$117.70 ,$473.98 ,$566.26 ,"$2,400.00 ","$2,040.00 ","$1,066.46 ","$2,208.00 ","$1,680.00 ","$2,400.00 ","$2,400.00 ","$1,461.60 ","$2,400.00 ","$1,658.40 ","$1,680.00 ",$478.72 ,"$1,728.00 ",$124.76 ,"$1,131.00 ","$1,131.00 ",$473.98 ,"$1,131.00 ",$473.98 ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,34100007,A9538,HC NM PYROPHOSPHATE 99M VIAL,341,1 ,$80.00 ,$40.00 ,$40.00 ,$80.00 ,$51.68 , N/A ,$51.75 ,$51.75 , N/A ,$48.00 ,$68.00 ,$56.00 , N/A ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 , N/A ,$52.00 ,$64.00 ,$58.40 , N/A , N/A ,$80.00 ,$80.00 ,$68.00 , N/A ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 , N/A ,$57.60 , N/A ,$80.00 ,$80.00 , N/A ,$80.00 , N/A ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,34100020,0042T,HC CT CEREBRAL PERFUSION W/BLOOD FLOW,351,1 ,"$2,100.00 ","$1,050.00 ",$90.16 ,"$2,100.00 ","$1,356.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ", N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$90.16 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$1,130.00 ","$1,785.00 ", N/A ,"$1,130.00 ","$1,680.00 ","$1,533.00 ",$90.16 , N/A ,$460.29 ,"$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$1,050.00 ","$1,260.00 ","$1,278.90 ","$1,050.00 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,34100027,79445,HC THERAPEUTIC RADIONUCLIDE INTRA/ART ADMIN,344,1 ,$915.00 ,$457.50 ,$82.66 ,$915.00 ,$591.09 ,$82.66 ,$401.53 ,$356.92 ,$241.76 ,$549.00 ,$777.75 ,$640.50 ,$82.66 ,$869.25 ,$658.80 ,$667.95 ,$270.90 ,$777.75 ,$241.76 ,$270.90 ,$732.00 ,$667.95 ,$82.66 ,$241.76 ,$384.30 ,$915.00 ,$777.75 ,$543.95 ,$841.80 ,$640.50 , N/A , N/A ,$557.24 , N/A ,$632.27 ,$640.50 ,$244.18 ,$658.80 ,$87.62 , N/A , N/A ,$241.76 , N/A ,$241.76 ,$658.80 ,$567.30 ,$658.80 ,$658.80 ,$549.00 ST VINCENT HOSPITAL - ACUTE,34100033,78831,HC TUMOR LOCAL SPECT MULT AREA 1 DAY OR SGL AREA W/MULT DAYS,341,1 ,"$2,450.00 ","$1,225.00 ",$289.73 ,"$2,845.81 ","$1,582.70 ",$289.73 ,"$2,450.00 ","$2,435.98 ","$1,264.80 ","$1,470.00 ","$2,082.50 ","$1,715.00 ",$289.73 ,"$2,327.50 ","$1,764.00 ","$1,788.50 ","$1,592.50 ","$2,082.50 ","$1,264.80 ","$1,592.50 ","$1,960.00 ","$1,788.50 ",$289.73 ,"$1,264.80 ",$566.26 ,"$2,450.00 ","$2,082.50 ","$2,845.81 ","$2,254.00 ","$1,715.00 ","$2,450.00 ","$2,450.00 ","$1,492.05 ","$2,450.00 ","$1,692.95 ","$1,715.00 ","$1,277.45 ","$1,764.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$1,764.00 ","$1,519.00 ","$1,764.00 ","$1,764.00 ","$1,470.00 " ST VINCENT HOSPITAL - ACUTE,34100034,78830,HC TUMOR IMAGING SPECT W/CT SGL AREA 1 DAY,341,1 ,"$2,450.00 ","$1,225.00 ",$289.73 ,"$2,845.81 ","$1,582.70 ",$289.73 ,"$1,846.99 ","$1,641.77 ","$1,264.80 ","$1,470.00 ","$2,082.50 ","$1,715.00 ",$289.73 ,"$2,327.50 ","$1,764.00 ","$1,788.50 ","$1,592.50 ","$2,082.50 ","$1,264.80 ","$1,592.50 ","$1,960.00 ","$1,788.50 ",$289.73 ,"$1,264.80 ",$566.26 ,"$2,450.00 ","$2,082.50 ","$2,845.81 ","$2,254.00 ","$1,715.00 ","$2,450.00 ","$2,450.00 ","$1,492.05 ","$2,450.00 ","$1,692.95 ","$1,715.00 ","$1,277.45 ","$1,764.00 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,264.80 ","$1,131.00 ","$1,264.80 ","$1,764.00 ","$1,519.00 ","$1,764.00 ","$1,764.00 ","$1,470.00 " ST VINCENT HOSPITAL - ACUTE,34100035,78832,HC TUMOR LOCAL SPECT W/CT MULT AREA 1 DAY OR SGL AREA W/MULT DAYS,341,1 ,"$2,770.00 ","$1,385.00 ",$289.73 ,"$3,225.85 ","$1,789.42 ",$289.73 ,"$2,770.00 ","$2,770.00 ","$1,433.71 ","$1,662.00 ","$2,354.50 ","$1,939.00 ",$289.73 ,"$2,631.50 ","$1,994.40 ","$2,022.10 ","$1,800.50 ","$2,354.50 ","$1,433.71 ","$1,800.50 ","$2,216.00 ","$2,022.10 ",$289.73 ,"$1,433.71 ",$566.26 ,"$2,770.00 ","$2,354.50 ","$3,225.85 ","$2,548.40 ","$1,939.00 ","$2,770.00 ","$2,770.00 ","$1,686.93 ","$2,770.00 ","$1,914.07 ","$1,939.00 ","$1,448.05 ","$1,994.40 ",$307.11 ,"$1,131.00 ","$1,131.00 ","$1,433.71 ","$1,131.00 ","$1,433.71 ","$1,994.40 ","$1,717.40 ","$1,994.40 ","$1,994.40 ","$1,662.00 " ST VINCENT HOSPITAL - ACUTE,34300002,A9500,HC DIAGNUCLIDE CARDIO UP TO 40MCI,343,1 ,$405.00 ,$202.50 ,$170.10 ,$405.00 ,$261.63 , N/A ,$261.99 ,$261.99 , N/A ,$243.00 ,$344.25 ,$283.50 , N/A ,$384.75 ,$291.60 ,$295.65 ,$218.42 ,$344.25 , N/A ,$218.42 ,$324.00 ,$295.65 , N/A , N/A ,$170.10 ,$405.00 ,$344.25 , N/A ,$372.60 ,$283.50 , N/A , N/A ,$246.65 , N/A ,$279.86 ,$283.50 , N/A ,$291.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$291.60 ,$251.10 ,$291.60 ,$291.60 ,$243.00 ST VINCENT HOSPITAL - ACUTE,34300004,A9503,HC DIAGNUCLIDE MDP UP TO 30MCI,343,1 ,$145.00 ,$72.50 ,$33.56 ,$145.00 ,$93.67 , N/A ,$93.80 ,$93.80 , N/A ,$87.00 ,$123.25 ,$101.50 , N/A ,$137.75 ,$104.40 ,$105.85 ,$33.56 ,$123.25 , N/A ,$33.56 ,$116.00 ,$105.85 , N/A , N/A ,$60.90 ,$145.00 ,$123.25 , N/A ,$133.40 ,$101.50 , N/A , N/A ,$88.31 , N/A ,$100.20 ,$101.50 , N/A ,$104.40 , N/A , N/A , N/A , N/A , N/A , N/A ,$104.40 ,$89.90 ,$104.40 ,$104.40 ,$87.00 ST VINCENT HOSPITAL - ACUTE,34300006,A9505,HC DIAGNUCLIDE THALL 201 PER MCI,343,1 ,$120.00 ,$60.00 ,$50.40 ,$120.00 ,$77.52 , N/A ,$77.63 ,$77.63 , N/A ,$72.00 ,$102.00 ,$84.00 , N/A ,$114.00 ,$86.40 ,$87.60 ,$61.98 ,$102.00 , N/A ,$61.98 ,$96.00 ,$87.60 , N/A , N/A ,$50.40 ,$120.00 ,$102.00 , N/A ,$110.40 ,$84.00 , N/A , N/A ,$73.08 , N/A ,$82.92 ,$84.00 , N/A ,$86.40 , N/A , N/A , N/A , N/A , N/A , N/A ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,34300007,A9507,HC DIAGNUCLIDE PROSTASCINT,343,1 ,"$6,100.00 ","$3,050.00 ","$2,562.00 ","$6,100.00 ","$3,940.60 ", N/A ,"$3,946.09 ","$3,946.09 ", N/A ,"$3,660.00 ","$5,185.00 ","$4,270.00 ", N/A ,"$5,795.00 ","$4,392.00 ","$4,453.00 ","$2,793.78 ","$5,185.00 ", N/A ,"$2,793.78 ","$4,880.00 ","$4,453.00 ", N/A , N/A ,"$2,562.00 ","$6,100.00 ","$5,185.00 ", N/A ,"$5,612.00 ","$4,270.00 ", N/A , N/A ,"$3,714.90 ", N/A ,"$4,215.10 ","$4,270.00 ", N/A ,"$4,392.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,392.00 ","$3,782.00 ","$4,392.00 ","$4,392.00 ","$3,660.00 " ST VINCENT HOSPITAL - ACUTE,34300009,A9512,HC TECHNETIUM TC99 PERTECH PER MCI,343,1 ,$45.00 ,$22.50 ,$18.90 ,$45.00 ,$29.07 , N/A ,$29.11 ,$29.11 , N/A ,$27.00 ,$38.25 ,$31.50 , N/A ,$42.75 ,$32.40 ,$32.85 ,$37.40 ,$38.25 , N/A ,$37.40 ,$36.00 ,$32.85 , N/A , N/A ,$18.90 ,$45.00 ,$38.25 , N/A ,$41.40 ,$31.50 , N/A , N/A ,$27.41 , N/A ,$31.10 ,$31.50 , N/A ,$32.40 , N/A , N/A , N/A , N/A , N/A , N/A ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,34300010,A9516,HC DIAGNUCLIDE I123 CAPS 100 MICR,343,1 ,$75.00 ,$37.50 ,$31.50 ,$75.00 ,$48.45 , N/A ,$48.52 ,$48.52 , N/A ,$45.00 ,$63.75 ,$52.50 , N/A ,$71.25 ,$54.00 ,$54.75 ,$75.00 ,$63.75 , N/A ,$75.00 ,$60.00 ,$54.75 , N/A , N/A ,$31.50 ,$75.00 ,$63.75 , N/A ,$69.00 ,$52.50 , N/A , N/A ,$45.68 , N/A ,$51.83 ,$52.50 , N/A ,$54.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,34300011,A9517,HC DIAGNUCLIDE I131 CAPS PER MCI,343,1 ,$205.00 ,$102.50 ,$20.12 ,$276.96 ,$132.43 ,$205.00 ,$132.61 ,$132.61 ,$20.12 ,$123.00 ,$174.25 ,$143.50 ,$261.28 ,$194.75 ,$147.60 ,$149.65 ,$72.83 ,$174.25 ,$20.12 ,$72.83 ,$164.00 ,$149.65 ,$261.28 ,$20.12 ,$22.85 ,$205.00 ,$174.25 ,$45.27 ,$188.60 ,$143.50 ,$30.00 ,$32.28 ,$124.85 ,$30.00 ,$141.66 ,$143.50 ,$20.32 ,$147.60 ,$276.96 ,$33.20 ,$33.20 ,$20.12 ,$33.20 ,$20.12 ,$147.60 ,$127.10 ,$147.60 ,$147.60 ,$123.00 ST VINCENT HOSPITAL - ACUTE,34300012,A9521,HC DIAGNUCLIDE CERETEC,343,1 ,"$2,320.00 ","$1,160.00 ",$974.40 ,"$2,320.00 ","$1,498.72 ", N/A ,"$1,500.81 ","$1,500.81 ", N/A ,"$1,392.00 ","$1,972.00 ","$1,624.00 ", N/A ,"$2,204.00 ","$1,670.40 ","$1,693.60 ","$2,320.00 ","$1,972.00 ", N/A ,"$2,320.00 ","$1,856.00 ","$1,693.60 ", N/A , N/A ,$974.40 ,"$2,320.00 ","$1,972.00 ", N/A ,"$2,134.40 ","$1,624.00 ", N/A , N/A ,"$1,412.88 ", N/A ,"$1,603.12 ","$1,624.00 ", N/A ,"$1,670.40 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,670.40 ","$1,438.40 ","$1,670.40 ","$1,670.40 ","$1,392.00 " ST VINCENT HOSPITAL - ACUTE,34300014,A9528,HC DIAGNUCLIDE I131 NECK/CHST,343,1 ,$190.00 ,$95.00 ,$69.16 ,$190.00 ,$122.74 , N/A ,$122.91 ,$122.91 , N/A ,$114.00 ,$161.50 ,$133.00 , N/A ,$180.50 ,$136.80 ,$138.70 ,$69.16 ,$161.50 , N/A ,$69.16 ,$152.00 ,$138.70 , N/A , N/A ,$79.80 ,$190.00 ,$161.50 , N/A ,$174.80 ,$133.00 , N/A , N/A ,$115.71 , N/A ,$131.29 ,$133.00 , N/A ,$136.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,34300015,A9530,HC THERAPEUTIC ISOTOPE SOLUTION PER MCI,343,1 ,$50.00 ,$25.00 ,$13.34 ,$276.96 ,$32.30 ,$50.00 ,$32.35 ,$32.35 ,$13.34 ,$30.00 ,$42.50 ,$35.00 ,$261.28 ,$47.50 ,$36.00 ,$36.50 ,$32.50 ,$42.50 ,$13.34 ,$32.50 ,$40.00 ,$36.50 ,$261.28 ,$13.34 ,$14.75 ,$50.00 ,$42.50 ,$30.02 ,$46.00 ,$35.00 ,$19.37 ,$20.84 ,$30.45 ,$19.37 ,$34.55 ,$35.00 ,$13.47 ,$36.00 ,$276.96 ,$22.01 ,$22.01 ,$13.34 ,$22.01 ,$13.34 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,34300016,A9537,HC DIAGNUCLIDE CHOLETEC HEPAT PER DOSE,343,1 ,$180.00 ,$90.00 ,$75.60 ,$180.00 ,$116.28 , N/A ,$116.44 ,$116.44 , N/A ,$108.00 ,$153.00 ,$126.00 , N/A ,$171.00 ,$129.60 ,$131.40 ,$101.66 ,$153.00 , N/A ,$101.66 ,$144.00 ,$131.40 , N/A , N/A ,$75.60 ,$180.00 ,$153.00 , N/A ,$165.60 ,$126.00 , N/A , N/A ,$109.62 , N/A ,$124.38 ,$126.00 , N/A ,$129.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,34300017,A9539,HC DIAGNUCLIDE DTPA KIDNEY PER DOSE,343,1 ,$155.00 ,$77.50 ,$63.92 ,$155.00 ,$100.13 , N/A ,$100.27 ,$100.27 , N/A ,$93.00 ,$131.75 ,$108.50 , N/A ,$147.25 ,$111.60 ,$113.15 ,$63.92 ,$131.75 , N/A ,$63.92 ,$124.00 ,$113.15 , N/A , N/A ,$65.10 ,$155.00 ,$131.75 , N/A ,$142.60 ,$108.50 , N/A , N/A ,$94.40 , N/A ,$107.11 ,$108.50 , N/A ,$111.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$111.60 ,$96.10 ,$111.60 ,$111.60 ,$93.00 ST VINCENT HOSPITAL - ACUTE,34300019,A9540,HC DIAGNUCLIDE MAA LUNG SCAN PER DOSE<10MCI,343,1 ,$630.00 ,$315.00 ,$61.20 ,$630.00 ,$406.98 , N/A ,$407.55 ,$407.55 , N/A ,$378.00 ,$535.50 ,$441.00 , N/A ,$598.50 ,$453.60 ,$459.90 ,$61.20 ,$535.50 , N/A ,$61.20 ,$504.00 ,$459.90 , N/A , N/A ,$264.60 ,$630.00 ,$535.50 , N/A ,$579.60 ,$441.00 , N/A , N/A ,$383.67 , N/A ,$435.33 ,$441.00 , N/A ,$453.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$453.60 ,$390.60 ,$453.60 ,$453.60 ,$378.00 ST VINCENT HOSPITAL - ACUTE,34300020,A9541,HC DIAGNUCLIDE SULFUR COLLOID UP TO 20MCI,343,1 ,$240.00 ,$120.00 ,$100.80 ,$240.00 ,$155.04 , N/A ,$155.26 ,$155.26 , N/A ,$144.00 ,$204.00 ,$168.00 , N/A ,$228.00 ,$172.80 ,$175.20 ,$240.00 ,$204.00 , N/A ,$240.00 ,$192.00 ,$175.20 , N/A , N/A ,$100.80 ,$240.00 ,$204.00 , N/A ,$220.80 ,$168.00 , N/A , N/A ,$146.16 , N/A ,$165.84 ,$168.00 , N/A ,$172.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,34300022,A9543,HC Y90 ZEVALIN THERAPEUTIC 40 MCI,343,1 ,"$71,260.00 ","$35,630.00 ","$4,338.17 ","$132,547.90 ","$46,033.96 ","$4,338.17 ","$46,098.09 ","$46,098.09 ","$58,910.18 ","$42,756.00 ","$60,571.00 ","$49,882.00 ","$4,338.17 ","$67,697.00 ","$51,307.20 ","$52,019.80 ","$71,260.00 ","$60,571.00 ","$58,910.18 ","$71,260.00 ","$57,008.00 ","$52,019.80 ","$4,338.17 ","$58,910.18 ","$62,659.96 ","$71,260.00 ","$60,571.00 ","$132,547.90 ","$65,559.20 ","$49,882.00 ","$71,260.00 ","$71,260.00 ","$43,397.34 ","$71,260.00 ","$49,240.66 ","$49,882.00 ","$59,499.28 ","$51,307.20 ","$4,598.46 ","$71,260.00 ","$71,260.00 ","$58,910.18 ","$71,260.00 ","$58,910.18 ","$51,307.20 ","$44,181.20 ","$51,307.20 ","$51,307.20 ","$42,756.00 " ST VINCENT HOSPITAL - ACUTE,34300024,A9547,HC DIAGNUCLIDE IN OXINE .5 MCI,343,1 ,"$2,600.00 ","$1,300.00 ","$1,092.00 ","$2,600.00 ","$1,679.60 ", N/A ,"$1,681.94 ","$1,681.94 ", N/A ,"$1,560.00 ","$2,210.00 ","$1,820.00 ", N/A ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$2,600.00 ","$2,210.00 ", N/A ,"$2,600.00 ","$2,080.00 ","$1,898.00 ", N/A , N/A ,"$1,092.00 ","$2,600.00 ","$2,210.00 ", N/A ,"$2,392.00 ","$1,820.00 ", N/A , N/A ,"$1,583.40 ", N/A ,"$1,796.60 ","$1,820.00 ", N/A ,"$1,872.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,34300025,A9548,HC DIAGNUCLIDE IN-111 WB PER.5MCI,343,1 ,"$4,335.00 ","$2,167.50 ",$842.91 ,"$4,335.00 ","$2,800.41 ", N/A ,"$2,804.31 ","$2,804.31 ", N/A ,"$2,601.00 ","$3,684.75 ","$3,034.50 ", N/A ,"$4,118.25 ","$3,121.20 ","$3,164.55 ",$842.91 ,"$3,684.75 ", N/A ,$842.91 ,"$3,468.00 ","$3,164.55 ", N/A , N/A ,"$1,820.70 ","$4,335.00 ","$3,684.75 ", N/A ,"$3,988.20 ","$3,034.50 ", N/A , N/A ,"$2,640.02 ", N/A ,"$2,995.49 ","$3,034.50 ", N/A ,"$3,121.20 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,121.20 ","$2,687.70 ","$3,121.20 ","$3,121.20 ","$2,601.00 " ST VINCENT HOSPITAL - ACUTE,34300026,A9548,HC DIAGNUCLIDE IN-111 DTPA,343,1 ,"$4,335.00 ","$2,167.50 ",$842.91 ,"$4,335.00 ","$2,800.41 ", N/A ,"$2,804.31 ","$2,804.31 ", N/A ,"$2,601.00 ","$3,684.75 ","$3,034.50 ", N/A ,"$4,118.25 ","$3,121.20 ","$3,164.55 ",$842.91 ,"$3,684.75 ", N/A ,$842.91 ,"$3,468.00 ","$3,164.55 ", N/A , N/A ,"$1,820.70 ","$4,335.00 ","$3,684.75 ", N/A ,"$3,988.20 ","$3,034.50 ", N/A , N/A ,"$2,640.02 ", N/A ,"$2,995.49 ","$3,034.50 ", N/A ,"$3,121.20 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,121.20 ","$2,687.70 ","$3,121.20 ","$3,121.20 ","$2,601.00 " ST VINCENT HOSPITAL - ACUTE,34300028,A9551,HC DIAGNUCLIDE DMSA,343,1 ,"$1,185.00 ",$592.50 ,$497.70 ,"$1,185.00 ",$765.51 , N/A ,$766.58 ,$766.58 , N/A ,$711.00 ,"$1,007.25 ",$829.50 , N/A ,"$1,125.75 ",$853.20 ,$865.05 ,"$1,185.00 ","$1,007.25 ", N/A ,"$1,185.00 ",$948.00 ,$865.05 , N/A , N/A ,$497.70 ,"$1,185.00 ","$1,007.25 ", N/A ,"$1,090.20 ",$829.50 , N/A , N/A ,$721.67 , N/A ,$818.84 ,$829.50 , N/A ,$853.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$853.20 ,$734.70 ,$853.20 ,$853.20 ,$711.00 ST VINCENT HOSPITAL - ACUTE,34300029,A9552,HC DIAGNUCLIDE 18FDG,343,1 ,"$1,040.00 ",$520.00 ,$436.80 ,"$1,040.00 ",$671.84 , N/A ,$672.78 ,$672.78 , N/A ,$624.00 ,$884.00 ,$728.00 , N/A ,$988.00 ,$748.80 ,$759.20 ,$544.34 ,$884.00 , N/A ,$544.34 ,$832.00 ,$759.20 , N/A , N/A ,$436.80 ,"$1,040.00 ",$884.00 , N/A ,$956.80 ,$728.00 , N/A , N/A ,$633.36 , N/A ,$718.64 ,$728.00 , N/A ,$748.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$748.80 ,$644.80 ,$748.80 ,$748.80 ,$624.00 ST VINCENT HOSPITAL - ACUTE,34300031,A9556,HC DIAGNUCLIDE GA67 PER MCI,343,1 ,$110.00 ,$55.00 ,$46.20 ,$110.00 ,$71.06 , N/A ,$71.16 ,$71.16 , N/A ,$66.00 ,$93.50 ,$77.00 , N/A ,$104.50 ,$79.20 ,$80.30 ,$110.00 ,$93.50 , N/A ,$110.00 ,$88.00 ,$80.30 , N/A , N/A ,$46.20 ,$110.00 ,$93.50 , N/A ,$101.20 ,$77.00 , N/A , N/A ,$66.99 , N/A ,$76.01 ,$77.00 , N/A ,$79.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,34300033,A9558,HC DIAGNUCLIDE XE133 10 MCI,343,1 ,$170.00 ,$85.00 ,$71.40 ,$170.00 ,$109.82 , N/A ,$109.97 ,$109.97 , N/A ,$102.00 ,$144.50 ,$119.00 , N/A ,$161.50 ,$122.40 ,$124.10 ,$170.00 ,$144.50 , N/A ,$170.00 ,$136.00 ,$124.10 , N/A , N/A ,$71.40 ,$170.00 ,$144.50 , N/A ,$156.40 ,$119.00 , N/A , N/A ,$103.53 , N/A ,$117.47 ,$119.00 , N/A ,$122.40 , N/A , N/A , N/A , N/A , N/A , N/A ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,34300035,A9560,HC TC99M GI BLD MUGA UP TO 30MCI,343,1 ,$310.00 ,$155.00 ,$130.20 ,$310.00 ,$200.26 , N/A ,$200.54 ,$200.54 , N/A ,$186.00 ,$263.50 ,$217.00 , N/A ,$294.50 ,$223.20 ,$226.30 ,$181.42 ,$263.50 , N/A ,$181.42 ,$248.00 ,$226.30 , N/A , N/A ,$130.20 ,$310.00 ,$263.50 , N/A ,$285.20 ,$217.00 , N/A , N/A ,$188.79 , N/A ,$214.21 ,$217.00 , N/A ,$223.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,34300036,A9560,HC RBC TAG KIT WITH TC99,343,1 ,$310.00 ,$155.00 ,$130.20 ,$310.00 ,$200.26 , N/A ,$200.54 ,$200.54 , N/A ,$186.00 ,$263.50 ,$217.00 , N/A ,$294.50 ,$223.20 ,$226.30 ,$181.42 ,$263.50 , N/A ,$181.42 ,$248.00 ,$226.30 , N/A , N/A ,$130.20 ,$310.00 ,$263.50 , N/A ,$285.20 ,$217.00 , N/A , N/A ,$188.79 , N/A ,$214.21 ,$217.00 , N/A ,$223.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,34300037,A9562,HC DIAG NUCLDE MAG 3 PER DOSE,343,1 ,$880.00 ,$440.00 ,$369.60 ,$880.00 ,$568.48 , N/A ,$569.27 ,$569.27 , N/A ,$528.00 ,$748.00 ,$616.00 , N/A ,$836.00 ,$633.60 ,$642.40 ,$880.00 ,$748.00 , N/A ,$880.00 ,$704.00 ,$642.40 , N/A , N/A ,$369.60 ,$880.00 ,$748.00 , N/A ,$809.60 ,$616.00 , N/A , N/A ,$535.92 , N/A ,$608.08 ,$616.00 , N/A ,$633.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$633.60 ,$545.60 ,$633.60 ,$633.60 ,$528.00 ST VINCENT HOSPITAL - ACUTE,34300038,A9572,HC DIAGNUCLIDE OCTREOTIDE PER DOSE UP TO 6MCI,343,1 ,"$6,995.00 ","$3,497.50 ","$2,937.90 ","$6,995.00 ","$4,518.77 ", N/A ,"$4,525.07 ","$4,525.07 ", N/A ,"$4,197.00 ","$5,945.75 ","$4,896.50 ", N/A ,"$6,645.25 ","$5,036.40 ","$5,106.35 ","$6,995.00 ","$5,945.75 ", N/A ,"$6,995.00 ","$5,596.00 ","$5,106.35 ", N/A , N/A ,"$2,937.90 ","$6,995.00 ","$5,945.75 ", N/A ,"$6,435.40 ","$4,896.50 ", N/A , N/A ,"$4,259.96 ", N/A ,"$4,833.55 ","$4,896.50 ", N/A ,"$5,036.40 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$5,036.40 ","$4,336.90 ","$5,036.40 ","$5,036.40 ","$4,197.00 " ST VINCENT HOSPITAL - ACUTE,34300039,A9582,HC DIAGNUCLIDE I 123 MIBG,343,1 ,"$6,210.00 ","$3,105.00 ","$2,608.20 ","$6,210.00 ","$4,011.66 ", N/A ,"$4,017.25 ","$4,017.25 ", N/A ,"$3,726.00 ","$5,278.50 ","$4,347.00 ", N/A ,"$5,899.50 ","$4,471.20 ","$4,533.30 ","$6,210.00 ","$5,278.50 ", N/A ,"$6,210.00 ","$4,968.00 ","$4,533.30 ", N/A , N/A ,"$2,608.20 ","$6,210.00 ","$5,278.50 ", N/A ,"$5,713.20 ","$4,347.00 ", N/A , N/A ,"$3,781.89 ", N/A ,"$4,291.11 ","$4,347.00 ", N/A ,"$4,471.20 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,471.20 ","$3,850.20 ","$4,471.20 ","$4,471.20 ","$3,726.00 " ST VINCENT HOSPITAL - ACUTE,34300040,A9604,HC THER ISOTOP SAMARIUM 153 UP TO 150MCI,343,1 ,"$20,250.00 ","$10,125.00 ","$1,979.43 ","$41,115.92 ","$13,081.50 ","$1,979.43 ","$13,099.73 ","$13,099.73 ","$18,273.74 ","$12,150.00 ","$17,212.50 ","$14,175.00 ","$1,979.43 ","$19,237.50 ","$14,580.00 ","$14,782.50 ","$20,250.00 ","$17,212.50 ","$18,273.74 ","$20,250.00 ","$16,200.00 ","$14,782.50 ","$1,979.43 ","$18,273.74 ","$8,505.00 ","$20,250.00 ","$17,212.50 ","$41,115.92 ","$18,630.00 ","$14,175.00 ", N/A , N/A ,"$12,332.25 ", N/A ,"$13,992.75 ","$14,175.00 ","$18,456.48 ","$14,580.00 ","$2,098.20 ","$20,250.00 ","$20,250.00 ","$18,273.74 ","$20,250.00 ","$18,273.74 ","$14,580.00 ","$12,555.00 ","$14,580.00 ","$14,580.00 ","$12,150.00 " ST VINCENT HOSPITAL - ACUTE,34300041,J2805,HC DIAGNUCLIDE CCK,636,1 ,$265.00 ,$132.50 ,$20.73 ,$265.00 ,$171.19 ,$20.73 ,$265.00 ,$200.41 , N/A ,$159.00 ,$225.25 ,$185.50 ,$20.73 ,$251.75 ,$190.80 ,$193.45 ,$200.41 ,$225.25 , N/A ,$200.41 ,$212.00 ,$193.45 ,$20.73 , N/A ,$130.17 ,$265.00 ,$225.25 , N/A ,$243.80 ,$185.50 ,$170.94 ,$183.91 ,$161.39 ,$170.94 ,$183.12 ,$185.50 , N/A ,$190.80 ,$21.97 , N/A , N/A , N/A , N/A , N/A ,$190.80 ,$164.30 ,$190.80 ,$190.80 ,$159.00 ST VINCENT HOSPITAL - ACUTE,34300049,A9509,HC DIAGNUCLIDE I123 CAP PER MILLICURIE,343,1 ,$480.00 ,$240.00 ,$201.60 ,$480.00 ,$310.08 , N/A ,$310.51 ,$310.51 , N/A ,$288.00 ,$408.00 ,$336.00 , N/A ,$456.00 ,$345.60 ,$350.40 ,$480.00 ,$408.00 , N/A ,$480.00 ,$384.00 ,$350.40 , N/A , N/A ,$201.60 ,$480.00 ,$408.00 , N/A ,$441.60 ,$336.00 , N/A , N/A ,$292.32 , N/A ,$331.68 ,$336.00 , N/A ,$345.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,34300051,A9541,HC DIAGNUCLIDE FILT SULF COLLOID UP TO 20MCI,343,1 ,$205.00 ,$102.50 ,$86.10 ,$205.00 ,$132.43 , N/A ,$132.61 ,$132.61 , N/A ,$123.00 ,$174.25 ,$143.50 , N/A ,$194.75 ,$147.60 ,$149.65 ,$205.00 ,$174.25 , N/A ,$205.00 ,$164.00 ,$149.65 , N/A , N/A ,$86.10 ,$205.00 ,$174.25 , N/A ,$188.60 ,$143.50 , N/A , N/A ,$124.85 , N/A ,$141.66 ,$143.50 , N/A ,$147.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$147.60 ,$127.10 ,$147.60 ,$147.60 ,$123.00 ST VINCENT HOSPITAL - ACUTE,34300052,A9539,HC DIAGNUCLIDE DTPA AEROSOL,343,1 ,$155.00 ,$77.50 ,$63.92 ,$155.00 ,$100.13 , N/A ,$100.27 ,$100.27 , N/A ,$93.00 ,$131.75 ,$108.50 , N/A ,$147.25 ,$111.60 ,$113.15 ,$63.92 ,$131.75 , N/A ,$63.92 ,$124.00 ,$113.15 , N/A , N/A ,$65.10 ,$155.00 ,$131.75 , N/A ,$142.60 ,$108.50 , N/A , N/A ,$94.40 , N/A ,$107.11 ,$108.50 , N/A ,$111.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$111.60 ,$96.10 ,$111.60 ,$111.60 ,$93.00 ST VINCENT HOSPITAL - ACUTE,34300053,A9606,HC NUCLIDE XOFIGO PER MICROCURIE,636,1 ,$200.00 ,$100.00 ,$100.00 ,"$4,598.46 ",$129.20 ,$200.00 , N/A , N/A ,$145.06 ,$120.00 ,$170.00 ,$140.00 ,"$4,338.17 ",$190.00 ,$144.00 ,$146.00 ,$200.00 ,$170.00 ,$145.06 ,$200.00 ,$160.00 ,$146.00 ,"$4,338.17 ",$145.06 , N/A ,$200.00 ,$170.00 ,$326.38 ,$184.00 ,$140.00 , N/A , N/A ,$121.80 , N/A ,$138.20 ,$140.00 ,$146.51 ,$144.00 ,"$4,598.46 ",$200.00 ,$200.00 ,$145.06 ,$200.00 ,$145.06 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,34300054,A9587,HC GALLIUM GA-68 DOTATATE DIAG 0.1 MCI,343,1 ,$126.00 ,$63.00 ,$52.92 ,$126.00 ,$81.40 , N/A ,$81.51 ,$81.51 , N/A ,$75.60 ,$107.10 ,$88.20 , N/A ,$119.70 ,$90.72 ,$91.98 ,$126.00 ,$107.10 , N/A ,$126.00 ,$100.80 ,$91.98 , N/A , N/A ,$52.92 ,$126.00 ,$107.10 , N/A ,$115.92 ,$88.20 , N/A , N/A ,$76.73 , N/A ,$87.07 ,$88.20 , N/A ,$90.72 , N/A , N/A , N/A , N/A , N/A , N/A ,$90.72 ,$78.12 ,$90.72 ,$90.72 ,$75.60 ST VINCENT HOSPITAL - ACUTE,34300055,A9588,HC FLUCICLOVINE F-18 DIAG 1 MCI,343,1 ,$850.00 ,$425.00 ,$357.00 ,$850.00 ,$549.10 , N/A ,$549.87 ,$549.87 , N/A ,$510.00 ,$722.50 ,$595.00 , N/A ,$807.50 ,$612.00 ,$620.50 ,$817.02 ,$722.50 , N/A ,$817.02 ,$680.00 ,$620.50 , N/A , N/A ,$357.00 ,$850.00 ,$722.50 , N/A ,$782.00 ,$595.00 , N/A , N/A ,$517.65 , N/A ,$587.35 ,$595.00 , N/A ,$612.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,34300060,A9520,HC DIAGNUCLIDE TC-99 TILMANOCEPT DIAG UP TO 0.5 MCI,343,1 ,"$1,044.00 ",$522.00 ,$438.48 ,"$1,044.00 ",$674.42 , N/A ,$675.36 ,$675.36 , N/A ,$626.40 ,$887.40 ,$730.80 , N/A ,$991.80 ,$751.68 ,$762.12 ,$958.39 ,$887.40 , N/A ,$958.39 ,$835.20 ,$762.12 , N/A , N/A ,$438.48 ,"$1,044.00 ",$887.40 , N/A ,$960.48 ,$730.80 , N/A , N/A ,$635.80 , N/A ,$721.40 ,$730.80 , N/A ,$751.68 , N/A , N/A , N/A , N/A , N/A , N/A ,$751.68 ,$647.28 ,$751.68 ,$751.68 ,$626.40 ST VINCENT HOSPITAL - ACUTE,34300066,Q9969,HC TC-99M NON-HUE ADD-ON PER STUDY DOSE,343,1 ,$10.00 ,$5.00 ,$4.20 ,$22.50 ,$6.46 , N/A ,$6.47 ,$6.47 ,$10.00 ,$6.00 ,$8.50 ,$7.00 , N/A ,$9.50 ,$7.20 ,$7.30 ,$6.50 ,$8.50 ,$10.00 ,$6.50 ,$8.00 ,$7.30 , N/A ,$10.00 ,$4.20 ,$10.00 ,$8.50 ,$22.50 ,$9.20 ,$7.00 , N/A , N/A ,$6.09 , N/A ,$6.91 ,$7.00 ,$10.10 ,$7.20 , N/A ,$10.00 ,$10.00 ,$10.00 ,$10.00 ,$10.00 ,$7.20 ,$6.20 ,$7.20 ,$7.20 ,$6.00 ST VINCENT HOSPITAL - ACUTE,35000002,20615,HC ASP/INJ CYST BONE,350,1 ,$920.00 ,$460.00 ,$162.48 ,"$4,310.52 ",$594.32 ,$162.48 ,$920.00 ,$920.00 ,$602.38 ,$552.00 ,$782.00 ,$644.00 ,$162.48 ,$874.00 ,$662.40 ,$671.60 ,$920.00 ,$782.00 ,$602.38 ,$920.00 ,$736.00 ,$671.60 ,$162.48 ,$602.38 ,$460.29 ,$920.00 ,$782.00 ,"$1,355.35 ",$846.40 ,$644.00 ,"$3,206.88 ","$4,310.52 ",$560.28 ,"$4,008.60 ",$635.72 ,$644.00 ,$608.40 ,$662.40 ,$172.23 ,$920.00 ,$920.00 ,$602.38 ,$920.00 ,$602.38 ,$662.40 ,$570.40 ,$662.40 ,$662.40 ,$552.00 ST VINCENT HOSPITAL - ACUTE,35000003,20982,HC ABLATION BONE TUMOR RADIOFREQUENCY,350,1 ,"$4,900.00 ","$2,450.00 ",$460.29 ,"$13,652.11 ","$3,165.40 ",$496.73 ,"$1,086.00 ","$1,086.00 ","$6,067.60 ","$2,940.00 ","$4,165.00 ","$3,430.00 ",$496.73 ,"$4,655.00 ","$3,528.00 ","$3,577.00 ","$1,130.00 ","$4,165.00 ","$6,067.60 ","$1,130.00 ","$3,920.00 ","$3,577.00 ",$496.73 ,"$6,067.60 ",$460.29 ,"$4,900.00 ","$4,165.00 ","$13,652.11 ","$4,508.00 ","$3,430.00 ","$2,066.93 ","$2,778.48 ","$2,984.10 ","$2,583.66 ","$3,385.90 ","$3,430.00 ","$6,128.28 ","$3,528.00 ",$526.53 ,"$1,103.00 ","$1,103.00 ","$6,067.60 ","$1,103.00 ","$6,067.60 ","$3,528.00 ","$3,038.00 ","$3,528.00 ","$3,528.00 ","$2,940.00 " ST VINCENT HOSPITAL - ACUTE,35000004,20999,HC MUSCULOSKELETAL UNLSTD PROC,350,1 ,"$2,800.00 ","$1,400.00 ",$199.70 ,"$2,800.00 ","$1,808.80 ",$392.13 ,"$1,086.00 ","$1,086.00 ",$199.70 ,"$1,680.00 ","$2,380.00 ","$1,960.00 ",$392.13 ,"$2,660.00 ","$2,016.00 ","$2,044.00 ","$1,130.00 ","$2,380.00 ",$199.70 ,"$1,130.00 ","$2,240.00 ","$2,044.00 ",$392.13 ,$199.70 ,$460.29 ,"$2,800.00 ","$2,380.00 ",$449.31 ,"$2,576.00 ","$1,960.00 ","$1,400.00 ","$1,680.00 ","$1,705.20 ","$1,400.00 ","$1,934.80 ","$1,960.00 ",$201.70 ,"$2,016.00 ",$415.66 ,"$1,103.00 ","$1,103.00 ",$199.70 ,"$1,103.00 ",$199.70 ,"$2,016.00 ","$1,736.00 ","$2,016.00 ","$2,016.00 ","$1,680.00 " ST VINCENT HOSPITAL - ACUTE,35000006,21550,HC BX TISSUE NECK/THORAX,350,1 ,"$2,200.00 ","$1,100.00 ",$460.29 ,"$3,066.03 ","$1,421.20 ",$639.42 ,"$1,086.00 ","$1,086.00 ","$1,362.68 ","$1,320.00 ","$1,870.00 ","$1,540.00 ",$639.42 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ","$1,362.68 ","$1,130.00 ","$1,760.00 ","$1,606.00 ",$639.42 ,"$1,362.68 ",$460.29 ,"$2,200.00 ","$1,870.00 ","$3,066.03 ","$2,024.00 ","$1,540.00 ","$2,066.93 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ","$1,376.31 ","$1,584.00 ",$677.79 ,"$1,103.00 ","$1,103.00 ","$1,362.68 ","$1,103.00 ","$1,362.68 ","$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000011,27299,HC CT RAMUS PUBOPLASTY,361,1 ,"$5,500.00 ","$2,750.00 ",$193.84 ,"$5,500.00 ","$3,553.00 ",$193.84 ,"$5,500.00 ","$5,500.00 ",$199.70 ,"$3,300.00 ","$4,675.00 ","$3,850.00 ",$193.84 ,"$5,225.00 ","$3,960.00 ","$4,015.00 ","$2,717.00 ","$4,675.00 ",$199.70 ,"$2,717.00 ","$4,400.00 ","$4,015.00 ",$193.84 ,$199.70 ,"$5,500.00 ","$5,500.00 ","$4,675.00 ",$449.31 ,"$5,060.00 ","$3,850.00 ", N/A , N/A ,"$3,349.50 ", N/A ,"$3,800.50 ","$3,850.00 ",$201.70 ,"$3,960.00 ",$205.47 ,"$1,858.00 ","$1,858.00 ",$199.70 ,"$1,858.00 ",$199.70 ,"$3,960.00 ","$3,410.00 ","$3,960.00 ","$3,960.00 ","$3,300.00 " ST VINCENT HOSPITAL - ACUTE,35000013,32400,HC BX PLEURA NEEDLE PERC,350,1 ,"$1,100.00 ",$550.00 ,$258.10 ,"$3,066.03 ",$710.60 ,$258.10 ,"$1,086.00 ","$1,086.00 ","$1,362.68 ",$660.00 ,$935.00 ,$770.00 ,$258.10 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 ,"$1,362.68 ","$1,100.00 ",$880.00 ,$803.00 ,$258.10 ,"$1,362.68 ",$460.29 ,"$1,100.00 ",$935.00 ,"$3,066.03 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,"$1,376.31 ",$792.00 ,$273.59 ,"$1,100.00 ","$1,100.00 ","$1,362.68 ","$1,100.00 ","$1,362.68 ",$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,35000014,32405,HC BX LUNG/MEDIASTINUM PERC NDL,350,1 ,"$1,600.00 ",$800.00 ,$460.29 ,"$1,600.00 ","$1,033.60 ", N/A ,"$1,086.00 ","$1,086.00 ", N/A ,$960.00 ,"$1,360.00 ","$1,120.00 ", N/A ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,130.00 ","$1,360.00 ", N/A ,"$1,130.00 ","$1,280.00 ","$1,168.00 ", N/A , N/A ,$460.29 ,"$1,600.00 ","$1,360.00 ", N/A ,"$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ", N/A ,"$1,152.00 ", N/A ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,35000017,32998,HC LUNG ABLATION,350,1 ,"$8,070.00 ","$4,035.00 ",$460.29 ,"$11,027.33 ","$5,213.22 ","$1,439.16 ","$1,086.00 ","$1,086.00 ","$4,901.04 ","$4,842.00 ","$6,859.50 ","$5,649.00 ","$1,439.16 ","$7,666.50 ","$5,810.40 ","$5,891.10 ","$1,130.00 ","$6,859.50 ","$4,901.04 ","$1,130.00 ","$6,456.00 ","$5,891.10 ","$1,439.16 ","$4,901.04 ",$460.29 ,"$8,070.00 ","$6,859.50 ","$11,027.33 ","$7,424.40 ","$5,649.00 ","$5,818.90 ","$7,821.36 ","$4,914.63 ","$7,273.62 ","$5,576.37 ","$5,649.00 ","$4,950.05 ","$5,810.40 ","$1,525.51 ","$1,103.00 ","$1,103.00 ","$4,901.04 ","$1,103.00 ","$4,901.04 ","$5,810.40 ","$5,003.40 ","$5,810.40 ","$5,810.40 ","$4,842.00 " ST VINCENT HOSPITAL - ACUTE,35000018,47000,HC BX LIVER NEEDLE PERC,350,1 ,"$1,600.00 ",$800.00 ,$202.63 ,"$3,066.03 ","$1,033.60 ",$202.63 ,"$1,086.00 ","$1,086.00 ","$1,362.68 ",$960.00 ,"$1,360.00 ","$1,120.00 ",$202.63 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,130.00 ","$1,360.00 ","$1,362.68 ","$1,130.00 ","$1,280.00 ","$1,168.00 ",$202.63 ,"$1,362.68 ",$460.29 ,"$1,600.00 ","$1,360.00 ","$3,066.03 ","$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ","$1,376.31 ","$1,152.00 ",$214.79 ,"$1,103.00 ","$1,103.00 ","$1,362.68 ","$1,103.00 ","$1,362.68 ","$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,35000019,47001,HC BIOPSY LIVER OTHER PROC,350,1 ,"$2,330.00 ","$1,165.00 ",$202.63 ,"$2,330.00 ","$1,505.18 ",$202.63 ,"$1,086.00 ","$1,086.00 ", N/A ,"$1,398.00 ","$1,980.50 ","$1,631.00 ",$202.63 ,"$2,213.50 ","$1,677.60 ","$1,700.90 ","$1,130.00 ","$1,980.50 ", N/A ,"$1,130.00 ","$1,864.00 ","$1,700.90 ",$202.63 , N/A ,$460.29 ,"$2,330.00 ","$1,980.50 ", N/A ,"$2,143.60 ","$1,631.00 ","$2,066.93 ","$2,330.00 ","$1,418.97 ","$2,330.00 ","$1,610.03 ","$1,631.00 ", N/A ,"$1,677.60 ",$214.79 ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,677.60 ","$1,444.60 ","$1,677.60 ","$1,677.60 ","$1,398.00 " ST VINCENT HOSPITAL - ACUTE,35000020,49405,HC PERC DRN ABSC/HEM/CYST VISCERAL,350,1 ,"$1,800.00 ",$900.00 ,$202.63 ,"$3,066.03 ","$1,162.80 ",$202.63 ,"$1,086.00 ","$1,086.00 ","$1,362.68 ","$1,080.00 ","$1,530.00 ","$1,260.00 ",$202.63 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ","$1,362.68 ","$1,130.00 ","$1,440.00 ","$1,314.00 ",$202.63 ,"$1,362.68 ",$460.29 ,"$1,800.00 ","$1,530.00 ","$3,066.03 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ","$1,376.31 ","$1,296.00 ",$214.79 ,"$1,103.00 ","$1,103.00 ","$1,362.68 ","$1,103.00 ","$1,362.68 ","$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000021,47382,HC ABLATION TUMR LIVER RADIO PERC,350,1 ,"$7,200.00 ","$3,600.00 ",$460.29 ,"$11,027.33 ","$4,651.20 ","$1,826.39 ","$1,086.00 ","$1,086.00 ","$4,901.04 ","$4,320.00 ","$6,120.00 ","$5,040.00 ","$1,826.39 ","$6,840.00 ","$5,184.00 ","$5,256.00 ","$1,130.00 ","$6,120.00 ","$4,901.04 ","$1,130.00 ","$5,760.00 ","$5,256.00 ","$1,826.39 ","$4,901.04 ",$460.29 ,"$7,200.00 ","$6,120.00 ","$11,027.33 ","$6,624.00 ","$5,040.00 ","$5,818.90 ","$7,821.36 ","$4,384.80 ","$7,273.62 ","$4,975.20 ","$5,040.00 ","$4,950.05 ","$5,184.00 ","$1,935.97 ","$1,103.00 ","$1,103.00 ","$4,901.04 ","$1,103.00 ","$4,901.04 ","$5,184.00 ","$4,464.00 ","$5,184.00 ","$5,184.00 ","$4,320.00 " ST VINCENT HOSPITAL - ACUTE,35000023,48102,HC BX PANCREAS NEEDLE PERC,350,1 ,"$1,400.00 ",$700.00 ,$202.63 ,"$3,066.03 ",$904.40 ,$202.63 ,"$1,086.00 ","$1,086.00 ","$1,362.68 ",$840.00 ,"$1,190.00 ",$980.00 ,$202.63 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ","$1,130.00 ","$1,190.00 ","$1,362.68 ","$1,130.00 ","$1,120.00 ","$1,022.00 ",$202.63 ,"$1,362.68 ",$460.29 ,"$1,400.00 ","$1,190.00 ","$3,066.03 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,"$1,376.31 ","$1,008.00 ",$214.79 ,"$1,103.00 ","$1,103.00 ","$1,362.68 ","$1,103.00 ","$1,362.68 ","$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,35000025,49180,HC ABDOM/RETRO/MASS BIOP,350,1 ,"$1,400.00 ",$700.00 ,$202.63 ,"$3,066.03 ",$904.40 ,$202.63 ,"$1,086.00 ","$1,086.00 ","$1,362.68 ",$840.00 ,"$1,190.00 ",$980.00 ,$202.63 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ","$1,130.00 ","$1,190.00 ","$1,362.68 ","$1,130.00 ","$1,120.00 ","$1,022.00 ",$202.63 ,"$1,362.68 ",$460.29 ,"$1,400.00 ","$1,190.00 ","$3,066.03 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,"$1,376.31 ","$1,008.00 ",$214.79 ,"$1,103.00 ","$1,103.00 ","$1,362.68 ","$1,103.00 ","$1,362.68 ","$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,35000026,50200,"HC PERC BIOPSY/KIDNEY, NEEDLE",350,1 ,"$1,600.00 ",$800.00 ,$430.16 ,"$3,066.03 ","$1,033.60 ",$430.16 ,"$1,086.00 ","$1,086.00 ","$1,362.68 ",$960.00 ,"$1,360.00 ","$1,120.00 ",$430.16 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,130.00 ","$1,360.00 ","$1,362.68 ","$1,130.00 ","$1,280.00 ","$1,168.00 ",$430.16 ,"$1,362.68 ",$460.29 ,"$1,600.00 ","$1,360.00 ","$3,066.03 ","$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ","$1,376.31 ","$1,152.00 ",$455.97 ,"$1,103.00 ","$1,103.00 ","$1,362.68 ","$1,103.00 ","$1,362.68 ","$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,35000027,50390,HC RENAL CYST/PELVIS ASP/INJ,350,1 ,"$1,400.00 ",$700.00 ,$125.13 ,"$1,400.00 ",$904.40 ,$125.13 ,"$1,086.00 ","$1,086.00 ",$602.38 ,$840.00 ,"$1,190.00 ",$980.00 ,$125.13 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ","$1,130.00 ","$1,190.00 ",$602.38 ,"$1,130.00 ","$1,120.00 ","$1,022.00 ",$125.13 ,$602.38 ,$460.29 ,"$1,400.00 ","$1,190.00 ","$1,355.35 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,$608.40 ,"$1,008.00 ",$132.64 ,"$1,103.00 ","$1,103.00 ",$602.38 ,"$1,103.00 ",$602.38 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,35000028,60100,HC BX THYROID NEEDLE PERC,350,1 ,$880.00 ,$440.00 ,$280.78 ,"$1,355.35 ",$568.48 ,$280.78 ,$880.00 ,$880.00 ,$602.38 ,$528.00 ,$748.00 ,$616.00 ,$280.78 ,$836.00 ,$633.60 ,$642.40 ,$880.00 ,$748.00 ,$602.38 ,$880.00 ,$704.00 ,$642.40 ,$280.78 ,$602.38 ,$460.29 ,$880.00 ,$748.00 ,"$1,355.35 ",$809.60 ,$616.00 ,$880.00 ,$880.00 ,$535.92 ,$880.00 ,$608.08 ,$616.00 ,$608.40 ,$633.60 ,$297.63 ,$880.00 ,$880.00 ,$602.38 ,$880.00 ,$602.38 ,$633.60 ,$545.60 ,$633.60 ,$633.60 ,$528.00 ST VINCENT HOSPITAL - ACUTE,35000029,60699,HC UNLISTED PROCEDURE ENDOCRINE SYSTEM,350,1 ,"$3,300.00 ","$1,650.00 ",$460.29 ,"$11,027.33 ","$2,131.80 ",$783.76 ,"$1,086.00 ","$1,086.00 ","$4,901.04 ","$1,980.00 ","$2,805.00 ","$2,310.00 ",$783.76 ,"$3,135.00 ","$2,376.00 ","$2,409.00 ","$1,130.00 ","$2,805.00 ","$4,901.04 ","$1,130.00 ","$2,640.00 ","$2,409.00 ",$783.76 ,"$4,901.04 ",$460.29 ,"$3,300.00 ","$2,805.00 ","$11,027.33 ","$3,036.00 ","$2,310.00 ","$1,650.00 ","$1,980.00 ","$2,009.70 ","$1,650.00 ","$2,280.30 ","$2,310.00 ","$4,950.05 ","$2,376.00 ",$830.79 ,"$1,103.00 ","$1,103.00 ","$4,901.04 ","$1,103.00 ","$4,901.04 ","$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,35000032,64430,HC INJ ANEST AGENT PUDENDAL NERVE,350,1 ,"$1,250.00 ",$625.00 ,$349.28 ,"$1,792.24 ",$807.50 ,$349.28 ,"$1,086.00 ","$1,086.00 ",$796.55 ,$750.00 ,"$1,062.50 ",$875.00 ,$349.28 ,"$1,187.50 ",$900.00 ,$912.50 ,"$1,130.00 ","$1,062.50 ",$796.55 ,"$1,130.00 ","$1,000.00 ",$912.50 ,$349.28 ,$796.55 ,$460.29 ,"$1,250.00 ","$1,062.50 ","$1,792.24 ","$1,150.00 ",$875.00 ,"$1,250.00 ","$1,250.00 ",$761.25 ,"$1,250.00 ",$863.75 ,$875.00 ,$804.52 ,$900.00 ,$370.24 ,"$1,103.00 ","$1,103.00 ",$796.55 ,"$1,103.00 ",$796.55 ,$900.00 ,$775.00 ,$900.00 ,$900.00 ,$750.00 ST VINCENT HOSPITAL - ACUTE,35000035,64680,HC DEST NERVE CELIAC PLEXUS,350,1 ,"$1,600.00 ",$800.00 ,$349.28 ,"$1,792.24 ","$1,033.60 ",$349.28 ,"$1,086.00 ","$1,086.00 ",$796.55 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$349.28 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,130.00 ","$1,360.00 ",$796.55 ,"$1,130.00 ","$1,280.00 ","$1,168.00 ",$349.28 ,$796.55 ,$460.29 ,"$1,600.00 ","$1,360.00 ","$1,792.24 ","$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ",$804.52 ,"$1,152.00 ",$370.24 ,"$1,103.00 ","$1,103.00 ",$796.55 ,"$1,103.00 ",$796.55 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,35000036,70450,HC CT HEAD/BRAIN W/O CONTRAST,350,1 ,"$1,800.00 ",$900.00 ,$90.16 ,"$1,800.00 ","$1,162.80 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$90.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$90.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000037,70460,HC CT HEAD/BRAIN W/CONTRAST,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$172.93 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$389.08 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$174.66 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000038,70470,HC CT HEAD/BRAIN W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$90.16 ,"$2,600.00 ","$1,679.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$90.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$943.96 ,"$1,016.57 ","$1,583.40 ",$943.96 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000039,70480,HC CT ORBIT/IAC/EAR W/O CONTRAST,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000041,70481,HC CT ORBIT/IAC/EAR W/CONTRAST,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$172.93 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$389.08 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$174.66 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000042,70482,HC CT ORBIT/IAC/EAR W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$90.16 ,"$2,600.00 ","$1,679.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$90.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$943.96 ,"$1,016.57 ","$1,583.40 ",$943.96 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000043,70486,HC CT MAX/FACIAL W/O CONTRAST,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000044,70486,HC CT SINUSES UNENHANCED/STEREOTACTIC,350,1 ,"$1,500.00 ",$750.00 ,$34.16 ,"$1,500.00 ",$969.00 ,$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$34.16 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,130.00 ","$1,275.00 ",$105.54 ,"$1,130.00 ","$1,200.00 ","$1,095.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,500.00 ","$1,275.00 ",$237.46 ,"$1,380.00 ","$1,050.00 ",$425.76 ,$458.51 ,$913.50 ,$425.76 ,"$1,036.50 ","$1,050.00 ",$106.60 ,"$1,080.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,35000045,70487,HC CT MAX/FACIAL W/CONTRAST,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$172.93 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$389.08 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$174.66 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000046,70488,HC CT MAX/FACIAL W AND W/O CONTRAST,350,1 ,"$2,400.00 ","$1,200.00 ",$90.16 ,"$2,400.00 ","$1,550.40 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,440.00 ","$2,040.00 ","$1,680.00 ",$90.16 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$1,130.00 ","$2,040.00 ",$172.93 ,"$1,130.00 ","$1,920.00 ","$1,752.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,400.00 ","$2,040.00 ",$389.08 ,"$2,208.00 ","$1,680.00 ",$943.96 ,"$1,016.57 ","$1,461.60 ",$943.96 ,"$1,658.40 ","$1,680.00 ",$174.66 ,"$1,728.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,35000047,70490,HC CT NECK SFT TISS W/O CONTRAST,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000048,70491,HC CT NECK SFT TISS W/CONTRAST,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$172.93 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$389.08 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$174.66 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000049,70492,HC CT NECK SFT TISS W AND WO CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$90.16 ,"$2,600.00 ","$1,679.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$90.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$943.96 ,"$1,016.57 ","$1,583.40 ",$943.96 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000050,70496,HC CT ANGIO HEAD W/WO,350,1 ,"$2,600.00 ","$1,300.00 ",$99.42 ,"$2,600.00 ","$1,679.60 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$99.42 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$99.42 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$982.89 ,"$1,058.50 ","$1,583.40 ",$982.89 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000051,70498,HC CT ANGIO NECK W/WO CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$99.42 ,"$2,600.00 ","$1,679.60 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$99.42 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$99.42 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$982.89 ,"$1,058.50 ","$1,583.40 ",$982.89 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000052,70540,HC MRI ORBIT/FACE/NECK W/O CON,610,1 ,"$3,000.00 ","$1,500.00 ",$76.81 ,"$3,000.00 ","$1,938.00 ",$76.81 ,"$1,288.00 ","$1,288.00 ",$222.88 ,"$1,800.00 ","$2,550.00 ","$2,100.00 ",$76.81 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ","$2,118.00 ","$2,550.00 ",$222.88 ,"$2,118.00 ","$2,400.00 ","$2,190.00 ",$76.81 ,$222.88 ,"$1,387.49 ","$3,000.00 ","$2,550.00 ",$501.48 ,"$2,760.00 ","$2,100.00 ",$992.38 ,"$1,068.72 ","$1,827.00 ",$992.38 ,"$2,073.00 ","$2,100.00 ",$225.11 ,"$2,160.00 ",$81.42 ,"$1,311.00 ","$1,311.00 ",$222.88 ,"$1,311.00 ",$222.88 ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,35000053,72125,HC CT C-SPINE W/O CONTRAST,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000055,72126,HC CT C-SPINE W/CONTRAST,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$356.52 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$356.52 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$356.52 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$802.18 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$360.09 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$356.52 ,"$1,103.00 ",$356.52 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000056,72127,HC CT C-SPINE W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$90.16 ,"$2,600.00 ","$1,679.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$90.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$943.96 ,"$1,016.57 ","$1,583.40 ",$943.96 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000057,72128,HC CT T-SPINE W/O CONTRAST,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000059,72129,HC CT T-SPINE W/CONTRAST,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$172.93 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$389.08 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$174.66 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000060,72130,HC CT T-SPINE W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$90.16 ,"$2,600.00 ","$1,679.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$90.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$943.96 ,"$1,016.57 ","$1,583.40 ",$943.96 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000061,72131,HC CT L-SPINE W/O CONTRAST,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000062,72132,HC CT L-SPINE W/CONTRAST,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$356.52 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$356.52 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$356.52 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$802.18 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$360.09 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$356.52 ,"$1,103.00 ",$356.52 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000063,72133,HC CT L-SPINE W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$90.16 ,"$2,600.00 ","$1,679.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$90.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$943.96 ,"$1,016.57 ","$1,583.40 ",$943.96 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000064,72191,HC CTA PELVIS W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$99.42 ,"$2,600.00 ","$1,679.60 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$99.42 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$99.42 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$982.89 ,"$1,058.50 ","$1,583.40 ",$982.89 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000065,72192,HC CT PELVIS W/O CONTRAST,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000066,72193,HC CT PELVIS W/CONTRAST,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$172.93 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$389.08 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$174.66 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000067,72194,HC CT PELVIS W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$90.16 ,"$2,600.00 ","$1,679.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$90.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$943.96 ,"$1,016.57 ","$1,583.40 ",$943.96 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000068,N/A,HC CT GUIDED VERTEBROPLASTY PERC,350,1 ,$940.00 ,$470.00 ,$460.29 ,$940.00 ,$607.24 , N/A ,$940.00 ,$940.00 , N/A ,$564.00 ,$799.00 ,$658.00 , N/A ,$893.00 ,$676.80 ,$686.20 ,$940.00 ,$799.00 , N/A ,$940.00 ,$752.00 ,$686.20 , N/A , N/A ,$460.29 ,$940.00 ,$799.00 , N/A ,$864.80 ,$658.00 ,$470.00 ,$564.00 ,$572.46 ,$470.00 ,$649.54 ,$658.00 , N/A ,$676.80 , N/A ,$940.00 ,$940.00 , N/A ,$940.00 , N/A ,$676.80 ,$582.80 ,$676.80 ,$676.80 ,$564.00 ST VINCENT HOSPITAL - ACUTE,35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$2,700.00 ","$1,350.00 ",$34.16 ,"$2,700.00 ","$1,744.20 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,620.00 ","$2,295.00 ","$1,890.00 ",$34.16 ,"$2,565.00 ","$1,944.00 ","$1,971.00 ","$1,130.00 ","$2,295.00 ",$105.54 ,"$1,130.00 ","$2,160.00 ","$1,971.00 ",$34.16 ,$105.54 ,$460.29 ,"$2,700.00 ","$2,295.00 ",$237.46 ,"$2,484.00 ","$1,890.00 ",$425.76 ,$458.51 ,"$1,644.30 ",$425.76 ,"$1,865.70 ","$1,890.00 ",$106.60 ,"$1,944.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,944.00 ","$1,674.00 ","$1,944.00 ","$1,944.00 ","$1,620.00 " ST VINCENT HOSPITAL - ACUTE,35000071,73201,HC CT UPPER EXTRM W CONT,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$356.52 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$356.52 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$356.52 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$802.18 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$360.09 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$356.52 ,"$1,103.00 ",$356.52 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$2,400.00 ","$1,200.00 ",$90.16 ,"$2,400.00 ","$1,550.40 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,440.00 ","$2,040.00 ","$1,680.00 ",$90.16 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$1,130.00 ","$2,040.00 ",$172.93 ,"$1,130.00 ","$1,920.00 ","$1,752.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,400.00 ","$2,040.00 ",$389.08 ,"$2,208.00 ","$1,680.00 ",$943.96 ,"$1,016.57 ","$1,461.60 ",$943.96 ,"$1,658.40 ","$1,680.00 ",$174.66 ,"$1,728.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,35000073,73206,HC CT ANGIO UPPER EXTREM W/WO CONT,350,1 ,"$2,600.00 ","$1,300.00 ",$99.42 ,"$2,600.00 ","$1,679.60 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$99.42 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$99.42 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$982.89 ,"$1,058.50 ","$1,583.40 ",$982.89 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$2,700.00 ","$1,350.00 ",$34.16 ,"$2,700.00 ","$1,744.20 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,620.00 ","$2,295.00 ","$1,890.00 ",$34.16 ,"$2,565.00 ","$1,944.00 ","$1,971.00 ","$1,130.00 ","$2,295.00 ",$105.54 ,"$1,130.00 ","$2,160.00 ","$1,971.00 ",$34.16 ,$105.54 ,$460.29 ,"$2,700.00 ","$2,295.00 ",$237.46 ,"$2,484.00 ","$1,890.00 ",$425.76 ,$458.51 ,"$1,644.30 ",$425.76 ,"$1,865.70 ","$1,890.00 ",$106.60 ,"$1,944.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,944.00 ","$1,674.00 ","$1,944.00 ","$1,944.00 ","$1,620.00 " ST VINCENT HOSPITAL - ACUTE,35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000075,73701,HC CT LOWER EXTREMITY W/CON,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$172.93 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$389.08 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$174.66 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000077,73702,HC CT LOWER EXTR W/WO CONTR,350,1 ,"$2,600.00 ","$1,300.00 ",$90.16 ,"$2,600.00 ","$1,679.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$90.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$943.96 ,"$1,016.57 ","$1,583.40 ",$943.96 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$2,600.00 ","$1,300.00 ",$99.42 ,"$2,600.00 ","$1,679.60 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$99.42 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$99.42 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$982.89 ,"$1,058.50 ","$1,583.40 ",$982.89 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000079,74150,HC CT ABD W/O CONTRAST,350,1 ,"$1,800.00 ",$900.00 ,$34.16 ,"$1,800.00 ","$1,162.80 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$34.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$105.54 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$237.46 ,"$1,656.00 ","$1,260.00 ",$425.76 ,$458.51 ,"$1,096.20 ",$425.76 ,"$1,243.80 ","$1,260.00 ",$106.60 ,"$1,296.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000080,74160,HC CT ABDOMEN W/CONTRAST,350,1 ,"$2,200.00 ","$1,100.00 ",$90.16 ,"$2,200.00 ","$1,421.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$90.16 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,130.00 ","$1,870.00 ",$172.93 ,"$1,130.00 ","$1,760.00 ","$1,606.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,200.00 ","$1,870.00 ",$389.08 ,"$2,024.00 ","$1,540.00 ",$838.25 ,$902.73 ,"$1,339.80 ",$838.25 ,"$1,520.20 ","$1,540.00 ",$174.66 ,"$1,584.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,35000081,74170,HC CT ABDOMEN W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$90.16 ,"$2,600.00 ","$1,679.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$90.16 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$90.16 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$943.96 ,"$1,016.57 ","$1,583.40 ",$943.96 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000082,74175,HC CTA ABDOMEN W AND W/O CONTRAST,350,1 ,"$2,600.00 ","$1,300.00 ",$99.42 ,"$2,600.00 ","$1,679.60 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$99.42 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$99.42 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$982.89 ,"$1,058.50 ","$1,583.40 ",$982.89 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000083,74176,HC CT ABDOMEN/PELVIS W/O CONTRAST,350,1 ,"$3,600.00 ","$1,800.00 ",$90.16 ,"$3,600.00 ","$2,325.60 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$222.88 ,"$2,160.00 ","$3,060.00 ","$2,520.00 ",$90.16 ,"$3,420.00 ","$2,592.00 ","$2,628.00 ","$1,130.00 ","$3,060.00 ",$222.88 ,"$1,130.00 ","$2,880.00 ","$2,628.00 ",$90.16 ,$222.88 ,$460.29 ,"$3,600.00 ","$3,060.00 ",$501.48 ,"$3,312.00 ","$2,520.00 ",$813.98 ,$876.59 ,"$2,192.40 ",$813.98 ,"$2,487.60 ","$2,520.00 ",$225.11 ,"$2,592.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$222.88 ,"$1,103.00 ",$222.88 ,"$2,592.00 ","$2,232.00 ","$2,592.00 ","$2,592.00 ","$2,160.00 " ST VINCENT HOSPITAL - ACUTE,35000084,74177,HC CT ABDOMEN/PELVIS W/CONTRAST,350,1 ,"$4,200.00 ","$2,100.00 ",$90.16 ,"$4,200.00 ","$2,713.20 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$356.52 ,"$2,520.00 ","$3,570.00 ","$2,940.00 ",$90.16 ,"$3,990.00 ","$3,024.00 ","$3,066.00 ","$1,130.00 ","$3,570.00 ",$356.52 ,"$1,130.00 ","$3,360.00 ","$3,066.00 ",$90.16 ,$356.52 ,$460.29 ,"$4,200.00 ","$3,570.00 ",$802.18 ,"$3,864.00 ","$2,940.00 ","$1,313.36 ","$1,414.39 ","$2,557.80 ","$1,313.36 ","$2,902.20 ","$2,940.00 ",$360.09 ,"$3,024.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$356.52 ,"$1,103.00 ",$356.52 ,"$3,024.00 ","$2,604.00 ","$3,024.00 ","$3,024.00 ","$2,520.00 " ST VINCENT HOSPITAL - ACUTE,35000085,74178,HC CT ABDOMEN/PELVIS W AND W/O CONTR,350,1 ,"$4,900.00 ","$2,450.00 ",$90.16 ,"$4,900.00 ","$3,165.40 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$356.52 ,"$2,940.00 ","$4,165.00 ","$3,430.00 ",$90.16 ,"$4,655.00 ","$3,528.00 ","$3,577.00 ","$1,130.00 ","$4,165.00 ",$356.52 ,"$1,130.00 ","$3,920.00 ","$3,577.00 ",$90.16 ,$356.52 ,$460.29 ,"$4,900.00 ","$4,165.00 ",$802.18 ,"$4,508.00 ","$3,430.00 ","$1,313.36 ","$1,414.39 ","$2,984.10 ","$1,313.36 ","$3,385.90 ","$3,430.00 ",$360.09 ,"$3,528.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$356.52 ,"$1,103.00 ",$356.52 ,"$3,528.00 ","$3,038.00 ","$3,528.00 ","$3,528.00 ","$2,940.00 " ST VINCENT HOSPITAL - ACUTE,35000086,74261,HC CT VIRTUAL COLONOSCOPY DX,350,1 ,"$1,600.00 ",$800.00 ,$34.16 ,"$1,600.00 ","$1,033.60 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$105.54 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$34.16 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,130.00 ","$1,360.00 ",$105.54 ,"$1,130.00 ","$1,280.00 ","$1,168.00 ",$34.16 ,$105.54 ,$460.29 ,"$1,600.00 ","$1,360.00 ",$237.46 ,"$1,472.00 ","$1,120.00 ",$425.76 ,$458.51 ,$974.40 ,$425.76 ,"$1,105.60 ","$1,120.00 ",$106.60 ,"$1,152.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$105.54 ,"$1,103.00 ",$105.54 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,35000087,75571,HC CT HRT W/O DYE W/CA TEST,350,1 ,"$1,600.00 ",$800.00 ,$34.16 ,"$1,600.00 ","$1,033.60 ",$34.16 ,"$1,086.00 ","$1,086.00 ",$78.35 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$34.16 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,130.00 ","$1,360.00 ",$78.35 ,"$1,130.00 ","$1,280.00 ","$1,168.00 ",$34.16 ,$78.35 ,$460.29 ,"$1,600.00 ","$1,360.00 ",$176.29 ,"$1,472.00 ","$1,120.00 ",$74.41 ,$80.14 ,$974.40 ,$74.41 ,"$1,105.60 ","$1,120.00 ",$79.13 ,"$1,152.00 ",$36.21 ,"$1,103.00 ","$1,103.00 ",$78.35 ,"$1,103.00 ",$78.35 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,35000088,N/A,HC CT HRT W/O DYE W/CA TEST (PROMO),350,1 ,$49.95 ,$24.98 ,$24.98 ,$49.95 ,$32.27 , N/A ,$49.95 ,$49.95 , N/A ,$29.97 ,$42.46 ,$34.97 , N/A ,$47.45 ,$35.96 ,$36.46 ,$49.95 ,$42.46 , N/A ,$49.95 ,$39.96 ,$36.46 , N/A , N/A ,$49.95 ,$49.95 ,$42.46 , N/A ,$45.95 ,$34.97 ,$24.98 ,$29.97 ,$30.42 ,$24.98 ,$34.52 ,$34.97 , N/A ,$35.96 , N/A ,$49.95 ,$49.95 , N/A ,$49.95 , N/A ,$35.96 ,$30.97 ,$35.96 ,$35.96 ,$29.97 ST VINCENT HOSPITAL - ACUTE,35000089,75572,HC CT HEART WO/W CONT FUNCT EVAL,350,1 ,"$1,800.00 ",$900.00 ,$90.16 ,"$1,800.00 ","$1,162.80 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$90.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$172.93 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$90.16 ,$172.93 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$389.08 ,"$1,656.00 ","$1,260.00 ",$747.40 ,$804.89 ,"$1,096.20 ",$747.40 ,"$1,243.80 ","$1,260.00 ",$174.66 ,"$1,296.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000090,75573,HC CT HRT W/3D IMAGE CONGEN,350,1 ,"$1,800.00 ",$900.00 ,$90.16 ,"$1,800.00 ","$1,162.80 ",$90.16 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$90.16 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$172.93 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$90.16 ,$172.93 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$389.08 ,"$1,656.00 ","$1,260.00 ",$747.40 ,$804.89 ,"$1,096.20 ",$747.40 ,"$1,243.80 ","$1,260.00 ",$174.66 ,"$1,296.00 ",$95.57 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000091,75574,HC CT CARD ANGIO W/CALC SCORING,350,1 ,"$2,000.00 ","$1,000.00 ",$99.42 ,"$2,000.00 ","$1,292.00 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$99.42 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,130.00 ","$1,700.00 ",$172.93 ,"$1,130.00 ","$1,600.00 ","$1,460.00 ",$99.42 ,$172.93 ,$460.29 ,"$2,000.00 ","$1,700.00 ",$389.08 ,"$1,840.00 ","$1,400.00 ",$747.40 ,$804.89 ,"$1,218.00 ",$747.40 ,"$1,382.00 ","$1,400.00 ",$174.66 ,"$1,440.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,35000094,75574,HC CTA HEART CORONARY W/CONTRAST 3D POST,350,1 ,"$1,800.00 ",$900.00 ,$99.42 ,"$1,800.00 ","$1,162.80 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$99.42 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,130.00 ","$1,530.00 ",$172.93 ,"$1,130.00 ","$1,440.00 ","$1,314.00 ",$99.42 ,$172.93 ,$460.29 ,"$1,800.00 ","$1,530.00 ",$389.08 ,"$1,656.00 ","$1,260.00 ",$747.40 ,$804.89 ,"$1,096.20 ",$747.40 ,"$1,243.80 ","$1,260.00 ",$174.66 ,"$1,296.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,35000098,75635,HC CTA ABDOMEN AORTA ILIOFEM RUNOFF,350,1 ,"$2,600.00 ","$1,300.00 ",$99.42 ,"$2,600.00 ","$1,679.60 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$172.93 ,"$1,560.00 ","$2,210.00 ","$1,820.00 ",$99.42 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,130.00 ","$2,210.00 ",$172.93 ,"$1,130.00 ","$2,080.00 ","$1,898.00 ",$99.42 ,$172.93 ,$460.29 ,"$2,600.00 ","$2,210.00 ",$389.08 ,"$2,392.00 ","$1,820.00 ",$982.89 ,"$1,058.50 ","$1,583.40 ",$982.89 ,"$1,796.60 ","$1,820.00 ",$174.66 ,"$1,872.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$172.93 ,"$1,103.00 ",$172.93 ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,35000099,76376,HC 3D RENDER CT NOT REQUIRE INDEP,350,1 ,$620.00 ,$310.00 ,$310.00 ,$620.00 ,$400.52 , N/A ,$620.00 ,$620.00 , N/A ,$372.00 ,$527.00 ,$434.00 , N/A ,$589.00 ,$446.40 ,$452.60 ,$620.00 ,$527.00 , N/A ,$620.00 ,$496.00 ,$452.60 , N/A , N/A ,$460.29 ,$620.00 ,$527.00 , N/A ,$570.40 ,$434.00 ,$310.00 ,$372.00 ,$377.58 ,$310.00 ,$428.42 ,$434.00 , N/A ,$446.40 , N/A ,$620.00 ,$620.00 , N/A ,$620.00 , N/A ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,35000100,76377,HC 3D RENDER CT REQUIRES INDEPENDENT,350,1 ,$700.00 ,$350.00 ,$350.00 ,$700.00 ,$452.20 , N/A ,$700.00 ,$700.00 , N/A ,$420.00 ,$595.00 ,$490.00 , N/A ,$665.00 ,$504.00 ,$511.00 ,$700.00 ,$595.00 , N/A ,$700.00 ,$560.00 ,$511.00 , N/A , N/A ,$460.29 ,$700.00 ,$595.00 , N/A ,$644.00 ,$490.00 ,$350.00 ,$420.00 ,$426.30 ,$350.00 ,$483.70 ,$490.00 , N/A ,$504.00 , N/A ,$700.00 ,$700.00 , N/A ,$700.00 , N/A ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,35000101,76380,HC CT LMTD OR LOCALIZ FU STUDY,350,1 ,"$1,100.00 ",$550.00 ,$34.16 ,"$1,100.00 ",$710.60 ,$34.16 ,"$1,086.00 ","$1,086.00 ",$78.35 ,$660.00 ,$935.00 ,$770.00 ,$34.16 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 ,$78.35 ,"$1,100.00 ",$880.00 ,$803.00 ,$34.16 ,$78.35 ,$460.29 ,"$1,100.00 ",$935.00 ,$176.29 ,"$1,012.00 ",$770.00 ,$267.85 ,$288.46 ,$669.90 ,$267.85 ,$760.10 ,$770.00 ,$79.13 ,$792.00 ,$36.21 ,"$1,100.00 ","$1,100.00 ",$78.35 ,"$1,100.00 ",$78.35 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,35000103,76497,HC UNLISTED CT PROC,350,1 ,$475.00 ,$237.50 ,$34.16 ,$475.00 ,$306.85 ,$34.16 ,$475.00 ,$475.00 ,$78.35 ,$285.00 ,$403.75 ,$332.50 ,$34.16 ,$451.25 ,$342.00 ,$346.75 ,$475.00 ,$403.75 ,$78.35 ,$475.00 ,$380.00 ,$346.75 ,$34.16 ,$78.35 ,$460.29 ,$475.00 ,$403.75 ,$176.29 ,$437.00 ,$332.50 ,$267.85 ,$288.46 ,$289.28 ,$267.85 ,$328.23 ,$332.50 ,$79.13 ,$342.00 ,$36.21 ,$475.00 ,$475.00 ,$78.35 ,$475.00 ,$78.35 ,$342.00 ,$294.50 ,$342.00 ,$342.00 ,$285.00 ST VINCENT HOSPITAL - ACUTE,35000104,77011,HC CT GUIDED LOCALIZATION STEREO,350,1 ,"$1,700.00 ",$850.00 ,$31.12 ,"$1,700.00 ","$1,098.20 ",$31.12 ,"$1,086.00 ","$1,086.00 ", N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$31.12 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,130.00 ","$1,445.00 ", N/A ,"$1,130.00 ","$1,360.00 ","$1,241.00 ",$31.12 , N/A ,$460.29 ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ",$32.99 ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,35000105,77011,HC CT GUIDED LOCALIZATION STEREO SINUS,350,1 ,"$1,700.00 ",$850.00 ,$31.12 ,"$1,700.00 ","$1,098.20 ",$31.12 ,"$1,086.00 ","$1,086.00 ", N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$31.12 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,130.00 ","$1,445.00 ", N/A ,"$1,130.00 ","$1,360.00 ","$1,241.00 ",$31.12 , N/A ,$460.29 ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ",$32.99 ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,35000106,77012,HC CT GUIDED NEEDLE PLACEMENT,350,1 ,"$1,700.00 ",$850.00 ,$31.12 ,"$1,700.00 ","$1,098.20 ",$31.12 ,"$1,086.00 ","$1,086.00 ", N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$31.12 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,130.00 ","$1,445.00 ", N/A ,"$1,130.00 ","$1,360.00 ","$1,241.00 ",$31.12 , N/A ,$460.29 ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ",$32.99 ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,35000108,77012,HC CT GUIDED NEEDLE PLACEMENT JOINT INJ,350,1 ,"$1,700.00 ",$850.00 ,$31.12 ,"$1,700.00 ","$1,098.20 ",$31.12 ,"$1,086.00 ","$1,086.00 ", N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$31.12 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,130.00 ","$1,445.00 ", N/A ,"$1,130.00 ","$1,360.00 ","$1,241.00 ",$31.12 , N/A ,$460.29 ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ",$32.99 ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,35000109,77013,HC CT GUIDED FOR ABLATION,350,1 ,"$1,700.00 ",$850.00 ,$31.12 ,"$1,700.00 ","$1,098.20 ",$31.12 ,"$1,086.00 ","$1,086.00 ", N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$31.12 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,130.00 ","$1,445.00 ", N/A ,"$1,130.00 ","$1,360.00 ","$1,241.00 ",$31.12 , N/A ,$460.29 ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ",$32.99 ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,35000110,77014,HC CT GUIDED THRPY PLACEMENT,350,1 ,"$1,700.00 ",$850.00 ,$31.12 ,"$1,700.00 ","$1,098.20 ",$31.12 ,"$1,086.00 ","$1,086.00 ", N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$31.12 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,130.00 ","$1,445.00 ", N/A ,"$1,130.00 ","$1,360.00 ","$1,241.00 ",$31.12 , N/A ,$460.29 ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ",$32.99 ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,35000111,77014,HC CT GUIDED THRPY PLACEMENT UNENHAN,350,1 ,"$1,700.00 ",$850.00 ,$31.12 ,"$1,700.00 ","$1,098.20 ",$31.12 ,"$1,086.00 ","$1,086.00 ", N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$31.12 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,130.00 ","$1,445.00 ", N/A ,"$1,130.00 ","$1,360.00 ","$1,241.00 ",$31.12 , N/A ,$460.29 ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ",$32.99 ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,35000112,77387,HC CT GUIDED THRPY PLACEMENT CONE BEAM,350,1 ,"$1,700.00 ",$850.00 ,$39.10 ,"$1,700.00 ","$1,098.20 ",$39.10 ,"$1,086.00 ","$1,086.00 ", N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$39.10 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,130.00 ","$1,445.00 ", N/A ,"$1,130.00 ","$1,360.00 ","$1,241.00 ",$39.10 , N/A ,$460.29 ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ",$41.45 ,"$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,35000113,51102,HC ASPIRATION OF BLADDER AND INSERT SUPRAPUBIC CATH,350,1 ,"$3,200.00 ","$1,600.00 ",$444.48 ,"$3,907.15 ","$2,067.20 ",$444.48 ,"$1,086.00 ","$1,086.00 ","$1,736.51 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$444.48 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$1,130.00 ","$2,720.00 ","$1,736.51 ","$1,130.00 ","$2,560.00 ","$2,336.00 ",$444.48 ,"$1,736.51 ",$460.29 ,"$3,200.00 ","$2,720.00 ","$3,907.15 ","$2,944.00 ","$2,240.00 ","$2,066.93 ","$2,778.48 ","$1,948.80 ","$2,583.66 ","$2,211.20 ","$2,240.00 ","$1,753.88 ","$2,304.00 ",$471.15 ,"$1,103.00 ","$1,103.00 ","$1,736.51 ","$1,103.00 ","$1,736.51 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,35000116,64510,HC INJECT STELLATE GANGLION,350,1 ,"$1,330.00 ",$665.00 ,$349.28 ,"$1,792.24 ",$859.18 ,$349.28 ,"$1,086.00 ","$1,086.00 ",$796.55 ,$798.00 ,"$1,130.50 ",$931.00 ,$349.28 ,"$1,263.50 ",$957.60 ,$970.90 ,"$1,130.00 ","$1,130.50 ",$796.55 ,"$1,130.00 ","$1,064.00 ",$970.90 ,$349.28 ,$796.55 ,$460.29 ,"$1,330.00 ","$1,130.50 ","$1,792.24 ","$1,223.60 ",$931.00 ,"$1,330.00 ","$1,330.00 ",$809.97 ,"$1,330.00 ",$919.03 ,$931.00 ,$804.52 ,$957.60 ,$370.24 ,"$1,103.00 ","$1,103.00 ",$796.55 ,"$1,103.00 ",$796.55 ,$957.60 ,$824.60 ,$957.60 ,$957.60 ,$798.00 ST VINCENT HOSPITAL - ACUTE,35000120,74174,HC CT ANGIO ABD/PELV W AND WO CONTRAST,350,1 ,"$4,800.00 ","$2,400.00 ",$99.42 ,"$4,800.00 ","$3,100.80 ",$99.42 ,"$1,086.00 ","$1,086.00 ",$356.52 ,"$2,880.00 ","$4,080.00 ","$3,360.00 ",$99.42 ,"$4,560.00 ","$3,456.00 ","$3,504.00 ","$1,130.00 ","$4,080.00 ",$356.52 ,"$1,130.00 ","$3,840.00 ","$3,504.00 ",$99.42 ,$356.52 ,$460.29 ,"$4,800.00 ","$4,080.00 ",$802.18 ,"$4,416.00 ","$3,360.00 ","$1,313.36 ","$1,414.39 ","$2,923.20 ","$1,313.36 ","$3,316.80 ","$3,360.00 ",$360.09 ,"$3,456.00 ",$105.39 ,"$1,103.00 ","$1,103.00 ",$356.52 ,"$1,103.00 ",$356.52 ,"$3,456.00 ","$2,976.00 ","$3,456.00 ","$3,456.00 ","$2,880.00 " ST VINCENT HOSPITAL - ACUTE,35000130,75574,HC CTA CORONARY ART W/SCORE RESCUE TR,350,1 ,$420.00 ,$210.00 ,$99.42 ,$420.00 ,$271.32 ,$99.42 ,$420.00 ,$420.00 ,$172.93 ,$252.00 ,$357.00 ,$294.00 ,$99.42 ,$399.00 ,$302.40 ,$306.60 ,$420.00 ,$357.00 ,$172.93 ,$420.00 ,$336.00 ,$306.60 ,$99.42 ,$172.93 ,$420.00 ,$420.00 ,$357.00 ,$389.08 ,$386.40 ,$294.00 ,$420.00 ,$420.00 ,$255.78 ,$420.00 ,$290.22 ,$294.00 ,$174.66 ,$302.40 ,$105.39 ,$420.00 ,$420.00 ,$172.93 ,$420.00 ,$172.93 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,35000132,G0260,HC INJECTION SACRO JOINT W/ ANESTH,350,1 ,"$1,700.00 ",$850.00 ,$162.48 ,"$1,700.00 ","$1,098.20 ",$162.48 ,"$1,086.00 ","$1,086.00 ",$614.60 ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$162.48 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,130.00 ","$1,445.00 ",$614.60 ,"$1,130.00 ","$1,360.00 ","$1,241.00 ",$162.48 ,$614.60 ,$460.29 ,"$1,700.00 ","$1,445.00 ","$1,382.85 ","$1,564.00 ","$1,190.00 ","$1,700.00 ","$1,700.00 ","$1,035.30 ","$1,700.00 ","$1,174.70 ","$1,190.00 ",$620.75 ,"$1,224.00 ",$172.23 ,"$1,103.00 ","$1,103.00 ",$614.60 ,"$1,103.00 ",$614.60 ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,35000133,48999,HC CRYO ABLATION PANCREAS UNLISTED,350,1 ,"$8,925.00 ","$4,462.50 ",$460.29 ,"$8,925.00 ","$5,765.55 ",$703.19 ,"$1,086.00 ","$1,086.00 ",$602.38 ,"$5,355.00 ","$7,586.25 ","$6,247.50 ",$703.19 ,"$8,478.75 ","$6,426.00 ","$6,515.25 ","$1,130.00 ","$7,586.25 ",$602.38 ,"$1,130.00 ","$7,140.00 ","$6,515.25 ",$703.19 ,$602.38 ,$460.29 ,"$8,925.00 ","$7,586.25 ","$1,355.35 ","$8,211.00 ","$6,247.50 ","$4,462.50 ","$5,355.00 ","$5,435.33 ","$4,462.50 ","$6,167.18 ","$6,247.50 ",$608.40 ,"$6,426.00 ",$745.38 ,"$1,103.00 ","$1,103.00 ",$602.38 ,"$1,103.00 ",$602.38 ,"$6,426.00 ","$5,533.50 ","$6,426.00 ","$6,426.00 ","$5,355.00 " ST VINCENT HOSPITAL - ACUTE,35000135,22513,HC VERTEBROPLASTY INJ PERC THOR KYPHOPLASTY,350,1 ,"$5,200.00 ","$2,600.00 ",$460.29 ,"$13,652.11 ","$3,359.20 ","$1,424.58 ","$1,086.00 ","$1,086.00 ","$6,067.60 ","$3,120.00 ","$4,420.00 ","$3,640.00 ","$1,424.58 ","$4,940.00 ","$3,744.00 ","$3,796.00 ","$1,130.00 ","$4,420.00 ","$6,067.60 ","$1,130.00 ","$4,160.00 ","$3,796.00 ","$1,424.58 ","$6,067.60 ",$460.29 ,"$5,200.00 ","$4,420.00 ","$13,652.11 ","$4,784.00 ","$3,640.00 ","$5,818.90 ","$7,821.36 ","$3,166.80 ","$7,273.62 ","$3,593.20 ","$3,640.00 ","$6,128.28 ","$3,744.00 ","$1,510.05 ","$1,103.00 ","$1,103.00 ","$6,067.60 ","$1,103.00 ","$6,067.60 ","$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,35000136,22514,HC VERTEBROPLASTY INJ PERC LUMBAR KYPHOPLASTY,350,1 ,"$5,200.00 ","$2,600.00 ",$460.29 ,"$13,652.11 ","$3,359.20 ","$1,424.58 ","$1,086.00 ","$1,086.00 ","$6,067.60 ","$3,120.00 ","$4,420.00 ","$3,640.00 ","$1,424.58 ","$4,940.00 ","$3,744.00 ","$3,796.00 ","$1,130.00 ","$4,420.00 ","$6,067.60 ","$1,130.00 ","$4,160.00 ","$3,796.00 ","$1,424.58 ","$6,067.60 ",$460.29 ,"$5,200.00 ","$4,420.00 ","$13,652.11 ","$4,784.00 ","$3,640.00 ","$5,818.90 ","$7,821.36 ","$3,166.80 ","$7,273.62 ","$3,593.20 ","$3,640.00 ","$6,128.28 ","$3,744.00 ","$1,510.05 ","$1,103.00 ","$1,103.00 ","$6,067.60 ","$1,103.00 ","$6,067.60 ","$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,35000137,22515,HC VERTEBROPLASTY INJ PERC EA ADDNT THOR OR LUMB KYPHO,350,1 ,"$5,200.00 ","$2,600.00 ",$460.29 ,"$7,821.36 ","$3,359.20 ","$3,804.82 ","$1,086.00 ","$1,086.00 ", N/A ,"$3,120.00 ","$4,420.00 ","$3,640.00 ","$3,804.82 ","$4,940.00 ","$3,744.00 ","$3,796.00 ","$1,130.00 ","$4,420.00 ", N/A ,"$1,130.00 ","$4,160.00 ","$3,796.00 ","$3,804.82 ", N/A ,$460.29 ,"$5,200.00 ","$4,420.00 ", N/A ,"$4,784.00 ","$3,640.00 ","$5,818.90 ","$7,821.36 ","$3,166.80 ","$7,273.62 ","$3,593.20 ","$3,640.00 ", N/A ,"$3,744.00 ","$4,033.11 ","$1,103.00 ","$1,103.00 ", N/A ,"$1,103.00 ", N/A ,"$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,35000150,G0297,HC CT LUNG SCREENING,350,1 ,"$1,100.00 ",$550.00 ,$460.29 ,"$1,100.00 ",$710.60 , N/A ,"$1,086.00 ","$1,086.00 ", N/A ,$660.00 ,$935.00 ,$770.00 , N/A ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 , N/A ,"$1,100.00 ",$880.00 ,$803.00 , N/A , N/A ,$460.29 ,"$1,100.00 ",$935.00 , N/A ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 , N/A ,$792.00 , N/A ,"$1,100.00 ","$1,100.00 ", N/A ,"$1,100.00 ", N/A ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,35000151,G0288,HC CT RECONSTRUCTION AORTA FOR VASC SURG,350,1 ,$220.00 ,$110.00 ,$110.00 ,$220.00 ,$142.12 , N/A ,$220.00 ,$220.00 , N/A ,$132.00 ,$187.00 ,$154.00 , N/A ,$209.00 ,$158.40 ,$160.60 ,$220.00 ,$187.00 , N/A ,$220.00 ,$176.00 ,$160.60 , N/A , N/A ,$220.00 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 , N/A ,$220.00 ,$220.00 , N/A ,$220.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,36000002,N/A,HC MINOR PROCEDURE,360,1 ,$150.00 ,$75.00 ,$75.00 ,$150.00 ,$96.90 , N/A , N/A , N/A , N/A ,$90.00 ,$127.50 ,$105.00 , N/A ,$142.50 ,$108.00 ,$109.50 , N/A ,$127.50 , N/A , N/A ,$120.00 ,$109.50 , N/A , N/A , N/A ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 , N/A ,$108.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,36000003,N/A,HC SCHEDULED PROCEDURE,360,1 ,"$1,600.00 ",$800.00 ,$800.00 ,"$1,600.00 ","$1,033.60 ", N/A , N/A , N/A , N/A ,$960.00 ,"$1,360.00 ","$1,120.00 ", N/A ,"$1,520.00 ","$1,152.00 ","$1,168.00 ", N/A ,"$1,360.00 ", N/A , N/A ,"$1,280.00 ","$1,168.00 ", N/A , N/A , N/A ,"$1,600.00 ","$1,360.00 ", N/A ,"$1,472.00 ","$1,120.00 ",$800.00 ,$960.00 ,$974.40 ,$800.00 ,"$1,105.60 ","$1,120.00 ", N/A ,"$1,152.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,36000004,N/A,HC SCHEDULED PROCEDURE LIMITED,360,1 ,$890.00 ,$445.00 ,$445.00 ,$890.00 ,$574.94 , N/A , N/A , N/A , N/A ,$534.00 ,$756.50 ,$623.00 , N/A ,$845.50 ,$640.80 ,$649.70 , N/A ,$756.50 , N/A , N/A ,$712.00 ,$649.70 , N/A , N/A , N/A ,$890.00 ,$756.50 , N/A ,$818.80 ,$623.00 ,$445.00 ,$534.00 ,$542.01 ,$445.00 ,$614.99 ,$623.00 , N/A ,$640.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$640.80 ,$551.80 ,$640.80 ,$640.80 ,$534.00 ST VINCENT HOSPITAL - ACUTE,36000010,40710,HC CARDIAC TEAM MAJOR 3 PER UNIT 40710,360,1 ,$400.00 ,$200.00 ,$200.00 ,$400.00 ,$258.40 , N/A , N/A , N/A , N/A ,$240.00 ,$340.00 ,$280.00 , N/A ,$380.00 ,$288.00 ,$292.00 ,$400.00 ,$340.00 , N/A ,$400.00 ,$320.00 ,$292.00 , N/A , N/A , N/A ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 , N/A ,$288.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,36000011,N/A,HC HYPOTHERMIA TOTAL BODY,360,1 ,$410.00 ,$205.00 ,$205.00 ,$410.00 ,$264.86 , N/A , N/A , N/A , N/A ,$246.00 ,$348.50 ,$287.00 , N/A ,$389.50 ,$295.20 ,$299.30 , N/A ,$348.50 , N/A , N/A ,$328.00 ,$299.30 , N/A , N/A , N/A ,$410.00 ,$348.50 , N/A ,$377.20 ,$287.00 ,$205.00 ,$246.00 ,$249.69 ,$205.00 ,$283.31 ,$287.00 , N/A ,$295.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,36000014,N/A,HC TRANSBRONCHIAL BX/NEEDLE EA ADD LOBE,360,1 ,$700.00 ,$350.00 ,$350.00 ,$700.00 ,$452.20 , N/A , N/A , N/A , N/A ,$420.00 ,$595.00 ,$490.00 , N/A ,$665.00 ,$504.00 ,$511.00 , N/A ,$595.00 , N/A , N/A ,$560.00 ,$511.00 , N/A , N/A , N/A ,$700.00 ,$595.00 , N/A ,$644.00 ,$490.00 ,$350.00 ,$420.00 ,$426.30 ,$350.00 ,$483.70 ,$490.00 , N/A ,$504.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,36000015,N/A,HC SUPER D WITH FIDUCIAL MARKERS,360,1 ,"$1,800.00 ",$900.00 ,$900.00 ,"$1,800.00 ","$1,162.80 ", N/A , N/A , N/A , N/A ,"$1,080.00 ","$1,530.00 ","$1,260.00 ", N/A ,"$1,710.00 ","$1,296.00 ","$1,314.00 ", N/A ,"$1,530.00 ", N/A , N/A ,"$1,440.00 ","$1,314.00 ", N/A , N/A , N/A ,"$1,800.00 ","$1,530.00 ", N/A ,"$1,656.00 ","$1,260.00 ",$900.00 ,"$1,080.00 ","$1,096.20 ",$900.00 ,"$1,243.80 ","$1,260.00 ", N/A ,"$1,296.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36000016,N/A,HC SUPER D IMAGING,360,1 ,"$3,200.00 ","$1,600.00 ","$1,600.00 ","$3,200.00 ","$2,067.20 ", N/A , N/A , N/A , N/A ,"$1,920.00 ","$2,720.00 ","$2,240.00 ", N/A ,"$3,040.00 ","$2,304.00 ","$2,336.00 ", N/A ,"$2,720.00 ", N/A , N/A ,"$2,560.00 ","$2,336.00 ", N/A , N/A , N/A ,"$3,200.00 ","$2,720.00 ", N/A ,"$2,944.00 ","$2,240.00 ","$1,600.00 ","$1,920.00 ","$1,948.80 ","$1,600.00 ","$2,211.20 ","$2,240.00 ", N/A ,"$2,304.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,36000017,N/A,HC XRAY HIP PINNING OR,360,1 ,"$1,000.00 ",$500.00 ,$500.00 ,"$1,000.00 ",$646.00 , N/A , N/A , N/A , N/A ,$600.00 ,$850.00 ,$700.00 , N/A ,$950.00 ,$720.00 ,$730.00 , N/A ,$850.00 , N/A , N/A ,$800.00 ,$730.00 , N/A , N/A , N/A ,"$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,36000018,N/A,HC FLUORO FOR BRONCHOSCOPY,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$1,200.00 ",$775.20 , N/A , N/A , N/A , N/A ,$720.00 ,"$1,020.00 ",$840.00 , N/A ,"$1,140.00 ",$864.00 ,$876.00 , N/A ,"$1,020.00 ", N/A , N/A ,$960.00 ,$876.00 , N/A , N/A , N/A ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 , N/A ,$864.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36000020,N/A,HC U/S CENTRAL LINE PLACEMENT,360,1 ,"$2,200.00 ","$1,100.00 ","$1,100.00 ","$2,200.00 ","$1,421.20 ", N/A , N/A , N/A , N/A ,"$1,320.00 ","$1,870.00 ","$1,540.00 ", N/A ,"$2,090.00 ","$1,584.00 ","$1,606.00 ", N/A ,"$1,870.00 ", N/A , N/A ,"$1,760.00 ","$1,606.00 ", N/A , N/A , N/A ,"$2,200.00 ","$1,870.00 ", N/A ,"$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ", N/A ,"$1,584.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,36000022,N/A,HC UMBILICAL CANNULATION,360,1 ,$210.00 ,$105.00 ,$105.00 ,$210.00 ,$135.66 , N/A , N/A , N/A , N/A ,$126.00 ,$178.50 ,$147.00 , N/A ,$199.50 ,$151.20 ,$153.30 , N/A ,$178.50 , N/A , N/A ,$168.00 ,$153.30 , N/A , N/A , N/A ,$210.00 ,$178.50 , N/A ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 , N/A ,$151.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,36000027,10060,HC I AND D ABSC SMP FAC,360,1 ,$270.00 ,$135.00 ,$74.70 ,$391.26 ,$174.42 ,$74.70 ,$270.00 ,$270.00 ,$173.89 ,$162.00 ,$229.50 ,$189.00 ,$74.70 ,$256.50 ,$194.40 ,$197.10 ,$270.00 ,$229.50 ,$173.89 ,$270.00 ,$216.00 ,$197.10 ,$74.70 ,$173.89 ,$270.00 ,$270.00 ,$229.50 ,$391.26 ,$248.40 ,$189.00 ,$270.00 ,$270.00 ,$164.43 ,$270.00 ,$186.57 ,$189.00 ,$175.63 ,$194.40 ,$79.18 ,$270.00 ,$270.00 ,$173.89 ,$270.00 ,$173.89 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,36000029,10140,HC I AND D HEMATOMA/SEROMA/FLUID,360,1 ,"$1,800.00 ",$900.00 ,$325.66 ,"$3,066.03 ","$1,162.80 ",$325.66 ,"$1,800.00 ","$1,800.00 ","$1,362.68 ","$1,080.00 ","$1,530.00 ","$1,260.00 ",$325.66 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ","$1,362.68 ","$1,800.00 ","$1,440.00 ","$1,314.00 ",$325.66 ,"$1,362.68 ","$1,800.00 ","$1,800.00 ","$1,530.00 ","$3,066.03 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ","$1,376.31 ","$1,296.00 ",$345.20 ,"$1,800.00 ","$1,800.00 ","$1,362.68 ","$1,800.00 ","$1,362.68 ","$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36000030,10160,HC ASP ABSC/HEMA/CYST/BULLA FAC,360,1 ,$430.00 ,$215.00 ,$74.70 ,$753.63 ,$277.78 ,$74.70 ,$430.00 ,$430.00 ,$334.95 ,$258.00 ,$365.50 ,$301.00 ,$74.70 ,$408.50 ,$309.60 ,$313.90 ,$430.00 ,$365.50 ,$334.95 ,$430.00 ,$344.00 ,$313.90 ,$74.70 ,$334.95 ,$430.00 ,$430.00 ,$365.50 ,$753.63 ,$395.60 ,$301.00 ,$430.00 ,$430.00 ,$261.87 ,$430.00 ,$297.13 ,$301.00 ,$338.30 ,$309.60 ,$79.18 ,$430.00 ,$430.00 ,$334.95 ,$430.00 ,$334.95 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,36000035,10030,HC GUIDE CATHET FLUID DRAINAGE,360,1 ,"$1,200.00 ",$600.00 ,$325.66 ,"$1,355.35 ",$775.20 ,$325.66 ,"$1,200.00 ","$1,200.00 ",$602.38 ,$720.00 ,"$1,020.00 ",$840.00 ,$325.66 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ",$602.38 ,"$1,200.00 ",$960.00 ,$876.00 ,$325.66 ,$602.38 ,"$1,200.00 ","$1,200.00 ","$1,020.00 ","$1,355.35 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,$608.40 ,$864.00 ,$345.20 ,"$1,200.00 ","$1,200.00 ",$602.38 ,"$1,200.00 ",$602.38 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36000040,31652,HC BRONCH RIGID/FLEX EBUS 1 OR 2 NODES,360,1 ,"$3,500.00 ","$1,750.00 ","$1,009.08 ","$7,821.36 ","$2,261.00 ","$1,009.08 ","$3,500.00 ","$3,500.00 ","$3,000.43 ","$2,100.00 ","$2,975.00 ","$2,450.00 ","$1,009.08 ","$3,325.00 ","$2,520.00 ","$2,555.00 ","$3,500.00 ","$2,975.00 ","$3,000.43 ","$3,500.00 ","$2,800.00 ","$2,555.00 ","$1,009.08 ","$3,000.43 ","$3,500.00 ","$3,500.00 ","$2,975.00 ","$6,750.97 ","$3,220.00 ","$2,450.00 ","$5,818.90 ","$7,821.36 ","$2,131.50 ","$7,273.62 ","$2,418.50 ","$2,450.00 ","$3,030.43 ","$2,520.00 ","$1,069.62 ","$3,500.00 ","$3,500.00 ","$3,000.43 ","$3,500.00 ","$3,000.43 ","$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,36000041,31653,HC BRONCH RIGID/FLEX EBUS 3 OR MORE NODES,360,1 ,"$3,600.00 ","$1,800.00 ","$1,009.08 ","$6,750.97 ","$2,325.60 ","$1,009.08 ","$3,600.00 ","$3,600.00 ","$3,000.43 ","$2,160.00 ","$3,060.00 ","$2,520.00 ","$1,009.08 ","$3,420.00 ","$2,592.00 ","$2,628.00 ","$3,600.00 ","$3,060.00 ","$3,000.43 ","$3,600.00 ","$2,880.00 ","$2,628.00 ","$1,009.08 ","$3,000.43 ","$3,600.00 ","$3,600.00 ","$3,060.00 ","$6,750.97 ","$3,312.00 ","$2,520.00 ","$3,206.88 ","$4,310.52 ","$2,192.40 ","$4,008.60 ","$2,487.60 ","$2,520.00 ","$3,030.43 ","$2,592.00 ","$1,069.62 ","$3,600.00 ","$3,600.00 ","$3,000.43 ","$3,600.00 ","$3,000.43 ","$2,592.00 ","$2,232.00 ","$2,592.00 ","$2,592.00 ","$2,160.00 " ST VINCENT HOSPITAL - ACUTE,36000042,31654,HC BRONCH RIGID/FLEX EBUS FOR PHERIPHERAL LESIONS ADD ON,360,1 ,$570.00 ,$285.00 ,$285.00 ,"$2,778.48 ",$368.22 ,$570.00 ,$570.00 ,$570.00 , N/A ,$342.00 ,$484.50 ,$399.00 ,"$1,009.08 ",$541.50 ,$410.40 ,$416.10 ,$570.00 ,$484.50 , N/A ,$570.00 ,$456.00 ,$416.10 ,"$1,009.08 ", N/A ,$570.00 ,$570.00 ,$484.50 , N/A ,$524.40 ,$399.00 ,"$2,066.52 ","$2,778.48 ",$347.13 ,"$2,583.66 ",$393.87 ,$399.00 , N/A ,$410.40 ,"$1,069.62 ",$570.00 ,$570.00 , N/A ,$570.00 , N/A ,$410.40 ,$353.40 ,$410.40 ,$410.40 ,$342.00 ST VINCENT HOSPITAL - ACUTE,36000050,12031,HC WOUND REPAIR INTERMEDIATE FACIL,761,1 ,$464.00 ,$232.00 ,$107.54 ,$753.63 ,$299.74 ,$107.54 ,$464.00 ,$464.00 ,$334.95 ,$278.40 ,$394.40 ,$324.80 ,$107.54 ,$440.80 ,$334.08 ,$338.72 ,$464.00 ,$394.40 ,$334.95 ,$464.00 ,$371.20 ,$338.72 ,$107.54 ,$334.95 ,$194.88 ,$464.00 ,$394.40 ,$753.63 ,$426.88 ,$324.80 ,$464.00 ,$464.00 ,$282.58 ,$464.00 ,$320.62 ,$324.80 ,$338.30 ,$334.08 ,$113.99 ,$278.40 ,$278.40 ,$334.95 ,$278.40 ,$334.95 ,$334.08 ,$287.68 ,$334.08 ,$334.08 ,$278.40 ST VINCENT HOSPITAL - ACUTE,36000078,19000,HC ASP CYST BREAST,360,1 ,$740.00 ,$370.00 ,$180.17 ,"$1,355.35 ",$478.04 ,$180.17 ,$740.00 ,$740.00 ,$602.38 ,$444.00 ,$629.00 ,$518.00 ,$180.17 ,$703.00 ,$532.80 ,$540.20 ,$740.00 ,$629.00 ,$602.38 ,$740.00 ,$592.00 ,$540.20 ,$180.17 ,$602.38 ,$740.00 ,$740.00 ,$629.00 ,"$1,355.35 ",$680.80 ,$518.00 ,$740.00 ,$740.00 ,$450.66 ,$740.00 ,$511.34 ,$518.00 ,$608.40 ,$532.80 ,$190.98 ,$740.00 ,$740.00 ,$602.38 ,$740.00 ,$602.38 ,$532.80 ,$458.80 ,$532.80 ,$532.80 ,$444.00 ST VINCENT HOSPITAL - ACUTE,36000079,19001,HC ASP CYST BREAST EA ADDL,360,1 ,$380.00 ,$190.00 ,$180.17 ,"$2,778.48 ",$245.48 ,$180.17 ,$380.00 ,$380.00 , N/A ,$228.00 ,$323.00 ,$266.00 ,$180.17 ,$361.00 ,$273.60 ,$277.40 ,$380.00 ,$323.00 , N/A ,$380.00 ,$304.00 ,$277.40 ,$180.17 , N/A ,$380.00 ,$380.00 ,$323.00 , N/A ,$349.60 ,$266.00 ,"$2,066.52 ","$2,778.48 ",$231.42 ,"$2,583.66 ",$262.58 ,$266.00 , N/A ,$273.60 ,$190.98 ,$380.00 ,$380.00 , N/A ,$380.00 , N/A ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,36000080,19020,HC BREAST ABSCESS DRAINAGE,360,1 ,"$2,489.00 ","$1,244.50 ",$405.89 ,"$3,066.03 ","$1,607.89 ",$405.89 ,"$2,489.00 ","$2,489.00 ","$1,362.68 ","$1,493.40 ","$2,115.65 ","$1,742.30 ",$405.89 ,"$2,364.55 ","$1,792.08 ","$1,816.97 ","$2,489.00 ","$2,115.65 ","$1,362.68 ","$2,489.00 ","$1,991.20 ","$1,816.97 ",$405.89 ,"$1,362.68 ","$2,489.00 ","$2,489.00 ","$2,115.65 ","$3,066.03 ","$2,289.88 ","$1,742.30 ","$2,331.31 ","$2,489.00 ","$1,515.80 ","$2,489.00 ","$1,719.90 ","$1,742.30 ","$1,376.31 ","$1,792.08 ",$430.24 ,"$2,489.00 ","$2,489.00 ","$1,362.68 ","$2,489.00 ","$1,362.68 ","$1,792.08 ","$1,543.18 ","$1,792.08 ","$1,792.08 ","$1,493.40 " ST VINCENT HOSPITAL - ACUTE,36000081,19030,HC INJECTION GALACTOGRAM,360,1 ,$294.00 ,$147.00 ,$86.58 ,$294.00 ,$189.92 ,$86.58 ,$294.00 ,$294.00 , N/A ,$176.40 ,$249.90 ,$205.80 ,$86.58 ,$279.30 ,$211.68 ,$214.62 ,$294.00 ,$249.90 , N/A ,$294.00 ,$235.20 ,$214.62 ,$86.58 , N/A ,$294.00 ,$294.00 ,$249.90 , N/A ,$270.48 ,$205.80 ,$294.00 ,$294.00 ,$179.05 ,$294.00 ,$203.15 ,$205.80 , N/A ,$211.68 ,$91.77 ,$294.00 ,$294.00 , N/A ,$294.00 , N/A ,$211.68 ,$182.28 ,$211.68 ,$211.68 ,$176.40 ST VINCENT HOSPITAL - ACUTE,36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$6,200.00 ","$3,100.00 ",$405.89 ,"$6,200.00 ","$4,005.20 ",$405.89 ,"$3,939.00 ","$3,535.00 ","$1,362.68 ","$3,720.00 ","$5,270.00 ","$4,340.00 ",$405.89 ,"$5,890.00 ","$4,464.00 ","$4,526.00 ","$6,200.00 ","$5,270.00 ","$1,362.68 ","$6,200.00 ","$4,960.00 ","$4,526.00 ",$405.89 ,"$1,362.68 ","$2,428.39 ","$6,200.00 ","$5,270.00 ","$3,066.03 ","$5,704.00 ","$4,340.00 ","$2,331.31 ","$3,133.44 ","$3,775.80 ","$2,914.14 ","$4,284.20 ","$4,340.00 ","$1,376.31 ","$4,464.00 ",$430.24 ,"$3,963.00 ","$3,963.00 ","$1,362.68 ","$3,963.00 ","$1,362.68 ","$4,464.00 ","$3,844.00 ","$4,464.00 ","$4,464.00 ","$3,720.00 " ST VINCENT HOSPITAL - ACUTE,36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$4,000.00 ","$2,000.00 ",$405.89 ,"$4,000.00 ","$2,584.00 ",$405.89 ,"$3,939.00 ","$3,535.00 ","$1,362.68 ","$2,400.00 ","$3,400.00 ","$2,800.00 ",$405.89 ,"$3,800.00 ","$2,880.00 ","$2,920.00 ","$4,000.00 ","$3,400.00 ","$1,362.68 ","$4,000.00 ","$3,200.00 ","$2,920.00 ",$405.89 ,"$1,362.68 ","$2,428.39 ","$4,000.00 ","$3,400.00 ","$3,066.03 ","$3,680.00 ","$2,800.00 ","$2,331.31 ","$3,133.44 ","$2,436.00 ","$2,914.14 ","$2,764.00 ","$2,800.00 ","$1,376.31 ","$2,880.00 ",$430.24 ,"$3,963.00 ","$3,963.00 ","$1,362.68 ","$3,963.00 ","$1,362.68 ","$2,880.00 ","$2,480.00 ","$2,880.00 ","$2,880.00 ","$2,400.00 " ST VINCENT HOSPITAL - ACUTE,36000085,19285,HC PLCMNT NEEDLE LOC WIRE BRST ULTRA,360,1 ,"$1,500.00 ",$750.00 ,$205.01 ,"$1,500.00 ",$969.00 ,$205.01 ,"$1,500.00 ","$1,500.00 ",$602.38 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$205.01 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,500.00 ","$1,275.00 ",$602.38 ,"$1,500.00 ","$1,200.00 ","$1,095.00 ",$205.01 ,$602.38 ,"$1,500.00 ","$1,500.00 ","$1,275.00 ","$1,355.35 ","$1,380.00 ","$1,050.00 ","$1,500.00 ","$1,500.00 ",$913.50 ,"$1,500.00 ","$1,036.50 ","$1,050.00 ",$608.40 ,"$1,080.00 ",$217.31 ,"$1,500.00 ","$1,500.00 ",$602.38 ,"$1,500.00 ",$602.38 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,36000086,19286,HC PLCMNT NEEDLE LOC WIRE BRST ADDL,360,1 ,$130.00 ,$65.00 ,$65.00 ,"$3,133.44 ",$83.98 ,$130.00 ,$130.00 ,$130.00 , N/A ,$78.00 ,$110.50 ,$91.00 ,$205.01 ,$123.50 ,$93.60 ,$94.90 ,$130.00 ,$110.50 , N/A ,$130.00 ,$104.00 ,$94.90 ,$205.01 , N/A ,$130.00 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,"$2,331.72 ","$3,133.44 ",$79.17 ,"$2,914.14 ",$89.83 ,$91.00 , N/A ,$93.60 ,$217.31 ,$130.00 ,$130.00 , N/A ,$130.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,36000088,20206,HC BX MUSCLE NEEDLE PERC,360,1 ,"$1,200.00 ",$600.00 ,$180.17 ,"$3,066.03 ",$775.20 ,$180.17 ,"$1,200.00 ","$1,200.00 ","$1,362.68 ",$720.00 ,"$1,020.00 ",$840.00 ,$180.17 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ","$1,362.68 ","$1,200.00 ",$960.00 ,$876.00 ,$180.17 ,"$1,362.68 ","$1,200.00 ","$1,200.00 ","$1,020.00 ","$3,066.03 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,"$1,376.31 ",$864.00 ,$190.98 ,"$1,200.00 ","$1,200.00 ","$1,362.68 ","$1,200.00 ","$1,362.68 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36000089,20220,HC BX BONE NEEDLE SUPERFIC FAC,360,1 ,"$1,400.00 ",$700.00 ,$180.17 ,"$3,066.03 ",$904.40 ,$180.17 ,"$1,400.00 ","$1,400.00 ","$1,362.68 ",$840.00 ,"$1,190.00 ",$980.00 ,$180.17 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ","$1,400.00 ","$1,190.00 ","$1,362.68 ","$1,400.00 ","$1,120.00 ","$1,022.00 ",$180.17 ,"$1,362.68 ","$1,400.00 ","$1,400.00 ","$1,190.00 ","$3,066.03 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,"$1,376.31 ","$1,008.00 ",$190.98 ,"$1,400.00 ","$1,400.00 ","$1,362.68 ","$1,400.00 ","$1,362.68 ","$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,36000090,20225,HC BX BONE NEEDLE DEEP,360,1 ,"$2,200.00 ","$1,100.00 ",$496.73 ,"$3,066.03 ","$1,421.20 ",$496.73 ,"$2,200.00 ","$2,200.00 ","$1,362.68 ","$1,320.00 ","$1,870.00 ","$1,540.00 ",$496.73 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ","$1,362.68 ","$2,200.00 ","$1,760.00 ","$1,606.00 ",$496.73 ,"$1,362.68 ","$2,200.00 ","$2,200.00 ","$1,870.00 ","$3,066.03 ","$2,024.00 ","$1,540.00 ","$2,200.00 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ","$1,376.31 ","$1,584.00 ",$526.53 ,"$2,200.00 ","$2,200.00 ","$1,362.68 ","$2,200.00 ","$1,362.68 ","$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,36000095,19499,HC BREAST PROCEDURE UNLISTED,360,1 ,$310.00 ,$155.00 ,$155.00 ,"$6,881.11 ",$200.26 ,$310.00 ,$310.00 ,$310.00 ,"$3,058.27 ",$186.00 ,$263.50 ,$217.00 ,$405.89 ,$294.50 ,$223.20 ,$226.30 ,$310.00 ,$263.50 ,"$3,058.27 ",$310.00 ,$248.00 ,$226.30 ,$405.89 ,"$3,058.27 ",$310.00 ,$310.00 ,$263.50 ,"$6,881.11 ",$285.20 ,$217.00 , N/A , N/A ,$188.79 , N/A ,$214.21 ,$217.00 ,"$3,088.85 ",$223.20 ,$430.24 ,$310.00 ,$310.00 ,"$3,058.27 ",$310.00 ,"$3,058.27 ",$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,36000101,29085,HC CAST APPL; HAND AND FOREARM,360,1 ,$235.00 ,$117.50 ,$57.61 ,$307.65 ,$151.81 ,$57.61 ,$235.00 ,$235.00 ,$136.73 ,$141.00 ,$199.75 ,$164.50 ,$57.61 ,$223.25 ,$169.20 ,$171.55 ,$235.00 ,$199.75 ,$136.73 ,$235.00 ,$188.00 ,$171.55 ,$57.61 ,$136.73 ,$235.00 ,$235.00 ,$199.75 ,$307.65 ,$216.20 ,$164.50 ,$235.00 ,$235.00 ,$143.12 ,$235.00 ,$162.39 ,$164.50 ,$138.10 ,$169.20 ,$61.07 ,$235.00 ,$235.00 ,$136.73 ,$235.00 ,$136.73 ,$169.20 ,$145.70 ,$169.20 ,$169.20 ,$141.00 ST VINCENT HOSPITAL - ACUTE,36000108,19082,HC BREAST LOC BX PERC STEREO ADDN LESION,360,1 ,$250.00 ,$125.00 ,$125.00 ,"$3,133.44 ",$161.50 ,$250.00 ,$250.00 ,$250.00 , N/A ,$150.00 ,$212.50 ,$175.00 ,$405.89 ,$237.50 ,$180.00 ,$182.50 ,$250.00 ,$212.50 , N/A ,$250.00 ,$200.00 ,$182.50 ,$405.89 , N/A ,$250.00 ,$250.00 ,$212.50 , N/A ,$230.00 ,$175.00 ,"$2,331.72 ","$3,133.44 ",$152.25 ,"$2,914.14 ",$172.75 ,$175.00 , N/A ,$180.00 ,$430.24 ,$250.00 ,$250.00 , N/A ,$250.00 , N/A ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,36000109,19084,HC BREAST LOC BX ULTRA ADDN LESION,360,1 ,$230.00 ,$115.00 ,$115.00 ,"$3,133.44 ",$148.58 ,$230.00 ,$230.00 ,$230.00 , N/A ,$138.00 ,$195.50 ,$161.00 ,$405.89 ,$218.50 ,$165.60 ,$167.90 ,$230.00 ,$195.50 , N/A ,$230.00 ,$184.00 ,$167.90 ,$405.89 , N/A ,$230.00 ,$230.00 ,$195.50 , N/A ,$211.60 ,$161.00 ,"$2,331.72 ","$3,133.44 ",$140.07 ,"$2,914.14 ",$158.93 ,$161.00 , N/A ,$165.60 ,$430.24 ,$230.00 ,$230.00 , N/A ,$230.00 , N/A ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,36000110,19085,HC BX BREAST 1ST LESION MR IMAG,360,1 ,"$1,000.00 ",$500.00 ,$405.89 ,"$3,066.03 ",$646.00 ,$405.89 ,"$1,000.00 ","$1,000.00 ","$1,362.68 ",$600.00 ,$850.00 ,$700.00 ,$405.89 ,$950.00 ,$720.00 ,$730.00 ,"$1,000.00 ",$850.00 ,"$1,362.68 ","$1,000.00 ",$800.00 ,$730.00 ,$405.89 ,"$1,362.68 ","$1,000.00 ","$1,000.00 ",$850.00 ,"$3,066.03 ",$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,"$1,376.31 ",$720.00 ,$430.24 ,"$1,000.00 ","$1,000.00 ","$1,362.68 ","$1,000.00 ","$1,362.68 ",$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,36000111,19086,HC BX BREAST ADDN LESION MR IMAG,360,1 ,$280.00 ,$140.00 ,$140.00 ,"$3,133.44 ",$180.88 ,$280.00 ,$280.00 ,$280.00 , N/A ,$168.00 ,$238.00 ,$196.00 ,$405.89 ,$266.00 ,$201.60 ,$204.40 ,$280.00 ,$238.00 , N/A ,$280.00 ,$224.00 ,$204.40 ,$405.89 , N/A ,$280.00 ,$280.00 ,$238.00 , N/A ,$257.60 ,$196.00 ,"$2,331.72 ","$3,133.44 ",$170.52 ,"$2,914.14 ",$193.48 ,$196.00 , N/A ,$201.60 ,$430.24 ,$280.00 ,$280.00 , N/A ,$280.00 , N/A ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,36000112,19287,HC PERCUTAN DEV BREAST 1ST MR GUIDE,360,1 ,$340.00 ,$170.00 ,$170.00 ,"$1,355.35 ",$219.64 ,$205.01 ,$340.00 ,$340.00 ,$602.38 ,$204.00 ,$289.00 ,$238.00 ,$205.01 ,$323.00 ,$244.80 ,$248.20 ,$340.00 ,$289.00 ,$602.38 ,$340.00 ,$272.00 ,$248.20 ,$205.01 ,$602.38 ,$340.00 ,$340.00 ,$289.00 ,"$1,355.35 ",$312.80 ,$238.00 ,$340.00 ,$340.00 ,$207.06 ,$340.00 ,$234.94 ,$238.00 ,$608.40 ,$244.80 ,$217.31 ,$340.00 ,$340.00 ,$602.38 ,$340.00 ,$602.38 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,36000113,19288,HC PERCUTAN DEV BREAST ADDN MR GUIDE,360,1 ,$105.00 ,$52.50 ,$52.50 ,"$3,133.44 ",$67.83 ,$105.00 ,$105.00 ,$105.00 , N/A ,$63.00 ,$89.25 ,$73.50 ,$205.01 ,$99.75 ,$75.60 ,$76.65 ,$105.00 ,$89.25 , N/A ,$105.00 ,$84.00 ,$76.65 ,$205.01 , N/A ,$105.00 ,$105.00 ,$89.25 , N/A ,$96.60 ,$73.50 ,"$2,331.72 ","$3,133.44 ",$63.95 ,"$2,914.14 ",$72.56 ,$73.50 , N/A ,$75.60 ,$217.31 ,$105.00 ,$105.00 , N/A ,$105.00 , N/A ,$75.60 ,$65.10 ,$75.60 ,$75.60 ,$63.00 ST VINCENT HOSPITAL - ACUTE,36000114,19282,HC BREAST NDL LOC BX ADDN LESION,360,1 ,$150.00 ,$75.00 ,$75.00 ,"$3,133.44 ",$96.90 ,$150.00 ,$150.00 ,$150.00 , N/A ,$90.00 ,$127.50 ,$105.00 ,$205.01 ,$142.50 ,$108.00 ,$109.50 ,$150.00 ,$127.50 , N/A ,$150.00 ,$120.00 ,$109.50 ,$205.01 , N/A ,$150.00 ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,"$2,331.72 ","$3,133.44 ",$91.35 ,"$2,914.14 ",$103.65 ,$105.00 , N/A ,$108.00 ,$217.31 ,$150.00 ,$150.00 , N/A ,$150.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,36000115,19284,HC BREAST STEREO NDL LOC BX ADDN LESION,360,1 ,$150.00 ,$75.00 ,$75.00 ,"$3,133.44 ",$96.90 ,$150.00 ,$150.00 ,$150.00 , N/A ,$90.00 ,$127.50 ,$105.00 ,$205.01 ,$142.50 ,$108.00 ,$109.50 ,$150.00 ,$127.50 , N/A ,$150.00 ,$120.00 ,$109.50 ,$205.01 , N/A ,$150.00 ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,"$2,331.72 ","$3,133.44 ",$91.35 ,"$2,914.14 ",$103.65 ,$105.00 , N/A ,$108.00 ,$217.31 ,$150.00 ,$150.00 , N/A ,$150.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,36000116,19286,HC BREAST NDL LOC BX ULTRA ADDN LESION,360,1 ,$130.00 ,$65.00 ,$65.00 ,"$3,133.44 ",$83.98 ,$130.00 ,$130.00 ,$130.00 , N/A ,$78.00 ,$110.50 ,$91.00 ,$205.01 ,$123.50 ,$93.60 ,$94.90 ,$130.00 ,$110.50 , N/A ,$130.00 ,$104.00 ,$94.90 ,$205.01 , N/A ,$130.00 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,"$2,331.72 ","$3,133.44 ",$79.17 ,"$2,914.14 ",$89.83 ,$91.00 , N/A ,$93.60 ,$217.31 ,$130.00 ,$130.00 , N/A ,$130.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,36000118,36470,HC INJ SCLEROSING SOLUTION SINGLE VEIN,360,1 ,$290.00 ,$145.00 ,$136.38 ,$753.63 ,$187.34 ,$136.38 ,$290.00 ,$290.00 ,$334.95 ,$174.00 ,$246.50 ,$203.00 ,$136.38 ,$275.50 ,$208.80 ,$211.70 ,$290.00 ,$246.50 ,$334.95 ,$290.00 ,$232.00 ,$211.70 ,$136.38 ,$334.95 ,$290.00 ,$290.00 ,$246.50 ,$753.63 ,$266.80 ,$203.00 ,$290.00 ,$290.00 ,$176.61 ,$290.00 ,$200.39 ,$203.00 ,$338.30 ,$208.80 ,$144.56 ,$290.00 ,$290.00 ,$334.95 ,$290.00 ,$334.95 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,36000119,36471,HC INJ SCLEROSING SOLUTN MULT VEIN,360,1 ,$330.00 ,$165.00 ,$136.38 ,$753.63 ,$213.18 ,$136.38 ,$330.00 ,$330.00 ,$334.95 ,$198.00 ,$280.50 ,$231.00 ,$136.38 ,$313.50 ,$237.60 ,$240.90 ,$330.00 ,$280.50 ,$334.95 ,$330.00 ,$264.00 ,$240.90 ,$136.38 ,$334.95 ,$330.00 ,$330.00 ,$280.50 ,$753.63 ,$303.60 ,$231.00 ,$330.00 ,$330.00 ,$200.97 ,$330.00 ,$228.03 ,$231.00 ,$338.30 ,$237.60 ,$144.56 ,$330.00 ,$330.00 ,$334.95 ,$330.00 ,$334.95 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,36000120,36481,HC CATH VEIN PORTAL PERC,360,1 ,"$1,827.00 ",$913.50 ,$202.63 ,"$1,827.00 ","$1,180.24 ",$202.63 ,"$1,827.00 ","$1,827.00 ", N/A ,"$1,096.20 ","$1,552.95 ","$1,278.90 ",$202.63 ,"$1,735.65 ","$1,315.44 ","$1,333.71 ","$1,827.00 ","$1,552.95 ", N/A ,"$1,827.00 ","$1,461.60 ","$1,333.71 ",$202.63 , N/A ,"$1,827.00 ","$1,827.00 ","$1,552.95 ", N/A ,"$1,680.84 ","$1,278.90 ","$1,827.00 ","$1,827.00 ","$1,112.64 ","$1,827.00 ","$1,262.46 ","$1,278.90 ", N/A ,"$1,315.44 ",$214.79 ,"$1,827.00 ","$1,827.00 ", N/A ,"$1,827.00 ", N/A ,"$1,315.44 ","$1,132.74 ","$1,315.44 ","$1,315.44 ","$1,096.20 " ST VINCENT HOSPITAL - ACUTE,36000121,36500,HC CATH VENOUS BLOOD SELECT SMPL,360,1 ,"$1,000.00 ",$500.00 ,$202.63 ,"$1,000.00 ",$646.00 ,$202.63 ,"$1,000.00 ","$1,000.00 ", N/A ,$600.00 ,$850.00 ,$700.00 ,$202.63 ,$950.00 ,$720.00 ,$730.00 ,"$1,000.00 ",$850.00 , N/A ,"$1,000.00 ",$800.00 ,$730.00 ,$202.63 , N/A ,"$1,000.00 ","$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 , N/A ,$720.00 ,$214.79 ,"$1,000.00 ","$1,000.00 ", N/A ,"$1,000.00 ", N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,36000122,36555,HC INS CATH CV NON-TUNL <5 YRS,360,1 ,"$2,900.00 ","$1,450.00 ",$322.47 ,"$6,235.91 ","$1,873.40 ",$322.47 ,"$2,900.00 ","$2,900.00 ","$2,771.52 ","$1,740.00 ","$2,465.00 ","$2,030.00 ",$322.47 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ","$2,717.00 ","$2,465.00 ","$2,771.52 ","$2,717.00 ","$2,320.00 ","$2,117.00 ",$322.47 ,"$2,771.52 ","$2,428.39 ","$2,900.00 ","$2,465.00 ","$6,235.91 ","$2,668.00 ","$2,030.00 ","$2,066.93 ","$2,778.48 ","$1,766.10 ","$2,583.66 ","$2,003.90 ","$2,030.00 ","$2,799.24 ","$2,088.00 ",$341.82 ,"$2,724.00 ","$2,724.00 ","$2,771.52 ","$2,724.00 ","$2,771.52 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,36000123,36556,HC INS CATH CV NON-TUNL >5 YR,360,1 ,"$2,500.00 ","$1,250.00 ",$322.47 ,"$6,235.91 ","$1,615.00 ",$322.47 ,"$2,500.00 ","$2,500.00 ","$2,771.52 ","$1,500.00 ","$2,125.00 ","$1,750.00 ",$322.47 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ","$2,500.00 ","$2,125.00 ","$2,771.52 ","$2,500.00 ","$2,000.00 ","$1,825.00 ",$322.47 ,"$2,771.52 ","$2,428.39 ","$2,500.00 ","$2,125.00 ","$6,235.91 ","$2,300.00 ","$1,750.00 ","$2,066.93 ","$2,500.00 ","$1,522.50 ","$2,500.00 ","$1,727.50 ","$1,750.00 ","$2,799.24 ","$1,800.00 ",$341.82 ,"$2,500.00 ","$2,500.00 ","$2,771.52 ","$2,500.00 ","$2,771.52 ","$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,36000124,36557,HC INSERT TUNNELED CVC <5 YEARS OLD,360,1 ,"$2,390.00 ","$1,195.00 ",$664.06 ,"$10,395.23 ","$1,543.94 ",$664.06 ,"$2,390.00 ","$2,390.00 ","$4,620.10 ","$1,434.00 ","$2,031.50 ","$1,673.00 ",$664.06 ,"$2,270.50 ","$1,720.80 ","$1,744.70 ","$2,390.00 ","$2,031.50 ","$4,620.10 ","$2,390.00 ","$1,912.00 ","$1,744.70 ",$664.06 ,"$4,620.10 ","$2,390.00 ","$2,390.00 ","$2,031.50 ","$10,395.23 ","$2,198.80 ","$1,673.00 ","$2,331.31 ","$2,390.00 ","$1,455.51 ","$2,390.00 ","$1,651.49 ","$1,673.00 ","$4,666.30 ","$1,720.80 ",$703.90 ,"$2,390.00 ","$2,390.00 ","$4,620.10 ","$2,390.00 ","$4,620.10 ","$1,720.80 ","$1,481.80 ","$1,720.80 ","$1,720.80 ","$1,434.00 " ST VINCENT HOSPITAL - ACUTE,36000125,36558,HC INSERT TUNNELED CVC > 5 YEARS OLD,360,1 ,"$4,300.00 ","$2,150.00 ",$664.06 ,"$6,235.91 ","$2,777.80 ",$664.06 ,"$4,300.00 ","$4,300.00 ","$2,771.52 ","$2,580.00 ","$3,655.00 ","$3,010.00 ",$664.06 ,"$4,085.00 ","$3,096.00 ","$3,139.00 ","$4,300.00 ","$3,655.00 ","$2,771.52 ","$4,300.00 ","$3,440.00 ","$3,139.00 ",$664.06 ,"$2,771.52 ","$4,300.00 ","$4,300.00 ","$3,655.00 ","$6,235.91 ","$3,956.00 ","$3,010.00 ","$2,331.31 ","$3,133.44 ","$2,618.70 ","$2,914.14 ","$2,971.30 ","$3,010.00 ","$2,799.24 ","$3,096.00 ",$703.90 ,"$4,300.00 ","$4,300.00 ","$2,771.52 ","$4,300.00 ","$2,771.52 ","$3,096.00 ","$2,666.00 ","$3,096.00 ","$3,096.00 ","$2,580.00 " ST VINCENT HOSPITAL - ACUTE,36000126,36560,HC INS DEVICE CV W/PORT <5 YRS,360,1 ,"$4,400.00 ","$2,200.00 ",$664.06 ,"$6,235.91 ","$2,842.40 ",$664.06 ,"$4,400.00 ","$4,400.00 ","$2,771.52 ","$2,640.00 ","$3,740.00 ","$3,080.00 ",$664.06 ,"$4,180.00 ","$3,168.00 ","$3,212.00 ","$4,400.00 ","$3,740.00 ","$2,771.52 ","$4,400.00 ","$3,520.00 ","$3,212.00 ",$664.06 ,"$2,771.52 ","$4,400.00 ","$4,400.00 ","$3,740.00 ","$6,235.91 ","$4,048.00 ","$3,080.00 ","$3,206.88 ","$4,310.52 ","$2,679.60 ","$4,008.60 ","$3,040.40 ","$3,080.00 ","$2,799.24 ","$3,168.00 ",$703.90 ,"$4,400.00 ","$4,400.00 ","$2,771.52 ","$4,400.00 ","$2,771.52 ","$3,168.00 ","$2,728.00 ","$3,168.00 ","$3,168.00 ","$2,640.00 " ST VINCENT HOSPITAL - ACUTE,36000127,36561,HC INSERT TUNEL CV CATH>5YR W/PORT,360,1 ,"$5,500.00 ","$2,750.00 ",$664.06 ,"$6,235.91 ","$3,553.00 ",$664.06 ,"$5,500.00 ","$5,500.00 ","$2,771.52 ","$3,300.00 ","$4,675.00 ","$3,850.00 ",$664.06 ,"$5,225.00 ","$3,960.00 ","$4,015.00 ","$5,500.00 ","$4,675.00 ","$2,771.52 ","$5,500.00 ","$4,400.00 ","$4,015.00 ",$664.06 ,"$2,771.52 ","$5,500.00 ","$5,500.00 ","$4,675.00 ","$6,235.91 ","$5,060.00 ","$3,850.00 ","$3,206.88 ","$4,310.52 ","$3,349.50 ","$4,008.60 ","$3,800.50 ","$3,850.00 ","$2,799.24 ","$3,960.00 ",$703.90 ,"$5,500.00 ","$5,500.00 ","$2,771.52 ","$5,500.00 ","$2,771.52 ","$3,960.00 ","$3,410.00 ","$3,960.00 ","$3,960.00 ","$3,300.00 " ST VINCENT HOSPITAL - ACUTE,36000131,36568,HC INS CATH PERIPH CV W/O PORT <5,360,1 ,"$1,200.00 ",$600.00 ,$322.47 ,"$3,064.15 ",$775.20 ,$322.47 ,"$1,200.00 ","$1,200.00 ","$1,361.85 ",$720.00 ,"$1,020.00 ",$840.00 ,$322.47 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ","$1,361.85 ","$1,200.00 ",$960.00 ,$876.00 ,$322.47 ,"$1,361.85 ","$1,200.00 ","$1,200.00 ","$1,020.00 ","$3,064.15 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,"$1,375.47 ",$864.00 ,$341.82 ,"$1,200.00 ","$1,200.00 ","$1,361.85 ","$1,200.00 ","$1,361.85 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36000132,36569,HC INS PER CV CATH W/O PORT 5>,360,1 ,"$1,500.00 ",$750.00 ,$322.47 ,"$3,064.15 ",$969.00 ,$322.47 ,"$1,500.00 ","$1,500.00 ","$1,361.85 ",$900.00 ,"$1,275.00 ","$1,050.00 ",$322.47 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,500.00 ","$1,275.00 ","$1,361.85 ","$1,500.00 ","$1,200.00 ","$1,095.00 ",$322.47 ,"$1,361.85 ","$1,500.00 ","$1,500.00 ","$1,275.00 ","$3,064.15 ","$1,380.00 ","$1,050.00 ","$1,500.00 ","$1,500.00 ",$913.50 ,"$1,500.00 ","$1,036.50 ","$1,050.00 ","$1,375.47 ","$1,080.00 ",$341.82 ,"$1,500.00 ","$1,500.00 ","$1,361.85 ","$1,500.00 ","$1,361.85 ","$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,36000134,36578,HC REPLACE CATH CV W/PORT/PUMP,360,1 ,"$2,760.00 ","$1,380.00 ",$222.52 ,"$6,235.91 ","$1,782.96 ",$222.52 ,"$2,760.00 ","$2,760.00 ","$2,771.52 ","$1,656.00 ","$2,346.00 ","$1,932.00 ",$222.52 ,"$2,622.00 ","$1,987.20 ","$2,014.80 ","$2,760.00 ","$2,346.00 ","$2,771.52 ","$2,760.00 ","$2,208.00 ","$2,014.80 ",$222.52 ,"$2,771.52 ","$2,760.00 ","$2,760.00 ","$2,346.00 ","$6,235.91 ","$2,539.20 ","$1,932.00 ","$2,331.31 ","$2,760.00 ","$1,680.84 ","$2,760.00 ","$1,907.16 ","$1,932.00 ","$2,799.24 ","$1,987.20 ",$235.87 ,"$2,760.00 ","$2,760.00 ","$2,771.52 ","$2,760.00 ","$2,771.52 ","$1,987.20 ","$1,711.20 ","$1,987.20 ","$1,987.20 ","$1,656.00 " ST VINCENT HOSPITAL - ACUTE,36000135,36580,HC REPL CATH CV NON-TNL W/O PORT,360,1 ,"$2,400.00 ","$1,200.00 ",$322.47 ,"$3,064.15 ","$1,550.40 ",$322.47 ,"$2,400.00 ","$2,400.00 ","$1,361.85 ","$1,440.00 ","$2,040.00 ","$1,680.00 ",$322.47 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$2,400.00 ","$2,040.00 ","$1,361.85 ","$2,400.00 ","$1,920.00 ","$1,752.00 ",$322.47 ,"$1,361.85 ","$2,400.00 ","$2,400.00 ","$2,040.00 ","$3,064.15 ","$2,208.00 ","$1,680.00 ","$2,066.93 ","$2,400.00 ","$1,461.60 ","$2,400.00 ","$1,658.40 ","$1,680.00 ","$1,375.47 ","$1,728.00 ",$341.82 ,"$2,400.00 ","$2,400.00 ","$1,361.85 ","$2,400.00 ","$1,361.85 ","$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,36000136,36581,HC REPL CATH CV TNL W/O PORT,360,1 ,"$3,700.00 ","$1,850.00 ",$664.06 ,"$6,235.91 ","$2,390.20 ",$664.06 ,"$3,700.00 ","$3,700.00 ","$2,771.52 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$664.06 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$3,700.00 ","$3,145.00 ","$2,771.52 ","$3,700.00 ","$2,960.00 ","$2,701.00 ",$664.06 ,"$2,771.52 ","$3,700.00 ","$3,700.00 ","$3,145.00 ","$6,235.91 ","$3,404.00 ","$2,590.00 ","$2,331.31 ","$3,133.44 ","$2,253.30 ","$2,914.14 ","$2,556.70 ","$2,590.00 ","$2,799.24 ","$2,664.00 ",$703.90 ,"$3,700.00 ","$3,700.00 ","$2,771.52 ","$3,700.00 ","$2,771.52 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,36000137,36582,HC REPL DEVICE CV TNL W/PORT,360,1 ,"$5,600.00 ","$2,800.00 ",$664.06 ,"$6,235.91 ","$3,617.60 ",$664.06 ,"$5,600.00 ","$5,600.00 ","$2,771.52 ","$3,360.00 ","$4,760.00 ","$3,920.00 ",$664.06 ,"$5,320.00 ","$4,032.00 ","$4,088.00 ","$5,600.00 ","$4,760.00 ","$2,771.52 ","$5,600.00 ","$4,480.00 ","$4,088.00 ",$664.06 ,"$2,771.52 ","$5,519.06 ","$5,600.00 ","$4,760.00 ","$6,235.91 ","$5,152.00 ","$3,920.00 ","$3,206.88 ","$4,310.52 ","$3,410.40 ","$4,008.60 ","$3,869.60 ","$3,920.00 ","$2,799.24 ","$4,032.00 ",$703.90 ,"$5,600.00 ","$5,600.00 ","$2,771.52 ","$5,600.00 ","$2,771.52 ","$4,032.00 ","$3,472.00 ","$4,032.00 ","$4,032.00 ","$3,360.00 " ST VINCENT HOSPITAL - ACUTE,36000139,36584,HC REPL PICC W/O PORT/PUMP,360,1 ,"$2,200.00 ","$1,100.00 ",$322.47 ,"$3,064.15 ","$1,421.20 ",$322.47 ,"$2,200.00 ","$2,200.00 ","$1,361.85 ","$1,320.00 ","$1,870.00 ","$1,540.00 ",$322.47 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ","$1,361.85 ","$2,200.00 ","$1,760.00 ","$1,606.00 ",$322.47 ,"$1,361.85 ","$2,200.00 ","$2,200.00 ","$1,870.00 ","$3,064.15 ","$2,024.00 ","$1,540.00 ","$2,066.93 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ","$1,375.47 ","$1,584.00 ",$341.82 ,"$2,200.00 ","$2,200.00 ","$1,361.85 ","$2,200.00 ","$1,361.85 ","$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,36000141,36589,HC REMOVE TUNNELED CATH-NO PORT,360,1 ,"$1,000.00 ",$500.00 ,$222.52 ,"$1,180.26 ",$646.00 ,$222.52 ,"$1,000.00 ","$1,000.00 ",$524.56 ,$600.00 ,$850.00 ,$700.00 ,$222.52 ,$950.00 ,$720.00 ,$730.00 ,"$1,000.00 ",$850.00 ,$524.56 ,"$1,000.00 ",$800.00 ,$730.00 ,$222.52 ,$524.56 ,"$1,000.00 ","$1,000.00 ",$850.00 ,"$1,180.26 ",$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$529.81 ,$720.00 ,$235.87 ,"$1,000.00 ","$1,000.00 ",$524.56 ,"$1,000.00 ",$524.56 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,36000142,36590,HC REM TNL CV ACC W/PORT/PUMP,360,1 ,"$2,200.00 ","$1,100.00 ",$222.52 ,"$3,064.15 ","$1,421.20 ",$222.52 ,"$2,200.00 ","$2,020.00 ","$1,361.85 ","$1,320.00 ","$1,870.00 ","$1,540.00 ",$222.52 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ","$1,361.85 ","$2,200.00 ","$1,760.00 ","$1,606.00 ",$222.52 ,"$1,361.85 ","$2,200.00 ","$2,200.00 ","$1,870.00 ","$3,064.15 ","$2,024.00 ","$1,540.00 ","$2,066.93 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ","$1,375.47 ","$1,584.00 ",$235.87 ,"$2,200.00 ","$2,200.00 ","$1,361.85 ","$2,200.00 ","$1,361.85 ","$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,36000144,36595,HC REM PERICATHETER MAT CV DEV,360,1 ,"$3,700.00 ","$1,850.00 ",$222.52 ,"$6,235.91 ","$2,390.20 ",$222.52 ,"$3,700.00 ","$3,700.00 ","$2,771.52 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$222.52 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$3,700.00 ","$3,145.00 ","$2,771.52 ","$3,700.00 ","$2,960.00 ","$2,701.00 ",$222.52 ,"$2,771.52 ","$3,700.00 ","$3,700.00 ","$3,145.00 ","$6,235.91 ","$3,404.00 ","$2,590.00 ","$2,066.93 ","$2,778.48 ","$2,253.30 ","$2,583.66 ","$2,556.70 ","$2,590.00 ","$2,799.24 ","$2,664.00 ",$235.87 ,"$3,700.00 ","$3,700.00 ","$2,771.52 ","$3,700.00 ","$2,771.52 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,36000145,36596,HC REM INTRALUM MAT CV LUMEN,360,1 ,"$1,655.00 ",$827.50 ,$222.52 ,"$3,064.15 ","$1,069.13 ",$222.52 ,"$1,655.00 ","$1,655.00 ","$1,361.85 ",$993.00 ,"$1,406.75 ","$1,158.50 ",$222.52 ,"$1,572.25 ","$1,191.60 ","$1,208.15 ","$1,655.00 ","$1,406.75 ","$1,361.85 ","$1,655.00 ","$1,324.00 ","$1,208.15 ",$222.52 ,"$1,361.85 ","$1,655.00 ","$1,655.00 ","$1,406.75 ","$3,064.15 ","$1,522.60 ","$1,158.50 ","$1,655.00 ","$1,655.00 ","$1,007.90 ","$1,655.00 ","$1,143.61 ","$1,158.50 ","$1,375.47 ","$1,191.60 ",$235.87 ,"$1,655.00 ","$1,655.00 ","$1,361.85 ","$1,655.00 ","$1,361.85 ","$1,191.60 ","$1,026.10 ","$1,191.60 ","$1,191.60 ",$993.00 ST VINCENT HOSPITAL - ACUTE,36000146,36597,HC REPOSITION CENTRAL VENOUS CATH,360,1 ,"$1,900.00 ",$950.00 ,$222.52 ,"$3,064.15 ","$1,227.40 ",$222.52 ,"$1,900.00 ","$1,900.00 ","$1,361.85 ","$1,140.00 ","$1,615.00 ","$1,330.00 ",$222.52 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,900.00 ","$1,615.00 ","$1,361.85 ","$1,900.00 ","$1,520.00 ","$1,387.00 ",$222.52 ,"$1,361.85 ","$1,900.00 ","$1,900.00 ","$1,615.00 ","$3,064.15 ","$1,748.00 ","$1,330.00 ","$1,900.00 ","$1,900.00 ","$1,157.10 ","$1,900.00 ","$1,312.90 ","$1,330.00 ","$1,375.47 ","$1,368.00 ",$235.87 ,"$1,900.00 ","$1,900.00 ","$1,361.85 ","$1,900.00 ","$1,361.85 ","$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,36000148,36620,HC CATH/CANN ARTERY PERC 36620,360,1 ,$650.00 ,$325.00 ,$202.63 ,$650.00 ,$419.90 ,$202.63 ,$650.00 ,$650.00 , N/A ,$390.00 ,$552.50 ,$455.00 ,$202.63 ,$617.50 ,$468.00 ,$474.50 ,$650.00 ,$552.50 , N/A ,$650.00 ,$520.00 ,$474.50 ,$202.63 , N/A ,$650.00 ,$650.00 ,$552.50 , N/A ,$598.00 ,$455.00 ,$325.00 ,$390.00 ,$395.85 ,$325.00 ,$449.15 ,$455.00 , N/A ,$468.00 ,$214.79 ,$650.00 ,$650.00 , N/A ,$650.00 , N/A ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,36000149,36810,HC HEMODIAYLSIS CATH INSERTION,360,1 ,"$3,895.00 ","$1,947.50 ",$664.06 ,"$6,235.91 ","$2,516.17 ",$664.06 ,"$3,895.00 ","$3,895.00 ","$2,771.52 ","$2,337.00 ","$3,310.75 ","$2,726.50 ",$664.06 ,"$3,700.25 ","$2,804.40 ","$2,843.35 ","$3,895.00 ","$3,310.75 ","$2,771.52 ","$3,895.00 ","$3,116.00 ","$2,843.35 ",$664.06 ,"$2,771.52 ","$3,895.00 ","$3,895.00 ","$3,310.75 ","$6,235.91 ","$3,583.40 ","$2,726.50 ","$3,206.88 ","$4,310.52 ","$2,372.06 ","$4,008.60 ","$2,691.45 ","$2,726.50 ","$2,799.24 ","$2,804.40 ",$703.90 ,"$3,895.00 ","$3,895.00 ","$2,771.52 ","$3,895.00 ","$2,771.52 ","$2,804.40 ","$2,414.90 ","$2,804.40 ","$2,804.40 ","$2,337.00 " ST VINCENT HOSPITAL - ACUTE,36000154,37182,HC TIPS,360,1 ,"$12,000.00 ","$6,000.00 ","$2,331.31 ","$21,884.82 ","$7,752.00 ","$3,338.02 ","$9,595.00 ","$7,196.00 ","$9,726.59 ","$7,200.00 ","$10,200.00 ","$8,400.00 ","$3,338.02 ","$11,400.00 ","$8,640.00 ","$8,760.00 ","$6,750.00 ","$10,200.00 ","$9,726.59 ","$6,750.00 ","$9,600.00 ","$8,760.00 ","$3,338.02 ","$9,726.59 ","$12,000.00 ","$12,000.00 ","$10,200.00 ","$21,884.82 ","$11,040.00 ","$8,400.00 ","$2,331.31 ","$3,133.44 ","$7,308.00 ","$2,914.14 ","$8,292.00 ","$8,400.00 ","$9,823.86 ","$8,640.00 ","$3,538.30 ","$10,162.00 ","$10,162.00 ","$9,726.59 ","$10,162.00 ","$9,726.59 ","$8,640.00 ","$7,440.00 ","$8,640.00 ","$8,640.00 ","$7,200.00 " ST VINCENT HOSPITAL - ACUTE,36000156,37183,HC TIPS REVISION,360,1 ,"$11,000.00 ","$5,500.00 ","$1,802.28 ","$11,000.00 ","$7,106.00 ","$1,802.28 ","$11,000.00 ","$9,595.00 ","$4,800.70 ","$6,600.00 ","$9,350.00 ","$7,700.00 ","$1,802.28 ","$10,450.00 ","$7,920.00 ","$8,030.00 ","$6,750.00 ","$9,350.00 ","$4,800.70 ","$6,750.00 ","$8,800.00 ","$8,030.00 ","$1,802.28 ","$4,800.70 ","$7,726.69 ","$11,000.00 ","$9,350.00 ","$10,801.57 ","$10,120.00 ","$7,700.00 ","$2,331.31 ","$3,133.44 ","$6,699.00 ","$2,914.14 ","$7,601.00 ","$7,700.00 ","$4,848.71 ","$7,920.00 ","$1,910.42 ","$10,162.00 ","$10,162.00 ","$4,800.70 ","$10,162.00 ","$4,800.70 ","$7,920.00 ","$6,820.00 ","$7,920.00 ","$7,920.00 ","$6,600.00 " ST VINCENT HOSPITAL - ACUTE,36000157,38220,HC ASP BONE MARROW ONLY,360,1 ,"$1,000.00 ",$500.00 ,$350.23 ,"$3,066.03 ",$646.00 ,$350.23 ,"$1,000.00 ","$1,000.00 ","$1,362.68 ",$600.00 ,$850.00 ,$700.00 ,$350.23 ,$950.00 ,$720.00 ,$730.00 ,"$1,000.00 ",$850.00 ,"$1,362.68 ","$1,000.00 ",$800.00 ,$730.00 ,$350.23 ,"$1,362.68 ","$1,000.00 ","$1,000.00 ",$850.00 ,"$3,066.03 ",$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,"$1,376.31 ",$720.00 ,$371.24 ,"$1,000.00 ","$1,000.00 ","$1,362.68 ","$1,000.00 ","$1,362.68 ",$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,36000158,38221,HC BX BONE MARROW ONLY,360,1 ,$720.00 ,$360.00 ,$350.23 ,"$3,066.03 ",$465.12 ,$350.23 ,$720.00 ,$720.00 ,"$1,362.68 ",$432.00 ,$612.00 ,$504.00 ,$350.23 ,$684.00 ,$518.40 ,$525.60 ,$720.00 ,$612.00 ,"$1,362.68 ",$720.00 ,$576.00 ,$525.60 ,$350.23 ,"$1,362.68 ",$720.00 ,$720.00 ,$612.00 ,"$3,066.03 ",$662.40 ,$504.00 ,$720.00 ,$720.00 ,$438.48 ,$720.00 ,$497.52 ,$504.00 ,"$1,376.31 ",$518.40 ,$371.24 ,$720.00 ,$720.00 ,"$1,362.68 ",$720.00 ,"$1,362.68 ",$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,36000159,38505,HC LYMPH NODE BIOPSY SUPERFICIAL,360,1 ,"$1,800.00 ",$900.00 ,$338.77 ,"$3,066.03 ","$1,162.80 ",$338.77 ,"$1,800.00 ","$1,800.00 ","$1,362.68 ","$1,080.00 ","$1,530.00 ","$1,260.00 ",$338.77 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ","$1,362.68 ","$1,800.00 ","$1,440.00 ","$1,314.00 ",$338.77 ,"$1,362.68 ","$1,800.00 ","$1,800.00 ","$1,530.00 ","$3,066.03 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ","$1,376.31 ","$1,296.00 ",$359.10 ,"$1,800.00 ","$1,800.00 ","$1,362.68 ","$1,800.00 ","$1,362.68 ","$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36000161,38792,HC INJ LYMPH NODE NO IMAGING,360,1 ,$760.00 ,$380.00 ,$117.70 ,$821.79 ,$490.96 ,$117.70 ,$760.00 ,$760.00 ,$365.24 ,$456.00 ,$646.00 ,$532.00 ,$117.70 ,$722.00 ,$547.20 ,$554.80 ,$760.00 ,$646.00 ,$365.24 ,$760.00 ,$608.00 ,$554.80 ,$117.70 ,$365.24 ,$760.00 ,$760.00 ,$646.00 ,$821.79 ,$699.20 ,$532.00 ,$760.00 ,$760.00 ,$462.84 ,$760.00 ,$525.16 ,$532.00 ,$368.89 ,$547.20 ,$124.76 ,$760.00 ,$760.00 ,$365.24 ,$760.00 ,$365.24 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,36000162,38999,HC HEMIC OR LYMPHATIC SYSTEM UNLISTED,360,1 ,"$1,900.00 ",$950.00 ,$384.55 ,"$1,900.00 ","$1,227.40 ",$783.76 ,"$1,900.00 ","$1,900.00 ",$384.55 ,"$1,140.00 ","$1,615.00 ","$1,330.00 ",$783.76 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,900.00 ","$1,615.00 ",$384.55 ,"$1,900.00 ","$1,520.00 ","$1,387.00 ",$783.76 ,$384.55 ,"$1,900.00 ","$1,900.00 ","$1,615.00 ",$865.24 ,"$1,748.00 ","$1,330.00 ", N/A , N/A ,"$1,157.10 ", N/A ,"$1,312.90 ","$1,330.00 ",$388.40 ,"$1,368.00 ",$830.79 ,"$1,858.00 ","$1,858.00 ",$384.55 ,"$1,858.00 ",$384.55 ,"$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,36000163,43246,HC PLACE G-TUBE PERC,360,1 ,"$2,205.00 ","$1,102.50 ",$269.10 ,"$3,541.12 ","$1,424.43 ",$269.10 ,"$2,205.00 ","$2,205.00 ","$1,573.83 ","$1,323.00 ","$1,874.25 ","$1,543.50 ",$269.10 ,"$2,094.75 ","$1,587.60 ","$1,609.65 ","$2,205.00 ","$1,874.25 ","$1,573.83 ","$2,205.00 ","$1,764.00 ","$1,609.65 ",$269.10 ,"$1,573.83 ","$2,205.00 ","$2,205.00 ","$1,874.25 ","$3,541.12 ","$2,028.60 ","$1,543.50 ","$2,205.00 ","$2,205.00 ","$1,342.85 ","$2,205.00 ","$1,523.66 ","$1,543.50 ","$1,589.57 ","$1,587.60 ",$285.25 ,"$2,205.00 ","$2,205.00 ","$1,573.83 ","$2,205.00 ","$1,573.83 ","$1,587.60 ","$1,367.10 ","$1,587.60 ","$1,587.60 ","$1,323.00 " ST VINCENT HOSPITAL - ACUTE,36000167,44640,HC TISSUE CLOSURE INTESTNL FISTULA,360,1 ,$220.00 ,$110.00 ,$110.00 ,"$7,821.36 ",$142.12 ,$220.00 ,$220.00 ,$220.00 , N/A ,$132.00 ,$187.00 ,$154.00 ,$899.79 ,$209.00 ,$158.40 ,$160.60 ,$220.00 ,$187.00 , N/A ,$220.00 ,$176.00 ,$160.60 ,$899.79 , N/A ,$220.00 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,"$5,818.90 ","$7,821.36 ",$133.98 ,"$7,273.62 ",$152.02 ,$154.00 , N/A ,$158.40 ,$953.78 ,$220.00 ,$220.00 , N/A ,$220.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,36000168,44799,"HC UNLISTED PROC, INTESTINE",360,1 ,$500.00 ,$250.00 ,$250.00 ,"$1,764.22 ",$323.00 ,$500.00 ,$500.00 ,$500.00 ,$784.10 ,$300.00 ,$425.00 ,$350.00 ,$538.40 ,$475.00 ,$360.00 ,$365.00 ,$500.00 ,$425.00 ,$784.10 ,$500.00 ,$400.00 ,$365.00 ,$538.40 ,$784.10 ,$500.00 ,$500.00 ,$425.00 ,"$1,764.22 ",$460.00 ,$350.00 , N/A , N/A ,$304.50 , N/A ,$345.50 ,$350.00 ,$791.94 ,$360.00 ,$570.70 ,$500.00 ,$500.00 ,$784.10 ,$500.00 ,$784.10 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,36000169,N/A,HC CAUTERY/ARGON PLASMA COAGULATION,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$1,200.00 ",$775.20 , N/A , N/A , N/A , N/A ,$720.00 ,"$1,020.00 ",$840.00 , N/A ,"$1,140.00 ",$864.00 ,$876.00 , N/A ,"$1,020.00 ", N/A , N/A ,$960.00 ,$876.00 , N/A , N/A , N/A ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 , N/A ,$864.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36000170,47010,HC HEPATOTOMY DRAIN ABSC OPEN,360,1 ,"$1,566.00 ",$783.00 ,$783.00 ,"$7,821.36 ","$1,011.64 ","$1,566.00 ","$1,566.00 ","$1,566.00 ", N/A ,$939.60 ,"$1,331.10 ","$1,096.20 ","$1,826.39 ","$1,487.70 ","$1,127.52 ","$1,143.18 ","$1,566.00 ","$1,331.10 ", N/A ,"$1,566.00 ","$1,252.80 ","$1,143.18 ","$1,826.39 ", N/A ,"$1,566.00 ","$1,566.00 ","$1,331.10 ", N/A ,"$1,440.72 ","$1,096.20 ","$5,818.90 ","$7,821.36 ",$953.69 ,"$7,273.62 ","$1,082.11 ","$1,096.20 ", N/A ,"$1,127.52 ","$1,935.97 ","$1,566.00 ","$1,566.00 ", N/A ,"$1,566.00 ", N/A ,"$1,127.52 ",$970.92 ,"$1,127.52 ","$1,127.52 ",$939.60 ST VINCENT HOSPITAL - ACUTE,36000171,47490,HC CHOLECYSTOSTOMY PERC,360,1 ,"$3,400.00 ","$1,700.00 ",$703.19 ,"$7,821.36 ","$2,196.40 ",$703.19 ,"$3,400.00 ","$3,400.00 ","$3,083.13 ","$2,040.00 ","$2,890.00 ","$2,380.00 ",$703.19 ,"$3,230.00 ","$2,448.00 ","$2,482.00 ","$2,717.00 ","$2,890.00 ","$3,083.13 ","$2,717.00 ","$2,720.00 ","$2,482.00 ",$703.19 ,"$3,083.13 ","$3,400.00 ","$3,400.00 ","$2,890.00 ","$6,937.05 ","$3,128.00 ","$2,380.00 ","$5,818.90 ","$7,821.36 ","$2,070.60 ","$7,273.62 ","$2,349.40 ","$2,380.00 ","$3,113.96 ","$2,448.00 ",$745.38 ,"$3,400.00 ","$3,400.00 ","$3,083.13 ","$3,400.00 ","$3,083.13 ","$2,448.00 ","$2,108.00 ","$2,448.00 ","$2,448.00 ","$2,040.00 " ST VINCENT HOSPITAL - ACUTE,36000175,49220,HC STAGING CELIOTOMY,360,1 ,$555.00 ,$277.50 ,$277.50 ,"$7,821.36 ",$358.53 , N/A , N/A , N/A , N/A ,$333.00 ,$471.75 ,$388.50 , N/A ,$527.25 ,$399.60 ,$405.15 ,$555.00 ,$471.75 , N/A ,$555.00 ,$444.00 ,$405.15 , N/A , N/A ,$555.00 ,$555.00 ,$471.75 , N/A ,$510.60 ,$388.50 ,"$5,818.90 ","$7,821.36 ",$338.00 ,"$7,273.62 ",$383.51 ,$388.50 , N/A ,$399.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$399.60 ,$344.10 ,$399.60 ,$399.60 ,$333.00 ST VINCENT HOSPITAL - ACUTE,36000176,49418,HC INSERT INTRAPERITONEAL CATH,360,1 ,"$6,100.00 ","$3,050.00 ",$202.63 ,"$6,937.05 ","$3,940.60 ",$202.63 ,"$6,100.00 ","$6,100.00 ","$3,083.13 ","$3,660.00 ","$5,185.00 ","$4,270.00 ",$202.63 ,"$5,795.00 ","$4,392.00 ","$4,453.00 ","$6,100.00 ","$5,185.00 ","$3,083.13 ","$6,100.00 ","$4,880.00 ","$4,453.00 ",$202.63 ,"$3,083.13 ","$5,519.06 ","$6,100.00 ","$5,185.00 ","$6,937.05 ","$5,612.00 ","$4,270.00 ","$2,066.93 ","$2,778.48 ","$3,714.90 ","$2,583.66 ","$4,215.10 ","$4,270.00 ","$3,113.96 ","$4,392.00 ",$214.79 ,"$6,100.00 ","$6,100.00 ","$3,083.13 ","$6,100.00 ","$3,083.13 ","$4,392.00 ","$3,782.00 ","$4,392.00 ","$4,392.00 ","$3,660.00 " ST VINCENT HOSPITAL - ACUTE,36000177,49421,HC INS CATH DRAIN PERITONEAL PERM,360,1 ,"$4,655.00 ","$2,327.50 ",$202.63 ,"$6,937.05 ","$3,007.13 ",$202.63 ,"$4,655.00 ","$4,655.00 ","$3,083.13 ","$2,793.00 ","$3,956.75 ","$3,258.50 ",$202.63 ,"$4,422.25 ","$3,351.60 ","$3,398.15 ","$2,717.00 ","$3,956.75 ","$3,083.13 ","$2,717.00 ","$3,724.00 ","$3,398.15 ",$202.63 ,"$3,083.13 ","$4,655.00 ","$4,655.00 ","$3,956.75 ","$6,937.05 ","$4,282.60 ","$3,258.50 ","$2,066.93 ","$2,778.48 ","$2,834.90 ","$2,583.66 ","$3,216.61 ","$3,258.50 ","$3,113.96 ","$3,351.60 ",$214.79 ,"$4,655.00 ","$4,655.00 ","$3,083.13 ","$4,655.00 ","$3,083.13 ","$3,351.60 ","$2,886.10 ","$3,351.60 ","$3,351.60 ","$2,793.00 " ST VINCENT HOSPITAL - ACUTE,36000178,49422,HC REM CATH INTRAPERITONEAL,360,1 ,"$4,400.00 ","$2,200.00 ",$202.63 ,"$6,235.91 ","$2,842.40 ",$202.63 ,"$4,400.00 ","$4,400.00 ","$2,771.52 ","$2,640.00 ","$3,740.00 ","$3,080.00 ",$202.63 ,"$4,180.00 ","$3,168.00 ","$3,212.00 ","$2,717.00 ","$3,740.00 ","$2,771.52 ","$2,717.00 ","$3,520.00 ","$3,212.00 ",$202.63 ,"$2,771.52 ","$4,400.00 ","$4,400.00 ","$3,740.00 ","$6,235.91 ","$4,048.00 ","$3,080.00 ","$2,066.93 ","$2,778.48 ","$2,679.60 ","$2,583.66 ","$3,040.40 ","$3,080.00 ","$2,799.24 ","$3,168.00 ",$214.79 ,"$4,400.00 ","$4,400.00 ","$2,771.52 ","$4,400.00 ","$2,771.52 ","$3,168.00 ","$2,728.00 ","$3,168.00 ","$3,168.00 ","$2,640.00 " ST VINCENT HOSPITAL - ACUTE,36000183,51710,HC CHG TUBE CYSTOSTOMY CPLX,360,1 ,"$1,800.00 ",$900.00 ,$60.28 ,"$1,800.00 ","$1,162.80 ",$60.28 ,"$1,800.00 ","$1,800.00 ",$556.66 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$60.28 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ",$556.66 ,"$1,800.00 ","$1,440.00 ","$1,314.00 ",$60.28 ,$556.66 ,"$1,655.72 ","$1,800.00 ","$1,530.00 ","$1,252.50 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ",$562.23 ,"$1,296.00 ",$63.90 ,"$1,800.00 ","$1,800.00 ",$556.66 ,"$1,800.00 ",$556.66 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36000184,51784,HC EMG BOWEL/BLADDER SPHINCTER,360,1 ,$220.00 ,$110.00 ,$110.00 ,$304.10 ,$142.12 ,$110.54 ,$220.00 ,$220.00 ,$135.15 ,$132.00 ,$187.00 ,$154.00 ,$110.54 ,$209.00 ,$158.40 ,$160.60 ,$220.00 ,$187.00 ,$135.15 ,$220.00 ,$176.00 ,$160.60 ,$110.54 ,$135.15 ,$220.00 ,$220.00 ,$187.00 ,$304.10 ,$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$136.50 ,$158.40 ,$117.17 ,$220.00 ,$220.00 ,$135.15 ,$220.00 ,$135.15 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,36000186,53899,HC URINARY SYSTEM UNLSTD PROC,360,1 ,"$1,170.00 ",$585.00 ,$257.76 ,"$1,170.00 ",$755.82 ,$430.16 ,"$1,170.00 ","$1,170.00 ",$257.76 ,$702.00 ,$994.50 ,$819.00 ,$430.16 ,"$1,111.50 ",$842.40 ,$854.10 ,"$1,170.00 ",$994.50 ,$257.76 ,"$1,170.00 ",$936.00 ,$854.10 ,$430.16 ,$257.76 ,"$1,170.00 ","$1,170.00 ",$994.50 ,$579.95 ,"$1,076.40 ",$819.00 , N/A , N/A ,$712.53 , N/A ,$808.47 ,$819.00 ,$260.34 ,$842.40 ,$455.97 ,"$1,170.00 ","$1,170.00 ",$257.76 ,"$1,170.00 ",$257.76 ,$842.40 ,$725.40 ,$842.40 ,$842.40 ,$702.00 ST VINCENT HOSPITAL - ACUTE,36000187,54150,HC CIRCUMCISION OP,360,1 ,"$1,200.00 ",$600.00 ,$598.13 ,"$3,907.15 ",$775.20 ,$598.13 ,"$1,200.00 ","$1,200.00 ","$1,736.51 ",$720.00 ,"$1,020.00 ",$840.00 ,$598.13 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ","$1,736.51 ","$1,200.00 ",$960.00 ,$876.00 ,$598.13 ,"$1,736.51 ","$1,200.00 ","$1,200.00 ","$1,020.00 ","$3,907.15 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,"$1,753.88 ",$864.00 ,$634.02 ,"$1,200.00 ","$1,200.00 ","$1,736.51 ","$1,200.00 ","$1,736.51 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36000188,55700,HC BX PROSTATE NEEDLE/PUNCH,360,1 ,"$2,300.00 ","$1,150.00 ",$489.02 ,"$3,907.15 ","$1,485.80 ",$489.02 ,"$2,300.00 ","$2,300.00 ","$1,736.51 ","$1,380.00 ","$1,955.00 ","$1,610.00 ",$489.02 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$2,300.00 ","$1,955.00 ","$1,736.51 ","$2,300.00 ","$1,840.00 ","$1,679.00 ",$489.02 ,"$1,736.51 ","$2,300.00 ","$2,300.00 ","$1,955.00 ","$3,907.15 ","$2,116.00 ","$1,610.00 ","$2,300.00 ","$2,300.00 ","$1,400.70 ","$2,300.00 ","$1,589.30 ","$1,610.00 ","$1,753.88 ","$1,656.00 ",$518.36 ,"$2,300.00 ","$2,300.00 ","$1,736.51 ","$2,300.00 ","$1,736.51 ","$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,36000189,58100,HC BIOPSY OF UTERUS PERCUTANEOUS,360,1 ,$510.00 ,$255.00 ,$152.54 ,$510.00 ,$329.46 ,$152.54 ,$510.00 ,$510.00 ,$164.95 ,$306.00 ,$433.50 ,$357.00 ,$152.54 ,$484.50 ,$367.20 ,$372.30 ,$510.00 ,$433.50 ,$164.95 ,$510.00 ,$408.00 ,$372.30 ,$152.54 ,$164.95 ,$510.00 ,$510.00 ,$433.50 ,$371.15 ,$469.20 ,$357.00 ,$510.00 ,$510.00 ,$310.59 ,$510.00 ,$352.41 ,$357.00 ,$166.60 ,$367.20 ,$161.69 ,$510.00 ,$510.00 ,$164.95 ,$510.00 ,$164.95 ,$367.20 ,$316.20 ,$367.20 ,$367.20 ,$306.00 ST VINCENT HOSPITAL - ACUTE,36000190,61624,HC OCC/EMB TRANSCATH CNS PERC,360,1 ,"$5,200.00 ","$2,600.00 ","$2,600.00 ","$35,005.46 ","$3,359.20 ","$3,338.02 ","$5,200.00 ","$5,200.00 ","$15,557.98 ","$3,120.00 ","$4,420.00 ","$3,640.00 ","$3,338.02 ","$4,940.00 ","$3,744.00 ","$3,796.00 ","$2,717.00 ","$4,420.00 ","$15,557.98 ","$2,717.00 ","$4,160.00 ","$3,796.00 ","$3,338.02 ","$15,557.98 ","$5,200.00 ","$5,200.00 ","$4,420.00 ","$35,005.46 ","$4,784.00 ","$3,640.00 ","$5,818.90 ","$7,821.36 ","$3,166.80 ","$7,273.62 ","$3,593.20 ","$3,640.00 ","$15,713.56 ","$3,744.00 ","$3,538.30 ","$5,200.00 ","$5,200.00 ","$15,557.98 ","$5,200.00 ","$15,557.98 ","$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,36000191,61626,HC OCC/EMB TRANSCATH EXT CRAN VSS,360,1 ,"$12,000.00 ","$6,000.00 ","$1,802.28 ","$21,884.82 ","$7,752.00 ","$1,802.28 ","$12,000.00 ","$11,363.00 ","$9,726.59 ","$7,200.00 ","$10,200.00 ","$8,400.00 ","$1,802.28 ","$11,400.00 ","$8,640.00 ","$8,760.00 ","$6,750.00 ","$10,200.00 ","$9,726.59 ","$6,750.00 ","$9,600.00 ","$8,760.00 ","$1,802.28 ","$9,726.59 ","$12,000.00 ","$12,000.00 ","$10,200.00 ","$21,884.82 ","$11,040.00 ","$8,400.00 ","$5,818.90 ","$7,821.36 ","$7,308.00 ","$7,273.62 ","$8,292.00 ","$8,400.00 ","$9,823.86 ","$8,640.00 ","$1,910.42 ","$10,162.00 ","$10,162.00 ","$9,726.59 ","$10,162.00 ","$9,726.59 ","$8,640.00 ","$7,440.00 ","$8,640.00 ","$8,640.00 ","$7,200.00 " ST VINCENT HOSPITAL - ACUTE,36000193,62267,HC DISC ASPIRATION,360,1 ,"$1,400.00 ",$700.00 ,$263.02 ,"$1,400.00 ",$904.40 ,$263.02 ,"$1,400.00 ","$1,400.00 ",$602.38 ,$840.00 ,"$1,190.00 ",$980.00 ,$263.02 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ","$1,400.00 ","$1,190.00 ",$602.38 ,"$1,400.00 ","$1,120.00 ","$1,022.00 ",$263.02 ,$602.38 ,"$1,400.00 ","$1,400.00 ","$1,190.00 ","$1,355.35 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,$608.40 ,"$1,008.00 ",$278.80 ,"$1,400.00 ","$1,400.00 ",$602.38 ,"$1,400.00 ",$602.38 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,36000194,62270,HC LUMBAR PUNCTURE,360,1 ,"$1,000.00 ",$500.00 ,$263.02 ,"$1,382.85 ",$646.00 ,$263.02 ,"$1,000.00 ","$1,000.00 ",$614.60 ,$600.00 ,$850.00 ,$700.00 ,$263.02 ,$950.00 ,$720.00 ,$730.00 ,"$1,000.00 ",$850.00 ,$614.60 ,"$1,000.00 ",$800.00 ,$730.00 ,$263.02 ,$614.60 ,"$1,000.00 ","$1,000.00 ",$850.00 ,"$1,382.85 ",$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$620.75 ,$720.00 ,$278.80 ,"$1,000.00 ","$1,000.00 ",$614.60 ,"$1,000.00 ",$614.60 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,36000195,10160,HC ASP BULLA FAC,761,1 ,$400.00 ,$200.00 ,$74.70 ,$753.63 ,$258.40 ,$74.70 ,$400.00 ,$400.00 ,$334.95 ,$240.00 ,$340.00 ,$280.00 ,$74.70 ,$380.00 ,$288.00 ,$292.00 ,$400.00 ,$340.00 ,$334.95 ,$400.00 ,$320.00 ,$292.00 ,$74.70 ,$334.95 ,$168.00 ,$400.00 ,$340.00 ,$753.63 ,$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 ,$338.30 ,$288.00 ,$79.18 ,$240.00 ,$240.00 ,$334.95 ,$240.00 ,$334.95 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,36000210,31647,HC BRONCHOSCOPY VALVE INSERT INITIAL LOBE,360,1 ,"$3,300.00 ","$1,650.00 ","$1,009.08 ","$12,688.52 ","$2,131.80 ","$1,009.08 ","$3,300.00 ","$3,300.00 ","$5,639.34 ","$1,980.00 ","$2,805.00 ","$2,310.00 ","$1,009.08 ","$3,135.00 ","$2,376.00 ","$2,409.00 ","$3,300.00 ","$2,805.00 ","$5,639.34 ","$3,300.00 ","$2,640.00 ","$2,409.00 ","$1,009.08 ","$5,639.34 ","$3,300.00 ","$3,300.00 ","$2,805.00 ","$12,688.52 ","$3,036.00 ","$2,310.00 ","$2,331.31 ","$3,133.44 ","$2,009.70 ","$2,914.14 ","$2,280.30 ","$2,310.00 ","$5,695.73 ","$2,376.00 ","$1,069.62 ","$3,300.00 ","$3,300.00 ","$5,639.34 ","$3,300.00 ","$5,639.34 ","$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,36000211,31648,HC BRONCHOSCOPY VALVE REMOVAL INITIAL LOBE,360,1 ,"$3,300.00 ","$1,650.00 ","$1,009.08 ","$6,750.97 ","$2,131.80 ","$1,009.08 ","$3,300.00 ","$3,300.00 ","$3,000.43 ","$1,980.00 ","$2,805.00 ","$2,310.00 ","$1,009.08 ","$3,135.00 ","$2,376.00 ","$2,409.00 ","$3,300.00 ","$2,805.00 ","$3,000.43 ","$3,300.00 ","$2,640.00 ","$2,409.00 ","$1,009.08 ","$3,000.43 ","$3,300.00 ","$3,300.00 ","$2,805.00 ","$6,750.97 ","$3,036.00 ","$2,310.00 ","$2,331.31 ","$3,133.44 ","$2,009.70 ","$2,914.14 ","$2,280.30 ","$2,310.00 ","$3,030.43 ","$2,376.00 ","$1,069.62 ","$3,300.00 ","$3,300.00 ","$3,000.43 ","$3,300.00 ","$3,000.43 ","$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,36000212,31649,HC BRONCHOSCOPY VALVE REMOVAL ADDNL LOBE,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$3,260.82 ",$775.20 ,"$1,009.08 ","$1,200.00 ","$1,200.00 ","$1,449.25 ",$720.00 ,"$1,020.00 ",$840.00 ,"$1,009.08 ","$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ","$1,449.25 ","$1,200.00 ",$960.00 ,$876.00 ,"$1,009.08 ","$1,449.25 ","$1,200.00 ","$1,200.00 ","$1,020.00 ","$3,260.82 ","$1,104.00 ",$840.00 ,"$2,331.72 ","$3,133.44 ",$730.80 ,"$2,914.14 ",$829.20 ,$840.00 ,"$1,463.74 ",$864.00 ,"$1,069.62 ","$1,200.00 ","$1,200.00 ","$1,449.25 ","$1,200.00 ","$1,449.25 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36000213,31651,HC BRONCHOSCOPY VALVE INSERT ADDNL LOBE,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$3,133.44 ",$775.20 ,"$1,009.08 ","$1,200.00 ","$1,200.00 ", N/A ,$720.00 ,"$1,020.00 ",$840.00 ,"$1,009.08 ","$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,200.00 ",$960.00 ,$876.00 ,"$1,009.08 ", N/A ,"$1,200.00 ","$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,"$2,331.72 ","$3,133.44 ",$730.80 ,"$2,914.14 ",$829.20 ,$840.00 , N/A ,$864.00 ,"$1,069.62 ","$1,200.00 ","$1,200.00 ", N/A ,"$1,200.00 ", N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36000214,31660,HC BRONCHOSCOPY THERMOPLASTY 1 LOBE,360,1 ,"$2,535.00 ","$1,267.50 ","$1,009.08 ","$12,688.52 ","$1,637.61 ","$1,009.08 ","$2,535.00 ","$2,535.00 ","$5,639.34 ","$1,521.00 ","$2,154.75 ","$1,774.50 ","$1,009.08 ","$2,408.25 ","$1,825.20 ","$1,850.55 ","$2,535.00 ","$2,154.75 ","$5,639.34 ","$2,535.00 ","$2,028.00 ","$1,850.55 ","$1,009.08 ","$5,639.34 ","$2,535.00 ","$2,535.00 ","$2,154.75 ","$12,688.52 ","$2,332.20 ","$1,774.50 ","$2,331.31 ","$2,535.00 ","$1,543.82 ","$2,535.00 ","$1,751.69 ","$1,774.50 ","$5,695.73 ","$1,825.20 ","$1,069.62 ","$2,535.00 ","$2,535.00 ","$5,639.34 ","$2,535.00 ","$5,639.34 ","$1,825.20 ","$1,571.70 ","$1,825.20 ","$1,825.20 ","$1,521.00 " ST VINCENT HOSPITAL - ACUTE,36000215,31661,HC BRONCHOSCOPY THERMOPLASTY 2 OR MORE LOBES,360,1 ,"$2,865.00 ","$1,432.50 ","$1,009.08 ","$12,688.52 ","$1,850.79 ","$1,009.08 ","$2,865.00 ","$2,865.00 ","$5,639.34 ","$1,719.00 ","$2,435.25 ","$2,005.50 ","$1,009.08 ","$2,721.75 ","$2,062.80 ","$2,091.45 ","$2,865.00 ","$2,435.25 ","$5,639.34 ","$2,865.00 ","$2,292.00 ","$2,091.45 ","$1,009.08 ","$5,639.34 ","$2,865.00 ","$2,865.00 ","$2,435.25 ","$12,688.52 ","$2,635.80 ","$2,005.50 ","$2,331.31 ","$2,865.00 ","$1,744.79 ","$2,865.00 ","$1,979.72 ","$2,005.50 ","$5,695.73 ","$2,062.80 ","$1,069.62 ","$2,865.00 ","$2,865.00 ","$5,639.34 ","$2,865.00 ","$5,639.34 ","$2,062.80 ","$1,776.30 ","$2,062.80 ","$2,062.80 ","$1,719.00 " ST VINCENT HOSPITAL - ACUTE,36000216,50593,HC ABLATION RENAL PERC CRYO,360,1 ,"$12,000.00 ","$6,000.00 ","$1,837.34 ","$19,410.90 ","$7,752.00 ","$1,837.34 ","$12,000.00 ","$11,363.00 ","$8,627.07 ","$7,200.00 ","$10,200.00 ","$8,400.00 ","$1,837.34 ","$11,400.00 ","$8,640.00 ","$8,760.00 ","$6,750.00 ","$10,200.00 ","$8,627.07 ","$6,750.00 ","$9,600.00 ","$8,760.00 ","$1,837.34 ","$8,627.07 ","$12,000.00 ","$12,000.00 ","$10,200.00 ","$19,410.90 ","$11,040.00 ","$8,400.00 ","$5,818.90 ","$7,821.36 ","$7,308.00 ","$7,273.62 ","$8,292.00 ","$8,400.00 ","$8,713.34 ","$8,640.00 ","$1,947.58 ","$8,890.00 ","$8,890.00 ","$8,627.07 ","$8,890.00 ","$8,627.07 ","$8,640.00 ","$7,440.00 ","$8,640.00 ","$8,640.00 ","$7,200.00 " ST VINCENT HOSPITAL - ACUTE,36000223,36575,HC REPAIR CATH CV W/O PORT/PUMP,360,1 ,"$1,675.00 ",$837.50 ,$222.52 ,"$1,675.00 ","$1,082.05 ",$222.52 ,"$1,675.00 ","$1,675.00 ",$524.56 ,"$1,005.00 ","$1,423.75 ","$1,172.50 ",$222.52 ,"$1,591.25 ","$1,206.00 ","$1,222.75 ","$1,675.00 ","$1,423.75 ",$524.56 ,"$1,675.00 ","$1,340.00 ","$1,222.75 ",$222.52 ,$524.56 ,"$1,655.72 ","$1,675.00 ","$1,423.75 ","$1,180.26 ","$1,541.00 ","$1,172.50 ","$1,675.00 ","$1,675.00 ","$1,020.08 ","$1,675.00 ","$1,157.43 ","$1,172.50 ",$529.81 ,"$1,206.00 ",$235.87 ,"$1,675.00 ","$1,675.00 ",$524.56 ,"$1,675.00 ",$524.56 ,"$1,206.00 ","$1,038.50 ","$1,206.00 ","$1,206.00 ","$1,005.00 " ST VINCENT HOSPITAL - ACUTE,36000240,42300,HC DRAIN ABSC PAROTID SMP,360,1 ,"$1,600.00 ",$800.00 ,$280.78 ,"$2,947.90 ","$1,033.60 ",$280.78 ,"$1,600.00 ","$1,600.00 ","$1,310.18 ",$960.00 ,"$1,360.00 ","$1,120.00 ",$280.78 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,600.00 ","$1,360.00 ","$1,310.18 ","$1,600.00 ","$1,280.00 ","$1,168.00 ",$280.78 ,"$1,310.18 ","$1,600.00 ","$1,600.00 ","$1,360.00 ","$2,947.90 ","$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ","$1,323.28 ","$1,152.00 ",$297.63 ,"$1,600.00 ","$1,600.00 ","$1,310.18 ","$1,600.00 ","$1,310.18 ","$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,36000250,49419,HC INSERT TUN IP CATH W/PORT,360,1 ,"$4,415.00 ","$2,207.50 ",$202.63 ,"$10,395.23 ","$2,852.09 ",$202.63 ,"$4,415.00 ","$4,415.00 ","$4,620.10 ","$2,649.00 ","$3,752.75 ","$3,090.50 ",$202.63 ,"$4,194.25 ","$3,178.80 ","$3,222.95 ","$2,717.00 ","$3,752.75 ","$4,620.10 ","$2,717.00 ","$3,532.00 ","$3,222.95 ",$202.63 ,"$4,620.10 ","$4,415.00 ","$4,415.00 ","$3,752.75 ","$10,395.23 ","$4,061.80 ","$3,090.50 ","$2,066.93 ","$2,778.48 ","$2,688.74 ","$2,583.66 ","$3,050.77 ","$3,090.50 ","$4,666.30 ","$3,178.80 ",$214.79 ,"$4,415.00 ","$4,415.00 ","$4,620.10 ","$4,415.00 ","$4,620.10 ","$3,178.80 ","$2,737.30 ","$3,178.80 ","$3,178.80 ","$2,649.00 " ST VINCENT HOSPITAL - ACUTE,36000251,50592,HC ABLATION RENAL PERC RADIOFREQ,360,1 ,"$7,025.00 ","$3,512.50 ",$898.01 ,"$11,027.33 ","$4,538.15 ",$898.01 ,"$7,025.00 ","$7,025.00 ","$4,901.04 ","$4,215.00 ","$5,971.25 ","$4,917.50 ",$898.01 ,"$6,673.75 ","$5,058.00 ","$5,128.25 ","$6,750.00 ","$5,971.25 ","$4,901.04 ","$6,750.00 ","$5,620.00 ","$5,128.25 ",$898.01 ,"$4,901.04 ","$7,025.00 ","$7,025.00 ","$5,971.25 ","$11,027.33 ","$6,463.00 ","$4,917.50 ","$2,066.93 ","$2,778.48 ","$4,278.23 ","$2,583.66 ","$4,854.28 ","$4,917.50 ","$4,950.05 ","$5,058.00 ",$951.89 ,"$7,025.00 ","$7,025.00 ","$4,901.04 ","$7,025.00 ","$4,901.04 ","$5,058.00 ","$4,355.50 ","$5,058.00 ","$5,058.00 ","$4,215.00 " ST VINCENT HOSPITAL - ACUTE,36000300,64635,HC RADIOFREQ;LUMBO/SACRAL;SINGLE,360,1 ,"$3,200.00 ","$1,600.00 ",$263.02 ,"$3,823.04 ","$2,067.20 ",$263.02 ,"$3,200.00 ","$3,200.00 ","$1,699.13 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$263.02 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$3,200.00 ","$2,720.00 ","$1,699.13 ","$3,200.00 ","$2,560.00 ","$2,336.00 ",$263.02 ,"$1,699.13 ","$3,200.00 ","$3,200.00 ","$2,720.00 ","$3,823.04 ","$2,944.00 ","$2,240.00 ","$2,066.93 ","$2,778.48 ","$1,948.80 ","$2,583.66 ","$2,211.20 ","$2,240.00 ","$1,716.12 ","$2,304.00 ",$278.80 ,"$3,200.00 ","$3,200.00 ","$1,699.13 ","$3,200.00 ","$1,699.13 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,36000301,64636,HC RADIOFREQ;LUMBO/SACRAL;ADDTL,360,1 ,$700.00 ,$350.00 ,$263.02 ,"$2,778.48 ",$452.20 ,$263.02 ,$700.00 ,$700.00 , N/A ,$420.00 ,$595.00 ,$490.00 ,$263.02 ,$665.00 ,$504.00 ,$511.00 ,$700.00 ,$595.00 , N/A ,$700.00 ,$560.00 ,$511.00 ,$263.02 , N/A ,$700.00 ,$700.00 ,$595.00 , N/A ,$644.00 ,$490.00 ,"$2,066.52 ","$2,778.48 ",$426.30 ,"$2,583.66 ",$483.70 ,$490.00 , N/A ,$504.00 ,$278.80 ,$700.00 ,$700.00 , N/A ,$700.00 , N/A ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,36000302,64633,HC RADIOFREQ;CERV/THOR;SINGLE,360,1 ,"$3,200.00 ","$1,600.00 ",$263.02 ,"$3,823.04 ","$2,067.20 ",$263.02 ,"$3,200.00 ","$3,200.00 ","$1,699.13 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$263.02 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$3,200.00 ","$2,720.00 ","$1,699.13 ","$3,200.00 ","$2,560.00 ","$2,336.00 ",$263.02 ,"$1,699.13 ","$3,200.00 ","$3,200.00 ","$2,720.00 ","$3,823.04 ","$2,944.00 ","$2,240.00 ","$2,066.93 ","$2,778.48 ","$1,948.80 ","$2,583.66 ","$2,211.20 ","$2,240.00 ","$1,716.12 ","$2,304.00 ",$278.80 ,"$3,200.00 ","$3,200.00 ","$1,699.13 ","$3,200.00 ","$1,699.13 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,36000303,64634,HC RADIOFREQ;CERV/THOR;ADDTL,360,1 ,$700.00 ,$350.00 ,$263.02 ,"$2,778.48 ",$452.20 ,$263.02 ,$700.00 ,$700.00 , N/A ,$420.00 ,$595.00 ,$490.00 ,$263.02 ,$665.00 ,$504.00 ,$511.00 ,$700.00 ,$595.00 , N/A ,$700.00 ,$560.00 ,$511.00 ,$263.02 , N/A ,$700.00 ,$700.00 ,$595.00 , N/A ,$644.00 ,$490.00 ,"$2,066.52 ","$2,778.48 ",$426.30 ,"$2,583.66 ",$483.70 ,$490.00 , N/A ,$504.00 ,$278.80 ,$700.00 ,$700.00 , N/A ,$700.00 , N/A ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,36000304,64640,HC RADIOFREQ;PERIPHERAL NERVE,360,1 ,"$2,150.00 ","$1,075.00 ",$349.28 ,"$2,150.00 ","$1,388.90 ",$349.28 ,"$2,150.00 ","$2,020.00 ",$796.55 ,"$1,290.00 ","$1,827.50 ","$1,505.00 ",$349.28 ,"$2,042.50 ","$1,548.00 ","$1,569.50 ","$2,150.00 ","$1,827.50 ",$796.55 ,"$2,150.00 ","$1,720.00 ","$1,569.50 ",$349.28 ,$796.55 ,"$1,655.72 ","$2,150.00 ","$1,827.50 ","$1,792.24 ","$1,978.00 ","$1,505.00 ","$2,066.93 ","$2,150.00 ","$1,309.35 ","$2,150.00 ","$1,485.65 ","$1,505.00 ",$804.52 ,"$1,548.00 ",$370.24 ,"$2,150.00 ","$2,150.00 ",$796.55 ,"$2,150.00 ",$796.55 ,"$1,548.00 ","$1,333.00 ","$1,548.00 ","$1,548.00 ","$1,290.00 " ST VINCENT HOSPITAL - ACUTE,36000310,64421,HC INJ ANES INTERCOSTAL NERVE EA ADDNT LEVEL,360,1 ,"$1,000.00 ",$500.00 ,$349.28 ,"$2,778.48 ",$646.00 ,$349.28 ,"$1,000.00 ","$1,000.00 ",$796.55 ,$600.00 ,$850.00 ,$700.00 ,$349.28 ,$950.00 ,$720.00 ,$730.00 ,"$1,000.00 ",$850.00 ,$796.55 ,"$1,000.00 ",$800.00 ,$730.00 ,$349.28 ,$796.55 ,"$1,000.00 ","$1,000.00 ",$850.00 ,"$1,792.24 ",$920.00 ,$700.00 ,"$2,066.52 ","$2,778.48 ",$609.00 ,"$2,583.66 ",$691.00 ,$700.00 ,$804.52 ,$720.00 ,$370.24 ,"$1,000.00 ","$1,000.00 ",$796.55 ,"$1,000.00 ",$796.55 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,36000311,64420,HC INJ INTERCOSTAL NERVE;SINGLE,360,1 ,$745.00 ,$372.50 ,$121.61 ,"$1,382.85 ",$481.27 ,$121.61 ,$745.00 ,$745.00 ,$614.60 ,$447.00 ,$633.25 ,$521.50 ,$121.61 ,$707.75 ,$536.40 ,$543.85 ,$745.00 ,$633.25 ,$614.60 ,$745.00 ,$596.00 ,$543.85 ,$121.61 ,$614.60 ,$745.00 ,$745.00 ,$633.25 ,"$1,382.85 ",$685.40 ,$521.50 ,$745.00 ,$745.00 ,$453.71 ,$745.00 ,$514.80 ,$521.50 ,$620.75 ,$536.40 ,$128.91 ,$745.00 ,$745.00 ,$614.60 ,$745.00 ,$614.60 ,$536.40 ,$461.90 ,$536.40 ,$536.40 ,$447.00 ST VINCENT HOSPITAL - ACUTE,36000313,64493,HC INJ FACET LUMBO SACRAL;SINGLE,360,1 ,"$2,300.00 ","$1,150.00 ",$263.02 ,"$2,300.00 ","$1,485.80 ",$263.02 ,"$2,300.00 ","$2,020.00 ",$796.55 ,"$1,380.00 ","$1,955.00 ","$1,610.00 ",$263.02 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$2,300.00 ","$1,955.00 ",$796.55 ,"$2,300.00 ","$1,840.00 ","$1,679.00 ",$263.02 ,$796.55 ,"$1,655.72 ","$2,300.00 ","$1,955.00 ","$1,792.24 ","$2,116.00 ","$1,610.00 ","$2,066.93 ","$2,300.00 ","$1,400.70 ","$2,300.00 ","$1,589.30 ","$1,610.00 ",$804.52 ,"$1,656.00 ",$278.80 ,"$2,300.00 ","$2,300.00 ",$796.55 ,"$2,300.00 ",$796.55 ,"$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,36000314,64494,HC INJ FACET LUMBO/SACRAL;2ND LEVEL,360,1 ,$400.00 ,$200.00 ,$200.00 ,"$2,778.48 ",$258.40 ,$263.02 ,$400.00 ,$400.00 , N/A ,$240.00 ,$340.00 ,$280.00 ,$263.02 ,$380.00 ,$288.00 ,$292.00 ,$400.00 ,$340.00 , N/A ,$400.00 ,$320.00 ,$292.00 ,$263.02 , N/A ,$400.00 ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,"$2,066.52 ","$2,778.48 ",$243.60 ,"$2,583.66 ",$276.40 ,$280.00 , N/A ,$288.00 ,$278.80 ,$400.00 ,$400.00 , N/A ,$400.00 , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,36000315,64495,HC INJ FACET LUMBO/SACRAL;3RD LEVEL,360,1 ,$400.00 ,$200.00 ,$200.00 ,"$2,778.48 ",$258.40 ,$263.02 ,$400.00 ,$400.00 , N/A ,$240.00 ,$340.00 ,$280.00 ,$263.02 ,$380.00 ,$288.00 ,$292.00 ,$400.00 ,$340.00 , N/A ,$400.00 ,$320.00 ,$292.00 ,$263.02 , N/A ,$400.00 ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,"$2,066.52 ","$2,778.48 ",$243.60 ,"$2,583.66 ",$276.40 ,$280.00 , N/A ,$288.00 ,$278.80 ,$400.00 ,$400.00 , N/A ,$400.00 , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,36000316,64490,HC INJ FACET CER/THORACIC;SINGLE,360,1 ,"$2,300.00 ","$1,150.00 ",$263.02 ,"$2,300.00 ","$1,485.80 ",$263.02 ,"$2,300.00 ","$2,020.00 ",$796.55 ,"$1,380.00 ","$1,955.00 ","$1,610.00 ",$263.02 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$2,300.00 ","$1,955.00 ",$796.55 ,"$2,300.00 ","$1,840.00 ","$1,679.00 ",$263.02 ,$796.55 ,"$1,655.72 ","$2,300.00 ","$1,955.00 ","$1,792.24 ","$2,116.00 ","$1,610.00 ","$2,066.93 ","$2,300.00 ","$1,400.70 ","$2,300.00 ","$1,589.30 ","$1,610.00 ",$804.52 ,"$1,656.00 ",$278.80 ,"$2,300.00 ","$2,300.00 ",$796.55 ,"$2,300.00 ",$796.55 ,"$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,36000317,64491,HC INJ FACET CER/THORACIC 2ND LEVEL,360,1 ,$400.00 ,$200.00 ,$200.00 ,"$2,778.48 ",$258.40 ,$263.02 ,$400.00 ,$400.00 , N/A ,$240.00 ,$340.00 ,$280.00 ,$263.02 ,$380.00 ,$288.00 ,$292.00 ,$400.00 ,$340.00 , N/A ,$400.00 ,$320.00 ,$292.00 ,$263.02 , N/A ,$400.00 ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,"$2,066.52 ","$2,778.48 ",$243.60 ,"$2,583.66 ",$276.40 ,$280.00 , N/A ,$288.00 ,$278.80 ,$400.00 ,$400.00 , N/A ,$400.00 , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,36000318,64492,HC INJ FACET CER/THORACIC 3RD LEVEL,360,1 ,$400.00 ,$200.00 ,$200.00 ,"$2,778.48 ",$258.40 ,$263.02 ,$400.00 ,$400.00 , N/A ,$240.00 ,$340.00 ,$280.00 ,$263.02 ,$380.00 ,$288.00 ,$292.00 ,$400.00 ,$340.00 , N/A ,$400.00 ,$320.00 ,$292.00 ,$263.02 , N/A ,$400.00 ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,"$2,066.52 ","$2,778.48 ",$243.60 ,"$2,583.66 ",$276.40 ,$280.00 , N/A ,$288.00 ,$278.80 ,$400.00 ,$400.00 , N/A ,$400.00 , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,36000322,64479,HC INJ TRANSF CERV/THORACIC SINGLE,360,1 ,"$1,430.00 ",$715.00 ,$263.02 ,"$1,792.24 ",$923.78 ,$263.02 ,"$1,430.00 ","$1,430.00 ",$796.55 ,$858.00 ,"$1,215.50 ","$1,001.00 ",$263.02 ,"$1,358.50 ","$1,029.60 ","$1,043.90 ","$1,430.00 ","$1,215.50 ",$796.55 ,"$1,430.00 ","$1,144.00 ","$1,043.90 ",$263.02 ,$796.55 ,"$1,430.00 ","$1,430.00 ","$1,215.50 ","$1,792.24 ","$1,315.60 ","$1,001.00 ","$1,430.00 ","$1,430.00 ",$870.87 ,"$1,430.00 ",$988.13 ,"$1,001.00 ",$804.52 ,"$1,029.60 ",$278.80 ,"$1,430.00 ","$1,430.00 ",$796.55 ,"$1,430.00 ",$796.55 ,"$1,029.60 ",$886.60 ,"$1,029.60 ","$1,029.60 ",$858.00 ST VINCENT HOSPITAL - ACUTE,36000323,64480,HC INJ TRANSF CERV/THORACIC ADDL,360,1 ,$730.00 ,$365.00 ,$263.02 ,"$2,778.48 ",$471.58 ,$263.02 ,$730.00 ,$730.00 , N/A ,$438.00 ,$620.50 ,$511.00 ,$263.02 ,$693.50 ,$525.60 ,$532.90 ,$730.00 ,$620.50 , N/A ,$730.00 ,$584.00 ,$532.90 ,$263.02 , N/A ,$730.00 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,"$2,066.52 ","$2,778.48 ",$444.57 ,"$2,583.66 ",$504.43 ,$511.00 , N/A ,$525.60 ,$278.80 ,$730.00 ,$730.00 , N/A ,$730.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,36000324,64483,HC INJ TRANSF LUMBAR SACRAL SINGLE,360,1 ,"$1,800.00 ",$900.00 ,$263.02 ,"$1,800.00 ","$1,162.80 ",$263.02 ,"$1,800.00 ","$1,800.00 ",$796.55 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$263.02 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ",$796.55 ,"$1,800.00 ","$1,440.00 ","$1,314.00 ",$263.02 ,$796.55 ,"$1,655.72 ","$1,800.00 ","$1,530.00 ","$1,792.24 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ",$804.52 ,"$1,296.00 ",$278.80 ,"$1,800.00 ","$1,800.00 ",$796.55 ,"$1,800.00 ",$796.55 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36000325,64484,HC INJ TRANSF LUMBAR SACRAL ADDL,360,1 ,$730.00 ,$365.00 ,$263.02 ,"$2,778.48 ",$471.58 ,$263.02 ,$730.00 ,$730.00 , N/A ,$438.00 ,$620.50 ,$511.00 ,$263.02 ,$693.50 ,$525.60 ,$532.90 ,$730.00 ,$620.50 , N/A ,$730.00 ,$584.00 ,$532.90 ,$263.02 , N/A ,$730.00 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,"$2,066.52 ","$2,778.48 ",$444.57 ,"$2,583.66 ",$504.43 ,$511.00 , N/A ,$525.60 ,$278.80 ,$730.00 ,$730.00 , N/A ,$730.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,36000326,64405,HC NERVE BLOCK; OCCIPITAL,360,1 ,$930.00 ,$465.00 ,$121.61 ,$930.00 ,$600.78 ,$121.61 ,$930.00 ,$930.00 ,$252.94 ,$558.00 ,$790.50 ,$651.00 ,$121.61 ,$883.50 ,$669.60 ,$678.90 ,$930.00 ,$790.50 ,$252.94 ,$930.00 ,$744.00 ,$678.90 ,$121.61 ,$252.94 ,$930.00 ,$930.00 ,$790.50 ,$569.12 ,$855.60 ,$651.00 ,$930.00 ,$930.00 ,$566.37 ,$930.00 ,$642.63 ,$651.00 ,$255.47 ,$669.60 ,$128.91 ,$930.00 ,$930.00 ,$252.94 ,$930.00 ,$252.94 ,$669.60 ,$576.60 ,$669.60 ,$669.60 ,$558.00 ST VINCENT HOSPITAL - ACUTE,36000339,64461,HC PARAVERTEBRAL PARASPINE BLOCK THORACIC SINGLE,360,1 ,$770.00 ,$385.00 ,$263.02 ,"$1,382.85 ",$497.42 ,$263.02 ,$770.00 ,$770.00 ,$614.60 ,$462.00 ,$654.50 ,$539.00 ,$263.02 ,$731.50 ,$554.40 ,$562.10 ,$770.00 ,$654.50 ,$614.60 ,$770.00 ,$616.00 ,$562.10 ,$263.02 ,$614.60 ,$770.00 ,$770.00 ,$654.50 ,"$1,382.85 ",$708.40 ,$539.00 ,$770.00 ,$770.00 ,$468.93 ,$770.00 ,$532.07 ,$539.00 ,$620.75 ,$554.40 ,$278.80 ,$770.00 ,$770.00 ,$614.60 ,$770.00 ,$614.60 ,$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,36000340,64462,HC PARAVERTEBRAL PARASPINE BLOCK THORACIC 2ND AND ADDN ADD ON,360,1 ,$200.00 ,$100.00 ,$100.00 ,"$2,778.48 ",$129.20 ,$200.00 ,$200.00 ,$200.00 , N/A ,$120.00 ,$170.00 ,$140.00 ,$263.02 ,$190.00 ,$144.00 ,$146.00 ,$200.00 ,$170.00 , N/A ,$200.00 ,$160.00 ,$146.00 ,$263.02 , N/A ,$200.00 ,$200.00 ,$170.00 , N/A ,$184.00 ,$140.00 ,"$2,066.52 ","$2,778.48 ",$121.80 ,"$2,583.66 ",$138.20 ,$140.00 , N/A ,$144.00 ,$278.80 ,$200.00 ,$200.00 , N/A ,$200.00 , N/A ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,36000341,64463,HC PARAVERTEBRAL PARASPINE BLOCK THORACIC CATH CONTINUOUS,360,1 ,$735.00 ,$367.50 ,$263.02 ,"$1,382.85 ",$474.81 ,$263.02 ,$735.00 ,$735.00 ,$614.60 ,$441.00 ,$624.75 ,$514.50 ,$263.02 ,$698.25 ,$529.20 ,$536.55 ,$735.00 ,$624.75 ,$614.60 ,$735.00 ,$588.00 ,$536.55 ,$263.02 ,$614.60 ,$735.00 ,$735.00 ,$624.75 ,"$1,382.85 ",$676.20 ,$514.50 ,$735.00 ,$735.00 ,$447.62 ,$735.00 ,$507.89 ,$514.50 ,$620.75 ,$529.20 ,$278.80 ,$735.00 ,$735.00 ,$614.60 ,$735.00 ,$614.60 ,$529.20 ,$455.70 ,$529.20 ,$529.20 ,$441.00 ST VINCENT HOSPITAL - ACUTE,36000352,37192,HC IVC FILTER REPOSITIONING 37192,360,1 ,"$5,760.00 ","$2,880.00 ","$1,095.68 ","$7,821.36 ","$3,720.96 ","$1,095.68 ","$5,760.00 ","$5,760.00 ","$2,771.52 ","$3,456.00 ","$4,896.00 ","$4,032.00 ","$1,095.68 ","$5,472.00 ","$4,147.20 ","$4,204.80 ","$5,760.00 ","$4,896.00 ","$2,771.52 ","$5,760.00 ","$4,608.00 ","$4,204.80 ","$1,095.68 ","$2,771.52 ","$5,519.06 ","$5,760.00 ","$4,896.00 ","$6,235.91 ","$5,299.20 ","$4,032.00 ","$5,818.90 ","$7,821.36 ","$3,507.84 ","$7,273.62 ","$3,980.16 ","$4,032.00 ","$2,799.24 ","$4,147.20 ","$1,161.42 ","$5,760.00 ","$5,760.00 ","$2,771.52 ","$5,760.00 ","$2,771.52 ","$4,147.20 ","$3,571.20 ","$4,147.20 ","$4,147.20 ","$3,456.00 " ST VINCENT HOSPITAL - ACUTE,36000353,36821,HC AV ANASTOMOSIS OPEN DIRECT,360,1 ,"$7,875.00 ","$3,937.50 ","$1,070.58 ","$7,875.00 ","$5,087.25 ","$1,070.58 ","$7,070.00 ","$6,565.00 ","$2,771.52 ","$4,725.00 ","$6,693.75 ","$5,512.50 ","$1,070.58 ","$7,481.25 ","$5,670.00 ","$5,748.75 ","$6,436.00 ","$6,693.75 ","$2,771.52 ","$6,436.00 ","$6,300.00 ","$5,748.75 ","$1,070.58 ","$2,771.52 ","$6,622.88 ","$7,875.00 ","$6,693.75 ","$6,235.91 ","$7,245.00 ","$5,512.50 ","$3,206.88 ","$4,310.52 ","$4,795.88 ","$4,008.60 ","$5,441.63 ","$5,512.50 ","$2,799.24 ","$5,670.00 ","$1,134.81 ","$6,668.00 ","$6,668.00 ","$2,771.52 ","$6,668.00 ","$2,771.52 ","$5,670.00 ","$4,882.50 ","$5,670.00 ","$5,670.00 ","$4,725.00 " ST VINCENT HOSPITAL - ACUTE,36000354,36830,HC AV FISTULA CREATION OTHER THAN DIRECT AV ANAST,360,1 ,"$9,370.00 ","$4,685.00 ","$1,070.58 ","$10,395.23 ","$6,053.02 ","$1,070.58 ","$9,370.00 ","$7,196.00 ","$4,620.10 ","$5,622.00 ","$7,964.50 ","$6,559.00 ","$1,070.58 ","$8,901.50 ","$6,746.40 ","$6,840.10 ","$9,370.00 ","$7,964.50 ","$4,620.10 ","$9,370.00 ","$7,496.00 ","$6,840.10 ","$1,070.58 ","$4,620.10 ","$6,622.88 ","$9,370.00 ","$7,964.50 ","$10,395.23 ","$8,620.40 ","$6,559.00 ","$3,819.70 ","$5,133.66 ","$5,706.33 ","$4,774.62 ","$6,474.67 ","$6,559.00 ","$4,666.30 ","$6,746.40 ","$1,134.81 ","$8,890.00 ","$8,890.00 ","$4,620.10 ","$8,890.00 ","$4,620.10 ","$6,746.40 ","$5,809.40 ","$6,746.40 ","$6,746.40 ","$5,622.00 " ST VINCENT HOSPITAL - ACUTE,36000355,36831,HC THROMBECTOMY OPEN AV FISTULA W/O REVISION,360,1 ,"$5,750.00 ","$2,875.00 ","$1,070.58 ","$10,395.23 ","$3,714.50 ","$1,070.58 ","$5,750.00 ","$5,750.00 ","$4,620.10 ","$3,450.00 ","$4,887.50 ","$4,025.00 ","$1,070.58 ","$5,462.50 ","$4,140.00 ","$4,197.50 ","$5,750.00 ","$4,887.50 ","$4,620.10 ","$5,750.00 ","$4,600.00 ","$4,197.50 ","$1,070.58 ","$4,620.10 ","$5,750.00 ","$5,750.00 ","$4,887.50 ","$10,395.23 ","$5,290.00 ","$4,025.00 ","$5,818.90 ","$7,821.36 ","$3,501.75 ","$7,273.62 ","$3,973.25 ","$4,025.00 ","$4,666.30 ","$4,140.00 ","$1,134.81 ","$5,750.00 ","$5,750.00 ","$4,620.10 ","$5,750.00 ","$4,620.10 ","$4,140.00 ","$3,565.00 ","$4,140.00 ","$4,140.00 ","$3,450.00 " ST VINCENT HOSPITAL - ACUTE,36000356,36832,HC AV FISTULA REVISION OPEN W/O THROMBECTOMY,360,1 ,"$8,255.00 ","$4,127.50 ","$1,070.58 ","$10,395.23 ","$5,332.73 ","$1,070.58 ","$8,255.00 ","$7,196.00 ","$4,620.10 ","$4,953.00 ","$7,016.75 ","$5,778.50 ","$1,070.58 ","$7,842.25 ","$5,943.60 ","$6,026.15 ","$8,255.00 ","$7,016.75 ","$4,620.10 ","$8,255.00 ","$6,604.00 ","$6,026.15 ","$1,070.58 ","$4,620.10 ","$6,622.88 ","$8,255.00 ","$7,016.75 ","$10,395.23 ","$7,594.60 ","$5,778.50 ","$3,819.70 ","$5,133.66 ","$5,027.30 ","$4,774.62 ","$5,704.21 ","$5,778.50 ","$4,666.30 ","$5,943.60 ","$1,134.81 ","$8,255.00 ","$8,255.00 ","$4,620.10 ","$8,255.00 ","$4,620.10 ","$5,943.60 ","$5,118.10 ","$5,943.60 ","$5,943.60 ","$4,953.00 " ST VINCENT HOSPITAL - ACUTE,36000357,36833,HC AV FISTULA OPEN WITH THROMBECTOMY,360,1 ,"$8,605.00 ","$4,302.50 ","$1,070.58 ","$10,395.23 ","$5,558.83 ","$1,070.58 ","$8,605.00 ","$7,196.00 ","$4,620.10 ","$5,163.00 ","$7,314.25 ","$6,023.50 ","$1,070.58 ","$8,174.75 ","$6,195.60 ","$6,281.65 ","$8,605.00 ","$7,314.25 ","$4,620.10 ","$8,605.00 ","$6,884.00 ","$6,281.65 ","$1,070.58 ","$4,620.10 ","$6,622.88 ","$8,605.00 ","$7,314.25 ","$10,395.23 ","$7,916.60 ","$6,023.50 ","$5,818.90 ","$7,821.36 ","$5,240.45 ","$7,273.62 ","$5,946.06 ","$6,023.50 ","$4,666.30 ","$6,195.60 ","$1,134.81 ","$8,605.00 ","$8,605.00 ","$4,620.10 ","$8,605.00 ","$4,620.10 ","$6,195.60 ","$5,335.10 ","$6,195.60 ","$6,195.60 ","$5,163.00 " ST VINCENT HOSPITAL - ACUTE,36000358,0345T,HC RPR TRNSCTH MITRAL VLV CORSINU,360,1 ,"$19,355.00 ","$9,677.50 ","$3,617.00 ","$19,355.00 ","$12,503.33 ", N/A ,"$18,180.00 ","$11,363.00 ", N/A ,"$11,613.00 ","$16,451.75 ","$13,548.50 ", N/A ,"$18,387.25 ","$13,935.60 ","$14,129.15 ","$6,750.00 ","$16,451.75 ", N/A ,"$6,750.00 ","$15,484.00 ","$14,129.15 ", N/A , N/A ,"$18,533.02 ","$19,355.00 ","$16,451.75 ", N/A ,"$17,806.60 ","$13,548.50 ","$9,677.50 ","$11,613.00 ","$11,787.20 ","$9,677.50 ","$13,374.31 ","$13,548.50 ", N/A ,"$13,935.60 ", N/A ,"$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$13,935.60 ","$12,000.10 ","$13,935.60 ","$13,935.60 ","$11,613.00 " ST VINCENT HOSPITAL - ACUTE,36000359,33880,HC ENDOVASC REPAIR TAA W/LT SUBCLVN ARTERY,360,1 ,"$23,000.00 ","$11,500.00 ","$3,617.00 ","$23,000.00 ","$14,858.00 ","$5,730.92 ","$18,180.00 ","$11,363.00 ", N/A ,"$13,800.00 ","$19,550.00 ","$16,100.00 ","$5,730.92 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ", N/A ,"$6,750.00 ","$18,400.00 ","$16,790.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$23,000.00 ","$19,550.00 ", N/A ,"$21,160.00 ","$16,100.00 ","$5,818.90 ","$7,821.36 ","$14,007.00 ","$7,273.62 ","$15,893.00 ","$16,100.00 ", N/A ,"$16,560.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,36000360,33881,HC ENDOVASC REPAIR TAA W/O LT SUBCLVN ARTERY,360,1 ,"$23,000.00 ","$11,500.00 ","$3,617.00 ","$23,000.00 ","$14,858.00 ","$5,730.92 ","$18,180.00 ","$11,363.00 ", N/A ,"$13,800.00 ","$19,550.00 ","$16,100.00 ","$5,730.92 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ", N/A ,"$6,750.00 ","$18,400.00 ","$16,790.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$23,000.00 ","$19,550.00 ", N/A ,"$21,160.00 ","$16,100.00 ","$5,818.90 ","$7,821.36 ","$14,007.00 ","$7,273.62 ","$15,893.00 ","$16,100.00 ", N/A ,"$16,560.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,36000361,33883,HC PLACE ENDOVASC PROSTHESIS PROXM EXT TAA INIT,360,1 ,"$3,300.00 ","$1,650.00 ","$1,650.00 ","$7,821.36 ","$2,131.80 ","$3,300.00 ","$3,300.00 ","$3,300.00 ", N/A ,"$1,980.00 ","$2,805.00 ","$2,310.00 ","$5,730.92 ","$3,135.00 ","$2,376.00 ","$2,409.00 ","$3,300.00 ","$2,805.00 ", N/A ,"$3,300.00 ","$2,640.00 ","$2,409.00 ","$5,730.92 ", N/A ,"$3,300.00 ","$3,300.00 ","$2,805.00 ", N/A ,"$3,036.00 ","$2,310.00 ","$5,818.90 ","$7,821.36 ","$2,009.70 ","$7,273.62 ","$2,280.30 ","$2,310.00 ", N/A ,"$2,376.00 ","$6,074.78 ","$3,300.00 ","$3,300.00 ", N/A ,"$3,300.00 ", N/A ,"$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,36000362,33884,HC PLACE ENDOVASC PROSTHESIS PROXM EXT TAA EA ADDL,360,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$7,821.36 ","$2,390.20 ","$3,700.00 ","$3,700.00 ","$3,700.00 ", N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ","$5,730.92 ","$3,515.00 ","$2,664.00 ","$2,701.00 ","$3,700.00 ","$3,145.00 ", N/A ,"$3,700.00 ","$2,960.00 ","$2,701.00 ","$5,730.92 ", N/A ,"$3,700.00 ","$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$5,819.10 ","$7,821.36 ","$2,253.30 ","$7,273.62 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,36000363,33886,HC PLACE PROSTHESIS DISTAL EXT POST ENDOVASC RPR,360,1 ,"$23,000.00 ","$11,500.00 ","$3,617.00 ","$23,000.00 ","$14,858.00 ","$5,730.92 ","$18,180.00 ","$11,363.00 ", N/A ,"$13,800.00 ","$19,550.00 ","$16,100.00 ","$5,730.92 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ", N/A ,"$6,750.00 ","$18,400.00 ","$16,790.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$23,000.00 ","$19,550.00 ", N/A ,"$21,160.00 ","$16,100.00 ","$5,818.90 ","$7,821.36 ","$14,007.00 ","$7,273.62 ","$15,893.00 ","$16,100.00 ", N/A ,"$16,560.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,36000368,34808,HC ENDOVASC PLACEMENT ILIAC ARTRY OCCLUSION DEVICE,360,1 ,$450.00 ,$225.00 ,$225.00 ,"$7,821.36 ",$290.70 ,$450.00 ,$450.00 ,$450.00 , N/A ,$270.00 ,$382.50 ,$315.00 ,"$5,730.92 ",$427.50 ,$324.00 ,$328.50 ,$450.00 ,$382.50 , N/A ,$450.00 ,$360.00 ,$328.50 ,"$5,730.92 ", N/A ,$450.00 ,$450.00 ,$382.50 , N/A ,$414.00 ,$315.00 ,"$5,819.10 ","$7,821.36 ",$274.05 ,"$7,273.62 ",$310.95 ,$315.00 , N/A ,$324.00 ,"$6,074.78 ",$450.00 ,$450.00 , N/A ,$450.00 , N/A ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,36000387,61623,HC ENDOVASC TEMP BALLOON ART OCCLUS HEAD/NECK,360,1 ,"$10,075.00 ","$5,037.50 ","$1,802.28 ","$21,884.82 ","$6,508.45 ","$1,802.28 ","$10,075.00 ","$10,075.00 ","$9,726.59 ","$6,045.00 ","$8,563.75 ","$7,052.50 ","$1,802.28 ","$9,571.25 ","$7,254.00 ","$7,354.75 ","$6,750.00 ","$8,563.75 ","$9,726.59 ","$6,750.00 ","$8,060.00 ","$7,354.75 ","$1,802.28 ","$9,726.59 ","$10,075.00 ","$10,075.00 ","$8,563.75 ","$21,884.82 ","$9,269.00 ","$7,052.50 ","$5,818.90 ","$7,821.36 ","$6,135.68 ","$7,273.62 ","$6,961.83 ","$7,052.50 ","$9,823.86 ","$7,254.00 ","$1,910.42 ","$10,075.00 ","$10,075.00 ","$9,726.59 ","$10,075.00 ","$9,726.59 ","$7,254.00 ","$6,246.50 ","$7,254.00 ","$7,254.00 ","$6,045.00 " ST VINCENT HOSPITAL - ACUTE,36000388,61630,HC ANGIOPLASTY BALLOON INTRACRANIAL PERC,360,1 ,"$5,600.00 ","$2,800.00 ","$1,802.28 ","$7,821.36 ","$3,617.60 ","$1,802.28 ","$5,600.00 ","$5,600.00 ", N/A ,"$3,360.00 ","$4,760.00 ","$3,920.00 ","$1,802.28 ","$5,320.00 ","$4,032.00 ","$4,088.00 ","$5,600.00 ","$4,760.00 ", N/A ,"$5,600.00 ","$4,480.00 ","$4,088.00 ","$1,802.28 ", N/A ,"$5,600.00 ","$5,600.00 ","$4,760.00 ", N/A ,"$5,152.00 ","$3,920.00 ","$5,818.90 ","$7,821.36 ","$3,410.40 ","$7,273.62 ","$3,869.60 ","$3,920.00 ", N/A ,"$4,032.00 ","$1,910.42 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$4,032.00 ","$3,472.00 ","$4,032.00 ","$4,032.00 ","$3,360.00 " ST VINCENT HOSPITAL - ACUTE,36000389,61635,HC PLACE STENT INTRACRAN/INTRAVASC,360,1 ,"$16,000.00 ","$8,000.00 ","$1,802.28 ","$16,000.00 ","$10,336.00 ","$1,802.28 ","$16,000.00 ","$11,110.00 ", N/A ,"$9,600.00 ","$13,600.00 ","$11,200.00 ","$1,802.28 ","$15,200.00 ","$11,520.00 ","$11,680.00 ","$6,750.00 ","$13,600.00 ", N/A ,"$6,750.00 ","$12,800.00 ","$11,680.00 ","$1,802.28 ", N/A ,"$16,000.00 ","$16,000.00 ","$13,600.00 ", N/A ,"$14,720.00 ","$11,200.00 ","$5,818.90 ","$7,821.36 ","$9,744.00 ","$7,273.62 ","$11,056.00 ","$11,200.00 ", N/A ,"$11,520.00 ","$1,910.42 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$11,520.00 ","$9,920.00 ","$11,520.00 ","$11,520.00 ","$9,600.00 " ST VINCENT HOSPITAL - ACUTE,36000393,61645,HC PERC ART THROMBECTOMY/INFUS W/GUID,360,1 ,"$15,000.00 ","$7,500.00 ","$3,338.02 ","$15,000.00 ","$9,690.00 ","$3,338.02 ","$15,000.00 ","$9,595.00 ", N/A ,"$9,000.00 ","$12,750.00 ","$10,500.00 ","$3,338.02 ","$14,250.00 ","$10,800.00 ","$10,950.00 ","$6,750.00 ","$12,750.00 ", N/A ,"$6,750.00 ","$12,000.00 ","$10,950.00 ","$3,338.02 ", N/A ,"$7,726.69 ","$15,000.00 ","$12,750.00 ", N/A ,"$13,800.00 ","$10,500.00 ","$5,818.90 ","$7,821.36 ","$9,135.00 ","$7,273.62 ","$10,365.00 ","$10,500.00 ", N/A ,"$10,800.00 ","$3,538.30 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$10,800.00 ","$9,300.00 ","$10,800.00 ","$10,800.00 ","$9,000.00 " ST VINCENT HOSPITAL - ACUTE,36000396,0076T,HC TRANSCATH XCRAN STENT PLACEMENT EA ADDL VSL,360,1 ,"$3,000.00 ","$1,500.00 ","$1,500.00 ","$7,821.36 ","$1,938.00 ","$3,000.00 ","$3,000.00 ","$3,000.00 ", N/A ,"$1,800.00 ","$2,550.00 ","$2,100.00 ","$3,338.02 ","$2,850.00 ","$2,160.00 ","$2,190.00 ","$3,000.00 ","$2,550.00 ", N/A ,"$3,000.00 ","$2,400.00 ","$2,190.00 ","$3,338.02 ", N/A ,"$3,000.00 ","$3,000.00 ","$2,550.00 ", N/A ,"$2,760.00 ","$2,100.00 ","$5,819.10 ","$7,821.36 ","$1,827.00 ","$7,273.62 ","$2,073.00 ","$2,100.00 ", N/A ,"$2,160.00 ","$3,538.30 ","$3,000.00 ","$3,000.00 ", N/A ,"$3,000.00 ", N/A ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,36000440,31622,HC BRONCHOSCOPY DIAG W/W/O WASHING,360,1 ,"$2,900.00 ","$1,450.00 ",$468.79 ,"$3,260.82 ","$1,873.40 ",$468.79 ,"$2,900.00 ","$2,900.00 ","$1,449.25 ","$1,740.00 ","$2,465.00 ","$2,030.00 ",$468.79 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ","$2,717.00 ","$2,465.00 ","$1,449.25 ","$2,717.00 ","$2,320.00 ","$2,117.00 ",$468.79 ,"$1,449.25 ","$2,428.39 ","$2,900.00 ","$2,465.00 ","$3,260.82 ","$2,668.00 ","$2,030.00 ","$2,066.93 ","$2,778.48 ","$1,766.10 ","$2,583.66 ","$2,003.90 ","$2,030.00 ","$1,463.74 ","$2,088.00 ",$496.92 ,"$2,900.00 ","$2,900.00 ","$1,449.25 ","$2,900.00 ","$1,449.25 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,36000498,N/A,HC BOWEL RESECTION,360,1 ,"$3,595.00 ","$1,797.50 ","$1,797.50 ","$3,595.00 ","$2,322.37 ", N/A , N/A , N/A , N/A ,"$2,157.00 ","$3,055.75 ","$2,516.50 ", N/A ,"$3,415.25 ","$2,588.40 ","$2,624.35 ", N/A ,"$3,055.75 ", N/A , N/A ,"$2,876.00 ","$2,624.35 ", N/A , N/A , N/A ,"$3,595.00 ","$3,055.75 ", N/A ,"$3,307.40 ","$2,516.50 ","$1,797.50 ","$2,157.00 ","$2,189.36 ","$1,797.50 ","$2,484.15 ","$2,516.50 ", N/A ,"$2,588.40 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,588.40 ","$2,228.90 ","$2,588.40 ","$2,588.40 ","$2,157.00 " ST VINCENT HOSPITAL - ACUTE,36000568,15860,HC IV INJ AGENT TEST VASCULAR FLOW FLAP/GRAFT,761,1 ,$180.00 ,$90.00 ,$75.60 ,$588.84 ,$116.28 ,$86.58 ,$180.00 ,$180.00 ,$261.71 ,$108.00 ,$153.00 ,$126.00 ,$86.58 ,$171.00 ,$129.60 ,$131.40 ,$180.00 ,$153.00 ,$261.71 ,$180.00 ,$144.00 ,$131.40 ,$86.58 ,$261.71 ,$75.60 ,$180.00 ,$153.00 ,$588.84 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$264.33 ,$129.60 ,$91.77 ,$108.00 ,$108.00 ,$261.71 ,$108.00 ,$261.71 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,36000569,64486,HC TAP BLOCK W/INJ UNILT,360,1 ,$880.00 ,$440.00 ,$121.61 ,$880.00 ,$568.48 ,$121.61 ,$880.00 ,$880.00 , N/A ,$528.00 ,$748.00 ,$616.00 ,$121.61 ,$836.00 ,$633.60 ,$642.40 ,$880.00 ,$748.00 , N/A ,$880.00 ,$704.00 ,$642.40 ,$121.61 , N/A ,$880.00 ,$880.00 ,$748.00 , N/A ,$809.60 ,$616.00 ,$880.00 ,$880.00 ,$535.92 ,$880.00 ,$608.08 ,$616.00 , N/A ,$633.60 ,$128.91 ,$880.00 ,$880.00 , N/A ,$880.00 , N/A ,$633.60 ,$545.60 ,$633.60 ,$633.60 ,$528.00 ST VINCENT HOSPITAL - ACUTE,36000609,34813,HC PLACE FEMORAL ENDOVASC GRAFT,360,1 ,"$16,000.00 ","$8,000.00 ","$2,717.00 ","$16,000.00 ","$10,336.00 ","$5,730.92 ","$7,070.00 ","$6,565.00 ", N/A ,"$9,600.00 ","$13,600.00 ","$11,200.00 ","$5,730.92 ","$15,200.00 ","$11,520.00 ","$11,680.00 ","$2,717.00 ","$13,600.00 ", N/A ,"$2,717.00 ","$12,800.00 ","$11,680.00 ","$5,730.92 ", N/A ,"$15,447.86 ","$16,000.00 ","$13,600.00 ", N/A ,"$14,720.00 ","$11,200.00 ","$5,819.10 ","$7,821.36 ","$9,744.00 ","$7,273.62 ","$11,056.00 ","$11,200.00 ", N/A ,"$11,520.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$11,520.00 ","$9,920.00 ","$11,520.00 ","$11,520.00 ","$9,600.00 " ST VINCENT HOSPITAL - ACUTE,36000611,34841,HC RPR ENDOVASC VISCERAL AORTA 1ST GRAFT,360,1 ,"$32,000.00 ","$16,000.00 ","$3,617.00 ","$32,000.00 ","$20,672.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$19,200.00 ","$27,200.00 ","$22,400.00 ","$5,730.92 ","$30,400.00 ","$23,040.00 ","$23,360.00 ","$6,750.00 ","$27,200.00 ", N/A ,"$6,750.00 ","$25,600.00 ","$23,360.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$32,000.00 ","$27,200.00 ", N/A ,"$29,440.00 ","$22,400.00 ","$5,818.90 ","$7,821.36 ","$19,488.00 ","$7,273.62 ","$22,112.00 ","$22,400.00 ", N/A ,"$23,040.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$23,040.00 ","$19,840.00 ","$23,040.00 ","$23,040.00 ","$19,200.00 " ST VINCENT HOSPITAL - ACUTE,36000612,34842,HC RPR ENDOVASC VISCERAL AORTA 2ND GRAFT,360,1 ,"$35,000.00 ","$17,500.00 ","$3,617.00 ","$35,000.00 ","$22,610.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$21,000.00 ","$29,750.00 ","$24,500.00 ","$5,730.92 ","$33,250.00 ","$25,200.00 ","$25,550.00 ","$6,750.00 ","$29,750.00 ", N/A ,"$6,750.00 ","$28,000.00 ","$25,550.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$35,000.00 ","$29,750.00 ", N/A ,"$32,200.00 ","$24,500.00 ","$5,818.90 ","$7,821.36 ","$21,315.00 ","$7,273.62 ","$24,185.00 ","$24,500.00 ", N/A ,"$25,200.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$25,200.00 ","$21,700.00 ","$25,200.00 ","$25,200.00 ","$21,000.00 " ST VINCENT HOSPITAL - ACUTE,36000613,34843,HC RPR ENDOVASC VISCERAL AORTA 3RD GRAFT,360,1 ,"$38,000.00 ","$19,000.00 ","$3,617.00 ","$38,000.00 ","$24,548.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$22,800.00 ","$32,300.00 ","$26,600.00 ","$5,730.92 ","$36,100.00 ","$27,360.00 ","$27,740.00 ","$6,750.00 ","$32,300.00 ", N/A ,"$6,750.00 ","$30,400.00 ","$27,740.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$38,000.00 ","$32,300.00 ", N/A ,"$34,960.00 ","$26,600.00 ","$5,818.90 ","$7,821.36 ","$23,142.00 ","$7,273.62 ","$26,258.00 ","$26,600.00 ", N/A ,"$27,360.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$27,360.00 ","$23,560.00 ","$27,360.00 ","$27,360.00 ","$22,800.00 " ST VINCENT HOSPITAL - ACUTE,36000614,34844,HC RPR ENDOVASC VISCERAL AORTA >4 GRAFTS,360,1 ,"$41,000.00 ","$20,500.00 ","$3,617.00 ","$41,000.00 ","$26,486.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$24,600.00 ","$34,850.00 ","$28,700.00 ","$5,730.92 ","$38,950.00 ","$29,520.00 ","$29,930.00 ","$6,750.00 ","$34,850.00 ", N/A ,"$6,750.00 ","$32,800.00 ","$29,930.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$41,000.00 ","$34,850.00 ", N/A ,"$37,720.00 ","$28,700.00 ","$5,818.90 ","$7,821.36 ","$24,969.00 ","$7,273.62 ","$28,331.00 ","$28,700.00 ", N/A ,"$29,520.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$29,520.00 ","$25,420.00 ","$29,520.00 ","$29,520.00 ","$24,600.00 " ST VINCENT HOSPITAL - ACUTE,36000615,34845,HC RPR ENDOVASC VISCERAL /INFRARENAL AORTA 1ST GRAFT,360,1 ,"$32,000.00 ","$16,000.00 ","$3,617.00 ","$32,000.00 ","$20,672.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$19,200.00 ","$27,200.00 ","$22,400.00 ","$5,730.92 ","$30,400.00 ","$23,040.00 ","$23,360.00 ","$6,750.00 ","$27,200.00 ", N/A ,"$6,750.00 ","$25,600.00 ","$23,360.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$32,000.00 ","$27,200.00 ", N/A ,"$29,440.00 ","$22,400.00 ","$5,818.90 ","$7,821.36 ","$19,488.00 ","$7,273.62 ","$22,112.00 ","$22,400.00 ", N/A ,"$23,040.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$23,040.00 ","$19,840.00 ","$23,040.00 ","$23,040.00 ","$19,200.00 " ST VINCENT HOSPITAL - ACUTE,36000616,34846,HC RPR ENDOVASC VISCERAL /INFRARENAL AORTA 2ND GRAFT,360,1 ,"$35,000.00 ","$17,500.00 ","$3,617.00 ","$35,000.00 ","$22,610.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$21,000.00 ","$29,750.00 ","$24,500.00 ","$5,730.92 ","$33,250.00 ","$25,200.00 ","$25,550.00 ","$6,750.00 ","$29,750.00 ", N/A ,"$6,750.00 ","$28,000.00 ","$25,550.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$35,000.00 ","$29,750.00 ", N/A ,"$32,200.00 ","$24,500.00 ","$5,818.90 ","$7,821.36 ","$21,315.00 ","$7,273.62 ","$24,185.00 ","$24,500.00 ", N/A ,"$25,200.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$25,200.00 ","$21,700.00 ","$25,200.00 ","$25,200.00 ","$21,000.00 " ST VINCENT HOSPITAL - ACUTE,36000617,34847,HC RPR ENDOVASC VISCERAL /INFRARENAL AORTA 3RD GRAFT,360,1 ,"$38,000.00 ","$19,000.00 ","$3,617.00 ","$38,000.00 ","$24,548.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$22,800.00 ","$32,300.00 ","$26,600.00 ","$5,730.92 ","$36,100.00 ","$27,360.00 ","$27,740.00 ","$6,750.00 ","$32,300.00 ", N/A ,"$6,750.00 ","$30,400.00 ","$27,740.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$38,000.00 ","$32,300.00 ", N/A ,"$34,960.00 ","$26,600.00 ","$5,818.90 ","$7,821.36 ","$23,142.00 ","$7,273.62 ","$26,258.00 ","$26,600.00 ", N/A ,"$27,360.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$27,360.00 ","$23,560.00 ","$27,360.00 ","$27,360.00 ","$22,800.00 " ST VINCENT HOSPITAL - ACUTE,36000618,34848,HC RPR ENDOVASC VISCERAL /INFRARENAL AORTA >4 GRAFTS,360,1 ,"$41,000.00 ","$20,500.00 ","$3,617.00 ","$41,000.00 ","$26,486.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$24,600.00 ","$34,850.00 ","$28,700.00 ","$5,730.92 ","$38,950.00 ","$29,520.00 ","$29,930.00 ","$6,750.00 ","$34,850.00 ", N/A ,"$6,750.00 ","$32,800.00 ","$29,930.00 ","$5,730.92 ", N/A ,"$18,533.02 ","$41,000.00 ","$34,850.00 ", N/A ,"$37,720.00 ","$28,700.00 ","$5,818.90 ","$7,821.36 ","$24,969.00 ","$7,273.62 ","$28,331.00 ","$28,700.00 ", N/A ,"$29,520.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$29,520.00 ","$25,420.00 ","$29,520.00 ","$29,520.00 ","$24,600.00 " ST VINCENT HOSPITAL - ACUTE,36000656,36660,HC CATHERIZATION UMBILICAL ARTERY NEWBORN,360,1 ,$140.00 ,$70.00 ,$17.61 ,$140.00 ,$90.44 ,$17.61 ,$140.00 ,$140.00 , N/A ,$84.00 ,$119.00 ,$98.00 ,$17.61 ,$133.00 ,$100.80 ,$102.20 ,$140.00 ,$119.00 , N/A ,$140.00 ,$112.00 ,$102.20 ,$17.61 , N/A ,$140.00 ,$140.00 ,$119.00 , N/A ,$128.80 ,$98.00 , N/A , N/A ,$85.26 , N/A ,$96.74 ,$98.00 , N/A ,$100.80 ,$18.67 ,$140.00 ,$140.00 , N/A ,$140.00 , N/A ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,36000690,34701,HC ENDOVASC RPR AORTA GRAFT OTHER THAN RUPTURE,360,1 ,"$23,000.00 ","$11,500.00 ","$3,617.00 ","$23,000.00 ","$14,858.00 ","$5,730.92 ","$18,180.00 ","$11,363.00 ", N/A ,"$13,800.00 ","$19,550.00 ","$16,100.00 ","$5,730.92 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ", N/A ,"$6,750.00 ","$18,400.00 ","$16,790.00 ","$5,730.92 ", N/A ,"$15,447.86 ","$23,000.00 ","$19,550.00 ", N/A ,"$21,160.00 ","$16,100.00 ","$11,500.00 ","$13,800.00 ","$14,007.00 ","$11,500.00 ","$15,893.00 ","$16,100.00 ", N/A ,"$16,560.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,36000691,34702,HC ENDOVASC RPR AORTA GRAFT W/RUPTURE,360,1 ,"$32,000.00 ","$16,000.00 ","$3,617.00 ","$32,000.00 ","$20,672.00 ","$5,730.92 ","$18,180.00 ","$11,363.00 ", N/A ,"$19,200.00 ","$27,200.00 ","$22,400.00 ","$5,730.92 ","$30,400.00 ","$23,040.00 ","$23,360.00 ","$6,750.00 ","$27,200.00 ", N/A ,"$6,750.00 ","$25,600.00 ","$23,360.00 ","$5,730.92 ", N/A ,"$15,447.86 ","$32,000.00 ","$27,200.00 ", N/A ,"$29,440.00 ","$22,400.00 ","$16,000.00 ","$19,200.00 ","$19,488.00 ","$16,000.00 ","$22,112.00 ","$22,400.00 ", N/A ,"$23,040.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$23,040.00 ","$19,840.00 ","$23,040.00 ","$23,040.00 ","$19,200.00 " ST VINCENT HOSPITAL - ACUTE,36000692,34703,HC ENDOVASC RPR AORTA-UNILAC GRAFT OTHER THAN RUPTURE,360,1 ,"$23,000.00 ","$11,500.00 ","$3,617.00 ","$23,000.00 ","$14,858.00 ","$5,730.92 ","$18,180.00 ","$11,363.00 ", N/A ,"$13,800.00 ","$19,550.00 ","$16,100.00 ","$5,730.92 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ", N/A ,"$6,750.00 ","$18,400.00 ","$16,790.00 ","$5,730.92 ", N/A ,"$15,447.86 ","$23,000.00 ","$19,550.00 ", N/A ,"$21,160.00 ","$16,100.00 ","$11,500.00 ","$13,800.00 ","$14,007.00 ","$11,500.00 ","$15,893.00 ","$16,100.00 ", N/A ,"$16,560.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,36000693,34704,HC ENDOVASC RPR AORTA-UNILAC GRAFT W/RUPTURE,360,1 ,"$32,000.00 ","$16,000.00 ","$3,617.00 ","$32,000.00 ","$20,672.00 ","$5,730.92 ","$18,180.00 ","$11,363.00 ", N/A ,"$19,200.00 ","$27,200.00 ","$22,400.00 ","$5,730.92 ","$30,400.00 ","$23,040.00 ","$23,360.00 ","$6,750.00 ","$27,200.00 ", N/A ,"$6,750.00 ","$25,600.00 ","$23,360.00 ","$5,730.92 ", N/A ,"$15,447.86 ","$32,000.00 ","$27,200.00 ", N/A ,"$29,440.00 ","$22,400.00 ","$16,000.00 ","$19,200.00 ","$19,488.00 ","$16,000.00 ","$22,112.00 ","$22,400.00 ", N/A ,"$23,040.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$23,040.00 ","$19,840.00 ","$23,040.00 ","$23,040.00 ","$19,200.00 " ST VINCENT HOSPITAL - ACUTE,36000694,34705,HC ENDOVASC RPR AORTA-BILIAC GRAFT OTHER THAN RUPTURE,360,1 ,"$23,000.00 ","$11,500.00 ","$3,617.00 ","$23,000.00 ","$14,858.00 ","$5,730.92 ","$18,180.00 ","$11,363.00 ", N/A ,"$13,800.00 ","$19,550.00 ","$16,100.00 ","$5,730.92 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ", N/A ,"$6,750.00 ","$18,400.00 ","$16,790.00 ","$5,730.92 ", N/A ,"$15,447.86 ","$23,000.00 ","$19,550.00 ", N/A ,"$21,160.00 ","$16,100.00 ","$11,500.00 ","$13,800.00 ","$14,007.00 ","$11,500.00 ","$15,893.00 ","$16,100.00 ", N/A ,"$16,560.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,36000695,34706,HC ENDOVASC RPR AORTA-BILIAC GRAFT W/RUPTURE,360,1 ,"$32,000.00 ","$16,000.00 ","$3,617.00 ","$32,000.00 ","$20,672.00 ","$5,730.92 ","$18,180.00 ","$11,363.00 ", N/A ,"$19,200.00 ","$27,200.00 ","$22,400.00 ","$5,730.92 ","$30,400.00 ","$23,040.00 ","$23,360.00 ","$6,750.00 ","$27,200.00 ", N/A ,"$6,750.00 ","$25,600.00 ","$23,360.00 ","$5,730.92 ", N/A ,"$15,447.86 ","$32,000.00 ","$27,200.00 ", N/A ,"$29,440.00 ","$22,400.00 ","$16,000.00 ","$19,200.00 ","$19,488.00 ","$16,000.00 ","$22,112.00 ","$22,400.00 ", N/A ,"$23,040.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$23,040.00 ","$19,840.00 ","$23,040.00 ","$23,040.00 ","$19,200.00 " ST VINCENT HOSPITAL - ACUTE,36000696,34709,HC PLACE PROSTH ILIAC ARTERY PER VESSEL,360,1 ,"$3,300.00 ","$1,650.00 ","$1,650.00 ","$6,074.78 ","$2,131.80 ","$3,300.00 ","$3,300.00 ","$3,300.00 ", N/A ,"$1,980.00 ","$2,805.00 ","$2,310.00 ","$5,730.92 ","$3,135.00 ","$2,376.00 ","$2,409.00 ","$3,300.00 ","$2,805.00 ", N/A ,"$3,300.00 ","$2,640.00 ","$2,409.00 ","$5,730.92 ", N/A ,"$3,300.00 ","$3,300.00 ","$2,805.00 ", N/A ,"$3,036.00 ","$2,310.00 ","$1,650.00 ","$1,980.00 ","$2,009.70 ","$1,650.00 ","$2,280.30 ","$2,310.00 ", N/A ,"$2,376.00 ","$6,074.78 ","$3,300.00 ","$3,300.00 ", N/A ,"$3,300.00 ", N/A ,"$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,36000697,34710,HC PLACE PROSTH REPAIR ABDOM ARTERY INIT VESSEL,360,1 ,"$23,000.00 ","$11,500.00 ","$3,617.00 ","$23,000.00 ","$14,858.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$13,800.00 ","$19,550.00 ","$16,100.00 ","$5,730.92 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ", N/A ,"$6,750.00 ","$18,400.00 ","$16,790.00 ","$5,730.92 ", N/A ,"$7,726.69 ","$23,000.00 ","$19,550.00 ", N/A ,"$21,160.00 ","$16,100.00 ","$11,500.00 ","$13,800.00 ","$14,007.00 ","$11,500.00 ","$15,893.00 ","$16,100.00 ", N/A ,"$16,560.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,36000698,34711,HC PLACE PROSTH REPAIR ABDOM ARTERY EA ADDL VESSEL,360,1 ,"$3,300.00 ","$1,650.00 ","$1,650.00 ","$6,074.78 ","$2,131.80 ","$3,300.00 ","$3,300.00 ","$3,300.00 ", N/A ,"$1,980.00 ","$2,805.00 ","$2,310.00 ","$5,730.92 ","$3,135.00 ","$2,376.00 ","$2,409.00 ","$3,300.00 ","$2,805.00 ", N/A ,"$3,300.00 ","$2,640.00 ","$2,409.00 ","$5,730.92 ", N/A ,"$3,300.00 ","$3,300.00 ","$2,805.00 ", N/A ,"$3,036.00 ","$2,310.00 ","$1,650.00 ","$1,980.00 ","$2,009.70 ","$1,650.00 ","$2,280.30 ","$2,310.00 ", N/A ,"$2,376.00 ","$6,074.78 ","$3,300.00 ","$3,300.00 ", N/A ,"$3,300.00 ", N/A ,"$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,36000699,34707,HC ENDOVASC RPR ILIAC ARTERY OTHER THAN RUPTURE,360,1 ,"$23,000.00 ","$11,500.00 ","$3,617.00 ","$23,000.00 ","$14,858.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$13,800.00 ","$19,550.00 ","$16,100.00 ","$5,730.92 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ", N/A ,"$6,750.00 ","$18,400.00 ","$16,790.00 ","$5,730.92 ", N/A ,"$7,726.69 ","$23,000.00 ","$19,550.00 ", N/A ,"$21,160.00 ","$16,100.00 ","$11,500.00 ","$13,800.00 ","$14,007.00 ","$11,500.00 ","$15,893.00 ","$16,100.00 ", N/A ,"$16,560.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,36000700,34708,HC ENDOVASC RPR ILIAC ARTERY W/RUPTURE,360,1 ,"$32,000.00 ","$16,000.00 ","$3,617.00 ","$32,000.00 ","$20,672.00 ","$5,730.92 ","$16,160.00 ","$9,595.00 ", N/A ,"$19,200.00 ","$27,200.00 ","$22,400.00 ","$5,730.92 ","$30,400.00 ","$23,040.00 ","$23,360.00 ","$6,750.00 ","$27,200.00 ", N/A ,"$6,750.00 ","$25,600.00 ","$23,360.00 ","$5,730.92 ", N/A ,"$7,726.69 ","$32,000.00 ","$27,200.00 ", N/A ,"$29,440.00 ","$22,400.00 ","$16,000.00 ","$19,200.00 ","$19,488.00 ","$16,000.00 ","$22,112.00 ","$22,400.00 ", N/A ,"$23,040.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$23,040.00 ","$19,840.00 ","$23,040.00 ","$23,040.00 ","$19,200.00 " ST VINCENT HOSPITAL - ACUTE,36000722,N/A,HC BRONCHOSCOPY W/DILATION/FX REDUCTION,360,1 ,"$3,200.00 ","$1,600.00 ","$1,600.00 ","$3,200.00 ","$2,067.20 ", N/A , N/A , N/A , N/A ,"$1,920.00 ","$2,720.00 ","$2,240.00 ", N/A ,"$3,040.00 ","$2,304.00 ","$2,336.00 ", N/A ,"$2,720.00 ", N/A , N/A ,"$2,560.00 ","$2,336.00 ", N/A , N/A , N/A ,"$3,200.00 ","$2,720.00 ", N/A ,"$2,944.00 ","$2,240.00 ","$1,600.00 ","$1,920.00 ","$1,948.80 ","$1,600.00 ","$2,211.20 ","$2,240.00 ", N/A ,"$2,304.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,36000723,34717,HC ENDOVASC REPAIR ARTERY ILIAC W/ENDOGRAFT,360,1 ,"$10,000.00 ","$5,000.00 ","$3,617.00 ","$10,000.00 ","$6,460.00 ","$5,730.92 ","$10,000.00 ","$10,000.00 ", N/A ,"$6,000.00 ","$8,500.00 ","$7,000.00 ","$5,730.92 ","$9,500.00 ","$7,200.00 ","$7,300.00 ","$6,750.00 ","$8,500.00 ", N/A ,"$6,750.00 ","$8,000.00 ","$7,300.00 ","$5,730.92 ", N/A ,"$10,000.00 ","$10,000.00 ","$8,500.00 ", N/A ,"$9,200.00 ","$7,000.00 ","$5,000.00 ","$6,000.00 ","$6,090.00 ","$5,000.00 ","$6,910.00 ","$7,000.00 ", N/A ,"$7,200.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,36000724,34718,HC ENDOVASC REPAIR ARTERY ILIAC W/O ENDOGRAFT,360,1 ,"$23,000.00 ","$11,500.00 ","$3,617.00 ","$23,000.00 ","$14,858.00 ","$5,730.92 ","$18,180.00 ","$11,363.00 ", N/A ,"$13,800.00 ","$19,550.00 ","$16,100.00 ","$5,730.92 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ", N/A ,"$6,750.00 ","$18,400.00 ","$16,790.00 ","$5,730.92 ", N/A ,"$15,447.86 ","$23,000.00 ","$19,550.00 ", N/A ,"$21,160.00 ","$16,100.00 ","$11,500.00 ","$13,800.00 ","$14,007.00 ","$11,500.00 ","$15,893.00 ","$16,100.00 ", N/A ,"$16,560.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,36000728,62160,HC NEUROENDOSCOPY INTRACRANIAL VENT CATHETER W/SHUNT,360,1 ,"$1,590.00 ",$795.00 ,$795.00 ,"$7,821.36 ","$1,027.14 ","$1,590.00 ","$1,590.00 ","$1,590.00 ", N/A ,$954.00 ,"$1,351.50 ","$1,113.00 ","$2,201.54 ","$1,510.50 ","$1,144.80 ","$1,160.70 ","$1,590.00 ","$1,351.50 ", N/A ,"$1,590.00 ","$1,272.00 ","$1,160.70 ","$2,201.54 ", N/A ,"$1,590.00 ","$1,590.00 ","$1,351.50 ", N/A ,"$1,462.80 ","$1,113.00 ","$5,819.10 ","$7,821.36 ",$968.31 ,"$7,273.62 ","$1,098.69 ","$1,113.00 ", N/A ,"$1,144.80 ","$2,333.63 ","$1,590.00 ","$1,590.00 ", N/A ,"$1,590.00 ", N/A ,"$1,144.80 ",$985.80 ,"$1,144.80 ","$1,144.80 ",$954.00 ST VINCENT HOSPITAL - ACUTE,36000729,31631,HC BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,360,1 ,"$6,200.00 ","$3,100.00 ","$1,009.08 ","$12,688.52 ","$4,005.20 ","$1,009.08 ","$6,200.00 ","$6,200.00 ","$5,639.34 ","$3,720.00 ","$5,270.00 ","$4,340.00 ","$1,009.08 ","$5,890.00 ","$4,464.00 ","$4,526.00 ","$4,459.00 ","$5,270.00 ","$5,639.34 ","$4,459.00 ","$4,960.00 ","$4,526.00 ","$1,009.08 ","$5,639.34 ","$6,200.00 ","$6,200.00 ","$5,270.00 ","$12,688.52 ","$5,704.00 ","$4,340.00 ","$2,331.31 ","$3,133.44 ","$3,775.80 ","$2,914.14 ","$4,284.20 ","$4,340.00 ","$5,695.73 ","$4,464.00 ","$1,069.62 ","$6,200.00 ","$6,200.00 ","$5,639.34 ","$6,200.00 ","$5,639.34 ","$4,464.00 ","$3,844.00 ","$4,464.00 ","$4,464.00 ","$3,720.00 " ST VINCENT HOSPITAL - ACUTE,36000730,31632,HC BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE ADDITIONAL,360,1 ,"$1,800.00 ",$900.00 ,$468.79 ,"$3,133.44 ","$1,162.80 ",$468.79 ,"$1,800.00 ","$1,800.00 ", N/A ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$468.79 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ", N/A ,"$1,800.00 ","$1,440.00 ","$1,314.00 ",$468.79 , N/A ,"$1,800.00 ","$1,800.00 ","$1,530.00 ", N/A ,"$1,656.00 ","$1,260.00 ","$2,331.72 ","$3,133.44 ","$1,096.20 ","$2,914.14 ","$1,243.80 ","$1,260.00 ", N/A ,"$1,296.00 ",$496.92 ,"$1,800.00 ","$1,800.00 ", N/A ,"$1,800.00 ", N/A ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36000731,31633,HC BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE ADDITIONAL,360,1 ,"$1,800.00 ",$900.00 ,$468.79 ,"$3,133.44 ","$1,162.80 ",$468.79 ,"$1,800.00 ","$1,800.00 ", N/A ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$468.79 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ", N/A ,"$1,800.00 ","$1,440.00 ","$1,314.00 ",$468.79 , N/A ,"$1,800.00 ","$1,800.00 ","$1,530.00 ", N/A ,"$1,656.00 ","$1,260.00 ","$2,331.72 ","$3,133.44 ","$1,096.20 ","$2,914.14 ","$1,243.80 ","$1,260.00 ", N/A ,"$1,296.00 ",$496.92 ,"$1,800.00 ","$1,800.00 ", N/A ,"$1,800.00 ", N/A ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36000732,31636,HC BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,360,1 ,"$6,200.00 ","$3,100.00 ","$1,009.08 ","$12,688.52 ","$4,005.20 ","$1,009.08 ","$6,200.00 ","$6,200.00 ","$5,639.34 ","$3,720.00 ","$5,270.00 ","$4,340.00 ","$1,009.08 ","$5,890.00 ","$4,464.00 ","$4,526.00 ","$4,459.00 ","$5,270.00 ","$5,639.34 ","$4,459.00 ","$4,960.00 ","$4,526.00 ","$1,009.08 ","$5,639.34 ","$6,200.00 ","$6,200.00 ","$5,270.00 ","$12,688.52 ","$5,704.00 ","$4,340.00 ","$2,331.31 ","$3,133.44 ","$3,775.80 ","$2,914.14 ","$4,284.20 ","$4,340.00 ","$5,695.73 ","$4,464.00 ","$1,069.62 ","$6,200.00 ","$6,200.00 ","$5,639.34 ","$6,200.00 ","$5,639.34 ","$4,464.00 ","$3,844.00 ","$4,464.00 ","$4,464.00 ","$3,720.00 " ST VINCENT HOSPITAL - ACUTE,36000733,31637,HC BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED ADDITIONAL,360,1 ,"$1,800.00 ",$900.00 ,$900.00 ,"$3,133.44 ","$1,162.80 ","$1,009.08 ","$1,800.00 ","$1,800.00 ", N/A ,"$1,080.00 ","$1,530.00 ","$1,260.00 ","$1,009.08 ","$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ", N/A ,"$1,800.00 ","$1,440.00 ","$1,314.00 ","$1,009.08 ", N/A ,"$1,800.00 ","$1,800.00 ","$1,530.00 ", N/A ,"$1,656.00 ","$1,260.00 ","$2,331.72 ","$3,133.44 ","$1,096.20 ","$2,914.14 ","$1,243.80 ","$1,260.00 ", N/A ,"$1,296.00 ","$1,069.62 ","$1,800.00 ","$1,800.00 ", N/A ,"$1,800.00 ", N/A ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36000734,31638,HC BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,360,1 ,"$6,200.00 ","$3,100.00 ","$1,009.08 ","$12,688.52 ","$4,005.20 ","$1,009.08 ","$6,200.00 ","$6,200.00 ","$5,639.34 ","$3,720.00 ","$5,270.00 ","$4,340.00 ","$1,009.08 ","$5,890.00 ","$4,464.00 ","$4,526.00 ","$4,459.00 ","$5,270.00 ","$5,639.34 ","$4,459.00 ","$4,960.00 ","$4,526.00 ","$1,009.08 ","$5,639.34 ","$6,200.00 ","$6,200.00 ","$5,270.00 ","$12,688.52 ","$5,704.00 ","$4,340.00 ","$2,331.31 ","$3,133.44 ","$3,775.80 ","$2,914.14 ","$4,284.20 ","$4,340.00 ","$5,695.73 ","$4,464.00 ","$1,069.62 ","$6,200.00 ","$6,200.00 ","$5,639.34 ","$6,200.00 ","$5,639.34 ","$4,464.00 ","$3,844.00 ","$4,464.00 ","$4,464.00 ","$3,720.00 " ST VINCENT HOSPITAL - ACUTE,36010026,N/A,HC CAPSULECTOMY,360,1 ,"$1,559.00 ",$779.50 ,$779.50 ,"$1,559.00 ","$1,007.11 ", N/A , N/A , N/A , N/A ,$935.40 ,"$1,325.15 ","$1,091.30 ", N/A ,"$1,481.05 ","$1,122.48 ","$1,138.07 ", N/A ,"$1,325.15 ", N/A , N/A ,"$1,247.20 ","$1,138.07 ", N/A , N/A , N/A ,"$1,559.00 ","$1,325.15 ", N/A ,"$1,434.28 ","$1,091.30 ",$779.50 ,$935.40 ,$949.43 ,$779.50 ,"$1,077.27 ","$1,091.30 ", N/A ,"$1,122.48 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,122.48 ",$966.58 ,"$1,122.48 ","$1,122.48 ",$935.40 ST VINCENT HOSPITAL - ACUTE,36010071,N/A,HC FASCIOTOMY,360,1 ,"$3,360.00 ","$1,680.00 ","$1,680.00 ","$3,360.00 ","$2,170.56 ", N/A , N/A , N/A , N/A ,"$2,016.00 ","$2,856.00 ","$2,352.00 ", N/A ,"$3,192.00 ","$2,419.20 ","$2,452.80 ", N/A ,"$2,856.00 ", N/A , N/A ,"$2,688.00 ","$2,452.80 ", N/A , N/A , N/A ,"$3,360.00 ","$2,856.00 ", N/A ,"$3,091.20 ","$2,352.00 ","$1,680.00 ","$2,016.00 ","$2,046.24 ","$1,680.00 ","$2,321.76 ","$2,352.00 ", N/A ,"$2,419.20 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,419.20 ","$2,083.20 ","$2,419.20 ","$2,419.20 ","$2,016.00 " ST VINCENT HOSPITAL - ACUTE,36010135,N/A,HC MINOR TREATMENT ROOM LEVEL 1,360,1 ,$960.00 ,$480.00 ,$480.00 ,$960.00 ,$620.16 , N/A , N/A , N/A , N/A ,$576.00 ,$816.00 ,$672.00 , N/A ,$912.00 ,$691.20 ,$700.80 , N/A ,$816.00 , N/A , N/A ,$768.00 ,$700.80 , N/A , N/A , N/A ,$960.00 ,$816.00 , N/A ,$883.20 ,$672.00 ,$480.00 ,$576.00 ,$584.64 ,$480.00 ,$663.36 ,$672.00 , N/A ,$691.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$691.20 ,$595.20 ,$691.20 ,$691.20 ,$576.00 ST VINCENT HOSPITAL - ACUTE,36010163,N/A,HC OTOPLASTY (BILATERAL),360,1 ,"$1,968.00 ",$984.00 ,$984.00 ,"$1,968.00 ","$1,271.33 ", N/A , N/A , N/A , N/A ,"$1,180.80 ","$1,672.80 ","$1,377.60 ", N/A ,"$1,869.60 ","$1,416.96 ","$1,436.64 ", N/A ,"$1,672.80 ", N/A , N/A ,"$1,574.40 ","$1,436.64 ", N/A , N/A , N/A ,"$1,968.00 ","$1,672.80 ", N/A ,"$1,810.56 ","$1,377.60 ",$984.00 ,"$1,180.80 ","$1,198.51 ",$984.00 ,"$1,359.89 ","$1,377.60 ", N/A ,"$1,416.96 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,416.96 ","$1,220.16 ","$1,416.96 ","$1,416.96 ","$1,180.80 " ST VINCENT HOSPITAL - ACUTE,36010230,N/A,HC TENOTOMY UPPER,360,1 ,"$5,040.00 ","$2,520.00 ","$2,520.00 ","$5,040.00 ","$3,255.84 ", N/A , N/A , N/A , N/A ,"$3,024.00 ","$4,284.00 ","$3,528.00 ", N/A ,"$4,788.00 ","$3,628.80 ","$3,679.20 ", N/A ,"$4,284.00 ", N/A , N/A ,"$4,032.00 ","$3,679.20 ", N/A , N/A , N/A ,"$5,040.00 ","$4,284.00 ", N/A ,"$4,636.80 ","$3,528.00 ","$2,520.00 ","$3,024.00 ","$3,069.36 ","$2,520.00 ","$3,482.64 ","$3,528.00 ", N/A ,"$3,628.80 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,628.80 ","$3,124.80 ","$3,628.80 ","$3,628.80 ","$3,024.00 " ST VINCENT HOSPITAL - ACUTE,36010231,N/A,HC TENOTOMY LOWER,360,1 ,"$3,360.00 ","$1,680.00 ","$1,680.00 ","$3,360.00 ","$2,170.56 ", N/A , N/A , N/A , N/A ,"$2,016.00 ","$2,856.00 ","$2,352.00 ", N/A ,"$3,192.00 ","$2,419.20 ","$2,452.80 ", N/A ,"$2,856.00 ", N/A , N/A ,"$2,688.00 ","$2,452.80 ", N/A , N/A , N/A ,"$3,360.00 ","$2,856.00 ", N/A ,"$3,091.20 ","$2,352.00 ","$1,680.00 ","$2,016.00 ","$2,046.24 ","$1,680.00 ","$2,321.76 ","$2,352.00 ", N/A ,"$2,419.20 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,419.20 ","$2,083.20 ","$2,419.20 ","$2,419.20 ","$2,016.00 " ST VINCENT HOSPITAL - ACUTE,36030001,N/A,HC ABDOMINOPLASTY MINI,360,1 ,"$2,648.00 ","$1,324.00 ","$1,324.00 ","$2,648.00 ","$1,710.61 ", N/A , N/A , N/A , N/A ,"$1,588.80 ","$2,250.80 ","$1,853.60 ", N/A ,"$2,515.60 ","$1,906.56 ","$1,933.04 ", N/A ,"$2,250.80 ", N/A , N/A ,"$2,118.40 ","$1,933.04 ", N/A , N/A , N/A ,"$2,648.00 ","$2,250.80 ", N/A ,"$2,436.16 ","$1,853.60 ","$1,324.00 ","$1,588.80 ","$1,612.63 ","$1,324.00 ","$1,829.77 ","$1,853.60 ", N/A ,"$1,906.56 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,906.56 ","$1,641.76 ","$1,906.56 ","$1,906.56 ","$1,588.80 " ST VINCENT HOSPITAL - ACUTE,36030002,N/A,HC ABDOMINOPLASTY OPEN/ENDOSCOPIC,360,1 ,"$3,228.00 ","$1,614.00 ","$1,614.00 ","$3,228.00 ","$2,085.29 ", N/A , N/A , N/A , N/A ,"$1,936.80 ","$2,743.80 ","$2,259.60 ", N/A ,"$3,066.60 ","$2,324.16 ","$2,356.44 ", N/A ,"$2,743.80 ", N/A , N/A ,"$2,582.40 ","$2,356.44 ", N/A , N/A , N/A ,"$3,228.00 ","$2,743.80 ", N/A ,"$2,969.76 ","$2,259.60 ","$1,614.00 ","$1,936.80 ","$1,965.85 ","$1,614.00 ","$2,230.55 ","$2,259.60 ", N/A ,"$2,324.16 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,324.16 ","$2,001.36 ","$2,324.16 ","$2,324.16 ","$1,936.80 " ST VINCENT HOSPITAL - ACUTE,36030003,N/A,HC BLEPHAROPLASTY LOWER,360,1 ,"$1,484.00 ",$742.00 ,$742.00 ,"$1,484.00 ",$958.66 , N/A , N/A , N/A , N/A ,$890.40 ,"$1,261.40 ","$1,038.80 ", N/A ,"$1,409.80 ","$1,068.48 ","$1,083.32 ", N/A ,"$1,261.40 ", N/A , N/A ,"$1,187.20 ","$1,083.32 ", N/A , N/A , N/A ,"$1,484.00 ","$1,261.40 ", N/A ,"$1,365.28 ","$1,038.80 ",$742.00 ,$890.40 ,$903.76 ,$742.00 ,"$1,025.44 ","$1,038.80 ", N/A ,"$1,068.48 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,068.48 ",$920.08 ,"$1,068.48 ","$1,068.48 ",$890.40 ST VINCENT HOSPITAL - ACUTE,36030004,N/A,HC BLEPHAROPLASTY UPPER,360,1 ,$903.00 ,$451.50 ,$451.50 ,$903.00 ,$583.34 , N/A , N/A , N/A , N/A ,$541.80 ,$767.55 ,$632.10 , N/A ,$857.85 ,$650.16 ,$659.19 , N/A ,$767.55 , N/A , N/A ,$722.40 ,$659.19 , N/A , N/A , N/A ,$903.00 ,$767.55 , N/A ,$830.76 ,$632.10 ,$451.50 ,$541.80 ,$549.93 ,$451.50 ,$623.97 ,$632.10 , N/A ,$650.16 , N/A , N/A , N/A , N/A , N/A , N/A ,$650.16 ,$559.86 ,$650.16 ,$650.16 ,$541.80 ST VINCENT HOSPITAL - ACUTE,36030005,N/A,HC BLEPHAROPLASTY UPPER/LOWER,360,1 ,"$2,067.00 ","$1,033.50 ","$1,033.50 ","$2,067.00 ","$1,335.28 ", N/A , N/A , N/A , N/A ,"$1,240.20 ","$1,756.95 ","$1,446.90 ", N/A ,"$1,963.65 ","$1,488.24 ","$1,508.91 ", N/A ,"$1,756.95 ", N/A , N/A ,"$1,653.60 ","$1,508.91 ", N/A , N/A , N/A ,"$2,067.00 ","$1,756.95 ", N/A ,"$1,901.64 ","$1,446.90 ","$1,033.50 ","$1,240.20 ","$1,258.80 ","$1,033.50 ","$1,428.30 ","$1,446.90 ", N/A ,"$1,488.24 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,488.24 ","$1,281.54 ","$1,488.24 ","$1,488.24 ","$1,240.20 " ST VINCENT HOSPITAL - ACUTE,36030006,N/A,HC BRACHIOPLASTY (ARM LIFT),360,1 ,"$2,648.00 ","$1,324.00 ","$1,324.00 ","$2,648.00 ","$1,710.61 ", N/A , N/A , N/A , N/A ,"$1,588.80 ","$2,250.80 ","$1,853.60 ", N/A ,"$2,515.60 ","$1,906.56 ","$1,933.04 ", N/A ,"$2,250.80 ", N/A , N/A ,"$2,118.40 ","$1,933.04 ", N/A , N/A , N/A ,"$2,648.00 ","$2,250.80 ", N/A ,"$2,436.16 ","$1,853.60 ","$1,324.00 ","$1,588.80 ","$1,612.63 ","$1,324.00 ","$1,829.77 ","$1,853.60 ", N/A ,"$1,906.56 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,906.56 ","$1,641.76 ","$1,906.56 ","$1,906.56 ","$1,588.80 " ST VINCENT HOSPITAL - ACUTE,36030007,N/A,HC BREAST AUG TRANSUMBILIC (TUBA),360,1 ,"$2,067.00 ","$1,033.50 ","$1,033.50 ","$2,067.00 ","$1,335.28 ", N/A , N/A , N/A , N/A ,"$1,240.20 ","$1,756.95 ","$1,446.90 ", N/A ,"$1,963.65 ","$1,488.24 ","$1,508.91 ", N/A ,"$1,756.95 ", N/A , N/A ,"$1,653.60 ","$1,508.91 ", N/A , N/A , N/A ,"$2,067.00 ","$1,756.95 ", N/A ,"$1,901.64 ","$1,446.90 ","$1,033.50 ","$1,240.20 ","$1,258.80 ","$1,033.50 ","$1,428.30 ","$1,446.90 ", N/A ,"$1,488.24 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,488.24 ","$1,281.54 ","$1,488.24 ","$1,488.24 ","$1,240.20 " ST VINCENT HOSPITAL - ACUTE,36030008,N/A,HC BREAST AUGMENTATION (BILAT),360,1 ,"$2,067.00 ","$1,033.50 ","$1,033.50 ","$2,067.00 ","$1,335.28 ", N/A , N/A , N/A , N/A ,"$1,240.20 ","$1,756.95 ","$1,446.90 ", N/A ,"$1,963.65 ","$1,488.24 ","$1,508.91 ", N/A ,"$1,756.95 ", N/A , N/A ,"$1,653.60 ","$1,508.91 ", N/A , N/A , N/A ,"$2,067.00 ","$1,756.95 ", N/A ,"$1,901.64 ","$1,446.90 ","$1,033.50 ","$1,240.20 ","$1,258.80 ","$1,033.50 ","$1,428.30 ","$1,446.90 ", N/A ,"$1,488.24 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,488.24 ","$1,281.54 ","$1,488.24 ","$1,488.24 ","$1,240.20 " ST VINCENT HOSPITAL - ACUTE,36030009,N/A,HC BREAST LIFT W/IMPLANTS (MASTOP,360,1 ,"$4,392.00 ","$2,196.00 ","$2,196.00 ","$4,392.00 ","$2,837.23 ", N/A , N/A , N/A , N/A ,"$2,635.20 ","$3,733.20 ","$3,074.40 ", N/A ,"$4,172.40 ","$3,162.24 ","$3,206.16 ", N/A ,"$3,733.20 ", N/A , N/A ,"$3,513.60 ","$3,206.16 ", N/A , N/A , N/A ,"$4,392.00 ","$3,733.20 ", N/A ,"$4,040.64 ","$3,074.40 ","$2,196.00 ","$2,635.20 ","$2,674.73 ","$2,196.00 ","$3,034.87 ","$3,074.40 ", N/A ,"$3,162.24 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,162.24 ","$2,723.04 ","$3,162.24 ","$3,162.24 ","$2,635.20 " ST VINCENT HOSPITAL - ACUTE,36030010,N/A,HC BREAST LIFT(MASTOPEXY),360,1 ,"$2,648.00 ","$1,324.00 ","$1,324.00 ","$2,648.00 ","$1,710.61 ", N/A , N/A , N/A , N/A ,"$1,588.80 ","$2,250.80 ","$1,853.60 ", N/A ,"$2,515.60 ","$1,906.56 ","$1,933.04 ", N/A ,"$2,250.80 ", N/A , N/A ,"$2,118.40 ","$1,933.04 ", N/A , N/A , N/A ,"$2,648.00 ","$2,250.80 ", N/A ,"$2,436.16 ","$1,853.60 ","$1,324.00 ","$1,588.80 ","$1,612.63 ","$1,324.00 ","$1,829.77 ","$1,853.60 ", N/A ,"$1,906.56 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,906.56 ","$1,641.76 ","$1,906.56 ","$1,906.56 ","$1,588.80 " ST VINCENT HOSPITAL - ACUTE,36030011,N/A,HC BREAST REDUCTION BILATERAL,360,1 ,"$3,810.00 ","$1,905.00 ","$1,905.00 ","$3,810.00 ","$2,461.26 ", N/A , N/A , N/A , N/A ,"$2,286.00 ","$3,238.50 ","$2,667.00 ", N/A ,"$3,619.50 ","$2,743.20 ","$2,781.30 ", N/A ,"$3,238.50 ", N/A , N/A ,"$3,048.00 ","$2,781.30 ", N/A , N/A , N/A ,"$3,810.00 ","$3,238.50 ", N/A ,"$3,505.20 ","$2,667.00 ","$1,905.00 ","$2,286.00 ","$2,320.29 ","$1,905.00 ","$2,632.71 ","$2,667.00 ", N/A ,"$2,743.20 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,743.20 ","$2,362.20 ","$2,743.20 ","$2,743.20 ","$2,286.00 " ST VINCENT HOSPITAL - ACUTE,36030012,N/A,HC BREAST REDUCTION UNILATERAL,360,1 ,"$1,484.00 ",$742.00 ,$742.00 ,"$1,484.00 ",$958.66 , N/A , N/A , N/A , N/A ,$890.40 ,"$1,261.40 ","$1,038.80 ", N/A ,"$1,409.80 ","$1,068.48 ","$1,083.32 ", N/A ,"$1,261.40 ", N/A , N/A ,"$1,187.20 ","$1,083.32 ", N/A , N/A , N/A ,"$1,484.00 ","$1,261.40 ", N/A ,"$1,365.28 ","$1,038.80 ",$742.00 ,$890.40 ,$903.76 ,$742.00 ,"$1,025.44 ","$1,038.80 ", N/A ,"$1,068.48 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,068.48 ",$920.08 ,"$1,068.48 ","$1,068.48 ",$890.40 ST VINCENT HOSPITAL - ACUTE,36030013,N/A,HC BREAST REVISION,360,1 ,"$1,484.00 ",$742.00 ,$742.00 ,"$1,484.00 ",$958.66 , N/A , N/A , N/A , N/A ,$890.40 ,"$1,261.40 ","$1,038.80 ", N/A ,"$1,409.80 ","$1,068.48 ","$1,083.32 ", N/A ,"$1,261.40 ", N/A , N/A ,"$1,187.20 ","$1,083.32 ", N/A , N/A , N/A ,"$1,484.00 ","$1,261.40 ", N/A ,"$1,365.28 ","$1,038.80 ",$742.00 ,$890.40 ,$903.76 ,$742.00 ,"$1,025.44 ","$1,038.80 ", N/A ,"$1,068.48 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,068.48 ",$920.08 ,"$1,068.48 ","$1,068.48 ",$890.40 ST VINCENT HOSPITAL - ACUTE,36030014,N/A,HC BROW LIFT ENDOSCOPIC,360,1 ,"$3,228.00 ","$1,614.00 ","$1,614.00 ","$3,228.00 ","$2,085.29 ", N/A , N/A , N/A , N/A ,"$1,936.80 ","$2,743.80 ","$2,259.60 ", N/A ,"$3,066.60 ","$2,324.16 ","$2,356.44 ", N/A ,"$2,743.80 ", N/A , N/A ,"$2,582.40 ","$2,356.44 ", N/A , N/A , N/A ,"$3,228.00 ","$2,743.80 ", N/A ,"$2,969.76 ","$2,259.60 ","$1,614.00 ","$1,936.80 ","$1,965.85 ","$1,614.00 ","$2,230.55 ","$2,259.60 ", N/A ,"$2,324.16 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,324.16 ","$2,001.36 ","$2,324.16 ","$2,324.16 ","$1,936.80 " ST VINCENT HOSPITAL - ACUTE,36030015,N/A,HC BROW LIFT OPEN,360,1 ,"$2,067.00 ","$1,033.50 ","$1,033.50 ","$2,067.00 ","$1,335.28 ", N/A , N/A , N/A , N/A ,"$1,240.20 ","$1,756.95 ","$1,446.90 ", N/A ,"$1,963.65 ","$1,488.24 ","$1,508.91 ", N/A ,"$1,756.95 ", N/A , N/A ,"$1,653.60 ","$1,508.91 ", N/A , N/A , N/A ,"$2,067.00 ","$1,756.95 ", N/A ,"$1,901.64 ","$1,446.90 ","$1,033.50 ","$1,240.20 ","$1,258.80 ","$1,033.50 ","$1,428.30 ","$1,446.90 ", N/A ,"$1,488.24 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,488.24 ","$1,281.54 ","$1,488.24 ","$1,488.24 ","$1,240.20 " ST VINCENT HOSPITAL - ACUTE,36030016,N/A,HC COSMETIC SCAR REVISION,360,1 ,"$1,484.00 ",$742.00 ,$742.00 ,"$1,484.00 ",$958.66 , N/A , N/A , N/A , N/A ,$890.40 ,"$1,261.40 ","$1,038.80 ", N/A ,"$1,409.80 ","$1,068.48 ","$1,083.32 ", N/A ,"$1,261.40 ", N/A , N/A ,"$1,187.20 ","$1,083.32 ", N/A , N/A , N/A ,"$1,484.00 ","$1,261.40 ", N/A ,"$1,365.28 ","$1,038.80 ",$742.00 ,$890.40 ,$903.76 ,$742.00 ,"$1,025.44 ","$1,038.80 ", N/A ,"$1,068.48 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,068.48 ",$920.08 ,"$1,068.48 ","$1,068.48 ",$890.40 ST VINCENT HOSPITAL - ACUTE,36030017,N/A,HC FACELIFT (RHYTIDECTOMY),360,1 ,"$4,392.00 ","$2,196.00 ","$2,196.00 ","$4,392.00 ","$2,837.23 ", N/A , N/A , N/A , N/A ,"$2,635.20 ","$3,733.20 ","$3,074.40 ", N/A ,"$4,172.40 ","$3,162.24 ","$3,206.16 ", N/A ,"$3,733.20 ", N/A , N/A ,"$3,513.60 ","$3,206.16 ", N/A , N/A , N/A ,"$4,392.00 ","$3,733.20 ", N/A ,"$4,040.64 ","$3,074.40 ","$2,196.00 ","$2,635.20 ","$2,674.73 ","$2,196.00 ","$3,034.87 ","$3,074.40 ", N/A ,"$3,162.24 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,162.24 ","$2,723.04 ","$3,162.24 ","$3,162.24 ","$2,635.20 " ST VINCENT HOSPITAL - ACUTE,36030018,N/A,HC GYNCOMASTIA W/LIPOSUCTION,360,1 ,"$2,067.00 ","$1,033.50 ","$1,033.50 ","$2,067.00 ","$1,335.28 ", N/A , N/A , N/A , N/A ,"$1,240.20 ","$1,756.95 ","$1,446.90 ", N/A ,"$1,963.65 ","$1,488.24 ","$1,508.91 ", N/A ,"$1,756.95 ", N/A , N/A ,"$1,653.60 ","$1,508.91 ", N/A , N/A , N/A ,"$2,067.00 ","$1,756.95 ", N/A ,"$1,901.64 ","$1,446.90 ","$1,033.50 ","$1,240.20 ","$1,258.80 ","$1,033.50 ","$1,428.30 ","$1,446.90 ", N/A ,"$1,488.24 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,488.24 ","$1,281.54 ","$1,488.24 ","$1,488.24 ","$1,240.20 " ST VINCENT HOSPITAL - ACUTE,36030019,N/A,HC LASER SKIN RESURFACING/SITE,360,1 ,"$2,067.00 ","$1,033.50 ","$1,033.50 ","$2,067.00 ","$1,335.28 ", N/A , N/A , N/A , N/A ,"$1,240.20 ","$1,756.95 ","$1,446.90 ", N/A ,"$1,963.65 ","$1,488.24 ","$1,508.91 ", N/A ,"$1,756.95 ", N/A , N/A ,"$1,653.60 ","$1,508.91 ", N/A , N/A , N/A ,"$2,067.00 ","$1,756.95 ", N/A ,"$1,901.64 ","$1,446.90 ","$1,033.50 ","$1,240.20 ","$1,258.80 ","$1,033.50 ","$1,428.30 ","$1,446.90 ", N/A ,"$1,488.24 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,488.24 ","$1,281.54 ","$1,488.24 ","$1,488.24 ","$1,240.20 " ST VINCENT HOSPITAL - ACUTE,36030054,N/A,HC LIPOSUCTION TOUCH UP 1/2 HOUR,360,1 ,"$1,095.00 ",$547.50 ,$547.50 ,"$1,095.00 ",$707.37 , N/A , N/A , N/A , N/A ,$657.00 ,$930.75 ,$766.50 , N/A ,"$1,040.25 ",$788.40 ,$799.35 , N/A ,$930.75 , N/A , N/A ,$876.00 ,$799.35 , N/A , N/A , N/A ,"$1,095.00 ",$930.75 , N/A ,"$1,007.40 ",$766.50 ,$547.50 ,$657.00 ,$666.86 ,$547.50 ,$756.65 ,$766.50 , N/A ,$788.40 , N/A , N/A , N/A , N/A , N/A , N/A ,$788.40 ,$678.90 ,$788.40 ,$788.40 ,$657.00 ST VINCENT HOSPITAL - ACUTE,36030055,N/A,HC NECKLIFT (PLATSYMAPLASTY),360,1 ,"$2,648.00 ","$1,324.00 ","$1,324.00 ","$2,648.00 ","$1,710.61 ", N/A , N/A , N/A , N/A ,"$1,588.80 ","$2,250.80 ","$1,853.60 ", N/A ,"$2,515.60 ","$1,906.56 ","$1,933.04 ", N/A ,"$2,250.80 ", N/A , N/A ,"$2,118.40 ","$1,933.04 ", N/A , N/A , N/A ,"$2,648.00 ","$2,250.80 ", N/A ,"$2,436.16 ","$1,853.60 ","$1,324.00 ","$1,588.80 ","$1,612.63 ","$1,324.00 ","$1,829.77 ","$1,853.60 ", N/A ,"$1,906.56 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,906.56 ","$1,641.76 ","$1,906.56 ","$1,906.56 ","$1,588.80 " ST VINCENT HOSPITAL - ACUTE,36030056,N/A,HC RHINOPLASTY (2 HR),360,1 ,"$3,228.00 ","$1,614.00 ","$1,614.00 ","$3,228.00 ","$2,085.29 ", N/A , N/A , N/A , N/A ,"$1,936.80 ","$2,743.80 ","$2,259.60 ", N/A ,"$3,066.60 ","$2,324.16 ","$2,356.44 ", N/A ,"$2,743.80 ", N/A , N/A ,"$2,582.40 ","$2,356.44 ", N/A , N/A , N/A ,"$3,228.00 ","$2,743.80 ", N/A ,"$2,969.76 ","$2,259.60 ","$1,614.00 ","$1,936.80 ","$1,965.85 ","$1,614.00 ","$2,230.55 ","$2,259.60 ", N/A ,"$2,324.16 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,324.16 ","$2,001.36 ","$2,324.16 ","$2,324.16 ","$1,936.80 " ST VINCENT HOSPITAL - ACUTE,36030057,S2055,HC TISSUE HARVEST/ORGAN PROC,360,1 ,$840.00 ,$420.00 ,$420.00 ,"$7,821.36 ",$542.64 , N/A , N/A , N/A , N/A ,$504.00 ,$714.00 ,$588.00 , N/A ,$798.00 ,$604.80 ,$613.20 ,$840.00 ,$714.00 , N/A ,$840.00 ,$672.00 ,$613.20 , N/A , N/A , N/A ,$840.00 ,$714.00 , N/A ,$772.80 ,$588.00 ,"$5,818.90 ","$7,821.36 ",$511.56 ,"$7,273.62 ",$580.44 ,$588.00 , N/A ,$604.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$604.80 ,$520.80 ,$604.80 ,$604.80 ,$504.00 ST VINCENT HOSPITAL - ACUTE,36030058,N/A,HC LABIALPLASTY,360,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$3,500.00 ","$2,261.00 ", N/A , N/A , N/A , N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ", N/A ,"$2,975.00 ", N/A , N/A ,"$2,800.00 ","$2,555.00 ", N/A , N/A , N/A ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,36030059,N/A,HC BREAST IMPLANT REMOVAL UNILAT,360,1 ,"$1,773.00 ",$886.50 ,$886.50 ,"$1,773.00 ","$1,145.36 ", N/A , N/A , N/A , N/A ,"$1,063.80 ","$1,507.05 ","$1,241.10 ", N/A ,"$1,684.35 ","$1,276.56 ","$1,294.29 ", N/A ,"$1,507.05 ", N/A , N/A ,"$1,418.40 ","$1,294.29 ", N/A , N/A , N/A ,"$1,773.00 ","$1,507.05 ", N/A ,"$1,631.16 ","$1,241.10 ",$886.50 ,"$1,063.80 ","$1,079.76 ",$886.50 ,"$1,225.14 ","$1,241.10 ", N/A ,"$1,276.56 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,276.56 ","$1,099.26 ","$1,276.56 ","$1,276.56 ","$1,063.80 " ST VINCENT HOSPITAL - ACUTE,36030078,N/A,HC RADIATION ONC TRMT PKG HOSPICE ASC,360,1 ,$840.00 ,$420.00 ,$420.00 ,$840.00 ,$542.64 , N/A , N/A , N/A , N/A ,$504.00 ,$714.00 ,$588.00 , N/A ,$798.00 ,$604.80 ,$613.20 , N/A ,$714.00 , N/A , N/A ,$672.00 ,$613.20 , N/A , N/A , N/A ,$840.00 ,$714.00 , N/A ,$772.80 ,$588.00 ,$420.00 ,$504.00 ,$511.56 ,$420.00 ,$580.44 ,$588.00 , N/A ,$604.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$604.80 ,$520.80 ,$604.80 ,$604.80 ,$504.00 ST VINCENT HOSPITAL - ACUTE,36030112,N/A,HC DENTAL 0-90 MIN ASC,360,1 ,"$6,300.00 ","$3,150.00 ","$3,150.00 ","$6,300.00 ","$4,069.80 ", N/A , N/A , N/A , N/A ,"$3,780.00 ","$5,355.00 ","$4,410.00 ", N/A ,"$5,985.00 ","$4,536.00 ","$4,599.00 ", N/A ,"$5,355.00 ", N/A , N/A ,"$5,040.00 ","$4,599.00 ", N/A , N/A , N/A ,"$6,300.00 ","$5,355.00 ", N/A ,"$5,796.00 ","$4,410.00 ","$3,150.00 ","$3,780.00 ","$3,836.70 ","$3,150.00 ","$4,353.30 ","$4,410.00 ", N/A ,"$4,536.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,536.00 ","$3,906.00 ","$4,536.00 ","$4,536.00 ","$3,780.00 " ST VINCENT HOSPITAL - ACUTE,36030113,N/A,HC DENTAL 91-150 MIN ASC,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$1,200.00 ",$775.20 , N/A , N/A , N/A , N/A ,$720.00 ,"$1,020.00 ",$840.00 , N/A ,"$1,140.00 ",$864.00 ,$876.00 , N/A ,"$1,020.00 ", N/A , N/A ,$960.00 ,$876.00 , N/A , N/A , N/A ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 , N/A ,$864.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36030114,N/A,HC DENTAL 151 AND GREATER ASC,360,1 ,"$1,800.00 ",$900.00 ,$900.00 ,"$1,800.00 ","$1,162.80 ", N/A , N/A , N/A , N/A ,"$1,080.00 ","$1,530.00 ","$1,260.00 ", N/A ,"$1,710.00 ","$1,296.00 ","$1,314.00 ", N/A ,"$1,530.00 ", N/A , N/A ,"$1,440.00 ","$1,314.00 ", N/A , N/A , N/A ,"$1,800.00 ","$1,530.00 ", N/A ,"$1,656.00 ","$1,260.00 ",$900.00 ,"$1,080.00 ","$1,096.20 ",$900.00 ,"$1,243.80 ","$1,260.00 ", N/A ,"$1,296.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36030120,N/A,HC LIPOSUCTION MINI,360,1 ,"$1,295.00 ",$647.50 ,$647.50 ,"$1,295.00 ",$836.57 , N/A , N/A , N/A , N/A ,$777.00 ,"$1,100.75 ",$906.50 , N/A ,"$1,230.25 ",$932.40 ,$945.35 , N/A ,"$1,100.75 ", N/A , N/A ,"$1,036.00 ",$945.35 , N/A , N/A , N/A ,"$1,295.00 ","$1,100.75 ", N/A ,"$1,191.40 ",$906.50 ,$647.50 ,$777.00 ,$788.66 ,$647.50 ,$894.85 ,$906.50 , N/A ,$932.40 , N/A , N/A , N/A , N/A , N/A , N/A ,$932.40 ,$802.90 ,$932.40 ,$932.40 ,$777.00 ST VINCENT HOSPITAL - ACUTE,36030121,N/A,HC LIPOSUCTION MEDIUM,360,1 ,"$1,941.00 ",$970.50 ,$970.50 ,"$1,941.00 ","$1,253.89 ", N/A , N/A , N/A , N/A ,"$1,164.60 ","$1,649.85 ","$1,358.70 ", N/A ,"$1,843.95 ","$1,397.52 ","$1,416.93 ", N/A ,"$1,649.85 ", N/A , N/A ,"$1,552.80 ","$1,416.93 ", N/A , N/A , N/A ,"$1,941.00 ","$1,649.85 ", N/A ,"$1,785.72 ","$1,358.70 ",$970.50 ,"$1,164.60 ","$1,182.07 ",$970.50 ,"$1,341.23 ","$1,358.70 ", N/A ,"$1,397.52 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,397.52 ","$1,203.42 ","$1,397.52 ","$1,397.52 ","$1,164.60 " ST VINCENT HOSPITAL - ACUTE,36030122,N/A,HC LIPOSUCTION FULL,360,1 ,"$2,588.00 ","$1,294.00 ","$1,294.00 ","$2,588.00 ","$1,671.85 ", N/A , N/A , N/A , N/A ,"$1,552.80 ","$2,199.80 ","$1,811.60 ", N/A ,"$2,458.60 ","$1,863.36 ","$1,889.24 ", N/A ,"$2,199.80 ", N/A , N/A ,"$2,070.40 ","$1,889.24 ", N/A , N/A , N/A ,"$2,588.00 ","$2,199.80 ", N/A ,"$2,380.96 ","$1,811.60 ","$1,294.00 ","$1,552.80 ","$1,576.09 ","$1,294.00 ","$1,788.31 ","$1,811.60 ", N/A ,"$1,863.36 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,863.36 ","$1,604.56 ","$1,863.36 ","$1,863.36 ","$1,552.80 " ST VINCENT HOSPITAL - ACUTE,36030123,N/A,HC SLIM LIPO PRO MINI,360,1 ,"$1,587.00 ",$793.50 ,$793.50 ,"$1,587.00 ","$1,025.20 ", N/A , N/A , N/A , N/A ,$952.20 ,"$1,348.95 ","$1,110.90 ", N/A ,"$1,507.65 ","$1,142.64 ","$1,158.51 ", N/A ,"$1,348.95 ", N/A , N/A ,"$1,269.60 ","$1,158.51 ", N/A , N/A , N/A ,"$1,587.00 ","$1,348.95 ", N/A ,"$1,460.04 ","$1,110.90 ",$793.50 ,$952.20 ,$966.48 ,$793.50 ,"$1,096.62 ","$1,110.90 ", N/A ,"$1,142.64 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,142.64 ",$983.94 ,"$1,142.64 ","$1,142.64 ",$952.20 ST VINCENT HOSPITAL - ACUTE,36030124,N/A,HC SLIM LIPO PRO MEDIUM,360,1 ,"$2,233.00 ","$1,116.50 ","$1,116.50 ","$2,233.00 ","$1,442.52 ", N/A , N/A , N/A , N/A ,"$1,339.80 ","$1,898.05 ","$1,563.10 ", N/A ,"$2,121.35 ","$1,607.76 ","$1,630.09 ", N/A ,"$1,898.05 ", N/A , N/A ,"$1,786.40 ","$1,630.09 ", N/A , N/A , N/A ,"$2,233.00 ","$1,898.05 ", N/A ,"$2,054.36 ","$1,563.10 ","$1,116.50 ","$1,339.80 ","$1,359.90 ","$1,116.50 ","$1,543.00 ","$1,563.10 ", N/A ,"$1,607.76 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,607.76 ","$1,384.46 ","$1,607.76 ","$1,607.76 ","$1,339.80 " ST VINCENT HOSPITAL - ACUTE,36030125,N/A,HC SLIM LIPO PRO FULL,360,1 ,"$2,880.00 ","$1,440.00 ","$1,440.00 ","$2,880.00 ","$1,860.48 ", N/A , N/A , N/A , N/A ,"$1,728.00 ","$2,448.00 ","$2,016.00 ", N/A ,"$2,736.00 ","$2,073.60 ","$2,102.40 ", N/A ,"$2,448.00 ", N/A , N/A ,"$2,304.00 ","$2,102.40 ", N/A , N/A , N/A ,"$2,880.00 ","$2,448.00 ", N/A ,"$2,649.60 ","$2,016.00 ","$1,440.00 ","$1,728.00 ","$1,753.92 ","$1,440.00 ","$1,990.08 ","$2,016.00 ", N/A ,"$2,073.60 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,073.60 ","$1,785.60 ","$2,073.60 ","$2,073.60 ","$1,728.00 " ST VINCENT HOSPITAL - ACUTE,36030126,N/A,HC INSERT GASTRIC BALLOON,360,1 ,"$5,200.00 ","$2,600.00 ","$2,600.00 ","$5,200.00 ","$3,359.20 ", N/A , N/A , N/A , N/A ,"$3,120.00 ","$4,420.00 ","$3,640.00 ", N/A ,"$4,940.00 ","$3,744.00 ","$3,796.00 ", N/A ,"$4,420.00 ", N/A , N/A ,"$4,160.00 ","$3,796.00 ", N/A , N/A , N/A ,"$5,200.00 ","$4,420.00 ", N/A ,"$4,784.00 ","$3,640.00 ","$2,600.00 ","$3,120.00 ","$3,166.80 ","$2,600.00 ","$3,593.20 ","$3,640.00 ", N/A ,"$3,744.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,36030127,N/A,HC VASOVASOSTOMY,360,1 ,"$5,000.00 ","$2,500.00 ","$2,500.00 ","$5,000.00 ","$3,230.00 ", N/A , N/A , N/A , N/A ,"$3,000.00 ","$4,250.00 ","$3,500.00 ", N/A ,"$4,750.00 ","$3,600.00 ","$3,650.00 ", N/A ,"$4,250.00 ", N/A , N/A ,"$4,000.00 ","$3,650.00 ", N/A , N/A , N/A ,"$5,000.00 ","$4,250.00 ", N/A ,"$4,600.00 ","$3,500.00 ","$2,500.00 ","$3,000.00 ","$3,045.00 ","$2,500.00 ","$3,455.00 ","$3,500.00 ", N/A ,"$3,600.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,600.00 ","$3,100.00 ","$3,600.00 ","$3,600.00 ","$3,000.00 " ST VINCENT HOSPITAL - ACUTE,36030128,N/A,HC GASTRECTOMY SLEEVE,360,1 ,"$13,825.00 ","$6,912.50 ","$6,912.50 ","$13,825.00 ","$8,930.95 ", N/A , N/A , N/A , N/A ,"$8,295.00 ","$11,751.25 ","$9,677.50 ", N/A ,"$13,133.75 ","$9,954.00 ","$10,092.25 ", N/A ,"$11,751.25 ", N/A , N/A ,"$11,060.00 ","$10,092.25 ", N/A , N/A , N/A ,"$13,825.00 ","$11,751.25 ", N/A ,"$12,719.00 ","$9,677.50 ","$6,912.50 ","$8,295.00 ","$8,419.43 ","$6,912.50 ","$9,553.08 ","$9,677.50 ", N/A ,"$9,954.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$9,954.00 ","$8,571.50 ","$9,954.00 ","$9,954.00 ","$8,295.00 " ST VINCENT HOSPITAL - ACUTE,36030129,N/A,HC MONSPLASTY,360,1 ,$860.00 ,$430.00 ,$430.00 ,$860.00 ,$555.56 , N/A , N/A , N/A , N/A ,$516.00 ,$731.00 ,$602.00 , N/A ,$817.00 ,$619.20 ,$627.80 , N/A ,$731.00 , N/A , N/A ,$688.00 ,$627.80 , N/A , N/A , N/A ,$860.00 ,$731.00 , N/A ,$791.20 ,$602.00 ,$430.00 ,$516.00 ,$523.74 ,$430.00 ,$594.26 ,$602.00 , N/A ,$619.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$619.20 ,$533.20 ,$619.20 ,$619.20 ,$516.00 ST VINCENT HOSPITAL - ACUTE,36030200,N/A,HC HEROLD COSMETIC 0-60 MIN,360,1 ,$800.00 ,$400.00 ,$400.00 ,$800.00 ,$516.80 , N/A , N/A , N/A , N/A ,$480.00 ,$680.00 ,$560.00 , N/A ,$760.00 ,$576.00 ,$584.00 , N/A ,$680.00 , N/A , N/A ,$640.00 ,$584.00 , N/A , N/A , N/A ,$800.00 ,$680.00 , N/A ,$736.00 ,$560.00 ,$400.00 ,$480.00 ,$487.20 ,$400.00 ,$552.80 ,$560.00 , N/A ,$576.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,36030201,N/A,HC HEROLD COSMETIC 61-90 MIN,360,1 ,"$1,150.00 ",$575.00 ,$575.00 ,"$1,150.00 ",$742.90 , N/A , N/A , N/A , N/A ,$690.00 ,$977.50 ,$805.00 , N/A ,"$1,092.50 ",$828.00 ,$839.50 , N/A ,$977.50 , N/A , N/A ,$920.00 ,$839.50 , N/A , N/A , N/A ,"$1,150.00 ",$977.50 , N/A ,"$1,058.00 ",$805.00 ,$575.00 ,$690.00 ,$700.35 ,$575.00 ,$794.65 ,$805.00 , N/A ,$828.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$828.00 ,$713.00 ,$828.00 ,$828.00 ,$690.00 ST VINCENT HOSPITAL - ACUTE,36030202,N/A,HC HEROLD COSMETIC 91-120 MIN,360,1 ,"$1,300.00 ",$650.00 ,$650.00 ,"$1,300.00 ",$839.80 , N/A , N/A , N/A , N/A ,$780.00 ,"$1,105.00 ",$910.00 , N/A ,"$1,235.00 ",$936.00 ,$949.00 , N/A ,"$1,105.00 ", N/A , N/A ,"$1,040.00 ",$949.00 , N/A , N/A , N/A ,"$1,300.00 ","$1,105.00 ", N/A ,"$1,196.00 ",$910.00 ,$650.00 ,$780.00 ,$791.70 ,$650.00 ,$898.30 ,$910.00 , N/A ,$936.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,36030203,N/A,HC HEROLD COSMETIC 121-150 MIN,360,1 ,"$1,500.00 ",$750.00 ,$750.00 ,"$1,500.00 ",$969.00 , N/A , N/A , N/A , N/A ,$900.00 ,"$1,275.00 ","$1,050.00 ", N/A ,"$1,425.00 ","$1,080.00 ","$1,095.00 ", N/A ,"$1,275.00 ", N/A , N/A ,"$1,200.00 ","$1,095.00 ", N/A , N/A , N/A ,"$1,500.00 ","$1,275.00 ", N/A ,"$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ", N/A ,"$1,080.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,36030204,N/A,HC HEROLD COSMETIC 151-180 MIN,360,1 ,"$1,650.00 ",$825.00 ,$825.00 ,"$1,650.00 ","$1,065.90 ", N/A , N/A , N/A , N/A ,$990.00 ,"$1,402.50 ","$1,155.00 ", N/A ,"$1,567.50 ","$1,188.00 ","$1,204.50 ", N/A ,"$1,402.50 ", N/A , N/A ,"$1,320.00 ","$1,204.50 ", N/A , N/A , N/A ,"$1,650.00 ","$1,402.50 ", N/A ,"$1,518.00 ","$1,155.00 ",$825.00 ,$990.00 ,"$1,004.85 ",$825.00 ,"$1,140.15 ","$1,155.00 ", N/A ,"$1,188.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,188.00 ","$1,023.00 ","$1,188.00 ","$1,188.00 ",$990.00 ST VINCENT HOSPITAL - ACUTE,36030205,N/A,HC HEROLD COSMETIC 181-210 MIN,360,1 ,"$1,800.00 ",$900.00 ,$900.00 ,"$1,800.00 ","$1,162.80 ", N/A , N/A , N/A , N/A ,"$1,080.00 ","$1,530.00 ","$1,260.00 ", N/A ,"$1,710.00 ","$1,296.00 ","$1,314.00 ", N/A ,"$1,530.00 ", N/A , N/A ,"$1,440.00 ","$1,314.00 ", N/A , N/A , N/A ,"$1,800.00 ","$1,530.00 ", N/A ,"$1,656.00 ","$1,260.00 ",$900.00 ,"$1,080.00 ","$1,096.20 ",$900.00 ,"$1,243.80 ","$1,260.00 ", N/A ,"$1,296.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36030206,N/A,HC HEROLD COSMETIC 211-240 MIN,360,1 ,"$2,000.00 ","$1,000.00 ","$1,000.00 ","$2,000.00 ","$1,292.00 ", N/A , N/A , N/A , N/A ,"$1,200.00 ","$1,700.00 ","$1,400.00 ", N/A ,"$1,900.00 ","$1,440.00 ","$1,460.00 ", N/A ,"$1,700.00 ", N/A , N/A ,"$1,600.00 ","$1,460.00 ", N/A , N/A , N/A ,"$2,000.00 ","$1,700.00 ", N/A ,"$1,840.00 ","$1,400.00 ","$1,000.00 ","$1,200.00 ","$1,218.00 ","$1,000.00 ","$1,382.00 ","$1,400.00 ", N/A ,"$1,440.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,36030207,N/A,HC HEROLD COSMETIC 241-270 MIN,360,1 ,"$2,150.00 ","$1,075.00 ","$1,075.00 ","$2,150.00 ","$1,388.90 ", N/A , N/A , N/A , N/A ,"$1,290.00 ","$1,827.50 ","$1,505.00 ", N/A ,"$2,042.50 ","$1,548.00 ","$1,569.50 ", N/A ,"$1,827.50 ", N/A , N/A ,"$1,720.00 ","$1,569.50 ", N/A , N/A , N/A ,"$2,150.00 ","$1,827.50 ", N/A ,"$1,978.00 ","$1,505.00 ","$1,075.00 ","$1,290.00 ","$1,309.35 ","$1,075.00 ","$1,485.65 ","$1,505.00 ", N/A ,"$1,548.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,548.00 ","$1,333.00 ","$1,548.00 ","$1,548.00 ","$1,290.00 " ST VINCENT HOSPITAL - ACUTE,36030208,N/A,HC HEROLD COSMETIC 271-300 MIN,360,1 ,"$2,300.00 ","$1,150.00 ","$1,150.00 ","$2,300.00 ","$1,485.80 ", N/A , N/A , N/A , N/A ,"$1,380.00 ","$1,955.00 ","$1,610.00 ", N/A ,"$2,185.00 ","$1,656.00 ","$1,679.00 ", N/A ,"$1,955.00 ", N/A , N/A ,"$1,840.00 ","$1,679.00 ", N/A , N/A , N/A ,"$2,300.00 ","$1,955.00 ", N/A ,"$2,116.00 ","$1,610.00 ","$1,150.00 ","$1,380.00 ","$1,400.70 ","$1,150.00 ","$1,589.30 ","$1,610.00 ", N/A ,"$1,656.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,36030209,N/A,HC HEROLD COSMETIC 301-330 MIN,360,1 ,"$2,450.00 ","$1,225.00 ","$1,225.00 ","$2,450.00 ","$1,582.70 ", N/A , N/A , N/A , N/A ,"$1,470.00 ","$2,082.50 ","$1,715.00 ", N/A ,"$2,327.50 ","$1,764.00 ","$1,788.50 ", N/A ,"$2,082.50 ", N/A , N/A ,"$1,960.00 ","$1,788.50 ", N/A , N/A , N/A ,"$2,450.00 ","$2,082.50 ", N/A ,"$2,254.00 ","$1,715.00 ","$1,225.00 ","$1,470.00 ","$1,492.05 ","$1,225.00 ","$1,692.95 ","$1,715.00 ", N/A ,"$1,764.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,764.00 ","$1,519.00 ","$1,764.00 ","$1,764.00 ","$1,470.00 " ST VINCENT HOSPITAL - ACUTE,36030210,N/A,HC HEROLD COSMETIC 331+ MIN,360,1 ,"$2,650.00 ","$1,325.00 ","$1,325.00 ","$2,650.00 ","$1,711.90 ", N/A , N/A , N/A , N/A ,"$1,590.00 ","$2,252.50 ","$1,855.00 ", N/A ,"$2,517.50 ","$1,908.00 ","$1,934.50 ", N/A ,"$2,252.50 ", N/A , N/A ,"$2,120.00 ","$1,934.50 ", N/A , N/A , N/A ,"$2,650.00 ","$2,252.50 ", N/A ,"$2,438.00 ","$1,855.00 ","$1,325.00 ","$1,590.00 ","$1,613.85 ","$1,325.00 ","$1,831.15 ","$1,855.00 ", N/A ,"$1,908.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,908.00 ","$1,643.00 ","$1,908.00 ","$1,908.00 ","$1,590.00 " ST VINCENT HOSPITAL - ACUTE,36030211,N/A,HC HEROLD COSMETIC BREAST AUGMENTATION,360,1 ,$850.00 ,$425.00 ,$425.00 ,$850.00 ,$549.10 , N/A , N/A , N/A , N/A ,$510.00 ,$722.50 ,$595.00 , N/A ,$807.50 ,$612.00 ,$620.50 , N/A ,$722.50 , N/A , N/A ,$680.00 ,$620.50 , N/A , N/A , N/A ,$850.00 ,$722.50 , N/A ,$782.00 ,$595.00 ,$425.00 ,$510.00 ,$517.65 ,$425.00 ,$587.35 ,$595.00 , N/A ,$612.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,36030300,N/A,HC CAMPBELL BROW LIFT,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$1,200.00 ",$775.20 , N/A , N/A , N/A , N/A ,$720.00 ,"$1,020.00 ",$840.00 , N/A ,"$1,140.00 ",$864.00 ,$876.00 , N/A ,"$1,020.00 ", N/A , N/A ,$960.00 ,$876.00 , N/A , N/A , N/A ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 , N/A ,$864.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36030301,N/A,HC CAMPBELL BLEPHAROPLASTY LOWER,360,1 ,$925.00 ,$462.50 ,$462.50 ,$925.00 ,$597.55 , N/A , N/A , N/A , N/A ,$555.00 ,$786.25 ,$647.50 , N/A ,$878.75 ,$666.00 ,$675.25 , N/A ,$786.25 , N/A , N/A ,$740.00 ,$675.25 , N/A , N/A , N/A ,$925.00 ,$786.25 , N/A ,$851.00 ,$647.50 ,$462.50 ,$555.00 ,$563.33 ,$462.50 ,$639.18 ,$647.50 , N/A ,$666.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$666.00 ,$573.50 ,$666.00 ,$666.00 ,$555.00 ST VINCENT HOSPITAL - ACUTE,36030302,N/A,HC CAMPBELL BLEPHAROPLASTY UPPER,360,1 ,$675.00 ,$337.50 ,$337.50 ,$675.00 ,$436.05 , N/A , N/A , N/A , N/A ,$405.00 ,$573.75 ,$472.50 , N/A ,$641.25 ,$486.00 ,$492.75 , N/A ,$573.75 , N/A , N/A ,$540.00 ,$492.75 , N/A , N/A , N/A ,$675.00 ,$573.75 , N/A ,$621.00 ,$472.50 ,$337.50 ,$405.00 ,$411.08 ,$337.50 ,$466.43 ,$472.50 , N/A ,$486.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$486.00 ,$418.50 ,$486.00 ,$486.00 ,$405.00 ST VINCENT HOSPITAL - ACUTE,36030303,N/A,HC CAMPBELL BLEPHAROPLASTY UPPER/LOWER,360,1 ,"$1,350.00 ",$675.00 ,$675.00 ,"$1,350.00 ",$872.10 , N/A , N/A , N/A , N/A ,$810.00 ,"$1,147.50 ",$945.00 , N/A ,"$1,282.50 ",$972.00 ,$985.50 , N/A ,"$1,147.50 ", N/A , N/A ,"$1,080.00 ",$985.50 , N/A , N/A , N/A ,"$1,350.00 ","$1,147.50 ", N/A ,"$1,242.00 ",$945.00 ,$675.00 ,$810.00 ,$822.15 ,$675.00 ,$932.85 ,$945.00 , N/A ,$972.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$972.00 ,$837.00 ,$972.00 ,$972.00 ,$810.00 ST VINCENT HOSPITAL - ACUTE,36030304,N/A,HC CAMPBELL MINI-FACELIFT,360,1 ,$700.00 ,$350.00 ,$350.00 ,$700.00 ,$452.20 , N/A , N/A , N/A , N/A ,$420.00 ,$595.00 ,$490.00 , N/A ,$665.00 ,$504.00 ,$511.00 , N/A ,$595.00 , N/A , N/A ,$560.00 ,$511.00 , N/A , N/A , N/A ,$700.00 ,$595.00 , N/A ,$644.00 ,$490.00 ,$350.00 ,$420.00 ,$426.30 ,$350.00 ,$483.70 ,$490.00 , N/A ,$504.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,36030305,N/A,HC CAMPBELL DEEP PLANE FACELIFT,360,1 ,"$1,400.00 ",$700.00 ,$700.00 ,"$1,400.00 ",$904.40 , N/A , N/A , N/A , N/A ,$840.00 ,"$1,190.00 ",$980.00 , N/A ,"$1,330.00 ","$1,008.00 ","$1,022.00 ", N/A ,"$1,190.00 ", N/A , N/A ,"$1,120.00 ","$1,022.00 ", N/A , N/A , N/A ,"$1,400.00 ","$1,190.00 ", N/A ,"$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 , N/A ,"$1,008.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,36030306,N/A,HC CAMPBELL FACIAL IMPLANTS,360,1 ,$400.00 ,$200.00 ,$200.00 ,$400.00 ,$258.40 , N/A , N/A , N/A , N/A ,$240.00 ,$340.00 ,$280.00 , N/A ,$380.00 ,$288.00 ,$292.00 , N/A ,$340.00 , N/A , N/A ,$320.00 ,$292.00 , N/A , N/A , N/A ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 , N/A ,$288.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,36030307,N/A,HC CAMPBELL OTOPLASTY,360,1 ,"$1,400.00 ",$700.00 ,$700.00 ,"$1,400.00 ",$904.40 , N/A , N/A , N/A , N/A ,$840.00 ,"$1,190.00 ",$980.00 , N/A ,"$1,330.00 ","$1,008.00 ","$1,022.00 ", N/A ,"$1,190.00 ", N/A , N/A ,"$1,120.00 ","$1,022.00 ", N/A , N/A , N/A ,"$1,400.00 ","$1,190.00 ", N/A ,"$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 , N/A ,"$1,008.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,36030308,N/A,HC CAMPBELL RHINOPLASTY,360,1 ,"$1,325.00 ",$662.50 ,$662.50 ,"$1,325.00 ",$855.95 , N/A , N/A , N/A , N/A ,$795.00 ,"$1,126.25 ",$927.50 , N/A ,"$1,258.75 ",$954.00 ,$967.25 , N/A ,"$1,126.25 ", N/A , N/A ,"$1,060.00 ",$967.25 , N/A , N/A , N/A ,"$1,325.00 ","$1,126.25 ", N/A ,"$1,219.00 ",$927.50 ,$662.50 ,$795.00 ,$806.93 ,$662.50 ,$915.58 ,$927.50 , N/A ,$954.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$954.00 ,$821.50 ,$954.00 ,$954.00 ,$795.00 ST VINCENT HOSPITAL - ACUTE,36030309,N/A,HC CAMPBELL ERBIUM LASER,360,1 ,$600.00 ,$300.00 ,$300.00 ,$600.00 ,$387.60 , N/A , N/A , N/A , N/A ,$360.00 ,$510.00 ,$420.00 , N/A ,$570.00 ,$432.00 ,$438.00 , N/A ,$510.00 , N/A , N/A ,$480.00 ,$438.00 , N/A , N/A , N/A ,$600.00 ,$510.00 , N/A ,$552.00 ,$420.00 ,$300.00 ,$360.00 ,$365.40 ,$300.00 ,$414.60 ,$420.00 , N/A ,$432.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,36030310,N/A,HC CAMPBELL COMPREHENSIVE REJUVENATION,360,1 ,"$3,000.00 ","$1,500.00 ","$1,500.00 ","$3,000.00 ","$1,938.00 ", N/A , N/A , N/A , N/A ,"$1,800.00 ","$2,550.00 ","$2,100.00 ", N/A ,"$2,850.00 ","$2,160.00 ","$2,190.00 ", N/A ,"$2,550.00 ", N/A , N/A ,"$2,400.00 ","$2,190.00 ", N/A , N/A , N/A ,"$3,000.00 ","$2,550.00 ", N/A ,"$2,760.00 ","$2,100.00 ","$1,500.00 ","$1,800.00 ","$1,827.00 ","$1,500.00 ","$2,073.00 ","$2,100.00 ", N/A ,"$2,160.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,36030311,N/A,HC CAMPBELL LIPO HEAD AND NECK,360,1 ,$300.00 ,$150.00 ,$150.00 ,$300.00 ,$193.80 , N/A , N/A , N/A , N/A ,$180.00 ,$255.00 ,$210.00 , N/A ,$285.00 ,$216.00 ,$219.00 , N/A ,$255.00 , N/A , N/A ,$240.00 ,$219.00 , N/A , N/A , N/A ,$300.00 ,$255.00 , N/A ,$276.00 ,$210.00 ,$150.00 ,$180.00 ,$182.70 ,$150.00 ,$207.30 ,$210.00 , N/A ,$216.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,36030312,N/A,HC CAMPBELL COLLAGEN BOTOX INJECTION,360,1 ,$400.00 ,$200.00 ,$200.00 ,$400.00 ,$258.40 , N/A , N/A , N/A , N/A ,$240.00 ,$340.00 ,$280.00 , N/A ,$380.00 ,$288.00 ,$292.00 , N/A ,$340.00 , N/A , N/A ,$320.00 ,$292.00 , N/A , N/A , N/A ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 , N/A ,$288.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,36030313,N/A,HC CAMPBELL CHIN IMPLANT,360,1 ,$875.00 ,$437.50 ,$437.50 ,$875.00 ,$565.25 , N/A , N/A , N/A , N/A ,$525.00 ,$743.75 ,$612.50 , N/A ,$831.25 ,$630.00 ,$638.75 , N/A ,$743.75 , N/A , N/A ,$700.00 ,$638.75 , N/A , N/A , N/A ,$875.00 ,$743.75 , N/A ,$805.00 ,$612.50 ,$437.50 ,$525.00 ,$532.88 ,$437.50 ,$604.63 ,$612.50 , N/A ,$630.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$630.00 ,$542.50 ,$630.00 ,$630.00 ,$525.00 ST VINCENT HOSPITAL - ACUTE,36030314,N/A,HC CAMPBELL SKIN TISSUE PROCEDURE,360,1 ,"$1,025.00 ",$512.50 ,$512.50 ,"$1,025.00 ",$662.15 , N/A , N/A , N/A , N/A ,$615.00 ,$871.25 ,$717.50 , N/A ,$973.75 ,$738.00 ,$748.25 , N/A ,$871.25 , N/A , N/A ,$820.00 ,$748.25 , N/A , N/A , N/A ,"$1,025.00 ",$871.25 , N/A ,$943.00 ,$717.50 ,$512.50 ,$615.00 ,$624.23 ,$512.50 ,$708.28 ,$717.50 , N/A ,$738.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$738.00 ,$635.50 ,$738.00 ,$738.00 ,$615.00 ST VINCENT HOSPITAL - ACUTE,36030315,N/A,HC CAMPBELL RHYTIDECTOMY,360,1 ,"$1,825.00 ",$912.50 ,$912.50 ,"$1,825.00 ","$1,178.95 ", N/A , N/A , N/A , N/A ,"$1,095.00 ","$1,551.25 ","$1,277.50 ", N/A ,"$1,733.75 ","$1,314.00 ","$1,332.25 ", N/A ,"$1,551.25 ", N/A , N/A ,"$1,460.00 ","$1,332.25 ", N/A , N/A , N/A ,"$1,825.00 ","$1,551.25 ", N/A ,"$1,679.00 ","$1,277.50 ",$912.50 ,"$1,095.00 ","$1,111.43 ",$912.50 ,"$1,261.08 ","$1,277.50 ", N/A ,"$1,314.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,314.00 ","$1,131.50 ","$1,314.00 ","$1,314.00 ","$1,095.00 " ST VINCENT HOSPITAL - ACUTE,36030316,N/A,HC CAMPBELL FAT GRAFTING,360,1 ,$500.00 ,$250.00 ,$250.00 ,$500.00 ,$323.00 , N/A , N/A , N/A , N/A ,$300.00 ,$425.00 ,$350.00 , N/A ,$475.00 ,$360.00 ,$365.00 , N/A ,$425.00 , N/A , N/A ,$400.00 ,$365.00 , N/A , N/A , N/A ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,36030317,N/A,HC CAMPBELL MINI W/PLATYSMA PLICATION,360,1 ,$900.00 ,$450.00 ,$450.00 ,$900.00 ,$581.40 , N/A , N/A , N/A , N/A ,$540.00 ,$765.00 ,$630.00 , N/A ,$855.00 ,$648.00 ,$657.00 , N/A ,$765.00 , N/A , N/A ,$720.00 ,$657.00 , N/A , N/A , N/A ,$900.00 ,$765.00 , N/A ,$828.00 ,$630.00 ,$450.00 ,$540.00 ,$548.10 ,$450.00 ,$621.90 ,$630.00 , N/A ,$648.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$648.00 ,$558.00 ,$648.00 ,$648.00 ,$540.00 ST VINCENT HOSPITAL - ACUTE,36030318,N/A,HC CAMPBELL MINOR DORSUM RHINOPLASTY,360,1 ,$500.00 ,$250.00 ,$250.00 ,$500.00 ,$323.00 , N/A , N/A , N/A , N/A ,$300.00 ,$425.00 ,$350.00 , N/A ,$475.00 ,$360.00 ,$365.00 , N/A ,$425.00 , N/A , N/A ,$400.00 ,$365.00 , N/A , N/A , N/A ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,36030325,N/A,HC BUTZ ABDOMINOPLASTY,360,1 ,"$2,000.00 ","$1,000.00 ","$1,000.00 ","$2,000.00 ","$1,292.00 ", N/A , N/A , N/A , N/A ,"$1,200.00 ","$1,700.00 ","$1,400.00 ", N/A ,"$1,900.00 ","$1,440.00 ","$1,460.00 ", N/A ,"$1,700.00 ", N/A , N/A ,"$1,600.00 ","$1,460.00 ", N/A , N/A , N/A ,"$2,000.00 ","$1,700.00 ", N/A ,"$1,840.00 ","$1,400.00 ","$1,000.00 ","$1,200.00 ","$1,218.00 ","$1,000.00 ","$1,382.00 ","$1,400.00 ", N/A ,"$1,440.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,36030326,N/A,HC BUTZ BLEPHAROPLASTY UPPER/LOWER,360,1 ,"$1,350.00 ",$675.00 ,$675.00 ,"$1,350.00 ",$872.10 , N/A , N/A , N/A , N/A ,$810.00 ,"$1,147.50 ",$945.00 , N/A ,"$1,282.50 ",$972.00 ,$985.50 , N/A ,"$1,147.50 ", N/A , N/A ,"$1,080.00 ",$985.50 , N/A , N/A , N/A ,"$1,350.00 ","$1,147.50 ", N/A ,"$1,242.00 ",$945.00 ,$675.00 ,$810.00 ,$822.15 ,$675.00 ,$932.85 ,$945.00 , N/A ,$972.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$972.00 ,$837.00 ,$972.00 ,$972.00 ,$810.00 ST VINCENT HOSPITAL - ACUTE,36030327,N/A,HC BUTZ BLEPHAROPLASTY LOWER,360,1 ,$925.00 ,$462.50 ,$462.50 ,$925.00 ,$597.55 , N/A , N/A , N/A , N/A ,$555.00 ,$786.25 ,$647.50 , N/A ,$878.75 ,$666.00 ,$675.25 , N/A ,$786.25 , N/A , N/A ,$740.00 ,$675.25 , N/A , N/A , N/A ,$925.00 ,$786.25 , N/A ,$851.00 ,$647.50 ,$462.50 ,$555.00 ,$563.33 ,$462.50 ,$639.18 ,$647.50 , N/A ,$666.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$666.00 ,$573.50 ,$666.00 ,$666.00 ,$555.00 ST VINCENT HOSPITAL - ACUTE,36030328,N/A,HC BUTZ BLEPHAROPLASTY UPPER,360,1 ,$675.00 ,$337.50 ,$337.50 ,$675.00 ,$436.05 , N/A , N/A , N/A , N/A ,$405.00 ,$573.75 ,$472.50 , N/A ,$641.25 ,$486.00 ,$492.75 , N/A ,$573.75 , N/A , N/A ,$540.00 ,$492.75 , N/A , N/A , N/A ,$675.00 ,$573.75 , N/A ,$621.00 ,$472.50 ,$337.50 ,$405.00 ,$411.08 ,$337.50 ,$466.43 ,$472.50 , N/A ,$486.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$486.00 ,$418.50 ,$486.00 ,$486.00 ,$405.00 ST VINCENT HOSPITAL - ACUTE,36030329,N/A,HC BUTZ BRACHIOPLASTY(BILATERAL),360,1 ,"$1,550.00 ",$775.00 ,$775.00 ,"$1,550.00 ","$1,001.30 ", N/A , N/A , N/A , N/A ,$930.00 ,"$1,317.50 ","$1,085.00 ", N/A ,"$1,472.50 ","$1,116.00 ","$1,131.50 ", N/A ,"$1,317.50 ", N/A , N/A ,"$1,240.00 ","$1,131.50 ", N/A , N/A , N/A ,"$1,550.00 ","$1,317.50 ", N/A ,"$1,426.00 ","$1,085.00 ",$775.00 ,$930.00 ,$943.95 ,$775.00 ,"$1,071.05 ","$1,085.00 ", N/A ,"$1,116.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,116.00 ",$961.00 ,"$1,116.00 ","$1,116.00 ",$930.00 ST VINCENT HOSPITAL - ACUTE,36030330,N/A,HC BUTZ BREAST AUGMENTATION (BILATERAL),360,1 ,"$1,225.00 ",$612.50 ,$612.50 ,"$1,225.00 ",$791.35 , N/A , N/A , N/A , N/A ,$735.00 ,"$1,041.25 ",$857.50 , N/A ,"$1,163.75 ",$882.00 ,$894.25 , N/A ,"$1,041.25 ", N/A , N/A ,$980.00 ,$894.25 , N/A , N/A , N/A ,"$1,225.00 ","$1,041.25 ", N/A ,"$1,127.00 ",$857.50 ,$612.50 ,$735.00 ,$746.03 ,$612.50 ,$846.48 ,$857.50 , N/A ,$882.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$882.00 ,$759.50 ,$882.00 ,$882.00 ,$735.00 ST VINCENT HOSPITAL - ACUTE,36030331,N/A,HC BUTZ BREAST IMPLANT UNILATERAL,360,1 ,$775.00 ,$387.50 ,$387.50 ,$775.00 ,$500.65 , N/A , N/A , N/A , N/A ,$465.00 ,$658.75 ,$542.50 , N/A ,$736.25 ,$558.00 ,$565.75 , N/A ,$658.75 , N/A , N/A ,$620.00 ,$565.75 , N/A , N/A , N/A ,$775.00 ,$658.75 , N/A ,$713.00 ,$542.50 ,$387.50 ,$465.00 ,$471.98 ,$387.50 ,$535.53 ,$542.50 , N/A ,$558.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$558.00 ,$480.50 ,$558.00 ,$558.00 ,$465.00 ST VINCENT HOSPITAL - ACUTE,36030332,N/A,HC BUTZ BREAST REDUCTION (BILATERAL),360,1 ,"$1,925.00 ",$962.50 ,$962.50 ,"$1,925.00 ","$1,243.55 ", N/A , N/A , N/A , N/A ,"$1,155.00 ","$1,636.25 ","$1,347.50 ", N/A ,"$1,828.75 ","$1,386.00 ","$1,405.25 ", N/A ,"$1,636.25 ", N/A , N/A ,"$1,540.00 ","$1,405.25 ", N/A , N/A , N/A ,"$1,925.00 ","$1,636.25 ", N/A ,"$1,771.00 ","$1,347.50 ",$962.50 ,"$1,155.00 ","$1,172.33 ",$962.50 ,"$1,330.18 ","$1,347.50 ", N/A ,"$1,386.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,386.00 ","$1,193.50 ","$1,386.00 ","$1,386.00 ","$1,155.00 " ST VINCENT HOSPITAL - ACUTE,36030333,N/A,HC BUTZ BROW LIFT,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$1,200.00 ",$775.20 , N/A , N/A , N/A , N/A ,$720.00 ,"$1,020.00 ",$840.00 , N/A ,"$1,140.00 ",$864.00 ,$876.00 , N/A ,"$1,020.00 ", N/A , N/A ,$960.00 ,$876.00 , N/A , N/A , N/A ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 , N/A ,$864.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36030334,N/A,HC BUTZ CANTHOPLASTY(BILATERAL),360,1 ,$800.00 ,$400.00 ,$400.00 ,$800.00 ,$516.80 , N/A , N/A , N/A , N/A ,$480.00 ,$680.00 ,$560.00 , N/A ,$760.00 ,$576.00 ,$584.00 , N/A ,$680.00 , N/A , N/A ,$640.00 ,$584.00 , N/A , N/A , N/A ,$800.00 ,$680.00 , N/A ,$736.00 ,$560.00 ,$400.00 ,$480.00 ,$487.20 ,$400.00 ,$552.80 ,$560.00 , N/A ,$576.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,36030335,N/A,HC BUTZ CHIN IMPLANT,360,1 ,$875.00 ,$437.50 ,$437.50 ,$875.00 ,$565.25 , N/A , N/A , N/A , N/A ,$525.00 ,$743.75 ,$612.50 , N/A ,$831.25 ,$630.00 ,$638.75 , N/A ,$743.75 , N/A , N/A ,$700.00 ,$638.75 , N/A , N/A , N/A ,$875.00 ,$743.75 , N/A ,$805.00 ,$612.50 ,$437.50 ,$525.00 ,$532.88 ,$437.50 ,$604.63 ,$612.50 , N/A ,$630.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$630.00 ,$542.50 ,$630.00 ,$630.00 ,$525.00 ST VINCENT HOSPITAL - ACUTE,36030336,N/A,HC BUTZ FAT TRANSFER,360,1 ,"$1,925.00 ",$962.50 ,$962.50 ,"$1,925.00 ","$1,243.55 ", N/A , N/A , N/A , N/A ,"$1,155.00 ","$1,636.25 ","$1,347.50 ", N/A ,"$1,828.75 ","$1,386.00 ","$1,405.25 ", N/A ,"$1,636.25 ", N/A , N/A ,"$1,540.00 ","$1,405.25 ", N/A , N/A , N/A ,"$1,925.00 ","$1,636.25 ", N/A ,"$1,771.00 ","$1,347.50 ",$962.50 ,"$1,155.00 ","$1,172.33 ",$962.50 ,"$1,330.18 ","$1,347.50 ", N/A ,"$1,386.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,386.00 ","$1,193.50 ","$1,386.00 ","$1,386.00 ","$1,155.00 " ST VINCENT HOSPITAL - ACUTE,36030337,N/A,HC BUTZ GYNECOMASTY(BILATERAL),360,1 ,"$1,250.00 ",$625.00 ,$625.00 ,"$1,250.00 ",$807.50 , N/A , N/A , N/A , N/A ,$750.00 ,"$1,062.50 ",$875.00 , N/A ,"$1,187.50 ",$900.00 ,$912.50 , N/A ,"$1,062.50 ", N/A , N/A ,"$1,000.00 ",$912.50 , N/A , N/A , N/A ,"$1,250.00 ","$1,062.50 ", N/A ,"$1,150.00 ",$875.00 ,$625.00 ,$750.00 ,$761.25 ,$625.00 ,$863.75 ,$875.00 , N/A ,$900.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$900.00 ,$775.00 ,$900.00 ,$900.00 ,$750.00 ST VINCENT HOSPITAL - ACUTE,36030338,N/A,HC BUTZ LESION REMOVAL,360,1 ,$675.00 ,$337.50 ,$337.50 ,$675.00 ,$436.05 , N/A , N/A , N/A , N/A ,$405.00 ,$573.75 ,$472.50 , N/A ,$641.25 ,$486.00 ,$492.75 , N/A ,$573.75 , N/A , N/A ,$540.00 ,$492.75 , N/A , N/A , N/A ,$675.00 ,$573.75 , N/A ,$621.00 ,$472.50 ,$337.50 ,$405.00 ,$411.08 ,$337.50 ,$466.43 ,$472.50 , N/A ,$486.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$486.00 ,$418.50 ,$486.00 ,$486.00 ,$405.00 ST VINCENT HOSPITAL - ACUTE,36030339,N/A,HC BUTZ LIPO CHIN/NECK,360,1 ,$700.00 ,$350.00 ,$350.00 ,$700.00 ,$452.20 , N/A , N/A , N/A , N/A ,$420.00 ,$595.00 ,$490.00 , N/A ,$665.00 ,$504.00 ,$511.00 , N/A ,$595.00 , N/A , N/A ,$560.00 ,$511.00 , N/A , N/A , N/A ,$700.00 ,$595.00 , N/A ,$644.00 ,$490.00 ,$350.00 ,$420.00 ,$426.30 ,$350.00 ,$483.70 ,$490.00 , N/A ,$504.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,36030340,N/A,HC BUTZ LIPO TORSO HIPS BUTTOCKS,360,1 ,"$1,350.00 ",$675.00 ,$675.00 ,"$1,350.00 ",$872.10 , N/A , N/A , N/A , N/A ,$810.00 ,"$1,147.50 ",$945.00 , N/A ,"$1,282.50 ",$972.00 ,$985.50 , N/A ,"$1,147.50 ", N/A , N/A ,"$1,080.00 ",$985.50 , N/A , N/A , N/A ,"$1,350.00 ","$1,147.50 ", N/A ,"$1,242.00 ",$945.00 ,$675.00 ,$810.00 ,$822.15 ,$675.00 ,$932.85 ,$945.00 , N/A ,$972.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$972.00 ,$837.00 ,$972.00 ,$972.00 ,$810.00 ST VINCENT HOSPITAL - ACUTE,36030341,N/A,HC BUTZ MATOPEXY,360,1 ,"$1,450.00 ",$725.00 ,$725.00 ,"$1,450.00 ",$936.70 , N/A , N/A , N/A , N/A ,$870.00 ,"$1,232.50 ","$1,015.00 ", N/A ,"$1,377.50 ","$1,044.00 ","$1,058.50 ", N/A ,"$1,232.50 ", N/A , N/A ,"$1,160.00 ","$1,058.50 ", N/A , N/A , N/A ,"$1,450.00 ","$1,232.50 ", N/A ,"$1,334.00 ","$1,015.00 ",$725.00 ,$870.00 ,$883.05 ,$725.00 ,"$1,001.95 ","$1,015.00 ", N/A ,"$1,044.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,044.00 ",$899.00 ,"$1,044.00 ","$1,044.00 ",$870.00 ST VINCENT HOSPITAL - ACUTE,36030342,N/A,HC BUTZ OTOPLASTY,360,1 ,"$1,400.00 ",$700.00 ,$700.00 ,"$1,400.00 ",$904.40 , N/A , N/A , N/A , N/A ,$840.00 ,"$1,190.00 ",$980.00 , N/A ,"$1,330.00 ","$1,008.00 ","$1,022.00 ", N/A ,"$1,190.00 ", N/A , N/A ,"$1,120.00 ","$1,022.00 ", N/A , N/A , N/A ,"$1,400.00 ","$1,190.00 ", N/A ,"$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 , N/A ,"$1,008.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,36030343,N/A,HC BUTZ RHINOPLASTY,360,1 ,"$1,325.00 ",$662.50 ,$662.50 ,"$1,325.00 ",$855.95 , N/A , N/A , N/A , N/A ,$795.00 ,"$1,126.25 ",$927.50 , N/A ,"$1,258.75 ",$954.00 ,$967.25 , N/A ,"$1,126.25 ", N/A , N/A ,"$1,060.00 ",$967.25 , N/A , N/A , N/A ,"$1,325.00 ","$1,126.25 ", N/A ,"$1,219.00 ",$927.50 ,$662.50 ,$795.00 ,$806.93 ,$662.50 ,$915.58 ,$927.50 , N/A ,$954.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$954.00 ,$821.50 ,$954.00 ,$954.00 ,$795.00 ST VINCENT HOSPITAL - ACUTE,36030344,N/A,HC BUTZ RHINOPLASTY TIP,360,1 ,$925.00 ,$462.50 ,$462.50 ,$925.00 ,$597.55 , N/A , N/A , N/A , N/A ,$555.00 ,$786.25 ,$647.50 , N/A ,$878.75 ,$666.00 ,$675.25 , N/A ,$786.25 , N/A , N/A ,$740.00 ,$675.25 , N/A , N/A , N/A ,$925.00 ,$786.25 , N/A ,$851.00 ,$647.50 ,$462.50 ,$555.00 ,$563.33 ,$462.50 ,$639.18 ,$647.50 , N/A ,$666.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$666.00 ,$573.50 ,$666.00 ,$666.00 ,$555.00 ST VINCENT HOSPITAL - ACUTE,36030345,N/A,HC BUTZ RHYTIDECTOMY,360,1 ,"$1,825.00 ",$912.50 ,$912.50 ,"$1,825.00 ","$1,178.95 ", N/A , N/A , N/A , N/A ,"$1,095.00 ","$1,551.25 ","$1,277.50 ", N/A ,"$1,733.75 ","$1,314.00 ","$1,332.25 ", N/A ,"$1,551.25 ", N/A , N/A ,"$1,460.00 ","$1,332.25 ", N/A , N/A , N/A ,"$1,825.00 ","$1,551.25 ", N/A ,"$1,679.00 ","$1,277.50 ",$912.50 ,"$1,095.00 ","$1,111.43 ",$912.50 ,"$1,261.08 ","$1,277.50 ", N/A ,"$1,314.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,314.00 ","$1,131.50 ","$1,314.00 ","$1,314.00 ","$1,095.00 " ST VINCENT HOSPITAL - ACUTE,36030346,N/A,HC BUTZ SCAR REVISION,360,1 ,$725.00 ,$362.50 ,$362.50 ,$725.00 ,$468.35 , N/A , N/A , N/A , N/A ,$435.00 ,$616.25 ,$507.50 , N/A ,$688.75 ,$522.00 ,$529.25 , N/A ,$616.25 , N/A , N/A ,$580.00 ,$529.25 , N/A , N/A , N/A ,$725.00 ,$616.25 , N/A ,$667.00 ,$507.50 ,$362.50 ,$435.00 ,$441.53 ,$362.50 ,$500.98 ,$507.50 , N/A ,$522.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$522.00 ,$449.50 ,$522.00 ,$522.00 ,$435.00 ST VINCENT HOSPITAL - ACUTE,36030347,N/A,HC BUTZ SEPTOPLASTY,360,1 ,$975.00 ,$487.50 ,$487.50 ,$975.00 ,$629.85 , N/A , N/A , N/A , N/A ,$585.00 ,$828.75 ,$682.50 , N/A ,$926.25 ,$702.00 ,$711.75 , N/A ,$828.75 , N/A , N/A ,$780.00 ,$711.75 , N/A , N/A , N/A ,$975.00 ,$828.75 , N/A ,$897.00 ,$682.50 ,$487.50 ,$585.00 ,$593.78 ,$487.50 ,$673.73 ,$682.50 , N/A ,$702.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$702.00 ,$604.50 ,$702.00 ,$702.00 ,$585.00 ST VINCENT HOSPITAL - ACUTE,36030348,N/A,HC BUTZ THIGH LIFT (BILATERAL),360,1 ,"$1,575.00 ",$787.50 ,$787.50 ,"$1,575.00 ","$1,017.45 ", N/A , N/A , N/A , N/A ,$945.00 ,"$1,338.75 ","$1,102.50 ", N/A ,"$1,496.25 ","$1,134.00 ","$1,149.75 ", N/A ,"$1,338.75 ", N/A , N/A ,"$1,260.00 ","$1,149.75 ", N/A , N/A , N/A ,"$1,575.00 ","$1,338.75 ", N/A ,"$1,449.00 ","$1,102.50 ",$787.50 ,$945.00 ,$959.18 ,$787.50 ,"$1,088.33 ","$1,102.50 ", N/A ,"$1,134.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,134.00 ",$976.50 ,"$1,134.00 ","$1,134.00 ",$945.00 ST VINCENT HOSPITAL - ACUTE,36030349,N/A,HC BUTZ TORSOPLASTY FULL,360,1 ,"$2,175.00 ","$1,087.50 ","$1,087.50 ","$2,175.00 ","$1,405.05 ", N/A , N/A , N/A , N/A ,"$1,305.00 ","$1,848.75 ","$1,522.50 ", N/A ,"$2,066.25 ","$1,566.00 ","$1,587.75 ", N/A ,"$1,848.75 ", N/A , N/A ,"$1,740.00 ","$1,587.75 ", N/A , N/A , N/A ,"$2,175.00 ","$1,848.75 ", N/A ,"$2,001.00 ","$1,522.50 ","$1,087.50 ","$1,305.00 ","$1,324.58 ","$1,087.50 ","$1,502.93 ","$1,522.50 ", N/A ,"$1,566.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,566.00 ","$1,348.50 ","$1,566.00 ","$1,566.00 ","$1,305.00 " ST VINCENT HOSPITAL - ACUTE,36030350,N/A,HC BUTZ TORSOPLASTY PARTIAL,360,1 ,"$1,500.00 ",$750.00 ,$750.00 ,"$1,500.00 ",$969.00 , N/A , N/A , N/A , N/A ,$900.00 ,"$1,275.00 ","$1,050.00 ", N/A ,"$1,425.00 ","$1,080.00 ","$1,095.00 ", N/A ,"$1,275.00 ", N/A , N/A ,"$1,200.00 ","$1,095.00 ", N/A , N/A , N/A ,"$1,500.00 ","$1,275.00 ", N/A ,"$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ", N/A ,"$1,080.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,36030351,N/A,HC BUTZ COSMETIC ADDL 30MIN,360,1 ,$150.00 ,$75.00 ,$75.00 ,$150.00 ,$96.90 , N/A , N/A , N/A , N/A ,$90.00 ,$127.50 ,$105.00 , N/A ,$142.50 ,$108.00 ,$109.50 , N/A ,$127.50 , N/A , N/A ,$120.00 ,$109.50 , N/A , N/A , N/A ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 , N/A ,$108.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,36030400,N/A,HC REFRACTIVE LENS STANDARD,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$1,200.00 ",$775.20 , N/A , N/A , N/A , N/A ,$720.00 ,"$1,020.00 ",$840.00 , N/A ,"$1,140.00 ",$864.00 ,$876.00 , N/A ,"$1,020.00 ", N/A , N/A ,$960.00 ,$876.00 , N/A , N/A , N/A ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 , N/A ,$864.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36030401,N/A,HC REFRACTIVE LENS TORIC,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$1,200.00 ",$775.20 , N/A , N/A , N/A , N/A ,$720.00 ,"$1,020.00 ",$840.00 , N/A ,"$1,140.00 ",$864.00 ,$876.00 , N/A ,"$1,020.00 ", N/A , N/A ,$960.00 ,$876.00 , N/A , N/A , N/A ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 , N/A ,$864.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36030402,N/A,HC REFRACTIVE LENS MULTIFOCAL,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$1,200.00 ",$775.20 , N/A , N/A , N/A , N/A ,$720.00 ,"$1,020.00 ",$840.00 , N/A ,"$1,140.00 ",$864.00 ,$876.00 , N/A ,"$1,020.00 ", N/A , N/A ,$960.00 ,$876.00 , N/A , N/A , N/A ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 , N/A ,$864.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36030403,N/A,HC DENTAL CASE PACKAGE SSC CASH ONLY,360,1 ,"$1,250.00 ",$625.00 ,$625.00 ,"$1,250.00 ",$807.50 , N/A , N/A , N/A , N/A ,$750.00 ,"$1,062.50 ",$875.00 , N/A ,"$1,187.50 ",$900.00 ,$912.50 , N/A ,"$1,062.50 ", N/A , N/A ,"$1,000.00 ",$912.50 , N/A , N/A , N/A ,"$1,250.00 ","$1,062.50 ", N/A ,"$1,150.00 ",$875.00 ,$625.00 ,$750.00 ,$761.25 ,$625.00 ,$863.75 ,$875.00 , N/A ,$900.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$900.00 ,$775.00 ,$900.00 ,$900.00 ,$750.00 ST VINCENT HOSPITAL - ACUTE,36030404,N/A,HC PIGGYBACK LENS PACKAGE SSC,360,1 ,"$1,200.00 ",$600.00 ,$600.00 ,"$1,200.00 ",$775.20 , N/A , N/A , N/A , N/A ,$720.00 ,"$1,020.00 ",$840.00 , N/A ,"$1,140.00 ",$864.00 ,$876.00 , N/A ,"$1,020.00 ", N/A , N/A ,$960.00 ,$876.00 , N/A , N/A , N/A ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 , N/A ,$864.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36030405,0232T,HC INJECTION PLATELET RICH PLASMA,360,1 ,$350.00 ,$175.00 ,$175.00 ,$588.84 ,$226.10 ,$217.59 ,$350.00 ,$350.00 ,$261.71 ,$210.00 ,$297.50 ,$245.00 ,$217.59 ,$332.50 ,$252.00 ,$255.50 ,$350.00 ,$297.50 ,$261.71 ,$350.00 ,$280.00 ,$255.50 ,$217.59 ,$261.71 ,$350.00 ,$350.00 ,$297.50 ,$588.84 ,$322.00 ,$245.00 ,$350.00 ,$350.00 ,$213.15 ,$350.00 ,$241.85 ,$245.00 ,$264.33 ,$252.00 ,$230.65 ,$350.00 ,$350.00 ,$261.71 ,$350.00 ,$261.71 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,36030406,0232T,HC INJECTION BONE MARROW,360,1 ,"$1,100.00 ",$550.00 ,$217.59 ,"$1,100.00 ",$710.60 ,$217.59 ,"$1,100.00 ","$1,100.00 ",$261.71 ,$660.00 ,$935.00 ,$770.00 ,$217.59 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 ,$261.71 ,"$1,100.00 ",$880.00 ,$803.00 ,$217.59 ,$261.71 ,"$1,100.00 ","$1,100.00 ",$935.00 ,$588.84 ,"$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$264.33 ,$792.00 ,$230.65 ,"$1,100.00 ","$1,100.00 ",$261.71 ,"$1,100.00 ",$261.71 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,36040003,N/A,HC SURG/PACU MAJOR TREATMENT ROOM,360,1 ,$310.00 ,$155.00 ,$155.00 ,$310.00 ,$200.26 , N/A , N/A , N/A , N/A ,$186.00 ,$263.50 ,$217.00 , N/A ,$294.50 ,$223.20 ,$226.30 , N/A ,$263.50 , N/A , N/A ,$248.00 ,$226.30 , N/A , N/A , N/A ,$310.00 ,$263.50 , N/A ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 , N/A ,$223.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,36040025,N/A,HC SURGICAL SUITE PER 15 MINS,360,1 ,"$1,000.00 ",$500.00 ,$500.00 ,"$1,000.00 ",$646.00 , N/A , N/A , N/A , N/A ,$600.00 ,$850.00 ,$700.00 , N/A ,$950.00 ,$720.00 ,$730.00 , N/A ,$850.00 , N/A , N/A ,$800.00 ,$730.00 , N/A , N/A , N/A ,"$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,36040027,N/A,HC SURGICAL PROCEDURE PER 15 MINS CATH/RAD ONC,360,1 ,"$1,000.00 ",$500.00 ,$500.00 ,"$1,000.00 ",$646.00 , N/A , N/A , N/A , N/A ,$600.00 ,$850.00 ,$700.00 , N/A ,$950.00 ,$720.00 ,$730.00 , N/A ,$850.00 , N/A , N/A ,$800.00 ,$730.00 , N/A , N/A , N/A ,"$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,36050640,N/A,HC LASER FOR CATARACT SURGERY,360,1 ,$582.00 ,$291.00 ,$291.00 ,$582.00 ,$375.97 , N/A , N/A , N/A , N/A ,$349.20 ,$494.70 ,$407.40 , N/A ,$552.90 ,$419.04 ,$424.86 , N/A ,$494.70 , N/A , N/A ,$465.60 ,$424.86 , N/A , N/A , N/A ,$582.00 ,$494.70 , N/A ,$535.44 ,$407.40 ,$291.00 ,$349.20 ,$354.44 ,$291.00 ,$402.16 ,$407.40 , N/A ,$419.04 , N/A , N/A , N/A , N/A , N/A , N/A ,$419.04 ,$360.84 ,$419.04 ,$419.04 ,$349.20 ST VINCENT HOSPITAL - ACUTE,36060001,N/A,HC OR LEVEL 1 BASE,360,1 ,"$3,600.00 ","$1,800.00 ","$1,800.00 ","$3,600.00 ","$2,325.60 ", N/A , N/A , N/A , N/A ,"$2,160.00 ","$3,060.00 ","$2,520.00 ", N/A ,"$3,420.00 ","$2,592.00 ","$2,628.00 ", N/A ,"$3,060.00 ", N/A , N/A ,"$2,880.00 ","$2,628.00 ", N/A , N/A , N/A ,"$3,600.00 ","$3,060.00 ", N/A ,"$3,312.00 ","$2,520.00 ","$1,800.00 ","$2,160.00 ","$2,192.40 ","$1,800.00 ","$2,487.60 ","$2,520.00 ", N/A ,"$2,592.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,592.00 ","$2,232.00 ","$2,592.00 ","$2,592.00 ","$2,160.00 " ST VINCENT HOSPITAL - ACUTE,36060002,N/A,HC OR LEVEL 2 BASE,360,1 ,"$5,200.00 ","$2,600.00 ","$2,600.00 ","$5,200.00 ","$3,359.20 ", N/A , N/A , N/A , N/A ,"$3,120.00 ","$4,420.00 ","$3,640.00 ", N/A ,"$4,940.00 ","$3,744.00 ","$3,796.00 ", N/A ,"$4,420.00 ", N/A , N/A ,"$4,160.00 ","$3,796.00 ", N/A , N/A , N/A ,"$5,200.00 ","$4,420.00 ", N/A ,"$4,784.00 ","$3,640.00 ","$2,600.00 ","$3,120.00 ","$3,166.80 ","$2,600.00 ","$3,593.20 ","$3,640.00 ", N/A ,"$3,744.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,36060003,N/A,HC OR LEVEL 3 BASE,360,1 ,"$6,700.00 ","$3,350.00 ","$3,350.00 ","$6,700.00 ","$4,328.20 ", N/A , N/A , N/A , N/A ,"$4,020.00 ","$5,695.00 ","$4,690.00 ", N/A ,"$6,365.00 ","$4,824.00 ","$4,891.00 ", N/A ,"$5,695.00 ", N/A , N/A ,"$5,360.00 ","$4,891.00 ", N/A , N/A , N/A ,"$6,700.00 ","$5,695.00 ", N/A ,"$6,164.00 ","$4,690.00 ","$3,350.00 ","$4,020.00 ","$4,080.30 ","$3,350.00 ","$4,629.70 ","$4,690.00 ", N/A ,"$4,824.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,824.00 ","$4,154.00 ","$4,824.00 ","$4,824.00 ","$4,020.00 " ST VINCENT HOSPITAL - ACUTE,36060004,N/A,HC OR LEVEL 4 BASE,360,1 ,"$9,300.00 ","$4,650.00 ","$4,650.00 ","$9,300.00 ","$6,007.80 ", N/A , N/A , N/A , N/A ,"$5,580.00 ","$7,905.00 ","$6,510.00 ", N/A ,"$8,835.00 ","$6,696.00 ","$6,789.00 ", N/A ,"$7,905.00 ", N/A , N/A ,"$7,440.00 ","$6,789.00 ", N/A , N/A , N/A ,"$9,300.00 ","$7,905.00 ", N/A ,"$8,556.00 ","$6,510.00 ","$4,650.00 ","$5,580.00 ","$5,663.70 ","$4,650.00 ","$6,426.30 ","$6,510.00 ", N/A ,"$6,696.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,696.00 ","$5,766.00 ","$6,696.00 ","$6,696.00 ","$5,580.00 " ST VINCENT HOSPITAL - ACUTE,36060005,N/A,HC OR LEVEL 5 BASE,360,1 ,"$11,000.00 ","$5,500.00 ","$5,500.00 ","$11,000.00 ","$7,106.00 ", N/A , N/A , N/A , N/A ,"$6,600.00 ","$9,350.00 ","$7,700.00 ", N/A ,"$10,450.00 ","$7,920.00 ","$8,030.00 ", N/A ,"$9,350.00 ", N/A , N/A ,"$8,800.00 ","$8,030.00 ", N/A , N/A , N/A ,"$11,000.00 ","$9,350.00 ", N/A ,"$10,120.00 ","$7,700.00 ","$5,500.00 ","$6,600.00 ","$6,699.00 ","$5,500.00 ","$7,601.00 ","$7,700.00 ", N/A ,"$7,920.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$7,920.00 ","$6,820.00 ","$7,920.00 ","$7,920.00 ","$6,600.00 " ST VINCENT HOSPITAL - ACUTE,36060006,N/A,HC OR LEVEL 6 BASE,360,1 ,"$14,000.00 ","$7,000.00 ","$7,000.00 ","$14,000.00 ","$9,044.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ","$11,900.00 ","$9,800.00 ", N/A ,"$13,300.00 ","$10,080.00 ","$10,220.00 ", N/A ,"$11,900.00 ", N/A , N/A ,"$11,200.00 ","$10,220.00 ", N/A , N/A , N/A ,"$14,000.00 ","$11,900.00 ", N/A ,"$12,880.00 ","$9,800.00 ","$7,000.00 ","$8,400.00 ","$8,526.00 ","$7,000.00 ","$9,674.00 ","$9,800.00 ", N/A ,"$10,080.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$10,080.00 ","$8,680.00 ","$10,080.00 ","$10,080.00 ","$8,400.00 " ST VINCENT HOSPITAL - ACUTE,36060007,N/A,HC OR LEVEL 1 PER MIN,360,1 ,$15.00 ,$7.50 ,$7.50 ,$15.00 ,$9.69 , N/A , N/A , N/A , N/A ,$9.00 ,$12.75 ,$10.50 , N/A ,$14.25 ,$10.80 ,$10.95 , N/A ,$12.75 , N/A , N/A ,$12.00 ,$10.95 , N/A , N/A , N/A ,$15.00 ,$12.75 , N/A ,$13.80 ,$10.50 ,$7.50 ,$9.00 ,$9.14 ,$7.50 ,$10.37 ,$10.50 , N/A ,$10.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$10.80 ,$9.30 ,$10.80 ,$10.80 ,$9.00 ST VINCENT HOSPITAL - ACUTE,36060008,N/A,HC OR LEVEL 2 PER MIN,360,1 ,$36.00 ,$18.00 ,$18.00 ,$36.00 ,$23.26 , N/A , N/A , N/A , N/A ,$21.60 ,$30.60 ,$25.20 , N/A ,$34.20 ,$25.92 ,$26.28 , N/A ,$30.60 , N/A , N/A ,$28.80 ,$26.28 , N/A , N/A , N/A ,$36.00 ,$30.60 , N/A ,$33.12 ,$25.20 ,$18.00 ,$21.60 ,$21.92 ,$18.00 ,$24.88 ,$25.20 , N/A ,$25.92 , N/A , N/A , N/A , N/A , N/A , N/A ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,36060009,N/A,HC OR LEVEL 3 PER MIN,360,1 ,$50.00 ,$25.00 ,$25.00 ,$50.00 ,$32.30 , N/A , N/A , N/A , N/A ,$30.00 ,$42.50 ,$35.00 , N/A ,$47.50 ,$36.00 ,$36.50 , N/A ,$42.50 , N/A , N/A ,$40.00 ,$36.50 , N/A , N/A , N/A ,$50.00 ,$42.50 , N/A ,$46.00 ,$35.00 ,$25.00 ,$30.00 ,$30.45 ,$25.00 ,$34.55 ,$35.00 , N/A ,$36.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,36060010,N/A,HC OR LEVEL 4 PER MIN,360,1 ,$80.00 ,$40.00 ,$40.00 ,$80.00 ,$51.68 , N/A , N/A , N/A , N/A ,$48.00 ,$68.00 ,$56.00 , N/A ,$76.00 ,$57.60 ,$58.40 , N/A ,$68.00 , N/A , N/A ,$64.00 ,$58.40 , N/A , N/A , N/A ,$80.00 ,$68.00 , N/A ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 , N/A ,$57.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,36060011,N/A,HC OR LEVEL 5 PER MIN,360,1 ,$90.00 ,$45.00 ,$45.00 ,$90.00 ,$58.14 , N/A , N/A , N/A , N/A ,$54.00 ,$76.50 ,$63.00 , N/A ,$85.50 ,$64.80 ,$65.70 , N/A ,$76.50 , N/A , N/A ,$72.00 ,$65.70 , N/A , N/A , N/A ,$90.00 ,$76.50 , N/A ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 , N/A ,$64.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,36060012,N/A,HC OR LEVEL 6 PER MIN,360,1 ,$100.00 ,$50.00 ,$50.00 ,$100.00 ,$64.60 , N/A , N/A , N/A , N/A ,$60.00 ,$85.00 ,$70.00 , N/A ,$95.00 ,$72.00 ,$73.00 , N/A ,$85.00 , N/A , N/A ,$80.00 ,$73.00 , N/A , N/A , N/A ,$100.00 ,$85.00 , N/A ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 , N/A ,$72.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,36100001,47537,HC REM BIL CATH W G SI CHOLANG,361,1 ,"$1,500.00 ",$750.00 ,$60.28 ,"$1,764.22 ",$969.00 ,$60.28 ,"$1,500.00 ","$1,500.00 ",$784.10 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$60.28 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,500.00 ","$1,275.00 ",$784.10 ,"$1,500.00 ","$1,200.00 ","$1,095.00 ",$60.28 ,$784.10 ,"$1,500.00 ","$1,500.00 ","$1,275.00 ","$1,764.22 ","$1,380.00 ","$1,050.00 ","$1,500.00 ","$1,500.00 ",$913.50 ,"$1,500.00 ","$1,036.50 ","$1,050.00 ",$791.94 ,"$1,080.00 ",$63.90 ,"$1,500.00 ","$1,500.00 ",$784.10 ,"$1,500.00 ",$784.10 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,36100002,47538,HC PLC BILE SNT W G SI EX/REMOVAL CHOLANG,361,1 ,"$7,700.00 ","$3,850.00 ",$703.19 ,"$11,027.33 ","$4,974.20 ",$703.19 ,"$7,700.00 ","$7,700.00 ","$4,901.04 ","$4,620.00 ","$6,545.00 ","$5,390.00 ",$703.19 ,"$7,315.00 ","$5,544.00 ","$5,621.00 ","$6,750.00 ","$6,545.00 ","$4,901.04 ","$6,750.00 ","$6,160.00 ","$5,621.00 ",$703.19 ,"$4,901.04 ","$7,700.00 ","$7,700.00 ","$6,545.00 ","$11,027.33 ","$7,084.00 ","$5,390.00 ","$5,818.90 ","$7,821.36 ","$4,689.30 ","$7,273.62 ","$5,320.70 ","$5,390.00 ","$4,950.05 ","$5,544.00 ",$745.38 ,"$7,700.00 ","$7,700.00 ","$4,901.04 ","$7,700.00 ","$4,901.04 ","$5,544.00 ","$4,774.00 ","$5,544.00 ","$5,544.00 ","$4,620.00 " ST VINCENT HOSPITAL - ACUTE,36100003,47540,HC PLC BILE SNT W GD SI NEW ACCESS,361,1 ,"$10,000.00 ","$5,000.00 ","$1,826.39 ","$11,027.33 ","$6,460.00 ","$1,826.39 ","$10,000.00 ","$9,191.00 ","$4,901.04 ","$6,000.00 ","$8,500.00 ","$7,000.00 ","$1,826.39 ","$9,500.00 ","$7,200.00 ","$7,300.00 ","$6,750.00 ","$8,500.00 ","$4,901.04 ","$6,750.00 ","$8,000.00 ","$7,300.00 ","$1,826.39 ","$4,901.04 ","$7,726.69 ","$10,000.00 ","$8,500.00 ","$11,027.33 ","$9,200.00 ","$7,000.00 ","$3,819.70 ","$5,133.66 ","$6,090.00 ","$4,774.62 ","$6,910.00 ","$7,000.00 ","$4,950.05 ","$7,200.00 ","$1,935.97 ","$8,890.00 ","$8,890.00 ","$4,901.04 ","$8,890.00 ","$4,901.04 ","$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,36100004,50430,HC INJ NEPH URET W G SI NEW ACCESS,361,1 ,"$1,800.00 ",$900.00 ,$125.13 ,"$5,491.68 ","$1,162.80 ",$125.13 ,"$1,800.00 ","$1,800.00 ",$556.66 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$125.13 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ",$556.66 ,"$1,800.00 ","$1,440.00 ","$1,314.00 ",$125.13 ,$556.66 ,"$1,655.72 ","$1,800.00 ","$1,530.00 ","$1,252.50 ","$1,656.00 ","$1,260.00 ","$4,085.71 ","$5,491.68 ","$1,096.20 ","$5,107.14 ","$1,243.80 ","$1,260.00 ",$562.23 ,"$1,296.00 ",$132.64 ,"$1,800.00 ","$1,800.00 ",$556.66 ,"$1,800.00 ",$556.66 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,36100005,50433,HC PL NEPH CAT W GD S AND I NEW ACCESS,361,1 ,"$6,400.00 ","$3,200.00 ",$898.01 ,"$6,703.73 ","$4,134.40 ",$898.01 ,"$3,939.00 ","$3,535.00 ","$2,979.44 ","$3,840.00 ","$5,440.00 ","$4,480.00 ",$898.01 ,"$6,080.00 ","$4,608.00 ","$4,672.00 ","$6,400.00 ","$5,440.00 ","$2,979.44 ","$6,400.00 ","$5,120.00 ","$4,672.00 ",$898.01 ,"$2,979.44 ","$4,415.25 ","$6,400.00 ","$5,440.00 ","$6,703.73 ","$5,888.00 ","$4,480.00 ","$2,331.31 ","$3,133.44 ","$3,897.60 ","$2,914.14 ","$4,422.40 ","$4,480.00 ","$3,009.23 ","$4,608.00 ",$951.89 ,"$5,082.00 ","$5,082.00 ","$2,979.44 ","$5,082.00 ","$2,979.44 ","$4,608.00 ","$3,968.00 ","$4,608.00 ","$4,608.00 ","$3,840.00 " ST VINCENT HOSPITAL - ACUTE,36100006,50434,HC CONVERT NEPH CTH NEPHUR CTH WG S AND I EXST TRACT,361,1 ,"$6,600.00 ","$3,300.00 ",$430.16 ,"$6,600.00 ","$4,263.60 ",$430.16 ,"$3,939.00 ","$3,535.00 ","$1,736.51 ","$3,960.00 ","$5,610.00 ","$4,620.00 ",$430.16 ,"$6,270.00 ","$4,752.00 ","$4,818.00 ","$6,600.00 ","$5,610.00 ","$1,736.51 ","$6,600.00 ","$5,280.00 ","$4,818.00 ",$430.16 ,"$1,736.51 ","$2,428.39 ","$6,600.00 ","$5,610.00 ","$3,907.15 ","$6,072.00 ","$4,620.00 ","$2,331.31 ","$3,133.44 ","$4,019.40 ","$2,914.14 ","$4,560.60 ","$4,620.00 ","$1,753.88 ","$4,752.00 ",$455.97 ,"$2,724.00 ","$2,724.00 ","$1,736.51 ","$2,724.00 ","$1,736.51 ","$4,752.00 ","$4,092.00 ","$4,752.00 ","$4,752.00 ","$3,960.00 " ST VINCENT HOSPITAL - ACUTE,36100007,50606,HC ENDO BX URETER/RENAL PELVIS W/G SI,361,1 ,$470.00 ,$235.00 ,$235.00 ,"$2,778.48 ",$303.62 ,$470.00 ,$470.00 ,$470.00 , N/A ,$282.00 ,$399.50 ,$329.00 ,"$1,837.34 ",$446.50 ,$338.40 ,$343.10 ,$470.00 ,$399.50 , N/A ,$470.00 ,$376.00 ,$343.10 ,"$1,837.34 ", N/A ,$470.00 ,$470.00 ,$399.50 , N/A ,$432.40 ,$329.00 ,"$2,066.52 ","$2,778.48 ",$286.23 ,"$2,583.66 ",$324.77 ,$329.00 , N/A ,$338.40 ,"$1,947.58 ",$470.00 ,$470.00 , N/A ,$470.00 , N/A ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,36100008,50694,HC PL URT STNT W G SI NEW ACCESS WO NEPH CATH,361,1 ,"$5,600.00 ","$2,800.00 ",$898.01 ,"$6,703.73 ","$3,617.60 ",$898.01 ,"$5,600.00 ","$5,600.00 ","$2,979.44 ","$3,360.00 ","$4,760.00 ","$3,920.00 ",$898.01 ,"$5,320.00 ","$4,032.00 ","$4,088.00 ","$5,600.00 ","$4,760.00 ","$2,979.44 ","$5,600.00 ","$4,480.00 ","$4,088.00 ",$898.01 ,"$2,979.44 ","$5,519.06 ","$5,600.00 ","$4,760.00 ","$6,703.73 ","$5,152.00 ","$3,920.00 ","$2,331.31 ","$3,133.44 ","$3,410.40 ","$2,914.14 ","$3,869.60 ","$3,920.00 ","$3,009.23 ","$4,032.00 ",$951.89 ,"$5,600.00 ","$5,600.00 ","$2,979.44 ","$5,600.00 ","$2,979.44 ","$4,032.00 ","$3,472.00 ","$4,032.00 ","$4,032.00 ","$3,360.00 " ST VINCENT HOSPITAL - ACUTE,36100009,50695,HC PL URT STNT W G SI NEW ACCESS WITH NEPH CATH,361,1 ,"$18,000.00 ","$9,000.00 ",$898.01 ,"$18,000.00 ","$11,628.00 ",$898.01 ,"$7,070.00 ","$6,565.00 ","$2,979.44 ","$10,800.00 ","$15,300.00 ","$12,600.00 ",$898.01 ,"$17,100.00 ","$12,960.00 ","$13,140.00 ","$6,750.00 ","$15,300.00 ","$2,979.44 ","$6,750.00 ","$14,400.00 ","$13,140.00 ",$898.01 ,"$2,979.44 ","$5,519.06 ","$18,000.00 ","$15,300.00 ","$6,703.73 ","$16,560.00 ","$12,600.00 ","$3,819.70 ","$5,133.66 ","$10,962.00 ","$4,774.62 ","$12,438.00 ","$12,600.00 ","$3,009.23 ","$12,960.00 ",$951.89 ,"$6,668.00 ","$6,668.00 ","$2,979.44 ","$6,668.00 ","$2,979.44 ","$12,960.00 ","$11,160.00 ","$12,960.00 ","$12,960.00 ","$10,800.00 " ST VINCENT HOSPITAL - ACUTE,36100010,50705,HC URETERAL EMBOL OR OCCLUSION W/G SI,361,1 ,$400.00 ,$200.00 ,$200.00 ,"$2,778.48 ",$258.40 ,$400.00 ,$400.00 ,$400.00 , N/A ,$240.00 ,$340.00 ,$280.00 ,"$1,837.34 ",$380.00 ,$288.00 ,$292.00 ,$400.00 ,$340.00 , N/A ,$400.00 ,$320.00 ,$292.00 ,"$1,837.34 ", N/A ,$400.00 ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,"$2,066.52 ","$2,778.48 ",$243.60 ,"$2,583.66 ",$276.40 ,$280.00 , N/A ,$288.00 ,"$1,947.58 ",$400.00 ,$400.00 , N/A ,$400.00 , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,36100011,49185,HC SCLEROTHERAPY FLUID COLLECTION PERC INJECT IG SI,361,1 ,"$2,400.00 ","$1,200.00 ",$202.63 ,"$2,400.00 ","$1,550.40 ",$202.63 ,"$2,400.00 ","$2,020.00 ",$602.38 ,"$1,440.00 ","$2,040.00 ","$1,680.00 ",$202.63 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$2,400.00 ","$2,040.00 ",$602.38 ,"$2,400.00 ","$1,920.00 ","$1,752.00 ",$202.63 ,$602.38 ,"$2,400.00 ","$2,400.00 ","$2,040.00 ","$1,355.35 ","$2,208.00 ","$1,680.00 ","$2,066.93 ","$2,400.00 ","$1,461.60 ","$2,400.00 ","$1,658.40 ","$1,680.00 ",$608.40 ,"$1,728.00 ",$214.79 ,"$2,400.00 ","$2,400.00 ",$602.38 ,"$2,400.00 ",$602.38 ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,36100012,50706,HC BALLOON DILATION URETERAL IG SI,361,1 ,$580.00 ,$290.00 ,$290.00 ,"$3,133.44 ",$374.68 ,$580.00 ,$580.00 ,$580.00 , N/A ,$348.00 ,$493.00 ,$406.00 ,"$1,837.34 ",$551.00 ,$417.60 ,$423.40 ,$580.00 ,$493.00 , N/A ,$580.00 ,$464.00 ,$423.40 ,"$1,837.34 ", N/A ,$580.00 ,$580.00 ,$493.00 , N/A ,$533.60 ,$406.00 ,"$2,331.72 ","$3,133.44 ",$353.22 ,"$2,914.14 ",$400.78 ,$406.00 , N/A ,$417.60 ,"$1,947.58 ",$580.00 ,$580.00 , N/A ,$580.00 , N/A ,$417.60 ,$359.60 ,$417.60 ,$417.60 ,$348.00 ST VINCENT HOSPITAL - ACUTE,36100013,47541,HC PLCMENT ACCESS BILIARY TREE BOWEL PERC IG SI,361,1 ,"$4,400.00 ","$2,200.00 ","$1,826.39 ","$6,937.05 ","$2,842.40 ","$1,826.39 ","$4,400.00 ","$4,400.00 ","$3,083.13 ","$2,640.00 ","$3,740.00 ","$3,080.00 ","$1,826.39 ","$4,180.00 ","$3,168.00 ","$3,212.00 ","$4,400.00 ","$3,740.00 ","$3,083.13 ","$4,400.00 ","$3,520.00 ","$3,212.00 ","$1,826.39 ","$3,083.13 ","$4,400.00 ","$4,400.00 ","$3,740.00 ","$6,937.05 ","$4,048.00 ","$3,080.00 ","$2,066.93 ","$2,778.48 ","$2,679.60 ","$2,583.66 ","$3,040.40 ","$3,080.00 ","$3,113.96 ","$3,168.00 ","$1,935.97 ","$4,400.00 ","$4,400.00 ","$3,083.13 ","$4,400.00 ","$3,083.13 ","$3,168.00 ","$2,728.00 ","$3,168.00 ","$3,168.00 ","$2,640.00 " ST VINCENT HOSPITAL - ACUTE,36100024,G0259,HC INJ ARTHROGRAM SACROILIAC JNT,361,1 ,"$1,500.00 ",$750.00 ,$162.48 ,"$1,500.00 ",$969.00 ,$162.48 , N/A , N/A , N/A ,$900.00 ,"$1,275.00 ","$1,050.00 ",$162.48 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,500.00 ","$1,275.00 ", N/A ,"$1,500.00 ","$1,200.00 ","$1,095.00 ",$162.48 , N/A , N/A ,"$1,500.00 ","$1,275.00 ", N/A ,"$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ", N/A ,"$1,080.00 ",$172.23 ,"$1,500.00 ","$1,500.00 ", N/A ,"$1,500.00 ", N/A ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,36100026,36510,HC UMBILICAL CATHETER INSERTION NEWBORN,361,1 ,$110.00 ,$55.00 ,$17.61 ,"$7,821.36 ",$71.06 ,$17.61 ,$110.00 ,$110.00 , N/A ,$66.00 ,$93.50 ,$77.00 ,$17.61 ,$104.50 ,$79.20 ,$80.30 ,$110.00 ,$93.50 , N/A ,$110.00 ,$88.00 ,$80.30 ,$17.61 , N/A ,$110.00 ,$110.00 ,$93.50 , N/A ,$101.20 ,$77.00 ,"$5,818.90 ","$7,821.36 ",$66.99 ,"$7,273.62 ",$76.01 ,$77.00 , N/A ,$79.20 ,$18.67 ,$110.00 ,$110.00 , N/A ,$110.00 , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,36100028,47383,HC ABLATION TUMOR LIVER CRYOABLATION,361,1 ,"$4,200.00 ","$2,100.00 ","$1,826.39 ","$11,027.33 ","$2,713.20 ","$1,826.39 ","$4,200.00 ","$4,200.00 ","$4,901.04 ","$2,520.00 ","$3,570.00 ","$2,940.00 ","$1,826.39 ","$3,990.00 ","$3,024.00 ","$3,066.00 ","$4,200.00 ","$3,570.00 ","$4,901.04 ","$4,200.00 ","$3,360.00 ","$3,066.00 ","$1,826.39 ","$4,901.04 ","$4,200.00 ","$4,200.00 ","$3,570.00 ","$11,027.33 ","$3,864.00 ","$2,940.00 ","$5,818.90 ","$7,821.36 ","$2,557.80 ","$7,273.62 ","$2,902.20 ","$2,940.00 ","$4,950.05 ","$3,024.00 ","$1,935.97 ","$4,200.00 ","$4,200.00 ","$4,901.04 ","$4,200.00 ","$4,901.04 ","$3,024.00 ","$2,604.00 ","$3,024.00 ","$3,024.00 ","$2,520.00 " ST VINCENT HOSPITAL - ACUTE,36100100,62320,HC INJ INTRLAMNR CERV/THOR W/O GUIDE,361,1 ,"$1,200.00 ",$600.00 ,$263.02 ,"$1,382.85 ",$775.20 ,$263.02 ,"$1,200.00 ","$1,200.00 ",$614.60 ,$720.00 ,"$1,020.00 ",$840.00 ,$263.02 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ",$614.60 ,"$1,200.00 ",$960.00 ,$876.00 ,$263.02 ,$614.60 ,"$1,200.00 ","$1,200.00 ","$1,020.00 ","$1,382.85 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,$620.75 ,$864.00 ,$278.80 ,"$1,200.00 ","$1,200.00 ",$614.60 ,"$1,200.00 ",$614.60 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36100101,62321,HC INJ INTRLAMNR CERV/THOR W/GUIDE,361,1 ,"$1,900.00 ",$950.00 ,$263.02 ,"$1,900.00 ","$1,227.40 ",$263.02 ,"$1,900.00 ","$1,900.00 ",$614.60 ,"$1,140.00 ","$1,615.00 ","$1,330.00 ",$263.02 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,900.00 ","$1,615.00 ",$614.60 ,"$1,900.00 ","$1,520.00 ","$1,387.00 ",$263.02 ,$614.60 ,"$1,900.00 ","$1,900.00 ","$1,615.00 ","$1,382.85 ","$1,748.00 ","$1,330.00 ","$1,900.00 ","$1,900.00 ","$1,157.10 ","$1,900.00 ","$1,312.90 ","$1,330.00 ",$620.75 ,"$1,368.00 ",$278.80 ,"$1,900.00 ","$1,900.00 ",$614.60 ,"$1,900.00 ",$614.60 ,"$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,36100102,62322,HC INJ INTRLAMNR LUM/SAC W/O GUIDE,361,1 ,"$1,200.00 ",$600.00 ,$263.02 ,"$1,382.85 ",$775.20 ,$263.02 ,"$1,200.00 ","$1,200.00 ",$614.60 ,$720.00 ,"$1,020.00 ",$840.00 ,$263.02 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ",$614.60 ,"$1,200.00 ",$960.00 ,$876.00 ,$263.02 ,$614.60 ,"$1,200.00 ","$1,200.00 ","$1,020.00 ","$1,382.85 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,$620.75 ,$864.00 ,$278.80 ,"$1,200.00 ","$1,200.00 ",$614.60 ,"$1,200.00 ",$614.60 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36100103,62323,HC INJ INTRLAMNR LUM/SAC W/GUIDE,361,1 ,"$1,500.00 ",$750.00 ,$263.02 ,"$1,500.00 ",$969.00 ,$263.02 ,"$1,500.00 ","$1,500.00 ",$614.60 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$263.02 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,500.00 ","$1,275.00 ",$614.60 ,"$1,500.00 ","$1,200.00 ","$1,095.00 ",$263.02 ,$614.60 ,"$1,500.00 ","$1,500.00 ","$1,275.00 ","$1,382.85 ","$1,380.00 ","$1,050.00 ","$1,500.00 ","$1,500.00 ",$913.50 ,"$1,500.00 ","$1,036.50 ","$1,050.00 ",$620.75 ,"$1,080.00 ",$278.80 ,"$1,500.00 ","$1,500.00 ",$614.60 ,"$1,500.00 ",$614.60 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,36100106,62326,HC INJ W/CATH LUM/SAC W/O GUIDE,361,1 ,"$1,200.00 ",$600.00 ,$263.02 ,"$1,792.24 ",$775.20 ,$263.02 ,"$1,200.00 ","$1,200.00 ",$796.55 ,$720.00 ,"$1,020.00 ",$840.00 ,$263.02 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ",$796.55 ,"$1,200.00 ",$960.00 ,$876.00 ,$263.02 ,$796.55 ,"$1,200.00 ","$1,200.00 ","$1,020.00 ","$1,792.24 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,$804.52 ,$864.00 ,$278.80 ,"$1,200.00 ","$1,200.00 ",$796.55 ,"$1,200.00 ",$796.55 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36100107,62327,HC INJ W/CATH LUM/SAC W/GUIDE,361,1 ,"$1,500.00 ",$750.00 ,$263.02 ,"$1,792.24 ",$969.00 ,$263.02 ,"$1,500.00 ","$1,500.00 ",$796.55 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$263.02 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,500.00 ","$1,275.00 ",$796.55 ,"$1,500.00 ","$1,200.00 ","$1,095.00 ",$263.02 ,$796.55 ,"$1,500.00 ","$1,500.00 ","$1,275.00 ","$1,792.24 ","$1,380.00 ","$1,050.00 ","$1,500.00 ","$1,500.00 ",$913.50 ,"$1,500.00 ","$1,036.50 ","$1,050.00 ",$804.52 ,"$1,080.00 ",$278.80 ,"$1,500.00 ","$1,500.00 ",$796.55 ,"$1,500.00 ",$796.55 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,36100108,29445,HC APPL CAST LEG RIGID CONTACT -BIL,361,1 ,$930.00 ,$465.00 ,$86.42 ,$930.00 ,$600.78 ,$86.42 ,$930.00 ,$930.00 ,$350.36 ,$558.00 ,$790.50 ,$651.00 ,$86.42 ,$883.50 ,$669.60 ,$678.90 ,$930.00 ,$790.50 ,$350.36 ,$930.00 ,$744.00 ,$678.90 ,$86.42 ,$350.36 ,$930.00 ,$930.00 ,$790.50 ,$788.31 ,$855.60 ,$651.00 ,$930.00 ,$930.00 ,$566.37 ,$930.00 ,$642.63 ,$651.00 ,$353.86 ,$669.60 ,$91.61 ,$930.00 ,$930.00 ,$350.36 ,$930.00 ,$350.36 ,$669.60 ,$576.60 ,$669.60 ,$669.60 ,$558.00 ST VINCENT HOSPITAL - ACUTE,36100135,31625,HC BRONCHOSCOPY BX SGL/MULT SITES,361,1 ,"$2,900.00 ","$1,450.00 ",$468.79 ,"$3,260.82 ","$1,873.40 ",$468.79 ,"$2,900.00 ","$2,900.00 ","$1,449.25 ","$1,740.00 ","$2,465.00 ","$2,030.00 ",$468.79 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ","$2,900.00 ","$2,465.00 ","$1,449.25 ","$2,900.00 ","$2,320.00 ","$2,117.00 ",$468.79 ,"$1,449.25 ","$2,428.39 ","$2,900.00 ","$2,465.00 ","$3,260.82 ","$2,668.00 ","$2,030.00 ","$2,331.31 ","$2,900.00 ","$1,766.10 ","$2,900.00 ","$2,003.90 ","$2,030.00 ","$1,463.74 ","$2,088.00 ",$496.92 ,"$2,900.00 ","$2,900.00 ","$1,449.25 ","$2,900.00 ","$1,449.25 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,36100136,31627,HC BRONCHOSCOPY NAVAGATIONAL,361,1 ,"$2,900.00 ","$1,450.00 ",$53.35 ,"$3,133.44 ","$1,873.40 ",$53.35 ,"$2,900.00 ","$2,900.00 ", N/A ,"$1,740.00 ","$2,465.00 ","$2,030.00 ",$53.35 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ","$2,900.00 ","$2,465.00 ", N/A ,"$2,900.00 ","$2,320.00 ","$2,117.00 ",$53.35 , N/A ,"$2,900.00 ","$2,900.00 ","$2,465.00 ", N/A ,"$2,668.00 ","$2,030.00 ","$2,331.72 ","$3,133.44 ","$1,766.10 ","$2,914.14 ","$2,003.90 ","$2,030.00 ", N/A ,"$2,088.00 ",$56.55 ,"$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,36100137,31629,HC BRONCHOSCOPY W/ASP BX TRANSHC BRONCH,361,1 ,"$3,200.00 ","$1,600.00 ",$468.79 ,"$6,750.97 ","$2,067.20 ",$468.79 ,"$3,200.00 ","$3,200.00 ","$3,000.43 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$468.79 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$3,200.00 ","$2,720.00 ","$3,000.43 ","$3,200.00 ","$2,560.00 ","$2,336.00 ",$468.79 ,"$3,000.43 ","$3,200.00 ","$3,200.00 ","$2,720.00 ","$6,750.97 ","$2,944.00 ","$2,240.00 ","$2,331.31 ","$3,133.44 ","$1,948.80 ","$2,914.14 ","$2,211.20 ","$2,240.00 ","$3,030.43 ","$2,304.00 ",$496.92 ,"$3,200.00 ","$3,200.00 ","$3,000.43 ","$3,200.00 ","$3,000.43 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,36100140,31623,HC BRONCHOSCOPY W/BRUSHING,361,1 ,"$2,900.00 ","$1,450.00 ",$468.79 ,"$3,260.82 ","$1,873.40 ",$468.79 ,"$2,900.00 ","$2,900.00 ","$1,449.25 ","$1,740.00 ","$2,465.00 ","$2,030.00 ",$468.79 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ","$2,900.00 ","$2,465.00 ","$1,449.25 ","$2,900.00 ","$2,320.00 ","$2,117.00 ",$468.79 ,"$1,449.25 ","$2,428.39 ","$2,900.00 ","$2,465.00 ","$3,260.82 ","$2,668.00 ","$2,030.00 ","$2,331.31 ","$2,900.00 ","$1,766.10 ","$2,900.00 ","$2,003.90 ","$2,030.00 ","$1,463.74 ","$2,088.00 ",$496.92 ,"$2,900.00 ","$2,900.00 ","$1,449.25 ","$2,900.00 ","$1,449.25 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,36100141,31628,HC BRONCHOSCOPY W/BX TRANSHC BRONCH SGL,361,1 ,"$3,200.00 ","$1,600.00 ",$468.79 ,"$6,750.97 ","$2,067.20 ",$468.79 ,"$3,200.00 ","$3,200.00 ","$3,000.43 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$468.79 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$3,200.00 ","$2,720.00 ","$3,000.43 ","$3,200.00 ","$2,560.00 ","$2,336.00 ",$468.79 ,"$3,000.43 ","$3,200.00 ","$3,200.00 ","$2,720.00 ","$6,750.97 ","$2,944.00 ","$2,240.00 ","$2,331.31 ","$3,133.44 ","$1,948.80 ","$2,914.14 ","$2,211.20 ","$2,240.00 ","$3,030.43 ","$2,304.00 ",$496.92 ,"$3,200.00 ","$3,200.00 ","$3,000.43 ","$3,200.00 ","$3,000.43 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,36100143,31624,HC BRONCHOSCOPY W/LAVAGE ALVEOLAR,361,1 ,"$2,900.00 ","$1,450.00 ",$468.79 ,"$3,260.82 ","$1,873.40 ",$468.79 ,"$2,900.00 ","$2,900.00 ","$1,449.25 ","$1,740.00 ","$2,465.00 ","$2,030.00 ",$468.79 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ","$2,900.00 ","$2,465.00 ","$1,449.25 ","$2,900.00 ","$2,320.00 ","$2,117.00 ",$468.79 ,"$1,449.25 ","$2,428.39 ","$2,900.00 ","$2,465.00 ","$3,260.82 ","$2,668.00 ","$2,030.00 ","$2,331.31 ","$2,900.00 ","$1,766.10 ","$2,900.00 ","$2,003.90 ","$2,030.00 ","$1,463.74 ","$2,088.00 ",$496.92 ,"$2,900.00 ","$2,900.00 ","$1,449.25 ","$2,900.00 ","$1,449.25 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,36100158,20983,HC ABLATION TUMOR BONE PERC W/GUIDANCE CRYO,361,1 ,"$4,900.00 ","$2,450.00 ",$496.73 ,"$13,652.11 ","$3,165.40 ",$496.73 ,"$4,900.00 ","$4,900.00 ","$6,067.60 ","$2,940.00 ","$4,165.00 ","$3,430.00 ",$496.73 ,"$4,655.00 ","$3,528.00 ","$3,577.00 ","$4,900.00 ","$4,165.00 ","$6,067.60 ","$4,900.00 ","$3,920.00 ","$3,577.00 ",$496.73 ,"$6,067.60 ","$4,900.00 ","$4,900.00 ","$4,165.00 ","$13,652.11 ","$4,508.00 ","$3,430.00 ","$2,066.93 ","$2,778.48 ","$2,984.10 ","$2,583.66 ","$3,385.90 ","$3,430.00 ","$6,128.28 ","$3,528.00 ",$526.53 ,"$4,900.00 ","$4,900.00 ","$6,067.60 ","$4,900.00 ","$6,067.60 ","$3,528.00 ","$3,038.00 ","$3,528.00 ","$3,528.00 ","$2,940.00 " ST VINCENT HOSPITAL - ACUTE,36100178,62264,HC INJ LYSIS EPID ADHESIONS W/RAD LOCAL 1 DAY,361,1 ,"$1,560.00 ",$780.00 ,$263.02 ,"$1,792.24 ","$1,007.76 ",$263.02 ,"$1,560.00 ","$1,560.00 ",$796.55 ,$936.00 ,"$1,326.00 ","$1,092.00 ",$263.02 ,"$1,482.00 ","$1,123.20 ","$1,138.80 ","$1,560.00 ","$1,326.00 ",$796.55 ,"$1,560.00 ","$1,248.00 ","$1,138.80 ",$263.02 ,$796.55 ,"$1,560.00 ","$1,560.00 ","$1,326.00 ","$1,792.24 ","$1,435.20 ","$1,092.00 ","$1,560.00 ","$1,560.00 ",$950.04 ,"$1,560.00 ","$1,077.96 ","$1,092.00 ",$804.52 ,"$1,123.20 ",$278.80 ,"$1,560.00 ","$1,560.00 ",$796.55 ,"$1,560.00 ",$796.55 ,"$1,123.20 ",$967.20 ,"$1,123.20 ","$1,123.20 ",$936.00 ST VINCENT HOSPITAL - ACUTE,36100226,58345,HC TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,361,1 ,"$1,598.00 ",$799.00 ,$689.81 ,"$5,716.30 ","$1,032.31 ",$689.81 ,"$1,598.00 ","$1,598.00 ","$2,540.58 ",$958.80 ,"$1,358.30 ","$1,118.60 ",$689.81 ,"$1,518.10 ","$1,150.56 ","$1,166.54 ","$1,598.00 ","$1,358.30 ","$2,540.58 ","$1,598.00 ","$1,278.40 ","$1,166.54 ",$689.81 ,"$2,540.58 ","$1,598.00 ","$1,598.00 ","$1,358.30 ","$5,716.30 ","$1,470.16 ","$1,118.60 ","$1,598.00 ","$1,598.00 ",$973.18 ,"$1,598.00 ","$1,104.22 ","$1,118.60 ","$2,565.99 ","$1,150.56 ",$731.20 ,"$1,598.00 ","$1,598.00 ","$2,540.58 ","$1,598.00 ","$2,540.58 ","$1,150.56 ",$990.76 ,"$1,150.56 ","$1,150.56 ",$958.80 ST VINCENT HOSPITAL - ACUTE,36100227,31635,HC BRONCHOSCOPY W/REM FOREIGN BODY,361,1 ,"$3,200.00 ","$1,600.00 ",$468.79 ,"$3,260.82 ","$2,067.20 ",$468.79 ,"$3,200.00 ","$3,200.00 ","$1,449.25 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$468.79 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$3,200.00 ","$2,720.00 ","$1,449.25 ","$3,200.00 ","$2,560.00 ","$2,336.00 ",$468.79 ,"$1,449.25 ","$2,428.39 ","$3,200.00 ","$2,720.00 ","$3,260.82 ","$2,944.00 ","$2,240.00 ","$2,331.31 ","$3,133.44 ","$1,948.80 ","$2,914.14 ","$2,211.20 ","$2,240.00 ","$1,463.74 ","$2,304.00 ",$496.92 ,"$3,200.00 ","$3,200.00 ","$1,449.25 ","$3,200.00 ","$1,449.25 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,36100228,31641,HC BRONCHOSCOPY W/TUMOR DESTRUCTION,361,1 ,"$3,200.00 ","$1,600.00 ","$1,009.08 ","$6,750.97 ","$2,067.20 ","$1,009.08 ","$3,200.00 ","$3,200.00 ","$3,000.43 ","$1,920.00 ","$2,720.00 ","$2,240.00 ","$1,009.08 ","$3,040.00 ","$2,304.00 ","$2,336.00 ","$3,200.00 ","$2,720.00 ","$3,000.43 ","$3,200.00 ","$2,560.00 ","$2,336.00 ","$1,009.08 ","$3,000.43 ","$3,200.00 ","$3,200.00 ","$2,720.00 ","$6,750.97 ","$2,944.00 ","$2,240.00 ","$2,331.31 ","$3,133.44 ","$1,948.80 ","$2,914.14 ","$2,211.20 ","$2,240.00 ","$3,030.43 ","$2,304.00 ","$1,069.62 ","$3,200.00 ","$3,200.00 ","$3,000.43 ","$3,200.00 ","$3,000.43 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,36100232,11103,HC BIOPSY SKIN TANGENTIAL ADDL LESN,361,1 ,$150.00 ,$75.00 ,$75.00 ,"$2,778.48 ",$96.90 ,$150.00 , N/A , N/A , N/A ,$90.00 ,$127.50 ,$105.00 ,$161.28 ,$142.50 ,$108.00 ,$109.50 ,$150.00 ,$127.50 , N/A ,$150.00 ,$120.00 ,$109.50 ,$161.28 , N/A , N/A ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,"$2,066.52 ","$2,778.48 ",$91.35 ,"$2,583.66 ",$103.65 ,$105.00 , N/A ,$108.00 ,$170.96 ,$150.00 ,$150.00 , N/A ,$150.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,36100233,11105,HC BIOPSY SKIN PUNCH ADDL LESN,361,1 ,$150.00 ,$75.00 ,$75.00 ,"$2,778.48 ",$96.90 ,$150.00 , N/A , N/A , N/A ,$90.00 ,$127.50 ,$105.00 ,$161.28 ,$142.50 ,$108.00 ,$109.50 ,$150.00 ,$127.50 , N/A ,$150.00 ,$120.00 ,$109.50 ,$161.28 , N/A , N/A ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,"$2,066.52 ","$2,778.48 ",$91.35 ,"$2,583.66 ",$103.65 ,$105.00 , N/A ,$108.00 ,$170.96 ,$150.00 ,$150.00 , N/A ,$150.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,36100234,11107,HC BIOPSY SKIN INCISIONAL ADDL LESN,361,1 ,$150.00 ,$75.00 ,$75.00 ,"$2,778.48 ",$96.90 ,$150.00 , N/A , N/A , N/A ,$90.00 ,$127.50 ,$105.00 ,$161.28 ,$142.50 ,$108.00 ,$109.50 ,$150.00 ,$127.50 , N/A ,$150.00 ,$120.00 ,$109.50 ,$161.28 , N/A , N/A ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,"$2,066.52 ","$2,778.48 ",$91.35 ,"$2,583.66 ",$103.65 ,$105.00 , N/A ,$108.00 ,$170.96 ,$150.00 ,$150.00 , N/A ,$150.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,36100235,11102,HC BIOPSY SKIN TANGENTIAL INIT LESN,361,1 ,$310.00 ,$155.00 ,$155.00 ,$391.26 ,$200.26 ,$161.28 ,$310.00 ,$310.00 ,$173.89 ,$186.00 ,$263.50 ,$217.00 ,$161.28 ,$294.50 ,$223.20 ,$226.30 ,$310.00 ,$263.50 ,$173.89 ,$310.00 ,$248.00 ,$226.30 ,$161.28 ,$173.89 ,$310.00 ,$310.00 ,$263.50 ,$391.26 ,$285.20 ,$217.00 ,$310.00 ,$310.00 ,$188.79 ,$310.00 ,$214.21 ,$217.00 ,$175.63 ,$223.20 ,$170.96 ,$310.00 ,$310.00 ,$173.89 ,$310.00 ,$173.89 ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,36100236,11104,HC BIOPSY SKIN PUNCH INIT LESN,361,1 ,$310.00 ,$155.00 ,$155.00 ,$753.63 ,$200.26 ,$161.28 ,$310.00 ,$310.00 ,$334.95 ,$186.00 ,$263.50 ,$217.00 ,$161.28 ,$294.50 ,$223.20 ,$226.30 ,$310.00 ,$263.50 ,$334.95 ,$310.00 ,$248.00 ,$226.30 ,$161.28 ,$334.95 ,$310.00 ,$310.00 ,$263.50 ,$753.63 ,$285.20 ,$217.00 ,$310.00 ,$310.00 ,$188.79 ,$310.00 ,$214.21 ,$217.00 ,$338.30 ,$223.20 ,$170.96 ,$310.00 ,$310.00 ,$334.95 ,$310.00 ,$334.95 ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,36100237,11106,HC BIOPSY SKIN INCISIONAL INIT LESN,361,1 ,$310.00 ,$155.00 ,$155.00 ,"$1,142.23 ",$200.26 ,$161.28 ,$310.00 ,$310.00 ,$507.66 ,$186.00 ,$263.50 ,$217.00 ,$161.28 ,$294.50 ,$223.20 ,$226.30 ,$310.00 ,$263.50 ,$507.66 ,$310.00 ,$248.00 ,$226.30 ,$161.28 ,$507.66 ,$310.00 ,$310.00 ,$263.50 ,"$1,142.23 ",$285.20 ,$217.00 ,$310.00 ,$310.00 ,$188.79 ,$310.00 ,$214.21 ,$217.00 ,$512.74 ,$223.20 ,$170.96 ,$310.00 ,$310.00 ,$507.66 ,$310.00 ,$507.66 ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,36100238,10005,HC ASP FINE NDL W/US GUIDE INIT LESN,361,1 ,"$1,100.00 ",$550.00 ,$180.17 ,"$1,355.35 ",$710.60 ,$180.17 ,"$1,100.00 ","$1,100.00 ",$602.38 ,$660.00 ,$935.00 ,$770.00 ,$180.17 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 ,$602.38 ,"$1,100.00 ",$880.00 ,$803.00 ,$180.17 ,$602.38 ,"$1,100.00 ","$1,100.00 ",$935.00 ,"$1,355.35 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$608.40 ,$792.00 ,$190.98 ,"$1,100.00 ","$1,100.00 ",$602.38 ,"$1,100.00 ",$602.38 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,36100239,10006,HC ASP FINE NDL W/US GUIDE EA ADDL LESN,361,1 ,$550.00 ,$275.00 ,$180.17 ,"$3,133.44 ",$355.30 ,$180.17 , N/A , N/A , N/A ,$330.00 ,$467.50 ,$385.00 ,$180.17 ,$522.50 ,$396.00 ,$401.50 ,$550.00 ,$467.50 , N/A ,$550.00 ,$440.00 ,$401.50 ,$180.17 , N/A , N/A ,$550.00 ,$467.50 , N/A ,$506.00 ,$385.00 ,"$2,331.72 ","$3,133.44 ",$334.95 ,"$2,914.14 ",$380.05 ,$385.00 , N/A ,$396.00 ,$190.98 ,$550.00 ,$550.00 , N/A ,$550.00 , N/A ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,36100240,10007,HC ASP FINE NDL W/FLUORO GUIDE INIT LESN,361,1 ,"$1,100.00 ",$550.00 ,$180.17 ,"$1,355.35 ",$710.60 ,$180.17 ,"$1,100.00 ","$1,100.00 ",$602.38 ,$660.00 ,$935.00 ,$770.00 ,$180.17 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 ,$602.38 ,"$1,100.00 ",$880.00 ,$803.00 ,$180.17 ,$602.38 ,"$1,100.00 ","$1,100.00 ",$935.00 ,"$1,355.35 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$608.40 ,$792.00 ,$190.98 ,"$1,100.00 ","$1,100.00 ",$602.38 ,"$1,100.00 ",$602.38 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,36100241,10008,HC ASP FINE NDL W/FLUORO GUIDE EA ADDL LESN,361,1 ,$550.00 ,$275.00 ,$180.17 ,"$3,133.44 ",$355.30 ,$180.17 , N/A , N/A , N/A ,$330.00 ,$467.50 ,$385.00 ,$180.17 ,$522.50 ,$396.00 ,$401.50 ,$550.00 ,$467.50 , N/A ,$550.00 ,$440.00 ,$401.50 ,$180.17 , N/A , N/A ,$550.00 ,$467.50 , N/A ,$506.00 ,$385.00 ,"$2,331.72 ","$3,133.44 ",$334.95 ,"$2,914.14 ",$380.05 ,$385.00 , N/A ,$396.00 ,$190.98 ,$550.00 ,$550.00 , N/A ,$550.00 , N/A ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,36100242,10009,HC ASP FINE NDL W/CT GUIDE INIT LESN,361,1 ,"$1,100.00 ",$550.00 ,$180.17 ,"$1,355.35 ",$710.60 ,$180.17 ,"$1,100.00 ","$1,100.00 ",$602.38 ,$660.00 ,$935.00 ,$770.00 ,$180.17 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 ,$602.38 ,"$1,100.00 ",$880.00 ,$803.00 ,$180.17 ,$602.38 ,"$1,100.00 ","$1,100.00 ",$935.00 ,"$1,355.35 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$608.40 ,$792.00 ,$190.98 ,"$1,100.00 ","$1,100.00 ",$602.38 ,"$1,100.00 ",$602.38 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,36100243,10010,HC ASP FINE NDL W/CT GUIDE EA ADDL LESN,361,1 ,$550.00 ,$275.00 ,$180.17 ,"$3,133.44 ",$355.30 ,$180.17 , N/A , N/A , N/A ,$330.00 ,$467.50 ,$385.00 ,$180.17 ,$522.50 ,$396.00 ,$401.50 ,$550.00 ,$467.50 , N/A ,$550.00 ,$440.00 ,$401.50 ,$180.17 , N/A , N/A ,$550.00 ,$467.50 , N/A ,$506.00 ,$385.00 ,"$2,331.72 ","$3,133.44 ",$334.95 ,"$2,914.14 ",$380.05 ,$385.00 , N/A ,$396.00 ,$190.98 ,$550.00 ,$550.00 , N/A ,$550.00 , N/A ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,36100246,36572,HC INS CATH PERIPH CV W/O PORT W/GUIDANCE <5,361,1 ,"$2,550.00 ","$1,275.00 ",$322.47 ,"$4,310.52 ","$1,647.30 ",$322.47 ,"$2,525.00 ","$2,020.00 ",$524.56 ,"$1,530.00 ","$2,167.50 ","$1,785.00 ",$322.47 ,"$2,422.50 ","$1,836.00 ","$1,861.50 ","$2,550.00 ","$2,167.50 ",$524.56 ,"$2,550.00 ","$2,040.00 ","$1,861.50 ",$322.47 ,$524.56 ,"$2,550.00 ","$2,550.00 ","$2,167.50 ","$1,180.26 ","$2,346.00 ","$1,785.00 ","$3,206.88 ","$4,310.52 ","$1,552.95 ","$4,008.60 ","$1,762.05 ","$1,785.00 ",$529.81 ,"$1,836.00 ",$341.82 ,"$2,550.00 ","$2,550.00 ",$524.56 ,"$2,550.00 ",$524.56 ,"$1,836.00 ","$1,581.00 ","$1,836.00 ","$1,836.00 ","$1,530.00 " ST VINCENT HOSPITAL - ACUTE,36100247,36573,HC INS PER CV CATH W/O PORT W/GUIDANCE 5>,361,1 ,"$2,900.00 ","$1,450.00 ",$322.47 ,"$4,310.52 ","$1,873.40 ",$322.47 ,"$2,900.00 ","$2,900.00 ","$1,361.85 ","$1,740.00 ","$2,465.00 ","$2,030.00 ",$322.47 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ","$2,900.00 ","$2,465.00 ","$1,361.85 ","$2,900.00 ","$2,320.00 ","$2,117.00 ",$322.47 ,"$1,361.85 ","$2,900.00 ","$2,900.00 ","$2,465.00 ","$3,064.15 ","$2,668.00 ","$2,030.00 ","$3,206.88 ","$4,310.52 ","$1,766.10 ","$4,008.60 ","$2,003.90 ","$2,030.00 ","$1,375.47 ","$2,088.00 ",$341.82 ,"$2,900.00 ","$2,900.00 ","$1,361.85 ","$2,900.00 ","$1,361.85 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,36100249,G2171,HC CREATE AV FISTULA PERC W/RAD FREQ MAGNETIC GUIDE,361,1 ,"$16,930.00 ","$8,465.00 ","$1,070.58 ","$35,005.46 ","$10,936.78 ","$1,070.58 ", N/A , N/A ,"$15,557.98 ","$10,158.00 ","$14,390.50 ","$11,851.00 ","$1,070.58 ","$16,083.50 ","$12,189.60 ","$12,358.90 ","$6,750.00 ","$14,390.50 ","$15,557.98 ","$6,750.00 ","$13,544.00 ","$12,358.90 ","$1,070.58 ","$15,557.98 ", N/A ,"$16,930.00 ","$14,390.50 ","$35,005.46 ","$15,575.60 ","$11,851.00 ","$8,465.00 ","$10,158.00 ","$10,310.37 ","$8,465.00 ","$11,698.63 ","$11,851.00 ","$15,713.56 ","$12,189.60 ","$1,134.81 ", N/A , N/A ,"$15,557.98 ", N/A ,"$15,557.98 ","$12,189.60 ","$10,496.60 ","$12,189.60 ","$12,189.60 ","$10,158.00 " ST VINCENT HOSPITAL - ACUTE,36100256,64999,HC ABLATION CYRO INTERCOSTAL NERVE,361,1 ,"$4,900.00 ","$2,450.00 ",$121.61 ,"$4,900.00 ","$3,165.40 ",$121.61 ,"$4,900.00 ","$4,900.00 ",$252.94 ,"$2,940.00 ","$4,165.00 ","$3,430.00 ",$121.61 ,"$4,655.00 ","$3,528.00 ","$3,577.00 ","$2,717.00 ","$4,165.00 ",$252.94 ,"$2,717.00 ","$3,920.00 ","$3,577.00 ",$121.61 ,$252.94 ,"$4,900.00 ","$4,900.00 ","$4,165.00 ",$569.12 ,"$4,508.00 ","$3,430.00 ", N/A , N/A ,"$2,984.10 ", N/A ,"$3,385.90 ","$3,430.00 ",$255.47 ,"$3,528.00 ",$128.91 ,"$1,858.00 ","$1,858.00 ",$252.94 ,"$1,858.00 ",$252.94 ,"$3,528.00 ","$3,038.00 ","$3,528.00 ","$3,528.00 ","$2,940.00 " ST VINCENT HOSPITAL - ACUTE,36100257,37799,HC ABLATION ARTERIES RADIOFREQ,361,1 ,"$4,900.00 ","$2,450.00 ",$524.56 ,"$4,900.00 ","$3,165.40 ",$624.62 ,"$4,900.00 ","$4,900.00 ",$524.56 ,"$2,940.00 ","$4,165.00 ","$3,430.00 ",$624.62 ,"$4,655.00 ","$3,528.00 ","$3,577.00 ","$2,717.00 ","$4,165.00 ",$524.56 ,"$2,717.00 ","$3,920.00 ","$3,577.00 ",$624.62 ,$524.56 ,"$4,900.00 ","$4,900.00 ","$4,165.00 ","$1,180.26 ","$4,508.00 ","$3,430.00 ","$2,450.00 ","$2,940.00 ","$2,984.10 ","$2,450.00 ","$3,385.90 ","$3,430.00 ",$529.81 ,"$3,528.00 ",$662.10 ,"$2,724.00 ","$2,724.00 ",$524.56 ,"$2,724.00 ",$524.56 ,"$3,528.00 ","$3,038.00 ","$3,528.00 ","$3,528.00 ","$2,940.00 " ST VINCENT HOSPITAL - ACUTE,36100264,33016,HC PERICARDIOCENTESIS W/ OR W/O IMAGING,361,1 ,"$1,700.00 ",$850.00 ,$258.10 ,"$3,064.15 ","$1,098.20 ",$258.10 ,"$1,700.00 ","$1,700.00 ","$1,361.85 ","$1,020.00 ","$1,445.00 ","$1,190.00 ",$258.10 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,700.00 ","$1,445.00 ","$1,361.85 ","$1,700.00 ","$1,360.00 ","$1,241.00 ",$258.10 ,"$1,361.85 ","$1,700.00 ","$1,700.00 ","$1,445.00 ","$3,064.15 ","$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ","$1,375.47 ","$1,224.00 ",$273.59 ,"$1,700.00 ","$1,700.00 ","$1,361.85 ","$1,700.00 ","$1,361.85 ","$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,36100265,33017,HC PERICARDIAL DRAINAGE =>6 YRS W/O CONGENITAL CARDIAC ANOMALY,361,1 ,"$2,100.00 ","$1,050.00 ",$258.10 ,"$2,100.00 ","$1,356.60 ",$258.10 ,"$2,100.00 ","$2,100.00 ", N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$258.10 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$2,100.00 ","$1,785.00 ", N/A ,"$2,100.00 ","$1,680.00 ","$1,533.00 ",$258.10 , N/A ,"$2,100.00 ","$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$1,050.00 ","$1,260.00 ","$1,278.90 ","$1,050.00 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ",$273.59 ,"$2,100.00 ","$2,100.00 ", N/A ,"$2,100.00 ", N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,36100266,33018,HC PERICARDIAL DRAINAGE <=5 YRS W/CONGENITAL CARDIAC ANOMALY,361,1 ,"$2,100.00 ","$1,050.00 ",$258.10 ,"$2,100.00 ","$1,356.60 ",$258.10 ,"$2,100.00 ","$2,100.00 ", N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$258.10 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$2,100.00 ","$1,785.00 ", N/A ,"$2,100.00 ","$1,680.00 ","$1,533.00 ",$258.10 , N/A ,"$2,100.00 ","$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$1,050.00 ","$1,260.00 ","$1,278.90 ","$1,050.00 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ",$273.59 ,"$2,100.00 ","$2,100.00 ", N/A ,"$2,100.00 ", N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,36100267,33019,HC PERICARDIAL DRAINAGE W/INS CATH PERC W/CT GUIDANCE,361,1 ,"$2,100.00 ","$1,050.00 ",$258.10 ,"$2,100.00 ","$1,356.60 ",$258.10 ,"$2,100.00 ","$2,100.00 ", N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$258.10 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$2,100.00 ","$1,785.00 ", N/A ,"$2,100.00 ","$1,680.00 ","$1,533.00 ",$258.10 , N/A ,"$2,100.00 ","$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$1,050.00 ","$1,260.00 ","$1,278.90 ","$1,050.00 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ",$273.59 ,"$2,100.00 ","$2,100.00 ", N/A ,"$2,100.00 ", N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,36100270,62328,HC LUMBAR PUNCTURE DIAGNOSTIC W/FLUORO OR CT GUID,361,1 ,"$1,200.00 ",$600.00 ,$263.02 ,"$1,382.85 ",$775.20 ,$263.02 ,"$1,200.00 ","$1,200.00 ",$614.60 ,$720.00 ,"$1,020.00 ",$840.00 ,$263.02 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ",$614.60 ,"$1,200.00 ",$960.00 ,$876.00 ,$263.02 ,$614.60 ,"$1,200.00 ","$1,200.00 ","$1,020.00 ","$1,382.85 ","$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$620.75 ,$864.00 ,$278.80 ,"$1,200.00 ","$1,200.00 ",$614.60 ,"$1,200.00 ",$614.60 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36100271,62329,HC LUMBAR PUNCTURE THERAPEUTIC/DRAINAGE W//FLUORO OR CT GUID,361,1 ,"$1,200.00 ",$600.00 ,$263.02 ,"$1,382.85 ",$775.20 ,$263.02 ,"$1,200.00 ","$1,200.00 ",$614.60 ,$720.00 ,"$1,020.00 ",$840.00 ,$263.02 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ",$614.60 ,"$1,200.00 ",$960.00 ,$876.00 ,$263.02 ,$614.60 ,"$1,200.00 ","$1,200.00 ","$1,020.00 ","$1,382.85 ","$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$620.75 ,$864.00 ,$278.80 ,"$1,200.00 ","$1,200.00 ",$614.60 ,"$1,200.00 ",$614.60 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,36100275,64625,HC ABLATION RF NERVES SI JOINT W/FLUORO OR CT GUID,361,1 ,"$3,300.00 ","$1,650.00 ",$424.65 ,"$3,823.04 ","$2,131.80 ",$424.65 ,"$3,300.00 ","$3,300.00 ","$1,699.13 ","$1,980.00 ","$2,805.00 ","$2,310.00 ",$424.65 ,"$3,135.00 ","$2,376.00 ","$2,409.00 ","$3,300.00 ","$2,805.00 ","$1,699.13 ","$3,300.00 ","$2,640.00 ","$2,409.00 ",$424.65 ,"$1,699.13 ","$3,300.00 ","$3,300.00 ","$2,805.00 ","$3,823.04 ","$3,036.00 ","$2,310.00 ","$1,650.00 ","$1,980.00 ","$2,009.70 ","$1,650.00 ","$2,280.30 ","$2,310.00 ","$1,716.12 ","$2,376.00 ",$450.13 ,"$3,300.00 ","$3,300.00 ","$1,699.13 ","$3,300.00 ","$1,699.13 ","$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,37000002,N/A,HC DIFFICULT AIRWAY CHARGE,370,1 ,$880.00 ,$440.00 ,$369.60 ,$880.00 ,$568.48 , N/A ,$569.27 ,$569.27 , N/A ,$528.00 ,$748.00 ,$616.00 , N/A ,$836.00 ,$633.60 ,$642.40 ,$572.00 ,$748.00 , N/A ,$572.00 ,$704.00 ,$642.40 , N/A , N/A ,$369.60 ,$880.00 ,$748.00 , N/A ,$809.60 ,$616.00 ,$440.00 ,$528.00 ,$535.92 ,$440.00 ,$608.08 ,$616.00 , N/A ,$633.60 , N/A ,$528.00 ,$528.00 , N/A ,$528.00 , N/A ,$633.60 ,$545.60 ,$633.60 ,$633.60 ,$528.00 ST VINCENT HOSPITAL - ACUTE,37000013,31500,HC INTUBATION ENDOTRACHEAL,361,1 ,"$1,100.00 ",$550.00 ,$204.93 ,"$1,100.00 ",$710.60 ,$234.58 ,"$1,100.00 ","$1,100.00 ",$204.93 ,$660.00 ,$935.00 ,$770.00 ,$234.58 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 ,$204.93 ,"$1,100.00 ",$880.00 ,$803.00 ,$234.58 ,$204.93 ,"$1,100.00 ","$1,100.00 ",$935.00 ,$461.10 ,"$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$206.98 ,$792.00 ,$248.65 ,"$1,100.00 ","$1,100.00 ",$204.93 ,"$1,100.00 ",$204.93 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,37000014,64448,HC FEMORAL NERVE BLOCK CONTINUOUS,370,1 ,$760.00 ,$380.00 ,$319.20 ,"$1,792.24 ",$490.96 ,$349.28 ,$491.64 ,$491.64 ,$796.55 ,$456.00 ,$646.00 ,$532.00 ,$349.28 ,$722.00 ,$547.20 ,$554.80 ,$494.00 ,$646.00 ,$796.55 ,$494.00 ,$608.00 ,$554.80 ,$349.28 ,$796.55 ,$319.20 ,$760.00 ,$646.00 ,"$1,792.24 ",$699.20 ,$532.00 ,$760.00 ,$760.00 ,$462.84 ,$760.00 ,$525.16 ,$532.00 ,$804.52 ,$547.20 ,$370.24 ,$456.00 ,$456.00 ,$796.55 ,$456.00 ,$796.55 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,37000017,99153,HC MODERATE SEDATION SAME PHY EA ADDL 15MIN,370,1 ,$80.00 ,$40.00 ,$7.20 ,$80.00 ,$51.68 ,$7.20 ,$51.75 ,$51.75 , N/A ,$48.00 ,$68.00 ,$56.00 ,$7.20 ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 , N/A ,$52.00 ,$64.00 ,$58.40 ,$7.20 , N/A ,$33.60 ,$80.00 ,$68.00 , N/A ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 , N/A ,$57.60 ,$7.63 ,$48.00 ,$48.00 , N/A ,$48.00 , N/A ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,37000020,99157,HC MODERATE SEDATION DIFF PHY EA ADDL 15MIN,370,1 ,$80.00 ,$40.00 ,$7.20 ,$80.00 ,$51.68 ,$7.20 ,$51.75 ,$51.75 , N/A ,$48.00 ,$68.00 ,$56.00 ,$7.20 ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 , N/A ,$52.00 ,$64.00 ,$58.40 ,$7.20 , N/A ,$33.60 ,$80.00 ,$68.00 , N/A ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 , N/A ,$57.60 ,$7.63 ,$48.00 ,$48.00 , N/A ,$48.00 , N/A ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,37000021,64447,HC FEMORAL NERVE BLOCK SINGLE,370,1 ,$620.00 ,$310.00 ,$121.61 ,"$1,382.85 ",$400.52 ,$121.61 ,$401.08 ,$401.08 ,$614.60 ,$372.00 ,$527.00 ,$434.00 ,$121.61 ,$589.00 ,$446.40 ,$452.60 ,$403.00 ,$527.00 ,$614.60 ,$403.00 ,$496.00 ,$452.60 ,$121.61 ,$614.60 ,$260.40 ,$620.00 ,$527.00 ,"$1,382.85 ",$570.40 ,$434.00 ,$620.00 ,$620.00 ,$377.58 ,$620.00 ,$428.42 ,$434.00 ,$620.75 ,$446.40 ,$128.91 ,$372.00 ,$372.00 ,$614.60 ,$372.00 ,$614.60 ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,37000022,64415,HC INTRASCALENE BLOCK SINGLE,370,1 ,$620.00 ,$310.00 ,$260.40 ,"$1,792.24 ",$400.52 ,$349.28 ,$401.08 ,$401.08 ,$796.55 ,$372.00 ,$527.00 ,$434.00 ,$349.28 ,$589.00 ,$446.40 ,$452.60 ,$403.00 ,$527.00 ,$796.55 ,$403.00 ,$496.00 ,$452.60 ,$349.28 ,$796.55 ,$260.40 ,$620.00 ,$527.00 ,"$1,792.24 ",$570.40 ,$434.00 ,$620.00 ,$620.00 ,$377.58 ,$620.00 ,$428.42 ,$434.00 ,$804.52 ,$446.40 ,$370.24 ,$372.00 ,$372.00 ,$796.55 ,$372.00 ,$796.55 ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,37000024,62321,HC EPIDURAL NERVE BLOCK,370,1 ,$620.00 ,$310.00 ,$260.40 ,"$1,382.85 ",$400.52 ,$263.02 ,$401.08 ,$401.08 ,$614.60 ,$372.00 ,$527.00 ,$434.00 ,$263.02 ,$589.00 ,$446.40 ,$452.60 ,$403.00 ,$527.00 ,$614.60 ,$403.00 ,$496.00 ,$452.60 ,$263.02 ,$614.60 ,$260.40 ,$620.00 ,$527.00 ,"$1,382.85 ",$570.40 ,$434.00 ,$620.00 ,$620.00 ,$377.58 ,$620.00 ,$428.42 ,$434.00 ,$620.75 ,$446.40 ,$278.80 ,$372.00 ,$372.00 ,$614.60 ,$372.00 ,$614.60 ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,37000026,N/A,HC ANES BLOCK PERIPHERAL,370,1 ,$620.00 ,$310.00 ,$260.40 ,$620.00 ,$400.52 , N/A ,$401.08 ,$401.08 , N/A ,$372.00 ,$527.00 ,$434.00 , N/A ,$589.00 ,$446.40 ,$452.60 ,$403.00 ,$527.00 , N/A ,$403.00 ,$496.00 ,$452.60 , N/A , N/A ,$260.40 ,$620.00 ,$527.00 , N/A ,$570.40 ,$434.00 ,$310.00 ,$372.00 ,$377.58 ,$310.00 ,$428.42 ,$434.00 , N/A ,$446.40 , N/A ,$372.00 ,$372.00 , N/A ,$372.00 , N/A ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,37000027,N/A,HC ANES SPINAL,370,1 ,$620.00 ,$310.00 ,$260.40 ,$620.00 ,$400.52 , N/A ,$401.08 ,$401.08 , N/A ,$372.00 ,$527.00 ,$434.00 , N/A ,$589.00 ,$446.40 ,$452.60 ,$403.00 ,$527.00 , N/A ,$403.00 ,$496.00 ,$452.60 , N/A , N/A ,$260.40 ,$620.00 ,$527.00 , N/A ,$570.40 ,$434.00 ,$310.00 ,$372.00 ,$377.58 ,$310.00 ,$428.42 ,$434.00 , N/A ,$446.40 , N/A ,$372.00 ,$372.00 , N/A ,$372.00 , N/A ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,37000028,N/A,HC ANES CENTRAL LINE,370,1 ,$620.00 ,$310.00 ,$260.40 ,$620.00 ,$400.52 , N/A ,$401.08 ,$401.08 , N/A ,$372.00 ,$527.00 ,$434.00 , N/A ,$589.00 ,$446.40 ,$452.60 ,$403.00 ,$527.00 , N/A ,$403.00 ,$496.00 ,$452.60 , N/A , N/A ,$260.40 ,$620.00 ,$527.00 , N/A ,$570.40 ,$434.00 ,$310.00 ,$372.00 ,$377.58 ,$310.00 ,$428.42 ,$434.00 , N/A ,$446.40 , N/A ,$372.00 ,$372.00 , N/A ,$372.00 , N/A ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,37000050,N/A,HC BIER BLOCK ANES INIT,370,1 ,$780.00 ,$390.00 ,$327.60 ,$780.00 ,$503.88 , N/A ,$504.58 ,$504.58 , N/A ,$468.00 ,$663.00 ,$546.00 , N/A ,$741.00 ,$561.60 ,$569.40 ,$507.00 ,$663.00 , N/A ,$507.00 ,$624.00 ,$569.40 , N/A , N/A ,$327.60 ,$780.00 ,$663.00 , N/A ,$717.60 ,$546.00 ,$390.00 ,$468.00 ,$475.02 ,$390.00 ,$538.98 ,$546.00 , N/A ,$561.60 , N/A ,$468.00 ,$468.00 , N/A ,$468.00 , N/A ,$561.60 ,$483.60 ,$561.60 ,$561.60 ,$468.00 ST VINCENT HOSPITAL - ACUTE,37000051,N/A,HC BIER BLOCK ANES ADDL,370,1 ,$160.00 ,$80.00 ,$67.20 ,$160.00 ,$103.36 , N/A ,$103.50 ,$103.50 , N/A ,$96.00 ,$136.00 ,$112.00 , N/A ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 , N/A ,$104.00 ,$128.00 ,$116.80 , N/A , N/A ,$67.20 ,$160.00 ,$136.00 , N/A ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , N/A ,$115.20 , N/A ,$96.00 ,$96.00 , N/A ,$96.00 , N/A ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,37000052,N/A,HC GENERAL ANES INIT,370,1 ,"$1,400.00 ",$700.00 ,$588.00 ,"$1,400.00 ",$904.40 , N/A ,$905.66 ,$905.66 , N/A ,$840.00 ,"$1,190.00 ",$980.00 , N/A ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ", N/A ,$910.00 ,"$1,120.00 ","$1,022.00 ", N/A , N/A ,$588.00 ,"$1,400.00 ","$1,190.00 ", N/A ,"$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 , N/A ,"$1,008.00 ", N/A ,$840.00 ,$840.00 , N/A ,$840.00 , N/A ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,37000053,N/A,HC GENERAL ANES ADDL,370,1 ,$190.00 ,$95.00 ,$79.80 ,$190.00 ,$122.74 , N/A ,$122.91 ,$122.91 , N/A ,$114.00 ,$161.50 ,$133.00 , N/A ,$180.50 ,$136.80 ,$138.70 ,$123.50 ,$161.50 , N/A ,$123.50 ,$152.00 ,$138.70 , N/A , N/A ,$79.80 ,$190.00 ,$161.50 , N/A ,$174.80 ,$133.00 ,$95.00 ,$114.00 ,$115.71 ,$95.00 ,$131.29 ,$133.00 , N/A ,$136.80 , N/A ,$114.00 ,$114.00 , N/A ,$114.00 , N/A ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,37000054,N/A,HC MONITORED ANES INIT,370,1 ,$620.00 ,$310.00 ,$260.40 ,$620.00 ,$400.52 , N/A ,$401.08 ,$401.08 , N/A ,$372.00 ,$527.00 ,$434.00 , N/A ,$589.00 ,$446.40 ,$452.60 ,$403.00 ,$527.00 , N/A ,$403.00 ,$496.00 ,$452.60 , N/A , N/A ,$260.40 ,$620.00 ,$527.00 , N/A ,$570.40 ,$434.00 ,$310.00 ,$372.00 ,$377.58 ,$310.00 ,$428.42 ,$434.00 , N/A ,$446.40 , N/A ,$372.00 ,$372.00 , N/A ,$372.00 , N/A ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,37000055,N/A,HC MONITORED ANES ADDL,370,1 ,$160.00 ,$80.00 ,$67.20 ,$160.00 ,$103.36 , N/A ,$103.50 ,$103.50 , N/A ,$96.00 ,$136.00 ,$112.00 , N/A ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 , N/A ,$104.00 ,$128.00 ,$116.80 , N/A , N/A ,$67.20 ,$160.00 ,$136.00 , N/A ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , N/A ,$115.20 , N/A ,$96.00 ,$96.00 , N/A ,$96.00 , N/A ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,37000056,N/A,HC SPINAL ANES INIT,370,1 ,"$1,400.00 ",$700.00 ,$588.00 ,"$1,400.00 ",$904.40 , N/A ,$905.66 ,$905.66 , N/A ,$840.00 ,"$1,190.00 ",$980.00 , N/A ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ", N/A ,$910.00 ,"$1,120.00 ","$1,022.00 ", N/A , N/A ,$588.00 ,"$1,400.00 ","$1,190.00 ", N/A ,"$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 , N/A ,"$1,008.00 ", N/A ,$840.00 ,$840.00 , N/A ,$840.00 , N/A ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,37000057,N/A,HC SPINAL ANES ADDL,370,1 ,$160.00 ,$80.00 ,$67.20 ,$160.00 ,$103.36 , N/A ,$103.50 ,$103.50 , N/A ,$96.00 ,$136.00 ,$112.00 , N/A ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 , N/A ,$104.00 ,$128.00 ,$116.80 , N/A , N/A ,$67.20 ,$160.00 ,$136.00 , N/A ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , N/A ,$115.20 , N/A ,$96.00 ,$96.00 , N/A ,$96.00 , N/A ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,37000058,N/A,HC CARDIAC ANES INIT,370,1 ,"$4,100.00 ","$2,050.00 ","$1,722.00 ","$4,100.00 ","$2,648.60 ", N/A ,"$2,652.29 ","$2,652.29 ", N/A ,"$2,460.00 ","$3,485.00 ","$2,870.00 ", N/A ,"$3,895.00 ","$2,952.00 ","$2,993.00 ","$2,665.00 ","$3,485.00 ", N/A ,"$2,665.00 ","$3,280.00 ","$2,993.00 ", N/A , N/A ,"$1,722.00 ","$4,100.00 ","$3,485.00 ", N/A ,"$3,772.00 ","$2,870.00 ","$2,050.00 ","$2,460.00 ","$2,496.90 ","$2,050.00 ","$2,833.10 ","$2,870.00 ", N/A ,"$2,952.00 ", N/A ,"$2,460.00 ","$2,460.00 ", N/A ,"$2,460.00 ", N/A ,"$2,952.00 ","$2,542.00 ","$2,952.00 ","$2,952.00 ","$2,460.00 " ST VINCENT HOSPITAL - ACUTE,37000059,N/A,HC CARDIAC ANES ADDL,370,1 ,$310.00 ,$155.00 ,$130.20 ,$310.00 ,$200.26 , N/A ,$200.54 ,$200.54 , N/A ,$186.00 ,$263.50 ,$217.00 , N/A ,$294.50 ,$223.20 ,$226.30 ,$201.50 ,$263.50 , N/A ,$201.50 ,$248.00 ,$226.30 , N/A , N/A ,$130.20 ,$310.00 ,$263.50 , N/A ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 , N/A ,$223.20 , N/A ,$186.00 ,$186.00 , N/A ,$186.00 , N/A ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,37000072,99151,HC MODERATE SEDATION SAME PHY <5YR 1ST 15MIN,370,1 ,$380.00 ,$190.00 ,$7.20 ,$380.00 ,$245.48 ,$7.20 ,$245.82 ,$245.82 , N/A ,$228.00 ,$323.00 ,$266.00 ,$7.20 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 , N/A ,$247.00 ,$304.00 ,$277.40 ,$7.20 , N/A ,$159.60 ,$380.00 ,$323.00 , N/A ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 , N/A ,$273.60 ,$7.63 ,$228.00 ,$228.00 , N/A ,$228.00 , N/A ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,37000073,99152,HC MODERATE SEDATION SAME PHY >5YR 1ST 15MIN,370,1 ,$380.00 ,$190.00 ,$7.20 ,$380.00 ,$245.48 ,$7.20 ,$245.82 ,$245.82 , N/A ,$228.00 ,$323.00 ,$266.00 ,$7.20 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 , N/A ,$247.00 ,$304.00 ,$277.40 ,$7.20 , N/A ,$159.60 ,$380.00 ,$323.00 , N/A ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 , N/A ,$273.60 ,$7.63 ,$228.00 ,$228.00 , N/A ,$228.00 , N/A ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,37000074,99155,HC MODERATE SEDATION DIFF PHY <5YR 1ST 15MIN,370,1 ,$380.00 ,$190.00 ,$7.20 ,$380.00 ,$245.48 ,$7.20 ,$245.82 ,$245.82 , N/A ,$228.00 ,$323.00 ,$266.00 ,$7.20 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 , N/A ,$247.00 ,$304.00 ,$277.40 ,$7.20 , N/A ,$159.60 ,$380.00 ,$323.00 , N/A ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 , N/A ,$273.60 ,$7.63 ,$228.00 ,$228.00 , N/A ,$228.00 , N/A ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,37000075,99156,HC MODERATE SEDATION DIFF PHY >5YR 1ST 15MIN,370,1 ,$380.00 ,$190.00 ,$7.20 ,$380.00 ,$245.48 ,$7.20 ,$245.82 ,$245.82 , N/A ,$228.00 ,$323.00 ,$266.00 ,$7.20 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 , N/A ,$247.00 ,$304.00 ,$277.40 ,$7.20 , N/A ,$159.60 ,$380.00 ,$323.00 , N/A ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 , N/A ,$273.60 ,$7.63 ,$228.00 ,$228.00 , N/A ,$228.00 , N/A ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,37000079,N/A,HC SEDATION DEEP/INTENSIVE,370,1 ,$600.00 ,$300.00 ,$252.00 ,$600.00 ,$387.60 , N/A ,$388.14 ,$388.14 , N/A ,$360.00 ,$510.00 ,$420.00 , N/A ,$570.00 ,$432.00 ,$438.00 ,$390.00 ,$510.00 , N/A ,$390.00 ,$480.00 ,$438.00 , N/A , N/A ,$252.00 ,$600.00 ,$510.00 , N/A ,$552.00 ,$420.00 ,$300.00 ,$360.00 ,$365.40 ,$300.00 ,$414.60 ,$420.00 , N/A ,$432.00 , N/A ,$360.00 ,$360.00 , N/A ,$360.00 , N/A ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,37000090,99152,HC BRONCH MODERATE SEDATION SAME PHY >5YR 1ST 15MIN,370,1 ,$380.00 ,$190.00 ,$7.20 ,$380.00 ,$245.48 ,$7.20 ,$245.82 ,$245.82 , N/A ,$228.00 ,$323.00 ,$266.00 ,$7.20 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 , N/A ,$247.00 ,$304.00 ,$277.40 ,$7.20 , N/A ,$159.60 ,$380.00 ,$323.00 , N/A ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 , N/A ,$273.60 ,$7.63 ,$228.00 ,$228.00 , N/A ,$228.00 , N/A ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,39000001,N/A,HC RED CROSS CMV TESTED PRD,390,1 ,$45.00 ,$22.50 ,$22.50 ,$45.00 ,$29.07 , N/A ,$29.11 ,$29.11 , N/A ,$27.00 ,$38.25 ,$31.50 , N/A ,$42.75 ,$32.40 ,$32.85 ,$29.25 ,$38.25 , N/A ,$29.25 ,$36.00 ,$32.85 , N/A , N/A ,$45.00 ,$45.00 ,$38.25 , N/A ,$41.40 ,$31.50 ,$22.50 ,$27.00 ,$27.41 ,$22.50 ,$31.10 ,$31.50 , N/A ,$32.40 , N/A ,$45.00 ,$45.00 , N/A ,$45.00 , N/A ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,39000101,P9010,HC WHOLE BLOOD EA AUTO,390,1 ,$460.00 ,$230.00 ,$150.14 ,$460.00 ,$297.16 ,$217.59 ,$297.57 ,$297.57 ,$150.14 ,$276.00 ,$391.00 ,$322.00 ,$217.59 ,$437.00 ,$331.20 ,$335.80 ,$299.00 ,$391.00 ,$150.14 ,$299.00 ,$368.00 ,$335.80 ,$217.59 ,$150.14 ,$443.73 ,$460.00 ,$391.00 ,$337.82 ,$423.20 ,$322.00 ,$460.00 ,$460.00 ,$280.14 ,$460.00 ,$317.86 ,$322.00 ,$151.64 ,$331.20 ,$230.65 ,$423.00 ,$423.00 ,$150.14 ,$423.00 ,$150.14 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,39000102,P9010,HC WHOLE BLOOD EA AUTO (RC),390,1 ,$460.00 ,$230.00 ,$150.14 ,$460.00 ,$297.16 ,$217.59 ,$297.57 ,$297.57 ,$150.14 ,$276.00 ,$391.00 ,$322.00 ,$217.59 ,$437.00 ,$331.20 ,$335.80 ,$299.00 ,$391.00 ,$150.14 ,$299.00 ,$368.00 ,$335.80 ,$217.59 ,$150.14 ,$443.73 ,$460.00 ,$391.00 ,$337.82 ,$423.20 ,$322.00 ,$460.00 ,$460.00 ,$280.14 ,$460.00 ,$317.86 ,$322.00 ,$151.64 ,$331.20 ,$230.65 ,$423.00 ,$423.00 ,$150.14 ,$423.00 ,$150.14 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,39000103,P9012,HC CRYOPRECIPITATE EA UNIT,390,1 ,$180.00 ,$90.00 ,$79.85 ,$230.65 ,$116.28 ,$180.00 ,$116.44 ,$116.44 ,$79.85 ,$108.00 ,$153.00 ,$126.00 ,$217.59 ,$171.00 ,$129.60 ,$131.40 ,$117.00 ,$153.00 ,$79.85 ,$117.00 ,$144.00 ,$131.40 ,$217.59 ,$79.85 ,$180.00 ,$180.00 ,$153.00 ,$179.66 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$80.65 ,$129.60 ,$230.65 ,$180.00 ,$180.00 ,$79.85 ,$180.00 ,$79.85 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,39000104,P9012,HC CRYOPRECIPITATE EA UNIT (REDUCED PLASMA),390,1 ,$180.00 ,$90.00 ,$79.85 ,$230.65 ,$116.28 ,$180.00 ,$116.44 ,$116.44 ,$79.85 ,$108.00 ,$153.00 ,$126.00 ,$217.59 ,$171.00 ,$129.60 ,$131.40 ,$117.00 ,$153.00 ,$79.85 ,$117.00 ,$144.00 ,$131.40 ,$217.59 ,$79.85 ,$180.00 ,$180.00 ,$153.00 ,$179.66 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$80.65 ,$129.60 ,$230.65 ,$180.00 ,$180.00 ,$79.85 ,$180.00 ,$79.85 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,39000105,P9012,HC CRYOPRECIPITATE EA UNIT (RC),390,1 ,$180.00 ,$90.00 ,$79.85 ,$230.65 ,$116.28 ,$180.00 ,$116.44 ,$116.44 ,$79.85 ,$108.00 ,$153.00 ,$126.00 ,$217.59 ,$171.00 ,$129.60 ,$131.40 ,$117.00 ,$153.00 ,$79.85 ,$117.00 ,$144.00 ,$131.40 ,$217.59 ,$79.85 ,$180.00 ,$180.00 ,$153.00 ,$179.66 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$80.65 ,$129.60 ,$230.65 ,$180.00 ,$180.00 ,$79.85 ,$180.00 ,$79.85 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,39000106,P9012,HC CRYOPRECIPITATE EA UNIT (POOLED),390,1 ,$180.00 ,$90.00 ,$79.85 ,$230.65 ,$116.28 ,$180.00 ,$116.44 ,$116.44 ,$79.85 ,$108.00 ,$153.00 ,$126.00 ,$217.59 ,$171.00 ,$129.60 ,$131.40 ,$117.00 ,$153.00 ,$79.85 ,$117.00 ,$144.00 ,$131.40 ,$217.59 ,$79.85 ,$180.00 ,$180.00 ,$153.00 ,$179.66 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$80.65 ,$129.60 ,$230.65 ,$180.00 ,$180.00 ,$79.85 ,$180.00 ,$79.85 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,39000107,P9016,HC RED CELLS L/R EA,390,1 ,$350.00 ,$175.00 ,$175.00 ,$424.15 ,$226.10 ,$350.00 ,$226.42 ,$226.42 ,$188.51 ,$210.00 ,$297.50 ,$245.00 ,$350.00 ,$332.50 ,$252.00 ,$255.50 ,$227.50 ,$297.50 ,$188.51 ,$227.50 ,$280.00 ,$255.50 ,$350.00 ,$188.51 ,$350.00 ,$350.00 ,$297.50 ,$424.15 ,$322.00 ,$245.00 ,$350.00 ,$350.00 ,$213.15 ,$350.00 ,$241.85 ,$245.00 ,$190.40 ,$252.00 ,$371.00 ,$350.00 ,$350.00 ,$188.51 ,$350.00 ,$188.51 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,39000108,P9016,HC RED CELLS L/R EA (S-RC),390,1 ,$540.00 ,$270.00 ,$188.51 ,$540.00 ,$348.84 ,$449.49 ,$349.33 ,$349.33 ,$188.51 ,$324.00 ,$459.00 ,$378.00 ,$449.49 ,$513.00 ,$388.80 ,$394.20 ,$351.00 ,$459.00 ,$188.51 ,$351.00 ,$432.00 ,$394.20 ,$449.49 ,$188.51 ,$443.73 ,$540.00 ,$459.00 ,$424.15 ,$496.80 ,$378.00 ,$540.00 ,$540.00 ,$328.86 ,$540.00 ,$373.14 ,$378.00 ,$190.40 ,$388.80 ,$476.46 ,$423.00 ,$423.00 ,$188.51 ,$423.00 ,$188.51 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,39000109,P9016,HC RED CELLS L/R EA (L-RC),390,1 ,$540.00 ,$270.00 ,$188.51 ,$540.00 ,$348.84 ,$449.49 ,$349.33 ,$349.33 ,$188.51 ,$324.00 ,$459.00 ,$378.00 ,$449.49 ,$513.00 ,$388.80 ,$394.20 ,$351.00 ,$459.00 ,$188.51 ,$351.00 ,$432.00 ,$394.20 ,$449.49 ,$188.51 ,$443.73 ,$540.00 ,$459.00 ,$424.15 ,$496.80 ,$378.00 ,$540.00 ,$540.00 ,$328.86 ,$540.00 ,$373.14 ,$378.00 ,$190.40 ,$388.80 ,$476.46 ,$423.00 ,$423.00 ,$188.51 ,$423.00 ,$188.51 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,39000110,P9017,HC FRESH FROZEN PLASMA EA,390,1 ,$220.00 ,$110.00 ,$38.65 ,$220.00 ,$142.12 ,$38.65 ,$142.32 ,$142.32 ,$82.66 ,$132.00 ,$187.00 ,$154.00 ,$38.65 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$82.66 ,$143.00 ,$176.00 ,$160.60 ,$38.65 ,$82.66 ,$220.00 ,$220.00 ,$187.00 ,$185.99 ,$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$83.49 ,$158.40 ,$40.97 ,$220.00 ,$220.00 ,$82.66 ,$220.00 ,$82.66 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,39000111,P9017,HC FRESH FROZEN PLASMA EA (PED),390,1 ,$220.00 ,$110.00 ,$38.65 ,$220.00 ,$142.12 ,$38.65 ,$142.32 ,$142.32 ,$82.66 ,$132.00 ,$187.00 ,$154.00 ,$38.65 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$82.66 ,$143.00 ,$176.00 ,$160.60 ,$38.65 ,$82.66 ,$220.00 ,$220.00 ,$187.00 ,$185.99 ,$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$83.49 ,$158.40 ,$40.97 ,$220.00 ,$220.00 ,$82.66 ,$220.00 ,$82.66 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,39000112,P9017,HC FRESH FROZEN PLASMA EA (AD-RC),390,1 ,$220.00 ,$110.00 ,$38.65 ,$220.00 ,$142.12 ,$38.65 ,$142.32 ,$142.32 ,$82.66 ,$132.00 ,$187.00 ,$154.00 ,$38.65 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$82.66 ,$143.00 ,$176.00 ,$160.60 ,$38.65 ,$82.66 ,$220.00 ,$220.00 ,$187.00 ,$185.99 ,$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$83.49 ,$158.40 ,$40.97 ,$220.00 ,$220.00 ,$82.66 ,$220.00 ,$82.66 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,39000113,P9017,HC FRESH FROZEN PLASMA EA (PE-RC),390,1 ,$220.00 ,$110.00 ,$38.65 ,$220.00 ,$142.12 ,$38.65 ,$142.32 ,$142.32 ,$82.66 ,$132.00 ,$187.00 ,$154.00 ,$38.65 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$82.66 ,$143.00 ,$176.00 ,$160.60 ,$38.65 ,$82.66 ,$220.00 ,$220.00 ,$187.00 ,$185.99 ,$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$83.49 ,$158.40 ,$40.97 ,$220.00 ,$220.00 ,$82.66 ,$220.00 ,$82.66 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,39000114,P9019,HC PLATELETS EA UNIT,390,1 ,$220.00 ,$110.00 ,$64.42 ,$220.00 ,$142.12 ,$64.42 ,$142.32 ,$142.32 ,$71.29 ,$132.00 ,$187.00 ,$154.00 ,$64.42 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$71.29 ,$143.00 ,$176.00 ,$160.60 ,$64.42 ,$71.29 ,$220.00 ,$220.00 ,$187.00 ,$160.40 ,$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$72.00 ,$158.40 ,$68.29 ,$220.00 ,$220.00 ,$71.29 ,$220.00 ,$71.29 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,39000115,P9021,HC RED CELLS PACKED EA (AUTOLOGOUS),390,1 ,$400.00 ,$200.00 ,$137.63 ,$400.00 ,$258.40 ,$217.59 ,$258.76 ,$258.76 ,$137.63 ,$240.00 ,$340.00 ,$280.00 ,$217.59 ,$380.00 ,$288.00 ,$292.00 ,$260.00 ,$340.00 ,$137.63 ,$260.00 ,$320.00 ,$292.00 ,$217.59 ,$137.63 ,$400.00 ,$400.00 ,$340.00 ,$309.67 ,$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 ,$139.01 ,$288.00 ,$230.65 ,$400.00 ,$400.00 ,$137.63 ,$400.00 ,$137.63 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,39000116,P9021,HC RED CELLS PACKED EA,390,1 ,$400.00 ,$200.00 ,$137.63 ,$400.00 ,$258.40 ,$217.59 ,$258.76 ,$258.76 ,$137.63 ,$240.00 ,$340.00 ,$280.00 ,$217.59 ,$380.00 ,$288.00 ,$292.00 ,$260.00 ,$340.00 ,$137.63 ,$260.00 ,$320.00 ,$292.00 ,$217.59 ,$137.63 ,$400.00 ,$400.00 ,$340.00 ,$309.67 ,$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 ,$139.01 ,$288.00 ,$230.65 ,$400.00 ,$400.00 ,$137.63 ,$400.00 ,$137.63 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,39000117,P9031,HC PLATELETS LEUKO RD EA UNIT,390,1 ,$315.00 ,$157.50 ,$149.92 ,$337.32 ,$203.49 ,$217.59 ,$203.77 ,$203.77 ,$149.92 ,$189.00 ,$267.75 ,$220.50 ,$217.59 ,$299.25 ,$226.80 ,$229.95 ,$204.75 ,$267.75 ,$149.92 ,$204.75 ,$252.00 ,$229.95 ,$217.59 ,$149.92 ,$315.00 ,$315.00 ,$267.75 ,$337.32 ,$289.80 ,$220.50 ,$315.00 ,$315.00 ,$191.84 ,$315.00 ,$217.67 ,$220.50 ,$151.42 ,$226.80 ,$230.65 ,$315.00 ,$315.00 ,$149.92 ,$315.00 ,$149.92 ,$226.80 ,$195.30 ,$226.80 ,$226.80 ,$189.00 ST VINCENT HOSPITAL - ACUTE,39000118,P9031,HC PLATELETS LEUKO RD EA UNIT (RC),390,1 ,$315.00 ,$157.50 ,$149.92 ,$337.32 ,$203.49 ,$217.59 ,$203.77 ,$203.77 ,$149.92 ,$189.00 ,$267.75 ,$220.50 ,$217.59 ,$299.25 ,$226.80 ,$229.95 ,$204.75 ,$267.75 ,$149.92 ,$204.75 ,$252.00 ,$229.95 ,$217.59 ,$149.92 ,$315.00 ,$315.00 ,$267.75 ,$337.32 ,$289.80 ,$220.50 ,$315.00 ,$315.00 ,$191.84 ,$315.00 ,$217.67 ,$220.50 ,$151.42 ,$226.80 ,$230.65 ,$315.00 ,$315.00 ,$149.92 ,$315.00 ,$149.92 ,$226.80 ,$195.30 ,$226.80 ,$226.80 ,$189.00 ST VINCENT HOSPITAL - ACUTE,39000119,P9033,HC PLATELETS L/R IRR EA,390,1 ,$460.00 ,$230.00 ,$213.19 ,$479.68 ,$297.16 ,$217.59 ,$297.57 ,$297.57 ,$213.19 ,$276.00 ,$391.00 ,$322.00 ,$217.59 ,$437.00 ,$331.20 ,$335.80 ,$299.00 ,$391.00 ,$213.19 ,$299.00 ,$368.00 ,$335.80 ,$217.59 ,$213.19 ,$443.73 ,$460.00 ,$391.00 ,$479.68 ,$423.20 ,$322.00 ,$460.00 ,$460.00 ,$280.14 ,$460.00 ,$317.86 ,$322.00 ,$215.32 ,$331.20 ,$230.65 ,$423.00 ,$423.00 ,$213.19 ,$423.00 ,$213.19 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,39000120,P9035,HC PLATELETS PHER L/R EA,390,1 ,"$1,400.00 ",$700.00 ,$217.59 ,"$1,400.00 ",$904.40 ,$217.59 ,$905.66 ,$905.66 ,$486.80 ,$840.00 ,"$1,190.00 ",$980.00 ,$217.59 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$486.80 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$217.59 ,$486.80 ,$443.73 ,"$1,400.00 ","$1,190.00 ","$1,095.30 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,$491.67 ,"$1,008.00 ",$230.65 ,$423.00 ,$423.00 ,$486.80 ,$423.00 ,$486.80 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,39000121,P9035,HC PLATELETS PHER L/R EA (SAL WASH),390,1 ,"$1,400.00 ",$700.00 ,$217.59 ,"$1,400.00 ",$904.40 ,$217.59 ,$905.66 ,$905.66 ,$486.80 ,$840.00 ,"$1,190.00 ",$980.00 ,$217.59 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$486.80 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$217.59 ,$486.80 ,$443.73 ,"$1,400.00 ","$1,190.00 ","$1,095.30 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,$491.67 ,"$1,008.00 ",$230.65 ,$423.00 ,$423.00 ,$486.80 ,$423.00 ,$486.80 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,39000122,P9037,HC PLATELETS PHER L/R IRR EA,390,1 ,"$1,400.00 ",$700.00 ,$217.59 ,"$1,400.00 ",$904.40 ,$217.59 ,$905.66 ,$905.66 ,$617.33 ,$840.00 ,"$1,190.00 ",$980.00 ,$217.59 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$617.33 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$217.59 ,$617.33 ,$443.73 ,"$1,400.00 ","$1,190.00 ","$1,388.99 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,$623.50 ,"$1,008.00 ",$230.65 ,$423.00 ,$423.00 ,$617.33 ,$423.00 ,$617.33 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,39000123,P9037,HC PLATELETS PHER L/R IRR EA (WASHED),390,1 ,"$1,600.00 ",$800.00 ,$217.59 ,"$1,600.00 ","$1,033.60 ",$217.59 ,"$1,035.04 ","$1,035.04 ",$617.33 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$217.59 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,040.00 ","$1,360.00 ",$617.33 ,"$1,040.00 ","$1,280.00 ","$1,168.00 ",$217.59 ,$617.33 ,$443.73 ,"$1,600.00 ","$1,360.00 ","$1,388.99 ","$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ",$623.50 ,"$1,152.00 ",$230.65 ,$423.00 ,$423.00 ,$617.33 ,$423.00 ,$617.33 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,39000124,P9040,HC RED CELLS L/R IRR EA,390,1 ,$770.00 ,$385.00 ,$217.59 ,$770.00 ,$497.42 ,$217.59 ,$498.11 ,$498.11 ,$260.55 ,$462.00 ,$654.50 ,$539.00 ,$217.59 ,$731.50 ,$554.40 ,$562.10 ,$500.50 ,$654.50 ,$260.55 ,$500.50 ,$616.00 ,$562.10 ,$217.59 ,$260.55 ,$443.73 ,$770.00 ,$654.50 ,$586.24 ,$708.40 ,$539.00 ,$770.00 ,$770.00 ,$468.93 ,$770.00 ,$532.07 ,$539.00 ,$263.16 ,$554.40 ,$230.65 ,$423.00 ,$423.00 ,$260.55 ,$423.00 ,$260.55 ,$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,39000125,P9040,HC RED CELLS L/R IRR EA (CMV/NEG),390,1 ,$770.00 ,$385.00 ,$217.59 ,$770.00 ,$497.42 ,$217.59 ,$498.11 ,$498.11 ,$260.55 ,$462.00 ,$654.50 ,$539.00 ,$217.59 ,$731.50 ,$554.40 ,$562.10 ,$500.50 ,$654.50 ,$260.55 ,$500.50 ,$616.00 ,$562.10 ,$217.59 ,$260.55 ,$443.73 ,$770.00 ,$654.50 ,$586.24 ,$708.40 ,$539.00 ,$770.00 ,$770.00 ,$468.93 ,$770.00 ,$532.07 ,$539.00 ,$263.16 ,$554.40 ,$230.65 ,$423.00 ,$423.00 ,$260.55 ,$423.00 ,$260.55 ,$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,39000126,P9040,HC RED CELLS L/R IRR EA (DIRECTED),390,1 ,$770.00 ,$385.00 ,$217.59 ,$770.00 ,$497.42 ,$217.59 ,$498.11 ,$498.11 ,$260.55 ,$462.00 ,$654.50 ,$539.00 ,$217.59 ,$731.50 ,$554.40 ,$562.10 ,$500.50 ,$654.50 ,$260.55 ,$500.50 ,$616.00 ,$562.10 ,$217.59 ,$260.55 ,$443.73 ,$770.00 ,$654.50 ,$586.24 ,$708.40 ,$539.00 ,$770.00 ,$770.00 ,$468.93 ,$770.00 ,$532.07 ,$539.00 ,$263.16 ,$554.40 ,$230.65 ,$423.00 ,$423.00 ,$260.55 ,$423.00 ,$260.55 ,$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,39000127,P9040,HC RED CELLS L/R IRR EA (LP),390,1 ,$770.00 ,$385.00 ,$217.59 ,$770.00 ,$497.42 ,$217.59 ,$498.11 ,$498.11 ,$260.55 ,$462.00 ,$654.50 ,$539.00 ,$217.59 ,$731.50 ,$554.40 ,$562.10 ,$500.50 ,$654.50 ,$260.55 ,$500.50 ,$616.00 ,$562.10 ,$217.59 ,$260.55 ,$443.73 ,$770.00 ,$654.50 ,$586.24 ,$708.40 ,$539.00 ,$770.00 ,$770.00 ,$468.93 ,$770.00 ,$532.07 ,$539.00 ,$263.16 ,$554.40 ,$230.65 ,$423.00 ,$423.00 ,$260.55 ,$423.00 ,$260.55 ,$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,39000128,P9047,HC ALBUMIN VL 25% 100 ML,390,1 ,$95.00 ,$47.50 ,$47.50 ,$230.65 ,$61.37 ,$95.00 ,$61.46 ,$61.46 ,$52.45 ,$57.00 ,$80.75 ,$66.50 ,$217.59 ,$90.25 ,$68.40 ,$69.35 ,$61.75 ,$80.75 ,$52.45 ,$61.75 ,$76.00 ,$69.35 ,$217.59 ,$52.45 ,$95.00 ,$95.00 ,$80.75 ,$118.01 ,$87.40 ,$66.50 ,$47.50 ,$57.00 ,$57.86 ,$47.50 ,$65.65 ,$66.50 ,$52.97 ,$68.40 ,$230.65 ,$95.00 ,$95.00 ,$52.45 ,$95.00 ,$52.45 ,$68.40 ,$58.90 ,$68.40 ,$68.40 ,$57.00 ST VINCENT HOSPITAL - ACUTE,39000129,P9050,HC GRANUOCYTES IRRAD,390,1 ,"$2,520.00 ","$1,260.00 ",$423.00 ,"$2,520.00 ","$1,627.92 ",$871.92 ,"$1,630.19 ","$1,630.19 ", N/A ,"$1,512.00 ","$2,142.00 ","$1,764.00 ",$871.92 ,"$2,394.00 ","$1,814.40 ","$1,839.60 ","$1,638.00 ","$2,142.00 ", N/A ,"$1,638.00 ","$2,016.00 ","$1,839.60 ",$871.92 , N/A ,$443.73 ,"$2,520.00 ","$2,142.00 ", N/A ,"$2,318.40 ","$1,764.00 ","$1,260.00 ","$1,512.00 ","$1,534.68 ","$1,260.00 ","$1,741.32 ","$1,764.00 ", N/A ,"$1,814.40 ",$924.24 ,$423.00 ,$423.00 , N/A ,$423.00 , N/A ,"$1,814.40 ","$1,562.40 ","$1,814.40 ","$1,814.40 ","$1,512.00 " ST VINCENT HOSPITAL - ACUTE,39000130,P9050,HC GRANUOCYTES IRRAD (CMV),390,1 ,"$2,520.00 ","$1,260.00 ",$423.00 ,"$2,520.00 ","$1,627.92 ",$871.92 ,"$1,630.19 ","$1,630.19 ", N/A ,"$1,512.00 ","$2,142.00 ","$1,764.00 ",$871.92 ,"$2,394.00 ","$1,814.40 ","$1,839.60 ","$1,638.00 ","$2,142.00 ", N/A ,"$1,638.00 ","$2,016.00 ","$1,839.60 ",$871.92 , N/A ,$443.73 ,"$2,520.00 ","$2,142.00 ", N/A ,"$2,318.40 ","$1,764.00 ","$1,260.00 ","$1,512.00 ","$1,534.68 ","$1,260.00 ","$1,741.32 ","$1,764.00 ", N/A ,"$1,814.40 ",$924.24 ,$423.00 ,$423.00 , N/A ,$423.00 , N/A ,"$1,814.40 ","$1,562.40 ","$1,814.40 ","$1,814.40 ","$1,512.00 " ST VINCENT HOSPITAL - ACUTE,39000131,P9051,HC RBC L/R CMV NEG EA,390,1 ,$570.00 ,$285.00 ,$212.23 ,$570.00 ,$368.22 ,$217.59 ,$368.73 ,$368.73 ,$212.23 ,$342.00 ,$484.50 ,$399.00 ,$217.59 ,$541.50 ,$410.40 ,$416.10 ,$370.50 ,$484.50 ,$212.23 ,$370.50 ,$456.00 ,$416.10 ,$217.59 ,$212.23 ,$443.73 ,$570.00 ,$484.50 ,$477.52 ,$524.40 ,$399.00 ,$570.00 ,$570.00 ,$347.13 ,$570.00 ,$393.87 ,$399.00 ,$214.35 ,$410.40 ,$230.65 ,$423.00 ,$423.00 ,$212.23 ,$423.00 ,$212.23 ,$410.40 ,$353.40 ,$410.40 ,$410.40 ,$342.00 ST VINCENT HOSPITAL - ACUTE,39000132,P9052,HC PLT APHER/PHER L/R HLA EA,390,1 ,"$2,100.00 ","$1,050.00 ",$217.59 ,"$2,100.00 ","$1,356.60 ",$217.59 ,"$1,358.49 ","$1,358.49 ",$805.18 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$217.59 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$1,365.00 ","$1,785.00 ",$805.18 ,"$1,365.00 ","$1,680.00 ","$1,533.00 ",$217.59 ,$805.18 ,$443.73 ,"$2,100.00 ","$1,785.00 ","$1,811.66 ","$1,932.00 ","$1,470.00 ","$2,100.00 ","$2,100.00 ","$1,278.90 ","$2,100.00 ","$1,451.10 ","$1,470.00 ",$813.23 ,"$1,512.00 ",$230.65 ,$423.00 ,$423.00 ,$805.18 ,$423.00 ,$805.18 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,39000133,P9052,HC PLT APHER/PHER L/R HLA EA (IRRAD),390,1 ,"$2,100.00 ","$1,050.00 ",$217.59 ,"$2,100.00 ","$1,356.60 ",$217.59 ,"$1,358.49 ","$1,358.49 ",$805.18 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$217.59 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$1,365.00 ","$1,785.00 ",$805.18 ,"$1,365.00 ","$1,680.00 ","$1,533.00 ",$217.59 ,$805.18 ,$443.73 ,"$2,100.00 ","$1,785.00 ","$1,811.66 ","$1,932.00 ","$1,470.00 ","$2,100.00 ","$2,100.00 ","$1,278.90 ","$2,100.00 ","$1,451.10 ","$1,470.00 ",$813.23 ,"$1,512.00 ",$230.65 ,$423.00 ,$423.00 ,$805.18 ,$423.00 ,$805.18 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,39000134,P9053,HC PLTS PHERESIS LEUKORED CMV IRR,390,1 ,"$1,800.00 ",$900.00 ,$217.59 ,"$1,800.00 ","$1,162.80 ",$217.59 ,"$1,164.42 ","$1,164.42 ",$447.31 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$217.59 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,170.00 ","$1,530.00 ",$447.31 ,"$1,170.00 ","$1,440.00 ","$1,314.00 ",$217.59 ,$447.31 ,$443.73 ,"$1,800.00 ","$1,530.00 ","$1,006.45 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ",$451.78 ,"$1,296.00 ",$230.65 ,$423.00 ,$423.00 ,$447.31 ,$423.00 ,$447.31 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,39000135,P9053,HC PLTS PHERESIS LEUKORED CMV IRR (SATEL),390,1 ,"$1,800.00 ",$900.00 ,$217.59 ,"$1,800.00 ","$1,162.80 ",$217.59 ,"$1,164.42 ","$1,164.42 ",$447.31 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$217.59 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,170.00 ","$1,530.00 ",$447.31 ,"$1,170.00 ","$1,440.00 ","$1,314.00 ",$217.59 ,$447.31 ,$443.73 ,"$1,800.00 ","$1,530.00 ","$1,006.45 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ",$451.78 ,"$1,296.00 ",$230.65 ,$423.00 ,$423.00 ,$447.31 ,$423.00 ,$447.31 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,39000136,P9054,HC RBC L/R WASHED DEGLYC (RC),390,1 ,$845.00 ,$422.50 ,$217.59 ,$845.00 ,$545.87 ,$217.59 ,$546.63 ,$546.63 ,$310.70 ,$507.00 ,$718.25 ,$591.50 ,$217.59 ,$802.75 ,$608.40 ,$616.85 ,$549.25 ,$718.25 ,$310.70 ,$549.25 ,$676.00 ,$616.85 ,$217.59 ,$310.70 ,$443.73 ,$845.00 ,$718.25 ,$699.08 ,$777.40 ,$591.50 ,$845.00 ,$845.00 ,$514.61 ,$845.00 ,$583.90 ,$591.50 ,$313.81 ,$608.40 ,$230.65 ,$423.00 ,$423.00 ,$310.70 ,$423.00 ,$310.70 ,$608.40 ,$523.90 ,$608.40 ,$608.40 ,$507.00 ST VINCENT HOSPITAL - ACUTE,39000137,P9016,HC RBC L/R WASHED SALINE (RC),390,1 ,$845.00 ,$422.50 ,$188.51 ,$845.00 ,$545.87 ,$449.49 ,$546.63 ,$546.63 ,$188.51 ,$507.00 ,$718.25 ,$591.50 ,$449.49 ,$802.75 ,$608.40 ,$616.85 ,$549.25 ,$718.25 ,$188.51 ,$549.25 ,$676.00 ,$616.85 ,$449.49 ,$188.51 ,$443.73 ,$845.00 ,$718.25 ,$424.15 ,$777.40 ,$591.50 ,$722.29 ,$775.79 ,$514.61 ,$722.29 ,$583.90 ,$591.50 ,$190.40 ,$608.40 ,$476.46 ,$423.00 ,$423.00 ,$188.51 ,$423.00 ,$188.51 ,$608.40 ,$523.90 ,$608.40 ,$608.40 ,$507.00 ST VINCENT HOSPITAL - ACUTE,39000138,P9055,HC PHER PLT LR CMV NEG,390,1 ,"$1,425.00 ",$712.50 ,$217.59 ,"$1,425.00 ",$920.55 ,$217.59 ,$921.83 ,$921.83 ,$480.04 ,$855.00 ,"$1,211.25 ",$997.50 ,$217.59 ,"$1,353.75 ","$1,026.00 ","$1,040.25 ",$926.25 ,"$1,211.25 ",$480.04 ,$926.25 ,"$1,140.00 ","$1,040.25 ",$217.59 ,$480.04 ,$443.73 ,"$1,425.00 ","$1,211.25 ","$1,080.09 ","$1,311.00 ",$997.50 ,"$1,425.00 ","$1,425.00 ",$867.83 ,"$1,425.00 ",$984.68 ,$997.50 ,$484.84 ,"$1,026.00 ",$230.65 ,$423.00 ,$423.00 ,$480.04 ,$423.00 ,$480.04 ,"$1,026.00 ",$883.50 ,"$1,026.00 ","$1,026.00 ",$855.00 ST VINCENT HOSPITAL - ACUTE,39000139,P9055,HC PHER PLT LR CMV NEG (HLA),390,1 ,"$1,425.00 ",$712.50 ,$217.59 ,"$1,425.00 ",$920.55 ,$217.59 ,$921.83 ,$921.83 ,$480.04 ,$855.00 ,"$1,211.25 ",$997.50 ,$217.59 ,"$1,353.75 ","$1,026.00 ","$1,040.25 ",$926.25 ,"$1,211.25 ",$480.04 ,$926.25 ,"$1,140.00 ","$1,040.25 ",$217.59 ,$480.04 ,$443.73 ,"$1,425.00 ","$1,211.25 ","$1,080.09 ","$1,311.00 ",$997.50 ,"$1,425.00 ","$1,425.00 ",$867.83 ,"$1,425.00 ",$984.68 ,$997.50 ,$484.84 ,"$1,026.00 ",$230.65 ,$423.00 ,$423.00 ,$480.04 ,$423.00 ,$480.04 ,"$1,026.00 ",$883.50 ,"$1,026.00 ","$1,026.00 ",$855.00 ST VINCENT HOSPITAL - ACUTE,39000140,P9058,HC RBC LEUKORED CMV NEG IRRAD,390,1 ,$720.00 ,$360.00 ,$217.59 ,$720.00 ,$465.12 ,$217.59 ,$465.77 ,$465.77 ,$243.87 ,$432.00 ,$612.00 ,$504.00 ,$217.59 ,$684.00 ,$518.40 ,$525.60 ,$468.00 ,$612.00 ,$243.87 ,$468.00 ,$576.00 ,$525.60 ,$217.59 ,$243.87 ,$443.73 ,$720.00 ,$612.00 ,$548.71 ,$662.40 ,$504.00 ,$720.00 ,$720.00 ,$438.48 ,$720.00 ,$497.52 ,$504.00 ,$246.31 ,$518.40 ,$230.65 ,$423.00 ,$423.00 ,$243.87 ,$423.00 ,$243.87 ,$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,39000141,P9058,HC RBC LEUKORED CMV NEG IRRAD (SATEL),390,1 ,$720.00 ,$360.00 ,$217.59 ,$720.00 ,$465.12 ,$217.59 ,$465.77 ,$465.77 ,$243.87 ,$432.00 ,$612.00 ,$504.00 ,$217.59 ,$684.00 ,$518.40 ,$525.60 ,$468.00 ,$612.00 ,$243.87 ,$468.00 ,$576.00 ,$525.60 ,$217.59 ,$243.87 ,$443.73 ,$720.00 ,$612.00 ,$548.71 ,$662.40 ,$504.00 ,$720.00 ,$720.00 ,$438.48 ,$720.00 ,$497.52 ,$504.00 ,$246.31 ,$518.40 ,$230.65 ,$423.00 ,$423.00 ,$243.87 ,$423.00 ,$243.87 ,$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,39000142,P9052,HC PLT APHER/PHER L/R HLA EA (CMV),390,1 ,"$2,100.00 ","$1,050.00 ",$217.59 ,"$2,100.00 ","$1,356.60 ",$217.59 ,"$1,358.49 ","$1,358.49 ",$805.18 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$217.59 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$1,365.00 ","$1,785.00 ",$805.18 ,"$1,365.00 ","$1,680.00 ","$1,533.00 ",$217.59 ,$805.18 ,$443.73 ,"$2,100.00 ","$1,785.00 ","$1,811.66 ","$1,932.00 ","$1,470.00 ","$2,100.00 ","$2,100.00 ","$1,278.90 ","$2,100.00 ","$1,451.10 ","$1,470.00 ",$813.23 ,"$1,512.00 ",$230.65 ,$423.00 ,$423.00 ,$805.18 ,$423.00 ,$805.18 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,39000209,P9040,HC RED CELLS L/R IRR EA SALINE WASH (RC),390,1 ,$845.00 ,$422.50 ,$217.59 ,$845.00 ,$545.87 ,$217.59 ,$546.63 ,$546.63 ,$260.55 ,$507.00 ,$718.25 ,$591.50 ,$217.59 ,$802.75 ,$608.40 ,$616.85 ,$549.25 ,$718.25 ,$260.55 ,$549.25 ,$676.00 ,$616.85 ,$217.59 ,$260.55 ,$443.73 ,$845.00 ,$718.25 ,$586.24 ,$777.40 ,$591.50 ,$845.00 ,$845.00 ,$514.61 ,$845.00 ,$583.90 ,$591.50 ,$263.16 ,$608.40 ,$230.65 ,$423.00 ,$423.00 ,$260.55 ,$423.00 ,$260.55 ,$608.40 ,$523.90 ,$608.40 ,$608.40 ,$507.00 ST VINCENT HOSPITAL - ACUTE,39100001,36430,HC BLOOD PROD ADMIN,391,1 ,$870.00 ,$435.00 ,$217.59 ,$870.00 ,$562.02 ,$217.59 ,$562.80 ,$562.80 ,$384.55 ,$522.00 ,$739.50 ,$609.00 ,$217.59 ,$826.50 ,$626.40 ,$635.10 ,$565.50 ,$739.50 ,$384.55 ,$565.50 ,$696.00 ,$635.10 ,$217.59 ,$384.55 ,$443.73 ,$870.00 ,$739.50 ,$865.24 ,$800.40 ,$609.00 ,$435.00 ,$522.00 ,$529.83 ,$435.00 ,$601.17 ,$609.00 ,$388.40 ,$626.40 ,$230.65 ,$423.00 ,$423.00 ,$384.55 ,$423.00 ,$384.55 ,$626.40 ,$539.40 ,$626.40 ,$626.40 ,$522.00 ST VINCENT HOSPITAL - ACUTE,39100002,36430,HC MASSIVE TRANSFUSION,391,1 ,"$1,500.00 ",$750.00 ,$217.59 ,"$1,500.00 ",$969.00 ,$217.59 ,$970.35 ,$970.35 ,$384.55 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$217.59 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ",$384.55 ,$975.00 ,"$1,200.00 ","$1,095.00 ",$217.59 ,$384.55 ,$443.73 ,"$1,500.00 ","$1,275.00 ",$865.24 ,"$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ",$388.40 ,"$1,080.00 ",$230.65 ,$423.00 ,$423.00 ,$384.55 ,$423.00 ,$384.55 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,40100001,77067,HC MAMM SCREEN BI W/CAD SELF REFERRAL,401,1 ,$296.00 ,$148.00 ,$24.55 ,$296.00 ,$191.22 ,$24.55 ,$296.00 ,$202.00 ,$90.82 ,$177.60 ,$251.60 ,$207.20 ,$24.55 ,$281.20 ,$213.12 ,$216.08 ,$186.18 ,$251.60 ,$90.82 ,$186.18 ,$236.80 ,$216.08 ,$24.55 ,$90.82 ,$154.53 ,$296.00 ,$251.60 ,$204.35 ,$272.32 ,$207.20 ,$296.00 ,$296.00 ,$180.26 ,$296.00 ,$204.54 ,$207.20 ,$91.73 ,$213.12 ,$26.02 ,$158.00 ,$158.00 ,$90.82 ,$158.00 ,$90.82 ,$213.12 ,$183.52 ,$213.12 ,$213.12 ,$177.60 ST VINCENT HOSPITAL - ACUTE,40100002,77067,HC MAMM SCREEN BI W/CAD CORPORATE,403,1 ,$134.30 ,$67.15 ,$24.55 ,$204.35 ,$86.76 ,$24.55 ,$134.30 ,$134.30 ,$90.82 ,$80.58 ,$114.16 ,$94.01 ,$24.55 ,$127.59 ,$96.70 ,$98.04 ,$134.30 ,$114.16 ,$90.82 ,$134.30 ,$107.44 ,$98.04 ,$24.55 ,$90.82 ,$134.30 ,$134.30 ,$114.16 ,$204.35 ,$123.56 ,$94.01 ,$134.30 ,$134.30 ,$81.79 ,$134.30 ,$92.80 ,$94.01 ,$91.73 ,$96.70 ,$26.02 ,$134.30 ,$134.30 ,$90.82 ,$134.30 ,$90.82 ,$96.70 ,$83.27 ,$96.70 ,$96.70 ,$80.58 ST VINCENT HOSPITAL - ACUTE,40100003,77066,HC MAMMOGRAM DIAG BILAT W/CAD,401,1 ,$460.00 ,$230.00 ,$24.55 ,$460.00 ,$297.16 ,$24.55 ,$303.00 ,$202.00 ,$109.89 ,$276.00 ,$391.00 ,$322.00 ,$24.55 ,$437.00 ,$331.20 ,$335.80 ,$225.27 ,$391.00 ,$109.89 ,$225.27 ,$368.00 ,$335.80 ,$24.55 ,$109.89 ,$154.53 ,$460.00 ,$391.00 ,$247.25 ,$423.20 ,$322.00 ,$359.33 ,$386.97 ,$280.14 ,$359.33 ,$317.86 ,$322.00 ,$110.99 ,$331.20 ,$26.02 ,$158.00 ,$158.00 ,$109.89 ,$158.00 ,$109.89 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,40100004,77066,HC MAMMOGRAM DIAG BILAT W/CAD ADDNT VIEW,401,1 ,$460.00 ,$230.00 ,$24.55 ,$460.00 ,$297.16 ,$24.55 ,$303.00 ,$202.00 ,$109.89 ,$276.00 ,$391.00 ,$322.00 ,$24.55 ,$437.00 ,$331.20 ,$335.80 ,$225.27 ,$391.00 ,$109.89 ,$225.27 ,$368.00 ,$335.80 ,$24.55 ,$109.89 ,$154.53 ,$460.00 ,$391.00 ,$247.25 ,$423.20 ,$322.00 ,$359.33 ,$386.97 ,$280.14 ,$359.33 ,$317.86 ,$322.00 ,$110.99 ,$331.20 ,$26.02 ,$158.00 ,$158.00 ,$109.89 ,$158.00 ,$109.89 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,40100005,77066,HC MAMMOGRAM DIAG BILAT W/CAD IMPLANT,401,1 ,$460.00 ,$230.00 ,$24.55 ,$460.00 ,$297.16 ,$24.55 ,$303.00 ,$202.00 ,$109.89 ,$276.00 ,$391.00 ,$322.00 ,$24.55 ,$437.00 ,$331.20 ,$335.80 ,$225.27 ,$391.00 ,$109.89 ,$225.27 ,$368.00 ,$335.80 ,$24.55 ,$109.89 ,$154.53 ,$460.00 ,$391.00 ,$247.25 ,$423.20 ,$322.00 ,$359.33 ,$386.97 ,$280.14 ,$359.33 ,$317.86 ,$322.00 ,$110.99 ,$331.20 ,$26.02 ,$158.00 ,$158.00 ,$109.89 ,$158.00 ,$109.89 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,40100006,77066,HC MAMMOGRAM DIAG W/CAD UPGRADE BIL,401,1 ,$460.00 ,$230.00 ,$24.55 ,$460.00 ,$297.16 ,$24.55 ,$303.00 ,$202.00 ,$109.89 ,$276.00 ,$391.00 ,$322.00 ,$24.55 ,$437.00 ,$331.20 ,$335.80 ,$225.27 ,$391.00 ,$109.89 ,$225.27 ,$368.00 ,$335.80 ,$24.55 ,$109.89 ,$154.53 ,$460.00 ,$391.00 ,$247.25 ,$423.20 ,$322.00 ,$359.33 ,$386.97 ,$280.14 ,$359.33 ,$317.86 ,$322.00 ,$110.99 ,$331.20 ,$26.02 ,$158.00 ,$158.00 ,$109.89 ,$158.00 ,$109.89 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,40100007,77065,HC MAMMOGRAM DIAG UNIL W/CAD,401,1 ,$350.00 ,$175.00 ,$24.55 ,$350.00 ,$226.10 ,$24.55 ,$303.00 ,$202.00 ,$85.89 ,$210.00 ,$297.50 ,$245.00 ,$24.55 ,$332.50 ,$252.00 ,$255.50 ,$176.07 ,$297.50 ,$85.89 ,$176.07 ,$280.00 ,$255.50 ,$24.55 ,$85.89 ,$154.53 ,$350.00 ,$297.50 ,$193.25 ,$322.00 ,$245.00 ,$281.14 ,$302.77 ,$213.15 ,$281.14 ,$241.85 ,$245.00 ,$86.75 ,$252.00 ,$26.02 ,$158.00 ,$158.00 ,$85.89 ,$158.00 ,$85.89 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,40100008,77065,HC MAMMOGRAM DIAG UNIL W/CAD ADDNT VIEW,401,1 ,$350.00 ,$175.00 ,$24.55 ,$350.00 ,$226.10 ,$24.55 ,$303.00 ,$202.00 ,$85.89 ,$210.00 ,$297.50 ,$245.00 ,$24.55 ,$332.50 ,$252.00 ,$255.50 ,$176.07 ,$297.50 ,$85.89 ,$176.07 ,$280.00 ,$255.50 ,$24.55 ,$85.89 ,$154.53 ,$350.00 ,$297.50 ,$193.25 ,$322.00 ,$245.00 ,$281.14 ,$302.77 ,$213.15 ,$281.14 ,$241.85 ,$245.00 ,$86.75 ,$252.00 ,$26.02 ,$158.00 ,$158.00 ,$85.89 ,$158.00 ,$85.89 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,40100009,77065,HC MAMMOGRAM DIAG UNIL W/CAD IMPLANT,401,1 ,$350.00 ,$175.00 ,$24.55 ,$350.00 ,$226.10 ,$24.55 ,$303.00 ,$202.00 ,$85.89 ,$210.00 ,$297.50 ,$245.00 ,$24.55 ,$332.50 ,$252.00 ,$255.50 ,$176.07 ,$297.50 ,$85.89 ,$176.07 ,$280.00 ,$255.50 ,$24.55 ,$85.89 ,$154.53 ,$350.00 ,$297.50 ,$193.25 ,$322.00 ,$245.00 ,$281.14 ,$302.77 ,$213.15 ,$281.14 ,$241.85 ,$245.00 ,$86.75 ,$252.00 ,$26.02 ,$158.00 ,$158.00 ,$85.89 ,$158.00 ,$85.89 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,40100010,77065,HC MAMMOGRAM DIAG UNIL W/CAD UPGRADE,401,1 ,$350.00 ,$175.00 ,$24.55 ,$350.00 ,$226.10 ,$24.55 ,$303.00 ,$202.00 ,$85.89 ,$210.00 ,$297.50 ,$245.00 ,$24.55 ,$332.50 ,$252.00 ,$255.50 ,$176.07 ,$297.50 ,$85.89 ,$176.07 ,$280.00 ,$255.50 ,$24.55 ,$85.89 ,$154.53 ,$350.00 ,$297.50 ,$193.25 ,$322.00 ,$245.00 ,$281.14 ,$302.77 ,$213.15 ,$281.14 ,$241.85 ,$245.00 ,$86.75 ,$252.00 ,$26.02 ,$158.00 ,$158.00 ,$85.89 ,$158.00 ,$85.89 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,40100014,G0279,HC DIAGNOSTIC DIGITAL BREAST TOMOSYTH UNI/BIL,401,1 ,$130.00 ,$65.00 ,$23.99 ,$130.00 ,$83.98 ,$24.55 ,$84.10 ,$84.10 ,$23.99 ,$78.00 ,$110.50 ,$91.00 ,$24.55 ,$123.50 ,$93.60 ,$94.90 ,$49.18 ,$110.50 ,$23.99 ,$49.18 ,$104.00 ,$94.90 ,$24.55 ,$23.99 ,$130.00 ,$130.00 ,$110.50 ,$53.98 ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 ,$24.23 ,$93.60 ,$26.02 ,$130.00 ,$130.00 ,$23.99 ,$130.00 ,$23.99 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,40200001,93880,HC CAROTID BI US SELF SCREEN,402,1 ,$80.00 ,$40.00 ,$40.00 ,$501.48 ,$51.68 ,$49.96 ,$80.00 ,$80.00 ,$222.88 ,$48.00 ,$68.00 ,$56.00 ,$49.96 ,$76.00 ,$57.60 ,$58.40 ,$80.00 ,$68.00 ,$222.88 ,$80.00 ,$64.00 ,$58.40 ,$49.96 ,$222.88 ,$80.00 ,$80.00 ,$68.00 ,$501.48 ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 ,$225.11 ,$57.60 ,$52.96 ,$80.00 ,$80.00 ,$222.88 ,$80.00 ,$222.88 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,40200002,20670,HC REM IMPL WIRE SUPERFIC,402,1 ,"$3,100.00 ","$1,550.00 ",$281.32 ,"$3,100.00 ","$2,002.60 ",$741.36 ,$556.00 ,$520.00 ,"$1,362.68 ","$1,860.00 ","$2,635.00 ","$2,170.00 ",$741.36 ,"$2,945.00 ","$2,232.00 ","$2,263.00 ",$281.32 ,"$2,635.00 ","$1,362.68 ",$281.32 ,"$2,480.00 ","$2,263.00 ",$741.36 ,"$1,362.68 ",$298.03 ,"$3,100.00 ","$2,635.00 ","$3,066.03 ","$2,852.00 ","$2,170.00 ","$2,066.93 ","$2,778.48 ","$1,887.90 ","$2,583.66 ","$2,142.10 ","$2,170.00 ","$1,376.31 ","$2,232.00 ",$785.84 ,$473.00 ,$473.00 ,"$1,362.68 ",$473.00 ,"$1,362.68 ","$2,232.00 ","$1,922.00 ","$2,232.00 ","$2,232.00 ","$1,860.00 " ST VINCENT HOSPITAL - ACUTE,40200003,21899,HC UNLISTED PROCEDURE NECK/THORAX,402,1 ,$465.00 ,$232.50 ,$204.93 ,$677.79 ,$300.39 ,$465.00 ,$465.00 ,$465.00 ,$204.93 ,$279.00 ,$395.25 ,$325.50 ,$639.42 ,$441.75 ,$334.80 ,$339.45 , N/A ,$395.25 ,$204.93 , N/A ,$372.00 ,$339.45 ,$639.42 ,$204.93 ,$298.03 ,$465.00 ,$395.25 ,$461.10 ,$427.80 ,$325.50 ,$232.50 ,$279.00 ,$283.19 ,$232.50 ,$321.32 ,$325.50 ,$206.98 ,$334.80 ,$677.79 ,$465.00 ,$465.00 ,$204.93 ,$465.00 ,$204.93 ,$334.80 ,$288.30 ,$334.80 ,$334.80 ,$279.00 ST VINCENT HOSPITAL - ACUTE,40200004,21920,HC BX SOFT TISSUE BACK/FLANK SUP,402,1 ,"$1,360.00 ",$680.00 ,$298.03 ,"$3,066.03 ",$878.56 ,$496.73 ,$556.00 ,$520.00 ,"$1,362.68 ",$816.00 ,"$1,156.00 ",$952.00 ,$496.73 ,"$1,292.00 ",$979.20 ,$992.80 ,$303.07 ,"$1,156.00 ","$1,362.68 ",$303.07 ,"$1,088.00 ",$992.80 ,$496.73 ,"$1,362.68 ",$298.03 ,"$1,360.00 ","$1,156.00 ","$3,066.03 ","$1,251.20 ",$952.00 ,"$1,360.00 ","$1,360.00 ",$828.24 ,"$1,360.00 ",$939.76 ,$952.00 ,"$1,376.31 ",$979.20 ,$526.53 ,$473.00 ,$473.00 ,"$1,362.68 ",$473.00 ,"$1,362.68 ",$979.20 ,$843.20 ,$979.20 ,$979.20 ,$816.00 ST VINCENT HOSPITAL - ACUTE,40200005,21925,HC BX SOFT TISSUE BACK/FLANK DEEP,402,1 ,"$3,600.00 ","$1,800.00 ",$298.03 ,"$3,600.00 ","$2,325.60 ",$496.73 ,$556.00 ,$520.00 ,"$1,362.68 ","$2,160.00 ","$3,060.00 ","$2,520.00 ",$496.73 ,"$3,420.00 ","$2,592.00 ","$2,628.00 ",$705.24 ,"$3,060.00 ","$1,362.68 ",$705.24 ,"$2,880.00 ","$2,628.00 ",$496.73 ,"$1,362.68 ",$298.03 ,"$3,600.00 ","$3,060.00 ","$3,066.03 ","$3,312.00 ","$2,520.00 ","$2,331.31 ","$3,133.44 ","$2,192.40 ","$2,914.14 ","$2,487.60 ","$2,520.00 ","$1,376.31 ","$2,592.00 ",$526.53 ,$473.00 ,$473.00 ,"$1,362.68 ",$473.00 ,"$1,362.68 ","$2,592.00 ","$2,232.00 ","$2,592.00 ","$2,592.00 ","$2,160.00 " ST VINCENT HOSPITAL - ACUTE,40200007,51798,HC US BLADDER SCAN,402,1 ,$170.00 ,$85.00 ,$19.76 ,$170.00 ,$109.82 ,$22.97 ,$170.00 ,$170.00 ,$53.91 ,$102.00 ,$144.50 ,$119.00 ,$22.97 ,$161.50 ,$122.40 ,$124.10 ,$19.76 ,$144.50 ,$53.91 ,$19.76 ,$136.00 ,$124.10 ,$22.97 ,$53.91 ,$170.00 ,$170.00 ,$144.50 ,$121.29 ,$156.40 ,$119.00 ,$170.00 ,$170.00 ,$103.53 ,$170.00 ,$117.47 ,$119.00 ,$54.45 ,$122.40 ,$24.35 ,$170.00 ,$170.00 ,$53.91 ,$170.00 ,$53.91 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,40200008,58805,HC OVARIAN CYST DRAIN ABDM,402,1 ,"$2,830.00 ","$1,415.00 ",$298.03 ,"$7,821.36 ","$1,828.18 ",$689.81 ,$556.00 ,$520.00 ,"$2,540.58 ","$1,698.00 ","$2,405.50 ","$1,981.00 ",$689.81 ,"$2,688.50 ","$2,037.60 ","$2,065.90 ",$827.18 ,"$2,405.50 ","$2,540.58 ",$827.18 ,"$2,264.00 ","$2,065.90 ",$689.81 ,"$2,540.58 ",$298.03 ,"$2,830.00 ","$2,405.50 ","$5,716.30 ","$2,603.60 ","$1,981.00 ","$5,818.90 ","$7,821.36 ","$1,723.47 ","$7,273.62 ","$1,955.53 ","$1,981.00 ","$2,565.99 ","$2,037.60 ",$731.20 ,$473.00 ,$473.00 ,"$2,540.58 ",$473.00 ,"$2,540.58 ","$2,037.60 ","$1,754.60 ","$2,037.60 ","$2,037.60 ","$1,698.00 " ST VINCENT HOSPITAL - ACUTE,40200009,49407,HC DRAIN ABSC PELVIC TRNSVAG PERC,402,1 ,"$2,400.00 ","$1,200.00 ",$202.63 ,"$3,066.03 ","$1,550.40 ",$202.63 ,$556.00 ,$520.00 ,"$1,362.68 ","$1,440.00 ","$2,040.00 ","$1,680.00 ",$202.63 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ",$404.55 ,"$2,040.00 ","$1,362.68 ",$404.55 ,"$1,920.00 ","$1,752.00 ",$202.63 ,"$1,362.68 ",$298.03 ,"$2,400.00 ","$2,040.00 ","$3,066.03 ","$2,208.00 ","$1,680.00 ","$2,331.31 ","$2,400.00 ","$1,461.60 ","$2,400.00 ","$1,658.40 ","$1,680.00 ","$1,376.31 ","$1,728.00 ",$214.79 ,$473.00 ,$473.00 ,"$1,362.68 ",$473.00 ,"$1,362.68 ","$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,40200010,59000,HC AMNIOCENTESIS DIAGNOSTIC,402,1 ,$575.00 ,$287.50 ,$146.68 ,"$1,380.28 ",$371.45 ,$168.81 ,$556.00 ,$520.00 ,$613.46 ,$345.00 ,$488.75 ,$402.50 ,$168.81 ,$546.25 ,$414.00 ,$419.75 ,$146.68 ,$488.75 ,$613.46 ,$146.68 ,$460.00 ,$419.75 ,$168.81 ,$613.46 ,$298.03 ,$575.00 ,$488.75 ,"$1,380.28 ",$529.00 ,$402.50 ,$575.00 ,$575.00 ,$350.18 ,$575.00 ,$397.33 ,$402.50 ,$619.59 ,$414.00 ,$178.94 ,$473.00 ,$473.00 ,$613.46 ,$473.00 ,$613.46 ,$414.00 ,$356.50 ,$414.00 ,$414.00 ,$345.00 ST VINCENT HOSPITAL - ACUTE,40200011,60300,HC ASP/INJ CYST THYROID,402,1 ,$635.00 ,$317.50 ,$95.76 ,"$1,355.35 ",$410.21 ,$280.78 ,$556.00 ,$520.00 ,$602.38 ,$381.00 ,$539.75 ,$444.50 ,$280.78 ,$603.25 ,$457.20 ,$463.55 ,$95.76 ,$539.75 ,$602.38 ,$95.76 ,$508.00 ,$463.55 ,$280.78 ,$602.38 ,$298.03 ,$635.00 ,$539.75 ,"$1,355.35 ",$584.20 ,$444.50 ,$635.00 ,$635.00 ,$386.72 ,$635.00 ,$438.79 ,$444.50 ,$608.40 ,$457.20 ,$297.63 ,$473.00 ,$473.00 ,$602.38 ,$473.00 ,$602.38 ,$457.20 ,$393.70 ,$457.20 ,$457.20 ,$381.00 ST VINCENT HOSPITAL - ACUTE,40200012,76506,HC US ENCEPHALOGRAM,402,1 ,$900.00 ,$450.00 ,$49.96 ,$900.00 ,$581.40 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$540.00 ,$765.00 ,$630.00 ,$49.96 ,$855.00 ,$648.00 ,$657.00 ,$170.01 ,$765.00 ,$105.54 ,$170.01 ,$720.00 ,$657.00 ,$49.96 ,$105.54 ,$298.03 ,$900.00 ,$765.00 ,$237.46 ,$828.00 ,$630.00 ,$453.02 ,$487.87 ,$548.10 ,$453.02 ,$621.90 ,$630.00 ,$106.60 ,$648.00 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$648.00 ,$558.00 ,$648.00 ,$648.00 ,$540.00 ST VINCENT HOSPITAL - ACUTE,40200013,76536,HC US SOFT TISSUE HEAD/NECK,402,1 ,$790.00 ,$395.00 ,$49.96 ,$790.00 ,$510.34 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$474.00 ,$671.50 ,$553.00 ,$49.96 ,$750.50 ,$568.80 ,$576.70 ,$175.40 ,$671.50 ,$105.54 ,$175.40 ,$632.00 ,$576.70 ,$49.96 ,$105.54 ,$298.03 ,$790.00 ,$671.50 ,$237.46 ,$726.80 ,$553.00 ,$453.02 ,$487.87 ,$481.11 ,$453.02 ,$545.89 ,$553.00 ,$106.60 ,$568.80 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,40200014,76604,HC US CHEST,402,1 ,$580.00 ,$290.00 ,$49.96 ,$580.00 ,$374.68 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$348.00 ,$493.00 ,$406.00 ,$49.96 ,$551.00 ,$417.60 ,$423.40 ,$76.34 ,$493.00 ,$105.54 ,$76.34 ,$464.00 ,$423.40 ,$49.96 ,$105.54 ,$298.03 ,$580.00 ,$493.00 ,$237.46 ,$533.60 ,$406.00 ,$453.02 ,$487.87 ,$353.22 ,$453.02 ,$400.78 ,$406.00 ,$106.60 ,$417.60 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$417.60 ,$359.60 ,$417.60 ,$417.60 ,$348.00 ST VINCENT HOSPITAL - ACUTE,40200015,76641,HC US BREAST COMPLETE,402,1 ,$680.00 ,$340.00 ,$49.96 ,$680.00 ,$439.28 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$408.00 ,$578.00 ,$476.00 ,$49.96 ,$646.00 ,$489.60 ,$496.40 ,$140.36 ,$578.00 ,$105.54 ,$140.36 ,$544.00 ,$496.40 ,$49.96 ,$105.54 ,$298.03 ,$680.00 ,$578.00 ,$237.46 ,$625.60 ,$476.00 ,$303.36 ,$326.69 ,$414.12 ,$303.36 ,$469.88 ,$476.00 ,$106.60 ,$489.60 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,40200015,76641,HC US BREAST COMPLETE,402,1 ,"$1,000.00 ",$500.00 ,$49.96 ,"$1,000.00 ",$646.00 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$600.00 ,$850.00 ,$700.00 ,$49.96 ,$950.00 ,$720.00 ,$730.00 ,$140.36 ,$850.00 ,$105.54 ,$140.36 ,$800.00 ,$730.00 ,$49.96 ,$105.54 ,$298.03 ,"$1,000.00 ",$850.00 ,$237.46 ,$920.00 ,$700.00 ,$303.36 ,$326.69 ,$609.00 ,$303.36 ,$691.00 ,$700.00 ,$106.60 ,$720.00 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,40200016,76642,HC US BREAST LIMITED,402,1 ,$830.00 ,$415.00 ,$49.96 ,$830.00 ,$536.18 ,$49.96 ,$556.00 ,$520.00 ,$78.35 ,$498.00 ,$705.50 ,$581.00 ,$49.96 ,$788.50 ,$597.60 ,$605.90 ,$107.34 ,$705.50 ,$78.35 ,$107.34 ,$664.00 ,$605.90 ,$49.96 ,$78.35 ,$298.03 ,$830.00 ,$705.50 ,$176.29 ,$763.60 ,$581.00 ,$303.36 ,$326.69 ,$505.47 ,$303.36 ,$573.53 ,$581.00 ,$79.13 ,$597.60 ,$52.96 ,$473.00 ,$473.00 ,$78.35 ,$473.00 ,$78.35 ,$597.60 ,$514.60 ,$597.60 ,$597.60 ,$498.00 ST VINCENT HOSPITAL - ACUTE,40200016,76642,HC US BREAST LIMITED,402,1 ,$550.00 ,$275.00 ,$49.96 ,$550.00 ,$355.30 ,$49.96 ,$550.00 ,$520.00 ,$78.35 ,$330.00 ,$467.50 ,$385.00 ,$49.96 ,$522.50 ,$396.00 ,$401.50 ,$107.34 ,$467.50 ,$78.35 ,$107.34 ,$440.00 ,$401.50 ,$49.96 ,$78.35 ,$298.03 ,$550.00 ,$467.50 ,$176.29 ,$506.00 ,$385.00 ,$303.36 ,$326.69 ,$334.95 ,$303.36 ,$380.05 ,$385.00 ,$79.13 ,$396.00 ,$52.96 ,$473.00 ,$473.00 ,$78.35 ,$473.00 ,$78.35 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,40200017,76700,HC US ABDOMEN CMPL,402,1 ,"$1,100.00 ",$550.00 ,$63.07 ,"$1,100.00 ",$710.60 ,$63.07 ,$556.00 ,$520.00 ,$105.54 ,$660.00 ,$935.00 ,$770.00 ,$63.07 ,"$1,045.00 ",$792.00 ,$803.00 ,$163.28 ,$935.00 ,$105.54 ,$163.28 ,$880.00 ,$803.00 ,$63.07 ,$105.54 ,$298.03 ,"$1,100.00 ",$935.00 ,$237.46 ,"$1,012.00 ",$770.00 ,$453.02 ,$487.87 ,$669.90 ,$453.02 ,$760.10 ,$770.00 ,$106.60 ,$792.00 ,$66.85 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,40200018,76705,HC US ABDOMEN LTD,402,1 ,$820.00 ,$410.00 ,$49.96 ,$820.00 ,$529.72 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$492.00 ,$697.00 ,$574.00 ,$49.96 ,$779.00 ,$590.40 ,$598.60 ,$122.86 ,$697.00 ,$105.54 ,$122.86 ,$656.00 ,$598.60 ,$49.96 ,$105.54 ,$298.03 ,$820.00 ,$697.00 ,$237.46 ,$754.40 ,$574.00 ,$453.02 ,$487.87 ,$499.38 ,$453.02 ,$566.62 ,$574.00 ,$106.60 ,$590.40 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$590.40 ,$508.40 ,$590.40 ,$590.40 ,$492.00 ST VINCENT HOSPITAL - ACUTE,40200019,76770,HC US RETROPERITIONEAL,402,1 ,$810.00 ,$405.00 ,$63.07 ,$810.00 ,$523.26 ,$63.07 ,$556.00 ,$520.00 ,$105.54 ,$486.00 ,$688.50 ,$567.00 ,$63.07 ,$769.50 ,$583.20 ,$591.30 ,$151.82 ,$688.50 ,$105.54 ,$151.82 ,$648.00 ,$591.30 ,$63.07 ,$105.54 ,$298.03 ,$810.00 ,$688.50 ,$237.46 ,$745.20 ,$567.00 ,$453.02 ,$487.87 ,$493.29 ,$453.02 ,$559.71 ,$567.00 ,$106.60 ,$583.20 ,$66.85 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$583.20 ,$502.20 ,$583.20 ,$583.20 ,$486.00 ST VINCENT HOSPITAL - ACUTE,40200020,76775,HC US RETROPERITONEAL LTD,402,1 ,$740.00 ,$370.00 ,$49.96 ,$740.00 ,$478.04 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$444.00 ,$629.00 ,$518.00 ,$49.96 ,$703.00 ,$532.80 ,$540.20 ,$59.51 ,$629.00 ,$105.54 ,$59.51 ,$592.00 ,$540.20 ,$49.96 ,$105.54 ,$298.03 ,$740.00 ,$629.00 ,$237.46 ,$680.80 ,$518.00 ,$453.02 ,$487.87 ,$450.66 ,$453.02 ,$511.34 ,$518.00 ,$106.60 ,$532.80 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$532.80 ,$458.80 ,$532.80 ,$532.80 ,$444.00 ST VINCENT HOSPITAL - ACUTE,40200021,76776,HC US KIDNEY TRANSPLANT W/DOPPLER,402,1 ,$820.00 ,$410.00 ,$49.96 ,$820.00 ,$529.72 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$492.00 ,$697.00 ,$574.00 ,$49.96 ,$779.00 ,$590.40 ,$598.60 ,$234.23 ,$697.00 ,$105.54 ,$234.23 ,$656.00 ,$598.60 ,$49.96 ,$105.54 ,$298.03 ,$820.00 ,$697.00 ,$237.46 ,$754.40 ,$574.00 ,$453.02 ,$487.87 ,$499.38 ,$453.02 ,$566.62 ,$574.00 ,$106.60 ,$590.40 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$590.40 ,$508.40 ,$590.40 ,$590.40 ,$492.00 ST VINCENT HOSPITAL - ACUTE,40200022,76800,HC US SPINAL CANAL AND CONTENTS,402,1 ,$500.00 ,$250.00 ,$49.96 ,$500.00 ,$323.00 ,$49.96 ,$500.00 ,$500.00 ,$105.54 ,$300.00 ,$425.00 ,$350.00 ,$49.96 ,$475.00 ,$360.00 ,$365.00 ,$168.67 ,$425.00 ,$105.54 ,$168.67 ,$400.00 ,$365.00 ,$49.96 ,$105.54 ,$298.03 ,$500.00 ,$425.00 ,$237.46 ,$460.00 ,$350.00 ,$303.14 ,$326.46 ,$304.50 ,$303.14 ,$345.50 ,$350.00 ,$106.60 ,$360.00 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,40200023,76801,HC US PREGNANCY <14 WEEKS SGL,402,1 ,$650.00 ,$325.00 ,$32.24 ,$650.00 ,$419.90 ,$32.24 ,$556.00 ,$520.00 ,$105.54 ,$390.00 ,$552.50 ,$455.00 ,$32.24 ,$617.50 ,$468.00 ,$474.50 ,$145.08 ,$552.50 ,$105.54 ,$145.08 ,$520.00 ,$474.50 ,$32.24 ,$105.54 ,$298.03 ,$650.00 ,$552.50 ,$237.46 ,$598.00 ,$455.00 ,$453.02 ,$487.87 ,$395.85 ,$453.02 ,$449.15 ,$455.00 ,$106.60 ,$468.00 ,$34.17 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,40200024,76802,HC US PREGNANCY <14 WEEKS ADDL,402,1 ,$360.00 ,$180.00 ,$32.24 ,$360.00 ,$232.56 ,$32.24 ,$360.00 ,$360.00 , N/A ,$216.00 ,$306.00 ,$252.00 ,$32.24 ,$342.00 ,$259.20 ,$262.80 ,$43.81 ,$306.00 , N/A ,$43.81 ,$288.00 ,$262.80 ,$32.24 , N/A ,$298.03 ,$360.00 ,$306.00 , N/A ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 , N/A ,$259.20 ,$34.17 ,$360.00 ,$360.00 , N/A ,$360.00 , N/A ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,40200025,76805,HC US PREGNANCY >14 WEEKS SGL,402,1 ,$820.00 ,$410.00 ,$32.24 ,$820.00 ,$529.72 ,$32.24 ,$556.00 ,$520.00 ,$105.54 ,$492.00 ,$697.00 ,$574.00 ,$32.24 ,$779.00 ,$590.40 ,$598.60 ,$181.47 ,$697.00 ,$105.54 ,$181.47 ,$656.00 ,$598.60 ,$32.24 ,$105.54 ,$298.03 ,$820.00 ,$697.00 ,$237.46 ,$754.40 ,$574.00 ,$453.02 ,$487.87 ,$499.38 ,$453.02 ,$566.62 ,$574.00 ,$106.60 ,$590.40 ,$34.17 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$590.40 ,$508.40 ,$590.40 ,$590.40 ,$492.00 ST VINCENT HOSPITAL - ACUTE,40200027,76810,HC US PREGNANCY >14 WEEKS ADDL,402,1 ,$440.00 ,$220.00 ,$32.24 ,$440.00 ,$284.24 ,$32.24 ,$440.00 ,$440.00 , N/A ,$264.00 ,$374.00 ,$308.00 ,$32.24 ,$418.00 ,$316.80 ,$321.20 ,$85.79 ,$374.00 , N/A ,$85.79 ,$352.00 ,$321.20 ,$32.24 , N/A ,$298.03 ,$440.00 ,$374.00 , N/A ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 , N/A ,$316.80 ,$34.17 ,$440.00 ,$440.00 , N/A ,$440.00 , N/A ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,40200028,76811,HC US PREGNANCY DETAILED SGL,402,1 ,$930.00 ,$465.00 ,$32.24 ,$930.00 ,$600.78 ,$32.24 ,$556.00 ,$520.00 ,$222.88 ,$558.00 ,$790.50 ,$651.00 ,$32.24 ,$883.50 ,$669.60 ,$678.90 ,$165.50 ,$790.50 ,$222.88 ,$165.50 ,$744.00 ,$678.90 ,$32.24 ,$222.88 ,$298.03 ,$930.00 ,$790.50 ,$501.48 ,$855.60 ,$651.00 ,$642.47 ,$691.89 ,$566.37 ,$642.47 ,$642.63 ,$651.00 ,$225.11 ,$669.60 ,$34.17 ,$473.00 ,$473.00 ,$222.88 ,$473.00 ,$222.88 ,$669.60 ,$576.60 ,$669.60 ,$669.60 ,$558.00 ST VINCENT HOSPITAL - ACUTE,40200029,76812,HC US PREGNANCY DETAILED ADDL,402,1 ,$425.00 ,$212.50 ,$32.24 ,$425.00 ,$274.55 ,$32.24 ,$425.00 ,$425.00 , N/A ,$255.00 ,$361.25 ,$297.50 ,$32.24 ,$403.75 ,$306.00 ,$310.25 ,$222.10 ,$361.25 , N/A ,$222.10 ,$340.00 ,$310.25 ,$32.24 , N/A ,$298.03 ,$425.00 ,$361.25 , N/A ,$391.00 ,$297.50 ,$212.50 ,$255.00 ,$258.83 ,$212.50 ,$293.68 ,$297.50 , N/A ,$306.00 ,$34.17 ,$425.00 ,$425.00 , N/A ,$425.00 , N/A ,$306.00 ,$263.50 ,$306.00 ,$306.00 ,$255.00 ST VINCENT HOSPITAL - ACUTE,40200030,76816,HC US OB GROWTH FOLLOWUP,402,1 ,$460.00 ,$230.00 ,$32.24 ,$460.00 ,$297.16 ,$32.24 ,$460.00 ,$460.00 ,$105.54 ,$276.00 ,$391.00 ,$322.00 ,$32.24 ,$437.00 ,$331.20 ,$335.80 ,$142.39 ,$391.00 ,$105.54 ,$142.39 ,$368.00 ,$335.80 ,$32.24 ,$105.54 ,$298.03 ,$460.00 ,$391.00 ,$237.46 ,$423.20 ,$322.00 ,$303.14 ,$326.46 ,$280.14 ,$303.14 ,$317.86 ,$322.00 ,$106.60 ,$331.20 ,$34.17 ,$460.00 ,$460.00 ,$105.54 ,$460.00 ,$105.54 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,40200031,76815,HC US FETAL HEART BEAT,402,1 ,$480.00 ,$240.00 ,$32.24 ,$480.00 ,$310.08 ,$32.24 ,$480.00 ,$480.00 ,$105.54 ,$288.00 ,$408.00 ,$336.00 ,$32.24 ,$456.00 ,$345.60 ,$350.40 ,$103.32 ,$408.00 ,$105.54 ,$103.32 ,$384.00 ,$350.40 ,$32.24 ,$105.54 ,$298.03 ,$480.00 ,$408.00 ,$237.46 ,$441.60 ,$336.00 ,$453.02 ,$480.00 ,$292.32 ,$453.02 ,$331.68 ,$336.00 ,$106.60 ,$345.60 ,$34.17 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,40200032,76817,HC US PREGNANCY TRANSVAGINAL,402,1 ,$630.00 ,$315.00 ,$32.24 ,$630.00 ,$406.98 ,$32.24 ,$556.00 ,$520.00 ,$105.54 ,$378.00 ,$535.50 ,$441.00 ,$32.24 ,$598.50 ,$453.60 ,$459.90 ,$117.44 ,$535.50 ,$105.54 ,$117.44 ,$504.00 ,$459.90 ,$32.24 ,$105.54 ,$298.03 ,$630.00 ,$535.50 ,$237.46 ,$579.60 ,$441.00 ,$453.02 ,$487.87 ,$383.67 ,$453.02 ,$435.33 ,$441.00 ,$106.60 ,$453.60 ,$34.17 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$453.60 ,$390.60 ,$453.60 ,$453.60 ,$378.00 ST VINCENT HOSPITAL - ACUTE,40200033,76818,HC US FETAL BIO PROFILE W/NST,402,1 ,$700.00 ,$350.00 ,$32.24 ,$700.00 ,$452.20 ,$32.24 ,$556.00 ,$520.00 ,$105.54 ,$420.00 ,$595.00 ,$490.00 ,$32.24 ,$665.00 ,$504.00 ,$511.00 ,$129.13 ,$595.00 ,$105.54 ,$129.13 ,$560.00 ,$511.00 ,$32.24 ,$105.54 ,$298.03 ,$700.00 ,$595.00 ,$237.46 ,$644.00 ,$490.00 ,$453.02 ,$487.87 ,$426.30 ,$453.02 ,$483.70 ,$490.00 ,$106.60 ,$504.00 ,$34.17 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,40200034,76819,HC US FETAL BIO PROFILE W/O NST,402,1 ,$570.00 ,$285.00 ,$32.24 ,$570.00 ,$368.22 ,$32.24 ,$556.00 ,$520.00 ,$105.54 ,$342.00 ,$484.50 ,$399.00 ,$32.24 ,$541.50 ,$410.40 ,$416.10 ,$95.90 ,$484.50 ,$105.54 ,$95.90 ,$456.00 ,$416.10 ,$32.24 ,$105.54 ,$298.03 ,$570.00 ,$484.50 ,$237.46 ,$524.40 ,$399.00 ,$453.02 ,$487.87 ,$347.13 ,$453.02 ,$393.87 ,$399.00 ,$106.60 ,$410.40 ,$34.17 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$410.40 ,$353.40 ,$410.40 ,$410.40 ,$342.00 ST VINCENT HOSPITAL - ACUTE,40200038,76830,HC US TRANSVAGINAL,402,1 ,$760.00 ,$380.00 ,$49.96 ,$760.00 ,$490.96 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$456.00 ,$646.00 ,$532.00 ,$49.96 ,$722.00 ,$547.20 ,$554.80 ,$178.76 ,$646.00 ,$105.54 ,$178.76 ,$608.00 ,$554.80 ,$49.96 ,$105.54 ,$298.03 ,$760.00 ,$646.00 ,$237.46 ,$699.20 ,$532.00 ,$453.02 ,$487.87 ,$462.84 ,$453.02 ,$525.16 ,$532.00 ,$106.60 ,$547.20 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,40200039,76831,HC US HYSTEROSONOGRAM,402,1 ,$700.00 ,$350.00 ,$63.07 ,$700.00 ,$452.20 ,$63.07 ,$556.00 ,$520.00 ,$222.88 ,$420.00 ,$595.00 ,$490.00 ,$63.07 ,$665.00 ,$504.00 ,$511.00 ,$169.35 ,$595.00 ,$222.88 ,$169.35 ,$560.00 ,$511.00 ,$63.07 ,$222.88 ,$298.03 ,$700.00 ,$595.00 ,$501.48 ,$644.00 ,$490.00 ,$642.47 ,$691.89 ,$426.30 ,$642.47 ,$483.70 ,$490.00 ,$225.11 ,$504.00 ,$66.85 ,$473.00 ,$473.00 ,$222.88 ,$473.00 ,$222.88 ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,40200040,76856,HC US PELVIS NON OB,402,1 ,$880.00 ,$440.00 ,$63.07 ,$880.00 ,$568.48 ,$63.07 ,$556.00 ,$520.00 ,$105.54 ,$528.00 ,$748.00 ,$616.00 ,$63.07 ,$836.00 ,$633.60 ,$642.40 ,$150.47 ,$748.00 ,$105.54 ,$150.47 ,$704.00 ,$642.40 ,$63.07 ,$105.54 ,$298.03 ,$880.00 ,$748.00 ,$237.46 ,$809.60 ,$616.00 ,$453.02 ,$487.87 ,$535.92 ,$453.02 ,$608.08 ,$616.00 ,$106.60 ,$633.60 ,$66.85 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$633.60 ,$545.60 ,$633.60 ,$633.60 ,$528.00 ST VINCENT HOSPITAL - ACUTE,40200041,76857,HC US PELVIS NON-OB LTD,402,1 ,$690.00 ,$345.00 ,$47.38 ,$690.00 ,$445.74 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$414.00 ,$586.50 ,$483.00 ,$49.96 ,$655.50 ,$496.80 ,$503.70 ,$47.38 ,$586.50 ,$105.54 ,$47.38 ,$552.00 ,$503.70 ,$49.96 ,$105.54 ,$298.03 ,$690.00 ,$586.50 ,$237.46 ,$634.80 ,$483.00 ,$303.14 ,$326.46 ,$420.21 ,$303.14 ,$476.79 ,$483.00 ,$106.60 ,$496.80 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$496.80 ,$427.80 ,$496.80 ,$496.80 ,$414.00 ST VINCENT HOSPITAL - ACUTE,40200042,76870,HC US SCROTUM,402,1 ,$740.00 ,$370.00 ,$49.96 ,$740.00 ,$478.04 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$444.00 ,$629.00 ,$518.00 ,$49.96 ,$703.00 ,$532.80 ,$540.20 ,$145.78 ,$629.00 ,$105.54 ,$145.78 ,$592.00 ,$540.20 ,$49.96 ,$105.54 ,$298.03 ,$740.00 ,$629.00 ,$237.46 ,$680.80 ,$518.00 ,$453.02 ,$487.87 ,$450.66 ,$453.02 ,$511.34 ,$518.00 ,$106.60 ,$532.80 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$532.80 ,$458.80 ,$532.80 ,$532.80 ,$444.00 ST VINCENT HOSPITAL - ACUTE,40200044,76873,HC US TRANSRECTAL PROSTATE VOLUME,402,1 ,$690.00 ,$345.00 ,$63.07 ,$690.00 ,$445.74 ,$63.07 ,$556.00 ,$520.00 ,$105.54 ,$414.00 ,$586.50 ,$483.00 ,$63.07 ,$655.50 ,$496.80 ,$503.70 ,$198.99 ,$586.50 ,$105.54 ,$198.99 ,$552.00 ,$503.70 ,$63.07 ,$105.54 ,$298.03 ,$690.00 ,$586.50 ,$237.46 ,$634.80 ,$483.00 ,$642.47 ,$690.00 ,$420.21 ,$642.47 ,$476.79 ,$483.00 ,$106.60 ,$496.80 ,$66.85 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$496.80 ,$427.80 ,$496.80 ,$496.80 ,$414.00 ST VINCENT HOSPITAL - ACUTE,40200045,76881,HC US EXTREMITY NON VASCULAR COMP,402,1 ,"$1,215.00 ",$607.50 ,$49.96 ,"$1,215.00 ",$784.89 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$729.00 ,"$1,032.75 ",$850.50 ,$49.96 ,"$1,154.25 ",$874.80 ,$886.95 ,$70.29 ,"$1,032.75 ",$105.54 ,$70.29 ,$972.00 ,$886.95 ,$49.96 ,$105.54 ,$298.03 ,"$1,215.00 ","$1,032.75 ",$237.46 ,"$1,117.80 ",$850.50 ,$453.02 ,$487.87 ,$739.94 ,$453.02 ,$839.57 ,$850.50 ,$106.60 ,$874.80 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$874.80 ,$753.30 ,$874.80 ,$874.80 ,$729.00 ST VINCENT HOSPITAL - ACUTE,40200045,76881,HC US EXTREMITY NON VASCULAR COMP,402,1 ,$810.00 ,$405.00 ,$49.96 ,$810.00 ,$523.26 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$486.00 ,$688.50 ,$567.00 ,$49.96 ,$769.50 ,$583.20 ,$591.30 ,$70.29 ,$688.50 ,$105.54 ,$70.29 ,$648.00 ,$591.30 ,$49.96 ,$105.54 ,$298.03 ,$810.00 ,$688.50 ,$237.46 ,$745.20 ,$567.00 ,$453.02 ,$487.87 ,$493.29 ,$453.02 ,$559.71 ,$567.00 ,$106.60 ,$583.20 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$583.20 ,$502.20 ,$583.20 ,$583.20 ,$486.00 ST VINCENT HOSPITAL - ACUTE,40200046,76882,HC US EXTREMITY NON VASCULAR LMTD,402,1 ,$550.00 ,$275.00 ,$49.96 ,$550.00 ,$355.30 ,$49.96 ,$550.00 ,$520.00 ,$105.54 ,$330.00 ,$467.50 ,$385.00 ,$49.96 ,$522.50 ,$396.00 ,$401.50 ,$64.90 ,$467.50 ,$105.54 ,$64.90 ,$440.00 ,$401.50 ,$49.96 ,$105.54 ,$298.03 ,$550.00 ,$467.50 ,$237.46 ,$506.00 ,$385.00 ,$303.14 ,$326.46 ,$334.95 ,$303.14 ,$380.05 ,$385.00 ,$106.60 ,$396.00 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,40200047,76882,HC US EXTREMITY NON VASCULAR KNEE,402,1 ,$550.00 ,$275.00 ,$49.96 ,$550.00 ,$355.30 ,$49.96 ,$550.00 ,$520.00 ,$105.54 ,$330.00 ,$467.50 ,$385.00 ,$49.96 ,$522.50 ,$396.00 ,$401.50 ,$64.90 ,$467.50 ,$105.54 ,$64.90 ,$440.00 ,$401.50 ,$49.96 ,$105.54 ,$298.03 ,$550.00 ,$467.50 ,$237.46 ,$506.00 ,$385.00 ,$303.14 ,$326.46 ,$334.95 ,$303.14 ,$380.05 ,$385.00 ,$106.60 ,$396.00 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,40200048,76885,HC US HIPS INFANT DYNAMIC,402,1 ,$540.00 ,$270.00 ,$49.96 ,$540.00 ,$348.84 ,$49.96 ,$540.00 ,$520.00 ,$78.35 ,$324.00 ,$459.00 ,$378.00 ,$49.96 ,$513.00 ,$388.80 ,$394.20 ,$211.79 ,$459.00 ,$78.35 ,$211.79 ,$432.00 ,$394.20 ,$49.96 ,$78.35 ,$298.03 ,$540.00 ,$459.00 ,$176.29 ,$496.80 ,$378.00 ,$303.14 ,$326.46 ,$328.86 ,$303.14 ,$373.14 ,$378.00 ,$79.13 ,$388.80 ,$52.96 ,$473.00 ,$473.00 ,$78.35 ,$473.00 ,$78.35 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,40200050,76936,HC US GUIDED COMPRESSION RPR,402,1 ,$850.00 ,$425.00 ,$53.35 ,$850.00 ,$549.10 ,$53.35 ,$556.00 ,$520.00 ,$256.12 ,$510.00 ,$722.50 ,$595.00 ,$53.35 ,$807.50 ,$612.00 ,$620.50 ,$345.18 ,$722.50 ,$256.12 ,$345.18 ,$680.00 ,$620.50 ,$53.35 ,$256.12 ,$298.03 ,$850.00 ,$722.50 ,$576.27 ,$782.00 ,$595.00 ,$441.23 ,$475.17 ,$517.65 ,$441.23 ,$587.35 ,$595.00 ,$258.68 ,$612.00 ,$56.55 ,$473.00 ,$473.00 ,$256.12 ,$473.00 ,$256.12 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,40200051,76937,HC US GUIDED VASCULAR ACCESS 76937,402,1 ,$530.00 ,$265.00 ,$35.59 ,$530.00 ,$342.38 ,$35.59 ,$530.00 ,$520.00 , N/A ,$318.00 ,$450.50 ,$371.00 ,$35.59 ,$503.50 ,$381.60 ,$386.90 ,$48.52 ,$450.50 , N/A ,$48.52 ,$424.00 ,$386.90 ,$35.59 , N/A ,$298.03 ,$530.00 ,$450.50 , N/A ,$487.60 ,$371.00 ,$265.00 ,$318.00 ,$322.77 ,$265.00 ,$366.23 ,$371.00 , N/A ,$381.60 ,$37.73 ,$473.00 ,$473.00 , N/A ,$473.00 , N/A ,$381.60 ,$328.60 ,$381.60 ,$381.60 ,$318.00 ST VINCENT HOSPITAL - ACUTE,40200052,76940,HC US GUIDANCE TISSUE ABLATION,402,1 ,$790.00 ,$395.00 ,$35.59 ,$790.00 ,$510.34 ,$35.59 ,$556.00 ,$520.00 , N/A ,$474.00 ,$671.50 ,$553.00 ,$35.59 ,$750.50 ,$568.80 ,$576.70 ,$139.73 ,$671.50 , N/A ,$139.73 ,$632.00 ,$576.70 ,$35.59 , N/A ,$298.03 ,$790.00 ,$671.50 , N/A ,$726.80 ,$553.00 ,$395.00 ,$474.00 ,$481.11 ,$395.00 ,$545.89 ,$553.00 , N/A ,$568.80 ,$37.73 ,$473.00 ,$473.00 , N/A ,$473.00 , N/A ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,40200053,76942,HC US GUIDED NEEDLE PLCMT,402,1 ,$890.00 ,$445.00 ,$35.59 ,$890.00 ,$574.94 ,$35.59 ,$556.00 ,$520.00 , N/A ,$534.00 ,$756.50 ,$623.00 ,$35.59 ,$845.50 ,$640.80 ,$649.70 ,$52.77 ,$756.50 , N/A ,$52.77 ,$712.00 ,$649.70 ,$35.59 , N/A ,$298.03 ,$890.00 ,$756.50 , N/A ,$818.80 ,$623.00 ,$445.00 ,$534.00 ,$542.01 ,$445.00 ,$614.99 ,$623.00 , N/A ,$640.80 ,$37.73 ,$473.00 ,$473.00 , N/A ,$473.00 , N/A ,$640.80 ,$551.80 ,$640.80 ,$640.80 ,$534.00 ST VINCENT HOSPITAL - ACUTE,40200056,19083,HC US GUIDED NEEDLE BX BREAST,402,1 ,"$1,200.00 ",$600.00 ,$298.03 ,"$3,066.03 ",$775.20 ,$405.89 ,$556.00 ,$520.00 ,"$1,362.68 ",$720.00 ,"$1,020.00 ",$840.00 ,$405.89 ,"$1,140.00 ",$864.00 ,$876.00 ,$303.99 ,"$1,020.00 ","$1,362.68 ",$303.99 ,$960.00 ,$876.00 ,$405.89 ,"$1,362.68 ",$298.03 ,"$1,200.00 ","$1,020.00 ","$3,066.03 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,"$1,376.31 ",$864.00 ,$430.24 ,$473.00 ,$473.00 ,"$1,362.68 ",$473.00 ,"$1,362.68 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,40200057,76942,HC US GUIDED NEEDLE BX THORA,402,1 ,"$1,000.00 ",$500.00 ,$35.59 ,"$1,000.00 ",$646.00 ,$35.59 ,$556.00 ,$520.00 , N/A ,$600.00 ,$850.00 ,$700.00 ,$35.59 ,$950.00 ,$720.00 ,$730.00 ,$52.77 ,$850.00 , N/A ,$52.77 ,$800.00 ,$730.00 ,$35.59 , N/A ,$298.03 ,"$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 ,$37.73 ,$473.00 ,$473.00 , N/A ,$473.00 , N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,40200059,76946,HC US GUIDED AMNIOCENTESIS,402,1 ,$220.00 ,$110.00 ,$27.16 ,$220.00 ,$142.12 ,$35.59 ,$220.00 ,$220.00 , N/A ,$132.00 ,$187.00 ,$154.00 ,$35.59 ,$209.00 ,$158.40 ,$160.60 ,$27.16 ,$187.00 , N/A ,$27.16 ,$176.00 ,$160.60 ,$35.59 , N/A ,$220.00 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 ,$37.73 ,$220.00 ,$220.00 , N/A ,$220.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,40200061,76965,HC US GUIDED INTERSTITIAL THRPY,402,1 ,$120.00 ,$60.00 ,$35.59 ,$120.00 ,$77.52 ,$35.59 ,$120.00 ,$120.00 , N/A ,$72.00 ,$102.00 ,$84.00 ,$35.59 ,$114.00 ,$86.40 ,$87.60 ,$50.74 ,$102.00 , N/A ,$50.74 ,$96.00 ,$87.60 ,$35.59 , N/A ,$120.00 ,$120.00 ,$102.00 , N/A ,$110.40 ,$84.00 ,$60.00 ,$72.00 ,$73.08 ,$60.00 ,$82.92 ,$84.00 , N/A ,$86.40 ,$37.73 ,$120.00 ,$120.00 , N/A ,$120.00 , N/A ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,40200062,76998,HC US INTRAOPERATIVE,402,1 ,"$1,200.00 ",$600.00 ,$35.59 ,"$1,200.00 ",$775.20 ,$35.59 ,$556.00 ,$520.00 , N/A ,$720.00 ,"$1,020.00 ",$840.00 ,$35.59 ,"$1,140.00 ",$864.00 ,$876.00 ,$103.26 ,"$1,020.00 ", N/A ,$103.26 ,$960.00 ,$876.00 ,$35.59 , N/A ,$298.03 ,"$1,200.00 ","$1,020.00 ", N/A ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 , N/A ,$864.00 ,$37.73 ,$473.00 ,$473.00 , N/A ,$473.00 , N/A ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,40200063,76999,HC UNLISTED PROCEDURE ULTRASOUND,402,1 ,$420.00 ,$210.00 ,$49.96 ,$420.00 ,$271.32 ,$49.96 ,$420.00 ,$420.00 ,$78.35 ,$252.00 ,$357.00 ,$294.00 ,$49.96 ,$399.00 ,$302.40 ,$306.60 , N/A ,$357.00 ,$78.35 , N/A ,$336.00 ,$306.60 ,$49.96 ,$78.35 ,$298.03 ,$420.00 ,$357.00 ,$176.29 ,$386.40 ,$294.00 ,$303.14 ,$326.46 ,$255.78 ,$303.14 ,$290.22 ,$294.00 ,$79.13 ,$302.40 ,$52.96 ,$420.00 ,$420.00 ,$78.35 ,$420.00 ,$78.35 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,40200064,93975,HC DUPLEX ABD/PEL/RETRO CMPL,402,1 ,"$1,100.00 ",$550.00 ,$63.07 ,"$1,100.00 ",$710.60 ,$63.07 ,$556.00 ,$520.00 ,$222.88 ,$660.00 ,$935.00 ,$770.00 ,$63.07 ,"$1,045.00 ",$792.00 ,$803.00 ,$436.79 ,$935.00 ,$222.88 ,$436.79 ,$880.00 ,$803.00 ,$63.07 ,$222.88 ,$298.03 ,"$1,100.00 ",$935.00 ,$501.48 ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$225.11 ,$792.00 ,$66.85 ,$473.00 ,$473.00 ,$222.88 ,$473.00 ,$222.88 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,40200065,93975,HC DUPLEX ABD/PEL/RETRO CMPLTESTICULAR,402,1 ,"$1,100.00 ",$550.00 ,$63.07 ,"$1,100.00 ",$710.60 ,$63.07 ,$556.00 ,$520.00 ,$222.88 ,$660.00 ,$935.00 ,$770.00 ,$63.07 ,"$1,045.00 ",$792.00 ,$803.00 ,$436.79 ,$935.00 ,$222.88 ,$436.79 ,$880.00 ,$803.00 ,$63.07 ,$222.88 ,$298.03 ,"$1,100.00 ",$935.00 ,$501.48 ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$225.11 ,$792.00 ,$66.85 ,$473.00 ,$473.00 ,$222.88 ,$473.00 ,$222.88 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,40200066,93975,HC DUPLEX ABD/PEL/RETRO CMPL RENAL,402,1 ,"$1,100.00 ",$550.00 ,$63.07 ,"$1,100.00 ",$710.60 ,$63.07 ,$556.00 ,$520.00 ,$222.88 ,$660.00 ,$935.00 ,$770.00 ,$63.07 ,"$1,045.00 ",$792.00 ,$803.00 ,$436.79 ,$935.00 ,$222.88 ,$436.79 ,$880.00 ,$803.00 ,$63.07 ,$222.88 ,$298.03 ,"$1,100.00 ",$935.00 ,$501.48 ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$225.11 ,$792.00 ,$66.85 ,$473.00 ,$473.00 ,$222.88 ,$473.00 ,$222.88 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,40200067,93975,HC DUPLEX ABD/PEL/RETRO CMPL AORTA,402,1 ,"$1,100.00 ",$550.00 ,$63.07 ,"$1,100.00 ",$710.60 ,$63.07 ,$556.00 ,$520.00 ,$222.88 ,$660.00 ,$935.00 ,$770.00 ,$63.07 ,"$1,045.00 ",$792.00 ,$803.00 ,$436.79 ,$935.00 ,$222.88 ,$436.79 ,$880.00 ,$803.00 ,$63.07 ,$222.88 ,$298.03 ,"$1,100.00 ",$935.00 ,$501.48 ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$225.11 ,$792.00 ,$66.85 ,$473.00 ,$473.00 ,$222.88 ,$473.00 ,$222.88 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,40200068,93976,HC DUPLEX ABD/PEL/RETRO LTD,402,1 ,"$1,000.00 ",$500.00 ,$63.07 ,"$1,000.00 ",$646.00 ,$63.07 ,$556.00 ,$520.00 ,$105.54 ,$600.00 ,$850.00 ,$700.00 ,$63.07 ,$950.00 ,$720.00 ,$730.00 ,$247.72 ,$850.00 ,$105.54 ,$247.72 ,$800.00 ,$730.00 ,$63.07 ,$105.54 ,$298.03 ,"$1,000.00 ",$850.00 ,$237.46 ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 ,$106.60 ,$720.00 ,$66.85 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,40200069,93976,HC DUPLEX ABD/PEL/RETRO LTD AORTA DOPPLER,402,1 ,"$1,000.00 ",$500.00 ,$63.07 ,"$1,000.00 ",$646.00 ,$63.07 ,$556.00 ,$520.00 ,$105.54 ,$600.00 ,$850.00 ,$700.00 ,$63.07 ,$950.00 ,$720.00 ,$730.00 ,$247.72 ,$850.00 ,$105.54 ,$247.72 ,$800.00 ,$730.00 ,$63.07 ,$105.54 ,$298.03 ,"$1,000.00 ",$850.00 ,$237.46 ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 ,$106.60 ,$720.00 ,$66.85 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,40200070,93976,HC DUPLEX ABD/PEL/RETRO LTD RENAL,402,1 ,"$1,000.00 ",$500.00 ,$63.07 ,"$1,000.00 ",$646.00 ,$63.07 ,$556.00 ,$520.00 ,$105.54 ,$600.00 ,$850.00 ,$700.00 ,$63.07 ,$950.00 ,$720.00 ,$730.00 ,$247.72 ,$850.00 ,$105.54 ,$247.72 ,$800.00 ,$730.00 ,$63.07 ,$105.54 ,$298.03 ,"$1,000.00 ",$850.00 ,$237.46 ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 ,$106.60 ,$720.00 ,$66.85 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,40200071,93976,HC DUPLEX ABD/PEL/RETRO SCAN LTD AORTA,402,1 ,"$1,000.00 ",$500.00 ,$63.07 ,"$1,000.00 ",$646.00 ,$63.07 ,$556.00 ,$520.00 ,$105.54 ,$600.00 ,$850.00 ,$700.00 ,$63.07 ,$950.00 ,$720.00 ,$730.00 ,$247.72 ,$850.00 ,$105.54 ,$247.72 ,$800.00 ,$730.00 ,$63.07 ,$105.54 ,$298.03 ,"$1,000.00 ",$850.00 ,$237.46 ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 ,$106.60 ,$720.00 ,$66.85 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,40200072,93976,HC DUPLEX ABD/PEL/RETRO LTD PELVIC,402,1 ,"$1,000.00 ",$500.00 ,$63.07 ,"$1,000.00 ",$646.00 ,$63.07 ,$556.00 ,$520.00 ,$105.54 ,$600.00 ,$850.00 ,$700.00 ,$63.07 ,$950.00 ,$720.00 ,$730.00 ,$247.72 ,$850.00 ,$105.54 ,$247.72 ,$800.00 ,$730.00 ,$63.07 ,$105.54 ,$298.03 ,"$1,000.00 ",$850.00 ,$237.46 ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 ,$106.60 ,$720.00 ,$66.85 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,40200073,93978,HC DUPLEX AORTA/IVC/GRAFT CMPL,402,1 ,$860.00 ,$430.00 ,$63.07 ,$860.00 ,$555.56 ,$63.07 ,$556.00 ,$520.00 ,$222.88 ,$516.00 ,$731.00 ,$602.00 ,$63.07 ,$817.00 ,$619.20 ,$627.80 ,$295.55 ,$731.00 ,$222.88 ,$295.55 ,$688.00 ,$627.80 ,$63.07 ,$222.88 ,$298.03 ,$860.00 ,$731.00 ,$501.48 ,$791.20 ,$602.00 ,$430.00 ,$516.00 ,$523.74 ,$430.00 ,$594.26 ,$602.00 ,$225.11 ,$619.20 ,$66.85 ,$473.00 ,$473.00 ,$222.88 ,$473.00 ,$222.88 ,$619.20 ,$533.20 ,$619.20 ,$619.20 ,$516.00 ST VINCENT HOSPITAL - ACUTE,40200074,93979,HC DUPLEX AORTA/IVC/GRAFT LTD,402,1 ,$660.00 ,$330.00 ,$49.96 ,$660.00 ,$426.36 ,$49.96 ,$556.00 ,$520.00 ,$105.54 ,$396.00 ,$561.00 ,$462.00 ,$49.96 ,$627.00 ,$475.20 ,$481.80 ,$193.15 ,$561.00 ,$105.54 ,$193.15 ,$528.00 ,$481.80 ,$49.96 ,$105.54 ,$298.03 ,$660.00 ,$561.00 ,$237.46 ,$607.20 ,$462.00 ,$330.00 ,$396.00 ,$401.94 ,$330.00 ,$456.06 ,$462.00 ,$106.60 ,$475.20 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$475.20 ,$409.20 ,$475.20 ,$475.20 ,$396.00 ST VINCENT HOSPITAL - ACUTE,40200075,76706,HC US AORTA (SCREENING),402,1 ,$500.00 ,$250.00 ,$49.96 ,$500.00 ,$323.00 ,$49.96 ,$500.00 ,$500.00 ,$105.54 ,$300.00 ,$425.00 ,$350.00 ,$49.96 ,$475.00 ,$360.00 ,$365.00 ,$163.28 ,$425.00 ,$105.54 ,$163.28 ,$400.00 ,$365.00 ,$49.96 ,$105.54 ,$298.03 ,$500.00 ,$425.00 ,$237.46 ,$460.00 ,$350.00 ,$367.72 ,$396.01 ,$304.50 ,$367.72 ,$345.50 ,$350.00 ,$106.60 ,$360.00 ,$52.96 ,$473.00 ,$473.00 ,$105.54 ,$473.00 ,$105.54 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,40200076,59015,HC CHORIONIC VILLUS SAMPLING,402,1 ,$390.00 ,$195.00 ,$168.81 ,"$1,380.28 ",$251.94 ,$168.81 ,$390.00 ,$390.00 ,$613.46 ,$234.00 ,$331.50 ,$273.00 ,$168.81 ,$370.50 ,$280.80 ,$284.70 ,$240.57 ,$331.50 ,$613.46 ,$240.57 ,$312.00 ,$284.70 ,$168.81 ,$613.46 ,$298.03 ,$390.00 ,$331.50 ,"$1,380.28 ",$358.80 ,$273.00 ,$390.00 ,$390.00 ,$237.51 ,$390.00 ,$269.49 ,$273.00 ,$619.59 ,$280.80 ,$178.94 ,$390.00 ,$390.00 ,$613.46 ,$390.00 ,$613.46 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,40200077,76706,HC ABD AORTA US SELF SCREEN CORP,402,1 ,$57.00 ,$28.50 ,$28.50 ,$237.46 ,$36.82 ,$49.96 ,$57.00 ,$57.00 ,$105.54 ,$34.20 ,$48.45 ,$39.90 ,$49.96 ,$54.15 ,$41.04 ,$41.61 ,$57.00 ,$48.45 ,$105.54 ,$57.00 ,$45.60 ,$41.61 ,$49.96 ,$105.54 ,$57.00 ,$57.00 ,$48.45 ,$237.46 ,$52.44 ,$39.90 ,$57.00 ,$57.00 ,$34.71 ,$57.00 ,$39.39 ,$39.90 ,$106.60 ,$41.04 ,$52.96 ,$57.00 ,$57.00 ,$105.54 ,$57.00 ,$105.54 ,$41.04 ,$35.34 ,$41.04 ,$41.04 ,$34.20 ST VINCENT HOSPITAL - ACUTE,40200092,76813,HC US FETAL NUCHAL TRANSLUCENCY SNG,402,1 ,$420.00 ,$210.00 ,$32.24 ,$420.00 ,$271.32 ,$32.24 ,$420.00 ,$420.00 ,$105.54 ,$252.00 ,$357.00 ,$294.00 ,$32.24 ,$399.00 ,$302.40 ,$306.60 ,$127.55 ,$357.00 ,$105.54 ,$127.55 ,$336.00 ,$306.60 ,$32.24 ,$105.54 ,$298.03 ,$420.00 ,$357.00 ,$237.46 ,$386.40 ,$294.00 ,$420.00 ,$420.00 ,$255.78 ,$420.00 ,$290.22 ,$294.00 ,$106.60 ,$302.40 ,$34.17 ,$420.00 ,$420.00 ,$105.54 ,$420.00 ,$105.54 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,40200093,76814,HC US FETAL NUCHAL TRANSLUCENCY ADDL,402,1 ,$330.00 ,$165.00 ,$32.24 ,$330.00 ,$213.18 ,$32.24 ,$330.00 ,$330.00 , N/A ,$198.00 ,$280.50 ,$231.00 ,$32.24 ,$313.50 ,$237.60 ,$240.90 ,$58.84 ,$280.50 , N/A ,$58.84 ,$264.00 ,$240.90 ,$32.24 , N/A ,$298.03 ,$330.00 ,$280.50 , N/A ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 , N/A ,$237.60 ,$34.17 ,$330.00 ,$330.00 , N/A ,$330.00 , N/A ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,40300003,77067,HC MAMMOGRAM SCREEN DIGI W/CAD,403,1 ,$350.00 ,$175.00 ,$24.55 ,$350.00 ,$226.10 ,$24.55 ,$303.00 ,$202.00 ,$90.82 ,$210.00 ,$297.50 ,$245.00 ,$24.55 ,$332.50 ,$252.00 ,$255.50 ,$186.18 ,$297.50 ,$90.82 ,$186.18 ,$280.00 ,$255.50 ,$24.55 ,$90.82 ,$154.53 ,$350.00 ,$297.50 ,$204.35 ,$322.00 ,$245.00 ,$297.21 ,$320.07 ,$213.15 ,$297.21 ,$241.85 ,$245.00 ,$91.73 ,$252.00 ,$26.02 ,$158.00 ,$158.00 ,$90.82 ,$158.00 ,$90.82 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$350.00 ,$175.00 ,$24.55 ,$350.00 ,$226.10 ,$24.55 ,$303.00 ,$202.00 ,$90.82 ,$210.00 ,$297.50 ,$245.00 ,$24.55 ,$332.50 ,$252.00 ,$255.50 ,$186.18 ,$297.50 ,$90.82 ,$186.18 ,$280.00 ,$255.50 ,$24.55 ,$90.82 ,$154.53 ,$350.00 ,$297.50 ,$204.35 ,$322.00 ,$245.00 ,$297.21 ,$320.07 ,$213.15 ,$297.21 ,$241.85 ,$245.00 ,$91.73 ,$252.00 ,$26.02 ,$158.00 ,$158.00 ,$90.82 ,$158.00 ,$90.82 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,40300006,77063,HC SCREEN DIGITAL BREAST TOMOSYTH BIL,403,1 ,$130.00 ,$65.00 ,$23.99 ,$130.00 ,$83.98 ,$24.55 ,$84.10 ,$84.10 ,$23.99 ,$78.00 ,$110.50 ,$91.00 ,$24.55 ,$123.50 ,$93.60 ,$94.90 ,$49.18 ,$110.50 ,$23.99 ,$49.18 ,$104.00 ,$94.90 ,$24.55 ,$23.99 ,$130.00 ,$130.00 ,$110.50 ,$53.98 ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 ,$24.23 ,$93.60 ,$26.02 ,$130.00 ,$130.00 ,$23.99 ,$130.00 ,$23.99 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,40300008,77063,HC SCREEN DIGITAL BREAST TOMOSYTH BIL CORPORATE,403,1 ,$40.00 ,$20.00 ,$20.00 ,$53.98 ,$25.84 ,$24.55 ,$25.88 ,$25.88 ,$23.99 ,$24.00 ,$34.00 ,$28.00 ,$24.55 ,$38.00 ,$28.80 ,$29.20 ,$40.00 ,$34.00 ,$23.99 ,$40.00 ,$32.00 ,$29.20 ,$24.55 ,$23.99 ,$40.00 ,$40.00 ,$34.00 ,$53.98 ,$36.80 ,$28.00 ,$20.00 ,$24.00 ,$24.36 ,$20.00 ,$27.64 ,$28.00 ,$24.23 ,$28.80 ,$26.02 ,$40.00 ,$40.00 ,$23.99 ,$40.00 ,$23.99 ,$28.80 ,$24.80 ,$28.80 ,$28.80 ,$24.00 ST VINCENT HOSPITAL - ACUTE,40400003,78814,HC PET W/CT TUMR LIMITED AREA,404,1 ,"$6,700.00 ","$3,350.00 ",$405.55 ,"$6,700.00 ","$4,328.20 ",$405.55 ,"$4,343.00 ","$4,141.00 ","$1,433.71 ","$4,020.00 ","$5,695.00 ","$4,690.00 ",$405.55 ,"$6,365.00 ","$4,824.00 ","$4,891.00 ","$5,800.64 ","$5,695.00 ","$1,433.71 ","$5,800.64 ","$5,360.00 ","$4,891.00 ",$405.55 ,"$1,433.71 ","$2,496.82 ","$6,700.00 ","$5,695.00 ","$3,225.85 ","$6,164.00 ","$4,690.00 ","$4,412.15 ","$4,751.54 ","$4,080.30 ","$4,412.15 ","$4,629.70 ","$4,690.00 ","$1,448.05 ","$4,824.00 ",$429.88 ,"$3,564.00 ","$3,564.00 ","$1,433.71 ","$3,564.00 ","$1,433.71 ","$4,824.00 ","$4,154.00 ","$4,824.00 ","$4,824.00 ","$4,020.00 " ST VINCENT HOSPITAL - ACUTE,40400004,78815,HC PET W/CT TUMR SKULL MID-THIGH,404,1 ,"$7,000.00 ","$3,500.00 ",$405.55 ,"$7,000.00 ","$4,522.00 ",$405.55 ,"$4,343.00 ","$4,141.00 ","$1,433.71 ","$4,200.00 ","$5,950.00 ","$4,900.00 ",$405.55 ,"$6,650.00 ","$5,040.00 ","$5,110.00 ","$5,800.64 ","$5,950.00 ","$1,433.71 ","$5,800.64 ","$5,600.00 ","$5,110.00 ",$405.55 ,"$1,433.71 ","$2,496.82 ","$7,000.00 ","$5,950.00 ","$3,225.85 ","$6,440.00 ","$4,900.00 ","$4,412.15 ","$4,751.54 ","$4,263.00 ","$4,412.15 ","$4,837.00 ","$4,900.00 ","$1,448.05 ","$5,040.00 ",$429.88 ,"$3,564.00 ","$3,564.00 ","$1,433.71 ","$3,564.00 ","$1,433.71 ","$5,040.00 ","$4,340.00 ","$5,040.00 ","$5,040.00 ","$4,200.00 " ST VINCENT HOSPITAL - ACUTE,40400005,78816,HC PET W/CT MELAN IMAG WHOLE BODY,404,1 ,"$7,000.00 ","$3,500.00 ",$405.55 ,"$7,000.00 ","$4,522.00 ",$405.55 ,"$4,343.00 ","$4,141.00 ","$1,433.71 ","$4,200.00 ","$5,950.00 ","$4,900.00 ",$405.55 ,"$6,650.00 ","$5,040.00 ","$5,110.00 ","$5,800.64 ","$5,950.00 ","$1,433.71 ","$5,800.64 ","$5,600.00 ","$5,110.00 ",$405.55 ,"$1,433.71 ","$2,496.82 ","$7,000.00 ","$5,950.00 ","$3,225.85 ","$6,440.00 ","$4,900.00 ","$4,412.15 ","$4,751.54 ","$4,263.00 ","$4,412.15 ","$4,837.00 ","$4,900.00 ","$1,448.05 ","$5,040.00 ",$429.88 ,"$3,564.00 ","$3,564.00 ","$1,433.71 ","$3,564.00 ","$1,433.71 ","$5,040.00 ","$4,340.00 ","$5,040.00 ","$5,040.00 ","$4,200.00 " ST VINCENT HOSPITAL - ACUTE,40400006,78608,HC PET BRAIN LIMITED ALZHEIMERS,404,1 ,"$6,700.00 ","$3,350.00 ",$405.55 ,"$6,700.00 ","$4,328.20 ",$405.55 ,"$4,343.00 ","$4,141.00 ","$1,433.71 ","$4,020.00 ","$5,695.00 ","$4,690.00 ",$405.55 ,"$6,365.00 ","$4,824.00 ","$4,891.00 ","$4,640.52 ","$5,695.00 ","$1,433.71 ","$4,640.52 ","$5,360.00 ","$4,891.00 ",$405.55 ,"$1,433.71 ","$2,496.82 ","$6,700.00 ","$5,695.00 ","$3,225.85 ","$6,164.00 ","$4,690.00 ","$4,412.15 ","$4,751.54 ","$4,080.30 ","$4,412.15 ","$4,629.70 ","$4,690.00 ","$1,448.05 ","$4,824.00 ",$429.88 ,"$3,564.00 ","$3,564.00 ","$1,433.71 ","$3,564.00 ","$1,433.71 ","$4,824.00 ","$4,154.00 ","$4,824.00 ","$4,824.00 ","$4,020.00 " ST VINCENT HOSPITAL - ACUTE,41000002,31502,HC CHG TUBE TRACHEOTOMY,410,1 ,$450.00 ,$225.00 ,$35.67 ,$461.10 ,$290.70 ,$35.67 ,$291.11 ,$291.11 ,$204.93 ,$270.00 ,$382.50 ,$315.00 ,$35.67 ,$427.50 ,$324.00 ,$328.50 ,$292.50 ,$382.50 ,$204.93 ,$292.50 ,$360.00 ,$328.50 ,$35.67 ,$204.93 ,$87.20 ,$450.00 ,$382.50 ,$461.10 ,$414.00 ,$315.00 ,$450.00 ,$450.00 ,$274.05 ,$450.00 ,$310.95 ,$315.00 ,$206.98 ,$324.00 ,$37.81 ,$83.00 ,$83.00 ,$204.93 ,$83.00 ,$204.93 ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,41000004,N/A,HC COUGH ASSIST,410,1 ,$150.00 ,$75.00 ,$75.00 ,$150.00 ,$96.90 , N/A ,$97.04 ,$97.04 , N/A ,$90.00 ,$127.50 ,$105.00 , N/A ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 , N/A ,$97.50 ,$120.00 ,$109.50 , N/A , N/A ,$87.20 ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 , N/A ,$108.00 , N/A ,$83.00 ,$83.00 , N/A ,$83.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,41000005,92950,HC CPR,480,1 ,$700.00 ,$350.00 ,$234.58 ,$700.00 ,$452.20 ,$234.58 ,$452.83 ,$452.83 ,$256.12 ,$420.00 ,$595.00 ,$490.00 ,$234.58 ,$665.00 ,$504.00 ,$511.00 ,$455.00 ,$595.00 ,$256.12 ,$455.00 ,$560.00 ,$511.00 ,$234.58 ,$256.12 ,$700.00 ,$700.00 ,$595.00 ,$576.27 ,$644.00 ,$490.00 ,$350.00 ,$420.00 ,$426.30 ,$350.00 ,$483.70 ,$490.00 ,$258.68 ,$504.00 ,$248.65 ,$700.00 ,$700.00 ,$256.12 ,$700.00 ,$256.12 ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,41000008,N/A,HC HIGH FLOW OXYGEN CANNULA,410,1 ,$80.00 ,$40.00 ,$40.00 ,$80.00 ,$51.68 , N/A ,$51.75 ,$51.75 , N/A ,$48.00 ,$68.00 ,$56.00 , N/A ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 , N/A ,$52.00 ,$64.00 ,$58.40 , N/A , N/A ,$80.00 ,$80.00 ,$68.00 , N/A ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 , N/A ,$57.60 , N/A ,$80.00 ,$80.00 , N/A ,$80.00 , N/A ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,41000009,94002,HC VENT MANGMNT INPT/OBS INIT DAY,410,1 ,$990.00 ,$495.00 ,$83.00 ,"$1,057.44 ",$639.54 ,$176.28 ,$640.43 ,$640.43 ,$469.97 ,$594.00 ,$841.50 ,$693.00 ,$176.28 ,$940.50 ,$712.80 ,$722.70 ,$643.50 ,$841.50 ,$469.97 ,$643.50 ,$792.00 ,$722.70 ,$176.28 ,$469.97 ,$87.20 ,$990.00 ,$841.50 ,"$1,057.44 ",$910.80 ,$693.00 ,$495.00 ,$594.00 ,$602.91 ,$495.00 ,$684.09 ,$693.00 ,$474.67 ,$712.80 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$712.80 ,$613.80 ,$712.80 ,$712.80 ,$594.00 ST VINCENT HOSPITAL - ACUTE,41000010,94002,HC VENTIL HI FREQ INTL DAY,410,1 ,$990.00 ,$495.00 ,$83.00 ,"$1,057.44 ",$639.54 ,$176.28 ,$640.43 ,$640.43 ,$469.97 ,$594.00 ,$841.50 ,$693.00 ,$176.28 ,$940.50 ,$712.80 ,$722.70 ,$643.50 ,$841.50 ,$469.97 ,$643.50 ,$792.00 ,$722.70 ,$176.28 ,$469.97 ,$87.20 ,$990.00 ,$841.50 ,"$1,057.44 ",$910.80 ,$693.00 ,$495.00 ,$594.00 ,$602.91 ,$495.00 ,$684.09 ,$693.00 ,$474.67 ,$712.80 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$712.80 ,$613.80 ,$712.80 ,$712.80 ,$594.00 ST VINCENT HOSPITAL - ACUTE,41000011,N/A,HC INPATIENT TRACH TUBE CHANGE,410,1 ,$100.00 ,$50.00 ,$50.00 ,$100.00 ,$64.60 , N/A ,$64.69 ,$64.69 , N/A ,$60.00 ,$85.00 ,$70.00 , N/A ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 , N/A ,$65.00 ,$80.00 ,$73.00 , N/A , N/A ,$87.20 ,$100.00 ,$85.00 , N/A ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 , N/A ,$72.00 , N/A ,$83.00 ,$83.00 , N/A ,$83.00 , N/A ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,41000012,94002,HC VENT SEDATED INTL DAY,410,1 ,$990.00 ,$495.00 ,$83.00 ,"$1,057.44 ",$639.54 ,$176.28 ,$640.43 ,$640.43 ,$469.97 ,$594.00 ,$841.50 ,$693.00 ,$176.28 ,$940.50 ,$712.80 ,$722.70 ,$643.50 ,$841.50 ,$469.97 ,$643.50 ,$792.00 ,$722.70 ,$176.28 ,$469.97 ,$87.20 ,$990.00 ,$841.50 ,"$1,057.44 ",$910.80 ,$693.00 ,$495.00 ,$594.00 ,$602.91 ,$495.00 ,$684.09 ,$693.00 ,$474.67 ,$712.80 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$712.80 ,$613.80 ,$712.80 ,$712.80 ,$594.00 ST VINCENT HOSPITAL - ACUTE,41000013,94660,HC VENT NONINVAS ADULT INTL DAY,410,1 ,$280.00 ,$140.00 ,$83.00 ,$409.41 ,$180.88 ,$176.28 ,$181.13 ,$181.13 ,$181.96 ,$168.00 ,$238.00 ,$196.00 ,$176.28 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$181.96 ,$182.00 ,$224.00 ,$204.40 ,$176.28 ,$181.96 ,$87.20 ,$280.00 ,$238.00 ,$409.41 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$183.78 ,$201.60 ,$186.86 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,41000014,94002,HC VENT WEANING FIRST DAY,410,1 ,$990.00 ,$495.00 ,$83.00 ,"$1,057.44 ",$639.54 ,$176.28 ,$640.43 ,$640.43 ,$469.97 ,$594.00 ,$841.50 ,$693.00 ,$176.28 ,$940.50 ,$712.80 ,$722.70 ,$643.50 ,$841.50 ,$469.97 ,$643.50 ,$792.00 ,$722.70 ,$176.28 ,$469.97 ,$87.20 ,$990.00 ,$841.50 ,"$1,057.44 ",$910.80 ,$693.00 ,$495.00 ,$594.00 ,$602.91 ,$495.00 ,$684.09 ,$693.00 ,$474.67 ,$712.80 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$712.80 ,$613.80 ,$712.80 ,$712.80 ,$594.00 ST VINCENT HOSPITAL - ACUTE,41000015,94002,HC VENT NEONATAL INTL DAY,410,1 ,$990.00 ,$495.00 ,$83.00 ,"$1,057.44 ",$639.54 ,$176.28 ,$640.43 ,$640.43 ,$469.97 ,$594.00 ,$841.50 ,$693.00 ,$176.28 ,$940.50 ,$712.80 ,$722.70 ,$643.50 ,$841.50 ,$469.97 ,$643.50 ,$792.00 ,$722.70 ,$176.28 ,$469.97 ,$87.20 ,$990.00 ,$841.50 ,"$1,057.44 ",$910.80 ,$693.00 ,$495.00 ,$594.00 ,$602.91 ,$495.00 ,$684.09 ,$693.00 ,$474.67 ,$712.80 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$712.80 ,$613.80 ,$712.80 ,$712.80 ,$594.00 ST VINCENT HOSPITAL - ACUTE,41000016,94660,HC VENT NONINVAS NEO INTL DAY,410,1 ,$820.00 ,$410.00 ,$83.00 ,$820.00 ,$529.72 ,$176.28 ,$530.46 ,$530.46 ,$181.96 ,$492.00 ,$697.00 ,$574.00 ,$176.28 ,$779.00 ,$590.40 ,$598.60 ,$533.00 ,$697.00 ,$181.96 ,$533.00 ,$656.00 ,$598.60 ,$176.28 ,$181.96 ,$87.20 ,$820.00 ,$697.00 ,$409.41 ,$754.40 ,$574.00 ,$410.00 ,$492.00 ,$499.38 ,$410.00 ,$566.62 ,$574.00 ,$183.78 ,$590.40 ,$186.86 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$590.40 ,$508.40 ,$590.40 ,$590.40 ,$492.00 ST VINCENT HOSPITAL - ACUTE,41000017,94002,HC VENT PEDS INIT DAY,410,1 ,$990.00 ,$495.00 ,$83.00 ,"$1,057.44 ",$639.54 ,$176.28 ,$640.43 ,$640.43 ,$469.97 ,$594.00 ,$841.50 ,$693.00 ,$176.28 ,$940.50 ,$712.80 ,$722.70 ,$643.50 ,$841.50 ,$469.97 ,$643.50 ,$792.00 ,$722.70 ,$176.28 ,$469.97 ,$87.20 ,$990.00 ,$841.50 ,"$1,057.44 ",$910.80 ,$693.00 ,$495.00 ,$594.00 ,$602.91 ,$495.00 ,$684.09 ,$693.00 ,$474.67 ,$712.80 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$712.80 ,$613.80 ,$712.80 ,$712.80 ,$594.00 ST VINCENT HOSPITAL - ACUTE,41000018,94660,HC VENT NONINVAS PEDS INTL DAY,410,1 ,$820.00 ,$410.00 ,$83.00 ,$820.00 ,$529.72 ,$176.28 ,$530.46 ,$530.46 ,$181.96 ,$492.00 ,$697.00 ,$574.00 ,$176.28 ,$779.00 ,$590.40 ,$598.60 ,$533.00 ,$697.00 ,$181.96 ,$533.00 ,$656.00 ,$598.60 ,$176.28 ,$181.96 ,$87.20 ,$820.00 ,$697.00 ,$409.41 ,$754.40 ,$574.00 ,$410.00 ,$492.00 ,$499.38 ,$410.00 ,$566.62 ,$574.00 ,$183.78 ,$590.40 ,$186.86 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$590.40 ,$508.40 ,$590.40 ,$590.40 ,$492.00 ST VINCENT HOSPITAL - ACUTE,41000020,N/A,HC PULM REHAB IP INIT VISIT,410,1 ,$75.00 ,$37.50 ,$37.50 ,$75.00 ,$48.45 , N/A ,$48.52 ,$48.52 , N/A ,$45.00 ,$63.75 ,$52.50 , N/A ,$71.25 ,$54.00 ,$54.75 ,$48.75 ,$63.75 , N/A ,$48.75 ,$60.00 ,$54.75 , N/A , N/A ,$75.00 ,$75.00 ,$63.75 , N/A ,$69.00 ,$52.50 ,$37.50 ,$45.00 ,$45.68 ,$37.50 ,$51.83 ,$52.50 , N/A ,$54.00 , N/A ,$75.00 ,$75.00 , N/A ,$75.00 , N/A ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,41000021,N/A,HC PULM REHAB IP SUBQ VIST/15 MINS,410,1 ,$31.00 ,$15.50 ,$15.50 ,$31.00 ,$20.03 , N/A ,$20.05 ,$20.05 , N/A ,$18.60 ,$26.35 ,$21.70 , N/A ,$29.45 ,$22.32 ,$22.63 ,$20.15 ,$26.35 , N/A ,$20.15 ,$24.80 ,$22.63 , N/A , N/A ,$31.00 ,$31.00 ,$26.35 , N/A ,$28.52 ,$21.70 ,$15.50 ,$18.60 ,$18.88 ,$15.50 ,$21.42 ,$21.70 , N/A ,$22.32 , N/A ,$31.00 ,$31.00 , N/A ,$31.00 , N/A ,$22.32 ,$19.22 ,$22.32 ,$22.32 ,$18.60 ST VINCENT HOSPITAL - ACUTE,41000022,N/A,HC TRANSPORT NEONATAL,410,1 ,"$1,400.00 ",$700.00 ,$83.00 ,"$1,400.00 ",$904.40 , N/A ,$905.66 ,$905.66 , N/A ,$840.00 ,"$1,190.00 ",$980.00 , N/A ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ", N/A ,$910.00 ,"$1,120.00 ","$1,022.00 ", N/A , N/A ,$87.20 ,"$1,400.00 ","$1,190.00 ", N/A ,"$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 , N/A ,"$1,008.00 ", N/A ,$83.00 ,$83.00 , N/A ,$83.00 , N/A ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,41000026,N/A,HC TRANSPORT VENT ADULT/PED,410,1 ,$270.00 ,$135.00 ,$83.00 ,$270.00 ,$174.42 , N/A ,$174.66 ,$174.66 , N/A ,$162.00 ,$229.50 ,$189.00 , N/A ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 , N/A ,$175.50 ,$216.00 ,$197.10 , N/A , N/A ,$87.20 ,$270.00 ,$229.50 , N/A ,$248.40 ,$189.00 ,$135.00 ,$162.00 ,$164.43 ,$135.00 ,$186.57 ,$189.00 , N/A ,$194.40 , N/A ,$83.00 ,$83.00 , N/A ,$83.00 , N/A ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,41000027,94003,HC VENT MANGMNT INPT/OBS SUBS DAY,410,1 ,$760.00 ,$380.00 ,$83.00 ,"$1,057.44 ",$490.96 ,$176.28 ,$491.64 ,$491.64 ,$469.97 ,$456.00 ,$646.00 ,$532.00 ,$176.28 ,$722.00 ,$547.20 ,$554.80 ,$494.00 ,$646.00 ,$469.97 ,$494.00 ,$608.00 ,$554.80 ,$176.28 ,$469.97 ,$87.20 ,$760.00 ,$646.00 ,"$1,057.44 ",$699.20 ,$532.00 ,$380.00 ,$456.00 ,$462.84 ,$380.00 ,$525.16 ,$532.00 ,$474.67 ,$547.20 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,41000028,94003,HC VENT HI FREQ SUBQ DAY,410,1 ,$760.00 ,$380.00 ,$83.00 ,"$1,057.44 ",$490.96 ,$176.28 ,$491.64 ,$491.64 ,$469.97 ,$456.00 ,$646.00 ,$532.00 ,$176.28 ,$722.00 ,$547.20 ,$554.80 ,$494.00 ,$646.00 ,$469.97 ,$494.00 ,$608.00 ,$554.80 ,$176.28 ,$469.97 ,$87.20 ,$760.00 ,$646.00 ,"$1,057.44 ",$699.20 ,$532.00 ,$380.00 ,$456.00 ,$462.84 ,$380.00 ,$525.16 ,$532.00 ,$474.67 ,$547.20 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,41000029,94660,HC VENT NONINVAS ADLT SUBQ DAY,410,1 ,$280.00 ,$140.00 ,$83.00 ,$409.41 ,$180.88 ,$176.28 ,$181.13 ,$181.13 ,$181.96 ,$168.00 ,$238.00 ,$196.00 ,$176.28 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$181.96 ,$182.00 ,$224.00 ,$204.40 ,$176.28 ,$181.96 ,$87.20 ,$280.00 ,$238.00 ,$409.41 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$183.78 ,$201.60 ,$186.86 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,41000030,94003,HC VENT WEANING SUBQ DAY,410,1 ,$760.00 ,$380.00 ,$83.00 ,"$1,057.44 ",$490.96 ,$176.28 ,$491.64 ,$491.64 ,$469.97 ,$456.00 ,$646.00 ,$532.00 ,$176.28 ,$722.00 ,$547.20 ,$554.80 ,$494.00 ,$646.00 ,$469.97 ,$494.00 ,$608.00 ,$554.80 ,$176.28 ,$469.97 ,$87.20 ,$760.00 ,$646.00 ,"$1,057.44 ",$699.20 ,$532.00 ,$380.00 ,$456.00 ,$462.84 ,$380.00 ,$525.16 ,$532.00 ,$474.67 ,$547.20 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,41000031,94003,HC VENT NEONATL SUBQ DAY,410,1 ,$760.00 ,$380.00 ,$83.00 ,"$1,057.44 ",$490.96 ,$176.28 ,$491.64 ,$491.64 ,$469.97 ,$456.00 ,$646.00 ,$532.00 ,$176.28 ,$722.00 ,$547.20 ,$554.80 ,$494.00 ,$646.00 ,$469.97 ,$494.00 ,$608.00 ,$554.80 ,$176.28 ,$469.97 ,$87.20 ,$760.00 ,$646.00 ,"$1,057.44 ",$699.20 ,$532.00 ,$380.00 ,$456.00 ,$462.84 ,$380.00 ,$525.16 ,$532.00 ,$474.67 ,$547.20 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,41000032,94003,HC VENT PEDS SUBQ DAY,410,1 ,$760.00 ,$380.00 ,$83.00 ,"$1,057.44 ",$490.96 ,$176.28 ,$491.64 ,$491.64 ,$469.97 ,$456.00 ,$646.00 ,$532.00 ,$176.28 ,$722.00 ,$547.20 ,$554.80 ,$494.00 ,$646.00 ,$469.97 ,$494.00 ,$608.00 ,$554.80 ,$176.28 ,$469.97 ,$87.20 ,$760.00 ,$646.00 ,"$1,057.44 ",$699.20 ,$532.00 ,$380.00 ,$456.00 ,$462.84 ,$380.00 ,$525.16 ,$532.00 ,$474.67 ,$547.20 ,$186.86 ,$83.00 ,$83.00 ,$469.97 ,$83.00 ,$469.97 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,41000033,94660,HC VENT NONINVAS PEDS SUBQ DAY,410,1 ,$650.00 ,$325.00 ,$83.00 ,$650.00 ,$419.90 ,$176.28 ,$420.49 ,$420.49 ,$181.96 ,$390.00 ,$552.50 ,$455.00 ,$176.28 ,$617.50 ,$468.00 ,$474.50 ,$422.50 ,$552.50 ,$181.96 ,$422.50 ,$520.00 ,$474.50 ,$176.28 ,$181.96 ,$87.20 ,$650.00 ,$552.50 ,$409.41 ,$598.00 ,$455.00 ,$325.00 ,$390.00 ,$395.85 ,$325.00 ,$449.15 ,$455.00 ,$183.78 ,$468.00 ,$186.86 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,41000035,94640,HC NEBULIZER TREATMENT EACH,410,1 ,$270.00 ,$135.00 ,$83.00 ,$409.41 ,$174.42 ,$111.83 ,$174.66 ,$174.66 ,$181.96 ,$162.00 ,$229.50 ,$189.00 ,$111.83 ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 ,$181.96 ,$175.50 ,$216.00 ,$197.10 ,$111.83 ,$181.96 ,$87.20 ,$270.00 ,$229.50 ,$409.41 ,$248.40 ,$189.00 ,$135.00 ,$162.00 ,$164.43 ,$135.00 ,$186.57 ,$189.00 ,$183.78 ,$194.40 ,$118.54 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,41000036,94640,HC HELI OX PROCEDURE,410,1 ,$70.00 ,$35.00 ,$35.00 ,$409.41 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$181.96 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$181.96 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$181.96 ,$70.00 ,$70.00 ,$59.50 ,$409.41 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$183.78 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$181.96 ,$70.00 ,$181.96 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000038,94640,HC AEROSOL GENTR SHORT-TERM,410,1 ,$70.00 ,$35.00 ,$35.00 ,$409.41 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$181.96 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$181.96 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$181.96 ,$70.00 ,$70.00 ,$59.50 ,$409.41 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$183.78 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$181.96 ,$70.00 ,$181.96 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000040,94640,HC EZ PAP TREATMENT,410,1 ,$70.00 ,$35.00 ,$35.00 ,$409.41 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$181.96 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$181.96 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$181.96 ,$70.00 ,$70.00 ,$59.50 ,$409.41 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$183.78 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$181.96 ,$70.00 ,$181.96 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000041,94640,HC MDI/DPI TX INITIAL,410,1 ,$70.00 ,$35.00 ,$35.00 ,$409.41 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$181.96 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$181.96 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$181.96 ,$70.00 ,$70.00 ,$59.50 ,$409.41 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$183.78 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$181.96 ,$70.00 ,$181.96 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000042,94640,HC SPUTUM SPECIMEN INDUCTION,410,1 ,$70.00 ,$35.00 ,$35.00 ,$409.41 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$181.96 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$181.96 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$181.96 ,$70.00 ,$70.00 ,$59.50 ,$409.41 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$183.78 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$181.96 ,$70.00 ,$181.96 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000043,94640,HC PERI NEB WITH INSTRUCTION,410,1 ,$70.00 ,$35.00 ,$35.00 ,$409.41 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$181.96 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$181.96 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$181.96 ,$70.00 ,$70.00 ,$59.50 ,$409.41 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$183.78 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$181.96 ,$70.00 ,$181.96 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000044,94640,HC UPDRAFT W/INSTRUCT AND EVAL,410,1 ,$70.00 ,$35.00 ,$35.00 ,$409.41 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$181.96 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$181.96 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$181.96 ,$70.00 ,$70.00 ,$59.50 ,$409.41 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$183.78 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$181.96 ,$70.00 ,$181.96 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000045,94640,HC AEROSOL GENERATOR CONT,410,1 ,$70.00 ,$35.00 ,$35.00 ,$409.41 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$181.96 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$181.96 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$181.96 ,$70.00 ,$70.00 ,$59.50 ,$409.41 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$183.78 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$181.96 ,$70.00 ,$181.96 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000046,94640,HC HIGH EFF NEB AERO EACH,410,1 ,$80.00 ,$40.00 ,$40.00 ,$409.41 ,$51.68 ,$80.00 ,$51.75 ,$51.75 ,$181.96 ,$48.00 ,$68.00 ,$56.00 ,$111.83 ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 ,$181.96 ,$52.00 ,$64.00 ,$58.40 ,$111.83 ,$181.96 ,$80.00 ,$80.00 ,$68.00 ,$409.41 ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 ,$183.78 ,$57.60 ,$118.54 ,$80.00 ,$80.00 ,$181.96 ,$80.00 ,$181.96 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,41000047,94640,HC HIGH EFF NEB AERO W/INSTR/TEACH DEVICE,410,1 ,$70.00 ,$35.00 ,$35.00 ,$409.41 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$181.96 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$181.96 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$181.96 ,$70.00 ,$70.00 ,$59.50 ,$409.41 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$183.78 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$181.96 ,$70.00 ,$181.96 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000049,94642,HC AEROSOL INHALATION PENTAMIDINE,410,1 ,$170.00 ,$85.00 ,$83.00 ,$409.41 ,$109.82 ,$111.83 ,$109.97 ,$109.97 ,$181.96 ,$102.00 ,$144.50 ,$119.00 ,$111.83 ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 ,$181.96 ,$110.50 ,$136.00 ,$124.10 ,$111.83 ,$181.96 ,$87.20 ,$170.00 ,$144.50 ,$409.41 ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 ,$183.78 ,$122.40 ,$118.54 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,41000050,94644,HC AEROSOL CONTINUOUS 1ST HR,410,1 ,$220.00 ,$110.00 ,$83.00 ,$243.95 ,$142.12 ,$111.83 ,$142.32 ,$142.32 ,$108.42 ,$132.00 ,$187.00 ,$154.00 ,$111.83 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$108.42 ,$143.00 ,$176.00 ,$160.60 ,$111.83 ,$108.42 ,$87.20 ,$220.00 ,$187.00 ,$243.95 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$109.50 ,$158.40 ,$118.54 ,$83.00 ,$83.00 ,$108.42 ,$83.00 ,$108.42 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,41000051,94645,HC AEROSOL CONTINUOUS ADDL HR,410,1 ,$41.00 ,$20.50 ,$20.50 ,$118.54 ,$26.49 ,$41.00 ,$26.52 ,$26.52 , N/A ,$24.60 ,$34.85 ,$28.70 ,$111.83 ,$38.95 ,$29.52 ,$29.93 ,$26.65 ,$34.85 , N/A ,$26.65 ,$32.80 ,$29.93 ,$111.83 , N/A ,$41.00 ,$41.00 ,$34.85 , N/A ,$37.72 ,$28.70 ,$20.50 ,$24.60 ,$24.97 ,$20.50 ,$28.33 ,$28.70 , N/A ,$29.52 ,$118.54 ,$41.00 ,$41.00 , N/A ,$41.00 , N/A ,$29.52 ,$25.42 ,$29.52 ,$29.52 ,$24.60 ST VINCENT HOSPITAL - ACUTE,41000052,94660,HC CPAP,410,1 ,$310.00 ,$155.00 ,$83.00 ,$409.41 ,$200.26 ,$176.28 ,$200.54 ,$200.54 ,$181.96 ,$186.00 ,$263.50 ,$217.00 ,$176.28 ,$294.50 ,$223.20 ,$226.30 ,$201.50 ,$263.50 ,$181.96 ,$201.50 ,$248.00 ,$226.30 ,$176.28 ,$181.96 ,$87.20 ,$310.00 ,$263.50 ,$409.41 ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 ,$183.78 ,$223.20 ,$186.86 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,41000053,94660,HC CPAP DAILY EST PT,410,1 ,$140.00 ,$70.00 ,$70.00 ,$409.41 ,$90.44 ,$140.00 ,$90.57 ,$90.57 ,$181.96 ,$84.00 ,$119.00 ,$98.00 ,$176.28 ,$133.00 ,$100.80 ,$102.20 ,$91.00 ,$119.00 ,$181.96 ,$91.00 ,$112.00 ,$102.20 ,$176.28 ,$181.96 ,$87.20 ,$140.00 ,$119.00 ,$409.41 ,$128.80 ,$98.00 ,$70.00 ,$84.00 ,$85.26 ,$70.00 ,$96.74 ,$98.00 ,$183.78 ,$100.80 ,$186.86 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,41000054,94660,HC CPAP NEONATAL/DAY,410,1 ,$340.00 ,$170.00 ,$83.00 ,$409.41 ,$219.64 ,$176.28 ,$219.95 ,$219.95 ,$181.96 ,$204.00 ,$289.00 ,$238.00 ,$176.28 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$181.96 ,$221.00 ,$272.00 ,$248.20 ,$176.28 ,$181.96 ,$87.20 ,$340.00 ,$289.00 ,$409.41 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$183.78 ,$244.80 ,$186.86 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,41000055,99211,HC CPAP THERAPY CONSULT INITIAL,510,1 ,$370.00 ,$185.00 ,$47.46 ,$370.00 ,$239.02 ,$47.46 ,$126.00 ,$101.00 , N/A ,$222.00 ,$314.50 ,$259.00 ,$47.46 ,$351.50 ,$266.40 ,$270.10 ,$100.00 ,$314.50 , N/A ,$100.00 ,$296.00 ,$270.10 ,$47.46 , N/A ,$63.04 ,$370.00 ,$314.50 , N/A ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 , N/A ,$266.40 ,$50.31 ,$222.00 ,$222.00 , N/A ,$222.00 , N/A ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,41000056,99211,HC CPAP THERAPY CONSULT FOLLOW UP,510,1 ,$340.00 ,$170.00 ,$47.46 ,$340.00 ,$219.64 ,$47.46 ,$126.00 ,$101.00 , N/A ,$204.00 ,$289.00 ,$238.00 ,$47.46 ,$323.00 ,$244.80 ,$248.20 ,$100.00 ,$289.00 , N/A ,$100.00 ,$272.00 ,$248.20 ,$47.46 , N/A ,$63.04 ,$340.00 ,$289.00 , N/A ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 , N/A ,$244.80 ,$50.31 ,$204.00 ,$204.00 , N/A ,$204.00 , N/A ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,41000057,94664,HC DEMO/EVAL/MDI/NEB DAILY,410,1 ,$170.00 ,$85.00 ,$83.00 ,$409.41 ,$109.82 ,$111.83 ,$109.97 ,$109.97 ,$181.96 ,$102.00 ,$144.50 ,$119.00 ,$111.83 ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 ,$181.96 ,$110.50 ,$136.00 ,$124.10 ,$111.83 ,$181.96 ,$87.20 ,$170.00 ,$144.50 ,$409.41 ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 ,$183.78 ,$122.40 ,$118.54 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,41000058,94667,HC CHEST PHYSIOTHRPY INIT,410,1 ,$90.00 ,$45.00 ,$45.00 ,$243.95 ,$58.14 ,$90.00 ,$58.22 ,$58.22 ,$108.42 ,$54.00 ,$76.50 ,$63.00 ,$111.83 ,$85.50 ,$64.80 ,$65.70 ,$58.50 ,$76.50 ,$108.42 ,$58.50 ,$72.00 ,$65.70 ,$111.83 ,$108.42 ,$87.20 ,$90.00 ,$76.50 ,$243.95 ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 ,$109.50 ,$64.80 ,$118.54 ,$83.00 ,$83.00 ,$108.42 ,$83.00 ,$108.42 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,41000059,94667,HC CHEST PHYSIOTHRPY INIT ACAPELLA,410,1 ,$90.00 ,$45.00 ,$45.00 ,$243.95 ,$58.14 ,$90.00 ,$58.22 ,$58.22 ,$108.42 ,$54.00 ,$76.50 ,$63.00 ,$111.83 ,$85.50 ,$64.80 ,$65.70 ,$58.50 ,$76.50 ,$108.42 ,$58.50 ,$72.00 ,$65.70 ,$111.83 ,$108.42 ,$87.20 ,$90.00 ,$76.50 ,$243.95 ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 ,$109.50 ,$64.80 ,$118.54 ,$83.00 ,$83.00 ,$108.42 ,$83.00 ,$108.42 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,41000060,94668,HC CHEST PHYSIOTHRPY SUBSQ,410,1 ,$70.00 ,$35.00 ,$35.00 ,$243.95 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$108.42 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$108.42 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$108.42 ,$70.00 ,$70.00 ,$59.50 ,$243.95 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$109.50 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$108.42 ,$70.00 ,$108.42 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000061,94668,HC CHEST PHYSIOTHRPY SUBSQ ACAPELLA,410,1 ,$70.00 ,$35.00 ,$35.00 ,$243.95 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$108.42 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$108.42 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$108.42 ,$70.00 ,$70.00 ,$59.50 ,$243.95 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$109.50 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$108.42 ,$70.00 ,$108.42 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000062,94668,HC CHEST PHYSIOTHRPY SUBSQ EXTENSIVE,410,1 ,$70.00 ,$35.00 ,$35.00 ,$243.95 ,$45.22 ,$70.00 ,$45.28 ,$45.28 ,$108.42 ,$42.00 ,$59.50 ,$49.00 ,$111.83 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$108.42 ,$45.50 ,$56.00 ,$51.10 ,$111.83 ,$108.42 ,$70.00 ,$70.00 ,$59.50 ,$243.95 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$109.50 ,$50.40 ,$118.54 ,$70.00 ,$70.00 ,$108.42 ,$70.00 ,$108.42 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000065,94799,HC CARBON MONOXIDE TEST,410,1 ,$110.00 ,$55.00 ,$21.41 ,$304.10 ,$71.06 ,$21.41 ,$71.16 ,$71.16 ,$135.15 ,$66.00 ,$93.50 ,$77.00 ,$21.41 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$135.15 ,$71.50 ,$88.00 ,$80.30 ,$21.41 ,$135.15 ,$87.20 ,$110.00 ,$93.50 ,$304.10 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$136.50 ,$79.20 ,$22.69 ,$83.00 ,$83.00 ,$135.15 ,$83.00 ,$135.15 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,41000066,94799,HC SEDATION BAGGING,410,1 ,$70.00 ,$35.00 ,$21.41 ,$304.10 ,$45.22 ,$21.41 ,$45.28 ,$45.28 ,$135.15 ,$42.00 ,$59.50 ,$49.00 ,$21.41 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$135.15 ,$45.50 ,$56.00 ,$51.10 ,$21.41 ,$135.15 ,$70.00 ,$70.00 ,$59.50 ,$304.10 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$136.50 ,$50.40 ,$22.69 ,$70.00 ,$70.00 ,$135.15 ,$70.00 ,$135.15 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000068,G0237,HC RESP STRENGTH/ENDURANCE 15 MIN,410,1 ,$80.00 ,$40.00 ,$15.28 ,$80.00 ,$51.68 ,$15.28 ,$51.75 ,$51.75 ,$23.89 ,$48.00 ,$68.00 ,$56.00 ,$15.28 ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 ,$23.89 ,$52.00 ,$64.00 ,$58.40 ,$15.28 ,$23.89 ,$80.00 ,$80.00 ,$68.00 ,$53.76 ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 ,$24.13 ,$57.60 ,$16.20 ,$80.00 ,$80.00 ,$23.89 ,$80.00 ,$23.89 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,41000069,G0238,HC RESP THRP FUNCTION 15 MIN,410,1 ,$85.00 ,$42.50 ,$15.28 ,$85.00 ,$54.91 ,$15.28 ,$54.99 ,$54.99 ,$23.89 ,$51.00 ,$72.25 ,$59.50 ,$15.28 ,$80.75 ,$61.20 ,$62.05 ,$55.25 ,$72.25 ,$23.89 ,$55.25 ,$68.00 ,$62.05 ,$15.28 ,$23.89 ,$85.00 ,$85.00 ,$72.25 ,$53.76 ,$78.20 ,$59.50 ,$42.50 ,$51.00 ,$51.77 ,$42.50 ,$58.74 ,$59.50 ,$24.13 ,$61.20 ,$16.20 ,$83.00 ,$83.00 ,$23.89 ,$83.00 ,$23.89 ,$61.20 ,$52.70 ,$61.20 ,$61.20 ,$51.00 ST VINCENT HOSPITAL - ACUTE,41000070,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$170.00 ,$85.00 ,$15.28 ,$170.00 ,$109.82 ,$15.28 ,$109.97 ,$109.97 ,$32.77 ,$102.00 ,$144.50 ,$119.00 ,$15.28 ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 ,$32.77 ,$110.50 ,$136.00 ,$124.10 ,$15.28 ,$32.77 ,$87.20 ,$170.00 ,$144.50 ,$73.74 ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 ,$33.10 ,$122.40 ,$16.20 ,$83.00 ,$83.00 ,$32.77 ,$83.00 ,$32.77 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,41000071,G0237,HC RESP STRENGTH/ENDURANCE 15 MIN-59,410,1 ,$70.00 ,$35.00 ,$15.28 ,$70.00 ,$45.22 ,$15.28 ,$45.28 ,$45.28 ,$23.89 ,$42.00 ,$59.50 ,$49.00 ,$15.28 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$23.89 ,$45.50 ,$56.00 ,$51.10 ,$15.28 ,$23.89 ,$70.00 ,$70.00 ,$59.50 ,$53.76 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$24.13 ,$50.40 ,$16.20 ,$70.00 ,$70.00 ,$23.89 ,$70.00 ,$23.89 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,41000072,G0238,HC RESP THRP FUNC 15 MIN-59,410,1 ,$85.00 ,$42.50 ,$15.28 ,$85.00 ,$54.91 ,$15.28 ,$54.99 ,$54.99 ,$23.89 ,$51.00 ,$72.25 ,$59.50 ,$15.28 ,$80.75 ,$61.20 ,$62.05 ,$55.25 ,$72.25 ,$23.89 ,$55.25 ,$68.00 ,$62.05 ,$15.28 ,$23.89 ,$85.00 ,$85.00 ,$72.25 ,$53.76 ,$78.20 ,$59.50 ,$42.50 ,$51.00 ,$51.77 ,$42.50 ,$58.74 ,$59.50 ,$24.13 ,$61.20 ,$16.20 ,$83.00 ,$83.00 ,$23.89 ,$83.00 ,$23.89 ,$61.20 ,$52.70 ,$61.20 ,$61.20 ,$51.00 ST VINCENT HOSPITAL - ACUTE,41000073,94660,HC VENT NONINVAS NEON SUBQ DAY,410,1 ,$280.00 ,$140.00 ,$83.00 ,$409.41 ,$180.88 ,$176.28 ,$181.13 ,$181.13 ,$181.96 ,$168.00 ,$238.00 ,$196.00 ,$176.28 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$181.96 ,$182.00 ,$224.00 ,$204.40 ,$176.28 ,$181.96 ,$87.20 ,$280.00 ,$238.00 ,$409.41 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$183.78 ,$201.60 ,$186.86 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,41000083,94660,HC CPAP/BIPAP SUBSQ,410,1 ,$533.00 ,$266.50 ,$83.00 ,$533.00 ,$344.32 ,$176.28 ,$344.80 ,$344.80 ,$181.96 ,$319.80 ,$453.05 ,$373.10 ,$176.28 ,$506.35 ,$383.76 ,$389.09 ,$346.45 ,$453.05 ,$181.96 ,$346.45 ,$426.40 ,$389.09 ,$176.28 ,$181.96 ,$87.20 ,$533.00 ,$453.05 ,$409.41 ,$490.36 ,$373.10 ,$266.50 ,$319.80 ,$324.60 ,$266.50 ,$368.30 ,$373.10 ,$183.78 ,$383.76 ,$186.86 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$383.76 ,$330.46 ,$383.76 ,$383.76 ,$319.80 ST VINCENT HOSPITAL - ACUTE,41000088,94669,HC MECHANICAL CHEST WALL OSCILLATION SUBSQ,410,1 ,$533.00 ,$266.50 ,$83.00 ,$533.00 ,$344.32 ,$111.83 ,$344.80 ,$344.80 ,$181.96 ,$319.80 ,$453.05 ,$373.10 ,$111.83 ,$506.35 ,$383.76 ,$389.09 ,$346.45 ,$453.05 ,$181.96 ,$346.45 ,$426.40 ,$389.09 ,$111.83 ,$181.96 ,$87.20 ,$533.00 ,$453.05 ,$409.41 ,$490.36 ,$373.10 ,$266.50 ,$319.80 ,$324.60 ,$266.50 ,$368.30 ,$373.10 ,$183.78 ,$383.76 ,$118.54 ,$83.00 ,$83.00 ,$181.96 ,$83.00 ,$181.96 ,$383.76 ,$330.46 ,$383.76 ,$383.76 ,$319.80 ST VINCENT HOSPITAL - ACUTE,41300000,99183,HC HYPERBARIC O2 PER SESSION,413,1 ,"$3,200.00 ","$1,600.00 ",$836.69 ,"$3,200.00 ","$2,067.20 ", N/A ,"$2,070.08 ","$2,070.08 ", N/A ,"$1,920.00 ","$2,720.00 ","$2,240.00 ", N/A ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$2,080.00 ","$2,720.00 ", N/A ,"$2,080.00 ","$2,560.00 ","$2,336.00 ", N/A , N/A ,$836.69 ,"$3,200.00 ","$2,720.00 ", N/A ,"$2,944.00 ","$2,240.00 ","$1,600.00 ","$1,920.00 ","$1,948.80 ","$1,600.00 ","$2,211.20 ","$2,240.00 ", N/A ,"$2,304.00 ", N/A ,"$2,996.00 ","$2,996.00 ", N/A ,"$2,996.00 ", N/A ,"$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,41300001,99183,HC HYPERBARIC O2 PER SESSION NP,413,1 ,"$3,200.00 ","$1,600.00 ",$836.69 ,"$3,200.00 ","$2,067.20 ", N/A ,"$2,070.08 ","$2,070.08 ", N/A ,"$1,920.00 ","$2,720.00 ","$2,240.00 ", N/A ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$2,080.00 ","$2,720.00 ", N/A ,"$2,080.00 ","$2,560.00 ","$2,336.00 ", N/A , N/A ,$836.69 ,"$3,200.00 ","$2,720.00 ", N/A ,"$2,944.00 ","$2,240.00 ","$1,600.00 ","$1,920.00 ","$1,948.80 ","$1,600.00 ","$2,211.20 ","$2,240.00 ", N/A ,"$2,304.00 ", N/A ,"$2,996.00 ","$2,996.00 ", N/A ,"$2,996.00 ", N/A ,"$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,41300002,G0277,HC HYPERBARIC O2 PER 30 MIN,413,1 ,$550.00 ,$275.00 ,$107.54 ,$550.00 ,$355.30 ,$107.54 ,$355.80 ,$355.80 ,$115.52 ,$330.00 ,$467.50 ,$385.00 ,$107.54 ,$522.50 ,$396.00 ,$401.50 ,$357.50 ,$467.50 ,$115.52 ,$357.50 ,$440.00 ,$401.50 ,$107.54 ,$115.52 ,$550.00 ,$550.00 ,$467.50 ,$259.93 ,$506.00 ,$385.00 ,$275.00 ,$330.00 ,$334.95 ,$275.00 ,$380.05 ,$385.00 ,$116.68 ,$396.00 ,$113.99 ,$550.00 ,$550.00 ,$115.52 ,$550.00 ,$115.52 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,41300003,G0277,HC HYPERBARIC O2 PER 30 MIN MD,413,1 ,$550.00 ,$275.00 ,$107.54 ,$550.00 ,$355.30 ,$107.54 ,$355.80 ,$355.80 ,$115.52 ,$330.00 ,$467.50 ,$385.00 ,$107.54 ,$522.50 ,$396.00 ,$401.50 ,$357.50 ,$467.50 ,$115.52 ,$357.50 ,$440.00 ,$401.50 ,$107.54 ,$115.52 ,$550.00 ,$550.00 ,$467.50 ,$259.93 ,$506.00 ,$385.00 ,$275.00 ,$330.00 ,$334.95 ,$275.00 ,$380.05 ,$385.00 ,$116.68 ,$396.00 ,$113.99 ,$550.00 ,$550.00 ,$115.52 ,$550.00 ,$115.52 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,41300004,99183,HC HYPERBARIC O2 PER SESSION MD,413,1 ,"$3,200.00 ","$1,600.00 ",$836.69 ,"$3,200.00 ","$2,067.20 ", N/A ,"$2,070.08 ","$2,070.08 ", N/A ,"$1,920.00 ","$2,720.00 ","$2,240.00 ", N/A ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$2,080.00 ","$2,720.00 ", N/A ,"$2,080.00 ","$2,560.00 ","$2,336.00 ", N/A , N/A ,$836.69 ,"$3,200.00 ","$2,720.00 ", N/A ,"$2,944.00 ","$2,240.00 ","$1,600.00 ","$1,920.00 ","$1,948.80 ","$1,600.00 ","$2,211.20 ","$2,240.00 ", N/A ,"$2,304.00 ", N/A ,"$2,996.00 ","$2,996.00 ", N/A ,"$2,996.00 ", N/A ,"$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,41300005,G0277,HC HYPERBARIC O2 PER 30 MIN W/NP,413,1 ,$550.00 ,$275.00 ,$107.54 ,$550.00 ,$355.30 ,$107.54 ,$355.80 ,$355.80 ,$115.52 ,$330.00 ,$467.50 ,$385.00 ,$107.54 ,$522.50 ,$396.00 ,$401.50 ,$357.50 ,$467.50 ,$115.52 ,$357.50 ,$440.00 ,$401.50 ,$107.54 ,$115.52 ,$550.00 ,$550.00 ,$467.50 ,$259.93 ,$506.00 ,$385.00 ,$275.00 ,$330.00 ,$334.95 ,$275.00 ,$380.05 ,$385.00 ,$116.68 ,$396.00 ,$113.99 ,$550.00 ,$550.00 ,$115.52 ,$550.00 ,$115.52 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,42000008,95992,HC CANNALITH REPOSITIONING,420,1 ,$130.00 ,$65.00 ,$12.90 ,$130.00 ,$83.98 , N/A ,$130.00 ,$130.00 ,$42.69 ,$78.00 ,$110.50 ,$91.00 , N/A ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 ,$42.69 ,$84.50 ,$104.00 ,$94.90 , N/A ,$42.69 ,$107.07 ,$130.00 ,$110.50 ,$96.05 ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 ,$43.12 ,$93.60 ,$12.90 ,$130.00 ,$130.00 ,$42.69 ,$130.00 ,$42.69 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,42000009,97012,HC TRACTION MECH APP,420,1 ,$100.00 ,$50.00 ,$10.80 ,$100.00 ,$64.60 ,$25.78 ,$100.00 ,$100.00 ,$14.41 ,$60.00 ,$85.00 ,$70.00 ,$25.78 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$14.41 ,$65.00 ,$80.00 ,$73.00 ,$25.78 ,$14.41 ,$100.00 ,$100.00 ,$85.00 ,$32.42 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$14.55 ,$72.00 ,$10.80 ,$100.00 ,$100.00 ,$14.41 ,$100.00 ,$14.41 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000010,97016,HC APPLY VASOPNEUMATIC DEVICE,420,1 ,$90.00 ,$45.00 ,$10.80 ,$90.00 ,$58.14 ,$25.19 ,$90.00 ,$90.00 ,$11.64 ,$54.00 ,$76.50 ,$63.00 ,$25.19 ,$85.50 ,$64.80 ,$65.70 ,$58.50 ,$76.50 ,$11.64 ,$58.50 ,$72.00 ,$65.70 ,$25.19 ,$11.64 ,$90.00 ,$90.00 ,$76.50 ,$26.19 ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 ,$11.76 ,$64.80 ,$10.80 ,$90.00 ,$90.00 ,$11.64 ,$90.00 ,$11.64 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,42000015,97022,HC WHIRLPOOL BATH,420,1 ,$110.00 ,$55.00 ,$10.80 ,$110.00 ,$71.06 ,$25.78 ,$110.00 ,$110.00 ,$17.21 ,$66.00 ,$93.50 ,$77.00 ,$25.78 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$17.21 ,$71.50 ,$88.00 ,$80.30 ,$25.78 ,$17.21 ,$107.07 ,$110.00 ,$93.50 ,$38.72 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$17.38 ,$79.20 ,$10.80 ,$110.00 ,$110.00 ,$17.21 ,$110.00 ,$17.21 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42000020,97022,HC FLUIDOTHERAPY,420,1 ,$110.00 ,$55.00 ,$10.80 ,$110.00 ,$71.06 ,$25.78 ,$110.00 ,$110.00 ,$17.21 ,$66.00 ,$93.50 ,$77.00 ,$25.78 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$17.21 ,$71.50 ,$88.00 ,$80.30 ,$25.78 ,$17.21 ,$107.07 ,$110.00 ,$93.50 ,$38.72 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$17.38 ,$79.20 ,$10.80 ,$110.00 ,$110.00 ,$17.21 ,$110.00 ,$17.21 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42000021,97022,HC LOW BOY WHIRLPOOL BATH,420,1 ,$110.00 ,$55.00 ,$10.80 ,$110.00 ,$71.06 ,$25.78 ,$110.00 ,$110.00 ,$17.21 ,$66.00 ,$93.50 ,$77.00 ,$25.78 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$17.21 ,$71.50 ,$88.00 ,$80.30 ,$25.78 ,$17.21 ,$107.07 ,$110.00 ,$93.50 ,$38.72 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$17.38 ,$79.20 ,$10.80 ,$110.00 ,$110.00 ,$17.21 ,$110.00 ,$17.21 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42000025,97032,HC ELECTRIC STIM EACH 15 MIN,420,1 ,$90.00 ,$45.00 ,$10.80 ,$90.00 ,$58.14 ,$22.38 ,$90.00 ,$90.00 ,$14.41 ,$54.00 ,$76.50 ,$63.00 ,$22.38 ,$85.50 ,$64.80 ,$65.70 ,$58.50 ,$76.50 ,$14.41 ,$58.50 ,$72.00 ,$65.70 ,$22.38 ,$14.41 ,$90.00 ,$90.00 ,$76.50 ,$32.42 ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 ,$14.55 ,$64.80 ,$10.80 ,$90.00 ,$90.00 ,$14.41 ,$90.00 ,$14.41 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,42000026,97032,HC TENS; EA 15 MIN,420,1 ,$90.00 ,$45.00 ,$10.80 ,$90.00 ,$58.14 ,$22.38 ,$90.00 ,$90.00 ,$14.41 ,$54.00 ,$76.50 ,$63.00 ,$22.38 ,$85.50 ,$64.80 ,$65.70 ,$58.50 ,$76.50 ,$14.41 ,$58.50 ,$72.00 ,$65.70 ,$22.38 ,$14.41 ,$90.00 ,$90.00 ,$76.50 ,$32.42 ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 ,$14.55 ,$64.80 ,$10.80 ,$90.00 ,$90.00 ,$14.41 ,$90.00 ,$14.41 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,42000031,97033,HC IONTOPHORESIS; EA 15 MIN,420,1 ,$110.00 ,$55.00 ,$10.80 ,$110.00 ,$71.06 ,$23.51 ,$110.00 ,$110.00 ,$19.69 ,$66.00 ,$93.50 ,$77.00 ,$23.51 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$19.69 ,$71.50 ,$88.00 ,$80.30 ,$23.51 ,$19.69 ,$107.07 ,$110.00 ,$93.50 ,$44.30 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$19.89 ,$79.20 ,$10.80 ,$110.00 ,$110.00 ,$19.69 ,$110.00 ,$19.69 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42000032,97033,HC IONTOPHORES 15MIN 2 SITE,420,1 ,$110.00 ,$55.00 ,$10.80 ,$110.00 ,$71.06 ,$23.51 ,$110.00 ,$110.00 ,$19.69 ,$66.00 ,$93.50 ,$77.00 ,$23.51 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$19.69 ,$71.50 ,$88.00 ,$80.30 ,$23.51 ,$19.69 ,$107.07 ,$110.00 ,$93.50 ,$44.30 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$19.89 ,$79.20 ,$10.80 ,$110.00 ,$110.00 ,$19.69 ,$110.00 ,$19.69 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42000033,97035,HC ULTRASOUND EA 15MIN,420,1 ,$90.00 ,$45.00 ,$10.80 ,$90.00 ,$58.14 ,$18.49 ,$90.00 ,$90.00 ,$14.00 ,$54.00 ,$76.50 ,$63.00 ,$18.49 ,$85.50 ,$64.80 ,$65.70 ,$58.50 ,$76.50 ,$14.00 ,$58.50 ,$72.00 ,$65.70 ,$18.49 ,$14.00 ,$90.00 ,$90.00 ,$76.50 ,$31.50 ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 ,$14.14 ,$64.80 ,$10.80 ,$90.00 ,$90.00 ,$14.00 ,$90.00 ,$14.00 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,42000037,97110,HC THERA EXER; EA 15 MIN,420,1 ,$100.00 ,$50.00 ,$12.90 ,$100.00 ,$64.60 ,$19.63 ,$100.00 ,$100.00 ,$29.06 ,$60.00 ,$85.00 ,$70.00 ,$19.63 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$29.06 ,$65.00 ,$80.00 ,$73.00 ,$19.63 ,$29.06 ,$100.00 ,$100.00 ,$85.00 ,$65.39 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$29.35 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$29.06 ,$100.00 ,$29.06 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000042,97110,HC THERA EXER; EA 15 MIN PRO,420,1 ,$100.00 ,$50.00 ,$12.90 ,$100.00 ,$64.60 ,$19.63 ,$100.00 ,$100.00 ,$29.06 ,$60.00 ,$85.00 ,$70.00 ,$19.63 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$29.06 ,$65.00 ,$80.00 ,$73.00 ,$19.63 ,$29.06 ,$100.00 ,$100.00 ,$85.00 ,$65.39 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$29.35 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$29.06 ,$100.00 ,$29.06 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000045,97112,HC NEUROMUSCULAR RE ED EA 15 MIN,420,1 ,$130.00 ,$65.00 ,$12.90 ,$130.00 ,$83.98 ,$19.32 ,$130.00 ,$130.00 ,$33.76 ,$78.00 ,$110.50 ,$91.00 ,$19.32 ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 ,$33.76 ,$84.50 ,$104.00 ,$94.90 ,$19.32 ,$33.76 ,$107.07 ,$130.00 ,$110.50 ,$75.96 ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 ,$34.10 ,$93.60 ,$12.90 ,$130.00 ,$130.00 ,$33.76 ,$130.00 ,$33.76 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,42000048,97112,HC NEUROMUSCULAR RE ED EA 15 MIN PRO,420,1 ,$130.00 ,$65.00 ,$12.90 ,$130.00 ,$83.98 ,$19.32 ,$130.00 ,$130.00 ,$33.76 ,$78.00 ,$110.50 ,$91.00 ,$19.32 ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 ,$33.76 ,$84.50 ,$104.00 ,$94.90 ,$19.32 ,$33.76 ,$107.07 ,$130.00 ,$110.50 ,$75.96 ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 ,$34.10 ,$93.60 ,$12.90 ,$130.00 ,$130.00 ,$33.76 ,$130.00 ,$33.76 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,42000049,97116,HC AMBULATION GAIT TRAIN EA 15 MIN,420,1 ,$100.00 ,$50.00 ,$10.80 ,$100.00 ,$64.60 ,$16.47 ,$100.00 ,$100.00 ,$29.06 ,$60.00 ,$85.00 ,$70.00 ,$16.47 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$29.06 ,$65.00 ,$80.00 ,$73.00 ,$16.47 ,$29.06 ,$100.00 ,$100.00 ,$85.00 ,$65.39 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$29.35 ,$72.00 ,$10.80 ,$100.00 ,$100.00 ,$29.06 ,$100.00 ,$29.06 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000052,97116,HC AMBULATION GAIT TRAIN EA 15 MIN PRO,420,1 ,$100.00 ,$50.00 ,$10.80 ,$100.00 ,$64.60 ,$16.47 ,$100.00 ,$100.00 ,$29.06 ,$60.00 ,$85.00 ,$70.00 ,$16.47 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$29.06 ,$65.00 ,$80.00 ,$73.00 ,$16.47 ,$29.06 ,$100.00 ,$100.00 ,$85.00 ,$65.39 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$29.35 ,$72.00 ,$10.80 ,$100.00 ,$100.00 ,$29.06 ,$100.00 ,$29.06 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000053,97124,HC THERAPEUTIC MASSAGE EA 15 MIN,420,1 ,$100.00 ,$50.00 ,$10.80 ,$100.00 ,$64.60 ,$23.41 ,$100.00 ,$100.00 ,$28.42 ,$60.00 ,$85.00 ,$70.00 ,$23.41 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$28.42 ,$65.00 ,$80.00 ,$73.00 ,$23.41 ,$28.42 ,$100.00 ,$100.00 ,$85.00 ,$63.95 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$28.70 ,$72.00 ,$10.80 ,$100.00 ,$100.00 ,$28.42 ,$100.00 ,$28.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000055,97124,HC THERAPEUTIC MASSAGE EA 15 MIN PRO,420,1 ,$100.00 ,$50.00 ,$10.80 ,$100.00 ,$64.60 ,$23.41 ,$100.00 ,$100.00 ,$28.42 ,$60.00 ,$85.00 ,$70.00 ,$23.41 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$28.42 ,$65.00 ,$80.00 ,$73.00 ,$23.41 ,$28.42 ,$100.00 ,$100.00 ,$85.00 ,$63.95 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$28.70 ,$72.00 ,$10.80 ,$100.00 ,$100.00 ,$28.42 ,$100.00 ,$28.42 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000056,97140,HC MANUAL THERAPY EA 15 MIN,420,1 ,$100.00 ,$50.00 ,$12.90 ,$100.00 ,$64.60 ,$25.53 ,$100.00 ,$100.00 ,$26.71 ,$60.00 ,$85.00 ,$70.00 ,$25.53 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$26.71 ,$65.00 ,$80.00 ,$73.00 ,$25.53 ,$26.71 ,$100.00 ,$100.00 ,$85.00 ,$60.10 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$26.98 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$26.71 ,$100.00 ,$26.71 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000059,97140,HC MANUAL THERAPY EA 15 MIN TRACTION,420,1 ,$100.00 ,$50.00 ,$12.90 ,$100.00 ,$64.60 ,$25.53 ,$100.00 ,$100.00 ,$26.71 ,$60.00 ,$85.00 ,$70.00 ,$25.53 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$26.71 ,$65.00 ,$80.00 ,$73.00 ,$25.53 ,$26.71 ,$100.00 ,$100.00 ,$85.00 ,$60.10 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$26.98 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$26.71 ,$100.00 ,$26.71 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000061,97140,HC MANUAL THERAPY EA 15 MIN PRO,420,1 ,$100.00 ,$50.00 ,$12.90 ,$100.00 ,$64.60 ,$25.53 ,$100.00 ,$100.00 ,$26.71 ,$60.00 ,$85.00 ,$70.00 ,$25.53 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$26.71 ,$65.00 ,$80.00 ,$73.00 ,$25.53 ,$26.71 ,$100.00 ,$100.00 ,$85.00 ,$60.10 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$26.98 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$26.71 ,$100.00 ,$26.71 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000063,97150,HC GROUP TREATMENT 15MIN,420,1 ,$100.00 ,$50.00 ,$6.08 ,$100.00 ,$64.60 ,$6.08 ,$100.00 ,$100.00 ,$17.45 ,$60.00 ,$85.00 ,$70.00 ,$6.08 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$17.45 ,$65.00 ,$80.00 ,$73.00 ,$6.08 ,$17.45 ,$100.00 ,$100.00 ,$85.00 ,$39.26 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$17.62 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$17.45 ,$100.00 ,$17.45 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000065,97530,HC THERAPEUTIC ACTIVITIES EA 15 MIN,420,1 ,$120.00 ,$60.00 ,$12.90 ,$120.00 ,$77.52 ,$18.05 ,$120.00 ,$120.00 ,$37.58 ,$72.00 ,$102.00 ,$84.00 ,$18.05 ,$114.00 ,$86.40 ,$87.60 ,$78.00 ,$102.00 ,$37.58 ,$78.00 ,$96.00 ,$87.60 ,$18.05 ,$37.58 ,$107.07 ,$120.00 ,$102.00 ,$84.56 ,$110.40 ,$84.00 ,$60.00 ,$72.00 ,$73.08 ,$60.00 ,$82.92 ,$84.00 ,$37.96 ,$86.40 ,$12.90 ,$120.00 ,$120.00 ,$37.58 ,$120.00 ,$37.58 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,42000068,97597,HC DEBR SKIN PART THICKNESS <20CM,420,1 ,$360.00 ,$180.00 ,$42.35 ,$360.00 ,$232.56 ,$42.35 ,$263.00 ,$212.00 ,$97.07 ,$216.00 ,$306.00 ,$252.00 ,$42.35 ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 ,$97.07 ,$234.00 ,$288.00 ,$262.80 ,$42.35 ,$97.07 ,$107.07 ,$360.00 ,$306.00 ,$218.41 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$98.04 ,$259.20 ,$113.99 ,$236.00 ,$236.00 ,$97.07 ,$236.00 ,$97.07 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,42000073,97597,HC SEL DEBRD<=20CM INIT LOWB WHIRL,420,1 ,$330.00 ,$165.00 ,$42.35 ,$330.00 ,$213.18 ,$42.35 ,$263.00 ,$212.00 ,$97.07 ,$198.00 ,$280.50 ,$231.00 ,$42.35 ,$313.50 ,$237.60 ,$240.90 ,$214.50 ,$280.50 ,$97.07 ,$214.50 ,$264.00 ,$240.90 ,$42.35 ,$97.07 ,$107.07 ,$330.00 ,$280.50 ,$218.41 ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 ,$98.04 ,$237.60 ,$113.99 ,$236.00 ,$236.00 ,$97.07 ,$236.00 ,$97.07 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,42000079,97597,HC ULTRA WND DEBRD/TX <=20 INIT,420,1 ,$330.00 ,$165.00 ,$42.35 ,$330.00 ,$213.18 ,$42.35 ,$263.00 ,$212.00 ,$97.07 ,$198.00 ,$280.50 ,$231.00 ,$42.35 ,$313.50 ,$237.60 ,$240.90 ,$214.50 ,$280.50 ,$97.07 ,$214.50 ,$264.00 ,$240.90 ,$42.35 ,$97.07 ,$107.07 ,$330.00 ,$280.50 ,$218.41 ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 ,$98.04 ,$237.60 ,$113.99 ,$236.00 ,$236.00 ,$97.07 ,$236.00 ,$97.07 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,42000081,97597,HC US DEBRID <=20CM INIT/DRESS,420,1 ,$330.00 ,$165.00 ,$42.35 ,$330.00 ,$213.18 ,$42.35 ,$263.00 ,$212.00 ,$97.07 ,$198.00 ,$280.50 ,$231.00 ,$42.35 ,$313.50 ,$237.60 ,$240.90 ,$214.50 ,$280.50 ,$97.07 ,$214.50 ,$264.00 ,$240.90 ,$42.35 ,$97.07 ,$107.07 ,$330.00 ,$280.50 ,$218.41 ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 ,$98.04 ,$237.60 ,$113.99 ,$236.00 ,$236.00 ,$97.07 ,$236.00 ,$97.07 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,42000083,97598,HC DEBR SKIN PART THICKNESS EA ADDN>20CM FACIL,420,1 ,$160.00 ,$80.00 ,$35.14 ,$306.16 ,$103.36 ,$35.14 ,$160.00 ,$160.00 , N/A ,$96.00 ,$136.00 ,$112.00 ,$35.14 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 , N/A ,$104.00 ,$128.00 ,$116.80 ,$35.14 , N/A ,$107.07 ,$160.00 ,$136.00 , N/A ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , N/A ,$115.20 ,$306.16 ,$160.00 ,$160.00 , N/A ,$160.00 , N/A ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,42000084,97602,HC DEBRIDEMENT NONSELECTIVE,420,1 ,$140.00 ,$70.00 ,$70.00 ,$140.00 ,$90.44 , N/A ,$140.00 ,$140.00 , N/A ,$84.00 ,$119.00 ,$98.00 , N/A ,$133.00 ,$100.80 ,$102.20 ,$91.00 ,$119.00 , N/A ,$91.00 ,$112.00 ,$102.20 , N/A , N/A ,$107.07 ,$140.00 ,$119.00 , N/A ,$128.80 ,$98.00 ,$70.00 ,$84.00 ,$85.26 ,$70.00 ,$96.74 ,$98.00 , N/A ,$100.80 ,$113.99 ,$140.00 ,$140.00 , N/A ,$140.00 , N/A ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,42000085,97605,HC NWPT <50 SQ CM FAC,420,1 ,$200.00 ,$100.00 ,$41.42 ,$200.00 ,$129.20 , N/A ,$200.00 ,$200.00 ,$41.42 ,$120.00 ,$170.00 ,$140.00 , N/A ,$190.00 ,$144.00 ,$146.00 ,$130.00 ,$170.00 ,$41.42 ,$130.00 ,$160.00 ,$146.00 , N/A ,$41.42 ,$107.07 ,$200.00 ,$170.00 ,$93.20 ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 ,$41.83 ,$144.00 ,$89.35 ,$200.00 ,$200.00 ,$41.42 ,$200.00 ,$41.42 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,42000089,97606,HC NWPT >50 SQ CM FAC,420,1 ,$260.00 ,$130.00 ,$49.08 ,$260.00 ,$167.96 , N/A ,$260.00 ,$212.00 ,$49.08 ,$156.00 ,$221.00 ,$182.00 , N/A ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 ,$49.08 ,$169.00 ,$208.00 ,$189.80 , N/A ,$49.08 ,$107.07 ,$260.00 ,$221.00 ,$110.43 ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 ,$49.57 ,$187.20 ,$113.99 ,$236.00 ,$236.00 ,$49.08 ,$236.00 ,$49.08 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,42000093,97750,HC PHYSICAL PERFORMANCE TST EA 15 MIN,420,1 ,$100.00 ,$50.00 ,$12.90 ,$100.00 ,$64.60 , N/A ,$100.00 ,$100.00 ,$33.00 ,$60.00 ,$85.00 ,$70.00 , N/A ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$33.00 ,$65.00 ,$80.00 ,$73.00 , N/A ,$33.00 ,$100.00 ,$100.00 ,$85.00 ,$74.25 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$33.33 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$33.00 ,$100.00 ,$33.00 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000094,97761,HC PROSTHETIC TRAINING EA 15 MIN,420,1 ,$100.00 ,$50.00 ,$12.90 ,$100.00 ,$64.60 ,$21.40 ,$100.00 ,$100.00 ,$40.66 ,$60.00 ,$85.00 ,$70.00 ,$21.40 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$40.66 ,$65.00 ,$80.00 ,$73.00 ,$21.40 ,$40.66 ,$100.00 ,$100.00 ,$85.00 ,$91.49 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$41.07 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$40.66 ,$100.00 ,$40.66 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000095,97763,HC ORTHTC/PRSTHTC CHECK EA 15MIN,420,1 ,$100.00 ,$50.00 ,$28.15 ,$118.01 ,$64.60 ,$28.15 ,$100.00 ,$100.00 ,$52.45 ,$60.00 ,$85.00 ,$70.00 ,$28.15 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$52.45 ,$65.00 ,$80.00 ,$73.00 ,$28.15 ,$52.45 ,$100.00 ,$100.00 ,$85.00 ,$118.01 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$52.97 ,$72.00 ,$29.84 ,$100.00 ,$100.00 ,$52.45 ,$100.00 ,$52.45 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000096,97799,HC CASTING ADDL UPPER EXTREMITY,420,1 ,$105.00 ,$52.50 ,$10.80 ,$105.00 ,$67.83 ,$81.73 ,$105.00 ,$105.00 , N/A ,$63.00 ,$89.25 ,$73.50 ,$81.73 ,$99.75 ,$75.60 ,$76.65 ,$68.25 ,$89.25 , N/A ,$68.25 ,$84.00 ,$76.65 ,$81.73 , N/A ,$105.00 ,$105.00 ,$89.25 ,$63.00 ,$96.60 ,$73.50 ,$52.50 ,$63.00 ,$63.95 ,$52.50 ,$72.56 ,$73.50 , N/A ,$75.60 ,$10.80 ,$105.00 ,$105.00 , N/A ,$105.00 , N/A ,$75.60 ,$65.10 ,$75.60 ,$75.60 ,$63.00 ST VINCENT HOSPITAL - ACUTE,42000097,97799,HC CASTING INIT LOWER EXTREM NO EVAL PRO,420,1 ,$370.00 ,$185.00 ,$10.80 ,$370.00 ,$239.02 ,$81.73 ,$263.00 ,$212.00 , N/A ,$222.00 ,$314.50 ,$259.00 ,$81.73 ,$351.50 ,$266.40 ,$270.10 ,$240.50 ,$314.50 , N/A ,$240.50 ,$296.00 ,$270.10 ,$81.73 , N/A ,$107.07 ,$370.00 ,$314.50 ,$222.00 ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 , N/A ,$266.40 ,$10.80 ,$236.00 ,$236.00 , N/A ,$236.00 , N/A ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,42000098,97799,HC CASTING ADDL LOWER EXTREMITY,420,1 ,$110.00 ,$55.00 ,$10.80 ,$110.00 ,$71.06 ,$81.73 ,$110.00 ,$110.00 , N/A ,$66.00 ,$93.50 ,$77.00 ,$81.73 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 , N/A ,$71.50 ,$88.00 ,$80.30 ,$81.73 , N/A ,$107.07 ,$110.00 ,$93.50 ,$66.00 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 , N/A ,$79.20 ,$10.80 ,$110.00 ,$110.00 , N/A ,$110.00 , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42000099,97799,HC CASTING UPPER EXTREMITY RECAST,420,1 ,$270.00 ,$135.00 ,$10.80 ,$270.00 ,$174.42 ,$81.73 ,$263.00 ,$212.00 , N/A ,$162.00 ,$229.50 ,$189.00 ,$81.73 ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 , N/A ,$175.50 ,$216.00 ,$197.10 ,$81.73 , N/A ,$107.07 ,$270.00 ,$229.50 ,$162.00 ,$248.40 ,$189.00 ,$135.00 ,$162.00 ,$164.43 ,$135.00 ,$186.57 ,$189.00 , N/A ,$194.40 ,$10.80 ,$236.00 ,$236.00 , N/A ,$236.00 , N/A ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,42000100,97799,HC CASTING INIT UPPER EXTREMTY,420,1 ,$370.00 ,$185.00 ,$10.80 ,$370.00 ,$239.02 ,$81.73 ,$263.00 ,$212.00 , N/A ,$222.00 ,$314.50 ,$259.00 ,$81.73 ,$351.50 ,$266.40 ,$270.10 ,$240.50 ,$314.50 , N/A ,$240.50 ,$296.00 ,$270.10 ,$81.73 , N/A ,$107.07 ,$370.00 ,$314.50 ,$222.00 ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 , N/A ,$266.40 ,$10.80 ,$236.00 ,$236.00 , N/A ,$236.00 , N/A ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,42000101,97799,HC CASTING INIT LOWER EXTREMTY,420,1 ,$370.00 ,$185.00 ,$10.80 ,$370.00 ,$239.02 ,$81.73 ,$263.00 ,$212.00 , N/A ,$222.00 ,$314.50 ,$259.00 ,$81.73 ,$351.50 ,$266.40 ,$270.10 ,$240.50 ,$314.50 , N/A ,$240.50 ,$296.00 ,$270.10 ,$81.73 , N/A ,$107.07 ,$370.00 ,$314.50 ,$222.00 ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 , N/A ,$266.40 ,$10.80 ,$236.00 ,$236.00 , N/A ,$236.00 , N/A ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,42000102,97799,HC CASTING LOWER EXTRM RECAST 2ND,420,1 ,$360.00 ,$180.00 ,$10.80 ,$360.00 ,$232.56 ,$81.73 ,$263.00 ,$212.00 , N/A ,$216.00 ,$306.00 ,$252.00 ,$81.73 ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 , N/A ,$234.00 ,$288.00 ,$262.80 ,$81.73 , N/A ,$107.07 ,$360.00 ,$306.00 ,$216.00 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 , N/A ,$259.20 ,$10.80 ,$236.00 ,$236.00 , N/A ,$236.00 , N/A ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,42000103,99368,HC MEDICAL TEAM CONFERENCE W/O PATIENT NON-PHYSICIAN,420,1 ,$130.00 ,$65.00 ,$33.58 ,$130.00 ,$83.98 , N/A ,$130.00 ,$130.00 , N/A ,$78.00 ,$110.50 ,$91.00 , N/A ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 , N/A ,$84.50 ,$104.00 ,$94.90 , N/A , N/A ,$107.07 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 , N/A ,$93.60 ,$33.58 ,$130.00 ,$130.00 , N/A ,$130.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,42000104,G0175,HC FAMILY CONFERENCE,420,1 ,$370.00 ,$185.00 ,$33.58 ,$792.63 ,$239.02 , N/A ,$263.00 ,$212.00 ,$352.28 ,$222.00 ,$314.50 ,$259.00 , N/A ,$351.50 ,$266.40 ,$270.10 ,$240.50 ,$314.50 ,$352.28 ,$240.50 ,$296.00 ,$270.10 , N/A ,$352.28 ,$107.07 ,$370.00 ,$314.50 ,$792.63 ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 ,$355.80 ,$266.40 ,$33.58 ,$236.00 ,$236.00 ,$352.28 ,$236.00 ,$352.28 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,42000105,G0175,HC FAMILY CONFERENCE,420,1 ,$370.00 ,$185.00 ,$33.58 ,$792.63 ,$239.02 , N/A ,$263.00 ,$212.00 ,$352.28 ,$222.00 ,$314.50 ,$259.00 , N/A ,$351.50 ,$266.40 ,$270.10 ,$240.50 ,$314.50 ,$352.28 ,$240.50 ,$296.00 ,$270.10 , N/A ,$352.28 ,$107.07 ,$370.00 ,$314.50 ,$792.63 ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 ,$355.80 ,$266.40 ,$33.58 ,$236.00 ,$236.00 ,$352.28 ,$236.00 ,$352.28 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,42000108,G0281,HC ELECT STIM(UNATTENDED) ULCER,420,1 ,$90.00 ,$45.00 ,$12.63 ,$90.00 ,$58.14 ,$22.38 ,$90.00 ,$90.00 ,$12.63 ,$54.00 ,$76.50 ,$63.00 ,$22.38 ,$85.50 ,$64.80 ,$65.70 ,$58.50 ,$76.50 ,$12.63 ,$58.50 ,$72.00 ,$65.70 ,$22.38 ,$12.63 ,$90.00 ,$90.00 ,$76.50 ,$28.42 ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 ,$12.76 ,$64.80 ,$89.35 ,$90.00 ,$90.00 ,$12.63 ,$90.00 ,$12.63 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,42000109,G0282,HC ELECT STIM(UNATTND)OTHER WOUND,420,1 ,$100.00 ,$50.00 ,$22.38 ,$100.00 ,$64.60 ,$22.38 ,$100.00 ,$100.00 , N/A ,$60.00 ,$85.00 ,$70.00 ,$22.38 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 , N/A ,$65.00 ,$80.00 ,$73.00 ,$22.38 , N/A ,$100.00 ,$100.00 ,$85.00 , N/A ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 , N/A ,$72.00 ,$89.35 ,$100.00 ,$100.00 , N/A ,$100.00 , N/A ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000110,G0283,HC ELECT STIM(UNATTEND) OTHER,420,1 ,$110.00 ,$55.00 ,$10.80 ,$110.00 ,$71.06 ,$22.38 ,$110.00 ,$110.00 ,$12.63 ,$66.00 ,$93.50 ,$77.00 ,$22.38 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$12.63 ,$71.50 ,$88.00 ,$80.30 ,$22.38 ,$12.63 ,$107.07 ,$110.00 ,$93.50 ,$28.42 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$12.76 ,$79.20 ,$10.80 ,$110.00 ,$110.00 ,$12.63 ,$110.00 ,$12.63 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42000120,97150,HC GROUP TREATMENT 30MIN,420,1 ,$100.00 ,$50.00 ,$6.08 ,$100.00 ,$64.60 ,$6.08 ,$100.00 ,$100.00 ,$17.45 ,$60.00 ,$85.00 ,$70.00 ,$6.08 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$17.45 ,$65.00 ,$80.00 ,$73.00 ,$6.08 ,$17.45 ,$100.00 ,$100.00 ,$85.00 ,$39.26 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$17.62 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$17.45 ,$100.00 ,$17.45 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000121,97150,HC GROUP TREATMENT 45MIN,420,1 ,$100.00 ,$50.00 ,$6.08 ,$100.00 ,$64.60 ,$6.08 ,$100.00 ,$100.00 ,$17.45 ,$60.00 ,$85.00 ,$70.00 ,$6.08 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$17.45 ,$65.00 ,$80.00 ,$73.00 ,$6.08 ,$17.45 ,$100.00 ,$100.00 ,$85.00 ,$39.26 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$17.62 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$17.45 ,$100.00 ,$17.45 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000122,97150,HC GROUP TREATMENT 60MIN,420,1 ,$100.00 ,$50.00 ,$6.08 ,$100.00 ,$64.60 ,$6.08 ,$100.00 ,$100.00 ,$17.45 ,$60.00 ,$85.00 ,$70.00 ,$6.08 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$17.45 ,$65.00 ,$80.00 ,$73.00 ,$6.08 ,$17.45 ,$100.00 ,$100.00 ,$85.00 ,$39.26 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$17.62 ,$72.00 ,$12.90 ,$100.00 ,$100.00 ,$17.45 ,$100.00 ,$17.45 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,42000130,97799,HC CASTING LOWER EXTREMITY RECAST,420,1 ,$110.00 ,$55.00 ,$10.80 ,$110.00 ,$71.06 ,$81.73 ,$110.00 ,$110.00 , N/A ,$66.00 ,$93.50 ,$77.00 ,$81.73 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 , N/A ,$71.50 ,$88.00 ,$80.30 ,$81.73 , N/A ,$107.07 ,$110.00 ,$93.50 ,$66.00 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 , N/A ,$79.20 ,$10.80 ,$110.00 ,$110.00 , N/A ,$110.00 , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42000145,97597,HC DEBR SKIN INIT 20CM/NWPT/WRAP,420,1 ,$360.00 ,$180.00 ,$42.35 ,$360.00 ,$232.56 ,$42.35 ,$263.00 ,$212.00 ,$97.07 ,$216.00 ,$306.00 ,$252.00 ,$42.35 ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 ,$97.07 ,$234.00 ,$288.00 ,$262.80 ,$42.35 ,$97.07 ,$107.07 ,$360.00 ,$306.00 ,$218.41 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$98.04 ,$259.20 ,$113.99 ,$236.00 ,$236.00 ,$97.07 ,$236.00 ,$97.07 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,42000146,97597,HC DEBR SKIN INIT 20CM/NWPT/BILWRAP,420,1 ,$360.00 ,$180.00 ,$42.35 ,$360.00 ,$232.56 ,$42.35 ,$263.00 ,$212.00 ,$97.07 ,$216.00 ,$306.00 ,$252.00 ,$42.35 ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 ,$97.07 ,$234.00 ,$288.00 ,$262.80 ,$42.35 ,$97.07 ,$107.07 ,$360.00 ,$306.00 ,$218.41 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$98.04 ,$259.20 ,$113.99 ,$236.00 ,$236.00 ,$97.07 ,$236.00 ,$97.07 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,42000151,29581,HC APPL MULTI COMP WRAP PT/OT,420,1 ,$280.00 ,$140.00 ,$61.07 ,$307.65 ,$180.88 , N/A ,$263.00 ,$212.00 ,$136.73 ,$168.00 ,$238.00 ,$196.00 , N/A ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$136.73 ,$182.00 ,$224.00 ,$204.40 , N/A ,$136.73 ,$107.07 ,$280.00 ,$238.00 ,$307.65 ,$257.60 ,$196.00 ,$280.00 ,$280.00 ,$170.52 ,$280.00 ,$193.48 ,$196.00 ,$138.10 ,$201.60 ,$61.07 ,$236.00 ,$236.00 ,$136.73 ,$236.00 ,$136.73 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,42000216,99366,HC MEDICAL TEAM CONFERENCE W/PATIENT NON-PHYSICIAN,420,1 ,$130.00 ,$65.00 ,$33.58 ,$130.00 ,$83.98 , N/A ,$130.00 ,$130.00 , N/A ,$78.00 ,$110.50 ,$91.00 , N/A ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 , N/A ,$84.50 ,$104.00 ,$94.90 , N/A , N/A ,$107.07 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 , N/A ,$93.60 ,$33.58 ,$130.00 ,$130.00 , N/A ,$130.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,42400043,97161,HC PT EVAL LOW COMPLEXITY 15MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400044,97161,HC PT EVAL LOW COMPLEXITY 30MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400045,97161,HC PT EVAL LOW COMPLEXITY 45MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400046,97161,HC PT EVAL LOW COMPLEXITY 60MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400055,97162,HC PT EVAL MOD COMPLEXITY 15MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400056,97162,HC PT EVAL MOD COMPLEXITY 30MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400057,97162,HC PT EVAL MOD COMPLEXITY 45MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400058,97162,HC PT EVAL MOD COMPLEXITY 60MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400067,97163,HC PT EVAL HIGH COMPLEXITY 15MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400068,97163,HC PT EVAL HIGH COMPLEXITY 30MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400069,97163,HC PT EVAL HIGH COMPLEXITY 45MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400070,97163,HC PT EVAL HIGH COMPLEXITY 60MIN,424,1 ,$210.00 ,$105.00 ,$62.66 ,$220.43 ,$135.66 ,$62.66 ,$210.00 ,$210.00 ,$97.97 ,$126.00 ,$178.50 ,$147.00 ,$62.66 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$97.97 ,$136.50 ,$168.00 ,$153.30 ,$62.66 ,$97.97 ,$107.07 ,$210.00 ,$178.50 ,$220.43 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$98.95 ,$151.20 ,$76.43 ,$210.00 ,$210.00 ,$97.97 ,$210.00 ,$97.97 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,42400079,97164,HC PT RE-EVAL 15MIN,424,1 ,$110.00 ,$55.00 ,$55.00 ,$150.26 ,$71.06 ,$62.66 ,$110.00 ,$110.00 ,$66.78 ,$66.00 ,$93.50 ,$77.00 ,$62.66 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$66.78 ,$71.50 ,$88.00 ,$80.30 ,$62.66 ,$66.78 ,$107.07 ,$110.00 ,$93.50 ,$150.26 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$67.45 ,$79.20 ,$76.43 ,$110.00 ,$110.00 ,$66.78 ,$110.00 ,$66.78 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42400080,97164,HC PT RE-EVAL 30MIN,424,1 ,$110.00 ,$55.00 ,$55.00 ,$150.26 ,$71.06 ,$62.66 ,$110.00 ,$110.00 ,$66.78 ,$66.00 ,$93.50 ,$77.00 ,$62.66 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$66.78 ,$71.50 ,$88.00 ,$80.30 ,$62.66 ,$66.78 ,$107.07 ,$110.00 ,$93.50 ,$150.26 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$67.45 ,$79.20 ,$76.43 ,$110.00 ,$110.00 ,$66.78 ,$110.00 ,$66.78 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42400081,97164,HC PT RE-EVAL 45MIN,424,1 ,$110.00 ,$55.00 ,$55.00 ,$150.26 ,$71.06 ,$62.66 ,$110.00 ,$110.00 ,$66.78 ,$66.00 ,$93.50 ,$77.00 ,$62.66 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$66.78 ,$71.50 ,$88.00 ,$80.30 ,$62.66 ,$66.78 ,$107.07 ,$110.00 ,$93.50 ,$150.26 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$67.45 ,$79.20 ,$76.43 ,$110.00 ,$110.00 ,$66.78 ,$110.00 ,$66.78 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,42400082,97164,HC PT RE-EVAL 60MIN,424,1 ,$110.00 ,$55.00 ,$55.00 ,$150.26 ,$71.06 ,$62.66 ,$110.00 ,$110.00 ,$66.78 ,$66.00 ,$93.50 ,$77.00 ,$62.66 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$66.78 ,$71.50 ,$88.00 ,$80.30 ,$62.66 ,$66.78 ,$107.07 ,$110.00 ,$93.50 ,$150.26 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$67.45 ,$79.20 ,$76.43 ,$110.00 ,$110.00 ,$66.78 ,$110.00 ,$66.78 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,43000016,97535,HC SELF CARE ADL TRAINING EA 15MIN,430,1 ,$110.00 ,$55.00 ,$10.80 ,$110.00 ,$71.06 ,$20.93 ,$110.00 ,$110.00 ,$32.34 ,$66.00 ,$93.50 ,$77.00 ,$20.93 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$32.34 ,$71.50 ,$88.00 ,$80.30 ,$20.93 ,$32.34 ,$107.07 ,$110.00 ,$93.50 ,$72.77 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$32.66 ,$79.20 ,$10.80 ,$110.00 ,$110.00 ,$32.34 ,$110.00 ,$32.34 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,43000017,97535,HC SELF CARE ADL TRAINING EA 15MIN MODIFICT,430,1 ,$110.00 ,$55.00 ,$10.80 ,$110.00 ,$71.06 ,$20.93 ,$110.00 ,$110.00 ,$32.34 ,$66.00 ,$93.50 ,$77.00 ,$20.93 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$32.34 ,$71.50 ,$88.00 ,$80.30 ,$20.93 ,$32.34 ,$107.07 ,$110.00 ,$93.50 ,$72.77 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$32.66 ,$79.20 ,$10.80 ,$110.00 ,$110.00 ,$32.34 ,$110.00 ,$32.34 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,43000024,97542,HC SEATING CLINIC EA 15 MIN,430,1 ,$80.00 ,$40.00 ,$12.90 ,$80.00 ,$51.68 ,$18.94 ,$80.00 ,$80.00 ,$31.42 ,$48.00 ,$68.00 ,$56.00 ,$18.94 ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 ,$31.42 ,$52.00 ,$64.00 ,$58.40 ,$18.94 ,$31.42 ,$80.00 ,$80.00 ,$68.00 ,$70.70 ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 ,$31.73 ,$57.60 ,$12.90 ,$80.00 ,$80.00 ,$31.42 ,$80.00 ,$31.42 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,43000027,97760,HC ORTHOTICS FABRICATION EA 15 MIN,430,1 ,$110.00 ,$55.00 ,$12.90 ,$110.00 ,$71.06 , N/A ,$110.00 ,$110.00 ,$47.89 ,$66.00 ,$93.50 ,$77.00 , N/A ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 ,$47.89 ,$71.50 ,$88.00 ,$80.30 , N/A ,$47.89 ,$107.07 ,$110.00 ,$93.50 ,$107.75 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$48.37 ,$79.20 ,$12.90 ,$110.00 ,$110.00 ,$47.89 ,$110.00 ,$47.89 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,43000029,99368,HC MEDICAL TEAM CONFERENCE W/O PATIENT NON-PHYSICIAN,430,1 ,$130.00 ,$65.00 ,$33.58 ,$130.00 ,$83.98 , N/A ,$130.00 ,$130.00 , N/A ,$78.00 ,$110.50 ,$91.00 , N/A ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 , N/A ,$84.50 ,$104.00 ,$94.90 , N/A , N/A ,$107.07 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 , N/A ,$93.60 ,$33.58 ,$130.00 ,$130.00 , N/A ,$130.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,43000061,97129,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION INITIAL 15 MIN,430,1 ,$90.00 ,$45.00 ,$19.99 ,$90.00 ,$58.14 , N/A ,$90.00 ,$90.00 ,$22.58 ,$54.00 ,$76.50 ,$63.00 , N/A ,$85.50 ,$64.80 ,$65.70 ,$58.50 ,$76.50 ,$22.58 ,$58.50 ,$72.00 ,$65.70 , N/A ,$22.58 ,$90.00 ,$90.00 ,$76.50 ,$50.81 ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 ,$22.81 ,$64.80 ,$19.99 ,$90.00 ,$90.00 ,$22.58 ,$90.00 ,$22.58 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,43000062,97130,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION ADDL 15 MIN,430,1 ,$90.00 ,$45.00 ,$19.09 ,$90.00 ,$58.14 , N/A ,$90.00 ,$90.00 ,$21.89 ,$54.00 ,$76.50 ,$63.00 , N/A ,$85.50 ,$64.80 ,$65.70 ,$58.50 ,$76.50 ,$21.89 ,$58.50 ,$72.00 ,$65.70 , N/A ,$21.89 ,$90.00 ,$90.00 ,$76.50 ,$49.25 ,$82.80 ,$63.00 ,$45.00 ,$54.00 ,$54.81 ,$45.00 ,$62.19 ,$63.00 ,$22.11 ,$64.80 ,$19.09 ,$90.00 ,$90.00 ,$21.89 ,$90.00 ,$21.89 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,43400034,97165,HC OT EVAL LOW COMPLEXITY 15MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400035,97165,HC OT EVAL LOW COMPLEXITY 30MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400036,97165,HC OT EVAL LOW COMPLEXITY 45MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400037,97165,HC OT EVAL LOW COMPLEXITY 60MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400046,97166,HC OT EVAL MOD COMPLEXITY 15MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400047,97166,HC OT EVAL MOD COMPLEXITY 30MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400048,97166,HC OT EVAL MOD COMPLEXITY 45MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400049,97166,HC OT EVAL MOD COMPLEXITY 60MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400058,97167,HC OT EVAL HIGH COMPLEXITY 15MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400059,97167,HC OT EVAL HIGH COMPLEXITY 30MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400060,97167,HC OT EVAL HIGH COMPLEXITY 45MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400061,97167,HC OT EVAL HIGH COMPLEXITY 60MIN,434,1 ,$220.00 ,$110.00 ,$58.98 ,$220.00 ,$142.12 ,$62.66 ,$220.00 ,$212.00 ,$95.01 ,$132.00 ,$187.00 ,$154.00 ,$62.66 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$95.01 ,$143.00 ,$176.00 ,$160.60 ,$62.66 ,$95.01 ,$107.07 ,$220.00 ,$187.00 ,$213.77 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$95.96 ,$158.40 ,$58.98 ,$220.00 ,$220.00 ,$95.01 ,$220.00 ,$95.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,43400070,97168,HC OT RE-EVAL 15MIN,434,1 ,$130.00 ,$65.00 ,$58.98 ,$143.60 ,$83.98 ,$62.66 ,$130.00 ,$130.00 ,$63.82 ,$78.00 ,$110.50 ,$91.00 ,$62.66 ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 ,$63.82 ,$84.50 ,$104.00 ,$94.90 ,$62.66 ,$63.82 ,$107.07 ,$130.00 ,$110.50 ,$143.60 ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 ,$64.46 ,$93.60 ,$58.98 ,$130.00 ,$130.00 ,$63.82 ,$130.00 ,$63.82 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,43400071,97168,HC OT RE-EVAL 30MIN,434,1 ,$130.00 ,$65.00 ,$58.98 ,$143.60 ,$83.98 ,$62.66 ,$130.00 ,$130.00 ,$63.82 ,$78.00 ,$110.50 ,$91.00 ,$62.66 ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 ,$63.82 ,$84.50 ,$104.00 ,$94.90 ,$62.66 ,$63.82 ,$107.07 ,$130.00 ,$110.50 ,$143.60 ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 ,$64.46 ,$93.60 ,$58.98 ,$130.00 ,$130.00 ,$63.82 ,$130.00 ,$63.82 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,43400072,97168,HC OT RE-EVAL 45MIN,434,1 ,$130.00 ,$65.00 ,$58.98 ,$143.60 ,$83.98 ,$62.66 ,$130.00 ,$130.00 ,$63.82 ,$78.00 ,$110.50 ,$91.00 ,$62.66 ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 ,$63.82 ,$84.50 ,$104.00 ,$94.90 ,$62.66 ,$63.82 ,$107.07 ,$130.00 ,$110.50 ,$143.60 ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 ,$64.46 ,$93.60 ,$58.98 ,$130.00 ,$130.00 ,$63.82 ,$130.00 ,$63.82 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,43400073,97168,HC OT RE-EVAL 60MIN,434,1 ,$130.00 ,$65.00 ,$58.98 ,$143.60 ,$83.98 ,$62.66 ,$130.00 ,$130.00 ,$63.82 ,$78.00 ,$110.50 ,$91.00 ,$62.66 ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 ,$63.82 ,$84.50 ,$104.00 ,$94.90 ,$62.66 ,$63.82 ,$107.07 ,$130.00 ,$110.50 ,$143.60 ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 ,$64.46 ,$93.60 ,$58.98 ,$130.00 ,$130.00 ,$63.82 ,$130.00 ,$63.82 ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,44000000,92507,HC SPEECH THERAPY TREATMENT 15MIN,440,1 ,$280.00 ,$140.00 ,$47.91 ,$280.00 ,$180.88 ,$47.91 ,$263.00 ,$212.00 ,$75.13 ,$168.00 ,$238.00 ,$196.00 ,$47.91 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$75.13 ,$182.00 ,$224.00 ,$204.40 ,$47.91 ,$75.13 ,$107.07 ,$280.00 ,$238.00 ,$169.04 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$75.88 ,$201.60 ,$73.78 ,$236.00 ,$236.00 ,$75.13 ,$236.00 ,$75.13 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44000001,92507,HC SPEECH THERAPY TREATMENT 30MIN,440,1 ,$280.00 ,$140.00 ,$47.91 ,$280.00 ,$180.88 ,$47.91 ,$263.00 ,$212.00 ,$75.13 ,$168.00 ,$238.00 ,$196.00 ,$47.91 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$75.13 ,$182.00 ,$224.00 ,$204.40 ,$47.91 ,$75.13 ,$107.07 ,$280.00 ,$238.00 ,$169.04 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$75.88 ,$201.60 ,$73.78 ,$236.00 ,$236.00 ,$75.13 ,$236.00 ,$75.13 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44000002,92507,HC SPEECH THERAPY TREATMENT 45MIN,440,1 ,$280.00 ,$140.00 ,$47.91 ,$280.00 ,$180.88 ,$47.91 ,$263.00 ,$212.00 ,$75.13 ,$168.00 ,$238.00 ,$196.00 ,$47.91 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$75.13 ,$182.00 ,$224.00 ,$204.40 ,$47.91 ,$75.13 ,$107.07 ,$280.00 ,$238.00 ,$169.04 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$75.88 ,$201.60 ,$73.78 ,$236.00 ,$236.00 ,$75.13 ,$236.00 ,$75.13 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44000003,92507,HC SPEECH THERAPY TREATMENT 60MIN,440,1 ,$280.00 ,$140.00 ,$47.91 ,$280.00 ,$180.88 ,$47.91 ,$263.00 ,$212.00 ,$75.13 ,$168.00 ,$238.00 ,$196.00 ,$47.91 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$75.13 ,$182.00 ,$224.00 ,$204.40 ,$47.91 ,$75.13 ,$107.07 ,$280.00 ,$238.00 ,$169.04 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$75.88 ,$201.60 ,$73.78 ,$236.00 ,$236.00 ,$75.13 ,$236.00 ,$75.13 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44000004,92507,HC SPEECH THERAPY TREATMENT,440,1 ,$280.00 ,$140.00 ,$47.91 ,$280.00 ,$180.88 ,$47.91 ,$263.00 ,$212.00 ,$75.13 ,$168.00 ,$238.00 ,$196.00 ,$47.91 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$75.13 ,$182.00 ,$224.00 ,$204.40 ,$47.91 ,$75.13 ,$107.07 ,$280.00 ,$238.00 ,$169.04 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$75.88 ,$201.60 ,$73.78 ,$236.00 ,$236.00 ,$75.13 ,$236.00 ,$75.13 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44000008,92520,HC LARYNGEAL FUNCTION STUDY,440,1 ,$280.00 ,$140.00 ,$31.07 ,$280.00 ,$180.88 ,$31.07 ,$263.00 ,$212.00 ,$78.19 ,$168.00 ,$238.00 ,$196.00 ,$31.07 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$78.19 ,$182.00 ,$224.00 ,$204.40 ,$31.07 ,$78.19 ,$107.07 ,$280.00 ,$238.00 ,$175.93 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$78.97 ,$201.60 ,$126.32 ,$236.00 ,$236.00 ,$78.19 ,$236.00 ,$78.19 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44000009,92526,HC DYSPHAGIA TREATMENT 15MIN,440,1 ,$280.00 ,$140.00 ,$12.90 ,$280.00 ,$180.88 ,$48.82 ,$263.00 ,$212.00 ,$83.10 ,$168.00 ,$238.00 ,$196.00 ,$48.82 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$83.10 ,$182.00 ,$224.00 ,$204.40 ,$48.82 ,$83.10 ,$107.07 ,$280.00 ,$238.00 ,$186.98 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$83.93 ,$201.60 ,$12.90 ,$236.00 ,$236.00 ,$83.10 ,$236.00 ,$83.10 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44000013,99368,HC MEDICAL TEAM CONFERENCE W/O PATIENT NON-PHYSICIAN,440,1 ,$130.00 ,$65.00 ,$33.58 ,$130.00 ,$83.98 , N/A ,$130.00 ,$130.00 , N/A ,$78.00 ,$110.50 ,$91.00 , N/A ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 , N/A ,$84.50 ,$104.00 ,$94.90 , N/A , N/A ,$107.07 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 , N/A ,$93.60 ,$33.58 ,$130.00 ,$130.00 , N/A ,$130.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,44000014,99368,HC MEDICAL TEAM CONFERENCE W/O PATIENT NON-PHYSICIAN,440,1 ,$130.00 ,$65.00 ,$33.58 ,$130.00 ,$83.98 , N/A ,$130.00 ,$130.00 , N/A ,$78.00 ,$110.50 ,$91.00 , N/A ,$123.50 ,$93.60 ,$94.90 ,$84.50 ,$110.50 , N/A ,$84.50 ,$104.00 ,$94.90 , N/A , N/A ,$107.07 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 , N/A ,$93.60 ,$33.58 ,$130.00 ,$130.00 , N/A ,$130.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,44000015,92526,HC DYSPHAGIA TREATMENT 30MIN,440,1 ,$280.00 ,$140.00 ,$12.90 ,$280.00 ,$180.88 ,$48.82 ,$263.00 ,$212.00 ,$83.10 ,$168.00 ,$238.00 ,$196.00 ,$48.82 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$83.10 ,$182.00 ,$224.00 ,$204.40 ,$48.82 ,$83.10 ,$107.07 ,$280.00 ,$238.00 ,$186.98 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$83.93 ,$201.60 ,$12.90 ,$236.00 ,$236.00 ,$83.10 ,$236.00 ,$83.10 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44000016,92526,HC DYSPHAGIA TREATMENT 45MIN,440,1 ,$280.00 ,$140.00 ,$12.90 ,$280.00 ,$180.88 ,$48.82 ,$263.00 ,$212.00 ,$83.10 ,$168.00 ,$238.00 ,$196.00 ,$48.82 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$83.10 ,$182.00 ,$224.00 ,$204.40 ,$48.82 ,$83.10 ,$107.07 ,$280.00 ,$238.00 ,$186.98 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$83.93 ,$201.60 ,$12.90 ,$236.00 ,$236.00 ,$83.10 ,$236.00 ,$83.10 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44000017,92526,HC DYSPHAGIA TREATMENT 60MIN,440,1 ,$280.00 ,$140.00 ,$12.90 ,$280.00 ,$180.88 ,$48.82 ,$263.00 ,$212.00 ,$83.10 ,$168.00 ,$238.00 ,$196.00 ,$48.82 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$83.10 ,$182.00 ,$224.00 ,$204.40 ,$48.82 ,$83.10 ,$107.07 ,$280.00 ,$238.00 ,$186.98 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$83.93 ,$201.60 ,$12.90 ,$236.00 ,$236.00 ,$83.10 ,$236.00 ,$83.10 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44400015,92597,HC VOICE PROST EVAL/FITTING,444,1 ,$360.00 ,$180.00 ,$69.79 ,$360.00 ,$232.56 ,$75.94 ,$263.00 ,$212.00 ,$69.79 ,$216.00 ,$306.00 ,$252.00 ,$75.94 ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 ,$69.79 ,$234.00 ,$288.00 ,$262.80 ,$75.94 ,$69.79 ,$107.07 ,$360.00 ,$306.00 ,$157.03 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$70.49 ,$259.20 ,$73.78 ,$236.00 ,$236.00 ,$69.79 ,$236.00 ,$69.79 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,44400016,92610,HC DYSHPAGIA THERAPY,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400017,92610,HC DYSPHAGIA EVALUATION 15MIN,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400018,92610,HC DYSPHAGIA EVALUATION 30MIN,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400019,92610,HC DYSPHAGIA EVALUATION 45MIN,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400020,92610,HC DYSPHAGIA EVALUATION 60MIN,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400021,92610,HC DYSPHAGIA REEVALUATION 15MIN,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400022,92610,HC DYSPHAGIA REEVALUATION 30MIN,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400023,92610,HC DYSPHAGIA REEVALUATION 45MIN,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400024,92610,HC EVAL SWALLOW-ORAL FEED,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400025,92610,HC DYSPHAGIA EVALUATION,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400026,92610,HC DYSPHAGIA EVALUATION PEDS,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400028,92610,HC DYSPHAGIA RE-EVALUATION,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400029,92611,HC DYSPHAGIA EVAL-VIDEO 15MIN,444,1 ,$390.00 ,$195.00 ,$39.92 ,$390.00 ,$251.94 ,$116.92 ,$263.00 ,$212.00 ,$89.10 ,$234.00 ,$331.50 ,$273.00 ,$116.92 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$89.10 ,$253.50 ,$312.00 ,$284.70 ,$116.92 ,$89.10 ,$107.07 ,$390.00 ,$331.50 ,$200.48 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$89.99 ,$280.80 ,$39.92 ,$236.00 ,$236.00 ,$89.10 ,$236.00 ,$89.10 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,44400030,92611,HC DYSPHAGIA EVAL-VIDEO 30MIN,444,1 ,$390.00 ,$195.00 ,$39.92 ,$390.00 ,$251.94 ,$116.92 ,$263.00 ,$212.00 ,$89.10 ,$234.00 ,$331.50 ,$273.00 ,$116.92 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$89.10 ,$253.50 ,$312.00 ,$284.70 ,$116.92 ,$89.10 ,$107.07 ,$390.00 ,$331.50 ,$200.48 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$89.99 ,$280.80 ,$39.92 ,$236.00 ,$236.00 ,$89.10 ,$236.00 ,$89.10 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,44400031,92611,HC DYSPHAGIA EVAL-VIDEO 45MIN,444,1 ,$390.00 ,$195.00 ,$39.92 ,$390.00 ,$251.94 ,$116.92 ,$263.00 ,$212.00 ,$89.10 ,$234.00 ,$331.50 ,$273.00 ,$116.92 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$89.10 ,$253.50 ,$312.00 ,$284.70 ,$116.92 ,$89.10 ,$107.07 ,$390.00 ,$331.50 ,$200.48 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$89.99 ,$280.80 ,$39.92 ,$236.00 ,$236.00 ,$89.10 ,$236.00 ,$89.10 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,44400032,92611,HC DYSPHAGIA EVAL-VIDEO 60MIN,444,1 ,$390.00 ,$195.00 ,$39.92 ,$390.00 ,$251.94 ,$116.92 ,$263.00 ,$212.00 ,$89.10 ,$234.00 ,$331.50 ,$273.00 ,$116.92 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$89.10 ,$253.50 ,$312.00 ,$284.70 ,$116.92 ,$89.10 ,$107.07 ,$390.00 ,$331.50 ,$200.48 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$89.99 ,$280.80 ,$39.92 ,$236.00 ,$236.00 ,$89.10 ,$236.00 ,$89.10 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,44400033,92611,HC DYSPHAGIA EVAL-VIDEO,444,1 ,$390.00 ,$195.00 ,$39.92 ,$390.00 ,$251.94 ,$116.92 ,$263.00 ,$212.00 ,$89.10 ,$234.00 ,$331.50 ,$273.00 ,$116.92 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$89.10 ,$253.50 ,$312.00 ,$284.70 ,$116.92 ,$89.10 ,$107.07 ,$390.00 ,$331.50 ,$200.48 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$89.99 ,$280.80 ,$39.92 ,$236.00 ,$236.00 ,$89.10 ,$236.00 ,$89.10 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,44400034,92611,HC DYSPHAGIA RE-EVAL VIDEO 15MIN,444,1 ,$390.00 ,$195.00 ,$39.92 ,$390.00 ,$251.94 ,$116.92 ,$263.00 ,$212.00 ,$89.10 ,$234.00 ,$331.50 ,$273.00 ,$116.92 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$89.10 ,$253.50 ,$312.00 ,$284.70 ,$116.92 ,$89.10 ,$107.07 ,$390.00 ,$331.50 ,$200.48 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$89.99 ,$280.80 ,$39.92 ,$236.00 ,$236.00 ,$89.10 ,$236.00 ,$89.10 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,44400040,92521,HC EVALUATION OF SPEECH FLUENCY 15 MIN,444,1 ,$280.00 ,$140.00 ,$30.27 ,$295.54 ,$180.88 ,$30.27 ,$263.00 ,$212.00 ,$131.35 ,$168.00 ,$238.00 ,$196.00 ,$30.27 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$131.35 ,$182.00 ,$224.00 ,$204.40 ,$30.27 ,$131.35 ,$107.07 ,$280.00 ,$238.00 ,$295.54 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$132.66 ,$201.60 ,$73.78 ,$236.00 ,$236.00 ,$131.35 ,$236.00 ,$131.35 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,44400041,92522,HC EVALUATE SPEECH PRODUCTION 15MIN,444,1 ,$260.00 ,$130.00 ,$24.58 ,$260.00 ,$167.96 ,$24.58 ,$260.00 ,$212.00 ,$109.44 ,$156.00 ,$221.00 ,$182.00 ,$24.58 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 ,$109.44 ,$169.00 ,$208.00 ,$189.80 ,$24.58 ,$109.44 ,$107.07 ,$260.00 ,$221.00 ,$246.24 ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 ,$110.53 ,$187.20 ,$73.78 ,$236.00 ,$236.00 ,$109.44 ,$236.00 ,$109.44 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,44400042,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 15MIN,444,1 ,$430.00 ,$215.00 ,$48.63 ,$508.34 ,$277.78 ,$48.63 ,$263.00 ,$212.00 ,$225.93 ,$258.00 ,$365.50 ,$301.00 ,$48.63 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$225.93 ,$279.50 ,$344.00 ,$313.90 ,$48.63 ,$225.93 ,$107.07 ,$430.00 ,$365.50 ,$508.34 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$228.19 ,$309.60 ,$73.78 ,$236.00 ,$236.00 ,$225.93 ,$236.00 ,$225.93 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,44400043,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 15MIN,444,1 ,$230.00 ,$115.00 ,$25.62 ,$241.58 ,$148.58 ,$25.62 ,$230.00 ,$212.00 ,$107.37 ,$138.00 ,$195.50 ,$161.00 ,$25.62 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$107.37 ,$149.50 ,$184.00 ,$167.90 ,$25.62 ,$107.37 ,$107.07 ,$230.00 ,$195.50 ,$241.58 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$108.44 ,$165.60 ,$73.78 ,$230.00 ,$230.00 ,$107.37 ,$230.00 ,$107.37 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,44400048,92610,HC DYSPHAGIA REEVALUATION 60MIN,444,1 ,$340.00 ,$170.00 ,$72.23 ,$340.00 ,$219.64 ,$72.23 ,$263.00 ,$212.00 ,$83.02 ,$204.00 ,$289.00 ,$238.00 ,$72.23 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$83.02 ,$221.00 ,$272.00 ,$248.20 ,$72.23 ,$83.02 ,$107.07 ,$340.00 ,$289.00 ,$186.80 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$83.85 ,$244.80 ,$73.78 ,$236.00 ,$236.00 ,$83.02 ,$236.00 ,$83.02 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,44400049,92611,HC DYSPHAGIA RE-EVAL VIDEO 30MIN,444,1 ,$390.00 ,$195.00 ,$39.92 ,$390.00 ,$251.94 ,$116.92 ,$263.00 ,$212.00 ,$89.10 ,$234.00 ,$331.50 ,$273.00 ,$116.92 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$89.10 ,$253.50 ,$312.00 ,$284.70 ,$116.92 ,$89.10 ,$107.07 ,$390.00 ,$331.50 ,$200.48 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$89.99 ,$280.80 ,$39.92 ,$236.00 ,$236.00 ,$89.10 ,$236.00 ,$89.10 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,44400050,92611,HC DYSPHAGIA RE-EVAL VIDEO 45MIN,444,1 ,$390.00 ,$195.00 ,$39.92 ,$390.00 ,$251.94 ,$116.92 ,$263.00 ,$212.00 ,$89.10 ,$234.00 ,$331.50 ,$273.00 ,$116.92 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$89.10 ,$253.50 ,$312.00 ,$284.70 ,$116.92 ,$89.10 ,$107.07 ,$390.00 ,$331.50 ,$200.48 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$89.99 ,$280.80 ,$39.92 ,$236.00 ,$236.00 ,$89.10 ,$236.00 ,$89.10 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,44400051,92611,HC DYSPHAGIA RE-EVAL VIDEO 60MIN,444,1 ,$390.00 ,$195.00 ,$39.92 ,$390.00 ,$251.94 ,$116.92 ,$263.00 ,$212.00 ,$89.10 ,$234.00 ,$331.50 ,$273.00 ,$116.92 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$89.10 ,$253.50 ,$312.00 ,$284.70 ,$116.92 ,$89.10 ,$107.07 ,$390.00 ,$331.50 ,$200.48 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$89.99 ,$280.80 ,$39.92 ,$236.00 ,$236.00 ,$89.10 ,$236.00 ,$89.10 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,44400052,92521,HC EVALUATION OF SPEECH FLUENCY 30MIN,444,1 ,$260.00 ,$130.00 ,$30.27 ,$295.54 ,$167.96 ,$30.27 ,$260.00 ,$212.00 ,$131.35 ,$156.00 ,$221.00 ,$182.00 ,$30.27 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 ,$131.35 ,$169.00 ,$208.00 ,$189.80 ,$30.27 ,$131.35 ,$107.07 ,$260.00 ,$221.00 ,$295.54 ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 ,$132.66 ,$187.20 ,$73.78 ,$236.00 ,$236.00 ,$131.35 ,$236.00 ,$131.35 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,44400053,92521,HC EVALUATION OF SPEECH FLUENCY 45MIN,444,1 ,$260.00 ,$130.00 ,$30.27 ,$295.54 ,$167.96 ,$30.27 ,$260.00 ,$212.00 ,$131.35 ,$156.00 ,$221.00 ,$182.00 ,$30.27 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 ,$131.35 ,$169.00 ,$208.00 ,$189.80 ,$30.27 ,$131.35 ,$107.07 ,$260.00 ,$221.00 ,$295.54 ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 ,$132.66 ,$187.20 ,$73.78 ,$236.00 ,$236.00 ,$131.35 ,$236.00 ,$131.35 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,44400054,92521,HC EVALUATION OF SPEECH FLUENCY 60MIN,444,1 ,$260.00 ,$130.00 ,$30.27 ,$295.54 ,$167.96 ,$30.27 ,$260.00 ,$212.00 ,$131.35 ,$156.00 ,$221.00 ,$182.00 ,$30.27 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 ,$131.35 ,$169.00 ,$208.00 ,$189.80 ,$30.27 ,$131.35 ,$107.07 ,$260.00 ,$221.00 ,$295.54 ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 ,$132.66 ,$187.20 ,$73.78 ,$236.00 ,$236.00 ,$131.35 ,$236.00 ,$131.35 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,44400055,92522,HC EVALUATE SPEECH PRODUCTION 30MIN,444,1 ,$260.00 ,$130.00 ,$24.58 ,$260.00 ,$167.96 ,$24.58 ,$260.00 ,$212.00 ,$109.44 ,$156.00 ,$221.00 ,$182.00 ,$24.58 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 ,$109.44 ,$169.00 ,$208.00 ,$189.80 ,$24.58 ,$109.44 ,$107.07 ,$260.00 ,$221.00 ,$246.24 ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 ,$110.53 ,$187.20 ,$73.78 ,$236.00 ,$236.00 ,$109.44 ,$236.00 ,$109.44 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,44400056,92522,HC EVALUATE SPEECH PRODUCTION 45MIN,444,1 ,$260.00 ,$130.00 ,$24.58 ,$260.00 ,$167.96 ,$24.58 ,$260.00 ,$212.00 ,$109.44 ,$156.00 ,$221.00 ,$182.00 ,$24.58 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 ,$109.44 ,$169.00 ,$208.00 ,$189.80 ,$24.58 ,$109.44 ,$107.07 ,$260.00 ,$221.00 ,$246.24 ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 ,$110.53 ,$187.20 ,$73.78 ,$236.00 ,$236.00 ,$109.44 ,$236.00 ,$109.44 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,44400057,92522,HC EVALUATE SPEECH PRODUCTION 60MIN,444,1 ,$260.00 ,$130.00 ,$24.58 ,$260.00 ,$167.96 ,$24.58 ,$260.00 ,$212.00 ,$109.44 ,$156.00 ,$221.00 ,$182.00 ,$24.58 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 ,$109.44 ,$169.00 ,$208.00 ,$189.80 ,$24.58 ,$109.44 ,$107.07 ,$260.00 ,$221.00 ,$246.24 ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 ,$110.53 ,$187.20 ,$73.78 ,$236.00 ,$236.00 ,$109.44 ,$236.00 ,$109.44 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,44400058,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 30MIN,444,1 ,$430.00 ,$215.00 ,$48.63 ,$508.34 ,$277.78 ,$48.63 ,$263.00 ,$212.00 ,$225.93 ,$258.00 ,$365.50 ,$301.00 ,$48.63 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$225.93 ,$279.50 ,$344.00 ,$313.90 ,$48.63 ,$225.93 ,$107.07 ,$430.00 ,$365.50 ,$508.34 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$228.19 ,$309.60 ,$73.78 ,$236.00 ,$236.00 ,$225.93 ,$236.00 ,$225.93 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,44400059,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 45MIN,444,1 ,$430.00 ,$215.00 ,$48.63 ,$508.34 ,$277.78 ,$48.63 ,$263.00 ,$212.00 ,$225.93 ,$258.00 ,$365.50 ,$301.00 ,$48.63 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$225.93 ,$279.50 ,$344.00 ,$313.90 ,$48.63 ,$225.93 ,$107.07 ,$430.00 ,$365.50 ,$508.34 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$228.19 ,$309.60 ,$73.78 ,$236.00 ,$236.00 ,$225.93 ,$236.00 ,$225.93 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,44400060,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 60MIN,444,1 ,$430.00 ,$215.00 ,$48.63 ,$508.34 ,$277.78 ,$48.63 ,$263.00 ,$212.00 ,$225.93 ,$258.00 ,$365.50 ,$301.00 ,$48.63 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$225.93 ,$279.50 ,$344.00 ,$313.90 ,$48.63 ,$225.93 ,$107.07 ,$430.00 ,$365.50 ,$508.34 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$228.19 ,$309.60 ,$73.78 ,$236.00 ,$236.00 ,$225.93 ,$236.00 ,$225.93 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,44400061,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 30MIN,444,1 ,$230.00 ,$115.00 ,$25.62 ,$241.58 ,$148.58 ,$25.62 ,$230.00 ,$212.00 ,$107.37 ,$138.00 ,$195.50 ,$161.00 ,$25.62 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$107.37 ,$149.50 ,$184.00 ,$167.90 ,$25.62 ,$107.37 ,$107.07 ,$230.00 ,$195.50 ,$241.58 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$108.44 ,$165.60 ,$73.78 ,$230.00 ,$230.00 ,$107.37 ,$230.00 ,$107.37 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,44400062,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 45MIN,444,1 ,$230.00 ,$115.00 ,$25.62 ,$241.58 ,$148.58 ,$25.62 ,$230.00 ,$212.00 ,$107.37 ,$138.00 ,$195.50 ,$161.00 ,$25.62 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$107.37 ,$149.50 ,$184.00 ,$167.90 ,$25.62 ,$107.37 ,$107.07 ,$230.00 ,$195.50 ,$241.58 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$108.44 ,$165.60 ,$73.78 ,$230.00 ,$230.00 ,$107.37 ,$230.00 ,$107.37 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,44400063,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 60MIN,444,1 ,$230.00 ,$115.00 ,$25.62 ,$241.58 ,$148.58 ,$25.62 ,$230.00 ,$212.00 ,$107.37 ,$138.00 ,$195.50 ,$161.00 ,$25.62 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$107.37 ,$149.50 ,$184.00 ,$167.90 ,$25.62 ,$107.37 ,$107.07 ,$230.00 ,$195.50 ,$241.58 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$108.44 ,$165.60 ,$73.78 ,$230.00 ,$230.00 ,$107.37 ,$230.00 ,$107.37 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,45000002,10061,HC I AND D ABSC CMPLX,450,1 ,$780.00 ,$390.00 ,$74.70 ,$780.00 ,$503.88 ,$74.70 ,$504.58 ,$504.58 ,$334.95 ,$468.00 ,$663.00 ,$546.00 ,$74.70 ,$741.00 ,$561.60 ,$569.40 ,$507.00 ,$663.00 ,$334.95 ,$507.00 ,$624.00 ,$569.40 ,$74.70 ,$334.95 ,$557.43 ,$780.00 ,$663.00 ,$753.63 ,$717.60 ,$546.00 ,$390.00 ,$468.00 ,$475.02 ,$390.00 ,$538.98 ,$546.00 ,$338.30 ,$561.60 ,$79.18 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$561.60 ,$483.60 ,$561.60 ,$561.60 ,$468.00 ST VINCENT HOSPITAL - ACUTE,45000003,10080,HC I AND D CYST PILONIDAL SMP,450,1 ,$440.00 ,$220.00 ,$74.70 ,"$1,355.35 ",$284.24 ,$74.70 ,$284.64 ,$284.64 ,$602.38 ,$264.00 ,$374.00 ,$308.00 ,$74.70 ,$418.00 ,$316.80 ,$321.20 ,$286.00 ,$374.00 ,$602.38 ,$286.00 ,$352.00 ,$321.20 ,$74.70 ,$602.38 ,$440.00 ,$440.00 ,$374.00 ,"$1,355.35 ",$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 ,$608.40 ,$316.80 ,$79.18 ,$440.00 ,$440.00 ,$602.38 ,$440.00 ,$602.38 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,45000004,10081,HC I AND D CYST PILONIDAL CPLX,450,1 ,"$2,400.00 ","$1,200.00 ",$325.66 ,"$2,400.00 ","$1,550.40 ",$325.66 ,"$1,552.56 ","$1,552.56 ",$602.38 ,"$1,440.00 ","$2,040.00 ","$1,680.00 ",$325.66 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$1,560.00 ","$2,040.00 ",$602.38 ,"$1,560.00 ","$1,920.00 ","$1,752.00 ",$325.66 ,$602.38 ,$557.43 ,"$2,400.00 ","$2,040.00 ","$1,355.35 ","$2,208.00 ","$1,680.00 ","$1,200.00 ","$1,440.00 ","$1,461.60 ","$1,200.00 ","$1,658.40 ","$1,680.00 ",$608.40 ,"$1,728.00 ",$345.20 ,$669.00 ,$669.00 ,$602.38 ,$669.00 ,$602.38 ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,45000005,10120,HC INCISION/REM FB SUBQ SMP,450,1 ,$360.00 ,$180.00 ,$74.70 ,$753.63 ,$232.56 ,$74.70 ,$232.88 ,$232.88 ,$334.95 ,$216.00 ,$306.00 ,$252.00 ,$74.70 ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 ,$334.95 ,$234.00 ,$288.00 ,$262.80 ,$74.70 ,$334.95 ,$360.00 ,$360.00 ,$306.00 ,$753.63 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$338.30 ,$259.20 ,$79.18 ,$360.00 ,$360.00 ,$334.95 ,$360.00 ,$334.95 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,45000009,11730,HC AVULSION NAIL PLATE SINGLE FAC,450,1 ,$270.00 ,$135.00 ,$31.89 ,$391.26 ,$174.42 ,$31.89 ,$174.66 ,$174.66 ,$173.89 ,$162.00 ,$229.50 ,$189.00 ,$31.89 ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 ,$173.89 ,$175.50 ,$216.00 ,$197.10 ,$31.89 ,$173.89 ,$270.00 ,$270.00 ,$229.50 ,$391.26 ,$248.40 ,$189.00 ,$135.00 ,$162.00 ,$164.43 ,$135.00 ,$186.57 ,$189.00 ,$175.63 ,$194.40 ,$33.80 ,$270.00 ,$270.00 ,$173.89 ,$270.00 ,$173.89 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,45000010,11732,HC AVULSION NAIL PL PT/CO EA ADDL FAC,450,1 ,$215.00 ,$107.50 ,$31.89 ,$215.00 ,$138.89 ,$31.89 ,$139.08 ,$139.08 , N/A ,$129.00 ,$182.75 ,$150.50 ,$31.89 ,$204.25 ,$154.80 ,$156.95 ,$139.75 ,$182.75 , N/A ,$139.75 ,$172.00 ,$156.95 ,$31.89 , N/A ,$215.00 ,$215.00 ,$182.75 , N/A ,$197.80 ,$150.50 ,$107.50 ,$129.00 ,$130.94 ,$107.50 ,$148.57 ,$150.50 , N/A ,$154.80 ,$33.80 ,$215.00 ,$215.00 , N/A ,$215.00 , N/A ,$154.80 ,$133.30 ,$154.80 ,$154.80 ,$129.00 ST VINCENT HOSPITAL - ACUTE,45000011,11740,HC EVAC HEMATOMA SUBUNGAL,450,1 ,$140.00 ,$70.00 ,$31.89 ,$243.95 ,$90.44 ,$31.89 ,$90.57 ,$90.57 ,$108.42 ,$84.00 ,$119.00 ,$98.00 ,$31.89 ,$133.00 ,$100.80 ,$102.20 ,$91.00 ,$119.00 ,$108.42 ,$91.00 ,$112.00 ,$102.20 ,$31.89 ,$108.42 ,$140.00 ,$140.00 ,$119.00 ,$243.95 ,$128.80 ,$98.00 ,$70.00 ,$84.00 ,$85.26 ,$70.00 ,$96.74 ,$98.00 ,$109.50 ,$100.80 ,$33.80 ,$140.00 ,$140.00 ,$108.42 ,$140.00 ,$108.42 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,45000012,11760,HC REPAIR NAIL BED,450,1 ,$430.00 ,$215.00 ,$31.89 ,"$1,142.23 ",$277.78 ,$31.89 ,$278.17 ,$278.17 ,$507.66 ,$258.00 ,$365.50 ,$301.00 ,$31.89 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$507.66 ,$279.50 ,$344.00 ,$313.90 ,$31.89 ,$507.66 ,$430.00 ,$430.00 ,$365.50 ,"$1,142.23 ",$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$512.74 ,$309.60 ,$33.80 ,$430.00 ,$430.00 ,$507.66 ,$430.00 ,$507.66 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,45000013,11765,HC EXC WEDGE SKIN NAIL FOLD,450,1 ,$370.00 ,$185.00 ,$31.89 ,$753.63 ,$239.02 ,$31.89 ,$239.35 ,$239.35 ,$334.95 ,$222.00 ,$314.50 ,$259.00 ,$31.89 ,$351.50 ,$266.40 ,$270.10 ,$240.50 ,$314.50 ,$334.95 ,$240.50 ,$296.00 ,$270.10 ,$31.89 ,$334.95 ,$370.00 ,$370.00 ,$314.50 ,$753.63 ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 ,$338.30 ,$266.40 ,$33.80 ,$370.00 ,$370.00 ,$334.95 ,$370.00 ,$334.95 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,45000014,12001,HC SIMP S/N/AX/GN/TRK/EXT 2.5CM <,450,1 ,$510.00 ,$255.00 ,$84.29 ,$510.00 ,$329.46 ,$84.29 ,$329.92 ,$329.92 ,$173.89 ,$306.00 ,$433.50 ,$357.00 ,$84.29 ,$484.50 ,$367.20 ,$372.30 ,$331.50 ,$433.50 ,$173.89 ,$331.50 ,$408.00 ,$372.30 ,$84.29 ,$173.89 ,$510.00 ,$510.00 ,$433.50 ,$391.26 ,$469.20 ,$357.00 ,$255.00 ,$306.00 ,$310.59 ,$255.00 ,$352.41 ,$357.00 ,$175.63 ,$367.20 ,$89.35 ,$510.00 ,$510.00 ,$173.89 ,$510.00 ,$173.89 ,$367.20 ,$316.20 ,$367.20 ,$367.20 ,$306.00 ST VINCENT HOSPITAL - ACUTE,45000015,12002,HC SIMP S/N/AX/GN/TRK/EXT 2.6-7.5,450,1 ,$560.00 ,$280.00 ,$84.29 ,$560.00 ,$361.76 ,$84.29 ,$362.26 ,$362.26 ,$173.89 ,$336.00 ,$476.00 ,$392.00 ,$84.29 ,$532.00 ,$403.20 ,$408.80 ,$364.00 ,$476.00 ,$173.89 ,$364.00 ,$448.00 ,$408.80 ,$84.29 ,$173.89 ,$557.43 ,$560.00 ,$476.00 ,$391.26 ,$515.20 ,$392.00 ,$280.00 ,$336.00 ,$341.04 ,$280.00 ,$386.96 ,$392.00 ,$175.63 ,$403.20 ,$89.35 ,$560.00 ,$560.00 ,$173.89 ,$560.00 ,$173.89 ,$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,45000016,12004,HC SIMP S/N/AX/GN/TRK/EXT7.6-12.5,450,1 ,$610.00 ,$305.00 ,$84.29 ,$610.00 ,$394.06 ,$84.29 ,$394.61 ,$394.61 ,$173.89 ,$366.00 ,$518.50 ,$427.00 ,$84.29 ,$579.50 ,$439.20 ,$445.30 ,$396.50 ,$518.50 ,$173.89 ,$396.50 ,$488.00 ,$445.30 ,$84.29 ,$173.89 ,$557.43 ,$610.00 ,$518.50 ,$391.26 ,$561.20 ,$427.00 ,$305.00 ,$366.00 ,$371.49 ,$305.00 ,$421.51 ,$427.00 ,$175.63 ,$439.20 ,$89.35 ,$610.00 ,$610.00 ,$173.89 ,$610.00 ,$173.89 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,45000017,12005,HC SIMP S/N/AX/GN/TRK/EXT 12.6-20,450,1 ,$660.00 ,$330.00 ,$84.29 ,$753.63 ,$426.36 ,$84.29 ,$426.95 ,$426.95 ,$334.95 ,$396.00 ,$561.00 ,$462.00 ,$84.29 ,$627.00 ,$475.20 ,$481.80 ,$429.00 ,$561.00 ,$334.95 ,$429.00 ,$528.00 ,$481.80 ,$84.29 ,$334.95 ,$557.43 ,$660.00 ,$561.00 ,$753.63 ,$607.20 ,$462.00 ,$330.00 ,$396.00 ,$401.94 ,$330.00 ,$456.06 ,$462.00 ,$338.30 ,$475.20 ,$89.35 ,$660.00 ,$660.00 ,$334.95 ,$660.00 ,$334.95 ,$475.20 ,$409.20 ,$475.20 ,$475.20 ,$396.00 ST VINCENT HOSPITAL - ACUTE,45000018,12006,HC SIMP S/N/AX/GN/TRK/EXT 20.1-30,450,1 ,$710.00 ,$355.00 ,$84.29 ,$753.63 ,$458.66 ,$84.29 ,$459.30 ,$459.30 ,$334.95 ,$426.00 ,$603.50 ,$497.00 ,$84.29 ,$674.50 ,$511.20 ,$518.30 ,$461.50 ,$603.50 ,$334.95 ,$461.50 ,$568.00 ,$518.30 ,$84.29 ,$334.95 ,$557.43 ,$710.00 ,$603.50 ,$753.63 ,$653.20 ,$497.00 ,$355.00 ,$426.00 ,$432.39 ,$355.00 ,$490.61 ,$497.00 ,$338.30 ,$511.20 ,$89.35 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$511.20 ,$440.20 ,$511.20 ,$511.20 ,$426.00 ST VINCENT HOSPITAL - ACUTE,45000019,12007,HC SIMP S/N/AX/GN/TRK/EXT > 30CM,450,1 ,$730.00 ,$365.00 ,$84.29 ,$730.00 ,$471.58 ,$84.29 ,$472.24 ,$472.24 ,$173.89 ,$438.00 ,$620.50 ,$511.00 ,$84.29 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 ,$173.89 ,$474.50 ,$584.00 ,$532.90 ,$84.29 ,$173.89 ,$557.43 ,$730.00 ,$620.50 ,$391.26 ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 ,$175.63 ,$525.60 ,$89.35 ,$669.00 ,$669.00 ,$173.89 ,$669.00 ,$173.89 ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,45000020,12011,HC SIMP F/E/E/N/L/MM 2.5CM OR <,450,1 ,$630.00 ,$315.00 ,$84.29 ,$630.00 ,$406.98 ,$84.29 ,$407.55 ,$407.55 ,$173.89 ,$378.00 ,$535.50 ,$441.00 ,$84.29 ,$598.50 ,$453.60 ,$459.90 ,$409.50 ,$535.50 ,$173.89 ,$409.50 ,$504.00 ,$459.90 ,$84.29 ,$173.89 ,$557.43 ,$630.00 ,$535.50 ,$391.26 ,$579.60 ,$441.00 ,$315.00 ,$378.00 ,$383.67 ,$315.00 ,$435.33 ,$441.00 ,$175.63 ,$453.60 ,$89.35 ,$630.00 ,$630.00 ,$173.89 ,$630.00 ,$173.89 ,$453.60 ,$390.60 ,$453.60 ,$453.60 ,$378.00 ST VINCENT HOSPITAL - ACUTE,45000021,12013,HC SIMP F/E/E/N/L/MM 2.6CM TO 5CM,450,1 ,$690.00 ,$345.00 ,$84.29 ,$690.00 ,$445.74 ,$84.29 ,$446.36 ,$446.36 ,$173.89 ,$414.00 ,$586.50 ,$483.00 ,$84.29 ,$655.50 ,$496.80 ,$503.70 ,$448.50 ,$586.50 ,$173.89 ,$448.50 ,$552.00 ,$503.70 ,$84.29 ,$173.89 ,$557.43 ,$690.00 ,$586.50 ,$391.26 ,$634.80 ,$483.00 ,$345.00 ,$414.00 ,$420.21 ,$345.00 ,$476.79 ,$483.00 ,$175.63 ,$496.80 ,$89.35 ,$669.00 ,$669.00 ,$173.89 ,$669.00 ,$173.89 ,$496.80 ,$427.80 ,$496.80 ,$496.80 ,$414.00 ST VINCENT HOSPITAL - ACUTE,45000022,12014,HC SIMP F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$710.00 ,$355.00 ,$84.29 ,$710.00 ,$458.66 ,$84.29 ,$459.30 ,$459.30 ,$173.89 ,$426.00 ,$603.50 ,$497.00 ,$84.29 ,$674.50 ,$511.20 ,$518.30 ,$461.50 ,$603.50 ,$173.89 ,$461.50 ,$568.00 ,$518.30 ,$84.29 ,$173.89 ,$557.43 ,$710.00 ,$603.50 ,$391.26 ,$653.20 ,$497.00 ,$355.00 ,$426.00 ,$432.39 ,$355.00 ,$490.61 ,$497.00 ,$175.63 ,$511.20 ,$89.35 ,$669.00 ,$669.00 ,$173.89 ,$669.00 ,$173.89 ,$511.20 ,$440.20 ,$511.20 ,$511.20 ,$426.00 ST VINCENT HOSPITAL - ACUTE,45000023,12015,HC SIMP F/E/E/N/L/MM 7.6 -12.5CM,450,1 ,$730.00 ,$365.00 ,$84.29 ,$730.00 ,$471.58 ,$84.29 ,$472.24 ,$472.24 ,$173.89 ,$438.00 ,$620.50 ,$511.00 ,$84.29 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 ,$173.89 ,$474.50 ,$584.00 ,$532.90 ,$84.29 ,$173.89 ,$557.43 ,$730.00 ,$620.50 ,$391.26 ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 ,$175.63 ,$525.60 ,$89.35 ,$669.00 ,$669.00 ,$173.89 ,$669.00 ,$173.89 ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,45000024,12016,HC SIMP F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$740.00 ,$370.00 ,$84.29 ,$753.63 ,$478.04 ,$84.29 ,$478.71 ,$478.71 ,$334.95 ,$444.00 ,$629.00 ,$518.00 ,$84.29 ,$703.00 ,$532.80 ,$540.20 ,$481.00 ,$629.00 ,$334.95 ,$481.00 ,$592.00 ,$540.20 ,$84.29 ,$334.95 ,$557.43 ,$740.00 ,$629.00 ,$753.63 ,$680.80 ,$518.00 ,$370.00 ,$444.00 ,$450.66 ,$370.00 ,$511.34 ,$518.00 ,$338.30 ,$532.80 ,$89.35 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$532.80 ,$458.80 ,$532.80 ,$532.80 ,$444.00 ST VINCENT HOSPITAL - ACUTE,45000025,12017,HC SIMP F/E/E/N/L/MM 20.1-30.0CM,450,1 ,$760.00 ,$380.00 ,$84.29 ,$760.00 ,$490.96 ,$84.29 ,$491.64 ,$491.64 ,$334.95 ,$456.00 ,$646.00 ,$532.00 ,$84.29 ,$722.00 ,$547.20 ,$554.80 ,$494.00 ,$646.00 ,$334.95 ,$494.00 ,$608.00 ,$554.80 ,$84.29 ,$334.95 ,$557.43 ,$760.00 ,$646.00 ,$753.63 ,$699.20 ,$532.00 ,$380.00 ,$456.00 ,$462.84 ,$380.00 ,$525.16 ,$532.00 ,$338.30 ,$547.20 ,$89.35 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,45000026,12018,HC SIMP F/E/E/N/L/MM OVER 30CM,450,1 ,$780.00 ,$390.00 ,$84.29 ,$780.00 ,$503.88 ,$84.29 ,$504.58 ,$504.58 ,$173.89 ,$468.00 ,$663.00 ,$546.00 ,$84.29 ,$741.00 ,$561.60 ,$569.40 ,$507.00 ,$663.00 ,$173.89 ,$507.00 ,$624.00 ,$569.40 ,$84.29 ,$173.89 ,$557.43 ,$780.00 ,$663.00 ,$391.26 ,$717.60 ,$546.00 ,$390.00 ,$468.00 ,$475.02 ,$390.00 ,$538.98 ,$546.00 ,$175.63 ,$561.60 ,$89.35 ,$669.00 ,$669.00 ,$173.89 ,$669.00 ,$173.89 ,$561.60 ,$483.60 ,$561.60 ,$561.60 ,$468.00 ST VINCENT HOSPITAL - ACUTE,45000027,12020,HC SIMP SUPERFICIAL DEHISCENCE,450,1 ,"$1,200.00 ",$600.00 ,$107.54 ,"$1,200.00 ",$775.20 ,$107.54 ,$776.28 ,$776.28 ,$507.66 ,$720.00 ,"$1,020.00 ",$840.00 ,$107.54 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$507.66 ,$780.00 ,$960.00 ,$876.00 ,$107.54 ,$507.66 ,$557.43 ,"$1,200.00 ","$1,020.00 ","$1,142.23 ","$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$512.74 ,$864.00 ,$113.99 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,45000029,12031,HC INTRM S/A/T/EXT 2.5CM OR <,450,1 ,$650.00 ,$325.00 ,$107.54 ,$753.63 ,$419.90 ,$107.54 ,$420.49 ,$420.49 ,$334.95 ,$390.00 ,$552.50 ,$455.00 ,$107.54 ,$617.50 ,$468.00 ,$474.50 ,$422.50 ,$552.50 ,$334.95 ,$422.50 ,$520.00 ,$474.50 ,$107.54 ,$334.95 ,$557.43 ,$650.00 ,$552.50 ,$753.63 ,$598.00 ,$455.00 ,$325.00 ,$390.00 ,$395.85 ,$325.00 ,$449.15 ,$455.00 ,$338.30 ,$468.00 ,$113.99 ,$650.00 ,$650.00 ,$334.95 ,$650.00 ,$334.95 ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,45000030,12032,HC INTRM S/A/T/EXT 2.6-7.5CM,450,1 ,$720.00 ,$360.00 ,$107.54 ,$753.63 ,$465.12 ,$107.54 ,$465.77 ,$465.77 ,$334.95 ,$432.00 ,$612.00 ,$504.00 ,$107.54 ,$684.00 ,$518.40 ,$525.60 ,$468.00 ,$612.00 ,$334.95 ,$468.00 ,$576.00 ,$525.60 ,$107.54 ,$334.95 ,$557.43 ,$720.00 ,$612.00 ,$753.63 ,$662.40 ,$504.00 ,$360.00 ,$432.00 ,$438.48 ,$360.00 ,$497.52 ,$504.00 ,$338.30 ,$518.40 ,$113.99 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,45000031,12034,HC INTRM S/A/T/EXT 7.6-12.5CM,450,1 ,$780.00 ,$390.00 ,$107.54 ,$780.00 ,$503.88 ,$107.54 ,$504.58 ,$504.58 ,$334.95 ,$468.00 ,$663.00 ,$546.00 ,$107.54 ,$741.00 ,$561.60 ,$569.40 ,$507.00 ,$663.00 ,$334.95 ,$507.00 ,$624.00 ,$569.40 ,$107.54 ,$334.95 ,$557.43 ,$780.00 ,$663.00 ,$753.63 ,$717.60 ,$546.00 ,$390.00 ,$468.00 ,$475.02 ,$390.00 ,$538.98 ,$546.00 ,$338.30 ,$561.60 ,$113.99 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$561.60 ,$483.60 ,$561.60 ,$561.60 ,$468.00 ST VINCENT HOSPITAL - ACUTE,45000032,12035,HC INTRM S/A/T/EXT 12.6-20.0CM,450,1 ,$850.00 ,$425.00 ,$107.54 ,$850.00 ,$549.10 ,$107.54 ,$549.87 ,$549.87 ,$334.95 ,$510.00 ,$722.50 ,$595.00 ,$107.54 ,$807.50 ,$612.00 ,$620.50 ,$552.50 ,$722.50 ,$334.95 ,$552.50 ,$680.00 ,$620.50 ,$107.54 ,$334.95 ,$557.43 ,$850.00 ,$722.50 ,$753.63 ,$782.00 ,$595.00 ,$425.00 ,$510.00 ,$517.65 ,$425.00 ,$587.35 ,$595.00 ,$338.30 ,$612.00 ,$113.99 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,45000033,12036,HC INTRM S/A/T/EXT 20.1-30.0CM,450,1 ,$910.00 ,$455.00 ,$107.54 ,"$1,142.23 ",$587.86 ,$107.54 ,$588.68 ,$588.68 ,$507.66 ,$546.00 ,$773.50 ,$637.00 ,$107.54 ,$864.50 ,$655.20 ,$664.30 ,$591.50 ,$773.50 ,$507.66 ,$591.50 ,$728.00 ,$664.30 ,$107.54 ,$507.66 ,$557.43 ,$910.00 ,$773.50 ,"$1,142.23 ",$837.20 ,$637.00 ,$455.00 ,$546.00 ,$554.19 ,$455.00 ,$628.81 ,$637.00 ,$512.74 ,$655.20 ,$113.99 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$655.20 ,$564.20 ,$655.20 ,$655.20 ,$546.00 ST VINCENT HOSPITAL - ACUTE,45000034,12037,HC INTRM S/A/T/EXT OVER 30CM,450,1 ,"$1,200.00 ",$600.00 ,$107.54 ,"$3,737.98 ",$775.20 ,$107.54 ,$776.28 ,$776.28 ,"$1,661.33 ",$720.00 ,"$1,020.00 ",$840.00 ,$107.54 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ","$1,661.33 ",$780.00 ,$960.00 ,$876.00 ,$107.54 ,"$1,661.33 ",$557.43 ,"$1,200.00 ","$1,020.00 ","$3,737.98 ","$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,"$1,677.94 ",$864.00 ,$113.99 ,$669.00 ,$669.00 ,"$1,661.33 ",$669.00 ,"$1,661.33 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,45000035,12041,HC INTRM N/H/F/GEN 2.5CM OR <,450,1 ,$590.00 ,$295.00 ,$107.54 ,$753.63 ,$381.14 ,$107.54 ,$381.67 ,$381.67 ,$334.95 ,$354.00 ,$501.50 ,$413.00 ,$107.54 ,$560.50 ,$424.80 ,$430.70 ,$383.50 ,$501.50 ,$334.95 ,$383.50 ,$472.00 ,$430.70 ,$107.54 ,$334.95 ,$557.43 ,$590.00 ,$501.50 ,$753.63 ,$542.80 ,$413.00 ,$295.00 ,$354.00 ,$359.31 ,$295.00 ,$407.69 ,$413.00 ,$338.30 ,$424.80 ,$113.99 ,$590.00 ,$590.00 ,$334.95 ,$590.00 ,$334.95 ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,45000036,12042,HC INTRM N/H/F/GEN 2.6-7.5CM,450,1 ,$650.00 ,$325.00 ,$107.54 ,$753.63 ,$419.90 ,$107.54 ,$420.49 ,$420.49 ,$334.95 ,$390.00 ,$552.50 ,$455.00 ,$107.54 ,$617.50 ,$468.00 ,$474.50 ,$422.50 ,$552.50 ,$334.95 ,$422.50 ,$520.00 ,$474.50 ,$107.54 ,$334.95 ,$557.43 ,$650.00 ,$552.50 ,$753.63 ,$598.00 ,$455.00 ,$325.00 ,$390.00 ,$395.85 ,$325.00 ,$449.15 ,$455.00 ,$338.30 ,$468.00 ,$113.99 ,$650.00 ,$650.00 ,$334.95 ,$650.00 ,$334.95 ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,45000037,12044,HC INTRM N/H/F/GEN 7.6-12.5CM,450,1 ,$720.00 ,$360.00 ,$107.54 ,"$1,142.23 ",$465.12 ,$107.54 ,$465.77 ,$465.77 ,$507.66 ,$432.00 ,$612.00 ,$504.00 ,$107.54 ,$684.00 ,$518.40 ,$525.60 ,$468.00 ,$612.00 ,$507.66 ,$468.00 ,$576.00 ,$525.60 ,$107.54 ,$507.66 ,$557.43 ,$720.00 ,$612.00 ,"$1,142.23 ",$662.40 ,$504.00 ,$360.00 ,$432.00 ,$438.48 ,$360.00 ,$497.52 ,$504.00 ,$512.74 ,$518.40 ,$113.99 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,45000038,12045,HC INTRM N/H/F/GEN 12.6-20.0CM,450,1 ,$850.00 ,$425.00 ,$107.54 ,"$1,142.23 ",$549.10 ,$107.54 ,$549.87 ,$549.87 ,$507.66 ,$510.00 ,$722.50 ,$595.00 ,$107.54 ,$807.50 ,$612.00 ,$620.50 ,$552.50 ,$722.50 ,$507.66 ,$552.50 ,$680.00 ,$620.50 ,$107.54 ,$507.66 ,$557.43 ,$850.00 ,$722.50 ,"$1,142.23 ",$782.00 ,$595.00 ,$425.00 ,$510.00 ,$517.65 ,$425.00 ,$587.35 ,$595.00 ,$512.74 ,$612.00 ,$113.99 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,45000039,12046,HC INTRM N/H/F/GEN 20.1-30CM,450,1 ,$910.00 ,$455.00 ,$107.54 ,"$1,142.23 ",$587.86 ,$107.54 ,$588.68 ,$588.68 ,$507.66 ,$546.00 ,$773.50 ,$637.00 ,$107.54 ,$864.50 ,$655.20 ,$664.30 ,$591.50 ,$773.50 ,$507.66 ,$591.50 ,$728.00 ,$664.30 ,$107.54 ,$507.66 ,$557.43 ,$910.00 ,$773.50 ,"$1,142.23 ",$837.20 ,$637.00 ,$455.00 ,$546.00 ,$554.19 ,$455.00 ,$628.81 ,$637.00 ,$512.74 ,$655.20 ,$113.99 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$655.20 ,$564.20 ,$655.20 ,$655.20 ,$546.00 ST VINCENT HOSPITAL - ACUTE,45000040,12047,HC INTRM N/H/F/GEN OVER 30CM,450,1 ,"$1,200.00 ",$600.00 ,$107.54 ,"$3,737.98 ",$775.20 ,$107.54 ,$776.28 ,$776.28 ,"$1,661.33 ",$720.00 ,"$1,020.00 ",$840.00 ,$107.54 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ","$1,661.33 ",$780.00 ,$960.00 ,$876.00 ,$107.54 ,"$1,661.33 ",$557.43 ,"$1,200.00 ","$1,020.00 ","$3,737.98 ","$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,"$1,677.94 ",$864.00 ,$113.99 ,$669.00 ,$669.00 ,"$1,661.33 ",$669.00 ,"$1,661.33 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,45000041,12051,HC INTRM F/E/E/N/L/MM 2.5CM OR <,450,1 ,$630.00 ,$315.00 ,$107.54 ,$753.63 ,$406.98 ,$107.54 ,$407.55 ,$407.55 ,$334.95 ,$378.00 ,$535.50 ,$441.00 ,$107.54 ,$598.50 ,$453.60 ,$459.90 ,$409.50 ,$535.50 ,$334.95 ,$409.50 ,$504.00 ,$459.90 ,$107.54 ,$334.95 ,$557.43 ,$630.00 ,$535.50 ,$753.63 ,$579.60 ,$441.00 ,$315.00 ,$378.00 ,$383.67 ,$315.00 ,$435.33 ,$441.00 ,$338.30 ,$453.60 ,$113.99 ,$630.00 ,$630.00 ,$334.95 ,$630.00 ,$334.95 ,$453.60 ,$390.60 ,$453.60 ,$453.60 ,$378.00 ST VINCENT HOSPITAL - ACUTE,45000042,12052,HC INTRM F/E/E/N/L/MM 2.6-5.0CM,450,1 ,$690.00 ,$345.00 ,$107.54 ,$753.63 ,$445.74 ,$107.54 ,$446.36 ,$446.36 ,$334.95 ,$414.00 ,$586.50 ,$483.00 ,$107.54 ,$655.50 ,$496.80 ,$503.70 ,$448.50 ,$586.50 ,$334.95 ,$448.50 ,$552.00 ,$503.70 ,$107.54 ,$334.95 ,$557.43 ,$690.00 ,$586.50 ,$753.63 ,$634.80 ,$483.00 ,$345.00 ,$414.00 ,$420.21 ,$345.00 ,$476.79 ,$483.00 ,$338.30 ,$496.80 ,$113.99 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$496.80 ,$427.80 ,$496.80 ,$496.80 ,$414.00 ST VINCENT HOSPITAL - ACUTE,45000043,12053,HC INTRM F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$750.00 ,$375.00 ,$107.54 ,$753.63 ,$484.50 ,$107.54 ,$485.18 ,$485.18 ,$334.95 ,$450.00 ,$637.50 ,$525.00 ,$107.54 ,$712.50 ,$540.00 ,$547.50 ,$487.50 ,$637.50 ,$334.95 ,$487.50 ,$600.00 ,$547.50 ,$107.54 ,$334.95 ,$557.43 ,$750.00 ,$637.50 ,$753.63 ,$690.00 ,$525.00 ,$375.00 ,$450.00 ,$456.75 ,$375.00 ,$518.25 ,$525.00 ,$338.30 ,$540.00 ,$113.99 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$540.00 ,$465.00 ,$540.00 ,$540.00 ,$450.00 ST VINCENT HOSPITAL - ACUTE,45000044,12054,HC INTRM F/E/E/N/L/MM 7.6-12.5CM,450,1 ,$820.00 ,$410.00 ,$107.54 ,$820.00 ,$529.72 ,$107.54 ,$530.46 ,$530.46 ,$334.95 ,$492.00 ,$697.00 ,$574.00 ,$107.54 ,$779.00 ,$590.40 ,$598.60 ,$533.00 ,$697.00 ,$334.95 ,$533.00 ,$656.00 ,$598.60 ,$107.54 ,$334.95 ,$557.43 ,$820.00 ,$697.00 ,$753.63 ,$754.40 ,$574.00 ,$410.00 ,$492.00 ,$499.38 ,$410.00 ,$566.62 ,$574.00 ,$338.30 ,$590.40 ,$113.99 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$590.40 ,$508.40 ,$590.40 ,$590.40 ,$492.00 ST VINCENT HOSPITAL - ACUTE,45000045,12055,HC INTRM F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$875.00 ,$437.50 ,$107.54 ,$875.00 ,$565.25 ,$107.54 ,$566.04 ,$566.04 ,$334.95 ,$525.00 ,$743.75 ,$612.50 ,$107.54 ,$831.25 ,$630.00 ,$638.75 ,$568.75 ,$743.75 ,$334.95 ,$568.75 ,$700.00 ,$638.75 ,$107.54 ,$334.95 ,$557.43 ,$875.00 ,$743.75 ,$753.63 ,$805.00 ,$612.50 ,$437.50 ,$525.00 ,$532.88 ,$437.50 ,$604.63 ,$612.50 ,$338.30 ,$630.00 ,$113.99 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$630.00 ,$542.50 ,$630.00 ,$630.00 ,$525.00 ST VINCENT HOSPITAL - ACUTE,45000046,12056,HC INTRM F/E/E/N/L/MM 20.1-30.0CM,450,1 ,$910.00 ,$455.00 ,$107.54 ,$910.00 ,$587.86 ,$107.54 ,$588.68 ,$588.68 ,$334.95 ,$546.00 ,$773.50 ,$637.00 ,$107.54 ,$864.50 ,$655.20 ,$664.30 ,$591.50 ,$773.50 ,$334.95 ,$591.50 ,$728.00 ,$664.30 ,$107.54 ,$334.95 ,$557.43 ,$910.00 ,$773.50 ,$753.63 ,$837.20 ,$637.00 ,$455.00 ,$546.00 ,$554.19 ,$455.00 ,$628.81 ,$637.00 ,$338.30 ,$655.20 ,$113.99 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$655.20 ,$564.20 ,$655.20 ,$655.20 ,$546.00 ST VINCENT HOSPITAL - ACUTE,45000047,12057,HC INTRM F/E/E/N/L/MM OVER 30.0CM,450,1 ,"$1,200.00 ",$600.00 ,$107.54 ,"$1,200.00 ",$775.20 ,$107.54 ,$776.28 ,$776.28 ,$334.95 ,$720.00 ,"$1,020.00 ",$840.00 ,$107.54 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$334.95 ,$780.00 ,$960.00 ,$876.00 ,$107.54 ,$334.95 ,$557.43 ,"$1,200.00 ","$1,020.00 ",$753.63 ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$338.30 ,$864.00 ,$113.99 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,45000048,13100,HC CMPLX TRUNK 1.1-2.5 CM,450,1 ,$910.00 ,$455.00 ,$161.28 ,"$1,142.23 ",$587.86 ,$161.28 ,$588.68 ,$588.68 ,$507.66 ,$546.00 ,$773.50 ,$637.00 ,$161.28 ,$864.50 ,$655.20 ,$664.30 ,$591.50 ,$773.50 ,$507.66 ,$591.50 ,$728.00 ,$664.30 ,$161.28 ,$507.66 ,$557.43 ,$910.00 ,$773.50 ,"$1,142.23 ",$837.20 ,$637.00 ,$455.00 ,$546.00 ,$554.19 ,$455.00 ,$628.81 ,$637.00 ,$512.74 ,$655.20 ,$170.96 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$655.20 ,$564.20 ,$655.20 ,$655.20 ,$546.00 ST VINCENT HOSPITAL - ACUTE,45000049,13101,HC CMPLX TRUNK 2.6-7.5 CM,450,1 ,$910.00 ,$455.00 ,$161.28 ,"$1,142.23 ",$587.86 ,$161.28 ,$588.68 ,$588.68 ,$507.66 ,$546.00 ,$773.50 ,$637.00 ,$161.28 ,$864.50 ,$655.20 ,$664.30 ,$591.50 ,$773.50 ,$507.66 ,$591.50 ,$728.00 ,$664.30 ,$161.28 ,$507.66 ,$557.43 ,$910.00 ,$773.50 ,"$1,142.23 ",$837.20 ,$637.00 ,$455.00 ,$546.00 ,$554.19 ,$455.00 ,$628.81 ,$637.00 ,$512.74 ,$655.20 ,$170.96 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$655.20 ,$564.20 ,$655.20 ,$655.20 ,$546.00 ST VINCENT HOSPITAL - ACUTE,45000050,13102,HC CMPLX TRUNK EA ADDL 5 CM OR LESS,450,1 ,$500.00 ,$250.00 ,$161.28 ,$500.00 ,$323.00 ,$161.28 ,$323.45 ,$323.45 , N/A ,$300.00 ,$425.00 ,$350.00 ,$161.28 ,$475.00 ,$360.00 ,$365.00 ,$325.00 ,$425.00 , N/A ,$325.00 ,$400.00 ,$365.00 ,$161.28 , N/A ,$500.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$170.96 ,$500.00 ,$500.00 , N/A ,$500.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,45000051,13120,HC CMPLX S/A/L 1.1-2.5 CM,450,1 ,$910.00 ,$455.00 ,$161.28 ,"$1,142.23 ",$587.86 ,$161.28 ,$588.68 ,$588.68 ,$507.66 ,$546.00 ,$773.50 ,$637.00 ,$161.28 ,$864.50 ,$655.20 ,$664.30 ,$591.50 ,$773.50 ,$507.66 ,$591.50 ,$728.00 ,$664.30 ,$161.28 ,$507.66 ,$557.43 ,$910.00 ,$773.50 ,"$1,142.23 ",$837.20 ,$637.00 ,$455.00 ,$546.00 ,$554.19 ,$455.00 ,$628.81 ,$637.00 ,$512.74 ,$655.20 ,$170.96 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$655.20 ,$564.20 ,$655.20 ,$655.20 ,$546.00 ST VINCENT HOSPITAL - ACUTE,45000052,13121,HC CMPLX S/A/L 2.6-7.5 CM,450,1 ,"$1,200.00 ",$600.00 ,$161.28 ,"$1,200.00 ",$775.20 ,$161.28 ,$776.28 ,$776.28 ,$507.66 ,$720.00 ,"$1,020.00 ",$840.00 ,$161.28 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$507.66 ,$780.00 ,$960.00 ,$876.00 ,$161.28 ,$507.66 ,$557.43 ,"$1,200.00 ","$1,020.00 ","$1,142.23 ","$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$512.74 ,$864.00 ,$170.96 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,45000053,13122,HC CMPLX S/A/L EA ADDL 5 CM OR LESS,450,1 ,$500.00 ,$250.00 ,$161.28 ,$500.00 ,$323.00 ,$161.28 ,$323.45 ,$323.45 , N/A ,$300.00 ,$425.00 ,$350.00 ,$161.28 ,$475.00 ,$360.00 ,$365.00 ,$325.00 ,$425.00 , N/A ,$325.00 ,$400.00 ,$365.00 ,$161.28 , N/A ,$500.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$170.96 ,$500.00 ,$500.00 , N/A ,$500.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,45000054,13131,HC CMPLX F/C/C/M/N/A/G/H/F 1.1-2.5 CM,450,1 ,"$1,200.00 ",$600.00 ,$161.28 ,"$1,200.00 ",$775.20 ,$161.28 ,$776.28 ,$776.28 ,$334.95 ,$720.00 ,"$1,020.00 ",$840.00 ,$161.28 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$334.95 ,$780.00 ,$960.00 ,$876.00 ,$161.28 ,$334.95 ,$557.43 ,"$1,200.00 ","$1,020.00 ",$753.63 ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$338.30 ,$864.00 ,$170.96 ,$669.00 ,$669.00 ,$334.95 ,$669.00 ,$334.95 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,45000055,13132,HC CMPLX F/C/C/M/N/A/G/H/F 2.6-7.5 CM,450,1 ,"$1,300.00 ",$650.00 ,$161.28 ,"$1,300.00 ",$839.80 ,$161.28 ,$840.97 ,$840.97 ,$507.66 ,$780.00 ,"$1,105.00 ",$910.00 ,$161.28 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$507.66 ,$845.00 ,"$1,040.00 ",$949.00 ,$161.28 ,$507.66 ,$557.43 ,"$1,300.00 ","$1,105.00 ","$1,142.23 ","$1,196.00 ",$910.00 ,$650.00 ,$780.00 ,$791.70 ,$650.00 ,$898.30 ,$910.00 ,$512.74 ,$936.00 ,$170.96 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,45000056,13133,HC CMPLX F/C/C/M/N/A/G/H/F EA ADDL 5 CM OR LESS,450,1 ,$500.00 ,$250.00 ,$161.28 ,$500.00 ,$323.00 ,$161.28 ,$323.45 ,$323.45 , N/A ,$300.00 ,$425.00 ,$350.00 ,$161.28 ,$475.00 ,$360.00 ,$365.00 ,$325.00 ,$425.00 , N/A ,$325.00 ,$400.00 ,$365.00 ,$161.28 , N/A ,$500.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$170.96 ,$500.00 ,$500.00 , N/A ,$500.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,45000058,13151,HC CMPLX E/N/E/L 1.1-2.5 CM,450,1 ,"$1,200.00 ",$600.00 ,$161.28 ,"$1,200.00 ",$775.20 ,$161.28 ,$776.28 ,$776.28 ,$507.66 ,$720.00 ,"$1,020.00 ",$840.00 ,$161.28 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$507.66 ,$780.00 ,$960.00 ,$876.00 ,$161.28 ,$507.66 ,$557.43 ,"$1,200.00 ","$1,020.00 ","$1,142.23 ","$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$512.74 ,$864.00 ,$170.96 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,45000059,13152,HC CMPLX E/N/E/L 2.6-7.5 CM,450,1 ,"$1,300.00 ",$650.00 ,$161.28 ,"$1,300.00 ",$839.80 ,$161.28 ,$840.97 ,$840.97 ,$507.66 ,$780.00 ,"$1,105.00 ",$910.00 ,$161.28 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$507.66 ,$845.00 ,"$1,040.00 ",$949.00 ,$161.28 ,$507.66 ,$557.43 ,"$1,300.00 ","$1,105.00 ","$1,142.23 ","$1,196.00 ",$910.00 ,$650.00 ,$780.00 ,$791.70 ,$650.00 ,$898.30 ,$910.00 ,$512.74 ,$936.00 ,$170.96 ,$669.00 ,$669.00 ,$507.66 ,$669.00 ,$507.66 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,45000060,13153,HC CMPLX E/N/E/L EA ADDL 5 CM OR LESS,450,1 ,$690.00 ,$345.00 ,$338.77 ,$690.00 ,$445.74 ,$338.77 ,$446.36 ,$446.36 , N/A ,$414.00 ,$586.50 ,$483.00 ,$338.77 ,$655.50 ,$496.80 ,$503.70 ,$448.50 ,$586.50 , N/A ,$448.50 ,$552.00 ,$503.70 ,$338.77 , N/A ,$557.43 ,$690.00 ,$586.50 , N/A ,$634.80 ,$483.00 ,$345.00 ,$414.00 ,$420.21 ,$345.00 ,$476.79 ,$483.00 , N/A ,$496.80 ,$359.10 ,$669.00 ,$669.00 , N/A ,$669.00 , N/A ,$496.80 ,$427.80 ,$496.80 ,$496.80 ,$414.00 ST VINCENT HOSPITAL - ACUTE,45000061,16000,HC TX BURN 1ST DEGREE INIT,450,1 ,$170.00 ,$85.00 ,$84.29 ,$391.26 ,$109.82 ,$84.29 ,$109.97 ,$109.97 ,$173.89 ,$102.00 ,$144.50 ,$119.00 ,$84.29 ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 ,$173.89 ,$110.50 ,$136.00 ,$124.10 ,$84.29 ,$173.89 ,$170.00 ,$170.00 ,$144.50 ,$391.26 ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 ,$175.63 ,$122.40 ,$89.35 ,$170.00 ,$170.00 ,$173.89 ,$170.00 ,$173.89 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,45000062,16020,HC DRESS/DEB BURN <5% TOTAL SM,450,1 ,$410.00 ,$205.00 ,$84.29 ,$410.00 ,$264.86 ,$84.29 ,$265.23 ,$265.23 ,$173.89 ,$246.00 ,$348.50 ,$287.00 ,$84.29 ,$389.50 ,$295.20 ,$299.30 ,$266.50 ,$348.50 ,$173.89 ,$266.50 ,$328.00 ,$299.30 ,$84.29 ,$173.89 ,$410.00 ,$410.00 ,$348.50 ,$391.26 ,$377.20 ,$287.00 ,$205.00 ,$246.00 ,$249.69 ,$205.00 ,$283.31 ,$287.00 ,$175.63 ,$295.20 ,$89.35 ,$410.00 ,$410.00 ,$173.89 ,$410.00 ,$173.89 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,45000063,16025,HC DRESS/DEB BURN 5-10% TOTAL MED,450,1 ,$440.00 ,$220.00 ,$84.29 ,$440.00 ,$284.24 ,$84.29 ,$284.64 ,$284.64 ,$173.89 ,$264.00 ,$374.00 ,$308.00 ,$84.29 ,$418.00 ,$316.80 ,$321.20 ,$286.00 ,$374.00 ,$173.89 ,$286.00 ,$352.00 ,$321.20 ,$84.29 ,$173.89 ,$440.00 ,$440.00 ,$374.00 ,$391.26 ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 ,$175.63 ,$316.80 ,$89.35 ,$440.00 ,$440.00 ,$173.89 ,$440.00 ,$173.89 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,45000064,16030,HC DRESS/DEBR BURN >10% TOTAL LRG,450,1 ,$530.00 ,$265.00 ,$107.54 ,$753.63 ,$342.38 ,$107.54 ,$342.86 ,$342.86 ,$334.95 ,$318.00 ,$450.50 ,$371.00 ,$107.54 ,$503.50 ,$381.60 ,$386.90 ,$344.50 ,$450.50 ,$334.95 ,$344.50 ,$424.00 ,$386.90 ,$107.54 ,$334.95 ,$530.00 ,$530.00 ,$450.50 ,$753.63 ,$487.60 ,$371.00 ,$265.00 ,$318.00 ,$322.77 ,$265.00 ,$366.23 ,$371.00 ,$338.30 ,$381.60 ,$113.99 ,$530.00 ,$530.00 ,$334.95 ,$530.00 ,$334.95 ,$381.60 ,$328.60 ,$381.60 ,$381.60 ,$318.00 ST VINCENT HOSPITAL - ACUTE,45000065,16035,HC ESCHARATOMY; INITIAL,450,1 ,$440.00 ,$220.00 ,$107.54 ,$753.63 ,$284.24 ,$107.54 ,$284.64 ,$284.64 ,$334.95 ,$264.00 ,$374.00 ,$308.00 ,$107.54 ,$418.00 ,$316.80 ,$321.20 ,$286.00 ,$374.00 ,$334.95 ,$286.00 ,$352.00 ,$321.20 ,$107.54 ,$334.95 ,$440.00 ,$440.00 ,$374.00 ,$753.63 ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 ,$338.30 ,$316.80 ,$113.99 ,$440.00 ,$440.00 ,$334.95 ,$440.00 ,$334.95 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,45000066,16036,HC ESCHARATOMY; EACH ADDL,450,1 ,$210.00 ,$105.00 ,$105.00 ,$210.00 ,$135.66 ,$107.54 ,$135.85 ,$135.85 , N/A ,$126.00 ,$178.50 ,$147.00 ,$107.54 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 , N/A ,$136.50 ,$168.00 ,$153.30 ,$107.54 , N/A ,$210.00 ,$210.00 ,$178.50 , N/A ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 , N/A ,$151.20 ,$113.99 ,$210.00 ,$210.00 , N/A ,$210.00 , N/A ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,45000067,17250,HC CAUT CHEM TISSUE GRANULATION,450,1 ,$340.00 ,$170.00 ,$74.70 ,$391.26 ,$219.64 ,$74.70 ,$219.95 ,$219.95 ,$173.89 ,$204.00 ,$289.00 ,$238.00 ,$74.70 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$173.89 ,$221.00 ,$272.00 ,$248.20 ,$74.70 ,$173.89 ,$340.00 ,$340.00 ,$289.00 ,$391.26 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$175.63 ,$244.80 ,$79.18 ,$340.00 ,$340.00 ,$173.89 ,$340.00 ,$173.89 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,45000068,20103,HC EXPL PENTR WOUND EXTREMITY,450,1 ,"$1,100.00 ",$550.00 ,$107.54 ,"$1,355.35 ",$710.60 ,$107.54 ,$711.59 ,$711.59 ,$602.38 ,$660.00 ,$935.00 ,$770.00 ,$107.54 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$602.38 ,$715.00 ,$880.00 ,$803.00 ,$107.54 ,$602.38 ,$557.43 ,"$1,100.00 ",$935.00 ,"$1,355.35 ","$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$608.40 ,$792.00 ,$113.99 ,$669.00 ,$669.00 ,$602.38 ,$669.00 ,$602.38 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,45000069,20600,HC ARTHROCENT ASP/INJ JT SMALL,450,1 ,$440.00 ,$220.00 ,$101.56 ,$569.12 ,$284.24 ,$101.56 ,$284.64 ,$284.64 ,$252.94 ,$264.00 ,$374.00 ,$308.00 ,$101.56 ,$418.00 ,$316.80 ,$321.20 ,$286.00 ,$374.00 ,$252.94 ,$286.00 ,$352.00 ,$321.20 ,$101.56 ,$252.94 ,$440.00 ,$440.00 ,$374.00 ,$569.12 ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 ,$255.47 ,$316.80 ,$107.65 ,$440.00 ,$440.00 ,$252.94 ,$440.00 ,$252.94 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,$650.00 ,$325.00 ,$101.56 ,$650.00 ,$419.90 ,$101.56 ,$420.49 ,$420.49 ,$252.94 ,$390.00 ,$552.50 ,$455.00 ,$101.56 ,$617.50 ,$468.00 ,$474.50 ,$422.50 ,$552.50 ,$252.94 ,$422.50 ,$520.00 ,$474.50 ,$101.56 ,$252.94 ,$557.43 ,$650.00 ,$552.50 ,$569.12 ,$598.00 ,$455.00 ,$325.00 ,$390.00 ,$395.85 ,$325.00 ,$449.15 ,$455.00 ,$255.47 ,$468.00 ,$107.65 ,$650.00 ,$650.00 ,$252.94 ,$650.00 ,$252.94 ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,$650.00 ,$325.00 ,$101.56 ,$650.00 ,$419.90 ,$101.56 ,$420.49 ,$420.49 ,$252.94 ,$390.00 ,$552.50 ,$455.00 ,$101.56 ,$617.50 ,$468.00 ,$474.50 ,$422.50 ,$552.50 ,$252.94 ,$422.50 ,$520.00 ,$474.50 ,$101.56 ,$252.94 ,$557.43 ,$650.00 ,$552.50 ,$569.12 ,$598.00 ,$455.00 ,$325.00 ,$390.00 ,$395.85 ,$325.00 ,$449.15 ,$455.00 ,$255.47 ,$468.00 ,$107.65 ,$650.00 ,$650.00 ,$252.94 ,$650.00 ,$252.94 ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,$975.00 ,$487.50 ,$101.56 ,$975.00 ,$629.85 ,$101.56 ,$630.73 ,$630.73 ,$252.94 ,$585.00 ,$828.75 ,$682.50 ,$101.56 ,$926.25 ,$702.00 ,$711.75 ,$633.75 ,$828.75 ,$252.94 ,$633.75 ,$780.00 ,$711.75 ,$101.56 ,$252.94 ,$557.43 ,$975.00 ,$828.75 ,$569.12 ,$897.00 ,$682.50 ,$487.50 ,$585.00 ,$593.78 ,$487.50 ,$673.73 ,$682.50 ,$255.47 ,$702.00 ,$107.65 ,$669.00 ,$669.00 ,$252.94 ,$669.00 ,$252.94 ,$702.00 ,$604.50 ,$702.00 ,$702.00 ,$585.00 ST VINCENT HOSPITAL - ACUTE,45000072,20612,HC INJ GANGLION CYST,450,1 ,$490.00 ,$245.00 ,$101.56 ,$569.12 ,$316.54 ,$101.56 ,$316.98 ,$316.98 ,$252.94 ,$294.00 ,$416.50 ,$343.00 ,$101.56 ,$465.50 ,$352.80 ,$357.70 ,$318.50 ,$416.50 ,$252.94 ,$318.50 ,$392.00 ,$357.70 ,$101.56 ,$252.94 ,$490.00 ,$490.00 ,$416.50 ,$569.12 ,$450.80 ,$343.00 ,$245.00 ,$294.00 ,$298.41 ,$245.00 ,$338.59 ,$343.00 ,$255.47 ,$352.80 ,$107.65 ,$490.00 ,$490.00 ,$252.94 ,$490.00 ,$252.94 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,45000074,23650,HC TX DISL SHLDR W/MAN CLS,450,1 ,$830.00 ,$415.00 ,$193.84 ,$830.00 ,$536.18 ,$193.84 ,$536.93 ,$536.93 ,$199.70 ,$498.00 ,$705.50 ,$581.00 ,$193.84 ,$788.50 ,$597.60 ,$605.90 ,$539.50 ,$705.50 ,$199.70 ,$539.50 ,$664.00 ,$605.90 ,$193.84 ,$199.70 ,$557.43 ,$830.00 ,$705.50 ,$449.31 ,$763.60 ,$581.00 ,$415.00 ,$498.00 ,$505.47 ,$415.00 ,$573.53 ,$581.00 ,$201.70 ,$597.60 ,$205.47 ,$669.00 ,$669.00 ,$199.70 ,$669.00 ,$199.70 ,$597.60 ,$514.60 ,$597.60 ,$597.60 ,$498.00 ST VINCENT HOSPITAL - ACUTE,45000075,23655,HC TX DISL SHLDR W/MAN/ANES CLS,450,1 ,"$1,400.00 ",$700.00 ,$330.53 ,"$3,034.10 ",$904.40 ,$330.53 ,$905.66 ,$905.66 ,"$1,348.49 ",$840.00 ,"$1,190.00 ",$980.00 ,$330.53 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ","$1,348.49 ",$910.00 ,"$1,120.00 ","$1,022.00 ",$330.53 ,"$1,348.49 ",$557.43 ,"$1,400.00 ","$1,190.00 ","$3,034.10 ","$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 ,"$1,361.97 ","$1,008.00 ",$350.36 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ","$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,45000076,24600,HC TX DISL ELBOW W/O ANES CLS,450,1 ,$530.00 ,$265.00 ,$193.84 ,$530.00 ,$342.38 ,$193.84 ,$342.86 ,$342.86 ,$199.70 ,$318.00 ,$450.50 ,$371.00 ,$193.84 ,$503.50 ,$381.60 ,$386.90 ,$344.50 ,$450.50 ,$199.70 ,$344.50 ,$424.00 ,$386.90 ,$193.84 ,$199.70 ,$530.00 ,$530.00 ,$450.50 ,$449.31 ,$487.60 ,$371.00 ,$265.00 ,$318.00 ,$322.77 ,$265.00 ,$366.23 ,$371.00 ,$201.70 ,$381.60 ,$205.47 ,$530.00 ,$530.00 ,$199.70 ,$530.00 ,$199.70 ,$381.60 ,$328.60 ,$381.60 ,$381.60 ,$318.00 ST VINCENT HOSPITAL - ACUTE,45000077,24605,HC CL TX ELBOW DISLOCATION W ANESTH,450,1 ,"$1,325.00 ",$662.50 ,$330.53 ,"$3,034.10 ",$855.95 ,$330.53 ,$857.14 ,$857.14 ,"$1,348.49 ",$795.00 ,"$1,126.25 ",$927.50 ,$330.53 ,"$1,258.75 ",$954.00 ,$967.25 ,$861.25 ,"$1,126.25 ","$1,348.49 ",$861.25 ,"$1,060.00 ",$967.25 ,$330.53 ,"$1,348.49 ",$557.43 ,"$1,325.00 ","$1,126.25 ","$3,034.10 ","$1,219.00 ",$927.50 ,$662.50 ,$795.00 ,$806.93 ,$662.50 ,$915.58 ,$927.50 ,"$1,361.97 ",$954.00 ,$350.36 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ",$954.00 ,$821.50 ,$954.00 ,$954.00 ,$795.00 ST VINCENT HOSPITAL - ACUTE,45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,$490.00 ,$245.00 ,$193.84 ,$490.00 ,$316.54 ,$193.84 ,$316.98 ,$316.98 ,$199.70 ,$294.00 ,$416.50 ,$343.00 ,$193.84 ,$465.50 ,$352.80 ,$357.70 ,$318.50 ,$416.50 ,$199.70 ,$318.50 ,$392.00 ,$357.70 ,$193.84 ,$199.70 ,$490.00 ,$490.00 ,$416.50 ,$449.31 ,$450.80 ,$343.00 ,$245.00 ,$294.00 ,$298.41 ,$245.00 ,$338.59 ,$343.00 ,$201.70 ,$352.80 ,$205.47 ,$490.00 ,$490.00 ,$199.70 ,$490.00 ,$199.70 ,$352.80 ,$303.80 ,$352.80 ,$352.80 ,$294.00 ST VINCENT HOSPITAL - ACUTE,45000081,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP,450,1 ,$770.00 ,$385.00 ,$193.84 ,"$3,034.10 ",$497.42 ,$193.84 ,$498.11 ,$498.11 ,"$1,348.49 ",$462.00 ,$654.50 ,$539.00 ,$193.84 ,$731.50 ,$554.40 ,$562.10 ,$500.50 ,$654.50 ,"$1,348.49 ",$500.50 ,$616.00 ,$562.10 ,$193.84 ,"$1,348.49 ",$557.43 ,$770.00 ,$654.50 ,"$3,034.10 ",$708.40 ,$539.00 ,$385.00 ,$462.00 ,$468.93 ,$385.00 ,$532.07 ,$539.00 ,"$1,361.97 ",$554.40 ,$205.47 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ",$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,45000082,25605,HC CL TX DIS RADIAL FX/EPIP SEP,450,1 ,$770.00 ,$385.00 ,$193.84 ,"$3,034.10 ",$497.42 ,$193.84 ,$498.11 ,$498.11 ,"$1,348.49 ",$462.00 ,$654.50 ,$539.00 ,$193.84 ,$731.50 ,$554.40 ,$562.10 ,$500.50 ,$654.50 ,"$1,348.49 ",$500.50 ,$616.00 ,$562.10 ,$193.84 ,"$1,348.49 ",$557.43 ,$770.00 ,$654.50 ,"$3,034.10 ",$708.40 ,$539.00 ,$385.00 ,$462.00 ,$468.93 ,$385.00 ,$532.07 ,$539.00 ,"$1,361.97 ",$554.40 ,$205.47 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ",$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,45000083,26010,HC DRAIN ABSC FINGER SIMPLE,450,1 ,$400.00 ,$200.00 ,$74.70 ,$400.00 ,$258.40 ,$74.70 ,$258.76 ,$258.76 ,$173.89 ,$240.00 ,$340.00 ,$280.00 ,$74.70 ,$380.00 ,$288.00 ,$292.00 ,$260.00 ,$340.00 ,$173.89 ,$260.00 ,$320.00 ,$292.00 ,$74.70 ,$173.89 ,$400.00 ,$400.00 ,$340.00 ,$391.26 ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 ,$175.63 ,$288.00 ,$79.18 ,$400.00 ,$400.00 ,$173.89 ,$400.00 ,$173.89 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,45000084,26011,HC DRAIN ABSC FINGER COMPLCD,450,1 ,"$1,300.00 ",$650.00 ,$325.66 ,"$3,066.03 ",$839.80 ,$325.66 ,$840.97 ,$840.97 ,"$1,362.68 ",$780.00 ,"$1,105.00 ",$910.00 ,$325.66 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ","$1,362.68 ",$845.00 ,"$1,040.00 ",$949.00 ,$325.66 ,"$1,362.68 ",$557.43 ,"$1,300.00 ","$1,105.00 ","$3,066.03 ","$1,196.00 ",$910.00 ,$650.00 ,$780.00 ,$791.70 ,$650.00 ,$898.30 ,$910.00 ,"$1,376.31 ",$936.00 ,$345.20 ,$669.00 ,$669.00 ,"$1,362.68 ",$669.00 ,"$1,362.68 ",$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,45000085,26410,HC RPR TENDON HAND EXTEN W/O,450,1 ,"$1,900.00 ",$950.00 ,$392.13 ,"$3,034.10 ","$1,227.40 ",$392.13 ,"$1,229.11 ","$1,229.11 ","$1,348.49 ","$1,140.00 ","$1,615.00 ","$1,330.00 ",$392.13 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,235.00 ","$1,615.00 ","$1,348.49 ","$1,235.00 ","$1,520.00 ","$1,387.00 ",$392.13 ,"$1,348.49 ",$557.43 ,"$1,900.00 ","$1,615.00 ","$3,034.10 ","$1,748.00 ","$1,330.00 ",$950.00 ,"$1,140.00 ","$1,157.10 ",$950.00 ,"$1,312.90 ","$1,330.00 ","$1,361.97 ","$1,368.00 ",$415.66 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ","$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,45000086,26418,HC RPR EXTEN TENDON FNGR W/O FREE,450,1 ,"$1,900.00 ",$950.00 ,$392.13 ,"$3,034.10 ","$1,227.40 ",$392.13 ,"$1,229.11 ","$1,229.11 ","$1,348.49 ","$1,140.00 ","$1,615.00 ","$1,330.00 ",$392.13 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,235.00 ","$1,615.00 ","$1,348.49 ","$1,235.00 ","$1,520.00 ","$1,387.00 ",$392.13 ,"$1,348.49 ",$557.43 ,"$1,900.00 ","$1,615.00 ","$3,034.10 ","$1,748.00 ","$1,330.00 ",$950.00 ,"$1,140.00 ","$1,157.10 ",$950.00 ,"$1,312.90 ","$1,330.00 ","$1,361.97 ","$1,368.00 ",$415.66 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ","$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,45000087,26725,HC TX FX PHALANX PROX W/MAN CLS,450,1 ,$710.00 ,$355.00 ,$193.84 ,$710.00 ,$458.66 ,$193.84 ,$459.30 ,$459.30 ,$199.70 ,$426.00 ,$603.50 ,$497.00 ,$193.84 ,$674.50 ,$511.20 ,$518.30 ,$461.50 ,$603.50 ,$199.70 ,$461.50 ,$568.00 ,$518.30 ,$193.84 ,$199.70 ,$557.43 ,$710.00 ,$603.50 ,$449.31 ,$653.20 ,$497.00 ,$355.00 ,$426.00 ,$432.39 ,$355.00 ,$490.61 ,$497.00 ,$201.70 ,$511.20 ,$205.47 ,$669.00 ,$669.00 ,$199.70 ,$669.00 ,$199.70 ,$511.20 ,$440.20 ,$511.20 ,$511.20 ,$426.00 ST VINCENT HOSPITAL - ACUTE,45000088,26742,HC TX FX (M-P)(I-P) JT W/MAN,450,1 ,$750.00 ,$375.00 ,$193.84 ,"$3,034.10 ",$484.50 ,$193.84 ,$485.18 ,$485.18 ,"$1,348.49 ",$450.00 ,$637.50 ,$525.00 ,$193.84 ,$712.50 ,$540.00 ,$547.50 ,$487.50 ,$637.50 ,"$1,348.49 ",$487.50 ,$600.00 ,$547.50 ,$193.84 ,"$1,348.49 ",$557.43 ,$750.00 ,$637.50 ,"$3,034.10 ",$690.00 ,$525.00 ,$375.00 ,$450.00 ,$456.75 ,$375.00 ,$518.25 ,$525.00 ,"$1,361.97 ",$540.00 ,$205.47 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ",$540.00 ,$465.00 ,$540.00 ,$540.00 ,$450.00 ST VINCENT HOSPITAL - ACUTE,45000089,26755,HC TX FX PHALANX DIST W/MAN CLS,450,1 ,$710.00 ,$355.00 ,$193.84 ,$710.00 ,$458.66 ,$193.84 ,$459.30 ,$459.30 ,$199.70 ,$426.00 ,$603.50 ,$497.00 ,$193.84 ,$674.50 ,$511.20 ,$518.30 ,$461.50 ,$603.50 ,$199.70 ,$461.50 ,$568.00 ,$518.30 ,$193.84 ,$199.70 ,$557.43 ,$710.00 ,$603.50 ,$449.31 ,$653.20 ,$497.00 ,$355.00 ,$426.00 ,$432.39 ,$355.00 ,$490.61 ,$497.00 ,$201.70 ,$511.20 ,$205.47 ,$669.00 ,$669.00 ,$199.70 ,$669.00 ,$199.70 ,$511.20 ,$440.20 ,$511.20 ,$511.20 ,$426.00 ST VINCENT HOSPITAL - ACUTE,45000090,26770,HC TX DISL (I-P) HAND W/O ANES,450,1 ,$790.00 ,$395.00 ,$193.84 ,$790.00 ,$510.34 ,$193.84 ,$511.05 ,$511.05 ,$199.70 ,$474.00 ,$671.50 ,$553.00 ,$193.84 ,$750.50 ,$568.80 ,$576.70 ,$513.50 ,$671.50 ,$199.70 ,$513.50 ,$632.00 ,$576.70 ,$193.84 ,$199.70 ,$557.43 ,$790.00 ,$671.50 ,$449.31 ,$726.80 ,$553.00 ,$395.00 ,$474.00 ,$481.11 ,$395.00 ,$545.89 ,$553.00 ,$201.70 ,$568.80 ,$205.47 ,$669.00 ,$669.00 ,$199.70 ,$669.00 ,$199.70 ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,45000091,26951,HC AMPUT FINGER/THUMB SGL CLSR,450,1 ,"$2,600.00 ","$1,300.00 ",$392.13 ,"$6,167.80 ","$1,679.60 ",$392.13 ,"$1,681.94 ","$1,681.94 ","$2,741.24 ","$1,560.00 ","$2,210.00 ","$1,820.00 ",$392.13 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$1,690.00 ","$2,210.00 ","$2,741.24 ","$1,690.00 ","$2,080.00 ","$1,898.00 ",$392.13 ,"$2,741.24 ",$557.43 ,"$2,600.00 ","$2,210.00 ","$6,167.80 ","$2,392.00 ","$1,820.00 ","$1,300.00 ","$1,560.00 ","$1,583.40 ","$1,300.00 ","$1,796.60 ","$1,820.00 ","$2,768.65 ","$1,872.00 ",$415.66 ,$669.00 ,$669.00 ,"$2,741.24 ",$669.00 ,"$2,741.24 ","$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,45000092,27250,HC TX DISCL HIP CLOSED W/O ANES,450,1 ,$670.00 ,$335.00 ,$193.84 ,$670.00 ,$432.82 ,$193.84 ,$433.42 ,$433.42 ,$199.70 ,$402.00 ,$569.50 ,$469.00 ,$193.84 ,$636.50 ,$482.40 ,$489.10 ,$435.50 ,$569.50 ,$199.70 ,$435.50 ,$536.00 ,$489.10 ,$193.84 ,$199.70 ,$557.43 ,$670.00 ,$569.50 ,$449.31 ,$616.40 ,$469.00 ,$335.00 ,$402.00 ,$408.03 ,$335.00 ,$462.97 ,$469.00 ,$201.70 ,$482.40 ,$205.47 ,$669.00 ,$669.00 ,$199.70 ,$669.00 ,$199.70 ,$482.40 ,$415.40 ,$482.40 ,$482.40 ,$402.00 ST VINCENT HOSPITAL - ACUTE,45000093,27252,HC CL TX HIP DISLOCATION; TRAUMATIC W ANESTH,450,1 ,"$1,160.00 ",$580.00 ,$330.53 ,"$3,034.10 ",$749.36 ,$330.53 ,$750.40 ,$750.40 ,"$1,348.49 ",$696.00 ,$986.00 ,$812.00 ,$330.53 ,"$1,102.00 ",$835.20 ,$846.80 ,$754.00 ,$986.00 ,"$1,348.49 ",$754.00 ,$928.00 ,$846.80 ,$330.53 ,"$1,348.49 ",$557.43 ,"$1,160.00 ",$986.00 ,"$3,034.10 ","$1,067.20 ",$812.00 ,$580.00 ,$696.00 ,$706.44 ,$580.00 ,$801.56 ,$812.00 ,"$1,361.97 ",$835.20 ,$350.36 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ",$835.20 ,$719.20 ,$835.20 ,$835.20 ,$696.00 ST VINCENT HOSPITAL - ACUTE,45000094,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT,450,1 ,$790.00 ,$395.00 ,$193.84 ,$790.00 ,$510.34 ,$193.84 ,$511.05 ,$511.05 ,$199.70 ,$474.00 ,$671.50 ,$553.00 ,$193.84 ,$750.50 ,$568.80 ,$576.70 ,$513.50 ,$671.50 ,$199.70 ,$513.50 ,$632.00 ,$576.70 ,$193.84 ,$199.70 ,$557.43 ,$790.00 ,$671.50 ,$449.31 ,$726.80 ,$553.00 ,$395.00 ,$474.00 ,$481.11 ,$395.00 ,$545.89 ,$553.00 ,$201.70 ,$568.80 ,$205.47 ,$669.00 ,$669.00 ,$199.70 ,$669.00 ,$199.70 ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,45000095,27266,HC CL TX POST HIP ARTHROPLASTY DISLOCAT W ANESTH,450,1 ,"$1,700.00 ",$850.00 ,$330.53 ,"$3,034.10 ","$1,098.20 ",$330.53 ,"$1,099.73 ","$1,099.73 ","$1,348.49 ","$1,020.00 ","$1,445.00 ","$1,190.00 ",$330.53 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,105.00 ","$1,445.00 ","$1,348.49 ","$1,105.00 ","$1,360.00 ","$1,241.00 ",$330.53 ,"$1,348.49 ",$557.43 ,"$1,700.00 ","$1,445.00 ","$3,034.10 ","$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ","$1,361.97 ","$1,224.00 ",$350.36 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ","$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,45000096,27560,HC TX DSL PTLR W/O ANS CL,450,1 ,$670.00 ,$335.00 ,$193.84 ,$670.00 ,$432.82 ,$193.84 ,$433.42 ,$433.42 ,$199.70 ,$402.00 ,$569.50 ,$469.00 ,$193.84 ,$636.50 ,$482.40 ,$489.10 ,$435.50 ,$569.50 ,$199.70 ,$435.50 ,$536.00 ,$489.10 ,$193.84 ,$199.70 ,$557.43 ,$670.00 ,$569.50 ,$449.31 ,$616.40 ,$469.00 ,$335.00 ,$402.00 ,$408.03 ,$335.00 ,$462.97 ,$469.00 ,$201.70 ,$482.40 ,$205.47 ,$669.00 ,$669.00 ,$199.70 ,$669.00 ,$199.70 ,$482.40 ,$415.40 ,$482.40 ,$482.40 ,$402.00 ST VINCENT HOSPITAL - ACUTE,45000097,28190,HC REM FB FOOT SUBQ,450,1 ,$840.00 ,$420.00 ,$161.28 ,"$1,355.35 ",$542.64 ,$161.28 ,$543.40 ,$543.40 ,$602.38 ,$504.00 ,$714.00 ,$588.00 ,$161.28 ,$798.00 ,$604.80 ,$613.20 ,$546.00 ,$714.00 ,$602.38 ,$546.00 ,$672.00 ,$613.20 ,$161.28 ,$602.38 ,$557.43 ,$840.00 ,$714.00 ,"$1,355.35 ",$772.80 ,$588.00 ,$420.00 ,$504.00 ,$511.56 ,$420.00 ,$580.44 ,$588.00 ,$608.40 ,$604.80 ,$170.96 ,$669.00 ,$669.00 ,$602.38 ,$669.00 ,$602.38 ,$604.80 ,$520.80 ,$604.80 ,$604.80 ,$504.00 ST VINCENT HOSPITAL - ACUTE,45000098,29065,HC APPL CAST ARM LONG,450,1 ,$280.00 ,$140.00 ,$57.61 ,$525.54 ,$180.88 ,$57.61 ,$181.13 ,$181.13 ,$233.57 ,$168.00 ,$238.00 ,$196.00 ,$57.61 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$233.57 ,$182.00 ,$224.00 ,$204.40 ,$57.61 ,$233.57 ,$280.00 ,$280.00 ,$238.00 ,$525.54 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$235.91 ,$201.60 ,$61.07 ,$280.00 ,$280.00 ,$233.57 ,$280.00 ,$233.57 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,45000099,29075,HC CAST APPL; ELBOW TO FINGERS,450,1 ,$280.00 ,$140.00 ,$57.61 ,$525.54 ,$180.88 ,$57.61 ,$181.13 ,$181.13 ,$233.57 ,$168.00 ,$238.00 ,$196.00 ,$57.61 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$233.57 ,$182.00 ,$224.00 ,$204.40 ,$57.61 ,$233.57 ,$280.00 ,$280.00 ,$238.00 ,$525.54 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$235.91 ,$201.60 ,$61.07 ,$280.00 ,$280.00 ,$233.57 ,$280.00 ,$233.57 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,45000100,29105,HC APPL SPLNT ARM LONG,450,1 ,$390.00 ,$195.00 ,$21.22 ,$390.00 ,$251.94 ,$21.22 ,$252.29 ,$252.29 ,$136.73 ,$234.00 ,$331.50 ,$273.00 ,$21.22 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$136.73 ,$253.50 ,$312.00 ,$284.70 ,$21.22 ,$136.73 ,$390.00 ,$390.00 ,$331.50 ,$307.65 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$138.10 ,$280.80 ,$22.49 ,$390.00 ,$390.00 ,$136.73 ,$390.00 ,$136.73 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,$280.00 ,$140.00 ,$21.22 ,$280.00 ,$180.88 ,$21.22 ,$181.13 ,$181.13 ,$108.42 ,$168.00 ,$238.00 ,$196.00 ,$21.22 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$108.42 ,$182.00 ,$224.00 ,$204.40 ,$21.22 ,$108.42 ,$280.00 ,$280.00 ,$238.00 ,$243.95 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$109.50 ,$201.60 ,$22.49 ,$280.00 ,$280.00 ,$108.42 ,$280.00 ,$108.42 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,45000102,29126,HC APPL SHRT ARM SPLNT DYNAM,450,1 ,$250.00 ,$125.00 ,$21.22 ,$250.00 ,$161.50 ,$21.22 ,$161.73 ,$161.73 ,$108.42 ,$150.00 ,$212.50 ,$175.00 ,$21.22 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$108.42 ,$162.50 ,$200.00 ,$182.50 ,$21.22 ,$108.42 ,$250.00 ,$250.00 ,$212.50 ,$243.95 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$109.50 ,$180.00 ,$22.49 ,$250.00 ,$250.00 ,$108.42 ,$250.00 ,$108.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,45000103,29130,HC APPL SPLNT FINGER STATIC,450,1 ,$320.00 ,$160.00 ,$21.22 ,$320.00 ,$206.72 ,$21.22 ,$207.01 ,$207.01 ,$108.42 ,$192.00 ,$272.00 ,$224.00 ,$21.22 ,$304.00 ,$230.40 ,$233.60 ,$208.00 ,$272.00 ,$108.42 ,$208.00 ,$256.00 ,$233.60 ,$21.22 ,$108.42 ,$320.00 ,$320.00 ,$272.00 ,$243.95 ,$294.40 ,$224.00 ,$160.00 ,$192.00 ,$194.88 ,$160.00 ,$221.12 ,$224.00 ,$109.50 ,$230.40 ,$22.49 ,$320.00 ,$320.00 ,$108.42 ,$320.00 ,$108.42 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,45000104,29131,HC APPL FINGER SPLINT DYNAMIC,450,1 ,$250.00 ,$125.00 ,$21.22 ,$250.00 ,$161.50 ,$21.22 ,$161.73 ,$161.73 ,$53.91 ,$150.00 ,$212.50 ,$175.00 ,$21.22 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$53.91 ,$162.50 ,$200.00 ,$182.50 ,$21.22 ,$53.91 ,$250.00 ,$250.00 ,$212.50 ,$121.29 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$54.45 ,$180.00 ,$22.49 ,$250.00 ,$250.00 ,$53.91 ,$250.00 ,$53.91 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,45000105,29240,HC STRAPPING SHLDR,450,1 ,$250.00 ,$125.00 ,$21.22 ,$250.00 ,$161.50 ,$21.22 ,$161.73 ,$161.73 ,$108.42 ,$150.00 ,$212.50 ,$175.00 ,$21.22 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$108.42 ,$162.50 ,$200.00 ,$182.50 ,$21.22 ,$108.42 ,$250.00 ,$250.00 ,$212.50 ,$243.95 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$109.50 ,$180.00 ,$22.49 ,$250.00 ,$250.00 ,$108.42 ,$250.00 ,$108.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,45000106,29405,HC APPL CAST SHORT LEG,450,1 ,$390.00 ,$195.00 ,$57.61 ,$525.54 ,$251.94 ,$57.61 ,$252.29 ,$252.29 ,$233.57 ,$234.00 ,$331.50 ,$273.00 ,$57.61 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$233.57 ,$253.50 ,$312.00 ,$284.70 ,$57.61 ,$233.57 ,$390.00 ,$390.00 ,$331.50 ,$525.54 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$235.91 ,$280.80 ,$61.07 ,$390.00 ,$390.00 ,$233.57 ,$390.00 ,$233.57 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,45000107,29505,HC APPL LONG LEG SPLNT,450,1 ,$390.00 ,$195.00 ,$21.22 ,$390.00 ,$251.94 ,$21.22 ,$252.29 ,$252.29 ,$136.73 ,$234.00 ,$331.50 ,$273.00 ,$21.22 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$136.73 ,$253.50 ,$312.00 ,$284.70 ,$21.22 ,$136.73 ,$390.00 ,$390.00 ,$331.50 ,$307.65 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$138.10 ,$280.80 ,$22.49 ,$390.00 ,$390.00 ,$136.73 ,$390.00 ,$136.73 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,$390.00 ,$195.00 ,$21.22 ,$390.00 ,$251.94 ,$21.22 ,$252.29 ,$252.29 ,$136.73 ,$234.00 ,$331.50 ,$273.00 ,$21.22 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$136.73 ,$253.50 ,$312.00 ,$284.70 ,$21.22 ,$136.73 ,$390.00 ,$390.00 ,$331.50 ,$307.65 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$138.10 ,$280.80 ,$22.49 ,$390.00 ,$390.00 ,$136.73 ,$390.00 ,$136.73 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,45000109,29705,HC REM/BIV CAST ARM/LEG,450,1 ,$440.00 ,$220.00 ,$57.61 ,$525.54 ,$284.24 ,$57.61 ,$284.64 ,$284.64 ,$233.57 ,$264.00 ,$374.00 ,$308.00 ,$57.61 ,$418.00 ,$316.80 ,$321.20 ,$286.00 ,$374.00 ,$233.57 ,$286.00 ,$352.00 ,$321.20 ,$57.61 ,$233.57 ,$440.00 ,$440.00 ,$374.00 ,$525.54 ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 ,$235.91 ,$316.80 ,$61.07 ,$440.00 ,$440.00 ,$233.57 ,$440.00 ,$233.57 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,45000110,30300,HC REM FB INTRANASAL,450,1 ,$350.00 ,$175.00 ,$35.67 ,$350.00 ,$226.10 ,$35.67 ,$226.42 ,$226.42 ,$108.42 ,$210.00 ,$297.50 ,$245.00 ,$35.67 ,$332.50 ,$252.00 ,$255.50 ,$227.50 ,$297.50 ,$108.42 ,$227.50 ,$280.00 ,$255.50 ,$35.67 ,$108.42 ,$350.00 ,$350.00 ,$297.50 ,$243.95 ,$322.00 ,$245.00 ,$175.00 ,$210.00 ,$213.15 ,$175.00 ,$241.85 ,$245.00 ,$109.50 ,$252.00 ,$37.81 ,$350.00 ,$350.00 ,$108.42 ,$350.00 ,$108.42 ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$360.00 ,$180.00 ,$35.67 ,$360.00 ,$232.56 ,$35.67 ,$232.88 ,$232.88 ,$108.42 ,$216.00 ,$306.00 ,$252.00 ,$35.67 ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 ,$108.42 ,$234.00 ,$288.00 ,$262.80 ,$35.67 ,$108.42 ,$360.00 ,$360.00 ,$306.00 ,$243.95 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$109.50 ,$259.20 ,$37.81 ,$360.00 ,$360.00 ,$108.42 ,$360.00 ,$108.42 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,45000112,30903,HC CNTRL NOSEBLEED ANT CPLX,450,1 ,$440.00 ,$220.00 ,$35.67 ,$440.00 ,$284.24 ,$35.67 ,$284.64 ,$284.64 ,$108.42 ,$264.00 ,$374.00 ,$308.00 ,$35.67 ,$418.00 ,$316.80 ,$321.20 ,$286.00 ,$374.00 ,$108.42 ,$286.00 ,$352.00 ,$321.20 ,$35.67 ,$108.42 ,$440.00 ,$440.00 ,$374.00 ,$243.95 ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 ,$109.50 ,$316.80 ,$37.81 ,$440.00 ,$440.00 ,$108.42 ,$440.00 ,$108.42 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,45000113,30905,HC CNTRL NOSEBLEED POST INIT,450,1 ,$400.00 ,$200.00 ,$35.67 ,$400.00 ,$258.40 ,$35.67 ,$258.76 ,$258.76 ,$108.42 ,$240.00 ,$340.00 ,$280.00 ,$35.67 ,$380.00 ,$288.00 ,$292.00 ,$260.00 ,$340.00 ,$108.42 ,$260.00 ,$320.00 ,$292.00 ,$35.67 ,$108.42 ,$400.00 ,$400.00 ,$340.00 ,$243.95 ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 ,$109.50 ,$288.00 ,$37.81 ,$400.00 ,$400.00 ,$108.42 ,$400.00 ,$108.42 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,45000114,31238,HC NASAL ENDO W EPISTAX CONTROL,450,1 ,"$3,100.00 ","$1,550.00 ",$557.43 ,"$3,260.82 ","$2,002.60 ",$624.53 ,"$2,005.39 ","$2,005.39 ","$1,449.25 ","$1,860.00 ","$2,635.00 ","$2,170.00 ",$624.53 ,"$2,945.00 ","$2,232.00 ","$2,263.00 ","$2,015.00 ","$2,635.00 ","$1,449.25 ","$2,015.00 ","$2,480.00 ","$2,263.00 ",$624.53 ,"$1,449.25 ",$557.43 ,"$3,100.00 ","$2,635.00 ","$3,260.82 ","$2,852.00 ","$2,170.00 ","$1,550.00 ","$1,860.00 ","$1,887.90 ","$1,550.00 ","$2,142.10 ","$2,170.00 ","$1,463.74 ","$2,232.00 ",$662.00 ,$669.00 ,$669.00 ,"$1,449.25 ",$669.00 ,"$1,449.25 ","$2,232.00 ","$1,922.00 ","$2,232.00 ","$2,232.00 ","$1,860.00 " ST VINCENT HOSPITAL - ACUTE,45000116,31720,HC ASP CATH NASOTRACHEAL,450,1 ,$230.00 ,$115.00 ,$111.83 ,$409.41 ,$148.58 ,$111.83 ,$148.79 ,$148.79 ,$181.96 ,$138.00 ,$195.50 ,$161.00 ,$111.83 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$181.96 ,$149.50 ,$184.00 ,$167.90 ,$111.83 ,$181.96 ,$230.00 ,$230.00 ,$195.50 ,$409.41 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$183.78 ,$165.60 ,$118.54 ,$230.00 ,$230.00 ,$181.96 ,$230.00 ,$181.96 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,45000123,36400,HC IV START < 3 YEARS OLD (MD),450,1 ,$160.00 ,$80.00 ,$0.72 ,$160.00 ,$103.36 ,$0.72 ,$103.50 ,$103.50 , N/A ,$96.00 ,$136.00 ,$112.00 ,$0.72 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 , N/A ,$104.00 ,$128.00 ,$116.80 ,$0.72 , N/A ,$160.00 ,$160.00 ,$136.00 , N/A ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , N/A ,$115.20 ,$0.76 ,$160.00 ,$160.00 , N/A ,$160.00 , N/A ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,45000124,36406,HC VENIPUNCTURE <3YR VEIN OTHR,450,1 ,$28.00 ,$14.00 ,$0.72 ,$28.00 ,$18.09 ,$0.72 ,$18.11 ,$18.11 , N/A ,$16.80 ,$23.80 ,$19.60 ,$0.72 ,$26.60 ,$20.16 ,$20.44 ,$18.20 ,$23.80 , N/A ,$18.20 ,$22.40 ,$20.44 ,$0.72 , N/A ,$28.00 ,$28.00 ,$23.80 , N/A ,$25.76 ,$19.60 ,$14.00 ,$16.80 ,$17.05 ,$14.00 ,$19.35 ,$19.60 , N/A ,$20.16 ,$0.76 ,$28.00 ,$28.00 , N/A ,$28.00 , N/A ,$20.16 ,$17.36 ,$20.16 ,$20.16 ,$16.80 ST VINCENT HOSPITAL - ACUTE,45000132,36680,HC PLACE NDL INFS INTRAOSSEOUS,450,1 ,$540.00 ,$270.00 ,$101.56 ,$588.84 ,$348.84 ,$101.56 ,$349.33 ,$349.33 ,$261.71 ,$324.00 ,$459.00 ,$378.00 ,$101.56 ,$513.00 ,$388.80 ,$394.20 ,$351.00 ,$459.00 ,$261.71 ,$351.00 ,$432.00 ,$394.20 ,$101.56 ,$261.71 ,$540.00 ,$540.00 ,$459.00 ,$588.84 ,$496.80 ,$378.00 ,$270.00 ,$324.00 ,$328.86 ,$270.00 ,$373.14 ,$378.00 ,$264.33 ,$388.80 ,$107.65 ,$540.00 ,$540.00 ,$261.71 ,$540.00 ,$261.71 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,45000133,40650,HC RPR LIP FULL THICK VERMILN,450,1 ,"$1,000.00 ",$500.00 ,$280.78 ,"$1,000.00 ",$646.00 ,$280.78 ,$646.90 ,$646.90 ,$438.11 ,$600.00 ,$850.00 ,$700.00 ,$280.78 ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 ,$438.11 ,$650.00 ,$800.00 ,$730.00 ,$280.78 ,$438.11 ,$557.43 ,"$1,000.00 ",$850.00 ,$985.75 ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 ,$442.49 ,$720.00 ,$297.63 ,$669.00 ,$669.00 ,$438.11 ,$669.00 ,$438.11 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,45000134,40652,HC RPR LIP UP 1/2 VERTICAL,450,1 ,"$1,000.00 ",$500.00 ,$280.78 ,"$1,000.00 ",$646.00 ,$280.78 ,$646.90 ,$646.90 ,$438.11 ,$600.00 ,$850.00 ,$700.00 ,$280.78 ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 ,$438.11 ,$650.00 ,$800.00 ,$730.00 ,$280.78 ,$438.11 ,$557.43 ,"$1,000.00 ",$850.00 ,$985.75 ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 ,$442.49 ,$720.00 ,$297.63 ,$669.00 ,$669.00 ,$438.11 ,$669.00 ,$438.11 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,45000135,40654,HC RPR LIP CPLX,450,1 ,"$1,400.00 ",$700.00 ,$280.78 ,"$2,947.90 ",$904.40 ,$280.78 ,$905.66 ,$905.66 ,"$1,310.18 ",$840.00 ,"$1,190.00 ",$980.00 ,$280.78 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ","$1,310.18 ",$910.00 ,"$1,120.00 ","$1,022.00 ",$280.78 ,"$1,310.18 ",$557.43 ,"$1,400.00 ","$1,190.00 ","$2,947.90 ","$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 ,"$1,323.28 ","$1,008.00 ",$297.63 ,$669.00 ,$669.00 ,"$1,310.18 ",$669.00 ,"$1,310.18 ","$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,45000137,40830,HC LAC REPAIR VESTIBULE MOUTH 2.5 CM OR LESS,450,1 ,$590.00 ,$295.00 ,$161.28 ,$590.00 ,$381.14 ,$161.28 ,$381.67 ,$381.67 ,$204.93 ,$354.00 ,$501.50 ,$413.00 ,$161.28 ,$560.50 ,$424.80 ,$430.70 ,$383.50 ,$501.50 ,$204.93 ,$383.50 ,$472.00 ,$430.70 ,$161.28 ,$204.93 ,$557.43 ,$590.00 ,$501.50 ,$461.10 ,$542.80 ,$413.00 ,$295.00 ,$354.00 ,$359.31 ,$295.00 ,$407.69 ,$413.00 ,$206.98 ,$424.80 ,$170.96 ,$590.00 ,$590.00 ,$204.93 ,$590.00 ,$204.93 ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,45000138,41250,HC RPR LAC MOUTH/TONGUE <2.5CM,450,1 ,$520.00 ,$260.00 ,$35.67 ,$588.84 ,$335.92 ,$35.67 ,$336.39 ,$336.39 ,$261.71 ,$312.00 ,$442.00 ,$364.00 ,$35.67 ,$494.00 ,$374.40 ,$379.60 ,$338.00 ,$442.00 ,$261.71 ,$338.00 ,$416.00 ,$379.60 ,$35.67 ,$261.71 ,$520.00 ,$520.00 ,$442.00 ,$588.84 ,$478.40 ,$364.00 ,$260.00 ,$312.00 ,$316.68 ,$260.00 ,$359.32 ,$364.00 ,$264.33 ,$374.40 ,$37.81 ,$520.00 ,$520.00 ,$261.71 ,$520.00 ,$261.71 ,$374.40 ,$322.40 ,$374.40 ,$374.40 ,$312.00 ST VINCENT HOSPITAL - ACUTE,45000139,41800,HC DRAIN ABSC/CYST DENTOALVLR,450,1 ,$390.00 ,$195.00 ,$35.67 ,$390.00 ,$251.94 ,$35.67 ,$252.29 ,$252.29 ,$108.42 ,$234.00 ,$331.50 ,$273.00 ,$35.67 ,$370.50 ,$280.80 ,$284.70 ,$253.50 ,$331.50 ,$108.42 ,$253.50 ,$312.00 ,$284.70 ,$35.67 ,$108.42 ,$390.00 ,$390.00 ,$331.50 ,$243.95 ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 ,$109.50 ,$280.80 ,$37.81 ,$390.00 ,$390.00 ,$108.42 ,$390.00 ,$108.42 ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,45000140,42700,HC I AND D ABSC PERITONSILLAR,450,1 ,$590.00 ,$295.00 ,$35.67 ,$590.00 ,$381.14 ,$35.67 ,$381.67 ,$381.67 ,$204.93 ,$354.00 ,$501.50 ,$413.00 ,$35.67 ,$560.50 ,$424.80 ,$430.70 ,$383.50 ,$501.50 ,$204.93 ,$383.50 ,$472.00 ,$430.70 ,$35.67 ,$204.93 ,$557.43 ,$590.00 ,$501.50 ,$461.10 ,$542.80 ,$413.00 ,$295.00 ,$354.00 ,$359.31 ,$295.00 ,$407.69 ,$413.00 ,$206.98 ,$424.80 ,$37.81 ,$590.00 ,$590.00 ,$204.93 ,$590.00 ,$204.93 ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,45000141,42809,HC REMOVE PHARYNX FOREIGN BODY,450,1 ,$200.00 ,$100.00 ,$35.67 ,$588.84 ,$129.20 ,$35.67 ,$129.38 ,$129.38 ,$261.71 ,$120.00 ,$170.00 ,$140.00 ,$35.67 ,$190.00 ,$144.00 ,$146.00 ,$130.00 ,$170.00 ,$261.71 ,$130.00 ,$160.00 ,$146.00 ,$35.67 ,$261.71 ,$200.00 ,$200.00 ,$170.00 ,$588.84 ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 ,$264.33 ,$144.00 ,$37.81 ,$200.00 ,$200.00 ,$261.71 ,$200.00 ,$261.71 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,45000143,43753,HC GASTRIC LAVAGE,450,1 ,$590.00 ,$295.00 ,$199.12 ,$590.00 ,$381.14 ,$199.12 ,$381.67 ,$381.67 ,$256.12 ,$354.00 ,$501.50 ,$413.00 ,$199.12 ,$560.50 ,$424.80 ,$430.70 ,$383.50 ,$501.50 ,$256.12 ,$383.50 ,$472.00 ,$430.70 ,$199.12 ,$256.12 ,$557.43 ,$590.00 ,$501.50 ,$576.27 ,$542.80 ,$413.00 ,$295.00 ,$354.00 ,$359.31 ,$295.00 ,$407.69 ,$413.00 ,$258.68 ,$424.80 ,$211.07 ,$590.00 ,$590.00 ,$256.12 ,$590.00 ,$256.12 ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,45000146,46040,HC INCISION RECTAL ABSCESS,450,1 ,"$2,500.00 ","$1,250.00 ",$481.41 ,"$2,500.00 ","$1,615.00 ",$481.41 ,"$1,617.25 ","$1,617.25 ","$1,004.30 ","$1,500.00 ","$2,125.00 ","$1,750.00 ",$481.41 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ","$1,625.00 ","$2,125.00 ","$1,004.30 ","$1,625.00 ","$2,000.00 ","$1,825.00 ",$481.41 ,"$1,004.30 ",$557.43 ,"$2,500.00 ","$2,125.00 ","$2,259.67 ","$2,300.00 ","$1,750.00 ","$1,250.00 ","$1,500.00 ","$1,522.50 ","$1,250.00 ","$1,727.50 ","$1,750.00 ","$1,014.34 ","$1,800.00 ",$510.29 ,$669.00 ,$669.00 ,"$1,004.30 ",$669.00 ,"$1,004.30 ","$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,45000147,46050,HC I AND D ABSC PERIANAL SUPFIC,450,1 ,"$1,100.00 ",$550.00 ,$481.41 ,"$1,729.46 ",$710.60 ,$481.41 ,$711.59 ,$711.59 ,$768.65 ,$660.00 ,$935.00 ,$770.00 ,$481.41 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$768.65 ,$715.00 ,$880.00 ,$803.00 ,$481.41 ,$768.65 ,$557.43 ,"$1,100.00 ",$935.00 ,"$1,729.46 ","$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$776.34 ,$792.00 ,$510.29 ,$669.00 ,$669.00 ,$768.65 ,$669.00 ,$768.65 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,45000148,46083,HC INC HEMORRHOID EXTERNAL,450,1 ,$440.00 ,$220.00 ,$220.00 ,$579.95 ,$284.24 ,$440.00 ,$284.64 ,$284.64 ,$257.76 ,$264.00 ,$374.00 ,$308.00 ,$481.41 ,$418.00 ,$316.80 ,$321.20 ,$286.00 ,$374.00 ,$257.76 ,$286.00 ,$352.00 ,$321.20 ,$481.41 ,$257.76 ,$440.00 ,$440.00 ,$374.00 ,$579.95 ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 ,$260.34 ,$316.80 ,$510.29 ,$440.00 ,$440.00 ,$257.76 ,$440.00 ,$257.76 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,45000149,46320,HC EXCISION THROMBOSED HEMORRHOID; EXTERNAL,450,1 ,"$2,200.00 ","$1,100.00 ",$481.41 ,"$2,259.67 ","$1,421.20 ",$481.41 ,"$1,423.18 ","$1,423.18 ","$1,004.30 ","$1,320.00 ","$1,870.00 ","$1,540.00 ",$481.41 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$1,430.00 ","$1,870.00 ","$1,004.30 ","$1,430.00 ","$1,760.00 ","$1,606.00 ",$481.41 ,"$1,004.30 ",$557.43 ,"$2,200.00 ","$1,870.00 ","$2,259.67 ","$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ","$1,014.34 ","$1,584.00 ",$510.29 ,$669.00 ,$669.00 ,"$1,004.30 ",$669.00 ,"$1,004.30 ","$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,45000150,46600,HC ANOSCOPY,450,1 ,$230.00 ,$115.00 ,$53.35 ,$243.95 ,$148.58 ,$53.35 ,$148.79 ,$148.79 ,$108.42 ,$138.00 ,$195.50 ,$161.00 ,$53.35 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$108.42 ,$149.50 ,$184.00 ,$167.90 ,$53.35 ,$108.42 ,$230.00 ,$230.00 ,$195.50 ,$243.95 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$109.50 ,$165.60 ,$56.55 ,$230.00 ,$230.00 ,$108.42 ,$230.00 ,$108.42 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,45000156,51700,HC IRRIG/LAVG/INSTL BLADDER,450,1 ,$480.00 ,$240.00 ,$22.97 ,$579.95 ,$310.08 ,$22.97 ,$310.51 ,$310.51 ,$257.76 ,$288.00 ,$408.00 ,$336.00 ,$22.97 ,$456.00 ,$345.60 ,$350.40 ,$312.00 ,$408.00 ,$257.76 ,$312.00 ,$384.00 ,$350.40 ,$22.97 ,$257.76 ,$480.00 ,$480.00 ,$408.00 ,$579.95 ,$441.60 ,$336.00 ,$240.00 ,$288.00 ,$292.32 ,$240.00 ,$331.68 ,$336.00 ,$260.34 ,$345.60 ,$24.35 ,$480.00 ,$480.00 ,$257.76 ,$480.00 ,$257.76 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,45000157,51705,HC CHG TUBE CYSTOSTOMY SMP,450,1 ,$550.00 ,$275.00 ,$60.28 ,$579.95 ,$355.30 ,$60.28 ,$355.80 ,$355.80 ,$257.76 ,$330.00 ,$467.50 ,$385.00 ,$60.28 ,$522.50 ,$396.00 ,$401.50 ,$357.50 ,$467.50 ,$257.76 ,$357.50 ,$440.00 ,$401.50 ,$60.28 ,$257.76 ,$550.00 ,$550.00 ,$467.50 ,$579.95 ,$506.00 ,$385.00 ,$275.00 ,$330.00 ,$334.95 ,$275.00 ,$380.05 ,$385.00 ,$260.34 ,$396.00 ,$63.90 ,$550.00 ,$550.00 ,$257.76 ,$550.00 ,$257.76 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,45000159,54220,HC IRRIG CORPORA CAVNOSA,450,1 ,$420.00 ,$210.00 ,$22.97 ,$579.95 ,$271.32 ,$22.97 ,$271.70 ,$271.70 ,$257.76 ,$252.00 ,$357.00 ,$294.00 ,$22.97 ,$399.00 ,$302.40 ,$306.60 ,$273.00 ,$357.00 ,$257.76 ,$273.00 ,$336.00 ,$306.60 ,$22.97 ,$257.76 ,$420.00 ,$420.00 ,$357.00 ,$579.95 ,$386.40 ,$294.00 ,$210.00 ,$252.00 ,$255.78 ,$210.00 ,$290.22 ,$294.00 ,$260.34 ,$302.40 ,$24.35 ,$420.00 ,$420.00 ,$257.76 ,$420.00 ,$257.76 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,45000161,54700,HC I AND D EPIDIDYMIS TESTIS OR SCROTAL SPACE,450,1 ,"$1,900.00 ",$950.00 ,$557.43 ,"$3,907.15 ","$1,227.40 ",$609.08 ,"$1,229.11 ","$1,229.11 ","$1,736.51 ","$1,140.00 ","$1,615.00 ","$1,330.00 ",$609.08 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,235.00 ","$1,615.00 ","$1,736.51 ","$1,235.00 ","$1,520.00 ","$1,387.00 ",$609.08 ,"$1,736.51 ",$557.43 ,"$1,900.00 ","$1,615.00 ","$3,907.15 ","$1,748.00 ","$1,330.00 ",$950.00 ,"$1,140.00 ","$1,157.10 ",$950.00 ,"$1,312.90 ","$1,330.00 ","$1,753.88 ","$1,368.00 ",$645.62 ,$669.00 ,$669.00 ,"$1,736.51 ",$669.00 ,"$1,736.51 ","$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,45000162,55100,HC DRAIN ABSC SCROTAL WALL,450,1 ,$870.00 ,$435.00 ,$435.00 ,"$3,066.03 ",$562.02 ,$609.08 ,$562.80 ,$562.80 ,"$1,362.68 ",$522.00 ,$739.50 ,$609.00 ,$609.08 ,$826.50 ,$626.40 ,$635.10 ,$565.50 ,$739.50 ,"$1,362.68 ",$565.50 ,$696.00 ,$635.10 ,$609.08 ,"$1,362.68 ",$557.43 ,$870.00 ,$739.50 ,"$3,066.03 ",$800.40 ,$609.00 ,$435.00 ,$522.00 ,$529.83 ,$435.00 ,$601.17 ,$609.00 ,"$1,376.31 ",$626.40 ,$645.62 ,$669.00 ,$669.00 ,"$1,362.68 ",$669.00 ,"$1,362.68 ",$626.40 ,$539.40 ,$626.40 ,$626.40 ,$522.00 ST VINCENT HOSPITAL - ACUTE,45000163,56405,HC I AND D ABSC VULVA/PERINEAL,450,1 ,$550.00 ,$275.00 ,$63.69 ,$613.38 ,$355.30 ,$63.69 ,$355.80 ,$355.80 ,$272.61 ,$330.00 ,$467.50 ,$385.00 ,$63.69 ,$522.50 ,$396.00 ,$401.50 ,$357.50 ,$467.50 ,$272.61 ,$357.50 ,$440.00 ,$401.50 ,$63.69 ,$272.61 ,$550.00 ,$550.00 ,$467.50 ,$613.38 ,$506.00 ,$385.00 ,$275.00 ,$330.00 ,$334.95 ,$275.00 ,$380.05 ,$385.00 ,$275.34 ,$396.00 ,$67.51 ,$550.00 ,$550.00 ,$272.61 ,$550.00 ,$272.61 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,45000164,56420,HC I AND D ABSC GLAND BARTHOLIN'S,450,1 ,$470.00 ,$235.00 ,$63.69 ,$470.00 ,$303.62 ,$63.69 ,$304.04 ,$304.04 ,$164.95 ,$282.00 ,$399.50 ,$329.00 ,$63.69 ,$446.50 ,$338.40 ,$343.10 ,$305.50 ,$399.50 ,$164.95 ,$305.50 ,$376.00 ,$343.10 ,$63.69 ,$164.95 ,$470.00 ,$470.00 ,$399.50 ,$371.15 ,$432.40 ,$329.00 ,$235.00 ,$282.00 ,$286.23 ,$235.00 ,$324.77 ,$329.00 ,$166.60 ,$338.40 ,$67.51 ,$470.00 ,$470.00 ,$164.95 ,$470.00 ,$164.95 ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,45000165,58301,HC REM DVC INTRAUTERINE,450,1 ,$210.00 ,$105.00 ,$63.69 ,$613.38 ,$135.66 ,$63.69 ,$135.85 ,$135.85 ,$272.61 ,$126.00 ,$178.50 ,$147.00 ,$63.69 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$272.61 ,$136.50 ,$168.00 ,$153.30 ,$63.69 ,$272.61 ,$210.00 ,$210.00 ,$178.50 ,$613.38 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$275.34 ,$151.20 ,$67.51 ,$210.00 ,$210.00 ,$272.61 ,$210.00 ,$272.61 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,45000166,59414,HC DELIVERY OF PLACENTA,450,1 ,"$3,200.00 ","$1,600.00 ",$398.72 ,"$5,716.30 ","$2,067.20 ",$398.72 ,"$2,070.08 ","$2,070.08 ","$2,540.58 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$398.72 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$2,080.00 ","$2,720.00 ","$2,540.58 ","$2,080.00 ","$2,560.00 ","$2,336.00 ",$398.72 ,"$2,540.58 ",$557.43 ,"$3,200.00 ","$2,720.00 ","$5,716.30 ","$2,944.00 ","$2,240.00 ","$1,600.00 ","$1,920.00 ","$1,948.80 ","$1,600.00 ","$2,211.20 ","$2,240.00 ","$2,565.99 ","$2,304.00 ",$422.64 ,$669.00 ,$669.00 ,"$2,540.58 ",$669.00 ,"$2,540.58 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,45000168,64400,HC DENTAL BLOCK,450,1 ,$710.00 ,$355.00 ,$121.61 ,$710.00 ,$458.66 ,$121.61 ,$459.30 ,$459.30 ,$252.94 ,$426.00 ,$603.50 ,$497.00 ,$121.61 ,$674.50 ,$511.20 ,$518.30 ,$461.50 ,$603.50 ,$252.94 ,$461.50 ,$568.00 ,$518.30 ,$121.61 ,$252.94 ,$557.43 ,$710.00 ,$603.50 ,$569.12 ,$653.20 ,$497.00 ,$355.00 ,$426.00 ,$432.39 ,$355.00 ,$490.61 ,$497.00 ,$255.47 ,$511.20 ,$128.91 ,$669.00 ,$669.00 ,$252.94 ,$669.00 ,$252.94 ,$511.20 ,$440.20 ,$511.20 ,$511.20 ,$426.00 ST VINCENT HOSPITAL - ACUTE,45000169,64999,HC INJECTION FACIAL NERVE,450,1 ,$380.00 ,$190.00 ,$121.61 ,$569.12 ,$245.48 ,$121.61 ,$245.82 ,$245.82 ,$252.94 ,$228.00 ,$323.00 ,$266.00 ,$121.61 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 ,$252.94 ,$247.00 ,$304.00 ,$277.40 ,$121.61 ,$252.94 ,$380.00 ,$380.00 ,$323.00 ,$569.12 ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 ,$255.47 ,$273.60 ,$128.91 ,$380.00 ,$380.00 ,$252.94 ,$380.00 ,$252.94 ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,45000170,64450,HC INJ ANES NERVE PERIPHERAL,450,1 ,$770.00 ,$385.00 ,$121.61 ,"$1,382.85 ",$497.42 ,$121.61 ,$498.11 ,$498.11 ,$614.60 ,$462.00 ,$654.50 ,$539.00 ,$121.61 ,$731.50 ,$554.40 ,$562.10 ,$500.50 ,$654.50 ,$614.60 ,$500.50 ,$616.00 ,$562.10 ,$121.61 ,$614.60 ,$557.43 ,$770.00 ,$654.50 ,"$1,382.85 ",$708.40 ,$539.00 ,$385.00 ,$462.00 ,$468.93 ,$385.00 ,$532.07 ,$539.00 ,$620.75 ,$554.40 ,$128.91 ,$669.00 ,$669.00 ,$614.60 ,$669.00 ,$614.60 ,$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,45000171,65205,HC REM EYE FB CONJUCT SUPER,450,1 ,$340.00 ,$170.00 ,$18.36 ,$340.00 ,$219.64 ,$18.36 ,$219.95 ,$219.95 ,$108.42 ,$204.00 ,$289.00 ,$238.00 ,$18.36 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$108.42 ,$221.00 ,$272.00 ,$248.20 ,$18.36 ,$108.42 ,$340.00 ,$340.00 ,$289.00 ,$243.95 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$109.50 ,$244.80 ,$19.46 ,$340.00 ,$340.00 ,$108.42 ,$340.00 ,$108.42 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,45000172,65210,HC REM EYE FB CONJUCT EMBED,450,1 ,$340.00 ,$170.00 ,$18.36 ,$588.84 ,$219.64 ,$18.36 ,$219.95 ,$219.95 ,$261.71 ,$204.00 ,$289.00 ,$238.00 ,$18.36 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$261.71 ,$221.00 ,$272.00 ,$248.20 ,$18.36 ,$261.71 ,$340.00 ,$340.00 ,$289.00 ,$588.84 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$264.33 ,$244.80 ,$19.46 ,$340.00 ,$340.00 ,$261.71 ,$340.00 ,$261.71 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,45000173,65220,HC REM FB CORNL W/O SLIT LA,450,1 ,$340.00 ,$170.00 ,$18.36 ,$588.84 ,$219.64 ,$18.36 ,$219.95 ,$219.95 ,$261.71 ,$204.00 ,$289.00 ,$238.00 ,$18.36 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 ,$261.71 ,$221.00 ,$272.00 ,$248.20 ,$18.36 ,$261.71 ,$340.00 ,$340.00 ,$289.00 ,$588.84 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$264.33 ,$244.80 ,$19.46 ,$340.00 ,$340.00 ,$261.71 ,$340.00 ,$261.71 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,45000174,65222,HC REM FB CORNL W/ SLIT LA,450,1 ,$360.00 ,$180.00 ,$18.36 ,$360.00 ,$232.56 ,$18.36 ,$232.88 ,$232.88 ,$108.42 ,$216.00 ,$306.00 ,$252.00 ,$18.36 ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 ,$108.42 ,$234.00 ,$288.00 ,$262.80 ,$18.36 ,$108.42 ,$360.00 ,$360.00 ,$306.00 ,$243.95 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$109.50 ,$259.20 ,$19.46 ,$360.00 ,$360.00 ,$108.42 ,$360.00 ,$108.42 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,45000175,65235,HC REMOVE FB EYE; INTRAOCULAR ANTERIOR CHAMBER,450,1 ,"$1,900.00 ",$950.00 ,$437.80 ,"$4,530.75 ","$1,227.40 ",$437.80 ,"$1,229.11 ","$1,229.11 ","$2,013.67 ","$1,140.00 ","$1,615.00 ","$1,330.00 ",$437.80 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,235.00 ","$1,615.00 ","$2,013.67 ","$1,235.00 ","$1,520.00 ","$1,387.00 ",$437.80 ,"$2,013.67 ",$557.43 ,"$1,900.00 ","$1,615.00 ","$4,530.75 ","$1,748.00 ","$1,330.00 ",$950.00 ,"$1,140.00 ","$1,157.10 ",$950.00 ,"$1,312.90 ","$1,330.00 ","$2,033.81 ","$1,368.00 ",$464.07 ,$669.00 ,$669.00 ,"$2,013.67 ",$669.00 ,"$2,013.67 ","$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,45000176,65260,HC REMOVE FB EYE; INTRAOCULAR POSTERIOR SEGMENT,450,1 ,$870.00 ,$435.00 ,$435.00 ,"$4,530.75 ",$562.02 ,$870.00 ,$562.80 ,$562.80 ,"$2,013.67 ",$522.00 ,$739.50 ,$609.00 ,"$1,021.68 ",$826.50 ,$626.40 ,$635.10 ,$565.50 ,$739.50 ,"$2,013.67 ",$565.50 ,$696.00 ,$635.10 ,"$1,021.68 ","$2,013.67 ",$557.43 ,$870.00 ,$739.50 ,"$4,530.75 ",$800.40 ,$609.00 ,$435.00 ,$522.00 ,$529.83 ,$435.00 ,$601.17 ,$609.00 ,"$2,033.81 ",$626.40 ,"$1,082.98 ",$669.00 ,$669.00 ,"$2,013.67 ",$669.00 ,"$2,013.67 ",$626.40 ,$539.40 ,$626.40 ,$626.40 ,$522.00 ST VINCENT HOSPITAL - ACUTE,45000177,67700,HC I AND D ABSCESS EYELID,450,1 ,$520.00 ,$260.00 ,$193.33 ,$569.36 ,$335.92 ,$193.33 ,$336.39 ,$336.39 ,$253.05 ,$312.00 ,$442.00 ,$364.00 ,$193.33 ,$494.00 ,$374.40 ,$379.60 ,$338.00 ,$442.00 ,$253.05 ,$338.00 ,$416.00 ,$379.60 ,$193.33 ,$253.05 ,$520.00 ,$520.00 ,$442.00 ,$569.36 ,$478.40 ,$364.00 ,$260.00 ,$312.00 ,$316.68 ,$260.00 ,$359.32 ,$364.00 ,$255.58 ,$374.40 ,$204.93 ,$520.00 ,$520.00 ,$253.05 ,$520.00 ,$253.05 ,$374.40 ,$322.40 ,$374.40 ,$374.40 ,$312.00 ST VINCENT HOSPITAL - ACUTE,45000178,67938,HC REMOVE EMBEDDED FB EYELID,450,1 ,$470.00 ,$235.00 ,$193.33 ,$569.36 ,$303.62 ,$193.33 ,$304.04 ,$304.04 ,$253.05 ,$282.00 ,$399.50 ,$329.00 ,$193.33 ,$446.50 ,$338.40 ,$343.10 ,$305.50 ,$399.50 ,$253.05 ,$305.50 ,$376.00 ,$343.10 ,$193.33 ,$253.05 ,$470.00 ,$470.00 ,$399.50 ,$569.36 ,$432.40 ,$329.00 ,$235.00 ,$282.00 ,$286.23 ,$235.00 ,$324.77 ,$329.00 ,$255.58 ,$338.40 ,$204.93 ,$470.00 ,$470.00 ,$253.05 ,$470.00 ,$253.05 ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,45000179,69000,HC DRAIN ABSC/HEMA EAR EXT SMP,450,1 ,$460.00 ,$230.00 ,$35.67 ,"$1,355.35 ",$297.16 ,$35.67 ,$297.57 ,$297.57 ,$602.38 ,$276.00 ,$391.00 ,$322.00 ,$35.67 ,$437.00 ,$331.20 ,$335.80 ,$299.00 ,$391.00 ,$602.38 ,$299.00 ,$368.00 ,$335.80 ,$35.67 ,$602.38 ,$460.00 ,$460.00 ,$391.00 ,"$1,355.35 ",$423.20 ,$322.00 ,$230.00 ,$276.00 ,$280.14 ,$230.00 ,$317.86 ,$322.00 ,$608.40 ,$331.20 ,$37.81 ,$460.00 ,$460.00 ,$602.38 ,$460.00 ,$602.38 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,45000180,69005,HC I AND D ABSCESS EXTERNAL EAR CMPLX,450,1 ,"$1,350.00 ",$675.00 ,$280.78 ,"$3,066.03 ",$872.10 ,$280.78 ,$873.32 ,$873.32 ,"$1,362.68 ",$810.00 ,"$1,147.50 ",$945.00 ,$280.78 ,"$1,282.50 ",$972.00 ,$985.50 ,$877.50 ,"$1,147.50 ","$1,362.68 ",$877.50 ,"$1,080.00 ",$985.50 ,$280.78 ,"$1,362.68 ",$557.43 ,"$1,350.00 ","$1,147.50 ","$3,066.03 ","$1,242.00 ",$945.00 ,$675.00 ,$810.00 ,$822.15 ,$675.00 ,$932.85 ,$945.00 ,"$1,376.31 ",$972.00 ,$297.63 ,$669.00 ,$669.00 ,"$1,362.68 ",$669.00 ,"$1,362.68 ",$972.00 ,$837.00 ,$972.00 ,$972.00 ,$810.00 ST VINCENT HOSPITAL - ACUTE,45000181,69200,HC FB REMOVAL EAR,450,1 ,$200.00 ,$100.00 ,$35.67 ,$243.95 ,$129.20 ,$35.67 ,$129.38 ,$129.38 ,$108.42 ,$120.00 ,$170.00 ,$140.00 ,$35.67 ,$190.00 ,$144.00 ,$146.00 ,$130.00 ,$170.00 ,$108.42 ,$130.00 ,$160.00 ,$146.00 ,$35.67 ,$108.42 ,$200.00 ,$200.00 ,$170.00 ,$243.95 ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 ,$109.50 ,$144.00 ,$37.81 ,$200.00 ,$200.00 ,$108.42 ,$200.00 ,$108.42 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,45000183,69210,HC REMOVE CERUMEN IMPACTED BY INSTRUMENTATION,450,1 ,$100.00 ,$50.00 ,$35.67 ,$121.29 ,$64.60 ,$35.67 ,$64.69 ,$64.69 ,$53.91 ,$60.00 ,$85.00 ,$70.00 ,$35.67 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$53.91 ,$65.00 ,$80.00 ,$73.00 ,$35.67 ,$53.91 ,$100.00 ,$100.00 ,$85.00 ,$121.29 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$54.45 ,$72.00 ,$37.81 ,$100.00 ,$100.00 ,$53.91 ,$100.00 ,$53.91 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,45000185,92511,HC NASOPHARYNGOSCOPY,450,1 ,$310.00 ,$155.00 ,$35.67 ,$358.23 ,$200.26 ,$35.67 ,$200.54 ,$200.54 ,$159.21 ,$186.00 ,$263.50 ,$217.00 ,$35.67 ,$294.50 ,$223.20 ,$226.30 ,$201.50 ,$263.50 ,$159.21 ,$201.50 ,$248.00 ,$226.30 ,$35.67 ,$159.21 ,$310.00 ,$310.00 ,$263.50 ,$358.23 ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 ,$160.80 ,$223.20 ,$37.81 ,$310.00 ,$310.00 ,$159.21 ,$310.00 ,$159.21 ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,45000186,92953,HC TEMPORARY EXTERNAL PACING,450,1 ,"$1,100.00 ",$550.00 ,$185.89 ,"$1,224.47 ",$710.60 ,$185.89 ,$711.59 ,$711.59 ,$544.21 ,$660.00 ,$935.00 ,$770.00 ,$185.89 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$544.21 ,$715.00 ,$880.00 ,$803.00 ,$185.89 ,$544.21 ,$557.43 ,"$1,100.00 ",$935.00 ,"$1,224.47 ","$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$549.65 ,$792.00 ,$197.04 ,$669.00 ,$669.00 ,$544.21 ,$669.00 ,$544.21 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,45000187,92977,HC THROMBOLYSIS CORONARY IV INFS,450,1 ,$807.00 ,$403.50 ,$145.88 ,$807.00 ,$521.32 ,$145.88 ,$522.05 ,$522.05 ,$300.96 ,$484.20 ,$685.95 ,$564.90 ,$145.88 ,$766.65 ,$581.04 ,$589.11 ,$524.55 ,$685.95 ,$300.96 ,$524.55 ,$645.60 ,$589.11 ,$145.88 ,$300.96 ,$557.43 ,$807.00 ,$685.95 ,$677.16 ,$742.44 ,$564.90 ,$403.50 ,$484.20 ,$491.46 ,$403.50 ,$557.64 ,$564.90 ,$303.97 ,$581.04 ,$154.63 ,$669.00 ,$669.00 ,$300.96 ,$669.00 ,$300.96 ,$581.04 ,$500.34 ,$581.04 ,$581.04 ,$484.20 ST VINCENT HOSPITAL - ACUTE,45000188,99281,HC ER LEVEL 1,450,1 ,$170.00 ,$85.00 ,$47.46 ,$170.00 ,$109.82 ,$47.46 ,$170.00 ,$170.00 ,$70.31 ,$102.00 ,$144.50 ,$119.00 ,$47.46 ,$161.50 ,$122.40 ,$124.10 ,$170.00 ,$144.50 ,$70.31 ,$170.00 ,$136.00 ,$124.10 ,$47.46 ,$70.31 ,$170.00 ,$170.00 ,$144.50 ,$158.20 ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 ,$71.01 ,$122.40 ,$50.31 ,$170.00 ,$170.00 ,$70.31 ,$170.00 ,$70.31 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,45000189,99282,HC ER LEVEL 2,450,1 ,$340.00 ,$170.00 ,$47.46 ,$340.00 ,$219.64 ,$47.46 ,$340.00 ,$340.00 ,$127.44 ,$204.00 ,$289.00 ,$238.00 ,$47.46 ,$323.00 ,$244.80 ,$248.20 ,$340.00 ,$289.00 ,$127.44 ,$340.00 ,$272.00 ,$248.20 ,$47.46 ,$127.44 ,$340.00 ,$340.00 ,$289.00 ,$286.75 ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 ,$128.71 ,$244.80 ,$50.31 ,$340.00 ,$340.00 ,$127.44 ,$340.00 ,$127.44 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,45000190,99283,HC ER LEVEL 3,450,1 ,"$1,200.00 ",$600.00 ,$47.46 ,"$1,200.00 ",$775.20 ,$47.46 ,"$1,200.00 ","$1,010.00 ",$224.30 ,$720.00 ,"$1,020.00 ",$840.00 ,$47.46 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ",$224.30 ,"$1,200.00 ",$960.00 ,$876.00 ,$47.46 ,$224.30 ,"$1,048.62 ","$1,200.00 ","$1,020.00 ",$504.69 ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$226.54 ,$864.00 ,$50.31 ,"$1,200.00 ","$1,200.00 ",$224.30 ,"$1,200.00 ",$224.30 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,45000191,99284,HC ER LEVEL 4,450,1 ,"$1,800.00 ",$900.00 ,$47.46 ,"$1,800.00 ","$1,162.80 ",$47.46 ,"$1,800.00 ","$1,800.00 ",$352.28 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$47.46 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ",$352.28 ,"$1,800.00 ","$1,440.00 ","$1,314.00 ",$47.46 ,$352.28 ,"$1,800.00 ","$1,800.00 ","$1,530.00 ",$792.63 ,"$1,656.00 ","$1,260.00 ",$900.00 ,"$1,080.00 ","$1,096.20 ",$900.00 ,"$1,243.80 ","$1,260.00 ",$355.80 ,"$1,296.00 ",$50.31 ,"$1,800.00 ","$1,800.00 ",$352.28 ,"$1,800.00 ",$352.28 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,45000192,99285,HC ER LEVEL 5,450,1 ,"$2,400.00 ","$1,200.00 ",$47.46 ,"$2,400.00 ","$1,550.40 ",$47.46 ,"$2,400.00 ","$2,400.00 ",$505.67 ,"$1,440.00 ","$2,040.00 ","$1,680.00 ",$47.46 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$2,400.00 ","$2,040.00 ",$505.67 ,"$2,400.00 ","$1,920.00 ","$1,752.00 ",$47.46 ,$505.67 ,"$2,318.01 ","$2,400.00 ","$2,040.00 ","$1,137.76 ","$2,208.00 ","$1,680.00 ","$1,200.00 ","$1,440.00 ","$1,461.60 ","$1,200.00 ","$1,658.40 ","$1,680.00 ",$510.73 ,"$1,728.00 ",$50.31 ,"$2,400.00 ","$2,400.00 ",$505.67 ,"$2,400.00 ",$505.67 ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,45000193,99291,HC CRITICAL CARE 30-74 MIN,450,1 ,"$2,900.00 ","$1,450.00 ",$47.46 ,"$2,900.00 ","$1,873.40 ",$47.46 ,"$2,900.00 ","$2,900.00 ",$670.86 ,"$1,740.00 ","$2,465.00 ","$2,030.00 ",$47.46 ,"$2,755.00 ","$2,088.00 ","$2,117.00 ","$2,900.00 ","$2,465.00 ",$670.86 ,"$2,900.00 ","$2,320.00 ","$2,117.00 ",$47.46 ,$670.86 ,"$2,869.91 ","$2,900.00 ","$2,465.00 ","$1,509.44 ","$2,668.00 ","$2,030.00 ","$1,450.00 ","$1,740.00 ","$1,766.10 ","$1,450.00 ","$2,003.90 ","$2,030.00 ",$677.57 ,"$2,088.00 ",$50.31 ,"$2,900.00 ","$2,900.00 ",$670.86 ,"$2,900.00 ",$670.86 ,"$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,45000194,99285,HC ER LEVEL 5 SANE,450,1 ,"$2,400.00 ","$1,200.00 ",$47.46 ,"$2,400.00 ","$1,550.40 ",$47.46 ,"$2,400.00 ","$2,400.00 ",$505.67 ,"$1,440.00 ","$2,040.00 ","$1,680.00 ",$47.46 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$2,400.00 ","$2,040.00 ",$505.67 ,"$2,400.00 ","$1,920.00 ","$1,752.00 ",$47.46 ,$505.67 ,"$2,318.01 ","$2,400.00 ","$2,040.00 ","$1,137.76 ","$2,208.00 ","$1,680.00 ","$1,200.00 ","$1,440.00 ","$1,461.60 ","$1,200.00 ","$1,658.40 ","$1,680.00 ",$510.73 ,"$1,728.00 ",$50.31 ,"$2,400.00 ","$2,400.00 ",$505.67 ,"$2,400.00 ",$505.67 ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,45000195,99292,HC CRITICAL CARE EA ADDN'T 30 MIN,450,1 ,$510.00 ,$255.00 ,$47.46 ,$510.00 ,$329.46 ,$47.46 ,$329.92 ,$329.92 , N/A ,$306.00 ,$433.50 ,$357.00 ,$47.46 ,$484.50 ,$367.20 ,$372.30 ,$331.50 ,$433.50 , N/A ,$331.50 ,$408.00 ,$372.30 ,$47.46 , N/A ,$510.00 ,$510.00 ,$433.50 , N/A ,$469.20 ,$357.00 ,$255.00 ,$306.00 ,$310.59 ,$255.00 ,$352.41 ,$357.00 , N/A ,$367.20 ,$50.31 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$367.20 ,$316.20 ,$367.20 ,$367.20 ,$306.00 ST VINCENT HOSPITAL - ACUTE,45000196,27810,HC TX FX BIM ANKLE W/MAN CLS,450,1 ,$770.00 ,$385.00 ,$193.84 ,"$3,034.10 ",$497.42 ,$193.84 ,$498.11 ,$498.11 ,"$1,348.49 ",$462.00 ,$654.50 ,$539.00 ,$193.84 ,$731.50 ,$554.40 ,$562.10 ,$500.50 ,$654.50 ,"$1,348.49 ",$500.50 ,$616.00 ,$562.10 ,$193.84 ,"$1,348.49 ",$557.43 ,$770.00 ,$654.50 ,"$3,034.10 ",$708.40 ,$539.00 ,$385.00 ,$462.00 ,$468.93 ,$385.00 ,$532.07 ,$539.00 ,"$1,361.97 ",$554.40 ,$205.47 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ",$554.40 ,$477.40 ,$554.40 ,$554.40 ,$462.00 ST VINCENT HOSPITAL - ACUTE,45000197,26700,HC TX DISL (M-P) W/O ANES CLS,450,1 ,$710.00 ,$355.00 ,$193.84 ,$710.00 ,$458.66 ,$193.84 ,$459.30 ,$459.30 ,$199.70 ,$426.00 ,$603.50 ,$497.00 ,$193.84 ,$674.50 ,$511.20 ,$518.30 ,$461.50 ,$603.50 ,$199.70 ,$461.50 ,$568.00 ,$518.30 ,$193.84 ,$199.70 ,$557.43 ,$710.00 ,$603.50 ,$449.31 ,$653.20 ,$497.00 ,$355.00 ,$426.00 ,$432.39 ,$355.00 ,$490.61 ,$497.00 ,$201.70 ,$511.20 ,$205.47 ,$669.00 ,$669.00 ,$199.70 ,$669.00 ,$199.70 ,$511.20 ,$440.20 ,$511.20 ,$511.20 ,$426.00 ST VINCENT HOSPITAL - ACUTE,45000198,21480,HC TX DISL JAW CLS-UNI,450,1 ,$430.00 ,$215.00 ,$35.67 ,$449.31 ,$277.78 ,$35.67 ,$278.17 ,$278.17 ,$199.70 ,$258.00 ,$365.50 ,$301.00 ,$35.67 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$199.70 ,$279.50 ,$344.00 ,$313.90 ,$35.67 ,$199.70 ,$430.00 ,$430.00 ,$365.50 ,$449.31 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$201.70 ,$309.60 ,$37.81 ,$430.00 ,$430.00 ,$199.70 ,$430.00 ,$199.70 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,45000199,35207,HC RPR VESSEL HAND/FINGER,450,1 ,"$3,400.00 ","$1,700.00 ",$557.43 ,"$6,235.91 ","$2,196.40 ",$624.62 ,"$2,199.46 ","$2,199.46 ","$2,771.52 ","$2,040.00 ","$2,890.00 ","$2,380.00 ",$624.62 ,"$3,230.00 ","$2,448.00 ","$2,482.00 ","$2,210.00 ","$2,890.00 ","$2,771.52 ","$2,210.00 ","$2,720.00 ","$2,482.00 ",$624.62 ,"$2,771.52 ",$557.43 ,"$3,400.00 ","$2,890.00 ","$6,235.91 ","$3,128.00 ","$2,380.00 ","$1,700.00 ","$2,040.00 ","$2,070.60 ","$1,700.00 ","$2,349.40 ","$2,380.00 ","$2,799.24 ","$2,448.00 ",$662.10 ,$669.00 ,$669.00 ,"$2,771.52 ",$669.00 ,"$2,771.52 ","$2,448.00 ","$2,108.00 ","$2,448.00 ","$2,448.00 ","$2,040.00 " ST VINCENT HOSPITAL - ACUTE,45000200,35206,HC RPR VESSEL EXTREM UPR,450,1 ,"$3,400.00 ","$1,700.00 ",$557.43 ,"$6,235.91 ","$2,196.40 ",$624.62 ,"$2,199.46 ","$2,199.46 ","$2,771.52 ","$2,040.00 ","$2,890.00 ","$2,380.00 ",$624.62 ,"$3,230.00 ","$2,448.00 ","$2,482.00 ","$2,210.00 ","$2,890.00 ","$2,771.52 ","$2,210.00 ","$2,720.00 ","$2,482.00 ",$624.62 ,"$2,771.52 ",$557.43 ,"$3,400.00 ","$2,890.00 ","$6,235.91 ","$3,128.00 ","$2,380.00 ","$1,700.00 ","$2,040.00 ","$2,070.60 ","$1,700.00 ","$2,349.40 ","$2,380.00 ","$2,799.24 ","$2,448.00 ",$662.10 ,$669.00 ,$669.00 ,"$2,771.52 ",$669.00 ,"$2,771.52 ","$2,448.00 ","$2,108.00 ","$2,448.00 ","$2,448.00 ","$2,040.00 " ST VINCENT HOSPITAL - ACUTE,45000202,26645,HC CL TX CARPOMETACARPAL FRAC DISLOC THUMB,450,1 ,$680.00 ,$340.00 ,$193.84 ,"$3,034.10 ",$439.28 ,$193.84 ,$439.89 ,$439.89 ,"$1,348.49 ",$408.00 ,$578.00 ,$476.00 ,$193.84 ,$646.00 ,$489.60 ,$496.40 ,$442.00 ,$578.00 ,"$1,348.49 ",$442.00 ,$544.00 ,$496.40 ,$193.84 ,"$1,348.49 ",$557.43 ,$680.00 ,$578.00 ,"$3,034.10 ",$625.60 ,$476.00 ,$340.00 ,$408.00 ,$414.12 ,$340.00 ,$469.88 ,$476.00 ,"$1,361.97 ",$489.60 ,$205.47 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ",$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,45000203,27840,HC TX DISL ANKE W/O ANES CLS,450,1 ,$550.00 ,$275.00 ,$193.84 ,$550.00 ,$355.30 ,$193.84 ,$355.80 ,$355.80 ,$199.70 ,$330.00 ,$467.50 ,$385.00 ,$193.84 ,$522.50 ,$396.00 ,$401.50 ,$357.50 ,$467.50 ,$199.70 ,$357.50 ,$440.00 ,$401.50 ,$193.84 ,$199.70 ,$550.00 ,$550.00 ,$467.50 ,$449.31 ,$506.00 ,$385.00 ,$275.00 ,$330.00 ,$334.95 ,$275.00 ,$380.05 ,$385.00 ,$201.70 ,$396.00 ,$205.47 ,$550.00 ,$550.00 ,$199.70 ,$550.00 ,$199.70 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,45000204,23931,HC I AND D BURSA ELBOW/ARM,450,1 ,"$1,400.00 ",$700.00 ,$496.73 ,"$3,066.03 ",$904.40 ,$496.73 ,$905.66 ,$905.66 ,"$1,362.68 ",$840.00 ,"$1,190.00 ",$980.00 ,$496.73 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ","$1,362.68 ",$910.00 ,"$1,120.00 ","$1,022.00 ",$496.73 ,"$1,362.68 ",$557.43 ,"$1,400.00 ","$1,190.00 ","$3,066.03 ","$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 ,"$1,376.31 ","$1,008.00 ",$526.53 ,$669.00 ,$669.00 ,"$1,362.68 ",$669.00 ,"$1,362.68 ","$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,45000205,31605,HC TRACHEOSTOMY,450,1 ,"$1,300.00 ",$650.00 ,$204.93 ,"$1,300.00 ",$839.80 ,$674.32 ,$840.97 ,$840.97 ,$204.93 ,$780.00 ,"$1,105.00 ",$910.00 ,$674.32 ,"$1,235.00 ",$936.00 ,$949.00 ,$845.00 ,"$1,105.00 ",$204.93 ,$845.00 ,"$1,040.00 ",$949.00 ,$674.32 ,$204.93 ,$557.43 ,"$1,300.00 ","$1,105.00 ",$461.10 ,"$1,196.00 ",$910.00 ,$650.00 ,$780.00 ,$791.70 ,$650.00 ,$898.30 ,$910.00 ,$206.98 ,$936.00 ,$714.78 ,$669.00 ,$669.00 ,$204.93 ,$669.00 ,$204.93 ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,45000206,36405,HC VENIPUNCTURE SCALP VEIN <3YRS,450,1 ,$42.00 ,$21.00 ,$0.72 ,$42.00 ,$27.13 ,$0.72 ,$27.17 ,$27.17 , N/A ,$25.20 ,$35.70 ,$29.40 ,$0.72 ,$39.90 ,$30.24 ,$30.66 ,$27.30 ,$35.70 , N/A ,$27.30 ,$33.60 ,$30.66 ,$0.72 , N/A ,$42.00 ,$42.00 ,$35.70 , N/A ,$38.64 ,$29.40 ,$21.00 ,$25.20 ,$25.58 ,$21.00 ,$29.02 ,$29.40 , N/A ,$30.24 ,$0.76 ,$42.00 ,$42.00 , N/A ,$42.00 , N/A ,$30.24 ,$26.04 ,$30.24 ,$30.24 ,$25.20 ST VINCENT HOSPITAL - ACUTE,45000207,49084,HC PERITONEAL LAVAGE,450,1 ,$965.00 ,$482.50 ,$202.63 ,"$1,764.22 ",$623.39 ,$202.63 ,$624.26 ,$624.26 ,$784.10 ,$579.00 ,$820.25 ,$675.50 ,$202.63 ,$916.75 ,$694.80 ,$704.45 ,$627.25 ,$820.25 ,$784.10 ,$627.25 ,$772.00 ,$704.45 ,$202.63 ,$784.10 ,$557.43 ,$965.00 ,$820.25 ,"$1,764.22 ",$887.80 ,$675.50 ,$482.50 ,$579.00 ,$587.69 ,$482.50 ,$666.82 ,$675.50 ,$791.94 ,$694.80 ,$214.79 ,$669.00 ,$669.00 ,$784.10 ,$669.00 ,$784.10 ,$694.80 ,$598.30 ,$694.80 ,$694.80 ,$579.00 ST VINCENT HOSPITAL - ACUTE,45000214,37195,HC THROMBOLYSIS;CEREB IV,450,1 ,$706.00 ,$353.00 ,$100.19 ,$706.00 ,$456.08 ,$100.19 ,$456.71 ,$456.71 ,$300.96 ,$423.60 ,$600.10 ,$494.20 ,$100.19 ,$670.70 ,$508.32 ,$515.38 ,$458.90 ,$600.10 ,$300.96 ,$458.90 ,$564.80 ,$515.38 ,$100.19 ,$300.96 ,$557.43 ,$706.00 ,$600.10 ,$677.16 ,$649.52 ,$494.20 ,$353.00 ,$423.60 ,$429.95 ,$353.00 ,$487.85 ,$494.20 ,$303.97 ,$508.32 ,$106.20 ,$669.00 ,$669.00 ,$300.96 ,$669.00 ,$300.96 ,$508.32 ,$437.72 ,$508.32 ,$508.32 ,$423.60 ST VINCENT HOSPITAL - ACUTE,45000219,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP,450,1 ,"$1,294.00 ",$647.00 ,$193.84 ,"$3,034.10 ",$835.92 ,$193.84 ,$837.09 ,$837.09 ,"$1,348.49 ",$776.40 ,"$1,099.90 ",$905.80 ,$193.84 ,"$1,229.30 ",$931.68 ,$944.62 ,$841.10 ,"$1,099.90 ","$1,348.49 ",$841.10 ,"$1,035.20 ",$944.62 ,$193.84 ,"$1,348.49 ",$557.43 ,"$1,294.00 ","$1,099.90 ","$3,034.10 ","$1,190.48 ",$905.80 ,$647.00 ,$776.40 ,$788.05 ,$647.00 ,$894.15 ,$905.80 ,"$1,361.97 ",$931.68 ,$205.47 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ",$931.68 ,$802.28 ,$931.68 ,$931.68 ,$776.40 ST VINCENT HOSPITAL - ACUTE,45000246,24505,HC HUMERAL CLOSED RED FX,450,1 ,"$1,500.00 ",$750.00 ,$193.84 ,"$3,034.10 ",$969.00 ,$193.84 ,$970.35 ,$970.35 ,"$1,348.49 ",$900.00 ,"$1,275.00 ","$1,050.00 ",$193.84 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ","$1,348.49 ",$975.00 ,"$1,200.00 ","$1,095.00 ",$193.84 ,"$1,348.49 ",$557.43 ,"$1,500.00 ","$1,275.00 ","$3,034.10 ","$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ","$1,361.97 ","$1,080.00 ",$205.47 ,$669.00 ,$669.00 ,"$1,348.49 ",$669.00 ,"$1,348.49 ","$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,45000270,20606,HC ARTHROCNT ASP/INJ JT INTRM W/ULTRA,450,1 ,$890.00 ,$445.00 ,$162.48 ,"$1,382.85 ",$574.94 ,$162.48 ,$575.74 ,$575.74 ,$614.60 ,$534.00 ,$756.50 ,$623.00 ,$162.48 ,$845.50 ,$640.80 ,$649.70 ,$578.50 ,$756.50 ,$614.60 ,$578.50 ,$712.00 ,$649.70 ,$162.48 ,$614.60 ,$557.43 ,$890.00 ,$756.50 ,"$1,382.85 ",$818.80 ,$623.00 ,$445.00 ,$534.00 ,$542.01 ,$445.00 ,$614.99 ,$623.00 ,$620.75 ,$640.80 ,$172.23 ,$669.00 ,$669.00 ,$614.60 ,$669.00 ,$614.60 ,$640.80 ,$551.80 ,$640.80 ,$640.80 ,$534.00 ST VINCENT HOSPITAL - ACUTE,45000271,20604,HC ARTHROCNT ASP/INJ JT SMALL W/ULTRA,450,1 ,$860.00 ,$430.00 ,$162.48 ,$860.00 ,$555.56 ,$162.48 ,$556.33 ,$556.33 ,$252.94 ,$516.00 ,$731.00 ,$602.00 ,$162.48 ,$817.00 ,$619.20 ,$627.80 ,$559.00 ,$731.00 ,$252.94 ,$559.00 ,$688.00 ,$627.80 ,$162.48 ,$252.94 ,$557.43 ,$860.00 ,$731.00 ,$569.12 ,$791.20 ,$602.00 ,$430.00 ,$516.00 ,$523.74 ,$430.00 ,$594.26 ,$602.00 ,$255.47 ,$619.20 ,$172.23 ,$669.00 ,$669.00 ,$252.94 ,$669.00 ,$252.94 ,$619.20 ,$533.20 ,$619.20 ,$619.20 ,$516.00 ST VINCENT HOSPITAL - ACUTE,45000272,20611,HC ARTHROCNT ASP/INJ JT MAJOR W/ ULTRA,450,1 ,"$1,100.00 ",$550.00 ,$162.48 ,"$1,100.00 ",$710.60 ,$162.48 ,$711.59 ,$711.59 ,$252.94 ,$660.00 ,$935.00 ,$770.00 ,$162.48 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$252.94 ,$715.00 ,$880.00 ,$803.00 ,$162.48 ,$252.94 ,$557.43 ,"$1,100.00 ",$935.00 ,$569.12 ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$255.47 ,$792.00 ,$172.23 ,$669.00 ,$669.00 ,$252.94 ,$669.00 ,$252.94 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$120.00 ,$60.00 ,$35.67 ,$121.29 ,$77.52 ,$35.67 ,$77.63 ,$77.63 ,$53.91 ,$72.00 ,$102.00 ,$84.00 ,$35.67 ,$114.00 ,$86.40 ,$87.60 ,$78.00 ,$102.00 ,$53.91 ,$78.00 ,$96.00 ,$87.60 ,$35.67 ,$53.91 ,$120.00 ,$120.00 ,$102.00 ,$121.29 ,$110.40 ,$84.00 ,$60.00 ,$72.00 ,$73.08 ,$60.00 ,$82.92 ,$84.00 ,$54.45 ,$86.40 ,$37.81 ,$120.00 ,$120.00 ,$53.91 ,$120.00 ,$53.91 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,45000281,N/A,HC ED PROC LEVEL 1,450,1 ,$300.00 ,$150.00 ,$150.00 ,$300.00 ,$193.80 , N/A ,$194.07 ,$194.07 , N/A ,$180.00 ,$255.00 ,$210.00 , N/A ,$285.00 ,$216.00 ,$219.00 ,$195.00 ,$255.00 , N/A ,$195.00 ,$240.00 ,$219.00 , N/A , N/A ,$300.00 ,$300.00 ,$255.00 , N/A ,$276.00 ,$210.00 ,$150.00 ,$180.00 ,$182.70 ,$150.00 ,$207.30 ,$210.00 , N/A ,$216.00 , N/A ,$300.00 ,$300.00 , N/A ,$300.00 , N/A ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,45000282,N/A,HC ED PROC LEVEL 2,450,1 ,$500.00 ,$250.00 ,$250.00 ,$500.00 ,$323.00 , N/A ,$323.45 ,$323.45 , N/A ,$300.00 ,$425.00 ,$350.00 , N/A ,$475.00 ,$360.00 ,$365.00 ,$325.00 ,$425.00 , N/A ,$325.00 ,$400.00 ,$365.00 , N/A , N/A ,$500.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 , N/A ,$500.00 ,$500.00 , N/A ,$500.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,45000283,N/A,HC ED PROC LEVEL 3,450,1 ,"$1,000.00 ",$500.00 ,$500.00 ,"$1,000.00 ",$646.00 , N/A ,$646.90 ,$646.90 , N/A ,$600.00 ,$850.00 ,$700.00 , N/A ,$950.00 ,$720.00 ,$730.00 ,$650.00 ,$850.00 , N/A ,$650.00 ,$800.00 ,$730.00 , N/A , N/A ,$557.43 ,"$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 , N/A ,$669.00 ,$669.00 , N/A ,$669.00 , N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,45000284,N/A,HC ED PROC LEVEL 4,450,1 ,"$2,000.00 ","$1,000.00 ",$557.43 ,"$2,000.00 ","$1,292.00 ", N/A ,"$1,293.80 ","$1,293.80 ", N/A ,"$1,200.00 ","$1,700.00 ","$1,400.00 ", N/A ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,300.00 ","$1,700.00 ", N/A ,"$1,300.00 ","$1,600.00 ","$1,460.00 ", N/A , N/A ,$557.43 ,"$2,000.00 ","$1,700.00 ", N/A ,"$1,840.00 ","$1,400.00 ","$1,000.00 ","$1,200.00 ","$1,218.00 ","$1,000.00 ","$1,382.00 ","$1,400.00 ", N/A ,"$1,440.00 ", N/A ,$669.00 ,$669.00 , N/A ,$669.00 , N/A ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,45000285,N/A,HC ED PROC LEVEL 5,450,1 ,"$3,000.00 ","$1,500.00 ",$557.43 ,"$3,000.00 ","$1,938.00 ", N/A ,"$1,940.70 ","$1,940.70 ", N/A ,"$1,800.00 ","$2,550.00 ","$2,100.00 ", N/A ,"$2,850.00 ","$2,160.00 ","$2,190.00 ","$1,950.00 ","$2,550.00 ", N/A ,"$1,950.00 ","$2,400.00 ","$2,190.00 ", N/A , N/A ,$557.43 ,"$3,000.00 ","$2,550.00 ", N/A ,"$2,760.00 ","$2,100.00 ","$1,500.00 ","$1,800.00 ","$1,827.00 ","$1,500.00 ","$2,073.00 ","$2,100.00 ", N/A ,"$2,160.00 ", N/A ,$669.00 ,$669.00 , N/A ,$669.00 , N/A ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,45000287,11402,HC EXCISION LESION BENIGN TRUNK/ARM/LEG 1.1-2.0CM,450,1 ,"$1,170.00 ",$585.00 ,$161.28 ,"$1,355.35 ",$755.82 ,$161.28 ,$756.87 ,$756.87 ,$602.38 ,$702.00 ,$994.50 ,$819.00 ,$161.28 ,"$1,111.50 ",$842.40 ,$854.10 ,$760.50 ,$994.50 ,$602.38 ,$760.50 ,$936.00 ,$854.10 ,$161.28 ,$602.38 ,$557.43 ,"$1,170.00 ",$994.50 ,"$1,355.35 ","$1,076.40 ",$819.00 ,$585.00 ,$702.00 ,$712.53 ,$585.00 ,$808.47 ,$819.00 ,$608.40 ,$842.40 ,$170.96 ,$669.00 ,$669.00 ,$602.38 ,$669.00 ,$602.38 ,$842.40 ,$725.40 ,$842.40 ,$842.40 ,$702.00 ST VINCENT HOSPITAL - ACUTE,45000289,11406,HC EXCISION LESION BENIGN TRUNK/ARM/LEG >4.0CM,450,1 ,"$3,945.00 ","$1,972.50 ",$519.54 ,"$3,945.00 ","$2,548.47 ",$519.54 ,"$2,552.02 ","$2,552.02 ","$1,362.68 ","$2,367.00 ","$3,353.25 ","$2,761.50 ",$519.54 ,"$3,747.75 ","$2,840.40 ","$2,879.85 ","$2,564.25 ","$3,353.25 ","$1,362.68 ","$2,564.25 ","$3,156.00 ","$2,879.85 ",$519.54 ,"$1,362.68 ",$557.43 ,"$3,945.00 ","$3,353.25 ","$3,066.03 ","$3,629.40 ","$2,761.50 ","$1,972.50 ","$2,367.00 ","$2,402.51 ","$1,972.50 ","$2,726.00 ","$2,761.50 ","$1,376.31 ","$2,840.40 ",$550.71 ,$669.00 ,$669.00 ,"$1,362.68 ",$669.00 ,"$1,362.68 ","$2,840.40 ","$2,445.90 ","$2,840.40 ","$2,840.40 ","$2,367.00 " ST VINCENT HOSPITAL - ACUTE,45000326,24670,HC CLOSED TX FX ULNAR PROX END W/MANIP,450,1 ,$518.00 ,$259.00 ,$193.84 ,$518.00 ,$334.63 ,$193.84 ,$335.09 ,$335.09 ,$199.70 ,$310.80 ,$440.30 ,$362.60 ,$193.84 ,$492.10 ,$372.96 ,$378.14 ,$336.70 ,$440.30 ,$199.70 ,$336.70 ,$414.40 ,$378.14 ,$193.84 ,$199.70 ,$518.00 ,$518.00 ,$440.30 ,$449.31 ,$476.56 ,$362.60 ,$259.00 ,$310.80 ,$315.46 ,$259.00 ,$357.94 ,$362.60 ,$201.70 ,$372.96 ,$205.47 ,$518.00 ,$518.00 ,$199.70 ,$518.00 ,$199.70 ,$372.96 ,$321.16 ,$372.96 ,$372.96 ,$310.80 ST VINCENT HOSPITAL - ACUTE,45000331,27788,HC CLOSED TX FX DISTAL FIBULAR W/MANIP,450,1 ,$510.00 ,$255.00 ,$193.84 ,$510.00 ,$329.46 ,$193.84 ,$329.92 ,$329.92 ,$199.70 ,$306.00 ,$433.50 ,$357.00 ,$193.84 ,$484.50 ,$367.20 ,$372.30 ,$331.50 ,$433.50 ,$199.70 ,$331.50 ,$408.00 ,$372.30 ,$193.84 ,$199.70 ,$510.00 ,$510.00 ,$433.50 ,$449.31 ,$469.20 ,$357.00 ,$255.00 ,$306.00 ,$310.59 ,$255.00 ,$352.41 ,$357.00 ,$201.70 ,$367.20 ,$205.47 ,$510.00 ,$510.00 ,$199.70 ,$510.00 ,$199.70 ,$367.20 ,$316.20 ,$367.20 ,$367.20 ,$306.00 ST VINCENT HOSPITAL - ACUTE,45001126,32160,HC THORACOTOMY OPEN HEART MASSAGE,450,1 ,"$2,257.00 ","$1,128.50 ",$557.43 ,"$2,257.00 ","$1,458.02 ", N/A ,"$1,460.05 ","$1,460.05 ", N/A ,"$1,354.20 ","$1,918.45 ","$1,579.90 ", N/A ,"$2,144.15 ","$1,625.04 ","$1,647.61 ","$1,467.05 ","$1,918.45 ", N/A ,"$1,467.05 ","$1,805.60 ","$1,647.61 ", N/A , N/A ,$557.43 ,"$2,257.00 ","$1,918.45 ", N/A ,"$2,076.44 ","$1,579.90 ","$1,128.50 ","$1,354.20 ","$1,374.51 ","$1,128.50 ","$1,559.59 ","$1,579.90 ", N/A ,"$1,625.04 ", N/A ,$669.00 ,$669.00 , N/A ,$669.00 , N/A ,"$1,625.04 ","$1,399.34 ","$1,625.04 ","$1,625.04 ","$1,354.20 " ST VINCENT HOSPITAL - ACUTE,45001173,61107,HC PUNCTURE VENTRICULAR CATHETER SUBDURAL,450,1 ,$300.00 ,$150.00 ,$150.00 ,"$2,333.63 ",$193.80 ,$300.00 ,$194.07 ,$194.07 , N/A ,$180.00 ,$255.00 ,$210.00 ,"$2,201.54 ",$285.00 ,$216.00 ,$219.00 ,$195.00 ,$255.00 , N/A ,$195.00 ,$240.00 ,$219.00 ,"$2,201.54 ", N/A ,$300.00 ,$300.00 ,$255.00 , N/A ,$276.00 ,$210.00 ,$150.00 ,$180.00 ,$182.70 ,$150.00 ,$207.30 ,$210.00 , N/A ,$216.00 ,"$2,333.63 ",$300.00 ,$300.00 , N/A ,$300.00 , N/A ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,45001258,99284,HC ER LEVEL 4 W/TRAUMA ACT UPON ARRIVAL LVL 1,450,1 ,"$6,200.00 ","$3,100.00 ",$47.46 ,"$6,200.00 ","$4,005.20 ",$47.46 ,"$3,434.00 ","$3,232.00 ",$352.28 ,"$3,720.00 ","$5,270.00 ","$4,340.00 ",$47.46 ,"$5,890.00 ","$4,464.00 ","$4,526.00 ","$3,401.00 ","$5,270.00 ",$352.28 ,"$3,401.00 ","$4,960.00 ","$4,526.00 ",$47.46 ,$352.28 ,"$1,986.86 ","$6,200.00 ","$5,270.00 ",$792.63 ,"$5,704.00 ","$4,340.00 ","$3,100.00 ","$3,720.00 ","$3,775.80 ","$3,100.00 ","$4,284.20 ","$4,340.00 ",$355.80 ,"$4,464.00 ",$50.31 ,"$3,250.00 ","$3,250.00 ",$352.28 ,"$3,250.00 ",$352.28 ,"$4,464.00 ","$3,844.00 ","$4,464.00 ","$4,464.00 ","$3,720.00 " ST VINCENT HOSPITAL - ACUTE,45001259,99285,HC ER LEVEL 5 W/TRAUMA ACT UPON ARRIVAL LVL 1,450,1 ,"$7,000.00 ","$3,500.00 ",$47.46 ,"$7,000.00 ","$4,522.00 ",$47.46 ,"$3,434.00 ","$3,232.00 ",$505.67 ,"$4,200.00 ","$5,950.00 ","$4,900.00 ",$47.46 ,"$6,650.00 ","$5,040.00 ","$5,110.00 ","$5,590.00 ","$5,950.00 ",$505.67 ,"$5,590.00 ","$5,600.00 ","$5,110.00 ",$47.46 ,$505.67 ,"$2,318.01 ","$7,000.00 ","$5,950.00 ","$1,137.76 ","$6,440.00 ","$4,900.00 ","$3,500.00 ","$4,200.00 ","$4,263.00 ","$3,500.00 ","$4,837.00 ","$4,900.00 ",$510.73 ,"$5,040.00 ",$50.31 ,"$3,250.00 ","$3,250.00 ",$505.67 ,"$3,250.00 ",$505.67 ,"$5,040.00 ","$4,340.00 ","$5,040.00 ","$5,040.00 ","$4,200.00 " ST VINCENT HOSPITAL - ACUTE,45001262,99291,HC ER CRITICAL CARE W/TRAUMA ACT UPON ARRIVAL LVL 1,450,1 ,"$7,400.00 ","$3,700.00 ",$47.46 ,"$7,400.00 ","$4,780.40 ",$47.46 ,"$6,666.00 ","$6,060.00 ",$670.86 ,"$4,440.00 ","$6,290.00 ","$5,180.00 ",$47.46 ,"$7,030.00 ","$5,328.00 ","$5,402.00 ","$6,672.00 ","$6,290.00 ",$670.86 ,"$6,672.00 ","$5,920.00 ","$5,402.00 ",$47.46 ,$670.86 ,"$2,869.91 ","$7,400.00 ","$6,290.00 ","$1,509.44 ","$6,808.00 ","$5,180.00 ","$3,700.00 ","$4,440.00 ","$4,506.60 ","$3,700.00 ","$5,113.40 ","$5,180.00 ",$677.57 ,"$5,328.00 ",$50.31 ,"$6,162.00 ","$6,162.00 ",$670.86 ,"$6,162.00 ",$670.86 ,"$5,328.00 ","$4,588.00 ","$5,328.00 ","$5,328.00 ","$4,440.00 " ST VINCENT HOSPITAL - ACUTE,45001331,43762,HC REPLACE GASTRO TUBE PERC,450,1 ,$710.00 ,$355.00 ,$60.28 ,$710.00 ,$458.66 ,$60.28 ,$459.30 ,$459.30 ,$257.76 ,$426.00 ,$603.50 ,$497.00 ,$60.28 ,$674.50 ,$511.20 ,$518.30 ,$461.50 ,$603.50 ,$257.76 ,$461.50 ,$568.00 ,$518.30 ,$60.28 ,$257.76 ,$557.43 ,$710.00 ,$603.50 ,$579.95 ,$653.20 ,$497.00 ,$355.00 ,$426.00 ,$432.39 ,$355.00 ,$490.61 ,$497.00 ,$260.34 ,$511.20 ,$63.90 ,$669.00 ,$669.00 ,$257.76 ,$669.00 ,$257.76 ,$511.20 ,$440.20 ,$511.20 ,$511.20 ,$426.00 ST VINCENT HOSPITAL - ACUTE,45001332,43763,HC REPLACE GASTRO TUBE PERC W/REVISE TRACT,450,1 ,$900.00 ,$450.00 ,$60.28 ,$900.00 ,$581.40 ,$60.28 ,$582.21 ,$582.21 ,$257.76 ,$540.00 ,$765.00 ,$630.00 ,$60.28 ,$855.00 ,$648.00 ,$657.00 ,$585.00 ,$765.00 ,$257.76 ,$585.00 ,$720.00 ,$657.00 ,$60.28 ,$257.76 ,$557.43 ,$900.00 ,$765.00 ,$579.95 ,$828.00 ,$630.00 ,$450.00 ,$540.00 ,$548.10 ,$450.00 ,$621.90 ,$630.00 ,$260.34 ,$648.00 ,$63.90 ,$669.00 ,$669.00 ,$257.76 ,$669.00 ,$257.76 ,$648.00 ,$558.00 ,$648.00 ,$648.00 ,$540.00 ST VINCENT HOSPITAL - ACUTE,45001345,49000,HC EXPLORE ABDOMEN W/WO BIOPSY,450,1 ,"$6,850.00 ","$3,425.00 ",$557.43 ,"$6,850.00 ","$4,425.10 ",$899.79 ,"$4,431.27 ","$4,431.27 ", N/A ,"$4,110.00 ","$5,822.50 ","$4,795.00 ",$899.79 ,"$6,507.50 ","$4,932.00 ","$5,000.50 ","$4,452.50 ","$5,822.50 ", N/A ,"$4,452.50 ","$5,480.00 ","$5,000.50 ",$899.79 , N/A ,$557.43 ,"$6,850.00 ","$5,822.50 ", N/A ,"$6,302.00 ","$4,795.00 ","$3,425.00 ","$4,110.00 ","$4,171.65 ","$3,425.00 ","$4,733.35 ","$4,795.00 ", N/A ,"$4,932.00 ",$953.78 ,$669.00 ,$669.00 , N/A ,$669.00 , N/A ,"$4,932.00 ","$4,247.00 ","$4,932.00 ","$4,932.00 ","$4,110.00 " ST VINCENT HOSPITAL - ACUTE,46000002,94010,HC SPIROMETRY/PFT PKG,460,1 ,$380.00 ,$190.00 ,$73.19 ,$380.00 ,$245.48 ,$73.19 ,$245.82 ,$245.82 ,$135.15 ,$228.00 ,$323.00 ,$266.00 ,$73.19 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 ,$135.15 ,$247.00 ,$304.00 ,$277.40 ,$73.19 ,$135.15 ,$339.97 ,$380.00 ,$323.00 ,$304.10 ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 ,$136.50 ,$273.60 ,$77.58 ,$380.00 ,$380.00 ,$135.15 ,$380.00 ,$135.15 ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,46000003,94010,HC SPIROMETRY/PFT PKG ATTEMPTED,460,1 ,$380.00 ,$190.00 ,$73.19 ,$380.00 ,$245.48 ,$73.19 ,$245.82 ,$245.82 ,$135.15 ,$228.00 ,$323.00 ,$266.00 ,$73.19 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 ,$135.15 ,$247.00 ,$304.00 ,$277.40 ,$73.19 ,$135.15 ,$339.97 ,$380.00 ,$323.00 ,$304.10 ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 ,$136.50 ,$273.60 ,$77.58 ,$380.00 ,$380.00 ,$135.15 ,$380.00 ,$135.15 ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,46000004,94060,HC SPIROMETRY/PFT PRE AND POST,460,1 ,$680.00 ,$340.00 ,$73.19 ,$680.00 ,$439.28 ,$73.19 ,$439.89 ,$439.89 ,$256.12 ,$408.00 ,$578.00 ,$476.00 ,$73.19 ,$646.00 ,$489.60 ,$496.40 ,$442.00 ,$578.00 ,$256.12 ,$442.00 ,$544.00 ,$496.40 ,$73.19 ,$256.12 ,$339.97 ,$680.00 ,$578.00 ,$576.27 ,$625.60 ,$476.00 ,$340.00 ,$408.00 ,$414.12 ,$340.00 ,$469.88 ,$476.00 ,$258.68 ,$489.60 ,$77.58 ,$575.00 ,$575.00 ,$256.12 ,$575.00 ,$256.12 ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,46000005,94060,HC SPIROMETRY/PFT PRE AND POST UPDRAFT,460,1 ,$630.00 ,$315.00 ,$73.19 ,$630.00 ,$406.98 ,$73.19 ,$407.55 ,$407.55 ,$256.12 ,$378.00 ,$535.50 ,$441.00 ,$73.19 ,$598.50 ,$453.60 ,$459.90 ,$409.50 ,$535.50 ,$256.12 ,$409.50 ,$504.00 ,$459.90 ,$73.19 ,$256.12 ,$339.97 ,$630.00 ,$535.50 ,$576.27 ,$579.60 ,$441.00 ,$315.00 ,$378.00 ,$383.67 ,$315.00 ,$435.33 ,$441.00 ,$258.68 ,$453.60 ,$77.58 ,$575.00 ,$575.00 ,$256.12 ,$575.00 ,$256.12 ,$453.60 ,$390.60 ,$453.60 ,$453.60 ,$378.00 ST VINCENT HOSPITAL - ACUTE,46000006,94070,HC SPIROMETRY/PFT CPLX,460,1 ,$970.00 ,$485.00 ,$73.19 ,$970.00 ,$626.62 ,$73.19 ,$627.49 ,$627.49 ,$256.12 ,$582.00 ,$824.50 ,$679.00 ,$73.19 ,$921.50 ,$698.40 ,$708.10 ,$630.50 ,$824.50 ,$256.12 ,$630.50 ,$776.00 ,$708.10 ,$73.19 ,$256.12 ,$339.97 ,$970.00 ,$824.50 ,$576.27 ,$892.40 ,$679.00 ,$485.00 ,$582.00 ,$590.73 ,$485.00 ,$670.27 ,$679.00 ,$258.68 ,$698.40 ,$77.58 ,$575.00 ,$575.00 ,$256.12 ,$575.00 ,$256.12 ,$698.40 ,$601.40 ,$698.40 ,$698.40 ,$582.00 ST VINCENT HOSPITAL - ACUTE,46000007,94150,HC VITAL CAPACITY TOTAL,460,1 ,$150.00 ,$75.00 ,$21.41 ,$304.10 ,$96.90 ,$21.41 ,$97.04 ,$97.04 ,$135.15 ,$90.00 ,$127.50 ,$105.00 ,$21.41 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 ,$135.15 ,$97.50 ,$120.00 ,$109.50 ,$21.41 ,$135.15 ,$150.00 ,$150.00 ,$127.50 ,$304.10 ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 ,$136.50 ,$108.00 ,$22.69 ,$150.00 ,$150.00 ,$135.15 ,$150.00 ,$135.15 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,46000008,94729,HC RESIDUAL LUNG CAPACITY,460,1 ,$290.00 ,$145.00 ,$21.41 ,$290.00 ,$187.34 ,$21.41 ,$187.60 ,$187.60 , N/A ,$174.00 ,$246.50 ,$203.00 ,$21.41 ,$275.50 ,$208.80 ,$211.70 ,$188.50 ,$246.50 , N/A ,$188.50 ,$232.00 ,$211.70 ,$21.41 , N/A ,$290.00 ,$290.00 ,$246.50 , N/A ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 , N/A ,$208.80 ,$22.69 ,$290.00 ,$290.00 , N/A ,$290.00 , N/A ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,46000009,94250,HC EXPIRED GAS COLLECTION,460,1 ,$150.00 ,$75.00 ,$75.00 ,$150.00 ,$96.90 , N/A ,$97.04 ,$97.04 , N/A ,$90.00 ,$127.50 ,$105.00 , N/A ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 , N/A ,$97.50 ,$120.00 ,$109.50 , N/A , N/A ,$150.00 ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 , N/A ,$108.00 , N/A ,$150.00 ,$150.00 , N/A ,$150.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,46000010,94726,HC THORACIC GAS VOLUME,460,1 ,$500.00 ,$250.00 ,$21.41 ,$576.27 ,$323.00 ,$21.41 ,$323.45 ,$323.45 ,$256.12 ,$300.00 ,$425.00 ,$350.00 ,$21.41 ,$475.00 ,$360.00 ,$365.00 ,$325.00 ,$425.00 ,$256.12 ,$325.00 ,$400.00 ,$365.00 ,$21.41 ,$256.12 ,$339.97 ,$500.00 ,$425.00 ,$576.27 ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 ,$258.68 ,$360.00 ,$22.69 ,$500.00 ,$500.00 ,$256.12 ,$500.00 ,$256.12 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,46000011,94727,HC NITROGEN WASHOUT CURVE,460,1 ,$290.00 ,$145.00 ,$21.41 ,$304.10 ,$187.34 ,$21.41 ,$187.60 ,$187.60 ,$135.15 ,$174.00 ,$246.50 ,$203.00 ,$21.41 ,$275.50 ,$208.80 ,$211.70 ,$188.50 ,$246.50 ,$135.15 ,$188.50 ,$232.00 ,$211.70 ,$21.41 ,$135.15 ,$290.00 ,$290.00 ,$246.50 ,$304.10 ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 ,$136.50 ,$208.80 ,$22.69 ,$290.00 ,$290.00 ,$135.15 ,$290.00 ,$135.15 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,46000012,94728,HC AIRFLOW RESISTANCE,460,1 ,$220.00 ,$110.00 ,$21.41 ,$576.27 ,$142.12 ,$21.41 ,$142.32 ,$142.32 ,$256.12 ,$132.00 ,$187.00 ,$154.00 ,$21.41 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$256.12 ,$143.00 ,$176.00 ,$160.60 ,$21.41 ,$256.12 ,$220.00 ,$220.00 ,$187.00 ,$576.27 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$258.68 ,$158.40 ,$22.69 ,$220.00 ,$220.00 ,$256.12 ,$220.00 ,$256.12 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,46000014,94618,HC WALK TEST 6 MIN,460,1 ,$470.00 ,$235.00 ,$73.19 ,$470.00 ,$303.62 ,$73.19 ,$304.04 ,$304.04 ,$108.42 ,$282.00 ,$399.50 ,$329.00 ,$73.19 ,$446.50 ,$338.40 ,$343.10 ,$305.50 ,$399.50 ,$108.42 ,$305.50 ,$376.00 ,$343.10 ,$73.19 ,$108.42 ,$339.97 ,$470.00 ,$399.50 ,$243.95 ,$432.40 ,$329.00 ,$235.00 ,$282.00 ,$286.23 ,$235.00 ,$324.77 ,$329.00 ,$109.50 ,$338.40 ,$77.58 ,$470.00 ,$470.00 ,$108.42 ,$470.00 ,$108.42 ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,46000016,94621,HC PULMONARY STRESS TEST CPLX,460,1 ,"$1,200.00 ",$600.00 ,$73.19 ,"$1,200.00 ",$775.20 ,$73.19 ,$776.28 ,$776.28 ,$256.12 ,$720.00 ,"$1,020.00 ",$840.00 ,$73.19 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$256.12 ,$780.00 ,$960.00 ,$876.00 ,$73.19 ,$256.12 ,$339.97 ,"$1,200.00 ","$1,020.00 ",$576.27 ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$258.68 ,$864.00 ,$77.58 ,$575.00 ,$575.00 ,$256.12 ,$575.00 ,$256.12 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,46000017,94729,HC CARBON MONOXIDE DIFF (DLCO),460,1 ,$300.00 ,$150.00 ,$21.41 ,$300.00 ,$193.80 ,$21.41 ,$194.07 ,$194.07 , N/A ,$180.00 ,$255.00 ,$210.00 ,$21.41 ,$285.00 ,$216.00 ,$219.00 ,$195.00 ,$255.00 , N/A ,$195.00 ,$240.00 ,$219.00 ,$21.41 , N/A ,$300.00 ,$300.00 ,$255.00 , N/A ,$276.00 ,$210.00 ,$150.00 ,$180.00 ,$182.70 ,$150.00 ,$207.30 ,$210.00 , N/A ,$216.00 ,$22.69 ,$300.00 ,$300.00 , N/A ,$300.00 , N/A ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,46000018,94762,HC OXIMETRY OVERNIGHT,460,1 ,$240.00 ,$120.00 ,$21.41 ,$304.10 ,$155.04 ,$21.41 ,$155.26 ,$155.26 ,$135.15 ,$144.00 ,$204.00 ,$168.00 ,$21.41 ,$228.00 ,$172.80 ,$175.20 ,$156.00 ,$204.00 ,$135.15 ,$156.00 ,$192.00 ,$175.20 ,$21.41 ,$135.15 ,$240.00 ,$240.00 ,$204.00 ,$304.10 ,$220.80 ,$168.00 ,$120.00 ,$144.00 ,$146.16 ,$120.00 ,$165.84 ,$168.00 ,$136.50 ,$172.80 ,$22.69 ,$240.00 ,$240.00 ,$135.15 ,$240.00 ,$135.15 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,46000020,95801,HC APNEALINK STUDY/SAT,460,1 ,$360.00 ,$180.00 ,$48.85 ,$360.00 ,$232.56 ,$48.85 ,$232.88 ,$232.88 ,$108.42 ,$216.00 ,$306.00 ,$252.00 ,$48.85 ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 ,$108.42 ,$234.00 ,$288.00 ,$262.80 ,$48.85 ,$108.42 ,$339.97 ,$360.00 ,$306.00 ,$243.95 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$109.50 ,$259.20 ,$51.78 ,$360.00 ,$360.00 ,$108.42 ,$360.00 ,$108.42 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,46000022,94200,HC MAXIMAL VOL VENTILATION,942,1 ,$200.00 ,$100.00 ,$21.41 ,$200.00 ,$129.20 ,$21.41 ,$129.38 ,$129.38 ,$53.91 ,$120.00 ,$170.00 ,$140.00 ,$21.41 ,$190.00 ,$144.00 ,$146.00 ,$130.00 ,$170.00 ,$53.91 ,$130.00 ,$160.00 ,$146.00 ,$21.41 ,$53.91 ,$126.94 ,$200.00 ,$170.00 ,$121.29 ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 ,$54.45 ,$144.00 ,$22.69 ,$132.00 ,$132.00 ,$53.91 ,$132.00 ,$53.91 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,46000032,94750,HC PULMONARY COMPLIANCE STUDY,460,1 ,$260.00 ,$130.00 ,$130.00 ,$260.00 ,$167.96 , N/A ,$168.19 ,$168.19 , N/A ,$156.00 ,$221.00 ,$182.00 , N/A ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 , N/A ,$169.00 ,$208.00 ,$189.80 , N/A , N/A ,$260.00 ,$260.00 ,$221.00 , N/A ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 , N/A ,$187.20 , N/A ,$260.00 ,$260.00 , N/A ,$260.00 , N/A ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,46000033,94617,HC EXERCISE TEST BRONCHOSPASM,460,1 ,$260.00 ,$130.00 ,$73.19 ,$260.00 ,$167.96 ,$73.19 ,$168.19 ,$168.19 ,$108.42 ,$156.00 ,$221.00 ,$182.00 ,$73.19 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 ,$108.42 ,$169.00 ,$208.00 ,$189.80 ,$73.19 ,$108.42 ,$260.00 ,$260.00 ,$221.00 ,$243.95 ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 ,$109.50 ,$187.20 ,$77.58 ,$260.00 ,$260.00 ,$108.42 ,$260.00 ,$108.42 ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,46000034,95070,HC INHALATION BRONCHIAL CHALLENGE TEST W/HISTAMINE/METHACHOLINE,460,1 ,$633.00 ,$316.50 ,$14.19 ,"$1,062.93 ",$408.92 ,$14.19 ,$409.49 ,$409.49 ,$472.41 ,$379.80 ,$538.05 ,$443.10 ,$14.19 ,$601.35 ,$455.76 ,$462.09 ,$411.45 ,$538.05 ,$472.41 ,$411.45 ,$506.40 ,$462.09 ,$14.19 ,$472.41 ,$339.97 ,$633.00 ,$538.05 ,"$1,062.93 ",$582.36 ,$443.10 ,$316.50 ,$379.80 ,$385.50 ,$316.50 ,$437.40 ,$443.10 ,$477.13 ,$455.76 ,$15.04 ,$575.00 ,$575.00 ,$472.41 ,$575.00 ,$472.41 ,$455.76 ,$392.46 ,$455.76 ,$455.76 ,$379.80 ST VINCENT HOSPITAL - ACUTE,47000000,92585,HC AUDITORY EVOKED POTENT COMPR,470,1 ,$720.00 ,$360.00 ,$72.00 ,$720.00 ,$465.12 , N/A ,$465.77 ,$465.77 , N/A ,$432.00 ,$612.00 ,$504.00 , N/A ,$684.00 ,$518.40 ,$525.60 ,$468.00 ,$612.00 , N/A ,$468.00 ,$576.00 ,$525.60 , N/A , N/A ,$75.06 ,$720.00 ,$612.00 , N/A ,$662.40 ,$504.00 ,$360.00 ,$432.00 ,$438.48 ,$360.00 ,$497.52 ,$504.00 , N/A ,$518.40 , N/A ,$72.00 ,$72.00 , N/A ,$72.00 , N/A ,$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,47000001,92587,HC DISTORTION EVOKED POTENT LTD,470,1 ,$170.00 ,$85.00 ,$47.82 ,$576.27 ,$109.82 ,$47.82 ,$109.97 ,$109.97 ,$256.12 ,$102.00 ,$144.50 ,$119.00 ,$47.82 ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 ,$256.12 ,$110.50 ,$136.00 ,$124.10 ,$47.82 ,$256.12 ,$75.06 ,$170.00 ,$144.50 ,$576.27 ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 ,$258.68 ,$122.40 ,$50.69 ,$72.00 ,$72.00 ,$256.12 ,$72.00 ,$256.12 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,47000003,92586,HC NEWBORN HEARING SCREENING,470,1 ,$250.00 ,$125.00 ,$72.00 ,$250.00 ,$161.50 , N/A ,$161.73 ,$161.73 , N/A ,$150.00 ,$212.50 ,$175.00 , N/A ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 , N/A ,$162.50 ,$200.00 ,$182.50 , N/A , N/A ,$75.06 ,$250.00 ,$212.50 , N/A ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 , N/A ,$180.00 , N/A ,$72.00 ,$72.00 , N/A ,$72.00 , N/A ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,48000005,92960,HC CARDIOVERSION EXTERNAL,480,1 ,"$1,500.00 ",$750.00 ,$185.89 ,"$1,500.00 ",$969.00 ,$185.89 ,$970.35 ,$970.35 ,$544.21 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$185.89 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ",$544.21 ,$975.00 ,"$1,200.00 ","$1,095.00 ",$185.89 ,$544.21 ,$907.33 ,"$1,500.00 ","$1,275.00 ","$1,224.47 ","$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ",$549.65 ,"$1,080.00 ",$197.04 ,"$1,187.00 ","$1,187.00 ",$544.21 ,"$1,187.00 ",$544.21 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,48000006,92961,HC CARDIOVERSION INTERNAL,480,1 ,$935.00 ,$467.50 ,$185.89 ,"$1,224.47 ",$604.01 ,$185.89 ,$604.85 ,$604.85 ,$544.21 ,$561.00 ,$794.75 ,$654.50 ,$185.89 ,$888.25 ,$673.20 ,$682.55 ,$607.75 ,$794.75 ,$544.21 ,$607.75 ,$748.00 ,$682.55 ,$185.89 ,$544.21 ,$907.33 ,$935.00 ,$794.75 ,"$1,224.47 ",$860.20 ,$654.50 ,$467.50 ,$561.00 ,$569.42 ,$467.50 ,$646.09 ,$654.50 ,$549.65 ,$673.20 ,$197.04 ,$935.00 ,$935.00 ,$544.21 ,$935.00 ,$544.21 ,$673.20 ,$579.70 ,$673.20 ,$673.20 ,$561.00 ST VINCENT HOSPITAL - ACUTE,48000007,93281,HC MULTI CHAM PACEMAKER ANALYSIS,480,1 ,$140.00 ,$70.00 ,$12.22 ,$140.00 ,$90.44 ,$12.22 ,$90.57 ,$90.57 ,$35.98 ,$84.00 ,$119.00 ,$98.00 ,$12.22 ,$133.00 ,$100.80 ,$102.20 ,$91.00 ,$119.00 ,$35.98 ,$91.00 ,$112.00 ,$102.20 ,$12.22 ,$35.98 ,$140.00 ,$140.00 ,$119.00 ,$80.95 ,$128.80 ,$98.00 ,$70.00 ,$84.00 ,$85.26 ,$70.00 ,$96.74 ,$98.00 ,$36.34 ,$100.80 ,$12.95 ,$140.00 ,$140.00 ,$35.98 ,$140.00 ,$35.98 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,48000008,G0269,HC PLACE OCCLUSIVE DEVICE A/VV G0269,480,1 ,$440.00 ,$220.00 ,$220.00 ,$440.00 ,$284.24 , N/A ,$284.64 ,$284.64 , N/A ,$264.00 ,$374.00 ,$308.00 , N/A ,$418.00 ,$316.80 ,$321.20 ,$286.00 ,$374.00 , N/A ,$286.00 ,$352.00 ,$321.20 , N/A , N/A ,$440.00 ,$440.00 ,$374.00 , N/A ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 , N/A ,$316.80 , N/A ,$440.00 ,$440.00 , N/A ,$440.00 , N/A ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,48000010,43280,HC DUAL CHAMBER PACEMAKER ANALYSIS,480,1 ,$140.00 ,$70.00 ,$70.00 ,"$19,410.90 ",$90.44 ,$140.00 ,$90.57 ,$90.57 ,"$8,627.07 ",$84.00 ,$119.00 ,$98.00 ,"$2,179.53 ",$133.00 ,$100.80 ,$102.20 ,$91.00 ,$119.00 ,"$8,627.07 ",$91.00 ,$112.00 ,$102.20 ,"$2,179.53 ","$8,627.07 ",$140.00 ,$140.00 ,$119.00 ,"$19,410.90 ",$128.80 ,$98.00 ,"$5,883.36 ","$7,908.06 ",$85.26 ,"$7,354.20 ",$96.74 ,$98.00 ,"$8,713.34 ",$100.80 ,"$2,310.30 ",$140.00 ,$140.00 ,"$8,627.07 ",$140.00 ,"$8,627.07 ",$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,48000011,93285,HC LOOP RECORDER PROGRAMMING,480,1 ,$105.00 ,$52.50 ,$12.22 ,$105.00 ,$67.83 ,$12.22 ,$67.92 ,$67.92 ,$35.98 ,$63.00 ,$89.25 ,$73.50 ,$12.22 ,$99.75 ,$75.60 ,$76.65 ,$68.25 ,$89.25 ,$35.98 ,$68.25 ,$84.00 ,$76.65 ,$12.22 ,$35.98 ,$105.00 ,$105.00 ,$89.25 ,$80.95 ,$96.60 ,$73.50 ,$52.50 ,$63.00 ,$63.95 ,$52.50 ,$72.56 ,$73.50 ,$36.34 ,$75.60 ,$12.95 ,$105.00 ,$105.00 ,$35.98 ,$105.00 ,$35.98 ,$75.60 ,$65.10 ,$75.60 ,$75.60 ,$63.00 ST VINCENT HOSPITAL - ACUTE,48000012,93261,HC S-ICD INTERROGATION,480,1 ,$105.00 ,$52.50 ,$12.22 ,$105.00 ,$67.83 ,$12.22 ,$67.92 ,$67.92 ,$35.98 ,$63.00 ,$89.25 ,$73.50 ,$12.22 ,$99.75 ,$75.60 ,$76.65 ,$68.25 ,$89.25 ,$35.98 ,$68.25 ,$84.00 ,$76.65 ,$12.22 ,$35.98 ,$105.00 ,$105.00 ,$89.25 ,$80.95 ,$96.60 ,$73.50 ,$52.50 ,$63.00 ,$63.95 ,$52.50 ,$72.56 ,$73.50 ,$36.34 ,$75.60 ,$12.95 ,$105.00 ,$105.00 ,$35.98 ,$105.00 ,$35.98 ,$75.60 ,$65.10 ,$75.60 ,$75.60 ,$63.00 ST VINCENT HOSPITAL - ACUTE,48000013,93260,HC S-ICD PROGRAMMING,480,1 ,$105.00 ,$52.50 ,$12.22 ,$105.00 ,$67.83 ,$12.22 ,$67.92 ,$67.92 ,$35.98 ,$63.00 ,$89.25 ,$73.50 ,$12.22 ,$99.75 ,$75.60 ,$76.65 ,$68.25 ,$89.25 ,$35.98 ,$68.25 ,$84.00 ,$76.65 ,$12.22 ,$35.98 ,$105.00 ,$105.00 ,$89.25 ,$80.95 ,$96.60 ,$73.50 ,$52.50 ,$63.00 ,$63.95 ,$52.50 ,$72.56 ,$73.50 ,$36.34 ,$75.60 ,$12.95 ,$105.00 ,$105.00 ,$35.98 ,$105.00 ,$35.98 ,$75.60 ,$65.10 ,$75.60 ,$75.60 ,$63.00 ST VINCENT HOSPITAL - ACUTE,48000014,93799,HC CARDIOVASCULAR PROCEDURE UNLISTED,480,1 ,$440.00 ,$220.00 ,$8.37 ,$440.00 ,$284.24 ,$8.37 ,$284.64 ,$284.64 ,$135.15 ,$264.00 ,$374.00 ,$308.00 ,$8.37 ,$418.00 ,$316.80 ,$321.20 ,$286.00 ,$374.00 ,$135.15 ,$286.00 ,$352.00 ,$321.20 ,$8.37 ,$135.15 ,$440.00 ,$440.00 ,$374.00 ,$304.10 ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 ,$136.50 ,$316.80 ,$8.87 ,$440.00 ,$440.00 ,$135.15 ,$440.00 ,$135.15 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,48000017,93640,HC EP EVAL CARDIO/DEFIB LEADS,480,1 ,"$2,644.00 ","$1,322.00 ",$907.33 ,"$2,644.00 ","$1,708.02 ","$1,412.36 ","$1,710.40 ","$1,710.40 ", N/A ,"$1,586.40 ","$2,247.40 ","$1,850.80 ","$1,412.36 ","$2,511.80 ","$1,903.68 ","$1,930.12 ","$1,718.60 ","$2,247.40 ", N/A ,"$1,718.60 ","$2,115.20 ","$1,930.12 ","$1,412.36 ", N/A ,$907.33 ,"$2,644.00 ","$2,247.40 ", N/A ,"$2,432.48 ","$1,850.80 ","$1,322.00 ","$1,586.40 ","$1,610.20 ","$1,322.00 ","$1,827.00 ","$1,850.80 ", N/A ,"$1,903.68 ","$1,497.10 ","$1,187.00 ","$1,187.00 ", N/A ,"$1,187.00 ", N/A ,"$1,903.68 ","$1,639.28 ","$1,903.68 ","$1,903.68 ","$1,586.40 " ST VINCENT HOSPITAL - ACUTE,48000024,93668,HC PAD REHAB PER SESSION,480,1 ,$106.00 ,$53.00 ,$13.25 ,$121.29 ,$68.48 ,$13.25 ,$68.57 ,$68.57 ,$53.91 ,$63.60 ,$90.10 ,$74.20 ,$13.25 ,$100.70 ,$76.32 ,$77.38 ,$68.90 ,$90.10 ,$53.91 ,$68.90 ,$84.80 ,$77.38 ,$13.25 ,$53.91 ,$106.00 ,$106.00 ,$90.10 ,$121.29 ,$97.52 ,$74.20 ,$53.00 ,$63.60 ,$64.55 ,$53.00 ,$73.25 ,$74.20 ,$54.45 ,$76.32 ,$14.05 ,$106.00 ,$106.00 ,$53.91 ,$106.00 ,$53.91 ,$76.32 ,$65.72 ,$76.32 ,$76.32 ,$63.60 ST VINCENT HOSPITAL - ACUTE,48100002,33206,HC INS/REPL PCMKR PERM ATRIAL 33206,481,1 ,"$7,400.00 ","$3,700.00 ","$2,452.48 ","$22,663.23 ","$4,780.40 ","$2,452.48 ","$7,400.00 ","$7,400.00 ","$10,072.55 ","$4,440.00 ","$6,290.00 ","$5,180.00 ","$2,452.48 ","$7,030.00 ","$5,328.00 ","$5,402.00 ","$7,400.00 ","$6,290.00 ","$10,072.55 ","$7,400.00 ","$5,920.00 ","$5,402.00 ","$2,452.48 ","$10,072.55 ","$7,400.00 ","$7,400.00 ","$6,290.00 ","$22,663.23 ","$6,808.00 ","$5,180.00 ","$5,818.90 ","$7,821.36 ","$4,506.60 ","$7,273.62 ","$5,113.40 ","$5,180.00 ","$10,173.28 ","$5,328.00 ","$2,599.63 ","$7,400.00 ","$7,400.00 ","$10,072.55 ","$7,400.00 ","$10,072.55 ","$5,328.00 ","$4,588.00 ","$5,328.00 ","$5,328.00 ","$4,440.00 " ST VINCENT HOSPITAL - ACUTE,48100003,33207,HC INS/REPL PACEMKR PERM VENTRIC 33207,481,1 ,"$7,400.00 ","$3,700.00 ","$2,452.48 ","$22,663.23 ","$4,780.40 ","$2,452.48 ","$7,400.00 ","$7,400.00 ","$10,072.55 ","$4,440.00 ","$6,290.00 ","$5,180.00 ","$2,452.48 ","$7,030.00 ","$5,328.00 ","$5,402.00 ","$7,400.00 ","$6,290.00 ","$10,072.55 ","$7,400.00 ","$5,920.00 ","$5,402.00 ","$2,452.48 ","$10,072.55 ","$7,400.00 ","$7,400.00 ","$6,290.00 ","$22,663.23 ","$6,808.00 ","$5,180.00 ","$5,818.90 ","$7,821.36 ","$4,506.60 ","$7,273.62 ","$5,113.40 ","$5,180.00 ","$10,173.28 ","$5,328.00 ","$2,599.63 ","$7,400.00 ","$7,400.00 ","$10,072.55 ","$7,400.00 ","$10,072.55 ","$5,328.00 ","$4,588.00 ","$5,328.00 ","$5,328.00 ","$4,440.00 " ST VINCENT HOSPITAL - ACUTE,48100004,33208,HC INS/REPL PACEMKR PERM A/V 33208,481,1 ,"$8,300.00 ","$4,150.00 ","$2,452.48 ","$22,663.23 ","$5,361.80 ","$2,452.48 ","$8,300.00 ","$8,300.00 ","$10,072.55 ","$4,980.00 ","$7,055.00 ","$5,810.00 ","$2,452.48 ","$7,885.00 ","$5,976.00 ","$6,059.00 ","$8,300.00 ","$7,055.00 ","$10,072.55 ","$8,300.00 ","$6,640.00 ","$6,059.00 ","$2,452.48 ","$10,072.55 ","$8,300.00 ","$8,300.00 ","$7,055.00 ","$22,663.23 ","$7,636.00 ","$5,810.00 ","$5,818.90 ","$7,821.36 ","$5,054.70 ","$7,273.62 ","$5,735.30 ","$5,810.00 ","$10,173.28 ","$5,976.00 ","$2,599.63 ","$8,300.00 ","$8,300.00 ","$10,072.55 ","$8,300.00 ","$10,072.55 ","$5,976.00 ","$5,146.00 ","$5,976.00 ","$5,976.00 ","$4,980.00 " ST VINCENT HOSPITAL - ACUTE,48100005,33210,HC INS/REPL TPM SGL ELEC/CATH 33210,481,1 ,"$4,000.00 ","$2,000.00 ",$430.13 ,"$17,765.49 ","$2,584.00 ",$430.13 ,"$4,000.00 ","$4,000.00 ","$7,895.77 ","$2,400.00 ","$3,400.00 ","$2,800.00 ",$430.13 ,"$3,800.00 ","$2,880.00 ","$2,920.00 ","$4,000.00 ","$3,400.00 ","$7,895.77 ","$4,000.00 ","$3,200.00 ","$2,920.00 ",$430.13 ,"$7,895.77 ","$4,000.00 ","$4,000.00 ","$3,400.00 ","$17,765.49 ","$3,680.00 ","$2,800.00 ","$5,818.90 ","$7,821.36 ","$2,436.00 ","$7,273.62 ","$2,764.00 ","$2,800.00 ","$7,974.73 ","$2,880.00 ",$455.94 ,"$4,000.00 ","$4,000.00 ","$7,895.77 ","$4,000.00 ","$7,895.77 ","$2,880.00 ","$2,480.00 ","$2,880.00 ","$2,880.00 ","$2,400.00 " ST VINCENT HOSPITAL - ACUTE,48100006,33212,HC INS PULSE GEN SGL CHAMBER 33212,481,1 ,"$7,400.00 ","$3,700.00 ","$2,452.48 ","$17,765.49 ","$4,780.40 ","$2,452.48 ","$7,400.00 ","$7,400.00 ","$7,895.77 ","$4,440.00 ","$6,290.00 ","$5,180.00 ","$2,452.48 ","$7,030.00 ","$5,328.00 ","$5,402.00 ","$6,436.00 ","$6,290.00 ","$7,895.77 ","$6,436.00 ","$5,920.00 ","$5,402.00 ","$2,452.48 ","$7,895.77 ","$7,400.00 ","$7,400.00 ","$6,290.00 ","$17,765.49 ","$6,808.00 ","$5,180.00 ","$5,818.90 ","$7,821.36 ","$4,506.60 ","$7,273.62 ","$5,113.40 ","$5,180.00 ","$7,974.73 ","$5,328.00 ","$2,599.63 ","$7,400.00 ","$7,400.00 ","$7,895.77 ","$7,400.00 ","$7,895.77 ","$5,328.00 ","$4,588.00 ","$5,328.00 ","$5,328.00 ","$4,440.00 " ST VINCENT HOSPITAL - ACUTE,48100007,33213,HC INS PULSE GEN DUAL CHAMBER 33213,481,1 ,"$9,375.00 ","$4,687.50 ","$2,452.48 ","$22,663.23 ","$6,056.25 ","$2,452.48 ","$9,375.00 ","$9,375.00 ","$10,072.55 ","$5,625.00 ","$7,968.75 ","$6,562.50 ","$2,452.48 ","$8,906.25 ","$6,750.00 ","$6,843.75 ","$6,436.00 ","$7,968.75 ","$10,072.55 ","$6,436.00 ","$7,500.00 ","$6,843.75 ","$2,452.48 ","$10,072.55 ","$9,375.00 ","$9,375.00 ","$7,968.75 ","$22,663.23 ","$8,625.00 ","$6,562.50 ","$3,206.88 ","$4,310.52 ","$5,709.38 ","$4,008.60 ","$6,478.13 ","$6,562.50 ","$10,173.28 ","$6,750.00 ","$2,599.63 ","$9,375.00 ","$9,375.00 ","$10,072.55 ","$9,375.00 ","$10,072.55 ","$6,750.00 ","$5,812.50 ","$6,750.00 ","$6,750.00 ","$5,625.00 " ST VINCENT HOSPITAL - ACUTE,48100008,33214,HC UPGRADE PACEMAKER SYSTEM 33214,481,1 ,"$13,230.00 ","$6,615.00 ","$2,452.48 ","$22,663.23 ","$8,546.58 ","$2,452.48 ","$13,230.00 ","$11,363.00 ","$10,072.55 ","$7,938.00 ","$11,245.50 ","$9,261.00 ","$2,452.48 ","$12,568.50 ","$9,525.60 ","$9,657.90 ","$13,230.00 ","$11,245.50 ","$10,072.55 ","$13,230.00 ","$10,584.00 ","$9,657.90 ","$2,452.48 ","$10,072.55 ","$13,230.00 ","$13,230.00 ","$11,245.50 ","$22,663.23 ","$12,171.60 ","$9,261.00 ","$5,818.90 ","$7,821.36 ","$8,057.07 ","$7,273.62 ","$9,141.93 ","$9,261.00 ","$10,173.28 ","$9,525.60 ","$2,599.63 ","$13,230.00 ","$13,230.00 ","$10,072.55 ","$13,230.00 ","$10,072.55 ","$9,525.60 ","$8,202.60 ","$9,525.60 ","$9,525.60 ","$7,938.00 " ST VINCENT HOSPITAL - ACUTE,48100009,33215,HC REPOSITION PACE/DEFIB LEAD 33215,481,1 ,"$3,200.00 ","$1,600.00 ",$430.13 ,"$7,821.36 ","$2,067.20 ",$430.13 ,"$3,200.00 ","$3,200.00 ","$2,771.52 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$430.13 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$3,200.00 ","$2,720.00 ","$2,771.52 ","$3,200.00 ","$2,560.00 ","$2,336.00 ",$430.13 ,"$2,771.52 ","$3,200.00 ","$3,200.00 ","$2,720.00 ","$6,235.91 ","$2,944.00 ","$2,240.00 ","$5,818.90 ","$7,821.36 ","$1,948.80 ","$7,273.62 ","$2,211.20 ","$2,240.00 ","$2,799.24 ","$2,304.00 ",$455.94 ,"$3,200.00 ","$3,200.00 ","$2,771.52 ","$3,200.00 ","$2,771.52 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,48100010,33216,HC INS ELECTRODE SGL CHAMBER 33216,481,1 ,"$5,515.00 ","$2,757.50 ",$430.13 ,"$17,765.49 ","$3,562.69 ",$430.13 ,"$5,515.00 ","$5,515.00 ","$7,895.77 ","$3,309.00 ","$4,687.75 ","$3,860.50 ",$430.13 ,"$5,239.25 ","$3,970.80 ","$4,025.95 ","$5,515.00 ","$4,687.75 ","$7,895.77 ","$5,515.00 ","$4,412.00 ","$4,025.95 ",$430.13 ,"$7,895.77 ","$5,515.00 ","$5,515.00 ","$4,687.75 ","$17,765.49 ","$5,073.80 ","$3,860.50 ","$5,818.90 ","$7,821.36 ","$3,358.64 ","$7,273.62 ","$3,810.87 ","$3,860.50 ","$7,974.73 ","$3,970.80 ",$455.94 ,"$5,515.00 ","$5,515.00 ","$7,895.77 ","$5,515.00 ","$7,895.77 ","$3,970.80 ","$3,419.30 ","$3,970.80 ","$3,970.80 ","$3,309.00 " ST VINCENT HOSPITAL - ACUTE,48100011,33217,HC INS ELECTRODE DUAL CHAMBER 33217,481,1 ,"$5,400.00 ","$2,700.00 ",$430.13 ,"$17,765.49 ","$3,488.40 ",$430.13 ,"$5,400.00 ","$5,400.00 ","$7,895.77 ","$3,240.00 ","$4,590.00 ","$3,780.00 ",$430.13 ,"$5,130.00 ","$3,888.00 ","$3,942.00 ","$5,400.00 ","$4,590.00 ","$7,895.77 ","$5,400.00 ","$4,320.00 ","$3,942.00 ",$430.13 ,"$7,895.77 ","$5,400.00 ","$5,400.00 ","$4,590.00 ","$17,765.49 ","$4,968.00 ","$3,780.00 ","$5,818.90 ","$7,821.36 ","$3,288.60 ","$7,273.62 ","$3,731.40 ","$3,780.00 ","$7,974.73 ","$3,888.00 ",$455.94 ,"$5,400.00 ","$5,400.00 ","$7,895.77 ","$5,400.00 ","$7,895.77 ","$3,888.00 ","$3,348.00 ","$3,888.00 ","$3,888.00 ","$3,240.00 " ST VINCENT HOSPITAL - ACUTE,48100012,33222,HC REVISE PACEMAKER POCKET 33222,481,1 ,"$3,200.00 ","$1,600.00 ",$430.13 ,"$3,737.98 ","$2,067.20 ",$430.13 ,"$3,200.00 ","$3,200.00 ","$1,661.33 ","$1,920.00 ","$2,720.00 ","$2,240.00 ",$430.13 ,"$3,040.00 ","$2,304.00 ","$2,336.00 ","$3,200.00 ","$2,720.00 ","$1,661.33 ","$3,200.00 ","$2,560.00 ","$2,336.00 ",$430.13 ,"$1,661.33 ","$3,200.00 ","$3,200.00 ","$2,720.00 ","$3,737.98 ","$2,944.00 ","$2,240.00 ","$2,066.93 ","$2,778.48 ","$1,948.80 ","$2,583.66 ","$2,211.20 ","$2,240.00 ","$1,677.94 ","$2,304.00 ",$455.94 ,"$3,200.00 ","$3,200.00 ","$1,661.33 ","$3,200.00 ","$1,661.33 ","$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,48100013,33223,HC REVISE C-D POCKET 33223,481,1 ,"$2,810.00 ","$1,405.00 ",$430.13 ,"$3,737.98 ","$1,815.26 ",$430.13 ,"$2,810.00 ","$2,810.00 ","$1,661.33 ","$1,686.00 ","$2,388.50 ","$1,967.00 ",$430.13 ,"$2,669.50 ","$2,023.20 ","$2,051.30 ","$2,810.00 ","$2,388.50 ","$1,661.33 ","$2,810.00 ","$2,248.00 ","$2,051.30 ",$430.13 ,"$1,661.33 ","$2,810.00 ","$2,810.00 ","$2,388.50 ","$3,737.98 ","$2,585.20 ","$1,967.00 ","$2,066.93 ","$2,778.48 ","$1,711.29 ","$2,583.66 ","$1,941.71 ","$1,967.00 ","$1,677.94 ","$2,023.20 ",$455.94 ,"$2,810.00 ","$2,810.00 ","$1,661.33 ","$2,810.00 ","$1,661.33 ","$2,023.20 ","$1,742.20 ","$2,023.20 ","$2,023.20 ","$1,686.00 " ST VINCENT HOSPITAL - ACUTE,48100014,33224,HC INSERT LV PACING ELECTRODE 33224,481,1 ,"$7,950.00 ","$3,975.00 ","$2,452.48 ","$22,663.23 ","$5,135.70 ","$2,452.48 ","$7,950.00 ","$7,950.00 ","$10,072.55 ","$4,770.00 ","$6,757.50 ","$5,565.00 ","$2,452.48 ","$7,552.50 ","$5,724.00 ","$5,803.50 ","$6,750.00 ","$6,757.50 ","$10,072.55 ","$6,750.00 ","$6,360.00 ","$5,803.50 ","$2,452.48 ","$10,072.55 ","$7,950.00 ","$7,950.00 ","$6,757.50 ","$22,663.23 ","$7,314.00 ","$5,565.00 ","$5,818.90 ","$7,821.36 ","$4,841.55 ","$7,273.62 ","$5,493.45 ","$5,565.00 ","$10,173.28 ","$5,724.00 ","$2,599.63 ","$7,950.00 ","$7,950.00 ","$10,072.55 ","$7,950.00 ","$10,072.55 ","$5,724.00 ","$4,929.00 ","$5,724.00 ","$5,724.00 ","$4,770.00 " ST VINCENT HOSPITAL - ACUTE,48100015,33225,HC INS LV PACING ELCT W/C-D/PACE 33225,481,1 ,"$7,800.00 ","$3,900.00 ","$2,452.48 ","$7,821.36 ","$5,038.80 ","$2,452.48 ","$7,800.00 ","$4,778.00 ", N/A ,"$4,680.00 ","$6,630.00 ","$5,460.00 ","$2,452.48 ","$7,410.00 ","$5,616.00 ","$5,694.00 ","$6,750.00 ","$6,630.00 ", N/A ,"$6,750.00 ","$6,240.00 ","$5,694.00 ","$2,452.48 ", N/A ,"$7,800.00 ","$7,800.00 ","$6,630.00 ", N/A ,"$7,176.00 ","$5,460.00 ","$5,819.10 ","$7,821.36 ","$4,750.20 ","$7,273.62 ","$5,389.80 ","$5,460.00 ", N/A ,"$5,616.00 ","$2,599.63 ","$7,800.00 ","$7,800.00 ", N/A ,"$7,800.00 ", N/A ,"$5,616.00 ","$4,836.00 ","$5,616.00 ","$5,616.00 ","$4,680.00 " ST VINCENT HOSPITAL - ACUTE,48100016,33226,HC REPOSITION LV ELECTRODE 33226,481,1 ,"$3,600.00 ","$1,800.00 ","$1,718.12 ","$7,821.36 ","$2,325.60 ","$1,718.12 ","$3,600.00 ","$3,600.00 ","$2,771.52 ","$2,160.00 ","$3,060.00 ","$2,520.00 ","$1,718.12 ","$3,420.00 ","$2,592.00 ","$2,628.00 ","$3,600.00 ","$3,060.00 ","$2,771.52 ","$3,600.00 ","$2,880.00 ","$2,628.00 ","$1,718.12 ","$2,771.52 ","$3,600.00 ","$3,600.00 ","$3,060.00 ","$6,235.91 ","$3,312.00 ","$2,520.00 ","$5,818.90 ","$7,821.36 ","$2,192.40 ","$7,273.62 ","$2,487.60 ","$2,520.00 ","$2,799.24 ","$2,592.00 ","$1,821.21 ","$3,600.00 ","$3,600.00 ","$2,771.52 ","$3,600.00 ","$2,771.52 ","$2,592.00 ","$2,232.00 ","$2,592.00 ","$2,592.00 ","$2,160.00 " ST VINCENT HOSPITAL - ACUTE,48100017,33233,HC REMOVE PPM 33233,481,1 ,"$3,400.00 ","$1,700.00 ","$1,700.00 ","$17,765.49 ","$2,196.40 ","$1,718.12 ","$3,400.00 ","$3,400.00 ","$7,895.77 ","$2,040.00 ","$2,890.00 ","$2,380.00 ","$1,718.12 ","$3,230.00 ","$2,448.00 ","$2,482.00 ","$3,400.00 ","$2,890.00 ","$7,895.77 ","$3,400.00 ","$2,720.00 ","$2,482.00 ","$1,718.12 ","$7,895.77 ","$3,400.00 ","$3,400.00 ","$2,890.00 ","$17,765.49 ","$3,128.00 ","$2,380.00 ","$5,818.90 ","$7,821.36 ","$2,070.60 ","$7,273.62 ","$2,349.40 ","$2,380.00 ","$7,974.73 ","$2,448.00 ","$1,821.21 ","$3,400.00 ","$3,400.00 ","$7,895.77 ","$3,400.00 ","$7,895.77 ","$2,448.00 ","$2,108.00 ","$2,448.00 ","$2,448.00 ","$2,040.00 " ST VINCENT HOSPITAL - ACUTE,48100018,33234,HC REMOVE ELECTRODE SGL 33234,481,1 ,"$2,890.00 ","$1,445.00 ",$430.13 ,"$7,821.36 ","$1,866.94 ",$430.13 ,"$2,890.00 ","$2,890.00 ","$3,332.00 ","$1,734.00 ","$2,456.50 ","$2,023.00 ",$430.13 ,"$2,745.50 ","$2,080.80 ","$2,109.70 ","$2,717.00 ","$2,456.50 ","$3,332.00 ","$2,717.00 ","$2,312.00 ","$2,109.70 ",$430.13 ,"$3,332.00 ","$2,890.00 ","$2,890.00 ","$2,456.50 ","$7,497.00 ","$2,658.80 ","$2,023.00 ","$5,818.90 ","$7,821.36 ","$1,760.01 ","$7,273.62 ","$1,996.99 ","$2,023.00 ","$3,365.32 ","$2,080.80 ",$455.94 ,"$2,890.00 ","$2,890.00 ","$3,332.00 ","$2,890.00 ","$3,332.00 ","$2,080.80 ","$1,791.80 ","$2,080.80 ","$2,080.80 ","$1,734.00 " ST VINCENT HOSPITAL - ACUTE,48100019,33235,HC REMOVE ELECTRODE DUAL 33235,481,1 ,"$2,300.00 ","$1,150.00 ",$430.13 ,"$7,821.36 ","$1,485.80 ",$430.13 ,"$2,300.00 ","$2,300.00 ","$3,332.00 ","$1,380.00 ","$1,955.00 ","$1,610.00 ",$430.13 ,"$2,185.00 ","$1,656.00 ","$1,679.00 ","$2,300.00 ","$1,955.00 ","$3,332.00 ","$2,300.00 ","$1,840.00 ","$1,679.00 ",$430.13 ,"$3,332.00 ","$2,300.00 ","$2,300.00 ","$1,955.00 ","$7,497.00 ","$2,116.00 ","$1,610.00 ","$5,818.90 ","$7,821.36 ","$1,400.70 ","$7,273.62 ","$1,589.30 ","$1,610.00 ","$3,365.32 ","$1,656.00 ",$455.94 ,"$2,300.00 ","$2,300.00 ","$3,332.00 ","$2,300.00 ","$3,332.00 ","$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,48100020,33240,HC INSERT SGL/DUAL CHAMBER C-D 33240,481,1 ,"$11,680.00 ","$5,840.00 ","$5,818.90 ","$50,207.39 ","$7,545.28 ","$7,563.07 ","$11,680.00 ","$11,680.00 ","$22,314.40 ","$7,008.00 ","$9,928.00 ","$8,176.00 ","$7,563.07 ","$11,096.00 ","$8,409.60 ","$8,526.40 ","$11,680.00 ","$9,928.00 ","$22,314.40 ","$11,680.00 ","$9,344.00 ","$8,526.40 ","$7,563.07 ","$22,314.40 ","$11,680.00 ","$11,680.00 ","$9,928.00 ","$50,207.39 ","$10,745.60 ","$8,176.00 ","$5,818.90 ","$7,821.36 ","$7,113.12 ","$7,273.62 ","$8,070.88 ","$8,176.00 ","$22,537.54 ","$8,409.60 ","$8,016.85 ","$11,680.00 ","$11,680.00 ","$22,314.40 ","$11,680.00 ","$22,314.40 ","$8,409.60 ","$7,241.60 ","$8,409.60 ","$8,409.60 ","$7,008.00 " ST VINCENT HOSPITAL - ACUTE,48100022,33241,HC REMOVE C-D PULSE GENERATOR 33241,481,1 ,"$2,900.00 ","$1,450.00 ","$1,450.00 ","$7,821.36 ","$1,873.40 ","$1,718.12 ","$2,900.00 ","$2,900.00 ","$3,332.00 ","$1,740.00 ","$2,465.00 ","$2,030.00 ","$1,718.12 ","$2,755.00 ","$2,088.00 ","$2,117.00 ","$2,717.00 ","$2,465.00 ","$3,332.00 ","$2,717.00 ","$2,320.00 ","$2,117.00 ","$1,718.12 ","$3,332.00 ","$2,900.00 ","$2,900.00 ","$2,465.00 ","$7,497.00 ","$2,668.00 ","$2,030.00 ","$5,818.90 ","$7,821.36 ","$1,766.10 ","$7,273.62 ","$2,003.90 ","$2,030.00 ","$3,365.32 ","$2,088.00 ","$1,821.21 ","$2,900.00 ","$2,900.00 ","$3,332.00 ","$2,900.00 ","$3,332.00 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,48100023,33244,HC REMOVE C-D ELECTRODES 33244,481,1 ,"$2,600.00 ","$1,300.00 ",$430.13 ,"$7,821.36 ","$1,679.60 ",$430.13 ,"$2,600.00 ","$2,600.00 ","$3,332.00 ","$1,560.00 ","$2,210.00 ","$1,820.00 ",$430.13 ,"$2,470.00 ","$1,872.00 ","$1,898.00 ","$2,600.00 ","$2,210.00 ","$3,332.00 ","$2,600.00 ","$2,080.00 ","$1,898.00 ",$430.13 ,"$3,332.00 ","$2,600.00 ","$2,600.00 ","$2,210.00 ","$7,497.00 ","$2,392.00 ","$1,820.00 ","$5,818.90 ","$7,821.36 ","$1,583.40 ","$7,273.62 ","$1,796.60 ","$1,820.00 ","$3,365.32 ","$1,872.00 ",$455.94 ,"$2,600.00 ","$2,600.00 ","$3,332.00 ","$2,600.00 ","$3,332.00 ","$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,48100024,33249,HC INS/REPOS DEFIB LEAD/GEN 33249,481,1 ,"$18,000.00 ","$9,000.00 ","$5,818.90 ","$71,560.05 ","$11,628.00 ","$7,563.07 ","$18,000.00 ","$13,130.00 ","$31,804.47 ","$10,800.00 ","$15,300.00 ","$12,600.00 ","$7,563.07 ","$17,100.00 ","$12,960.00 ","$13,140.00 ","$18,000.00 ","$15,300.00 ","$31,804.47 ","$18,000.00 ","$14,400.00 ","$13,140.00 ","$7,563.07 ","$31,804.47 ","$18,000.00 ","$18,000.00 ","$15,300.00 ","$71,560.05 ","$16,560.00 ","$12,600.00 ","$5,818.90 ","$7,821.36 ","$10,962.00 ","$7,273.62 ","$12,438.00 ","$12,600.00 ","$32,122.51 ","$12,960.00 ","$8,016.85 ","$18,000.00 ","$18,000.00 ","$31,804.47 ","$18,000.00 ","$31,804.47 ","$12,960.00 ","$11,160.00 ","$12,960.00 ","$12,960.00 ","$10,800.00 " ST VINCENT HOSPITAL - ACUTE,48100028,33285,HC IMPLANT CARDIAC EVENT RECORDER,481,1 ,"$5,700.00 ","$2,850.00 ","$2,850.00 ","$17,765.49 ","$3,682.20 ","$4,893.94 ","$5,700.00 ","$5,700.00 ","$7,895.77 ","$3,420.00 ","$4,845.00 ","$3,990.00 ","$4,893.94 ","$5,415.00 ","$4,104.00 ","$4,161.00 ","$5,700.00 ","$4,845.00 ","$7,895.77 ","$5,700.00 ","$4,560.00 ","$4,161.00 ","$4,893.94 ","$7,895.77 ","$5,700.00 ","$5,700.00 ","$4,845.00 ","$17,765.49 ","$5,244.00 ","$3,990.00 ","$5,818.90 ","$7,821.36 ","$3,471.30 ","$7,273.62 ","$3,938.70 ","$3,990.00 ","$7,974.73 ","$4,104.00 ","$5,187.58 ","$5,700.00 ","$5,700.00 ","$7,895.77 ","$5,700.00 ","$7,895.77 ","$4,104.00 ","$3,534.00 ","$4,104.00 ","$4,104.00 ","$3,420.00 " ST VINCENT HOSPITAL - ACUTE,48100029,33286,HC REMOVE CARDIAC EVENT RECORDER,481,1 ,"$1,600.00 ",$800.00 ,$430.13 ,"$7,821.36 ","$1,033.60 ",$430.13 ,"$1,600.00 ","$1,600.00 ",$602.38 ,$960.00 ,"$1,360.00 ","$1,120.00 ",$430.13 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,600.00 ","$1,360.00 ",$602.38 ,"$1,600.00 ","$1,280.00 ","$1,168.00 ",$430.13 ,$602.38 ,"$1,600.00 ","$1,600.00 ","$1,360.00 ","$1,355.35 ","$1,472.00 ","$1,120.00 ","$5,818.90 ","$7,821.36 ",$974.40 ,"$7,273.62 ","$1,105.60 ","$1,120.00 ",$608.40 ,"$1,152.00 ",$455.94 ,"$1,600.00 ","$1,600.00 ",$602.38 ,"$1,600.00 ",$602.38 ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,48100030,33967,HC IABP INSERTION 33967,481,1 ,"$2,100.00 ","$1,050.00 ","$1,050.00 ","$7,821.36 ","$1,356.60 ","$2,100.00 ","$2,100.00 ","$2,100.00 ", N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ","$2,452.48 ","$1,995.00 ","$1,512.00 ","$1,533.00 ","$2,100.00 ","$1,785.00 ", N/A ,"$2,100.00 ","$1,680.00 ","$1,533.00 ","$2,452.48 ", N/A ,"$2,100.00 ","$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$5,818.90 ","$7,821.36 ","$1,278.90 ","$7,273.62 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ","$2,599.63 ","$2,100.00 ","$2,100.00 ", N/A ,"$2,100.00 ", N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,48100032,33968,HC REMV BALLN INTRA-AORTIC PERC,481,1 ,"$2,100.00 ","$1,050.00 ","$1,050.00 ","$7,821.36 ","$1,356.60 ","$1,718.12 ","$2,100.00 ","$2,100.00 ", N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ","$1,718.12 ","$1,995.00 ","$1,512.00 ","$1,533.00 ","$2,100.00 ","$1,785.00 ", N/A ,"$2,100.00 ","$1,680.00 ","$1,533.00 ","$1,718.12 ", N/A ,"$2,100.00 ","$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$5,818.90 ","$7,821.36 ","$1,278.90 ","$7,273.62 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ","$1,821.21 ","$2,100.00 ","$2,100.00 ", N/A ,"$2,100.00 ", N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,48100039,36010,HC INTRO CATH VENA CAVA SUP/IN,481,1 ,"$1,100.00 ",$550.00 ,$202.63 ,"$1,100.00 ",$710.60 ,$202.63 ,"$1,100.00 ","$1,100.00 ", N/A ,$660.00 ,$935.00 ,$770.00 ,$202.63 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 , N/A ,"$1,100.00 ",$880.00 ,$803.00 ,$202.63 , N/A ,"$1,100.00 ","$1,100.00 ",$935.00 , N/A ,"$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 , N/A ,$792.00 ,$214.79 ,"$1,100.00 ","$1,100.00 ", N/A ,"$1,100.00 ", N/A ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,48100040,36011,"HC CATH PLCMT VENOUS, 1ST ORDER",481,1 ,$950.00 ,$475.00 ,$202.63 ,$950.00 ,$613.70 ,$202.63 ,$950.00 ,$950.00 , N/A ,$570.00 ,$807.50 ,$665.00 ,$202.63 ,$902.50 ,$684.00 ,$693.50 ,$950.00 ,$807.50 , N/A ,$950.00 ,$760.00 ,$693.50 ,$202.63 , N/A ,$950.00 ,$950.00 ,$807.50 , N/A ,$874.00 ,$665.00 ,$950.00 ,$950.00 ,$578.55 ,$950.00 ,$656.45 ,$665.00 , N/A ,$684.00 ,$214.79 ,$950.00 ,$950.00 , N/A ,$950.00 , N/A ,$684.00 ,$589.00 ,$684.00 ,$684.00 ,$570.00 ST VINCENT HOSPITAL - ACUTE,48100041,36012,"HC CATH PLCMT VENOUS, 2ND ORDER",481,1 ,"$1,100.00 ",$550.00 ,$202.63 ,"$1,100.00 ",$710.60 ,$202.63 ,"$1,100.00 ","$1,100.00 ", N/A ,$660.00 ,$935.00 ,$770.00 ,$202.63 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 , N/A ,"$1,100.00 ",$880.00 ,$803.00 ,$202.63 , N/A ,"$1,100.00 ","$1,100.00 ",$935.00 , N/A ,"$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 , N/A ,$792.00 ,$214.79 ,"$1,100.00 ","$1,100.00 ", N/A ,"$1,100.00 ", N/A ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,48100042,36013,HC INTRO CATH ARTERY HEART/PULM,481,1 ,$750.00 ,$375.00 ,$202.63 ,$750.00 ,$484.50 ,$202.63 ,$750.00 ,$750.00 , N/A ,$450.00 ,$637.50 ,$525.00 ,$202.63 ,$712.50 ,$540.00 ,$547.50 ,$750.00 ,$637.50 , N/A ,$750.00 ,$600.00 ,$547.50 ,$202.63 , N/A ,$750.00 ,$750.00 ,$637.50 , N/A ,$690.00 ,$525.00 ,$750.00 ,$750.00 ,$456.75 ,$750.00 ,$518.25 ,$525.00 , N/A ,$540.00 ,$214.79 ,$750.00 ,$750.00 , N/A ,$750.00 , N/A ,$540.00 ,$465.00 ,$540.00 ,$540.00 ,$450.00 ST VINCENT HOSPITAL - ACUTE,48100043,36014,HC SELECT CATH L/R PULM ART,481,1 ,"$1,100.00 ",$550.00 ,$202.63 ,"$1,100.00 ",$710.60 ,$202.63 ,"$1,100.00 ","$1,100.00 ", N/A ,$660.00 ,$935.00 ,$770.00 ,$202.63 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 , N/A ,"$1,100.00 ",$880.00 ,$803.00 ,$202.63 , N/A ,"$1,100.00 ","$1,100.00 ",$935.00 , N/A ,"$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 , N/A ,$792.00 ,$214.79 ,"$1,100.00 ","$1,100.00 ", N/A ,"$1,100.00 ", N/A ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,48100044,36015,HC PLACE CATH ARTERY PULM SEG,481,1 ,$720.00 ,$360.00 ,$202.63 ,$720.00 ,$465.12 ,$202.63 ,$720.00 ,$720.00 , N/A ,$432.00 ,$612.00 ,$504.00 ,$202.63 ,$684.00 ,$518.40 ,$525.60 ,$720.00 ,$612.00 , N/A ,$720.00 ,$576.00 ,$525.60 ,$202.63 , N/A ,$720.00 ,$720.00 ,$612.00 , N/A ,$662.40 ,$504.00 ,$720.00 ,$720.00 ,$438.48 ,$720.00 ,$497.52 ,$504.00 , N/A ,$518.40 ,$214.79 ,$720.00 ,$720.00 , N/A ,$720.00 , N/A ,$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,48100045,36100,HC INTRO CATH/NDLE CAROTID/VERTB,481,1 ,"$1,400.00 ",$700.00 ,$202.63 ,"$1,400.00 ",$904.40 ,$202.63 ,"$1,400.00 ","$1,400.00 ", N/A ,$840.00 ,"$1,190.00 ",$980.00 ,$202.63 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ","$1,400.00 ","$1,190.00 ", N/A ,"$1,400.00 ","$1,120.00 ","$1,022.00 ",$202.63 , N/A ,"$1,400.00 ","$1,400.00 ","$1,190.00 ", N/A ,"$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 , N/A ,"$1,008.00 ",$214.79 ,"$1,400.00 ","$1,400.00 ", N/A ,"$1,400.00 ", N/A ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,48100047,36140,HC INTRO NDL/CATH ARTERY EXTREM 36140,481,1 ,"$1,100.00 ",$550.00 ,$202.63 ,"$1,100.00 ",$710.60 ,$202.63 ,"$1,100.00 ","$1,100.00 ", N/A ,$660.00 ,$935.00 ,$770.00 ,$202.63 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 , N/A ,"$1,100.00 ",$880.00 ,$803.00 ,$202.63 , N/A ,"$1,100.00 ","$1,100.00 ",$935.00 , N/A ,"$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 , N/A ,$792.00 ,$214.79 ,"$1,100.00 ","$1,100.00 ", N/A ,"$1,100.00 ", N/A ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,48100050,36160,HC INTRO AORTIC TRANSLUMBR,481,1 ,$500.00 ,$250.00 ,$202.63 ,$500.00 ,$323.00 ,$202.63 ,$500.00 ,$500.00 , N/A ,$300.00 ,$425.00 ,$350.00 ,$202.63 ,$475.00 ,$360.00 ,$365.00 ,$500.00 ,$425.00 , N/A ,$500.00 ,$400.00 ,$365.00 ,$202.63 , N/A ,$500.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$500.00 ,$500.00 ,$304.50 ,$500.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$214.79 ,$500.00 ,$500.00 , N/A ,$500.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,48100051,36200,HC INTRO CATH AORTA 36200,481,1 ,"$1,400.00 ",$700.00 ,$202.63 ,"$1,400.00 ",$904.40 ,$202.63 ,"$1,400.00 ","$1,400.00 ", N/A ,$840.00 ,"$1,190.00 ",$980.00 ,$202.63 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ","$1,400.00 ","$1,190.00 ", N/A ,"$1,400.00 ","$1,120.00 ","$1,022.00 ",$202.63 , N/A ,"$1,400.00 ","$1,400.00 ","$1,190.00 ", N/A ,"$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 , N/A ,"$1,008.00 ",$214.79 ,"$1,400.00 ","$1,400.00 ", N/A ,"$1,400.00 ", N/A ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,48100052,36215,HC PLACE CATH THOR/BRAC 1ST ORDER 36215,481,1 ,$690.00 ,$345.00 ,$202.63 ,$690.00 ,$445.74 ,$202.63 ,$690.00 ,$690.00 , N/A ,$414.00 ,$586.50 ,$483.00 ,$202.63 ,$655.50 ,$496.80 ,$503.70 ,$690.00 ,$586.50 , N/A ,$690.00 ,$552.00 ,$503.70 ,$202.63 , N/A ,$690.00 ,$690.00 ,$586.50 , N/A ,$634.80 ,$483.00 ,$690.00 ,$690.00 ,$420.21 ,$690.00 ,$476.79 ,$483.00 , N/A ,$496.80 ,$214.79 ,$690.00 ,$690.00 , N/A ,$690.00 , N/A ,$496.80 ,$427.80 ,$496.80 ,$496.80 ,$414.00 ST VINCENT HOSPITAL - ACUTE,48100053,36216,HC PL CATH THOR/BRAC 2ND ORDER 36216,481,1 ,"$1,400.00 ",$700.00 ,$202.63 ,"$1,400.00 ",$904.40 ,$202.63 ,"$1,400.00 ","$1,400.00 ", N/A ,$840.00 ,"$1,190.00 ",$980.00 ,$202.63 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ","$1,400.00 ","$1,190.00 ", N/A ,"$1,400.00 ","$1,120.00 ","$1,022.00 ",$202.63 , N/A ,"$1,400.00 ","$1,400.00 ","$1,190.00 ", N/A ,"$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 , N/A ,"$1,008.00 ",$214.79 ,"$1,400.00 ","$1,400.00 ", N/A ,"$1,400.00 ", N/A ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,48100054,36217,HC PL CATH THOR/BRAC 3RD ORDER 36217,481,1 ,"$1,500.00 ",$750.00 ,$202.63 ,"$1,500.00 ",$969.00 ,$202.63 ,"$1,500.00 ","$1,500.00 ", N/A ,$900.00 ,"$1,275.00 ","$1,050.00 ",$202.63 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,500.00 ","$1,275.00 ", N/A ,"$1,500.00 ","$1,200.00 ","$1,095.00 ",$202.63 , N/A ,"$1,500.00 ","$1,500.00 ","$1,275.00 ", N/A ,"$1,380.00 ","$1,050.00 ","$1,500.00 ","$1,500.00 ",$913.50 ,"$1,500.00 ","$1,036.50 ","$1,050.00 ", N/A ,"$1,080.00 ",$214.79 ,"$1,500.00 ","$1,500.00 ", N/A ,"$1,500.00 ", N/A ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,48100055,36218,HC PL CATH THOR/BRAC ADDL 36218,481,1 ,$670.00 ,$335.00 ,$202.63 ,"$2,778.48 ",$432.82 ,$202.63 ,$670.00 ,$670.00 , N/A ,$402.00 ,$569.50 ,$469.00 ,$202.63 ,$636.50 ,$482.40 ,$489.10 ,$670.00 ,$569.50 , N/A ,$670.00 ,$536.00 ,$489.10 ,$202.63 , N/A ,$670.00 ,$670.00 ,$569.50 , N/A ,$616.40 ,$469.00 ,"$2,066.52 ","$2,778.48 ",$408.03 ,"$2,583.66 ",$462.97 ,$469.00 , N/A ,$482.40 ,$214.79 ,$670.00 ,$670.00 , N/A ,$670.00 , N/A ,$482.40 ,$415.40 ,$482.40 ,$482.40 ,$402.00 ST VINCENT HOSPITAL - ACUTE,48100056,36245,HC ABD 1ST ORDER 36245,481,1 ,"$1,600.00 ",$800.00 ,$202.63 ,"$1,600.00 ","$1,033.60 ",$202.63 ,"$1,600.00 ","$1,600.00 ", N/A ,$960.00 ,"$1,360.00 ","$1,120.00 ",$202.63 ,"$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,600.00 ","$1,360.00 ", N/A ,"$1,600.00 ","$1,280.00 ","$1,168.00 ",$202.63 , N/A ,"$1,600.00 ","$1,600.00 ","$1,360.00 ", N/A ,"$1,472.00 ","$1,120.00 ","$1,600.00 ","$1,600.00 ",$974.40 ,"$1,600.00 ","$1,105.60 ","$1,120.00 ", N/A ,"$1,152.00 ",$214.79 ,"$1,600.00 ","$1,600.00 ", N/A ,"$1,600.00 ", N/A ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,48100057,36246,HC ABD INITIAL 2ND ORDER 36246,481,1 ,"$1,300.00 ",$650.00 ,$202.63 ,"$1,300.00 ",$839.80 ,$202.63 ,"$1,300.00 ","$1,300.00 ", N/A ,$780.00 ,"$1,105.00 ",$910.00 ,$202.63 ,"$1,235.00 ",$936.00 ,$949.00 ,"$1,300.00 ","$1,105.00 ", N/A ,"$1,300.00 ","$1,040.00 ",$949.00 ,$202.63 , N/A ,"$1,300.00 ","$1,300.00 ","$1,105.00 ", N/A ,"$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 , N/A ,$936.00 ,$214.79 ,"$1,300.00 ","$1,300.00 ", N/A ,"$1,300.00 ", N/A ,$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,48100058,36247,HC ABD INT 3RD/PLUS ORDER 36247,481,1 ,"$1,500.00 ",$750.00 ,$202.63 ,"$1,500.00 ",$969.00 ,$202.63 ,"$1,500.00 ","$1,500.00 ", N/A ,$900.00 ,"$1,275.00 ","$1,050.00 ",$202.63 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,500.00 ","$1,275.00 ", N/A ,"$1,500.00 ","$1,200.00 ","$1,095.00 ",$202.63 , N/A ,"$1,500.00 ","$1,500.00 ","$1,275.00 ", N/A ,"$1,380.00 ","$1,050.00 ","$1,500.00 ","$1,500.00 ",$913.50 ,"$1,500.00 ","$1,036.50 ","$1,050.00 ", N/A ,"$1,080.00 ",$214.79 ,"$1,500.00 ","$1,500.00 ", N/A ,"$1,500.00 ", N/A ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,48100059,36248,HC ABD ADDL 2ND/PLUS ORDER 36248,481,1 ,"$1,100.00 ",$550.00 ,$202.63 ,"$2,778.48 ",$710.60 ,$202.63 ,"$1,100.00 ","$1,100.00 ", N/A ,$660.00 ,$935.00 ,$770.00 ,$202.63 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 , N/A ,"$1,100.00 ",$880.00 ,$803.00 ,$202.63 , N/A ,"$1,100.00 ","$1,100.00 ",$935.00 , N/A ,"$1,012.00 ",$770.00 ,"$2,066.52 ","$2,778.48 ",$669.90 ,"$2,583.66 ",$760.10 ,$770.00 , N/A ,$792.00 ,$214.79 ,"$1,100.00 ","$1,100.00 ", N/A ,"$1,100.00 ", N/A ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,48100060,37184,HC PERIPH THROMBECK ONLY W/TPA 37184,481,1 ,"$4,600.00 ","$2,300.00 ","$1,802.28 ","$21,884.82 ","$2,971.60 ","$1,802.28 ","$4,600.00 ","$4,600.00 ","$9,726.59 ","$2,760.00 ","$3,910.00 ","$3,220.00 ","$1,802.28 ","$4,370.00 ","$3,312.00 ","$3,358.00 ","$4,600.00 ","$3,910.00 ","$9,726.59 ","$4,600.00 ","$3,680.00 ","$3,358.00 ","$1,802.28 ","$9,726.59 ","$4,600.00 ","$4,600.00 ","$3,910.00 ","$21,884.82 ","$4,232.00 ","$3,220.00 ","$5,818.90 ","$7,821.36 ","$2,801.40 ","$7,273.62 ","$3,178.60 ","$3,220.00 ","$9,823.86 ","$3,312.00 ","$1,910.42 ","$4,600.00 ","$4,600.00 ","$9,726.59 ","$4,600.00 ","$9,726.59 ","$3,312.00 ","$2,852.00 ","$3,312.00 ","$3,312.00 ","$2,760.00 " ST VINCENT HOSPITAL - ACUTE,48100061,37185,HC PRIM PERC THROMB EA ADDL 37185,481,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$7,821.36 ","$2,261.00 ","$1,802.28 ","$3,500.00 ","$3,500.00 ", N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ","$1,802.28 ","$3,325.00 ","$2,520.00 ","$2,555.00 ","$3,500.00 ","$2,975.00 ", N/A ,"$3,500.00 ","$2,800.00 ","$2,555.00 ","$1,802.28 ", N/A ,"$3,500.00 ","$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$5,819.10 ","$7,821.36 ","$2,131.50 ","$7,273.62 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ","$1,910.42 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,48100062,37186,HC SEC PERC THROMB EA VESSEL ADDL 37186,481,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$7,821.36 ","$2,261.00 ","$3,338.02 ","$3,500.00 ","$3,500.00 ", N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ","$3,338.02 ","$3,325.00 ","$2,520.00 ","$2,555.00 ","$3,500.00 ","$2,975.00 ", N/A ,"$3,500.00 ","$2,800.00 ","$2,555.00 ","$3,338.02 ", N/A ,"$3,500.00 ","$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$5,819.10 ","$7,821.36 ","$2,131.50 ","$7,273.62 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ","$3,538.30 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,48100063,37187,HC PRIMARY VENOUS THROMBECTOMY,481,1 ,"$4,700.00 ","$2,350.00 ","$1,095.68 ","$21,884.82 ","$3,036.20 ","$1,095.68 ","$4,700.00 ","$4,700.00 ","$9,726.59 ","$2,820.00 ","$3,995.00 ","$3,290.00 ","$1,095.68 ","$4,465.00 ","$3,384.00 ","$3,431.00 ","$4,700.00 ","$3,995.00 ","$9,726.59 ","$4,700.00 ","$3,760.00 ","$3,431.00 ","$1,095.68 ","$9,726.59 ","$4,700.00 ","$4,700.00 ","$3,995.00 ","$21,884.82 ","$4,324.00 ","$3,290.00 ","$5,818.90 ","$7,821.36 ","$2,862.30 ","$7,273.62 ","$3,247.70 ","$3,290.00 ","$9,823.86 ","$3,384.00 ","$1,161.42 ","$4,700.00 ","$4,700.00 ","$9,726.59 ","$4,700.00 ","$9,726.59 ","$3,384.00 ","$2,914.00 ","$3,384.00 ","$3,384.00 ","$2,820.00 " ST VINCENT HOSPITAL - ACUTE,48100064,37188,HC SUBSEQUENT VENOUS THROMBECTOMY,481,1 ,"$3,080.00 ","$1,540.00 ","$1,095.68 ","$7,821.36 ","$1,989.68 ","$1,095.68 ","$3,080.00 ","$3,080.00 ","$2,771.52 ","$1,848.00 ","$2,618.00 ","$2,156.00 ","$1,095.68 ","$2,926.00 ","$2,217.60 ","$2,248.40 ","$3,080.00 ","$2,618.00 ","$2,771.52 ","$3,080.00 ","$2,464.00 ","$2,248.40 ","$1,095.68 ","$2,771.52 ","$3,080.00 ","$3,080.00 ","$2,618.00 ","$6,235.91 ","$2,833.60 ","$2,156.00 ","$5,818.90 ","$7,821.36 ","$1,875.72 ","$7,273.62 ","$2,128.28 ","$2,156.00 ","$2,799.24 ","$2,217.60 ","$1,161.42 ","$3,080.00 ","$3,080.00 ","$2,771.52 ","$3,080.00 ","$2,771.52 ","$2,217.60 ","$1,909.60 ","$2,217.60 ","$2,217.60 ","$1,848.00 " ST VINCENT HOSPITAL - ACUTE,48100065,37200,HC BIOPSY TRANSCATHETER,481,1 ,"$2,300.00 ","$1,150.00 ","$1,095.68 ","$10,395.23 ","$1,485.80 ","$1,095.68 ","$2,300.00 ","$2,300.00 ","$4,620.10 ","$1,380.00 ","$1,955.00 ","$1,610.00 ","$1,095.68 ","$2,185.00 ","$1,656.00 ","$1,679.00 ","$2,300.00 ","$1,955.00 ","$4,620.10 ","$2,300.00 ","$1,840.00 ","$1,679.00 ","$1,095.68 ","$4,620.10 ","$2,300.00 ","$2,300.00 ","$1,955.00 ","$10,395.23 ","$2,116.00 ","$1,610.00 ","$5,818.90 ","$7,821.36 ","$1,400.70 ","$7,273.62 ","$1,589.30 ","$1,610.00 ","$4,666.30 ","$1,656.00 ","$1,161.42 ","$2,300.00 ","$2,300.00 ","$4,620.10 ","$2,300.00 ","$4,620.10 ","$1,656.00 ","$1,426.00 ","$1,656.00 ","$1,656.00 ","$1,380.00 " ST VINCENT HOSPITAL - ACUTE,48100067,61650,HC THPY INFS NON-THROMBO INTITIAL,481,1 ,"$1,600.00 ",$800.00 ,$800.00 ,"$7,821.36 ","$1,033.60 ","$1,095.68 ","$1,600.00 ","$1,600.00 ", N/A ,$960.00 ,"$1,360.00 ","$1,120.00 ","$1,095.68 ","$1,520.00 ","$1,152.00 ","$1,168.00 ","$1,600.00 ","$1,360.00 ", N/A ,"$1,600.00 ","$1,280.00 ","$1,168.00 ","$1,095.68 ", N/A ,"$1,600.00 ","$1,600.00 ","$1,360.00 ", N/A ,"$1,472.00 ","$1,120.00 ","$5,818.90 ","$7,821.36 ",$974.40 ,"$7,273.62 ","$1,105.60 ","$1,120.00 ", N/A ,"$1,152.00 ","$1,161.42 ","$1,600.00 ","$1,600.00 ", N/A ,"$1,600.00 ", N/A ,"$1,152.00 ",$992.00 ,"$1,152.00 ","$1,152.00 ",$960.00 ST VINCENT HOSPITAL - ACUTE,48100069,37241,HC OCCL/EMBOL TRANSCATH PERC 37241,481,1 ,"$6,700.00 ","$3,350.00 ","$3,338.02 ","$21,884.82 ","$4,328.20 ","$3,338.02 ","$6,700.00 ","$6,700.00 ","$9,726.59 ","$4,020.00 ","$5,695.00 ","$4,690.00 ","$3,338.02 ","$6,365.00 ","$4,824.00 ","$4,891.00 ","$6,700.00 ","$5,695.00 ","$9,726.59 ","$6,700.00 ","$5,360.00 ","$4,891.00 ","$3,338.02 ","$9,726.59 ","$6,700.00 ","$6,700.00 ","$5,695.00 ","$21,884.82 ","$6,164.00 ","$4,690.00 ","$5,818.90 ","$7,821.36 ","$4,080.30 ","$7,273.62 ","$4,629.70 ","$4,690.00 ","$9,823.86 ","$4,824.00 ","$3,538.30 ","$6,700.00 ","$6,700.00 ","$9,726.59 ","$6,700.00 ","$9,726.59 ","$4,824.00 ","$4,154.00 ","$4,824.00 ","$4,824.00 ","$4,020.00 " ST VINCENT HOSPITAL - ACUTE,48100070,37236,HC PL STENT INTRAVAS PERC INIT 37236,481,1 ,"$7,600.00 ","$3,800.00 ","$3,338.02 ","$21,884.82 ","$4,909.60 ","$3,338.02 ","$7,600.00 ","$7,600.00 ","$9,726.59 ","$4,560.00 ","$6,460.00 ","$5,320.00 ","$3,338.02 ","$7,220.00 ","$5,472.00 ","$5,548.00 ","$6,750.00 ","$6,460.00 ","$9,726.59 ","$6,750.00 ","$6,080.00 ","$5,548.00 ","$3,338.02 ","$9,726.59 ","$7,600.00 ","$7,600.00 ","$6,460.00 ","$21,884.82 ","$6,992.00 ","$5,320.00 ","$5,818.90 ","$7,821.36 ","$4,628.40 ","$7,273.62 ","$5,251.60 ","$5,320.00 ","$9,823.86 ","$5,472.00 ","$3,538.30 ","$7,600.00 ","$7,600.00 ","$9,726.59 ","$7,600.00 ","$9,726.59 ","$5,472.00 ","$4,712.00 ","$5,472.00 ","$5,472.00 ","$4,560.00 " ST VINCENT HOSPITAL - ACUTE,48100071,37237,HC PLACE STENT PERC ADDL 37237,481,1 ,"$6,535.00 ","$3,267.50 ","$3,267.50 ","$7,821.36 ","$4,221.61 ","$3,338.02 ","$6,535.00 ","$4,778.00 ", N/A ,"$3,921.00 ","$5,554.75 ","$4,574.50 ","$3,338.02 ","$6,208.25 ","$4,705.20 ","$4,770.55 ","$6,535.00 ","$5,554.75 ", N/A ,"$6,535.00 ","$5,228.00 ","$4,770.55 ","$3,338.02 ", N/A ,"$3,863.35 ","$6,535.00 ","$5,554.75 ", N/A ,"$6,012.20 ","$4,574.50 ","$5,819.10 ","$7,821.36 ","$3,979.82 ","$7,273.62 ","$4,515.69 ","$4,574.50 ", N/A ,"$4,705.20 ","$3,538.30 ","$6,535.00 ","$6,535.00 ", N/A ,"$6,535.00 ", N/A ,"$4,705.20 ","$4,051.70 ","$4,705.20 ","$4,705.20 ","$3,921.00 " ST VINCENT HOSPITAL - ACUTE,48100075,37243,HC EMBOLIZATION UTERINE FIBROID,481,1 ,"$10,975.00 ","$5,487.50 ","$3,338.02 ","$21,884.82 ","$7,089.85 ","$3,338.02 ","$10,975.00 ","$10,975.00 ","$9,726.59 ","$6,585.00 ","$9,328.75 ","$7,682.50 ","$3,338.02 ","$10,426.25 ","$7,902.00 ","$8,011.75 ","$6,750.00 ","$9,328.75 ","$9,726.59 ","$6,750.00 ","$8,780.00 ","$8,011.75 ","$3,338.02 ","$9,726.59 ","$10,975.00 ","$10,975.00 ","$9,328.75 ","$21,884.82 ","$10,097.00 ","$7,682.50 ","$5,818.90 ","$7,821.36 ","$6,683.78 ","$7,273.62 ","$7,583.73 ","$7,682.50 ","$9,823.86 ","$7,902.00 ","$3,538.30 ","$10,162.00 ","$10,162.00 ","$9,726.59 ","$10,162.00 ","$9,726.59 ","$7,902.00 ","$6,804.50 ","$7,902.00 ","$7,902.00 ","$6,585.00 " ST VINCENT HOSPITAL - ACUTE,48100076,37215,HC PL STENT TRNSCATH CAROT ART W/ 37215,481,1 ,"$6,700.00 ","$3,350.00 ","$1,802.28 ","$7,821.36 ","$4,328.20 ","$1,802.28 ","$6,700.00 ","$6,565.00 ", N/A ,"$4,020.00 ","$5,695.00 ","$4,690.00 ","$1,802.28 ","$6,365.00 ","$4,824.00 ","$4,891.00 ","$6,700.00 ","$5,695.00 ", N/A ,"$6,700.00 ","$5,360.00 ","$4,891.00 ","$1,802.28 ", N/A ,"$6,700.00 ","$6,700.00 ","$5,695.00 ", N/A ,"$6,164.00 ","$4,690.00 ","$5,818.90 ","$7,821.36 ","$4,080.30 ","$7,273.62 ","$4,629.70 ","$4,690.00 ", N/A ,"$4,824.00 ","$1,910.42 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$4,824.00 ","$4,154.00 ","$4,824.00 ","$4,824.00 ","$4,020.00 " ST VINCENT HOSPITAL - ACUTE,48100077,37220,HC RVC EN PRC ICA W/ANG INT VSL 37220,481,1 ,"$12,000.00 ","$6,000.00 ","$1,802.28 ","$12,000.00 ","$7,752.00 ","$1,802.28 ","$12,000.00 ","$9,595.00 ","$4,800.70 ","$7,200.00 ","$10,200.00 ","$8,400.00 ","$1,802.28 ","$11,400.00 ","$8,640.00 ","$8,760.00 ","$6,750.00 ","$10,200.00 ","$4,800.70 ","$6,750.00 ","$9,600.00 ","$8,760.00 ","$1,802.28 ","$4,800.70 ","$7,726.69 ","$12,000.00 ","$10,200.00 ","$10,801.57 ","$11,040.00 ","$8,400.00 ","$5,818.90 ","$7,821.36 ","$7,308.00 ","$7,273.62 ","$8,292.00 ","$8,400.00 ","$4,848.71 ","$8,640.00 ","$1,910.42 ","$8,890.00 ","$8,890.00 ","$4,800.70 ","$8,890.00 ","$4,800.70 ","$8,640.00 ","$7,440.00 ","$8,640.00 ","$8,640.00 ","$7,200.00 " ST VINCENT HOSPITAL - ACUTE,48100077,37220,HC RVC EN PRC ICA W/ANG INT VSL 37220,481,1 ,"$7,100.00 ","$3,550.00 ","$1,802.28 ","$10,801.57 ","$4,586.60 ","$1,802.28 ","$7,100.00 ","$7,100.00 ","$4,800.70 ","$4,260.00 ","$6,035.00 ","$4,970.00 ","$1,802.28 ","$6,745.00 ","$5,112.00 ","$5,183.00 ","$6,750.00 ","$6,035.00 ","$4,800.70 ","$6,750.00 ","$5,680.00 ","$5,183.00 ","$1,802.28 ","$4,800.70 ","$7,100.00 ","$7,100.00 ","$6,035.00 ","$10,801.57 ","$6,532.00 ","$4,970.00 ","$5,818.90 ","$7,821.36 ","$4,323.90 ","$7,273.62 ","$4,906.10 ","$4,970.00 ","$4,848.71 ","$5,112.00 ","$1,910.42 ","$7,100.00 ","$7,100.00 ","$4,800.70 ","$7,100.00 ","$4,800.70 ","$5,112.00 ","$4,402.00 ","$5,112.00 ","$5,112.00 ","$4,260.00 " ST VINCENT HOSPITAL - ACUTE,48100078,37221,HC RVC EN PRC ICA W/TRN SNT INT V 37221,481,1 ,"$26,000.00 ","$13,000.00 ","$3,338.02 ","$26,000.00 ","$16,796.00 ","$3,338.02 ","$18,180.00 ","$11,363.00 ","$9,726.59 ","$15,600.00 ","$22,100.00 ","$18,200.00 ","$3,338.02 ","$24,700.00 ","$18,720.00 ","$18,980.00 ","$6,750.00 ","$22,100.00 ","$9,726.59 ","$6,750.00 ","$20,800.00 ","$18,980.00 ","$3,338.02 ","$9,726.59 ","$15,447.86 ","$26,000.00 ","$22,100.00 ","$21,884.82 ","$23,920.00 ","$18,200.00 ","$5,818.90 ","$7,821.36 ","$15,834.00 ","$7,273.62 ","$17,966.00 ","$18,200.00 ","$9,823.86 ","$18,720.00 ","$3,538.30 ","$10,162.00 ","$10,162.00 ","$9,726.59 ","$10,162.00 ","$9,726.59 ","$18,720.00 ","$16,120.00 ","$18,720.00 ","$18,720.00 ","$15,600.00 " ST VINCENT HOSPITAL - ACUTE,48100078,37221,HC RVC EN PRC ICA W/TRN SNT INT V 37221,481,1 ,"$17,000.00 ","$8,500.00 ","$3,338.02 ","$21,884.82 ","$10,982.00 ","$3,338.02 ","$17,000.00 ","$11,363.00 ","$9,726.59 ","$10,200.00 ","$14,450.00 ","$11,900.00 ","$3,338.02 ","$16,150.00 ","$12,240.00 ","$12,410.00 ","$6,750.00 ","$14,450.00 ","$9,726.59 ","$6,750.00 ","$13,600.00 ","$12,410.00 ","$3,338.02 ","$9,726.59 ","$15,447.86 ","$17,000.00 ","$14,450.00 ","$21,884.82 ","$15,640.00 ","$11,900.00 ","$5,818.90 ","$7,821.36 ","$10,353.00 ","$7,273.62 ","$11,747.00 ","$11,900.00 ","$9,823.86 ","$12,240.00 ","$3,538.30 ","$10,162.00 ","$10,162.00 ","$9,726.59 ","$10,162.00 ","$9,726.59 ","$12,240.00 ","$10,540.00 ","$12,240.00 ","$12,240.00 ","$10,200.00 " ST VINCENT HOSPITAL - ACUTE,48100079,37222,HC RVC EN PRC ICA W/ANG EA AD VS 37222,481,1 ,"$5,800.00 ","$2,900.00 ","$2,900.00 ","$7,821.36 ","$3,746.80 ","$3,338.02 ","$5,800.00 ","$4,778.00 ", N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ","$3,338.02 ","$5,510.00 ","$4,176.00 ","$4,234.00 ","$5,800.00 ","$4,930.00 ", N/A ,"$5,800.00 ","$4,640.00 ","$4,234.00 ","$3,338.02 ", N/A ,"$3,863.35 ","$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$5,819.10 ","$7,821.36 ","$3,532.20 ","$7,273.62 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ","$3,538.30 ","$5,800.00 ","$5,800.00 ", N/A ,"$5,800.00 ", N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,48100080,37223,HC RVC EN PRC ICA W/TRN ST AD VS 37223,481,1 ,"$7,400.00 ","$3,700.00 ","$3,338.02 ","$7,821.36 ","$4,780.40 ","$3,338.02 ","$7,400.00 ","$4,778.00 ", N/A ,"$4,440.00 ","$6,290.00 ","$5,180.00 ","$3,338.02 ","$7,030.00 ","$5,328.00 ","$5,402.00 ","$6,750.00 ","$6,290.00 ", N/A ,"$6,750.00 ","$5,920.00 ","$5,402.00 ","$3,338.02 ", N/A ,"$3,863.35 ","$7,400.00 ","$6,290.00 ", N/A ,"$6,808.00 ","$5,180.00 ","$5,819.10 ","$7,821.36 ","$4,506.60 ","$7,273.62 ","$5,113.40 ","$5,180.00 ", N/A ,"$5,328.00 ","$3,538.30 ","$7,400.00 ","$7,400.00 ", N/A ,"$7,400.00 ", N/A ,"$5,328.00 ","$4,588.00 ","$5,328.00 ","$5,328.00 ","$4,440.00 " ST VINCENT HOSPITAL - ACUTE,48100081,37224,HC RVC EN PRC R/P W/ANG INT VSL 37224,481,1 ,"$9,800.00 ","$4,900.00 ","$1,802.28 ","$10,801.57 ","$6,330.80 ","$1,802.28 ","$9,800.00 ","$9,595.00 ","$4,800.70 ","$5,880.00 ","$8,330.00 ","$6,860.00 ","$1,802.28 ","$9,310.00 ","$7,056.00 ","$7,154.00 ","$6,750.00 ","$8,330.00 ","$4,800.70 ","$6,750.00 ","$7,840.00 ","$7,154.00 ","$1,802.28 ","$4,800.70 ","$7,726.69 ","$9,800.00 ","$8,330.00 ","$10,801.57 ","$9,016.00 ","$6,860.00 ","$5,818.90 ","$7,821.36 ","$5,968.20 ","$7,273.62 ","$6,771.80 ","$6,860.00 ","$4,848.71 ","$7,056.00 ","$1,910.42 ","$8,890.00 ","$8,890.00 ","$4,800.70 ","$8,890.00 ","$4,800.70 ","$7,056.00 ","$6,076.00 ","$7,056.00 ","$7,056.00 ","$5,880.00 " ST VINCENT HOSPITAL - ACUTE,48100081,37224,HC RVC EN PRC R/P W/ANG INT VSL 37224,481,1 ,"$6,500.00 ","$3,250.00 ","$1,802.28 ","$10,801.57 ","$4,199.00 ","$1,802.28 ","$6,500.00 ","$6,500.00 ","$4,800.70 ","$3,900.00 ","$5,525.00 ","$4,550.00 ","$1,802.28 ","$6,175.00 ","$4,680.00 ","$4,745.00 ","$6,500.00 ","$5,525.00 ","$4,800.70 ","$6,500.00 ","$5,200.00 ","$4,745.00 ","$1,802.28 ","$4,800.70 ","$6,500.00 ","$6,500.00 ","$5,525.00 ","$10,801.57 ","$5,980.00 ","$4,550.00 ","$5,818.90 ","$7,821.36 ","$3,958.50 ","$7,273.62 ","$4,491.50 ","$4,550.00 ","$4,848.71 ","$4,680.00 ","$1,910.42 ","$6,500.00 ","$6,500.00 ","$4,800.70 ","$6,500.00 ","$4,800.70 ","$4,680.00 ","$4,030.00 ","$4,680.00 ","$4,680.00 ","$3,900.00 " ST VINCENT HOSPITAL - ACUTE,48100082,37225,HC RVC EN PRC F/P W/ANT INT VSL 37225,481,1 ,"$19,000.00 ","$9,500.00 ","$3,338.02 ","$21,884.82 ","$12,274.00 ","$3,338.02 ","$18,180.00 ","$11,363.00 ","$9,726.59 ","$11,400.00 ","$16,150.00 ","$13,300.00 ","$3,338.02 ","$18,050.00 ","$13,680.00 ","$13,870.00 ","$6,750.00 ","$16,150.00 ","$9,726.59 ","$6,750.00 ","$15,200.00 ","$13,870.00 ","$3,338.02 ","$9,726.59 ","$15,447.86 ","$19,000.00 ","$16,150.00 ","$21,884.82 ","$17,480.00 ","$13,300.00 ","$5,818.90 ","$7,821.36 ","$11,571.00 ","$7,273.62 ","$13,129.00 ","$13,300.00 ","$9,823.86 ","$13,680.00 ","$3,538.30 ","$10,162.00 ","$10,162.00 ","$9,726.59 ","$10,162.00 ","$9,726.59 ","$13,680.00 ","$11,780.00 ","$13,680.00 ","$13,680.00 ","$11,400.00 " ST VINCENT HOSPITAL - ACUTE,48100083,37226,HC RVC EN PRC F/P W/TRN SNT IN VS 37226,481,1 ,"$19,000.00 ","$9,500.00 ","$3,338.02 ","$21,884.82 ","$12,274.00 ","$3,338.02 ","$18,180.00 ","$11,363.00 ","$9,726.59 ","$11,400.00 ","$16,150.00 ","$13,300.00 ","$3,338.02 ","$18,050.00 ","$13,680.00 ","$13,870.00 ","$6,750.00 ","$16,150.00 ","$9,726.59 ","$6,750.00 ","$15,200.00 ","$13,870.00 ","$3,338.02 ","$9,726.59 ","$15,447.86 ","$19,000.00 ","$16,150.00 ","$21,884.82 ","$17,480.00 ","$13,300.00 ","$5,818.90 ","$7,821.36 ","$11,571.00 ","$7,273.62 ","$13,129.00 ","$13,300.00 ","$9,823.86 ","$13,680.00 ","$3,538.30 ","$10,162.00 ","$10,162.00 ","$9,726.59 ","$10,162.00 ","$9,726.59 ","$13,680.00 ","$11,780.00 ","$13,680.00 ","$13,680.00 ","$11,400.00 " ST VINCENT HOSPITAL - ACUTE,48100083,37226,HC RVC EN PRC F/P W/TRN SNT IN VS 37226,481,1 ,"$29,000.00 ","$14,500.00 ","$3,338.02 ","$29,000.00 ","$18,734.00 ","$3,338.02 ","$18,180.00 ","$11,363.00 ","$9,726.59 ","$17,400.00 ","$24,650.00 ","$20,300.00 ","$3,338.02 ","$27,550.00 ","$20,880.00 ","$21,170.00 ","$6,750.00 ","$24,650.00 ","$9,726.59 ","$6,750.00 ","$23,200.00 ","$21,170.00 ","$3,338.02 ","$9,726.59 ","$15,447.86 ","$29,000.00 ","$24,650.00 ","$21,884.82 ","$26,680.00 ","$20,300.00 ","$5,818.90 ","$7,821.36 ","$17,661.00 ","$7,273.62 ","$20,039.00 ","$20,300.00 ","$9,823.86 ","$20,880.00 ","$3,538.30 ","$10,162.00 ","$10,162.00 ","$9,726.59 ","$10,162.00 ","$9,726.59 ","$20,880.00 ","$17,980.00 ","$20,880.00 ","$20,880.00 ","$17,400.00 " ST VINCENT HOSPITAL - ACUTE,48100084,37227,HC RVC EN PRC F/P W/AN/TR ST INT 37227,481,1 ,"$21,000.00 ","$10,500.00 ","$3,338.02 ","$35,005.46 ","$13,566.00 ","$3,338.02 ","$19,190.00 ","$13,130.00 ","$15,557.98 ","$12,600.00 ","$17,850.00 ","$14,700.00 ","$3,338.02 ","$19,950.00 ","$15,120.00 ","$15,330.00 ","$6,750.00 ","$17,850.00 ","$15,557.98 ","$6,750.00 ","$16,800.00 ","$15,330.00 ","$3,338.02 ","$15,557.98 ","$18,533.02 ","$21,000.00 ","$17,850.00 ","$35,005.46 ","$19,320.00 ","$14,700.00 ","$5,818.90 ","$7,821.36 ","$12,789.00 ","$7,273.62 ","$14,511.00 ","$14,700.00 ","$15,713.56 ","$15,120.00 ","$3,538.30 ","$14,224.00 ","$14,224.00 ","$15,557.98 ","$14,224.00 ","$15,557.98 ","$15,120.00 ","$13,020.00 ","$15,120.00 ","$15,120.00 ","$12,600.00 " ST VINCENT HOSPITAL - ACUTE,48100085,37228,HC RVC EN PRC T/P W/ANG INT VSL 37228,481,1 ,"$10,000.00 ","$5,000.00 ","$1,802.28 ","$21,884.82 ","$6,460.00 ","$1,802.28 ","$10,000.00 ","$10,000.00 ","$9,726.59 ","$6,000.00 ","$8,500.00 ","$7,000.00 ","$1,802.28 ","$9,500.00 ","$7,200.00 ","$7,300.00 ","$6,750.00 ","$8,500.00 ","$9,726.59 ","$6,750.00 ","$8,000.00 ","$7,300.00 ","$1,802.28 ","$9,726.59 ","$10,000.00 ","$10,000.00 ","$8,500.00 ","$21,884.82 ","$9,200.00 ","$7,000.00 ","$5,818.90 ","$7,821.36 ","$6,090.00 ","$7,273.62 ","$6,910.00 ","$7,000.00 ","$9,823.86 ","$7,200.00 ","$1,910.42 ","$8,890.00 ","$8,890.00 ","$9,726.59 ","$8,890.00 ","$9,726.59 ","$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,48100085,37228,HC RVC EN PRC T/P W/ANG INT VSL 37228,481,1 ,"$6,800.00 ","$3,400.00 ","$1,802.28 ","$21,884.82 ","$4,392.80 ","$1,802.28 ","$6,800.00 ","$6,800.00 ","$9,726.59 ","$4,080.00 ","$5,780.00 ","$4,760.00 ","$1,802.28 ","$6,460.00 ","$4,896.00 ","$4,964.00 ","$6,750.00 ","$5,780.00 ","$9,726.59 ","$6,750.00 ","$5,440.00 ","$4,964.00 ","$1,802.28 ","$9,726.59 ","$6,800.00 ","$6,800.00 ","$5,780.00 ","$21,884.82 ","$6,256.00 ","$4,760.00 ","$5,818.90 ","$7,821.36 ","$4,141.20 ","$7,273.62 ","$4,698.80 ","$4,760.00 ","$9,823.86 ","$4,896.00 ","$1,910.42 ","$6,800.00 ","$6,800.00 ","$9,726.59 ","$6,800.00 ","$9,726.59 ","$4,896.00 ","$4,216.00 ","$4,896.00 ","$4,896.00 ","$4,080.00 " ST VINCENT HOSPITAL - ACUTE,48100086,37229,HC RVC EN PRC T/P W/ANT INT VSL 37229,481,1 ,"$18,000.00 ","$9,000.00 ","$3,338.02 ","$35,005.46 ","$11,628.00 ","$3,338.02 ","$18,000.00 ","$13,130.00 ","$15,557.98 ","$10,800.00 ","$15,300.00 ","$12,600.00 ","$3,338.02 ","$17,100.00 ","$12,960.00 ","$13,140.00 ","$6,750.00 ","$15,300.00 ","$15,557.98 ","$6,750.00 ","$14,400.00 ","$13,140.00 ","$3,338.02 ","$15,557.98 ","$18,000.00 ","$18,000.00 ","$15,300.00 ","$35,005.46 ","$16,560.00 ","$12,600.00 ","$5,818.90 ","$7,821.36 ","$10,962.00 ","$7,273.62 ","$12,438.00 ","$12,600.00 ","$15,713.56 ","$12,960.00 ","$3,538.30 ","$10,162.00 ","$10,162.00 ","$15,557.98 ","$10,162.00 ","$15,557.98 ","$12,960.00 ","$11,160.00 ","$12,960.00 ","$12,960.00 ","$10,800.00 " ST VINCENT HOSPITAL - ACUTE,48100087,37230,HC RVC EN PRC T/P W/TRN SNT IN VS 37230,481,1 ,"$18,000.00 ","$9,000.00 ","$3,338.02 ","$35,005.46 ","$11,628.00 ","$3,338.02 ","$18,000.00 ","$13,130.00 ","$15,557.98 ","$10,800.00 ","$15,300.00 ","$12,600.00 ","$3,338.02 ","$17,100.00 ","$12,960.00 ","$13,140.00 ","$6,750.00 ","$15,300.00 ","$15,557.98 ","$6,750.00 ","$14,400.00 ","$13,140.00 ","$3,338.02 ","$15,557.98 ","$18,000.00 ","$18,000.00 ","$15,300.00 ","$35,005.46 ","$16,560.00 ","$12,600.00 ","$5,818.90 ","$7,821.36 ","$10,962.00 ","$7,273.62 ","$12,438.00 ","$12,600.00 ","$15,713.56 ","$12,960.00 ","$3,538.30 ","$10,162.00 ","$10,162.00 ","$15,557.98 ","$10,162.00 ","$15,557.98 ","$12,960.00 ","$11,160.00 ","$12,960.00 ","$12,960.00 ","$10,800.00 " ST VINCENT HOSPITAL - ACUTE,48100088,37231,HC RVC EN PRC T/P W/AN/TR ST IN V 37231,481,1 ,"$23,000.00 ","$11,500.00 ","$3,338.02 ","$35,005.46 ","$14,858.00 ","$3,338.02 ","$19,190.00 ","$13,130.00 ","$15,557.98 ","$13,800.00 ","$19,550.00 ","$16,100.00 ","$3,338.02 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ","$15,557.98 ","$6,750.00 ","$18,400.00 ","$16,790.00 ","$3,338.02 ","$15,557.98 ","$18,533.02 ","$23,000.00 ","$19,550.00 ","$35,005.46 ","$21,160.00 ","$16,100.00 ","$5,818.90 ","$7,821.36 ","$14,007.00 ","$7,273.62 ","$15,893.00 ","$16,100.00 ","$15,713.56 ","$16,560.00 ","$3,538.30 ","$14,224.00 ","$14,224.00 ","$15,557.98 ","$14,224.00 ","$15,557.98 ","$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,48100089,37232,HC RVC EN PRC T/P W/ANG EA AD VS 37232,481,1 ,"$5,700.00 ","$2,850.00 ","$2,850.00 ","$7,821.36 ","$3,682.20 ","$3,338.02 ","$5,700.00 ","$4,778.00 ", N/A ,"$3,420.00 ","$4,845.00 ","$3,990.00 ","$3,338.02 ","$5,415.00 ","$4,104.00 ","$4,161.00 ","$5,700.00 ","$4,845.00 ", N/A ,"$5,700.00 ","$4,560.00 ","$4,161.00 ","$3,338.02 ", N/A ,"$3,863.35 ","$5,700.00 ","$4,845.00 ", N/A ,"$5,244.00 ","$3,990.00 ","$5,819.10 ","$7,821.36 ","$3,471.30 ","$7,273.62 ","$3,938.70 ","$3,990.00 ", N/A ,"$4,104.00 ","$3,538.30 ","$5,700.00 ","$5,700.00 ", N/A ,"$5,700.00 ", N/A ,"$4,104.00 ","$3,534.00 ","$4,104.00 ","$4,104.00 ","$3,420.00 " ST VINCENT HOSPITAL - ACUTE,48100090,37233,HC RVC EN PRC T/P W/ANT EA AD VS 37233,481,1 ,"$13,285.00 ","$6,642.50 ","$3,338.02 ","$13,285.00 ","$8,582.11 ","$3,338.02 ","$8,484.00 ","$4,778.00 ", N/A ,"$7,971.00 ","$11,292.25 ","$9,299.50 ","$3,338.02 ","$12,620.75 ","$9,565.20 ","$9,698.05 ","$6,750.00 ","$11,292.25 ", N/A ,"$6,750.00 ","$10,628.00 ","$9,698.05 ","$3,338.02 ", N/A ,"$3,863.35 ","$13,285.00 ","$11,292.25 ", N/A ,"$12,222.20 ","$9,299.50 ","$5,819.10 ","$7,821.36 ","$8,090.57 ","$7,273.62 ","$9,179.94 ","$9,299.50 ", N/A ,"$9,565.20 ","$3,538.30 ","$10,162.00 ","$10,162.00 ", N/A ,"$10,162.00 ", N/A ,"$9,565.20 ","$8,236.70 ","$9,565.20 ","$9,565.20 ","$7,971.00 " ST VINCENT HOSPITAL - ACUTE,48100091,37234,HC RVC EN PRC T/P W/TRN SNT EA VS 37234,481,1 ,"$8,600.00 ","$4,300.00 ","$3,338.02 ","$8,600.00 ","$5,555.60 ","$3,338.02 ","$8,484.00 ","$4,778.00 ", N/A ,"$5,160.00 ","$7,310.00 ","$6,020.00 ","$3,338.02 ","$8,170.00 ","$6,192.00 ","$6,278.00 ","$6,750.00 ","$7,310.00 ", N/A ,"$6,750.00 ","$6,880.00 ","$6,278.00 ","$3,338.02 ", N/A ,"$3,863.35 ","$8,600.00 ","$7,310.00 ", N/A ,"$7,912.00 ","$6,020.00 ","$5,819.10 ","$7,821.36 ","$5,237.40 ","$7,273.62 ","$5,942.60 ","$6,020.00 ", N/A ,"$6,192.00 ","$3,538.30 ","$8,600.00 ","$8,600.00 ", N/A ,"$8,600.00 ", N/A ,"$6,192.00 ","$5,332.00 ","$6,192.00 ","$6,192.00 ","$5,160.00 " ST VINCENT HOSPITAL - ACUTE,48100092,37235,HC RVC EN PRC T/P W/AN/TR ST AD V 37235,481,1 ,"$8,300.00 ","$4,150.00 ","$3,338.02 ","$8,300.00 ","$5,361.80 ","$3,338.02 ","$8,300.00 ","$4,778.00 ", N/A ,"$4,980.00 ","$7,055.00 ","$5,810.00 ","$3,338.02 ","$7,885.00 ","$5,976.00 ","$6,059.00 ","$6,750.00 ","$7,055.00 ", N/A ,"$6,750.00 ","$6,640.00 ","$6,059.00 ","$3,338.02 ", N/A ,"$3,863.35 ","$8,300.00 ","$7,055.00 ", N/A ,"$7,636.00 ","$5,810.00 ","$5,819.10 ","$7,821.36 ","$5,054.70 ","$7,273.62 ","$5,735.30 ","$5,810.00 ", N/A ,"$5,976.00 ","$3,538.30 ","$8,300.00 ","$8,300.00 ", N/A ,"$8,300.00 ", N/A ,"$5,976.00 ","$5,146.00 ","$5,976.00 ","$5,976.00 ","$4,980.00 " ST VINCENT HOSPITAL - ACUTE,48100093,37252,HC US VASCULAR NON-CORONARY INIT 37252,481,1 ,"$2,200.00 ","$1,100.00 ",$534.02 ,"$2,778.48 ","$1,421.20 ",$534.02 ,"$2,200.00 ","$2,200.00 ", N/A ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$534.02 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ", N/A ,"$2,200.00 ","$1,760.00 ","$1,606.00 ",$534.02 , N/A ,"$2,200.00 ","$2,200.00 ","$1,870.00 ", N/A ,"$2,024.00 ","$1,540.00 ","$2,066.52 ","$2,778.48 ","$1,339.80 ","$2,583.66 ","$1,520.20 ","$1,540.00 ", N/A ,"$1,584.00 ",$566.06 ,"$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,48100094,37253,HC US VASCULAR NON-CORON ADDL EA 37253,481,1 ,"$2,000.00 ","$1,000.00 ",$534.02 ,"$2,778.48 ","$1,292.00 ",$534.02 ,"$2,000.00 ","$2,000.00 ", N/A ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$534.02 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$2,000.00 ","$1,700.00 ", N/A ,"$2,000.00 ","$1,600.00 ","$1,460.00 ",$534.02 , N/A ,"$2,000.00 ","$2,000.00 ","$1,700.00 ", N/A ,"$1,840.00 ","$1,400.00 ","$2,066.52 ","$2,778.48 ","$1,218.00 ","$2,583.66 ","$1,382.00 ","$1,400.00 ", N/A ,"$1,440.00 ",$566.06 ,"$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,48100096,92973,HC PTC TRANSLUM CORONARY THROMB 92973,481,1 ,"$4,300.00 ","$2,150.00 ","$1,858.00 ","$4,300.00 ","$2,777.80 ","$2,710.53 ", N/A , N/A , N/A ,"$2,580.00 ","$3,655.00 ","$3,010.00 ","$2,710.53 ","$4,085.00 ","$3,096.00 ","$3,139.00 ","$4,300.00 ","$3,655.00 ", N/A ,"$4,300.00 ","$3,440.00 ","$3,139.00 ","$2,710.53 ", N/A , N/A ,"$4,300.00 ","$3,655.00 ", N/A ,"$3,956.00 ","$3,010.00 ","$2,150.00 ","$2,580.00 ","$2,618.70 ","$2,150.00 ","$2,971.30 ","$3,010.00 ", N/A ,"$3,096.00 ","$2,873.16 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$3,096.00 ","$2,666.00 ","$3,096.00 ","$3,096.00 ","$2,580.00 " ST VINCENT HOSPITAL - ACUTE,48100097,92978,HC INTRAVASCULAR ULTRSOUND INTIAL 92978,481,1 ,"$2,200.00 ","$1,100.00 ",$53.35 ,"$2,200.00 ","$1,421.20 ",$53.35 ,"$2,200.00 ","$2,200.00 ", N/A ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$53.35 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ", N/A ,"$2,200.00 ","$1,760.00 ","$1,606.00 ",$53.35 , N/A , N/A ,"$2,200.00 ","$1,870.00 ", N/A ,"$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ", N/A ,"$1,584.00 ",$56.55 ,"$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,48100098,92979,HC INTRAVASCULAR ULTRSOUND EA ADD 92979,481,1 ,"$1,700.00 ",$850.00 ,$53.35 ,"$1,700.00 ","$1,098.20 ",$53.35 , N/A , N/A , N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$53.35 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,700.00 ","$1,445.00 ", N/A ,"$1,700.00 ","$1,360.00 ","$1,241.00 ",$53.35 , N/A , N/A ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ",$56.55 ,"$1,700.00 ","$1,700.00 ", N/A ,"$1,700.00 ", N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,48100103,92986,HC VALVULOPLASTY AORTIC VALVE 92986,481,1 ,"$7,500.00 ","$3,750.00 ","$2,710.53 ","$10,801.57 ","$4,845.00 ","$2,710.53 ","$7,500.00 ","$7,500.00 ","$4,800.70 ","$4,500.00 ","$6,375.00 ","$5,250.00 ","$2,710.53 ","$7,125.00 ","$5,400.00 ","$5,475.00 ","$2,717.00 ","$6,375.00 ","$4,800.70 ","$2,717.00 ","$6,000.00 ","$5,475.00 ","$2,710.53 ","$4,800.70 ","$7,500.00 ","$7,500.00 ","$6,375.00 ","$10,801.57 ","$6,900.00 ","$5,250.00 ","$3,750.00 ","$4,500.00 ","$4,567.50 ","$3,750.00 ","$5,182.50 ","$5,250.00 ","$4,848.71 ","$5,400.00 ","$2,873.16 ","$7,500.00 ","$7,500.00 ","$4,800.70 ","$7,500.00 ","$4,800.70 ","$5,400.00 ","$4,650.00 ","$5,400.00 ","$5,400.00 ","$4,500.00 " ST VINCENT HOSPITAL - ACUTE,48100104,92987,HC VALVULOPLASTY MITRAL VALVE 92987,481,1 ,"$9,000.00 ","$4,500.00 ","$2,710.53 ","$21,884.82 ","$5,814.00 ","$2,710.53 ","$9,000.00 ","$9,000.00 ","$9,726.59 ","$5,400.00 ","$7,650.00 ","$6,300.00 ","$2,710.53 ","$8,550.00 ","$6,480.00 ","$6,570.00 ","$2,717.00 ","$7,650.00 ","$9,726.59 ","$2,717.00 ","$7,200.00 ","$6,570.00 ","$2,710.53 ","$9,726.59 ","$9,000.00 ","$9,000.00 ","$7,650.00 ","$21,884.82 ","$8,280.00 ","$6,300.00 ","$4,500.00 ","$5,400.00 ","$5,481.00 ","$4,500.00 ","$6,219.00 ","$6,300.00 ","$9,823.86 ","$6,480.00 ","$2,873.16 ","$8,890.00 ","$8,890.00 ","$9,726.59 ","$8,890.00 ","$9,726.59 ","$6,480.00 ","$5,580.00 ","$6,480.00 ","$6,480.00 ","$5,400.00 " ST VINCENT HOSPITAL - ACUTE,48100107,93451,HC CATH RIGHT HEART 93451,481,1 ,"$5,400.00 ","$2,700.00 ",$729.19 ,"$6,317.33 ","$3,488.40 ",$729.19 ,"$5,400.00 ","$5,400.00 ","$2,807.70 ","$3,240.00 ","$4,590.00 ","$3,780.00 ",$729.19 ,"$5,130.00 ","$3,888.00 ","$3,942.00 ","$5,400.00 ","$4,590.00 ","$2,807.70 ","$5,400.00 ","$4,320.00 ","$3,942.00 ",$729.19 ,"$2,807.70 ","$5,400.00 ","$5,400.00 ","$4,590.00 ","$6,317.33 ","$4,968.00 ","$3,780.00 ","$2,700.00 ","$3,240.00 ","$3,288.60 ","$2,700.00 ","$3,731.40 ","$3,780.00 ","$2,835.78 ","$3,888.00 ",$772.94 ,"$5,400.00 ","$5,400.00 ","$2,807.70 ","$5,400.00 ","$2,807.70 ","$3,888.00 ","$3,348.00 ","$3,888.00 ","$3,888.00 ","$3,240.00 " ST VINCENT HOSPITAL - ACUTE,48100108,93452,HC LHC ONLY NO COROS 93452,481,1 ,"$7,000.00 ","$3,500.00 ",$729.19 ,"$7,000.00 ","$4,522.00 ",$729.19 ,"$7,000.00 ","$7,000.00 ","$2,807.70 ","$4,200.00 ","$5,950.00 ","$4,900.00 ",$729.19 ,"$6,650.00 ","$5,040.00 ","$5,110.00 ","$6,750.00 ","$5,950.00 ","$2,807.70 ","$6,750.00 ","$5,600.00 ","$5,110.00 ",$729.19 ,"$2,807.70 ","$5,519.06 ","$7,000.00 ","$5,950.00 ","$6,317.33 ","$6,440.00 ","$4,900.00 ","$3,500.00 ","$4,200.00 ","$4,263.00 ","$3,500.00 ","$4,837.00 ","$4,900.00 ","$2,835.78 ","$5,040.00 ",$772.94 ,"$7,000.00 ","$7,000.00 ","$2,807.70 ","$7,000.00 ","$2,807.70 ","$5,040.00 ","$4,340.00 ","$5,040.00 ","$5,040.00 ","$4,200.00 " ST VINCENT HOSPITAL - ACUTE,48100109,93453,HC RHC/LHC ONLY/NO CORS 93453,481,1 ,"$7,800.00 ","$3,900.00 ",$729.19 ,"$7,800.00 ","$5,038.80 ",$729.19 ,"$7,800.00 ","$7,800.00 ","$2,807.70 ","$4,680.00 ","$6,630.00 ","$5,460.00 ",$729.19 ,"$7,410.00 ","$5,616.00 ","$5,694.00 ","$6,750.00 ","$6,630.00 ","$2,807.70 ","$6,750.00 ","$6,240.00 ","$5,694.00 ",$729.19 ,"$2,807.70 ","$5,519.06 ","$7,800.00 ","$6,630.00 ","$6,317.33 ","$7,176.00 ","$5,460.00 ","$3,900.00 ","$4,680.00 ","$4,750.20 ","$3,900.00 ","$5,389.80 ","$5,460.00 ","$2,835.78 ","$5,616.00 ",$772.94 ,"$7,554.00 ","$7,554.00 ","$2,807.70 ","$7,554.00 ","$2,807.70 ","$5,616.00 ","$4,836.00 ","$5,616.00 ","$5,616.00 ","$4,680.00 " ST VINCENT HOSPITAL - ACUTE,48100110,93454,HC CORONARY ANGIO ONLY/NO LV 93454,481,1 ,"$11,000.00 ","$5,500.00 ",$729.19 ,"$11,000.00 ","$7,106.00 ",$729.19 ,"$11,000.00 ","$11,000.00 ","$2,807.70 ","$6,600.00 ","$9,350.00 ","$7,700.00 ",$729.19 ,"$10,450.00 ","$7,920.00 ","$8,030.00 ","$6,750.00 ","$9,350.00 ","$2,807.70 ","$6,750.00 ","$8,800.00 ","$8,030.00 ",$729.19 ,"$2,807.70 ","$5,519.06 ","$11,000.00 ","$9,350.00 ","$6,317.33 ","$10,120.00 ","$7,700.00 ","$5,500.00 ","$6,600.00 ","$6,699.00 ","$5,500.00 ","$7,601.00 ","$7,700.00 ","$2,835.78 ","$7,920.00 ",$772.94 ,"$7,554.00 ","$7,554.00 ","$2,807.70 ","$7,554.00 ","$2,807.70 ","$7,920.00 ","$6,820.00 ","$7,920.00 ","$7,920.00 ","$6,600.00 " ST VINCENT HOSPITAL - ACUTE,48100111,93455,HC CORO ANGIO AND GRAFTS ONLY NO LV 93455,481,1 ,"$10,000.00 ","$5,000.00 ",$729.19 ,"$10,000.00 ","$6,460.00 ",$729.19 ,"$10,000.00 ","$10,000.00 ","$2,807.70 ","$6,000.00 ","$8,500.00 ","$7,000.00 ",$729.19 ,"$9,500.00 ","$7,200.00 ","$7,300.00 ","$6,750.00 ","$8,500.00 ","$2,807.70 ","$6,750.00 ","$8,000.00 ","$7,300.00 ",$729.19 ,"$2,807.70 ","$5,519.06 ","$10,000.00 ","$8,500.00 ","$6,317.33 ","$9,200.00 ","$7,000.00 ","$5,000.00 ","$6,000.00 ","$6,090.00 ","$5,000.00 ","$6,910.00 ","$7,000.00 ","$2,835.78 ","$7,200.00 ",$772.94 ,"$7,554.00 ","$7,554.00 ","$2,807.70 ","$7,554.00 ","$2,807.70 ","$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,48100112,93456,HC RHC CORONARY ANGIO/NO LV 93456,481,1 ,"$8,800.00 ","$4,400.00 ",$729.19 ,"$8,800.00 ","$5,684.80 ",$729.19 ,"$8,800.00 ","$8,800.00 ","$2,807.70 ","$5,280.00 ","$7,480.00 ","$6,160.00 ",$729.19 ,"$8,360.00 ","$6,336.00 ","$6,424.00 ","$6,750.00 ","$7,480.00 ","$2,807.70 ","$6,750.00 ","$7,040.00 ","$6,424.00 ",$729.19 ,"$2,807.70 ","$5,519.06 ","$8,800.00 ","$7,480.00 ","$6,317.33 ","$8,096.00 ","$6,160.00 ","$4,400.00 ","$5,280.00 ","$5,359.20 ","$4,400.00 ","$6,080.80 ","$6,160.00 ","$2,835.78 ","$6,336.00 ",$772.94 ,"$7,554.00 ","$7,554.00 ","$2,807.70 ","$7,554.00 ","$2,807.70 ","$6,336.00 ","$5,456.00 ","$6,336.00 ","$6,336.00 ","$5,280.00 " ST VINCENT HOSPITAL - ACUTE,48100113,93457,HC RHC CORO ANGIO AND GRAFTS/NO LV 93457,481,1 ,"$9,700.00 ","$4,850.00 ",$729.19 ,"$9,700.00 ","$6,266.20 ",$729.19 ,"$9,700.00 ","$9,700.00 ","$2,807.70 ","$5,820.00 ","$8,245.00 ","$6,790.00 ",$729.19 ,"$9,215.00 ","$6,984.00 ","$7,081.00 ","$6,750.00 ","$8,245.00 ","$2,807.70 ","$6,750.00 ","$7,760.00 ","$7,081.00 ",$729.19 ,"$2,807.70 ","$5,519.06 ","$9,700.00 ","$8,245.00 ","$6,317.33 ","$8,924.00 ","$6,790.00 ","$4,850.00 ","$5,820.00 ","$5,907.30 ","$4,850.00 ","$6,702.70 ","$6,790.00 ","$2,835.78 ","$6,984.00 ",$772.94 ,"$7,554.00 ","$7,554.00 ","$2,807.70 ","$7,554.00 ","$2,807.70 ","$6,984.00 ","$6,014.00 ","$6,984.00 ","$6,984.00 ","$5,820.00 " ST VINCENT HOSPITAL - ACUTE,48100114,93458,HC CORONARY ANGIO WITH LV 93458,481,1 ,"$10,000.00 ","$5,000.00 ",$729.19 ,"$10,000.00 ","$6,460.00 ",$729.19 ,"$10,000.00 ","$10,000.00 ","$2,807.70 ","$6,000.00 ","$8,500.00 ","$7,000.00 ",$729.19 ,"$9,500.00 ","$7,200.00 ","$7,300.00 ","$6,750.00 ","$8,500.00 ","$2,807.70 ","$6,750.00 ","$8,000.00 ","$7,300.00 ",$729.19 ,"$2,807.70 ","$5,519.06 ","$10,000.00 ","$8,500.00 ","$6,317.33 ","$9,200.00 ","$7,000.00 ","$5,000.00 ","$6,000.00 ","$6,090.00 ","$5,000.00 ","$6,910.00 ","$7,000.00 ","$2,835.78 ","$7,200.00 ",$772.94 ,"$7,554.00 ","$7,554.00 ","$2,807.70 ","$7,554.00 ","$2,807.70 ","$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,48100115,93459,HC CORONARY ANGIO W GRAFTS AND LV 93459,481,1 ,"$8,200.00 ","$4,100.00 ",$729.19 ,"$8,200.00 ","$5,297.20 ",$729.19 ,"$8,200.00 ","$8,200.00 ","$2,807.70 ","$4,920.00 ","$6,970.00 ","$5,740.00 ",$729.19 ,"$7,790.00 ","$5,904.00 ","$5,986.00 ","$6,750.00 ","$6,970.00 ","$2,807.70 ","$6,750.00 ","$6,560.00 ","$5,986.00 ",$729.19 ,"$2,807.70 ","$5,519.06 ","$8,200.00 ","$6,970.00 ","$6,317.33 ","$7,544.00 ","$5,740.00 ","$4,100.00 ","$4,920.00 ","$4,993.80 ","$4,100.00 ","$5,666.20 ","$5,740.00 ","$2,835.78 ","$5,904.00 ",$772.94 ,"$7,554.00 ","$7,554.00 ","$2,807.70 ","$7,554.00 ","$2,807.70 ","$5,904.00 ","$5,084.00 ","$5,904.00 ","$5,904.00 ","$4,920.00 " ST VINCENT HOSPITAL - ACUTE,48100116,93460,HC RHC/LHC/CORONAY ANGIO AND LV 93460,481,1 ,"$8,700.00 ","$4,350.00 ",$729.19 ,"$8,700.00 ","$5,620.20 ",$729.19 ,"$8,700.00 ","$8,700.00 ","$2,807.70 ","$5,220.00 ","$7,395.00 ","$6,090.00 ",$729.19 ,"$8,265.00 ","$6,264.00 ","$6,351.00 ","$6,750.00 ","$7,395.00 ","$2,807.70 ","$6,750.00 ","$6,960.00 ","$6,351.00 ",$729.19 ,"$2,807.70 ","$5,519.06 ","$8,700.00 ","$7,395.00 ","$6,317.33 ","$8,004.00 ","$6,090.00 ","$4,350.00 ","$5,220.00 ","$5,298.30 ","$4,350.00 ","$6,011.70 ","$6,090.00 ","$2,835.78 ","$6,264.00 ",$772.94 ,"$7,554.00 ","$7,554.00 ","$2,807.70 ","$7,554.00 ","$2,807.70 ","$6,264.00 ","$5,394.00 ","$6,264.00 ","$6,264.00 ","$5,220.00 " ST VINCENT HOSPITAL - ACUTE,48100117,93461,HC RHC/LHC/CORON ANGIO GRAFTS AND LV 93461,481,1 ,"$11,000.00 ","$5,500.00 ",$729.19 ,"$11,000.00 ","$7,106.00 ",$729.19 ,"$11,000.00 ","$11,000.00 ","$2,807.70 ","$6,600.00 ","$9,350.00 ","$7,700.00 ",$729.19 ,"$10,450.00 ","$7,920.00 ","$8,030.00 ","$6,750.00 ","$9,350.00 ","$2,807.70 ","$6,750.00 ","$8,800.00 ","$8,030.00 ",$729.19 ,"$2,807.70 ","$5,519.06 ","$11,000.00 ","$9,350.00 ","$6,317.33 ","$10,120.00 ","$7,700.00 ","$5,500.00 ","$6,600.00 ","$6,699.00 ","$5,500.00 ","$7,601.00 ","$7,700.00 ","$2,835.78 ","$7,920.00 ",$772.94 ,"$7,554.00 ","$7,554.00 ","$2,807.70 ","$7,554.00 ","$2,807.70 ","$7,920.00 ","$6,820.00 ","$7,920.00 ","$7,920.00 ","$6,600.00 " ST VINCENT HOSPITAL - ACUTE,48100118,93463,HC NITRIC OXIDE STUDY 93463,481,1 ,$450.00 ,$225.00 ,$14.00 ,$450.00 ,$290.70 ,$14.00 ,$450.00 ,$450.00 , N/A ,$270.00 ,$382.50 ,$315.00 ,$14.00 ,$427.50 ,$324.00 ,$328.50 ,$450.00 ,$382.50 , N/A ,$450.00 ,$360.00 ,$328.50 ,$14.00 , N/A , N/A ,$450.00 ,$382.50 , N/A ,$414.00 ,$315.00 ,$225.00 ,$270.00 ,$274.05 ,$225.00 ,$310.95 ,$315.00 , N/A ,$324.00 ,$14.84 ,$450.00 ,$450.00 , N/A ,$450.00 , N/A ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,48100119,93567,HC AORTAGRAM 93567,481,1 ,$790.00 ,$395.00 ,$86.58 ,$790.00 ,$510.34 ,$86.58 , N/A , N/A , N/A ,$474.00 ,$671.50 ,$553.00 ,$86.58 ,$750.50 ,$568.80 ,$576.70 ,$790.00 ,$671.50 , N/A ,$790.00 ,$632.00 ,$576.70 ,$86.58 , N/A , N/A ,$790.00 ,$671.50 , N/A ,$726.80 ,$553.00 ,$395.00 ,$474.00 ,$481.11 ,$395.00 ,$545.89 ,$553.00 , N/A ,$568.80 ,$91.77 ,$790.00 ,$790.00 , N/A ,$790.00 , N/A ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,48100120,93571,HC INTRAVASC DOPP COLOR FLOW INIT 93571,481,1 ,"$1,500.00 ",$750.00 ,$534.02 ,"$1,500.00 ",$969.00 ,$534.02 ,"$1,500.00 ","$1,500.00 ", N/A ,$900.00 ,"$1,275.00 ","$1,050.00 ",$534.02 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,500.00 ","$1,275.00 ", N/A ,"$1,500.00 ","$1,200.00 ","$1,095.00 ",$534.02 , N/A , N/A ,"$1,500.00 ","$1,275.00 ", N/A ,"$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ", N/A ,"$1,080.00 ",$566.06 ,"$1,500.00 ","$1,500.00 ", N/A ,"$1,500.00 ", N/A ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,48100121,93572,HC INTRAVASC DOPP COLOR FLOW ADDL 93572,481,1 ,$780.00 ,$390.00 ,$390.00 ,$780.00 ,$503.88 ,$534.02 ,$780.00 ,$780.00 , N/A ,$468.00 ,$663.00 ,$546.00 ,$534.02 ,$741.00 ,$561.60 ,$569.40 ,$780.00 ,$663.00 , N/A ,$780.00 ,$624.00 ,$569.40 ,$534.02 , N/A , N/A ,$780.00 ,$663.00 , N/A ,$717.60 ,$546.00 ,$390.00 ,$468.00 ,$475.02 ,$390.00 ,$538.98 ,$546.00 , N/A ,$561.60 ,$566.06 ,$780.00 ,$780.00 , N/A ,$780.00 , N/A ,$561.60 ,$483.60 ,$561.60 ,$561.60 ,$468.00 ST VINCENT HOSPITAL - ACUTE,48100122,93580,HC PTC W/IMPLNT ATRIAL 93580,481,1 ,"$11,000.00 ","$5,500.00 ","$2,872.01 ","$35,005.46 ","$7,106.00 ","$2,872.01 ","$11,000.00 ","$11,000.00 ","$15,557.98 ","$6,600.00 ","$9,350.00 ","$7,700.00 ","$2,872.01 ","$10,450.00 ","$7,920.00 ","$8,030.00 ","$6,750.00 ","$9,350.00 ","$15,557.98 ","$6,750.00 ","$8,800.00 ","$8,030.00 ","$2,872.01 ","$15,557.98 ","$11,000.00 ","$11,000.00 ","$9,350.00 ","$35,005.46 ","$10,120.00 ","$7,700.00 ","$5,500.00 ","$6,600.00 ","$6,699.00 ","$5,500.00 ","$7,601.00 ","$7,700.00 ","$15,713.56 ","$7,920.00 ","$3,044.33 ","$11,000.00 ","$11,000.00 ","$15,557.98 ","$11,000.00 ","$15,557.98 ","$7,920.00 ","$6,820.00 ","$7,920.00 ","$7,920.00 ","$6,600.00 " ST VINCENT HOSPITAL - ACUTE,48100123,93600,HC HIS BUNDLE RECORDING,481,1 ,"$3,400.00 ","$1,700.00 ","$1,412.36 ","$13,245.77 ","$2,196.40 ","$1,412.36 ","$3,400.00 ","$3,400.00 ","$5,887.01 ","$2,040.00 ","$2,890.00 ","$2,380.00 ","$1,412.36 ","$3,230.00 ","$2,448.00 ","$2,482.00 ","$3,400.00 ","$2,890.00 ","$5,887.01 ","$3,400.00 ","$2,720.00 ","$2,482.00 ","$1,412.36 ","$5,887.01 ","$3,400.00 ","$3,400.00 ","$2,890.00 ","$13,245.77 ","$3,128.00 ","$2,380.00 ","$1,700.00 ","$2,040.00 ","$2,070.60 ","$1,700.00 ","$2,349.40 ","$2,380.00 ","$5,945.88 ","$2,448.00 ","$1,497.10 ","$3,400.00 ","$3,400.00 ","$5,887.01 ","$3,400.00 ","$5,887.01 ","$2,448.00 ","$2,108.00 ","$2,448.00 ","$2,448.00 ","$2,040.00 " ST VINCENT HOSPITAL - ACUTE,48100124,93602,HC INTRA-ATRIAL RECORDING,481,1 ,"$3,535.00 ","$1,767.50 ","$1,412.36 ","$13,245.77 ","$2,283.61 ","$1,412.36 ","$3,535.00 ","$3,535.00 ","$5,887.01 ","$2,121.00 ","$3,004.75 ","$2,474.50 ","$1,412.36 ","$3,358.25 ","$2,545.20 ","$2,580.55 ","$3,535.00 ","$3,004.75 ","$5,887.01 ","$3,535.00 ","$2,828.00 ","$2,580.55 ","$1,412.36 ","$5,887.01 ","$3,535.00 ","$3,535.00 ","$3,004.75 ","$13,245.77 ","$3,252.20 ","$2,474.50 ","$1,767.50 ","$2,121.00 ","$2,152.82 ","$1,767.50 ","$2,442.69 ","$2,474.50 ","$5,945.88 ","$2,545.20 ","$1,497.10 ","$3,535.00 ","$3,535.00 ","$5,887.01 ","$3,535.00 ","$5,887.01 ","$2,545.20 ","$2,191.70 ","$2,545.20 ","$2,545.20 ","$2,121.00 " ST VINCENT HOSPITAL - ACUTE,48100125,93609,HC TACHYCARDIA SITE MAPPING 93609,481,1 ,"$3,530.00 ","$1,765.00 ","$1,765.00 ","$5,105.70 ","$2,280.38 ","$3,530.00 ","$3,530.00 ","$3,530.00 ", N/A ,"$2,118.00 ","$3,000.50 ","$2,471.00 ","$4,816.70 ","$3,353.50 ","$2,541.60 ","$2,576.90 ","$3,530.00 ","$3,000.50 ", N/A ,"$3,530.00 ","$2,824.00 ","$2,576.90 ","$4,816.70 ", N/A ,"$3,530.00 ","$3,530.00 ","$3,000.50 ", N/A ,"$3,247.60 ","$2,471.00 ","$1,765.00 ","$2,118.00 ","$2,149.77 ","$1,765.00 ","$2,439.23 ","$2,471.00 ", N/A ,"$2,541.60 ","$5,105.70 ","$3,530.00 ","$3,530.00 ", N/A ,"$3,530.00 ", N/A ,"$2,541.60 ","$2,188.60 ","$2,541.60 ","$2,541.60 ","$2,118.00 " ST VINCENT HOSPITAL - ACUTE,48100126,93612,HC EP INTRAVENTRIC PACING,481,1 ,"$4,815.00 ","$2,407.50 ","$1,412.36 ","$13,245.77 ","$3,110.49 ","$1,412.36 ","$4,815.00 ","$4,815.00 ","$5,887.01 ","$2,889.00 ","$4,092.75 ","$3,370.50 ","$1,412.36 ","$4,574.25 ","$3,466.80 ","$3,514.95 ","$4,815.00 ","$4,092.75 ","$5,887.01 ","$4,815.00 ","$3,852.00 ","$3,514.95 ","$1,412.36 ","$5,887.01 ","$4,815.00 ","$4,815.00 ","$4,092.75 ","$13,245.77 ","$4,429.80 ","$3,370.50 ","$2,407.50 ","$2,889.00 ","$2,932.34 ","$2,407.50 ","$3,327.17 ","$3,370.50 ","$5,945.88 ","$3,466.80 ","$1,497.10 ","$4,815.00 ","$4,815.00 ","$5,887.01 ","$4,815.00 ","$5,887.01 ","$3,466.80 ","$2,985.30 ","$3,466.80 ","$3,466.80 ","$2,889.00 " ST VINCENT HOSPITAL - ACUTE,48100127,93613,HC EP INTRACARDIAC 3-D MAPPING 93613,481,1 ,"$10,000.00 ","$5,000.00 ","$4,816.70 ","$10,000.00 ","$6,460.00 ","$4,816.70 ","$10,000.00 ","$10,000.00 ", N/A ,"$6,000.00 ","$8,500.00 ","$7,000.00 ","$4,816.70 ","$9,500.00 ","$7,200.00 ","$7,300.00 ","$10,000.00 ","$8,500.00 ", N/A ,"$10,000.00 ","$8,000.00 ","$7,300.00 ","$4,816.70 ", N/A ,"$10,000.00 ","$10,000.00 ","$8,500.00 ", N/A ,"$9,200.00 ","$7,000.00 ","$5,000.00 ","$6,000.00 ","$6,090.00 ","$5,000.00 ","$6,910.00 ","$7,000.00 ", N/A ,"$7,200.00 ","$5,105.70 ","$6,797.00 ","$6,797.00 ", N/A ,"$6,797.00 ", N/A ,"$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,48100128,93619,HC EP COMPREHENSIVE W/O ARRHYTHMI 93619,481,1 ,"$7,500.00 ","$3,750.00 ","$3,750.00 ","$13,245.77 ","$4,845.00 ","$4,816.70 ","$7,500.00 ","$7,500.00 ","$5,887.01 ","$4,500.00 ","$6,375.00 ","$5,250.00 ","$4,816.70 ","$7,125.00 ","$5,400.00 ","$5,475.00 ","$7,500.00 ","$6,375.00 ","$5,887.01 ","$7,500.00 ","$6,000.00 ","$5,475.00 ","$4,816.70 ","$5,887.01 ","$7,500.00 ","$7,500.00 ","$6,375.00 ","$13,245.77 ","$6,900.00 ","$5,250.00 ","$3,750.00 ","$4,500.00 ","$4,567.50 ","$3,750.00 ","$5,182.50 ","$5,250.00 ","$5,945.88 ","$5,400.00 ","$5,105.70 ","$7,500.00 ","$7,500.00 ","$5,887.01 ","$7,500.00 ","$5,887.01 ","$5,400.00 ","$4,650.00 ","$5,400.00 ","$5,400.00 ","$4,500.00 " ST VINCENT HOSPITAL - ACUTE,48100129,93620,HC EP COMPREHENSIVE W/ ARRHYTHMIA 93620,481,1 ,"$7,100.00 ","$3,550.00 ","$3,550.00 ","$13,245.77 ","$4,586.60 ","$4,816.70 ","$7,100.00 ","$7,100.00 ","$5,887.01 ","$4,260.00 ","$6,035.00 ","$4,970.00 ","$4,816.70 ","$6,745.00 ","$5,112.00 ","$5,183.00 ","$7,100.00 ","$6,035.00 ","$5,887.01 ","$7,100.00 ","$5,680.00 ","$5,183.00 ","$4,816.70 ","$5,887.01 ","$7,100.00 ","$7,100.00 ","$6,035.00 ","$13,245.77 ","$6,532.00 ","$4,970.00 ","$3,550.00 ","$4,260.00 ","$4,323.90 ","$3,550.00 ","$4,906.10 ","$4,970.00 ","$5,945.88 ","$5,112.00 ","$5,105.70 ","$7,100.00 ","$7,100.00 ","$5,887.01 ","$7,100.00 ","$5,887.01 ","$5,112.00 ","$4,402.00 ","$5,112.00 ","$5,112.00 ","$4,260.00 " ST VINCENT HOSPITAL - ACUTE,48100130,93621,HC EP COMPREHENSIVE W/LT ATRIUM 93621,481,1 ,"$7,000.00 ","$3,500.00 ","$3,500.00 ","$7,000.00 ","$4,522.00 ","$4,816.70 ","$7,000.00 ","$7,000.00 ", N/A ,"$4,200.00 ","$5,950.00 ","$4,900.00 ","$4,816.70 ","$6,650.00 ","$5,040.00 ","$5,110.00 ","$7,000.00 ","$5,950.00 ", N/A ,"$7,000.00 ","$5,600.00 ","$5,110.00 ","$4,816.70 ", N/A ,"$7,000.00 ","$7,000.00 ","$5,950.00 ", N/A ,"$6,440.00 ","$4,900.00 ","$3,500.00 ","$4,200.00 ","$4,263.00 ","$3,500.00 ","$4,837.00 ","$4,900.00 ", N/A ,"$5,040.00 ","$5,105.70 ","$6,797.00 ","$6,797.00 ", N/A ,"$6,797.00 ", N/A ,"$5,040.00 ","$4,340.00 ","$5,040.00 ","$5,040.00 ","$4,200.00 " ST VINCENT HOSPITAL - ACUTE,48100131,93622,HC EP COMPREHENSIVE W/LT VENTRIC 93622,481,1 ,"$4,800.00 ","$2,400.00 ","$2,400.00 ","$5,105.70 ","$3,100.80 ","$4,800.00 ","$4,800.00 ","$4,800.00 ", N/A ,"$2,880.00 ","$4,080.00 ","$3,360.00 ","$4,816.70 ","$4,560.00 ","$3,456.00 ","$3,504.00 ","$4,800.00 ","$4,080.00 ", N/A ,"$4,800.00 ","$3,840.00 ","$3,504.00 ","$4,816.70 ", N/A ,"$4,800.00 ","$4,800.00 ","$4,080.00 ", N/A ,"$4,416.00 ","$3,360.00 ","$2,400.00 ","$2,880.00 ","$2,923.20 ","$2,400.00 ","$3,316.80 ","$3,360.00 ", N/A ,"$3,456.00 ","$5,105.70 ","$4,800.00 ","$4,800.00 ", N/A ,"$4,800.00 ", N/A ,"$3,456.00 ","$2,976.00 ","$3,456.00 ","$3,456.00 ","$2,880.00 " ST VINCENT HOSPITAL - ACUTE,48100132,93623,HC EP IV DRUG INFUSION PACING 93623,481,1 ,"$2,600.00 ","$1,300.00 ","$1,300.00 ","$5,105.70 ","$1,679.60 ","$2,600.00 ","$2,600.00 ","$2,600.00 ", N/A ,"$1,560.00 ","$2,210.00 ","$1,820.00 ","$4,816.70 ","$2,470.00 ","$1,872.00 ","$1,898.00 ","$2,600.00 ","$2,210.00 ", N/A ,"$2,600.00 ","$2,080.00 ","$1,898.00 ","$4,816.70 ", N/A ,"$2,600.00 ","$2,600.00 ","$2,210.00 ", N/A ,"$2,392.00 ","$1,820.00 ","$1,300.00 ","$1,560.00 ","$1,583.40 ","$1,300.00 ","$1,796.60 ","$1,820.00 ", N/A ,"$1,872.00 ","$5,105.70 ","$2,600.00 ","$2,600.00 ", N/A ,"$2,600.00 ", N/A ,"$1,872.00 ","$1,612.00 ","$1,872.00 ","$1,872.00 ","$1,560.00 " ST VINCENT HOSPITAL - ACUTE,48100133,93641,HC EP EVAL CARDIO/DEFIB GENERATOR 93641,481,1 ,"$2,200.00 ","$1,100.00 ","$1,100.00 ","$2,200.00 ","$1,421.20 ","$1,412.36 ", N/A , N/A , N/A ,"$1,320.00 ","$1,870.00 ","$1,540.00 ","$1,412.36 ","$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ", N/A ,"$2,200.00 ","$1,760.00 ","$1,606.00 ","$1,412.36 ", N/A , N/A ,"$2,200.00 ","$1,870.00 ", N/A ,"$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ", N/A ,"$1,584.00 ","$1,497.10 ","$2,200.00 ","$2,200.00 ", N/A ,"$2,200.00 ", N/A ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,48100134,93641,HC ICD TESTING 93641,481,1 ,"$2,215.00 ","$1,107.50 ","$1,107.50 ","$2,215.00 ","$1,430.89 ","$1,412.36 ", N/A , N/A , N/A ,"$1,329.00 ","$1,882.75 ","$1,550.50 ","$1,412.36 ","$2,104.25 ","$1,594.80 ","$1,616.95 ","$2,215.00 ","$1,882.75 ", N/A ,"$2,215.00 ","$1,772.00 ","$1,616.95 ","$1,412.36 ", N/A , N/A ,"$2,215.00 ","$1,882.75 ", N/A ,"$2,037.80 ","$1,550.50 ","$1,107.50 ","$1,329.00 ","$1,348.94 ","$1,107.50 ","$1,530.57 ","$1,550.50 ", N/A ,"$1,594.80 ","$1,497.10 ","$2,215.00 ","$2,215.00 ", N/A ,"$2,215.00 ", N/A ,"$1,594.80 ","$1,373.30 ","$1,594.80 ","$1,594.80 ","$1,329.00 " ST VINCENT HOSPITAL - ACUTE,48100135,93642,HC EP EVAL CARDIO/DEFIB SGL/DUAL 93642,481,1 ,"$2,200.00 ","$1,100.00 ","$1,077.73 ","$2,424.89 ","$1,421.20 ","$1,412.36 ", N/A , N/A ,"$1,077.73 ","$1,320.00 ","$1,870.00 ","$1,540.00 ","$1,412.36 ","$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ","$1,077.73 ","$2,200.00 ","$1,760.00 ","$1,606.00 ","$1,412.36 ","$1,077.73 ", N/A ,"$2,200.00 ","$1,870.00 ","$2,424.89 ","$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ","$1,088.51 ","$1,584.00 ","$1,497.10 ","$2,200.00 ","$2,200.00 ","$1,077.73 ","$2,200.00 ","$1,077.73 ","$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,48100136,93650,HC ABLATION ATRIOVENTRICULAR FNCT 93650,481,1 ,"$5,300.00 ","$2,650.00 ","$2,650.00 ","$13,245.77 ","$3,423.80 ","$4,816.70 ","$5,300.00 ","$5,300.00 ","$5,887.01 ","$3,180.00 ","$4,505.00 ","$3,710.00 ","$4,816.70 ","$5,035.00 ","$3,816.00 ","$3,869.00 ","$5,300.00 ","$4,505.00 ","$5,887.01 ","$5,300.00 ","$4,240.00 ","$3,869.00 ","$4,816.70 ","$5,887.01 ","$5,300.00 ","$5,300.00 ","$4,505.00 ","$13,245.77 ","$4,876.00 ","$3,710.00 ","$2,650.00 ","$3,180.00 ","$3,227.70 ","$2,650.00 ","$3,662.30 ","$3,710.00 ","$5,945.88 ","$3,816.00 ","$5,105.70 ","$5,300.00 ","$5,300.00 ","$5,887.01 ","$5,300.00 ","$5,887.01 ","$3,816.00 ","$3,286.00 ","$3,816.00 ","$3,816.00 ","$3,180.00 " ST VINCENT HOSPITAL - ACUTE,48100139,93660,HC TILT TABLE EVALUATION 93660,481,1 ,"$1,700.00 ",$850.00 ,$76.32 ,"$1,700.00 ","$1,098.20 ",$76.32 ,"$1,700.00 ","$1,700.00 ",$472.41 ,"$1,020.00 ","$1,445.00 ","$1,190.00 ",$76.32 ,"$1,615.00 ","$1,224.00 ","$1,241.00 ","$1,700.00 ","$1,445.00 ",$472.41 ,"$1,700.00 ","$1,360.00 ","$1,241.00 ",$76.32 ,$472.41 ,"$1,700.00 ","$1,700.00 ","$1,445.00 ","$1,062.93 ","$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ",$477.13 ,"$1,224.00 ",$80.90 ,"$1,700.00 ","$1,700.00 ",$472.41 ,"$1,700.00 ",$472.41 ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,48100140,93662,HC EP INTRACARDIAC ECHO INTERVENT 93662,481,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$5,105.70 ","$2,390.20 ","$3,700.00 ","$3,700.00 ","$3,700.00 ", N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ","$4,816.70 ","$3,515.00 ","$2,664.00 ","$2,701.00 ","$3,700.00 ","$3,145.00 ", N/A ,"$3,700.00 ","$2,960.00 ","$2,701.00 ","$4,816.70 ", N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ","$5,105.70 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,48100150,93503,HC PLACEMENT SWANZ GAN CATH MONIT 93503,481,1 ,"$2,500.00 ","$1,250.00 ",$322.47 ,"$3,064.15 ","$1,615.00 ",$322.47 ,"$2,500.00 ","$2,500.00 ","$1,361.85 ","$1,500.00 ","$2,125.00 ","$1,750.00 ",$322.47 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ","$2,500.00 ","$2,125.00 ","$1,361.85 ","$2,500.00 ","$2,000.00 ","$1,825.00 ",$322.47 ,"$1,361.85 ","$2,500.00 ","$2,500.00 ","$2,125.00 ","$3,064.15 ","$2,300.00 ","$1,750.00 ","$1,250.00 ","$1,500.00 ","$1,522.50 ","$1,250.00 ","$1,727.50 ","$1,750.00 ","$1,375.47 ","$1,800.00 ",$341.82 ,"$2,500.00 ","$2,500.00 ","$1,361.85 ","$2,500.00 ","$1,361.85 ","$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,48100151,33227,HC REM/REPL PCMKR PUL GEN SGL 33227,481,1 ,"$5,200.00 ","$2,600.00 ","$2,452.48 ","$17,765.49 ","$3,359.20 ","$2,452.48 ","$5,200.00 ","$5,200.00 ","$7,895.77 ","$3,120.00 ","$4,420.00 ","$3,640.00 ","$2,452.48 ","$4,940.00 ","$3,744.00 ","$3,796.00 ","$5,200.00 ","$4,420.00 ","$7,895.77 ","$5,200.00 ","$4,160.00 ","$3,796.00 ","$2,452.48 ","$7,895.77 ","$5,200.00 ","$5,200.00 ","$4,420.00 ","$17,765.49 ","$4,784.00 ","$3,640.00 ","$5,818.90 ","$7,821.36 ","$3,166.80 ","$7,273.62 ","$3,593.20 ","$3,640.00 ","$7,974.73 ","$3,744.00 ","$2,599.63 ","$5,200.00 ","$5,200.00 ","$7,895.77 ","$5,200.00 ","$7,895.77 ","$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,48100152,33228,HC REM/REPL PCMKR PUL GEN DUAL 33228,481,1 ,"$5,900.00 ","$2,950.00 ","$2,452.48 ","$22,663.23 ","$3,811.40 ","$2,452.48 ","$5,900.00 ","$5,900.00 ","$10,072.55 ","$3,540.00 ","$5,015.00 ","$4,130.00 ","$2,452.48 ","$5,605.00 ","$4,248.00 ","$4,307.00 ","$5,900.00 ","$5,015.00 ","$10,072.55 ","$5,900.00 ","$4,720.00 ","$4,307.00 ","$2,452.48 ","$10,072.55 ","$5,900.00 ","$5,900.00 ","$5,015.00 ","$22,663.23 ","$5,428.00 ","$4,130.00 ","$5,818.90 ","$7,821.36 ","$3,593.10 ","$7,273.62 ","$4,076.90 ","$4,130.00 ","$10,173.28 ","$4,248.00 ","$2,599.63 ","$5,900.00 ","$5,900.00 ","$10,072.55 ","$5,900.00 ","$10,072.55 ","$4,248.00 ","$3,658.00 ","$4,248.00 ","$4,248.00 ","$3,540.00 " ST VINCENT HOSPITAL - ACUTE,48100153,33229,HC REM/REPL PCMKR PUL GEN MULT 33229,481,1 ,"$8,100.00 ","$4,050.00 ","$2,452.48 ","$40,556.26 ","$5,232.60 ","$2,452.48 ","$8,100.00 ","$8,100.00 ","$18,025.01 ","$4,860.00 ","$6,885.00 ","$5,670.00 ","$2,452.48 ","$7,695.00 ","$5,832.00 ","$5,913.00 ","$8,100.00 ","$6,885.00 ","$18,025.01 ","$8,100.00 ","$6,480.00 ","$5,913.00 ","$2,452.48 ","$18,025.01 ","$8,100.00 ","$8,100.00 ","$6,885.00 ","$40,556.26 ","$7,452.00 ","$5,670.00 ","$5,818.90 ","$7,821.36 ","$4,932.90 ","$7,273.62 ","$5,597.10 ","$5,670.00 ","$18,205.26 ","$5,832.00 ","$2,599.63 ","$8,100.00 ","$8,100.00 ","$18,025.01 ","$8,100.00 ","$18,025.01 ","$5,832.00 ","$5,022.00 ","$5,832.00 ","$5,832.00 ","$4,860.00 " ST VINCENT HOSPITAL - ACUTE,48100154,33262,HC REM/REPL DEFIB PUL GEN SGL 33262,481,1 ,"$13,000.00 ","$6,500.00 ","$5,818.90 ","$50,207.39 ","$8,398.00 ","$7,563.07 ","$13,000.00 ","$13,000.00 ","$22,314.40 ","$7,800.00 ","$11,050.00 ","$9,100.00 ","$7,563.07 ","$12,350.00 ","$9,360.00 ","$9,490.00 ","$13,000.00 ","$11,050.00 ","$22,314.40 ","$13,000.00 ","$10,400.00 ","$9,490.00 ","$7,563.07 ","$22,314.40 ","$13,000.00 ","$13,000.00 ","$11,050.00 ","$50,207.39 ","$11,960.00 ","$9,100.00 ","$5,818.90 ","$7,821.36 ","$7,917.00 ","$7,273.62 ","$8,983.00 ","$9,100.00 ","$22,537.54 ","$9,360.00 ","$8,016.85 ","$13,000.00 ","$13,000.00 ","$22,314.40 ","$13,000.00 ","$22,314.40 ","$9,360.00 ","$8,060.00 ","$9,360.00 ","$9,360.00 ","$7,800.00 " ST VINCENT HOSPITAL - ACUTE,48100155,33263,HC REM/REPL DEFIB PUL GEN DUAL 33263,481,1 ,"$13,000.00 ","$6,500.00 ","$5,818.90 ","$50,207.39 ","$8,398.00 ","$7,563.07 ","$13,000.00 ","$13,000.00 ","$22,314.40 ","$7,800.00 ","$11,050.00 ","$9,100.00 ","$7,563.07 ","$12,350.00 ","$9,360.00 ","$9,490.00 ","$13,000.00 ","$11,050.00 ","$22,314.40 ","$13,000.00 ","$10,400.00 ","$9,490.00 ","$7,563.07 ","$22,314.40 ","$13,000.00 ","$13,000.00 ","$11,050.00 ","$50,207.39 ","$11,960.00 ","$9,100.00 ","$5,818.90 ","$7,821.36 ","$7,917.00 ","$7,273.62 ","$8,983.00 ","$9,100.00 ","$22,537.54 ","$9,360.00 ","$8,016.85 ","$13,000.00 ","$13,000.00 ","$22,314.40 ","$13,000.00 ","$22,314.40 ","$9,360.00 ","$8,060.00 ","$9,360.00 ","$9,360.00 ","$7,800.00 " ST VINCENT HOSPITAL - ACUTE,48100156,33264,HC REM/REPL DEFIB PUL GEN MULT 33264,481,1 ,"$17,000.00 ","$8,500.00 ","$5,818.90 ","$71,560.05 ","$10,982.00 ","$7,563.07 ","$17,000.00 ","$13,130.00 ","$31,804.47 ","$10,200.00 ","$14,450.00 ","$11,900.00 ","$7,563.07 ","$16,150.00 ","$12,240.00 ","$12,410.00 ","$17,000.00 ","$14,450.00 ","$31,804.47 ","$17,000.00 ","$13,600.00 ","$12,410.00 ","$7,563.07 ","$31,804.47 ","$17,000.00 ","$17,000.00 ","$14,450.00 ","$71,560.05 ","$15,640.00 ","$11,900.00 ","$5,818.90 ","$7,821.36 ","$10,353.00 ","$7,273.62 ","$11,747.00 ","$11,900.00 ","$32,122.51 ","$12,240.00 ","$8,016.85 ","$17,000.00 ","$17,000.00 ","$31,804.47 ","$17,000.00 ","$31,804.47 ","$12,240.00 ","$10,540.00 ","$12,240.00 ","$12,240.00 ","$10,200.00 " ST VINCENT HOSPITAL - ACUTE,48100157,0075T,HC TRANSCATH XCRAN STENT PLCMT,481,1 ,"$6,200.00 ","$3,100.00 ","$1,802.28 ","$7,821.36 ","$4,005.20 ","$1,802.28 ","$6,200.00 ","$6,200.00 ", N/A ,"$3,720.00 ","$5,270.00 ","$4,340.00 ","$1,802.28 ","$5,890.00 ","$4,464.00 ","$4,526.00 ","$6,200.00 ","$5,270.00 ", N/A ,"$6,200.00 ","$4,960.00 ","$4,526.00 ","$1,802.28 ", N/A ,"$6,200.00 ","$6,200.00 ","$5,270.00 ", N/A ,"$5,704.00 ","$4,340.00 ","$5,818.90 ","$7,821.36 ","$3,775.80 ","$7,273.62 ","$4,284.20 ","$4,340.00 ", N/A ,"$4,464.00 ","$1,910.42 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$4,464.00 ","$3,844.00 ","$4,464.00 ","$4,464.00 ","$3,720.00 " ST VINCENT HOSPITAL - ACUTE,48100158,0237T,HC ARTHERECTOMY BRACHIOCEPHA PERC 0237T,481,1 ,"$10,070.00 ","$5,035.00 ","$3,338.02 ","$21,884.82 ","$6,505.22 ","$3,338.02 ","$10,070.00 ","$10,070.00 ","$9,726.59 ","$6,042.00 ","$8,559.50 ","$7,049.00 ","$3,338.02 ","$9,566.50 ","$7,250.40 ","$7,351.10 ","$6,750.00 ","$8,559.50 ","$9,726.59 ","$6,750.00 ","$8,056.00 ","$7,351.10 ","$3,338.02 ","$9,726.59 ","$10,070.00 ","$10,070.00 ","$8,559.50 ","$21,884.82 ","$9,264.40 ","$7,049.00 ","$5,818.90 ","$7,821.36 ","$6,132.63 ","$7,273.62 ","$6,958.37 ","$7,049.00 ","$9,823.86 ","$7,250.40 ","$3,538.30 ","$10,070.00 ","$10,070.00 ","$9,726.59 ","$10,070.00 ","$9,726.59 ","$7,250.40 ","$6,243.40 ","$7,250.40 ","$7,250.40 ","$6,042.00 " ST VINCENT HOSPITAL - ACUTE,48100160,33270,HC INS/REP SUBQ DEFIBRILLATOR 33270,481,1 ,"$23,485.00 ","$11,742.50 ","$5,818.90 ","$71,560.05 ","$15,171.31 ","$7,563.07 ","$19,190.00 ","$13,130.00 ","$31,804.47 ","$14,091.00 ","$19,962.25 ","$16,439.50 ","$7,563.07 ","$22,310.75 ","$16,909.20 ","$17,144.05 ","$6,750.00 ","$19,962.25 ","$31,804.47 ","$6,750.00 ","$18,788.00 ","$17,144.05 ","$7,563.07 ","$31,804.47 ","$18,533.02 ","$23,485.00 ","$19,962.25 ","$71,560.05 ","$21,606.20 ","$16,439.50 ","$5,818.90 ","$7,821.36 ","$14,302.37 ","$7,273.62 ","$16,228.14 ","$16,439.50 ","$32,122.51 ","$16,909.20 ","$8,016.85 ","$23,485.00 ","$23,485.00 ","$31,804.47 ","$23,485.00 ","$31,804.47 ","$16,909.20 ","$14,560.70 ","$16,909.20 ","$16,909.20 ","$14,091.00 " ST VINCENT HOSPITAL - ACUTE,48100165,93462,HC LHC TRANSEPTAL PUNCTURE 93462,481,1 ,"$5,300.00 ","$2,650.00 ",$729.19 ,"$5,300.00 ","$3,423.80 ",$729.19 ,"$5,300.00 ","$5,300.00 ", N/A ,"$3,180.00 ","$4,505.00 ","$3,710.00 ",$729.19 ,"$5,035.00 ","$3,816.00 ","$3,869.00 ","$5,300.00 ","$4,505.00 ", N/A ,"$5,300.00 ","$4,240.00 ","$3,869.00 ",$729.19 , N/A , N/A ,"$5,300.00 ","$4,505.00 ", N/A ,"$4,876.00 ","$3,710.00 ","$2,650.00 ","$3,180.00 ","$3,227.70 ","$2,650.00 ","$3,662.30 ","$3,710.00 ", N/A ,"$3,816.00 ",$772.94 ,"$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$3,816.00 ","$3,286.00 ","$3,816.00 ","$3,816.00 ","$3,180.00 " ST VINCENT HOSPITAL - ACUTE,48100170,93566,HC RT VENT OR AORTIC ANGIOGRAM,481,1 ,"$1,145.00 ",$572.50 ,$86.58 ,"$1,145.00 ",$739.67 ,$86.58 , N/A , N/A , N/A ,$687.00 ,$973.25 ,$801.50 ,$86.58 ,"$1,087.75 ",$824.40 ,$835.85 ,"$1,145.00 ",$973.25 , N/A ,"$1,145.00 ",$916.00 ,$835.85 ,$86.58 , N/A , N/A ,"$1,145.00 ",$973.25 , N/A ,"$1,053.40 ",$801.50 ,$572.50 ,$687.00 ,$697.31 ,$572.50 ,$791.20 ,$801.50 , N/A ,$824.40 ,$91.77 ,"$1,145.00 ","$1,145.00 ", N/A ,"$1,145.00 ", N/A ,$824.40 ,$709.90 ,$824.40 ,$824.40 ,$687.00 ST VINCENT HOSPITAL - ACUTE,48100171,36253,HC PLC CATH RENAL ANGIO 1< UNI,481,1 ,"$2,200.00 ","$1,100.00 ","$1,067.27 ","$10,395.23 ","$1,421.20 ","$1,067.27 ","$2,200.00 ","$2,200.00 ","$4,620.10 ","$1,320.00 ","$1,870.00 ","$1,540.00 ","$1,067.27 ","$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ","$4,620.10 ","$2,200.00 ","$1,760.00 ","$1,606.00 ","$1,067.27 ","$4,620.10 ","$2,200.00 ","$2,200.00 ","$1,870.00 ","$10,395.23 ","$2,024.00 ","$1,540.00 ","$2,066.93 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ","$4,666.30 ","$1,584.00 ","$1,131.31 ","$2,200.00 ","$2,200.00 ","$4,620.10 ","$2,200.00 ","$4,620.10 ","$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,48100173,37193,HC FILTER REMOVAL,481,1 ,"$5,500.00 ","$2,750.00 ","$1,095.68 ","$7,821.36 ","$3,553.00 ","$1,095.68 ","$5,500.00 ","$5,500.00 ","$2,771.52 ","$3,300.00 ","$4,675.00 ","$3,850.00 ","$1,095.68 ","$5,225.00 ","$3,960.00 ","$4,015.00 ","$5,500.00 ","$4,675.00 ","$2,771.52 ","$5,500.00 ","$4,400.00 ","$4,015.00 ","$1,095.68 ","$2,771.52 ","$5,500.00 ","$5,500.00 ","$4,675.00 ","$6,235.91 ","$5,060.00 ","$3,850.00 ","$5,818.90 ","$7,821.36 ","$3,349.50 ","$7,273.62 ","$3,800.50 ","$3,850.00 ","$2,799.24 ","$3,960.00 ","$1,161.42 ","$5,500.00 ","$5,500.00 ","$2,771.52 ","$5,500.00 ","$2,771.52 ","$3,960.00 ","$3,410.00 ","$3,960.00 ","$3,960.00 ","$3,300.00 " ST VINCENT HOSPITAL - ACUTE,48100174,33230,HC INS DEFIB PULSE GEN W/EST DUAL,481,1 ,"$14,115.00 ","$7,057.50 ","$5,818.90 ","$50,207.39 ","$9,118.29 ","$7,563.07 ","$14,115.00 ","$13,130.00 ","$22,314.40 ","$8,469.00 ","$11,997.75 ","$9,880.50 ","$7,563.07 ","$13,409.25 ","$10,162.80 ","$10,303.95 ","$14,115.00 ","$11,997.75 ","$22,314.40 ","$14,115.00 ","$11,292.00 ","$10,303.95 ","$7,563.07 ","$22,314.40 ","$14,115.00 ","$14,115.00 ","$11,997.75 ","$50,207.39 ","$12,985.80 ","$9,880.50 ","$5,818.90 ","$7,821.36 ","$8,596.04 ","$7,273.62 ","$9,753.47 ","$9,880.50 ","$22,537.54 ","$10,162.80 ","$8,016.85 ","$14,115.00 ","$14,115.00 ","$22,314.40 ","$14,115.00 ","$22,314.40 ","$10,162.80 ","$8,751.30 ","$10,162.80 ","$10,162.80 ","$8,469.00 " ST VINCENT HOSPITAL - ACUTE,48100175,33231,HC INS DEFIB PULSE GEN W/EST MULT,481,1 ,"$15,215.00 ","$7,607.50 ","$5,818.90 ","$71,560.05 ","$9,828.89 ","$7,563.07 ","$15,215.00 ","$13,130.00 ","$31,804.47 ","$9,129.00 ","$12,932.75 ","$10,650.50 ","$7,563.07 ","$14,454.25 ","$10,954.80 ","$11,106.95 ","$15,215.00 ","$12,932.75 ","$31,804.47 ","$15,215.00 ","$12,172.00 ","$11,106.95 ","$7,563.07 ","$31,804.47 ","$15,215.00 ","$15,215.00 ","$12,932.75 ","$71,560.05 ","$13,997.80 ","$10,650.50 ","$5,818.90 ","$7,821.36 ","$9,265.94 ","$7,273.62 ","$10,513.57 ","$10,650.50 ","$32,122.51 ","$10,954.80 ","$8,016.85 ","$15,215.00 ","$15,215.00 ","$31,804.47 ","$15,215.00 ","$31,804.47 ","$10,954.80 ","$9,433.30 ","$10,954.80 ","$10,954.80 ","$9,129.00 " ST VINCENT HOSPITAL - ACUTE,48100176,37216,HC PL STENT TRNSCATH CAROT ART W/O,481,1 ,"$5,500.00 ","$2,750.00 ","$1,802.28 ","$7,821.36 ","$3,553.00 ","$1,802.28 ","$5,500.00 ","$5,500.00 ", N/A ,"$3,300.00 ","$4,675.00 ","$3,850.00 ","$1,802.28 ","$5,225.00 ","$3,960.00 ","$4,015.00 ","$5,500.00 ","$4,675.00 ", N/A ,"$5,500.00 ","$4,400.00 ","$4,015.00 ","$1,802.28 ", N/A ,"$5,500.00 ","$5,500.00 ","$4,675.00 ", N/A ,"$5,060.00 ","$3,850.00 ","$5,818.90 ","$7,821.36 ","$3,349.50 ","$7,273.62 ","$3,800.50 ","$3,850.00 ", N/A ,"$3,960.00 ","$1,910.42 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$3,960.00 ","$3,410.00 ","$3,960.00 ","$3,960.00 ","$3,300.00 " ST VINCENT HOSPITAL - ACUTE,48100177,93464,HC EXERCISE W/HEMODYNAMIC MEAS 93464,481,1 ,$630.00 ,$315.00 ,$76.32 ,$630.00 ,$406.98 ,$76.32 ,$630.00 ,$630.00 , N/A ,$378.00 ,$535.50 ,$441.00 ,$76.32 ,$598.50 ,$453.60 ,$459.90 ,$630.00 ,$535.50 , N/A ,$630.00 ,$504.00 ,$459.90 ,$76.32 , N/A , N/A ,$630.00 ,$535.50 , N/A ,$579.60 ,$441.00 ,$315.00 ,$378.00 ,$383.67 ,$315.00 ,$435.33 ,$441.00 , N/A ,$453.60 ,$80.90 ,$630.00 ,$630.00 , N/A ,$630.00 , N/A ,$453.60 ,$390.60 ,$453.60 ,$453.60 ,$378.00 ST VINCENT HOSPITAL - ACUTE,48100178,93565,HC LT VENT OR AORTIC ANGIOGRAM 93565,481,1 ,"$1,060.00 ",$530.00 ,$86.58 ,"$1,060.00 ",$684.76 ,$86.58 , N/A , N/A , N/A ,$636.00 ,$901.00 ,$742.00 ,$86.58 ,"$1,007.00 ",$763.20 ,$773.80 ,"$1,060.00 ",$901.00 , N/A ,"$1,060.00 ",$848.00 ,$773.80 ,$86.58 , N/A , N/A ,"$1,060.00 ",$901.00 , N/A ,$975.20 ,$742.00 ,$530.00 ,$636.00 ,$645.54 ,$530.00 ,$732.46 ,$742.00 , N/A ,$763.20 ,$91.77 ,"$1,060.00 ","$1,060.00 ", N/A ,"$1,060.00 ", N/A ,$763.20 ,$657.20 ,$763.20 ,$763.20 ,$636.00 ST VINCENT HOSPITAL - ACUTE,48100179,93568,HC PULMONARY ANGIOGRAM,481,1 ,"$1,375.00 ",$687.50 ,$86.58 ,"$1,375.00 ",$888.25 ,$86.58 , N/A , N/A , N/A ,$825.00 ,"$1,168.75 ",$962.50 ,$86.58 ,"$1,306.25 ",$990.00 ,"$1,003.75 ","$1,375.00 ","$1,168.75 ", N/A ,"$1,375.00 ","$1,100.00 ","$1,003.75 ",$86.58 , N/A , N/A ,"$1,375.00 ","$1,168.75 ", N/A ,"$1,265.00 ",$962.50 ,$687.50 ,$825.00 ,$837.38 ,$687.50 ,$950.13 ,$962.50 , N/A ,$990.00 ,$91.77 ,"$1,375.00 ","$1,375.00 ", N/A ,"$1,375.00 ", N/A ,$990.00 ,$852.50 ,$990.00 ,$990.00 ,$825.00 ST VINCENT HOSPITAL - ACUTE,48100181,37212,HC VENOUS THROMBOLYSIS; INIT DAY 37212,481,1 ,"$3,100.00 ","$1,550.00 ","$1,095.68 ","$7,821.36 ","$2,002.60 ","$1,095.68 ","$3,100.00 ","$3,100.00 ","$2,771.52 ","$1,860.00 ","$2,635.00 ","$2,170.00 ","$1,095.68 ","$2,945.00 ","$2,232.00 ","$2,263.00 ","$3,100.00 ","$2,635.00 ","$2,771.52 ","$3,100.00 ","$2,480.00 ","$2,263.00 ","$1,095.68 ","$2,771.52 ","$3,100.00 ","$3,100.00 ","$2,635.00 ","$6,235.91 ","$2,852.00 ","$2,170.00 ","$5,818.90 ","$7,821.36 ","$1,887.90 ","$7,273.62 ","$2,142.10 ","$2,170.00 ","$2,799.24 ","$2,232.00 ","$1,161.42 ","$3,100.00 ","$3,100.00 ","$2,771.52 ","$3,100.00 ","$2,771.52 ","$2,232.00 ","$1,922.00 ","$2,232.00 ","$2,232.00 ","$1,860.00 " ST VINCENT HOSPITAL - ACUTE,48100182,37214,HC THROMBO CESS/CLOS; SUBSQ DAY 37214,481,1 ,"$3,800.00 ","$1,900.00 ","$1,095.68 ","$7,821.36 ","$2,454.80 ","$1,095.68 ","$3,800.00 ","$3,535.00 ","$2,771.52 ","$2,280.00 ","$3,230.00 ","$2,660.00 ","$1,095.68 ","$3,610.00 ","$2,736.00 ","$2,774.00 ","$3,800.00 ","$3,230.00 ","$2,771.52 ","$3,800.00 ","$3,040.00 ","$2,774.00 ","$1,095.68 ","$2,771.52 ","$3,800.00 ","$3,800.00 ","$3,230.00 ","$6,235.91 ","$3,496.00 ","$2,660.00 ","$5,818.90 ","$7,821.36 ","$2,314.20 ","$7,273.62 ","$2,625.80 ","$2,660.00 ","$2,799.24 ","$2,736.00 ","$1,161.42 ","$2,724.00 ","$2,724.00 ","$2,771.52 ","$2,724.00 ","$2,771.52 ","$2,736.00 ","$2,356.00 ","$2,736.00 ","$2,736.00 ","$2,280.00 " ST VINCENT HOSPITAL - ACUTE,48100183,36225,HC CATH PLCMT SEL SUBCL/INOM VERTEB UNI 36225,481,1 ,"$5,200.00 ","$2,600.00 ","$1,067.27 ","$6,235.91 ","$3,359.20 ","$1,067.27 ","$5,200.00 ","$5,200.00 ","$2,771.52 ","$3,120.00 ","$4,420.00 ","$3,640.00 ","$1,067.27 ","$4,940.00 ","$3,744.00 ","$3,796.00 ","$5,200.00 ","$4,420.00 ","$2,771.52 ","$5,200.00 ","$4,160.00 ","$3,796.00 ","$1,067.27 ","$2,771.52 ","$5,200.00 ","$5,200.00 ","$4,420.00 ","$6,235.91 ","$4,784.00 ","$3,640.00 ","$2,066.93 ","$2,778.48 ","$3,166.80 ","$2,583.66 ","$3,593.20 ","$3,640.00 ","$2,799.24 ","$3,744.00 ","$1,131.31 ","$5,200.00 ","$5,200.00 ","$2,771.52 ","$5,200.00 ","$2,771.52 ","$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,48100184,36228,HC CATH PLCMT SEL EA INTRACRN BRANCH UNI 36228,481,1 ,"$2,400.00 ","$1,200.00 ","$1,067.27 ","$2,778.48 ","$1,550.40 ","$1,067.27 ","$2,400.00 ","$2,400.00 ", N/A ,"$1,440.00 ","$2,040.00 ","$1,680.00 ","$1,067.27 ","$2,280.00 ","$1,728.00 ","$1,752.00 ","$2,400.00 ","$2,040.00 ", N/A ,"$2,400.00 ","$1,920.00 ","$1,752.00 ","$1,067.27 ", N/A ,"$2,400.00 ","$2,400.00 ","$2,040.00 ", N/A ,"$2,208.00 ","$1,680.00 ","$2,066.52 ","$2,778.48 ","$1,461.60 ","$2,583.66 ","$1,658.40 ","$1,680.00 ", N/A ,"$1,728.00 ","$1,131.31 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,48100185,37211,HC ARTRL THROMBOLYSIS; INIT DAY 37211,481,1 ,"$4,600.00 ","$2,300.00 ","$1,095.68 ","$10,395.23 ","$2,971.60 ","$1,095.68 ","$4,600.00 ","$4,600.00 ","$4,620.10 ","$2,760.00 ","$3,910.00 ","$3,220.00 ","$1,095.68 ","$4,370.00 ","$3,312.00 ","$3,358.00 ","$4,600.00 ","$3,910.00 ","$4,620.10 ","$4,600.00 ","$3,680.00 ","$3,358.00 ","$1,095.68 ","$4,620.10 ","$4,600.00 ","$4,600.00 ","$3,910.00 ","$10,395.23 ","$4,232.00 ","$3,220.00 ","$5,818.90 ","$7,821.36 ","$2,801.40 ","$7,273.62 ","$3,178.60 ","$3,220.00 ","$4,666.30 ","$3,312.00 ","$1,161.42 ","$4,600.00 ","$4,600.00 ","$4,620.10 ","$4,600.00 ","$4,620.10 ","$3,312.00 ","$2,852.00 ","$3,312.00 ","$3,312.00 ","$2,760.00 " ST VINCENT HOSPITAL - ACUTE,48100186,37213,HC ARTRL/VENOUS THROMBOLYSIS; SUBSQ DAY 37213,481,1 ,"$3,800.00 ","$1,900.00 ","$1,095.68 ","$7,821.36 ","$2,454.80 ","$1,095.68 ","$3,800.00 ","$3,535.00 ","$2,771.52 ","$2,280.00 ","$3,230.00 ","$2,660.00 ","$1,095.68 ","$3,610.00 ","$2,736.00 ","$2,774.00 ","$3,800.00 ","$3,230.00 ","$2,771.52 ","$3,800.00 ","$3,040.00 ","$2,774.00 ","$1,095.68 ","$2,771.52 ","$3,800.00 ","$3,800.00 ","$3,230.00 ","$6,235.91 ","$3,496.00 ","$2,660.00 ","$5,818.90 ","$7,821.36 ","$2,314.20 ","$7,273.62 ","$2,625.80 ","$2,660.00 ","$2,799.24 ","$2,736.00 ","$1,161.42 ","$2,724.00 ","$2,724.00 ","$2,771.52 ","$2,724.00 ","$2,771.52 ","$2,736.00 ","$2,356.00 ","$2,736.00 ","$2,736.00 ","$2,280.00 " ST VINCENT HOSPITAL - ACUTE,48100187,37197,HC TRANSCATH RETRVAL FOREIGN BODY 37197,481,1 ,"$2,900.00 ","$1,450.00 ","$1,095.68 ","$7,821.36 ","$1,873.40 ","$1,095.68 ","$2,900.00 ","$2,900.00 ","$2,771.52 ","$1,740.00 ","$2,465.00 ","$2,030.00 ","$1,095.68 ","$2,755.00 ","$2,088.00 ","$2,117.00 ","$2,900.00 ","$2,465.00 ","$2,771.52 ","$2,900.00 ","$2,320.00 ","$2,117.00 ","$1,095.68 ","$2,771.52 ","$2,900.00 ","$2,900.00 ","$2,465.00 ","$6,235.91 ","$2,668.00 ","$2,030.00 ","$5,818.90 ","$7,821.36 ","$1,766.10 ","$7,273.62 ","$2,003.90 ","$2,030.00 ","$2,799.24 ","$2,088.00 ","$1,161.42 ","$2,900.00 ","$2,900.00 ","$2,771.52 ","$2,900.00 ","$2,771.52 ","$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,48100188,36221,HC CATH PLCMT NON SEL THORAC AORTA 36221,481,1 ,"$4,400.00 ","$2,200.00 ","$1,067.27 ","$6,235.91 ","$2,842.40 ","$1,067.27 ","$4,400.00 ","$4,400.00 ","$2,771.52 ","$2,640.00 ","$3,740.00 ","$3,080.00 ","$1,067.27 ","$4,180.00 ","$3,168.00 ","$3,212.00 ","$4,400.00 ","$3,740.00 ","$2,771.52 ","$4,400.00 ","$3,520.00 ","$3,212.00 ","$1,067.27 ","$2,771.52 ","$4,400.00 ","$4,400.00 ","$3,740.00 ","$6,235.91 ","$4,048.00 ","$3,080.00 ","$2,066.93 ","$2,778.48 ","$2,679.60 ","$2,583.66 ","$3,040.40 ","$3,080.00 ","$2,799.24 ","$3,168.00 ","$1,131.31 ","$4,400.00 ","$4,400.00 ","$2,771.52 ","$4,400.00 ","$2,771.52 ","$3,168.00 ","$2,728.00 ","$3,168.00 ","$3,168.00 ","$2,640.00 " ST VINCENT HOSPITAL - ACUTE,48100189,36222,HC CATH PLCMT SEL COM CAR/INOM EXTRACRN UNI 36222,481,1 ,"$7,400.00 ","$3,700.00 ","$1,067.27 ","$7,400.00 ","$4,780.40 ","$1,067.27 ","$7,070.00 ","$6,565.00 ","$2,771.52 ","$4,440.00 ","$6,290.00 ","$5,180.00 ","$1,067.27 ","$7,030.00 ","$5,328.00 ","$5,402.00 ","$6,750.00 ","$6,290.00 ","$2,771.52 ","$6,750.00 ","$5,920.00 ","$5,402.00 ","$1,067.27 ","$2,771.52 ","$5,519.06 ","$7,400.00 ","$6,290.00 ","$6,235.91 ","$6,808.00 ","$5,180.00 ","$2,066.93 ","$2,778.48 ","$4,506.60 ","$2,583.66 ","$5,113.40 ","$5,180.00 ","$2,799.24 ","$5,328.00 ","$1,131.31 ","$6,668.00 ","$6,668.00 ","$2,771.52 ","$6,668.00 ","$2,771.52 ","$5,328.00 ","$4,588.00 ","$5,328.00 ","$5,328.00 ","$4,440.00 " ST VINCENT HOSPITAL - ACUTE,48100189,36222,HC CATH PLCMT SEL COM CAR/INOM EXTRACRN UNI 36222,481,1 ,"$4,900.00 ","$2,450.00 ","$1,067.27 ","$6,235.91 ","$3,165.40 ","$1,067.27 ","$4,900.00 ","$4,900.00 ","$2,771.52 ","$2,940.00 ","$4,165.00 ","$3,430.00 ","$1,067.27 ","$4,655.00 ","$3,528.00 ","$3,577.00 ","$4,900.00 ","$4,165.00 ","$2,771.52 ","$4,900.00 ","$3,920.00 ","$3,577.00 ","$1,067.27 ","$2,771.52 ","$4,900.00 ","$4,900.00 ","$4,165.00 ","$6,235.91 ","$4,508.00 ","$3,430.00 ","$2,066.93 ","$2,778.48 ","$2,984.10 ","$2,583.66 ","$3,385.90 ","$3,430.00 ","$2,799.24 ","$3,528.00 ","$1,131.31 ","$4,900.00 ","$4,900.00 ","$2,771.52 ","$4,900.00 ","$2,771.52 ","$3,528.00 ","$3,038.00 ","$3,528.00 ","$3,528.00 ","$2,940.00 " ST VINCENT HOSPITAL - ACUTE,48100190,36223,HC CATH PLCMT SEL COM CAR/INOM INTRACRN UNI 36223,481,1 ,"$8,900.00 ","$4,450.00 ","$1,067.27 ","$10,395.23 ","$5,749.40 ","$1,067.27 ","$8,900.00 ","$7,196.00 ","$4,620.10 ","$5,340.00 ","$7,565.00 ","$6,230.00 ","$1,067.27 ","$8,455.00 ","$6,408.00 ","$6,497.00 ","$6,750.00 ","$7,565.00 ","$4,620.10 ","$6,750.00 ","$7,120.00 ","$6,497.00 ","$1,067.27 ","$4,620.10 ","$5,519.06 ","$8,900.00 ","$7,565.00 ","$10,395.23 ","$8,188.00 ","$6,230.00 ","$2,066.93 ","$2,778.48 ","$5,420.10 ","$2,583.66 ","$6,149.90 ","$6,230.00 ","$4,666.30 ","$6,408.00 ","$1,131.31 ","$8,890.00 ","$8,890.00 ","$4,620.10 ","$8,890.00 ","$4,620.10 ","$6,408.00 ","$5,518.00 ","$6,408.00 ","$6,408.00 ","$5,340.00 " ST VINCENT HOSPITAL - ACUTE,48100191,36224,HC CATH PLCMT SEL INTERNAL CAR UNI 36224,481,1 ,"$4,600.00 ","$2,300.00 ","$1,067.27 ","$10,395.23 ","$2,971.60 ","$1,067.27 ","$4,600.00 ","$4,600.00 ","$4,620.10 ","$2,760.00 ","$3,910.00 ","$3,220.00 ","$1,067.27 ","$4,370.00 ","$3,312.00 ","$3,358.00 ","$4,600.00 ","$3,910.00 ","$4,620.10 ","$4,600.00 ","$3,680.00 ","$3,358.00 ","$1,067.27 ","$4,620.10 ","$4,600.00 ","$4,600.00 ","$3,910.00 ","$10,395.23 ","$4,232.00 ","$3,220.00 ","$2,066.93 ","$2,778.48 ","$2,801.40 ","$2,583.66 ","$3,178.60 ","$3,220.00 ","$4,666.30 ","$3,312.00 ","$1,131.31 ","$4,600.00 ","$4,600.00 ","$4,620.10 ","$4,600.00 ","$4,620.10 ","$3,312.00 ","$2,852.00 ","$3,312.00 ","$3,312.00 ","$2,760.00 " ST VINCENT HOSPITAL - ACUTE,48100192,36226,HC CATH PLCMT SEL VERTEBRAL UNI 36226,481,1 ,"$7,000.00 ","$3,500.00 ","$1,067.27 ","$10,395.23 ","$4,522.00 ","$1,067.27 ","$7,000.00 ","$7,000.00 ","$4,620.10 ","$4,200.00 ","$5,950.00 ","$4,900.00 ","$1,067.27 ","$6,650.00 ","$5,040.00 ","$5,110.00 ","$6,750.00 ","$5,950.00 ","$4,620.10 ","$6,750.00 ","$5,600.00 ","$5,110.00 ","$1,067.27 ","$4,620.10 ","$7,000.00 ","$7,000.00 ","$5,950.00 ","$10,395.23 ","$6,440.00 ","$4,900.00 ","$2,066.93 ","$2,778.48 ","$4,263.00 ","$2,583.66 ","$4,837.00 ","$4,900.00 ","$4,666.30 ","$5,040.00 ","$1,131.31 ","$7,000.00 ","$7,000.00 ","$4,620.10 ","$7,000.00 ","$4,620.10 ","$5,040.00 ","$4,340.00 ","$5,040.00 ","$5,040.00 ","$4,200.00 " ST VINCENT HOSPITAL - ACUTE,48100193,36227,HC CATH PLCMT SEL EXTERNAL CAR UNI 36227,481,1 ,"$2,000.00 ","$1,000.00 ","$1,000.00 ","$2,778.48 ","$1,292.00 ","$1,067.27 ","$2,000.00 ","$2,000.00 ", N/A ,"$1,200.00 ","$1,700.00 ","$1,400.00 ","$1,067.27 ","$1,900.00 ","$1,440.00 ","$1,460.00 ","$2,000.00 ","$1,700.00 ", N/A ,"$2,000.00 ","$1,600.00 ","$1,460.00 ","$1,067.27 ", N/A ,"$2,000.00 ","$2,000.00 ","$1,700.00 ", N/A ,"$1,840.00 ","$1,400.00 ","$2,066.52 ","$2,778.48 ","$1,218.00 ","$2,583.66 ","$1,382.00 ","$1,400.00 ", N/A ,"$1,440.00 ","$1,131.31 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,48100200,92920,HC PTCA SINGL MAJ ART/BRANCH 92920,481,1 ,"$7,100.00 ","$3,550.00 ","$2,710.53 ","$10,801.57 ","$4,586.60 ","$2,710.53 ","$7,100.00 ","$7,100.00 ","$4,800.70 ","$4,260.00 ","$6,035.00 ","$4,970.00 ","$2,710.53 ","$6,745.00 ","$5,112.00 ","$5,183.00 ","$7,100.00 ","$6,035.00 ","$4,800.70 ","$7,100.00 ","$5,680.00 ","$5,183.00 ","$2,710.53 ","$4,800.70 ","$7,100.00 ","$7,100.00 ","$6,035.00 ","$10,801.57 ","$6,532.00 ","$4,970.00 ","$5,818.90 ","$7,821.36 ","$4,323.90 ","$7,273.62 ","$4,906.10 ","$4,970.00 ","$4,848.71 ","$5,112.00 ","$2,873.16 ","$7,100.00 ","$7,100.00 ","$4,800.70 ","$7,100.00 ","$4,800.70 ","$5,112.00 ","$4,402.00 ","$5,112.00 ","$5,112.00 ","$4,260.00 " ST VINCENT HOSPITAL - ACUTE,48100201,92921,HC PTCA EA ADDL BRANCH MAJ ART 92921,481,1 ,"$4,800.00 ","$2,400.00 ","$2,400.00 ","$7,821.36 ","$3,100.80 ","$2,710.53 ","$4,800.00 ","$4,800.00 ", N/A ,"$2,880.00 ","$4,080.00 ","$3,360.00 ","$2,710.53 ","$4,560.00 ","$3,456.00 ","$3,504.00 ","$4,800.00 ","$4,080.00 ", N/A ,"$4,800.00 ","$3,840.00 ","$3,504.00 ","$2,710.53 ", N/A , N/A ,"$4,800.00 ","$4,080.00 ", N/A ,"$4,416.00 ","$3,360.00 ","$5,819.10 ","$7,821.36 ","$2,923.20 ","$7,273.62 ","$3,316.80 ","$3,360.00 ", N/A ,"$3,456.00 ","$2,873.16 ","$4,800.00 ","$4,800.00 ", N/A ,"$4,800.00 ", N/A ,"$3,456.00 ","$2,976.00 ","$3,456.00 ","$3,456.00 ","$2,880.00 " ST VINCENT HOSPITAL - ACUTE,48100202,92924,HC ROTOBLATOR SINGL MAJ ART/BRANCH 92924,481,1 ,"$14,000.00 ","$7,000.00 ","$2,710.53 ","$21,884.82 ","$9,044.00 ","$2,710.53 ","$14,000.00 ","$14,000.00 ","$9,726.59 ","$8,400.00 ","$11,900.00 ","$9,800.00 ","$2,710.53 ","$13,300.00 ","$10,080.00 ","$10,220.00 ","$14,000.00 ","$11,900.00 ","$9,726.59 ","$14,000.00 ","$11,200.00 ","$10,220.00 ","$2,710.53 ","$9,726.59 ","$14,000.00 ","$14,000.00 ","$11,900.00 ","$21,884.82 ","$12,880.00 ","$9,800.00 ","$5,818.90 ","$7,821.36 ","$8,526.00 ","$7,273.62 ","$9,674.00 ","$9,800.00 ","$9,823.86 ","$10,080.00 ","$2,873.16 ","$13,136.00 ","$13,136.00 ","$9,726.59 ","$13,136.00 ","$9,726.59 ","$10,080.00 ","$8,680.00 ","$10,080.00 ","$10,080.00 ","$8,400.00 " ST VINCENT HOSPITAL - ACUTE,48100203,92925,HC ROTOBLATOR EA ADDL BRANCH MAJ ART 92925,481,1 ,"$8,270.00 ","$4,135.00 ","$2,710.53 ","$8,270.00 ","$5,342.42 ","$2,710.53 ","$8,270.00 ","$8,270.00 ", N/A ,"$4,962.00 ","$7,029.50 ","$5,789.00 ","$2,710.53 ","$7,856.50 ","$5,954.40 ","$6,037.10 ","$8,270.00 ","$7,029.50 ", N/A ,"$8,270.00 ","$6,616.00 ","$6,037.10 ","$2,710.53 ", N/A , N/A ,"$8,270.00 ","$7,029.50 ", N/A ,"$7,608.40 ","$5,789.00 ","$5,819.10 ","$7,821.36 ","$5,036.43 ","$7,273.62 ","$5,714.57 ","$5,789.00 ", N/A ,"$5,954.40 ","$2,873.16 ","$8,270.00 ","$8,270.00 ", N/A ,"$8,270.00 ", N/A ,"$5,954.40 ","$5,127.40 ","$5,954.40 ","$5,954.40 ","$4,962.00 " ST VINCENT HOSPITAL - ACUTE,48100204,92928,HC BMS SINGL MAJ ART/BRANCH 92928,481,1 ,"$10,000.00 ","$5,000.00 ","$2,710.53 ","$21,884.82 ","$6,460.00 ","$2,710.53 ","$10,000.00 ","$10,000.00 ","$9,726.59 ","$6,000.00 ","$8,500.00 ","$7,000.00 ","$2,710.53 ","$9,500.00 ","$7,200.00 ","$7,300.00 ","$6,750.00 ","$8,500.00 ","$9,726.59 ","$6,750.00 ","$8,000.00 ","$7,300.00 ","$2,710.53 ","$9,726.59 ","$10,000.00 ","$10,000.00 ","$8,500.00 ","$21,884.82 ","$9,200.00 ","$7,000.00 ","$5,818.90 ","$7,821.36 ","$6,090.00 ","$7,273.62 ","$6,910.00 ","$7,000.00 ","$9,823.86 ","$7,200.00 ","$2,873.16 ","$10,000.00 ","$10,000.00 ","$9,726.59 ","$10,000.00 ","$9,726.59 ","$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,48100205,92929,HC BMS EA ADDL BRANCH MAJ ART 92929,481,1 ,"$11,000.00 ","$5,500.00 ","$2,710.53 ","$11,000.00 ","$7,106.00 ","$2,710.53 ","$11,000.00 ","$11,000.00 ", N/A ,"$6,600.00 ","$9,350.00 ","$7,700.00 ","$2,710.53 ","$10,450.00 ","$7,920.00 ","$8,030.00 ","$6,750.00 ","$9,350.00 ", N/A ,"$6,750.00 ","$8,800.00 ","$8,030.00 ","$2,710.53 ", N/A ,"$11,000.00 ","$11,000.00 ","$9,350.00 ", N/A ,"$10,120.00 ","$7,700.00 ","$5,819.10 ","$7,821.36 ","$6,699.00 ","$7,273.62 ","$7,601.00 ","$7,700.00 ", N/A ,"$7,920.00 ","$2,873.16 ","$11,000.00 ","$11,000.00 ", N/A ,"$11,000.00 ", N/A ,"$7,920.00 ","$6,820.00 ","$7,920.00 ","$7,920.00 ","$6,600.00 " ST VINCENT HOSPITAL - ACUTE,48100206,92933,HC ROTOBLATOR/BMS SINGL MAJ ART/BRANCH 92933,481,1 ,"$19,000.00 ","$9,500.00 ","$2,710.53 ","$35,005.46 ","$12,274.00 ","$2,710.53 ","$19,000.00 ","$19,000.00 ","$15,557.98 ","$11,400.00 ","$16,150.00 ","$13,300.00 ","$2,710.53 ","$18,050.00 ","$13,680.00 ","$13,870.00 ","$6,750.00 ","$16,150.00 ","$15,557.98 ","$6,750.00 ","$15,200.00 ","$13,870.00 ","$2,710.53 ","$15,557.98 ","$16,425.84 ","$19,000.00 ","$16,150.00 ","$35,005.46 ","$17,480.00 ","$13,300.00 ","$5,818.90 ","$7,821.36 ","$11,571.00 ","$7,273.62 ","$13,129.00 ","$13,300.00 ","$15,713.56 ","$13,680.00 ","$2,873.16 ","$16,825.00 ","$16,825.00 ","$15,557.98 ","$16,825.00 ","$15,557.98 ","$13,680.00 ","$11,780.00 ","$13,680.00 ","$13,680.00 ","$11,400.00 " ST VINCENT HOSPITAL - ACUTE,48100207,92934,HC ROTOBLATOR/BMS EA ADDL BRANCH MAJ ART 92934,481,1 ,"$14,335.00 ","$7,167.50 ","$2,710.53 ","$14,335.00 ","$9,260.41 ","$2,710.53 ","$14,335.00 ","$14,335.00 ", N/A ,"$8,601.00 ","$12,184.75 ","$10,034.50 ","$2,710.53 ","$13,618.25 ","$10,321.20 ","$10,464.55 ","$6,750.00 ","$12,184.75 ", N/A ,"$6,750.00 ","$11,468.00 ","$10,464.55 ","$2,710.53 ", N/A ,"$14,335.00 ","$14,335.00 ","$12,184.75 ", N/A ,"$13,188.20 ","$10,034.50 ","$5,819.10 ","$7,821.36 ","$8,730.02 ","$7,273.62 ","$9,905.49 ","$10,034.50 ", N/A ,"$10,321.20 ","$2,873.16 ","$14,335.00 ","$14,335.00 ", N/A ,"$14,335.00 ", N/A ,"$10,321.20 ","$8,887.70 ","$10,321.20 ","$10,321.20 ","$8,601.00 " ST VINCENT HOSPITAL - ACUTE,48100208,92937,HC BYPASS GRAFT BMS SINGL MAJ ART/BRANCH 92937,481,1 ,"$13,000.00 ","$6,500.00 ","$2,710.53 ","$21,884.82 ","$8,398.00 ","$2,710.53 ","$13,000.00 ","$13,000.00 ","$9,726.59 ","$7,800.00 ","$11,050.00 ","$9,100.00 ","$2,710.53 ","$12,350.00 ","$9,360.00 ","$9,490.00 ","$6,750.00 ","$11,050.00 ","$9,726.59 ","$6,750.00 ","$10,400.00 ","$9,490.00 ","$2,710.53 ","$9,726.59 ","$13,000.00 ","$13,000.00 ","$11,050.00 ","$21,884.82 ","$11,960.00 ","$9,100.00 ","$5,818.90 ","$7,821.36 ","$7,917.00 ","$7,273.62 ","$8,983.00 ","$9,100.00 ","$9,823.86 ","$9,360.00 ","$2,873.16 ","$13,000.00 ","$13,000.00 ","$9,726.59 ","$13,000.00 ","$9,726.59 ","$9,360.00 ","$8,060.00 ","$9,360.00 ","$9,360.00 ","$7,800.00 " ST VINCENT HOSPITAL - ACUTE,48100209,92938,HC BYPASS GRAFT BMS EA ADDL BRNCH MAJ ART 92938,481,1 ,"$7,400.00 ","$3,700.00 ","$2,710.53 ","$7,821.36 ","$4,780.40 ","$2,710.53 ","$7,400.00 ","$7,400.00 ", N/A ,"$4,440.00 ","$6,290.00 ","$5,180.00 ","$2,710.53 ","$7,030.00 ","$5,328.00 ","$5,402.00 ","$6,750.00 ","$6,290.00 ", N/A ,"$6,750.00 ","$5,920.00 ","$5,402.00 ","$2,710.53 ", N/A ,"$7,400.00 ","$7,400.00 ","$6,290.00 ", N/A ,"$6,808.00 ","$5,180.00 ","$5,819.10 ","$7,821.36 ","$4,506.60 ","$7,273.62 ","$5,113.40 ","$5,180.00 ", N/A ,"$5,328.00 ","$2,873.16 ","$7,400.00 ","$7,400.00 ", N/A ,"$7,400.00 ", N/A ,"$5,328.00 ","$4,588.00 ","$5,328.00 ","$5,328.00 ","$4,440.00 " ST VINCENT HOSPITAL - ACUTE,48100210,92941,HC STEMI/NSTEMI BMS SING VESS 92941,481,1 ,"$14,000.00 ","$7,000.00 ","$2,710.53 ","$14,000.00 ","$9,044.00 ","$2,710.53 ","$14,000.00 ","$14,000.00 ", N/A ,"$8,400.00 ","$11,900.00 ","$9,800.00 ","$2,710.53 ","$13,300.00 ","$10,080.00 ","$10,220.00 ","$6,750.00 ","$11,900.00 ", N/A ,"$6,750.00 ","$11,200.00 ","$10,220.00 ","$2,710.53 ", N/A ,"$14,000.00 ","$14,000.00 ","$11,900.00 ", N/A ,"$12,880.00 ","$9,800.00 ","$5,818.90 ","$7,821.36 ","$8,526.00 ","$7,273.62 ","$9,674.00 ","$9,800.00 ", N/A ,"$10,080.00 ","$2,873.16 ","$14,000.00 ","$14,000.00 ", N/A ,"$14,000.00 ", N/A ,"$10,080.00 ","$8,680.00 ","$10,080.00 ","$10,080.00 ","$8,400.00 " ST VINCENT HOSPITAL - ACUTE,48100211,92943,HC CTO BMS SING MAJ ART/BRNCH 92943,481,1 ,"$15,000.00 ","$7,500.00 ","$2,710.53 ","$21,884.82 ","$9,690.00 ","$2,710.53 ","$15,000.00 ","$15,000.00 ","$9,726.59 ","$9,000.00 ","$12,750.00 ","$10,500.00 ","$2,710.53 ","$14,250.00 ","$10,800.00 ","$10,950.00 ","$6,750.00 ","$12,750.00 ","$9,726.59 ","$6,750.00 ","$12,000.00 ","$10,950.00 ","$2,710.53 ","$9,726.59 ","$15,000.00 ","$15,000.00 ","$12,750.00 ","$21,884.82 ","$13,800.00 ","$10,500.00 ","$5,818.90 ","$7,821.36 ","$9,135.00 ","$7,273.62 ","$10,365.00 ","$10,500.00 ","$9,823.86 ","$10,800.00 ","$2,873.16 ","$15,000.00 ","$15,000.00 ","$9,726.59 ","$15,000.00 ","$9,726.59 ","$10,800.00 ","$9,300.00 ","$10,800.00 ","$10,800.00 ","$9,000.00 " ST VINCENT HOSPITAL - ACUTE,48100212,92944,HC CTO BMS EA ADD BNCH MAJ ART 92944,481,1 ,"$12,000.00 ","$6,000.00 ","$2,710.53 ","$12,000.00 ","$7,752.00 ","$2,710.53 ","$12,000.00 ","$12,000.00 ", N/A ,"$7,200.00 ","$10,200.00 ","$8,400.00 ","$2,710.53 ","$11,400.00 ","$8,640.00 ","$8,760.00 ","$6,750.00 ","$10,200.00 ", N/A ,"$6,750.00 ","$9,600.00 ","$8,760.00 ","$2,710.53 ", N/A ,"$12,000.00 ","$12,000.00 ","$10,200.00 ", N/A ,"$11,040.00 ","$8,400.00 ","$5,819.10 ","$7,821.36 ","$7,308.00 ","$7,273.62 ","$8,292.00 ","$8,400.00 ", N/A ,"$8,640.00 ","$2,873.16 ","$12,000.00 ","$12,000.00 ", N/A ,"$12,000.00 ", N/A ,"$8,640.00 ","$7,440.00 ","$8,640.00 ","$8,640.00 ","$7,200.00 " ST VINCENT HOSPITAL - ACUTE,48100213,93653,HC EP STUDY PLUS SVT ABLATION 93653,481,1 ,"$20,000.00 ","$10,000.00 ","$4,816.70 ","$46,773.63 ","$12,920.00 ","$4,816.70 ","$20,000.00 ","$20,000.00 ","$20,788.28 ","$12,000.00 ","$17,000.00 ","$14,000.00 ","$4,816.70 ","$19,000.00 ","$14,400.00 ","$14,600.00 ","$15,422.00 ","$17,000.00 ","$20,788.28 ","$15,422.00 ","$16,000.00 ","$14,600.00 ","$4,816.70 ","$20,788.28 ","$15,453.38 ","$20,000.00 ","$17,000.00 ","$46,773.63 ","$18,400.00 ","$14,000.00 ","$10,000.00 ","$12,000.00 ","$12,180.00 ","$10,000.00 ","$13,820.00 ","$14,000.00 ","$20,996.16 ","$14,400.00 ","$5,105.70 ","$18,693.00 ","$18,693.00 ","$20,788.28 ","$18,693.00 ","$20,788.28 ","$14,400.00 ","$12,400.00 ","$14,400.00 ","$14,400.00 ","$12,000.00 " ST VINCENT HOSPITAL - ACUTE,48100214,93654,HC EP STUDY PLUS VT ABLATION 93654,481,1 ,"$20,000.00 ","$10,000.00 ","$4,816.70 ","$46,773.63 ","$12,920.00 ","$4,816.70 ","$20,000.00 ","$20,000.00 ","$20,788.28 ","$12,000.00 ","$17,000.00 ","$14,000.00 ","$4,816.70 ","$19,000.00 ","$14,400.00 ","$14,600.00 ","$15,422.00 ","$17,000.00 ","$20,788.28 ","$15,422.00 ","$16,000.00 ","$14,600.00 ","$4,816.70 ","$20,788.28 ","$15,453.38 ","$20,000.00 ","$17,000.00 ","$46,773.63 ","$18,400.00 ","$14,000.00 ","$10,000.00 ","$12,000.00 ","$12,180.00 ","$10,000.00 ","$13,820.00 ","$14,000.00 ","$20,996.16 ","$14,400.00 ","$5,105.70 ","$18,693.00 ","$18,693.00 ","$20,788.28 ","$18,693.00 ","$20,788.28 ","$14,400.00 ","$12,400.00 ","$14,400.00 ","$14,400.00 ","$12,000.00 " ST VINCENT HOSPITAL - ACUTE,48100215,93655,HC ADD ON ABLAT POST ABLAT ORIG RHYTHM 93655,481,1 ,"$3,400.00 ","$1,700.00 ","$1,700.00 ","$5,105.70 ","$2,196.40 ","$3,400.00 ","$3,400.00 ","$3,400.00 ", N/A ,"$2,040.00 ","$2,890.00 ","$2,380.00 ","$4,816.70 ","$3,230.00 ","$2,448.00 ","$2,482.00 ","$3,400.00 ","$2,890.00 ", N/A ,"$3,400.00 ","$2,720.00 ","$2,482.00 ","$4,816.70 ", N/A ,"$3,400.00 ","$3,400.00 ","$2,890.00 ", N/A ,"$3,128.00 ","$2,380.00 ","$1,700.00 ","$2,040.00 ","$2,070.60 ","$1,700.00 ","$2,349.40 ","$2,380.00 ", N/A ,"$2,448.00 ","$5,105.70 ","$3,400.00 ","$3,400.00 ", N/A ,"$3,400.00 ", N/A ,"$2,448.00 ","$2,108.00 ","$2,448.00 ","$2,448.00 ","$2,040.00 " ST VINCENT HOSPITAL - ACUTE,48100216,93656,HC EP STUDY PLUS AFIB ABLATION 93656,481,1 ,"$20,000.00 ","$10,000.00 ","$4,816.70 ","$46,773.63 ","$12,920.00 ","$4,816.70 ","$20,000.00 ","$20,000.00 ","$20,788.28 ","$12,000.00 ","$17,000.00 ","$14,000.00 ","$4,816.70 ","$19,000.00 ","$14,400.00 ","$14,600.00 ","$15,422.00 ","$17,000.00 ","$20,788.28 ","$15,422.00 ","$16,000.00 ","$14,600.00 ","$4,816.70 ","$20,788.28 ","$15,453.38 ","$20,000.00 ","$17,000.00 ","$46,773.63 ","$18,400.00 ","$14,000.00 ","$10,000.00 ","$12,000.00 ","$12,180.00 ","$10,000.00 ","$13,820.00 ","$14,000.00 ","$20,996.16 ","$14,400.00 ","$5,105.70 ","$18,693.00 ","$18,693.00 ","$20,788.28 ","$18,693.00 ","$20,788.28 ","$14,400.00 ","$12,400.00 ","$14,400.00 ","$14,400.00 ","$12,000.00 " ST VINCENT HOSPITAL - ACUTE,48100217,93657,HC ADD ON AFIB ABLAT POST COMPL PVI 93657,481,1 ,"$3,400.00 ","$1,700.00 ","$1,700.00 ","$5,105.70 ","$2,196.40 ","$3,400.00 ","$3,400.00 ","$3,400.00 ", N/A ,"$2,040.00 ","$2,890.00 ","$2,380.00 ","$4,816.70 ","$3,230.00 ","$2,448.00 ","$2,482.00 ","$3,400.00 ","$2,890.00 ", N/A ,"$3,400.00 ","$2,720.00 ","$2,482.00 ","$4,816.70 ", N/A ,"$3,400.00 ","$3,400.00 ","$2,890.00 ", N/A ,"$3,128.00 ","$2,380.00 ","$1,700.00 ","$2,040.00 ","$2,070.60 ","$1,700.00 ","$2,349.40 ","$2,380.00 ", N/A ,"$2,448.00 ","$5,105.70 ","$3,400.00 ","$3,400.00 ", N/A ,"$3,400.00 ", N/A ,"$2,448.00 ","$2,108.00 ","$2,448.00 ","$2,448.00 ","$2,040.00 " ST VINCENT HOSPITAL - ACUTE,48100218,C9600,HC DES SING MAJ ART/BRNCH C9600,481,1 ,"$11,000.00 ","$5,500.00 ","$2,710.53 ","$21,884.82 ","$7,106.00 ","$2,710.53 ","$11,000.00 ","$11,000.00 ","$9,726.59 ","$6,600.00 ","$9,350.00 ","$7,700.00 ","$2,710.53 ","$10,450.00 ","$7,920.00 ","$8,030.00 ","$11,000.00 ","$9,350.00 ","$9,726.59 ","$11,000.00 ","$8,800.00 ","$8,030.00 ","$2,710.53 ","$9,726.59 ","$11,000.00 ","$11,000.00 ","$9,350.00 ","$21,884.82 ","$10,120.00 ","$7,700.00 ","$5,818.90 ","$7,821.36 ","$6,699.00 ","$7,273.62 ","$7,601.00 ","$7,700.00 ","$9,823.86 ","$7,920.00 ","$2,873.16 ","$11,000.00 ","$11,000.00 ","$9,726.59 ","$11,000.00 ","$9,726.59 ","$7,920.00 ","$6,820.00 ","$7,920.00 ","$7,920.00 ","$6,600.00 " ST VINCENT HOSPITAL - ACUTE,48100219,C9601,HC DES EA ADD BNCH MAJ ART C9601,481,1 ,"$11,000.00 ","$5,500.00 ","$2,710.53 ","$11,000.00 ","$7,106.00 ","$2,710.53 ","$11,000.00 ","$11,000.00 ", N/A ,"$6,600.00 ","$9,350.00 ","$7,700.00 ","$2,710.53 ","$10,450.00 ","$7,920.00 ","$8,030.00 ","$11,000.00 ","$9,350.00 ", N/A ,"$11,000.00 ","$8,800.00 ","$8,030.00 ","$2,710.53 ", N/A ,"$11,000.00 ","$11,000.00 ","$9,350.00 ", N/A ,"$10,120.00 ","$7,700.00 ","$5,500.00 ","$6,600.00 ","$6,699.00 ","$5,500.00 ","$7,601.00 ","$7,700.00 ", N/A ,"$7,920.00 ","$2,873.16 ","$11,000.00 ","$11,000.00 ", N/A ,"$11,000.00 ", N/A ,"$7,920.00 ","$6,820.00 ","$7,920.00 ","$7,920.00 ","$6,600.00 " ST VINCENT HOSPITAL - ACUTE,48100220,C9602,HC ROTOBLAT/DES SING MAJ ART/BRNCH C9602,481,1 ,"$15,000.00 ","$7,500.00 ","$2,710.53 ","$35,005.46 ","$9,690.00 ","$2,710.53 ","$15,000.00 ","$15,000.00 ","$15,557.98 ","$9,000.00 ","$12,750.00 ","$10,500.00 ","$2,710.53 ","$14,250.00 ","$10,800.00 ","$10,950.00 ","$15,000.00 ","$12,750.00 ","$15,557.98 ","$15,000.00 ","$12,000.00 ","$10,950.00 ","$2,710.53 ","$15,557.98 ","$15,000.00 ","$15,000.00 ","$12,750.00 ","$35,005.46 ","$13,800.00 ","$10,500.00 ","$7,500.00 ","$9,000.00 ","$9,135.00 ","$7,500.00 ","$10,365.00 ","$10,500.00 ","$15,713.56 ","$10,800.00 ","$2,873.16 ","$15,000.00 ","$15,000.00 ","$15,557.98 ","$15,000.00 ","$15,557.98 ","$10,800.00 ","$9,300.00 ","$10,800.00 ","$10,800.00 ","$9,000.00 " ST VINCENT HOSPITAL - ACUTE,48100221,C9603,HC ROTOBLAT/DES EA ADD BNCH MAJ ART C9603,481,1 ,"$14,335.00 ","$7,167.50 ","$2,710.53 ","$14,335.00 ","$9,260.41 ","$2,710.53 ","$14,335.00 ","$14,335.00 ", N/A ,"$8,601.00 ","$12,184.75 ","$10,034.50 ","$2,710.53 ","$13,618.25 ","$10,321.20 ","$10,464.55 ","$14,335.00 ","$12,184.75 ", N/A ,"$14,335.00 ","$11,468.00 ","$10,464.55 ","$2,710.53 ", N/A ,"$14,335.00 ","$14,335.00 ","$12,184.75 ", N/A ,"$13,188.20 ","$10,034.50 ","$7,167.50 ","$8,601.00 ","$8,730.02 ","$7,167.50 ","$9,905.49 ","$10,034.50 ", N/A ,"$10,321.20 ","$2,873.16 ","$14,335.00 ","$14,335.00 ", N/A ,"$14,335.00 ", N/A ,"$10,321.20 ","$8,887.70 ","$10,321.20 ","$10,321.20 ","$8,601.00 " ST VINCENT HOSPITAL - ACUTE,48100222,C9604,HC BYPASS GRAFT DES SING MAJ ART/BRNCH C9604,481,1 ,"$13,000.00 ","$6,500.00 ","$2,710.53 ","$21,884.82 ","$8,398.00 ","$2,710.53 ","$13,000.00 ","$13,000.00 ","$9,726.59 ","$7,800.00 ","$11,050.00 ","$9,100.00 ","$2,710.53 ","$12,350.00 ","$9,360.00 ","$9,490.00 ","$13,000.00 ","$11,050.00 ","$9,726.59 ","$13,000.00 ","$10,400.00 ","$9,490.00 ","$2,710.53 ","$9,726.59 ","$13,000.00 ","$13,000.00 ","$11,050.00 ","$21,884.82 ","$11,960.00 ","$9,100.00 ","$6,500.00 ","$7,800.00 ","$7,917.00 ","$6,500.00 ","$8,983.00 ","$9,100.00 ","$9,823.86 ","$9,360.00 ","$2,873.16 ","$13,000.00 ","$13,000.00 ","$9,726.59 ","$13,000.00 ","$9,726.59 ","$9,360.00 ","$8,060.00 ","$9,360.00 ","$9,360.00 ","$7,800.00 " ST VINCENT HOSPITAL - ACUTE,48100223,C9605,HC BYPASS GRFT DES EA ADD BRNCH MAJ ART C9605,481,1 ,"$7,400.00 ","$3,700.00 ","$2,710.53 ","$7,400.00 ","$4,780.40 ","$2,710.53 ","$7,400.00 ","$7,400.00 ", N/A ,"$4,440.00 ","$6,290.00 ","$5,180.00 ","$2,710.53 ","$7,030.00 ","$5,328.00 ","$5,402.00 ","$7,400.00 ","$6,290.00 ", N/A ,"$7,400.00 ","$5,920.00 ","$5,402.00 ","$2,710.53 ", N/A ,"$7,400.00 ","$7,400.00 ","$6,290.00 ", N/A ,"$6,808.00 ","$5,180.00 ","$3,700.00 ","$4,440.00 ","$4,506.60 ","$3,700.00 ","$5,113.40 ","$5,180.00 ", N/A ,"$5,328.00 ","$2,873.16 ","$7,400.00 ","$7,400.00 ", N/A ,"$7,400.00 ", N/A ,"$5,328.00 ","$4,588.00 ","$5,328.00 ","$5,328.00 ","$4,440.00 " ST VINCENT HOSPITAL - ACUTE,48100224,C9607,HC CTO DES SING MAJ ART/BRNCH C9607,481,1 ,"$15,000.00 ","$7,500.00 ","$2,710.53 ","$35,005.46 ","$9,690.00 ","$2,710.53 ","$15,000.00 ","$15,000.00 ","$15,557.98 ","$9,000.00 ","$12,750.00 ","$10,500.00 ","$2,710.53 ","$14,250.00 ","$10,800.00 ","$10,950.00 ","$15,000.00 ","$12,750.00 ","$15,557.98 ","$15,000.00 ","$12,000.00 ","$10,950.00 ","$2,710.53 ","$15,557.98 ","$15,000.00 ","$15,000.00 ","$12,750.00 ","$35,005.46 ","$13,800.00 ","$10,500.00 ","$7,500.00 ","$9,000.00 ","$9,135.00 ","$7,500.00 ","$10,365.00 ","$10,500.00 ","$15,713.56 ","$10,800.00 ","$2,873.16 ","$15,000.00 ","$15,000.00 ","$15,557.98 ","$15,000.00 ","$15,557.98 ","$10,800.00 ","$9,300.00 ","$10,800.00 ","$10,800.00 ","$9,000.00 " ST VINCENT HOSPITAL - ACUTE,48100225,C9608,HC CTO DES EA ADD BRNCH MAJ ART C9608,481,1 ,"$11,910.00 ","$5,955.00 ","$2,710.53 ","$11,910.00 ","$7,693.86 ","$2,710.53 ","$11,910.00 ","$11,910.00 ", N/A ,"$7,146.00 ","$10,123.50 ","$8,337.00 ","$2,710.53 ","$11,314.50 ","$8,575.20 ","$8,694.30 ","$11,910.00 ","$10,123.50 ", N/A ,"$11,910.00 ","$9,528.00 ","$8,694.30 ","$2,710.53 ", N/A ,"$11,910.00 ","$11,910.00 ","$10,123.50 ", N/A ,"$10,957.20 ","$8,337.00 ","$5,955.00 ","$7,146.00 ","$7,253.19 ","$5,955.00 ","$8,229.81 ","$8,337.00 ", N/A ,"$8,575.20 ","$2,873.16 ","$11,910.00 ","$11,910.00 ", N/A ,"$11,910.00 ", N/A ,"$8,575.20 ","$7,384.20 ","$8,575.20 ","$8,575.20 ","$7,146.00 " ST VINCENT HOSPITAL - ACUTE,48100226,C9606,HC STEMI/NSTEMI DES SINGL VESSEL C9606,481,1 ,"$14,000.00 ","$7,000.00 ","$2,710.53 ","$14,000.00 ","$9,044.00 ","$2,710.53 ","$14,000.00 ","$14,000.00 ", N/A ,"$8,400.00 ","$11,900.00 ","$9,800.00 ","$2,710.53 ","$13,300.00 ","$10,080.00 ","$10,220.00 ","$14,000.00 ","$11,900.00 ", N/A ,"$14,000.00 ","$11,200.00 ","$10,220.00 ","$2,710.53 ", N/A ,"$14,000.00 ","$14,000.00 ","$11,900.00 ", N/A ,"$12,880.00 ","$9,800.00 ","$7,000.00 ","$8,400.00 ","$8,526.00 ","$7,000.00 ","$9,674.00 ","$9,800.00 ", N/A ,"$10,080.00 ","$2,873.16 ","$14,000.00 ","$14,000.00 ", N/A ,"$14,000.00 ", N/A ,"$10,080.00 ","$8,680.00 ","$10,080.00 ","$10,080.00 ","$8,400.00 " ST VINCENT HOSPITAL - ACUTE,48100227,93286,HC PRE OR POST PACEMAKER EVAL 93286,481,1 ,$190.00 ,$95.00 ,$12.22 ,$190.00 ,$122.74 ,$12.22 , N/A , N/A , N/A ,$114.00 ,$161.50 ,$133.00 ,$12.22 ,$180.50 ,$136.80 ,$138.70 ,$190.00 ,$161.50 , N/A ,$190.00 ,$152.00 ,$138.70 ,$12.22 , N/A , N/A ,$190.00 ,$161.50 , N/A ,$174.80 ,$133.00 ,$95.00 ,$114.00 ,$115.71 ,$95.00 ,$131.29 ,$133.00 , N/A ,$136.80 ,$12.95 , N/A , N/A , N/A , N/A , N/A ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,48100230,37241,HC VENOUS EMBO FOR VEIN MALFORMATION 37241,481,1 ,"$8,900.00 ","$4,450.00 ","$3,338.02 ","$21,884.82 ","$5,749.40 ","$3,338.02 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$5,340.00 ","$7,565.00 ","$6,230.00 ","$3,338.02 ","$8,455.00 ","$6,408.00 ","$6,497.00 ","$6,750.00 ","$7,565.00 ","$9,726.59 ","$6,750.00 ","$7,120.00 ","$6,497.00 ","$3,338.02 ","$9,726.59 ","$8,900.00 ","$8,900.00 ","$7,565.00 ","$21,884.82 ","$8,188.00 ","$6,230.00 ","$5,818.90 ","$7,821.36 ","$5,420.10 ","$7,273.62 ","$6,149.90 ","$6,230.00 ","$9,823.86 ","$6,408.00 ","$3,538.30 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$8,900.00 ","$9,726.59 ","$6,408.00 ","$5,518.00 ","$6,408.00 ","$6,408.00 ","$5,340.00 " ST VINCENT HOSPITAL - ACUTE,48100231,37242,HC ARTERIAL EMBO FOR AVM ANER PRE/PST AAA 37242,481,1 ,"$8,900.00 ","$4,450.00 ","$3,338.02 ","$21,884.82 ","$5,749.40 ","$3,338.02 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$5,340.00 ","$7,565.00 ","$6,230.00 ","$3,338.02 ","$8,455.00 ","$6,408.00 ","$6,497.00 ","$6,750.00 ","$7,565.00 ","$9,726.59 ","$6,750.00 ","$7,120.00 ","$6,497.00 ","$3,338.02 ","$9,726.59 ","$8,900.00 ","$8,900.00 ","$7,565.00 ","$21,884.82 ","$8,188.00 ","$6,230.00 ","$5,818.90 ","$7,821.36 ","$5,420.10 ","$7,273.62 ","$6,149.90 ","$6,230.00 ","$9,823.86 ","$6,408.00 ","$3,538.30 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$8,900.00 ","$9,726.59 ","$6,408.00 ","$5,518.00 ","$6,408.00 ","$6,408.00 ","$5,340.00 " ST VINCENT HOSPITAL - ACUTE,48100232,37243,HC EMBOLIZATION OF TUMOR UFE CHEMO 37243,481,1 ,"$8,900.00 ","$4,450.00 ","$3,338.02 ","$21,884.82 ","$5,749.40 ","$3,338.02 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$5,340.00 ","$7,565.00 ","$6,230.00 ","$3,338.02 ","$8,455.00 ","$6,408.00 ","$6,497.00 ","$6,750.00 ","$7,565.00 ","$9,726.59 ","$6,750.00 ","$7,120.00 ","$6,497.00 ","$3,338.02 ","$9,726.59 ","$8,900.00 ","$8,900.00 ","$7,565.00 ","$21,884.82 ","$8,188.00 ","$6,230.00 ","$5,818.90 ","$7,821.36 ","$5,420.10 ","$7,273.62 ","$6,149.90 ","$6,230.00 ","$9,823.86 ","$6,408.00 ","$3,538.30 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$8,900.00 ","$9,726.59 ","$6,408.00 ","$5,518.00 ","$6,408.00 ","$6,408.00 ","$5,340.00 " ST VINCENT HOSPITAL - ACUTE,48100233,37244,HC EMBOLIZATION FOR HEMORRAGE ART/VEN 37244,481,1 ,"$8,900.00 ","$4,450.00 ","$3,338.02 ","$21,884.82 ","$5,749.40 ","$3,338.02 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$5,340.00 ","$7,565.00 ","$6,230.00 ","$3,338.02 ","$8,455.00 ","$6,408.00 ","$6,497.00 ","$6,750.00 ","$7,565.00 ","$9,726.59 ","$6,750.00 ","$7,120.00 ","$6,497.00 ","$3,338.02 ","$9,726.59 ","$8,900.00 ","$8,900.00 ","$7,565.00 ","$21,884.82 ","$8,188.00 ","$6,230.00 ","$5,818.90 ","$7,821.36 ","$5,420.10 ","$7,273.62 ","$6,149.90 ","$6,230.00 ","$9,823.86 ","$6,408.00 ","$3,538.30 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$8,900.00 ","$9,726.59 ","$6,408.00 ","$5,518.00 ","$6,408.00 ","$6,408.00 ","$5,340.00 " ST VINCENT HOSPITAL - ACUTE,48100234,37236,HC STENT INIT ARTERY UPPER EXT VISCERAL 37236,481,1 ,"$8,900.00 ","$4,450.00 ","$3,338.02 ","$21,884.82 ","$5,749.40 ","$3,338.02 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$5,340.00 ","$7,565.00 ","$6,230.00 ","$3,338.02 ","$8,455.00 ","$6,408.00 ","$6,497.00 ","$6,750.00 ","$7,565.00 ","$9,726.59 ","$6,750.00 ","$7,120.00 ","$6,497.00 ","$3,338.02 ","$9,726.59 ","$8,900.00 ","$8,900.00 ","$7,565.00 ","$21,884.82 ","$8,188.00 ","$6,230.00 ","$5,818.90 ","$7,821.36 ","$5,420.10 ","$7,273.62 ","$6,149.90 ","$6,230.00 ","$9,823.86 ","$6,408.00 ","$3,538.30 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$8,900.00 ","$9,726.59 ","$6,408.00 ","$5,518.00 ","$6,408.00 ","$6,408.00 ","$5,340.00 " ST VINCENT HOSPITAL - ACUTE,48100235,37237,HC STENT ADDN ARTERY UPPER EXT VISERAL 37237,481,1 ,"$4,500.00 ","$2,250.00 ","$2,250.00 ","$7,821.36 ","$2,907.00 ","$3,338.02 ","$4,500.00 ","$4,500.00 ", N/A ,"$2,700.00 ","$3,825.00 ","$3,150.00 ","$3,338.02 ","$4,275.00 ","$3,240.00 ","$3,285.00 ","$4,500.00 ","$3,825.00 ", N/A ,"$4,500.00 ","$3,600.00 ","$3,285.00 ","$3,338.02 ", N/A ,"$3,863.35 ","$4,500.00 ","$3,825.00 ", N/A ,"$4,140.00 ","$3,150.00 ","$5,819.10 ","$7,821.36 ","$2,740.50 ","$7,273.62 ","$3,109.50 ","$3,150.00 ", N/A ,"$3,240.00 ","$3,538.30 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ", N/A ,"$3,240.00 ","$2,790.00 ","$3,240.00 ","$3,240.00 ","$2,700.00 " ST VINCENT HOSPITAL - ACUTE,48100236,37238,HC STENT INIT VENOUS UPPER EXT VISERAL 37238,481,1 ,"$8,900.00 ","$4,450.00 ","$3,338.02 ","$21,884.82 ","$5,749.40 ","$3,338.02 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$5,340.00 ","$7,565.00 ","$6,230.00 ","$3,338.02 ","$8,455.00 ","$6,408.00 ","$6,497.00 ","$6,750.00 ","$7,565.00 ","$9,726.59 ","$6,750.00 ","$7,120.00 ","$6,497.00 ","$3,338.02 ","$9,726.59 ","$8,900.00 ","$8,900.00 ","$7,565.00 ","$21,884.82 ","$8,188.00 ","$6,230.00 ","$5,818.90 ","$7,821.36 ","$5,420.10 ","$7,273.62 ","$6,149.90 ","$6,230.00 ","$9,823.86 ","$6,408.00 ","$3,538.30 ","$8,900.00 ","$8,900.00 ","$9,726.59 ","$8,900.00 ","$9,726.59 ","$6,408.00 ","$5,518.00 ","$6,408.00 ","$6,408.00 ","$5,340.00 " ST VINCENT HOSPITAL - ACUTE,48100237,37239,HC STENT ADDN VENOUS UPPER EXT VISERAL 37239,481,1 ,"$4,500.00 ","$2,250.00 ","$2,250.00 ","$7,821.36 ","$2,907.00 ","$3,338.02 ","$4,500.00 ","$4,500.00 ", N/A ,"$2,700.00 ","$3,825.00 ","$3,150.00 ","$3,338.02 ","$4,275.00 ","$3,240.00 ","$3,285.00 ","$4,500.00 ","$3,825.00 ", N/A ,"$4,500.00 ","$3,600.00 ","$3,285.00 ","$3,338.02 ", N/A ,"$3,863.35 ","$4,500.00 ","$3,825.00 ", N/A ,"$4,140.00 ","$3,150.00 ","$5,819.10 ","$7,821.36 ","$2,740.50 ","$7,273.62 ","$3,109.50 ","$3,150.00 ", N/A ,"$3,240.00 ","$3,538.30 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ", N/A ,"$3,240.00 ","$2,790.00 ","$3,240.00 ","$3,240.00 ","$2,700.00 " ST VINCENT HOSPITAL - ACUTE,48100238,37217,HC STENT CAROTID OPEN 37217,481,1 ,"$6,065.00 ","$3,032.50 ","$1,802.28 ","$7,821.36 ","$3,917.99 ","$1,802.28 ","$6,065.00 ","$6,065.00 ", N/A ,"$3,639.00 ","$5,155.25 ","$4,245.50 ","$1,802.28 ","$5,761.75 ","$4,366.80 ","$4,427.45 ","$6,065.00 ","$5,155.25 ", N/A ,"$6,065.00 ","$4,852.00 ","$4,427.45 ","$1,802.28 ", N/A ,"$6,065.00 ","$6,065.00 ","$5,155.25 ", N/A ,"$5,579.80 ","$4,245.50 ","$5,818.90 ","$7,821.36 ","$3,693.59 ","$7,273.62 ","$4,190.92 ","$4,245.50 ", N/A ,"$4,366.80 ","$1,910.42 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$4,366.80 ","$3,760.30 ","$4,366.80 ","$4,366.80 ","$3,639.00 " ST VINCENT HOSPITAL - ACUTE,48100239,93724,HC EP EVAL PACEMAKER SYSTEM 93724,481,1 ,"$2,000.00 ","$1,000.00 ",$99.20 ,"$2,000.00 ","$1,292.00 ",$99.20 , N/A , N/A ,$263.89 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$99.20 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$2,000.00 ","$1,700.00 ",$263.89 ,"$2,000.00 ","$1,600.00 ","$1,460.00 ",$99.20 ,$263.89 , N/A ,"$2,000.00 ","$1,700.00 ",$593.75 ,"$1,840.00 ","$1,400.00 ","$1,000.00 ","$1,200.00 ","$1,218.00 ","$1,000.00 ","$1,382.00 ","$1,400.00 ",$266.53 ,"$1,440.00 ",$105.15 , N/A , N/A ,$263.89 , N/A ,$263.89 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,48100240,93644,HC S-ICD TESTING ONLY,481,1 ,$140.00 ,$70.00 ,$70.00 ,"$1,497.10 ",$90.44 ,$140.00 , N/A , N/A , N/A ,$84.00 ,$119.00 ,$98.00 ,"$1,412.36 ",$133.00 ,$100.80 ,$102.20 ,$140.00 ,$119.00 , N/A ,$140.00 ,$112.00 ,$102.20 ,"$1,412.36 ", N/A , N/A ,$140.00 ,$119.00 , N/A ,$128.80 ,$98.00 ,$70.00 ,$84.00 ,$85.26 ,$70.00 ,$96.74 ,$98.00 , N/A ,$100.80 ,"$1,497.10 ",$140.00 ,$140.00 , N/A ,$140.00 , N/A ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,48100241,33361,HC REPL TAVR W/PRO PERC FEM ART,481,1 ,"$14,000.00 ","$7,000.00 ","$2,872.01 ","$14,000.00 ","$9,044.00 ","$2,872.01 ","$14,000.00 ","$11,363.00 ", N/A ,"$8,400.00 ","$11,900.00 ","$9,800.00 ","$2,872.01 ","$13,300.00 ","$10,080.00 ","$10,220.00 ","$6,750.00 ","$11,900.00 ", N/A ,"$6,750.00 ","$11,200.00 ","$10,220.00 ","$2,872.01 ", N/A ,"$14,000.00 ","$14,000.00 ","$11,900.00 ", N/A ,"$12,880.00 ","$9,800.00 ","$5,818.90 ","$7,821.36 ","$8,526.00 ","$7,273.62 ","$9,674.00 ","$9,800.00 ", N/A ,"$10,080.00 ","$3,044.33 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$10,080.00 ","$8,680.00 ","$10,080.00 ","$10,080.00 ","$8,400.00 " ST VINCENT HOSPITAL - ACUTE,48100242,33362,HC REPL TAVR W/PRO OPEN FEM ART,481,1 ,"$18,000.00 ","$9,000.00 ","$2,872.01 ","$18,000.00 ","$11,628.00 ","$2,872.01 ","$18,000.00 ","$11,363.00 ", N/A ,"$10,800.00 ","$15,300.00 ","$12,600.00 ","$2,872.01 ","$17,100.00 ","$12,960.00 ","$13,140.00 ","$6,750.00 ","$15,300.00 ", N/A ,"$6,750.00 ","$14,400.00 ","$13,140.00 ","$2,872.01 ", N/A ,"$18,000.00 ","$18,000.00 ","$15,300.00 ", N/A ,"$16,560.00 ","$12,600.00 ","$5,818.90 ","$7,821.36 ","$10,962.00 ","$7,273.62 ","$12,438.00 ","$12,600.00 ", N/A ,"$12,960.00 ","$3,044.33 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$12,960.00 ","$11,160.00 ","$12,960.00 ","$12,960.00 ","$10,800.00 " ST VINCENT HOSPITAL - ACUTE,48100243,33363,HC REPL TAVR W/PRO OPEN AXIL ART,481,1 ,"$18,000.00 ","$9,000.00 ","$2,872.01 ","$18,000.00 ","$11,628.00 ","$2,872.01 ","$18,000.00 ","$11,363.00 ", N/A ,"$10,800.00 ","$15,300.00 ","$12,600.00 ","$2,872.01 ","$17,100.00 ","$12,960.00 ","$13,140.00 ","$6,750.00 ","$15,300.00 ", N/A ,"$6,750.00 ","$14,400.00 ","$13,140.00 ","$2,872.01 ", N/A ,"$18,000.00 ","$18,000.00 ","$15,300.00 ", N/A ,"$16,560.00 ","$12,600.00 ","$5,818.90 ","$7,821.36 ","$10,962.00 ","$7,273.62 ","$12,438.00 ","$12,600.00 ", N/A ,"$12,960.00 ","$3,044.33 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$12,960.00 ","$11,160.00 ","$12,960.00 ","$12,960.00 ","$10,800.00 " ST VINCENT HOSPITAL - ACUTE,48100244,33364,HC REPL TAVR W/PRO OPEN ILIAC ART,481,1 ,"$18,000.00 ","$9,000.00 ","$2,872.01 ","$18,000.00 ","$11,628.00 ","$2,872.01 ","$18,000.00 ","$11,363.00 ", N/A ,"$10,800.00 ","$15,300.00 ","$12,600.00 ","$2,872.01 ","$17,100.00 ","$12,960.00 ","$13,140.00 ","$6,750.00 ","$15,300.00 ", N/A ,"$6,750.00 ","$14,400.00 ","$13,140.00 ","$2,872.01 ", N/A ,"$18,000.00 ","$18,000.00 ","$15,300.00 ", N/A ,"$16,560.00 ","$12,600.00 ","$5,818.90 ","$7,821.36 ","$10,962.00 ","$7,273.62 ","$12,438.00 ","$12,600.00 ", N/A ,"$12,960.00 ","$3,044.33 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$12,960.00 ","$11,160.00 ","$12,960.00 ","$12,960.00 ","$10,800.00 " ST VINCENT HOSPITAL - ACUTE,48100245,33365,HC REPL TAVR TRANSAORTIC APPRCH,481,1 ,"$26,000.00 ","$13,000.00 ","$2,872.01 ","$26,000.00 ","$16,796.00 ","$2,872.01 ","$18,180.00 ","$11,363.00 ", N/A ,"$15,600.00 ","$22,100.00 ","$18,200.00 ","$2,872.01 ","$24,700.00 ","$18,720.00 ","$18,980.00 ","$6,750.00 ","$22,100.00 ", N/A ,"$6,750.00 ","$20,800.00 ","$18,980.00 ","$2,872.01 ", N/A ,"$18,533.02 ","$26,000.00 ","$22,100.00 ", N/A ,"$23,920.00 ","$18,200.00 ","$5,818.90 ","$7,821.36 ","$15,834.00 ","$7,273.62 ","$17,966.00 ","$18,200.00 ", N/A ,"$18,720.00 ","$3,044.33 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$18,720.00 ","$16,120.00 ","$18,720.00 ","$18,720.00 ","$15,600.00 " ST VINCENT HOSPITAL - ACUTE,48100246,33366,HC REPL TAVR TRANSAPICAL APPRCH,481,1 ,"$25,000.00 ","$12,500.00 ","$2,872.01 ","$25,000.00 ","$16,150.00 ","$2,872.01 ","$18,180.00 ","$11,363.00 ", N/A ,"$15,000.00 ","$21,250.00 ","$17,500.00 ","$2,872.01 ","$23,750.00 ","$18,000.00 ","$18,250.00 ","$6,750.00 ","$21,250.00 ", N/A ,"$6,750.00 ","$20,000.00 ","$18,250.00 ","$2,872.01 ", N/A ,"$18,533.02 ","$25,000.00 ","$21,250.00 ", N/A ,"$23,000.00 ","$17,500.00 ","$5,818.90 ","$7,821.36 ","$15,225.00 ","$7,273.62 ","$17,275.00 ","$17,500.00 ", N/A ,"$18,000.00 ","$3,044.33 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$18,000.00 ","$15,500.00 ","$18,000.00 ","$18,000.00 ","$15,000.00 " ST VINCENT HOSPITAL - ACUTE,48100247,33367,HC REPL TAVR W/ PERC PERIPH BYPASS,481,1 ,"$3,525.00 ","$1,762.50 ","$1,762.50 ","$7,821.36 ","$2,277.15 ","$2,872.01 ","$3,525.00 ","$3,525.00 ", N/A ,"$2,115.00 ","$2,996.25 ","$2,467.50 ","$2,872.01 ","$3,348.75 ","$2,538.00 ","$2,573.25 ","$3,525.00 ","$2,996.25 ", N/A ,"$3,525.00 ","$2,820.00 ","$2,573.25 ","$2,872.01 ", N/A ,"$3,525.00 ","$3,525.00 ","$2,996.25 ", N/A ,"$3,243.00 ","$2,467.50 ","$5,819.10 ","$7,821.36 ","$2,146.73 ","$7,273.62 ","$2,435.78 ","$2,467.50 ", N/A ,"$2,538.00 ","$3,044.33 ","$3,525.00 ","$3,525.00 ", N/A ,"$3,525.00 ", N/A ,"$2,538.00 ","$2,185.50 ","$2,538.00 ","$2,538.00 ","$2,115.00 " ST VINCENT HOSPITAL - ACUTE,48100248,33368,HC REPL TAVR W/OPEN PERIPH BYPASS,481,1 ,"$3,525.00 ","$1,762.50 ","$1,762.50 ","$7,821.36 ","$2,277.15 ","$2,872.01 ","$3,525.00 ","$3,525.00 ", N/A ,"$2,115.00 ","$2,996.25 ","$2,467.50 ","$2,872.01 ","$3,348.75 ","$2,538.00 ","$2,573.25 ","$3,525.00 ","$2,996.25 ", N/A ,"$3,525.00 ","$2,820.00 ","$2,573.25 ","$2,872.01 ", N/A ,"$3,525.00 ","$3,525.00 ","$2,996.25 ", N/A ,"$3,243.00 ","$2,467.50 ","$5,819.10 ","$7,821.36 ","$2,146.73 ","$7,273.62 ","$2,435.78 ","$2,467.50 ", N/A ,"$2,538.00 ","$3,044.33 ","$3,525.00 ","$3,525.00 ", N/A ,"$3,525.00 ", N/A ,"$2,538.00 ","$2,185.50 ","$2,538.00 ","$2,538.00 ","$2,115.00 " ST VINCENT HOSPITAL - ACUTE,48100250,33418,HC RPR TRNSCTH MITRL VLV INT PROS,481,1 ,"$19,355.00 ","$9,677.50 ","$2,872.01 ","$19,355.00 ","$12,503.33 ","$2,872.01 ","$7,070.00 ","$6,565.00 ", N/A ,"$11,613.00 ","$16,451.75 ","$13,548.50 ","$2,872.01 ","$18,387.25 ","$13,935.60 ","$14,129.15 ","$6,750.00 ","$16,451.75 ", N/A ,"$6,750.00 ","$15,484.00 ","$14,129.15 ","$2,872.01 ", N/A ,"$15,447.86 ","$19,355.00 ","$16,451.75 ", N/A ,"$17,806.60 ","$13,548.50 ","$5,818.90 ","$7,821.36 ","$11,787.20 ","$7,273.62 ","$13,374.31 ","$13,548.50 ", N/A ,"$13,935.60 ","$3,044.33 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$13,935.60 ","$12,000.10 ","$13,935.60 ","$13,935.60 ","$11,613.00 " ST VINCENT HOSPITAL - ACUTE,48100251,33419,HC RPR TRNSCTH MITRL VLV SUB PROS,481,1 ,"$9,680.00 ","$4,840.00 ","$1,858.00 ","$9,680.00 ","$6,253.28 ","$2,872.01 ","$8,484.00 ","$4,778.00 ", N/A ,"$5,808.00 ","$8,228.00 ","$6,776.00 ","$2,872.01 ","$9,196.00 ","$6,969.60 ","$7,066.40 ","$6,750.00 ","$8,228.00 ", N/A ,"$6,750.00 ","$7,744.00 ","$7,066.40 ","$2,872.01 ", N/A ,"$3,863.35 ","$9,680.00 ","$8,228.00 ", N/A ,"$8,905.60 ","$6,776.00 ","$5,819.10 ","$7,821.36 ","$5,895.12 ","$7,273.62 ","$6,688.88 ","$6,776.00 ", N/A ,"$6,969.60 ","$3,044.33 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$6,969.60 ","$6,001.60 ","$6,969.60 ","$6,969.60 ","$5,808.00 " ST VINCENT HOSPITAL - ACUTE,48100252,33271,HC INSERT SUBQ DEFIBRILLATOR,481,1 ,"$14,465.00 ","$7,232.50 ",$430.13 ,"$17,765.49 ","$9,344.39 ",$430.13 ,"$14,465.00 ","$11,363.00 ","$7,895.77 ","$8,679.00 ","$12,295.25 ","$10,125.50 ",$430.13 ,"$13,741.75 ","$10,414.80 ","$10,559.45 ","$6,750.00 ","$12,295.25 ","$7,895.77 ","$6,750.00 ","$11,572.00 ","$10,559.45 ",$430.13 ,"$7,895.77 ","$14,465.00 ","$14,465.00 ","$12,295.25 ","$17,765.49 ","$13,307.80 ","$10,125.50 ","$5,818.90 ","$7,821.36 ","$8,809.19 ","$7,273.62 ","$9,995.32 ","$10,125.50 ","$7,974.73 ","$10,414.80 ",$455.94 ,"$14,465.00 ","$14,465.00 ","$7,895.77 ","$14,465.00 ","$7,895.77 ","$10,414.80 ","$8,968.30 ","$10,414.80 ","$10,414.80 ","$8,679.00 " ST VINCENT HOSPITAL - ACUTE,48100253,33272,HC REMOVAL SUBQ DEFIBRILATOR,481,1 ,"$4,470.00 ","$2,235.00 ",$430.13 ,"$7,821.36 ","$2,887.62 ",$430.13 ,"$4,470.00 ","$4,470.00 ","$3,332.00 ","$2,682.00 ","$3,799.50 ","$3,129.00 ",$430.13 ,"$4,246.50 ","$3,218.40 ","$3,263.10 ","$4,470.00 ","$3,799.50 ","$3,332.00 ","$4,470.00 ","$3,576.00 ","$3,263.10 ",$430.13 ,"$3,332.00 ","$4,470.00 ","$4,470.00 ","$3,799.50 ","$7,497.00 ","$4,112.40 ","$3,129.00 ","$5,818.90 ","$7,821.36 ","$2,722.23 ","$7,273.62 ","$3,088.77 ","$3,129.00 ","$3,365.32 ","$3,218.40 ",$455.94 ,"$4,470.00 ","$4,470.00 ","$3,332.00 ","$4,470.00 ","$3,332.00 ","$3,218.40 ","$2,771.40 ","$3,218.40 ","$3,218.40 ","$2,682.00 " ST VINCENT HOSPITAL - ACUTE,48100254,33273,HC REPOSTION SUBQ DEFIBRILLATIOR,481,1 ,"$4,470.00 ","$2,235.00 ",$430.13 ,"$7,821.36 ","$2,887.62 ",$430.13 ,"$4,470.00 ","$4,470.00 ","$3,332.00 ","$2,682.00 ","$3,799.50 ","$3,129.00 ",$430.13 ,"$4,246.50 ","$3,218.40 ","$3,263.10 ","$4,470.00 ","$3,799.50 ","$3,332.00 ","$4,470.00 ","$3,576.00 ","$3,263.10 ",$430.13 ,"$3,332.00 ","$4,470.00 ","$4,470.00 ","$3,799.50 ","$7,497.00 ","$4,112.40 ","$3,129.00 ","$5,818.90 ","$7,821.36 ","$2,722.23 ","$7,273.62 ","$3,088.77 ","$3,129.00 ","$3,365.32 ","$3,218.40 ",$455.94 ,"$4,470.00 ","$4,470.00 ","$3,332.00 ","$4,470.00 ","$3,332.00 ","$3,218.40 ","$2,771.40 ","$3,218.40 ","$3,218.40 ","$2,682.00 " ST VINCENT HOSPITAL - ACUTE,48100255,61651,HC THPY INFS NON-THROMBO ADDNT,481,1 ,$815.00 ,$407.50 ,$407.50 ,"$2,778.48 ",$526.49 ,$815.00 ,$815.00 ,$815.00 , N/A ,$489.00 ,$692.75 ,$570.50 ,"$1,802.28 ",$774.25 ,$586.80 ,$594.95 ,$815.00 ,$692.75 , N/A ,$815.00 ,$652.00 ,$594.95 ,"$1,802.28 ", N/A ,$815.00 ,$815.00 ,$692.75 , N/A ,$749.80 ,$570.50 ,"$2,066.52 ","$2,778.48 ",$496.34 ,"$2,583.66 ",$563.17 ,$570.50 , N/A ,$586.80 ,"$1,910.42 ",$815.00 ,$815.00 , N/A ,$815.00 , N/A ,$586.80 ,$505.30 ,$586.80 ,$586.80 ,$489.00 ST VINCENT HOSPITAL - ACUTE,48100263,36902,HC INTRO CATH/CIRCUIT W/ANGIO 36902,481,1 ,"$9,000.00 ","$4,500.00 ","$1,095.68 ","$10,801.57 ","$5,814.00 ","$1,095.68 ","$9,000.00 ","$9,000.00 ","$4,800.70 ","$5,400.00 ","$7,650.00 ","$6,300.00 ","$1,095.68 ","$8,550.00 ","$6,480.00 ","$6,570.00 ","$6,750.00 ","$7,650.00 ","$4,800.70 ","$6,750.00 ","$7,200.00 ","$6,570.00 ","$1,095.68 ","$4,800.70 ","$7,726.69 ","$9,000.00 ","$7,650.00 ","$10,801.57 ","$8,280.00 ","$6,300.00 ","$2,066.93 ","$2,778.48 ","$5,481.00 ","$2,583.66 ","$6,219.00 ","$6,300.00 ","$4,848.71 ","$6,480.00 ","$1,161.42 ","$8,890.00 ","$8,890.00 ","$4,800.70 ","$8,890.00 ","$4,800.70 ","$6,480.00 ","$5,580.00 ","$6,480.00 ","$6,480.00 ","$5,400.00 " ST VINCENT HOSPITAL - ACUTE,48100264,36905,HC THROMBECTOMY/INFUS CIRCUIT W/ANGIO 36905,481,1 ,"$13,000.00 ","$6,500.00 ","$1,802.28 ","$21,884.82 ","$8,398.00 ","$1,802.28 ","$13,000.00 ","$11,363.00 ","$9,726.59 ","$7,800.00 ","$11,050.00 ","$9,100.00 ","$1,802.28 ","$12,350.00 ","$9,360.00 ","$9,490.00 ","$6,750.00 ","$11,050.00 ","$9,726.59 ","$6,750.00 ","$10,400.00 ","$9,490.00 ","$1,802.28 ","$9,726.59 ","$13,000.00 ","$13,000.00 ","$11,050.00 ","$21,884.82 ","$11,960.00 ","$9,100.00 ","$5,818.90 ","$7,821.36 ","$7,917.00 ","$7,273.62 ","$8,983.00 ","$9,100.00 ","$9,823.86 ","$9,360.00 ","$1,910.42 ","$10,162.00 ","$10,162.00 ","$9,726.59 ","$10,162.00 ","$9,726.59 ","$9,360.00 ","$8,060.00 ","$9,360.00 ","$9,360.00 ","$7,800.00 " ST VINCENT HOSPITAL - ACUTE,48100265,36907,HC ANGIOPLASTY CTR DIALYSIS SEGMENT 36907,481,1 ,"$7,800.00 ","$3,900.00 ","$1,802.28 ","$7,821.36 ","$5,038.80 ","$1,802.28 ", N/A , N/A , N/A ,"$4,680.00 ","$6,630.00 ","$5,460.00 ","$1,802.28 ","$7,410.00 ","$5,616.00 ","$5,694.00 ","$6,750.00 ","$6,630.00 ", N/A ,"$6,750.00 ","$6,240.00 ","$5,694.00 ","$1,802.28 ", N/A , N/A ,"$7,800.00 ","$6,630.00 ", N/A ,"$7,176.00 ","$5,460.00 ","$5,819.10 ","$7,821.36 ","$4,750.20 ","$7,273.62 ","$5,389.80 ","$5,460.00 ", N/A ,"$5,616.00 ","$1,910.42 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$5,616.00 ","$4,836.00 ","$5,616.00 ","$5,616.00 ","$4,680.00 " ST VINCENT HOSPITAL - ACUTE,48100266,37246,HC ANGIOPLASTY TRANLUM BALN INIT ARTERY 37246,481,1 ,"$7,100.00 ","$3,550.00 ","$1,095.68 ","$10,801.57 ","$4,586.60 ","$1,095.68 ","$7,100.00 ","$7,100.00 ","$4,800.70 ","$4,260.00 ","$6,035.00 ","$4,970.00 ","$1,095.68 ","$6,745.00 ","$5,112.00 ","$5,183.00 ","$6,750.00 ","$6,035.00 ","$4,800.70 ","$6,750.00 ","$5,680.00 ","$5,183.00 ","$1,095.68 ","$4,800.70 ","$7,100.00 ","$7,100.00 ","$6,035.00 ","$10,801.57 ","$6,532.00 ","$4,970.00 ","$5,818.90 ","$7,821.36 ","$4,323.90 ","$7,273.62 ","$4,906.10 ","$4,970.00 ","$4,848.71 ","$5,112.00 ","$1,161.42 ","$7,100.00 ","$7,100.00 ","$4,800.70 ","$7,100.00 ","$4,800.70 ","$5,112.00 ","$4,402.00 ","$5,112.00 ","$5,112.00 ","$4,260.00 " ST VINCENT HOSPITAL - ACUTE,48100267,37247,HC ANGIOPLASTY TRANLUM BALN ADDL ARTERY 37247,481,1 ,"$5,800.00 ","$2,900.00 ","$1,802.28 ","$7,821.36 ","$3,746.80 ","$1,802.28 ", N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ","$1,802.28 ","$5,510.00 ","$4,176.00 ","$4,234.00 ","$5,800.00 ","$4,930.00 ", N/A ,"$5,800.00 ","$4,640.00 ","$4,234.00 ","$1,802.28 ", N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$5,819.10 ","$7,821.36 ","$3,532.20 ","$7,273.62 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ","$1,910.42 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,48100268,37248,HC ANGIOPLASTY TRANLUM BALN INIT VEIN 37248,481,1 ,"$7,100.00 ","$3,550.00 ","$1,095.68 ","$10,801.57 ","$4,586.60 ","$1,095.68 ","$7,100.00 ","$7,100.00 ","$4,800.70 ","$4,260.00 ","$6,035.00 ","$4,970.00 ","$1,095.68 ","$6,745.00 ","$5,112.00 ","$5,183.00 ","$6,750.00 ","$6,035.00 ","$4,800.70 ","$6,750.00 ","$5,680.00 ","$5,183.00 ","$1,095.68 ","$4,800.70 ","$7,100.00 ","$7,100.00 ","$6,035.00 ","$10,801.57 ","$6,532.00 ","$4,970.00 ","$5,818.90 ","$7,821.36 ","$4,323.90 ","$7,273.62 ","$4,906.10 ","$4,970.00 ","$4,848.71 ","$5,112.00 ","$1,161.42 ","$7,100.00 ","$7,100.00 ","$4,800.70 ","$7,100.00 ","$4,800.70 ","$5,112.00 ","$4,402.00 ","$5,112.00 ","$5,112.00 ","$4,260.00 " ST VINCENT HOSPITAL - ACUTE,48100269,37249,HC ANGIOPLASTY TRANLUM BALN ADDL VEIN 37249,481,1 ,"$5,800.00 ","$2,900.00 ","$1,802.28 ","$7,821.36 ","$3,746.80 ","$1,802.28 ", N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ","$1,802.28 ","$5,510.00 ","$4,176.00 ","$4,234.00 ","$5,800.00 ","$4,930.00 ", N/A ,"$5,800.00 ","$4,640.00 ","$4,234.00 ","$1,802.28 ", N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$5,819.10 ","$7,821.36 ","$3,532.20 ","$7,273.62 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ","$1,910.42 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,48100270,36908,HC PLACE STENT CENTRAL DIAL SEGMENT 36908,481,1 ,"$8,900.00 ","$4,450.00 ","$1,802.28 ","$8,900.00 ","$5,749.40 ","$1,802.28 ", N/A , N/A , N/A ,"$5,340.00 ","$7,565.00 ","$6,230.00 ","$1,802.28 ","$8,455.00 ","$6,408.00 ","$6,497.00 ","$6,750.00 ","$7,565.00 ", N/A ,"$6,750.00 ","$7,120.00 ","$6,497.00 ","$1,802.28 ", N/A , N/A ,"$8,900.00 ","$7,565.00 ", N/A ,"$8,188.00 ","$6,230.00 ","$5,819.10 ","$7,821.36 ","$5,420.10 ","$7,273.62 ","$6,149.90 ","$6,230.00 ", N/A ,"$6,408.00 ","$1,910.42 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$6,408.00 ","$5,518.00 ","$6,408.00 ","$6,408.00 ","$5,340.00 " ST VINCENT HOSPITAL - ACUTE,48100271,36909,HC DIAL CIRCUIT VASC EMBOL/OCCUL 36909,481,1 ,"$8,900.00 ","$4,450.00 ","$1,858.00 ","$8,900.00 ","$5,749.40 ","$3,338.02 ", N/A , N/A , N/A ,"$5,340.00 ","$7,565.00 ","$6,230.00 ","$3,338.02 ","$8,455.00 ","$6,408.00 ","$6,497.00 ","$6,750.00 ","$7,565.00 ", N/A ,"$6,750.00 ","$7,120.00 ","$6,497.00 ","$3,338.02 ", N/A , N/A ,"$8,900.00 ","$7,565.00 ", N/A ,"$8,188.00 ","$6,230.00 ","$5,819.10 ","$7,821.36 ","$5,420.10 ","$7,273.62 ","$6,149.90 ","$6,230.00 ", N/A ,"$6,408.00 ","$3,538.30 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$6,408.00 ","$5,518.00 ","$6,408.00 ","$6,408.00 ","$5,340.00 " ST VINCENT HOSPITAL - ACUTE,48100272,36901,HC INTRO CATH DIALYSIS CIRCUIT 36901,481,1 ,"$1,400.00 ",$700.00 ,$534.02 ,"$3,064.15 ",$904.40 ,$534.02 ,"$1,400.00 ","$1,400.00 ","$1,361.85 ",$840.00 ,"$1,190.00 ",$980.00 ,$534.02 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ","$1,400.00 ","$1,190.00 ","$1,361.85 ","$1,400.00 ","$1,120.00 ","$1,022.00 ",$534.02 ,"$1,361.85 ","$1,400.00 ","$1,400.00 ","$1,190.00 ","$3,064.15 ","$1,288.00 ",$980.00 ,"$1,400.00 ","$1,400.00 ",$852.60 ,"$1,400.00 ",$967.40 ,$980.00 ,"$1,375.47 ","$1,008.00 ",$566.06 ,"$1,400.00 ","$1,400.00 ","$1,361.85 ","$1,400.00 ","$1,361.85 ","$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,48100273,36903,HC INTRO CATH/CIRCUIT W/STENT 36903,481,1 ,"$18,000.00 ","$9,000.00 ","$2,066.93 ","$21,884.82 ","$11,628.00 ","$3,338.02 ","$18,000.00 ","$11,363.00 ","$9,726.59 ","$10,800.00 ","$15,300.00 ","$12,600.00 ","$3,338.02 ","$17,100.00 ","$12,960.00 ","$13,140.00 ","$6,750.00 ","$15,300.00 ","$9,726.59 ","$6,750.00 ","$14,400.00 ","$13,140.00 ","$3,338.02 ","$9,726.59 ","$15,447.86 ","$18,000.00 ","$15,300.00 ","$21,884.82 ","$16,560.00 ","$12,600.00 ","$2,066.93 ","$2,778.48 ","$10,962.00 ","$2,583.66 ","$12,438.00 ","$12,600.00 ","$9,823.86 ","$12,960.00 ","$3,538.30 ","$10,162.00 ","$10,162.00 ","$9,726.59 ","$10,162.00 ","$9,726.59 ","$12,960.00 ","$11,160.00 ","$12,960.00 ","$12,960.00 ","$10,800.00 " ST VINCENT HOSPITAL - ACUTE,48100274,36904,HC THROMBECTOMY/INFUS DIALYSIS CIRCUIT 36904,481,1 ,"$6,000.00 ","$3,000.00 ","$1,095.68 ","$10,801.57 ","$3,876.00 ","$1,095.68 ","$6,000.00 ","$6,000.00 ","$4,800.70 ","$3,600.00 ","$5,100.00 ","$4,200.00 ","$1,095.68 ","$5,700.00 ","$4,320.00 ","$4,380.00 ","$6,000.00 ","$5,100.00 ","$4,800.70 ","$6,000.00 ","$4,800.00 ","$4,380.00 ","$1,095.68 ","$4,800.70 ","$6,000.00 ","$6,000.00 ","$5,100.00 ","$10,801.57 ","$5,520.00 ","$4,200.00 ","$2,066.93 ","$2,778.48 ","$3,654.00 ","$2,583.66 ","$4,146.00 ","$4,200.00 ","$4,848.71 ","$4,320.00 ","$1,161.42 ","$6,000.00 ","$6,000.00 ","$4,800.70 ","$6,000.00 ","$4,800.70 ","$4,320.00 ","$3,720.00 ","$4,320.00 ","$4,320.00 ","$3,600.00 " ST VINCENT HOSPITAL - ACUTE,48100275,36906,HC THROMBECTOMY/INFUS CIRCUIT W/STENT 36906,481,1 ,"$25,000.00 ","$12,500.00 ","$2,066.93 ","$35,005.46 ","$16,150.00 ","$3,338.02 ","$19,190.00 ","$13,130.00 ","$15,557.98 ","$15,000.00 ","$21,250.00 ","$17,500.00 ","$3,338.02 ","$23,750.00 ","$18,000.00 ","$18,250.00 ","$6,750.00 ","$21,250.00 ","$15,557.98 ","$6,750.00 ","$20,000.00 ","$18,250.00 ","$3,338.02 ","$15,557.98 ","$18,533.02 ","$25,000.00 ","$21,250.00 ","$35,005.46 ","$23,000.00 ","$17,500.00 ","$2,066.93 ","$2,778.48 ","$15,225.00 ","$2,583.66 ","$17,275.00 ","$17,500.00 ","$15,713.56 ","$18,000.00 ","$3,538.30 ","$14,224.00 ","$14,224.00 ","$15,557.98 ","$14,224.00 ","$15,557.98 ","$18,000.00 ","$15,500.00 ","$18,000.00 ","$18,000.00 ","$15,000.00 " ST VINCENT HOSPITAL - ACUTE,48100277,93288,HC INTERROG DEVICE EVAL PACEMAKER SYSTEM,481,1 ,$120.00 ,$60.00 ,$12.22 ,$120.00 ,$77.52 ,$12.22 ,$120.00 ,$120.00 ,$35.98 ,$72.00 ,$102.00 ,$84.00 ,$12.22 ,$114.00 ,$86.40 ,$87.60 ,$120.00 ,$102.00 ,$35.98 ,$120.00 ,$96.00 ,$87.60 ,$12.22 ,$35.98 , N/A ,$120.00 ,$102.00 ,$80.95 ,$110.40 ,$84.00 ,$60.00 ,$72.00 ,$73.08 ,$60.00 ,$82.92 ,$84.00 ,$36.34 ,$86.40 ,$12.95 , N/A , N/A ,$35.98 , N/A ,$35.98 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,48100430,33340,HC LAA PERC CLOSURE W/ENDOCARDIAL IMPLANT S AND I,481,1 ,"$14,000.00 ","$7,000.00 ","$2,872.01 ","$14,000.00 ","$9,044.00 ","$2,872.01 ","$14,000.00 ","$11,363.00 ", N/A ,"$8,400.00 ","$11,900.00 ","$9,800.00 ","$2,872.01 ","$13,300.00 ","$10,080.00 ","$10,220.00 ","$6,750.00 ","$11,900.00 ", N/A ,"$6,750.00 ","$11,200.00 ","$10,220.00 ","$2,872.01 ", N/A ,"$14,000.00 ","$14,000.00 ","$11,900.00 ", N/A ,"$12,880.00 ","$9,800.00 ","$5,818.90 ","$7,821.36 ","$8,526.00 ","$7,273.62 ","$9,674.00 ","$9,800.00 ", N/A ,"$10,080.00 ","$3,044.33 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$10,080.00 ","$8,680.00 ","$10,080.00 ","$10,080.00 ","$8,400.00 " ST VINCENT HOSPITAL - ACUTE,48100443,34812,HC EXPOSE FEMORAL ARTERY W/PROSTHESIS UNILATERAL,481,1 ,"$8,000.00 ","$4,000.00 ","$1,045.13 ","$8,000.00 ","$5,168.00 ","$1,045.13 ","$3,939.00 ","$3,535.00 ", N/A ,"$4,800.00 ","$6,800.00 ","$5,600.00 ","$1,045.13 ","$7,600.00 ","$5,760.00 ","$5,840.00 ","$2,717.00 ","$6,800.00 ", N/A ,"$2,717.00 ","$6,400.00 ","$5,840.00 ","$1,045.13 ", N/A ,"$8,000.00 ","$8,000.00 ","$6,800.00 ", N/A ,"$7,360.00 ","$5,600.00 ","$5,819.10 ","$7,821.36 ","$4,872.00 ","$7,273.62 ","$5,528.00 ","$5,600.00 ", N/A ,"$5,760.00 ","$1,107.84 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$5,760.00 ","$4,960.00 ","$5,760.00 ","$5,760.00 ","$4,800.00 " ST VINCENT HOSPITAL - ACUTE,48100484,33274,HC TRANSCATH INS/REPLC VENTRIC PACEMAKER LEADLESS W/GUIDE,481,1 ,"$7,900.00 ","$3,950.00 ",$444.29 ,"$35,005.46 ","$5,103.40 ",$444.29 ,"$7,900.00 ","$7,900.00 ","$15,557.98 ","$4,740.00 ","$6,715.00 ","$5,530.00 ",$444.29 ,"$7,505.00 ","$5,688.00 ","$5,767.00 ","$6,750.00 ","$6,715.00 ","$15,557.98 ","$6,750.00 ","$6,320.00 ","$5,767.00 ",$444.29 ,"$15,557.98 ","$7,900.00 ","$7,900.00 ","$6,715.00 ","$35,005.46 ","$7,268.00 ","$5,530.00 ","$3,950.00 ","$4,740.00 ","$4,811.10 ","$3,950.00 ","$5,458.90 ","$5,530.00 ","$15,713.56 ","$5,688.00 ",$470.95 ,"$7,900.00 ","$7,900.00 ","$15,557.98 ","$7,900.00 ","$15,557.98 ","$5,688.00 ","$4,898.00 ","$5,688.00 ","$5,688.00 ","$4,740.00 " ST VINCENT HOSPITAL - ACUTE,48100485,33275,HC TRANSCATH REMOVE VENTRIC PACEMAKER LEADLESS,481,1 ,"$5,570.00 ","$2,785.00 ","$1,718.12 ","$6,235.91 ","$3,598.22 ","$1,718.12 ","$5,570.00 ","$5,570.00 ","$2,771.52 ","$3,342.00 ","$4,734.50 ","$3,899.00 ","$1,718.12 ","$5,291.50 ","$4,010.40 ","$4,066.10 ","$5,570.00 ","$4,734.50 ","$2,771.52 ","$5,570.00 ","$4,456.00 ","$4,066.10 ","$1,718.12 ","$2,771.52 ","$4,415.25 ","$5,570.00 ","$4,734.50 ","$6,235.91 ","$5,124.40 ","$3,899.00 ","$2,785.00 ","$3,342.00 ","$3,392.13 ","$2,785.00 ","$3,848.87 ","$3,899.00 ","$2,799.24 ","$4,010.40 ","$1,821.21 ","$5,570.00 ","$5,570.00 ","$2,771.52 ","$5,570.00 ","$2,771.52 ","$4,010.40 ","$3,453.40 ","$4,010.40 ","$4,010.40 ","$3,342.00 " ST VINCENT HOSPITAL - ACUTE,48100486,93286,HC PERIPROC DEVICE EVAL PACEMAKER LEADLESS,481,1 ,$105.00 ,$52.50 ,$12.22 ,$105.00 ,$67.83 ,$12.22 , N/A , N/A , N/A ,$63.00 ,$89.25 ,$73.50 ,$12.22 ,$99.75 ,$75.60 ,$76.65 ,$105.00 ,$89.25 , N/A ,$105.00 ,$84.00 ,$76.65 ,$12.22 , N/A , N/A ,$105.00 ,$89.25 , N/A ,$96.60 ,$73.50 ,$52.50 ,$63.00 ,$63.95 ,$52.50 ,$72.56 ,$73.50 , N/A ,$75.60 ,$12.95 , N/A , N/A , N/A , N/A , N/A ,$75.60 ,$65.10 ,$75.60 ,$75.60 ,$63.00 ST VINCENT HOSPITAL - ACUTE,48100487,93288,HC INTERROG DEVICE EVAL PACEMAKER LEADLESS,481,1 ,$220.00 ,$110.00 ,$12.22 ,$220.00 ,$142.12 ,$12.22 ,$220.00 ,$220.00 ,$35.98 ,$132.00 ,$187.00 ,$154.00 ,$12.22 ,$209.00 ,$158.40 ,$160.60 ,$220.00 ,$187.00 ,$35.98 ,$220.00 ,$176.00 ,$160.60 ,$12.22 ,$35.98 , N/A ,$220.00 ,$187.00 ,$80.95 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$36.34 ,$158.40 ,$12.95 , N/A , N/A ,$35.98 , N/A ,$35.98 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,48100492,34712,HC TRANSCATH DELV FIX DEVICE W/S AND I,481,1 ,"$1,000.00 ",$500.00 ,$500.00 ,"$6,074.78 ",$646.00 ,"$1,000.00 ","$1,000.00 ","$1,000.00 ", N/A ,$600.00 ,$850.00 ,$700.00 ,"$5,730.92 ",$950.00 ,$720.00 ,$730.00 ,"$1,000.00 ",$850.00 , N/A ,"$1,000.00 ",$800.00 ,$730.00 ,"$5,730.92 ", N/A ,"$1,000.00 ","$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 ,"$6,074.78 ","$1,000.00 ","$1,000.00 ", N/A ,"$1,000.00 ", N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,48100493,34713,HC PERQ ACCESS/CLOSURE FEM ARTY ENDOGRAFT UNI,481,1 ,$440.00 ,$220.00 ,$220.00 ,"$6,074.78 ",$284.24 ,$440.00 , N/A , N/A , N/A ,$264.00 ,$374.00 ,$308.00 ,"$5,730.92 ",$418.00 ,$316.80 ,$321.20 ,$440.00 ,$374.00 , N/A ,$440.00 ,$352.00 ,$321.20 ,"$5,730.92 ", N/A , N/A ,$440.00 ,$374.00 , N/A ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 , N/A ,$316.80 ,"$6,074.78 ",$440.00 ,$440.00 , N/A ,$440.00 , N/A ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,48100499,33889,HC ARTERY TRANSPOSE/ENDO TAA,481,1 ,"$10,000.00 ","$5,000.00 ","$1,045.13 ","$10,000.00 ","$6,460.00 ","$1,045.13 ","$10,000.00 ","$10,000.00 ", N/A ,"$6,000.00 ","$8,500.00 ","$7,000.00 ","$1,045.13 ","$9,500.00 ","$7,200.00 ","$7,300.00 ","$6,750.00 ","$8,500.00 ", N/A ,"$6,750.00 ","$8,000.00 ","$7,300.00 ","$1,045.13 ", N/A ,"$10,000.00 ","$10,000.00 ","$8,500.00 ", N/A ,"$9,200.00 ","$7,000.00 ","$5,818.90 ","$7,821.36 ","$6,090.00 ","$7,273.62 ","$6,910.00 ","$7,000.00 ", N/A ,"$7,200.00 ","$1,107.84 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,48100500,34714,HC OPEN FEM ARTERY EXPOSE CONDUIT,481,1 ,"$10,000.00 ","$5,000.00 ","$1,045.13 ","$10,000.00 ","$6,460.00 ","$1,045.13 ", N/A , N/A , N/A ,"$6,000.00 ","$8,500.00 ","$7,000.00 ","$1,045.13 ","$9,500.00 ","$7,200.00 ","$7,300.00 ","$6,750.00 ","$8,500.00 ", N/A ,"$6,750.00 ","$8,000.00 ","$7,300.00 ","$1,045.13 ", N/A , N/A ,"$10,000.00 ","$8,500.00 ", N/A ,"$9,200.00 ","$7,000.00 ","$5,000.00 ","$6,000.00 ","$6,090.00 ","$5,000.00 ","$6,910.00 ","$7,000.00 ", N/A ,"$7,200.00 ","$1,107.84 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,48100501,34715,HC OPEN AXIL/SUBCLA ARTERY EXPOSE,481,1 ,"$8,000.00 ","$4,000.00 ","$1,045.13 ","$8,000.00 ","$5,168.00 ","$1,045.13 ", N/A , N/A , N/A ,"$4,800.00 ","$6,800.00 ","$5,600.00 ","$1,045.13 ","$7,600.00 ","$5,760.00 ","$5,840.00 ","$6,750.00 ","$6,800.00 ", N/A ,"$6,750.00 ","$6,400.00 ","$5,840.00 ","$1,045.13 ", N/A , N/A ,"$8,000.00 ","$6,800.00 ", N/A ,"$7,360.00 ","$5,600.00 ","$4,000.00 ","$4,800.00 ","$4,872.00 ","$4,000.00 ","$5,528.00 ","$5,600.00 ", N/A ,"$5,760.00 ","$1,107.84 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$5,760.00 ","$4,960.00 ","$5,760.00 ","$5,760.00 ","$4,800.00 " ST VINCENT HOSPITAL - ACUTE,48100502,34716,HC OPEN AXIL/SUBCLA ARTERY EXPOSE CONDUIT,481,1 ,"$10,000.00 ","$5,000.00 ","$1,045.13 ","$10,000.00 ","$6,460.00 ","$1,045.13 ", N/A , N/A , N/A ,"$6,000.00 ","$8,500.00 ","$7,000.00 ","$1,045.13 ","$9,500.00 ","$7,200.00 ","$7,300.00 ","$6,750.00 ","$8,500.00 ", N/A ,"$6,750.00 ","$8,000.00 ","$7,300.00 ","$1,045.13 ", N/A , N/A ,"$10,000.00 ","$8,500.00 ", N/A ,"$9,200.00 ","$7,000.00 ","$5,000.00 ","$6,000.00 ","$6,090.00 ","$5,000.00 ","$6,910.00 ","$7,000.00 ", N/A ,"$7,200.00 ","$1,107.84 ","$1,858.00 ","$1,858.00 ", N/A ,"$1,858.00 ", N/A ,"$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,48100503,34820,HC OPEN ILIAC ART EXPOSE,481,1 ,"$10,000.00 ","$5,000.00 ","$2,717.00 ","$10,000.00 ","$6,460.00 ","$5,730.92 ","$7,070.00 ","$6,565.00 ", N/A ,"$6,000.00 ","$8,500.00 ","$7,000.00 ","$5,730.92 ","$9,500.00 ","$7,200.00 ","$7,300.00 ","$2,717.00 ","$8,500.00 ", N/A ,"$2,717.00 ","$8,000.00 ","$7,300.00 ","$5,730.92 ", N/A ,"$10,000.00 ","$10,000.00 ","$8,500.00 ", N/A ,"$9,200.00 ","$7,000.00 ","$5,819.10 ","$7,821.36 ","$6,090.00 ","$7,273.62 ","$6,910.00 ","$7,000.00 ", N/A ,"$7,200.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,48100504,34830,HC OPEN AORTIC TUBE PROSTH REPAIR,481,1 ,"$40,000.00 ","$20,000.00 ","$3,617.00 ","$40,000.00 ","$25,840.00 ", N/A ,"$18,180.00 ","$11,363.00 ", N/A ,"$24,000.00 ","$34,000.00 ","$28,000.00 ", N/A ,"$38,000.00 ","$28,800.00 ","$29,200.00 ","$12,963.00 ","$34,000.00 ", N/A ,"$12,963.00 ","$32,000.00 ","$29,200.00 ", N/A , N/A ,"$18,533.02 ","$40,000.00 ","$34,000.00 ", N/A ,"$36,800.00 ","$28,000.00 ","$5,818.90 ","$7,821.36 ","$24,360.00 ","$7,273.62 ","$27,640.00 ","$28,000.00 ", N/A ,"$28,800.00 ", N/A ,"$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$28,800.00 ","$24,800.00 ","$28,800.00 ","$28,800.00 ","$24,000.00 " ST VINCENT HOSPITAL - ACUTE,48100505,34831,HC OPEN AORTOILIAC PROSTH REPAIR,481,1 ,"$40,000.00 ","$20,000.00 ","$3,617.00 ","$40,000.00 ","$25,840.00 ", N/A ,"$18,180.00 ","$11,363.00 ", N/A ,"$24,000.00 ","$34,000.00 ","$28,000.00 ", N/A ,"$38,000.00 ","$28,800.00 ","$29,200.00 ","$9,943.00 ","$34,000.00 ", N/A ,"$9,943.00 ","$32,000.00 ","$29,200.00 ", N/A , N/A ,"$18,533.02 ","$40,000.00 ","$34,000.00 ", N/A ,"$36,800.00 ","$28,000.00 ","$5,818.90 ","$7,821.36 ","$24,360.00 ","$7,273.62 ","$27,640.00 ","$28,000.00 ", N/A ,"$28,800.00 ", N/A ,"$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$28,800.00 ","$24,800.00 ","$28,800.00 ","$28,800.00 ","$24,000.00 " ST VINCENT HOSPITAL - ACUTE,48100506,34832,HC OPEN AORTOFEMOR PROSTH REPAIR,481,1 ,"$40,000.00 ","$20,000.00 ","$3,617.00 ","$40,000.00 ","$25,840.00 ", N/A ,"$18,180.00 ","$11,363.00 ", N/A ,"$24,000.00 ","$34,000.00 ","$28,000.00 ", N/A ,"$38,000.00 ","$28,800.00 ","$29,200.00 ","$9,943.00 ","$34,000.00 ", N/A ,"$9,943.00 ","$32,000.00 ","$29,200.00 ", N/A , N/A ,"$18,533.02 ","$40,000.00 ","$34,000.00 ", N/A ,"$36,800.00 ","$28,000.00 ","$5,818.90 ","$7,821.36 ","$24,360.00 ","$7,273.62 ","$27,640.00 ","$28,000.00 ", N/A ,"$28,800.00 ", N/A ,"$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$28,800.00 ","$24,800.00 ","$28,800.00 ","$28,800.00 ","$24,000.00 " ST VINCENT HOSPITAL - ACUTE,48100507,34833,HC OPEN ILIAC ARTERY EXPOSE CONDUIT,481,1 ,"$10,000.00 ","$5,000.00 ","$3,617.00 ","$10,000.00 ","$6,460.00 ","$5,730.92 ","$7,070.00 ","$6,565.00 ", N/A ,"$6,000.00 ","$8,500.00 ","$7,000.00 ","$5,730.92 ","$9,500.00 ","$7,200.00 ","$7,300.00 ","$6,750.00 ","$8,500.00 ", N/A ,"$6,750.00 ","$8,000.00 ","$7,300.00 ","$5,730.92 ", N/A ,"$10,000.00 ","$10,000.00 ","$8,500.00 ", N/A ,"$9,200.00 ","$7,000.00 ","$5,819.10 ","$7,821.36 ","$6,090.00 ","$7,273.62 ","$6,910.00 ","$7,000.00 ", N/A ,"$7,200.00 ","$6,074.78 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$7,200.00 ","$6,200.00 ","$7,200.00 ","$7,200.00 ","$6,000.00 " ST VINCENT HOSPITAL - ACUTE,48100508,34834,HC OPEN BRACHIAL ARTY EXPOS ENDO PROST,481,1 ,"$8,000.00 ","$4,000.00 ","$1,045.13 ","$8,000.00 ","$5,168.00 ","$1,045.13 ","$3,939.00 ","$3,535.00 ", N/A ,"$4,800.00 ","$6,800.00 ","$5,600.00 ","$1,045.13 ","$7,600.00 ","$5,760.00 ","$5,840.00 ","$6,750.00 ","$6,800.00 ", N/A ,"$6,750.00 ","$6,400.00 ","$5,840.00 ","$1,045.13 ", N/A ,"$8,000.00 ","$8,000.00 ","$6,800.00 ", N/A ,"$7,360.00 ","$5,600.00 ","$5,819.10 ","$7,821.36 ","$4,872.00 ","$7,273.62 ","$5,528.00 ","$5,600.00 ", N/A ,"$5,760.00 ","$1,107.84 ","$3,617.00 ","$3,617.00 ", N/A ,"$3,617.00 ", N/A ,"$5,760.00 ","$4,960.00 ","$5,760.00 ","$5,760.00 ","$4,800.00 " ST VINCENT HOSPITAL - ACUTE,48100523,93287,HC PERI-PROC DEVICE EVAL/PROGRAM DEFIB SYSTEM,481,1 ,$215.00 ,$107.50 ,$12.22 ,$215.00 ,$138.89 ,$12.22 , N/A , N/A , N/A ,$129.00 ,$182.75 ,$150.50 ,$12.22 ,$204.25 ,$154.80 ,$156.95 ,$215.00 ,$182.75 , N/A ,$215.00 ,$172.00 ,$156.95 ,$12.22 , N/A , N/A ,$215.00 ,$182.75 , N/A ,$197.80 ,$150.50 ,$107.50 ,$129.00 ,$130.94 ,$107.50 ,$148.57 ,$150.50 , N/A ,$154.80 ,$12.95 , N/A , N/A , N/A , N/A , N/A ,$154.80 ,$133.30 ,$154.80 ,$154.80 ,$129.00 ST VINCENT HOSPITAL - ACUTE,48100536,C9764,HC REVASC INTRAVASC LITHOTRIPSY,481,1 ,"$6,500.00 ","$3,250.00 ","$1,095.68 ","$10,801.57 ","$4,199.00 ","$1,095.68 ", N/A , N/A ,"$4,800.70 ","$3,900.00 ","$5,525.00 ","$4,550.00 ","$1,095.68 ","$6,175.00 ","$4,680.00 ","$4,745.00 ","$6,500.00 ","$5,525.00 ","$4,800.70 ","$6,500.00 ","$5,200.00 ","$4,745.00 ","$1,095.68 ","$4,800.70 ", N/A ,"$6,500.00 ","$5,525.00 ","$10,801.57 ","$5,980.00 ","$4,550.00 ","$3,250.00 ","$3,900.00 ","$3,958.50 ","$3,250.00 ","$4,491.50 ","$4,550.00 ","$4,848.71 ","$4,680.00 ","$1,161.42 ", N/A , N/A ,"$4,800.70 ", N/A ,"$4,800.70 ","$4,680.00 ","$4,030.00 ","$4,680.00 ","$4,680.00 ","$3,900.00 " ST VINCENT HOSPITAL - ACUTE,48100537,C9765,HC REVASC INTRA LITHOTRIP-STENT,481,1 ,"$10,070.00 ","$5,035.00 ","$1,802.28 ","$21,884.82 ","$6,505.22 ","$1,802.28 ", N/A , N/A ,"$9,726.59 ","$6,042.00 ","$8,559.50 ","$7,049.00 ","$1,802.28 ","$9,566.50 ","$7,250.40 ","$7,351.10 ","$6,750.00 ","$8,559.50 ","$9,726.59 ","$6,750.00 ","$8,056.00 ","$7,351.10 ","$1,802.28 ","$9,726.59 ", N/A ,"$10,070.00 ","$8,559.50 ","$21,884.82 ","$9,264.40 ","$7,049.00 ","$5,035.00 ","$6,042.00 ","$6,132.63 ","$5,035.00 ","$6,958.37 ","$7,049.00 ","$9,823.86 ","$7,250.40 ","$1,910.42 ", N/A , N/A ,"$9,726.59 ", N/A ,"$9,726.59 ","$7,250.40 ","$6,243.40 ","$7,250.40 ","$7,250.40 ","$6,042.00 " ST VINCENT HOSPITAL - ACUTE,48100538,C9766,HC REVASC INTRA LITHOTRIP-ATHER,481,1 ,"$10,070.00 ","$5,035.00 ","$1,095.68 ","$21,884.82 ","$6,505.22 ","$1,095.68 ", N/A , N/A ,"$9,726.59 ","$6,042.00 ","$8,559.50 ","$7,049.00 ","$1,095.68 ","$9,566.50 ","$7,250.40 ","$7,351.10 ","$6,750.00 ","$8,559.50 ","$9,726.59 ","$6,750.00 ","$8,056.00 ","$7,351.10 ","$1,095.68 ","$9,726.59 ", N/A ,"$10,070.00 ","$8,559.50 ","$21,884.82 ","$9,264.40 ","$7,049.00 ","$5,035.00 ","$6,042.00 ","$6,132.63 ","$5,035.00 ","$6,958.37 ","$7,049.00 ","$9,823.86 ","$7,250.40 ","$1,161.42 ", N/A , N/A ,"$9,726.59 ", N/A ,"$9,726.59 ","$7,250.40 ","$6,243.40 ","$7,250.40 ","$7,250.40 ","$6,042.00 " ST VINCENT HOSPITAL - ACUTE,48100539,C9767,HC REVASC LITHOTRIP-STENT-ATHER,481,1 ,"$23,000.00 ","$11,500.00 ","$1,802.28 ","$35,005.46 ","$14,858.00 ","$1,802.28 ", N/A , N/A ,"$15,557.98 ","$13,800.00 ","$19,550.00 ","$16,100.00 ","$1,802.28 ","$21,850.00 ","$16,560.00 ","$16,790.00 ","$6,750.00 ","$19,550.00 ","$15,557.98 ","$6,750.00 ","$18,400.00 ","$16,790.00 ","$1,802.28 ","$15,557.98 ", N/A ,"$23,000.00 ","$19,550.00 ","$35,005.46 ","$21,160.00 ","$16,100.00 ","$11,500.00 ","$13,800.00 ","$14,007.00 ","$11,500.00 ","$15,893.00 ","$16,100.00 ","$15,713.56 ","$16,560.00 ","$1,910.42 ", N/A , N/A ,"$15,557.98 ", N/A ,"$15,557.98 ","$16,560.00 ","$14,260.00 ","$16,560.00 ","$16,560.00 ","$13,800.00 " ST VINCENT HOSPITAL - ACUTE,48200000,93017,HC STRESS TEST TRACING ONLY,482,1 ,"$1,100.00 ",$550.00 ,$76.32 ,"$1,100.00 ",$710.60 ,$76.32 ,$711.59 ,$711.59 ,$256.12 ,$660.00 ,$935.00 ,$770.00 ,$76.32 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$256.12 ,$715.00 ,$880.00 ,$803.00 ,$76.32 ,$256.12 ,$618.14 ,"$1,100.00 ",$935.00 ,$576.27 ,"$1,012.00 ",$770.00 ,$811.58 ,$874.82 ,$669.90 ,$811.58 ,$760.10 ,$770.00 ,$258.68 ,$792.00 ,$80.90 ,$721.00 ,$721.00 ,$256.12 ,$721.00 ,$256.12 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,48200001,93017,HC STRESS TEST TRACING ONLY CORPORATE,482,1 ,$124.00 ,$62.00 ,$62.00 ,$576.27 ,$80.10 ,$76.32 ,$80.22 ,$80.22 ,$256.12 ,$74.40 ,$105.40 ,$86.80 ,$76.32 ,$117.80 ,$89.28 ,$90.52 ,$80.60 ,$105.40 ,$256.12 ,$80.60 ,$99.20 ,$90.52 ,$76.32 ,$256.12 ,$124.00 ,$124.00 ,$105.40 ,$576.27 ,$114.08 ,$86.80 ,$124.00 ,$124.00 ,$75.52 ,$124.00 ,$85.68 ,$86.80 ,$258.68 ,$89.28 ,$80.90 ,$124.00 ,$124.00 ,$256.12 ,$124.00 ,$256.12 ,$89.28 ,$76.88 ,$89.28 ,$89.28 ,$74.40 ST VINCENT HOSPITAL - ACUTE,48200006,93017,HC STRESS TEST TRACING ONLY ECHO,482,1 ,"$1,100.00 ",$550.00 ,$76.32 ,"$1,100.00 ",$710.60 ,$76.32 ,$711.59 ,$711.59 ,$256.12 ,$660.00 ,$935.00 ,$770.00 ,$76.32 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$256.12 ,$715.00 ,$880.00 ,$803.00 ,$76.32 ,$256.12 ,$618.14 ,"$1,100.00 ",$935.00 ,$576.27 ,"$1,012.00 ",$770.00 ,$811.58 ,$874.82 ,$669.90 ,$811.58 ,$760.10 ,$770.00 ,$258.68 ,$792.00 ,$80.90 ,$721.00 ,$721.00 ,$256.12 ,$721.00 ,$256.12 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,48300000,93306,HC ECHO/CARDIAC DOP/COLOR FLOW,483,1 ,"$2,000.00 ","$1,000.00 ",$133.42 ,"$2,000.00 ","$1,292.00 ",$133.42 ,"$1,293.80 ","$1,293.80 ",$467.68 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$133.42 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,300.00 ","$1,700.00 ",$467.68 ,"$1,300.00 ","$1,600.00 ","$1,460.00 ",$133.42 ,$467.68 ,$298.03 ,"$2,000.00 ","$1,700.00 ","$1,052.28 ","$1,840.00 ","$1,400.00 ","$1,419.97 ","$1,530.62 ","$1,218.00 ","$1,419.97 ","$1,382.00 ","$1,400.00 ",$472.36 ,"$1,440.00 ",$141.43 ,$475.00 ,$475.00 ,$467.68 ,$475.00 ,$467.68 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,48300001,93307,HC ECHOCARDIOGRAM 2D W/O DOP,483,1 ,"$1,720.00 ",$860.00 ,$133.42 ,"$1,720.00 ","$1,111.12 ",$133.42 ,"$1,112.67 ","$1,112.67 ",$222.88 ,"$1,032.00 ","$1,462.00 ","$1,204.00 ",$133.42 ,"$1,634.00 ","$1,238.40 ","$1,255.60 ","$1,118.00 ","$1,462.00 ",$222.88 ,"$1,118.00 ","$1,376.00 ","$1,255.60 ",$133.42 ,$222.88 ,$298.03 ,"$1,720.00 ","$1,462.00 ",$501.48 ,"$1,582.40 ","$1,204.00 ","$1,419.97 ","$1,530.62 ","$1,047.48 ","$1,419.97 ","$1,188.52 ","$1,204.00 ",$225.11 ,"$1,238.40 ",$141.43 ,$475.00 ,$475.00 ,$222.88 ,$475.00 ,$222.88 ,"$1,238.40 ","$1,066.40 ","$1,238.40 ","$1,238.40 ","$1,032.00 " ST VINCENT HOSPITAL - ACUTE,48300002,93308,HC ECHO 2D W/W/O M-MODE LTD,483,1 ,$880.00 ,$440.00 ,$133.42 ,$880.00 ,$568.48 ,$133.42 ,$569.27 ,$569.27 ,$222.88 ,$528.00 ,$748.00 ,$616.00 ,$133.42 ,$836.00 ,$633.60 ,$642.40 ,$572.00 ,$748.00 ,$222.88 ,$572.00 ,$704.00 ,$642.40 ,$133.42 ,$222.88 ,$298.03 ,$880.00 ,$748.00 ,$501.48 ,$809.60 ,$616.00 ,$833.08 ,$880.00 ,$535.92 ,$833.08 ,$608.08 ,$616.00 ,$225.11 ,$633.60 ,$141.43 ,$475.00 ,$475.00 ,$222.88 ,$475.00 ,$222.88 ,$633.60 ,$545.60 ,$633.60 ,$633.60 ,$528.00 ST VINCENT HOSPITAL - ACUTE,48300003,93312,HC ECHO TEE CMPL W/PF,483,1 ,"$2,500.00 ","$1,250.00 ",$133.42 ,"$2,500.00 ","$1,615.00 ",$133.42 ,"$1,617.25 ","$1,617.25 ",$467.68 ,"$1,500.00 ","$2,125.00 ","$1,750.00 ",$133.42 ,"$2,375.00 ","$1,800.00 ","$1,825.00 ","$1,625.00 ","$2,125.00 ",$467.68 ,"$1,625.00 ","$2,000.00 ","$1,825.00 ",$133.42 ,$467.68 ,$298.03 ,"$2,500.00 ","$2,125.00 ","$1,052.28 ","$2,300.00 ","$1,750.00 ","$1,975.42 ","$2,129.35 ","$1,522.50 ","$1,975.42 ","$1,727.50 ","$1,750.00 ",$472.36 ,"$1,800.00 ",$141.43 ,$475.00 ,$475.00 ,$467.68 ,$475.00 ,$467.68 ,"$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,48300004,93316,HC ECHO TEE CONGT CARDIAC ANOM PROBE,483,1 ,"$1,040.00 ",$520.00 ,$133.42 ,"$1,052.28 ",$671.84 ,$133.42 ,$672.78 ,$672.78 ,$467.68 ,$624.00 ,$884.00 ,$728.00 ,$133.42 ,$988.00 ,$748.80 ,$759.20 ,$676.00 ,$884.00 ,$467.68 ,$676.00 ,$832.00 ,$759.20 ,$133.42 ,$467.68 ,$298.03 ,"$1,040.00 ",$884.00 ,"$1,052.28 ",$956.80 ,$728.00 ,"$1,040.00 ","$1,040.00 ",$633.36 ,"$1,040.00 ",$718.64 ,$728.00 ,$472.36 ,$748.80 ,$141.43 ,$475.00 ,$475.00 ,$467.68 ,$475.00 ,$467.68 ,$748.80 ,$644.80 ,$748.80 ,$748.80 ,$624.00 ST VINCENT HOSPITAL - ACUTE,48300005,93320,HC ECHO DOPPLER,483,1 ,$540.00 ,$270.00 ,$133.42 ,$540.00 ,$348.84 ,$133.42 ,$349.33 ,$349.33 , N/A ,$324.00 ,$459.00 ,$378.00 ,$133.42 ,$513.00 ,$388.80 ,$394.20 ,$351.00 ,$459.00 , N/A ,$351.00 ,$432.00 ,$394.20 ,$133.42 , N/A ,$298.03 ,$540.00 ,$459.00 , N/A ,$496.80 ,$378.00 ,$270.00 ,$324.00 ,$328.86 ,$270.00 ,$373.14 ,$378.00 , N/A ,$388.80 ,$141.43 ,$475.00 ,$475.00 , N/A ,$475.00 , N/A ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,48300006,93325,HC ECHO COLOR FLOW MAPPING,483,1 ,$500.00 ,$250.00 ,$49.96 ,$500.00 ,$323.00 ,$49.96 ,$323.45 ,$323.45 , N/A ,$300.00 ,$425.00 ,$350.00 ,$49.96 ,$475.00 ,$360.00 ,$365.00 ,$325.00 ,$425.00 , N/A ,$325.00 ,$400.00 ,$365.00 ,$49.96 , N/A ,$298.03 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$52.96 ,$475.00 ,$475.00 , N/A ,$475.00 , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,48300007,93350,HC ECHO REST AND STRESS W/PF,483,1 ,"$1,900.00 ",$950.00 ,$133.42 ,"$1,900.00 ","$1,227.40 ",$133.42 ,"$1,229.11 ","$1,229.11 ",$467.68 ,"$1,140.00 ","$1,615.00 ","$1,330.00 ",$133.42 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,235.00 ","$1,615.00 ",$467.68 ,"$1,235.00 ","$1,520.00 ","$1,387.00 ",$133.42 ,$467.68 ,$298.03 ,"$1,900.00 ","$1,615.00 ","$1,052.28 ","$1,748.00 ","$1,330.00 ","$1,419.97 ","$1,530.62 ","$1,157.10 ","$1,419.97 ","$1,312.90 ","$1,330.00 ",$472.36 ,"$1,368.00 ",$141.43 ,$475.00 ,$475.00 ,$467.68 ,$475.00 ,$467.68 ,"$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,48300008,93303,HC ECHO PEDS CONGENITAL,483,1 ,"$2,425.00 ","$1,212.50 ",$133.42 ,"$2,425.00 ","$1,566.55 ",$133.42 ,"$1,568.73 ","$1,568.73 ",$467.68 ,"$1,455.00 ","$2,061.25 ","$1,697.50 ",$133.42 ,"$2,303.75 ","$1,746.00 ","$1,770.25 ","$1,576.25 ","$2,061.25 ",$467.68 ,"$1,576.25 ","$1,940.00 ","$1,770.25 ",$133.42 ,$467.68 ,$298.03 ,"$2,425.00 ","$2,061.25 ","$1,052.28 ","$2,231.00 ","$1,697.50 ","$1,975.42 ","$2,129.35 ","$1,476.83 ","$1,975.42 ","$1,675.68 ","$1,697.50 ",$472.36 ,"$1,746.00 ",$141.43 ,$475.00 ,$475.00 ,$467.68 ,$475.00 ,$467.68 ,"$1,746.00 ","$1,503.50 ","$1,746.00 ","$1,746.00 ","$1,455.00 " ST VINCENT HOSPITAL - ACUTE,48300009,93304,HC ECHO PEDS CONGENITAL LMTD,483,1 ,"$1,810.00 ",$905.00 ,$133.42 ,"$1,810.00 ","$1,169.26 ",$133.42 ,"$1,170.89 ","$1,170.89 ",$467.68 ,"$1,086.00 ","$1,538.50 ","$1,267.00 ",$133.42 ,"$1,719.50 ","$1,303.20 ","$1,321.30 ","$1,176.50 ","$1,538.50 ",$467.68 ,"$1,176.50 ","$1,448.00 ","$1,321.30 ",$133.42 ,$467.68 ,$298.03 ,"$1,810.00 ","$1,538.50 ","$1,052.28 ","$1,665.20 ","$1,267.00 ","$1,419.97 ","$1,530.62 ","$1,102.29 ","$1,419.97 ","$1,250.71 ","$1,267.00 ",$472.36 ,"$1,303.20 ",$141.43 ,$475.00 ,$475.00 ,$467.68 ,$475.00 ,$467.68 ,"$1,303.20 ","$1,122.20 ","$1,303.20 ","$1,303.20 ","$1,086.00 " ST VINCENT HOSPITAL - ACUTE,48300010,93321,HC ECHO DOPPLER LMTD,483,1 ,$455.00 ,$227.50 ,$133.42 ,$455.00 ,$293.93 ,$133.42 ,$294.34 ,$294.34 , N/A ,$273.00 ,$386.75 ,$318.50 ,$133.42 ,$432.25 ,$327.60 ,$332.15 ,$295.75 ,$386.75 , N/A ,$295.75 ,$364.00 ,$332.15 ,$133.42 , N/A ,$298.03 ,$455.00 ,$386.75 , N/A ,$418.60 ,$318.50 ,$227.50 ,$273.00 ,$277.10 ,$227.50 ,$314.41 ,$318.50 , N/A ,$327.60 ,$141.43 ,$455.00 ,$455.00 , N/A ,$455.00 , N/A ,$327.60 ,$282.10 ,$327.60 ,$327.60 ,$273.00 ST VINCENT HOSPITAL - ACUTE,48300011,93351,HC ECHO 2D STRESS CONT MONITORING,483,1 ,"$2,425.00 ","$1,212.50 ",$133.42 ,"$2,425.00 ","$1,566.55 ",$133.42 ,"$1,568.73 ","$1,568.73 ",$467.68 ,"$1,455.00 ","$2,061.25 ","$1,697.50 ",$133.42 ,"$2,303.75 ","$1,746.00 ","$1,770.25 ","$1,576.25 ","$2,061.25 ",$467.68 ,"$1,576.25 ","$1,940.00 ","$1,770.25 ",$133.42 ,$467.68 ,$298.03 ,"$2,425.00 ","$2,061.25 ","$1,052.28 ","$2,231.00 ","$1,697.50 ","$1,975.42 ","$2,129.35 ","$1,476.83 ","$1,975.42 ","$1,675.68 ","$1,697.50 ",$472.36 ,"$1,746.00 ",$141.43 ,$475.00 ,$475.00 ,$467.68 ,$475.00 ,$467.68 ,"$1,746.00 ","$1,503.50 ","$1,746.00 ","$1,746.00 ","$1,455.00 " ST VINCENT HOSPITAL - ACUTE,48300016,C8924,HC ECHO TTE W/W/O CONT AND W/CONT LIMIT,483,1 ,"$1,100.00 ",$550.00 ,$133.42 ,"$1,100.00 ",$710.60 ,$133.42 ,$711.59 ,$711.59 ,$356.52 ,$660.00 ,$935.00 ,$770.00 ,$133.42 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$356.52 ,$715.00 ,$880.00 ,$803.00 ,$133.42 ,$356.52 ,$298.03 ,"$1,100.00 ",$935.00 ,$802.18 ,"$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$360.09 ,$792.00 ,$141.43 ,$475.00 ,$475.00 ,$356.52 ,$475.00 ,$356.52 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,48300018,C8928,HC ECHO TTE 2D STRESS W/W/O CONT AND W/CONT W/PF,483,1 ,"$1,961.00 ",$980.50 ,$133.42 ,"$1,961.00 ","$1,266.81 ",$133.42 ,"$1,268.57 ","$1,268.57 ",$692.65 ,"$1,176.60 ","$1,666.85 ","$1,372.70 ",$133.42 ,"$1,862.95 ","$1,411.92 ","$1,431.53 ","$1,274.65 ","$1,666.85 ",$692.65 ,"$1,274.65 ","$1,568.80 ","$1,431.53 ",$133.42 ,$692.65 ,$298.03 ,"$1,961.00 ","$1,666.85 ","$1,558.47 ","$1,804.12 ","$1,372.70 ","$1,961.00 ","$1,961.00 ","$1,194.25 ","$1,961.00 ","$1,355.05 ","$1,372.70 ",$699.58 ,"$1,411.92 ",$141.43 ,$475.00 ,$475.00 ,$692.65 ,$475.00 ,$692.65 ,"$1,411.92 ","$1,215.82 ","$1,411.92 ","$1,411.92 ","$1,176.60 " ST VINCENT HOSPITAL - ACUTE,48300019,C8929,HC ECHO TTE 2D W/DOPPLER W/W/O CONT AND W/CONT,483,1 ,"$1,961.00 ",$980.50 ,$133.42 ,"$1,961.00 ","$1,266.81 ",$133.42 ,"$1,268.57 ","$1,268.57 ",$692.65 ,"$1,176.60 ","$1,666.85 ","$1,372.70 ",$133.42 ,"$1,862.95 ","$1,411.92 ","$1,431.53 ","$1,274.65 ","$1,666.85 ",$692.65 ,"$1,274.65 ","$1,568.80 ","$1,431.53 ",$133.42 ,$692.65 ,$298.03 ,"$1,961.00 ","$1,666.85 ","$1,558.47 ","$1,804.12 ","$1,372.70 ","$1,961.00 ","$1,961.00 ","$1,194.25 ","$1,961.00 ","$1,355.05 ","$1,372.70 ",$699.58 ,"$1,411.92 ",$141.43 ,$475.00 ,$475.00 ,$692.65 ,$475.00 ,$692.65 ,"$1,411.92 ","$1,215.82 ","$1,411.92 ","$1,411.92 ","$1,176.60 " ST VINCENT HOSPITAL - ACUTE,51000001,N/A,HC DISCONTINUED PROCEDURE,510,1 ,"$1,000.00 ",$500.00 ,$63.04 ,"$1,000.00 ",$646.00 , N/A ,$126.00 ,$101.00 , N/A ,$600.00 ,$850.00 ,$700.00 , N/A ,$950.00 ,$720.00 ,$730.00 ,$100.00 ,$850.00 , N/A ,$100.00 ,$800.00 ,$730.00 , N/A , N/A ,$63.04 ,"$1,000.00 ",$850.00 , N/A ,$920.00 ,$700.00 ,$500.00 ,$600.00 ,$609.00 ,$500.00 ,$691.00 ,$700.00 , N/A ,$720.00 , N/A ,$600.00 ,$600.00 , N/A ,$600.00 , N/A ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,51000002,95117,HC ALLERGY SHOTS 2 OR MORE,510,1 ,$60.00 ,$30.00 ,$7.49 ,$87.17 ,$38.76 ,$7.49 ,$60.00 ,$60.00 ,$38.74 ,$36.00 ,$51.00 ,$42.00 ,$7.49 ,$57.00 ,$43.20 ,$43.80 ,$60.00 ,$51.00 ,$38.74 ,$60.00 ,$48.00 ,$43.80 ,$7.49 ,$38.74 ,$60.00 ,$60.00 ,$51.00 ,$87.17 ,$55.20 ,$42.00 ,$30.00 ,$36.00 ,$36.54 ,$30.00 ,$41.46 ,$42.00 ,$39.13 ,$43.20 ,$7.94 ,$36.00 ,$36.00 ,$38.74 ,$36.00 ,$38.74 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,51000005,11042,HC DEBR SKIN/SUBQ TISS INIT 20CM FAC,510,1 ,$470.00 ,$235.00 ,$63.04 ,$753.63 ,$303.62 ,$107.54 ,$126.00 ,$101.00 ,$334.95 ,$282.00 ,$399.50 ,$329.00 ,$107.54 ,$446.50 ,$338.40 ,$343.10 ,$100.00 ,$399.50 ,$334.95 ,$100.00 ,$376.00 ,$343.10 ,$107.54 ,$334.95 ,$63.04 ,$470.00 ,$399.50 ,$753.63 ,$432.40 ,$329.00 ,$470.00 ,$470.00 ,$286.23 ,$470.00 ,$324.77 ,$329.00 ,$338.30 ,$338.40 ,$113.99 ,$282.00 ,$282.00 ,$334.95 ,$282.00 ,$334.95 ,$338.40 ,$291.40 ,$338.40 ,$338.40 ,$282.00 ST VINCENT HOSPITAL - ACUTE,51000006,11043,HC DEBR SKIN/SUBQ TISSUE/MUSCLE FAC,510,1 ,"$1,000.00 ",$500.00 ,$63.04 ,"$1,142.23 ",$646.00 ,$107.54 ,$126.00 ,$101.00 ,$507.66 ,$600.00 ,$850.00 ,$700.00 ,$107.54 ,$950.00 ,$720.00 ,$730.00 ,$100.00 ,$850.00 ,$507.66 ,$100.00 ,$800.00 ,$730.00 ,$107.54 ,$507.66 ,$63.04 ,"$1,000.00 ",$850.00 ,"$1,142.23 ",$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,$512.74 ,$720.00 ,$113.99 ,$600.00 ,$600.00 ,$507.66 ,$600.00 ,$507.66 ,$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,51000007,11044,HC DEBR SKIN/SUB TIS/MUS/BONE INT 20 FAC,510,1 ,"$2,200.00 ","$1,100.00 ",$63.04 ,"$3,066.03 ","$1,421.20 ",$288.83 ,$126.00 ,$101.00 ,"$1,362.68 ","$1,320.00 ","$1,870.00 ","$1,540.00 ",$288.83 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ",$100.00 ,"$1,870.00 ","$1,362.68 ",$100.00 ,"$1,760.00 ","$1,606.00 ",$288.83 ,"$1,362.68 ",$63.04 ,"$2,200.00 ","$1,870.00 ","$3,066.03 ","$2,024.00 ","$1,540.00 ","$2,200.00 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ","$1,376.31 ","$1,584.00 ",$306.16 ,"$1,320.00 ","$1,320.00 ","$1,362.68 ","$1,320.00 ","$1,362.68 ","$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,51000008,N/A,HC LIFETIME EX 3D/WK COUPLE,510,1 ,$120.00 ,$60.00 ,$60.00 ,$120.00 ,$77.52 , N/A ,$120.00 ,$101.00 , N/A ,$72.00 ,$102.00 ,$84.00 , N/A ,$114.00 ,$86.40 ,$87.60 ,$100.00 ,$102.00 , N/A ,$100.00 ,$96.00 ,$87.60 , N/A , N/A ,$63.04 ,$120.00 ,$102.00 , N/A ,$110.40 ,$84.00 ,$60.00 ,$72.00 ,$73.08 ,$60.00 ,$82.92 ,$84.00 , N/A ,$86.40 , N/A ,$72.00 ,$72.00 , N/A ,$72.00 , N/A ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,51000009,11045,HC DEBR SKIN/SUBQ TIS EA ADL 20CM FAC,510,1 ,$100.00 ,$50.00 ,$50.00 ,$306.16 ,$64.60 ,$100.00 ,$100.00 ,$100.00 , N/A ,$60.00 ,$85.00 ,$70.00 ,$288.83 ,$95.00 ,$72.00 ,$73.00 ,$100.00 ,$85.00 , N/A ,$100.00 ,$80.00 ,$73.00 ,$288.83 , N/A ,$63.04 ,$100.00 ,$85.00 , N/A ,$92.00 ,$70.00 ,$100.00 ,$100.00 ,$60.90 ,$100.00 ,$69.10 ,$70.00 , N/A ,$72.00 ,$306.16 ,$60.00 ,$60.00 , N/A ,$60.00 , N/A ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,51000010,11046,HC DEBR SKIN/SUBQ MUS/FAS ADL 20C FAC,510,1 ,$730.00 ,$365.00 ,$63.04 ,$730.00 ,$471.58 ,$288.83 ,$126.00 ,$101.00 , N/A ,$438.00 ,$620.50 ,$511.00 ,$288.83 ,$693.50 ,$525.60 ,$532.90 ,$100.00 ,$620.50 , N/A ,$100.00 ,$584.00 ,$532.90 ,$288.83 , N/A ,$63.04 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,$730.00 ,$730.00 ,$444.57 ,$730.00 ,$504.43 ,$511.00 , N/A ,$525.60 ,$306.16 ,$438.00 ,$438.00 , N/A ,$438.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,51000011,11047,HC DEBR SKIN/SUB TIS/MUS/BN ADL 20C FAC,510,1 ,"$1,390.00 ",$695.00 ,$63.04 ,"$1,390.00 ",$897.94 ,$288.83 ,$126.00 ,$101.00 , N/A ,$834.00 ,"$1,181.50 ",$973.00 ,$288.83 ,"$1,320.50 ","$1,000.80 ","$1,014.70 ",$100.00 ,"$1,181.50 ", N/A ,$100.00 ,"$1,112.00 ","$1,014.70 ",$288.83 , N/A ,$63.04 ,"$1,390.00 ","$1,181.50 ", N/A ,"$1,278.80 ",$973.00 ,"$1,390.00 ","$1,390.00 ",$846.51 ,"$1,390.00 ",$960.49 ,$973.00 , N/A ,"$1,000.80 ",$306.16 ,$834.00 ,$834.00 , N/A ,$834.00 , N/A ,"$1,000.80 ",$861.80 ,"$1,000.80 ","$1,000.80 ",$834.00 ST VINCENT HOSPITAL - ACUTE,51000012,11055,HC PARING LESN BENIGN 1 FAC,510,1 ,$150.00 ,$75.00 ,$63.04 ,$391.26 ,$96.90 ,$74.70 ,$126.00 ,$101.00 ,$173.89 ,$90.00 ,$127.50 ,$105.00 ,$74.70 ,$142.50 ,$108.00 ,$109.50 ,$100.00 ,$127.50 ,$173.89 ,$100.00 ,$120.00 ,$109.50 ,$74.70 ,$173.89 ,$63.04 ,$150.00 ,$127.50 ,$391.26 ,$138.00 ,$105.00 ,$150.00 ,$150.00 ,$91.35 ,$150.00 ,$103.65 ,$105.00 ,$175.63 ,$108.00 ,$79.18 ,$90.00 ,$90.00 ,$173.89 ,$90.00 ,$173.89 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,51000014,11056,HC PARING LESN BENIGN 2-4 FAC,510,1 ,$180.00 ,$90.00 ,$63.04 ,$391.26 ,$116.28 ,$74.70 ,$126.00 ,$101.00 ,$173.89 ,$108.00 ,$153.00 ,$126.00 ,$74.70 ,$171.00 ,$129.60 ,$131.40 ,$100.00 ,$153.00 ,$173.89 ,$100.00 ,$144.00 ,$131.40 ,$74.70 ,$173.89 ,$63.04 ,$180.00 ,$153.00 ,$391.26 ,$165.60 ,$126.00 ,$180.00 ,$180.00 ,$109.62 ,$180.00 ,$124.38 ,$126.00 ,$175.63 ,$129.60 ,$79.18 ,$108.00 ,$108.00 ,$173.89 ,$108.00 ,$173.89 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,51000021,11719,HC TRIM NAILS NONDYSTROPHIC FAC,510,1 ,$120.00 ,$60.00 ,$31.89 ,$121.29 ,$77.52 ,$31.89 ,$120.00 ,$101.00 ,$53.91 ,$72.00 ,$102.00 ,$84.00 ,$31.89 ,$114.00 ,$86.40 ,$87.60 ,$100.00 ,$102.00 ,$53.91 ,$100.00 ,$96.00 ,$87.60 ,$31.89 ,$53.91 ,$63.04 ,$120.00 ,$102.00 ,$121.29 ,$110.40 ,$84.00 ,$120.00 ,$120.00 ,$73.08 ,$120.00 ,$82.92 ,$84.00 ,$54.45 ,$86.40 ,$33.80 ,$72.00 ,$72.00 ,$53.91 ,$72.00 ,$53.91 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,51000023,11720,HC DEBR NAIL(S) UP TO 5,510,1 ,$90.00 ,$45.00 ,$31.89 ,$121.29 ,$58.14 ,$31.89 ,$90.00 ,$90.00 ,$53.91 ,$54.00 ,$76.50 ,$63.00 ,$31.89 ,$85.50 ,$64.80 ,$65.70 ,$90.00 ,$76.50 ,$53.91 ,$90.00 ,$72.00 ,$65.70 ,$31.89 ,$53.91 ,$63.04 ,$90.00 ,$76.50 ,$121.29 ,$82.80 ,$63.00 ,$90.00 ,$90.00 ,$54.81 ,$90.00 ,$62.19 ,$63.00 ,$54.45 ,$64.80 ,$33.80 ,$54.00 ,$54.00 ,$53.91 ,$54.00 ,$53.91 ,$64.80 ,$55.80 ,$64.80 ,$64.80 ,$54.00 ST VINCENT HOSPITAL - ACUTE,51000024,11721,HC DEBR NAIL(S) 6 OR MORE,510,1 ,$120.00 ,$60.00 ,$31.89 ,$121.29 ,$77.52 ,$31.89 ,$120.00 ,$101.00 ,$53.91 ,$72.00 ,$102.00 ,$84.00 ,$31.89 ,$114.00 ,$86.40 ,$87.60 ,$100.00 ,$102.00 ,$53.91 ,$100.00 ,$96.00 ,$87.60 ,$31.89 ,$53.91 ,$63.04 ,$120.00 ,$102.00 ,$121.29 ,$110.40 ,$84.00 ,$120.00 ,$120.00 ,$73.08 ,$120.00 ,$82.92 ,$84.00 ,$54.45 ,$86.40 ,$33.80 ,$72.00 ,$72.00 ,$53.91 ,$72.00 ,$53.91 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,51000025,11750,HC REMOVE NAIL BED FACIL,510,1 ,"$1,100.00 ",$550.00 ,$63.04 ,"$1,100.00 ",$710.60 ,$161.28 ,$126.00 ,$101.00 ,$334.95 ,$660.00 ,$935.00 ,$770.00 ,$161.28 ,"$1,045.00 ",$792.00 ,$803.00 ,$100.00 ,$935.00 ,$334.95 ,$100.00 ,$880.00 ,$803.00 ,$161.28 ,$334.95 ,$63.04 ,"$1,100.00 ",$935.00 ,$753.63 ,"$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$338.30 ,$792.00 ,$170.96 ,$660.00 ,$660.00 ,$334.95 ,$660.00 ,$334.95 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,51000026,15002,HC WND PREP REC ST T/A/L<100,510,1 ,"$1,235.00 ",$617.50 ,$63.04 ,"$3,737.98 ",$797.81 ,$288.83 ,$126.00 ,$101.00 ,"$1,661.33 ",$741.00 ,"$1,049.75 ",$864.50 ,$288.83 ,"$1,173.25 ",$889.20 ,$901.55 ,$100.00 ,"$1,049.75 ","$1,661.33 ",$100.00 ,$988.00 ,$901.55 ,$288.83 ,"$1,661.33 ",$63.04 ,"$1,235.00 ","$1,049.75 ","$3,737.98 ","$1,136.20 ",$864.50 ,"$1,235.00 ","$1,235.00 ",$752.12 ,"$1,235.00 ",$853.39 ,$864.50 ,"$1,677.94 ",$889.20 ,$306.16 ,$741.00 ,$741.00 ,"$1,661.33 ",$741.00 ,"$1,661.33 ",$889.20 ,$765.70 ,$889.20 ,$889.20 ,$741.00 ST VINCENT HOSPITAL - ACUTE,51000027,15004,HC WND PREP REC ST F/N/H/F/G<100,510,1 ,"$1,060.00 ",$530.00 ,$63.04 ,"$1,142.23 ",$684.76 ,$288.83 ,$126.00 ,$101.00 ,$507.66 ,$636.00 ,$901.00 ,$742.00 ,$288.83 ,"$1,007.00 ",$763.20 ,$773.80 ,$100.00 ,$901.00 ,$507.66 ,$100.00 ,$848.00 ,$773.80 ,$288.83 ,$507.66 ,$63.04 ,"$1,060.00 ",$901.00 ,"$1,142.23 ",$975.20 ,$742.00 ,"$1,060.00 ","$1,060.00 ",$645.54 ,"$1,060.00 ",$732.46 ,$742.00 ,$512.74 ,$763.20 ,$306.16 ,$636.00 ,$636.00 ,$507.66 ,$636.00 ,$507.66 ,$763.20 ,$657.20 ,$763.20 ,$763.20 ,$636.00 ST VINCENT HOSPITAL - ACUTE,51000028,15100,HC AUTOGRPH T A L 100SQCM< FAC,510,1 ,"$3,710.00 ","$1,855.00 ",$63.04 ,"$3,737.98 ","$2,396.66 ",$552.66 ,$126.00 ,$101.00 ,"$1,661.33 ","$2,226.00 ","$3,153.50 ","$2,597.00 ",$552.66 ,"$3,524.50 ","$2,671.20 ","$2,708.30 ",$100.00 ,"$3,153.50 ","$1,661.33 ",$100.00 ,"$2,968.00 ","$2,708.30 ",$552.66 ,"$1,661.33 ",$63.04 ,"$3,710.00 ","$3,153.50 ","$3,737.98 ","$3,413.20 ","$2,597.00 ","$2,331.31 ","$3,133.44 ","$2,259.39 ","$2,914.14 ","$2,563.61 ","$2,597.00 ","$1,677.94 ","$2,671.20 ",$585.82 ,"$2,226.00 ","$2,226.00 ","$1,661.33 ","$2,226.00 ","$1,661.33 ","$2,671.20 ","$2,300.20 ","$2,671.20 ","$2,671.20 ","$2,226.00 " ST VINCENT HOSPITAL - ACUTE,51000029,15120,HC AUTOGRPH F F DG 100SQCM< FAC,510,1 ,"$3,360.00 ","$1,680.00 ",$63.04 ,"$7,675.21 ","$2,170.56 ",$552.66 ,$126.00 ,$101.00 ,"$3,411.20 ","$2,016.00 ","$2,856.00 ","$2,352.00 ",$552.66 ,"$3,192.00 ","$2,419.20 ","$2,452.80 ",$100.00 ,"$2,856.00 ","$3,411.20 ",$100.00 ,"$2,688.00 ","$2,452.80 ",$552.66 ,"$3,411.20 ",$63.04 ,"$3,360.00 ","$2,856.00 ","$7,675.21 ","$3,091.20 ","$2,352.00 ","$2,331.31 ","$3,133.44 ","$2,046.24 ","$2,914.14 ","$2,321.76 ","$2,352.00 ","$3,445.31 ","$2,419.20 ",$585.82 ,"$2,016.00 ","$2,016.00 ","$3,411.20 ","$2,016.00 ","$3,411.20 ","$2,419.20 ","$2,083.20 ","$2,419.20 ","$2,419.20 ","$2,016.00 " ST VINCENT HOSPITAL - ACUTE,51000044,15786,HC ABRASION LESION SINGLE,510,1 ,$290.00 ,$145.00 ,$63.04 ,$391.26 ,$187.34 ,$74.70 ,$126.00 ,$101.00 ,$173.89 ,$174.00 ,$246.50 ,$203.00 ,$74.70 ,$275.50 ,$208.80 ,$211.70 ,$100.00 ,$246.50 ,$173.89 ,$100.00 ,$232.00 ,$211.70 ,$74.70 ,$173.89 ,$63.04 ,$290.00 ,$246.50 ,$391.26 ,$266.80 ,$203.00 ,$290.00 ,$290.00 ,$176.61 ,$290.00 ,$200.39 ,$203.00 ,$175.63 ,$208.80 ,$79.18 ,$174.00 ,$174.00 ,$173.89 ,$174.00 ,$173.89 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,51000045,36593,HC DECLOTTING/ACCESS DEVICE/CATH,510,1 ,$590.00 ,$295.00 ,$63.04 ,$677.16 ,$381.14 ,$100.19 ,$126.00 ,$101.00 ,$300.96 ,$354.00 ,$501.50 ,$413.00 ,$100.19 ,$560.50 ,$424.80 ,$430.70 ,$100.00 ,$501.50 ,$300.96 ,$100.00 ,$472.00 ,$430.70 ,$100.19 ,$300.96 ,$63.04 ,$590.00 ,$501.50 ,$677.16 ,$542.80 ,$413.00 ,$590.00 ,$590.00 ,$359.31 ,$590.00 ,$407.69 ,$413.00 ,$303.97 ,$424.80 ,$106.20 ,$354.00 ,$354.00 ,$300.96 ,$354.00 ,$300.96 ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,51000052,29445,HC APPL CAST LEG RIGID CONTACT FAC,510,1 ,$620.00 ,$310.00 ,$57.61 ,$620.00 ,$400.52 ,$57.61 ,$126.00 ,$101.00 ,$233.57 ,$372.00 ,$527.00 ,$434.00 ,$57.61 ,$589.00 ,$446.40 ,$452.60 ,$100.00 ,$527.00 ,$233.57 ,$100.00 ,$496.00 ,$452.60 ,$57.61 ,$233.57 ,$63.04 ,$620.00 ,$527.00 ,$525.54 ,$570.40 ,$434.00 ,$620.00 ,$620.00 ,$377.58 ,$620.00 ,$428.42 ,$434.00 ,$235.91 ,$446.40 ,$61.07 ,$372.00 ,$372.00 ,$233.57 ,$372.00 ,$233.57 ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,51000053,29580,HC APPLY UNNA BOOT,510,1 ,$310.00 ,$155.00 ,$57.61 ,$310.00 ,$200.26 ,$57.61 ,$126.00 ,$101.00 ,$136.73 ,$186.00 ,$263.50 ,$217.00 ,$57.61 ,$294.50 ,$223.20 ,$226.30 ,$100.00 ,$263.50 ,$136.73 ,$100.00 ,$248.00 ,$226.30 ,$57.61 ,$136.73 ,$63.04 ,$310.00 ,$263.50 ,$307.65 ,$285.20 ,$217.00 ,$310.00 ,$310.00 ,$188.79 ,$310.00 ,$214.21 ,$217.00 ,$138.10 ,$223.20 ,$61.07 ,$186.00 ,$186.00 ,$136.73 ,$186.00 ,$136.73 ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,51000053,29580,HC APPLY UNNA BOOT,510,1 ,$460.00 ,$230.00 ,$57.61 ,$460.00 ,$297.16 ,$57.61 ,$126.00 ,$101.00 ,$136.73 ,$276.00 ,$391.00 ,$322.00 ,$57.61 ,$437.00 ,$331.20 ,$335.80 ,$100.00 ,$391.00 ,$136.73 ,$100.00 ,$368.00 ,$335.80 ,$57.61 ,$136.73 ,$63.04 ,$460.00 ,$391.00 ,$307.65 ,$423.20 ,$322.00 ,$460.00 ,$460.00 ,$280.14 ,$460.00 ,$317.86 ,$322.00 ,$138.10 ,$331.20 ,$61.07 ,$276.00 ,$276.00 ,$136.73 ,$276.00 ,$136.73 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,51000055,29581,HC APPLY MULTI COMP LOWER LEG FAC,510,1 ,$480.00 ,$240.00 ,$57.61 ,$480.00 ,$310.08 ,$57.61 ,$126.00 ,$101.00 ,$136.73 ,$288.00 ,$408.00 ,$336.00 ,$57.61 ,$456.00 ,$345.60 ,$350.40 ,$100.00 ,$408.00 ,$136.73 ,$100.00 ,$384.00 ,$350.40 ,$57.61 ,$136.73 ,$63.04 ,$480.00 ,$408.00 ,$307.65 ,$441.60 ,$336.00 ,$480.00 ,$480.00 ,$292.32 ,$480.00 ,$331.68 ,$336.00 ,$138.10 ,$345.60 ,$61.07 ,$288.00 ,$288.00 ,$136.73 ,$288.00 ,$136.73 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,51000055,29581,HC APPLY MULTI COMP LOWER LEG FAC,510,1 ,$320.00 ,$160.00 ,$57.61 ,$320.00 ,$206.72 ,$57.61 ,$126.00 ,$101.00 ,$136.73 ,$192.00 ,$272.00 ,$224.00 ,$57.61 ,$304.00 ,$230.40 ,$233.60 ,$100.00 ,$272.00 ,$136.73 ,$100.00 ,$256.00 ,$233.60 ,$57.61 ,$136.73 ,$63.04 ,$320.00 ,$272.00 ,$307.65 ,$294.40 ,$224.00 ,$320.00 ,$320.00 ,$194.88 ,$320.00 ,$221.12 ,$224.00 ,$138.10 ,$230.40 ,$61.07 ,$192.00 ,$192.00 ,$136.73 ,$192.00 ,$136.73 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,51000063,96372,HC INJECTION IM/SUBQ,260,1 ,$100.00 ,$50.00 ,$14.00 ,$135.04 ,$64.60 ,$14.00 ,$64.69 ,$64.69 ,$60.02 ,$60.00 ,$85.00 ,$70.00 ,$14.00 ,$95.00 ,$72.00 ,$73.00 ,$65.00 ,$85.00 ,$60.02 ,$65.00 ,$80.00 ,$73.00 ,$14.00 ,$60.02 ,$42.00 ,$100.00 ,$85.00 ,$135.04 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$60.62 ,$72.00 ,$14.84 ,$50.00 ,$50.00 ,$60.02 ,$50.00 ,$60.02 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,51000065,96374,HC INJ IV PUSH SINGL/INITIAL,260,1 ,$200.00 ,$100.00 ,$14.00 ,$443.45 ,$129.20 ,$14.00 ,$129.38 ,$129.38 ,$197.09 ,$120.00 ,$170.00 ,$140.00 ,$14.00 ,$190.00 ,$144.00 ,$146.00 ,$130.00 ,$170.00 ,$197.09 ,$130.00 ,$160.00 ,$146.00 ,$14.00 ,$197.09 ,$84.00 ,$200.00 ,$170.00 ,$443.45 ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 ,$199.06 ,$144.00 ,$14.84 ,$100.00 ,$100.00 ,$197.09 ,$100.00 ,$197.09 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,51000066,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$160.00 ,$80.00 ,$14.00 ,$160.00 ,$103.36 ,$14.00 ,$103.50 ,$103.50 ,$38.74 ,$96.00 ,$136.00 ,$112.00 ,$14.00 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 ,$38.74 ,$104.00 ,$128.00 ,$116.80 ,$14.00 ,$38.74 ,$67.20 ,$160.00 ,$136.00 ,$87.17 ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 ,$39.13 ,$115.20 ,$14.84 ,$80.00 ,$80.00 ,$38.74 ,$80.00 ,$38.74 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,51000067,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$160.00 ,$80.00 ,$14.00 ,$160.00 ,$103.36 ,$14.00 ,$103.50 ,$103.50 , N/A ,$96.00 ,$136.00 ,$112.00 ,$14.00 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 , N/A ,$104.00 ,$128.00 ,$116.80 ,$14.00 , N/A ,$67.20 ,$160.00 ,$136.00 , N/A ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , N/A ,$115.20 ,$14.84 ,$80.00 ,$80.00 , N/A ,$80.00 , N/A ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,51000068,96523,HC IRRIGAT IMPLANT VEN ACCESS DEV,510,1 ,$120.00 ,$60.00 ,$14.00 ,$121.29 ,$77.52 ,$14.00 ,$120.00 ,$101.00 ,$53.91 ,$72.00 ,$102.00 ,$84.00 ,$14.00 ,$114.00 ,$86.40 ,$87.60 ,$100.00 ,$102.00 ,$53.91 ,$100.00 ,$96.00 ,$87.60 ,$14.00 ,$53.91 ,$63.04 ,$120.00 ,$102.00 ,$121.29 ,$110.40 ,$84.00 ,$60.00 ,$72.00 ,$73.08 ,$60.00 ,$82.92 ,$84.00 ,$54.45 ,$86.40 ,$14.84 ,$72.00 ,$72.00 ,$53.91 ,$72.00 ,$53.91 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,51000072,97597,HC DEBR SKIN PART THICKNESS <20CM FAC,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000078,97597,HC DEBR SKIN INTL CAST REMOVAL/APPLY FACIL,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000079,97597,HC DEBR SKIN INTL 20CM BIL UNNA FACIL,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000080,97597,HC DEBR SKIN INTL 20CM NWPT/UNNA FAC,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000083,97597,HC DEBR SKIN INTL 20CM WRAP BILAT FAC,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000084,97597,HC DEBR SKIN INTL 20CM WRAP FACILITY,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000086,97597,HC DEBR SKIN INTL 20CM/UNNA FACILITY,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000087,97597,HC DEBR SKIN INTL NWPT 20CM FACIL,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000088,G0296,HC CLINIC VISIT CONSULT LOW DOSE LUNG SCREEN,510,1 ,$100.00 ,$50.00 ,$47.46 ,$163.15 ,$64.60 ,$47.46 ,$100.00 ,$100.00 ,$72.51 ,$60.00 ,$85.00 ,$70.00 ,$47.46 ,$95.00 ,$72.00 ,$73.00 ,$100.00 ,$85.00 ,$72.51 ,$100.00 ,$80.00 ,$73.00 ,$47.46 ,$72.51 ,$63.04 ,$100.00 ,$85.00 ,$163.15 ,$92.00 ,$70.00 ,$50.00 ,$60.00 ,$60.90 ,$50.00 ,$69.10 ,$70.00 ,$73.24 ,$72.00 ,$50.31 ,$60.00 ,$60.00 ,$72.51 ,$60.00 ,$72.51 ,$72.00 ,$62.00 ,$72.00 ,$72.00 ,$60.00 ST VINCENT HOSPITAL - ACUTE,51000099,99201,HC CLINIC VISIT BRIEF NEW,510,1 ,$220.00 ,$110.00 ,$63.04 ,$220.00 ,$142.12 , N/A ,$126.00 ,$101.00 , N/A ,$132.00 ,$187.00 ,$154.00 , N/A ,$209.00 ,$158.40 ,$160.60 ,$100.00 ,$187.00 , N/A ,$100.00 ,$176.00 ,$160.60 , N/A , N/A ,$63.04 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 , N/A ,$132.00 ,$132.00 , N/A ,$132.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,51000101,99202,HC CLINIC VISIT LIMITED NEW,510,1 ,$240.00 ,$120.00 ,$47.46 ,$240.00 ,$155.04 ,$47.46 ,$126.00 ,$101.00 , N/A ,$144.00 ,$204.00 ,$168.00 ,$47.46 ,$228.00 ,$172.80 ,$175.20 ,$100.00 ,$204.00 , N/A ,$100.00 ,$192.00 ,$175.20 ,$47.46 , N/A ,$63.04 ,$240.00 ,$204.00 , N/A ,$220.80 ,$168.00 ,$120.00 ,$144.00 ,$146.16 ,$120.00 ,$165.84 ,$168.00 , N/A ,$172.80 ,$50.31 ,$144.00 ,$144.00 , N/A ,$144.00 , N/A ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,51000104,99203,HC CLINIC VISIT INTERM NEW,510,1 ,$290.00 ,$145.00 ,$47.46 ,$290.00 ,$187.34 ,$47.46 ,$126.00 ,$101.00 , N/A ,$174.00 ,$246.50 ,$203.00 ,$47.46 ,$275.50 ,$208.80 ,$211.70 ,$100.00 ,$246.50 , N/A ,$100.00 ,$232.00 ,$211.70 ,$47.46 , N/A ,$63.04 ,$290.00 ,$246.50 , N/A ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 , N/A ,$208.80 ,$50.31 ,$174.00 ,$174.00 , N/A ,$174.00 , N/A ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,51000105,99203,HC LACTATION NEW PAT-LIMIT,510,1 ,$290.00 ,$145.00 ,$47.46 ,$290.00 ,$187.34 ,$47.46 ,$126.00 ,$101.00 , N/A ,$174.00 ,$246.50 ,$203.00 ,$47.46 ,$275.50 ,$208.80 ,$211.70 ,$100.00 ,$246.50 , N/A ,$100.00 ,$232.00 ,$211.70 ,$47.46 , N/A ,$63.04 ,$290.00 ,$246.50 , N/A ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 , N/A ,$208.80 ,$50.31 ,$174.00 ,$174.00 , N/A ,$174.00 , N/A ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,51000106,99203,HC CLINIC VISIT INTERM NEW CHRN LUNG,510,1 ,$290.00 ,$145.00 ,$47.46 ,$290.00 ,$187.34 ,$47.46 ,$126.00 ,$101.00 , N/A ,$174.00 ,$246.50 ,$203.00 ,$47.46 ,$275.50 ,$208.80 ,$211.70 ,$100.00 ,$246.50 , N/A ,$100.00 ,$232.00 ,$211.70 ,$47.46 , N/A ,$63.04 ,$290.00 ,$246.50 , N/A ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 , N/A ,$208.80 ,$50.31 ,$174.00 ,$174.00 , N/A ,$174.00 , N/A ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,51000107,99211,HC DRESSING CHANGE/ENEMA MINOR,510,1 ,$220.00 ,$110.00 ,$47.46 ,$220.00 ,$142.12 ,$47.46 ,$126.00 ,$101.00 , N/A ,$132.00 ,$187.00 ,$154.00 ,$47.46 ,$209.00 ,$158.40 ,$160.60 ,$100.00 ,$187.00 , N/A ,$100.00 ,$176.00 ,$160.60 ,$47.46 , N/A ,$63.04 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 ,$50.31 ,$132.00 ,$132.00 , N/A ,$132.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,51000109,99204,HC CLINIC VISIT COMPLEX NEW,510,1 ,$330.00 ,$165.00 ,$47.46 ,$330.00 ,$213.18 ,$47.46 ,$126.00 ,$101.00 , N/A ,$198.00 ,$280.50 ,$231.00 ,$47.46 ,$313.50 ,$237.60 ,$240.90 ,$100.00 ,$280.50 , N/A ,$100.00 ,$264.00 ,$240.90 ,$47.46 , N/A ,$63.04 ,$330.00 ,$280.50 , N/A ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 , N/A ,$237.60 ,$50.31 ,$198.00 ,$198.00 , N/A ,$198.00 , N/A ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,51000111,99204,HC CLINIC VISIT COMPLEX NEW CHRN LUNG,510,1 ,$330.00 ,$165.00 ,$47.46 ,$330.00 ,$213.18 ,$47.46 ,$126.00 ,$101.00 , N/A ,$198.00 ,$280.50 ,$231.00 ,$47.46 ,$313.50 ,$237.60 ,$240.90 ,$100.00 ,$280.50 , N/A ,$100.00 ,$264.00 ,$240.90 ,$47.46 , N/A ,$63.04 ,$330.00 ,$280.50 , N/A ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 , N/A ,$237.60 ,$50.31 ,$198.00 ,$198.00 , N/A ,$198.00 , N/A ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,51000113,99205,HC CLINIC VISIT COMPREH NEW,510,1 ,$400.00 ,$200.00 ,$47.46 ,$400.00 ,$258.40 ,$47.46 ,$126.00 ,$101.00 , N/A ,$240.00 ,$340.00 ,$280.00 ,$47.46 ,$380.00 ,$288.00 ,$292.00 ,$100.00 ,$340.00 , N/A ,$100.00 ,$320.00 ,$292.00 ,$47.46 , N/A ,$63.04 ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 , N/A ,$288.00 ,$50.31 ,$240.00 ,$240.00 , N/A ,$240.00 , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,51000114,99211,HC CLINIC VISIT BRIEF EST,510,1 ,$220.00 ,$110.00 ,$47.46 ,$220.00 ,$142.12 ,$47.46 ,$126.00 ,$101.00 , N/A ,$132.00 ,$187.00 ,$154.00 ,$47.46 ,$209.00 ,$158.40 ,$160.60 ,$100.00 ,$187.00 , N/A ,$100.00 ,$176.00 ,$160.60 ,$47.46 , N/A ,$63.04 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 ,$50.31 ,$132.00 ,$132.00 , N/A ,$132.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,51000115,99211,HC LACTATION EST PAT-BRIEF,510,1 ,$220.00 ,$110.00 ,$47.46 ,$220.00 ,$142.12 ,$47.46 ,$126.00 ,$101.00 , N/A ,$132.00 ,$187.00 ,$154.00 ,$47.46 ,$209.00 ,$158.40 ,$160.60 ,$100.00 ,$187.00 , N/A ,$100.00 ,$176.00 ,$160.60 ,$47.46 , N/A ,$63.04 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 ,$50.31 ,$132.00 ,$132.00 , N/A ,$132.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,51000116,99211,HC CLINIC VISIT BRIEF EST GEN CONSULT,510,1 ,$220.00 ,$110.00 ,$47.46 ,$220.00 ,$142.12 ,$47.46 ,$126.00 ,$101.00 , N/A ,$132.00 ,$187.00 ,$154.00 ,$47.46 ,$209.00 ,$158.40 ,$160.60 ,$100.00 ,$187.00 , N/A ,$100.00 ,$176.00 ,$160.60 ,$47.46 , N/A ,$63.04 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 ,$50.31 ,$132.00 ,$132.00 , N/A ,$132.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,51000119,99211,HC CLINIC VISIT BRIEF EST CATH CARE,510,1 ,$220.00 ,$110.00 ,$47.46 ,$220.00 ,$142.12 ,$47.46 ,$126.00 ,$101.00 , N/A ,$132.00 ,$187.00 ,$154.00 ,$47.46 ,$209.00 ,$158.40 ,$160.60 ,$100.00 ,$187.00 , N/A ,$100.00 ,$176.00 ,$160.60 ,$47.46 , N/A ,$63.04 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 ,$50.31 ,$132.00 ,$132.00 , N/A ,$132.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,51000120,99212,HC CLINIC VISIT LIMIT EST,510,1 ,$230.00 ,$115.00 ,$47.46 ,$230.00 ,$148.58 ,$47.46 ,$126.00 ,$101.00 , N/A ,$138.00 ,$195.50 ,$161.00 ,$47.46 ,$218.50 ,$165.60 ,$167.90 ,$100.00 ,$195.50 , N/A ,$100.00 ,$184.00 ,$167.90 ,$47.46 , N/A ,$63.04 ,$230.00 ,$195.50 , N/A ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 , N/A ,$165.60 ,$50.31 ,$138.00 ,$138.00 , N/A ,$138.00 , N/A ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,51000126,99212,HC CLINIC VISIT LIMIT EST CHR LUNG,510,1 ,$230.00 ,$115.00 ,$47.46 ,$230.00 ,$148.58 ,$47.46 ,$126.00 ,$101.00 , N/A ,$138.00 ,$195.50 ,$161.00 ,$47.46 ,$218.50 ,$165.60 ,$167.90 ,$100.00 ,$195.50 , N/A ,$100.00 ,$184.00 ,$167.90 ,$47.46 , N/A ,$63.04 ,$230.00 ,$195.50 , N/A ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 , N/A ,$165.60 ,$50.31 ,$138.00 ,$138.00 , N/A ,$138.00 , N/A ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,51000127,99212,HC CLINIC VISIT LIMIT EST GENETIC,510,1 ,$230.00 ,$115.00 ,$47.46 ,$230.00 ,$148.58 ,$47.46 ,$126.00 ,$101.00 , N/A ,$138.00 ,$195.50 ,$161.00 ,$47.46 ,$218.50 ,$165.60 ,$167.90 ,$100.00 ,$195.50 , N/A ,$100.00 ,$184.00 ,$167.90 ,$47.46 , N/A ,$63.04 ,$230.00 ,$195.50 , N/A ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 , N/A ,$165.60 ,$50.31 ,$138.00 ,$138.00 , N/A ,$138.00 , N/A ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,51000131,99213,HC CLINIC VISIT INTERM EST,510,1 ,$280.00 ,$140.00 ,$47.46 ,$280.00 ,$180.88 ,$47.46 ,$126.00 ,$101.00 , N/A ,$168.00 ,$238.00 ,$196.00 ,$47.46 ,$266.00 ,$201.60 ,$204.40 ,$100.00 ,$238.00 , N/A ,$100.00 ,$224.00 ,$204.40 ,$47.46 , N/A ,$63.04 ,$280.00 ,$238.00 , N/A ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 , N/A ,$201.60 ,$50.31 ,$168.00 ,$168.00 , N/A ,$168.00 , N/A ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,51000132,99213,HC CLINIC VISIT INTERM EST CHR LUNG,510,1 ,$280.00 ,$140.00 ,$47.46 ,$280.00 ,$180.88 ,$47.46 ,$126.00 ,$101.00 , N/A ,$168.00 ,$238.00 ,$196.00 ,$47.46 ,$266.00 ,$201.60 ,$204.40 ,$100.00 ,$238.00 , N/A ,$100.00 ,$224.00 ,$204.40 ,$47.46 , N/A ,$63.04 ,$280.00 ,$238.00 , N/A ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 , N/A ,$201.60 ,$50.31 ,$168.00 ,$168.00 , N/A ,$168.00 , N/A ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,51000133,99213,HC CLINIC VISIT INTERM EST GEN CONSULT,510,1 ,$280.00 ,$140.00 ,$47.46 ,$280.00 ,$180.88 ,$47.46 ,$126.00 ,$101.00 , N/A ,$168.00 ,$238.00 ,$196.00 ,$47.46 ,$266.00 ,$201.60 ,$204.40 ,$100.00 ,$238.00 , N/A ,$100.00 ,$224.00 ,$204.40 ,$47.46 , N/A ,$63.04 ,$280.00 ,$238.00 , N/A ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 , N/A ,$201.60 ,$50.31 ,$168.00 ,$168.00 , N/A ,$168.00 , N/A ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,51000136,99214,HC CLINIC VISIT COMPLX EST,510,1 ,$310.00 ,$155.00 ,$47.46 ,$310.00 ,$200.26 ,$47.46 ,$126.00 ,$101.00 , N/A ,$186.00 ,$263.50 ,$217.00 ,$47.46 ,$294.50 ,$223.20 ,$226.30 ,$100.00 ,$263.50 , N/A ,$100.00 ,$248.00 ,$226.30 ,$47.46 , N/A ,$63.04 ,$310.00 ,$263.50 , N/A ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 , N/A ,$223.20 ,$50.31 ,$186.00 ,$186.00 , N/A ,$186.00 , N/A ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,51000138,99215,HC CLINIC VISIT COMPRH EST GEN CONSULT,510,1 ,$390.00 ,$195.00 ,$47.46 ,$390.00 ,$251.94 ,$47.46 ,$126.00 ,$101.00 , N/A ,$234.00 ,$331.50 ,$273.00 ,$47.46 ,$370.50 ,$280.80 ,$284.70 ,$100.00 ,$331.50 , N/A ,$100.00 ,$312.00 ,$284.70 ,$47.46 , N/A ,$63.04 ,$390.00 ,$331.50 , N/A ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 , N/A ,$280.80 ,$50.31 ,$234.00 ,$234.00 , N/A ,$234.00 , N/A ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,51000139,99215,HC CLINIC VISIT COMPRH EST,510,1 ,$390.00 ,$195.00 ,$47.46 ,$390.00 ,$251.94 ,$47.46 ,$126.00 ,$101.00 , N/A ,$234.00 ,$331.50 ,$273.00 ,$47.46 ,$370.50 ,$280.80 ,$284.70 ,$100.00 ,$331.50 , N/A ,$100.00 ,$312.00 ,$284.70 ,$47.46 , N/A ,$63.04 ,$390.00 ,$331.50 , N/A ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 , N/A ,$280.80 ,$50.31 ,$234.00 ,$234.00 , N/A ,$234.00 , N/A ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,51000145,G0127,HC TRIM NAILS DYSTROPHIC FAC,510,1 ,$110.00 ,$55.00 ,$31.89 ,$121.29 ,$71.06 ,$31.89 ,$110.00 ,$101.00 ,$53.91 ,$66.00 ,$93.50 ,$77.00 ,$31.89 ,$104.50 ,$79.20 ,$80.30 ,$100.00 ,$93.50 ,$53.91 ,$100.00 ,$88.00 ,$80.30 ,$31.89 ,$53.91 ,$63.04 ,$110.00 ,$93.50 ,$121.29 ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 ,$54.45 ,$79.20 ,$33.80 ,$66.00 ,$66.00 ,$53.91 ,$66.00 ,$53.91 ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,51000147,P9612,HC CATH FOR SPECIMEN COLLECTION,300,1 ,$42.00 ,$21.00 ,$0.72 ,$42.00 ,$27.13 ,$0.72 ,$10.50 ,$9.00 ,$3.00 ,$25.20 ,$35.70 ,$29.40 ,$0.72 ,$39.90 ,$30.24 ,$30.66 ,$5.10 ,$35.70 ,$3.00 ,$5.10 ,$33.60 ,$30.66 ,$0.72 ,$3.00 ,$3.31 ,$42.00 ,$35.70 ,$6.75 ,$38.64 ,$29.40 ,$10.53 ,$11.31 ,$25.58 ,$10.53 ,$29.02 ,$29.40 ,$3.03 ,$30.24 ,$0.76 ,$3.60 ,$3.60 ,$3.00 ,$3.60 ,$3.00 ,$30.24 ,$26.04 ,$30.24 ,$30.24 ,$25.20 ST VINCENT HOSPITAL - ACUTE,51000159,16020,HC BURN DRS AND /OR DEBRID <5% FACIL,510,1 ,$380.00 ,$190.00 ,$63.04 ,$391.26 ,$245.48 ,$84.29 ,$126.00 ,$101.00 ,$173.89 ,$228.00 ,$323.00 ,$266.00 ,$84.29 ,$361.00 ,$273.60 ,$277.40 ,$100.00 ,$323.00 ,$173.89 ,$100.00 ,$304.00 ,$277.40 ,$84.29 ,$173.89 ,$63.04 ,$380.00 ,$323.00 ,$391.26 ,$349.60 ,$266.00 ,$380.00 ,$380.00 ,$231.42 ,$380.00 ,$262.58 ,$266.00 ,$175.63 ,$273.60 ,$89.35 ,$228.00 ,$228.00 ,$173.89 ,$228.00 ,$173.89 ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,51000160,16020,HC BURN DR AND OR DEBRD NWPT <5% FACILITY,510,1 ,$380.00 ,$190.00 ,$63.04 ,$391.26 ,$245.48 ,$84.29 ,$126.00 ,$101.00 ,$173.89 ,$228.00 ,$323.00 ,$266.00 ,$84.29 ,$361.00 ,$273.60 ,$277.40 ,$100.00 ,$323.00 ,$173.89 ,$100.00 ,$304.00 ,$277.40 ,$84.29 ,$173.89 ,$63.04 ,$380.00 ,$323.00 ,$391.26 ,$349.60 ,$266.00 ,$380.00 ,$380.00 ,$231.42 ,$380.00 ,$262.58 ,$266.00 ,$175.63 ,$273.60 ,$89.35 ,$228.00 ,$228.00 ,$173.89 ,$228.00 ,$173.89 ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,51000161,17110,HC DESTRUCT BENIGN LESION <15 FACIL,510,1 ,$150.00 ,$75.00 ,$63.04 ,$391.26 ,$96.90 ,$74.70 ,$126.00 ,$101.00 ,$173.89 ,$90.00 ,$127.50 ,$105.00 ,$74.70 ,$142.50 ,$108.00 ,$109.50 ,$100.00 ,$127.50 ,$173.89 ,$100.00 ,$120.00 ,$109.50 ,$74.70 ,$173.89 ,$63.04 ,$150.00 ,$127.50 ,$391.26 ,$138.00 ,$105.00 ,$150.00 ,$150.00 ,$91.35 ,$150.00 ,$103.65 ,$105.00 ,$175.63 ,$108.00 ,$79.18 ,$90.00 ,$90.00 ,$173.89 ,$90.00 ,$173.89 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,51000162,97597,HC AWC WITH CHEM CAUTERY,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000164,17250,HC CHEM CAUTERY/NWPT FACILITY,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$74.70 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$74.70 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$74.70 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$360.00 ,$360.00 ,$219.24 ,$360.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$79.18 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000169,17250,HC CHEM CAUTERY FACILITY,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$74.70 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$74.70 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$74.70 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$360.00 ,$360.00 ,$219.24 ,$360.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$79.18 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000170,97597,HC AWC>20SQCM/CAUT/UNNA FACIL,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000171,51701,HC CATH BLADDER NON-INDWELLING,510,1 ,$190.00 ,$95.00 ,$22.97 ,$243.95 ,$122.74 ,$22.97 ,$126.00 ,$101.00 ,$108.42 ,$114.00 ,$161.50 ,$133.00 ,$22.97 ,$180.50 ,$136.80 ,$138.70 ,$100.00 ,$161.50 ,$108.42 ,$100.00 ,$152.00 ,$138.70 ,$22.97 ,$108.42 ,$63.04 ,$190.00 ,$161.50 ,$243.95 ,$174.80 ,$133.00 ,$190.00 ,$190.00 ,$115.71 ,$190.00 ,$131.29 ,$133.00 ,$109.50 ,$136.80 ,$24.35 ,$114.00 ,$114.00 ,$108.42 ,$114.00 ,$108.42 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,51000172,51702,HC CATH BLADDER SMP,510,1 ,$190.00 ,$95.00 ,$22.97 ,$243.95 ,$122.74 ,$22.97 ,$126.00 ,$101.00 ,$108.42 ,$114.00 ,$161.50 ,$133.00 ,$22.97 ,$180.50 ,$136.80 ,$138.70 ,$100.00 ,$161.50 ,$108.42 ,$100.00 ,$152.00 ,$138.70 ,$22.97 ,$108.42 ,$63.04 ,$190.00 ,$161.50 ,$243.95 ,$174.80 ,$133.00 ,$190.00 ,$190.00 ,$115.71 ,$190.00 ,$131.29 ,$133.00 ,$109.50 ,$136.80 ,$24.35 ,$114.00 ,$114.00 ,$108.42 ,$114.00 ,$108.42 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,51000173,51703,HC CATH BLADDER CPLX,510,1 ,$340.00 ,$170.00 ,$22.97 ,$340.00 ,$219.64 ,$22.97 ,$126.00 ,$101.00 ,$135.15 ,$204.00 ,$289.00 ,$238.00 ,$22.97 ,$323.00 ,$244.80 ,$248.20 ,$100.00 ,$289.00 ,$135.15 ,$100.00 ,$272.00 ,$248.20 ,$22.97 ,$135.15 ,$63.04 ,$340.00 ,$289.00 ,$304.10 ,$312.80 ,$238.00 ,$340.00 ,$340.00 ,$207.06 ,$340.00 ,$234.94 ,$238.00 ,$136.50 ,$244.80 ,$24.35 ,$204.00 ,$204.00 ,$135.15 ,$204.00 ,$135.15 ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,51000174,99211,HC BLOOD DRAW NON DIALYSIS,510,1 ,$115.00 ,$57.50 ,$47.46 ,$115.00 ,$74.29 ,$47.46 ,$115.00 ,$101.00 , N/A ,$69.00 ,$97.75 ,$80.50 ,$47.46 ,$109.25 ,$82.80 ,$83.95 ,$100.00 ,$97.75 , N/A ,$100.00 ,$92.00 ,$83.95 ,$47.46 , N/A ,$63.04 ,$115.00 ,$97.75 , N/A ,$105.80 ,$80.50 ,$57.50 ,$69.00 ,$70.04 ,$57.50 ,$79.47 ,$80.50 , N/A ,$82.80 ,$50.31 ,$69.00 ,$69.00 , N/A ,$69.00 , N/A ,$82.80 ,$71.30 ,$82.80 ,$82.80 ,$69.00 ST VINCENT HOSPITAL - ACUTE,51000175,94780,HC CARSEAT ANALYSIS FIRST 60MIN,510,1 ,$190.00 ,$95.00 ,$21.41 ,$190.00 ,$122.74 ,$21.41 ,$126.00 ,$101.00 ,$32.77 ,$114.00 ,$161.50 ,$133.00 ,$21.41 ,$180.50 ,$136.80 ,$138.70 ,$100.00 ,$161.50 ,$32.77 ,$100.00 ,$152.00 ,$138.70 ,$21.41 ,$32.77 ,$63.04 ,$190.00 ,$161.50 ,$73.74 ,$174.80 ,$133.00 ,$95.00 ,$114.00 ,$115.71 ,$95.00 ,$131.29 ,$133.00 ,$33.10 ,$136.80 ,$22.69 ,$114.00 ,$114.00 ,$32.77 ,$114.00 ,$32.77 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,51000176,99213,HC CHANGE EXER ASSESS EVAL,510,1 ,$130.00 ,$65.00 ,$47.46 ,$130.00 ,$83.98 ,$47.46 ,$126.00 ,$101.00 , N/A ,$78.00 ,$110.50 ,$91.00 ,$47.46 ,$123.50 ,$93.60 ,$94.90 ,$100.00 ,$110.50 , N/A ,$100.00 ,$104.00 ,$94.90 ,$47.46 , N/A ,$63.04 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 , N/A ,$93.60 ,$50.31 ,$78.00 ,$78.00 , N/A ,$78.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,51000177,99214,HC CLINIC VISIT COMPLX EST CHR LUNG,510,1 ,$310.00 ,$155.00 ,$47.46 ,$310.00 ,$200.26 ,$47.46 ,$126.00 ,$101.00 , N/A ,$186.00 ,$263.50 ,$217.00 ,$47.46 ,$294.50 ,$223.20 ,$226.30 ,$100.00 ,$263.50 , N/A ,$100.00 ,$248.00 ,$226.30 ,$47.46 , N/A ,$63.04 ,$310.00 ,$263.50 , N/A ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 , N/A ,$223.20 ,$50.31 ,$186.00 ,$186.00 , N/A ,$186.00 , N/A ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,51000178,99214,HC CLINIC VISIT COMPLX EST GEN CONSULT,510,1 ,$310.00 ,$155.00 ,$47.46 ,$310.00 ,$200.26 ,$47.46 ,$126.00 ,$101.00 , N/A ,$186.00 ,$263.50 ,$217.00 ,$47.46 ,$294.50 ,$223.20 ,$226.30 ,$100.00 ,$263.50 , N/A ,$100.00 ,$248.00 ,$226.30 ,$47.46 , N/A ,$63.04 ,$310.00 ,$263.50 , N/A ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 , N/A ,$223.20 ,$50.31 ,$186.00 ,$186.00 , N/A ,$186.00 , N/A ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,51000182,99215,HC DRESSING CHANGE/ENEMA MAJOR,510,1 ,$390.00 ,$195.00 ,$47.46 ,$390.00 ,$251.94 ,$47.46 ,$126.00 ,$101.00 , N/A ,$234.00 ,$331.50 ,$273.00 ,$47.46 ,$370.50 ,$280.80 ,$284.70 ,$100.00 ,$331.50 , N/A ,$100.00 ,$312.00 ,$284.70 ,$47.46 , N/A ,$63.04 ,$390.00 ,$331.50 , N/A ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 , N/A ,$280.80 ,$50.31 ,$234.00 ,$234.00 , N/A ,$234.00 , N/A ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,51000184,99211,HC L AND D OUTPATIENT TREATMENT,510,1 ,$210.00 ,$105.00 ,$47.46 ,$210.00 ,$135.66 ,$47.46 ,$126.00 ,$101.00 , N/A ,$126.00 ,$178.50 ,$147.00 ,$47.46 ,$199.50 ,$151.20 ,$153.30 ,$100.00 ,$178.50 , N/A ,$100.00 ,$168.00 ,$153.30 ,$47.46 , N/A ,$63.04 ,$210.00 ,$178.50 , N/A ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 , N/A ,$151.20 ,$50.31 ,$126.00 ,$126.00 , N/A ,$126.00 , N/A ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,51000187,99212,HC LACTATION EST PAT-LIMITED,510,1 ,$230.00 ,$115.00 ,$47.46 ,$230.00 ,$148.58 ,$47.46 ,$126.00 ,$101.00 , N/A ,$138.00 ,$195.50 ,$161.00 ,$47.46 ,$218.50 ,$165.60 ,$167.90 ,$100.00 ,$195.50 , N/A ,$100.00 ,$184.00 ,$167.90 ,$47.46 , N/A ,$63.04 ,$230.00 ,$195.50 , N/A ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 , N/A ,$165.60 ,$50.31 ,$138.00 ,$138.00 , N/A ,$138.00 , N/A ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,51000188,99213,HC LACTATION EST PAT-INTERM,510,1 ,$280.00 ,$140.00 ,$47.46 ,$280.00 ,$180.88 ,$47.46 ,$126.00 ,$101.00 , N/A ,$168.00 ,$238.00 ,$196.00 ,$47.46 ,$266.00 ,$201.60 ,$204.40 ,$100.00 ,$238.00 , N/A ,$100.00 ,$224.00 ,$204.40 ,$47.46 , N/A ,$63.04 ,$280.00 ,$238.00 , N/A ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 , N/A ,$201.60 ,$50.31 ,$168.00 ,$168.00 , N/A ,$168.00 , N/A ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,51000189,99214,HC LACTATION EST PAT-COMPLEX,510,1 ,$310.00 ,$155.00 ,$47.46 ,$310.00 ,$200.26 ,$47.46 ,$126.00 ,$101.00 , N/A ,$186.00 ,$263.50 ,$217.00 ,$47.46 ,$294.50 ,$223.20 ,$226.30 ,$100.00 ,$263.50 , N/A ,$100.00 ,$248.00 ,$226.30 ,$47.46 , N/A ,$63.04 ,$310.00 ,$263.50 , N/A ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 , N/A ,$223.20 ,$50.31 ,$186.00 ,$186.00 , N/A ,$186.00 , N/A ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,51000190,99215,HC LACTATION EST PAT-COMPRH,510,1 ,$390.00 ,$195.00 ,$47.46 ,$390.00 ,$251.94 ,$47.46 ,$126.00 ,$101.00 , N/A ,$234.00 ,$331.50 ,$273.00 ,$47.46 ,$370.50 ,$280.80 ,$284.70 ,$100.00 ,$331.50 , N/A ,$100.00 ,$312.00 ,$284.70 ,$47.46 , N/A ,$63.04 ,$390.00 ,$331.50 , N/A ,$358.80 ,$273.00 ,$195.00 ,$234.00 ,$237.51 ,$195.00 ,$269.49 ,$273.00 , N/A ,$280.80 ,$50.31 ,$234.00 ,$234.00 , N/A ,$234.00 , N/A ,$280.80 ,$241.80 ,$280.80 ,$280.80 ,$234.00 ST VINCENT HOSPITAL - ACUTE,51000191,99211,HC OP SCHED DRESSING CHANGE,510,1 ,$220.00 ,$110.00 ,$47.46 ,$220.00 ,$142.12 ,$47.46 ,$126.00 ,$101.00 , N/A ,$132.00 ,$187.00 ,$154.00 ,$47.46 ,$209.00 ,$158.40 ,$160.60 ,$100.00 ,$187.00 , N/A ,$100.00 ,$176.00 ,$160.60 ,$47.46 , N/A ,$63.04 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 ,$50.31 ,$132.00 ,$132.00 , N/A ,$132.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,51000192,99212,HC PEG CHECK OR REMOVAL (NON INCISIONAL),510,1 ,$230.00 ,$115.00 ,$47.46 ,$230.00 ,$148.58 ,$47.46 ,$126.00 ,$101.00 , N/A ,$138.00 ,$195.50 ,$161.00 ,$47.46 ,$218.50 ,$165.60 ,$167.90 ,$100.00 ,$195.50 , N/A ,$100.00 ,$184.00 ,$167.90 ,$47.46 , N/A ,$63.04 ,$230.00 ,$195.50 , N/A ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 , N/A ,$165.60 ,$50.31 ,$138.00 ,$138.00 , N/A ,$138.00 , N/A ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,51000194,99203,HC TREATMENT ROOM MAJOR,510,1 ,$300.00 ,$150.00 ,$47.46 ,$300.00 ,$193.80 ,$47.46 ,$126.00 ,$101.00 , N/A ,$180.00 ,$255.00 ,$210.00 ,$47.46 ,$285.00 ,$216.00 ,$219.00 ,$100.00 ,$255.00 , N/A ,$100.00 ,$240.00 ,$219.00 ,$47.46 , N/A ,$63.04 ,$300.00 ,$255.00 , N/A ,$276.00 ,$210.00 ,$150.00 ,$180.00 ,$182.70 ,$150.00 ,$207.30 ,$210.00 , N/A ,$216.00 ,$50.31 ,$180.00 ,$180.00 , N/A ,$180.00 , N/A ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,51000198,29445,HC APPL/REMOVE CAST FACILITY,510,1 ,$620.00 ,$310.00 ,$57.61 ,$620.00 ,$400.52 ,$57.61 ,$126.00 ,$101.00 ,$233.57 ,$372.00 ,$527.00 ,$434.00 ,$57.61 ,$589.00 ,$446.40 ,$452.60 ,$100.00 ,$527.00 ,$233.57 ,$100.00 ,$496.00 ,$452.60 ,$57.61 ,$233.57 ,$63.04 ,$620.00 ,$527.00 ,$525.54 ,$570.40 ,$434.00 ,$620.00 ,$620.00 ,$377.58 ,$620.00 ,$428.42 ,$434.00 ,$235.91 ,$446.40 ,$61.07 ,$372.00 ,$372.00 ,$233.57 ,$372.00 ,$233.57 ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,51000201,29799,HC REMOVAL REVISION LEGCAST FACILITY,510,1 ,$290.00 ,$145.00 ,$21.22 ,$307.65 ,$187.34 ,$21.22 ,$126.00 ,$101.00 ,$136.73 ,$174.00 ,$246.50 ,$203.00 ,$21.22 ,$275.50 ,$208.80 ,$211.70 ,$100.00 ,$246.50 ,$136.73 ,$100.00 ,$232.00 ,$211.70 ,$21.22 ,$136.73 ,$63.04 ,$290.00 ,$246.50 ,$307.65 ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 ,$138.10 ,$208.80 ,$22.49 ,$174.00 ,$174.00 ,$136.73 ,$174.00 ,$136.73 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,51000207,52000,HC CYSTOURETHROSCOPY,510,1 ,"$1,500.00 ",$750.00 ,$63.04 ,"$1,500.00 ",$969.00 ,$444.48 ,$126.00 ,$101.00 ,$556.66 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$444.48 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$100.00 ,"$1,275.00 ",$556.66 ,$100.00 ,"$1,200.00 ","$1,095.00 ",$444.48 ,$556.66 ,$63.04 ,"$1,500.00 ","$1,275.00 ","$1,252.50 ","$1,380.00 ","$1,050.00 ","$1,500.00 ","$1,500.00 ",$913.50 ,"$1,500.00 ","$1,036.50 ","$1,050.00 ",$562.23 ,"$1,080.00 ",$471.15 ,$900.00 ,$900.00 ,$556.66 ,$900.00 ,$556.66 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,51000233,57500,HC BIOPSY/EXCISE CERVICAL LESION,510,1 ,"$1,100.00 ",$550.00 ,$63.04 ,"$1,380.28 ",$710.60 ,$152.54 ,$126.00 ,$101.00 ,$613.46 ,$660.00 ,$935.00 ,$770.00 ,$152.54 ,"$1,045.00 ",$792.00 ,$803.00 ,$100.00 ,$935.00 ,$613.46 ,$100.00 ,$880.00 ,$803.00 ,$152.54 ,$613.46 ,$63.04 ,"$1,100.00 ",$935.00 ,"$1,380.28 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$619.59 ,$792.00 ,$161.69 ,$660.00 ,$660.00 ,$613.46 ,$660.00 ,$613.46 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,51000315,38222,HC BM ASPIRATION (BX/ASP SAME SITE),360,1 ,"$1,300.00 ",$650.00 ,$350.23 ,"$5,164.55 ",$839.80 ,$350.23 ,"$1,300.00 ","$1,300.00 ","$2,295.35 ",$780.00 ,"$1,105.00 ",$910.00 ,$350.23 ,"$1,235.00 ",$936.00 ,$949.00 ,"$1,300.00 ","$1,105.00 ","$2,295.35 ","$1,300.00 ","$1,040.00 ",$949.00 ,$350.23 ,"$2,295.35 ","$1,300.00 ","$1,300.00 ","$1,105.00 ","$5,164.55 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,"$2,318.30 ",$936.00 ,$371.24 ,"$1,300.00 ","$1,300.00 ","$2,295.35 ","$1,300.00 ","$2,295.35 ",$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,51000320,94781,HC CARSEAT ANALYSIS EA ADDN 30MIN,510,1 ,$130.00 ,$65.00 ,$21.41 ,$130.00 ,$83.98 ,$21.41 ,$126.00 ,$101.00 , N/A ,$78.00 ,$110.50 ,$91.00 ,$21.41 ,$123.50 ,$93.60 ,$94.90 ,$100.00 ,$110.50 , N/A ,$100.00 ,$104.00 ,$94.90 ,$21.41 , N/A ,$63.04 ,$130.00 ,$110.50 , N/A ,$119.60 ,$91.00 ,$65.00 ,$78.00 ,$79.17 ,$65.00 ,$89.83 ,$91.00 , N/A ,$93.60 ,$22.69 ,$78.00 ,$78.00 , N/A ,$78.00 , N/A ,$93.60 ,$80.60 ,$93.60 ,$93.60 ,$78.00 ST VINCENT HOSPITAL - ACUTE,51000325,15271,HC APL SKIN SUB TAL<100 INT 25CM,761,1 ,"$1,200.00 ",$600.00 ,$504.00 ,"$3,737.98 ",$775.20 ,$552.66 ,"$1,200.00 ","$1,200.00 ","$1,661.33 ",$720.00 ,"$1,020.00 ",$840.00 ,$552.66 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ","$1,661.33 ","$1,200.00 ",$960.00 ,$876.00 ,$552.66 ,"$1,661.33 ",$504.00 ,"$1,200.00 ","$1,020.00 ","$3,737.98 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,"$1,677.94 ",$864.00 ,$585.82 ,$720.00 ,$720.00 ,"$1,661.33 ",$720.00 ,"$1,661.33 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,51000326,15272,HC APL SKIN SUB TAL<100 ADL 25CM,761,1 ,$370.00 ,$185.00 ,$155.40 ,$585.82 ,$239.02 ,$370.00 ,$370.00 ,$370.00 , N/A ,$222.00 ,$314.50 ,$259.00 ,$552.66 ,$351.50 ,$266.40 ,$270.10 ,$370.00 ,$314.50 , N/A ,$370.00 ,$296.00 ,$270.10 ,$552.66 , N/A ,$155.40 ,$370.00 ,$314.50 , N/A ,$340.40 ,$259.00 ,$370.00 ,$370.00 ,$225.33 ,$370.00 ,$255.67 ,$259.00 , N/A ,$266.40 ,$585.82 ,$222.00 ,$222.00 , N/A ,$222.00 , N/A ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,51000327,15273,HC APL SKIN SUB TAL>100 INT 100CM,761,1 ,"$1,300.00 ",$650.00 ,$546.00 ,"$7,675.21 ",$839.80 ,$552.66 ,"$1,300.00 ","$1,300.00 ","$3,411.20 ",$780.00 ,"$1,105.00 ",$910.00 ,$552.66 ,"$1,235.00 ",$936.00 ,$949.00 ,"$1,300.00 ","$1,105.00 ","$3,411.20 ","$1,300.00 ","$1,040.00 ",$949.00 ,$552.66 ,"$3,411.20 ",$546.00 ,"$1,300.00 ","$1,105.00 ","$7,675.21 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,"$3,445.31 ",$936.00 ,$585.82 ,$780.00 ,$780.00 ,"$3,411.20 ",$780.00 ,"$3,411.20 ",$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,51000328,15274,HC APL SKIN SUB TAL>100 ADL 100CM,761,1 ,$690.00 ,$345.00 ,$289.80 ,$690.00 ,$445.74 ,$552.66 ,$690.00 ,$690.00 , N/A ,$414.00 ,$586.50 ,$483.00 ,$552.66 ,$655.50 ,$496.80 ,$503.70 ,$690.00 ,$586.50 , N/A ,$690.00 ,$552.00 ,$503.70 ,$552.66 , N/A ,$289.80 ,$690.00 ,$586.50 , N/A ,$634.80 ,$483.00 ,$690.00 ,$690.00 ,$420.21 ,$690.00 ,$476.79 ,$483.00 , N/A ,$496.80 ,$585.82 ,$414.00 ,$414.00 , N/A ,$414.00 , N/A ,$496.80 ,$427.80 ,$496.80 ,$496.80 ,$414.00 ST VINCENT HOSPITAL - ACUTE,51000329,15275,HC APL SKIN SUB OTH<100 INT 25CM,761,1 ,"$1,200.00 ",$600.00 ,$504.00 ,"$3,737.98 ",$775.20 ,$552.66 ,"$1,200.00 ","$1,200.00 ","$1,661.33 ",$720.00 ,"$1,020.00 ",$840.00 ,$552.66 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ","$1,661.33 ","$1,200.00 ",$960.00 ,$876.00 ,$552.66 ,"$1,661.33 ",$504.00 ,"$1,200.00 ","$1,020.00 ","$3,737.98 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,"$1,677.94 ",$864.00 ,$585.82 ,$720.00 ,$720.00 ,"$1,661.33 ",$720.00 ,"$1,661.33 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,51000330,15276,HC APL SKIN SUB OTH<100 ADL 25CM,761,1 ,$350.00 ,$175.00 ,$147.00 ,$585.82 ,$226.10 ,$350.00 ,$350.00 ,$350.00 , N/A ,$210.00 ,$297.50 ,$245.00 ,$552.66 ,$332.50 ,$252.00 ,$255.50 ,$350.00 ,$297.50 , N/A ,$350.00 ,$280.00 ,$255.50 ,$552.66 , N/A ,$147.00 ,$350.00 ,$297.50 , N/A ,$322.00 ,$245.00 ,$350.00 ,$350.00 ,$213.15 ,$350.00 ,$241.85 ,$245.00 , N/A ,$252.00 ,$585.82 ,$210.00 ,$210.00 , N/A ,$210.00 , N/A ,$252.00 ,$217.00 ,$252.00 ,$252.00 ,$210.00 ST VINCENT HOSPITAL - ACUTE,51000331,15277,HC APL SKIN SUB OTH>100 INT 100CM,761,1 ,"$1,000.00 ",$500.00 ,$420.00 ,"$3,737.98 ",$646.00 ,$552.66 ,"$1,000.00 ","$1,000.00 ","$1,661.33 ",$600.00 ,$850.00 ,$700.00 ,$552.66 ,$950.00 ,$720.00 ,$730.00 ,"$1,000.00 ",$850.00 ,"$1,661.33 ","$1,000.00 ",$800.00 ,$730.00 ,$552.66 ,"$1,661.33 ",$420.00 ,"$1,000.00 ",$850.00 ,"$3,737.98 ",$920.00 ,$700.00 ,"$1,000.00 ","$1,000.00 ",$609.00 ,"$1,000.00 ",$691.00 ,$700.00 ,"$1,677.94 ",$720.00 ,$585.82 ,$600.00 ,$600.00 ,"$1,661.33 ",$600.00 ,"$1,661.33 ",$720.00 ,$620.00 ,$720.00 ,$720.00 ,$600.00 ST VINCENT HOSPITAL - ACUTE,51000332,15278,HC APL SKIN SUB OTH>100 ADL 100CM,761,1 ,$850.00 ,$425.00 ,$357.00 ,$850.00 ,$549.10 ,$552.66 ,$850.00 ,$850.00 , N/A ,$510.00 ,$722.50 ,$595.00 ,$552.66 ,$807.50 ,$612.00 ,$620.50 ,$850.00 ,$722.50 , N/A ,$850.00 ,$680.00 ,$620.50 ,$552.66 , N/A ,$357.00 ,$850.00 ,$722.50 , N/A ,$782.00 ,$595.00 ,$850.00 ,$850.00 ,$517.65 ,$850.00 ,$587.35 ,$595.00 , N/A ,$612.00 ,$585.82 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,51000333,15271,HC APL SKIN SUB TAL<100 INT 25CM W/PROC,761,1 ,"$1,200.00 ",$600.00 ,$504.00 ,"$3,737.98 ",$775.20 ,$552.66 ,"$1,200.00 ","$1,200.00 ","$1,661.33 ",$720.00 ,"$1,020.00 ",$840.00 ,$552.66 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ","$1,661.33 ","$1,200.00 ",$960.00 ,$876.00 ,$552.66 ,"$1,661.33 ",$504.00 ,"$1,200.00 ","$1,020.00 ","$3,737.98 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,"$1,677.94 ",$864.00 ,$585.82 ,$720.00 ,$720.00 ,"$1,661.33 ",$720.00 ,"$1,661.33 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,51000334,15273,HC APL SKIN SUB TAL>100 INT 100CM W/PROC,761,1 ,"$1,300.00 ",$650.00 ,$546.00 ,"$7,675.21 ",$839.80 ,$552.66 ,"$1,300.00 ","$1,300.00 ","$3,411.20 ",$780.00 ,"$1,105.00 ",$910.00 ,$552.66 ,"$1,235.00 ",$936.00 ,$949.00 ,"$1,300.00 ","$1,105.00 ","$3,411.20 ","$1,300.00 ","$1,040.00 ",$949.00 ,$552.66 ,"$3,411.20 ",$546.00 ,"$1,300.00 ","$1,105.00 ","$7,675.21 ","$1,196.00 ",$910.00 ,"$1,300.00 ","$1,300.00 ",$791.70 ,"$1,300.00 ",$898.30 ,$910.00 ,"$3,445.31 ",$936.00 ,$585.82 ,$780.00 ,$780.00 ,"$3,411.20 ",$780.00 ,"$3,411.20 ",$936.00 ,$806.00 ,$936.00 ,$936.00 ,$780.00 ST VINCENT HOSPITAL - ACUTE,51000335,15275,HC APL SKIN SUB OTH<100 INT 25CM W/PROC,761,1 ,"$1,200.00 ",$600.00 ,$504.00 ,"$3,737.98 ",$775.20 ,$552.66 ,"$1,200.00 ","$1,200.00 ","$1,661.33 ",$720.00 ,"$1,020.00 ",$840.00 ,$552.66 ,"$1,140.00 ",$864.00 ,$876.00 ,"$1,200.00 ","$1,020.00 ","$1,661.33 ","$1,200.00 ",$960.00 ,$876.00 ,$552.66 ,"$1,661.33 ",$504.00 ,"$1,200.00 ","$1,020.00 ","$3,737.98 ","$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,"$1,677.94 ",$864.00 ,$585.82 ,$720.00 ,$720.00 ,"$1,661.33 ",$720.00 ,"$1,661.33 ",$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,51000336,15277,HC APL SKIN SUB OTH>100 INT 100CM W/PROC,761,1 ,$950.00 ,$475.00 ,$399.00 ,"$3,737.98 ",$613.70 ,$552.66 ,$950.00 ,$950.00 ,"$1,661.33 ",$570.00 ,$807.50 ,$665.00 ,$552.66 ,$902.50 ,$684.00 ,$693.50 ,$950.00 ,$807.50 ,"$1,661.33 ",$950.00 ,$760.00 ,$693.50 ,$552.66 ,"$1,661.33 ",$399.00 ,$950.00 ,$807.50 ,"$3,737.98 ",$874.00 ,$665.00 ,$950.00 ,$950.00 ,$578.55 ,$950.00 ,$656.45 ,$665.00 ,"$1,677.94 ",$684.00 ,$585.82 ,$570.00 ,$570.00 ,"$1,661.33 ",$570.00 ,"$1,661.33 ",$684.00 ,$589.00 ,$684.00 ,$684.00 ,$570.00 ST VINCENT HOSPITAL - ACUTE,51000348,16025,HC BURN DRESS/DEB 5-10% TOTAL FACIL,761,1 ,$410.00 ,$205.00 ,$84.29 ,$410.00 ,$264.86 ,$84.29 ,$410.00 ,$410.00 ,$173.89 ,$246.00 ,$348.50 ,$287.00 ,$84.29 ,$389.50 ,$295.20 ,$299.30 ,$410.00 ,$348.50 ,$173.89 ,$410.00 ,$328.00 ,$299.30 ,$84.29 ,$173.89 ,$172.20 ,$410.00 ,$348.50 ,$391.26 ,$377.20 ,$287.00 ,$410.00 ,$410.00 ,$249.69 ,$410.00 ,$283.31 ,$287.00 ,$175.63 ,$295.20 ,$89.35 ,$246.00 ,$246.00 ,$173.89 ,$246.00 ,$173.89 ,$295.20 ,$254.20 ,$295.20 ,$295.20 ,$246.00 ST VINCENT HOSPITAL - ACUTE,51000350,16030,HC BURN DRESS AND /OR DEBRID >10% FACIL,761,1 ,$540.00 ,$270.00 ,$107.54 ,$753.63 ,$348.84 ,$107.54 ,$540.00 ,$540.00 ,$334.95 ,$324.00 ,$459.00 ,$378.00 ,$107.54 ,$513.00 ,$388.80 ,$394.20 ,$540.00 ,$459.00 ,$334.95 ,$540.00 ,$432.00 ,$394.20 ,$107.54 ,$334.95 ,$226.80 ,$540.00 ,$459.00 ,$753.63 ,$496.80 ,$378.00 ,$540.00 ,$540.00 ,$328.86 ,$540.00 ,$373.14 ,$378.00 ,$338.30 ,$388.80 ,$113.99 ,$324.00 ,$324.00 ,$334.95 ,$324.00 ,$334.95 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,51000352,11057,HC PARING LESN BENIGN >4 FAC,510,1 ,$230.00 ,$115.00 ,$63.04 ,$391.26 ,$148.58 ,$74.70 ,$126.00 ,$101.00 ,$173.89 ,$138.00 ,$195.50 ,$161.00 ,$74.70 ,$218.50 ,$165.60 ,$167.90 ,$100.00 ,$195.50 ,$173.89 ,$100.00 ,$184.00 ,$167.90 ,$74.70 ,$173.89 ,$63.04 ,$230.00 ,$195.50 ,$391.26 ,$211.60 ,$161.00 ,$230.00 ,$230.00 ,$140.07 ,$230.00 ,$158.93 ,$161.00 ,$175.63 ,$165.60 ,$79.18 ,$138.00 ,$138.00 ,$173.89 ,$138.00 ,$173.89 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,51000400,29580,HC APPLY UNNA BOOT BILAT FAC,510,1 ,$460.00 ,$230.00 ,$63.04 ,$461.47 ,$297.16 ,$86.42 ,$126.00 ,$101.00 ,$205.10 ,$276.00 ,$391.00 ,$322.00 ,$86.42 ,$437.00 ,$331.20 ,$335.80 ,$100.00 ,$391.00 ,$205.10 ,$100.00 ,$368.00 ,$335.80 ,$86.42 ,$205.10 ,$63.04 ,$460.00 ,$391.00 ,$461.47 ,$423.20 ,$322.00 ,$460.00 ,$460.00 ,$280.14 ,$460.00 ,$317.86 ,$322.00 ,$207.15 ,$331.20 ,$91.61 ,$276.00 ,$276.00 ,$205.10 ,$276.00 ,$205.10 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,51000401,29581,HC APPLY MULTI COMP LWR LEG BIL FAC,510,1 ,$480.00 ,$240.00 ,$63.04 ,$480.00 ,$310.08 ,$86.42 ,$126.00 ,$101.00 ,$205.10 ,$288.00 ,$408.00 ,$336.00 ,$86.42 ,$456.00 ,$345.60 ,$350.40 ,$100.00 ,$408.00 ,$205.10 ,$100.00 ,$384.00 ,$350.40 ,$86.42 ,$205.10 ,$63.04 ,$480.00 ,$408.00 ,$461.47 ,$441.60 ,$336.00 ,$480.00 ,$480.00 ,$292.32 ,$480.00 ,$331.68 ,$336.00 ,$207.15 ,$345.60 ,$91.61 ,$288.00 ,$288.00 ,$205.10 ,$288.00 ,$205.10 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,51000401,29581,HC APPLY MULTI COMP LWR LEG BIL FAC,510,1 ,$320.00 ,$160.00 ,$63.04 ,$461.47 ,$206.72 ,$86.42 ,$126.00 ,$101.00 ,$205.10 ,$192.00 ,$272.00 ,$224.00 ,$86.42 ,$304.00 ,$230.40 ,$233.60 ,$100.00 ,$272.00 ,$205.10 ,$100.00 ,$256.00 ,$233.60 ,$86.42 ,$205.10 ,$63.04 ,$320.00 ,$272.00 ,$461.47 ,$294.40 ,$224.00 ,$320.00 ,$320.00 ,$194.88 ,$320.00 ,$221.12 ,$224.00 ,$207.15 ,$230.40 ,$91.61 ,$192.00 ,$192.00 ,$205.10 ,$192.00 ,$205.10 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,51000407,11200,HC REMOVAL SKIN TAG LESIONS <=15 FAC,510,1 ,$250.00 ,$125.00 ,$63.04 ,$391.26 ,$161.50 ,$74.70 ,$126.00 ,$101.00 ,$173.89 ,$150.00 ,$212.50 ,$175.00 ,$74.70 ,$237.50 ,$180.00 ,$182.50 ,$100.00 ,$212.50 ,$173.89 ,$100.00 ,$200.00 ,$182.50 ,$74.70 ,$173.89 ,$63.04 ,$250.00 ,$212.50 ,$391.26 ,$230.00 ,$175.00 ,$250.00 ,$250.00 ,$152.25 ,$250.00 ,$172.75 ,$175.00 ,$175.63 ,$180.00 ,$79.18 ,$150.00 ,$150.00 ,$173.89 ,$150.00 ,$173.89 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,51000414,10140,HC I AND D HEMATOMA/SEROMA/FLUID BIL UNNA FAC,510,1 ,"$1,345.00 ",$672.50 ,$63.04 ,"$3,066.03 ",$868.87 ,$325.66 ,$126.00 ,$101.00 ,"$1,362.68 ",$807.00 ,"$1,143.25 ",$941.50 ,$325.66 ,"$1,277.75 ",$968.40 ,$981.85 ,$100.00 ,"$1,143.25 ","$1,362.68 ",$100.00 ,"$1,076.00 ",$981.85 ,$325.66 ,"$1,362.68 ",$63.04 ,"$1,345.00 ","$1,143.25 ","$3,066.03 ","$1,237.40 ",$941.50 ,"$1,345.00 ","$1,345.00 ",$819.11 ,"$1,345.00 ",$929.40 ,$941.50 ,"$1,376.31 ",$968.40 ,$345.20 ,$807.00 ,$807.00 ,"$1,362.68 ",$807.00 ,"$1,362.68 ",$968.40 ,$833.90 ,$968.40 ,$968.40 ,$807.00 ST VINCENT HOSPITAL - ACUTE,51000419,97597,HC AWC/CHEM CAUTERY/CAST FACIL,761,1 ,$330.00 ,$165.00 ,$107.54 ,$391.26 ,$213.18 ,$107.54 ,$330.00 ,$330.00 ,$173.89 ,$198.00 ,$280.50 ,$231.00 ,$107.54 ,$313.50 ,$237.60 ,$240.90 ,$330.00 ,$280.50 ,$173.89 ,$330.00 ,$264.00 ,$240.90 ,$107.54 ,$173.89 ,$138.60 ,$330.00 ,$280.50 ,$391.26 ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 ,$175.63 ,$237.60 ,$113.99 ,$198.00 ,$198.00 ,$173.89 ,$198.00 ,$173.89 ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,51000420,10140,HC I AND D HEMATOMA/SEROMA/FLUID/WRAP FACIL,761,1 ,"$1,345.00 ",$672.50 ,$325.66 ,"$3,066.03 ",$868.87 ,$325.66 ,"$1,345.00 ","$1,345.00 ","$1,362.68 ",$807.00 ,"$1,143.25 ",$941.50 ,$325.66 ,"$1,277.75 ",$968.40 ,$981.85 ,"$1,345.00 ","$1,143.25 ","$1,362.68 ","$1,345.00 ","$1,076.00 ",$981.85 ,$325.66 ,"$1,362.68 ",$564.90 ,"$1,345.00 ","$1,143.25 ","$3,066.03 ","$1,237.40 ",$941.50 ,"$1,345.00 ","$1,345.00 ",$819.11 ,"$1,345.00 ",$929.40 ,$941.50 ,"$1,376.31 ",$968.40 ,$345.20 ,$807.00 ,$807.00 ,"$1,362.68 ",$807.00 ,"$1,362.68 ",$968.40 ,$833.90 ,$968.40 ,$968.40 ,$807.00 ST VINCENT HOSPITAL - ACUTE,51000421,97597,HC AWC/CHEM CAUTERY/WRAP FACIL,761,1 ,$360.00 ,$180.00 ,$107.54 ,$391.26 ,$232.56 ,$107.54 ,$360.00 ,$360.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$360.00 ,$306.00 ,$173.89 ,$360.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$151.20 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000424,97597,HC DEBR SKIN INTL 20CM/BIOPSY FAC,510,1 ,$360.00 ,$180.00 ,$63.04 ,$391.26 ,$232.56 ,$107.54 ,$126.00 ,$101.00 ,$173.89 ,$216.00 ,$306.00 ,$252.00 ,$107.54 ,$342.00 ,$259.20 ,$262.80 ,$100.00 ,$306.00 ,$173.89 ,$100.00 ,$288.00 ,$262.80 ,$107.54 ,$173.89 ,$63.04 ,$360.00 ,$306.00 ,$391.26 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$175.63 ,$259.20 ,$113.99 ,$216.00 ,$216.00 ,$173.89 ,$216.00 ,$173.89 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,51000425,15110,HC EPIDRM A-GRFT TRNK/ARM/LEG CM,510,1 ,"$2,400.00 ","$1,200.00 ",$63.04 ,"$3,737.98 ","$1,550.40 ",$552.66 ,$126.00 ,$101.00 ,"$1,661.33 ","$1,440.00 ","$2,040.00 ","$1,680.00 ",$552.66 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ",$100.00 ,"$2,040.00 ","$1,661.33 ",$100.00 ,"$1,920.00 ","$1,752.00 ",$552.66 ,"$1,661.33 ",$63.04 ,"$2,400.00 ","$2,040.00 ","$3,737.98 ","$2,208.00 ","$1,680.00 ","$2,331.31 ","$2,400.00 ","$1,461.60 ","$2,400.00 ","$1,658.40 ","$1,680.00 ","$1,677.94 ","$1,728.00 ",$585.82 ,"$1,440.00 ","$1,440.00 ","$1,661.33 ","$1,440.00 ","$1,661.33 ","$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,51000426,15115,HC EPIDRM A-GRFT FACE/NCK/HF/G,510,1 ,"$1,800.00 ",$900.00 ,$63.04 ,"$3,737.98 ","$1,162.80 ",$552.66 ,$126.00 ,$101.00 ,"$1,661.33 ","$1,080.00 ","$1,530.00 ","$1,260.00 ",$552.66 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ",$100.00 ,"$1,530.00 ","$1,661.33 ",$100.00 ,"$1,440.00 ","$1,314.00 ",$552.66 ,"$1,661.33 ",$63.04 ,"$1,800.00 ","$1,530.00 ","$3,737.98 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ","$1,677.94 ","$1,296.00 ",$585.82 ,"$1,080.00 ","$1,080.00 ","$1,661.33 ","$1,080.00 ","$1,661.33 ","$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,51000427,17999,HC UNLISTED SKIN TISSUE PROCEDURE,510,1 ,$195.00 ,$97.50 ,$63.04 ,$391.26 ,$125.97 ,$74.70 ,$126.00 ,$101.00 ,$173.89 ,$117.00 ,$165.75 ,$136.50 ,$74.70 ,$185.25 ,$140.40 ,$142.35 ,$100.00 ,$165.75 ,$173.89 ,$100.00 ,$156.00 ,$142.35 ,$74.70 ,$173.89 ,$63.04 ,$195.00 ,$165.75 ,$391.26 ,$179.40 ,$136.50 ,$97.50 ,$117.00 ,$118.76 ,$97.50 ,$134.75 ,$136.50 ,$175.63 ,$140.40 ,$79.18 ,$117.00 ,$117.00 ,$173.89 ,$117.00 ,$173.89 ,$140.40 ,$120.90 ,$140.40 ,$140.40 ,$117.00 ST VINCENT HOSPITAL - ACUTE,51000428,15111,HC EPIDRM A-GRFT TRNK/ARM/LEG CM ADDN 100,510,1 ,$195.00 ,$97.50 ,$63.04 ,$585.82 ,$125.97 ,$195.00 ,$126.00 ,$101.00 , N/A ,$117.00 ,$165.75 ,$136.50 ,$552.66 ,$185.25 ,$140.40 ,$142.35 ,$100.00 ,$165.75 , N/A ,$100.00 ,$156.00 ,$142.35 ,$552.66 , N/A ,$63.04 ,$195.00 ,$165.75 , N/A ,$179.40 ,$136.50 ,$195.00 ,$195.00 ,$118.76 ,$195.00 ,$134.75 ,$136.50 , N/A ,$140.40 ,$585.82 ,$117.00 ,$117.00 , N/A ,$117.00 , N/A ,$140.40 ,$120.90 ,$140.40 ,$140.40 ,$117.00 ST VINCENT HOSPITAL - ACUTE,51000429,15116,HC EPIDRM A-GRFT FACE/NCK/HF/G CM ADDN 100,510,1 ,$195.00 ,$97.50 ,$63.04 ,$585.82 ,$125.97 ,$195.00 ,$126.00 ,$101.00 , N/A ,$117.00 ,$165.75 ,$136.50 ,$552.66 ,$185.25 ,$140.40 ,$142.35 ,$100.00 ,$165.75 , N/A ,$100.00 ,$156.00 ,$142.35 ,$552.66 , N/A ,$63.04 ,$195.00 ,$165.75 , N/A ,$179.40 ,$136.50 ,$195.00 ,$195.00 ,$118.76 ,$195.00 ,$134.75 ,$136.50 , N/A ,$140.40 ,$585.82 ,$117.00 ,$117.00 , N/A ,$117.00 , N/A ,$140.40 ,$120.90 ,$140.40 ,$140.40 ,$117.00 ST VINCENT HOSPITAL - ACUTE,51000430,15110,HC EPIDRM A-GRFT TRNK ARMS LEGS FIRST 100CM W/PROC,510,1 ,"$2,800.00 ","$1,400.00 ",$63.04 ,"$3,737.98 ","$1,808.80 ",$552.66 ,$126.00 ,$101.00 ,"$1,661.33 ","$1,680.00 ","$2,380.00 ","$1,960.00 ",$552.66 ,"$2,660.00 ","$2,016.00 ","$2,044.00 ",$100.00 ,"$2,380.00 ","$1,661.33 ",$100.00 ,"$2,240.00 ","$2,044.00 ",$552.66 ,"$1,661.33 ",$63.04 ,"$2,800.00 ","$2,380.00 ","$3,737.98 ","$2,576.00 ","$1,960.00 ","$2,331.31 ","$2,800.00 ","$1,705.20 ","$2,800.00 ","$1,934.80 ","$1,960.00 ","$1,677.94 ","$2,016.00 ",$585.82 ,"$1,680.00 ","$1,680.00 ","$1,661.33 ","$1,680.00 ","$1,661.33 ","$2,016.00 ","$1,736.00 ","$2,016.00 ","$2,016.00 ","$1,680.00 " ST VINCENT HOSPITAL - ACUTE,51000431,15115,HC EPIDRM A-GRFT FACE SCLP HAND ETC FIRST 100CM W/PROC,510,1 ,"$1,800.00 ",$900.00 ,$63.04 ,"$3,737.98 ","$1,162.80 ",$552.66 ,$126.00 ,$101.00 ,"$1,661.33 ","$1,080.00 ","$1,530.00 ","$1,260.00 ",$552.66 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ",$100.00 ,"$1,530.00 ","$1,661.33 ",$100.00 ,"$1,440.00 ","$1,314.00 ",$552.66 ,"$1,661.33 ",$63.04 ,"$1,800.00 ","$1,530.00 ","$3,737.98 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ","$1,677.94 ","$1,296.00 ",$585.82 ,"$1,080.00 ","$1,080.00 ","$1,661.33 ","$1,080.00 ","$1,661.33 ","$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,51000450,C5271,HC APL SKIN SUB TAL<100 INT 25CM LOW,510,1 ,$785.00 ,$392.50 ,$63.04 ,"$1,142.23 ",$507.11 ,$552.66 ,$126.00 ,$101.00 ,$507.66 ,$471.00 ,$667.25 ,$549.50 ,$552.66 ,$745.75 ,$565.20 ,$573.05 ,$100.00 ,$667.25 ,$507.66 ,$100.00 ,$628.00 ,$573.05 ,$552.66 ,$507.66 ,$63.04 ,$785.00 ,$667.25 ,"$1,142.23 ",$722.20 ,$549.50 ,$392.50 ,$471.00 ,$478.07 ,$392.50 ,$542.44 ,$549.50 ,$512.74 ,$565.20 ,$585.82 ,$471.00 ,$471.00 ,$507.66 ,$471.00 ,$507.66 ,$565.20 ,$486.70 ,$565.20 ,$565.20 ,$471.00 ST VINCENT HOSPITAL - ACUTE,51000451,C5271,HC APL SKIN SUB TAL<100 INT 25CM W/PROC LOW,510,1 ,$785.00 ,$392.50 ,$63.04 ,"$1,142.23 ",$507.11 ,$552.66 ,$126.00 ,$101.00 ,$507.66 ,$471.00 ,$667.25 ,$549.50 ,$552.66 ,$745.75 ,$565.20 ,$573.05 ,$100.00 ,$667.25 ,$507.66 ,$100.00 ,$628.00 ,$573.05 ,$552.66 ,$507.66 ,$63.04 ,$785.00 ,$667.25 ,"$1,142.23 ",$722.20 ,$549.50 ,$392.50 ,$471.00 ,$478.07 ,$392.50 ,$542.44 ,$549.50 ,$512.74 ,$565.20 ,$585.82 ,$471.00 ,$471.00 ,$507.66 ,$471.00 ,$507.66 ,$565.20 ,$486.70 ,$565.20 ,$565.20 ,$471.00 ST VINCENT HOSPITAL - ACUTE,51000452,C5272,HC APL SKIN SUB TAL<100 ADL 25CM LOW,510,1 ,$345.00 ,$172.50 ,$63.04 ,$585.82 ,$222.87 ,$345.00 ,$126.00 ,$101.00 , N/A ,$207.00 ,$293.25 ,$241.50 ,$552.66 ,$327.75 ,$248.40 ,$251.85 ,$100.00 ,$293.25 , N/A ,$100.00 ,$276.00 ,$251.85 ,$552.66 , N/A ,$63.04 ,$345.00 ,$293.25 , N/A ,$317.40 ,$241.50 ,$172.50 ,$207.00 ,$210.11 ,$172.50 ,$238.40 ,$241.50 , N/A ,$248.40 ,$585.82 ,$207.00 ,$207.00 , N/A ,$207.00 , N/A ,$248.40 ,$213.90 ,$248.40 ,$248.40 ,$207.00 ST VINCENT HOSPITAL - ACUTE,51000453,C5273,HC APL SKIN SUB TAL>100 INT 100CM LOW,510,1 ,"$1,045.00 ",$522.50 ,$63.04 ,"$3,737.98 ",$675.07 ,$552.66 ,$126.00 ,$101.00 ,"$1,661.33 ",$627.00 ,$888.25 ,$731.50 ,$552.66 ,$992.75 ,$752.40 ,$762.85 ,$100.00 ,$888.25 ,"$1,661.33 ",$100.00 ,$836.00 ,$762.85 ,$552.66 ,"$1,661.33 ",$63.04 ,"$1,045.00 ",$888.25 ,"$3,737.98 ",$961.40 ,$731.50 ,$522.50 ,$627.00 ,$636.41 ,$522.50 ,$722.10 ,$731.50 ,"$1,677.94 ",$752.40 ,$585.82 ,$627.00 ,$627.00 ,"$1,661.33 ",$627.00 ,"$1,661.33 ",$752.40 ,$647.90 ,$752.40 ,$752.40 ,$627.00 ST VINCENT HOSPITAL - ACUTE,51000454,C5273,HC APL SKIN SUB TAL>100 INT 100CM W/PROC LOW,510,1 ,"$1,045.00 ",$522.50 ,$63.04 ,"$3,737.98 ",$675.07 ,$552.66 ,$126.00 ,$101.00 ,"$1,661.33 ",$627.00 ,$888.25 ,$731.50 ,$552.66 ,$992.75 ,$752.40 ,$762.85 ,$100.00 ,$888.25 ,"$1,661.33 ",$100.00 ,$836.00 ,$762.85 ,$552.66 ,"$1,661.33 ",$63.04 ,"$1,045.00 ",$888.25 ,"$3,737.98 ",$961.40 ,$731.50 ,$522.50 ,$627.00 ,$636.41 ,$522.50 ,$722.10 ,$731.50 ,"$1,677.94 ",$752.40 ,$585.82 ,$627.00 ,$627.00 ,"$1,661.33 ",$627.00 ,"$1,661.33 ",$752.40 ,$647.90 ,$752.40 ,$752.40 ,$627.00 ST VINCENT HOSPITAL - ACUTE,51000455,C5274,HC APL SKIN SUB TAL>100 ADL 100CM LOW,510,1 ,$624.00 ,$312.00 ,$63.04 ,$624.00 ,$403.10 ,$552.66 ,$126.00 ,$101.00 , N/A ,$374.40 ,$530.40 ,$436.80 ,$552.66 ,$592.80 ,$449.28 ,$455.52 ,$100.00 ,$530.40 , N/A ,$100.00 ,$499.20 ,$455.52 ,$552.66 , N/A ,$63.04 ,$624.00 ,$530.40 , N/A ,$574.08 ,$436.80 ,$312.00 ,$374.40 ,$380.02 ,$312.00 ,$431.18 ,$436.80 , N/A ,$449.28 ,$585.82 ,$374.40 ,$374.40 , N/A ,$374.40 , N/A ,$449.28 ,$386.88 ,$449.28 ,$449.28 ,$374.40 ST VINCENT HOSPITAL - ACUTE,51000456,C5275,HC APL SKIN SUB OTH<100 INT 25CM LOW,510,1 ,$790.00 ,$395.00 ,$63.04 ,"$1,142.23 ",$510.34 ,$552.66 ,$126.00 ,$101.00 ,$507.66 ,$474.00 ,$671.50 ,$553.00 ,$552.66 ,$750.50 ,$568.80 ,$576.70 ,$100.00 ,$671.50 ,$507.66 ,$100.00 ,$632.00 ,$576.70 ,$552.66 ,$507.66 ,$63.04 ,$790.00 ,$671.50 ,"$1,142.23 ",$726.80 ,$553.00 ,$395.00 ,$474.00 ,$481.11 ,$395.00 ,$545.89 ,$553.00 ,$512.74 ,$568.80 ,$585.82 ,$474.00 ,$474.00 ,$507.66 ,$474.00 ,$507.66 ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,51000457,C5275,HC APL SKIN SUB OTH<100 INT 25CM W/PROC LOW,510,1 ,$790.00 ,$395.00 ,$63.04 ,"$1,142.23 ",$510.34 ,$552.66 ,$126.00 ,$101.00 ,$507.66 ,$474.00 ,$671.50 ,$553.00 ,$552.66 ,$750.50 ,$568.80 ,$576.70 ,$100.00 ,$671.50 ,$507.66 ,$100.00 ,$632.00 ,$576.70 ,$552.66 ,$507.66 ,$63.04 ,$790.00 ,$671.50 ,"$1,142.23 ",$726.80 ,$553.00 ,$395.00 ,$474.00 ,$481.11 ,$395.00 ,$545.89 ,$553.00 ,$512.74 ,$568.80 ,$585.82 ,$474.00 ,$474.00 ,$507.66 ,$474.00 ,$507.66 ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,51000458,C5276,HC APL SKIN SUB OTH<100 ADL 25CM LOW,510,1 ,$310.00 ,$155.00 ,$63.04 ,$585.82 ,$200.26 ,$310.00 ,$126.00 ,$101.00 , N/A ,$186.00 ,$263.50 ,$217.00 ,$552.66 ,$294.50 ,$223.20 ,$226.30 ,$100.00 ,$263.50 , N/A ,$100.00 ,$248.00 ,$226.30 ,$552.66 , N/A ,$63.04 ,$310.00 ,$263.50 , N/A ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 , N/A ,$223.20 ,$585.82 ,$186.00 ,$186.00 , N/A ,$186.00 , N/A ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,51000459,C5277,HC APL SKIN SUB OTH>100 INT 100CM LOW,510,1 ,$875.00 ,$437.50 ,$63.04 ,"$1,142.23 ",$565.25 ,$552.66 ,$126.00 ,$101.00 ,$507.66 ,$525.00 ,$743.75 ,$612.50 ,$552.66 ,$831.25 ,$630.00 ,$638.75 ,$100.00 ,$743.75 ,$507.66 ,$100.00 ,$700.00 ,$638.75 ,$552.66 ,$507.66 ,$63.04 ,$875.00 ,$743.75 ,"$1,142.23 ",$805.00 ,$612.50 ,$437.50 ,$525.00 ,$532.88 ,$437.50 ,$604.63 ,$612.50 ,$512.74 ,$630.00 ,$585.82 ,$525.00 ,$525.00 ,$507.66 ,$525.00 ,$507.66 ,$630.00 ,$542.50 ,$630.00 ,$630.00 ,$525.00 ST VINCENT HOSPITAL - ACUTE,51000460,C5277,HC APL SKIN SUB OTH>100 INT 100CM W/PROC LOW,510,1 ,$875.00 ,$437.50 ,$63.04 ,"$1,142.23 ",$565.25 ,$552.66 ,$126.00 ,$101.00 ,$507.66 ,$525.00 ,$743.75 ,$612.50 ,$552.66 ,$831.25 ,$630.00 ,$638.75 ,$100.00 ,$743.75 ,$507.66 ,$100.00 ,$700.00 ,$638.75 ,$552.66 ,$507.66 ,$63.04 ,$875.00 ,$743.75 ,"$1,142.23 ",$805.00 ,$612.50 ,$437.50 ,$525.00 ,$532.88 ,$437.50 ,$604.63 ,$612.50 ,$512.74 ,$630.00 ,$585.82 ,$525.00 ,$525.00 ,$507.66 ,$525.00 ,$507.66 ,$630.00 ,$542.50 ,$630.00 ,$630.00 ,$525.00 ST VINCENT HOSPITAL - ACUTE,51000461,C5278,HC APL SKIN SUB OTH>100 ADL 100CM LOW,510,1 ,$810.00 ,$405.00 ,$63.04 ,$810.00 ,$523.26 ,$552.66 ,$126.00 ,$101.00 , N/A ,$486.00 ,$688.50 ,$567.00 ,$552.66 ,$769.50 ,$583.20 ,$591.30 ,$100.00 ,$688.50 , N/A ,$100.00 ,$648.00 ,$591.30 ,$552.66 , N/A ,$63.04 ,$810.00 ,$688.50 , N/A ,$745.20 ,$567.00 ,$405.00 ,$486.00 ,$493.29 ,$405.00 ,$559.71 ,$567.00 , N/A ,$583.20 ,$585.82 ,$486.00 ,$486.00 , N/A ,$486.00 , N/A ,$583.20 ,$502.20 ,$583.20 ,$583.20 ,$486.00 ST VINCENT HOSPITAL - ACUTE,51000462,11900,HC INJECT SKIN LESIONS HR SURGERY,710,1 ,$420.00 ,$210.00 ,$176.40 ,$420.00 ,$271.32 , N/A ,$271.70 ,$271.70 , N/A ,$252.00 ,$357.00 ,$294.00 , N/A ,$399.00 ,$302.40 ,$306.60 ,$273.00 ,$357.00 , N/A ,$273.00 ,$336.00 ,$306.60 , N/A , N/A ,$176.40 ,$420.00 ,$357.00 , N/A ,$386.40 ,$294.00 ,$210.00 ,$252.00 ,$255.78 ,$210.00 ,$290.22 ,$294.00 , N/A ,$302.40 , N/A ,$252.00 ,$252.00 , N/A ,$252.00 , N/A ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,71000200,N/A,HC RECOVERY CLASS 2 INIT,710,1 ,$630.00 ,$315.00 ,$264.60 ,$630.00 ,$406.98 , N/A ,$407.55 ,$407.55 , N/A ,$378.00 ,$535.50 ,$441.00 , N/A ,$598.50 ,$453.60 ,$459.90 ,$409.50 ,$535.50 , N/A ,$409.50 ,$504.00 ,$459.90 , N/A , N/A ,$264.60 ,$630.00 ,$535.50 , N/A ,$579.60 ,$441.00 ,$315.00 ,$378.00 ,$383.67 ,$315.00 ,$435.33 ,$441.00 , N/A ,$453.60 , N/A ,$378.00 ,$378.00 , N/A ,$378.00 , N/A ,$453.60 ,$390.60 ,$453.60 ,$453.60 ,$378.00 ST VINCENT HOSPITAL - ACUTE,71000201,N/A,HC RECOVERY CLASS 2 ADDL,710,1 ,$420.00 ,$210.00 ,$176.40 ,$420.00 ,$271.32 , N/A ,$271.70 ,$271.70 , N/A ,$252.00 ,$357.00 ,$294.00 , N/A ,$399.00 ,$302.40 ,$306.60 ,$273.00 ,$357.00 , N/A ,$273.00 ,$336.00 ,$306.60 , N/A , N/A ,$176.40 ,$420.00 ,$357.00 , N/A ,$386.40 ,$294.00 ,$210.00 ,$252.00 ,$255.78 ,$210.00 ,$290.22 ,$294.00 , N/A ,$302.40 , N/A ,$252.00 ,$252.00 , N/A ,$252.00 , N/A ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,71000202,N/A,HC RECOVERY CLASS 3 INIT,710,1 ,$840.00 ,$420.00 ,$352.80 ,$840.00 ,$542.64 , N/A ,$543.40 ,$543.40 , N/A ,$504.00 ,$714.00 ,$588.00 , N/A ,$798.00 ,$604.80 ,$613.20 ,$546.00 ,$714.00 , N/A ,$546.00 ,$672.00 ,$613.20 , N/A , N/A ,$352.80 ,$840.00 ,$714.00 , N/A ,$772.80 ,$588.00 ,$420.00 ,$504.00 ,$511.56 ,$420.00 ,$580.44 ,$588.00 , N/A ,$604.80 , N/A ,$504.00 ,$504.00 , N/A ,$504.00 , N/A ,$604.80 ,$520.80 ,$604.80 ,$604.80 ,$504.00 ST VINCENT HOSPITAL - ACUTE,71000203,N/A,HC RECOVERY CLASS 3 ADDL,710,1 ,$420.00 ,$210.00 ,$176.40 ,$420.00 ,$271.32 , N/A ,$271.70 ,$271.70 , N/A ,$252.00 ,$357.00 ,$294.00 , N/A ,$399.00 ,$302.40 ,$306.60 ,$273.00 ,$357.00 , N/A ,$273.00 ,$336.00 ,$306.60 , N/A , N/A ,$176.40 ,$420.00 ,$357.00 , N/A ,$386.40 ,$294.00 ,$210.00 ,$252.00 ,$255.78 ,$210.00 ,$290.22 ,$294.00 , N/A ,$302.40 , N/A ,$252.00 ,$252.00 , N/A ,$252.00 , N/A ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,71000204,N/A,HC RECOVERY CLASS 4 INIT,710,1 ,"$1,100.00 ",$550.00 ,$462.00 ,"$1,100.00 ",$710.60 , N/A ,$711.59 ,$711.59 , N/A ,$660.00 ,$935.00 ,$770.00 , N/A ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 , N/A ,$715.00 ,$880.00 ,$803.00 , N/A , N/A ,$462.00 ,"$1,100.00 ",$935.00 , N/A ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 , N/A ,$792.00 , N/A ,$660.00 ,$660.00 , N/A ,$660.00 , N/A ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,71000205,N/A,HC RECOVERY CLASS 4 ADDL,710,1 ,$630.00 ,$315.00 ,$264.60 ,$630.00 ,$406.98 , N/A ,$407.55 ,$407.55 , N/A ,$378.00 ,$535.50 ,$441.00 , N/A ,$598.50 ,$453.60 ,$459.90 ,$409.50 ,$535.50 , N/A ,$409.50 ,$504.00 ,$459.90 , N/A , N/A ,$264.60 ,$630.00 ,$535.50 , N/A ,$579.60 ,$441.00 ,$315.00 ,$378.00 ,$383.67 ,$315.00 ,$435.33 ,$441.00 , N/A ,$453.60 , N/A ,$378.00 ,$378.00 , N/A ,$378.00 , N/A ,$453.60 ,$390.60 ,$453.60 ,$453.60 ,$378.00 ST VINCENT HOSPITAL - ACUTE,71000257,N/A,HC RECOVERY BRONCH PER HOUR,710,1 ,$740.00 ,$370.00 ,$310.80 ,$740.00 ,$478.04 , N/A ,$478.71 ,$478.71 , N/A ,$444.00 ,$629.00 ,$518.00 , N/A ,$703.00 ,$532.80 ,$540.20 ,$481.00 ,$629.00 , N/A ,$481.00 ,$592.00 ,$540.20 , N/A , N/A ,$310.80 ,$740.00 ,$629.00 , N/A ,$680.80 ,$518.00 ,$370.00 ,$444.00 ,$450.66 ,$370.00 ,$511.34 ,$518.00 , N/A ,$532.80 , N/A ,$444.00 ,$444.00 , N/A ,$444.00 , N/A ,$532.80 ,$458.80 ,$532.80 ,$532.80 ,$444.00 ST VINCENT HOSPITAL - ACUTE,72000003,N/A,HC AMNIOINFUSION,720,1 ,$330.00 ,$165.00 ,$165.00 ,$330.00 ,$213.18 , N/A ,$213.48 ,$213.48 , N/A ,$198.00 ,$280.50 ,$231.00 , N/A ,$313.50 ,$237.60 ,$240.90 ,$214.50 ,$280.50 , N/A ,$214.50 ,$264.00 ,$240.90 , N/A , N/A ,$330.00 ,$330.00 ,$280.50 , N/A ,$303.60 ,$231.00 ,$165.00 ,$198.00 ,$200.97 ,$165.00 ,$228.03 ,$231.00 , N/A ,$237.60 , N/A ,$330.00 ,$330.00 , N/A ,$330.00 , N/A ,$237.60 ,$204.60 ,$237.60 ,$237.60 ,$198.00 ST VINCENT HOSPITAL - ACUTE,72000008,59412,HC EXTERNAL CEPHALIC VERSION,720,1 ,"$2,400.00 ","$1,200.00 ",$168.81 ,"$5,716.30 ","$1,550.40 ",$168.81 ,"$1,552.56 ","$1,552.56 ","$2,540.58 ","$1,440.00 ","$2,040.00 ","$1,680.00 ",$168.81 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$1,560.00 ","$2,040.00 ","$2,540.58 ","$1,560.00 ","$1,920.00 ","$1,752.00 ",$168.81 ,"$2,540.58 ",$428.28 ,"$2,400.00 ","$2,040.00 ","$5,716.30 ","$2,208.00 ","$1,680.00 ","$2,066.93 ","$2,400.00 ","$1,461.60 ","$2,400.00 ","$1,658.40 ","$1,680.00 ","$2,565.99 ","$1,728.00 ",$178.94 ,"$1,209.00 ","$1,209.00 ","$2,540.58 ","$1,209.00 ","$2,540.58 ","$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,72000009,99464,HC ATTEND HIGH RISK DELIVERY,720,1 ,$290.00 ,$145.00 ,$145.00 ,$290.00 ,$187.34 , N/A ,$187.60 ,$187.60 , N/A ,$174.00 ,$246.50 ,$203.00 , N/A ,$275.50 ,$208.80 ,$211.70 ,$188.50 ,$246.50 , N/A ,$188.50 ,$232.00 ,$211.70 , N/A , N/A ,$290.00 ,$290.00 ,$246.50 , N/A ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 , N/A ,$208.80 , N/A ,$290.00 ,$290.00 , N/A ,$290.00 , N/A ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,72100001,N/A,HC LABOR LEVEL I PER HOUR,721,1 ,$107.00 ,$53.50 ,$53.50 ,$107.00 ,$69.12 , N/A ,$69.22 ,$69.22 , N/A ,$64.20 ,$90.95 ,$74.90 , N/A ,$101.65 ,$77.04 ,$78.11 ,$69.55 ,$90.95 , N/A ,$69.55 ,$85.60 ,$78.11 , N/A , N/A ,$107.00 ,$107.00 ,$90.95 , N/A ,$98.44 ,$74.90 ,$53.50 ,$64.20 ,$65.16 ,$53.50 ,$73.94 ,$74.90 , N/A ,$77.04 , N/A ,$107.00 ,$107.00 , N/A ,$107.00 , N/A ,$77.04 ,$66.34 ,$77.04 ,$77.04 ,$64.20 ST VINCENT HOSPITAL - ACUTE,72100002,N/A,HC LABOR LEVEL II PER HOUR,721,1 ,$160.00 ,$80.00 ,$80.00 ,$160.00 ,$103.36 , N/A ,$103.50 ,$103.50 , N/A ,$96.00 ,$136.00 ,$112.00 , N/A ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 , N/A ,$104.00 ,$128.00 ,$116.80 , N/A , N/A ,$160.00 ,$160.00 ,$136.00 , N/A ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , N/A ,$115.20 , N/A ,$160.00 ,$160.00 , N/A ,$160.00 , N/A ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,72100003,N/A,HC LABOR LEVEL III PER HOUR,721,1 ,$180.00 ,$90.00 ,$90.00 ,$180.00 ,$116.28 , N/A ,$116.44 ,$116.44 , N/A ,$108.00 ,$153.00 ,$126.00 , N/A ,$171.00 ,$129.60 ,$131.40 ,$117.00 ,$153.00 , N/A ,$117.00 ,$144.00 ,$131.40 , N/A , N/A ,$180.00 ,$180.00 ,$153.00 , N/A ,$165.60 ,$126.00 ,$90.00 ,$108.00 ,$109.62 ,$90.00 ,$124.38 ,$126.00 , N/A ,$129.60 , N/A ,$180.00 ,$180.00 , N/A ,$180.00 , N/A ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,72200002,N/A,HC DELIVERY CHARGE LEVEL I,722,1 ,"$2,075.00 ","$1,037.50 ",$428.28 ,"$2,075.00 ","$1,340.45 ", N/A ,"$1,342.32 ","$1,342.32 ", N/A ,"$1,245.00 ","$1,763.75 ","$1,452.50 ", N/A ,"$1,971.25 ","$1,494.00 ","$1,514.75 ","$1,348.75 ","$1,763.75 ", N/A ,"$1,348.75 ","$1,660.00 ","$1,514.75 ", N/A , N/A ,$428.28 ,"$2,075.00 ","$1,763.75 ", N/A ,"$1,909.00 ","$1,452.50 ","$1,037.50 ","$1,245.00 ","$1,263.68 ","$1,037.50 ","$1,433.83 ","$1,452.50 ", N/A ,"$1,494.00 ", N/A ,"$1,209.00 ","$1,209.00 ", N/A ,"$1,209.00 ", N/A ,"$1,494.00 ","$1,286.50 ","$1,494.00 ","$1,494.00 ","$1,245.00 " ST VINCENT HOSPITAL - ACUTE,72200003,N/A,HC DELIVERY CHARGE LEVEL II,722,1 ,"$3,900.00 ","$1,950.00 ",$428.28 ,"$3,900.00 ","$2,519.40 ", N/A ,"$2,522.91 ","$2,522.91 ", N/A ,"$2,340.00 ","$3,315.00 ","$2,730.00 ", N/A ,"$3,705.00 ","$2,808.00 ","$2,847.00 ","$2,535.00 ","$3,315.00 ", N/A ,"$2,535.00 ","$3,120.00 ","$2,847.00 ", N/A , N/A ,$428.28 ,"$3,900.00 ","$3,315.00 ", N/A ,"$3,588.00 ","$2,730.00 ","$1,950.00 ","$2,340.00 ","$2,375.10 ","$1,950.00 ","$2,694.90 ","$2,730.00 ", N/A ,"$2,808.00 ", N/A ,"$1,209.00 ","$1,209.00 ", N/A ,"$1,209.00 ", N/A ,"$2,808.00 ","$2,418.00 ","$2,808.00 ","$2,808.00 ","$2,340.00 " ST VINCENT HOSPITAL - ACUTE,72200004,N/A,HC DELIVERY CHARGE LEVEL III,722,1 ,"$4,200.00 ","$2,100.00 ",$428.28 ,"$4,200.00 ","$2,713.20 ", N/A ,"$2,716.98 ","$2,716.98 ", N/A ,"$2,520.00 ","$3,570.00 ","$2,940.00 ", N/A ,"$3,990.00 ","$3,024.00 ","$3,066.00 ","$2,730.00 ","$3,570.00 ", N/A ,"$2,730.00 ","$3,360.00 ","$3,066.00 ", N/A , N/A ,$428.28 ,"$4,200.00 ","$3,570.00 ", N/A ,"$3,864.00 ","$2,940.00 ","$2,100.00 ","$2,520.00 ","$2,557.80 ","$2,100.00 ","$2,902.20 ","$2,940.00 ", N/A ,"$3,024.00 ", N/A ,"$1,209.00 ","$1,209.00 ", N/A ,"$1,209.00 ", N/A ,"$3,024.00 ","$2,604.00 ","$3,024.00 ","$3,024.00 ","$2,520.00 " ST VINCENT HOSPITAL - ACUTE,72200005,N/A,HC C-SECT INIT 1 HR SINGLE,722,1 ,"$4,200.00 ","$2,100.00 ",$428.28 ,"$4,200.00 ","$2,713.20 ", N/A ,"$2,716.98 ","$2,716.98 ", N/A ,"$2,520.00 ","$3,570.00 ","$2,940.00 ", N/A ,"$3,990.00 ","$3,024.00 ","$3,066.00 ","$2,730.00 ","$3,570.00 ", N/A ,"$2,730.00 ","$3,360.00 ","$3,066.00 ", N/A , N/A ,$428.28 ,"$4,200.00 ","$3,570.00 ", N/A ,"$3,864.00 ","$2,940.00 ","$2,100.00 ","$2,520.00 ","$2,557.80 ","$2,100.00 ","$2,902.20 ","$2,940.00 ", N/A ,"$3,024.00 ", N/A ,"$1,209.00 ","$1,209.00 ", N/A ,"$1,209.00 ", N/A ,"$3,024.00 ","$2,604.00 ","$3,024.00 ","$3,024.00 ","$2,520.00 " ST VINCENT HOSPITAL - ACUTE,72200006,N/A,HC C-SECT INIT 1 HR TRIPLET,722,1 ,"$4,800.00 ","$2,400.00 ",$428.28 ,"$4,800.00 ","$3,100.80 ", N/A ,"$3,105.12 ","$3,105.12 ", N/A ,"$2,880.00 ","$4,080.00 ","$3,360.00 ", N/A ,"$4,560.00 ","$3,456.00 ","$3,504.00 ","$3,120.00 ","$4,080.00 ", N/A ,"$3,120.00 ","$3,840.00 ","$3,504.00 ", N/A , N/A ,$428.28 ,"$4,800.00 ","$4,080.00 ", N/A ,"$4,416.00 ","$3,360.00 ","$2,400.00 ","$2,880.00 ","$2,923.20 ","$2,400.00 ","$3,316.80 ","$3,360.00 ", N/A ,"$3,456.00 ", N/A ,"$1,209.00 ","$1,209.00 ", N/A ,"$1,209.00 ", N/A ,"$3,456.00 ","$2,976.00 ","$3,456.00 ","$3,456.00 ","$2,880.00 " ST VINCENT HOSPITAL - ACUTE,72200007,N/A,HC C-SECT INIT 1 HR TWIN,722,1 ,"$4,400.00 ","$2,200.00 ",$428.28 ,"$4,400.00 ","$2,842.40 ", N/A ,"$2,846.36 ","$2,846.36 ", N/A ,"$2,640.00 ","$3,740.00 ","$3,080.00 ", N/A ,"$4,180.00 ","$3,168.00 ","$3,212.00 ","$2,860.00 ","$3,740.00 ", N/A ,"$2,860.00 ","$3,520.00 ","$3,212.00 ", N/A , N/A ,$428.28 ,"$4,400.00 ","$3,740.00 ", N/A ,"$4,048.00 ","$3,080.00 ","$2,200.00 ","$2,640.00 ","$2,679.60 ","$2,200.00 ","$3,040.40 ","$3,080.00 ", N/A ,"$3,168.00 ", N/A ,"$1,209.00 ","$1,209.00 ", N/A ,"$1,209.00 ", N/A ,"$3,168.00 ","$2,728.00 ","$3,168.00 ","$3,168.00 ","$2,640.00 " ST VINCENT HOSPITAL - ACUTE,72200008,N/A,HC C-SECT ADDL 1/2 HR,722,1 ,$420.00 ,$210.00 ,$210.00 ,$420.00 ,$271.32 , N/A ,$271.70 ,$271.70 , N/A ,$252.00 ,$357.00 ,$294.00 , N/A ,$399.00 ,$302.40 ,$306.60 ,$273.00 ,$357.00 , N/A ,$273.00 ,$336.00 ,$306.60 , N/A , N/A ,$420.00 ,$420.00 ,$357.00 , N/A ,$386.40 ,$294.00 ,$210.00 ,$252.00 ,$255.78 ,$210.00 ,$290.22 ,$294.00 , N/A ,$302.40 , N/A ,$420.00 ,$420.00 , N/A ,$420.00 , N/A ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,72200010,N/A,HC OUTPATIENT DELIVERY LEVEL 1,722,1 ,"$3,500.00 ","$1,750.00 ",$428.28 ,"$3,500.00 ","$2,261.00 ", N/A ,"$2,264.15 ","$2,264.15 ", N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ","$2,275.00 ","$2,975.00 ", N/A ,"$2,275.00 ","$2,800.00 ","$2,555.00 ", N/A , N/A ,$428.28 ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A ,"$1,209.00 ","$1,209.00 ", N/A ,"$1,209.00 ", N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,72200011,N/A,HC OUTPATIENT DELIVERY LEVEL 2,722,1 ,"$3,700.00 ","$1,850.00 ",$428.28 ,"$3,700.00 ","$2,390.20 ", N/A ,"$2,393.53 ","$2,393.53 ", N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$2,405.00 ","$3,145.00 ", N/A ,"$2,405.00 ","$2,960.00 ","$2,701.00 ", N/A , N/A ,$428.28 ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A ,"$1,209.00 ","$1,209.00 ", N/A ,"$1,209.00 ", N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,72200012,N/A,HC OUTPATIENT DELIVERY LEVEL 3,360,1 ,"$4,000.00 ","$2,000.00 ","$2,000.00 ","$4,000.00 ","$2,584.00 ", N/A , N/A , N/A , N/A ,"$2,400.00 ","$3,400.00 ","$2,800.00 ", N/A ,"$3,800.00 ","$2,880.00 ","$2,920.00 ", N/A ,"$3,400.00 ", N/A , N/A ,"$3,200.00 ","$2,920.00 ", N/A , N/A , N/A ,"$4,000.00 ","$3,400.00 ", N/A ,"$3,680.00 ","$2,800.00 ","$2,000.00 ","$2,400.00 ","$2,436.00 ","$2,000.00 ","$2,764.00 ","$2,800.00 ", N/A ,"$2,880.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,880.00 ","$2,480.00 ","$2,880.00 ","$2,880.00 ","$2,400.00 " ST VINCENT HOSPITAL - ACUTE,72300001,54150,HC CIRCUMCISION IP,723,1 ,$94.00 ,$47.00 ,$39.48 ,"$3,907.15 ",$60.72 ,$94.00 ,$60.81 ,$60.81 ,"$1,736.51 ",$56.40 ,$79.90 ,$65.80 ,$598.13 ,$89.30 ,$67.68 ,$68.62 ,$61.10 ,$79.90 ,"$1,736.51 ",$61.10 ,$75.20 ,$68.62 ,$598.13 ,"$1,736.51 ",$39.48 ,$94.00 ,$79.90 ,"$3,907.15 ",$86.48 ,$65.80 ,$94.00 ,$94.00 ,$57.25 ,$94.00 ,$64.95 ,$65.80 ,"$1,753.88 ",$67.68 ,$634.02 ,$56.40 ,$56.40 ,"$1,736.51 ",$56.40 ,"$1,736.51 ",$67.68 ,$58.28 ,$67.68 ,$67.68 ,$56.40 ST VINCENT HOSPITAL - ACUTE,73000002,93005,HC EKG,730,1 ,$180.00 ,$90.00 ,$8.37 ,$180.00 ,$116.28 ,$8.37 ,$116.44 ,$116.44 ,$53.91 ,$108.00 ,$153.00 ,$126.00 ,$8.37 ,$171.00 ,$129.60 ,$131.40 ,$117.00 ,$153.00 ,$53.91 ,$117.00 ,$144.00 ,$131.40 ,$8.37 ,$53.91 ,$136.87 ,$180.00 ,$153.00 ,$121.29 ,$165.60 ,$126.00 ,$90.12 ,$97.14 ,$109.62 ,$90.12 ,$124.38 ,$126.00 ,$54.45 ,$129.60 ,$8.87 ,$132.00 ,$132.00 ,$53.91 ,$132.00 ,$53.91 ,$129.60 ,$111.60 ,$129.60 ,$129.60 ,$108.00 ST VINCENT HOSPITAL - ACUTE,73000003,93041,HC EKG RHYTHM STRIP TRACING,730,1 ,$150.00 ,$75.00 ,$8.37 ,$150.00 ,$96.90 ,$8.37 ,$97.04 ,$97.04 ,$53.91 ,$90.00 ,$127.50 ,$105.00 ,$8.37 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 ,$53.91 ,$97.50 ,$120.00 ,$109.50 ,$8.37 ,$53.91 ,$136.87 ,$150.00 ,$127.50 ,$121.29 ,$138.00 ,$105.00 ,$150.00 ,$150.00 ,$91.35 ,$150.00 ,$103.65 ,$105.00 ,$54.45 ,$108.00 ,$8.87 ,$132.00 ,$132.00 ,$53.91 ,$132.00 ,$53.91 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,73100000,93225,HC HOLTER MONITOR RECORDING,731,1 ,$440.00 ,$220.00 ,$19.55 ,$440.00 ,$284.24 ,$19.55 ,$284.64 ,$284.64 ,$108.42 ,$264.00 ,$374.00 ,$308.00 ,$19.55 ,$418.00 ,$316.80 ,$321.20 ,$286.00 ,$374.00 ,$108.42 ,$286.00 ,$352.00 ,$321.20 ,$19.55 ,$108.42 ,$206.41 ,$440.00 ,$374.00 ,$243.95 ,$404.80 ,$308.00 ,$220.00 ,$264.00 ,$267.96 ,$220.00 ,$304.04 ,$308.00 ,$109.50 ,$316.80 ,$20.72 ,$440.00 ,$440.00 ,$108.42 ,$440.00 ,$108.42 ,$316.80 ,$272.80 ,$316.80 ,$316.80 ,$264.00 ST VINCENT HOSPITAL - ACUTE,73100001,93226,HC HOLTER SCAN AND REPORT 24 HR,731,1 ,$560.00 ,$280.00 ,$19.55 ,$560.00 ,$361.76 ,$19.55 ,$362.26 ,$362.26 ,$108.42 ,$336.00 ,$476.00 ,$392.00 ,$19.55 ,$532.00 ,$403.20 ,$408.80 ,$364.00 ,$476.00 ,$108.42 ,$364.00 ,$448.00 ,$408.80 ,$19.55 ,$108.42 ,$206.41 ,$560.00 ,$476.00 ,$243.95 ,$515.20 ,$392.00 ,$280.00 ,$336.00 ,$341.04 ,$280.00 ,$386.96 ,$392.00 ,$109.50 ,$403.20 ,$20.72 ,$495.00 ,$495.00 ,$108.42 ,$495.00 ,$108.42 ,$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,73100002,93226,HC HOLTER SCAN AND REPORT 48 HR,731,1 ,$640.00 ,$320.00 ,$19.55 ,$640.00 ,$413.44 ,$19.55 ,$414.02 ,$414.02 ,$108.42 ,$384.00 ,$544.00 ,$448.00 ,$19.55 ,$608.00 ,$460.80 ,$467.20 ,$416.00 ,$544.00 ,$108.42 ,$416.00 ,$512.00 ,$467.20 ,$19.55 ,$108.42 ,$206.41 ,$640.00 ,$544.00 ,$243.95 ,$588.80 ,$448.00 ,$320.00 ,$384.00 ,$389.76 ,$320.00 ,$442.24 ,$448.00 ,$109.50 ,$460.80 ,$20.72 ,$495.00 ,$495.00 ,$108.42 ,$495.00 ,$108.42 ,$460.80 ,$396.80 ,$460.80 ,$460.80 ,$384.00 ST VINCENT HOSPITAL - ACUTE,73100003,93229,HC EKG RECORDING ACT,731,1 ,"$1,200.00 ",$600.00 ,$19.55 ,"$1,200.00 ",$775.20 ,$19.55 ,$776.28 ,$776.28 ,$135.15 ,$720.00 ,"$1,020.00 ",$840.00 ,$19.55 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$135.15 ,$780.00 ,$960.00 ,$876.00 ,$19.55 ,$135.15 ,$206.41 ,"$1,200.00 ","$1,020.00 ",$304.10 ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$136.50 ,$864.00 ,$20.72 ,$495.00 ,$495.00 ,$135.15 ,$495.00 ,$135.15 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,73100004,93270,HC CARDIAC EVENT RECORDER,731,1 ,$250.00 ,$125.00 ,$19.55 ,$250.00 ,$161.50 ,$19.55 ,$161.73 ,$161.73 ,$35.98 ,$150.00 ,$212.50 ,$175.00 ,$19.55 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$35.98 ,$162.50 ,$200.00 ,$182.50 ,$19.55 ,$35.98 ,$206.41 ,$250.00 ,$212.50 ,$80.95 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$36.34 ,$180.00 ,$20.72 ,$250.00 ,$250.00 ,$35.98 ,$250.00 ,$35.98 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,73100005,93271,HC CARDIAC EVENT MONITOR,731,1 ,$750.00 ,$375.00 ,$19.55 ,$750.00 ,$484.50 ,$19.55 ,$485.18 ,$485.18 ,$97.15 ,$450.00 ,$637.50 ,$525.00 ,$19.55 ,$712.50 ,$540.00 ,$547.50 ,$487.50 ,$637.50 ,$97.15 ,$487.50 ,$600.00 ,$547.50 ,$19.55 ,$97.15 ,$206.41 ,$750.00 ,$637.50 ,$218.59 ,$690.00 ,$525.00 ,$375.00 ,$450.00 ,$456.75 ,$375.00 ,$518.25 ,$525.00 ,$98.12 ,$540.00 ,$20.72 ,$495.00 ,$495.00 ,$97.15 ,$495.00 ,$97.15 ,$540.00 ,$465.00 ,$540.00 ,$540.00 ,$450.00 ST VINCENT HOSPITAL - ACUTE,73100006,0296T,HC HOLTER MONITOR RECORDING EXTENDED >48HRS <21DAYS,731,1 ,$560.00 ,$280.00 ,$206.41 ,$560.00 ,$361.76 , N/A ,$362.26 ,$362.26 , N/A ,$336.00 ,$476.00 ,$392.00 , N/A ,$532.00 ,$403.20 ,$408.80 ,$364.00 ,$476.00 , N/A ,$364.00 ,$448.00 ,$408.80 , N/A , N/A ,$206.41 ,$560.00 ,$476.00 , N/A ,$515.20 ,$392.00 ,$280.00 ,$336.00 ,$341.04 ,$280.00 ,$386.96 ,$392.00 , N/A ,$403.20 , N/A ,$495.00 ,$495.00 , N/A ,$495.00 , N/A ,$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,73100007,0297T,HC HOLTER MONITOR SCAN AND REPORT EXTENDED >48HRS <21DAYS,731,1 ,$640.00 ,$320.00 ,$206.41 ,$640.00 ,$413.44 , N/A ,$414.02 ,$414.02 , N/A ,$384.00 ,$544.00 ,$448.00 , N/A ,$608.00 ,$460.80 ,$467.20 ,$416.00 ,$544.00 , N/A ,$416.00 ,$512.00 ,$467.20 , N/A , N/A ,$206.41 ,$640.00 ,$544.00 , N/A ,$588.80 ,$448.00 ,$320.00 ,$384.00 ,$389.76 ,$320.00 ,$442.24 ,$448.00 , N/A ,$460.80 , N/A ,$495.00 ,$495.00 , N/A ,$495.00 , N/A ,$460.80 ,$396.80 ,$460.80 ,$460.80 ,$384.00 ST VINCENT HOSPITAL - ACUTE,74000000,94776,HC PED HOME APNEA RECORD DOWNLOAD,740,1 ,$460.00 ,$230.00 ,$21.41 ,$460.00 ,$297.16 ,$21.41 ,$297.57 ,$297.57 ,$135.15 ,$276.00 ,$391.00 ,$322.00 ,$21.41 ,$437.00 ,$331.20 ,$335.80 ,$299.00 ,$391.00 ,$135.15 ,$299.00 ,$368.00 ,$335.80 ,$21.41 ,$135.15 ,$193.20 ,$460.00 ,$391.00 ,$304.10 ,$423.20 ,$322.00 ,$230.00 ,$276.00 ,$280.14 ,$230.00 ,$317.86 ,$322.00 ,$136.50 ,$331.20 ,$22.69 ,$414.00 ,$414.00 ,$135.15 ,$414.00 ,$135.15 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,74000001,95803,HC ACTIGRAPHY TESTING 72HR TO 14 DAYS,740,1 ,$600.00 ,$300.00 ,$19.55 ,$600.00 ,$387.60 ,$19.55 ,$600.00 ,$600.00 ,$53.91 ,$360.00 ,$510.00 ,$420.00 ,$19.55 ,$570.00 ,$432.00 ,$438.00 ,$390.00 ,$510.00 ,$53.91 ,$390.00 ,$480.00 ,$438.00 ,$19.55 ,$53.91 ,$600.00 ,$600.00 ,$510.00 ,$121.29 ,$552.00 ,$420.00 ,$300.00 ,$360.00 ,$365.40 ,$300.00 ,$414.60 ,$420.00 ,$54.45 ,$432.00 ,$20.72 ,$414.00 ,$414.00 ,$53.91 ,$414.00 ,$53.91 ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,74000002,95805,HC MULTIPLE SLEEP LATENCY,740,1 ,"$3,600.00 ","$1,800.00 ",$241.53 ,"$3,600.00 ","$2,325.60 ",$241.53 ,"$3,030.00 ","$2,626.00 ",$472.41 ,"$2,160.00 ","$3,060.00 ","$2,520.00 ",$241.53 ,"$3,420.00 ","$2,592.00 ","$2,628.00 ","$2,340.00 ","$3,060.00 ",$472.41 ,"$2,340.00 ","$2,880.00 ","$2,628.00 ",$241.53 ,$472.41 ,"$2,207.63 ","$3,600.00 ","$3,060.00 ","$1,062.93 ","$3,312.00 ","$2,520.00 ","$1,800.00 ","$2,160.00 ","$2,192.40 ","$1,800.00 ","$2,487.60 ","$2,520.00 ",$477.13 ,"$2,592.00 ",$256.02 ,"$3,537.00 ","$3,537.00 ",$472.41 ,"$3,537.00 ",$472.41 ,"$2,592.00 ","$2,232.00 ","$2,592.00 ","$2,592.00 ","$2,160.00 " ST VINCENT HOSPITAL - ACUTE,74000003,95806,HC SLEEP STUDY UNATTENDED,740,1 ,$630.00 ,$315.00 ,$48.85 ,$630.00 ,$406.98 ,$48.85 ,$630.00 ,$630.00 ,$135.15 ,$378.00 ,$535.50 ,$441.00 ,$48.85 ,$598.50 ,$453.60 ,$459.90 ,$409.50 ,$535.50 ,$135.15 ,$409.50 ,$504.00 ,$459.90 ,$48.85 ,$135.15 ,$496.72 ,$630.00 ,$535.50 ,$304.10 ,$579.60 ,$441.00 ,$315.00 ,$378.00 ,$383.67 ,$315.00 ,$435.33 ,$441.00 ,$136.50 ,$453.60 ,$51.78 ,$630.00 ,$630.00 ,$135.15 ,$630.00 ,$135.15 ,$453.60 ,$390.60 ,$453.60 ,$453.60 ,$378.00 ST VINCENT HOSPITAL - ACUTE,74000004,95806,HC APNEALINK STUDY,740,1 ,$300.00 ,$150.00 ,$48.85 ,$304.10 ,$193.80 ,$48.85 ,$300.00 ,$300.00 ,$135.15 ,$180.00 ,$255.00 ,$210.00 ,$48.85 ,$285.00 ,$216.00 ,$219.00 ,$195.00 ,$255.00 ,$135.15 ,$195.00 ,$240.00 ,$219.00 ,$48.85 ,$135.15 ,$300.00 ,$300.00 ,$255.00 ,$304.10 ,$276.00 ,$210.00 ,$150.00 ,$180.00 ,$182.70 ,$150.00 ,$207.30 ,$210.00 ,$136.50 ,$216.00 ,$51.78 ,$300.00 ,$300.00 ,$135.15 ,$300.00 ,$135.15 ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,74000005,95807,HC PAP NAP,740,1 ,"$2,000.00 ","$1,000.00 ",$241.53 ,"$2,000.00 ","$1,292.00 ",$241.53 ,"$2,000.00 ","$2,000.00 ",$472.41 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$241.53 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,300.00 ","$1,700.00 ",$472.41 ,"$1,300.00 ","$1,600.00 ","$1,460.00 ",$241.53 ,$472.41 ,"$2,000.00 ","$2,000.00 ","$1,700.00 ","$1,062.93 ","$1,840.00 ","$1,400.00 ","$1,000.00 ","$1,200.00 ","$1,218.00 ","$1,000.00 ","$1,382.00 ","$1,400.00 ",$477.13 ,"$1,440.00 ",$256.02 ,"$2,000.00 ","$2,000.00 ",$472.41 ,"$2,000.00 ",$472.41 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,74000006,95810,HC SLEEP STUDY,740,1 ,"$3,900.00 ","$1,950.00 ",$241.53 ,"$3,900.00 ","$2,519.40 ",$241.53 ,"$3,030.00 ","$2,626.00 ",$890.85 ,"$2,340.00 ","$3,315.00 ","$2,730.00 ",$241.53 ,"$3,705.00 ","$2,808.00 ","$2,847.00 ","$2,535.00 ","$3,315.00 ",$890.85 ,"$2,535.00 ","$3,120.00 ","$2,847.00 ",$241.53 ,$890.85 ,"$2,207.63 ","$3,900.00 ","$3,315.00 ","$2,004.40 ","$3,588.00 ","$2,730.00 ","$1,950.00 ","$2,340.00 ","$2,375.10 ","$1,950.00 ","$2,694.90 ","$2,730.00 ",$899.76 ,"$2,808.00 ",$256.02 ,"$3,537.00 ","$3,537.00 ",$890.85 ,"$3,537.00 ",$890.85 ,"$2,808.00 ","$2,418.00 ","$2,808.00 ","$2,808.00 ","$2,340.00 " ST VINCENT HOSPITAL - ACUTE,74000006,95810,HC SLEEP STUDY,740,1 ,"$4,600.00 ","$2,300.00 ",$241.53 ,"$4,600.00 ","$2,971.60 ",$241.53 ,"$3,030.00 ","$2,626.00 ",$890.85 ,"$2,760.00 ","$3,910.00 ","$3,220.00 ",$241.53 ,"$4,370.00 ","$3,312.00 ","$3,358.00 ","$2,990.00 ","$3,910.00 ",$890.85 ,"$2,990.00 ","$3,680.00 ","$3,358.00 ",$241.53 ,$890.85 ,"$2,207.63 ","$4,600.00 ","$3,910.00 ","$2,004.40 ","$4,232.00 ","$3,220.00 ","$2,300.00 ","$2,760.00 ","$2,801.40 ","$2,300.00 ","$3,178.60 ","$3,220.00 ",$899.76 ,"$3,312.00 ",$256.02 ,"$3,537.00 ","$3,537.00 ",$890.85 ,"$3,537.00 ",$890.85 ,"$3,312.00 ","$2,852.00 ","$3,312.00 ","$3,312.00 ","$2,760.00 " ST VINCENT HOSPITAL - ACUTE,74000008,95810,HC SLEEP STUDY ONE ON ONE,740,1 ,"$4,900.00 ","$2,450.00 ",$241.53 ,"$4,900.00 ","$3,165.40 ",$241.53 ,"$3,030.00 ","$2,626.00 ",$890.85 ,"$2,940.00 ","$4,165.00 ","$3,430.00 ",$241.53 ,"$4,655.00 ","$3,528.00 ","$3,577.00 ","$3,185.00 ","$4,165.00 ",$890.85 ,"$3,185.00 ","$3,920.00 ","$3,577.00 ",$241.53 ,$890.85 ,"$2,207.63 ","$4,900.00 ","$4,165.00 ","$2,004.40 ","$4,508.00 ","$3,430.00 ","$2,450.00 ","$2,940.00 ","$2,984.10 ","$2,450.00 ","$3,385.90 ","$3,430.00 ",$899.76 ,"$3,528.00 ",$256.02 ,"$3,537.00 ","$3,537.00 ",$890.85 ,"$3,537.00 ",$890.85 ,"$3,528.00 ","$3,038.00 ","$3,528.00 ","$3,528.00 ","$2,940.00 " ST VINCENT HOSPITAL - ACUTE,74000009,95811,HC SLEEP STUDY W/CPAP,740,1 ,"$4,900.00 ","$2,450.00 ",$241.53 ,"$4,900.00 ","$3,165.40 ",$241.53 ,"$3,030.00 ","$2,626.00 ",$890.85 ,"$2,940.00 ","$4,165.00 ","$3,430.00 ",$241.53 ,"$4,655.00 ","$3,528.00 ","$3,577.00 ","$3,185.00 ","$4,165.00 ",$890.85 ,"$3,185.00 ","$3,920.00 ","$3,577.00 ",$241.53 ,$890.85 ,"$2,207.63 ","$4,900.00 ","$4,165.00 ","$2,004.40 ","$4,508.00 ","$3,430.00 ","$2,450.00 ","$2,940.00 ","$2,984.10 ","$2,450.00 ","$3,385.90 ","$3,430.00 ",$899.76 ,"$3,528.00 ",$256.02 ,"$3,537.00 ","$3,537.00 ",$890.85 ,"$3,537.00 ",$890.85 ,"$3,528.00 ","$3,038.00 ","$3,528.00 ","$3,528.00 ","$2,940.00 " ST VINCENT HOSPITAL - ACUTE,74000009,95811,HC SLEEP STUDY W/CPAP,740,1 ,"$4,300.00 ","$2,150.00 ",$241.53 ,"$4,300.00 ","$2,777.80 ",$241.53 ,"$3,030.00 ","$2,626.00 ",$890.85 ,"$2,580.00 ","$3,655.00 ","$3,010.00 ",$241.53 ,"$4,085.00 ","$3,096.00 ","$3,139.00 ","$2,795.00 ","$3,655.00 ",$890.85 ,"$2,795.00 ","$3,440.00 ","$3,139.00 ",$241.53 ,$890.85 ,"$2,207.63 ","$4,300.00 ","$3,655.00 ","$2,004.40 ","$3,956.00 ","$3,010.00 ","$2,150.00 ","$2,580.00 ","$2,618.70 ","$2,150.00 ","$2,971.30 ","$3,010.00 ",$899.76 ,"$3,096.00 ",$256.02 ,"$3,537.00 ","$3,537.00 ",$890.85 ,"$3,537.00 ",$890.85 ,"$3,096.00 ","$2,666.00 ","$3,096.00 ","$3,096.00 ","$2,580.00 " ST VINCENT HOSPITAL - ACUTE,74000011,95811,HC SLEEP STUDY W/CPAP ONE ON ONE,740,1 ,"$5,200.00 ","$2,600.00 ",$241.53 ,"$5,200.00 ","$3,359.20 ",$241.53 ,"$3,030.00 ","$2,626.00 ",$890.85 ,"$3,120.00 ","$4,420.00 ","$3,640.00 ",$241.53 ,"$4,940.00 ","$3,744.00 ","$3,796.00 ","$3,380.00 ","$4,420.00 ",$890.85 ,"$3,380.00 ","$4,160.00 ","$3,796.00 ",$241.53 ,$890.85 ,"$2,207.63 ","$5,200.00 ","$4,420.00 ","$2,004.40 ","$4,784.00 ","$3,640.00 ","$2,600.00 ","$3,120.00 ","$3,166.80 ","$2,600.00 ","$3,593.20 ","$3,640.00 ",$899.76 ,"$3,744.00 ",$256.02 ,"$3,537.00 ","$3,537.00 ",$890.85 ,"$3,537.00 ",$890.85 ,"$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,74000012,95812,HC EEG MONITOR 41-60 MIN,740,1 ,$860.00 ,$430.00 ,$156.65 ,$860.00 ,$555.56 ,$156.65 ,$556.33 ,$556.33 ,$256.12 ,$516.00 ,$731.00 ,$602.00 ,$156.65 ,$817.00 ,$619.20 ,$627.80 ,$559.00 ,$731.00 ,$256.12 ,$559.00 ,$688.00 ,$627.80 ,$156.65 ,$256.12 ,$361.20 ,$860.00 ,$731.00 ,$576.27 ,$791.20 ,$602.00 ,$430.00 ,$516.00 ,$523.74 ,$430.00 ,$594.26 ,$602.00 ,$258.68 ,$619.20 ,$166.05 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,$619.20 ,$533.20 ,$619.20 ,$619.20 ,$516.00 ST VINCENT HOSPITAL - ACUTE,74000013,95813,HC EEG MONITOR > 1 HR,740,1 ,"$1,500.00 ",$750.00 ,$156.65 ,"$1,500.00 ",$969.00 ,$156.65 ,$970.35 ,$970.35 ,$256.12 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$156.65 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ",$256.12 ,$975.00 ,"$1,200.00 ","$1,095.00 ",$156.65 ,$256.12 ,$630.00 ,"$1,500.00 ","$1,275.00 ",$576.27 ,"$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ",$258.68 ,"$1,080.00 ",$166.05 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,74000014,95816,HC EEG AWAKE/DROWSY,740,1 ,$760.00 ,$380.00 ,$76.87 ,$760.00 ,$490.96 ,$76.87 ,$491.64 ,$491.64 ,$256.12 ,$456.00 ,$646.00 ,$532.00 ,$76.87 ,$722.00 ,$547.20 ,$554.80 ,$494.00 ,$646.00 ,$256.12 ,$494.00 ,$608.00 ,$554.80 ,$76.87 ,$256.12 ,$319.20 ,$760.00 ,$646.00 ,$576.27 ,$699.20 ,$532.00 ,$380.00 ,$456.00 ,$462.84 ,$380.00 ,$525.16 ,$532.00 ,$258.68 ,$547.20 ,$81.48 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,74000016,95819,HC EEG AWAKE/ASLEEP,740,1 ,"$1,500.00 ",$750.00 ,$76.87 ,"$1,500.00 ",$969.00 ,$76.87 ,$970.35 ,$970.35 ,$256.12 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$76.87 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ",$256.12 ,$975.00 ,"$1,200.00 ","$1,095.00 ",$76.87 ,$256.12 ,$630.00 ,"$1,500.00 ","$1,275.00 ",$576.27 ,"$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ",$258.68 ,"$1,080.00 ",$81.48 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,74000018,95822,HC EEG COMA OR SLEEP ONLY,740,1 ,"$1,200.00 ",$600.00 ,$76.87 ,"$1,200.00 ",$775.20 ,$76.87 ,$776.28 ,$776.28 ,$256.12 ,$720.00 ,"$1,020.00 ",$840.00 ,$76.87 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$256.12 ,$780.00 ,$960.00 ,$876.00 ,$76.87 ,$256.12 ,$504.00 ,"$1,200.00 ","$1,020.00 ",$576.27 ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$258.68 ,$864.00 ,$81.48 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,74000020,95824,HC EEG CEREBRAL DEATH EVAL,740,1 ,$960.00 ,$480.00 ,$76.87 ,"$1,062.93 ",$620.16 ,$76.87 ,$621.02 ,$621.02 ,$472.41 ,$576.00 ,$816.00 ,$672.00 ,$76.87 ,$912.00 ,$691.20 ,$700.80 ,$624.00 ,$816.00 ,$472.41 ,$624.00 ,$768.00 ,$700.80 ,$76.87 ,$472.41 ,$403.20 ,$960.00 ,$816.00 ,"$1,062.93 ",$883.20 ,$672.00 ,$480.00 ,$576.00 ,$584.64 ,$480.00 ,$663.36 ,$672.00 ,$477.13 ,$691.20 ,$81.48 ,$414.00 ,$414.00 ,$472.41 ,$414.00 ,$472.41 ,$691.20 ,$595.20 ,$691.20 ,$691.20 ,$576.00 ST VINCENT HOSPITAL - ACUTE,74000023,95928,HC TCMEP UPPER LIMBS,740,1 ,$520.00 ,$260.00 ,$110.54 ,"$2,004.40 ",$335.92 ,$110.54 ,$336.39 ,$336.39 ,$890.85 ,$312.00 ,$442.00 ,$364.00 ,$110.54 ,$494.00 ,$374.40 ,$379.60 ,$338.00 ,$442.00 ,$890.85 ,$338.00 ,$416.00 ,$379.60 ,$110.54 ,$890.85 ,$218.40 ,$520.00 ,$442.00 ,"$2,004.40 ",$478.40 ,$364.00 ,$260.00 ,$312.00 ,$316.68 ,$260.00 ,$359.32 ,$364.00 ,$899.76 ,$374.40 ,$117.17 ,$414.00 ,$414.00 ,$890.85 ,$414.00 ,$890.85 ,$374.40 ,$322.40 ,$374.40 ,$374.40 ,$312.00 ST VINCENT HOSPITAL - ACUTE,74000024,95929,HC TCMEP LWR LIMBS,740,1 ,$600.00 ,$300.00 ,$110.54 ,"$1,062.93 ",$387.60 ,$110.54 ,$388.14 ,$388.14 ,$472.41 ,$360.00 ,$510.00 ,$420.00 ,$110.54 ,$570.00 ,$432.00 ,$438.00 ,$390.00 ,$510.00 ,$472.41 ,$390.00 ,$480.00 ,$438.00 ,$110.54 ,$472.41 ,$252.00 ,$600.00 ,$510.00 ,"$1,062.93 ",$552.00 ,$420.00 ,$300.00 ,$360.00 ,$365.40 ,$300.00 ,$414.60 ,$420.00 ,$477.13 ,$432.00 ,$117.17 ,$414.00 ,$414.00 ,$472.41 ,$414.00 ,$472.41 ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,74000025,95937,HC NEUROMUSCULAR JUNCTION TEST,740,1 ,$480.00 ,$240.00 ,$110.54 ,$480.00 ,$310.08 ,$110.54 ,$310.51 ,$310.51 ,$135.15 ,$288.00 ,$408.00 ,$336.00 ,$110.54 ,$456.00 ,$345.60 ,$350.40 ,$312.00 ,$408.00 ,$135.15 ,$312.00 ,$384.00 ,$350.40 ,$110.54 ,$135.15 ,$201.60 ,$480.00 ,$408.00 ,$304.10 ,$441.60 ,$336.00 ,$240.00 ,$288.00 ,$292.32 ,$240.00 ,$331.68 ,$336.00 ,$136.50 ,$345.60 ,$117.17 ,$414.00 ,$414.00 ,$135.15 ,$414.00 ,$135.15 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,74000029,95955,HC EEG INTRAOP,740,1 ,"$1,900.00 ",$950.00 ,$76.87 ,"$1,900.00 ","$1,227.40 ",$76.87 ,"$1,229.11 ","$1,229.11 ", N/A ,"$1,140.00 ","$1,615.00 ","$1,330.00 ",$76.87 ,"$1,805.00 ","$1,368.00 ","$1,387.00 ","$1,235.00 ","$1,615.00 ", N/A ,"$1,235.00 ","$1,520.00 ","$1,387.00 ",$76.87 , N/A ,$798.00 ,"$1,900.00 ","$1,615.00 ", N/A ,"$1,748.00 ","$1,330.00 ",$950.00 ,"$1,140.00 ","$1,157.10 ",$950.00 ,"$1,312.90 ","$1,330.00 ", N/A ,"$1,368.00 ",$81.48 ,$414.00 ,$414.00 , N/A ,$414.00 , N/A ,"$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,74000032,95957,HC EEG DIGITAL ANLYS,740,1 ,$590.00 ,$295.00 ,$12.22 ,$590.00 ,$381.14 ,$12.22 ,$381.67 ,$381.67 , N/A ,$354.00 ,$501.50 ,$413.00 ,$12.22 ,$560.50 ,$424.80 ,$430.70 ,$383.50 ,$501.50 , N/A ,$383.50 ,$472.00 ,$430.70 ,$12.22 , N/A ,$247.80 ,$590.00 ,$501.50 , N/A ,$542.80 ,$413.00 ,$295.00 ,$354.00 ,$359.31 ,$295.00 ,$407.69 ,$413.00 , N/A ,$424.80 ,$12.95 ,$414.00 ,$414.00 , N/A ,$414.00 , N/A ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,74000033,95939,HC TCMEP UPPER AND LOWER,740,1 ,$700.00 ,$350.00 ,$110.54 ,"$2,004.40 ",$452.20 ,$110.54 ,$452.83 ,$452.83 ,$890.85 ,$420.00 ,$595.00 ,$490.00 ,$110.54 ,$665.00 ,$504.00 ,$511.00 ,$455.00 ,$595.00 ,$890.85 ,$455.00 ,$560.00 ,$511.00 ,$110.54 ,$890.85 ,$294.00 ,$700.00 ,$595.00 ,"$2,004.40 ",$644.00 ,$490.00 ,$350.00 ,$420.00 ,$426.30 ,$350.00 ,$483.70 ,$490.00 ,$899.76 ,$504.00 ,$117.17 ,$414.00 ,$414.00 ,$890.85 ,$414.00 ,$890.85 ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,74000035,G0399,HC SLEEP STUDY HOME ADULT,740,1 ,$570.00 ,$285.00 ,$48.85 ,$570.00 ,$368.22 ,$48.85 ,$570.00 ,$570.00 ,$135.15 ,$342.00 ,$484.50 ,$399.00 ,$48.85 ,$541.50 ,$410.40 ,$416.10 ,$370.50 ,$484.50 ,$135.15 ,$370.50 ,$456.00 ,$416.10 ,$48.85 ,$135.15 ,$496.72 ,$570.00 ,$484.50 ,$304.10 ,$524.40 ,$399.00 ,$285.00 ,$342.00 ,$347.13 ,$285.00 ,$393.87 ,$399.00 ,$136.50 ,$410.40 ,$51.78 ,$570.00 ,$570.00 ,$135.15 ,$570.00 ,$135.15 ,$410.40 ,$353.40 ,$410.40 ,$410.40 ,$342.00 ST VINCENT HOSPITAL - ACUTE,74000041,95782,HC SLEEP STUDY ONE ON ONE <6 YRS,740,1 ,"$4,900.00 ","$2,450.00 ",$241.53 ,"$4,900.00 ","$3,165.40 ",$241.53 ,"$3,030.00 ","$2,626.00 ",$890.85 ,"$2,940.00 ","$4,165.00 ","$3,430.00 ",$241.53 ,"$4,655.00 ","$3,528.00 ","$3,577.00 ","$3,185.00 ","$4,165.00 ",$890.85 ,"$3,185.00 ","$3,920.00 ","$3,577.00 ",$241.53 ,$890.85 ,"$2,207.63 ","$4,900.00 ","$4,165.00 ","$2,004.40 ","$4,508.00 ","$3,430.00 ","$2,450.00 ","$2,940.00 ","$2,984.10 ","$2,450.00 ","$3,385.90 ","$3,430.00 ",$899.76 ,"$3,528.00 ",$256.02 ,"$3,537.00 ","$3,537.00 ",$890.85 ,"$3,537.00 ",$890.85 ,"$3,528.00 ","$3,038.00 ","$3,528.00 ","$3,528.00 ","$2,940.00 " ST VINCENT HOSPITAL - ACUTE,74000042,95783,HC SLEEP STUDY W/CPAP ONE ON ONE <6 YRS,740,1 ,"$5,200.00 ","$2,600.00 ",$241.53 ,"$5,200.00 ","$3,359.20 ",$241.53 ,"$3,030.00 ","$2,626.00 ",$890.85 ,"$3,120.00 ","$4,420.00 ","$3,640.00 ",$241.53 ,"$4,940.00 ","$3,744.00 ","$3,796.00 ","$3,380.00 ","$4,420.00 ",$890.85 ,"$3,380.00 ","$4,160.00 ","$3,796.00 ",$241.53 ,$890.85 ,"$2,207.63 ","$5,200.00 ","$4,420.00 ","$2,004.40 ","$4,784.00 ","$3,640.00 ","$2,600.00 ","$3,120.00 ","$3,166.80 ","$2,600.00 ","$3,593.20 ","$3,640.00 ",$899.76 ,"$3,744.00 ",$256.02 ,"$3,537.00 ","$3,537.00 ",$890.85 ,"$3,537.00 ",$890.85 ,"$3,744.00 ","$3,224.00 ","$3,744.00 ","$3,744.00 ","$3,120.00 " ST VINCENT HOSPITAL - ACUTE,74000043,95940,HC NEURO TEST INTRAOPER PER 15MIN,740,1 ,$220.00 ,$110.00 ,$92.40 ,$220.00 ,$142.12 , N/A ,$142.32 ,$142.32 , N/A ,$132.00 ,$187.00 ,$154.00 , N/A ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 , N/A ,$143.00 ,$176.00 ,$160.60 , N/A , N/A ,$92.40 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 , N/A ,$220.00 ,$220.00 , N/A ,$220.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,74000044,95941,HC NEURO TEST INTRAOPER REMOTE/> 1 OR PER HR,740,1 ,$620.00 ,$310.00 ,$260.40 ,$620.00 ,$400.52 , N/A ,$401.08 ,$401.08 , N/A ,$372.00 ,$527.00 ,$434.00 , N/A ,$589.00 ,$446.40 ,$452.60 ,$403.00 ,$527.00 , N/A ,$403.00 ,$496.00 ,$452.60 , N/A , N/A ,$260.40 ,$620.00 ,$527.00 , N/A ,$570.40 ,$434.00 ,$310.00 ,$372.00 ,$377.58 ,$310.00 ,$428.42 ,$434.00 , N/A ,$446.40 , N/A ,$414.00 ,$414.00 , N/A ,$414.00 , N/A ,$446.40 ,$384.40 ,$446.40 ,$446.40 ,$372.00 ST VINCENT HOSPITAL - ACUTE,74000082,95700,HC EEG CONT RECORDING W/VIDEO ADMIN TECH MINIMUM 8 CHANNELS,740,1 ,"$2,800.00 ","$1,400.00 ",$76.87 ,"$2,800.00 ","$1,808.80 ",$76.87 ,"$1,811.32 ","$1,811.32 ",$256.12 ,"$1,680.00 ","$2,380.00 ","$1,960.00 ",$76.87 ,"$2,660.00 ","$2,016.00 ","$2,044.00 ","$1,820.00 ","$2,380.00 ",$256.12 ,"$1,820.00 ","$2,240.00 ","$2,044.00 ",$76.87 ,$256.12 ,"$1,176.00 ","$2,800.00 ","$2,380.00 ",$576.27 ,"$2,576.00 ","$1,960.00 ","$1,400.00 ","$1,680.00 ","$1,705.20 ","$1,400.00 ","$1,934.80 ","$1,960.00 ",$258.68 ,"$2,016.00 ",$81.48 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,"$2,016.00 ","$1,736.00 ","$2,016.00 ","$2,016.00 ","$1,680.00 " ST VINCENT HOSPITAL - ACUTE,74000083,95705,HC EEG W/O VIDEO BY TECH 2-12 HOURS UNMONITORED,740,1 ,"$2,700.00 ","$1,350.00 ",$76.87 ,"$2,700.00 ","$1,744.20 ",$76.87 ,"$1,746.63 ","$1,746.63 ",$256.12 ,"$1,620.00 ","$2,295.00 ","$1,890.00 ",$76.87 ,"$2,565.00 ","$1,944.00 ","$1,971.00 ","$1,755.00 ","$2,295.00 ",$256.12 ,"$1,755.00 ","$2,160.00 ","$1,971.00 ",$76.87 ,$256.12 ,"$1,134.00 ","$2,700.00 ","$2,295.00 ",$576.27 ,"$2,484.00 ","$1,890.00 ","$1,350.00 ","$1,620.00 ","$1,644.30 ","$1,350.00 ","$1,865.70 ","$1,890.00 ",$258.68 ,"$1,944.00 ",$81.48 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,"$1,944.00 ","$1,674.00 ","$1,944.00 ","$1,944.00 ","$1,620.00 " ST VINCENT HOSPITAL - ACUTE,74000084,95706,HC EEG W/O VIDEO BY TECH 2-12 HOURS W/INTERMITTENT MONITORING,740,1 ,"$3,000.00 ","$1,500.00 ",$76.87 ,"$3,000.00 ","$1,938.00 ",$76.87 ,"$1,940.70 ","$1,940.70 ",$256.12 ,"$1,800.00 ","$2,550.00 ","$2,100.00 ",$76.87 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ","$1,950.00 ","$2,550.00 ",$256.12 ,"$1,950.00 ","$2,400.00 ","$2,190.00 ",$76.87 ,$256.12 ,"$1,260.00 ","$3,000.00 ","$2,550.00 ",$576.27 ,"$2,760.00 ","$2,100.00 ","$1,500.00 ","$1,800.00 ","$1,827.00 ","$1,500.00 ","$2,073.00 ","$2,100.00 ",$258.68 ,"$2,160.00 ",$81.48 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,74000085,95707,HC EEG W/O VIDEO BY TECH 2-12 HOURS W/CONTINUOUS REAL-TIME MONITORING,740,1 ,"$3,500.00 ","$1,750.00 ",$76.87 ,"$3,500.00 ","$2,261.00 ",$76.87 ,"$2,264.15 ","$2,264.15 ",$256.12 ,"$2,100.00 ","$2,975.00 ","$2,450.00 ",$76.87 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ","$2,275.00 ","$2,975.00 ",$256.12 ,"$2,275.00 ","$2,800.00 ","$2,555.00 ",$76.87 ,$256.12 ,"$1,470.00 ","$3,500.00 ","$2,975.00 ",$576.27 ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ",$258.68 ,"$2,520.00 ",$81.48 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,74000086,95708,HC EEG W/O VIDEO BY TECH 12-26 HOURS EACH INCREMENT UNMONITORED,740,1 ,"$5,000.00 ","$2,500.00 ",$156.65 ,"$5,000.00 ","$3,230.00 ",$156.65 ,"$3,234.50 ","$3,234.50 ",$472.41 ,"$3,000.00 ","$4,250.00 ","$3,500.00 ",$156.65 ,"$4,750.00 ","$3,600.00 ","$3,650.00 ","$3,250.00 ","$4,250.00 ",$472.41 ,"$3,250.00 ","$4,000.00 ","$3,650.00 ",$156.65 ,$472.41 ,"$2,100.00 ","$5,000.00 ","$4,250.00 ","$1,062.93 ","$4,600.00 ","$3,500.00 ","$2,500.00 ","$3,000.00 ","$3,045.00 ","$2,500.00 ","$3,455.00 ","$3,500.00 ",$477.13 ,"$3,600.00 ",$166.05 ,$414.00 ,$414.00 ,$472.41 ,$414.00 ,$472.41 ,"$3,600.00 ","$3,100.00 ","$3,600.00 ","$3,600.00 ","$3,000.00 " ST VINCENT HOSPITAL - ACUTE,74000087,95709,HC EEG W/O VIDEO BY TECH 12-26 HOURS EACH INCREMENT W/INTERMITTENT MONITORING,740,1 ,"$5,300.00 ","$2,650.00 ",$156.65 ,"$5,300.00 ","$3,423.80 ",$156.65 ,"$3,428.57 ","$3,428.57 ",$472.41 ,"$3,180.00 ","$4,505.00 ","$3,710.00 ",$156.65 ,"$5,035.00 ","$3,816.00 ","$3,869.00 ","$3,445.00 ","$4,505.00 ",$472.41 ,"$3,445.00 ","$4,240.00 ","$3,869.00 ",$156.65 ,$472.41 ,"$2,226.00 ","$5,300.00 ","$4,505.00 ","$1,062.93 ","$4,876.00 ","$3,710.00 ","$2,650.00 ","$3,180.00 ","$3,227.70 ","$2,650.00 ","$3,662.30 ","$3,710.00 ",$477.13 ,"$3,816.00 ",$166.05 ,$414.00 ,$414.00 ,$472.41 ,$414.00 ,$472.41 ,"$3,816.00 ","$3,286.00 ","$3,816.00 ","$3,816.00 ","$3,180.00 " ST VINCENT HOSPITAL - ACUTE,74000089,95711,HC VEEG W/VIDEO BY TECH 2-12 HOURS UNMONITORED,740,1 ,"$2,700.00 ","$1,350.00 ",$76.87 ,"$2,700.00 ","$1,744.20 ",$76.87 ,"$1,746.63 ","$1,746.63 ",$256.12 ,"$1,620.00 ","$2,295.00 ","$1,890.00 ",$76.87 ,"$2,565.00 ","$1,944.00 ","$1,971.00 ","$1,755.00 ","$2,295.00 ",$256.12 ,"$1,755.00 ","$2,160.00 ","$1,971.00 ",$76.87 ,$256.12 ,"$1,134.00 ","$2,700.00 ","$2,295.00 ",$576.27 ,"$2,484.00 ","$1,890.00 ","$1,350.00 ","$1,620.00 ","$1,644.30 ","$1,350.00 ","$1,865.70 ","$1,890.00 ",$258.68 ,"$1,944.00 ",$81.48 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,"$1,944.00 ","$1,674.00 ","$1,944.00 ","$1,944.00 ","$1,620.00 " ST VINCENT HOSPITAL - ACUTE,74000090,95712,HC VEEG W/VIDEO BY TECH 2-12 HOURS W/INTERMITTENT MONITORING,740,1 ,"$3,000.00 ","$1,500.00 ",$76.87 ,"$3,000.00 ","$1,938.00 ",$76.87 ,"$1,940.70 ","$1,940.70 ",$256.12 ,"$1,800.00 ","$2,550.00 ","$2,100.00 ",$76.87 ,"$2,850.00 ","$2,160.00 ","$2,190.00 ","$1,950.00 ","$2,550.00 ",$256.12 ,"$1,950.00 ","$2,400.00 ","$2,190.00 ",$76.87 ,$256.12 ,"$1,260.00 ","$3,000.00 ","$2,550.00 ",$576.27 ,"$2,760.00 ","$2,100.00 ","$1,500.00 ","$1,800.00 ","$1,827.00 ","$1,500.00 ","$2,073.00 ","$2,100.00 ",$258.68 ,"$2,160.00 ",$81.48 ,$414.00 ,$414.00 ,$256.12 ,$414.00 ,$256.12 ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,74000091,95713,HC VEEG W/VIDEO BY TECH 2-12 HOURS W/CONTINUOUS REAL-TIME MONITORING,740,1 ,"$3,500.00 ","$1,750.00 ",$76.87 ,"$3,500.00 ","$2,261.00 ",$76.87 ,"$2,264.15 ","$2,264.15 ",$472.41 ,"$2,100.00 ","$2,975.00 ","$2,450.00 ",$76.87 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ","$2,275.00 ","$2,975.00 ",$472.41 ,"$2,275.00 ","$2,800.00 ","$2,555.00 ",$76.87 ,$472.41 ,"$1,470.00 ","$3,500.00 ","$2,975.00 ","$1,062.93 ","$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ",$477.13 ,"$2,520.00 ",$81.48 ,$414.00 ,$414.00 ,$472.41 ,$414.00 ,$472.41 ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,74000092,95714,HC VEEG W/VIDEO BY TECH 12-26 HOURS EACH INCREMENT UNMONITORED,740,1 ,"$5,000.00 ","$2,500.00 ",$156.65 ,"$5,000.00 ","$3,230.00 ",$156.65 ,"$3,234.50 ","$3,234.50 ",$472.41 ,"$3,000.00 ","$4,250.00 ","$3,500.00 ",$156.65 ,"$4,750.00 ","$3,600.00 ","$3,650.00 ","$3,250.00 ","$4,250.00 ",$472.41 ,"$3,250.00 ","$4,000.00 ","$3,650.00 ",$156.65 ,$472.41 ,"$2,100.00 ","$5,000.00 ","$4,250.00 ","$1,062.93 ","$4,600.00 ","$3,500.00 ","$2,500.00 ","$3,000.00 ","$3,045.00 ","$2,500.00 ","$3,455.00 ","$3,500.00 ",$477.13 ,"$3,600.00 ",$166.05 ,$414.00 ,$414.00 ,$472.41 ,$414.00 ,$472.41 ,"$3,600.00 ","$3,100.00 ","$3,600.00 ","$3,600.00 ","$3,000.00 " ST VINCENT HOSPITAL - ACUTE,74000093,95715,HC VEEG W/VIDEO BY TECH 12-26 HOURS EACH INCREMENT W/INTERMITTENT MONITORING,740,1 ,"$5,300.00 ","$2,650.00 ",$156.65 ,"$5,300.00 ","$3,423.80 ",$156.65 ,"$3,428.57 ","$3,428.57 ",$472.41 ,"$3,180.00 ","$4,505.00 ","$3,710.00 ",$156.65 ,"$5,035.00 ","$3,816.00 ","$3,869.00 ","$3,445.00 ","$4,505.00 ",$472.41 ,"$3,445.00 ","$4,240.00 ","$3,869.00 ",$156.65 ,$472.41 ,"$2,226.00 ","$5,300.00 ","$4,505.00 ","$1,062.93 ","$4,876.00 ","$3,710.00 ","$2,650.00 ","$3,180.00 ","$3,227.70 ","$2,650.00 ","$3,662.30 ","$3,710.00 ",$477.13 ,"$3,816.00 ",$166.05 ,$414.00 ,$414.00 ,$472.41 ,$414.00 ,$472.41 ,"$3,816.00 ","$3,286.00 ","$3,816.00 ","$3,816.00 ","$3,180.00 " ST VINCENT HOSPITAL - ACUTE,75000001,N/A,HC COLONOSCOPY,750,1 ,"$3,300.00 ","$1,650.00 ","$1,650.00 ","$3,300.00 ","$2,131.80 ", N/A , N/A , N/A , N/A ,"$1,980.00 ","$2,805.00 ","$2,310.00 ", N/A ,"$3,135.00 ","$2,376.00 ","$2,409.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$2,640.00 ","$2,409.00 ", N/A , N/A , N/A ,"$3,300.00 ","$2,805.00 ", N/A ,"$3,036.00 ","$2,310.00 ","$1,650.00 ","$1,980.00 ","$2,009.70 ","$1,650.00 ","$2,280.30 ","$2,310.00 ", N/A ,"$2,376.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,75000002,45380,HC COLONOSCOPY W/BX,750,1 ,"$3,700.00 ","$1,850.00 ",$224.41 ,"$3,700.00 ","$2,390.20 ",$224.41 ,"$3,700.00 ","$3,535.00 ","$1,004.30 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$224.41 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$3,700.00 ","$3,145.00 ","$1,004.30 ","$3,700.00 ","$2,960.00 ","$2,701.00 ",$224.41 ,"$1,004.30 ","$2,428.39 ","$3,700.00 ","$3,145.00 ","$2,259.67 ","$3,404.00 ","$2,590.00 ","$2,331.31 ","$3,133.44 ","$2,253.30 ","$2,914.14 ","$2,556.70 ","$2,590.00 ","$1,014.34 ","$2,664.00 ",$237.87 ,"$3,700.00 ","$3,700.00 ","$1,004.30 ","$3,700.00 ","$1,004.30 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000003,45385,HC COLONOSCOPY W/ SNARE,750,1 ,"$3,700.00 ","$1,850.00 ",$293.78 ,"$3,700.00 ","$2,390.20 ",$293.78 ,"$3,700.00 ","$3,535.00 ","$1,004.30 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$293.78 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$3,700.00 ","$3,145.00 ","$1,004.30 ","$3,700.00 ","$2,960.00 ","$2,701.00 ",$293.78 ,"$1,004.30 ","$2,428.39 ","$3,700.00 ","$3,145.00 ","$2,259.67 ","$3,404.00 ","$2,590.00 ","$2,331.31 ","$3,133.44 ","$2,253.30 ","$2,914.14 ","$2,556.70 ","$2,590.00 ","$1,014.34 ","$2,664.00 ",$311.41 ,"$3,700.00 ","$3,700.00 ","$1,004.30 ","$3,700.00 ","$1,004.30 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000004,45384,HC COLONOSCOPY W HOT BX,750,1 ,"$3,700.00 ","$1,850.00 ",$293.78 ,"$3,700.00 ","$2,390.20 ",$293.78 ,"$3,700.00 ","$3,535.00 ","$1,004.30 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$293.78 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$3,700.00 ","$3,145.00 ","$1,004.30 ","$3,700.00 ","$2,960.00 ","$2,701.00 ",$293.78 ,"$1,004.30 ","$2,428.39 ","$3,700.00 ","$3,145.00 ","$2,259.67 ","$3,404.00 ","$2,590.00 ","$2,331.31 ","$3,133.44 ","$2,253.30 ","$2,914.14 ","$2,556.70 ","$2,590.00 ","$1,014.34 ","$2,664.00 ",$311.41 ,"$3,700.00 ","$3,700.00 ","$1,004.30 ","$3,700.00 ","$1,004.30 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000005,45382,HC COLONOSCOPY W/CONTROL BLEEDING OR ERBE,750,1 ,"$3,700.00 ","$1,850.00 ",$293.78 ,"$3,700.00 ","$2,390.20 ",$293.78 ,"$3,700.00 ","$3,535.00 ","$1,004.30 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$293.78 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$3,700.00 ","$3,145.00 ","$1,004.30 ","$3,700.00 ","$2,960.00 ","$2,701.00 ",$293.78 ,"$1,004.30 ","$2,428.39 ","$3,700.00 ","$3,145.00 ","$2,259.67 ","$3,404.00 ","$2,590.00 ","$2,331.31 ","$3,133.44 ","$2,253.30 ","$2,914.14 ","$2,556.70 ","$2,590.00 ","$1,014.34 ","$2,664.00 ",$311.41 ,"$3,700.00 ","$3,700.00 ","$1,004.30 ","$3,700.00 ","$1,004.30 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000007,45379,HC COLONOSCOPY W/ REMOVAL FB,750,1 ,"$3,700.00 ","$1,850.00 ",$293.78 ,"$3,700.00 ","$2,390.20 ",$293.78 ,"$3,700.00 ","$3,535.00 ","$1,004.30 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$293.78 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$3,700.00 ","$3,145.00 ","$1,004.30 ","$3,700.00 ","$2,960.00 ","$2,701.00 ",$293.78 ,"$1,004.30 ","$2,428.39 ","$3,700.00 ","$3,145.00 ","$2,259.67 ","$3,404.00 ","$2,590.00 ","$2,331.31 ","$3,133.44 ","$2,253.30 ","$2,914.14 ","$2,556.70 ","$2,590.00 ","$1,014.34 ","$2,664.00 ",$311.41 ,"$3,700.00 ","$3,700.00 ","$1,004.30 ","$3,700.00 ","$1,004.30 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000008,N/A,HC COLONOSCOPY W/ BALLOON DILATION,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000009,N/A,HC COLONOSCOPY/DECOMP,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000010,N/A,HC COLONOSCOPY W/STENT,750,1 ,"$5,800.00 ","$2,900.00 ","$2,900.00 ","$5,800.00 ","$3,746.80 ", N/A , N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ", N/A ,"$5,510.00 ","$4,176.00 ","$4,234.00 ", N/A ,"$4,930.00 ", N/A , N/A ,"$4,640.00 ","$4,234.00 ", N/A , N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$2,900.00 ","$3,480.00 ","$3,532.20 ","$2,900.00 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,75000011,45381,HC COLONOSCOPY W/ SUBMUCOSAL INJ,750,1 ,"$3,700.00 ","$1,850.00 ",$293.78 ,"$3,700.00 ","$2,390.20 ",$293.78 ,"$3,700.00 ","$3,535.00 ","$1,004.30 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$293.78 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$3,700.00 ","$3,145.00 ","$1,004.30 ","$3,700.00 ","$2,960.00 ","$2,701.00 ",$293.78 ,"$1,004.30 ","$2,428.39 ","$3,700.00 ","$3,145.00 ","$2,259.67 ","$3,404.00 ","$2,590.00 ","$2,331.31 ","$3,133.44 ","$2,253.30 ","$2,914.14 ","$2,556.70 ","$2,590.00 ","$1,014.34 ","$2,664.00 ",$311.41 ,"$3,700.00 ","$3,700.00 ","$1,004.30 ","$3,700.00 ","$1,004.30 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000013,N/A,HC CAPSULE ENDOSCOPY,750,1 ,"$2,900.00 ","$1,450.00 ","$1,450.00 ","$2,900.00 ","$1,873.40 ", N/A , N/A , N/A , N/A ,"$1,740.00 ","$2,465.00 ","$2,030.00 ", N/A ,"$2,755.00 ","$2,088.00 ","$2,117.00 ", N/A ,"$2,465.00 ", N/A , N/A ,"$2,320.00 ","$2,117.00 ", N/A , N/A , N/A ,"$2,900.00 ","$2,465.00 ", N/A ,"$2,668.00 ","$2,030.00 ","$1,450.00 ","$1,740.00 ","$1,766.10 ","$1,450.00 ","$2,003.90 ","$2,030.00 ", N/A ,"$2,088.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,088.00 ","$1,798.00 ","$2,088.00 ","$2,088.00 ","$1,740.00 " ST VINCENT HOSPITAL - ACUTE,75000014,N/A,HC EGD,750,1 ,"$3,100.00 ","$1,550.00 ","$1,550.00 ","$3,100.00 ","$2,002.60 ", N/A , N/A , N/A , N/A ,"$1,860.00 ","$2,635.00 ","$2,170.00 ", N/A ,"$2,945.00 ","$2,232.00 ","$2,263.00 ", N/A ,"$2,635.00 ", N/A , N/A ,"$2,480.00 ","$2,263.00 ", N/A , N/A , N/A ,"$3,100.00 ","$2,635.00 ", N/A ,"$2,852.00 ","$2,170.00 ","$1,550.00 ","$1,860.00 ","$1,887.90 ","$1,550.00 ","$2,142.10 ","$2,170.00 ", N/A ,"$2,232.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,232.00 ","$1,922.00 ","$2,232.00 ","$2,232.00 ","$1,860.00 " ST VINCENT HOSPITAL - ACUTE,75000015,43239,HC EGD/BIOPSY,750,1 ,"$3,500.00 ","$1,750.00 ",$269.10 ,"$3,500.00 ","$2,261.00 ",$269.10 ,"$2,525.00 ","$2,020.00 ",$784.10 ,"$2,100.00 ","$2,975.00 ","$2,450.00 ",$269.10 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ","$3,500.00 ","$2,975.00 ",$784.10 ,"$3,500.00 ","$2,800.00 ","$2,555.00 ",$269.10 ,$784.10 ,"$2,428.39 ","$3,500.00 ","$2,975.00 ","$1,764.22 ","$3,220.00 ","$2,450.00 ","$2,331.31 ","$3,133.44 ","$2,131.50 ","$2,914.14 ","$2,418.50 ","$2,450.00 ",$791.94 ,"$2,520.00 ",$285.25 ,"$3,500.00 ","$3,500.00 ",$784.10 ,"$3,500.00 ",$784.10 ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000016,N/A,HC EGD/ERBE,750,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$3,500.00 ","$2,261.00 ", N/A , N/A , N/A , N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ", N/A ,"$2,975.00 ", N/A , N/A ,"$2,800.00 ","$2,555.00 ", N/A , N/A , N/A ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000017,N/A,HC EGD/HEMOSTASIS,750,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$3,500.00 ","$2,261.00 ", N/A , N/A , N/A , N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ", N/A ,"$2,975.00 ", N/A , N/A ,"$2,800.00 ","$2,555.00 ", N/A , N/A , N/A ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000018,N/A,HC EGD/BANDING,750,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$3,500.00 ","$2,261.00 ", N/A , N/A , N/A , N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ", N/A ,"$2,975.00 ", N/A , N/A ,"$2,800.00 ","$2,555.00 ", N/A , N/A , N/A ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000019,43233,HC EGD W/DILAT ESOPH BALLOON,750,1 ,"$3,500.00 ","$1,750.00 ",$269.10 ,"$3,541.12 ","$2,261.00 ",$269.10 ,"$3,500.00 ","$3,500.00 ","$1,573.83 ","$2,100.00 ","$2,975.00 ","$2,450.00 ",$269.10 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ","$3,500.00 ","$2,975.00 ","$1,573.83 ","$3,500.00 ","$2,800.00 ","$2,555.00 ",$269.10 ,"$1,573.83 ","$2,428.39 ","$3,500.00 ","$2,975.00 ","$3,541.12 ","$3,220.00 ","$2,450.00 ","$2,331.31 ","$3,133.44 ","$2,131.50 ","$2,914.14 ","$2,418.50 ","$2,450.00 ","$1,589.57 ","$2,520.00 ",$285.25 ,"$3,500.00 ","$3,500.00 ","$1,573.83 ","$3,500.00 ","$1,573.83 ","$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000020,N/A,HC EGD/FB REMOVAL,750,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$3,500.00 ","$2,261.00 ", N/A , N/A , N/A , N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ", N/A ,"$2,975.00 ", N/A , N/A ,"$2,800.00 ","$2,555.00 ", N/A , N/A , N/A ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000021,N/A,HC EGD/PEG PLACEMENT,750,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$3,500.00 ","$2,261.00 ", N/A , N/A , N/A , N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ", N/A ,"$2,975.00 ", N/A , N/A ,"$2,800.00 ","$2,555.00 ", N/A , N/A , N/A ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000022,43248,HC EGD W/DILAT ESOPH GD WIRE,750,1 ,"$3,500.00 ","$1,750.00 ",$269.10 ,"$3,500.00 ","$2,261.00 ",$269.10 ,"$2,525.00 ","$2,020.00 ",$784.10 ,"$2,100.00 ","$2,975.00 ","$2,450.00 ",$269.10 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ","$3,500.00 ","$2,975.00 ",$784.10 ,"$3,500.00 ","$2,800.00 ","$2,555.00 ",$269.10 ,$784.10 ,"$2,428.39 ","$3,500.00 ","$2,975.00 ","$1,764.22 ","$3,220.00 ","$2,450.00 ","$2,331.31 ","$3,133.44 ","$2,131.50 ","$2,914.14 ","$2,418.50 ","$2,450.00 ",$791.94 ,"$2,520.00 ",$285.25 ,"$3,500.00 ","$3,500.00 ",$784.10 ,"$3,500.00 ",$784.10 ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000023,43250,HC EGD/HOT BX,750,1 ,"$3,500.00 ","$1,750.00 ",$269.10 ,"$3,541.12 ","$2,261.00 ",$269.10 ,"$3,500.00 ","$3,500.00 ","$1,573.83 ","$2,100.00 ","$2,975.00 ","$2,450.00 ",$269.10 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ","$3,500.00 ","$2,975.00 ","$1,573.83 ","$3,500.00 ","$2,800.00 ","$2,555.00 ",$269.10 ,"$1,573.83 ","$2,428.39 ","$3,500.00 ","$2,975.00 ","$3,541.12 ","$3,220.00 ","$2,450.00 ","$2,331.31 ","$3,133.44 ","$2,131.50 ","$2,914.14 ","$2,418.50 ","$2,450.00 ","$1,589.57 ","$2,520.00 ",$285.25 ,"$3,500.00 ","$3,500.00 ","$1,573.83 ","$3,500.00 ","$1,573.83 ","$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000024,N/A,HC EGD/PYLORIC DILATION,750,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$3,500.00 ","$2,261.00 ", N/A , N/A , N/A , N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ", N/A ,"$2,975.00 ", N/A , N/A ,"$2,800.00 ","$2,555.00 ", N/A , N/A , N/A ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000025,N/A,HC EGD/SCLEROTHERAPY,750,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$3,500.00 ","$2,261.00 ", N/A , N/A , N/A , N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ", N/A ,"$2,975.00 ", N/A , N/A ,"$2,800.00 ","$2,555.00 ", N/A , N/A , N/A ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000026,43251,HC EGD/SNARE,750,1 ,"$3,500.00 ","$1,750.00 ",$269.10 ,"$3,541.12 ","$2,261.00 ",$269.10 ,"$3,500.00 ","$3,500.00 ","$1,573.83 ","$2,100.00 ","$2,975.00 ","$2,450.00 ",$269.10 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ","$3,500.00 ","$2,975.00 ","$1,573.83 ","$3,500.00 ","$2,800.00 ","$2,555.00 ",$269.10 ,"$1,573.83 ","$2,428.39 ","$3,500.00 ","$2,975.00 ","$3,541.12 ","$3,220.00 ","$2,450.00 ","$2,331.31 ","$3,133.44 ","$2,131.50 ","$2,914.14 ","$2,418.50 ","$2,450.00 ","$1,589.57 ","$2,520.00 ",$285.25 ,"$3,500.00 ","$3,500.00 ","$1,573.83 ","$3,500.00 ","$1,573.83 ","$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000028,N/A,HC EGD/STENT,750,1 ,"$5,800.00 ","$2,900.00 ","$2,900.00 ","$5,800.00 ","$3,746.80 ", N/A , N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ", N/A ,"$5,510.00 ","$4,176.00 ","$4,234.00 ", N/A ,"$4,930.00 ", N/A , N/A ,"$4,640.00 ","$4,234.00 ", N/A , N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$2,900.00 ","$3,480.00 ","$3,532.20 ","$2,900.00 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,75000029,N/A,HC ENTEROSCOPY BALLOON,750,1 ,"$3,600.00 ","$1,800.00 ","$1,800.00 ","$3,600.00 ","$2,325.60 ", N/A , N/A , N/A , N/A ,"$2,160.00 ","$3,060.00 ","$2,520.00 ", N/A ,"$3,420.00 ","$2,592.00 ","$2,628.00 ", N/A ,"$3,060.00 ", N/A , N/A ,"$2,880.00 ","$2,628.00 ", N/A , N/A , N/A ,"$3,600.00 ","$3,060.00 ", N/A ,"$3,312.00 ","$2,520.00 ","$1,800.00 ","$2,160.00 ","$2,192.40 ","$1,800.00 ","$2,487.60 ","$2,520.00 ", N/A ,"$2,592.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,592.00 ","$2,232.00 ","$2,592.00 ","$2,592.00 ","$2,160.00 " ST VINCENT HOSPITAL - ACUTE,75000030,N/A,HC ENTEROSCOPY BALLOON/HEMOSTASIS,750,1 ,"$3,600.00 ","$1,800.00 ","$1,800.00 ","$3,600.00 ","$2,325.60 ", N/A , N/A , N/A , N/A ,"$2,160.00 ","$3,060.00 ","$2,520.00 ", N/A ,"$3,420.00 ","$2,592.00 ","$2,628.00 ", N/A ,"$3,060.00 ", N/A , N/A ,"$2,880.00 ","$2,628.00 ", N/A , N/A , N/A ,"$3,600.00 ","$3,060.00 ", N/A ,"$3,312.00 ","$2,520.00 ","$1,800.00 ","$2,160.00 ","$2,192.40 ","$1,800.00 ","$2,487.60 ","$2,520.00 ", N/A ,"$2,592.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,592.00 ","$2,232.00 ","$2,592.00 ","$2,592.00 ","$2,160.00 " ST VINCENT HOSPITAL - ACUTE,75000031,N/A,HC BRAVO PH STUDY,750,1 ,"$1,700.00 ",$850.00 ,$850.00 ,"$1,700.00 ","$1,098.20 ", N/A , N/A , N/A , N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ", N/A ,"$1,615.00 ","$1,224.00 ","$1,241.00 ", N/A ,"$1,445.00 ", N/A , N/A ,"$1,360.00 ","$1,241.00 ", N/A , N/A , N/A ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,75000032,N/A,HC HEMORRHOID BAND WITH SCOPE,750,1 ,"$2,200.00 ","$1,100.00 ","$1,100.00 ","$2,200.00 ","$1,421.20 ", N/A , N/A , N/A , N/A ,"$1,320.00 ","$1,870.00 ","$1,540.00 ", N/A ,"$2,090.00 ","$1,584.00 ","$1,606.00 ", N/A ,"$1,870.00 ", N/A , N/A ,"$1,760.00 ","$1,606.00 ", N/A , N/A , N/A ,"$2,200.00 ","$1,870.00 ", N/A ,"$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ", N/A ,"$1,584.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000033,N/A,HC STOMA COLONOSCOPY,750,1 ,"$3,300.00 ","$1,650.00 ","$1,650.00 ","$3,300.00 ","$2,131.80 ", N/A , N/A , N/A , N/A ,"$1,980.00 ","$2,805.00 ","$2,310.00 ", N/A ,"$3,135.00 ","$2,376.00 ","$2,409.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$2,640.00 ","$2,409.00 ", N/A , N/A , N/A ,"$3,300.00 ","$2,805.00 ", N/A ,"$3,036.00 ","$2,310.00 ","$1,650.00 ","$1,980.00 ","$2,009.70 ","$1,650.00 ","$2,280.30 ","$2,310.00 ", N/A ,"$2,376.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,75000034,N/A,HC STOMA COLONOSCOPY W/ HOT BX,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000035,44394,HC STOMA COLONOSCOPY W/ SNARE,750,1 ,"$3,700.00 ","$1,850.00 ",$293.78 ,"$3,700.00 ","$2,390.20 ",$293.78 ,"$3,700.00 ","$3,535.00 ","$1,004.30 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$293.78 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$2,717.00 ","$3,145.00 ","$1,004.30 ","$2,717.00 ","$2,960.00 ","$2,701.00 ",$293.78 ,"$1,004.30 ","$2,428.39 ","$3,700.00 ","$3,145.00 ","$2,259.67 ","$3,404.00 ","$2,590.00 ","$2,066.93 ","$2,778.48 ","$2,253.30 ","$2,583.66 ","$2,556.70 ","$2,590.00 ","$1,014.34 ","$2,664.00 ",$311.41 ,"$3,700.00 ","$3,700.00 ","$1,004.30 ","$3,700.00 ","$1,004.30 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000036,44389,HC STOMA COLONOSCOPY W/BX,750,1 ,"$3,700.00 ","$1,850.00 ",$293.78 ,"$3,700.00 ","$2,390.20 ",$293.78 ,"$3,700.00 ","$3,535.00 ","$1,004.30 ","$2,220.00 ","$3,145.00 ","$2,590.00 ",$293.78 ,"$3,515.00 ","$2,664.00 ","$2,701.00 ","$2,717.00 ","$3,145.00 ","$1,004.30 ","$2,717.00 ","$2,960.00 ","$2,701.00 ",$293.78 ,"$1,004.30 ","$2,428.39 ","$3,700.00 ","$3,145.00 ","$2,259.67 ","$3,404.00 ","$2,590.00 ","$2,066.93 ","$2,778.48 ","$2,253.30 ","$2,583.66 ","$2,556.70 ","$2,590.00 ","$1,014.34 ","$2,664.00 ",$311.41 ,"$3,700.00 ","$3,700.00 ","$1,004.30 ","$3,700.00 ","$1,004.30 ","$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000037,N/A,HC STOMA COLONOSCOPY W/ HEMOSTASIS,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000038,N/A,HC EGD/EMR,750,1 ,"$2,100.00 ","$1,050.00 ","$1,050.00 ","$2,100.00 ","$1,356.60 ", N/A , N/A , N/A , N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ", N/A ,"$1,995.00 ","$1,512.00 ","$1,533.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,680.00 ","$1,533.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$1,050.00 ","$1,260.00 ","$1,278.90 ","$1,050.00 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,75000039,N/A,HC ENTEROSCOPY,750,1 ,"$3,300.00 ","$1,650.00 ","$1,650.00 ","$3,300.00 ","$2,131.80 ", N/A , N/A , N/A , N/A ,"$1,980.00 ","$2,805.00 ","$2,310.00 ", N/A ,"$3,135.00 ","$2,376.00 ","$2,409.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$2,640.00 ","$2,409.00 ", N/A , N/A , N/A ,"$3,300.00 ","$2,805.00 ", N/A ,"$3,036.00 ","$2,310.00 ","$1,650.00 ","$1,980.00 ","$2,009.70 ","$1,650.00 ","$2,280.30 ","$2,310.00 ", N/A ,"$2,376.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,75000040,N/A,HC ENTEROSCOPY W/ HOT BX,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000041,N/A,HC ENTEROSCOPY W/HEMOSTATIS,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000042,N/A,HC ENTEROSCOPY W/ BIOPSY,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000043,N/A,HC ENTEROSCOPY W/ ABLATION,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000044,N/A,HC ENTEROSCOPY W/SNARE,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000045,N/A,HC ENTEROSCOPY W/ STENT,750,1 ,"$5,800.00 ","$2,900.00 ","$2,900.00 ","$5,800.00 ","$3,746.80 ", N/A , N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ", N/A ,"$5,510.00 ","$4,176.00 ","$4,234.00 ", N/A ,"$4,930.00 ", N/A , N/A ,"$4,640.00 ","$4,234.00 ", N/A , N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$2,900.00 ","$3,480.00 ","$3,532.20 ","$2,900.00 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,75000046,N/A,HC ERCP,750,1 ,"$4,800.00 ","$2,400.00 ","$2,400.00 ","$4,800.00 ","$3,100.80 ", N/A , N/A , N/A , N/A ,"$2,880.00 ","$4,080.00 ","$3,360.00 ", N/A ,"$4,560.00 ","$3,456.00 ","$3,504.00 ", N/A ,"$4,080.00 ", N/A , N/A ,"$3,840.00 ","$3,504.00 ", N/A , N/A , N/A ,"$4,800.00 ","$4,080.00 ", N/A ,"$4,416.00 ","$3,360.00 ","$2,400.00 ","$2,880.00 ","$2,923.20 ","$2,400.00 ","$3,316.80 ","$3,360.00 ", N/A ,"$3,456.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,456.00 ","$2,976.00 ","$3,456.00 ","$3,456.00 ","$2,880.00 " ST VINCENT HOSPITAL - ACUTE,75000047,N/A,HC ERCP W/ STENT PLACEMENT,750,1 ,"$5,800.00 ","$2,900.00 ","$2,900.00 ","$5,800.00 ","$3,746.80 ", N/A , N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ", N/A ,"$5,510.00 ","$4,176.00 ","$4,234.00 ", N/A ,"$4,930.00 ", N/A , N/A ,"$4,640.00 ","$4,234.00 ", N/A , N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$2,900.00 ","$3,480.00 ","$3,532.20 ","$2,900.00 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,75000048,N/A,HC ERCP W/ FB REMOVAL OR STENT REMOVAL,750,1 ,"$5,800.00 ","$2,900.00 ","$2,900.00 ","$5,800.00 ","$3,746.80 ", N/A , N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ", N/A ,"$5,510.00 ","$4,176.00 ","$4,234.00 ", N/A ,"$4,930.00 ", N/A , N/A ,"$4,640.00 ","$4,234.00 ", N/A , N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$2,900.00 ","$3,480.00 ","$3,532.20 ","$2,900.00 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,75000049,N/A,HC ERCP W/ BALLOON DILATION,750,1 ,"$4,800.00 ","$2,400.00 ","$2,400.00 ","$4,800.00 ","$3,100.80 ", N/A , N/A , N/A , N/A ,"$2,880.00 ","$4,080.00 ","$3,360.00 ", N/A ,"$4,560.00 ","$3,456.00 ","$3,504.00 ", N/A ,"$4,080.00 ", N/A , N/A ,"$3,840.00 ","$3,504.00 ", N/A , N/A , N/A ,"$4,800.00 ","$4,080.00 ", N/A ,"$4,416.00 ","$3,360.00 ","$2,400.00 ","$2,880.00 ","$2,923.20 ","$2,400.00 ","$3,316.80 ","$3,360.00 ", N/A ,"$3,456.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,456.00 ","$2,976.00 ","$3,456.00 ","$3,456.00 ","$2,880.00 " ST VINCENT HOSPITAL - ACUTE,75000050,N/A,HC ERCP W/ BIOPSY,750,1 ,"$4,800.00 ","$2,400.00 ","$2,400.00 ","$4,800.00 ","$3,100.80 ", N/A , N/A , N/A , N/A ,"$2,880.00 ","$4,080.00 ","$3,360.00 ", N/A ,"$4,560.00 ","$3,456.00 ","$3,504.00 ", N/A ,"$4,080.00 ", N/A , N/A ,"$3,840.00 ","$3,504.00 ", N/A , N/A , N/A ,"$4,800.00 ","$4,080.00 ", N/A ,"$4,416.00 ","$3,360.00 ","$2,400.00 ","$2,880.00 ","$2,923.20 ","$2,400.00 ","$3,316.80 ","$3,360.00 ", N/A ,"$3,456.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,456.00 ","$2,976.00 ","$3,456.00 ","$3,456.00 ","$2,880.00 " ST VINCENT HOSPITAL - ACUTE,75000051,N/A,HC ERCP W/LITHOTRIPSY,750,1 ,"$4,800.00 ","$2,400.00 ","$2,400.00 ","$4,800.00 ","$3,100.80 ", N/A , N/A , N/A , N/A ,"$2,880.00 ","$4,080.00 ","$3,360.00 ", N/A ,"$4,560.00 ","$3,456.00 ","$3,504.00 ", N/A ,"$4,080.00 ", N/A , N/A ,"$3,840.00 ","$3,504.00 ", N/A , N/A , N/A ,"$4,800.00 ","$4,080.00 ", N/A ,"$4,416.00 ","$3,360.00 ","$2,400.00 ","$2,880.00 ","$2,923.20 ","$2,400.00 ","$3,316.80 ","$3,360.00 ", N/A ,"$3,456.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,456.00 ","$2,976.00 ","$3,456.00 ","$3,456.00 ","$2,880.00 " ST VINCENT HOSPITAL - ACUTE,75000052,N/A,HC ERCP W/ SPHINCTEROTOMY,750,1 ,"$4,800.00 ","$2,400.00 ","$2,400.00 ","$4,800.00 ","$3,100.80 ", N/A , N/A , N/A , N/A ,"$2,880.00 ","$4,080.00 ","$3,360.00 ", N/A ,"$4,560.00 ","$3,456.00 ","$3,504.00 ", N/A ,"$4,080.00 ", N/A , N/A ,"$3,840.00 ","$3,504.00 ", N/A , N/A , N/A ,"$4,800.00 ","$4,080.00 ", N/A ,"$4,416.00 ","$3,360.00 ","$2,400.00 ","$2,880.00 ","$2,923.20 ","$2,400.00 ","$3,316.80 ","$3,360.00 ", N/A ,"$3,456.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,456.00 ","$2,976.00 ","$3,456.00 ","$3,456.00 ","$2,880.00 " ST VINCENT HOSPITAL - ACUTE,75000053,N/A,HC ERCP W/ STONE REMOVAL,750,1 ,"$4,800.00 ","$2,400.00 ","$2,400.00 ","$4,800.00 ","$3,100.80 ", N/A , N/A , N/A , N/A ,"$2,880.00 ","$4,080.00 ","$3,360.00 ", N/A ,"$4,560.00 ","$3,456.00 ","$3,504.00 ", N/A ,"$4,080.00 ", N/A , N/A ,"$3,840.00 ","$3,504.00 ", N/A , N/A , N/A ,"$4,800.00 ","$4,080.00 ", N/A ,"$4,416.00 ","$3,360.00 ","$2,400.00 ","$2,880.00 ","$2,923.20 ","$2,400.00 ","$3,316.80 ","$3,360.00 ", N/A ,"$3,456.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,456.00 ","$2,976.00 ","$3,456.00 ","$3,456.00 ","$2,880.00 " ST VINCENT HOSPITAL - ACUTE,75000055,N/A,HC ESOPHAGOSCOPY,750,1 ,"$3,000.00 ","$1,500.00 ","$1,500.00 ","$3,000.00 ","$1,938.00 ", N/A , N/A , N/A , N/A ,"$1,800.00 ","$2,550.00 ","$2,100.00 ", N/A ,"$2,850.00 ","$2,160.00 ","$2,190.00 ", N/A ,"$2,550.00 ", N/A , N/A ,"$2,400.00 ","$2,190.00 ", N/A , N/A , N/A ,"$3,000.00 ","$2,550.00 ", N/A ,"$2,760.00 ","$2,100.00 ","$1,500.00 ","$1,800.00 ","$1,827.00 ","$1,500.00 ","$2,073.00 ","$2,100.00 ", N/A ,"$2,160.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,160.00 ","$1,860.00 ","$2,160.00 ","$2,160.00 ","$1,800.00 " ST VINCENT HOSPITAL - ACUTE,75000056,N/A,HC ESOPHAGOSCOPY 360 ABLATION HALO,750,1 ,"$4,700.00 ","$2,350.00 ","$2,350.00 ","$4,700.00 ","$3,036.20 ", N/A , N/A , N/A , N/A ,"$2,820.00 ","$3,995.00 ","$3,290.00 ", N/A ,"$4,465.00 ","$3,384.00 ","$3,431.00 ", N/A ,"$3,995.00 ", N/A , N/A ,"$3,760.00 ","$3,431.00 ", N/A , N/A , N/A ,"$4,700.00 ","$3,995.00 ", N/A ,"$4,324.00 ","$3,290.00 ","$2,350.00 ","$2,820.00 ","$2,862.30 ","$2,350.00 ","$3,247.70 ","$3,290.00 ", N/A ,"$3,384.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,384.00 ","$2,914.00 ","$3,384.00 ","$3,384.00 ","$2,820.00 " ST VINCENT HOSPITAL - ACUTE,75000057,N/A,HC ESOPHAGOSCOPY 90 ABLATION HALO,750,1 ,"$4,700.00 ","$2,350.00 ","$2,350.00 ","$4,700.00 ","$3,036.20 ", N/A , N/A , N/A , N/A ,"$2,820.00 ","$3,995.00 ","$3,290.00 ", N/A ,"$4,465.00 ","$3,384.00 ","$3,431.00 ", N/A ,"$3,995.00 ", N/A , N/A ,"$3,760.00 ","$3,431.00 ", N/A , N/A , N/A ,"$4,700.00 ","$3,995.00 ", N/A ,"$4,324.00 ","$3,290.00 ","$2,350.00 ","$2,820.00 ","$2,862.30 ","$2,350.00 ","$3,247.70 ","$3,290.00 ", N/A ,"$3,384.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,384.00 ","$2,914.00 ","$3,384.00 ","$3,384.00 ","$2,820.00 " ST VINCENT HOSPITAL - ACUTE,75000058,N/A,HC ENDOSCOPIC ULTRASOUND,750,1 ,"$2,200.00 ","$1,100.00 ","$1,100.00 ","$2,200.00 ","$1,421.20 ", N/A , N/A , N/A , N/A ,"$1,320.00 ","$1,870.00 ","$1,540.00 ", N/A ,"$2,090.00 ","$1,584.00 ","$1,606.00 ", N/A ,"$1,870.00 ", N/A , N/A ,"$1,760.00 ","$1,606.00 ", N/A , N/A , N/A ,"$2,200.00 ","$1,870.00 ", N/A ,"$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ", N/A ,"$1,584.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000059,43215,HC ESOPHAGOSCOPY W/ FB REMOVAL,750,1 ,"$3,500.00 ","$1,750.00 ",$269.10 ,"$3,541.12 ","$2,261.00 ",$269.10 ,"$3,500.00 ","$3,500.00 ","$1,573.83 ","$2,100.00 ","$2,975.00 ","$2,450.00 ",$269.10 ,"$3,325.00 ","$2,520.00 ","$2,555.00 ","$2,717.00 ","$2,975.00 ","$1,573.83 ","$2,717.00 ","$2,800.00 ","$2,555.00 ",$269.10 ,"$1,573.83 ","$2,428.39 ","$3,500.00 ","$2,975.00 ","$3,541.12 ","$3,220.00 ","$2,450.00 ","$2,066.93 ","$2,778.48 ","$2,131.50 ","$2,583.66 ","$2,418.50 ","$2,450.00 ","$1,589.57 ","$2,520.00 ",$285.25 ,"$3,500.00 ","$3,500.00 ","$1,573.83 ","$3,500.00 ","$1,573.83 ","$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000060,N/A,HC ESOPHAGOSCOPY W/ STENT PLACEMENT,750,1 ,"$5,800.00 ","$2,900.00 ","$2,900.00 ","$5,800.00 ","$3,746.80 ", N/A , N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ", N/A ,"$5,510.00 ","$4,176.00 ","$4,234.00 ", N/A ,"$4,930.00 ", N/A , N/A ,"$4,640.00 ","$4,234.00 ", N/A , N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$2,900.00 ","$3,480.00 ","$3,532.20 ","$2,900.00 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,75000061,N/A,HC FISSURE INJECTION,750,1 ,"$2,100.00 ","$1,050.00 ","$1,050.00 ","$2,100.00 ","$1,356.60 ", N/A , N/A , N/A , N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ", N/A ,"$1,995.00 ","$1,512.00 ","$1,533.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,680.00 ","$1,533.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$1,050.00 ","$1,260.00 ","$1,278.90 ","$1,050.00 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,75000063,N/A,HC EUS W/ FNA AND CORE NEEDLE,750,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$3,500.00 ","$2,261.00 ", N/A , N/A , N/A , N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ", N/A ,"$2,975.00 ", N/A , N/A ,"$2,800.00 ","$2,555.00 ", N/A , N/A , N/A ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000064,N/A,HC EUS W/ FNA AND ECHOTIP,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000066,N/A,HC HYDROGEN BREATH TEST,750,1 ,$570.00 ,$285.00 ,$285.00 ,$570.00 ,$368.22 , N/A , N/A , N/A , N/A ,$342.00 ,$484.50 ,$399.00 , N/A ,$541.50 ,$410.40 ,$416.10 , N/A ,$484.50 , N/A , N/A ,$456.00 ,$416.10 , N/A , N/A , N/A ,$570.00 ,$484.50 , N/A ,$524.40 ,$399.00 ,$285.00 ,$342.00 ,$347.13 ,$285.00 ,$393.87 ,$399.00 , N/A ,$410.40 , N/A , N/A , N/A , N/A , N/A , N/A ,$410.40 ,$353.40 ,$410.40 ,$410.40 ,$342.00 ST VINCENT HOSPITAL - ACUTE,75000067,N/A,HC ILEOSCOPY STOMA,750,1 ,"$3,200.00 ","$1,600.00 ","$1,600.00 ","$3,200.00 ","$2,067.20 ", N/A , N/A , N/A , N/A ,"$1,920.00 ","$2,720.00 ","$2,240.00 ", N/A ,"$3,040.00 ","$2,304.00 ","$2,336.00 ", N/A ,"$2,720.00 ", N/A , N/A ,"$2,560.00 ","$2,336.00 ", N/A , N/A , N/A ,"$3,200.00 ","$2,720.00 ", N/A ,"$2,944.00 ","$2,240.00 ","$1,600.00 ","$1,920.00 ","$1,948.80 ","$1,600.00 ","$2,211.20 ","$2,240.00 ", N/A ,"$2,304.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,304.00 ","$1,984.00 ","$2,304.00 ","$2,304.00 ","$1,920.00 " ST VINCENT HOSPITAL - ACUTE,75000068,44382,HC ILEOSCOPY STOMA W/ BX,750,1 ,"$3,600.00 ","$1,800.00 ",$293.78 ,"$3,600.00 ","$2,325.60 ",$293.78 ,"$2,525.00 ","$2,020.00 ",$784.10 ,"$2,160.00 ","$3,060.00 ","$2,520.00 ",$293.78 ,"$3,420.00 ","$2,592.00 ","$2,628.00 ","$2,717.00 ","$3,060.00 ",$784.10 ,"$2,717.00 ","$2,880.00 ","$2,628.00 ",$293.78 ,$784.10 ,"$2,428.39 ","$3,600.00 ","$3,060.00 ","$1,764.22 ","$3,312.00 ","$2,520.00 ","$2,066.93 ","$2,778.48 ","$2,192.40 ","$2,583.66 ","$2,487.60 ","$2,520.00 ",$791.94 ,"$2,592.00 ",$311.41 ,"$3,600.00 ","$3,600.00 ",$784.10 ,"$3,600.00 ",$784.10 ,"$2,592.00 ","$2,232.00 ","$2,592.00 ","$2,592.00 ","$2,160.00 " ST VINCENT HOSPITAL - ACUTE,75000069,N/A,HC LIVER BIOPSY,750,1 ,"$1,700.00 ",$850.00 ,$850.00 ,"$1,700.00 ","$1,098.20 ", N/A , N/A , N/A , N/A ,"$1,020.00 ","$1,445.00 ","$1,190.00 ", N/A ,"$1,615.00 ","$1,224.00 ","$1,241.00 ", N/A ,"$1,445.00 ", N/A , N/A ,"$1,360.00 ","$1,241.00 ", N/A , N/A , N/A ,"$1,700.00 ","$1,445.00 ", N/A ,"$1,564.00 ","$1,190.00 ",$850.00 ,"$1,020.00 ","$1,035.30 ",$850.00 ,"$1,174.70 ","$1,190.00 ", N/A ,"$1,224.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,224.00 ","$1,054.00 ","$1,224.00 ","$1,224.00 ","$1,020.00 " ST VINCENT HOSPITAL - ACUTE,75000070,N/A,HC POUCHOSCOPY,750,1 ,"$3,300.00 ","$1,650.00 ","$1,650.00 ","$3,300.00 ","$2,131.80 ", N/A , N/A , N/A , N/A ,"$1,980.00 ","$2,805.00 ","$2,310.00 ", N/A ,"$3,135.00 ","$2,376.00 ","$2,409.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$2,640.00 ","$2,409.00 ", N/A , N/A , N/A ,"$3,300.00 ","$2,805.00 ", N/A ,"$3,036.00 ","$2,310.00 ","$1,650.00 ","$1,980.00 ","$2,009.70 ","$1,650.00 ","$2,280.30 ","$2,310.00 ", N/A ,"$2,376.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,376.00 ","$2,046.00 ","$2,376.00 ","$2,376.00 ","$1,980.00 " ST VINCENT HOSPITAL - ACUTE,75000071,N/A,HC POUCHOSCOPY W/BX,750,1 ,"$3,600.00 ","$1,800.00 ","$1,800.00 ","$3,600.00 ","$2,325.60 ", N/A , N/A , N/A , N/A ,"$2,160.00 ","$3,060.00 ","$2,520.00 ", N/A ,"$3,420.00 ","$2,592.00 ","$2,628.00 ", N/A ,"$3,060.00 ", N/A , N/A ,"$2,880.00 ","$2,628.00 ", N/A , N/A , N/A ,"$3,600.00 ","$3,060.00 ", N/A ,"$3,312.00 ","$2,520.00 ","$1,800.00 ","$2,160.00 ","$2,192.40 ","$1,800.00 ","$2,487.60 ","$2,520.00 ", N/A ,"$2,592.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,592.00 ","$2,232.00 ","$2,592.00 ","$2,592.00 ","$2,160.00 " ST VINCENT HOSPITAL - ACUTE,75000073,N/A,HC SIGMOIDOSCOPY,750,1 ,"$1,900.00 ",$950.00 ,$950.00 ,"$1,900.00 ","$1,227.40 ", N/A , N/A , N/A , N/A ,"$1,140.00 ","$1,615.00 ","$1,330.00 ", N/A ,"$1,805.00 ","$1,368.00 ","$1,387.00 ", N/A ,"$1,615.00 ", N/A , N/A ,"$1,520.00 ","$1,387.00 ", N/A , N/A , N/A ,"$1,900.00 ","$1,615.00 ", N/A ,"$1,748.00 ","$1,330.00 ",$950.00 ,"$1,140.00 ","$1,157.10 ",$950.00 ,"$1,312.90 ","$1,330.00 ", N/A ,"$1,368.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,368.00 ","$1,178.00 ","$1,368.00 ","$1,368.00 ","$1,140.00 " ST VINCENT HOSPITAL - ACUTE,75000074,45331,HC SIGMOIDOSCOPY W/BX,750,1 ,"$2,200.00 ","$1,100.00 ",$293.78 ,"$2,200.00 ","$1,421.20 ",$293.78 ,"$2,200.00 ","$2,020.00 ",$768.65 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$293.78 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ",$768.65 ,"$2,200.00 ","$1,760.00 ","$1,606.00 ",$293.78 ,$768.65 ,"$1,655.72 ","$2,200.00 ","$1,870.00 ","$1,729.46 ","$2,024.00 ","$1,540.00 ","$2,066.93 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ",$776.34 ,"$1,584.00 ",$311.41 ,"$2,200.00 ","$2,200.00 ",$768.65 ,"$2,200.00 ",$768.65 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000075,45333,HC SIGMOIDOSCOPY W/ HOT BX,750,1 ,"$2,200.00 ","$1,100.00 ",$293.78 ,"$2,200.00 ","$1,421.20 ",$293.78 ,"$2,200.00 ","$2,020.00 ",$768.65 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$293.78 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ",$768.65 ,"$2,200.00 ","$1,760.00 ","$1,606.00 ",$293.78 ,$768.65 ,"$1,655.72 ","$2,200.00 ","$1,870.00 ","$1,729.46 ","$2,024.00 ","$1,540.00 ","$2,066.93 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ",$776.34 ,"$1,584.00 ",$311.41 ,"$2,200.00 ","$2,200.00 ",$768.65 ,"$2,200.00 ",$768.65 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000076,45332,HC SIGMOIDOSCOPY W/ FB REMOVAL,750,1 ,"$2,200.00 ","$1,100.00 ",$293.78 ,"$2,259.67 ","$1,421.20 ",$293.78 ,"$2,200.00 ","$2,200.00 ","$1,004.30 ","$1,320.00 ","$1,870.00 ","$1,540.00 ",$293.78 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ","$1,004.30 ","$2,200.00 ","$1,760.00 ","$1,606.00 ",$293.78 ,"$1,004.30 ","$2,200.00 ","$2,200.00 ","$1,870.00 ","$2,259.67 ","$2,024.00 ","$1,540.00 ","$2,066.93 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ","$1,014.34 ","$1,584.00 ",$311.41 ,"$2,200.00 ","$2,200.00 ","$1,004.30 ","$2,200.00 ","$1,004.30 ","$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000077,45338,HC SIGMOIDOSCOPY W/ SNARE,750,1 ,"$2,200.00 ","$1,100.00 ",$293.78 ,"$2,259.67 ","$1,421.20 ",$293.78 ,"$2,200.00 ","$2,200.00 ","$1,004.30 ","$1,320.00 ","$1,870.00 ","$1,540.00 ",$293.78 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ","$1,004.30 ","$2,200.00 ","$1,760.00 ","$1,606.00 ",$293.78 ,"$1,004.30 ","$2,200.00 ","$2,200.00 ","$1,870.00 ","$2,259.67 ","$2,024.00 ","$1,540.00 ","$2,066.93 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ","$1,014.34 ","$1,584.00 ",$311.41 ,"$2,200.00 ","$2,200.00 ","$1,004.30 ","$2,200.00 ","$1,004.30 ","$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000078,N/A,HC SIGMOIDOSCOPY W/ HEMOSTASIS,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000079,N/A,HC SIGMOIDOSCOPY W/ DECOMPRESSION,750,1 ,"$2,200.00 ","$1,100.00 ","$1,100.00 ","$2,200.00 ","$1,421.20 ", N/A , N/A , N/A , N/A ,"$1,320.00 ","$1,870.00 ","$1,540.00 ", N/A ,"$2,090.00 ","$1,584.00 ","$1,606.00 ", N/A ,"$1,870.00 ", N/A , N/A ,"$1,760.00 ","$1,606.00 ", N/A , N/A , N/A ,"$2,200.00 ","$1,870.00 ", N/A ,"$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ", N/A ,"$1,584.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000080,N/A,HC SIGMOIDOSCOPY W/ ABLATION,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000081,45335,HC SIGMOIDOSCOPY SEDATED W/ SUBMUCOSAL INJ,750,1 ,"$2,200.00 ","$1,100.00 ",$293.78 ,"$2,200.00 ","$1,421.20 ",$293.78 ,"$2,200.00 ","$2,020.00 ",$768.65 ,"$1,320.00 ","$1,870.00 ","$1,540.00 ",$293.78 ,"$2,090.00 ","$1,584.00 ","$1,606.00 ","$2,200.00 ","$1,870.00 ",$768.65 ,"$2,200.00 ","$1,760.00 ","$1,606.00 ",$293.78 ,$768.65 ,"$1,655.72 ","$2,200.00 ","$1,870.00 ","$1,729.46 ","$2,024.00 ","$1,540.00 ","$2,066.93 ","$2,200.00 ","$1,339.80 ","$2,200.00 ","$1,520.20 ","$1,540.00 ",$776.34 ,"$1,584.00 ",$311.41 ,"$2,200.00 ","$2,200.00 ",$768.65 ,"$2,200.00 ",$768.65 ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000082,N/A,HC SIGMOIDOSCOPY SEDATED W/ BALLOON DIL,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000083,N/A,HC SIGMOIDOSCOPY SEDATED W/ STENT,750,1 ,"$5,800.00 ","$2,900.00 ","$2,900.00 ","$5,800.00 ","$3,746.80 ", N/A , N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ", N/A ,"$5,510.00 ","$4,176.00 ","$4,234.00 ", N/A ,"$4,930.00 ", N/A , N/A ,"$4,640.00 ","$4,234.00 ", N/A , N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$2,900.00 ","$3,480.00 ","$3,532.20 ","$2,900.00 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,75000084,N/A,HC SIGMOIDOSCOPY W/ ERBE,750,1 ,"$3,700.00 ","$1,850.00 ","$1,850.00 ","$3,700.00 ","$2,390.20 ", N/A , N/A , N/A , N/A ,"$2,220.00 ","$3,145.00 ","$2,590.00 ", N/A ,"$3,515.00 ","$2,664.00 ","$2,701.00 ", N/A ,"$3,145.00 ", N/A , N/A ,"$2,960.00 ","$2,701.00 ", N/A , N/A , N/A ,"$3,700.00 ","$3,145.00 ", N/A ,"$3,404.00 ","$2,590.00 ","$1,850.00 ","$2,220.00 ","$2,253.30 ","$1,850.00 ","$2,556.70 ","$2,590.00 ", N/A ,"$2,664.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,664.00 ","$2,294.00 ","$2,664.00 ","$2,664.00 ","$2,220.00 " ST VINCENT HOSPITAL - ACUTE,75000085,N/A,HC EUS RECTAL ULTRASOUND,750,1 ,"$2,200.00 ","$1,100.00 ","$1,100.00 ","$2,200.00 ","$1,421.20 ", N/A , N/A , N/A , N/A ,"$1,320.00 ","$1,870.00 ","$1,540.00 ", N/A ,"$2,090.00 ","$1,584.00 ","$1,606.00 ", N/A ,"$1,870.00 ", N/A , N/A ,"$1,760.00 ","$1,606.00 ", N/A , N/A , N/A ,"$2,200.00 ","$1,870.00 ", N/A ,"$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ", N/A ,"$1,584.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000092,N/A,HC TATTOOING/ENDOSCOPIC,750,1 ,"$1,800.00 ",$900.00 ,$900.00 ,"$1,800.00 ","$1,162.80 ", N/A , N/A , N/A , N/A ,"$1,080.00 ","$1,530.00 ","$1,260.00 ", N/A ,"$1,710.00 ","$1,296.00 ","$1,314.00 ", N/A ,"$1,530.00 ", N/A , N/A ,"$1,440.00 ","$1,314.00 ", N/A , N/A , N/A ,"$1,800.00 ","$1,530.00 ", N/A ,"$1,656.00 ","$1,260.00 ",$900.00 ,"$1,080.00 ","$1,096.20 ",$900.00 ,"$1,243.80 ","$1,260.00 ", N/A ,"$1,296.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,75000093,N/A,HC EGD/ SUBMUCOSAL INJ,750,1 ,"$3,500.00 ","$1,750.00 ","$1,750.00 ","$3,500.00 ","$2,261.00 ", N/A , N/A , N/A , N/A ,"$2,100.00 ","$2,975.00 ","$2,450.00 ", N/A ,"$3,325.00 ","$2,520.00 ","$2,555.00 ", N/A ,"$2,975.00 ", N/A , N/A ,"$2,800.00 ","$2,555.00 ", N/A , N/A , N/A ,"$3,500.00 ","$2,975.00 ", N/A ,"$3,220.00 ","$2,450.00 ","$1,750.00 ","$2,100.00 ","$2,131.50 ","$1,750.00 ","$2,418.50 ","$2,450.00 ", N/A ,"$2,520.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,520.00 ","$2,170.00 ","$2,520.00 ","$2,520.00 ","$2,100.00 " ST VINCENT HOSPITAL - ACUTE,75000094,N/A,HC PEG TUBE CHANGE,750,1 ,$380.00 ,$190.00 ,$190.00 ,$380.00 ,$245.48 , N/A , N/A , N/A , N/A ,$228.00 ,$323.00 ,$266.00 , N/A ,$361.00 ,$273.60 ,$277.40 , N/A ,$323.00 , N/A , N/A ,$304.00 ,$277.40 , N/A , N/A , N/A ,$380.00 ,$323.00 , N/A ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 , N/A ,$273.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,75000095,78267,HC UREA BREATH TEST C-14 ISOTO,300,1 ,$480.00 ,$240.00 ,$9.88 ,$480.00 ,$310.08 ,$9.88 ,$38.71 ,$33.18 ,$11.06 ,$288.00 ,$408.00 ,$336.00 ,$9.88 ,$456.00 ,$345.60 ,$350.40 ,$18.80 ,$408.00 ,$11.06 ,$18.80 ,$384.00 ,$350.40 ,$9.88 ,$11.06 ,$12.21 ,$480.00 ,$408.00 ,$24.89 ,$441.60 ,$336.00 ,$33.48 ,$36.05 ,$292.32 ,$33.48 ,$331.68 ,$336.00 ,$11.17 ,$345.60 ,$10.47 , N/A , N/A ,$11.06 , N/A ,$11.06 ,$345.60 ,$297.60 ,$345.60 ,$345.60 ,$288.00 ST VINCENT HOSPITAL - ACUTE,75000097,91034,HC ACID REFLUX TEST NASAL PH ELEC,750,1 ,$800.00 ,$400.00 ,$199.12 ,"$1,062.93 ",$516.80 ,$199.12 ,$800.00 ,$800.00 ,$472.41 ,$480.00 ,$680.00 ,$560.00 ,$199.12 ,$760.00 ,$576.00 ,$584.00 ,$800.00 ,$680.00 ,$472.41 ,$800.00 ,$640.00 ,$584.00 ,$199.12 ,$472.41 ,$800.00 ,$800.00 ,$680.00 ,"$1,062.93 ",$736.00 ,$560.00 , N/A , N/A ,$487.20 , N/A ,$552.80 ,$560.00 ,$477.13 ,$576.00 ,$211.07 ,$800.00 ,$800.00 ,$472.41 ,$800.00 ,$472.41 ,$576.00 ,$496.00 ,$576.00 ,$576.00 ,$480.00 ST VINCENT HOSPITAL - ACUTE,75000098,49083,HC PARACENTESIS W/IMAGING,750,1 ,"$1,800.00 ",$900.00 ,$202.63 ,"$1,800.00 ","$1,162.80 ",$202.63 ,"$1,800.00 ","$1,800.00 ",$784.10 ,"$1,080.00 ","$1,530.00 ","$1,260.00 ",$202.63 ,"$1,710.00 ","$1,296.00 ","$1,314.00 ","$1,800.00 ","$1,530.00 ",$784.10 ,"$1,800.00 ","$1,440.00 ","$1,314.00 ",$202.63 ,$784.10 ,"$1,655.72 ","$1,800.00 ","$1,530.00 ","$1,764.22 ","$1,656.00 ","$1,260.00 ","$1,800.00 ","$1,800.00 ","$1,096.20 ","$1,800.00 ","$1,243.80 ","$1,260.00 ",$791.94 ,"$1,296.00 ",$214.79 ,"$1,800.00 ","$1,800.00 ",$784.10 ,"$1,800.00 ",$784.10 ,"$1,296.00 ","$1,116.00 ","$1,296.00 ","$1,296.00 ","$1,080.00 " ST VINCENT HOSPITAL - ACUTE,75000099,90945,HC PERITONEAL SUBSQ,750,1 ,$700.00 ,$350.00 ,$209.59 ,$792.63 ,$452.20 ,$209.59 , N/A , N/A ,$352.28 ,$420.00 ,$595.00 ,$490.00 ,$209.59 ,$665.00 ,$504.00 ,$511.00 ,$700.00 ,$595.00 ,$352.28 ,$700.00 ,$560.00 ,$511.00 ,$209.59 ,$352.28 , N/A ,$700.00 ,$595.00 ,$792.63 ,$644.00 ,$490.00 ,$350.00 ,$420.00 ,$426.30 ,$350.00 ,$483.70 ,$490.00 ,$355.80 ,$504.00 ,$222.17 , N/A , N/A ,$352.28 , N/A ,$352.28 ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,75000102,N/A,HC SECONDARY GI PROC COLONOSCOPY,750,1 ,"$2,100.00 ","$1,050.00 ","$1,050.00 ","$2,100.00 ","$1,356.60 ", N/A , N/A , N/A , N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ", N/A ,"$1,995.00 ","$1,512.00 ","$1,533.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,680.00 ","$1,533.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$1,050.00 ","$1,260.00 ","$1,278.90 ","$1,050.00 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,75000103,N/A,HC SECONDARY GI PROC EGD,750,1 ,"$2,200.00 ","$1,100.00 ","$1,100.00 ","$2,200.00 ","$1,421.20 ", N/A , N/A , N/A , N/A ,"$1,320.00 ","$1,870.00 ","$1,540.00 ", N/A ,"$2,090.00 ","$1,584.00 ","$1,606.00 ", N/A ,"$1,870.00 ", N/A , N/A ,"$1,760.00 ","$1,606.00 ", N/A , N/A , N/A ,"$2,200.00 ","$1,870.00 ", N/A ,"$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ", N/A ,"$1,584.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000104,N/A,HC SECONDARY GI PROC ERCP,750,1 ,"$2,700.00 ","$1,350.00 ","$1,350.00 ","$2,700.00 ","$1,744.20 ", N/A , N/A , N/A , N/A ,"$1,620.00 ","$2,295.00 ","$1,890.00 ", N/A ,"$2,565.00 ","$1,944.00 ","$1,971.00 ", N/A ,"$2,295.00 ", N/A , N/A ,"$2,160.00 ","$1,971.00 ", N/A , N/A , N/A ,"$2,700.00 ","$2,295.00 ", N/A ,"$2,484.00 ","$1,890.00 ","$1,350.00 ","$1,620.00 ","$1,644.30 ","$1,350.00 ","$1,865.70 ","$1,890.00 ", N/A ,"$1,944.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,944.00 ","$1,674.00 ","$1,944.00 ","$1,944.00 ","$1,620.00 " ST VINCENT HOSPITAL - ACUTE,75000105,N/A,HC SECONDARY GI PROC EUS,750,1 ,"$2,200.00 ","$1,100.00 ","$1,100.00 ","$2,200.00 ","$1,421.20 ", N/A , N/A , N/A , N/A ,"$1,320.00 ","$1,870.00 ","$1,540.00 ", N/A ,"$2,090.00 ","$1,584.00 ","$1,606.00 ", N/A ,"$1,870.00 ", N/A , N/A ,"$1,760.00 ","$1,606.00 ", N/A , N/A , N/A ,"$2,200.00 ","$1,870.00 ", N/A ,"$2,024.00 ","$1,540.00 ","$1,100.00 ","$1,320.00 ","$1,339.80 ","$1,100.00 ","$1,520.20 ","$1,540.00 ", N/A ,"$1,584.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,584.00 ","$1,364.00 ","$1,584.00 ","$1,584.00 ","$1,320.00 " ST VINCENT HOSPITAL - ACUTE,75000106,N/A,HC SECONDARY GI PROC ENTEROSCOPY,750,1 ,"$2,100.00 ","$1,050.00 ","$1,050.00 ","$2,100.00 ","$1,356.60 ", N/A , N/A , N/A , N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ", N/A ,"$1,995.00 ","$1,512.00 ","$1,533.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,680.00 ","$1,533.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$1,050.00 ","$1,260.00 ","$1,278.90 ","$1,050.00 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,75000107,N/A,HC SECONDARY PROCEDURE SIGMOIDOSCOPY,750,1 ,"$2,100.00 ","$1,050.00 ","$1,050.00 ","$2,100.00 ","$1,356.60 ", N/A , N/A , N/A , N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ", N/A ,"$1,995.00 ","$1,512.00 ","$1,533.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,680.00 ","$1,533.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$1,050.00 ","$1,260.00 ","$1,278.90 ","$1,050.00 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,75000114,N/A,HC ERCP W/STENT REPLACEMENT,750,1 ,"$5,800.00 ","$2,900.00 ","$2,900.00 ","$5,800.00 ","$3,746.80 ", N/A , N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ", N/A ,"$5,510.00 ","$4,176.00 ","$4,234.00 ", N/A ,"$4,930.00 ", N/A , N/A ,"$4,640.00 ","$4,234.00 ", N/A , N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$2,900.00 ","$3,480.00 ","$3,532.20 ","$2,900.00 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,75000115,46999,HC ANOSCOPY/INJECTION SOLESTA,750,1 ,"$2,100.00 ","$1,050.00 ",$481.41 ,"$2,100.00 ","$1,356.60 ",$481.41 ,"$2,100.00 ","$2,100.00 ",$768.65 ,"$1,260.00 ","$1,785.00 ","$1,470.00 ",$481.41 ,"$1,995.00 ","$1,512.00 ","$1,533.00 ","$2,100.00 ","$1,785.00 ",$768.65 ,"$2,100.00 ","$1,680.00 ","$1,533.00 ",$481.41 ,$768.65 ,"$2,100.00 ","$2,100.00 ","$1,785.00 ","$1,729.46 ","$1,932.00 ","$1,470.00 ", N/A , N/A ,"$1,278.90 ", N/A ,"$1,451.10 ","$1,470.00 ",$776.34 ,"$1,512.00 ",$510.29 ,"$2,100.00 ","$2,100.00 ",$768.65 ,"$2,100.00 ",$768.65 ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,75000510,49082,HC PARACENTESIS W/O IMAGING,750,1 ,"$1,100.00 ",$550.00 ,$202.63 ,"$1,764.22 ",$710.60 ,$202.63 ,"$1,100.00 ","$1,100.00 ",$784.10 ,$660.00 ,$935.00 ,$770.00 ,$202.63 ,"$1,045.00 ",$792.00 ,$803.00 ,"$1,100.00 ",$935.00 ,$784.10 ,"$1,100.00 ",$880.00 ,$803.00 ,$202.63 ,$784.10 ,"$1,100.00 ","$1,100.00 ",$935.00 ,"$1,764.22 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$791.94 ,$792.00 ,$214.79 ,"$1,100.00 ","$1,100.00 ",$784.10 ,"$1,100.00 ",$784.10 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,75001004,N/A,HC ESOPHAGEAL MOTILITY/MANOMETRY,750,1 ,"$2,100.00 ","$1,050.00 ","$1,050.00 ","$2,100.00 ","$1,356.60 ", N/A , N/A , N/A , N/A ,"$1,260.00 ","$1,785.00 ","$1,470.00 ", N/A ,"$1,995.00 ","$1,512.00 ","$1,533.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,680.00 ","$1,533.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,785.00 ", N/A ,"$1,932.00 ","$1,470.00 ","$1,050.00 ","$1,260.00 ","$1,278.90 ","$1,050.00 ","$1,451.10 ","$1,470.00 ", N/A ,"$1,512.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,512.00 ","$1,302.00 ","$1,512.00 ","$1,512.00 ","$1,260.00 " ST VINCENT HOSPITAL - ACUTE,75001005,99215,HC PEG REMOVAL W/SEDATION (GI),750,1 ,$400.00 ,$200.00 ,$47.46 ,$400.00 ,$258.40 ,$47.46 , N/A , N/A , N/A ,$240.00 ,$340.00 ,$280.00 ,$47.46 ,$380.00 ,$288.00 ,$292.00 ,$400.00 ,$340.00 , N/A ,$400.00 ,$320.00 ,$292.00 ,$47.46 , N/A , N/A ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 , N/A ,$288.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,75001052,N/A,HC COLONSCOPY FLEX W/BAND LIGATION,750,1 ,"$5,800.00 ","$2,900.00 ","$2,900.00 ","$5,800.00 ","$3,746.80 ", N/A , N/A , N/A , N/A ,"$3,480.00 ","$4,930.00 ","$4,060.00 ", N/A ,"$5,510.00 ","$4,176.00 ","$4,234.00 ", N/A ,"$4,930.00 ", N/A , N/A ,"$4,640.00 ","$4,234.00 ", N/A , N/A , N/A ,"$5,800.00 ","$4,930.00 ", N/A ,"$5,336.00 ","$4,060.00 ","$2,900.00 ","$3,480.00 ","$3,532.20 ","$2,900.00 ","$4,007.80 ","$4,060.00 ", N/A ,"$4,176.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,176.00 ","$3,596.00 ","$4,176.00 ","$4,176.00 ","$3,480.00 " ST VINCENT HOSPITAL - ACUTE,75001106,43450,HC ESOPHAGUS DILATION UNGUIDED SGL/MULT PASS - 43450,750,1 ,"$3,400.00 ","$1,700.00 ",$199.12 ,"$3,400.00 ","$2,196.40 ",$199.12 ,"$2,525.00 ","$2,020.00 ",$784.10 ,"$2,040.00 ","$2,890.00 ","$2,380.00 ",$199.12 ,"$3,230.00 ","$2,448.00 ","$2,482.00 ","$2,717.00 ","$2,890.00 ",$784.10 ,"$2,717.00 ","$2,720.00 ","$2,482.00 ",$199.12 ,$784.10 ,"$2,428.39 ","$3,400.00 ","$2,890.00 ","$1,764.22 ","$3,128.00 ","$2,380.00 ","$2,066.93 ","$2,778.48 ","$2,070.60 ","$2,583.66 ","$2,349.40 ","$2,380.00 ",$791.94 ,"$2,448.00 ",$211.07 ,"$3,400.00 ","$3,400.00 ",$784.10 ,"$3,400.00 ",$784.10 ,"$2,448.00 ","$2,108.00 ","$2,448.00 ","$2,448.00 ","$2,040.00 " ST VINCENT HOSPITAL - ACUTE,75001138,44705,HC PREPARE FECAL MICROBIOTA - 44705,750,1 ,"$1,500.00 ",$750.00 ,$750.00 ,"$7,821.36 ",$969.00 , N/A ,"$1,500.00 ","$1,500.00 ", N/A ,$900.00 ,"$1,275.00 ","$1,050.00 ", N/A ,"$1,425.00 ","$1,080.00 ","$1,095.00 ","$1,500.00 ","$1,275.00 ", N/A ,"$1,500.00 ","$1,200.00 ","$1,095.00 ", N/A , N/A ,"$1,500.00 ","$1,500.00 ","$1,275.00 ", N/A ,"$1,380.00 ","$1,050.00 ","$5,818.90 ","$7,821.36 ",$913.50 ,"$7,273.62 ","$1,036.50 ","$1,050.00 ", N/A ,"$1,080.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,76000004,31579,HC LARYNG VIDEOSTROB INITIAL,760,1 ,$855.00 ,$427.50 ,$250.60 ,$855.00 ,$552.33 ,$250.60 ,$553.10 ,$553.10 ,$364.65 ,$513.00 ,$726.75 ,$598.50 ,$250.60 ,$812.25 ,$615.60 ,$624.15 ,$555.75 ,$726.75 ,$364.65 ,$555.75 ,$684.00 ,$624.15 ,$250.60 ,$364.65 ,$359.10 ,$855.00 ,$726.75 ,$820.46 ,$786.60 ,$598.50 ,$855.00 ,$855.00 ,$520.70 ,$855.00 ,$590.81 ,$598.50 ,$368.30 ,$615.60 ,$265.64 ,$513.00 ,$513.00 ,$364.65 ,$513.00 ,$364.65 ,$615.60 ,$530.10 ,$615.60 ,$615.60 ,$513.00 ST VINCENT HOSPITAL - ACUTE,76000008,31579,HC LRY VSTRB-WITH PHYS-INT,760,1 ,$855.00 ,$427.50 ,$250.60 ,$855.00 ,$552.33 ,$250.60 ,$553.10 ,$553.10 ,$364.65 ,$513.00 ,$726.75 ,$598.50 ,$250.60 ,$812.25 ,$615.60 ,$624.15 ,$555.75 ,$726.75 ,$364.65 ,$555.75 ,$684.00 ,$624.15 ,$250.60 ,$364.65 ,$359.10 ,$855.00 ,$726.75 ,$820.46 ,$786.60 ,$598.50 ,$855.00 ,$855.00 ,$520.70 ,$855.00 ,$590.81 ,$598.50 ,$368.30 ,$615.60 ,$265.64 ,$513.00 ,$513.00 ,$364.65 ,$513.00 ,$364.65 ,$615.60 ,$530.10 ,$615.60 ,$615.60 ,$513.00 ST VINCENT HOSPITAL - ACUTE,76000012,36514,HC PLASMAPHERESIS THERAPY,361,1 ,"$3,400.00 ","$1,700.00 ",$871.92 ,"$3,400.00 ","$2,196.40 ",$871.92 ,"$3,400.00 ","$3,400.00 ","$1,320.22 ","$2,040.00 ","$2,890.00 ","$2,380.00 ",$871.92 ,"$3,230.00 ","$2,448.00 ","$2,482.00 ","$3,400.00 ","$2,890.00 ","$1,320.22 ","$3,400.00 ","$2,720.00 ","$2,482.00 ",$871.92 ,"$1,320.22 ","$2,428.39 ","$3,400.00 ","$2,890.00 ","$2,970.50 ","$3,128.00 ","$2,380.00 ", N/A , N/A ,"$2,070.60 ", N/A ,"$2,349.40 ","$2,380.00 ","$1,333.42 ","$2,448.00 ",$924.24 ,"$3,400.00 ","$3,400.00 ","$1,320.22 ","$3,400.00 ","$1,320.22 ","$2,448.00 ","$2,108.00 ","$2,448.00 ","$2,448.00 ","$2,040.00 " ST VINCENT HOSPITAL - ACUTE,76000013,36516,HC IMMUNO COLUMN-2 HOURS,361,1 ,"$5,000.00 ","$2,500.00 ",$871.92 ,"$8,798.67 ","$3,230.00 ",$871.92 ,"$5,000.00 ","$5,000.00 ","$3,910.52 ","$3,000.00 ","$4,250.00 ","$3,500.00 ",$871.92 ,"$4,750.00 ","$3,600.00 ","$3,650.00 ","$5,000.00 ","$4,250.00 ","$3,910.52 ","$5,000.00 ","$4,000.00 ","$3,650.00 ",$871.92 ,"$3,910.52 ","$5,000.00 ","$5,000.00 ","$4,250.00 ","$8,798.67 ","$4,600.00 ","$3,500.00 ", N/A , N/A ,"$3,045.00 ", N/A ,"$3,455.00 ","$3,500.00 ","$3,949.63 ","$3,600.00 ",$924.24 ,"$5,000.00 ","$5,000.00 ","$3,910.52 ","$5,000.00 ","$3,910.52 ","$3,600.00 ","$3,100.00 ","$3,600.00 ","$3,600.00 ","$3,000.00 " ST VINCENT HOSPITAL - ACUTE,76000014,62273,HC INJ EPIDURAL BLD/CLOT PATCH,760,1 ,"$1,100.00 ",$550.00 ,$263.02 ,"$1,382.85 ",$710.60 ,$263.02 ,$711.59 ,$711.59 ,$614.60 ,$660.00 ,$935.00 ,$770.00 ,$263.02 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$614.60 ,$715.00 ,$880.00 ,$803.00 ,$263.02 ,$614.60 ,$462.00 ,"$1,100.00 ",$935.00 ,"$1,382.85 ","$1,012.00 ",$770.00 ,"$1,100.00 ","$1,100.00 ",$669.90 ,"$1,100.00 ",$760.10 ,$770.00 ,$620.75 ,$792.00 ,$278.80 ,$660.00 ,$660.00 ,$614.60 ,$660.00 ,$614.60 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,76100001,29700,HC REMOVE/REVISION CAST,761,1 ,$220.00 ,$110.00 ,$57.61 ,$525.54 ,$142.12 ,$57.61 ,$220.00 ,$220.00 ,$233.57 ,$132.00 ,$187.00 ,$154.00 ,$57.61 ,$209.00 ,$158.40 ,$160.60 ,$220.00 ,$187.00 ,$233.57 ,$220.00 ,$176.00 ,$160.60 ,$57.61 ,$233.57 ,$92.40 ,$220.00 ,$187.00 ,$525.54 ,$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$235.91 ,$158.40 ,$61.07 ,$132.00 ,$132.00 ,$233.57 ,$132.00 ,$233.57 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,76100054,64999,HC GANGLION IMPAR BLOCK,761,1 ,"$1,330.00 ",$665.00 ,$121.61 ,"$1,330.00 ",$859.18 ,$121.61 ,"$1,330.00 ","$1,330.00 ",$252.94 ,$798.00 ,"$1,130.50 ",$931.00 ,$121.61 ,"$1,263.50 ",$957.60 ,$970.90 ,"$1,330.00 ","$1,130.50 ",$252.94 ,"$1,330.00 ","$1,064.00 ",$970.90 ,$121.61 ,$252.94 ,$558.60 ,"$1,330.00 ","$1,130.50 ",$569.12 ,"$1,223.60 ",$931.00 ,$665.00 ,$798.00 ,$809.97 ,$665.00 ,$919.03 ,$931.00 ,$255.47 ,$957.60 ,$128.91 ,$798.00 ,$798.00 ,$252.94 ,$798.00 ,$252.94 ,$957.60 ,$824.60 ,$957.60 ,$957.60 ,$798.00 ST VINCENT HOSPITAL - ACUTE,76200000,G0378,HC OBSERVATION ROOM 1ST HR,762,1 ,$360.00 ,$180.00 ,$180.00 ,$360.00 ,$232.56 , N/A ,$360.00 ,$360.00 , N/A ,$216.00 ,$306.00 ,$252.00 , N/A ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 , N/A ,$234.00 ,$288.00 ,$262.80 , N/A , N/A ,$360.00 ,$360.00 ,$306.00 , N/A ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 , N/A ,$259.20 , N/A ,$360.00 ,$360.00 , N/A ,$360.00 , N/A ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,76200001,G0378,HC OBSERVATION ROOM 1ST HR ICU,762,1 ,$840.00 ,$420.00 ,$420.00 ,$840.00 ,$542.64 , N/A ,$840.00 ,$840.00 , N/A ,$504.00 ,$714.00 ,$588.00 , N/A ,$798.00 ,$604.80 ,$613.20 ,$546.00 ,$714.00 , N/A ,$546.00 ,$672.00 ,$613.20 , N/A , N/A ,$840.00 ,$840.00 ,$714.00 , N/A ,$772.80 ,$588.00 ,$420.00 ,$504.00 ,$511.56 ,$420.00 ,$580.44 ,$588.00 , N/A ,$604.80 , N/A ,$840.00 ,$840.00 , N/A ,$840.00 , N/A ,$604.80 ,$520.80 ,$604.80 ,$604.80 ,$504.00 ST VINCENT HOSPITAL - ACUTE,76200002,G0378,HC OBSERVATION ADDL HOUR,762,1 ,$60.00 ,$30.00 ,$30.00 ,$60.00 ,$38.76 , N/A ,$60.00 ,$60.00 , N/A ,$36.00 ,$51.00 ,$42.00 , N/A ,$57.00 ,$43.20 ,$43.80 ,$39.00 ,$51.00 , N/A ,$39.00 ,$48.00 ,$43.80 , N/A , N/A ,$60.00 ,$60.00 ,$51.00 , N/A ,$55.20 ,$42.00 ,$30.00 ,$36.00 ,$36.54 ,$30.00 ,$41.46 ,$42.00 , N/A ,$43.20 , N/A ,$60.00 ,$60.00 , N/A ,$60.00 , N/A ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,76200003,G0378,HC OBSERVATION ADDL HOUR ICU,762,1 ,$150.00 ,$75.00 ,$75.00 ,$150.00 ,$96.90 , N/A ,$150.00 ,$150.00 , N/A ,$90.00 ,$127.50 ,$105.00 , N/A ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 , N/A ,$97.50 ,$120.00 ,$109.50 , N/A , N/A ,$150.00 ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 , N/A ,$108.00 , N/A ,$150.00 ,$150.00 , N/A ,$150.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,76200004,G0378,HC CDTU LV I PER HOUR,762,1 ,$160.00 ,$80.00 ,$80.00 ,$160.00 ,$103.36 , N/A ,$160.00 ,$160.00 , N/A ,$96.00 ,$136.00 ,$112.00 , N/A ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 , N/A ,$104.00 ,$128.00 ,$116.80 , N/A , N/A ,$160.00 ,$160.00 ,$136.00 , N/A ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 , N/A ,$115.20 , N/A ,$160.00 ,$160.00 , N/A ,$160.00 , N/A ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,76200005,G0378,HC CDTU LV II PER HOUR,762,1 ,$200.00 ,$100.00 ,$100.00 ,$200.00 ,$129.20 , N/A ,$200.00 ,$200.00 , N/A ,$120.00 ,$170.00 ,$140.00 , N/A ,$190.00 ,$144.00 ,$146.00 ,$130.00 ,$170.00 , N/A ,$130.00 ,$160.00 ,$146.00 , N/A , N/A ,$200.00 ,$200.00 ,$170.00 , N/A ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 , N/A ,$144.00 , N/A ,$200.00 ,$200.00 , N/A ,$200.00 , N/A ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,76200006,G0378,HC OBSERVATION ROOM 1ST HR IMCU,762,1 ,$580.00 ,$290.00 ,$290.00 ,$580.00 ,$374.68 , N/A ,$580.00 ,$580.00 , N/A ,$348.00 ,$493.00 ,$406.00 , N/A ,$551.00 ,$417.60 ,$423.40 ,$377.00 ,$493.00 , N/A ,$377.00 ,$464.00 ,$423.40 , N/A , N/A ,$580.00 ,$580.00 ,$493.00 , N/A ,$533.60 ,$406.00 ,$290.00 ,$348.00 ,$353.22 ,$290.00 ,$400.78 ,$406.00 , N/A ,$417.60 , N/A ,$580.00 ,$580.00 , N/A ,$580.00 , N/A ,$417.60 ,$359.60 ,$417.60 ,$417.60 ,$348.00 ST VINCENT HOSPITAL - ACUTE,76200007,G0378,HC OBSERVATION ADDL HOUR IMCU,762,1 ,$120.00 ,$60.00 ,$60.00 ,$120.00 ,$77.52 , N/A ,$120.00 ,$120.00 , N/A ,$72.00 ,$102.00 ,$84.00 , N/A ,$114.00 ,$86.40 ,$87.60 ,$78.00 ,$102.00 , N/A ,$78.00 ,$96.00 ,$87.60 , N/A , N/A ,$120.00 ,$120.00 ,$102.00 , N/A ,$110.40 ,$84.00 ,$60.00 ,$72.00 ,$73.08 ,$60.00 ,$82.92 ,$84.00 , N/A ,$86.40 , N/A ,$120.00 ,$120.00 , N/A ,$120.00 , N/A ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,76200008,G0379,HC OBSERVATION DIRECT ADMIT,762,1 ,$370.00 ,$185.00 ,$47.46 ,$370.00 ,$239.02 ,$47.46 ,$370.00 ,$370.00 , N/A ,$222.00 ,$314.50 ,$259.00 ,$47.46 ,$351.50 ,$266.40 ,$270.10 ,$240.50 ,$314.50 , N/A ,$240.50 ,$296.00 ,$270.10 ,$47.46 , N/A ,$370.00 ,$370.00 ,$314.50 , N/A ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 , N/A ,$266.40 ,$50.31 ,$370.00 ,$370.00 , N/A ,$370.00 , N/A ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,76200013,N/A,HC OBSERVATION PER HOUR NO CODE,762,1 ,$370.00 ,$185.00 ,$185.00 ,$370.00 ,$239.02 , N/A ,$370.00 ,$370.00 , N/A ,$222.00 ,$314.50 ,$259.00 , N/A ,$351.50 ,$266.40 ,$270.10 ,$240.50 ,$314.50 , N/A ,$240.50 ,$296.00 ,$270.10 , N/A , N/A ,$370.00 ,$370.00 ,$314.50 , N/A ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 , N/A ,$266.40 , N/A ,$370.00 ,$370.00 , N/A ,$370.00 , N/A ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,76200016,G0378,HC OBSERVATION HOURLY OB/GYN,762,1 ,$710.00 ,$355.00 ,$355.00 ,$710.00 ,$458.66 , N/A ,$710.00 ,$710.00 , N/A ,$426.00 ,$603.50 ,$497.00 , N/A ,$674.50 ,$511.20 ,$518.30 ,$461.50 ,$603.50 , N/A ,$461.50 ,$568.00 ,$518.30 , N/A , N/A ,$710.00 ,$710.00 ,$603.50 , N/A ,$653.20 ,$497.00 ,$355.00 ,$426.00 ,$432.39 ,$355.00 ,$490.61 ,$497.00 , N/A ,$511.20 , N/A ,$710.00 ,$710.00 , N/A ,$710.00 , N/A ,$511.20 ,$440.20 ,$511.20 ,$511.20 ,$426.00 ST VINCENT HOSPITAL - ACUTE,77056073,S9443,"HC LACTATION CLASSES, NON-PHYS, PER SESSION",770,1 ,$280.00 ,$140.00 ,$117.60 ,$280.00 ,$180.88 , N/A ,$181.13 ,$181.13 , N/A ,$168.00 ,$238.00 ,$196.00 , N/A ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 , N/A ,$182.00 ,$224.00 ,$204.40 , N/A , N/A ,$117.60 ,$280.00 ,$238.00 , N/A ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 , N/A ,$201.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,77100000,90471,HC IMMUN ADMIN ONE VACC,771,1 ,$70.00 ,$35.00 ,$11.86 ,$135.04 ,$45.22 ,$11.86 ,$45.28 ,$45.28 ,$60.02 ,$42.00 ,$59.50 ,$49.00 ,$11.86 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$60.02 ,$45.50 ,$56.00 ,$51.10 ,$11.86 ,$60.02 ,$29.40 ,$70.00 ,$59.50 ,$135.04 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$60.62 ,$50.40 ,$12.57 , N/A , N/A ,$60.02 , N/A ,$60.02 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,77100001,90471,HC RABIES VACC ADMIN IM,771,1 ,$150.00 ,$75.00 ,$11.86 ,$150.00 ,$96.90 ,$11.86 ,$97.04 ,$97.04 ,$60.02 ,$90.00 ,$127.50 ,$105.00 ,$11.86 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 ,$60.02 ,$97.50 ,$120.00 ,$109.50 ,$11.86 ,$60.02 ,$63.00 ,$150.00 ,$127.50 ,$135.04 ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 ,$60.62 ,$108.00 ,$12.57 , N/A , N/A ,$60.02 , N/A ,$60.02 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,77100002,90472,HC IMMUN ADMIN EA ADD VACC,771,1 ,$47.00 ,$23.50 ,$11.86 ,$47.00 ,$30.36 ,$11.86 ,$30.40 ,$30.40 , N/A ,$28.20 ,$39.95 ,$32.90 ,$11.86 ,$44.65 ,$33.84 ,$34.31 ,$30.55 ,$39.95 , N/A ,$30.55 ,$37.60 ,$34.31 ,$11.86 , N/A ,$19.74 ,$47.00 ,$39.95 , N/A ,$43.24 ,$32.90 ,$23.50 ,$28.20 ,$28.62 ,$23.50 ,$32.48 ,$32.90 , N/A ,$33.84 ,$12.57 , N/A , N/A , N/A , N/A , N/A ,$33.84 ,$29.14 ,$33.84 ,$33.84 ,$28.20 ST VINCENT HOSPITAL - ACUTE,77100003,G0008,HC ADMIN INFLUENZA VACCINE,771,1 ,$70.00 ,$35.00 ,$11.86 ,$87.17 ,$45.22 ,$11.86 ,$45.28 ,$45.28 ,$38.74 ,$42.00 ,$59.50 ,$49.00 ,$11.86 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$38.74 ,$45.50 ,$56.00 ,$51.10 ,$11.86 ,$38.74 ,$29.40 ,$70.00 ,$59.50 ,$87.17 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$39.13 ,$50.40 ,$12.57 , N/A , N/A ,$38.74 , N/A ,$38.74 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,77100004,G0008,HC ADMIN INFLUENZA COMMUNITY VACCINE,771,1 ,$48.00 ,$24.00 ,$11.86 ,$87.17 ,$31.01 ,$11.86 ,$31.05 ,$31.05 ,$38.74 ,$28.80 ,$40.80 ,$33.60 ,$11.86 ,$45.60 ,$34.56 ,$35.04 ,$31.20 ,$40.80 ,$38.74 ,$31.20 ,$38.40 ,$35.04 ,$11.86 ,$38.74 ,$20.16 ,$48.00 ,$40.80 ,$87.17 ,$44.16 ,$33.60 ,$24.00 ,$28.80 ,$29.23 ,$24.00 ,$33.17 ,$33.60 ,$39.13 ,$34.56 ,$12.57 , N/A , N/A ,$38.74 , N/A ,$38.74 ,$34.56 ,$29.76 ,$34.56 ,$34.56 ,$28.80 ST VINCENT HOSPITAL - ACUTE,77100005,G0009,HC ADMIN PNEUMOCOCCAL VACCINE,771,1 ,$80.00 ,$40.00 ,$11.86 ,$87.17 ,$51.68 ,$11.86 ,$51.75 ,$51.75 ,$38.74 ,$48.00 ,$68.00 ,$56.00 ,$11.86 ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 ,$38.74 ,$52.00 ,$64.00 ,$58.40 ,$11.86 ,$38.74 ,$33.60 ,$80.00 ,$68.00 ,$87.17 ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 ,$39.13 ,$57.60 ,$12.57 , N/A , N/A ,$38.74 , N/A ,$38.74 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,77100006,G0010,HC INJECTION-HEPATITIS B VACCINE,771,1 ,$70.00 ,$35.00 ,$11.86 ,$87.17 ,$45.22 ,$11.86 ,$45.28 ,$45.28 ,$38.74 ,$42.00 ,$59.50 ,$49.00 ,$11.86 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$38.74 ,$45.50 ,$56.00 ,$51.10 ,$11.86 ,$38.74 ,$29.40 ,$70.00 ,$59.50 ,$87.17 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$39.13 ,$50.40 ,$12.57 , N/A , N/A ,$38.74 , N/A ,$38.74 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,78000001,Q3014,HC TELEHEALTH ORIGINATING FAC FEE,780,1 ,$250.00 ,$125.00 ,$2.77 ,$250.00 ,$161.50 ,$2.77 ,$161.73 ,$161.73 ,$27.02 ,$150.00 ,$212.50 ,$175.00 ,$2.77 ,$237.50 ,$180.00 ,$182.50 ,$53.00 ,$212.50 ,$27.02 ,$53.00 ,$200.00 ,$182.50 ,$2.77 ,$27.02 ,$105.00 ,$250.00 ,$212.50 ,$60.80 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$27.29 ,$180.00 ,$2.94 ,$27.00 ,$27.00 ,$27.02 ,$27.00 ,$27.02 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,78000020,77427,PC RADIATION MNGT 5 TREATMENTS - 95,961,1 ,"$1,555.00 ",$777.50 ,$86.55 ,"$1,555.00 ","$1,004.53 ",$86.55 ,"$1,005.93 ","$1,005.93 ", N/A ,$933.00 ,"$1,321.75 ","$1,088.50 ",$86.55 ,"$1,477.25 ","$1,119.60 ","$1,135.15 ","$1,010.75 ","$1,321.75 ", N/A ,"$1,010.75 ","$1,244.00 ","$1,135.15 ",$86.55 , N/A ,$653.10 ,"$1,555.00 ","$1,321.75 ", N/A ,"$1,430.60 ","$1,088.50 ",$777.50 ,$933.00 ,$947.00 ,$777.50 ,"$1,074.51 ","$1,088.50 ", N/A ,"$1,119.60 ",$91.74 , N/A , N/A , N/A , N/A , N/A ,"$1,119.60 ",$964.10 ,"$1,119.60 ","$1,119.60 ",$933.00 ST VINCENT HOSPITAL - ACUTE,78000022,90791,PC EVAL PSYCH DIAG - 95,961,1 ,$275.00 ,$137.50 ,$81.49 ,$291.20 ,$177.65 ,$81.49 ,$177.90 ,$177.90 ,$129.42 ,$165.00 ,$233.75 ,$192.50 ,$81.49 ,$261.25 ,$198.00 ,$200.75 ,$178.75 ,$233.75 ,$129.42 ,$178.75 ,$220.00 ,$200.75 ,$81.49 ,$129.42 ,$115.50 ,$275.00 ,$233.75 ,$291.20 ,$253.00 ,$192.50 ,$137.50 ,$165.00 ,$167.48 ,$137.50 ,$190.03 ,$192.50 ,$130.71 ,$198.00 ,$86.38 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,78000024,90832,PC THERAPY INDIVIDUAL PSYCH 30 MIN - 95,961,1 ,$125.00 ,$62.50 ,$47.57 ,$291.20 ,$80.75 ,$47.57 ,$80.86 ,$80.86 ,$129.42 ,$75.00 ,$106.25 ,$87.50 ,$47.57 ,$118.75 ,$90.00 ,$91.25 ,$81.25 ,$106.25 ,$129.42 ,$81.25 ,$100.00 ,$91.25 ,$47.57 ,$129.42 ,$52.50 ,$125.00 ,$106.25 ,$291.20 ,$115.00 ,$87.50 ,$62.50 ,$75.00 ,$76.13 ,$62.50 ,$86.38 ,$87.50 ,$130.71 ,$90.00 ,$50.42 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$90.00 ,$77.50 ,$90.00 ,$90.00 ,$75.00 ST VINCENT HOSPITAL - ACUTE,78000026,90834,PC THERAPY INDIVIDUAL PSYCH 45 MIN - 95,961,1 ,$150.00 ,$75.00 ,$46.53 ,$291.20 ,$96.90 ,$46.53 ,$97.04 ,$97.04 ,$129.42 ,$90.00 ,$127.50 ,$105.00 ,$46.53 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 ,$129.42 ,$97.50 ,$120.00 ,$109.50 ,$46.53 ,$129.42 ,$63.00 ,$150.00 ,$127.50 ,$291.20 ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 ,$130.71 ,$108.00 ,$49.32 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,78000028,90837,PC THERAPY INDIVIDUAL PSYCH 60 MIN - 95,961,1 ,$250.00 ,$125.00 ,$46.53 ,$291.20 ,$161.50 ,$46.53 ,$161.73 ,$161.73 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.53 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.53 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.32 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,78000035,90853,PC THERAPY GROUP PSYCH - 95,961,1 ,$250.00 ,$125.00 ,$38.42 ,$250.00 ,$161.50 ,$38.42 ,$161.73 ,$161.73 ,$72.51 ,$150.00 ,$212.50 ,$175.00 ,$38.42 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$72.51 ,$162.50 ,$200.00 ,$182.50 ,$38.42 ,$72.51 ,$105.00 ,$250.00 ,$212.50 ,$163.15 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$73.24 ,$180.00 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,78000084,99201,PC CLINIC VISIT BRIEF NEW - 95,961,1 ,$190.00 ,$95.00 ,$79.80 ,$190.00 ,$122.74 , N/A ,$122.91 ,$122.91 , N/A ,$114.00 ,$161.50 ,$133.00 , N/A ,$180.50 ,$136.80 ,$138.70 ,$123.50 ,$161.50 , N/A ,$123.50 ,$152.00 ,$138.70 , N/A , N/A ,$79.80 ,$190.00 ,$161.50 , N/A ,$174.80 ,$133.00 ,$95.00 ,$114.00 ,$115.71 ,$95.00 ,$131.29 ,$133.00 , N/A ,$136.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,78000085,99202,PC CLINIC VISIT LIMITED NEW- 95,961,1 ,$200.00 ,$100.00 ,$47.46 ,$200.00 ,$129.20 ,$47.46 ,$129.38 ,$129.38 , N/A ,$120.00 ,$170.00 ,$140.00 ,$47.46 ,$190.00 ,$144.00 ,$146.00 ,$130.00 ,$170.00 , N/A ,$130.00 ,$160.00 ,$146.00 ,$47.46 , N/A ,$84.00 ,$200.00 ,$170.00 , N/A ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 , N/A ,$144.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,78000086,99203,PC CLINIC VISIT INTERM NEW - 95,961,1 ,$240.00 ,$120.00 ,$47.46 ,$240.00 ,$155.04 ,$47.46 ,$155.26 ,$155.26 , N/A ,$144.00 ,$204.00 ,$168.00 ,$47.46 ,$228.00 ,$172.80 ,$175.20 ,$156.00 ,$204.00 , N/A ,$156.00 ,$192.00 ,$175.20 ,$47.46 , N/A ,$100.80 ,$240.00 ,$204.00 , N/A ,$220.80 ,$168.00 ,$120.00 ,$144.00 ,$146.16 ,$120.00 ,$165.84 ,$168.00 , N/A ,$172.80 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,78000087,99204,PC CLINIC VISIT COMPLEX NEW - 95,961,1 ,$290.00 ,$145.00 ,$47.46 ,$290.00 ,$187.34 ,$47.46 ,$187.60 ,$187.60 , N/A ,$174.00 ,$246.50 ,$203.00 ,$47.46 ,$275.50 ,$208.80 ,$211.70 ,$188.50 ,$246.50 , N/A ,$188.50 ,$232.00 ,$211.70 ,$47.46 , N/A ,$121.80 ,$290.00 ,$246.50 , N/A ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 , N/A ,$208.80 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,78000088,99205,PC CLINIC VISIT COMPREH NEW - 95,961,1 ,$375.00 ,$187.50 ,$47.46 ,$375.00 ,$242.25 ,$47.46 ,$242.59 ,$242.59 , N/A ,$225.00 ,$318.75 ,$262.50 ,$47.46 ,$356.25 ,$270.00 ,$273.75 ,$243.75 ,$318.75 , N/A ,$243.75 ,$300.00 ,$273.75 ,$47.46 , N/A ,$157.50 ,$375.00 ,$318.75 , N/A ,$345.00 ,$262.50 ,$187.50 ,$225.00 ,$228.38 ,$187.50 ,$259.13 ,$262.50 , N/A ,$270.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$270.00 ,$232.50 ,$270.00 ,$270.00 ,$225.00 ST VINCENT HOSPITAL - ACUTE,78000089,99211,PC CLINIC VISIT BRIEF ESTAB - 95,961,1 ,$185.00 ,$92.50 ,$47.46 ,$185.00 ,$119.51 ,$47.46 ,$119.68 ,$119.68 , N/A ,$111.00 ,$157.25 ,$129.50 ,$47.46 ,$175.75 ,$133.20 ,$135.05 ,$120.25 ,$157.25 , N/A ,$120.25 ,$148.00 ,$135.05 ,$47.46 , N/A ,$77.70 ,$185.00 ,$157.25 , N/A ,$170.20 ,$129.50 ,$92.50 ,$111.00 ,$112.67 ,$92.50 ,$127.84 ,$129.50 , N/A ,$133.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$133.20 ,$114.70 ,$133.20 ,$133.20 ,$111.00 ST VINCENT HOSPITAL - ACUTE,78000090,99212,PC CLINIC VISIT LIMITED ESTAB - 95,961,1 ,$195.00 ,$97.50 ,$47.46 ,$195.00 ,$125.97 ,$47.46 ,$126.15 ,$126.15 , N/A ,$117.00 ,$165.75 ,$136.50 ,$47.46 ,$185.25 ,$140.40 ,$142.35 ,$126.75 ,$165.75 , N/A ,$126.75 ,$156.00 ,$142.35 ,$47.46 , N/A ,$81.90 ,$195.00 ,$165.75 , N/A ,$179.40 ,$136.50 ,$97.50 ,$117.00 ,$118.76 ,$97.50 ,$134.75 ,$136.50 , N/A ,$140.40 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$140.40 ,$120.90 ,$140.40 ,$140.40 ,$117.00 ST VINCENT HOSPITAL - ACUTE,78000091,99213,PC CLINIC VISIT INTERM ESTAB - 95,961,1 ,$235.00 ,$117.50 ,$47.46 ,$235.00 ,$151.81 ,$47.46 ,$152.02 ,$152.02 , N/A ,$141.00 ,$199.75 ,$164.50 ,$47.46 ,$223.25 ,$169.20 ,$171.55 ,$152.75 ,$199.75 , N/A ,$152.75 ,$188.00 ,$171.55 ,$47.46 , N/A ,$98.70 ,$235.00 ,$199.75 , N/A ,$216.20 ,$164.50 ,$117.50 ,$141.00 ,$143.12 ,$117.50 ,$162.39 ,$164.50 , N/A ,$169.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$169.20 ,$145.70 ,$169.20 ,$169.20 ,$141.00 ST VINCENT HOSPITAL - ACUTE,78000092,99214,PC CLINIC VISIT COMPLEX ESTAB - 95,961,1 ,$260.00 ,$130.00 ,$47.46 ,$260.00 ,$167.96 ,$47.46 ,$168.19 ,$168.19 , N/A ,$156.00 ,$221.00 ,$182.00 ,$47.46 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 , N/A ,$169.00 ,$208.00 ,$189.80 ,$47.46 , N/A ,$109.20 ,$260.00 ,$221.00 , N/A ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 , N/A ,$187.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,78000093,99215,PC CLINIC VISIT COMPREH ESTAB - 95,961,1 ,$325.00 ,$162.50 ,$47.46 ,$325.00 ,$209.95 ,$47.46 ,$210.24 ,$210.24 , N/A ,$195.00 ,$276.25 ,$227.50 ,$47.46 ,$308.75 ,$234.00 ,$237.25 ,$211.25 ,$276.25 , N/A ,$211.25 ,$260.00 ,$237.25 ,$47.46 , N/A ,$136.50 ,$325.00 ,$276.25 , N/A ,$299.00 ,$227.50 ,$162.50 ,$195.00 ,$197.93 ,$162.50 ,$224.58 ,$227.50 , N/A ,$234.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$234.00 ,$201.50 ,$234.00 ,$234.00 ,$195.00 ST VINCENT HOSPITAL - ACUTE,78000191,G0508,PC TELEHEALTH CRITICAL CARE CONSULT 60 MIN - 95,961,1 ,$250.00 ,$125.00 ,$47.46 ,$250.00 ,$161.50 ,$47.46 ,$161.73 ,$161.73 , N/A ,$150.00 ,$212.50 ,$175.00 ,$47.46 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 , N/A ,$162.50 ,$200.00 ,$182.50 ,$47.46 , N/A ,$105.00 ,$250.00 ,$212.50 , N/A ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 , N/A ,$180.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,78000220,96040,HC MEDICAL GENETIC COUNSELING EA 30 MINUTES - 95,780,1 ,$150.00 ,$75.00 ,$47.46 ,$150.00 ,$96.90 ,$47.46 ,$97.04 ,$97.04 , N/A ,$90.00 ,$127.50 ,$105.00 ,$47.46 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 , N/A ,$97.50 ,$120.00 ,$109.50 ,$47.46 , N/A ,$63.00 ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 , N/A ,$108.00 ,$50.31 ,$90.00 ,$90.00 , N/A ,$90.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,80000003,G0257,HC PERITONEAL DIA.CHRONIC,800,1 ,$730.00 ,$365.00 ,$209.59 ,"$1,425.89 ",$471.58 ,$209.59 ,$472.24 ,$472.24 ,$633.73 ,$438.00 ,$620.50 ,$511.00 ,$209.59 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 ,$633.73 ,$474.50 ,$584.00 ,$532.90 ,$209.59 ,$633.73 ,$306.60 ,$730.00 ,$620.50 ,"$1,425.89 ",$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 ,$640.07 ,$525.60 ,$222.17 ,$438.00 ,$438.00 ,$633.73 ,$438.00 ,$633.73 ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,80100000,90999,HC RENAL DIALYSIS IP,801,1 ,$730.00 ,$365.00 ,$209.59 ,$730.00 ,$471.58 ,$209.59 ,$472.24 ,$472.24 , N/A ,$438.00 ,$620.50 ,$511.00 ,$209.59 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 , N/A ,$474.50 ,$584.00 ,$532.90 ,$209.59 , N/A ,$306.60 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 , N/A ,$525.60 ,$222.17 ,$438.00 ,$438.00 , N/A ,$438.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,80100001,N/A,HC DIALYSIS-BELLIN/ICU,801,1 ,$730.00 ,$365.00 ,$306.60 ,$730.00 ,$471.58 , N/A ,$472.24 ,$472.24 , N/A ,$438.00 ,$620.50 ,$511.00 , N/A ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 , N/A ,$474.50 ,$584.00 ,$532.90 , N/A , N/A ,$306.60 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 , N/A ,$525.60 , N/A ,$438.00 ,$438.00 , N/A ,$438.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,80100003,N/A,HC PRISMA HEMOFILTRATION-ICU,801,1 ,"$2,500.00 ","$1,250.00 ","$1,050.00 ","$2,500.00 ","$1,615.00 ", N/A ,"$1,617.25 ","$1,617.25 ", N/A ,"$1,500.00 ","$2,125.00 ","$1,750.00 ", N/A ,"$2,375.00 ","$1,800.00 ","$1,825.00 ","$1,625.00 ","$2,125.00 ", N/A ,"$1,625.00 ","$2,000.00 ","$1,825.00 ", N/A , N/A ,"$1,050.00 ","$2,500.00 ","$2,125.00 ", N/A ,"$2,300.00 ","$1,750.00 ","$1,250.00 ","$1,500.00 ","$1,522.50 ","$1,250.00 ","$1,727.50 ","$1,750.00 ", N/A ,"$1,800.00 ", N/A ,"$1,500.00 ","$1,500.00 ", N/A ,"$1,500.00 ", N/A ,"$1,800.00 ","$1,550.00 ","$1,800.00 ","$1,800.00 ","$1,500.00 " ST VINCENT HOSPITAL - ACUTE,80100005,90999,HC RENAL DIALYSIS-ACUTE/ICU,801,1 ,$730.00 ,$365.00 ,$209.59 ,$730.00 ,$471.58 ,$209.59 ,$472.24 ,$472.24 , N/A ,$438.00 ,$620.50 ,$511.00 ,$209.59 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 , N/A ,$474.50 ,$584.00 ,$532.90 ,$209.59 , N/A ,$306.60 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 , N/A ,$525.60 ,$222.17 ,$438.00 ,$438.00 , N/A ,$438.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,80100006,90999,HC RENAL DIALYSIS-ACUTE,801,1 ,$730.00 ,$365.00 ,$209.59 ,$730.00 ,$471.58 ,$209.59 ,$472.24 ,$472.24 , N/A ,$438.00 ,$620.50 ,$511.00 ,$209.59 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 , N/A ,$474.50 ,$584.00 ,$532.90 ,$209.59 , N/A ,$306.60 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 , N/A ,$525.60 ,$222.17 ,$438.00 ,$438.00 , N/A ,$438.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,80100007,90935,HC HEMODIALYSIS ONE EVALUATION,821,1 ,$730.00 ,$365.00 ,$209.59 ,"$1,425.89 ",$471.58 ,$209.59 ,$730.00 ,$730.00 ,$633.73 ,$438.00 ,$620.50 ,$511.00 ,$209.59 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 ,$633.73 ,$474.50 ,$584.00 ,$532.90 ,$209.59 ,$633.73 ,$306.60 ,$730.00 ,$620.50 ,"$1,425.89 ",$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 ,$640.07 ,$525.60 ,$222.17 ,$730.00 ,$730.00 ,$633.73 ,$730.00 ,$633.73 ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,80100008,G0491,HC RENAL DIALYSIS W/KIDNEY INJ W/O ESRD IP,801,1 ,$730.00 ,$365.00 ,$209.59 ,$730.00 ,$471.58 ,$209.59 ,$472.24 ,$472.24 , N/A ,$438.00 ,$620.50 ,$511.00 ,$209.59 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 , N/A ,$474.50 ,$584.00 ,$532.90 ,$209.59 , N/A ,$306.60 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 , N/A ,$525.60 ,$222.17 ,$438.00 ,$438.00 , N/A ,$438.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,80100009,G0492,HC RENAL DIALYSIS W/KIDNEY INJ W/O ESRD W/PHY EVAL IP,801,1 ,$730.00 ,$365.00 ,$209.59 ,$730.00 ,$471.58 ,$209.59 ,$472.24 ,$472.24 , N/A ,$438.00 ,$620.50 ,$511.00 ,$209.59 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 , N/A ,$474.50 ,$584.00 ,$532.90 ,$209.59 , N/A ,$306.60 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 , N/A ,$525.60 ,$222.17 ,$438.00 ,$438.00 , N/A ,$438.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,82100000,90999,HC RENAL DIALYSIS OP,821,1 ,$730.00 ,$365.00 ,$209.59 ,$730.00 ,$471.58 ,$209.59 ,$730.00 ,$730.00 , N/A ,$438.00 ,$620.50 ,$511.00 ,$209.59 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 , N/A ,$474.50 ,$584.00 ,$532.90 ,$209.59 , N/A ,$306.60 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 , N/A ,$525.60 ,$222.17 ,$730.00 ,$730.00 , N/A ,$730.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,82100003,G0491,HC RENAL DIALYSIS W/KIDNEY INJ W/O ESRD OP,821,1 ,$730.00 ,$365.00 ,$209.59 ,$730.00 ,$471.58 ,$209.59 ,$730.00 ,$730.00 , N/A ,$438.00 ,$620.50 ,$511.00 ,$209.59 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 , N/A ,$474.50 ,$584.00 ,$532.90 ,$209.59 , N/A ,$306.60 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 , N/A ,$525.60 ,$222.17 ,$730.00 ,$730.00 , N/A ,$730.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,82100004,G0492,HC RENAL DIALYSIS W/KIDNEY INJ W/O ESRD W/PHY EVAL OP,821,1 ,$730.00 ,$365.00 ,$209.59 ,$730.00 ,$471.58 ,$209.59 ,$730.00 ,$730.00 , N/A ,$438.00 ,$620.50 ,$511.00 ,$209.59 ,$693.50 ,$525.60 ,$532.90 ,$474.50 ,$620.50 , N/A ,$474.50 ,$584.00 ,$532.90 ,$209.59 , N/A ,$306.60 ,$730.00 ,$620.50 , N/A ,$671.60 ,$511.00 ,$365.00 ,$438.00 ,$444.57 ,$365.00 ,$504.43 ,$511.00 , N/A ,$525.60 ,$222.17 ,$730.00 ,$730.00 , N/A ,$730.00 , N/A ,$525.60 ,$452.60 ,$525.60 ,$525.60 ,$438.00 ST VINCENT HOSPITAL - ACUTE,90000001,90785,HC PSYCH THERAPY COMPLEX INTERACTIVE,900,1 ,$50.00 ,$25.00 ,$21.00 ,$50.42 ,$32.30 ,$47.57 ,$32.35 ,$32.35 , N/A ,$30.00 ,$42.50 ,$35.00 ,$47.57 ,$47.50 ,$36.00 ,$36.50 ,$32.50 ,$42.50 , N/A ,$32.50 ,$40.00 ,$36.50 ,$47.57 , N/A ,$21.00 ,$50.00 ,$42.50 , N/A ,$46.00 ,$35.00 ,$25.00 ,$30.00 ,$30.45 ,$25.00 ,$34.55 ,$35.00 , N/A ,$36.00 ,$50.42 ,$50.00 ,$50.00 , N/A ,$50.00 , N/A ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,90000003,90792,HC EVAL PSYCH DIAG W/MED SERVICE MD,900,1 ,$250.00 ,$125.00 ,$81.49 ,$291.20 ,$161.50 ,$81.49 ,$161.73 ,$161.73 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$81.49 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$81.49 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$86.38 ,$250.00 ,$250.00 ,$129.42 ,$250.00 ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,90000004,90887,HC CONSULTATION WITH FAMILY,900,1 ,$50.00 ,$25.00 ,$21.00 ,$50.00 ,$32.30 ,$46.64 ,$32.35 ,$32.35 , N/A ,$30.00 ,$42.50 ,$35.00 ,$46.64 ,$47.50 ,$36.00 ,$36.50 ,$32.50 ,$42.50 , N/A ,$32.50 ,$40.00 ,$36.50 ,$46.64 , N/A ,$21.00 ,$50.00 ,$42.50 , N/A ,$46.00 ,$35.00 ,$25.00 ,$30.00 ,$30.45 ,$25.00 ,$34.55 ,$35.00 , N/A ,$36.00 ,$49.44 ,$50.00 ,$50.00 , N/A ,$50.00 , N/A ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,90000005,H0047,HC ALCOHOL/DRUG ABUSE SVCS NOS,900,1 ,$125.00 ,$62.50 ,$47.57 ,$125.00 ,$80.75 ,$47.57 ,$80.86 ,$80.86 , N/A ,$75.00 ,$106.25 ,$87.50 ,$47.57 ,$118.75 ,$90.00 ,$91.25 ,$81.25 ,$106.25 , N/A ,$81.25 ,$100.00 ,$91.25 ,$47.57 , N/A ,$52.50 ,$125.00 ,$106.25 , N/A ,$115.00 ,$87.50 ,$62.50 ,$75.00 ,$76.13 ,$62.50 ,$86.38 ,$87.50 , N/A ,$90.00 ,$50.42 ,$125.00 ,$125.00 , N/A ,$125.00 , N/A ,$90.00 ,$77.50 ,$90.00 ,$90.00 ,$75.00 ST VINCENT HOSPITAL - ACUTE,90000006,H2012,HC BEHAVIORAL HEALTH DAY TREATMENT PER HOUR,900,1 ,$75.00 ,$37.50 ,$31.50 ,$167.20 ,$48.45 ,$75.00 ,$48.52 ,$48.52 , N/A ,$45.00 ,$63.75 ,$52.50 ,$157.74 ,$71.25 ,$54.00 ,$54.75 ,$48.75 ,$63.75 , N/A ,$48.75 ,$60.00 ,$54.75 ,$157.74 , N/A ,$31.50 ,$75.00 ,$63.75 , N/A ,$69.00 ,$52.50 ,$37.50 ,$45.00 ,$45.68 ,$37.50 ,$51.83 ,$52.50 , N/A ,$54.00 ,$167.20 ,$75.00 ,$75.00 , N/A ,$75.00 , N/A ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,90600001,H0005,HC ALCOHOL/DRUG COUNSELING GROUP,906,1 ,$25.00 ,$12.50 ,$10.50 ,$40.73 ,$16.15 ,$25.00 ,$25.00 ,$25.00 , N/A ,$15.00 ,$21.25 ,$17.50 ,$38.42 ,$23.75 ,$18.00 ,$18.25 ,$16.25 ,$21.25 , N/A ,$16.25 ,$20.00 ,$18.25 ,$38.42 , N/A ,$10.50 ,$25.00 ,$21.25 , N/A ,$23.00 ,$17.50 ,$12.50 ,$15.00 ,$15.23 ,$12.50 ,$17.28 ,$17.50 , N/A ,$18.00 ,$40.73 , N/A , N/A , N/A , N/A , N/A ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,90600002,H0022,HC ALCOHOL/DRUG INTERVENTION SERVICE PLANNED,906,1 ,$25.00 ,$12.50 ,$10.50 ,$47.57 ,$16.15 , N/A ,$25.00 ,$25.00 , N/A ,$15.00 ,$21.25 ,$17.50 ,$47.57 ,$23.75 ,$18.00 ,$18.25 ,$16.25 ,$21.25 , N/A ,$16.25 ,$20.00 ,$18.25 ,$47.57 , N/A ,$10.50 ,$25.00 ,$21.25 , N/A ,$23.00 ,$17.50 ,$12.50 ,$15.00 ,$15.23 ,$12.50 ,$17.28 ,$17.50 , N/A ,$18.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,90600003,T1006,HC ALCOHOL/DRUG COUNSELING FAMILY/COUPLE,906,1 ,$25.00 ,$12.50 ,$10.50 ,$49.44 ,$16.15 ,$25.00 ,$25.00 ,$25.00 , N/A ,$15.00 ,$21.25 ,$17.50 ,$46.64 ,$23.75 ,$18.00 ,$18.25 ,$16.25 ,$21.25 , N/A ,$16.25 ,$20.00 ,$18.25 ,$46.64 , N/A ,$10.50 ,$25.00 ,$21.25 , N/A ,$23.00 ,$17.50 ,$12.50 ,$15.00 ,$15.23 ,$12.50 ,$17.28 ,$17.50 , N/A ,$18.00 ,$49.44 , N/A , N/A , N/A , N/A , N/A ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,90600004,H0005,PC ALCOHOL/DRUG COUNSELING GROUP-95,906,1 ,$25.00 ,$12.50 ,$10.50 ,$40.73 ,$16.15 ,$25.00 ,$25.00 ,$25.00 , N/A ,$15.00 ,$21.25 ,$17.50 ,$38.42 ,$23.75 ,$18.00 ,$18.25 ,$16.25 ,$21.25 , N/A ,$16.25 ,$20.00 ,$18.25 ,$38.42 , N/A ,$10.50 ,$25.00 ,$21.25 , N/A ,$23.00 ,$17.50 ,$12.50 ,$15.00 ,$15.23 ,$12.50 ,$17.28 ,$17.50 , N/A ,$18.00 ,$40.73 , N/A , N/A , N/A , N/A , N/A ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,91400013,90839,HC THERAPY INDIVIDUAL PSYCH CRISIS 60MIN,914,1 ,$250.00 ,$125.00 ,$46.53 ,$291.20 ,$161.50 ,$46.53 ,$250.00 ,$212.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.53 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.53 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.32 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,91400014,90840,HC THERAPY INDIVIDUAL PSYCH CRISIS EA ADDL 30MIN,914,1 ,$125.00 ,$62.50 ,$46.53 ,$125.00 ,$80.75 ,$46.53 ,$125.00 ,$125.00 , N/A ,$75.00 ,$106.25 ,$87.50 ,$46.53 ,$118.75 ,$90.00 ,$91.25 ,$81.25 ,$106.25 , N/A ,$81.25 ,$100.00 ,$91.25 ,$46.53 , N/A ,$52.50 ,$125.00 ,$106.25 , N/A ,$115.00 ,$87.50 ,$62.50 ,$75.00 ,$76.13 ,$62.50 ,$86.38 ,$87.50 , N/A ,$90.00 ,$49.32 , N/A , N/A , N/A , N/A , N/A ,$90.00 ,$77.50 ,$90.00 ,$90.00 ,$75.00 ST VINCENT HOSPITAL - ACUTE,91400018,90833,HC THERAPY INDIVIDUAL PSYCH W/MED EVAL 30MIN,914,1 ,$125.00 ,$62.50 ,$47.57 ,$125.00 ,$80.75 ,$47.57 ,$125.00 ,$125.00 , N/A ,$75.00 ,$106.25 ,$87.50 ,$47.57 ,$118.75 ,$90.00 ,$91.25 ,$81.25 ,$106.25 , N/A ,$81.25 ,$100.00 ,$91.25 ,$47.57 , N/A ,$52.50 ,$125.00 ,$106.25 , N/A ,$115.00 ,$87.50 ,$62.50 ,$75.00 ,$76.13 ,$62.50 ,$86.38 ,$87.50 , N/A ,$90.00 ,$50.42 , N/A , N/A , N/A , N/A , N/A ,$90.00 ,$77.50 ,$90.00 ,$90.00 ,$75.00 ST VINCENT HOSPITAL - ACUTE,91400019,90836,HC THERAPY INDIVIDUAL PSYCH W/MED EVAL 45MIN,914,1 ,$150.00 ,$75.00 ,$46.53 ,$150.00 ,$96.90 ,$46.53 ,$150.00 ,$150.00 , N/A ,$90.00 ,$127.50 ,$105.00 ,$46.53 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 , N/A ,$97.50 ,$120.00 ,$109.50 ,$46.53 , N/A ,$63.00 ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 , N/A ,$108.00 ,$49.32 , N/A , N/A , N/A , N/A , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,91400020,90838,HC PSYCH THERAPY INDIV W/MED EVAL 60MIN,914,1 ,$175.00 ,$87.50 ,$46.53 ,$175.00 ,$113.05 ,$46.53 ,$175.00 ,$175.00 , N/A ,$105.00 ,$148.75 ,$122.50 ,$46.53 ,$166.25 ,$126.00 ,$127.75 ,$113.75 ,$148.75 , N/A ,$113.75 ,$140.00 ,$127.75 ,$46.53 , N/A ,$73.50 ,$175.00 ,$148.75 , N/A ,$161.00 ,$122.50 ,$87.50 ,$105.00 ,$106.58 ,$87.50 ,$120.93 ,$122.50 , N/A ,$126.00 ,$49.32 , N/A , N/A , N/A , N/A , N/A ,$126.00 ,$108.50 ,$126.00 ,$126.00 ,$105.00 ST VINCENT HOSPITAL - ACUTE,91400021,90845,HC PSYCHOANALYSIS,914,1 ,$250.00 ,$125.00 ,$46.53 ,$291.20 ,$161.50 ,$46.53 ,$250.00 ,$212.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.53 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.53 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.32 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,91500004,G0410,HC THERAPY GROUP NON-FAMILY PER HOUR,915,1 ,$250.00 ,$125.00 ,$38.42 ,$250.00 ,$161.50 ,$38.42 ,$250.00 ,$212.00 , N/A ,$150.00 ,$212.50 ,$175.00 ,$38.42 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 , N/A ,$162.50 ,$200.00 ,$182.50 ,$38.42 , N/A ,$105.00 ,$250.00 ,$212.50 , N/A ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 , N/A ,$180.00 ,$40.73 , N/A , N/A , N/A , N/A , N/A ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,91500005,G0411,HC THERAPY GROUP INTERACTIVE PER HR,915,1 ,$250.00 ,$125.00 ,$38.42 ,$250.00 ,$161.50 ,$38.42 ,$250.00 ,$212.00 , N/A ,$150.00 ,$212.50 ,$175.00 ,$38.42 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 , N/A ,$162.50 ,$200.00 ,$182.50 ,$38.42 , N/A ,$105.00 ,$250.00 ,$212.50 , N/A ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 , N/A ,$180.00 ,$40.73 , N/A , N/A , N/A , N/A , N/A ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,91600005,90846,HC THERAPY FAMILY PSYCH W/O PATIENT 50 MIN,916,1 ,$250.00 ,$125.00 ,$46.64 ,$291.20 ,$161.50 ,$46.64 ,$250.00 ,$212.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.64 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.64 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.44 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,91600006,90847,HC THERAPY FAMILY PSYCH W/PATIENT 50 MIN,916,1 ,$250.00 ,$125.00 ,$46.64 ,$291.20 ,$161.50 ,$46.64 ,$250.00 ,$212.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.64 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.64 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.44 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,91600008,96154,HC BEHAVIOR HEALTH FAMILY W/PAT 15MIN,916,1 ,$75.00 ,$37.50 ,$31.50 ,$75.00 ,$48.45 , N/A ,$75.00 ,$75.00 , N/A ,$45.00 ,$63.75 ,$52.50 , N/A ,$71.25 ,$54.00 ,$54.75 ,$48.75 ,$63.75 , N/A ,$48.75 ,$60.00 ,$54.75 , N/A , N/A ,$31.50 ,$75.00 ,$63.75 , N/A ,$69.00 ,$52.50 ,$37.50 ,$45.00 ,$45.68 ,$37.50 ,$51.83 ,$52.50 , N/A ,$54.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,91600009,96155,HC BEHAVIOR HEALTH FAMILY W/O PAT 15MIN,916,1 ,$50.00 ,$25.00 ,$21.00 ,$50.00 ,$32.30 , N/A ,$50.00 ,$50.00 , N/A ,$30.00 ,$42.50 ,$35.00 , N/A ,$47.50 ,$36.00 ,$36.50 ,$32.50 ,$42.50 , N/A ,$32.50 ,$40.00 ,$36.50 , N/A , N/A ,$21.00 ,$50.00 ,$42.50 , N/A ,$46.00 ,$35.00 ,$25.00 ,$30.00 ,$30.45 ,$25.00 ,$34.55 ,$35.00 , N/A ,$36.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,91600010,90849,HC THERAPY GROUP PSYCH MULTIPLE FAMILY,916,1 ,$250.00 ,$125.00 ,$38.42 ,$291.20 ,$161.50 ,$38.42 ,$250.00 ,$212.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$38.42 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$38.42 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$40.73 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,91700001,90875,HC PSYCHOPHYSIO THPY BIOFEEDBACK TRAIN INDIV 30MIN,917,1 ,$125.00 ,$62.50 ,$47.99 ,$125.00 ,$80.75 ,$47.99 ,$80.86 ,$80.86 , N/A ,$75.00 ,$106.25 ,$87.50 ,$47.99 ,$118.75 ,$90.00 ,$91.25 ,$81.25 ,$106.25 , N/A ,$81.25 ,$100.00 ,$91.25 ,$47.99 , N/A ,$52.50 ,$125.00 ,$106.25 , N/A ,$115.00 ,$87.50 ,$62.50 ,$75.00 ,$76.13 ,$62.50 ,$86.38 ,$87.50 , N/A ,$90.00 ,$50.87 ,$125.00 ,$125.00 , N/A ,$125.00 , N/A ,$90.00 ,$77.50 ,$90.00 ,$90.00 ,$75.00 ST VINCENT HOSPITAL - ACUTE,91700002,90876,HC PSYCHOPHYSIO THPY BIOFEEDBACK TRAIN INDIV 45MIN,917,1 ,$150.00 ,$75.00 ,$47.99 ,$150.00 ,$96.90 ,$47.99 ,$97.04 ,$97.04 , N/A ,$90.00 ,$127.50 ,$105.00 ,$47.99 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 , N/A ,$97.50 ,$120.00 ,$109.50 ,$47.99 , N/A ,$63.00 ,$150.00 ,$127.50 , N/A ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 , N/A ,$108.00 ,$50.87 ,$150.00 ,$150.00 , N/A ,$150.00 , N/A ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,91800008,96112,HC DEVELOPMENT TEST ADMIN MD/QHCP INIT HOUR,918,1 ,$270.00 ,$135.00 ,$113.40 ,$567.64 ,$174.42 ,$176.59 ,$174.66 ,$174.66 ,$252.28 ,$162.00 ,$229.50 ,$189.00 ,$176.59 ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 ,$252.28 ,$175.50 ,$216.00 ,$197.10 ,$176.59 ,$252.28 ,$113.40 ,$270.00 ,$229.50 ,$567.64 ,$248.40 ,$189.00 ,$135.00 ,$162.00 ,$164.43 ,$135.00 ,$186.57 ,$189.00 ,$254.80 ,$194.40 ,$187.19 ,$270.00 ,$270.00 ,$252.28 ,$270.00 ,$252.28 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,92000001,59020,HC TEST STRESS FETAL,920,1 ,$500.00 ,$250.00 ,$85.39 ,$500.00 ,$323.00 ,$85.39 ,$323.45 ,$323.45 ,$164.95 ,$300.00 ,$425.00 ,$350.00 ,$85.39 ,$475.00 ,$360.00 ,$365.00 ,$325.00 ,$425.00 ,$164.95 ,$325.00 ,$400.00 ,$365.00 ,$85.39 ,$164.95 ,$298.03 ,$500.00 ,$425.00 ,$371.15 ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 ,$166.60 ,$360.00 ,$90.51 ,$411.00 ,$411.00 ,$164.95 ,$411.00 ,$164.95 ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,92000002,59025,HC TEST NON STRESS FETAL,920,1 ,$420.00 ,$210.00 ,$85.39 ,$420.00 ,$271.32 ,$85.39 ,$271.70 ,$271.70 ,$164.95 ,$252.00 ,$357.00 ,$294.00 ,$85.39 ,$399.00 ,$302.40 ,$306.60 ,$273.00 ,$357.00 ,$164.95 ,$273.00 ,$336.00 ,$306.60 ,$85.39 ,$164.95 ,$298.03 ,$420.00 ,$357.00 ,$371.15 ,$386.40 ,$294.00 ,$210.00 ,$252.00 ,$255.78 ,$210.00 ,$290.22 ,$294.00 ,$166.60 ,$302.40 ,$90.51 ,$411.00 ,$411.00 ,$164.95 ,$411.00 ,$164.95 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,92000003,93786,HC AMBUL BLOOD PRESS MONITR,920,1 ,$230.00 ,$115.00 ,$19.55 ,$243.95 ,$148.58 ,$19.55 ,$148.79 ,$148.79 ,$108.42 ,$138.00 ,$195.50 ,$161.00 ,$19.55 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$108.42 ,$149.50 ,$184.00 ,$167.90 ,$19.55 ,$108.42 ,$230.00 ,$230.00 ,$195.50 ,$243.95 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$109.50 ,$165.60 ,$20.72 ,$230.00 ,$230.00 ,$108.42 ,$230.00 ,$108.42 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,92000012,93788,HC AMBUL BLOOD PRESS MONITR W/REPORT,920,1 ,$280.00 ,$140.00 ,$19.55 ,$280.00 ,$180.88 ,$19.55 ,$181.13 ,$181.13 ,$108.42 ,$168.00 ,$238.00 ,$196.00 ,$19.55 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$108.42 ,$182.00 ,$224.00 ,$204.40 ,$19.55 ,$108.42 ,$280.00 ,$280.00 ,$238.00 ,$243.95 ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 ,$109.50 ,$201.60 ,$20.72 ,$280.00 ,$280.00 ,$108.42 ,$280.00 ,$108.42 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,92000034,92202,HC OPHTHALMOSCOPY EXT W/OPTIC NERVE DRAWING I AND R UNI/BIL,920,1 ,$210.00 ,$105.00 ,$18.36 ,$210.00 ,$135.66 ,$18.36 ,$135.85 ,$135.85 ,$53.91 ,$126.00 ,$178.50 ,$147.00 ,$18.36 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$53.91 ,$136.50 ,$168.00 ,$153.30 ,$18.36 ,$53.91 ,$210.00 ,$210.00 ,$178.50 ,$121.29 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$54.45 ,$151.20 ,$19.46 ,$210.00 ,$210.00 ,$53.91 ,$210.00 ,$53.91 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,92100001,N/A,HC PULSE VOLUME RECORD BI,921,1 ,$260.00 ,$130.00 ,$130.00 ,$260.00 ,$167.96 , N/A ,$168.19 ,$168.19 , N/A ,$156.00 ,$221.00 ,$182.00 , N/A ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 , N/A ,$169.00 ,$208.00 ,$189.80 , N/A , N/A ,$260.00 ,$260.00 ,$221.00 , N/A ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 , N/A ,$187.20 , N/A ,$260.00 ,$260.00 , N/A ,$260.00 , N/A ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,92100002,93880,HC DUPLEX CAROTID BILAT,921,1 ,"$1,200.00 ",$600.00 ,$49.96 ,"$1,200.00 ",$775.20 ,$49.96 ,$776.28 ,$776.28 ,$222.88 ,$720.00 ,"$1,020.00 ",$840.00 ,$49.96 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$222.88 ,$780.00 ,$960.00 ,$876.00 ,$49.96 ,$222.88 ,$298.03 ,"$1,200.00 ","$1,020.00 ",$501.48 ,"$1,104.00 ",$840.00 ,$600.00 ,$720.00 ,$730.80 ,$600.00 ,$829.20 ,$840.00 ,$225.11 ,$864.00 ,$52.96 ,$428.00 ,$428.00 ,$222.88 ,$428.00 ,$222.88 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,92100003,93882,HC DUPLEX CAROTID UNI,921,1 ,$590.00 ,$295.00 ,$49.96 ,$590.00 ,$381.14 ,$49.96 ,$381.67 ,$381.67 ,$105.54 ,$354.00 ,$501.50 ,$413.00 ,$49.96 ,$560.50 ,$424.80 ,$430.70 ,$383.50 ,$501.50 ,$105.54 ,$383.50 ,$472.00 ,$430.70 ,$49.96 ,$105.54 ,$298.03 ,$590.00 ,$501.50 ,$237.46 ,$542.80 ,$413.00 ,$295.00 ,$354.00 ,$359.31 ,$295.00 ,$407.69 ,$413.00 ,$106.60 ,$424.80 ,$52.96 ,$428.00 ,$428.00 ,$105.54 ,$428.00 ,$105.54 ,$424.80 ,$365.80 ,$424.80 ,$424.80 ,$354.00 ST VINCENT HOSPITAL - ACUTE,92100004,93888,HC DOPPLER TRANSCRANIAL LTD,921,1 ,$520.00 ,$260.00 ,$49.96 ,$520.00 ,$335.92 ,$49.96 ,$336.39 ,$336.39 ,$105.54 ,$312.00 ,$442.00 ,$364.00 ,$49.96 ,$494.00 ,$374.40 ,$379.60 ,$338.00 ,$442.00 ,$105.54 ,$338.00 ,$416.00 ,$379.60 ,$49.96 ,$105.54 ,$298.03 ,$520.00 ,$442.00 ,$237.46 ,$478.40 ,$364.00 ,$260.00 ,$312.00 ,$316.68 ,$260.00 ,$359.32 ,$364.00 ,$106.60 ,$374.40 ,$52.96 ,$428.00 ,$428.00 ,$105.54 ,$428.00 ,$105.54 ,$374.40 ,$322.40 ,$374.40 ,$374.40 ,$312.00 ST VINCENT HOSPITAL - ACUTE,92100005,93922,HC ABI/PPG SINGLE LEVEL,921,1 ,$430.00 ,$215.00 ,$76.32 ,$430.00 ,$277.78 ,$76.32 ,$278.17 ,$278.17 ,$108.42 ,$258.00 ,$365.50 ,$301.00 ,$76.32 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$108.42 ,$279.50 ,$344.00 ,$313.90 ,$76.32 ,$108.42 ,$298.03 ,$430.00 ,$365.50 ,$243.95 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$109.50 ,$309.60 ,$80.90 ,$428.00 ,$428.00 ,$108.42 ,$428.00 ,$108.42 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,92100006,93922,HC TCPO2/SPP UNILATERAL 1-2 LEVELS W/FULL STUDY - 93922,921,1 ,$430.00 ,$215.00 ,$76.32 ,$430.00 ,$277.78 ,$76.32 ,$278.17 ,$278.17 ,$108.42 ,$258.00 ,$365.50 ,$301.00 ,$76.32 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$108.42 ,$279.50 ,$344.00 ,$313.90 ,$76.32 ,$108.42 ,$298.03 ,$430.00 ,$365.50 ,$243.95 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$109.50 ,$309.60 ,$80.90 ,$428.00 ,$428.00 ,$108.42 ,$428.00 ,$108.42 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,92100007,93922,HC TCPO2/SPP UNILATERAL 3 OR MORE LEVEL - 93922,921,1 ,$430.00 ,$215.00 ,$76.32 ,$430.00 ,$277.78 ,$76.32 ,$278.17 ,$278.17 ,$108.42 ,$258.00 ,$365.50 ,$301.00 ,$76.32 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$108.42 ,$279.50 ,$344.00 ,$313.90 ,$76.32 ,$108.42 ,$298.03 ,$430.00 ,$365.50 ,$243.95 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$109.50 ,$309.60 ,$80.90 ,$428.00 ,$428.00 ,$108.42 ,$428.00 ,$108.42 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,92100011,93922,HC TCPO2 UNLIATERAL 1-2 LEVEL - 93922-52,921,1 ,$430.00 ,$215.00 ,$54.21 ,$430.00 ,$277.78 ,$76.32 ,$278.17 ,$278.17 ,$54.21 ,$258.00 ,$365.50 ,$301.00 ,$76.32 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$54.21 ,$279.50 ,$344.00 ,$313.90 ,$76.32 ,$54.21 ,$298.03 ,$430.00 ,$365.50 ,$121.98 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$54.75 ,$309.60 ,$80.90 ,$428.00 ,$428.00 ,$54.21 ,$428.00 ,$54.21 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,92100012,93922,HC DUPLEX DOPPLER LO EXT,921,1 ,$430.00 ,$215.00 ,$76.32 ,$430.00 ,$277.78 ,$76.32 ,$278.17 ,$278.17 ,$108.42 ,$258.00 ,$365.50 ,$301.00 ,$76.32 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$108.42 ,$279.50 ,$344.00 ,$313.90 ,$76.32 ,$108.42 ,$298.03 ,$430.00 ,$365.50 ,$243.95 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$109.50 ,$309.60 ,$80.90 ,$428.00 ,$428.00 ,$108.42 ,$428.00 ,$108.42 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,92100023,93923,HC TCPO2/ABI/PPG MULT LEVELS,921,1 ,$610.00 ,$305.00 ,$76.32 ,$610.00 ,$394.06 ,$76.32 ,$394.61 ,$394.61 ,$135.15 ,$366.00 ,$518.50 ,$427.00 ,$76.32 ,$579.50 ,$439.20 ,$445.30 ,$396.50 ,$518.50 ,$135.15 ,$396.50 ,$488.00 ,$445.30 ,$76.32 ,$135.15 ,$298.03 ,$610.00 ,$518.50 ,$304.10 ,$561.20 ,$427.00 ,$305.00 ,$366.00 ,$371.49 ,$305.00 ,$421.51 ,$427.00 ,$136.50 ,$439.20 ,$80.90 ,$428.00 ,$428.00 ,$135.15 ,$428.00 ,$135.15 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,92100026,93923,HC TCPO2/SPP BIL 1-2 LEVELS W/FULL STUDY -93923,921,1 ,$610.00 ,$305.00 ,$76.32 ,$610.00 ,$394.06 ,$76.32 ,$394.61 ,$394.61 ,$135.15 ,$366.00 ,$518.50 ,$427.00 ,$76.32 ,$579.50 ,$439.20 ,$445.30 ,$396.50 ,$518.50 ,$135.15 ,$396.50 ,$488.00 ,$445.30 ,$76.32 ,$135.15 ,$298.03 ,$610.00 ,$518.50 ,$304.10 ,$561.20 ,$427.00 ,$305.00 ,$366.00 ,$371.49 ,$305.00 ,$421.51 ,$427.00 ,$136.50 ,$439.20 ,$80.90 ,$428.00 ,$428.00 ,$135.15 ,$428.00 ,$135.15 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,92100027,93923,HC TCPO2/SPP BIL 3 OR MORE LEVELS - 93923,921,1 ,$610.00 ,$305.00 ,$76.32 ,$610.00 ,$394.06 ,$76.32 ,$394.61 ,$394.61 ,$135.15 ,$366.00 ,$518.50 ,$427.00 ,$76.32 ,$579.50 ,$439.20 ,$445.30 ,$396.50 ,$518.50 ,$135.15 ,$396.50 ,$488.00 ,$445.30 ,$76.32 ,$135.15 ,$298.03 ,$610.00 ,$518.50 ,$304.10 ,$561.20 ,$427.00 ,$305.00 ,$366.00 ,$371.49 ,$305.00 ,$421.51 ,$427.00 ,$136.50 ,$439.20 ,$80.90 ,$428.00 ,$428.00 ,$135.15 ,$428.00 ,$135.15 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,92100029,93923,HC ARTERIAL PPG BILATERAL FOR TOS,921,1 ,$610.00 ,$305.00 ,$76.32 ,$610.00 ,$394.06 ,$76.32 ,$394.61 ,$394.61 ,$135.15 ,$366.00 ,$518.50 ,$427.00 ,$76.32 ,$579.50 ,$439.20 ,$445.30 ,$396.50 ,$518.50 ,$135.15 ,$396.50 ,$488.00 ,$445.30 ,$76.32 ,$135.15 ,$298.03 ,$610.00 ,$518.50 ,$304.10 ,$561.20 ,$427.00 ,$305.00 ,$366.00 ,$371.49 ,$305.00 ,$421.51 ,$427.00 ,$136.50 ,$439.20 ,$80.90 ,$428.00 ,$428.00 ,$135.15 ,$428.00 ,$135.15 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,92100030,93923,HC RESTING ARTERIAL LOWER BILATERAL,921,1 ,$610.00 ,$305.00 ,$76.32 ,$610.00 ,$394.06 ,$76.32 ,$394.61 ,$394.61 ,$135.15 ,$366.00 ,$518.50 ,$427.00 ,$76.32 ,$579.50 ,$439.20 ,$445.30 ,$396.50 ,$518.50 ,$135.15 ,$396.50 ,$488.00 ,$445.30 ,$76.32 ,$135.15 ,$298.03 ,$610.00 ,$518.50 ,$304.10 ,$561.20 ,$427.00 ,$305.00 ,$366.00 ,$371.49 ,$305.00 ,$421.51 ,$427.00 ,$136.50 ,$439.20 ,$80.90 ,$428.00 ,$428.00 ,$135.15 ,$428.00 ,$135.15 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,92100031,93923,HC RESTING ARTERIAL UPPER BILATERAL,921,1 ,$610.00 ,$305.00 ,$76.32 ,$610.00 ,$394.06 ,$76.32 ,$394.61 ,$394.61 ,$135.15 ,$366.00 ,$518.50 ,$427.00 ,$76.32 ,$579.50 ,$439.20 ,$445.30 ,$396.50 ,$518.50 ,$135.15 ,$396.50 ,$488.00 ,$445.30 ,$76.32 ,$135.15 ,$298.03 ,$610.00 ,$518.50 ,$304.10 ,$561.20 ,$427.00 ,$305.00 ,$366.00 ,$371.49 ,$305.00 ,$421.51 ,$427.00 ,$136.50 ,$439.20 ,$80.90 ,$428.00 ,$428.00 ,$135.15 ,$428.00 ,$135.15 ,$439.20 ,$378.20 ,$439.20 ,$439.20 ,$366.00 ST VINCENT HOSPITAL - ACUTE,92100032,93924,HC DOPPLER ARTERY LWR EXT STRESS,921,1 ,"$1,100.00 ",$550.00 ,$49.96 ,"$1,100.00 ",$710.60 ,$49.96 ,$711.59 ,$711.59 ,$256.12 ,$660.00 ,$935.00 ,$770.00 ,$49.96 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$256.12 ,$715.00 ,$880.00 ,$803.00 ,$49.96 ,$256.12 ,$298.03 ,"$1,100.00 ",$935.00 ,$576.27 ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$258.68 ,$792.00 ,$52.96 ,$428.00 ,$428.00 ,$256.12 ,$428.00 ,$256.12 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,92100033,93924,HC DOPPLER ARTERY UPP EXT STRESS,921,1 ,"$1,100.00 ",$550.00 ,$49.96 ,"$1,100.00 ",$710.60 ,$49.96 ,$711.59 ,$711.59 ,$256.12 ,$660.00 ,$935.00 ,$770.00 ,$49.96 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$256.12 ,$715.00 ,$880.00 ,$803.00 ,$49.96 ,$256.12 ,$298.03 ,"$1,100.00 ",$935.00 ,$576.27 ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$258.68 ,$792.00 ,$52.96 ,$428.00 ,$428.00 ,$256.12 ,$428.00 ,$256.12 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,92100034,93925,HC DUPLEX ARTERIAL LWR EXT BI,921,1 ,"$1,400.00 ",$700.00 ,$63.07 ,"$1,400.00 ",$904.40 ,$63.07 ,$905.66 ,$905.66 ,$222.88 ,$840.00 ,"$1,190.00 ",$980.00 ,$63.07 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$222.88 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$63.07 ,$222.88 ,$298.03 ,"$1,400.00 ","$1,190.00 ",$501.48 ,"$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 ,$225.11 ,"$1,008.00 ",$66.85 ,$428.00 ,$428.00 ,$222.88 ,$428.00 ,$222.88 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,92100035,93926,HC DUPLEX ARTRL LWR EXT UNI/LMT,921,1 ,$840.00 ,$420.00 ,$49.96 ,$840.00 ,$542.64 ,$49.96 ,$543.40 ,$543.40 ,$105.54 ,$504.00 ,$714.00 ,$588.00 ,$49.96 ,$798.00 ,$604.80 ,$613.20 ,$546.00 ,$714.00 ,$105.54 ,$546.00 ,$672.00 ,$613.20 ,$49.96 ,$105.54 ,$298.03 ,$840.00 ,$714.00 ,$237.46 ,$772.80 ,$588.00 ,$420.00 ,$504.00 ,$511.56 ,$420.00 ,$580.44 ,$588.00 ,$106.60 ,$604.80 ,$52.96 ,$428.00 ,$428.00 ,$105.54 ,$428.00 ,$105.54 ,$604.80 ,$520.80 ,$604.80 ,$604.80 ,$504.00 ST VINCENT HOSPITAL - ACUTE,92100036,93926,HC DUPLEX ARTRL LWR EXT UNI/LMT PSEUD,921,1 ,$840.00 ,$420.00 ,$49.96 ,$840.00 ,$542.64 ,$49.96 ,$543.40 ,$543.40 ,$105.54 ,$504.00 ,$714.00 ,$588.00 ,$49.96 ,$798.00 ,$604.80 ,$613.20 ,$546.00 ,$714.00 ,$105.54 ,$546.00 ,$672.00 ,$613.20 ,$49.96 ,$105.54 ,$298.03 ,$840.00 ,$714.00 ,$237.46 ,$772.80 ,$588.00 ,$420.00 ,$504.00 ,$511.56 ,$420.00 ,$580.44 ,$588.00 ,$106.60 ,$604.80 ,$52.96 ,$428.00 ,$428.00 ,$105.54 ,$428.00 ,$105.54 ,$604.80 ,$520.80 ,$604.80 ,$604.80 ,$504.00 ST VINCENT HOSPITAL - ACUTE,92100037,93930,HC DUPLEX ARTERIAL UPR EXT BI,921,1 ,"$1,100.00 ",$550.00 ,$49.96 ,"$1,100.00 ",$710.60 ,$49.96 ,$711.59 ,$711.59 ,$222.88 ,$660.00 ,$935.00 ,$770.00 ,$49.96 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$222.88 ,$715.00 ,$880.00 ,$803.00 ,$49.96 ,$222.88 ,$298.03 ,"$1,100.00 ",$935.00 ,$501.48 ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$225.11 ,$792.00 ,$52.96 ,$428.00 ,$428.00 ,$222.88 ,$428.00 ,$222.88 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,92100038,93931,HC DUPLEX ARTRL UPR EXT UNI/LMT,921,1 ,$760.00 ,$380.00 ,$49.96 ,$760.00 ,$490.96 ,$49.96 ,$491.64 ,$491.64 ,$105.54 ,$456.00 ,$646.00 ,$532.00 ,$49.96 ,$722.00 ,$547.20 ,$554.80 ,$494.00 ,$646.00 ,$105.54 ,$494.00 ,$608.00 ,$554.80 ,$49.96 ,$105.54 ,$298.03 ,$760.00 ,$646.00 ,$237.46 ,$699.20 ,$532.00 ,$380.00 ,$456.00 ,$462.84 ,$380.00 ,$525.16 ,$532.00 ,$106.60 ,$547.20 ,$52.96 ,$428.00 ,$428.00 ,$105.54 ,$428.00 ,$105.54 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,92100039,93931,HC DUPLEX ARTRL UPR EXT PSEUD ONLY,921,1 ,$760.00 ,$380.00 ,$49.96 ,$760.00 ,$490.96 ,$49.96 ,$491.64 ,$491.64 ,$105.54 ,$456.00 ,$646.00 ,$532.00 ,$49.96 ,$722.00 ,$547.20 ,$554.80 ,$494.00 ,$646.00 ,$105.54 ,$494.00 ,$608.00 ,$554.80 ,$49.96 ,$105.54 ,$298.03 ,$760.00 ,$646.00 ,$237.46 ,$699.20 ,$532.00 ,$380.00 ,$456.00 ,$462.84 ,$380.00 ,$525.16 ,$532.00 ,$106.60 ,$547.20 ,$52.96 ,$428.00 ,$428.00 ,$105.54 ,$428.00 ,$105.54 ,$547.20 ,$471.20 ,$547.20 ,$547.20 ,$456.00 ST VINCENT HOSPITAL - ACUTE,92100041,93970,HC DUPLEX VENOUS EXT BI,921,1 ,"$1,400.00 ",$700.00 ,$63.07 ,"$1,400.00 ",$904.40 ,$63.07 ,$905.66 ,$905.66 ,$222.88 ,$840.00 ,"$1,190.00 ",$980.00 ,$63.07 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$222.88 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$63.07 ,$222.88 ,$298.03 ,"$1,400.00 ","$1,190.00 ",$501.48 ,"$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 ,$225.11 ,"$1,008.00 ",$66.85 ,$428.00 ,$428.00 ,$222.88 ,$428.00 ,$222.88 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,92100042,93970,HC DUPLEX VENOUS EXT BI UPPER,921,1 ,"$1,400.00 ",$700.00 ,$63.07 ,"$1,400.00 ",$904.40 ,$63.07 ,$905.66 ,$905.66 ,$222.88 ,$840.00 ,"$1,190.00 ",$980.00 ,$63.07 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$222.88 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$63.07 ,$222.88 ,$298.03 ,"$1,400.00 ","$1,190.00 ",$501.48 ,"$1,288.00 ",$980.00 ,$700.00 ,$840.00 ,$852.60 ,$700.00 ,$967.40 ,$980.00 ,$225.11 ,"$1,008.00 ",$66.85 ,$428.00 ,$428.00 ,$222.88 ,$428.00 ,$222.88 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,92100043,93971,HC DUPLEX VENOUS EXT UNI/LMTD,921,1 ,$860.00 ,$430.00 ,$49.96 ,$860.00 ,$555.56 ,$49.96 ,$556.33 ,$556.33 ,$105.54 ,$516.00 ,$731.00 ,$602.00 ,$49.96 ,$817.00 ,$619.20 ,$627.80 ,$559.00 ,$731.00 ,$105.54 ,$559.00 ,$688.00 ,$627.80 ,$49.96 ,$105.54 ,$298.03 ,$860.00 ,$731.00 ,$237.46 ,$791.20 ,$602.00 ,$430.00 ,$516.00 ,$523.74 ,$430.00 ,$594.26 ,$602.00 ,$106.60 ,$619.20 ,$52.96 ,$428.00 ,$428.00 ,$105.54 ,$428.00 ,$105.54 ,$619.20 ,$533.20 ,$619.20 ,$619.20 ,$516.00 ST VINCENT HOSPITAL - ACUTE,92100044,93971,HC VENOUS REFLUX ASSESSMENT UNILAT,921,1 ,$860.00 ,$430.00 ,$49.96 ,$860.00 ,$555.56 ,$49.96 ,$556.33 ,$556.33 ,$105.54 ,$516.00 ,$731.00 ,$602.00 ,$49.96 ,$817.00 ,$619.20 ,$627.80 ,$559.00 ,$731.00 ,$105.54 ,$559.00 ,$688.00 ,$627.80 ,$49.96 ,$105.54 ,$298.03 ,$860.00 ,$731.00 ,$237.46 ,$791.20 ,$602.00 ,$430.00 ,$516.00 ,$523.74 ,$430.00 ,$594.26 ,$602.00 ,$106.60 ,$619.20 ,$52.96 ,$428.00 ,$428.00 ,$105.54 ,$428.00 ,$105.54 ,$619.20 ,$533.20 ,$619.20 ,$619.20 ,$516.00 ST VINCENT HOSPITAL - ACUTE,92100045,93971,HC DUPLEX VENOUS EXT UNI/LMTD UPPER,921,1 ,$860.00 ,$430.00 ,$49.96 ,$860.00 ,$555.56 ,$49.96 ,$556.33 ,$556.33 ,$105.54 ,$516.00 ,$731.00 ,$602.00 ,$49.96 ,$817.00 ,$619.20 ,$627.80 ,$559.00 ,$731.00 ,$105.54 ,$559.00 ,$688.00 ,$627.80 ,$49.96 ,$105.54 ,$298.03 ,$860.00 ,$731.00 ,$237.46 ,$791.20 ,$602.00 ,$430.00 ,$516.00 ,$523.74 ,$430.00 ,$594.26 ,$602.00 ,$106.60 ,$619.20 ,$52.96 ,$428.00 ,$428.00 ,$105.54 ,$428.00 ,$105.54 ,$619.20 ,$533.20 ,$619.20 ,$619.20 ,$516.00 ST VINCENT HOSPITAL - ACUTE,92100046,93990,HC DUPLEX HEMODIALYSIS ACCESS,921,1 ,$700.00 ,$350.00 ,$49.96 ,$700.00 ,$452.20 ,$49.96 ,$452.83 ,$452.83 ,$105.54 ,$420.00 ,$595.00 ,$490.00 ,$49.96 ,$665.00 ,$504.00 ,$511.00 ,$455.00 ,$595.00 ,$105.54 ,$455.00 ,$560.00 ,$511.00 ,$49.96 ,$105.54 ,$298.03 ,$700.00 ,$595.00 ,$237.46 ,$644.00 ,$490.00 ,$350.00 ,$420.00 ,$426.30 ,$350.00 ,$483.70 ,$490.00 ,$106.60 ,$504.00 ,$52.96 ,$428.00 ,$428.00 ,$105.54 ,$428.00 ,$105.54 ,$504.00 ,$434.00 ,$504.00 ,$504.00 ,$420.00 ST VINCENT HOSPITAL - ACUTE,92100048,93886,HC DOPPLER TRANSCRANIAL COMPLETE,921,1 ,"$1,065.00 ",$532.50 ,$63.07 ,"$1,065.00 ",$687.99 ,$63.07 ,$688.95 ,$688.95 ,$222.88 ,$639.00 ,$905.25 ,$745.50 ,$63.07 ,"$1,011.75 ",$766.80 ,$777.45 ,$692.25 ,$905.25 ,$222.88 ,$692.25 ,$852.00 ,$777.45 ,$63.07 ,$222.88 ,$298.03 ,"$1,065.00 ",$905.25 ,$501.48 ,$979.80 ,$745.50 ,$532.50 ,$639.00 ,$648.59 ,$532.50 ,$735.92 ,$745.50 ,$225.11 ,$766.80 ,$66.85 ,$428.00 ,$428.00 ,$222.88 ,$428.00 ,$222.88 ,$766.80 ,$660.30 ,$766.80 ,$766.80 ,$639.00 ST VINCENT HOSPITAL - ACUTE,92100053,93985,HC DUPLEX SCAN ARTERIAL/VENOUS HEMO ACCESS COMPL BILATERAL STUDY,921,1 ,$790.00 ,$395.00 ,$49.96 ,$790.00 ,$510.34 ,$49.96 ,$511.05 ,$511.05 ,$222.88 ,$474.00 ,$671.50 ,$553.00 ,$49.96 ,$750.50 ,$568.80 ,$576.70 ,$513.50 ,$671.50 ,$222.88 ,$513.50 ,$632.00 ,$576.70 ,$49.96 ,$222.88 ,$298.03 ,$790.00 ,$671.50 ,$501.48 ,$726.80 ,$553.00 ,$395.00 ,$474.00 ,$481.11 ,$395.00 ,$545.89 ,$553.00 ,$225.11 ,$568.80 ,$52.96 ,$428.00 ,$428.00 ,$222.88 ,$428.00 ,$222.88 ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,92100054,93986,HC DUPLEX SCAN ARTERIAL/VENOUS HEMO ACCESS COMPL UNILATERAL STUDY,921,1 ,$215.00 ,$107.50 ,$49.96 ,$237.46 ,$138.89 ,$49.96 ,$139.08 ,$139.08 ,$105.54 ,$129.00 ,$182.75 ,$150.50 ,$49.96 ,$204.25 ,$154.80 ,$156.95 ,$139.75 ,$182.75 ,$105.54 ,$139.75 ,$172.00 ,$156.95 ,$49.96 ,$105.54 ,$215.00 ,$215.00 ,$182.75 ,$237.46 ,$197.80 ,$150.50 ,$107.50 ,$129.00 ,$130.94 ,$107.50 ,$148.57 ,$150.50 ,$106.60 ,$154.80 ,$52.96 ,$215.00 ,$215.00 ,$105.54 ,$215.00 ,$105.54 ,$154.80 ,$133.30 ,$154.80 ,$154.80 ,$129.00 ST VINCENT HOSPITAL - ACUTE,92200000,95860,HC EMG ONE EXTREMITY,922,1 ,$420.00 ,$210.00 ,$108.42 ,$420.00 ,$271.32 ,$110.54 ,$271.70 ,$271.70 ,$108.42 ,$252.00 ,$357.00 ,$294.00 ,$110.54 ,$399.00 ,$302.40 ,$306.60 ,$273.00 ,$357.00 ,$108.42 ,$273.00 ,$336.00 ,$306.60 ,$110.54 ,$108.42 ,$251.67 ,$420.00 ,$357.00 ,$243.95 ,$386.40 ,$294.00 ,$210.00 ,$252.00 ,$255.78 ,$210.00 ,$290.22 ,$294.00 ,$109.50 ,$302.40 ,$117.17 ,$420.00 ,$420.00 ,$108.42 ,$420.00 ,$108.42 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,92200001,95861,HC EMG TWO EXTREMITIES,922,1 ,$540.00 ,$270.00 ,$108.42 ,$540.00 ,$348.84 ,$110.54 ,$349.33 ,$349.33 ,$108.42 ,$324.00 ,$459.00 ,$378.00 ,$110.54 ,$513.00 ,$388.80 ,$394.20 ,$351.00 ,$459.00 ,$108.42 ,$351.00 ,$432.00 ,$394.20 ,$110.54 ,$108.42 ,$251.67 ,$540.00 ,$459.00 ,$243.95 ,$496.80 ,$378.00 ,$270.00 ,$324.00 ,$328.86 ,$270.00 ,$373.14 ,$378.00 ,$109.50 ,$388.80 ,$117.17 ,$540.00 ,$540.00 ,$108.42 ,$540.00 ,$108.42 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,92200002,95863,HC EMG THREE EXTREMITIES,922,1 ,$600.00 ,$300.00 ,$110.54 ,$600.00 ,$387.60 ,$110.54 ,$388.14 ,$388.14 ,$135.15 ,$360.00 ,$510.00 ,$420.00 ,$110.54 ,$570.00 ,$432.00 ,$438.00 ,$390.00 ,$510.00 ,$135.15 ,$390.00 ,$480.00 ,$438.00 ,$110.54 ,$135.15 ,$251.67 ,$600.00 ,$510.00 ,$304.10 ,$552.00 ,$420.00 ,$300.00 ,$360.00 ,$365.40 ,$300.00 ,$414.60 ,$420.00 ,$136.50 ,$432.00 ,$117.17 ,$600.00 ,$600.00 ,$135.15 ,$600.00 ,$135.15 ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,92200003,95867,HC EMG CRANIAL NERVE UNI,922,1 ,$420.00 ,$210.00 ,$110.54 ,$576.27 ,$271.32 ,$110.54 ,$271.70 ,$271.70 ,$256.12 ,$252.00 ,$357.00 ,$294.00 ,$110.54 ,$399.00 ,$302.40 ,$306.60 ,$273.00 ,$357.00 ,$256.12 ,$273.00 ,$336.00 ,$306.60 ,$110.54 ,$256.12 ,$251.67 ,$420.00 ,$357.00 ,$576.27 ,$386.40 ,$294.00 ,$210.00 ,$252.00 ,$255.78 ,$210.00 ,$290.22 ,$294.00 ,$258.68 ,$302.40 ,$117.17 ,$420.00 ,$420.00 ,$256.12 ,$420.00 ,$256.12 ,$302.40 ,$260.40 ,$302.40 ,$302.40 ,$252.00 ST VINCENT HOSPITAL - ACUTE,92200004,95872,HC EMG SINGLE FIBER DENSITY,922,1 ,$600.00 ,$300.00 ,$110.54 ,$600.00 ,$387.60 ,$110.54 ,$388.14 ,$388.14 ,$135.15 ,$360.00 ,$510.00 ,$420.00 ,$110.54 ,$570.00 ,$432.00 ,$438.00 ,$390.00 ,$510.00 ,$135.15 ,$390.00 ,$480.00 ,$438.00 ,$110.54 ,$135.15 ,$251.67 ,$600.00 ,$510.00 ,$304.10 ,$552.00 ,$420.00 ,$300.00 ,$360.00 ,$365.40 ,$300.00 ,$414.60 ,$420.00 ,$136.50 ,$432.00 ,$117.17 ,$600.00 ,$600.00 ,$135.15 ,$600.00 ,$135.15 ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,92200008,95925,HC SSEP UPPER LIMBS,922,1 ,$950.00 ,$475.00 ,$110.54 ,$950.00 ,$613.70 ,$110.54 ,$614.56 ,$614.56 ,$256.12 ,$570.00 ,$807.50 ,$665.00 ,$110.54 ,$902.50 ,$684.00 ,$693.50 ,$617.50 ,$807.50 ,$256.12 ,$617.50 ,$760.00 ,$693.50 ,$110.54 ,$256.12 ,$251.67 ,$950.00 ,$807.50 ,$576.27 ,$874.00 ,$665.00 ,$475.00 ,$570.00 ,$578.55 ,$475.00 ,$656.45 ,$665.00 ,$258.68 ,$684.00 ,$117.17 ,$803.00 ,$803.00 ,$256.12 ,$803.00 ,$256.12 ,$684.00 ,$589.00 ,$684.00 ,$684.00 ,$570.00 ST VINCENT HOSPITAL - ACUTE,92200009,95926,HC SSEP LOWER LIMBS,922,1 ,$950.00 ,$475.00 ,$110.54 ,$950.00 ,$613.70 ,$110.54 ,$614.56 ,$614.56 ,$256.12 ,$570.00 ,$807.50 ,$665.00 ,$110.54 ,$902.50 ,$684.00 ,$693.50 ,$617.50 ,$807.50 ,$256.12 ,$617.50 ,$760.00 ,$693.50 ,$110.54 ,$256.12 ,$251.67 ,$950.00 ,$807.50 ,$576.27 ,$874.00 ,$665.00 ,$475.00 ,$570.00 ,$578.55 ,$475.00 ,$656.45 ,$665.00 ,$258.68 ,$684.00 ,$117.17 ,$803.00 ,$803.00 ,$256.12 ,$803.00 ,$256.12 ,$684.00 ,$589.00 ,$684.00 ,$684.00 ,$570.00 ST VINCENT HOSPITAL - ACUTE,92200010,95930,HC EVOKED POTENTIAL VISUAL,922,1 ,"$1,500.00 ",$750.00 ,$110.54 ,"$1,500.00 ",$969.00 ,$110.54 ,$970.35 ,$970.35 ,$256.12 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$110.54 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ",$256.12 ,$975.00 ,"$1,200.00 ","$1,095.00 ",$110.54 ,$256.12 ,$251.67 ,"$1,500.00 ","$1,275.00 ",$576.27 ,"$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ",$258.68 ,"$1,080.00 ",$117.17 ,$803.00 ,$803.00 ,$256.12 ,$803.00 ,$256.12 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,92200011,95886,HC EMG ADD ON >5 MUSCLES,922,1 ,$220.00 ,$110.00 ,$110.00 ,$220.00 ,$142.12 ,$110.54 ,$142.32 ,$142.32 , N/A ,$132.00 ,$187.00 ,$154.00 ,$110.54 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 , N/A ,$143.00 ,$176.00 ,$160.60 ,$110.54 , N/A ,$220.00 ,$220.00 ,$187.00 , N/A ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 , N/A ,$158.40 ,$117.17 ,$220.00 ,$220.00 , N/A ,$220.00 , N/A ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,92200012,95864,HC EMG 4 EXTREMITIES,922,1 ,$720.00 ,$360.00 ,$110.54 ,$720.00 ,$465.12 ,$110.54 ,$465.77 ,$465.77 ,$135.15 ,$432.00 ,$612.00 ,$504.00 ,$110.54 ,$684.00 ,$518.40 ,$525.60 ,$468.00 ,$612.00 ,$135.15 ,$468.00 ,$576.00 ,$525.60 ,$110.54 ,$135.15 ,$251.67 ,$720.00 ,$612.00 ,$304.10 ,$662.40 ,$504.00 ,$360.00 ,$432.00 ,$438.48 ,$360.00 ,$497.52 ,$504.00 ,$136.50 ,$518.40 ,$117.17 ,$720.00 ,$720.00 ,$135.15 ,$720.00 ,$135.15 ,$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,92200015,95938,HC SSEP UPPER AND LOWER,922,1 ,"$1,500.00 ",$750.00 ,$110.54 ,"$1,500.00 ",$969.00 ,$110.54 ,$970.35 ,$970.35 ,$472.41 ,$900.00 ,"$1,275.00 ","$1,050.00 ",$110.54 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ",$472.41 ,$975.00 ,"$1,200.00 ","$1,095.00 ",$110.54 ,$472.41 ,$251.67 ,"$1,500.00 ","$1,275.00 ","$1,062.93 ","$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ",$477.13 ,"$1,080.00 ",$117.17 ,$803.00 ,$803.00 ,$472.41 ,$803.00 ,$472.41 ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,92200016,95885,HC EMG ADD ON <5 MUSCLES,922,1 ,$170.00 ,$85.00 ,$85.00 ,$170.00 ,$109.82 ,$110.54 ,$109.97 ,$109.97 , N/A ,$102.00 ,$144.50 ,$119.00 ,$110.54 ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 , N/A ,$110.50 ,$136.00 ,$124.10 ,$110.54 , N/A ,$170.00 ,$170.00 ,$144.50 , N/A ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 , N/A ,$122.40 ,$117.17 ,$170.00 ,$170.00 , N/A ,$170.00 , N/A ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,92200017,95887,HC EMG ADD ON CRANIAL,922,1 ,$170.00 ,$85.00 ,$85.00 ,$170.00 ,$109.82 ,$110.54 ,$109.97 ,$109.97 , N/A ,$102.00 ,$144.50 ,$119.00 ,$110.54 ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 , N/A ,$110.50 ,$136.00 ,$124.10 ,$110.54 , N/A ,$170.00 ,$170.00 ,$144.50 , N/A ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 , N/A ,$122.40 ,$117.17 ,$170.00 ,$170.00 , N/A ,$170.00 , N/A ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,92200021,95907,HC NVR CNDJ TST 1-2 STUDIES,922,1 ,$360.00 ,$180.00 ,$110.54 ,$360.00 ,$232.56 ,$110.54 ,$232.88 ,$232.88 ,$135.15 ,$216.00 ,$306.00 ,$252.00 ,$110.54 ,$342.00 ,$259.20 ,$262.80 ,$234.00 ,$306.00 ,$135.15 ,$234.00 ,$288.00 ,$262.80 ,$110.54 ,$135.15 ,$251.67 ,$360.00 ,$306.00 ,$304.10 ,$331.20 ,$252.00 ,$180.00 ,$216.00 ,$219.24 ,$180.00 ,$248.76 ,$252.00 ,$136.50 ,$259.20 ,$117.17 ,$360.00 ,$360.00 ,$135.15 ,$360.00 ,$135.15 ,$259.20 ,$223.20 ,$259.20 ,$259.20 ,$216.00 ST VINCENT HOSPITAL - ACUTE,92200022,95908,HC NVR CNDJ TST 3-4 STUDIES,922,1 ,$570.00 ,$285.00 ,$110.54 ,$576.27 ,$368.22 ,$110.54 ,$368.73 ,$368.73 ,$256.12 ,$342.00 ,$484.50 ,$399.00 ,$110.54 ,$541.50 ,$410.40 ,$416.10 ,$370.50 ,$484.50 ,$256.12 ,$370.50 ,$456.00 ,$416.10 ,$110.54 ,$256.12 ,$251.67 ,$570.00 ,$484.50 ,$576.27 ,$524.40 ,$399.00 ,$285.00 ,$342.00 ,$347.13 ,$285.00 ,$393.87 ,$399.00 ,$258.68 ,$410.40 ,$117.17 ,$570.00 ,$570.00 ,$256.12 ,$570.00 ,$256.12 ,$410.40 ,$353.40 ,$410.40 ,$410.40 ,$342.00 ST VINCENT HOSPITAL - ACUTE,92200023,95909,HC NVR CNDJ TST 5-6 STUDIES,922,1 ,$790.00 ,$395.00 ,$110.54 ,$790.00 ,$510.34 ,$110.54 ,$511.05 ,$511.05 ,$256.12 ,$474.00 ,$671.50 ,$553.00 ,$110.54 ,$750.50 ,$568.80 ,$576.70 ,$513.50 ,$671.50 ,$256.12 ,$513.50 ,$632.00 ,$576.70 ,$110.54 ,$256.12 ,$251.67 ,$790.00 ,$671.50 ,$576.27 ,$726.80 ,$553.00 ,$395.00 ,$474.00 ,$481.11 ,$395.00 ,$545.89 ,$553.00 ,$258.68 ,$568.80 ,$117.17 ,$790.00 ,$790.00 ,$256.12 ,$790.00 ,$256.12 ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,92200024,95910,HC NVR CNDJ TST 7-8 STUDIES,922,1 ,"$1,100.00 ",$550.00 ,$110.54 ,"$1,100.00 ",$710.60 ,$110.54 ,$711.59 ,$711.59 ,$256.12 ,$660.00 ,$935.00 ,$770.00 ,$110.54 ,"$1,045.00 ",$792.00 ,$803.00 ,$715.00 ,$935.00 ,$256.12 ,$715.00 ,$880.00 ,$803.00 ,$110.54 ,$256.12 ,$251.67 ,"$1,100.00 ",$935.00 ,$576.27 ,"$1,012.00 ",$770.00 ,$550.00 ,$660.00 ,$669.90 ,$550.00 ,$760.10 ,$770.00 ,$258.68 ,$792.00 ,$117.17 ,$803.00 ,$803.00 ,$256.12 ,$803.00 ,$256.12 ,$792.00 ,$682.00 ,$792.00 ,$792.00 ,$660.00 ST VINCENT HOSPITAL - ACUTE,92200025,95911,HC NVR CNDJ TST 9-10 STUDIES,922,1 ,"$2,000.00 ","$1,000.00 ",$110.54 ,"$2,000.00 ","$1,292.00 ",$110.54 ,"$1,293.80 ","$1,293.80 ",$472.41 ,"$1,200.00 ","$1,700.00 ","$1,400.00 ",$110.54 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,300.00 ","$1,700.00 ",$472.41 ,"$1,300.00 ","$1,600.00 ","$1,460.00 ",$110.54 ,$472.41 ,$251.67 ,"$2,000.00 ","$1,700.00 ","$1,062.93 ","$1,840.00 ","$1,400.00 ","$1,000.00 ","$1,200.00 ","$1,218.00 ","$1,000.00 ","$1,382.00 ","$1,400.00 ",$477.13 ,"$1,440.00 ",$117.17 ,$803.00 ,$803.00 ,$472.41 ,$803.00 ,$472.41 ,"$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,92200026,95912,HC NVR CNDJ TST 11-12 STUDIES,922,1 ,"$2,700.00 ","$1,350.00 ",$110.54 ,"$2,700.00 ","$1,744.20 ",$110.54 ,"$1,746.63 ","$1,746.63 ",$472.41 ,"$1,620.00 ","$2,295.00 ","$1,890.00 ",$110.54 ,"$2,565.00 ","$1,944.00 ","$1,971.00 ","$1,755.00 ","$2,295.00 ",$472.41 ,"$1,755.00 ","$2,160.00 ","$1,971.00 ",$110.54 ,$472.41 ,$251.67 ,"$2,700.00 ","$2,295.00 ","$1,062.93 ","$2,484.00 ","$1,890.00 ","$1,350.00 ","$1,620.00 ","$1,644.30 ","$1,350.00 ","$1,865.70 ","$1,890.00 ",$477.13 ,"$1,944.00 ",$117.17 ,$803.00 ,$803.00 ,$472.41 ,$803.00 ,$472.41 ,"$1,944.00 ","$1,674.00 ","$1,944.00 ","$1,944.00 ","$1,620.00 " ST VINCENT HOSPITAL - ACUTE,92200027,95913,HC NVR CNDJ TST 13 AND > STUDIES,922,1 ,"$2,400.00 ","$1,200.00 ",$110.54 ,"$2,400.00 ","$1,550.40 ",$110.54 ,"$1,552.56 ","$1,552.56 ",$472.41 ,"$1,440.00 ","$2,040.00 ","$1,680.00 ",$110.54 ,"$2,280.00 ","$1,728.00 ","$1,752.00 ","$1,560.00 ","$2,040.00 ",$472.41 ,"$1,560.00 ","$1,920.00 ","$1,752.00 ",$110.54 ,$472.41 ,$251.67 ,"$2,400.00 ","$2,040.00 ","$1,062.93 ","$2,208.00 ","$1,680.00 ","$1,200.00 ","$1,440.00 ","$1,461.60 ","$1,200.00 ","$1,658.40 ","$1,680.00 ",$477.13 ,"$1,728.00 ",$117.17 ,$803.00 ,$803.00 ,$472.41 ,$803.00 ,$472.41 ,"$1,728.00 ","$1,488.00 ","$1,728.00 ","$1,728.00 ","$1,440.00 " ST VINCENT HOSPITAL - ACUTE,92200028,95868,HC EMG CRANIAL NERVE BILAT,922,1 ,$550.00 ,$275.00 ,$110.54 ,$576.27 ,$355.30 ,$110.54 ,$355.80 ,$355.80 ,$256.12 ,$330.00 ,$467.50 ,$385.00 ,$110.54 ,$522.50 ,$396.00 ,$401.50 ,$357.50 ,$467.50 ,$256.12 ,$357.50 ,$440.00 ,$401.50 ,$110.54 ,$256.12 ,$251.67 ,$550.00 ,$467.50 ,$576.27 ,$506.00 ,$385.00 ,$275.00 ,$330.00 ,$334.95 ,$275.00 ,$380.05 ,$385.00 ,$258.68 ,$396.00 ,$117.17 ,$550.00 ,$550.00 ,$256.12 ,$550.00 ,$256.12 ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,92200029,95870,HC EMG NON LIMB,922,1 ,$210.00 ,$105.00 ,$105.00 ,$243.95 ,$135.66 ,$110.54 ,$135.85 ,$135.85 ,$108.42 ,$126.00 ,$178.50 ,$147.00 ,$110.54 ,$199.50 ,$151.20 ,$153.30 ,$136.50 ,$178.50 ,$108.42 ,$136.50 ,$168.00 ,$153.30 ,$110.54 ,$108.42 ,$210.00 ,$210.00 ,$178.50 ,$243.95 ,$193.20 ,$147.00 ,$105.00 ,$126.00 ,$127.89 ,$105.00 ,$145.11 ,$147.00 ,$109.50 ,$151.20 ,$117.17 ,$210.00 ,$210.00 ,$108.42 ,$210.00 ,$108.42 ,$151.20 ,$130.20 ,$151.20 ,$151.20 ,$126.00 ST VINCENT HOSPITAL - ACUTE,94000101,99195,HC PHLEBOTOMY THERAPEUTIC,940,1 ,$230.00 ,$115.00 ,$17.61 ,$243.95 ,$148.58 ,$17.61 ,$148.79 ,$148.79 ,$108.42 ,$138.00 ,$195.50 ,$161.00 ,$17.61 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$108.42 ,$149.50 ,$184.00 ,$167.90 ,$17.61 ,$108.42 ,$210.83 ,$230.00 ,$195.50 ,$243.95 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$109.50 ,$165.60 ,$18.67 ,$201.00 ,$201.00 ,$108.42 ,$201.00 ,$108.42 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,94000106,96379,HC INJ CONTRAST MEDIA LUNA PROCEDURE,940,1 ,$290.00 ,$145.00 ,$14.00 ,$290.00 ,$187.34 ,$14.00 ,$187.60 ,$187.60 ,$38.74 ,$174.00 ,$246.50 ,$203.00 ,$14.00 ,$275.50 ,$208.80 ,$211.70 ,$188.50 ,$246.50 ,$38.74 ,$188.50 ,$232.00 ,$211.70 ,$14.00 ,$38.74 ,$210.83 ,$290.00 ,$246.50 ,$87.17 ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 ,$39.13 ,$208.80 ,$14.84 ,$201.00 ,$201.00 ,$38.74 ,$201.00 ,$38.74 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,94000109,95180,HC RAPID DESENSITIZATION EA HOUR,940,1 ,$170.00 ,$85.00 ,$14.19 ,$588.84 ,$109.82 ,$14.19 ,$109.97 ,$109.97 ,$261.71 ,$102.00 ,$144.50 ,$119.00 ,$14.19 ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 ,$261.71 ,$110.50 ,$136.00 ,$124.10 ,$14.19 ,$261.71 ,$170.00 ,$170.00 ,$144.50 ,$588.84 ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 ,$264.33 ,$122.40 ,$15.04 ,$170.00 ,$170.00 ,$261.71 ,$170.00 ,$261.71 ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,94200005,97802,HC NUTRITION THRPY EVAL 15 MIN,942,1 ,$96.00 ,$48.00 ,$30.70 ,$96.00 ,$62.02 ,$53.83 ,$62.10 ,$62.10 ,$30.70 ,$57.60 ,$81.60 ,$67.20 ,$53.83 ,$91.20 ,$69.12 ,$70.08 ,$62.40 ,$81.60 ,$30.70 ,$62.40 ,$76.80 ,$70.08 ,$53.83 ,$30.70 ,$96.00 ,$96.00 ,$81.60 ,$81.27 ,$88.32 ,$67.20 ,$48.00 ,$57.60 ,$58.46 ,$48.00 ,$66.34 ,$67.20 ,$31.01 ,$69.12 ,$57.06 ,$96.00 ,$96.00 ,$30.70 ,$96.00 ,$30.70 ,$69.12 ,$59.52 ,$69.12 ,$69.12 ,$57.60 ST VINCENT HOSPITAL - ACUTE,94200006,97803,HC NUTRITION THRPY RE-EVAL 15 MIN,942,1 ,$81.00 ,$40.50 ,$26.38 ,$81.00 ,$52.33 ,$53.83 ,$52.40 ,$52.40 ,$26.38 ,$48.60 ,$68.85 ,$56.70 ,$53.83 ,$76.95 ,$58.32 ,$59.13 ,$52.65 ,$68.85 ,$26.38 ,$52.65 ,$64.80 ,$59.13 ,$53.83 ,$26.38 ,$81.00 ,$81.00 ,$68.85 ,$69.82 ,$74.52 ,$56.70 ,$40.50 ,$48.60 ,$49.33 ,$40.50 ,$55.97 ,$56.70 ,$26.64 ,$58.32 ,$57.06 ,$81.00 ,$81.00 ,$26.38 ,$81.00 ,$26.38 ,$58.32 ,$50.22 ,$58.32 ,$58.32 ,$48.60 ST VINCENT HOSPITAL - ACUTE,94200008,99406,HC SMOKING CESSATION PULM 3-10MIN,942,1 ,$42.00 ,$21.00 ,$7.92 ,$57.16 ,$27.13 ,$7.92 ,$27.17 ,$27.17 ,$25.40 ,$25.20 ,$35.70 ,$29.40 ,$7.92 ,$39.90 ,$30.24 ,$30.66 ,$27.30 ,$35.70 ,$25.40 ,$27.30 ,$33.60 ,$30.66 ,$7.92 ,$25.40 ,$42.00 ,$42.00 ,$35.70 ,$57.16 ,$38.64 ,$29.40 ,$21.00 ,$25.20 ,$25.58 ,$21.00 ,$29.02 ,$29.40 ,$25.65 ,$30.24 ,$8.40 ,$42.00 ,$42.00 ,$25.40 ,$42.00 ,$25.40 ,$30.24 ,$26.04 ,$30.24 ,$30.24 ,$25.20 ST VINCENT HOSPITAL - ACUTE,94200009,99407,HC SMOKING CESSATION PULM >10 MIN,942,1 ,$60.00 ,$30.00 ,$7.92 ,$60.00 ,$38.76 ,$7.92 ,$38.81 ,$38.81 ,$25.40 ,$36.00 ,$51.00 ,$42.00 ,$7.92 ,$57.00 ,$43.20 ,$43.80 ,$39.00 ,$51.00 ,$25.40 ,$39.00 ,$48.00 ,$43.80 ,$7.92 ,$25.40 ,$60.00 ,$60.00 ,$51.00 ,$57.16 ,$55.20 ,$42.00 ,$30.00 ,$36.00 ,$36.54 ,$30.00 ,$41.46 ,$42.00 ,$25.65 ,$43.20 ,$8.40 ,$60.00 ,$60.00 ,$25.40 ,$60.00 ,$25.40 ,$43.20 ,$37.20 ,$43.20 ,$43.20 ,$36.00 ST VINCENT HOSPITAL - ACUTE,94200011,G0108,HC DIABETES SELF MGT ED 30 MIN,942,1 ,$160.00 ,$80.00 ,$15.87 ,$160.00 ,$103.36 ,$15.87 ,$103.50 ,$103.50 ,$53.61 ,$96.00 ,$136.00 ,$112.00 ,$15.87 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 ,$53.61 ,$104.00 ,$128.00 ,$116.80 ,$15.87 ,$53.61 ,$126.94 ,$160.00 ,$136.00 ,$120.62 ,$147.20 ,$112.00 ,$80.00 ,$96.00 ,$97.44 ,$80.00 ,$110.56 ,$112.00 ,$54.15 ,$115.20 ,$16.82 ,$132.00 ,$132.00 ,$53.61 ,$132.00 ,$53.61 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,94201000,N/A,HC NUTRITION SUPPORT IP,942,1 ,$55.00 ,$27.50 ,$27.50 ,$55.00 ,$35.53 , N/A ,$35.58 ,$35.58 , N/A ,$33.00 ,$46.75 ,$38.50 , N/A ,$52.25 ,$39.60 ,$40.15 ,$35.75 ,$46.75 , N/A ,$35.75 ,$44.00 ,$40.15 , N/A , N/A ,$55.00 ,$55.00 ,$46.75 , N/A ,$50.60 ,$38.50 ,$27.50 ,$33.00 ,$33.50 ,$27.50 ,$38.01 ,$38.50 , N/A ,$39.60 , N/A ,$55.00 ,$55.00 , N/A ,$55.00 , N/A ,$39.60 ,$34.10 ,$39.60 ,$39.60 ,$33.00 ST VINCENT HOSPITAL - ACUTE,94300004,93797,HC CARDIAC REHAB W/O EKG SESSION,943,1 ,$70.00 ,$35.00 ,$35.00 ,$252.91 ,$45.22 ,$42.15 ,$70.00 ,$70.00 ,$112.40 ,$42.00 ,$59.50 ,$49.00 ,$42.15 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 ,$112.40 ,$45.50 ,$56.00 ,$51.10 ,$42.15 ,$112.40 ,$70.00 ,$70.00 ,$59.50 ,$252.91 ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 ,$113.52 ,$50.40 ,$44.68 ,$70.00 ,$70.00 ,$112.40 ,$70.00 ,$112.40 ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,94300005,93798,HC CARDIAC REHAB W/EKG SESSION (PH2),943,1 ,$370.00 ,$185.00 ,$42.15 ,$370.00 ,$239.02 ,$42.15 ,$370.00 ,$370.00 ,$112.40 ,$222.00 ,$314.50 ,$259.00 ,$42.15 ,$351.50 ,$266.40 ,$270.10 ,$240.50 ,$314.50 ,$112.40 ,$240.50 ,$296.00 ,$270.10 ,$42.15 ,$112.40 ,$126.94 ,$370.00 ,$314.50 ,$252.91 ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 ,$113.52 ,$266.40 ,$44.68 ,$370.00 ,$370.00 ,$112.40 ,$370.00 ,$112.40 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,94300006,93798,HC CARDIAC REHAB W/EKG SESSION (LV1),943,1 ,$370.00 ,$185.00 ,$42.15 ,$370.00 ,$239.02 ,$42.15 ,$370.00 ,$370.00 ,$112.40 ,$222.00 ,$314.50 ,$259.00 ,$42.15 ,$351.50 ,$266.40 ,$270.10 ,$240.50 ,$314.50 ,$112.40 ,$240.50 ,$296.00 ,$270.10 ,$42.15 ,$112.40 ,$126.94 ,$370.00 ,$314.50 ,$252.91 ,$340.40 ,$259.00 ,$185.00 ,$222.00 ,$225.33 ,$185.00 ,$255.67 ,$259.00 ,$113.52 ,$266.40 ,$44.68 ,$370.00 ,$370.00 ,$112.40 ,$370.00 ,$112.40 ,$266.40 ,$229.40 ,$266.40 ,$266.40 ,$222.00 ST VINCENT HOSPITAL - ACUTE,94300008,G0424,HC PULMONARY REHAB PER HOUR,948,1 ,$230.00 ,$115.00 ,$15.28 ,$230.00 ,$148.58 ,$15.28 ,$148.79 ,$148.79 ,$53.91 ,$138.00 ,$195.50 ,$161.00 ,$15.28 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$53.91 ,$149.50 ,$184.00 ,$167.90 ,$15.28 ,$53.91 ,$96.60 ,$230.00 ,$195.50 ,$121.29 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$54.45 ,$165.60 ,$16.20 ,$115.00 ,$115.00 ,$53.91 ,$115.00 ,$53.91 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,94300009,93798,HC CARDIAC REHAB W/EKG SESSION (ASSESSMENT),943,1 ,$430.00 ,$215.00 ,$42.15 ,$430.00 ,$277.78 ,$42.15 ,$430.00 ,$429.00 ,$112.40 ,$258.00 ,$365.50 ,$301.00 ,$42.15 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$112.40 ,$279.50 ,$344.00 ,$313.90 ,$42.15 ,$112.40 ,$126.94 ,$430.00 ,$365.50 ,$252.91 ,$395.60 ,$301.00 ,$215.00 ,$258.00 ,$261.87 ,$215.00 ,$297.13 ,$301.00 ,$113.52 ,$309.60 ,$44.68 ,$430.00 ,$430.00 ,$112.40 ,$430.00 ,$112.40 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,94300010,N/A,HC CARDIAC REHAB PHASE I INIT 15MIN,940,1 ,$120.00 ,$60.00 ,$60.00 ,$120.00 ,$77.52 , N/A ,$77.63 ,$77.63 , N/A ,$72.00 ,$102.00 ,$84.00 , N/A ,$114.00 ,$86.40 ,$87.60 ,$78.00 ,$102.00 , N/A ,$78.00 ,$96.00 ,$87.60 , N/A , N/A ,$120.00 ,$120.00 ,$102.00 , N/A ,$110.40 ,$84.00 ,$60.00 ,$72.00 ,$73.08 ,$60.00 ,$82.92 ,$84.00 , N/A ,$86.40 , N/A ,$120.00 ,$120.00 , N/A ,$120.00 , N/A ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,94300011,N/A,HC CARDIAC REHAB PHASE I ADDNT 15MIN,940,1 ,$41.00 ,$20.50 ,$20.50 ,$41.00 ,$26.49 , N/A ,$26.52 ,$26.52 , N/A ,$24.60 ,$34.85 ,$28.70 , N/A ,$38.95 ,$29.52 ,$29.93 ,$26.65 ,$34.85 , N/A ,$26.65 ,$32.80 ,$29.93 , N/A , N/A ,$41.00 ,$41.00 ,$34.85 , N/A ,$37.72 ,$28.70 ,$20.50 ,$24.60 ,$24.97 ,$20.50 ,$28.33 ,$28.70 , N/A ,$29.52 , N/A ,$41.00 ,$41.00 , N/A ,$41.00 , N/A ,$29.52 ,$25.42 ,$29.52 ,$29.52 ,$24.60 ST VINCENT HOSPITAL - ACUTE,94300012,G0424,HC PULMONARY REHAB PER HOUR-KX,948,1 ,$230.00 ,$115.00 ,$15.28 ,$230.00 ,$148.58 ,$15.28 ,$148.79 ,$148.79 ,$53.91 ,$138.00 ,$195.50 ,$161.00 ,$15.28 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$53.91 ,$149.50 ,$184.00 ,$167.90 ,$15.28 ,$53.91 ,$96.60 ,$230.00 ,$195.50 ,$121.29 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$54.45 ,$165.60 ,$16.20 ,$115.00 ,$115.00 ,$53.91 ,$115.00 ,$53.91 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,94300013,93797,HC CARDIAC REHAB W/O EKG SESSION-59,943,1 ,$83.00 ,$41.50 ,$41.50 ,$252.91 ,$53.62 ,$42.15 ,$83.00 ,$83.00 ,$112.40 ,$49.80 ,$70.55 ,$58.10 ,$42.15 ,$78.85 ,$59.76 ,$60.59 ,$53.95 ,$70.55 ,$112.40 ,$53.95 ,$66.40 ,$60.59 ,$42.15 ,$112.40 ,$83.00 ,$83.00 ,$70.55 ,$252.91 ,$76.36 ,$58.10 ,$41.50 ,$49.80 ,$50.55 ,$41.50 ,$57.35 ,$58.10 ,$113.52 ,$59.76 ,$44.68 ,$83.00 ,$83.00 ,$112.40 ,$83.00 ,$112.40 ,$59.76 ,$51.46 ,$59.76 ,$59.76 ,$49.80 ST VINCENT HOSPITAL - ACUTE,94400001,90853,HC DRUG GROUP THERAPY 90 MIN,944,1 ,$200.00 ,$100.00 ,$38.42 ,$200.00 ,$129.20 ,$38.42 ,$200.00 ,$200.00 ,$72.51 ,$120.00 ,$170.00 ,$140.00 ,$38.42 ,$190.00 ,$144.00 ,$146.00 ,$130.00 ,$170.00 ,$72.51 ,$130.00 ,$160.00 ,$146.00 ,$38.42 ,$72.51 ,$84.00 ,$200.00 ,$170.00 ,$163.15 ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 ,$73.24 ,$144.00 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,94400002,90853,HC DRUG AFTERCARE ADULT,944,1 ,$140.00 ,$70.00 ,$38.42 ,$163.15 ,$90.44 ,$38.42 ,$140.00 ,$140.00 ,$72.51 ,$84.00 ,$119.00 ,$98.00 ,$38.42 ,$133.00 ,$100.80 ,$102.20 ,$91.00 ,$119.00 ,$72.51 ,$91.00 ,$112.00 ,$102.20 ,$38.42 ,$72.51 ,$58.80 ,$140.00 ,$119.00 ,$163.15 ,$128.80 ,$98.00 ,$70.00 ,$84.00 ,$85.26 ,$70.00 ,$96.74 ,$98.00 ,$73.24 ,$100.80 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,94400003,90853,HC DRUG AFTERCARE ADOL 90 MIN,944,1 ,$155.00 ,$77.50 ,$38.42 ,$163.15 ,$100.13 ,$38.42 ,$155.00 ,$155.00 ,$72.51 ,$93.00 ,$131.75 ,$108.50 ,$38.42 ,$147.25 ,$111.60 ,$113.15 ,$100.75 ,$131.75 ,$72.51 ,$100.75 ,$124.00 ,$113.15 ,$38.42 ,$72.51 ,$65.10 ,$155.00 ,$131.75 ,$163.15 ,$142.60 ,$108.50 ,$77.50 ,$93.00 ,$94.40 ,$77.50 ,$107.11 ,$108.50 ,$73.24 ,$111.60 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$111.60 ,$96.10 ,$111.60 ,$111.60 ,$93.00 ST VINCENT HOSPITAL - ACUTE,94400004,90853,HC DRUG IOP ADULT,906,1 ,$275.00 ,$137.50 ,$38.42 ,$275.00 ,$177.65 ,$38.42 ,$275.00 ,$275.00 ,$72.51 ,$165.00 ,$233.75 ,$192.50 ,$38.42 ,$261.25 ,$198.00 ,$200.75 ,$178.75 ,$233.75 ,$72.51 ,$178.75 ,$220.00 ,$200.75 ,$38.42 ,$72.51 ,$115.50 ,$275.00 ,$233.75 ,$163.15 ,$253.00 ,$192.50 ,$137.50 ,$165.00 ,$167.48 ,$137.50 ,$190.03 ,$192.50 ,$73.24 ,$198.00 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,94400005,90853,HC DRUG IOP ADOL,906,1 ,$220.00 ,$110.00 ,$38.42 ,$220.00 ,$142.12 ,$38.42 ,$220.00 ,$220.00 ,$72.51 ,$132.00 ,$187.00 ,$154.00 ,$38.42 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$72.51 ,$143.00 ,$176.00 ,$160.60 ,$38.42 ,$72.51 ,$92.40 ,$220.00 ,$187.00 ,$163.15 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$73.24 ,$158.40 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,94400006,90834,HC DRUG PSYCH THERAPY ADOL 45 MIN,944,1 ,$250.00 ,$125.00 ,$46.53 ,$291.20 ,$161.50 ,$46.53 ,$250.00 ,$250.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.53 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.53 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.32 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,94400007,90834,HC DRUG PSYCH THERAPY ADULT 45 MIN,944,1 ,$250.00 ,$125.00 ,$46.53 ,$291.20 ,$161.50 ,$46.53 ,$250.00 ,$250.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.53 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.53 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.32 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,94400008,90791,HC DRUG EVAL PSYCH DIAG ADOL,944,1 ,$275.00 ,$137.50 ,$81.49 ,$291.20 ,$177.65 ,$81.49 ,$275.00 ,$275.00 ,$129.42 ,$165.00 ,$233.75 ,$192.50 ,$81.49 ,$261.25 ,$198.00 ,$200.75 ,$178.75 ,$233.75 ,$129.42 ,$178.75 ,$220.00 ,$200.75 ,$81.49 ,$129.42 ,$115.50 ,$275.00 ,$233.75 ,$291.20 ,$253.00 ,$192.50 ,$137.50 ,$165.00 ,$167.48 ,$137.50 ,$190.03 ,$192.50 ,$130.71 ,$198.00 ,$86.38 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,94400009,90791,HC DRUG EVAL PSYCH DIAG ADULT,944,1 ,$275.00 ,$137.50 ,$81.49 ,$291.20 ,$177.65 ,$81.49 ,$275.00 ,$275.00 ,$129.42 ,$165.00 ,$233.75 ,$192.50 ,$81.49 ,$261.25 ,$198.00 ,$200.75 ,$178.75 ,$233.75 ,$129.42 ,$178.75 ,$220.00 ,$200.75 ,$81.49 ,$129.42 ,$115.50 ,$275.00 ,$233.75 ,$291.20 ,$253.00 ,$192.50 ,$137.50 ,$165.00 ,$167.48 ,$137.50 ,$190.03 ,$192.50 ,$130.71 ,$198.00 ,$86.38 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,94400013,90832,HC DRUG THERAPY INDIVIDUAL 30MIN,944,1 ,$125.00 ,$62.50 ,$47.57 ,$291.20 ,$80.75 ,$47.57 ,$125.00 ,$125.00 ,$129.42 ,$75.00 ,$106.25 ,$87.50 ,$47.57 ,$118.75 ,$90.00 ,$91.25 ,$81.25 ,$106.25 ,$129.42 ,$81.25 ,$100.00 ,$91.25 ,$47.57 ,$129.42 ,$52.50 ,$125.00 ,$106.25 ,$291.20 ,$115.00 ,$87.50 ,$62.50 ,$75.00 ,$76.13 ,$62.50 ,$86.38 ,$87.50 ,$130.71 ,$90.00 ,$50.42 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$90.00 ,$77.50 ,$90.00 ,$90.00 ,$75.00 ST VINCENT HOSPITAL - ACUTE,94400015,90837,HC DRUG THERAPY INDIVIDUAL 60MIN,944,1 ,$250.00 ,$125.00 ,$46.53 ,$291.20 ,$161.50 ,$46.53 ,$250.00 ,$250.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.53 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.53 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.32 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,94400019,90853,HC DRUG GROUP THERAPY 120 MIN,944,1 ,$255.00 ,$127.50 ,$38.42 ,$255.00 ,$164.73 ,$38.42 ,$255.00 ,$255.00 ,$72.51 ,$153.00 ,$216.75 ,$178.50 ,$38.42 ,$242.25 ,$183.60 ,$186.15 ,$165.75 ,$216.75 ,$72.51 ,$165.75 ,$204.00 ,$186.15 ,$38.42 ,$72.51 ,$107.10 ,$255.00 ,$216.75 ,$163.15 ,$234.60 ,$178.50 ,$127.50 ,$153.00 ,$155.30 ,$127.50 ,$176.21 ,$178.50 ,$73.24 ,$183.60 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$183.60 ,$158.10 ,$183.60 ,$183.60 ,$153.00 ST VINCENT HOSPITAL - ACUTE,94400020,99408,HC DRUG ABUSE SCREEN W/INTERV 15-30MIN,944,1 ,$85.00 ,$42.50 ,$7.92 ,$85.00 ,$54.91 ,$7.92 ,$85.00 ,$85.00 , N/A ,$51.00 ,$72.25 ,$59.50 ,$7.92 ,$80.75 ,$61.20 ,$62.05 ,$55.25 ,$72.25 , N/A ,$55.25 ,$68.00 ,$62.05 ,$7.92 , N/A ,$35.70 ,$85.00 ,$72.25 , N/A ,$78.20 ,$59.50 ,$42.50 ,$51.00 ,$51.77 ,$42.50 ,$58.74 ,$59.50 , N/A ,$61.20 ,$8.40 , N/A , N/A , N/A , N/A , N/A ,$61.20 ,$52.70 ,$61.20 ,$61.20 ,$51.00 ST VINCENT HOSPITAL - ACUTE,94400021,99409,HC DRUG ABUSE SCREEN W/INTERV > 30MIN,944,1 ,$175.00 ,$87.50 ,$7.92 ,$175.00 ,$113.05 ,$7.92 ,$175.00 ,$175.00 , N/A ,$105.00 ,$148.75 ,$122.50 ,$7.92 ,$166.25 ,$126.00 ,$127.75 ,$113.75 ,$148.75 , N/A ,$113.75 ,$140.00 ,$127.75 ,$7.92 , N/A ,$73.50 ,$175.00 ,$148.75 , N/A ,$161.00 ,$122.50 ,$87.50 ,$105.00 ,$106.58 ,$87.50 ,$120.93 ,$122.50 , N/A ,$126.00 ,$8.40 , N/A , N/A , N/A , N/A , N/A ,$126.00 ,$108.50 ,$126.00 ,$126.00 ,$105.00 ST VINCENT HOSPITAL - ACUTE,94500001,90853,HC ALCOHOL GROUP THERAPY 90 MIN,945,1 ,$200.00 ,$100.00 ,$38.42 ,$200.00 ,$129.20 ,$38.42 ,$200.00 ,$200.00 ,$72.51 ,$120.00 ,$170.00 ,$140.00 ,$38.42 ,$190.00 ,$144.00 ,$146.00 ,$130.00 ,$170.00 ,$72.51 ,$130.00 ,$160.00 ,$146.00 ,$38.42 ,$72.51 ,$84.00 ,$200.00 ,$170.00 ,$163.15 ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 ,$73.24 ,$144.00 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,94500002,90853,HC ALCOHOL AFTERCARE ADULT,945,1 ,$140.00 ,$70.00 ,$38.42 ,$163.15 ,$90.44 ,$38.42 ,$140.00 ,$140.00 ,$72.51 ,$84.00 ,$119.00 ,$98.00 ,$38.42 ,$133.00 ,$100.80 ,$102.20 ,$91.00 ,$119.00 ,$72.51 ,$91.00 ,$112.00 ,$102.20 ,$38.42 ,$72.51 ,$58.80 ,$140.00 ,$119.00 ,$163.15 ,$128.80 ,$98.00 ,$70.00 ,$84.00 ,$85.26 ,$70.00 ,$96.74 ,$98.00 ,$73.24 ,$100.80 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,94500003,90853,HC ALCOHOL AFTERCARE ADOL 90 MIN,945,1 ,$155.00 ,$77.50 ,$38.42 ,$163.15 ,$100.13 ,$38.42 ,$155.00 ,$155.00 ,$72.51 ,$93.00 ,$131.75 ,$108.50 ,$38.42 ,$147.25 ,$111.60 ,$113.15 ,$100.75 ,$131.75 ,$72.51 ,$100.75 ,$124.00 ,$113.15 ,$38.42 ,$72.51 ,$65.10 ,$155.00 ,$131.75 ,$163.15 ,$142.60 ,$108.50 ,$77.50 ,$93.00 ,$94.40 ,$77.50 ,$107.11 ,$108.50 ,$73.24 ,$111.60 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$111.60 ,$96.10 ,$111.60 ,$111.60 ,$93.00 ST VINCENT HOSPITAL - ACUTE,94500004,90853,HC ALCOHOL IOP ADULT,906,1 ,$275.00 ,$137.50 ,$38.42 ,$275.00 ,$177.65 ,$38.42 ,$275.00 ,$275.00 ,$72.51 ,$165.00 ,$233.75 ,$192.50 ,$38.42 ,$261.25 ,$198.00 ,$200.75 ,$178.75 ,$233.75 ,$72.51 ,$178.75 ,$220.00 ,$200.75 ,$38.42 ,$72.51 ,$115.50 ,$275.00 ,$233.75 ,$163.15 ,$253.00 ,$192.50 ,$137.50 ,$165.00 ,$167.48 ,$137.50 ,$190.03 ,$192.50 ,$73.24 ,$198.00 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,94500005,90853,HC ALCOHOL IOP ADOL,906,1 ,$220.00 ,$110.00 ,$38.42 ,$220.00 ,$142.12 ,$38.42 ,$220.00 ,$220.00 ,$72.51 ,$132.00 ,$187.00 ,$154.00 ,$38.42 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$72.51 ,$143.00 ,$176.00 ,$160.60 ,$38.42 ,$72.51 ,$92.40 ,$220.00 ,$187.00 ,$163.15 ,$202.40 ,$154.00 ,$110.00 ,$132.00 ,$133.98 ,$110.00 ,$152.02 ,$154.00 ,$73.24 ,$158.40 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,94500006,90834,HC ALCOHOL PSYCH THERAPY ADOL 45 MIN,945,1 ,$250.00 ,$125.00 ,$46.53 ,$291.20 ,$161.50 ,$46.53 ,$250.00 ,$250.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.53 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.53 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.32 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,94500007,90834,HC ALCOHOL PSYCH THERAPY ADULT 45 MIN,945,1 ,$250.00 ,$125.00 ,$46.53 ,$291.20 ,$161.50 ,$46.53 ,$250.00 ,$250.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.53 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.53 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.32 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,94500008,90791,HC ALCOHOL EVAL PSYCH DIAG ADOL,945,1 ,$275.00 ,$137.50 ,$81.49 ,$291.20 ,$177.65 ,$81.49 ,$275.00 ,$275.00 ,$129.42 ,$165.00 ,$233.75 ,$192.50 ,$81.49 ,$261.25 ,$198.00 ,$200.75 ,$178.75 ,$233.75 ,$129.42 ,$178.75 ,$220.00 ,$200.75 ,$81.49 ,$129.42 ,$115.50 ,$275.00 ,$233.75 ,$291.20 ,$253.00 ,$192.50 ,$137.50 ,$165.00 ,$167.48 ,$137.50 ,$190.03 ,$192.50 ,$130.71 ,$198.00 ,$86.38 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,94500009,90791,HC ALCOHOL EVAL PSYCH DIAG ADULT,945,1 ,$275.00 ,$137.50 ,$81.49 ,$291.20 ,$177.65 ,$81.49 ,$275.00 ,$275.00 ,$129.42 ,$165.00 ,$233.75 ,$192.50 ,$81.49 ,$261.25 ,$198.00 ,$200.75 ,$178.75 ,$233.75 ,$129.42 ,$178.75 ,$220.00 ,$200.75 ,$81.49 ,$129.42 ,$115.50 ,$275.00 ,$233.75 ,$291.20 ,$253.00 ,$192.50 ,$137.50 ,$165.00 ,$167.48 ,$137.50 ,$190.03 ,$192.50 ,$130.71 ,$198.00 ,$86.38 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,94500013,90832,HC ALCOHOL THERAPY INDIVIDUAL 30MIN,945,1 ,$125.00 ,$62.50 ,$47.57 ,$291.20 ,$80.75 ,$47.57 ,$125.00 ,$125.00 ,$129.42 ,$75.00 ,$106.25 ,$87.50 ,$47.57 ,$118.75 ,$90.00 ,$91.25 ,$81.25 ,$106.25 ,$129.42 ,$81.25 ,$100.00 ,$91.25 ,$47.57 ,$129.42 ,$52.50 ,$125.00 ,$106.25 ,$291.20 ,$115.00 ,$87.50 ,$62.50 ,$75.00 ,$76.13 ,$62.50 ,$86.38 ,$87.50 ,$130.71 ,$90.00 ,$50.42 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$90.00 ,$77.50 ,$90.00 ,$90.00 ,$75.00 ST VINCENT HOSPITAL - ACUTE,94500015,90837,HC ALCOHOL THERAPY INDIVIDUAL 60MIN,945,1 ,$250.00 ,$125.00 ,$46.53 ,$291.20 ,$161.50 ,$46.53 ,$250.00 ,$250.00 ,$129.42 ,$150.00 ,$212.50 ,$175.00 ,$46.53 ,$237.50 ,$180.00 ,$182.50 ,$162.50 ,$212.50 ,$129.42 ,$162.50 ,$200.00 ,$182.50 ,$46.53 ,$129.42 ,$105.00 ,$250.00 ,$212.50 ,$291.20 ,$230.00 ,$175.00 ,$125.00 ,$150.00 ,$152.25 ,$125.00 ,$172.75 ,$175.00 ,$130.71 ,$180.00 ,$49.32 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$180.00 ,$155.00 ,$180.00 ,$180.00 ,$150.00 ST VINCENT HOSPITAL - ACUTE,94500019,90853,HC ALCOHOL GROUP THERAPY 120 MIN,945,1 ,$255.00 ,$127.50 ,$38.42 ,$255.00 ,$164.73 ,$38.42 ,$255.00 ,$255.00 ,$72.51 ,$153.00 ,$216.75 ,$178.50 ,$38.42 ,$242.25 ,$183.60 ,$186.15 ,$165.75 ,$216.75 ,$72.51 ,$165.75 ,$204.00 ,$186.15 ,$38.42 ,$72.51 ,$107.10 ,$255.00 ,$216.75 ,$163.15 ,$234.60 ,$178.50 ,$127.50 ,$153.00 ,$155.30 ,$127.50 ,$176.21 ,$178.50 ,$73.24 ,$183.60 ,$40.73 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$183.60 ,$158.10 ,$183.60 ,$183.60 ,$153.00 ST VINCENT HOSPITAL - ACUTE,96000001,99307,PC NURSING FAC VISIT SUBSQ PER DAY MINIMAL 10MIN,960,1 ,$115.00 ,$57.50 ,$47.46 ,$115.00 ,$74.29 ,$47.46 ,$74.39 ,$74.39 , N/A ,$69.00 ,$97.75 ,$80.50 ,$47.46 ,$109.25 ,$82.80 ,$83.95 ,$74.75 ,$97.75 , N/A ,$74.75 ,$92.00 ,$83.95 ,$47.46 , N/A ,$48.30 ,$115.00 ,$97.75 , N/A ,$105.80 ,$80.50 ,$57.50 ,$69.00 ,$70.04 ,$57.50 ,$79.47 ,$80.50 , N/A ,$82.80 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$82.80 ,$71.30 ,$82.80 ,$82.80 ,$69.00 ST VINCENT HOSPITAL - ACUTE,96000002,99308,PC NURSING FAC VISIT SUBSQ PER DAY LOW 15MIN,960,1 ,$190.00 ,$95.00 ,$47.46 ,$190.00 ,$122.74 ,$47.46 ,$122.91 ,$122.91 , N/A ,$114.00 ,$161.50 ,$133.00 ,$47.46 ,$180.50 ,$136.80 ,$138.70 ,$123.50 ,$161.50 , N/A ,$123.50 ,$152.00 ,$138.70 ,$47.46 , N/A ,$79.80 ,$190.00 ,$161.50 , N/A ,$174.80 ,$133.00 ,$95.00 ,$114.00 ,$115.71 ,$95.00 ,$131.29 ,$133.00 , N/A ,$136.80 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,96000003,99309,PC NURSING FAC VISIT SUBSQ PER DAY MOD 25MIN,960,1 ,$270.00 ,$135.00 ,$47.46 ,$270.00 ,$174.42 ,$47.46 ,$174.66 ,$174.66 , N/A ,$162.00 ,$229.50 ,$189.00 ,$47.46 ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 , N/A ,$175.50 ,$216.00 ,$197.10 ,$47.46 , N/A ,$113.40 ,$270.00 ,$229.50 , N/A ,$248.40 ,$189.00 ,$135.00 ,$162.00 ,$164.43 ,$135.00 ,$186.57 ,$189.00 , N/A ,$194.40 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,96000004,99310,PC NURSING FAC VISIT SUBSQ PER DAY HIGH 35MIN,960,1 ,$340.00 ,$170.00 ,$47.46 ,$340.00 ,$219.64 ,$47.46 ,$219.95 ,$219.95 , N/A ,$204.00 ,$289.00 ,$238.00 ,$47.46 ,$323.00 ,$244.80 ,$248.20 ,$221.00 ,$289.00 , N/A ,$221.00 ,$272.00 ,$248.20 ,$47.46 , N/A ,$142.80 ,$340.00 ,$289.00 , N/A ,$312.80 ,$238.00 ,$170.00 ,$204.00 ,$207.06 ,$170.00 ,$234.94 ,$238.00 , N/A ,$244.80 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$244.80 ,$210.80 ,$244.80 ,$244.80 ,$204.00 ST VINCENT HOSPITAL - ACUTE,96000044,G2061,PC NON PHYSICIAN EST PT 5-10 MIN,960,1 ,$25.00 ,$12.50 ,$10.50 ,$25.00 ,$16.15 , N/A ,$16.17 ,$16.17 , N/A ,$15.00 ,$21.25 ,$17.50 , N/A ,$23.75 ,$18.00 ,$18.25 ,$16.25 ,$21.25 , N/A ,$16.25 ,$20.00 ,$18.25 , N/A , N/A ,$10.50 ,$25.00 ,$21.25 , N/A ,$23.00 ,$17.50 ,$12.50 ,$15.00 ,$15.23 ,$12.50 ,$17.28 ,$17.50 , N/A ,$18.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,96000045,G2062,PC NON PHYSICIAN EST PT 11-20 MIN,960,1 ,$50.00 ,$25.00 ,$21.00 ,$50.00 ,$32.30 , N/A ,$32.35 ,$32.35 , N/A ,$30.00 ,$42.50 ,$35.00 , N/A ,$47.50 ,$36.00 ,$36.50 ,$32.50 ,$42.50 , N/A ,$32.50 ,$40.00 ,$36.50 , N/A , N/A ,$21.00 ,$50.00 ,$42.50 , N/A ,$46.00 ,$35.00 ,$25.00 ,$30.00 ,$30.45 ,$25.00 ,$34.55 ,$35.00 , N/A ,$36.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,96000046,G2063,PC NON PHYSICIAN EST PT > 21 MIN,960,1 ,$75.00 ,$37.50 ,$31.50 ,$75.00 ,$48.45 , N/A ,$48.52 ,$48.52 , N/A ,$45.00 ,$63.75 ,$52.50 , N/A ,$71.25 ,$54.00 ,$54.75 ,$48.75 ,$63.75 , N/A ,$48.75 ,$60.00 ,$54.75 , N/A , N/A ,$31.50 ,$75.00 ,$63.75 , N/A ,$69.00 ,$52.50 ,$37.50 ,$45.00 ,$45.68 ,$37.50 ,$51.83 ,$52.50 , N/A ,$54.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,96000047,99421,PC ONLINE DIG E/M SVC 5-10 MIN-95,960,1 ,$35.00 ,$17.50 ,$11.70 ,$35.00 ,$22.61 ,$11.70 ,$22.64 ,$22.64 , N/A ,$21.00 ,$29.75 ,$24.50 ,$11.70 ,$33.25 ,$25.20 ,$25.55 ,$22.75 ,$29.75 , N/A ,$22.75 ,$28.00 ,$25.55 ,$11.70 , N/A ,$14.70 ,$35.00 ,$29.75 , N/A ,$32.20 ,$24.50 ,$17.50 ,$21.00 ,$21.32 ,$17.50 ,$24.19 ,$24.50 , N/A ,$25.20 ,$12.40 , N/A , N/A , N/A , N/A , N/A ,$25.20 ,$21.70 ,$25.20 ,$25.20 ,$21.00 ST VINCENT HOSPITAL - ACUTE,96000048,99422,PC ONLINE DIG E/M SVC 11-20 MIN-95,960,1 ,$70.00 ,$35.00 ,$23.25 ,$70.00 ,$45.22 ,$23.25 ,$45.28 ,$45.28 , N/A ,$42.00 ,$59.50 ,$49.00 ,$23.25 ,$66.50 ,$50.40 ,$51.10 ,$45.50 ,$59.50 , N/A ,$45.50 ,$56.00 ,$51.10 ,$23.25 , N/A ,$29.40 ,$70.00 ,$59.50 , N/A ,$64.40 ,$49.00 ,$35.00 ,$42.00 ,$42.63 ,$35.00 ,$48.37 ,$49.00 , N/A ,$50.40 ,$24.65 , N/A , N/A , N/A , N/A , N/A ,$50.40 ,$43.40 ,$50.40 ,$50.40 ,$42.00 ST VINCENT HOSPITAL - ACUTE,96000049,99423,PC ONLINE DIG E/M SVC 21+ MIN-95,960,1 ,$105.00 ,$52.50 ,$37.58 ,$105.00 ,$67.83 ,$37.58 ,$67.92 ,$67.92 , N/A ,$63.00 ,$89.25 ,$73.50 ,$37.58 ,$99.75 ,$75.60 ,$76.65 ,$68.25 ,$89.25 , N/A ,$68.25 ,$84.00 ,$76.65 ,$37.58 , N/A ,$44.10 ,$105.00 ,$89.25 , N/A ,$96.60 ,$73.50 ,$52.50 ,$63.00 ,$63.95 ,$52.50 ,$72.56 ,$73.50 , N/A ,$75.60 ,$39.83 , N/A , N/A , N/A , N/A , N/A ,$75.60 ,$65.10 ,$75.60 ,$75.60 ,$63.00 ST VINCENT HOSPITAL - ACUTE,96000050,G2010,PC REMOTE IMAGE SUBMIT BY PATIENT,960,1 ,$25.00 ,$12.50 ,$10.50 ,$25.00 ,$16.15 ,$11.64 ,$16.17 ,$16.17 , N/A ,$15.00 ,$21.25 ,$17.50 ,$11.64 ,$23.75 ,$18.00 ,$18.25 ,$16.25 ,$21.25 , N/A ,$16.25 ,$20.00 ,$18.25 ,$11.64 , N/A ,$10.50 ,$25.00 ,$21.25 , N/A ,$23.00 ,$17.50 ,$12.50 ,$15.00 ,$15.23 ,$12.50 ,$17.28 ,$17.50 , N/A ,$18.00 ,$12.34 , N/A , N/A , N/A , N/A , N/A ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,96000051,G2012,PC BRIEF CHECK IN BY MD/QHP-95,960,1 ,$30.00 ,$15.00 ,$12.60 ,$30.00 ,$19.38 ,$13.86 ,$19.41 ,$19.41 , N/A ,$18.00 ,$25.50 ,$21.00 ,$13.86 ,$28.50 ,$21.60 ,$21.90 ,$19.50 ,$25.50 , N/A ,$19.50 ,$24.00 ,$21.90 ,$13.86 , N/A ,$12.60 ,$30.00 ,$25.50 , N/A ,$27.60 ,$21.00 ,$15.00 ,$18.00 ,$18.27 ,$15.00 ,$20.73 ,$21.00 , N/A ,$21.60 ,$14.69 , N/A , N/A , N/A , N/A , N/A ,$21.60 ,$18.60 ,$21.60 ,$21.60 ,$18.00 ST VINCENT HOSPITAL - ACUTE,96080000,36000,PC IV START > 3YR OLD,960,1 ,$110.00 ,$55.00 ,$17.61 ,$110.00 ,$71.06 ,$17.61 ,$71.16 ,$71.16 , N/A ,$66.00 ,$93.50 ,$77.00 ,$17.61 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 , N/A ,$71.50 ,$88.00 ,$80.30 ,$17.61 , N/A ,$46.20 ,$110.00 ,$93.50 , N/A ,$101.20 ,$77.00 ,$110.00 ,$110.00 ,$66.99 ,$110.00 ,$76.01 ,$77.00 , N/A ,$79.20 ,$18.67 , N/A , N/A , N/A , N/A , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,96080001,36415,PC VENIPUNCTURE,960,1 ,$36.00 ,$18.00 ,$0.72 ,$36.00 ,$23.26 ,$0.72 ,$23.29 ,$23.29 ,$3.00 ,$21.60 ,$30.60 ,$25.20 ,$0.72 ,$34.20 ,$25.92 ,$26.28 ,$23.40 ,$30.60 ,$3.00 ,$23.40 ,$28.80 ,$26.28 ,$0.72 ,$3.00 ,$15.12 ,$36.00 ,$30.60 ,$6.75 ,$33.12 ,$25.20 ,$10.53 ,$11.31 ,$21.92 ,$10.53 ,$24.88 ,$25.20 ,$3.03 ,$25.92 ,$0.76 , N/A , N/A ,$3.00 , N/A ,$3.00 ,$25.92 ,$22.32 ,$25.92 ,$25.92 ,$21.60 ST VINCENT HOSPITAL - ACUTE,96080002,36416,PC CAPILLARY COLLECTION,960,1 ,$29.00 ,$14.50 ,$0.72 ,$29.00 ,$18.73 ,$0.72 ,$18.76 ,$18.76 , N/A ,$17.40 ,$24.65 ,$20.30 ,$0.72 ,$27.55 ,$20.88 ,$21.17 ,$18.85 ,$24.65 , N/A ,$18.85 ,$23.20 ,$21.17 ,$0.72 , N/A ,$12.18 ,$29.00 ,$24.65 , N/A ,$26.68 ,$20.30 ,$14.50 ,$17.40 ,$17.66 ,$14.50 ,$20.04 ,$20.30 , N/A ,$20.88 ,$0.76 , N/A , N/A , N/A , N/A , N/A ,$20.88 ,$17.98 ,$20.88 ,$20.88 ,$17.40 ST VINCENT HOSPITAL - ACUTE,96080003,36589,PC REMOVE TUNNELED CATH-NO PORT,960,1 ,$150.00 ,$75.00 ,$63.00 ,"$1,180.26 ",$96.90 ,$150.00 ,$97.04 ,$97.04 ,$524.56 ,$90.00 ,$127.50 ,$105.00 ,$222.52 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 ,$524.56 ,$97.50 ,$120.00 ,$109.50 ,$222.52 ,$524.56 ,$63.00 ,$150.00 ,$127.50 ,"$1,180.26 ",$138.00 ,$105.00 ,$150.00 ,$150.00 ,$91.35 ,$150.00 ,$103.65 ,$105.00 ,$529.81 ,$108.00 ,$235.87 , N/A , N/A ,$524.56 , N/A ,$524.56 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,96080004,36591,PC COLLECT BLOOD PORT/ACCESS DVC,960,1 ,$120.00 ,$60.00 ,$17.61 ,$243.95 ,$77.52 ,$17.61 ,$77.63 ,$77.63 ,$108.42 ,$72.00 ,$102.00 ,$84.00 ,$17.61 ,$114.00 ,$86.40 ,$87.60 ,$78.00 ,$102.00 ,$108.42 ,$78.00 ,$96.00 ,$87.60 ,$17.61 ,$108.42 ,$50.40 ,$120.00 ,$102.00 ,$243.95 ,$110.40 ,$84.00 ,$120.00 ,$120.00 ,$73.08 ,$120.00 ,$82.92 ,$84.00 ,$109.50 ,$86.40 ,$18.67 , N/A , N/A ,$108.42 , N/A ,$108.42 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,96080005,36592,PC COLLECT BLD CENTRL/PERPH CATH,960,1 ,$50.00 ,$25.00 ,$17.61 ,$243.95 ,$32.30 ,$17.61 ,$32.35 ,$32.35 ,$108.42 ,$30.00 ,$42.50 ,$35.00 ,$17.61 ,$47.50 ,$36.00 ,$36.50 ,$32.50 ,$42.50 ,$108.42 ,$32.50 ,$40.00 ,$36.50 ,$17.61 ,$108.42 ,$21.00 ,$50.00 ,$42.50 ,$243.95 ,$46.00 ,$35.00 ,$50.00 ,$50.00 ,$30.45 ,$50.00 ,$34.55 ,$35.00 ,$109.50 ,$36.00 ,$18.67 , N/A , N/A ,$108.42 , N/A ,$108.42 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,96080006,38220,PC ASP BONE MARROW ONLY,960,1 ,$600.00 ,$300.00 ,$252.00 ,"$3,066.03 ",$387.60 ,$350.23 ,$388.14 ,$388.14 ,"$1,362.68 ",$360.00 ,$510.00 ,$420.00 ,$350.23 ,$570.00 ,$432.00 ,$438.00 ,$390.00 ,$510.00 ,"$1,362.68 ",$390.00 ,$480.00 ,$438.00 ,$350.23 ,"$1,362.68 ",$252.00 ,$600.00 ,$510.00 ,"$3,066.03 ",$552.00 ,$420.00 ,$600.00 ,$600.00 ,$365.40 ,$600.00 ,$414.60 ,$420.00 ,"$1,376.31 ",$432.00 ,$371.24 , N/A , N/A ,"$1,362.68 ", N/A ,"$1,362.68 ",$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,96080007,38221,PC BX BONE MARROW NEEDLE,960,1 ,$850.00 ,$425.00 ,$350.23 ,"$3,066.03 ",$549.10 ,$350.23 ,$549.87 ,$549.87 ,"$1,362.68 ",$510.00 ,$722.50 ,$595.00 ,$350.23 ,$807.50 ,$612.00 ,$620.50 ,$552.50 ,$722.50 ,"$1,362.68 ",$552.50 ,$680.00 ,$620.50 ,$350.23 ,"$1,362.68 ",$357.00 ,$850.00 ,$722.50 ,"$3,066.03 ",$782.00 ,$595.00 ,$850.00 ,$850.00 ,$517.65 ,$850.00 ,$587.35 ,$595.00 ,"$1,376.31 ",$612.00 ,$371.24 , N/A , N/A ,"$1,362.68 ", N/A ,"$1,362.68 ",$612.00 ,$527.00 ,$612.00 ,$612.00 ,$510.00 ST VINCENT HOSPITAL - ACUTE,96080008,92511,PC NASOPHARYNGOSCOPY,960,1 ,$600.00 ,$300.00 ,$35.67 ,$600.00 ,$387.60 ,$35.67 ,$388.14 ,$388.14 ,$159.21 ,$360.00 ,$510.00 ,$420.00 ,$35.67 ,$570.00 ,$432.00 ,$438.00 ,$390.00 ,$510.00 ,$159.21 ,$390.00 ,$480.00 ,$438.00 ,$35.67 ,$159.21 ,$252.00 ,$600.00 ,$510.00 ,$358.23 ,$552.00 ,$420.00 ,$300.00 ,$360.00 ,$365.40 ,$300.00 ,$414.60 ,$420.00 ,$160.80 ,$432.00 ,$37.81 , N/A , N/A ,$159.21 , N/A ,$159.21 ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,96080009,38222,PC BONE MARROW ASPIRATE (WHEN DONE WITH BIOPSY) FOR MEDICARE PTS ONLY,960,1 ,$665.00 ,$332.50 ,$279.30 ,"$5,164.55 ",$429.59 ,$350.23 ,$430.19 ,$430.19 ,"$2,295.35 ",$399.00 ,$565.25 ,$465.50 ,$350.23 ,$631.75 ,$478.80 ,$485.45 ,$432.25 ,$565.25 ,"$2,295.35 ",$432.25 ,$532.00 ,$485.45 ,$350.23 ,"$2,295.35 ",$279.30 ,$665.00 ,$565.25 ,"$5,164.55 ",$611.80 ,$465.50 ,$665.00 ,$665.00 ,$404.99 ,$665.00 ,$459.52 ,$465.50 ,"$2,318.30 ",$478.80 ,$371.24 , N/A , N/A ,"$2,295.35 ", N/A ,"$2,295.35 ",$478.80 ,$412.30 ,$478.80 ,$478.80 ,$399.00 ST VINCENT HOSPITAL - ACUTE,96080010,57410,PC PELVIC EXAM UNDER ANEST 57410,960,1 ,$485.00 ,$242.50 ,$63.69 ,"$5,716.30 ",$313.31 ,$63.69 ,$313.75 ,$313.75 ,"$2,540.58 ",$291.00 ,$412.25 ,$339.50 ,$63.69 ,$460.75 ,$349.20 ,$354.05 ,$315.25 ,$412.25 ,"$2,540.58 ",$315.25 ,$388.00 ,$354.05 ,$63.69 ,"$2,540.58 ",$203.70 ,$485.00 ,$412.25 ,"$5,716.30 ",$446.20 ,$339.50 ,$485.00 ,$485.00 ,$295.37 ,$485.00 ,$335.14 ,$339.50 ,"$2,565.99 ",$349.20 ,$67.51 , N/A , N/A ,"$2,540.58 ", N/A ,"$2,540.58 ",$349.20 ,$300.70 ,$349.20 ,$349.20 ,$291.00 ST VINCENT HOSPITAL - ACUTE,96080011,99495,PC TRANSITIONAL CARE MGMT SERV MOD COMPLEXITY,960,1 ,$450.00 ,$225.00 ,$31.68 ,$450.00 ,$290.70 ,$31.68 ,$291.11 ,$291.11 ,$115.00 ,$270.00 ,$382.50 ,$315.00 ,$31.68 ,$427.50 ,$324.00 ,$328.50 ,$292.50 ,$382.50 ,$115.00 ,$292.50 ,$360.00 ,$328.50 ,$31.68 ,$115.00 ,$189.00 ,$450.00 ,$382.50 ,$258.75 ,$414.00 ,$315.00 ,$225.00 ,$270.00 ,$274.05 ,$225.00 ,$310.95 ,$315.00 ,$116.15 ,$324.00 ,$33.58 , N/A , N/A ,$115.00 , N/A ,$115.00 ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,96080012,99496,PC TRANSITIONAL CARE MGMT SERV HIGH COMPLEXITY,960,1 ,$625.00 ,$312.50 ,$31.68 ,$625.00 ,$403.75 ,$31.68 ,$404.31 ,$404.31 ,$115.00 ,$375.00 ,$531.25 ,$437.50 ,$31.68 ,$593.75 ,$450.00 ,$456.25 ,$406.25 ,$531.25 ,$115.00 ,$406.25 ,$500.00 ,$456.25 ,$31.68 ,$115.00 ,$262.50 ,$625.00 ,$531.25 ,$258.75 ,$575.00 ,$437.50 ,$312.50 ,$375.00 ,$380.63 ,$312.50 ,$431.88 ,$437.50 ,$116.15 ,$450.00 ,$33.58 , N/A , N/A ,$115.00 , N/A ,$115.00 ,$450.00 ,$387.50 ,$450.00 ,$450.00 ,$375.00 ST VINCENT HOSPITAL - ACUTE,96100003,90792,PC EVAL PSYCH DIAG W/MED SERVICE MD,961,1 ,$150.00 ,$75.00 ,$63.00 ,$291.20 ,$96.90 ,$81.49 ,$97.04 ,$97.04 ,$129.42 ,$90.00 ,$127.50 ,$105.00 ,$81.49 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 ,$129.42 ,$97.50 ,$120.00 ,$109.50 ,$81.49 ,$129.42 ,$63.00 ,$150.00 ,$127.50 ,$291.20 ,$138.00 ,$105.00 ,$75.00 ,$90.00 ,$91.35 ,$75.00 ,$103.65 ,$105.00 ,$130.71 ,$108.00 ,$86.38 , N/A , N/A ,$129.42 , N/A ,$129.42 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,97280000,77014,PC CT GUIDED THRPY PLACEMENT,972,1 ,$400.00 ,$200.00 ,$31.12 ,$400.00 ,$258.40 ,$31.12 ,$258.76 ,$258.76 , N/A ,$240.00 ,$340.00 ,$280.00 ,$31.12 ,$380.00 ,$288.00 ,$292.00 ,$260.00 ,$340.00 , N/A ,$260.00 ,$320.00 ,$292.00 ,$31.12 , N/A ,$168.00 ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 , N/A ,$288.00 ,$32.99 , N/A , N/A , N/A , N/A , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,97280001,76000,PC FLUOROSCOPY UP TO 1 HR 76000,972,1 ,$95.00 ,$47.50 ,$37.66 ,$501.48 ,$61.37 ,$37.66 ,$61.46 ,$61.46 ,$222.88 ,$57.00 ,$80.75 ,$66.50 ,$37.66 ,$90.25 ,$68.40 ,$69.35 ,$61.75 ,$80.75 ,$222.88 ,$61.75 ,$76.00 ,$69.35 ,$37.66 ,$222.88 ,$39.90 ,$95.00 ,$80.75 ,$501.48 ,$87.40 ,$66.50 ,$95.00 ,$95.00 ,$57.86 ,$95.00 ,$65.65 ,$66.50 ,$225.11 ,$68.40 ,$39.92 , N/A , N/A ,$222.88 , N/A ,$222.88 ,$68.40 ,$58.90 ,$68.40 ,$68.40 ,$57.00 ST VINCENT HOSPITAL - ACUTE,97280002,76873,PC US TRANSRECTAL PROSTATE VOLUME,972,1 ,$335.00 ,$167.50 ,$63.07 ,$335.00 ,$216.41 ,$63.07 ,$216.71 ,$216.71 ,$105.54 ,$201.00 ,$284.75 ,$234.50 ,$63.07 ,$318.25 ,$241.20 ,$244.55 ,$217.75 ,$284.75 ,$105.54 ,$217.75 ,$268.00 ,$244.55 ,$63.07 ,$105.54 ,$140.70 ,$335.00 ,$284.75 ,$237.46 ,$308.20 ,$234.50 ,$335.00 ,$335.00 ,$204.02 ,$335.00 ,$231.49 ,$234.50 ,$106.60 ,$241.20 ,$66.85 , N/A , N/A ,$105.54 , N/A ,$105.54 ,$241.20 ,$207.70 ,$241.20 ,$241.20 ,$201.00 ST VINCENT HOSPITAL - ACUTE,97280003,76965,PC US GUIDED INTERSTITIAL THERAPY,972,1 ,$280.00 ,$140.00 ,$35.59 ,$280.00 ,$180.88 ,$35.59 ,$181.13 ,$181.13 , N/A ,$168.00 ,$238.00 ,$196.00 ,$35.59 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 , N/A ,$182.00 ,$224.00 ,$204.40 ,$35.59 , N/A ,$117.60 ,$280.00 ,$238.00 , N/A ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 , N/A ,$201.60 ,$37.73 , N/A , N/A , N/A , N/A , N/A ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,97280004,75710,PC ANGIO EXTEMITY UNI,972,1 ,"$3,750.00 ","$1,875.00 ",$534.02 ,"$6,235.91 ","$2,422.50 ",$534.02 ,"$2,425.88 ","$2,425.88 ","$2,771.52 ","$2,250.00 ","$3,187.50 ","$2,625.00 ",$534.02 ,"$3,562.50 ","$2,700.00 ","$2,737.50 ","$2,437.50 ","$3,187.50 ","$2,771.52 ","$2,437.50 ","$3,000.00 ","$2,737.50 ",$534.02 ,"$2,771.52 ","$1,575.00 ","$3,750.00 ","$3,187.50 ","$6,235.91 ","$3,450.00 ","$2,625.00 ","$3,750.00 ","$3,750.00 ","$2,283.75 ","$3,750.00 ","$2,591.25 ","$2,625.00 ","$2,799.24 ","$2,700.00 ",$566.06 , N/A , N/A ,"$2,771.52 ", N/A ,"$2,771.52 ","$2,700.00 ","$2,325.00 ","$2,700.00 ","$2,700.00 ","$2,250.00 " ST VINCENT HOSPITAL - ACUTE,97280005,75716,PC ANGIO EXTREMITY BILAT,972,1 ,"$4,255.00 ","$2,127.50 ",$534.02 ,"$6,235.91 ","$2,748.73 ",$534.02 ,"$2,752.56 ","$2,752.56 ","$2,771.52 ","$2,553.00 ","$3,616.75 ","$2,978.50 ",$534.02 ,"$4,042.25 ","$3,063.60 ","$3,106.15 ","$2,765.75 ","$3,616.75 ","$2,771.52 ","$2,765.75 ","$3,404.00 ","$3,106.15 ",$534.02 ,"$2,771.52 ","$1,787.10 ","$4,255.00 ","$3,616.75 ","$6,235.91 ","$3,914.60 ","$2,978.50 ","$4,255.00 ","$4,255.00 ","$2,591.30 ","$4,255.00 ","$2,940.21 ","$2,978.50 ","$2,799.24 ","$3,063.60 ",$566.06 , N/A , N/A ,"$2,771.52 ", N/A ,"$2,771.52 ","$3,063.60 ","$2,638.10 ","$3,063.60 ","$3,063.60 ","$2,553.00 " ST VINCENT HOSPITAL - ACUTE,97380000,49411,PC PLCMT INSTST DEV ABD/PELV/RETR,973,1 ,$575.00 ,$287.50 ,$241.50 ,"$2,750.45 ",$371.45 ,$555.45 ,$371.97 ,$371.97 ,"$1,222.42 ",$345.00 ,$488.75 ,$402.50 ,$555.45 ,$546.25 ,$414.00 ,$419.75 ,$373.75 ,$488.75 ,"$1,222.42 ",$373.75 ,$460.00 ,$419.75 ,$555.45 ,"$1,222.42 ",$241.50 ,$575.00 ,$488.75 ,"$2,750.45 ",$529.00 ,$402.50 ,$575.00 ,$575.00 ,$350.18 ,$575.00 ,$397.33 ,$402.50 ,"$1,234.64 ",$414.00 ,$588.78 , N/A , N/A ,"$1,222.42 ", N/A ,"$1,222.42 ",$414.00 ,$356.50 ,$414.00 ,$414.00 ,$345.00 ST VINCENT HOSPITAL - ACUTE,97380001,55876,PC PLCMT INSTST DEV PROSTATE,973,1 ,$485.00 ,$242.50 ,$203.70 ,"$5,133.66 ",$313.31 ,$485.00 ,$313.75 ,$313.75 ,"$1,222.42 ",$291.00 ,$412.25 ,$339.50 ,$555.45 ,$460.75 ,$349.20 ,$354.05 ,$315.25 ,$412.25 ,"$1,222.42 ",$315.25 ,$388.00 ,$354.05 ,$555.45 ,"$1,222.42 ",$203.70 ,$485.00 ,$412.25 ,"$2,750.45 ",$446.20 ,$339.50 ,"$3,819.70 ","$5,133.66 ",$295.37 ,"$4,774.62 ",$335.14 ,$339.50 ,"$1,234.64 ",$349.20 ,$588.78 , N/A , N/A ,"$1,222.42 ", N/A ,"$1,222.42 ",$349.20 ,$300.70 ,$349.20 ,$349.20 ,$291.00 ST VINCENT HOSPITAL - ACUTE,97380002,61020,PC OMAYA VENTRICULAR PUNCTURE - NO INJ,973,1 ,$495.00 ,$247.50 ,$121.61 ,"$1,792.24 ",$319.77 ,$121.61 ,$320.22 ,$320.22 ,$796.55 ,$297.00 ,$420.75 ,$346.50 ,$121.61 ,$470.25 ,$356.40 ,$361.35 ,$321.75 ,$420.75 ,$796.55 ,$321.75 ,$396.00 ,$361.35 ,$121.61 ,$796.55 ,$207.90 ,$495.00 ,$420.75 ,"$1,792.24 ",$455.40 ,$346.50 ,$495.00 ,$495.00 ,$301.46 ,$495.00 ,$342.05 ,$346.50 ,$804.52 ,$356.40 ,$128.91 , N/A , N/A ,$796.55 , N/A ,$796.55 ,$356.40 ,$306.90 ,$356.40 ,$356.40 ,$297.00 ST VINCENT HOSPITAL - ACUTE,97380003,61026,PC VENTRICULAR PUNCTURE WITH INJECTION,973,1 ,$385.00 ,$192.50 ,$161.70 ,"$1,382.85 ",$248.71 ,$349.28 ,$249.06 ,$249.06 ,$614.60 ,$231.00 ,$327.25 ,$269.50 ,$349.28 ,$365.75 ,$277.20 ,$281.05 ,$250.25 ,$327.25 ,$614.60 ,$250.25 ,$308.00 ,$281.05 ,$349.28 ,$614.60 ,$161.70 ,$385.00 ,$327.25 ,"$1,382.85 ",$354.20 ,$269.50 ,$385.00 ,$385.00 ,$234.47 ,$385.00 ,$266.04 ,$269.50 ,$620.75 ,$277.20 ,$370.24 , N/A , N/A ,$614.60 , N/A ,$614.60 ,$277.20 ,$238.70 ,$277.20 ,$277.20 ,$231.00 ST VINCENT HOSPITAL - ACUTE,97380004,62270,PC LUMBAR PUNCTURE,973,1 ,$585.00 ,$292.50 ,$245.70 ,"$1,382.85 ",$377.91 ,$263.02 ,$378.44 ,$378.44 ,$614.60 ,$351.00 ,$497.25 ,$409.50 ,$263.02 ,$555.75 ,$421.20 ,$427.05 ,$380.25 ,$497.25 ,$614.60 ,$380.25 ,$468.00 ,$427.05 ,$263.02 ,$614.60 ,$245.70 ,$585.00 ,$497.25 ,"$1,382.85 ",$538.20 ,$409.50 ,$585.00 ,$585.00 ,$356.27 ,$585.00 ,$404.24 ,$409.50 ,$620.75 ,$421.20 ,$278.80 , N/A , N/A ,$614.60 , N/A ,$614.60 ,$421.20 ,$362.70 ,$421.20 ,$421.20 ,$351.00 ST VINCENT HOSPITAL - ACUTE,97380005,77261,PC CLINICAL TREATMENT PLANNING: SIMPLE,973,1 ,"$1,575.00 ",$787.50 ,$39.10 ,"$1,575.00 ","$1,017.45 ",$39.10 ,"$1,018.87 ","$1,018.87 ", N/A ,$945.00 ,"$1,338.75 ","$1,102.50 ",$39.10 ,"$1,496.25 ","$1,134.00 ","$1,149.75 ","$1,023.75 ","$1,338.75 ", N/A ,"$1,023.75 ","$1,260.00 ","$1,149.75 ",$39.10 , N/A ,$661.50 ,"$1,575.00 ","$1,338.75 ", N/A ,"$1,449.00 ","$1,102.50 ",$787.50 ,$945.00 ,$959.18 ,$787.50 ,"$1,088.33 ","$1,102.50 ", N/A ,"$1,134.00 ",$41.45 , N/A , N/A , N/A , N/A , N/A ,"$1,134.00 ",$976.50 ,"$1,134.00 ","$1,134.00 ",$945.00 ST VINCENT HOSPITAL - ACUTE,97380006,77262,PC CLINICAL TREATMENT PLANNING: INTERMED,973,1 ,"$2,055.00 ","$1,027.50 ",$39.10 ,"$2,055.00 ","$1,327.53 ",$39.10 ,"$1,329.38 ","$1,329.38 ", N/A ,"$1,233.00 ","$1,746.75 ","$1,438.50 ",$39.10 ,"$1,952.25 ","$1,479.60 ","$1,500.15 ","$1,335.75 ","$1,746.75 ", N/A ,"$1,335.75 ","$1,644.00 ","$1,500.15 ",$39.10 , N/A ,$863.10 ,"$2,055.00 ","$1,746.75 ", N/A ,"$1,890.60 ","$1,438.50 ","$1,027.50 ","$1,233.00 ","$1,251.50 ","$1,027.50 ","$1,420.01 ","$1,438.50 ", N/A ,"$1,479.60 ",$41.45 , N/A , N/A , N/A , N/A , N/A ,"$1,479.60 ","$1,274.10 ","$1,479.60 ","$1,479.60 ","$1,233.00 " ST VINCENT HOSPITAL - ACUTE,97380007,77263,PC CLINICAL TREATMENT PLANNING: COMPLEX,973,1 ,"$2,810.00 ","$1,405.00 ",$39.10 ,"$2,810.00 ","$1,815.26 ",$39.10 ,"$1,817.79 ","$1,817.79 ", N/A ,"$1,686.00 ","$2,388.50 ","$1,967.00 ",$39.10 ,"$2,669.50 ","$2,023.20 ","$2,051.30 ","$1,826.50 ","$2,388.50 ", N/A ,"$1,826.50 ","$2,248.00 ","$2,051.30 ",$39.10 , N/A ,"$1,180.20 ","$2,810.00 ","$2,388.50 ", N/A ,"$2,585.20 ","$1,967.00 ","$1,405.00 ","$1,686.00 ","$1,711.29 ","$1,405.00 ","$1,941.71 ","$1,967.00 ", N/A ,"$2,023.20 ",$41.45 , N/A , N/A , N/A , N/A , N/A ,"$2,023.20 ","$1,742.20 ","$2,023.20 ","$2,023.20 ","$1,686.00 " ST VINCENT HOSPITAL - ACUTE,97380008,77280,PC SIMULATION SIMPLE,973,1 ,$920.00 ,$460.00 ,$39.10 ,$920.00 ,$594.32 ,$39.10 ,$595.15 ,$595.15 ,$122.87 ,$552.00 ,$782.00 ,$644.00 ,$39.10 ,$874.00 ,$662.40 ,$671.60 ,$598.00 ,$782.00 ,$122.87 ,$598.00 ,$736.00 ,$671.60 ,$39.10 ,$122.87 ,$386.40 ,$920.00 ,$782.00 ,$276.47 ,$846.40 ,$644.00 ,$385.98 ,$415.67 ,$560.28 ,$385.98 ,$635.72 ,$644.00 ,$124.10 ,$662.40 ,$41.45 , N/A , N/A ,$122.87 , N/A ,$122.87 ,$662.40 ,$570.40 ,$662.40 ,$662.40 ,$552.00 ST VINCENT HOSPITAL - ACUTE,97380009,77285,PC SIMULATION INTERMEDIATE,973,1 ,"$1,175.00 ",$587.50 ,$60.87 ,"$1,175.00 ",$759.05 ,$60.87 ,$760.11 ,$760.11 ,$328.01 ,$705.00 ,$998.75 ,$822.50 ,$60.87 ,"$1,116.25 ",$846.00 ,$857.75 ,$763.75 ,$998.75 ,$328.01 ,$763.75 ,$940.00 ,$857.75 ,$60.87 ,$328.01 ,$493.50 ,"$1,175.00 ",$998.75 ,$738.03 ,"$1,081.00 ",$822.50 ,"$1,048.23 ","$1,128.86 ",$715.58 ,"$1,048.23 ",$811.93 ,$822.50 ,$331.29 ,$846.00 ,$64.52 , N/A , N/A ,$328.01 , N/A ,$328.01 ,$846.00 ,$728.50 ,$846.00 ,$846.00 ,$705.00 ST VINCENT HOSPITAL - ACUTE,97380010,77290,PC SIMULATION COMPLEX,973,1 ,"$1,505.00 ",$752.50 ,$60.87 ,"$1,505.00 ",$972.23 ,$60.87 ,$973.58 ,$973.58 ,$328.01 ,$903.00 ,"$1,279.25 ","$1,053.50 ",$60.87 ,"$1,429.75 ","$1,083.60 ","$1,098.65 ",$978.25 ,"$1,279.25 ",$328.01 ,$978.25 ,"$1,204.00 ","$1,098.65 ",$60.87 ,$328.01 ,$632.10 ,"$1,505.00 ","$1,279.25 ",$738.03 ,"$1,384.60 ","$1,053.50 ","$1,048.23 ","$1,128.86 ",$916.55 ,"$1,048.23 ","$1,039.96 ","$1,053.50 ",$331.29 ,"$1,083.60 ",$64.52 , N/A , N/A ,$328.01 , N/A ,$328.01 ,"$1,083.60 ",$933.10 ,"$1,083.60 ","$1,083.60 ",$903.00 ST VINCENT HOSPITAL - ACUTE,97380011,77293,PC RESPIRATORY MOTION MGMT SIM,973,1 ,"$1,450.00 ",$725.00 ,$39.10 ,"$1,450.00 ",$936.70 ,$39.10 ,$938.01 ,$938.01 , N/A ,$870.00 ,"$1,232.50 ","$1,015.00 ",$39.10 ,"$1,377.50 ","$1,044.00 ","$1,058.50 ",$942.50 ,"$1,232.50 ", N/A ,$942.50 ,"$1,160.00 ","$1,058.50 ",$39.10 , N/A ,$609.00 ,"$1,450.00 ","$1,232.50 ", N/A ,"$1,334.00 ","$1,015.00 ",$725.00 ,$870.00 ,$883.05 ,$725.00 ,"$1,001.95 ","$1,015.00 ", N/A ,"$1,044.00 ",$41.45 , N/A , N/A , N/A , N/A , N/A ,"$1,044.00 ",$899.00 ,"$1,044.00 ","$1,044.00 ",$870.00 ST VINCENT HOSPITAL - ACUTE,97380013,77295,PC SIMULATION 3 DIMENSIONAL,973,1 ,"$2,000.00 ","$1,000.00 ",$347.06 ,"$2,750.45 ","$1,292.00 ",$347.06 ,"$1,293.80 ","$1,293.80 ","$1,222.42 ","$1,200.00 ","$1,700.00 ","$1,400.00 ",$347.06 ,"$1,900.00 ","$1,440.00 ","$1,460.00 ","$1,300.00 ","$1,700.00 ","$1,222.42 ","$1,300.00 ","$1,600.00 ","$1,460.00 ",$347.06 ,"$1,222.42 ",$840.00 ,"$2,000.00 ","$1,700.00 ","$2,750.45 ","$1,840.00 ","$1,400.00 ","$2,000.00 ","$2,000.00 ","$1,218.00 ","$2,000.00 ","$1,382.00 ","$1,400.00 ","$1,234.64 ","$1,440.00 ",$367.88 , N/A , N/A ,"$1,222.42 ", N/A ,"$1,222.42 ","$1,440.00 ","$1,240.00 ","$1,440.00 ","$1,440.00 ","$1,200.00 " ST VINCENT HOSPITAL - ACUTE,97380014,77300,PC DOSIMETRY CALCULATION BASIC,973,1 ,$325.00 ,$162.50 ,$60.87 ,$325.00 ,$209.95 ,$60.87 ,$210.24 ,$210.24 ,$122.87 ,$195.00 ,$276.25 ,$227.50 ,$60.87 ,$308.75 ,$234.00 ,$237.25 ,$211.25 ,$276.25 ,$122.87 ,$211.25 ,$260.00 ,$237.25 ,$60.87 ,$122.87 ,$136.50 ,$325.00 ,$276.25 ,$276.47 ,$299.00 ,$227.50 ,$325.00 ,$325.00 ,$197.93 ,$325.00 ,$224.58 ,$227.50 ,$124.10 ,$234.00 ,$64.52 , N/A , N/A ,$122.87 , N/A ,$122.87 ,$234.00 ,$201.50 ,$234.00 ,$234.00 ,$195.00 ST VINCENT HOSPITAL - ACUTE,97380015,77301,PC IMRT TX PLAN,973,1 ,"$3,885.00 ","$1,942.50 ",$347.06 ,"$3,885.00 ","$2,509.71 ",$347.06 ,"$2,513.21 ","$2,513.21 ","$1,222.42 ","$2,331.00 ","$3,302.25 ","$2,719.50 ",$347.06 ,"$3,690.75 ","$2,797.20 ","$2,836.05 ","$2,525.25 ","$3,302.25 ","$1,222.42 ","$2,525.25 ","$3,108.00 ","$2,836.05 ",$347.06 ,"$1,222.42 ","$1,631.70 ","$3,885.00 ","$3,302.25 ","$2,750.45 ","$3,574.20 ","$2,719.50 ","$3,489.03 ","$3,757.42 ","$2,365.97 ","$3,489.03 ","$2,684.54 ","$2,719.50 ","$1,234.64 ","$2,797.20 ",$367.88 , N/A , N/A ,"$1,222.42 ", N/A ,"$1,222.42 ","$2,797.20 ","$2,408.70 ","$2,797.20 ","$2,797.20 ","$2,331.00 " ST VINCENT HOSPITAL - ACUTE,97380016,77306,PC ISODOSE PLAN SIMPLE,973,1 ,"$1,150.00 ",$575.00 ,$39.10 ,"$1,150.00 ",$742.90 ,$39.10 ,$743.94 ,$743.94 ,$328.01 ,$690.00 ,$977.50 ,$805.00 ,$39.10 ,"$1,092.50 ",$828.00 ,$839.50 ,$747.50 ,$977.50 ,$328.01 ,$747.50 ,$920.00 ,$839.50 ,$39.10 ,$328.01 ,$483.00 ,"$1,150.00 ",$977.50 ,$738.03 ,"$1,058.00 ",$805.00 ,$374.40 ,$403.20 ,$700.35 ,$374.40 ,$794.65 ,$805.00 ,$331.29 ,$828.00 ,$41.45 , N/A , N/A ,$328.01 , N/A ,$328.01 ,$828.00 ,$713.00 ,$828.00 ,$828.00 ,$690.00 ST VINCENT HOSPITAL - ACUTE,97380017,77307,PC ISODOSE PLAN COMPLEX,973,1 ,"$1,720.00 ",$860.00 ,$60.87 ,"$1,720.00 ","$1,111.12 ",$60.87 ,"$1,112.67 ","$1,112.67 ",$328.01 ,"$1,032.00 ","$1,462.00 ","$1,204.00 ",$60.87 ,"$1,634.00 ","$1,238.40 ","$1,255.60 ","$1,118.00 ","$1,462.00 ",$328.01 ,"$1,118.00 ","$1,376.00 ","$1,255.60 ",$60.87 ,$328.01 ,$722.40 ,"$1,720.00 ","$1,462.00 ",$738.03 ,"$1,582.40 ","$1,204.00 ",$374.40 ,$403.20 ,"$1,047.48 ",$374.40 ,"$1,188.52 ","$1,204.00 ",$331.29 ,"$1,238.40 ",$64.52 , N/A , N/A ,$328.01 , N/A ,$328.01 ,"$1,238.40 ","$1,066.40 ","$1,238.40 ","$1,238.40 ","$1,032.00 " ST VINCENT HOSPITAL - ACUTE,97380018,77321,PC PORT PLAN SPECIAL,973,1 ,$430.00 ,$215.00 ,$60.87 ,$738.03 ,$277.78 ,$60.87 ,$278.17 ,$278.17 ,$328.01 ,$258.00 ,$365.50 ,$301.00 ,$60.87 ,$408.50 ,$309.60 ,$313.90 ,$279.50 ,$365.50 ,$328.01 ,$279.50 ,$344.00 ,$313.90 ,$60.87 ,$328.01 ,$180.60 ,$430.00 ,$365.50 ,$738.03 ,$395.60 ,$301.00 ,$430.00 ,$430.00 ,$261.87 ,$430.00 ,$297.13 ,$301.00 ,$331.29 ,$309.60 ,$64.52 , N/A , N/A ,$328.01 , N/A ,$328.01 ,$309.60 ,$266.60 ,$309.60 ,$309.60 ,$258.00 ST VINCENT HOSPITAL - ACUTE,97380019,77331,PC DOSIMETRY CALCULATION SPECIAL,973,1 ,$540.00 ,$270.00 ,$39.10 ,$540.00 ,$348.84 ,$39.10 ,$349.33 ,$349.33 ,$122.87 ,$324.00 ,$459.00 ,$378.00 ,$39.10 ,$513.00 ,$388.80 ,$394.20 ,$351.00 ,$459.00 ,$122.87 ,$351.00 ,$432.00 ,$394.20 ,$39.10 ,$122.87 ,$226.80 ,$540.00 ,$459.00 ,$276.47 ,$496.80 ,$378.00 ,$385.98 ,$415.67 ,$328.86 ,$385.98 ,$373.14 ,$378.00 ,$124.10 ,$388.80 ,$41.45 , N/A , N/A ,$122.87 , N/A ,$122.87 ,$388.80 ,$334.80 ,$388.80 ,$388.80 ,$324.00 ST VINCENT HOSPITAL - ACUTE,97380020,77332,PC TREATMENT DEVICE SIMPLE,973,1 ,$140.00 ,$70.00 ,$39.10 ,$276.47 ,$90.44 ,$39.10 ,$90.57 ,$90.57 ,$122.87 ,$84.00 ,$119.00 ,$98.00 ,$39.10 ,$133.00 ,$100.80 ,$102.20 ,$91.00 ,$119.00 ,$122.87 ,$91.00 ,$112.00 ,$102.20 ,$39.10 ,$122.87 ,$58.80 ,$140.00 ,$119.00 ,$276.47 ,$128.80 ,$98.00 ,$140.00 ,$140.00 ,$85.26 ,$140.00 ,$96.74 ,$98.00 ,$124.10 ,$100.80 ,$41.45 , N/A , N/A ,$122.87 , N/A ,$122.87 ,$100.80 ,$86.80 ,$100.80 ,$100.80 ,$84.00 ST VINCENT HOSPITAL - ACUTE,97380021,77333,PC TREATMENT DEVICE INTERMEDIATE,973,1 ,$225.00 ,$112.50 ,$39.10 ,$276.47 ,$145.35 ,$39.10 ,$145.55 ,$145.55 ,$122.87 ,$135.00 ,$191.25 ,$157.50 ,$39.10 ,$213.75 ,$162.00 ,$164.25 ,$146.25 ,$191.25 ,$122.87 ,$146.25 ,$180.00 ,$164.25 ,$39.10 ,$122.87 ,$94.50 ,$225.00 ,$191.25 ,$276.47 ,$207.00 ,$157.50 ,$225.00 ,$225.00 ,$137.03 ,$225.00 ,$155.48 ,$157.50 ,$124.10 ,$162.00 ,$41.45 , N/A , N/A ,$122.87 , N/A ,$122.87 ,$162.00 ,$139.50 ,$162.00 ,$162.00 ,$135.00 ST VINCENT HOSPITAL - ACUTE,97380022,77334,PC TREATMENT DEVICE COMPLEX,973,1 ,$650.00 ,$325.00 ,$60.87 ,$738.03 ,$419.90 ,$60.87 ,$420.49 ,$420.49 ,$328.01 ,$390.00 ,$552.50 ,$455.00 ,$60.87 ,$617.50 ,$468.00 ,$474.50 ,$422.50 ,$552.50 ,$328.01 ,$422.50 ,$520.00 ,$474.50 ,$60.87 ,$328.01 ,$273.00 ,$650.00 ,$552.50 ,$738.03 ,$598.00 ,$455.00 ,$650.00 ,$650.00 ,$395.85 ,$650.00 ,$449.15 ,$455.00 ,$331.29 ,$468.00 ,$64.52 , N/A , N/A ,$328.01 , N/A ,$328.01 ,$468.00 ,$403.00 ,$468.00 ,$468.00 ,$390.00 ST VINCENT HOSPITAL - ACUTE,97380023,77338,PC MLC DEVICE FOR IMRT,973,1 ,"$1,710.00 ",$855.00 ,$60.87 ,"$1,710.00 ","$1,104.66 ",$60.87 ,"$1,106.20 ","$1,106.20 ",$328.01 ,"$1,026.00 ","$1,453.50 ","$1,197.00 ",$60.87 ,"$1,624.50 ","$1,231.20 ","$1,248.30 ","$1,111.50 ","$1,453.50 ",$328.01 ,"$1,111.50 ","$1,368.00 ","$1,248.30 ",$60.87 ,$328.01 ,$718.20 ,"$1,710.00 ","$1,453.50 ",$738.03 ,"$1,573.20 ","$1,197.00 ","$1,048.23 ","$1,128.86 ","$1,041.39 ","$1,048.23 ","$1,181.61 ","$1,197.00 ",$331.29 ,"$1,231.20 ",$64.52 , N/A , N/A ,$328.01 , N/A ,$328.01 ,"$1,231.20 ","$1,060.20 ","$1,231.20 ","$1,231.20 ","$1,026.00 " ST VINCENT HOSPITAL - ACUTE,97380024,77427,PC TREATMENT MANAGEMENT EVERY 5 TREATMENTS,973,1 ,"$1,555.00 ",$777.50 ,$86.55 ,"$1,555.00 ","$1,004.53 ",$86.55 ,"$1,005.93 ","$1,005.93 ", N/A ,$933.00 ,"$1,321.75 ","$1,088.50 ",$86.55 ,"$1,477.25 ","$1,119.60 ","$1,135.15 ","$1,010.75 ","$1,321.75 ", N/A ,"$1,010.75 ","$1,244.00 ","$1,135.15 ",$86.55 , N/A ,$653.10 ,"$1,555.00 ","$1,321.75 ", N/A ,"$1,430.60 ","$1,088.50 ",$777.50 ,$933.00 ,$947.00 ,$777.50 ,"$1,074.51 ","$1,088.50 ", N/A ,"$1,119.60 ",$91.74 , N/A , N/A , N/A , N/A , N/A ,"$1,119.60 ",$964.10 ,"$1,119.60 ","$1,119.60 ",$933.00 ST VINCENT HOSPITAL - ACUTE,97380025,77431,PC SHORT COURSE TREATMENT MANAGEMENT,973,1 ,$735.00 ,$367.50 ,$86.55 ,$735.00 ,$474.81 ,$86.55 ,$475.47 ,$475.47 , N/A ,$441.00 ,$624.75 ,$514.50 ,$86.55 ,$698.25 ,$529.20 ,$536.55 ,$477.75 ,$624.75 , N/A ,$477.75 ,$588.00 ,$536.55 ,$86.55 , N/A ,$308.70 ,$735.00 ,$624.75 , N/A ,$676.20 ,$514.50 ,$367.50 ,$441.00 ,$447.62 ,$367.50 ,$507.89 ,$514.50 , N/A ,$529.20 ,$91.74 , N/A , N/A , N/A , N/A , N/A ,$529.20 ,$455.70 ,$529.20 ,$529.20 ,$441.00 ST VINCENT HOSPITAL - ACUTE,97380026,77435,PC SBRT TREATMENT MANAGEMENT,973,1 ,"$2,080.00 ","$1,040.00 ",$86.55 ,"$2,080.00 ","$1,343.68 ",$86.55 ,"$1,345.55 ","$1,345.55 ", N/A ,"$1,248.00 ","$1,768.00 ","$1,456.00 ",$86.55 ,"$1,976.00 ","$1,497.60 ","$1,518.40 ","$1,352.00 ","$1,768.00 ", N/A ,"$1,352.00 ","$1,664.00 ","$1,518.40 ",$86.55 , N/A ,$873.60 ,"$2,080.00 ","$1,768.00 ", N/A ,"$1,913.60 ","$1,456.00 ","$1,040.00 ","$1,248.00 ","$1,266.72 ","$1,040.00 ","$1,437.28 ","$1,456.00 ", N/A ,"$1,497.60 ",$91.74 , N/A , N/A , N/A , N/A , N/A ,"$1,497.60 ","$1,289.60 ","$1,497.60 ","$1,497.60 ","$1,248.00 " ST VINCENT HOSPITAL - ACUTE,97380027,77470,PC SPECIAL TREATMENT PROCEDURE,973,1 ,"$1,400.00 ",$700.00 ,$153.16 ,"$1,400.00 ",$904.40 ,$153.16 ,$905.66 ,$905.66 ,$525.46 ,$840.00 ,"$1,190.00 ",$980.00 ,$153.16 ,"$1,330.00 ","$1,008.00 ","$1,022.00 ",$910.00 ,"$1,190.00 ",$525.46 ,$910.00 ,"$1,120.00 ","$1,022.00 ",$153.16 ,$525.46 ,$588.00 ,"$1,400.00 ","$1,190.00 ","$1,182.28 ","$1,288.00 ",$980.00 ,"$1,391.11 ","$1,400.00 ",$852.60 ,"$1,391.11 ",$967.40 ,$980.00 ,$530.71 ,"$1,008.00 ",$162.35 , N/A , N/A ,$525.46 , N/A ,$525.46 ,"$1,008.00 ",$868.00 ,"$1,008.00 ","$1,008.00 ",$840.00 ST VINCENT HOSPITAL - ACUTE,97380028,G6002,PC STEREOSCOPIC X-RAY GUIDANCE FOR LOCALIZATION G6002,973,1 ,$535.00 ,$267.50 ,$53.35 ,$535.00 ,$345.61 ,$53.35 ,$346.09 ,$346.09 , N/A ,$321.00 ,$454.75 ,$374.50 ,$53.35 ,$508.25 ,$385.20 ,$390.55 ,$347.75 ,$454.75 , N/A ,$347.75 ,$428.00 ,$390.55 ,$53.35 , N/A ,$224.70 ,$535.00 ,$454.75 , N/A ,$492.20 ,$374.50 ,$267.50 ,$321.00 ,$325.82 ,$267.50 ,$369.69 ,$374.50 , N/A ,$385.20 ,$56.55 , N/A , N/A , N/A , N/A , N/A ,$385.20 ,$331.70 ,$385.20 ,$385.20 ,$321.00 ST VINCENT HOSPITAL - ACUTE,97380030,S0353,"PC TREATMENT PLANNING, INITIAL TREATMENT S0353",973,1 ,$380.00 ,$190.00 ,$31.68 ,$380.00 ,$245.48 ,$31.68 ,$245.82 ,$245.82 , N/A ,$228.00 ,$323.00 ,$266.00 ,$31.68 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 , N/A ,$247.00 ,$304.00 ,$277.40 ,$31.68 , N/A ,$159.60 ,$380.00 ,$323.00 , N/A ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 , N/A ,$273.60 ,$33.58 , N/A , N/A , N/A , N/A , N/A ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,97380031,S0354,"PC TREATMENT PLANNING, CHANGE OF REGIMEN S0354",973,1 ,$380.00 ,$190.00 ,$31.68 ,$380.00 ,$245.48 ,$31.68 ,$245.82 ,$245.82 , N/A ,$228.00 ,$323.00 ,$266.00 ,$31.68 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 , N/A ,$247.00 ,$304.00 ,$277.40 ,$31.68 , N/A ,$159.60 ,$380.00 ,$323.00 , N/A ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 , N/A ,$273.60 ,$33.58 , N/A , N/A , N/A , N/A , N/A ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,97380032,77432,PC STEREOTACTIC RADIATION TX CRANIAL LESION 77432,973,1 ,"$1,500.00 ",$750.00 ,$86.55 ,"$1,500.00 ",$969.00 ,$86.55 ,$970.35 ,$970.35 , N/A ,$900.00 ,"$1,275.00 ","$1,050.00 ",$86.55 ,"$1,425.00 ","$1,080.00 ","$1,095.00 ",$975.00 ,"$1,275.00 ", N/A ,$975.00 ,"$1,200.00 ","$1,095.00 ",$86.55 , N/A ,$630.00 ,"$1,500.00 ","$1,275.00 ", N/A ,"$1,380.00 ","$1,050.00 ",$750.00 ,$900.00 ,$913.50 ,$750.00 ,"$1,036.50 ","$1,050.00 ", N/A ,"$1,080.00 ",$91.74 , N/A , N/A , N/A , N/A , N/A ,"$1,080.00 ",$930.00 ,"$1,080.00 ","$1,080.00 ",$900.00 ST VINCENT HOSPITAL - ACUTE,97380033,77316,PC BRACY ISODOSE CALC SIMPLE,973,1 ,$220.00 ,$110.00 ,$39.10 ,$738.03 ,$142.12 ,$39.10 ,$142.32 ,$142.32 ,$328.01 ,$132.00 ,$187.00 ,$154.00 ,$39.10 ,$209.00 ,$158.40 ,$160.60 ,$143.00 ,$187.00 ,$328.01 ,$143.00 ,$176.00 ,$160.60 ,$39.10 ,$328.01 ,$92.40 ,$220.00 ,$187.00 ,$738.03 ,$202.40 ,$154.00 ,$220.00 ,$220.00 ,$133.98 ,$220.00 ,$152.02 ,$154.00 ,$331.29 ,$158.40 ,$41.45 , N/A , N/A ,$328.01 , N/A ,$328.01 ,$158.40 ,$136.40 ,$158.40 ,$158.40 ,$132.00 ST VINCENT HOSPITAL - ACUTE,97380034,77317,PC BRACHY ISODOSE CALC INTERMED,973,1 ,$285.00 ,$142.50 ,$60.87 ,$738.03 ,$184.11 ,$60.87 ,$184.37 ,$184.37 ,$328.01 ,$171.00 ,$242.25 ,$199.50 ,$60.87 ,$270.75 ,$205.20 ,$208.05 ,$185.25 ,$242.25 ,$328.01 ,$185.25 ,$228.00 ,$208.05 ,$60.87 ,$328.01 ,$119.70 ,$285.00 ,$242.25 ,$738.03 ,$262.20 ,$199.50 ,$285.00 ,$285.00 ,$173.57 ,$285.00 ,$196.94 ,$199.50 ,$331.29 ,$205.20 ,$64.52 , N/A , N/A ,$328.01 , N/A ,$328.01 ,$205.20 ,$176.70 ,$205.20 ,$205.20 ,$171.00 ST VINCENT HOSPITAL - ACUTE,97380035,77318,PC BRACHY ISODOSE CALC COMPLEX,973,1 ,$450.00 ,$225.00 ,$60.87 ,$738.03 ,$290.70 ,$60.87 ,$291.11 ,$291.11 ,$328.01 ,$270.00 ,$382.50 ,$315.00 ,$60.87 ,$427.50 ,$324.00 ,$328.50 ,$292.50 ,$382.50 ,$328.01 ,$292.50 ,$360.00 ,$328.50 ,$60.87 ,$328.01 ,$189.00 ,$450.00 ,$382.50 ,$738.03 ,$414.00 ,$315.00 ,$450.00 ,$450.00 ,$274.05 ,$450.00 ,$310.95 ,$315.00 ,$331.29 ,$324.00 ,$64.52 , N/A , N/A ,$328.01 , N/A ,$328.01 ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,97380036,77761,PC INTRACAVITRY APPL SIMPLE,973,1 ,$565.00 ,$282.50 ,$153.16 ,"$1,182.28 ",$364.99 ,$153.16 ,$365.50 ,$365.50 ,$525.46 ,$339.00 ,$480.25 ,$395.50 ,$153.16 ,$536.75 ,$406.80 ,$412.45 ,$367.25 ,$480.25 ,$525.46 ,$367.25 ,$452.00 ,$412.45 ,$153.16 ,$525.46 ,$237.30 ,$565.00 ,$480.25 ,"$1,182.28 ",$519.80 ,$395.50 ,$565.00 ,$565.00 ,$344.09 ,$565.00 ,$390.42 ,$395.50 ,$530.71 ,$406.80 ,$162.35 , N/A , N/A ,$525.46 , N/A ,$525.46 ,$406.80 ,$350.30 ,$406.80 ,$406.80 ,$339.00 ST VINCENT HOSPITAL - ACUTE,97380037,77762,PC INTRACAVITARY APPL INTERM,973,1 ,$945.00 ,$472.50 ,$396.90 ,"$1,182.28 ",$610.47 ,$473.35 ,$611.32 ,$611.32 ,$525.46 ,$567.00 ,$803.25 ,$661.50 ,$473.35 ,$897.75 ,$680.40 ,$689.85 ,$614.25 ,$803.25 ,$525.46 ,$614.25 ,$756.00 ,$689.85 ,$473.35 ,$525.46 ,$396.90 ,$945.00 ,$803.25 ,"$1,182.28 ",$869.40 ,$661.50 ,$945.00 ,$945.00 ,$575.51 ,$945.00 ,$653.00 ,$661.50 ,$530.71 ,$680.40 ,$501.75 , N/A , N/A ,$525.46 , N/A ,$525.46 ,$680.40 ,$585.90 ,$680.40 ,$680.40 ,$567.00 ST VINCENT HOSPITAL - ACUTE,97380038,77763,PC INTRACAVITARY APPL COMPLEX,973,1 ,"$1,340.00 ",$670.00 ,$473.35 ,"$1,543.82 ",$865.64 ,$473.35 ,$866.85 ,$866.85 ,$686.14 ,$804.00 ,"$1,139.00 ",$938.00 ,$473.35 ,"$1,273.00 ",$964.80 ,$978.20 ,$871.00 ,"$1,139.00 ",$686.14 ,$871.00 ,"$1,072.00 ",$978.20 ,$473.35 ,$686.14 ,$562.80 ,"$1,340.00 ","$1,139.00 ","$1,543.82 ","$1,232.80 ",$938.00 ,"$1,216.30 ","$1,309.86 ",$816.06 ,"$1,216.30 ",$925.94 ,$938.00 ,$693.00 ,$964.80 ,$501.75 , N/A , N/A ,$686.14 , N/A ,$686.14 ,$964.80 ,$830.80 ,$964.80 ,$964.80 ,$804.00 ST VINCENT HOSPITAL - ACUTE,97380039,77799,PC INTERSTITIAL APPL SIMPLE,973,1 ,$720.00 ,$360.00 ,$58.54 ,$720.00 ,$465.12 ,$58.54 ,$465.77 ,$465.77 ,$116.74 ,$432.00 ,$612.00 ,$504.00 ,$58.54 ,$684.00 ,$518.40 ,$525.60 ,$468.00 ,$612.00 ,$116.74 ,$468.00 ,$576.00 ,$525.60 ,$58.54 ,$116.74 ,$302.40 ,$720.00 ,$612.00 ,$262.67 ,$662.40 ,$504.00 ,$720.00 ,$720.00 ,$438.48 ,$720.00 ,$497.52 ,$504.00 ,$117.91 ,$518.40 ,$62.05 , N/A , N/A ,$116.74 , N/A ,$116.74 ,$518.40 ,$446.40 ,$518.40 ,$518.40 ,$432.00 ST VINCENT HOSPITAL - ACUTE,97380040,77799,PC INTERSTITIAL APPL INTERM,973,1 ,"$1,170.00 ",$585.00 ,$58.54 ,"$1,170.00 ",$755.82 ,$58.54 ,$756.87 ,$756.87 ,$116.74 ,$702.00 ,$994.50 ,$819.00 ,$58.54 ,"$1,111.50 ",$842.40 ,$854.10 ,$760.50 ,$994.50 ,$116.74 ,$760.50 ,$936.00 ,$854.10 ,$58.54 ,$116.74 ,$491.40 ,"$1,170.00 ",$994.50 ,$262.67 ,"$1,076.40 ",$819.00 ,"$1,170.00 ","$1,170.00 ",$712.53 ,"$1,170.00 ",$808.47 ,$819.00 ,$117.91 ,$842.40 ,$62.05 , N/A , N/A ,$116.74 , N/A ,$116.74 ,$842.40 ,$725.40 ,$842.40 ,$842.40 ,$702.00 ST VINCENT HOSPITAL - ACUTE,97380041,77778,PC INTERSTITIAL APPL COMPLEX,973,1 ,"$1,835.00 ",$917.50 ,$473.35 ,"$1,835.00 ","$1,185.41 ",$473.35 ,"$1,187.06 ","$1,187.06 ",$686.14 ,"$1,101.00 ","$1,559.75 ","$1,284.50 ",$473.35 ,"$1,743.25 ","$1,321.20 ","$1,339.55 ","$1,192.75 ","$1,559.75 ",$686.14 ,"$1,192.75 ","$1,468.00 ","$1,339.55 ",$473.35 ,$686.14 ,$770.70 ,"$1,835.00 ","$1,559.75 ","$1,543.82 ","$1,688.20 ","$1,284.50 ","$1,835.00 ","$1,835.00 ","$1,117.52 ","$1,835.00 ","$1,267.99 ","$1,284.50 ",$693.00 ,"$1,321.20 ",$501.75 , N/A , N/A ,$686.14 , N/A ,$686.14 ,"$1,321.20 ","$1,137.70 ","$1,321.20 ","$1,321.20 ","$1,101.00 " ST VINCENT HOSPITAL - ACUTE,97380042,77770,PC HDR AFTERLOAD 1 CHANNEL,973,1 ,$295.00 ,$147.50 ,$123.90 ,"$1,543.82 ",$190.57 ,$153.16 ,$190.84 ,$190.84 ,$686.14 ,$177.00 ,$250.75 ,$206.50 ,$153.16 ,$280.25 ,$212.40 ,$215.35 ,$191.75 ,$250.75 ,$686.14 ,$191.75 ,$236.00 ,$215.35 ,$153.16 ,$686.14 ,$123.90 ,$295.00 ,$250.75 ,"$1,543.82 ",$271.40 ,$206.50 ,$295.00 ,$295.00 ,$179.66 ,$295.00 ,$203.85 ,$206.50 ,$693.00 ,$212.40 ,$162.35 , N/A , N/A ,$686.14 , N/A ,$686.14 ,$212.40 ,$182.90 ,$212.40 ,$212.40 ,$177.00 ST VINCENT HOSPITAL - ACUTE,97380043,77771,PC HDR AFTERLOAD 2-12 CHANNELS,973,1 ,$845.00 ,$422.50 ,$354.90 ,"$1,543.82 ",$545.87 ,$473.35 ,$546.63 ,$546.63 ,$686.14 ,$507.00 ,$718.25 ,$591.50 ,$473.35 ,$802.75 ,$608.40 ,$616.85 ,$549.25 ,$718.25 ,$686.14 ,$549.25 ,$676.00 ,$616.85 ,$473.35 ,$686.14 ,$354.90 ,$845.00 ,$718.25 ,"$1,543.82 ",$777.40 ,$591.50 ,$845.00 ,$845.00 ,$514.61 ,$845.00 ,$583.90 ,$591.50 ,$693.00 ,$608.40 ,$501.75 , N/A , N/A ,$686.14 , N/A ,$686.14 ,$608.40 ,$523.90 ,$608.40 ,$608.40 ,$507.00 ST VINCENT HOSPITAL - ACUTE,97380044,77772,PC HDR AFTERLOAD > 12 CHANNELS,973,1 ,"$1,040.00 ",$520.00 ,$436.80 ,"$1,543.82 ",$671.84 ,$473.35 ,$672.78 ,$672.78 ,$686.14 ,$624.00 ,$884.00 ,$728.00 ,$473.35 ,$988.00 ,$748.80 ,$759.20 ,$676.00 ,$884.00 ,$686.14 ,$676.00 ,$832.00 ,$759.20 ,$473.35 ,$686.14 ,$436.80 ,"$1,040.00 ",$884.00 ,"$1,543.82 ",$956.80 ,$728.00 ,"$1,040.00 ","$1,040.00 ",$633.36 ,"$1,040.00 ",$718.64 ,$728.00 ,$693.00 ,$748.80 ,$501.75 , N/A , N/A ,$686.14 , N/A ,$686.14 ,$748.80 ,$644.80 ,$748.80 ,$748.80 ,$624.00 ST VINCENT HOSPITAL - ACUTE,97380045,77789,PC STRONTIUM-90,973,1 ,$190.00 ,$95.00 ,$58.54 ,$262.67 ,$122.74 ,$58.54 ,$122.91 ,$122.91 ,$116.74 ,$114.00 ,$161.50 ,$133.00 ,$58.54 ,$180.50 ,$136.80 ,$138.70 ,$123.50 ,$161.50 ,$116.74 ,$123.50 ,$152.00 ,$138.70 ,$58.54 ,$116.74 ,$79.80 ,$190.00 ,$161.50 ,$262.67 ,$174.80 ,$133.00 ,$190.00 ,$190.00 ,$115.71 ,$190.00 ,$131.29 ,$133.00 ,$117.91 ,$136.80 ,$62.05 , N/A , N/A ,$116.74 , N/A ,$116.74 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,97380046,57156,PC INSERTION OF VAG CLY BRACHY DEVICE,973,1 ,$555.00 ,$277.50 ,$205.01 ,$613.38 ,$358.53 ,$205.01 ,$359.03 ,$359.03 ,$272.61 ,$333.00 ,$471.75 ,$388.50 ,$205.01 ,$527.25 ,$399.60 ,$405.15 ,$360.75 ,$471.75 ,$272.61 ,$360.75 ,$444.00 ,$405.15 ,$205.01 ,$272.61 ,$233.10 ,$555.00 ,$471.75 ,$613.38 ,$510.60 ,$388.50 ,$555.00 ,$555.00 ,$338.00 ,$555.00 ,$383.51 ,$388.50 ,$275.34 ,$399.60 ,$217.31 , N/A , N/A ,$272.61 , N/A ,$272.61 ,$399.60 ,$344.10 ,$399.60 ,$399.60 ,$333.00 ST VINCENT HOSPITAL - ACUTE,97380047,57155,PC INSERTION TANDEM OR OVOID VAG BRACHYTHERAPY,973,1 ,"$1,240.00 ",$620.00 ,$520.80 ,"$9,608.94 ",$801.04 ,$555.45 ,$802.16 ,$802.16 ,"$4,270.64 ",$744.00 ,"$1,054.00 ",$868.00 ,$555.45 ,"$1,178.00 ",$892.80 ,$905.20 ,$806.00 ,"$1,054.00 ","$4,270.64 ",$806.00 ,$992.00 ,$905.20 ,$555.45 ,"$4,270.64 ",$520.80 ,"$1,240.00 ","$1,054.00 ","$9,608.94 ","$1,140.80 ",$868.00 ,"$1,240.00 ","$1,240.00 ",$755.16 ,"$1,240.00 ",$856.84 ,$868.00 ,"$4,313.35 ",$892.80 ,$588.78 , N/A , N/A ,"$4,270.64 ", N/A ,"$4,270.64 ",$892.80 ,$768.80 ,$892.80 ,$892.80 ,$744.00 ST VINCENT HOSPITAL - ACUTE,97380048,77799,PC REMOVE CATHETER BREAST SAVI,973,1 ,$150.00 ,$75.00 ,$58.54 ,$262.67 ,$96.90 ,$58.54 ,$97.04 ,$97.04 ,$116.74 ,$90.00 ,$127.50 ,$105.00 ,$58.54 ,$142.50 ,$108.00 ,$109.50 ,$97.50 ,$127.50 ,$116.74 ,$97.50 ,$120.00 ,$109.50 ,$58.54 ,$116.74 ,$63.00 ,$150.00 ,$127.50 ,$262.67 ,$138.00 ,$105.00 ,$150.00 ,$150.00 ,$91.35 ,$150.00 ,$103.65 ,$105.00 ,$117.91 ,$108.00 ,$62.05 , N/A , N/A ,$116.74 , N/A ,$116.74 ,$108.00 ,$93.00 ,$108.00 ,$108.00 ,$90.00 ST VINCENT HOSPITAL - ACUTE,97521072,10021,PC ASP FINE NDL W/O IMAGING GUIDE PRO,975,1 ,$160.00 ,$80.00 ,$67.20 ,$753.63 ,$103.36 ,$160.00 ,$103.50 ,$103.50 ,$334.95 ,$96.00 ,$136.00 ,$112.00 ,$180.17 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 ,$334.95 ,$104.00 ,$128.00 ,$116.80 ,$180.17 ,$334.95 ,$67.20 ,$160.00 ,$136.00 ,$753.63 ,$147.20 ,$112.00 ,$160.00 ,$160.00 ,$97.44 ,$160.00 ,$110.56 ,$112.00 ,$338.30 ,$115.20 ,$190.98 , N/A , N/A ,$334.95 , N/A ,$334.95 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,98180465,99282,"PC EMERGENCY DEPT VISIT,LEVEL II",981,1 ,$190.00 ,$95.00 ,$47.46 ,$286.75 ,$122.74 ,$47.46 ,$122.91 ,$122.91 ,$127.44 ,$114.00 ,$161.50 ,$133.00 ,$47.46 ,$180.50 ,$136.80 ,$138.70 ,$123.50 ,$161.50 ,$127.44 ,$123.50 ,$152.00 ,$138.70 ,$47.46 ,$127.44 ,$79.80 ,$190.00 ,$161.50 ,$286.75 ,$174.80 ,$133.00 ,$95.00 ,$114.00 ,$115.71 ,$95.00 ,$131.29 ,$133.00 ,$128.71 ,$136.80 ,$50.31 , N/A , N/A ,$127.44 , N/A ,$127.44 ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,98180466,99283,"PC EMERGENCY DEPT VISIT,LEVEL III",981,1 ,$290.00 ,$145.00 ,$47.46 ,$504.69 ,$187.34 ,$47.46 ,$187.60 ,$187.60 ,$224.30 ,$174.00 ,$246.50 ,$203.00 ,$47.46 ,$275.50 ,$208.80 ,$211.70 ,$188.50 ,$246.50 ,$224.30 ,$188.50 ,$232.00 ,$211.70 ,$47.46 ,$224.30 ,$121.80 ,$290.00 ,$246.50 ,$504.69 ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 ,$226.54 ,$208.80 ,$50.31 , N/A , N/A ,$224.30 , N/A ,$224.30 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,98180467,99284,"PC EMERGENCY DEPT VISIT,LEVEL IV",981,1 ,$400.00 ,$200.00 ,$47.46 ,$792.63 ,$258.40 ,$47.46 ,$258.76 ,$258.76 ,$352.28 ,$240.00 ,$340.00 ,$280.00 ,$47.46 ,$380.00 ,$288.00 ,$292.00 ,$260.00 ,$340.00 ,$352.28 ,$260.00 ,$320.00 ,$292.00 ,$47.46 ,$352.28 ,$168.00 ,$400.00 ,$340.00 ,$792.63 ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 ,$355.80 ,$288.00 ,$50.31 , N/A , N/A ,$352.28 , N/A ,$352.28 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,98180479,69209,"PC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL",981,1 ,$40.00 ,$20.00 ,$16.80 ,$121.29 ,$25.84 ,$35.67 ,$25.88 ,$25.88 ,$53.91 ,$24.00 ,$34.00 ,$28.00 ,$35.67 ,$38.00 ,$28.80 ,$29.20 ,$26.00 ,$34.00 ,$53.91 ,$26.00 ,$32.00 ,$29.20 ,$35.67 ,$53.91 ,$16.80 ,$40.00 ,$34.00 ,$121.29 ,$36.80 ,$28.00 ,$40.00 ,$40.00 ,$24.36 ,$40.00 ,$27.64 ,$28.00 ,$54.45 ,$28.80 ,$37.81 , N/A , N/A ,$53.91 , N/A ,$53.91 ,$28.80 ,$24.80 ,$28.80 ,$28.80 ,$24.00 ST VINCENT HOSPITAL - ACUTE,98180947,G0425,PC TELEHEALTH CONSULT 30 MIN,981,1 ,$300.00 ,$150.00 ,$47.46 ,$300.00 ,$193.80 ,$47.46 ,$194.07 ,$194.07 , N/A ,$180.00 ,$255.00 ,$210.00 ,$47.46 ,$285.00 ,$216.00 ,$219.00 ,$195.00 ,$255.00 , N/A ,$195.00 ,$240.00 ,$219.00 ,$47.46 , N/A ,$126.00 ,$300.00 ,$255.00 , N/A ,$276.00 ,$210.00 ,$150.00 ,$180.00 ,$182.70 ,$150.00 ,$207.30 ,$210.00 , N/A ,$216.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$216.00 ,$186.00 ,$216.00 ,$216.00 ,$180.00 ST VINCENT HOSPITAL - ACUTE,98180948,G0426,PC TELEHEALTH CONSULT 50 MIN,981,1 ,$400.00 ,$200.00 ,$47.46 ,$400.00 ,$258.40 ,$47.46 ,$258.76 ,$258.76 , N/A ,$240.00 ,$340.00 ,$280.00 ,$47.46 ,$380.00 ,$288.00 ,$292.00 ,$260.00 ,$340.00 , N/A ,$260.00 ,$320.00 ,$292.00 ,$47.46 , N/A ,$168.00 ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 , N/A ,$288.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,98180949,G0427,PC TELEHEALTH CONSULT 70 MIN,981,1 ,$500.00 ,$250.00 ,$47.46 ,$500.00 ,$323.00 ,$47.46 ,$323.45 ,$323.45 , N/A ,$300.00 ,$425.00 ,$350.00 ,$47.46 ,$475.00 ,$360.00 ,$365.00 ,$325.00 ,$425.00 , N/A ,$325.00 ,$400.00 ,$365.00 ,$47.46 , N/A ,$210.00 ,$500.00 ,$425.00 , N/A ,$460.00 ,$350.00 ,$250.00 ,$300.00 ,$304.50 ,$250.00 ,$345.50 ,$350.00 , N/A ,$360.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$360.00 ,$310.00 ,$360.00 ,$360.00 ,$300.00 ST VINCENT HOSPITAL - ACUTE,98180978,G0508,PC TELEHEALTH CRITICAL CARE CONSULT 60 MIN,981,1 ,$600.00 ,$300.00 ,$47.46 ,$600.00 ,$387.60 ,$47.46 ,$388.14 ,$388.14 , N/A ,$360.00 ,$510.00 ,$420.00 ,$47.46 ,$570.00 ,$432.00 ,$438.00 ,$390.00 ,$510.00 , N/A ,$390.00 ,$480.00 ,$438.00 ,$47.46 , N/A ,$252.00 ,$600.00 ,$510.00 , N/A ,$552.00 ,$420.00 ,$300.00 ,$360.00 ,$365.40 ,$300.00 ,$414.60 ,$420.00 , N/A ,$432.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,98200001,99201,PC CLINIC VISIT BRIEF NEW PRO,982,1 ,$190.00 ,$95.00 ,$79.80 ,$190.00 ,$122.74 , N/A ,$122.91 ,$122.91 , N/A ,$114.00 ,$161.50 ,$133.00 , N/A ,$180.50 ,$136.80 ,$138.70 ,$123.50 ,$161.50 , N/A ,$123.50 ,$152.00 ,$138.70 , N/A , N/A ,$79.80 ,$190.00 ,$161.50 , N/A ,$174.80 ,$133.00 ,$95.00 ,$114.00 ,$115.71 ,$95.00 ,$131.29 ,$133.00 , N/A ,$136.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$136.80 ,$117.80 ,$136.80 ,$136.80 ,$114.00 ST VINCENT HOSPITAL - ACUTE,98200002,99202,PC CLINIC VISIT LIMITED NEW PRO,982,1 ,$200.00 ,$100.00 ,$47.46 ,$200.00 ,$129.20 ,$47.46 ,$129.38 ,$129.38 , N/A ,$120.00 ,$170.00 ,$140.00 ,$47.46 ,$190.00 ,$144.00 ,$146.00 ,$130.00 ,$170.00 , N/A ,$130.00 ,$160.00 ,$146.00 ,$47.46 , N/A ,$84.00 ,$200.00 ,$170.00 , N/A ,$184.00 ,$140.00 ,$100.00 ,$120.00 ,$121.80 ,$100.00 ,$138.20 ,$140.00 , N/A ,$144.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$144.00 ,$124.00 ,$144.00 ,$144.00 ,$120.00 ST VINCENT HOSPITAL - ACUTE,98200003,99203,PC CLINIC VISIT INTERM NEW PRO,982,1 ,$240.00 ,$120.00 ,$47.46 ,$240.00 ,$155.04 ,$47.46 ,$155.26 ,$155.26 , N/A ,$144.00 ,$204.00 ,$168.00 ,$47.46 ,$228.00 ,$172.80 ,$175.20 ,$156.00 ,$204.00 , N/A ,$156.00 ,$192.00 ,$175.20 ,$47.46 , N/A ,$100.80 ,$240.00 ,$204.00 , N/A ,$220.80 ,$168.00 ,$120.00 ,$144.00 ,$146.16 ,$120.00 ,$165.84 ,$168.00 , N/A ,$172.80 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,98200004,99204,PC CLINIC VISIT COMPLEX NEW PRO,982,1 ,$290.00 ,$145.00 ,$47.46 ,$290.00 ,$187.34 ,$47.46 ,$187.60 ,$187.60 , N/A ,$174.00 ,$246.50 ,$203.00 ,$47.46 ,$275.50 ,$208.80 ,$211.70 ,$188.50 ,$246.50 , N/A ,$188.50 ,$232.00 ,$211.70 ,$47.46 , N/A ,$121.80 ,$290.00 ,$246.50 , N/A ,$266.80 ,$203.00 ,$145.00 ,$174.00 ,$176.61 ,$145.00 ,$200.39 ,$203.00 , N/A ,$208.80 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,98200005,99205,PC CLINIC VISIT COMPREH NEW PRO,982,1 ,$375.00 ,$187.50 ,$47.46 ,$375.00 ,$242.25 ,$47.46 ,$242.59 ,$242.59 , N/A ,$225.00 ,$318.75 ,$262.50 ,$47.46 ,$356.25 ,$270.00 ,$273.75 ,$243.75 ,$318.75 , N/A ,$243.75 ,$300.00 ,$273.75 ,$47.46 , N/A ,$157.50 ,$375.00 ,$318.75 , N/A ,$345.00 ,$262.50 ,$187.50 ,$225.00 ,$228.38 ,$187.50 ,$259.13 ,$262.50 , N/A ,$270.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$270.00 ,$232.50 ,$270.00 ,$270.00 ,$225.00 ST VINCENT HOSPITAL - ACUTE,98200006,99211,PC CLINIC VISIT BRIEF EST PRO,982,1 ,$185.00 ,$92.50 ,$47.46 ,$185.00 ,$119.51 ,$47.46 ,$119.68 ,$119.68 , N/A ,$111.00 ,$157.25 ,$129.50 ,$47.46 ,$175.75 ,$133.20 ,$135.05 ,$120.25 ,$157.25 , N/A ,$120.25 ,$148.00 ,$135.05 ,$47.46 , N/A ,$77.70 ,$185.00 ,$157.25 , N/A ,$170.20 ,$129.50 ,$92.50 ,$111.00 ,$112.67 ,$92.50 ,$127.84 ,$129.50 , N/A ,$133.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$133.20 ,$114.70 ,$133.20 ,$133.20 ,$111.00 ST VINCENT HOSPITAL - ACUTE,98200007,99212,PC CLINIC VISIT LIMIT EST PRO,982,1 ,$195.00 ,$97.50 ,$47.46 ,$195.00 ,$125.97 ,$47.46 ,$126.15 ,$126.15 , N/A ,$117.00 ,$165.75 ,$136.50 ,$47.46 ,$185.25 ,$140.40 ,$142.35 ,$126.75 ,$165.75 , N/A ,$126.75 ,$156.00 ,$142.35 ,$47.46 , N/A ,$81.90 ,$195.00 ,$165.75 , N/A ,$179.40 ,$136.50 ,$97.50 ,$117.00 ,$118.76 ,$97.50 ,$134.75 ,$136.50 , N/A ,$140.40 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$140.40 ,$120.90 ,$140.40 ,$140.40 ,$117.00 ST VINCENT HOSPITAL - ACUTE,98200008,99213,PC CLINIC VISIT INTERM EST PRO,982,1 ,$235.00 ,$117.50 ,$47.46 ,$235.00 ,$151.81 ,$47.46 ,$152.02 ,$152.02 , N/A ,$141.00 ,$199.75 ,$164.50 ,$47.46 ,$223.25 ,$169.20 ,$171.55 ,$152.75 ,$199.75 , N/A ,$152.75 ,$188.00 ,$171.55 ,$47.46 , N/A ,$98.70 ,$235.00 ,$199.75 , N/A ,$216.20 ,$164.50 ,$117.50 ,$141.00 ,$143.12 ,$117.50 ,$162.39 ,$164.50 , N/A ,$169.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$169.20 ,$145.70 ,$169.20 ,$169.20 ,$141.00 ST VINCENT HOSPITAL - ACUTE,98200009,99214,PC CLINIC VISIT COMPLX EST PRO,982,1 ,$260.00 ,$130.00 ,$47.46 ,$260.00 ,$167.96 ,$47.46 ,$168.19 ,$168.19 , N/A ,$156.00 ,$221.00 ,$182.00 ,$47.46 ,$247.00 ,$187.20 ,$189.80 ,$169.00 ,$221.00 , N/A ,$169.00 ,$208.00 ,$189.80 ,$47.46 , N/A ,$109.20 ,$260.00 ,$221.00 , N/A ,$239.20 ,$182.00 ,$130.00 ,$156.00 ,$158.34 ,$130.00 ,$179.66 ,$182.00 , N/A ,$187.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$187.20 ,$161.20 ,$187.20 ,$187.20 ,$156.00 ST VINCENT HOSPITAL - ACUTE,98200010,99215,PC CLINIC VISIT COMPRH EST PRO,982,1 ,$325.00 ,$162.50 ,$47.46 ,$325.00 ,$209.95 ,$47.46 ,$210.24 ,$210.24 , N/A ,$195.00 ,$276.25 ,$227.50 ,$47.46 ,$308.75 ,$234.00 ,$237.25 ,$211.25 ,$276.25 , N/A ,$211.25 ,$260.00 ,$237.25 ,$47.46 , N/A ,$136.50 ,$325.00 ,$276.25 , N/A ,$299.00 ,$227.50 ,$162.50 ,$195.00 ,$197.93 ,$162.50 ,$224.58 ,$227.50 , N/A ,$234.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$234.00 ,$201.50 ,$234.00 ,$234.00 ,$195.00 ST VINCENT HOSPITAL - ACUTE,98280001,99241,PC OFFICE CONSULT LEVEL 1,982,1 ,$235.00 ,$117.50 ,$47.46 ,$235.00 ,$151.81 ,$47.46 ,$152.02 ,$152.02 , N/A ,$141.00 ,$199.75 ,$164.50 ,$47.46 ,$223.25 ,$169.20 ,$171.55 ,$152.75 ,$199.75 , N/A ,$152.75 ,$188.00 ,$171.55 ,$47.46 , N/A ,$98.70 ,$235.00 ,$199.75 , N/A ,$216.20 ,$164.50 ,$117.50 ,$141.00 ,$143.12 ,$117.50 ,$162.39 ,$164.50 , N/A ,$169.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$169.20 ,$145.70 ,$169.20 ,$169.20 ,$141.00 ST VINCENT HOSPITAL - ACUTE,98280002,99242,PC OFFICE CONSULT LEVEL 2,982,1 ,$315.00 ,$157.50 ,$47.46 ,$315.00 ,$203.49 ,$47.46 ,$203.77 ,$203.77 , N/A ,$189.00 ,$267.75 ,$220.50 ,$47.46 ,$299.25 ,$226.80 ,$229.95 ,$204.75 ,$267.75 , N/A ,$204.75 ,$252.00 ,$229.95 ,$47.46 , N/A ,$132.30 ,$315.00 ,$267.75 , N/A ,$289.80 ,$220.50 ,$157.50 ,$189.00 ,$191.84 ,$157.50 ,$217.67 ,$220.50 , N/A ,$226.80 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$226.80 ,$195.30 ,$226.80 ,$226.80 ,$189.00 ST VINCENT HOSPITAL - ACUTE,98280003,99243,PC OFFICE CONSULT LEVEL 3,982,1 ,$400.00 ,$200.00 ,$47.46 ,$400.00 ,$258.40 ,$47.46 ,$258.76 ,$258.76 , N/A ,$240.00 ,$340.00 ,$280.00 ,$47.46 ,$380.00 ,$288.00 ,$292.00 ,$260.00 ,$340.00 , N/A ,$260.00 ,$320.00 ,$292.00 ,$47.46 , N/A ,$168.00 ,$400.00 ,$340.00 , N/A ,$368.00 ,$280.00 ,$200.00 ,$240.00 ,$243.60 ,$200.00 ,$276.40 ,$280.00 , N/A ,$288.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,98280004,99244,PC OFFICE CONSULT LEVEL 4,982,1 ,$550.00 ,$275.00 ,$47.46 ,$550.00 ,$355.30 ,$47.46 ,$355.80 ,$355.80 , N/A ,$330.00 ,$467.50 ,$385.00 ,$47.46 ,$522.50 ,$396.00 ,$401.50 ,$357.50 ,$467.50 , N/A ,$357.50 ,$440.00 ,$401.50 ,$47.46 , N/A ,$231.00 ,$550.00 ,$467.50 , N/A ,$506.00 ,$385.00 ,$275.00 ,$330.00 ,$334.95 ,$275.00 ,$380.05 ,$385.00 , N/A ,$396.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$396.00 ,$341.00 ,$396.00 ,$396.00 ,$330.00 ST VINCENT HOSPITAL - ACUTE,98280005,99245,PC OFFICE CONSULT LEVEL 5.,982,1 ,$675.00 ,$337.50 ,$47.46 ,$675.00 ,$436.05 ,$47.46 ,$436.66 ,$436.66 , N/A ,$405.00 ,$573.75 ,$472.50 ,$47.46 ,$641.25 ,$486.00 ,$492.75 ,$438.75 ,$573.75 , N/A ,$438.75 ,$540.00 ,$492.75 ,$47.46 , N/A ,$283.50 ,$675.00 ,$573.75 , N/A ,$621.00 ,$472.50 ,$337.50 ,$405.00 ,$411.08 ,$337.50 ,$466.43 ,$472.50 , N/A ,$486.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$486.00 ,$418.50 ,$486.00 ,$486.00 ,$405.00 ST VINCENT HOSPITAL - ACUTE,98280006,99406,PC SMOKING/TOBACCO COUNSELING 3 TO 10 MIN.,982,1 ,$50.00 ,$25.00 ,$7.92 ,$57.16 ,$32.30 ,$7.92 ,$32.35 ,$32.35 ,$25.40 ,$30.00 ,$42.50 ,$35.00 ,$7.92 ,$47.50 ,$36.00 ,$36.50 ,$32.50 ,$42.50 ,$25.40 ,$32.50 ,$40.00 ,$36.50 ,$7.92 ,$25.40 ,$21.00 ,$50.00 ,$42.50 ,$57.16 ,$46.00 ,$35.00 ,$25.00 ,$30.00 ,$30.45 ,$25.00 ,$34.55 ,$35.00 ,$25.65 ,$36.00 ,$8.40 , N/A , N/A ,$25.40 , N/A ,$25.40 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,98280007,99407,PC SMOKING CESSATION > 10 MINUTES,982,1 ,$80.00 ,$40.00 ,$7.92 ,$80.00 ,$51.68 ,$7.92 ,$51.75 ,$51.75 ,$25.40 ,$48.00 ,$68.00 ,$56.00 ,$7.92 ,$76.00 ,$57.60 ,$58.40 ,$52.00 ,$68.00 ,$25.40 ,$52.00 ,$64.00 ,$58.40 ,$7.92 ,$25.40 ,$33.60 ,$80.00 ,$68.00 ,$57.16 ,$73.60 ,$56.00 ,$40.00 ,$48.00 ,$48.72 ,$40.00 ,$55.28 ,$56.00 ,$25.65 ,$57.60 ,$8.40 , N/A , N/A ,$25.40 , N/A ,$25.40 ,$57.60 ,$49.60 ,$57.60 ,$57.60 ,$48.00 ST VINCENT HOSPITAL - ACUTE,98280009,99441,PC TELEPHONE E/M 5-10 MINS OF MEDICAL DISCUSSION,982,1 ,$25.00 ,$12.50 ,$10.50 ,$50.31 ,$16.15 ,$25.00 ,$16.17 ,$16.17 , N/A ,$15.00 ,$21.25 ,$17.50 ,$47.46 ,$23.75 ,$18.00 ,$18.25 ,$16.25 ,$21.25 , N/A ,$16.25 ,$20.00 ,$18.25 ,$47.46 , N/A ,$10.50 ,$25.00 ,$21.25 , N/A ,$23.00 ,$17.50 ,$12.50 ,$15.00 ,$15.23 ,$12.50 ,$17.28 ,$17.50 , N/A ,$18.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$18.00 ,$15.50 ,$18.00 ,$18.00 ,$15.00 ST VINCENT HOSPITAL - ACUTE,98280010,99442,PC TELEPHONE E/M 11-20 MINS OF MEDICAL DISCUSSION,982,1 ,$50.00 ,$25.00 ,$21.00 ,$50.31 ,$32.30 ,$47.46 ,$32.35 ,$32.35 , N/A ,$30.00 ,$42.50 ,$35.00 ,$47.46 ,$47.50 ,$36.00 ,$36.50 ,$32.50 ,$42.50 , N/A ,$32.50 ,$40.00 ,$36.50 ,$47.46 , N/A ,$21.00 ,$50.00 ,$42.50 , N/A ,$46.00 ,$35.00 ,$25.00 ,$30.00 ,$30.45 ,$25.00 ,$34.55 ,$35.00 , N/A ,$36.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,98280011,99443,PC TELEPHONE E/M 21-30 MINS OF MEDICAL DISCUSSION,982,1 ,$75.00 ,$37.50 ,$31.50 ,$75.00 ,$48.45 ,$47.46 ,$48.52 ,$48.52 , N/A ,$45.00 ,$63.75 ,$52.50 ,$47.46 ,$71.25 ,$54.00 ,$54.75 ,$48.75 ,$63.75 , N/A ,$48.75 ,$60.00 ,$54.75 ,$47.46 , N/A ,$31.50 ,$75.00 ,$63.75 , N/A ,$69.00 ,$52.50 ,$37.50 ,$45.00 ,$45.68 ,$37.50 ,$51.83 ,$52.50 , N/A ,$54.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$54.00 ,$46.50 ,$54.00 ,$54.00 ,$45.00 ST VINCENT HOSPITAL - ACUTE,98300001,10060,PC I AND D ABSC SMP PRO,983,1 ,$375.00 ,$187.50 ,$74.70 ,$391.26 ,$242.25 ,$74.70 ,$242.59 ,$242.59 ,$173.89 ,$225.00 ,$318.75 ,$262.50 ,$74.70 ,$356.25 ,$270.00 ,$273.75 ,$243.75 ,$318.75 ,$173.89 ,$243.75 ,$300.00 ,$273.75 ,$74.70 ,$173.89 ,$157.50 ,$375.00 ,$318.75 ,$391.26 ,$345.00 ,$262.50 ,$375.00 ,$375.00 ,$228.38 ,$375.00 ,$259.13 ,$262.50 ,$175.63 ,$270.00 ,$79.18 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$270.00 ,$232.50 ,$270.00 ,$270.00 ,$225.00 ST VINCENT HOSPITAL - ACUTE,98300002,10120,PC INCISION/REM FB SUBQ SMP PRO,983,1 ,$450.00 ,$225.00 ,$74.70 ,$753.63 ,$290.70 ,$74.70 ,$291.11 ,$291.11 ,$334.95 ,$270.00 ,$382.50 ,$315.00 ,$74.70 ,$427.50 ,$324.00 ,$328.50 ,$292.50 ,$382.50 ,$334.95 ,$292.50 ,$360.00 ,$328.50 ,$74.70 ,$334.95 ,$189.00 ,$450.00 ,$382.50 ,$753.63 ,$414.00 ,$315.00 ,$450.00 ,$450.00 ,$274.05 ,$450.00 ,$310.95 ,$315.00 ,$338.30 ,$324.00 ,$79.18 , N/A , N/A ,$334.95 , N/A ,$334.95 ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,98300003,10160,PC ASP ABSC/HEMA/CYST/BULLA PRO,983,1 ,$395.00 ,$197.50 ,$74.70 ,$753.63 ,$255.17 ,$74.70 ,$255.53 ,$255.53 ,$334.95 ,$237.00 ,$335.75 ,$276.50 ,$74.70 ,$375.25 ,$284.40 ,$288.35 ,$256.75 ,$335.75 ,$334.95 ,$256.75 ,$316.00 ,$288.35 ,$74.70 ,$334.95 ,$165.90 ,$395.00 ,$335.75 ,$753.63 ,$363.40 ,$276.50 ,$395.00 ,$395.00 ,$240.56 ,$395.00 ,$272.95 ,$276.50 ,$338.30 ,$284.40 ,$79.18 , N/A , N/A ,$334.95 , N/A ,$334.95 ,$284.40 ,$244.90 ,$284.40 ,$284.40 ,$237.00 ST VINCENT HOSPITAL - ACUTE,98300004,11042,PC DEBR SKIN/SUBQ TISS INIT 20CM PRO,983,1 ,$460.00 ,$230.00 ,$107.54 ,$753.63 ,$297.16 ,$107.54 ,$297.57 ,$297.57 ,$334.95 ,$276.00 ,$391.00 ,$322.00 ,$107.54 ,$437.00 ,$331.20 ,$335.80 ,$299.00 ,$391.00 ,$334.95 ,$299.00 ,$368.00 ,$335.80 ,$107.54 ,$334.95 ,$193.20 ,$460.00 ,$391.00 ,$753.63 ,$423.20 ,$322.00 ,$460.00 ,$460.00 ,$280.14 ,$460.00 ,$317.86 ,$322.00 ,$338.30 ,$331.20 ,$113.99 , N/A , N/A ,$334.95 , N/A ,$334.95 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,98300005,11042,PC DEBR SKIN/SUBQ TISS/PROC INIT 20CM PRO,983,1 ,$460.00 ,$230.00 ,$107.54 ,$753.63 ,$297.16 ,$107.54 ,$297.57 ,$297.57 ,$334.95 ,$276.00 ,$391.00 ,$322.00 ,$107.54 ,$437.00 ,$331.20 ,$335.80 ,$299.00 ,$391.00 ,$334.95 ,$299.00 ,$368.00 ,$335.80 ,$107.54 ,$334.95 ,$193.20 ,$460.00 ,$391.00 ,$753.63 ,$423.20 ,$322.00 ,$460.00 ,$460.00 ,$280.14 ,$460.00 ,$317.86 ,$322.00 ,$338.30 ,$331.20 ,$113.99 , N/A , N/A ,$334.95 , N/A ,$334.95 ,$331.20 ,$285.20 ,$331.20 ,$331.20 ,$276.00 ST VINCENT HOSPITAL - ACUTE,98300006,11043,PC DEBR SKIN/SUBQ TISSUE/MUSCLE PRO,983,1 ,$585.00 ,$292.50 ,$107.54 ,"$1,142.23 ",$377.91 ,$107.54 ,$378.44 ,$378.44 ,$507.66 ,$351.00 ,$497.25 ,$409.50 ,$107.54 ,$555.75 ,$421.20 ,$427.05 ,$380.25 ,$497.25 ,$507.66 ,$380.25 ,$468.00 ,$427.05 ,$107.54 ,$507.66 ,$245.70 ,$585.00 ,$497.25 ,"$1,142.23 ",$538.20 ,$409.50 ,$585.00 ,$585.00 ,$356.27 ,$585.00 ,$404.24 ,$409.50 ,$512.74 ,$421.20 ,$113.99 , N/A , N/A ,$507.66 , N/A ,$507.66 ,$421.20 ,$362.70 ,$421.20 ,$421.20 ,$351.00 ST VINCENT HOSPITAL - ACUTE,98300007,11043,PC DEBR SKIN/SUBQ TISSUE/MUSCLE PROC PRO,983,1 ,$585.00 ,$292.50 ,$107.54 ,"$1,142.23 ",$377.91 ,$107.54 ,$378.44 ,$378.44 ,$507.66 ,$351.00 ,$497.25 ,$409.50 ,$107.54 ,$555.75 ,$421.20 ,$427.05 ,$380.25 ,$497.25 ,$507.66 ,$380.25 ,$468.00 ,$427.05 ,$107.54 ,$507.66 ,$245.70 ,$585.00 ,$497.25 ,"$1,142.23 ",$538.20 ,$409.50 ,$585.00 ,$585.00 ,$356.27 ,$585.00 ,$404.24 ,$409.50 ,$512.74 ,$421.20 ,$113.99 , N/A , N/A ,$507.66 , N/A ,$507.66 ,$421.20 ,$362.70 ,$421.20 ,$421.20 ,$351.00 ST VINCENT HOSPITAL - ACUTE,98300008,11044,PC DEBR SKIN/SUB TIS/MUS/BONE INT 20 PRO,983,1 ,"$1,295.00 ",$647.50 ,$288.83 ,"$3,066.03 ",$836.57 ,$288.83 ,$837.74 ,$837.74 ,"$1,362.68 ",$777.00 ,"$1,100.75 ",$906.50 ,$288.83 ,"$1,230.25 ",$932.40 ,$945.35 ,$841.75 ,"$1,100.75 ","$1,362.68 ",$841.75 ,"$1,036.00 ",$945.35 ,$288.83 ,"$1,362.68 ",$543.90 ,"$1,295.00 ","$1,100.75 ","$3,066.03 ","$1,191.40 ",$906.50 ,"$1,295.00 ","$1,295.00 ",$788.66 ,"$1,295.00 ",$894.85 ,$906.50 ,"$1,376.31 ",$932.40 ,$306.16 , N/A , N/A ,"$1,362.68 ", N/A ,"$1,362.68 ",$932.40 ,$802.90 ,$932.40 ,$932.40 ,$777.00 ST VINCENT HOSPITAL - ACUTE,98300009,11044,PC DEBR SKIN/SUB TIS/MUS/BONE INT 20PROC PRO,983,1 ,"$1,295.00 ",$647.50 ,$288.83 ,"$3,066.03 ",$836.57 ,$288.83 ,$837.74 ,$837.74 ,"$1,362.68 ",$777.00 ,"$1,100.75 ",$906.50 ,$288.83 ,"$1,230.25 ",$932.40 ,$945.35 ,$841.75 ,"$1,100.75 ","$1,362.68 ",$841.75 ,"$1,036.00 ",$945.35 ,$288.83 ,"$1,362.68 ",$543.90 ,"$1,295.00 ","$1,100.75 ","$3,066.03 ","$1,191.40 ",$906.50 ,"$1,295.00 ","$1,295.00 ",$788.66 ,"$1,295.00 ",$894.85 ,$906.50 ,"$1,376.31 ",$932.40 ,$306.16 , N/A , N/A ,"$1,362.68 ", N/A ,"$1,362.68 ",$932.40 ,$802.90 ,$932.40 ,$932.40 ,$777.00 ST VINCENT HOSPITAL - ACUTE,98300010,11045,PC DEBR SKIN/SUBQ TIS EA ADL 20CM PRO,983,1 ,$110.00 ,$55.00 ,$46.20 ,$306.16 ,$71.06 ,$110.00 ,$71.16 ,$71.16 , N/A ,$66.00 ,$93.50 ,$77.00 ,$288.83 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 , N/A ,$71.50 ,$88.00 ,$80.30 ,$288.83 , N/A ,$46.20 ,$110.00 ,$93.50 , N/A ,$101.20 ,$77.00 ,$110.00 ,$110.00 ,$66.99 ,$110.00 ,$76.01 ,$77.00 , N/A ,$79.20 ,$306.16 , N/A , N/A , N/A , N/A , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,98300011,11046,PC DEBR SKIN/SUBQ MUS/FAS ADL 20C PRO,983,1 ,$230.00 ,$115.00 ,$96.60 ,$306.16 ,$148.58 ,$230.00 ,$148.79 ,$148.79 , N/A ,$138.00 ,$195.50 ,$161.00 ,$288.83 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 , N/A ,$149.50 ,$184.00 ,$167.90 ,$288.83 , N/A ,$96.60 ,$230.00 ,$195.50 , N/A ,$211.60 ,$161.00 ,$230.00 ,$230.00 ,$140.07 ,$230.00 ,$158.93 ,$161.00 , N/A ,$165.60 ,$306.16 , N/A , N/A , N/A , N/A , N/A ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,98300012,11047,PC DEBR SKIN/SUB TIS/MUS/BN ADL 20C PRO,983,1 ,$385.00 ,$192.50 ,$161.70 ,$385.00 ,$248.71 ,$288.83 ,$249.06 ,$249.06 , N/A ,$231.00 ,$327.25 ,$269.50 ,$288.83 ,$365.75 ,$277.20 ,$281.05 ,$250.25 ,$327.25 , N/A ,$250.25 ,$308.00 ,$281.05 ,$288.83 , N/A ,$161.70 ,$385.00 ,$327.25 , N/A ,$354.20 ,$269.50 ,$385.00 ,$385.00 ,$234.47 ,$385.00 ,$266.04 ,$269.50 , N/A ,$277.20 ,$306.16 , N/A , N/A , N/A , N/A , N/A ,$277.20 ,$238.70 ,$277.20 ,$277.20 ,$231.00 ST VINCENT HOSPITAL - ACUTE,98300013,11055,PC PARING LESN BENIGN 1 PRO,983,1 ,$160.00 ,$80.00 ,$67.20 ,$391.26 ,$103.36 ,$74.70 ,$103.50 ,$103.50 ,$173.89 ,$96.00 ,$136.00 ,$112.00 ,$74.70 ,$152.00 ,$115.20 ,$116.80 ,$104.00 ,$136.00 ,$173.89 ,$104.00 ,$128.00 ,$116.80 ,$74.70 ,$173.89 ,$67.20 ,$160.00 ,$136.00 ,$391.26 ,$147.20 ,$112.00 ,$160.00 ,$160.00 ,$97.44 ,$160.00 ,$110.56 ,$112.00 ,$175.63 ,$115.20 ,$79.18 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$115.20 ,$99.20 ,$115.20 ,$115.20 ,$96.00 ST VINCENT HOSPITAL - ACUTE,98300014,11056,PC PARING LESN BENIGN 2-4 PRO,983,1 ,$230.00 ,$115.00 ,$74.70 ,$391.26 ,$148.58 ,$74.70 ,$148.79 ,$148.79 ,$173.89 ,$138.00 ,$195.50 ,$161.00 ,$74.70 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$173.89 ,$149.50 ,$184.00 ,$167.90 ,$74.70 ,$173.89 ,$96.60 ,$230.00 ,$195.50 ,$391.26 ,$211.60 ,$161.00 ,$230.00 ,$230.00 ,$140.07 ,$230.00 ,$158.93 ,$161.00 ,$175.63 ,$165.60 ,$79.18 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,98300018,11719,PC TRIM NAILS NONDYSTROPHIC PRO,983,1 ,$50.00 ,$25.00 ,$21.00 ,$121.29 ,$32.30 ,$31.89 ,$32.35 ,$32.35 ,$53.91 ,$30.00 ,$42.50 ,$35.00 ,$31.89 ,$47.50 ,$36.00 ,$36.50 ,$32.50 ,$42.50 ,$53.91 ,$32.50 ,$40.00 ,$36.50 ,$31.89 ,$53.91 ,$21.00 ,$50.00 ,$42.50 ,$121.29 ,$46.00 ,$35.00 ,$50.00 ,$50.00 ,$30.45 ,$50.00 ,$34.55 ,$35.00 ,$54.45 ,$36.00 ,$33.80 , N/A , N/A ,$53.91 , N/A ,$53.91 ,$36.00 ,$31.00 ,$36.00 ,$36.00 ,$30.00 ST VINCENT HOSPITAL - ACUTE,98300019,15100,PC AUTOGRPH T A L 100SQCM< PRO,983,1 ,"$2,795.00 ","$1,397.50 ",$552.66 ,"$3,737.98 ","$1,805.57 ",$552.66 ,"$1,808.09 ","$1,808.09 ","$1,661.33 ","$1,677.00 ","$2,375.75 ","$1,956.50 ",$552.66 ,"$2,655.25 ","$2,012.40 ","$2,040.35 ","$1,816.75 ","$2,375.75 ","$1,661.33 ","$1,816.75 ","$2,236.00 ","$2,040.35 ",$552.66 ,"$1,661.33 ","$1,173.90 ","$2,795.00 ","$2,375.75 ","$3,737.98 ","$2,571.40 ","$1,956.50 ","$2,331.31 ","$2,795.00 ","$1,702.16 ","$2,795.00 ","$1,931.35 ","$1,956.50 ","$1,677.94 ","$2,012.40 ",$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ","$2,012.40 ","$1,732.90 ","$2,012.40 ","$2,012.40 ","$1,677.00 " ST VINCENT HOSPITAL - ACUTE,98300020,15101,PC AUTOGRPH T A L EA ADD100CM PRO,983,1 ,$880.00 ,$440.00 ,$369.60 ,"$4,310.52 ",$568.48 ,$552.66 ,$569.27 ,$569.27 , N/A ,$528.00 ,$748.00 ,$616.00 ,$552.66 ,$836.00 ,$633.60 ,$642.40 ,$572.00 ,$748.00 , N/A ,$572.00 ,$704.00 ,$642.40 ,$552.66 , N/A ,$369.60 ,$880.00 ,$748.00 , N/A ,$809.60 ,$616.00 ,"$3,206.88 ","$4,310.52 ",$535.92 ,"$4,008.60 ",$608.08 ,$616.00 , N/A ,$633.60 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$633.60 ,$545.60 ,$633.60 ,$633.60 ,$528.00 ST VINCENT HOSPITAL - ACUTE,98300021,15120,PC AUTOGRPH F F DG 100SQCM< PRO,983,1 ,"$4,495.00 ","$2,247.50 ",$552.66 ,"$7,675.21 ","$2,903.77 ",$552.66 ,"$2,907.82 ","$2,907.82 ","$3,411.20 ","$2,697.00 ","$3,820.75 ","$3,146.50 ",$552.66 ,"$4,270.25 ","$3,236.40 ","$3,281.35 ","$2,921.75 ","$3,820.75 ","$3,411.20 ","$2,921.75 ","$3,596.00 ","$3,281.35 ",$552.66 ,"$3,411.20 ","$1,887.90 ","$4,495.00 ","$3,820.75 ","$7,675.21 ","$4,135.40 ","$3,146.50 ","$2,331.31 ","$3,133.44 ","$2,737.46 ","$2,914.14 ","$3,106.05 ","$3,146.50 ","$3,445.31 ","$3,236.40 ",$585.82 , N/A , N/A ,"$3,411.20 ", N/A ,"$3,411.20 ","$3,236.40 ","$2,786.90 ","$3,236.40 ","$3,236.40 ","$2,697.00 " ST VINCENT HOSPITAL - ACUTE,98300022,15121,PC AUTOGRPH F F DG EA ADD 100CM PRO,983,1 ,"$2,247.00 ","$1,123.50 ",$552.66 ,"$4,310.52 ","$1,451.56 ",$552.66 ,"$1,453.58 ","$1,453.58 ", N/A ,"$1,348.20 ","$1,909.95 ","$1,572.90 ",$552.66 ,"$2,134.65 ","$1,617.84 ","$1,640.31 ","$1,460.55 ","$1,909.95 ", N/A ,"$1,460.55 ","$1,797.60 ","$1,640.31 ",$552.66 , N/A ,$943.74 ,"$2,247.00 ","$1,909.95 ", N/A ,"$2,067.24 ","$1,572.90 ","$3,206.88 ","$4,310.52 ","$1,368.42 ","$4,008.60 ","$1,552.68 ","$1,572.90 ", N/A ,"$1,617.84 ",$585.82 , N/A , N/A , N/A , N/A , N/A ,"$1,617.84 ","$1,393.14 ","$1,617.84 ","$1,617.84 ","$1,348.20 " ST VINCENT HOSPITAL - ACUTE,98300028,16020,PC BURN DRESS AND /OR DEBRIDE PRO <5%,983,1 ,$280.00 ,$140.00 ,$84.29 ,$391.26 ,$180.88 ,$84.29 ,$181.13 ,$181.13 ,$173.89 ,$168.00 ,$238.00 ,$196.00 ,$84.29 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$173.89 ,$182.00 ,$224.00 ,$204.40 ,$84.29 ,$173.89 ,$117.60 ,$280.00 ,$238.00 ,$391.26 ,$257.60 ,$196.00 ,$280.00 ,$280.00 ,$170.52 ,$280.00 ,$193.48 ,$196.00 ,$175.63 ,$201.60 ,$89.35 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,98300029,16020,PC BURN DRESS AND OR DEBRD NWPT PRO<5%,983,1 ,$280.00 ,$140.00 ,$84.29 ,$391.26 ,$180.88 ,$84.29 ,$181.13 ,$181.13 ,$173.89 ,$168.00 ,$238.00 ,$196.00 ,$84.29 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 ,$173.89 ,$182.00 ,$224.00 ,$204.40 ,$84.29 ,$173.89 ,$117.60 ,$280.00 ,$238.00 ,$391.26 ,$257.60 ,$196.00 ,$280.00 ,$280.00 ,$170.52 ,$280.00 ,$193.48 ,$196.00 ,$175.63 ,$201.60 ,$89.35 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,98300030,17250,PC CHEM CAUTERY/NWPT PRO,983,1 ,$270.00 ,$135.00 ,$74.70 ,$391.26 ,$174.42 ,$74.70 ,$174.66 ,$174.66 ,$173.89 ,$162.00 ,$229.50 ,$189.00 ,$74.70 ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 ,$173.89 ,$175.50 ,$216.00 ,$197.10 ,$74.70 ,$173.89 ,$113.40 ,$270.00 ,$229.50 ,$391.26 ,$248.40 ,$189.00 ,$270.00 ,$270.00 ,$164.43 ,$270.00 ,$186.57 ,$189.00 ,$175.63 ,$194.40 ,$79.18 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,98300031,17250,PC CHEM CAUTERY PRO,983,1 ,$270.00 ,$135.00 ,$74.70 ,$391.26 ,$174.42 ,$74.70 ,$174.66 ,$174.66 ,$173.89 ,$162.00 ,$229.50 ,$189.00 ,$74.70 ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 ,$173.89 ,$175.50 ,$216.00 ,$197.10 ,$74.70 ,$173.89 ,$113.40 ,$270.00 ,$229.50 ,$391.26 ,$248.40 ,$189.00 ,$270.00 ,$270.00 ,$164.43 ,$270.00 ,$186.57 ,$189.00 ,$175.63 ,$194.40 ,$79.18 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,98300032,97597,PC AWC WITH CHEM CAUTERY PRO,983,1 ,$270.00 ,$135.00 ,$107.54 ,$391.26 ,$174.42 ,$107.54 ,$174.66 ,$174.66 ,$173.89 ,$162.00 ,$229.50 ,$189.00 ,$107.54 ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 ,$173.89 ,$175.50 ,$216.00 ,$197.10 ,$107.54 ,$173.89 ,$113.40 ,$270.00 ,$229.50 ,$391.26 ,$248.40 ,$189.00 ,$135.00 ,$162.00 ,$164.43 ,$135.00 ,$186.57 ,$189.00 ,$175.63 ,$194.40 ,$113.99 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,98300033,20220,PC BX BONE NEEDLE SUPERFIC PRO,983,1 ,$525.00 ,$262.50 ,$180.17 ,"$3,066.03 ",$339.15 ,$180.17 ,$339.62 ,$339.62 ,"$1,362.68 ",$315.00 ,$446.25 ,$367.50 ,$180.17 ,$498.75 ,$378.00 ,$383.25 ,$341.25 ,$446.25 ,"$1,362.68 ",$341.25 ,$420.00 ,$383.25 ,$180.17 ,"$1,362.68 ",$220.50 ,$525.00 ,$446.25 ,"$3,066.03 ",$483.00 ,$367.50 ,$525.00 ,$525.00 ,$319.73 ,$525.00 ,$362.78 ,$367.50 ,"$1,376.31 ",$378.00 ,$190.98 , N/A , N/A ,"$1,362.68 ", N/A ,"$1,362.68 ",$378.00 ,$325.50 ,$378.00 ,$378.00 ,$315.00 ST VINCENT HOSPITAL - ACUTE,98300034,29445,PC APPL CAST LEG RIGID CONTACT PRO,983,1 ,"$1,200.00 ",$600.00 ,$57.61 ,"$1,200.00 ",$775.20 ,$57.61 ,$776.28 ,$776.28 ,$233.57 ,$720.00 ,"$1,020.00 ",$840.00 ,$57.61 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$233.57 ,$780.00 ,$960.00 ,$876.00 ,$57.61 ,$233.57 ,$504.00 ,"$1,200.00 ","$1,020.00 ",$525.54 ,"$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,$235.91 ,$864.00 ,$61.07 , N/A , N/A ,$233.57 , N/A ,$233.57 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,98300035,29445,PC APPL/REMOVAL CAST PRO,983,1 ,"$1,200.00 ",$600.00 ,$57.61 ,"$1,200.00 ",$775.20 ,$57.61 ,$776.28 ,$776.28 ,$233.57 ,$720.00 ,"$1,020.00 ",$840.00 ,$57.61 ,"$1,140.00 ",$864.00 ,$876.00 ,$780.00 ,"$1,020.00 ",$233.57 ,$780.00 ,$960.00 ,$876.00 ,$57.61 ,$233.57 ,$504.00 ,"$1,200.00 ","$1,020.00 ",$525.54 ,"$1,104.00 ",$840.00 ,"$1,200.00 ","$1,200.00 ",$730.80 ,"$1,200.00 ",$829.20 ,$840.00 ,$235.91 ,$864.00 ,$61.07 , N/A , N/A ,$233.57 , N/A ,$233.57 ,$864.00 ,$744.00 ,$864.00 ,$864.00 ,$720.00 ST VINCENT HOSPITAL - ACUTE,98300036,29580,PC UNNA BOOT APPLICATION PRO,983,1 ,$215.00 ,$107.50 ,$57.61 ,$307.65 ,$138.89 ,$57.61 ,$139.08 ,$139.08 ,$136.73 ,$129.00 ,$182.75 ,$150.50 ,$57.61 ,$204.25 ,$154.80 ,$156.95 ,$139.75 ,$182.75 ,$136.73 ,$139.75 ,$172.00 ,$156.95 ,$57.61 ,$136.73 ,$90.30 ,$215.00 ,$182.75 ,$307.65 ,$197.80 ,$150.50 ,$215.00 ,$215.00 ,$130.94 ,$215.00 ,$148.57 ,$150.50 ,$138.10 ,$154.80 ,$61.07 , N/A , N/A ,$136.73 , N/A ,$136.73 ,$154.80 ,$133.30 ,$154.80 ,$154.80 ,$129.00 ST VINCENT HOSPITAL - ACUTE,98300037,29580,PC BILATERAL UNNA BOOT APPL PRO,983,1 ,$320.00 ,$160.00 ,$57.61 ,$320.00 ,$206.72 ,$57.61 ,$207.01 ,$207.01 ,$136.73 ,$192.00 ,$272.00 ,$224.00 ,$57.61 ,$304.00 ,$230.40 ,$233.60 ,$208.00 ,$272.00 ,$136.73 ,$208.00 ,$256.00 ,$233.60 ,$57.61 ,$136.73 ,$134.40 ,$320.00 ,$272.00 ,$307.65 ,$294.40 ,$224.00 ,$320.00 ,$320.00 ,$194.88 ,$320.00 ,$221.12 ,$224.00 ,$138.10 ,$230.40 ,$61.07 , N/A , N/A ,$136.73 , N/A ,$136.73 ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,98300038,29581,PC APPL MULTI COMP LOWER LEG PRO,983,1 ,$400.00 ,$200.00 ,$57.61 ,$400.00 ,$258.40 ,$57.61 ,$258.76 ,$258.76 ,$136.73 ,$240.00 ,$340.00 ,$280.00 ,$57.61 ,$380.00 ,$288.00 ,$292.00 ,$260.00 ,$340.00 ,$136.73 ,$260.00 ,$320.00 ,$292.00 ,$57.61 ,$136.73 ,$168.00 ,$400.00 ,$340.00 ,$307.65 ,$368.00 ,$280.00 ,$400.00 ,$400.00 ,$243.60 ,$400.00 ,$276.40 ,$280.00 ,$138.10 ,$288.00 ,$61.07 , N/A , N/A ,$136.73 , N/A ,$136.73 ,$288.00 ,$248.00 ,$288.00 ,$288.00 ,$240.00 ST VINCENT HOSPITAL - ACUTE,98300039,29581,PC APPL BIL MULT COMP LOWLEG PRO,983,1 ,$600.00 ,$300.00 ,$57.61 ,$600.00 ,$387.60 ,$57.61 ,$388.14 ,$388.14 ,$136.73 ,$360.00 ,$510.00 ,$420.00 ,$57.61 ,$570.00 ,$432.00 ,$438.00 ,$390.00 ,$510.00 ,$136.73 ,$390.00 ,$480.00 ,$438.00 ,$57.61 ,$136.73 ,$252.00 ,$600.00 ,$510.00 ,$307.65 ,$552.00 ,$420.00 ,$600.00 ,$600.00 ,$365.40 ,$600.00 ,$414.60 ,$420.00 ,$138.10 ,$432.00 ,$61.07 , N/A , N/A ,$136.73 , N/A ,$136.73 ,$432.00 ,$372.00 ,$432.00 ,$432.00 ,$360.00 ST VINCENT HOSPITAL - ACUTE,98300040,29799,PC REMOVAL/REVISION LEGCAST PRO,983,1 ,$215.00 ,$107.50 ,$21.22 ,$307.65 ,$138.89 ,$21.22 ,$139.08 ,$139.08 ,$136.73 ,$129.00 ,$182.75 ,$150.50 ,$21.22 ,$204.25 ,$154.80 ,$156.95 ,$139.75 ,$182.75 ,$136.73 ,$139.75 ,$172.00 ,$156.95 ,$21.22 ,$136.73 ,$90.30 ,$215.00 ,$182.75 ,$307.65 ,$197.80 ,$150.50 ,$107.50 ,$129.00 ,$130.94 ,$107.50 ,$148.57 ,$150.50 ,$138.10 ,$154.80 ,$22.49 , N/A , N/A ,$136.73 , N/A ,$136.73 ,$154.80 ,$133.30 ,$154.80 ,$154.80 ,$129.00 ST VINCENT HOSPITAL - ACUTE,98300043,97597,PC DEBR SKIN INTL 20CM PRO,983,1 ,$205.00 ,$102.50 ,$86.10 ,$391.26 ,$132.43 ,$107.54 ,$132.61 ,$132.61 ,$173.89 ,$123.00 ,$174.25 ,$143.50 ,$107.54 ,$194.75 ,$147.60 ,$149.65 ,$133.25 ,$174.25 ,$173.89 ,$133.25 ,$164.00 ,$149.65 ,$107.54 ,$173.89 ,$86.10 ,$205.00 ,$174.25 ,$391.26 ,$188.60 ,$143.50 ,$102.50 ,$123.00 ,$124.85 ,$102.50 ,$141.66 ,$143.50 ,$175.63 ,$147.60 ,$113.99 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$147.60 ,$127.10 ,$147.60 ,$147.60 ,$123.00 ST VINCENT HOSPITAL - ACUTE,98300044,97597,PC DEBR SKIN INTL 20CM UNNA PRO,983,1 ,$205.00 ,$102.50 ,$86.10 ,$391.26 ,$132.43 ,$107.54 ,$132.61 ,$132.61 ,$173.89 ,$123.00 ,$174.25 ,$143.50 ,$107.54 ,$194.75 ,$147.60 ,$149.65 ,$133.25 ,$174.25 ,$173.89 ,$133.25 ,$164.00 ,$149.65 ,$107.54 ,$173.89 ,$86.10 ,$205.00 ,$174.25 ,$391.26 ,$188.60 ,$143.50 ,$102.50 ,$123.00 ,$124.85 ,$102.50 ,$141.66 ,$143.50 ,$175.63 ,$147.60 ,$113.99 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$147.60 ,$127.10 ,$147.60 ,$147.60 ,$123.00 ST VINCENT HOSPITAL - ACUTE,98300045,97597,PC DEBR SKIN INTL NWPT INTL 20CM PRO,983,1 ,$205.00 ,$102.50 ,$86.10 ,$391.26 ,$132.43 ,$107.54 ,$132.61 ,$132.61 ,$173.89 ,$123.00 ,$174.25 ,$143.50 ,$107.54 ,$194.75 ,$147.60 ,$149.65 ,$133.25 ,$174.25 ,$173.89 ,$133.25 ,$164.00 ,$149.65 ,$107.54 ,$173.89 ,$86.10 ,$205.00 ,$174.25 ,$391.26 ,$188.60 ,$143.50 ,$102.50 ,$123.00 ,$124.85 ,$102.50 ,$141.66 ,$143.50 ,$175.63 ,$147.60 ,$113.99 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$147.60 ,$127.10 ,$147.60 ,$147.60 ,$123.00 ST VINCENT HOSPITAL - ACUTE,98300046,97597,PC DEBR SKIN INTL 20CM NWPT/UNNA PRO,983,1 ,$205.00 ,$102.50 ,$86.10 ,$391.26 ,$132.43 ,$107.54 ,$132.61 ,$132.61 ,$173.89 ,$123.00 ,$174.25 ,$143.50 ,$107.54 ,$194.75 ,$147.60 ,$149.65 ,$133.25 ,$174.25 ,$173.89 ,$133.25 ,$164.00 ,$149.65 ,$107.54 ,$173.89 ,$86.10 ,$205.00 ,$174.25 ,$391.26 ,$188.60 ,$143.50 ,$102.50 ,$123.00 ,$124.85 ,$102.50 ,$141.66 ,$143.50 ,$175.63 ,$147.60 ,$113.99 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$147.60 ,$127.10 ,$147.60 ,$147.60 ,$123.00 ST VINCENT HOSPITAL - ACUTE,98300047,97597,PC DEBR SKIN INTL 20CM WRAP BIL PRO,983,1 ,$205.00 ,$102.50 ,$86.10 ,$391.26 ,$132.43 ,$107.54 ,$132.61 ,$132.61 ,$173.89 ,$123.00 ,$174.25 ,$143.50 ,$107.54 ,$194.75 ,$147.60 ,$149.65 ,$133.25 ,$174.25 ,$173.89 ,$133.25 ,$164.00 ,$149.65 ,$107.54 ,$173.89 ,$86.10 ,$205.00 ,$174.25 ,$391.26 ,$188.60 ,$143.50 ,$102.50 ,$123.00 ,$124.85 ,$102.50 ,$141.66 ,$143.50 ,$175.63 ,$147.60 ,$113.99 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$147.60 ,$127.10 ,$147.60 ,$147.60 ,$123.00 ST VINCENT HOSPITAL - ACUTE,98300048,97597,PC DEBR SKIN INTL 20CM WRAP PRO,983,1 ,$205.00 ,$102.50 ,$86.10 ,$391.26 ,$132.43 ,$107.54 ,$132.61 ,$132.61 ,$173.89 ,$123.00 ,$174.25 ,$143.50 ,$107.54 ,$194.75 ,$147.60 ,$149.65 ,$133.25 ,$174.25 ,$173.89 ,$133.25 ,$164.00 ,$149.65 ,$107.54 ,$173.89 ,$86.10 ,$205.00 ,$174.25 ,$391.26 ,$188.60 ,$143.50 ,$102.50 ,$123.00 ,$124.85 ,$102.50 ,$141.66 ,$143.50 ,$175.63 ,$147.60 ,$113.99 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$147.60 ,$127.10 ,$147.60 ,$147.60 ,$123.00 ST VINCENT HOSPITAL - ACUTE,98300049,97598,PC DEBR SKIN PART THICKNESS EA ADDN>20CM PRO,983,1 ,$230.00 ,$115.00 ,$96.60 ,$306.16 ,$148.58 ,$230.00 ,$148.79 ,$148.79 , N/A ,$138.00 ,$195.50 ,$161.00 ,$288.83 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 , N/A ,$149.50 ,$184.00 ,$167.90 ,$288.83 , N/A ,$96.60 ,$230.00 ,$195.50 , N/A ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 , N/A ,$165.60 ,$306.16 , N/A , N/A , N/A , N/A , N/A ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,98300050,97605,PC NWPT <50 SQ CM PRO,983,1 ,$120.00 ,$60.00 ,$50.40 ,$391.26 ,$77.52 ,$84.29 ,$77.63 ,$77.63 ,$173.89 ,$72.00 ,$102.00 ,$84.00 ,$84.29 ,$114.00 ,$86.40 ,$87.60 ,$78.00 ,$102.00 ,$173.89 ,$78.00 ,$96.00 ,$87.60 ,$84.29 ,$173.89 ,$50.40 ,$120.00 ,$102.00 ,$391.26 ,$110.40 ,$84.00 ,$60.00 ,$72.00 ,$73.08 ,$60.00 ,$82.92 ,$84.00 ,$175.63 ,$86.40 ,$89.35 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,98300051,97606,PC NWPT >50 SQ CM PRO,983,1 ,$230.00 ,$115.00 ,$96.60 ,$753.63 ,$148.58 ,$107.54 ,$148.79 ,$148.79 ,$334.95 ,$138.00 ,$195.50 ,$161.00 ,$107.54 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 ,$334.95 ,$149.50 ,$184.00 ,$167.90 ,$107.54 ,$334.95 ,$96.60 ,$230.00 ,$195.50 ,$753.63 ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 ,$338.30 ,$165.60 ,$113.99 , N/A , N/A ,$334.95 , N/A ,$334.95 ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,98300052,99464,PC ATTEND HIGH RISK DELIVERY NNP,983,1 ,$155.00 ,$77.50 ,$65.10 ,$155.00 ,$100.13 , N/A ,$100.27 ,$100.27 , N/A ,$93.00 ,$131.75 ,$108.50 , N/A ,$147.25 ,$111.60 ,$113.15 ,$100.75 ,$131.75 , N/A ,$100.75 ,$124.00 ,$113.15 , N/A , N/A ,$65.10 ,$155.00 ,$131.75 , N/A ,$142.60 ,$108.50 ,$77.50 ,$93.00 ,$94.40 ,$77.50 ,$107.11 ,$108.50 , N/A ,$111.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$111.60 ,$96.10 ,$111.60 ,$111.60 ,$93.00 ST VINCENT HOSPITAL - ACUTE,98300053,99465,PC DELIV/BIRTH RM RESUSCIT NNP,983,1 ,$315.00 ,$157.50 ,$132.30 ,"$1,224.47 ",$203.49 ,$234.58 ,$203.77 ,$203.77 ,$544.21 ,$189.00 ,$267.75 ,$220.50 ,$234.58 ,$299.25 ,$226.80 ,$229.95 ,$204.75 ,$267.75 ,$544.21 ,$204.75 ,$252.00 ,$229.95 ,$234.58 ,$544.21 ,$132.30 ,$315.00 ,$267.75 ,"$1,224.47 ",$289.80 ,$220.50 ,$157.50 ,$189.00 ,$191.84 ,$157.50 ,$217.67 ,$220.50 ,$549.65 ,$226.80 ,$248.65 , N/A , N/A ,$544.21 , N/A ,$544.21 ,$226.80 ,$195.30 ,$226.80 ,$226.80 ,$189.00 ST VINCENT HOSPITAL - ACUTE,98300054,G0127,PC TRIM NAILS DYSTROPHIC PRO,983,1 ,$45.00 ,$22.50 ,$18.90 ,$121.29 ,$29.07 ,$31.89 ,$29.11 ,$29.11 ,$53.91 ,$27.00 ,$38.25 ,$31.50 ,$31.89 ,$42.75 ,$32.40 ,$32.85 ,$29.25 ,$38.25 ,$53.91 ,$29.25 ,$36.00 ,$32.85 ,$31.89 ,$53.91 ,$18.90 ,$45.00 ,$38.25 ,$121.29 ,$41.40 ,$31.50 ,$22.50 ,$27.00 ,$27.41 ,$22.50 ,$31.10 ,$31.50 ,$54.45 ,$32.40 ,$33.80 , N/A , N/A ,$53.91 , N/A ,$53.91 ,$32.40 ,$27.90 ,$32.40 ,$32.40 ,$27.00 ST VINCENT HOSPITAL - ACUTE,98300075,99183,PC HYPERBARIC 02 NP PRO FEE,983,1 ,$920.00 ,$460.00 ,$386.40 ,$920.00 ,$594.32 , N/A ,$595.15 ,$595.15 , N/A ,$552.00 ,$782.00 ,$644.00 , N/A ,$874.00 ,$662.40 ,$671.60 ,$598.00 ,$782.00 , N/A ,$598.00 ,$736.00 ,$671.60 , N/A , N/A ,$386.40 ,$920.00 ,$782.00 , N/A ,$846.40 ,$644.00 ,$460.00 ,$552.00 ,$560.28 ,$460.00 ,$635.72 ,$644.00 , N/A ,$662.40 , N/A , N/A , N/A , N/A , N/A , N/A ,$662.40 ,$570.40 ,$662.40 ,$662.40 ,$552.00 ST VINCENT HOSPITAL - ACUTE,98300080,15271,PC APL SKIN SUB TAL<100 INT 25CM PRO,983,1 ,$560.00 ,$280.00 ,$235.20 ,"$3,737.98 ",$361.76 ,$552.66 ,$362.26 ,$362.26 ,"$1,661.33 ",$336.00 ,$476.00 ,$392.00 ,$552.66 ,$532.00 ,$403.20 ,$408.80 ,$364.00 ,$476.00 ,"$1,661.33 ",$364.00 ,$448.00 ,$408.80 ,$552.66 ,"$1,661.33 ",$235.20 ,$560.00 ,$476.00 ,"$3,737.98 ",$515.20 ,$392.00 ,$560.00 ,$560.00 ,$341.04 ,$560.00 ,$386.96 ,$392.00 ,"$1,677.94 ",$403.20 ,$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ",$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,98300081,15271,PC APL SKIN SUB TAL<100 INT 25CM PRO W/PROC,983,1 ,$560.00 ,$280.00 ,$235.20 ,"$3,737.98 ",$361.76 ,$552.66 ,$362.26 ,$362.26 ,"$1,661.33 ",$336.00 ,$476.00 ,$392.00 ,$552.66 ,$532.00 ,$403.20 ,$408.80 ,$364.00 ,$476.00 ,"$1,661.33 ",$364.00 ,$448.00 ,$408.80 ,$552.66 ,"$1,661.33 ",$235.20 ,$560.00 ,$476.00 ,"$3,737.98 ",$515.20 ,$392.00 ,$560.00 ,$560.00 ,$341.04 ,$560.00 ,$386.96 ,$392.00 ,"$1,677.94 ",$403.20 ,$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ",$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,98300082,15272,PC APL SKIN SUB TAL<100 ADL 25CM PRO,983,1 ,$110.00 ,$55.00 ,$46.20 ,$585.82 ,$71.06 ,$110.00 ,$71.16 ,$71.16 , N/A ,$66.00 ,$93.50 ,$77.00 ,$552.66 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 , N/A ,$71.50 ,$88.00 ,$80.30 ,$552.66 , N/A ,$46.20 ,$110.00 ,$93.50 , N/A ,$101.20 ,$77.00 ,$110.00 ,$110.00 ,$66.99 ,$110.00 ,$76.01 ,$77.00 , N/A ,$79.20 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,98300083,15273,PC APL SKIN SUB TAL>100 INT 100CM PRO,983,1 ,"$1,150.00 ",$575.00 ,$483.00 ,"$7,675.21 ",$742.90 ,$552.66 ,$743.94 ,$743.94 ,"$3,411.20 ",$690.00 ,$977.50 ,$805.00 ,$552.66 ,"$1,092.50 ",$828.00 ,$839.50 ,$747.50 ,$977.50 ,"$3,411.20 ",$747.50 ,$920.00 ,$839.50 ,$552.66 ,"$3,411.20 ",$483.00 ,"$1,150.00 ",$977.50 ,"$7,675.21 ","$1,058.00 ",$805.00 ,"$1,150.00 ","$1,150.00 ",$700.35 ,"$1,150.00 ",$794.65 ,$805.00 ,"$3,445.31 ",$828.00 ,$585.82 , N/A , N/A ,"$3,411.20 ", N/A ,"$3,411.20 ",$828.00 ,$713.00 ,$828.00 ,$828.00 ,$690.00 ST VINCENT HOSPITAL - ACUTE,98300084,15273,PC APL SKIN SUB TAL>100 INT 100CM W/PROC PRO,983,1 ,"$1,150.00 ",$575.00 ,$483.00 ,"$7,675.21 ",$742.90 ,$552.66 ,$743.94 ,$743.94 ,"$3,411.20 ",$690.00 ,$977.50 ,$805.00 ,$552.66 ,"$1,092.50 ",$828.00 ,$839.50 ,$747.50 ,$977.50 ,"$3,411.20 ",$747.50 ,$920.00 ,$839.50 ,$552.66 ,"$3,411.20 ",$483.00 ,"$1,150.00 ",$977.50 ,"$7,675.21 ","$1,058.00 ",$805.00 ,"$1,150.00 ","$1,150.00 ",$700.35 ,"$1,150.00 ",$794.65 ,$805.00 ,"$3,445.31 ",$828.00 ,$585.82 , N/A , N/A ,"$3,411.20 ", N/A ,"$3,411.20 ",$828.00 ,$713.00 ,$828.00 ,$828.00 ,$690.00 ST VINCENT HOSPITAL - ACUTE,98300085,15274,PC APL SKIN SUB TAL>100 ADL 100CM PRO,983,1 ,$275.00 ,$137.50 ,$115.50 ,$585.82 ,$177.65 ,$275.00 ,$177.90 ,$177.90 , N/A ,$165.00 ,$233.75 ,$192.50 ,$552.66 ,$261.25 ,$198.00 ,$200.75 ,$178.75 ,$233.75 , N/A ,$178.75 ,$220.00 ,$200.75 ,$552.66 , N/A ,$115.50 ,$275.00 ,$233.75 , N/A ,$253.00 ,$192.50 ,$275.00 ,$275.00 ,$167.48 ,$275.00 ,$190.03 ,$192.50 , N/A ,$198.00 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$198.00 ,$170.50 ,$198.00 ,$198.00 ,$165.00 ST VINCENT HOSPITAL - ACUTE,98300086,15275,PC APL SKIN SUB OTH<100 INT 25CM PRO,983,1 ,$605.00 ,$302.50 ,$254.10 ,"$3,737.98 ",$390.83 ,$552.66 ,$391.37 ,$391.37 ,"$1,661.33 ",$363.00 ,$514.25 ,$423.50 ,$552.66 ,$574.75 ,$435.60 ,$441.65 ,$393.25 ,$514.25 ,"$1,661.33 ",$393.25 ,$484.00 ,$441.65 ,$552.66 ,"$1,661.33 ",$254.10 ,$605.00 ,$514.25 ,"$3,737.98 ",$556.60 ,$423.50 ,$605.00 ,$605.00 ,$368.45 ,$605.00 ,$418.06 ,$423.50 ,"$1,677.94 ",$435.60 ,$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ",$435.60 ,$375.10 ,$435.60 ,$435.60 ,$363.00 ST VINCENT HOSPITAL - ACUTE,98300087,15275,PC APL SKIN SUB OTH<100 INT 25CM W/PROC PRO,983,1 ,$605.00 ,$302.50 ,$254.10 ,"$3,737.98 ",$390.83 ,$552.66 ,$391.37 ,$391.37 ,"$1,661.33 ",$363.00 ,$514.25 ,$423.50 ,$552.66 ,$574.75 ,$435.60 ,$441.65 ,$393.25 ,$514.25 ,"$1,661.33 ",$393.25 ,$484.00 ,$441.65 ,$552.66 ,"$1,661.33 ",$254.10 ,$605.00 ,$514.25 ,"$3,737.98 ",$556.60 ,$423.50 ,$605.00 ,$605.00 ,$368.45 ,$605.00 ,$418.06 ,$423.50 ,"$1,677.94 ",$435.60 ,$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ",$435.60 ,$375.10 ,$435.60 ,$435.60 ,$363.00 ST VINCENT HOSPITAL - ACUTE,98300088,15276,PC APL SKIN SUB OTH<100 ADL 25CM PRO,983,1 ,$145.00 ,$72.50 ,$60.90 ,$585.82 ,$93.67 ,$145.00 ,$93.80 ,$93.80 , N/A ,$87.00 ,$123.25 ,$101.50 ,$552.66 ,$137.75 ,$104.40 ,$105.85 ,$94.25 ,$123.25 , N/A ,$94.25 ,$116.00 ,$105.85 ,$552.66 , N/A ,$60.90 ,$145.00 ,$123.25 , N/A ,$133.40 ,$101.50 ,$145.00 ,$145.00 ,$88.31 ,$145.00 ,$100.20 ,$101.50 , N/A ,$104.40 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$104.40 ,$89.90 ,$104.40 ,$104.40 ,$87.00 ST VINCENT HOSPITAL - ACUTE,98300089,15277,PC APL SKIN SUB OTH>100 INT 100CM PRO,983,1 ,"$1,150.00 ",$575.00 ,$483.00 ,"$3,737.98 ",$742.90 ,$552.66 ,$743.94 ,$743.94 ,"$1,661.33 ",$690.00 ,$977.50 ,$805.00 ,$552.66 ,"$1,092.50 ",$828.00 ,$839.50 ,$747.50 ,$977.50 ,"$1,661.33 ",$747.50 ,$920.00 ,$839.50 ,$552.66 ,"$1,661.33 ",$483.00 ,"$1,150.00 ",$977.50 ,"$3,737.98 ","$1,058.00 ",$805.00 ,"$1,150.00 ","$1,150.00 ",$700.35 ,"$1,150.00 ",$794.65 ,$805.00 ,"$1,677.94 ",$828.00 ,$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ",$828.00 ,$713.00 ,$828.00 ,$828.00 ,$690.00 ST VINCENT HOSPITAL - ACUTE,98300090,15277,PC APL SKIN SUB OTH>100 INT 100CM W/PROC PRO,983,1 ,"$1,150.00 ",$575.00 ,$483.00 ,"$3,737.98 ",$742.90 ,$552.66 ,$743.94 ,$743.94 ,"$1,661.33 ",$690.00 ,$977.50 ,$805.00 ,$552.66 ,"$1,092.50 ",$828.00 ,$839.50 ,$747.50 ,$977.50 ,"$1,661.33 ",$747.50 ,$920.00 ,$839.50 ,$552.66 ,"$1,661.33 ",$483.00 ,"$1,150.00 ",$977.50 ,"$3,737.98 ","$1,058.00 ",$805.00 ,"$1,150.00 ","$1,150.00 ",$700.35 ,"$1,150.00 ",$794.65 ,$805.00 ,"$1,677.94 ",$828.00 ,$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ",$828.00 ,$713.00 ,$828.00 ,$828.00 ,$690.00 ST VINCENT HOSPITAL - ACUTE,98300091,15278,PC APL SKIN SUB OTH>100 ADL 100CM PRO,983,1 ,$320.00 ,$160.00 ,$134.40 ,$585.82 ,$206.72 ,$320.00 ,$207.01 ,$207.01 , N/A ,$192.00 ,$272.00 ,$224.00 ,$552.66 ,$304.00 ,$230.40 ,$233.60 ,$208.00 ,$272.00 , N/A ,$208.00 ,$256.00 ,$233.60 ,$552.66 , N/A ,$134.40 ,$320.00 ,$272.00 , N/A ,$294.40 ,$224.00 ,$320.00 ,$320.00 ,$194.88 ,$320.00 ,$221.12 ,$224.00 , N/A ,$230.40 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$230.40 ,$198.40 ,$230.40 ,$230.40 ,$192.00 ST VINCENT HOSPITAL - ACUTE,98300092,10140,PC I AND D HEMATOMA/SEROMA/FLUID PRO,983,1 ,$560.00 ,$280.00 ,$235.20 ,"$3,066.03 ",$361.76 ,$325.66 ,$362.26 ,$362.26 ,"$1,362.68 ",$336.00 ,$476.00 ,$392.00 ,$325.66 ,$532.00 ,$403.20 ,$408.80 ,$364.00 ,$476.00 ,"$1,362.68 ",$364.00 ,$448.00 ,$408.80 ,$325.66 ,"$1,362.68 ",$235.20 ,$560.00 ,$476.00 ,"$3,066.03 ",$515.20 ,$392.00 ,$560.00 ,$560.00 ,$341.04 ,$560.00 ,$386.96 ,$392.00 ,"$1,376.31 ",$403.20 ,$345.20 , N/A , N/A ,"$1,362.68 ", N/A ,"$1,362.68 ",$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,98300093,16030,PC BURN DRESS AND /OR DEBRIDE PRO >10%,983,1 ,$520.00 ,$260.00 ,$107.54 ,$753.63 ,$335.92 ,$107.54 ,$336.39 ,$336.39 ,$334.95 ,$312.00 ,$442.00 ,$364.00 ,$107.54 ,$494.00 ,$374.40 ,$379.60 ,$338.00 ,$442.00 ,$334.95 ,$338.00 ,$416.00 ,$379.60 ,$107.54 ,$334.95 ,$218.40 ,$520.00 ,$442.00 ,$753.63 ,$478.40 ,$364.00 ,$520.00 ,$520.00 ,$316.68 ,$520.00 ,$359.32 ,$364.00 ,$338.30 ,$374.40 ,$113.99 , N/A , N/A ,$334.95 , N/A ,$334.95 ,$374.40 ,$322.40 ,$374.40 ,$374.40 ,$312.00 ST VINCENT HOSPITAL - ACUTE,98300094,16025,PC BURN DRESS AND /OR DEBRIDE PRO 5-10%,983,1 ,$475.00 ,$237.50 ,$84.29 ,$475.00 ,$306.85 ,$84.29 ,$307.28 ,$307.28 ,$173.89 ,$285.00 ,$403.75 ,$332.50 ,$84.29 ,$451.25 ,$342.00 ,$346.75 ,$308.75 ,$403.75 ,$173.89 ,$308.75 ,$380.00 ,$346.75 ,$84.29 ,$173.89 ,$199.50 ,$475.00 ,$403.75 ,$391.26 ,$437.00 ,$332.50 ,$475.00 ,$475.00 ,$289.28 ,$475.00 ,$328.23 ,$332.50 ,$175.63 ,$342.00 ,$89.35 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$342.00 ,$294.50 ,$342.00 ,$342.00 ,$285.00 ST VINCENT HOSPITAL - ACUTE,98300095,11057,PC PARING LESN BENIGN >4 PRO,983,1 ,$290.00 ,$145.00 ,$74.70 ,$391.26 ,$187.34 ,$74.70 ,$187.60 ,$187.60 ,$173.89 ,$174.00 ,$246.50 ,$203.00 ,$74.70 ,$275.50 ,$208.80 ,$211.70 ,$188.50 ,$246.50 ,$173.89 ,$188.50 ,$232.00 ,$211.70 ,$74.70 ,$173.89 ,$121.80 ,$290.00 ,$246.50 ,$391.26 ,$266.80 ,$203.00 ,$290.00 ,$290.00 ,$176.61 ,$290.00 ,$200.39 ,$203.00 ,$175.63 ,$208.80 ,$79.18 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$208.80 ,$179.80 ,$208.80 ,$208.80 ,$174.00 ST VINCENT HOSPITAL - ACUTE,98300096,11200,PC REMOVAL SKIN TAG LESIONS <=15 PRO,983,1 ,$240.00 ,$120.00 ,$74.70 ,$391.26 ,$155.04 ,$74.70 ,$155.26 ,$155.26 ,$173.89 ,$144.00 ,$204.00 ,$168.00 ,$74.70 ,$228.00 ,$172.80 ,$175.20 ,$156.00 ,$204.00 ,$173.89 ,$156.00 ,$192.00 ,$175.20 ,$74.70 ,$173.89 ,$100.80 ,$240.00 ,$204.00 ,$391.26 ,$220.80 ,$168.00 ,$240.00 ,$240.00 ,$146.16 ,$240.00 ,$165.84 ,$168.00 ,$175.63 ,$172.80 ,$79.18 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,98300097,29515,PC APPL SHRT LEG SPLNT PRO,983,1 ,$270.00 ,$135.00 ,$21.22 ,$307.65 ,$174.42 ,$21.22 ,$174.66 ,$174.66 ,$136.73 ,$162.00 ,$229.50 ,$189.00 ,$21.22 ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 ,$136.73 ,$175.50 ,$216.00 ,$197.10 ,$21.22 ,$136.73 ,$113.40 ,$270.00 ,$229.50 ,$307.65 ,$248.40 ,$189.00 ,$270.00 ,$270.00 ,$164.43 ,$270.00 ,$186.57 ,$189.00 ,$138.10 ,$194.40 ,$22.49 , N/A , N/A ,$136.73 , N/A ,$136.73 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,98300098,97597,PC AWC/CHEM CAUTERY/CAST PRO,983,1 ,$270.00 ,$135.00 ,$107.54 ,$391.26 ,$174.42 ,$107.54 ,$174.66 ,$174.66 ,$173.89 ,$162.00 ,$229.50 ,$189.00 ,$107.54 ,$256.50 ,$194.40 ,$197.10 ,$175.50 ,$229.50 ,$173.89 ,$175.50 ,$216.00 ,$197.10 ,$107.54 ,$173.89 ,$113.40 ,$270.00 ,$229.50 ,$391.26 ,$248.40 ,$189.00 ,$135.00 ,$162.00 ,$164.43 ,$135.00 ,$186.57 ,$189.00 ,$175.63 ,$194.40 ,$113.99 , N/A , N/A ,$173.89 , N/A ,$173.89 ,$194.40 ,$167.40 ,$194.40 ,$194.40 ,$162.00 ST VINCENT HOSPITAL - ACUTE,98300099,15110,PC EPIDERMAL GRAFT TRNK ARMS LEGS FIRST 100CM PRO,983,1 ,"$3,900.00 ","$1,950.00 ",$552.66 ,"$3,900.00 ","$2,519.40 ",$552.66 ,"$2,522.91 ","$2,522.91 ","$1,661.33 ","$2,340.00 ","$3,315.00 ","$2,730.00 ",$552.66 ,"$3,705.00 ","$2,808.00 ","$2,847.00 ","$2,535.00 ","$3,315.00 ","$1,661.33 ","$2,535.00 ","$3,120.00 ","$2,847.00 ",$552.66 ,"$1,661.33 ","$1,638.00 ","$3,900.00 ","$3,315.00 ","$3,737.98 ","$3,588.00 ","$2,730.00 ","$2,331.31 ","$3,133.44 ","$2,375.10 ","$2,914.14 ","$2,694.90 ","$2,730.00 ","$1,677.94 ","$2,808.00 ",$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ","$2,808.00 ","$2,418.00 ","$2,808.00 ","$2,808.00 ","$2,340.00 " ST VINCENT HOSPITAL - ACUTE,98300100,15111,PC EPIDERMAL GRAFT TRNK ARM LEG EA ADDNT 100CM PRO,983,1 ,$615.00 ,$307.50 ,$258.30 ,$615.00 ,$397.29 ,$552.66 ,$397.84 ,$397.84 , N/A ,$369.00 ,$522.75 ,$430.50 ,$552.66 ,$584.25 ,$442.80 ,$448.95 ,$399.75 ,$522.75 , N/A ,$399.75 ,$492.00 ,$448.95 ,$552.66 , N/A ,$258.30 ,$615.00 ,$522.75 , N/A ,$565.80 ,$430.50 ,$615.00 ,$615.00 ,$374.54 ,$615.00 ,$424.97 ,$430.50 , N/A ,$442.80 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$442.80 ,$381.30 ,$442.80 ,$442.80 ,$369.00 ST VINCENT HOSPITAL - ACUTE,98300101,15115,PC EPIDERMAL GRAFT FACE SCLP HAND ETC FIRST 100CM PRO,983,1 ,"$3,730.00 ","$1,865.00 ",$552.66 ,"$3,737.98 ","$2,409.58 ",$552.66 ,"$2,412.94 ","$2,412.94 ","$1,661.33 ","$2,238.00 ","$3,170.50 ","$2,611.00 ",$552.66 ,"$3,543.50 ","$2,685.60 ","$2,722.90 ","$2,424.50 ","$3,170.50 ","$1,661.33 ","$2,424.50 ","$2,984.00 ","$2,722.90 ",$552.66 ,"$1,661.33 ","$1,566.60 ","$3,730.00 ","$3,170.50 ","$3,737.98 ","$3,431.60 ","$2,611.00 ","$2,331.31 ","$3,133.44 ","$2,271.57 ","$2,914.14 ","$2,577.43 ","$2,611.00 ","$1,677.94 ","$2,685.60 ",$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ","$2,685.60 ","$2,312.60 ","$2,685.60 ","$2,685.60 ","$2,238.00 " ST VINCENT HOSPITAL - ACUTE,98300102,15116,PC EPIDERMAL GRAFT FACE SCLP HAND ETC EA ADD 100CM PRO,983,1 ,$790.00 ,$395.00 ,$331.80 ,$790.00 ,$510.34 ,$552.66 ,$511.05 ,$511.05 , N/A ,$474.00 ,$671.50 ,$553.00 ,$552.66 ,$750.50 ,$568.80 ,$576.70 ,$513.50 ,$671.50 , N/A ,$513.50 ,$632.00 ,$576.70 ,$552.66 , N/A ,$331.80 ,$790.00 ,$671.50 , N/A ,$726.80 ,$553.00 ,$790.00 ,$790.00 ,$481.11 ,$790.00 ,$545.89 ,$553.00 , N/A ,$568.80 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$568.80 ,$489.80 ,$568.80 ,$568.80 ,$474.00 ST VINCENT HOSPITAL - ACUTE,98300103,15110,PC EPIDERMAL GRAFT TRNK ARMS LEGS FIRST 100CM PRO W/PROC,983,1 ,"$3,900.00 ","$1,950.00 ",$552.66 ,"$3,900.00 ","$2,519.40 ",$552.66 ,"$2,522.91 ","$2,522.91 ","$1,661.33 ","$2,340.00 ","$3,315.00 ","$2,730.00 ",$552.66 ,"$3,705.00 ","$2,808.00 ","$2,847.00 ","$2,535.00 ","$3,315.00 ","$1,661.33 ","$2,535.00 ","$3,120.00 ","$2,847.00 ",$552.66 ,"$1,661.33 ","$1,638.00 ","$3,900.00 ","$3,315.00 ","$3,737.98 ","$3,588.00 ","$2,730.00 ","$2,331.31 ","$3,133.44 ","$2,375.10 ","$2,914.14 ","$2,694.90 ","$2,730.00 ","$1,677.94 ","$2,808.00 ",$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ","$2,808.00 ","$2,418.00 ","$2,808.00 ","$2,808.00 ","$2,340.00 " ST VINCENT HOSPITAL - ACUTE,98300104,15115,PC EPIDERMAL GRAFT FACE SCLP HAND ETC FIRST 100CM PRO W/PROC,983,1 ,"$3,730.00 ","$1,865.00 ",$552.66 ,"$3,737.98 ","$2,409.58 ",$552.66 ,"$2,412.94 ","$2,412.94 ","$1,661.33 ","$2,238.00 ","$3,170.50 ","$2,611.00 ",$552.66 ,"$3,543.50 ","$2,685.60 ","$2,722.90 ","$2,424.50 ","$3,170.50 ","$1,661.33 ","$2,424.50 ","$2,984.00 ","$2,722.90 ",$552.66 ,"$1,661.33 ","$1,566.60 ","$3,730.00 ","$3,170.50 ","$3,737.98 ","$3,431.60 ","$2,611.00 ","$2,331.31 ","$3,133.44 ","$2,271.57 ","$2,914.14 ","$2,577.43 ","$2,611.00 ","$1,677.94 ","$2,685.60 ",$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ","$2,685.60 ","$2,312.60 ","$2,685.60 ","$2,685.60 ","$2,238.00 " ST VINCENT HOSPITAL - ACUTE,98300105,96372,PC INJECTION IM/SUBQ PRO,983,1 ,$105.00 ,$52.50 ,$14.00 ,$135.04 ,$67.83 ,$14.00 ,$67.92 ,$67.92 ,$60.02 ,$63.00 ,$89.25 ,$73.50 ,$14.00 ,$99.75 ,$75.60 ,$76.65 ,$68.25 ,$89.25 ,$60.02 ,$68.25 ,$84.00 ,$76.65 ,$14.00 ,$60.02 ,$44.10 ,$105.00 ,$89.25 ,$135.04 ,$96.60 ,$73.50 ,$52.50 ,$63.00 ,$63.95 ,$52.50 ,$72.56 ,$73.50 ,$60.62 ,$75.60 ,$14.84 , N/A , N/A ,$60.02 , N/A ,$60.02 ,$75.60 ,$65.10 ,$75.60 ,$75.60 ,$63.00 ST VINCENT HOSPITAL - ACUTE,98300110,C5271,PC APL SKIN SUB TAL<100 INT 25CM PRO LOW,983,1 ,$560.00 ,$280.00 ,$235.20 ,"$1,142.23 ",$361.76 ,$552.66 ,$362.26 ,$362.26 ,$507.66 ,$336.00 ,$476.00 ,$392.00 ,$552.66 ,$532.00 ,$403.20 ,$408.80 ,$364.00 ,$476.00 ,$507.66 ,$364.00 ,$448.00 ,$408.80 ,$552.66 ,$507.66 ,$235.20 ,$560.00 ,$476.00 ,"$1,142.23 ",$515.20 ,$392.00 ,$280.00 ,$336.00 ,$341.04 ,$280.00 ,$386.96 ,$392.00 ,$512.74 ,$403.20 ,$585.82 , N/A , N/A ,$507.66 , N/A ,$507.66 ,$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,98300111,C5271,PC APL SKIN SUB TAL<100 INT 25CM PRO W/PROC LOW,983,1 ,$560.00 ,$280.00 ,$235.20 ,"$1,142.23 ",$361.76 ,$552.66 ,$362.26 ,$362.26 ,$507.66 ,$336.00 ,$476.00 ,$392.00 ,$552.66 ,$532.00 ,$403.20 ,$408.80 ,$364.00 ,$476.00 ,$507.66 ,$364.00 ,$448.00 ,$408.80 ,$552.66 ,$507.66 ,$235.20 ,$560.00 ,$476.00 ,"$1,142.23 ",$515.20 ,$392.00 ,$280.00 ,$336.00 ,$341.04 ,$280.00 ,$386.96 ,$392.00 ,$512.74 ,$403.20 ,$585.82 , N/A , N/A ,$507.66 , N/A ,$507.66 ,$403.20 ,$347.20 ,$403.20 ,$403.20 ,$336.00 ST VINCENT HOSPITAL - ACUTE,98300112,C5272,PC APL SKIN SUB TAL<100 ADL 25CM PRO LOW,983,1 ,$110.00 ,$55.00 ,$46.20 ,$585.82 ,$71.06 ,$110.00 ,$71.16 ,$71.16 , N/A ,$66.00 ,$93.50 ,$77.00 ,$552.66 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 , N/A ,$71.50 ,$88.00 ,$80.30 ,$552.66 , N/A ,$46.20 ,$110.00 ,$93.50 , N/A ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 , N/A ,$79.20 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,98300113,C5273,PC APL SKIN SUB TAL>100 INT 100CM PRO LOW,983,1 ,"$1,140.00 ",$570.00 ,$478.80 ,"$3,737.98 ",$736.44 ,$552.66 ,$737.47 ,$737.47 ,"$1,661.33 ",$684.00 ,$969.00 ,$798.00 ,$552.66 ,"$1,083.00 ",$820.80 ,$832.20 ,$741.00 ,$969.00 ,"$1,661.33 ",$741.00 ,$912.00 ,$832.20 ,$552.66 ,"$1,661.33 ",$478.80 ,"$1,140.00 ",$969.00 ,"$3,737.98 ","$1,048.80 ",$798.00 ,$570.00 ,$684.00 ,$694.26 ,$570.00 ,$787.74 ,$798.00 ,"$1,677.94 ",$820.80 ,$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ",$820.80 ,$706.80 ,$820.80 ,$820.80 ,$684.00 ST VINCENT HOSPITAL - ACUTE,98300114,C5273,PC APL SKIN SUB TAL>100 INT 100CM W/PROC PRO LOW,983,1 ,"$1,140.00 ",$570.00 ,$478.80 ,"$3,737.98 ",$736.44 ,$552.66 ,$737.47 ,$737.47 ,"$1,661.33 ",$684.00 ,$969.00 ,$798.00 ,$552.66 ,"$1,083.00 ",$820.80 ,$832.20 ,$741.00 ,$969.00 ,"$1,661.33 ",$741.00 ,$912.00 ,$832.20 ,$552.66 ,"$1,661.33 ",$478.80 ,"$1,140.00 ",$969.00 ,"$3,737.98 ","$1,048.80 ",$798.00 ,$570.00 ,$684.00 ,$694.26 ,$570.00 ,$787.74 ,$798.00 ,"$1,677.94 ",$820.80 ,$585.82 , N/A , N/A ,"$1,661.33 ", N/A ,"$1,661.33 ",$820.80 ,$706.80 ,$820.80 ,$820.80 ,$684.00 ST VINCENT HOSPITAL - ACUTE,98300115,C5274,PC APL SKIN SUB TAL>100 ADL 100CM PRO LOW,983,1 ,$280.00 ,$140.00 ,$117.60 ,$585.82 ,$180.88 ,$280.00 ,$181.13 ,$181.13 , N/A ,$168.00 ,$238.00 ,$196.00 ,$552.66 ,$266.00 ,$201.60 ,$204.40 ,$182.00 ,$238.00 , N/A ,$182.00 ,$224.00 ,$204.40 ,$552.66 , N/A ,$117.60 ,$280.00 ,$238.00 , N/A ,$257.60 ,$196.00 ,$140.00 ,$168.00 ,$170.52 ,$140.00 ,$193.48 ,$196.00 , N/A ,$201.60 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$201.60 ,$173.60 ,$201.60 ,$201.60 ,$168.00 ST VINCENT HOSPITAL - ACUTE,98300116,C5275,PC APL SKIN SUB OTH<100 INT 25CM PRO LOW,983,1 ,$605.00 ,$302.50 ,$254.10 ,"$1,142.23 ",$390.83 ,$552.66 ,$391.37 ,$391.37 ,$507.66 ,$363.00 ,$514.25 ,$423.50 ,$552.66 ,$574.75 ,$435.60 ,$441.65 ,$393.25 ,$514.25 ,$507.66 ,$393.25 ,$484.00 ,$441.65 ,$552.66 ,$507.66 ,$254.10 ,$605.00 ,$514.25 ,"$1,142.23 ",$556.60 ,$423.50 ,$302.50 ,$363.00 ,$368.45 ,$302.50 ,$418.06 ,$423.50 ,$512.74 ,$435.60 ,$585.82 , N/A , N/A ,$507.66 , N/A ,$507.66 ,$435.60 ,$375.10 ,$435.60 ,$435.60 ,$363.00 ST VINCENT HOSPITAL - ACUTE,98300117,C5275,PC APL SKIN SUB OTH<100 INT 25CM W/PROC PRO LOW,983,1 ,$605.00 ,$302.50 ,$254.10 ,"$1,142.23 ",$390.83 ,$552.66 ,$391.37 ,$391.37 ,$507.66 ,$363.00 ,$514.25 ,$423.50 ,$552.66 ,$574.75 ,$435.60 ,$441.65 ,$393.25 ,$514.25 ,$507.66 ,$393.25 ,$484.00 ,$441.65 ,$552.66 ,$507.66 ,$254.10 ,$605.00 ,$514.25 ,"$1,142.23 ",$556.60 ,$423.50 ,$302.50 ,$363.00 ,$368.45 ,$302.50 ,$418.06 ,$423.50 ,$512.74 ,$435.60 ,$585.82 , N/A , N/A ,$507.66 , N/A ,$507.66 ,$435.60 ,$375.10 ,$435.60 ,$435.60 ,$363.00 ST VINCENT HOSPITAL - ACUTE,98300118,C5276,PC APL SKIN SUB OTH<100 ADL 25CM PRO LOW,983,1 ,$145.00 ,$72.50 ,$60.90 ,$585.82 ,$93.67 ,$145.00 ,$93.80 ,$93.80 , N/A ,$87.00 ,$123.25 ,$101.50 ,$552.66 ,$137.75 ,$104.40 ,$105.85 ,$94.25 ,$123.25 , N/A ,$94.25 ,$116.00 ,$105.85 ,$552.66 , N/A ,$60.90 ,$145.00 ,$123.25 , N/A ,$133.40 ,$101.50 ,$72.50 ,$87.00 ,$88.31 ,$72.50 ,$100.20 ,$101.50 , N/A ,$104.40 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$104.40 ,$89.90 ,$104.40 ,$104.40 ,$87.00 ST VINCENT HOSPITAL - ACUTE,98300119,C5277,PC APL SKIN SUB OTH>100 INT 100CM PRO LOW,983,1 ,"$1,140.00 ",$570.00 ,$478.80 ,"$1,142.23 ",$736.44 ,$552.66 ,$737.47 ,$737.47 ,$507.66 ,$684.00 ,$969.00 ,$798.00 ,$552.66 ,"$1,083.00 ",$820.80 ,$832.20 ,$741.00 ,$969.00 ,$507.66 ,$741.00 ,$912.00 ,$832.20 ,$552.66 ,$507.66 ,$478.80 ,"$1,140.00 ",$969.00 ,"$1,142.23 ","$1,048.80 ",$798.00 ,$570.00 ,$684.00 ,$694.26 ,$570.00 ,$787.74 ,$798.00 ,$512.74 ,$820.80 ,$585.82 , N/A , N/A ,$507.66 , N/A ,$507.66 ,$820.80 ,$706.80 ,$820.80 ,$820.80 ,$684.00 ST VINCENT HOSPITAL - ACUTE,98300120,C5277,PC APL SKIN SUB OTH>100 INT 100CM W/PROC PRO LOW,983,1 ,"$1,140.00 ",$570.00 ,$478.80 ,"$1,142.23 ",$736.44 ,$552.66 ,$737.47 ,$737.47 ,$507.66 ,$684.00 ,$969.00 ,$798.00 ,$552.66 ,"$1,083.00 ",$820.80 ,$832.20 ,$741.00 ,$969.00 ,$507.66 ,$741.00 ,$912.00 ,$832.20 ,$552.66 ,$507.66 ,$478.80 ,"$1,140.00 ",$969.00 ,"$1,142.23 ","$1,048.80 ",$798.00 ,$570.00 ,$684.00 ,$694.26 ,$570.00 ,$787.74 ,$798.00 ,$512.74 ,$820.80 ,$585.82 , N/A , N/A ,$507.66 , N/A ,$507.66 ,$820.80 ,$706.80 ,$820.80 ,$820.80 ,$684.00 ST VINCENT HOSPITAL - ACUTE,98300121,C5278,PC APL SKIN SUB OTH>100 ADL 100CM PRO LOW,983,1 ,$325.00 ,$162.50 ,$136.50 ,$585.82 ,$209.95 ,$325.00 ,$210.24 ,$210.24 , N/A ,$195.00 ,$276.25 ,$227.50 ,$552.66 ,$308.75 ,$234.00 ,$237.25 ,$211.25 ,$276.25 , N/A ,$211.25 ,$260.00 ,$237.25 ,$552.66 , N/A ,$136.50 ,$325.00 ,$276.25 , N/A ,$299.00 ,$227.50 ,$162.50 ,$195.00 ,$197.93 ,$162.50 ,$224.58 ,$227.50 , N/A ,$234.00 ,$585.82 , N/A , N/A , N/A , N/A , N/A ,$234.00 ,$201.50 ,$234.00 ,$234.00 ,$195.00 ST VINCENT HOSPITAL - ACUTE,98300122,11900,PC INJECT SKIN LESIONS 30MIN,987,1 ,$380.00 ,$190.00 ,$31.68 ,$380.00 ,$245.48 ,$31.68 ,$245.82 ,$245.82 , N/A ,$228.00 ,$323.00 ,$266.00 ,$31.68 ,$361.00 ,$273.60 ,$277.40 ,$247.00 ,$323.00 , N/A ,$247.00 ,$304.00 ,$277.40 ,$31.68 , N/A ,$159.60 ,$380.00 ,$323.00 , N/A ,$349.60 ,$266.00 ,$190.00 ,$228.00 ,$231.42 ,$190.00 ,$262.58 ,$266.00 , N/A ,$273.60 ,$33.58 , N/A , N/A , N/A , N/A , N/A ,$273.60 ,$235.60 ,$273.60 ,$273.60 ,$228.00 ST VINCENT HOSPITAL - ACUTE,98800013,99221,PC INITIAL HOSPITAL CARE LVL 1 LOW 30MIN,987,1 ,$230.00 ,$115.00 ,$47.46 ,$230.00 ,$148.58 ,$47.46 ,$148.79 ,$148.79 , N/A ,$138.00 ,$195.50 ,$161.00 ,$47.46 ,$218.50 ,$165.60 ,$167.90 ,$149.50 ,$195.50 , N/A ,$149.50 ,$184.00 ,$167.90 ,$47.46 , N/A ,$96.60 ,$230.00 ,$195.50 , N/A ,$211.60 ,$161.00 ,$115.00 ,$138.00 ,$140.07 ,$115.00 ,$158.93 ,$161.00 , N/A ,$165.60 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$165.60 ,$142.60 ,$165.60 ,$165.60 ,$138.00 ST VINCENT HOSPITAL - ACUTE,98800015,99222,PC INITIAL HOSPITAL CARE LVL 2 MOD 50MIN,987,1 ,$310.00 ,$155.00 ,$47.46 ,$310.00 ,$200.26 ,$47.46 ,$200.54 ,$200.54 , N/A ,$186.00 ,$263.50 ,$217.00 ,$47.46 ,$294.50 ,$223.20 ,$226.30 ,$201.50 ,$263.50 , N/A ,$201.50 ,$248.00 ,$226.30 ,$47.46 , N/A ,$130.20 ,$310.00 ,$263.50 , N/A ,$285.20 ,$217.00 ,$155.00 ,$186.00 ,$188.79 ,$155.00 ,$214.21 ,$217.00 , N/A ,$223.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$223.20 ,$192.20 ,$223.20 ,$223.20 ,$186.00 ST VINCENT HOSPITAL - ACUTE,98800016,99223,PC INITIAL HOSPITAL CARE LVL 3 HIGH 70MIN,987,1 ,$450.00 ,$225.00 ,$47.46 ,$450.00 ,$290.70 ,$47.46 ,$291.11 ,$291.11 , N/A ,$270.00 ,$382.50 ,$315.00 ,$47.46 ,$427.50 ,$324.00 ,$328.50 ,$292.50 ,$382.50 , N/A ,$292.50 ,$360.00 ,$328.50 ,$47.46 , N/A ,$189.00 ,$450.00 ,$382.50 , N/A ,$414.00 ,$315.00 ,$225.00 ,$270.00 ,$274.05 ,$225.00 ,$310.95 ,$315.00 , N/A ,$324.00 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$324.00 ,$279.00 ,$324.00 ,$324.00 ,$270.00 ST VINCENT HOSPITAL - ACUTE,98800017,99231,PC SUBSQ HOSPITAL CARE LVL 1 LOW 15MIN,987,1 ,$110.00 ,$55.00 ,$46.20 ,$110.00 ,$71.06 ,$47.46 ,$71.16 ,$71.16 , N/A ,$66.00 ,$93.50 ,$77.00 ,$47.46 ,$104.50 ,$79.20 ,$80.30 ,$71.50 ,$93.50 , N/A ,$71.50 ,$88.00 ,$80.30 ,$47.46 , N/A ,$46.20 ,$110.00 ,$93.50 , N/A ,$101.20 ,$77.00 ,$55.00 ,$66.00 ,$66.99 ,$55.00 ,$76.01 ,$77.00 , N/A ,$79.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$79.20 ,$68.20 ,$79.20 ,$79.20 ,$66.00 ST VINCENT HOSPITAL - ACUTE,98800018,99232,PC SUBSQ HOSPITAL CARE LVL 2 MOD 25MIN,987,1 ,$170.00 ,$85.00 ,$47.46 ,$170.00 ,$109.82 ,$47.46 ,$109.97 ,$109.97 , N/A ,$102.00 ,$144.50 ,$119.00 ,$47.46 ,$161.50 ,$122.40 ,$124.10 ,$110.50 ,$144.50 , N/A ,$110.50 ,$136.00 ,$124.10 ,$47.46 , N/A ,$71.40 ,$170.00 ,$144.50 , N/A ,$156.40 ,$119.00 ,$85.00 ,$102.00 ,$103.53 ,$85.00 ,$117.47 ,$119.00 , N/A ,$122.40 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$122.40 ,$105.40 ,$122.40 ,$122.40 ,$102.00 ST VINCENT HOSPITAL - ACUTE,98800019,99233,PC SUBSQ HOSPITAL CARE LVL 3 HIGH 35MIN,987,1 ,$235.00 ,$117.50 ,$47.46 ,$235.00 ,$151.81 ,$47.46 ,$152.02 ,$152.02 , N/A ,$141.00 ,$199.75 ,$164.50 ,$47.46 ,$223.25 ,$169.20 ,$171.55 ,$152.75 ,$199.75 , N/A ,$152.75 ,$188.00 ,$171.55 ,$47.46 , N/A ,$98.70 ,$235.00 ,$199.75 , N/A ,$216.20 ,$164.50 ,$117.50 ,$141.00 ,$143.12 ,$117.50 ,$162.39 ,$164.50 , N/A ,$169.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$169.20 ,$145.70 ,$169.20 ,$169.20 ,$141.00 ST VINCENT HOSPITAL - ACUTE,98800022,99356,PC PROLONG VISIT IP FIRST HR,988,1 ,$240.00 ,$120.00 ,$100.80 ,$240.00 ,$155.04 , N/A ,$155.26 ,$155.26 , N/A ,$144.00 ,$204.00 ,$168.00 , N/A ,$228.00 ,$172.80 ,$175.20 ,$156.00 ,$204.00 , N/A ,$156.00 ,$192.00 ,$175.20 , N/A , N/A ,$100.80 ,$240.00 ,$204.00 , N/A ,$220.80 ,$168.00 ,$120.00 ,$144.00 ,$146.16 ,$120.00 ,$165.84 ,$168.00 , N/A ,$172.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$172.80 ,$148.80 ,$172.80 ,$172.80 ,$144.00 ST VINCENT HOSPITAL - ACUTE,98800023,99357,PC PROLONG VST IP EA ADD 30MI,988,1 ,$120.00 ,$60.00 ,$50.40 ,$120.00 ,$77.52 , N/A ,$77.63 ,$77.63 , N/A ,$72.00 ,$102.00 ,$84.00 , N/A ,$114.00 ,$86.40 ,$87.60 ,$78.00 ,$102.00 , N/A ,$78.00 ,$96.00 ,$87.60 , N/A , N/A ,$50.40 ,$120.00 ,$102.00 , N/A ,$110.40 ,$84.00 ,$60.00 ,$72.00 ,$73.08 ,$60.00 ,$82.92 ,$84.00 , N/A ,$86.40 , N/A , N/A , N/A , N/A , N/A , N/A ,$86.40 ,$74.40 ,$86.40 ,$86.40 ,$72.00 ST VINCENT HOSPITAL - ACUTE,98880000,99251,PC INPATIENT CONSULTATION 1 LIMITED 20MIN,988,1 ,$235.00 ,$117.50 ,$47.46 ,$235.00 ,$151.81 ,$47.46 ,$152.02 ,$152.02 , N/A ,$141.00 ,$199.75 ,$164.50 ,$47.46 ,$223.25 ,$169.20 ,$171.55 ,$152.75 ,$199.75 , N/A ,$152.75 ,$188.00 ,$171.55 ,$47.46 , N/A ,$98.70 ,$235.00 ,$199.75 , N/A ,$216.20 ,$164.50 ,$117.50 ,$141.00 ,$143.12 ,$117.50 ,$162.39 ,$164.50 , N/A ,$169.20 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$169.20 ,$145.70 ,$169.20 ,$169.20 ,$141.00 ST VINCENT HOSPITAL - ACUTE,98880001,99252,PC INPATIENT CONSULTATION 2 LOW 40MIN,988,1 ,$315.00 ,$157.50 ,$47.46 ,$315.00 ,$203.49 ,$47.46 ,$203.77 ,$203.77 , N/A ,$189.00 ,$267.75 ,$220.50 ,$47.46 ,$299.25 ,$226.80 ,$229.95 ,$204.75 ,$267.75 , N/A ,$204.75 ,$252.00 ,$229.95 ,$47.46 , N/A ,$132.30 ,$315.00 ,$267.75 , N/A ,$289.80 ,$220.50 ,$157.50 ,$189.00 ,$191.84 ,$157.50 ,$217.67 ,$220.50 , N/A ,$226.80 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$226.80 ,$195.30 ,$226.80 ,$226.80 ,$189.00 ST VINCENT HOSPITAL - ACUTE,98880002,99253,PC INPATIENT CONSULTATION 3 MOD 55MIN,988,1 ,$395.00 ,$197.50 ,$47.46 ,$395.00 ,$255.17 ,$47.46 ,$255.53 ,$255.53 , N/A ,$237.00 ,$335.75 ,$276.50 ,$47.46 ,$375.25 ,$284.40 ,$288.35 ,$256.75 ,$335.75 , N/A ,$256.75 ,$316.00 ,$288.35 ,$47.46 , N/A ,$165.90 ,$395.00 ,$335.75 , N/A ,$363.40 ,$276.50 ,$197.50 ,$237.00 ,$240.56 ,$197.50 ,$272.95 ,$276.50 , N/A ,$284.40 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$284.40 ,$244.90 ,$284.40 ,$284.40 ,$237.00 ST VINCENT HOSPITAL - ACUTE,98880003,99254,PC INPATIENT CONSULTATION 4 MOD-HIGH 80MIN,988,1 ,$545.00 ,$272.50 ,$47.46 ,$545.00 ,$352.07 ,$47.46 ,$352.56 ,$352.56 , N/A ,$327.00 ,$463.25 ,$381.50 ,$47.46 ,$517.75 ,$392.40 ,$397.85 ,$354.25 ,$463.25 , N/A ,$354.25 ,$436.00 ,$397.85 ,$47.46 , N/A ,$228.90 ,$545.00 ,$463.25 , N/A ,$501.40 ,$381.50 ,$272.50 ,$327.00 ,$331.91 ,$272.50 ,$376.60 ,$381.50 , N/A ,$392.40 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$392.40 ,$337.90 ,$392.40 ,$392.40 ,$327.00 ST VINCENT HOSPITAL - ACUTE,98880004,99255,PC INPATIENT CONSULTATION 5 HIGH 110MIN,988,1 ,$680.00 ,$340.00 ,$47.46 ,$680.00 ,$439.28 ,$47.46 ,$439.89 ,$439.89 , N/A ,$408.00 ,$578.00 ,$476.00 ,$47.46 ,$646.00 ,$489.60 ,$496.40 ,$442.00 ,$578.00 , N/A ,$442.00 ,$544.00 ,$496.40 ,$47.46 , N/A ,$285.60 ,$680.00 ,$578.00 , N/A ,$625.60 ,$476.00 ,$340.00 ,$408.00 ,$414.12 ,$340.00 ,$469.88 ,$476.00 , N/A ,$489.60 ,$50.31 , N/A , N/A , N/A , N/A , N/A ,$489.60 ,$421.60 ,$489.60 ,$489.60 ,$408.00 ST VINCENT HOSPITAL - ACUTE,98880005,G0296,PC CLINIC COUNSELING FOR LOW DOSE LUNG SCREEN,988,1 ,$115.00 ,$57.50 ,$47.46 ,$163.15 ,$74.29 ,$47.46 ,$74.39 ,$74.39 ,$72.51 ,$69.00 ,$97.75 ,$80.50 ,$47.46 ,$109.25 ,$82.80 ,$83.95 ,$74.75 ,$97.75 ,$72.51 ,$74.75 ,$92.00 ,$83.95 ,$47.46 ,$72.51 ,$48.30 ,$115.00 ,$97.75 ,$163.15 ,$105.80 ,$80.50 ,$57.50 ,$69.00 ,$70.04 ,$57.50 ,$79.47 ,$80.50 ,$73.24 ,$82.80 ,$50.31 , N/A , N/A ,$72.51 , N/A ,$72.51 ,$82.80 ,$71.30 ,$82.80 ,$82.80 ,$69.00