HOLY FAMILY HOSPITAL - Price Transparency,,,,,,,,,,,,,,,,,,,,,,,,,,,
Site,Svc_Cd,HCPC/Cpt_Cd,CDM_Svc_Descr,Rev_Cd, Quantity/Units , Hopsital_Cdm_Chg , Self_Pay_Chg , Minimum_Negotiated_Chg , Maximum_Negotiated_Chg , AETNA , AETNA MEDICARE , BCBS OF ILLINOIS PPO , BLUE CROSS BLUE SHIELD OUT OF STATE , CARE IMPROVEMENT PLUS , CIGNA , COFINITY , CONSOCIATE , FIRST HEALTH NETWORK , HEALTH ALLIANCE , HEALTHLINK , HFN PPO , HUMANA , HUMANA MEDICARE ADVANTAGE , MULTIPLAN , NAPHCARE , UNITED HEALTH ALL PAYOR , UNITED HEALTHCARE MEDICARE 
HSHS HOLY FAMILY HOSPITAL INC (ACU),140505,36430,BLOOD ADMINISTRATION OR,391,1 ,$557.00 ,$362.05 ,$272.00 ,$797.24 ,$381.55 ,$370.81 ,$326.40 ,$326.40 ,$378.23 ,$456.74 ,$473.45 ,$501.30 ,$417.75 ,$389.90 ,$412.18 ,$501.30 ,$473.45 ,$370.81 ,$473.45 ,$797.24 ,$272.00 ,$370.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144000,N/A,OR STANDBY PER 60 MINS,360,1 ,$362.00 ,$235.30 ,$212.13 ,$325.80 ,$247.97 , N/A ,$212.13 ,$212.13 , N/A ,$296.84 ,$307.70 ,$325.80 ,$271.50 ,$253.40 ,$267.88 ,$325.80 ,$307.70 , N/A ,$307.70 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144100,N/A,GI INITIAL PROCEDURE,360,1 ,"$2,177.00 ","$1,415.05 ","$1,275.72 ","$1,959.30 ","$1,491.25 ", N/A ,"$1,275.72 ","$1,275.72 ", N/A ,"$1,785.14 ","$1,850.45 ","$1,959.30 ","$1,632.75 ","$1,523.90 ","$1,610.98 ","$1,959.30 ","$1,850.45 ", N/A ,"$1,850.45 ", N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144105,N/A,GI ADDITIONAL PROCEDURE,360,1 ,"$1,307.00 ",$849.55 ,$765.90 ,"$1,176.30 ",$895.30 , N/A ,$765.90 ,$765.90 , N/A ,"$1,071.74 ","$1,110.95 ","$1,176.30 ",$980.25 ,$914.90 ,$967.18 ,"$1,176.30 ","$1,110.95 ", N/A ,"$1,110.95 ", N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144110,N/A,GI INIT SPECIMEN COLL BIOPSY,360,1 ,$391.00 ,$254.15 ,$229.13 ,$351.90 ,$267.84 , N/A ,$229.13 ,$229.13 , N/A ,$320.62 ,$332.35 ,$351.90 ,$293.25 ,$273.70 ,$289.34 ,$351.90 ,$332.35 , N/A ,$332.35 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144115,N/A,GI ADDTL SPECIMEN COLL BIOPSY,360,1 ,$235.00 ,$152.75 ,$137.71 ,$211.50 ,$160.98 , N/A ,$137.71 ,$137.71 , N/A ,$192.70 ,$199.75 ,$211.50 ,$176.25 ,$164.50 ,$173.90 ,$211.50 ,$199.75 , N/A ,$199.75 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144120,N/A,GI INTERVENTION,360,1 ,$235.00 ,$152.75 ,$137.71 ,$211.50 ,$160.98 , N/A ,$137.71 ,$137.71 , N/A ,$192.70 ,$199.75 ,$211.50 ,$176.25 ,$164.50 ,$173.90 ,$211.50 ,$199.75 , N/A ,$199.75 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144200,N/A,OR ORTHO INIT UP TO 15 MINS,360,1 ,"$5,139.00 ","$3,340.35 ","$3,011.45 ","$4,625.10 ","$3,520.22 ", N/A ,"$3,011.45 ","$3,011.45 ", N/A ,"$4,213.98 ","$4,368.15 ","$4,625.10 ","$3,854.25 ","$3,597.30 ","$3,802.86 ","$4,625.10 ","$4,368.15 ", N/A ,"$4,368.15 ", N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144205,N/A,OR ORTHO ADDTL 15 MINS,360,1 ,$685.00 ,$445.25 ,$401.41 ,$616.50 ,$469.23 , N/A ,$401.41 ,$401.41 , N/A ,$561.70 ,$582.25 ,$616.50 ,$513.75 ,$479.50 ,$506.90 ,$616.50 ,$582.25 , N/A ,$582.25 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144210,N/A,OR ORTHO ADDTL PROC MINOR,360,1 ,$858.00 ,$557.70 ,$502.79 ,$772.20 ,$587.73 , N/A ,$502.79 ,$502.79 , N/A ,$703.56 ,$729.30 ,$772.20 ,$643.50 ,$600.60 ,$634.92 ,$772.20 ,$729.30 , N/A ,$729.30 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144300,N/A,OR OBGYN INIT UP TO 15 MINS,360,1 ,"$3,424.00 ","$2,225.60 ","$2,006.46 ","$3,081.60 ","$2,345.44 ", N/A ,"$2,006.46 ","$2,006.46 ", N/A ,"$2,807.68 ","$2,910.40 ","$3,081.60 ","$2,568.00 ","$2,396.80 ","$2,533.76 ","$3,081.60 ","$2,910.40 ", N/A ,"$2,910.40 ", N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144305,N/A,OR OBGYN ADDTL 15 MINS,360,1 ,$572.00 ,$371.80 ,$335.19 ,$514.80 ,$391.82 , N/A ,$335.19 ,$335.19 , N/A ,$469.04 ,$486.20 ,$514.80 ,$429.00 ,$400.40 ,$423.28 ,$514.80 ,$486.20 , N/A ,$486.20 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144310,N/A,OR OBGYN ADDTL PROC MINOR,360,1 ,$858.00 ,$557.70 ,$502.79 ,$772.20 ,$587.73 , N/A ,$502.79 ,$502.79 , N/A ,$703.56 ,$729.30 ,$772.20 ,$643.50 ,$600.60 ,$634.92 ,$772.20 ,$729.30 , N/A ,$729.30 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144400,N/A,OR GEN LEV I INIT UP TO 15 MINS,360,1 ,"$2,571.00 ","$1,671.15 ","$1,506.61 ","$2,313.90 ","$1,761.14 ", N/A ,"$1,506.61 ","$1,506.61 ", N/A ,"$2,108.22 ","$2,185.35 ","$2,313.90 ","$1,928.25 ","$1,799.70 ","$1,902.54 ","$2,313.90 ","$2,185.35 ", N/A ,"$2,185.35 ", N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144405,N/A,OR GEN LEV I ADDTL 15 MINS,360,1 ,$472.00 ,$306.80 ,$276.59 ,$424.80 ,$323.32 , N/A ,$276.59 ,$276.59 , N/A ,$387.04 ,$401.20 ,$424.80 ,$354.00 ,$330.40 ,$349.28 ,$424.80 ,$401.20 , N/A ,$401.20 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144410,N/A,OR GEN LEV II INIT UP TO 15 MINS,360,1 ,"$4,284.00 ","$2,784.60 ","$2,510.42 ","$3,855.60 ","$2,934.54 ", N/A ,"$2,510.42 ","$2,510.42 ", N/A ,"$3,512.88 ","$3,641.40 ","$3,855.60 ","$3,213.00 ","$2,998.80 ","$3,170.16 ","$3,855.60 ","$3,641.40 ", N/A ,"$3,641.40 ", N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144415,N/A,OR GEN LEV II ADDTL 15 MINS,360,1 ,$572.00 ,$371.80 ,$335.19 ,$514.80 ,$391.82 , N/A ,$335.19 ,$335.19 , N/A ,$469.04 ,$486.20 ,$514.80 ,$429.00 ,$400.40 ,$423.28 ,$514.80 ,$486.20 , N/A ,$486.20 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144420,N/A,OR GEN LEV III INIT UP TO 15 MINS,360,1 ,"$5,996.00 ","$3,897.40 ","$3,513.66 ","$5,396.40 ","$4,107.26 ", N/A ,"$3,513.66 ","$3,513.66 ", N/A ,"$4,916.72 ","$5,096.60 ","$5,396.40 ","$4,497.00 ","$4,197.20 ","$4,437.04 ","$5,396.40 ","$5,096.60 ", N/A ,"$5,096.60 ", N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144425,N/A,OR GEN LEV III ADDTL 15 MINS,360,1 ,$685.00 ,$445.25 ,$401.41 ,$616.50 ,$469.23 , N/A ,$401.41 ,$401.41 , N/A ,$561.70 ,$582.25 ,$616.50 ,$513.75 ,$479.50 ,$506.90 ,$616.50 ,$582.25 , N/A ,$582.25 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144430,N/A,OR GEN ADDTL PROC MINOR,360,1 ,$858.00 ,$557.70 ,$502.79 ,$772.20 ,$587.73 , N/A ,$502.79 ,$502.79 , N/A ,$703.56 ,$729.30 ,$772.20 ,$643.50 ,$600.60 ,$634.92 ,$772.20 ,$729.30 , N/A ,$729.30 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144600,N/A,EYE INITIAL PROCEDURE,360,1 ,"$4,202.00 ","$2,731.30 ","$2,462.37 ","$3,781.80 ","$2,878.37 ", N/A ,"$2,462.37 ","$2,462.37 ", N/A ,"$3,445.64 ","$3,571.70 ","$3,781.80 ","$3,151.50 ","$2,941.40 ","$3,109.48 ","$3,781.80 ","$3,571.70 ", N/A ,"$3,571.70 ", N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144605,N/A,EYE ADDTL 15 MINS,360,1 ,$560.00 ,$364.00 ,$328.16 ,$504.00 ,$383.60 , N/A ,$328.16 ,$328.16 , N/A ,$459.20 ,$476.00 ,$504.00 ,$420.00 ,$392.00 ,$414.40 ,$504.00 ,$476.00 , N/A ,$476.00 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),144610,N/A,EYE ADDITIONAL PROCEDURE,360,1 ,"$1,282.00 ",$833.30 ,$751.25 ,"$1,153.80 ",$878.17 , N/A ,$751.25 ,$751.25 , N/A ,"$1,051.24 ","$1,089.70 ","$1,153.80 ",$961.50 ,$897.40 ,$948.68 ,"$1,153.80 ","$1,089.70 ", N/A ,"$1,089.70 ", N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),145000,N/A,RECOVERY INITIAL 15 MINS,710,1 ,$393.00 ,$255.45 ,$207.50 ,$353.70 ,$269.21 , N/A ,$230.30 ,$230.30 , N/A ,$322.26 ,$334.05 ,$353.70 ,$294.75 ,$275.10 ,$290.82 ,$353.70 ,$334.05 , N/A ,$334.05 , N/A ,$207.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),145005,N/A,RECOVERY ADDITIONAL 15 MINS,710,1 ,$393.00 ,$255.45 ,$207.50 ,$353.70 ,$269.21 , N/A ,$230.30 ,$230.30 , N/A ,$322.26 ,$334.05 ,$353.70 ,$294.75 ,$275.10 ,$290.82 ,$353.70 ,$334.05 , N/A ,$334.05 , N/A ,$207.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),145010,N/A,PHASE 2 RECOVERY INIT 15 MINS,710,1 ,$198.00 ,$128.70 ,$104.54 ,$178.20 ,$135.63 , N/A ,$116.03 ,$116.03 , N/A ,$162.36 ,$168.30 ,$178.20 ,$148.50 ,$138.60 ,$146.52 ,$178.20 ,$168.30 , N/A ,$168.30 , N/A ,$104.54 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),145015,N/A,PHASE 2 RECOVERY ADDTL 15 MINS,710,1 ,$98.00 ,$63.70 ,$51.74 ,$88.20 ,$67.13 , N/A ,$57.43 ,$57.43 , N/A ,$80.36 ,$83.30 ,$88.20 ,$73.50 ,$68.60 ,$72.52 ,$88.20 ,$83.30 , N/A ,$83.30 , N/A ,$51.74 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),146000,N/A,OR PRE OP CARE,360,1 ,$98.00 ,$63.70 ,$57.43 ,$88.20 ,$67.13 , N/A ,$57.43 ,$57.43 , N/A ,$80.36 ,$83.30 ,$88.20 ,$73.50 ,$68.60 ,$72.52 ,$88.20 ,$83.30 , N/A ,$83.30 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),147100,N/A,ANESTH LEVEL I GENERAL MAC BLOCK,370,1 ,$60.00 ,$39.00 ,$31.68 ,$54.00 ,$41.10 , N/A ,$35.16 ,$35.16 , N/A ,$49.20 ,$51.00 ,$54.00 ,$45.00 ,$42.00 ,$44.40 ,$54.00 ,$51.00 , N/A ,$51.00 , N/A ,$31.68 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),147200,N/A,ANESTH LEVEL II EPIDURAL SPINAL,370,1 ,$100.00 ,$65.00 ,$52.80 ,$90.00 ,$68.50 , N/A ,$58.60 ,$58.60 , N/A ,$82.00 ,$85.00 ,$90.00 ,$75.00 ,$70.00 ,$74.00 ,$90.00 ,$85.00 , N/A ,$85.00 , N/A ,$52.80 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),147300,N/A,ANESTH LEVEL III LOCAL IV SED,370,1 ,$150.00 ,$97.50 ,$79.20 ,$135.00 ,$102.75 , N/A ,$87.90 ,$87.90 , N/A ,$123.00 ,$127.50 ,$135.00 ,$112.50 ,$105.00 ,$111.00 ,$135.00 ,$127.50 , N/A ,$127.50 , N/A ,$79.20 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168000,1520,ANESTH-PROC ON VEINS OF LOWER LEG,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168004,36410,ANESTH-VENIPUNCTURE OVER 3 YRS,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168006,164,ANESTH-BIOPSY SOFT TISSUE,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168033,1710,"ANESTH-PROC ON NERVES MUSCLES, TENDONS,",964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168106,1830,ANESTH-OPEN OR SURGICAL ARTHROSCOPIC/END,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168113,142,ANESTH-PROC LENS SURGERY,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168117,300,ANESTH-PROC NECK PROCEDURES,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168118,320,"ANESTH-ESOPH,THYROID,LARYNX,TRAC",964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168121,404,ANESTH-PROC RAD OR MOD BREAST SURG,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168124,520,"ANESTH-CLOSED CHEST PROC(BRON,PAC)",964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168127,732,ANESTH-UPPER GI ENDOSCOPY,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168129,752,ANESTH-LUMBAR & VENTRAL (INCIS),964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168131,790,ANESTH-INTRAPERITONEAL-UPPER ABD,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168132,800,ANESTH-LOWER ANT ABD WALL,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168135,811,ANESTH-INTEST ENDOSCOPIC PROC,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168136,830,"ANESTH-PROC HERNIA REPAIRS, LOWER ABD",964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168137,832,ANESTH-VENTRAL & INCIS HERNIAS,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168138,840,ANESTH-INTRAPERITONEAL-LOWER ABD,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168143,902,ANESTH-ANORECTAL PROCEDURE,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168144,910,ANESTH-PROC T.U.R. (INC. CYSTOS),964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168145,912,ANESTH-T.U.R. BLADDER TUMORS,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168148,920,ANESTH-PROC MALE EXT GENITALIA,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168152,940,ANESTH-PROC VAGINAL + BIOP,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168154,944,ANESTH-VAGINAL HYSTERECTOMY,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168155,1960,ANESTH-VAGINAL DELIVERY,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168156,1200,ANESTH-CLOSED PROC HIP JOINT,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168163,1462,"ANESTH-CLOSED PROC L.LEG,ANKLE",964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168165,1620,ANESTH-PROC CLOSED HUMERUS AC JOINT,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168168,1810,"ANESTH-PROC NERVES,MUSCLE,TENDON FOREARM",964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168181,36589,ANESTH-REMOVAL CENTRAL LINE,964,1 ,$492.00 ,$319.80 ,$288.31 ,"$1,295.41 ",$337.02 ,$602.52 ,$288.31 ,$288.31 ,$614.57 ,$403.44 ,$418.20 ,$442.80 ,$369.00 ,$344.40 ,$364.08 ,$442.80 ,$418.20 ,$602.52 ,$418.20 ,"$1,295.41 ", N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168182,1480,ANESTH-ORIF ANKLE,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168186,1968,ANESTH-CONT EPIDURAL FOR LABOR/C-SECTION,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168187,1967,ANESTH-CONT EPIDURAL FOR LABOR/VAGINALDE,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168190,1250,ANESTH-UPPER LEG SURGERY,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168192,952,ANESTH-HYSTEROSCOPY,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),168193,400,ANESTH-INTEGUMENTARY SYSTEM,964,1 ,$88.00 ,$57.20 ,$51.57 ,$79.20 ,$60.28 , N/A ,$51.57 ,$51.57 , N/A ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 , N/A ,$74.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),175000,90792,INITIAL PSYCHIATRIC EVAL,987,1 ,$431.00 ,$280.15 ,$125.53 ,$387.90 ,$295.24 ,$125.53 ,$252.57 ,$252.57 ,$128.04 ,$353.42 ,$366.35 ,$387.90 ,$323.25 ,$301.70 ,$318.94 ,$387.90 ,$366.35 ,$125.53 ,$366.35 ,$269.88 , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),175001,99232,"VISIT, MODERATE COMPLEXITY",987,1 ,$169.00 ,$109.85 ,$99.03 ,$152.10 ,$115.77 , N/A ,$99.03 ,$99.03 , N/A ,$138.58 ,$143.65 ,$152.10 ,$126.75 ,$118.30 ,$125.06 ,$152.10 ,$143.65 , N/A ,$143.65 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),175002,99233,"VISIT, HIGH COMPLEXITY",987,1 ,$313.00 ,$203.45 ,$183.42 ,$281.70 ,$214.41 , N/A ,$183.42 ,$183.42 , N/A ,$256.66 ,$266.05 ,$281.70 ,$234.75 ,$219.10 ,$231.62 ,$281.70 ,$266.05 , N/A ,$266.05 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),175004,99238,"DISCHARGE, 30 MINUTES OR LESS",987,1 ,$218.00 ,$141.70 ,$127.75 ,$196.20 ,$149.33 , N/A ,$127.75 ,$127.75 , N/A ,$178.76 ,$185.30 ,$196.20 ,$163.50 ,$152.60 ,$161.32 ,$196.20 ,$185.30 , N/A ,$185.30 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),200505,36430,BLOOD ADMINISTRATION OB,391,1 ,$557.00 ,$362.05 ,$272.00 ,$797.24 ,$381.55 ,$370.81 ,$326.40 ,$326.40 ,$378.23 ,$456.74 ,$473.45 ,$501.30 ,$417.75 ,$389.90 ,$412.18 ,$501.30 ,$473.45 ,$370.81 ,$473.45 ,$797.24 ,$272.00 ,$370.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),210802,N/A,LABOR HOUR-LEVEL II,721,1 ,"$1,337.50 ",$869.38 ,$783.78 ,"$1,230.00 ",$916.19 , N/A ,$783.78 ,$783.78 , N/A ,"$1,096.75 ","$1,136.88 ","$1,203.75 ","$1,003.13 ",$936.25 ,$989.75 ,"$1,203.75 ","$1,136.88 ", N/A ,"$1,136.88 ", N/A ,"$1,230.00 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),210803,N/A,LABOR HOUR-LEVEL III,721,1 ,"$2,227.74 ","$1,448.03 ","$1,230.00 ","$2,004.97 ","$1,526.00 ", N/A ,"$1,305.46 ","$1,305.46 ", N/A ,"$1,826.75 ","$1,893.58 ","$2,004.97 ","$1,670.81 ","$1,559.42 ","$1,648.53 ","$2,004.97 ","$1,893.58 ", N/A ,"$1,893.58 ", N/A ,"$1,230.00 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),210804,N/A,DELIVERY CHARGE-LEVEL I,722,1 ,$446.19 ,$290.02 ,$261.47 ,$446.19 ,$305.64 , N/A ,$261.47 ,$261.47 , N/A ,$365.88 ,$379.26 ,$401.57 ,$334.64 ,$312.33 ,$330.18 ,$401.57 ,$379.26 , N/A ,$379.26 , N/A ,$446.19 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),210805,G0379,OB OBSERVATION 1ST HOUR,762,1 ,$276.10 ,$179.47 ,$161.79 ,$276.10 ,$189.13 , N/A ,$161.79 ,$161.79 , N/A ,$226.40 ,$234.69 ,$248.49 ,$207.08 ,$193.27 ,$204.31 ,$248.49 ,$234.69 , N/A ,$234.69 , N/A ,$276.10 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),210806,G0378,OB OBSERVATION-ADDTL HR,762,1 ,$27.50 ,$17.88 ,$16.12 ,$27.50 ,$18.84 , N/A ,$16.12 ,$16.12 , N/A ,$22.55 ,$23.38 ,$24.75 ,$20.63 ,$19.25 ,$20.35 ,$24.75 ,$23.38 , N/A ,$23.38 , N/A ,$27.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),210809,59025,NST,729,1 ,$499.00 ,$324.35 ,$158.68 ,$499.00 ,$341.82 ,$158.68 ,$292.41 ,$292.41 ,$161.85 ,$409.18 ,$424.15 ,$449.10 ,$374.25 ,$349.30 ,$369.26 ,$449.10 ,$424.15 ,$158.68 ,$424.15 ,$341.16 ,$499.00 ,$158.68 
HSHS HOLY FAMILY HOSPITAL INC (ACU),220606,54150,CIRCUMCISION,723,1 ,$425.86 ,$276.81 ,$224.85 ,"$3,639.72 ",$291.71 ,"$1,692.89 ",$249.55 ,$249.55 ,"$1,726.75 ",$349.21 ,$361.98 ,$383.27 ,$319.40 ,$298.10 ,$315.14 ,$383.27 ,$361.98 ,"$1,692.89 ",$361.98 ,"$3,639.72 ",$224.85 ,"$1,692.89 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),220607,96900,PHOTOTHERAPY PER DAY,231,1 ,$144.00 ,$93.60 ,$31.95 ,$129.60 ,$98.64 ,$31.95 ,$84.38 ,$84.38 ,$32.58 ,$118.08 ,$122.40 ,$129.60 ,$108.00 ,$100.80 ,$106.56 ,$129.60 ,$122.40 ,$31.95 ,$122.40 ,$68.68 ,$76.03 ,$31.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),300002,N/A,OM UA DIPSTICK ONLY,300,1 ,$51.00 ,$33.15 ,$29.89 ,$51.00 ,$34.94 , N/A ,$29.89 ,$29.89 , N/A ,$41.82 ,$43.35 ,$45.90 ,$38.25 ,$35.70 ,$37.74 ,$45.90 ,$43.35 , N/A ,$43.35 , N/A ,$51.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),300014,80307,OM DRUG SCREEN 13 HFG,300,1 ,$46.00 ,$29.90 ,$26.96 ,$98.90 ,$31.51 ,$46.00 ,$26.96 ,$26.96 ,$46.92 ,$37.72 ,$39.10 ,$41.40 ,$34.50 ,$32.20 ,$34.04 ,$41.40 ,$39.10 ,$46.00 ,$39.10 ,$98.90 ,$46.00 ,$46.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),304010,81050,TOTAL URINE VOL MEASURMENT,300,1 ,$37.25 ,$24.21 ,$3.64 ,$37.25 ,$25.52 ,$3.64 ,$21.83 ,$21.83 ,$3.71 ,$30.55 ,$31.66 ,$33.53 ,$27.94 ,$26.08 ,$27.57 ,$33.53 ,$31.66 ,$3.64 ,$31.66 ,$7.83 ,$37.25 ,$3.64 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305002,85730,PTT,300,1 ,$138.00 ,$89.70 ,$6.01 ,$124.20 ,$94.53 ,$6.01 ,$80.87 ,$80.87 ,$6.13 ,$113.16 ,$117.30 ,$124.20 ,$103.50 ,$96.60 ,$102.12 ,$124.20 ,$117.30 ,$6.01 ,$117.30 ,$12.92 ,$56.00 ,$6.01 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305004,N/A,SPECIAL HANDLING,300,1 ,$78.00 ,$50.70 ,$45.71 ,$70.20 ,$53.43 , N/A ,$45.71 ,$45.71 , N/A ,$63.96 ,$66.30 ,$70.20 ,$58.50 ,$54.60 ,$57.72 ,$70.20 ,$66.30 , N/A ,$66.30 , N/A ,$56.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305005,84155,CSF PROTEIN,300,1 ,$168.45 ,$109.49 ,$3.67 ,$151.61 ,$115.39 ,$3.67 ,$98.71 ,$98.71 ,$3.74 ,$138.13 ,$143.18 ,$151.61 ,$126.34 ,$117.92 ,$124.65 ,$151.61 ,$143.18 ,$3.67 ,$143.18 ,$7.89 ,$56.00 ,$3.67 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305007,86703,HIV I AND II SCREEN,300,1 ,$148.35 ,$96.43 ,$13.71 ,$133.52 ,$101.62 ,$13.71 ,$86.93 ,$86.93 ,$13.98 ,$121.65 ,$126.10 ,$133.52 ,$111.26 ,$103.85 ,$109.78 ,$133.52 ,$126.10 ,$13.71 ,$126.10 ,$29.48 ,$56.00 ,$13.71 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305009,84439,T4 FREE  FREE THYROXIN,300,1 ,$167.39 ,$108.80 ,$9.02 ,$150.65 ,$114.66 ,$9.02 ,$98.09 ,$98.09 ,$9.20 ,$137.26 ,$142.28 ,$150.65 ,$125.54 ,$117.17 ,$123.87 ,$150.65 ,$142.28 ,$9.02 ,$142.28 ,$19.39 ,$56.00 ,$9.02 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305010,85027,CBC WITHOUT DIFFERENTIAL,300,1 ,$96.00 ,$62.40 ,$6.47 ,$86.40 ,$65.76 ,$6.47 ,$56.26 ,$56.26 ,$6.60 ,$78.72 ,$81.60 ,$86.40 ,$72.00 ,$67.20 ,$71.04 ,$86.40 ,$81.60 ,$6.47 ,$81.60 ,$13.91 ,$56.00 ,$6.47 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305011,85025,CBC,300,1 ,$127.00 ,$82.55 ,$7.77 ,$114.30 ,$87.00 ,$7.77 ,$74.42 ,$74.42 ,$7.93 ,$104.14 ,$107.95 ,$114.30 ,$95.25 ,$88.90 ,$93.98 ,$114.30 ,$107.95 ,$7.77 ,$107.95 ,$16.71 ,$56.00 ,$7.77 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305012,87804,.INFLUENZA A,300,1 ,$142.60 ,$92.69 ,$16.55 ,$128.34 ,$97.68 ,$16.55 ,$83.56 ,$83.56 ,$16.88 ,$116.93 ,$121.21 ,$128.34 ,$106.95 ,$99.82 ,$105.52 ,$128.34 ,$121.21 ,$16.55 ,$121.21 ,$35.58 ,$56.00 ,$16.55 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305016,85652,SED RATE AUTOMATED,300,1 ,$75.00 ,$48.75 ,$2.70 ,$67.50 ,$51.38 ,$2.70 ,$43.95 ,$43.95 ,$2.75 ,$61.50 ,$63.75 ,$67.50 ,$56.25 ,$52.50 ,$55.50 ,$67.50 ,$63.75 ,$2.70 ,$63.75 ,$5.81 ,$56.00 ,$2.70 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305017,85014,HEMATOCRIT,300,1 ,$44.00 ,$28.60 ,$2.37 ,$44.00 ,$30.14 ,$2.37 ,$25.78 ,$25.78 ,$2.42 ,$36.08 ,$37.40 ,$39.60 ,$33.00 ,$30.80 ,$32.56 ,$39.60 ,$37.40 ,$2.37 ,$37.40 ,$5.10 ,$44.00 ,$2.37 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305019,85018,HEMOGLOBIN,300,1 ,$44.00 ,$28.60 ,$2.37 ,$44.00 ,$30.14 ,$2.37 ,$25.78 ,$25.78 ,$2.42 ,$36.08 ,$37.40 ,$39.60 ,$33.00 ,$30.80 ,$32.56 ,$39.60 ,$37.40 ,$2.37 ,$37.40 ,$5.10 ,$44.00 ,$2.37 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305024,80202,VANCOMYCIN TR,300,1 ,$193.00 ,$125.45 ,$13.54 ,$173.70 ,$132.21 ,$13.54 ,$113.10 ,$113.10 ,$13.81 ,$158.26 ,$164.05 ,$173.70 ,$144.75 ,$135.10 ,$142.82 ,$173.70 ,$164.05 ,$13.54 ,$164.05 ,$29.11 ,$56.00 ,$13.54 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305025,85049,PLATELET COUNT,300,1 ,$57.00 ,$37.05 ,$4.48 ,$56.00 ,$39.05 ,$4.48 ,$33.40 ,$33.40 ,$4.57 ,$46.74 ,$48.45 ,$51.30 ,$42.75 ,$39.90 ,$42.18 ,$51.30 ,$48.45 ,$4.48 ,$48.45 ,$9.63 ,$56.00 ,$4.48 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305026,80170,.GENTAMICIN TROUGH,300,1 ,$191.00 ,$124.15 ,$16.38 ,$171.90 ,$130.84 ,$16.38 ,$111.93 ,$111.93 ,$16.71 ,$156.62 ,$162.35 ,$171.90 ,$143.25 ,$133.70 ,$141.34 ,$171.90 ,$162.35 ,$16.38 ,$162.35 ,$35.22 ,$56.00 ,$16.38 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305027,85610,PROTIME (INR),300,1 ,$84.00 ,$54.60 ,$4.29 ,$75.60 ,$57.54 ,$4.29 ,$49.22 ,$49.22 ,$4.38 ,$68.88 ,$71.40 ,$75.60 ,$63.00 ,$58.80 ,$62.16 ,$75.60 ,$71.40 ,$4.29 ,$71.40 ,$9.22 ,$56.00 ,$4.29 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305035,85007,DIFFERENTIAL COUNT MANUAL,300,1 ,$58.00 ,$37.70 ,$3.80 ,$56.00 ,$39.73 ,$3.80 ,$33.99 ,$33.99 ,$3.88 ,$47.56 ,$49.30 ,$52.20 ,$43.50 ,$40.60 ,$42.92 ,$52.20 ,$49.30 ,$3.80 ,$49.30 ,$8.17 ,$56.00 ,$3.80 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305036,85048,WBC WHITE BLOOD COUNT,300,1 ,$75.00 ,$48.75 ,$2.54 ,$67.50 ,$51.38 ,$2.54 ,$43.95 ,$43.95 ,$2.59 ,$61.50 ,$63.75 ,$67.50 ,$56.25 ,$52.50 ,$55.50 ,$67.50 ,$63.75 ,$2.54 ,$63.75 ,$5.46 ,$56.00 ,$2.54 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305044,84300,SODIUM URINE  RANDOM,300,1 ,$68.43 ,$44.48 ,$5.06 ,$61.59 ,$46.87 ,$5.06 ,$40.10 ,$40.10 ,$5.16 ,$56.11 ,$58.17 ,$61.59 ,$51.32 ,$47.90 ,$50.64 ,$61.59 ,$58.17 ,$5.06 ,$58.17 ,$10.88 ,$56.00 ,$5.06 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305045,84133,POTASSIUM URINE RANDOM,300,1 ,$168.45 ,$109.49 ,$4.73 ,$151.61 ,$115.39 ,$4.73 ,$98.71 ,$98.71 ,$4.82 ,$138.13 ,$143.18 ,$151.61 ,$126.34 ,$117.92 ,$124.65 ,$151.61 ,$143.18 ,$4.73 ,$143.18 ,$10.17 ,$56.00 ,$4.73 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305098,87493,STOOL C DIFF MOLECULAR,300,1 ,$282.90 ,$183.89 ,$37.27 ,$254.61 ,$193.79 ,$37.27 ,$165.78 ,$165.78 ,$38.02 ,$231.98 ,$240.47 ,$254.61 ,$212.18 ,$198.03 ,$209.35 ,$254.61 ,$240.47 ,$37.27 ,$240.47 ,$80.13 ,$56.00 ,$37.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305103,82040,ALBUMIN SERUM,300,1 ,$72.64 ,$47.22 ,$4.95 ,$65.38 ,$49.76 ,$4.95 ,$42.57 ,$42.57 ,$5.05 ,$59.56 ,$61.74 ,$65.38 ,$54.48 ,$50.85 ,$53.75 ,$65.38 ,$61.74 ,$4.95 ,$61.74 ,$10.64 ,$56.00 ,$4.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305105,84075,ALKALINE PHOSPHATASE,300,1 ,$73.69 ,$47.90 ,$5.18 ,$66.32 ,$50.48 ,$5.18 ,$43.18 ,$43.18 ,$5.28 ,$60.43 ,$62.64 ,$66.32 ,$55.27 ,$51.58 ,$54.53 ,$66.32 ,$62.64 ,$5.18 ,$62.64 ,$11.14 ,$56.00 ,$5.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305109,82150,AMYLASE SERUM,300,1 ,$127.39 ,$82.80 ,$6.48 ,$114.65 ,$87.26 ,$6.48 ,$74.65 ,$74.65 ,$6.61 ,$104.46 ,$108.28 ,$114.65 ,$95.54 ,$89.17 ,$94.27 ,$114.65 ,$108.28 ,$6.48 ,$108.28 ,$13.93 ,$56.00 ,$6.48 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305114,82248,BILIRUBIN  DIRECT,300,1 ,$84.22 ,$54.74 ,$5.02 ,$75.80 ,$57.69 ,$5.02 ,$49.35 ,$49.35 ,$5.12 ,$69.06 ,$71.59 ,$75.80 ,$63.17 ,$58.95 ,$62.32 ,$75.80 ,$71.59 ,$5.02 ,$71.59 ,$10.79 ,$56.00 ,$5.02 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305115,82247,BILIRUBIN TOTAL,300,1 ,$74.75 ,$48.59 ,$5.02 ,$67.28 ,$51.20 ,$5.02 ,$43.80 ,$43.80 ,$5.12 ,$61.30 ,$63.54 ,$67.28 ,$56.06 ,$52.33 ,$55.32 ,$67.28 ,$63.54 ,$5.02 ,$63.54 ,$10.79 ,$56.00 ,$5.02 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305119,82310,CALCIUM,300,1 ,$94.75 ,$61.59 ,$5.16 ,$85.28 ,$64.90 ,$5.16 ,$55.52 ,$55.52 ,$5.26 ,$77.70 ,$80.54 ,$85.28 ,$71.06 ,$66.33 ,$70.12 ,$85.28 ,$80.54 ,$5.16 ,$80.54 ,$11.09 ,$56.00 ,$5.16 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305120,82803,ABG ANALYSIS,300,1 ,$348.47 ,$226.51 ,$26.07 ,$313.62 ,$238.70 ,$26.07 ,$204.20 ,$204.20 ,$26.59 ,$285.75 ,$296.20 ,$313.62 ,$261.35 ,$243.93 ,$257.87 ,$313.62 ,$296.20 ,$26.07 ,$296.20 ,$56.05 ,$56.00 ,$26.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305122,87420,RSV-NASAL SWAB,300,1 ,$340.35 ,$221.23 ,$13.91 ,$306.32 ,$233.14 ,$13.91 ,$199.45 ,$199.45 ,$14.19 ,$279.09 ,$289.30 ,$306.32 ,$255.26 ,$238.25 ,$251.86 ,$306.32 ,$289.30 ,$13.91 ,$289.30 ,$29.91 ,$56.00 ,$13.91 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305124,82375,CARBOXYHEMOGLOBIN,300,1 ,$165.29 ,$107.44 ,$12.32 ,$148.76 ,$113.22 ,$12.32 ,$96.86 ,$96.86 ,$12.57 ,$135.54 ,$140.50 ,$148.76 ,$123.97 ,$115.70 ,$122.31 ,$148.76 ,$140.50 ,$12.32 ,$140.50 ,$26.49 ,$56.00 ,$12.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305129,82550,CK TOTAL,300,1 ,$127.39 ,$82.80 ,$6.51 ,$114.65 ,$87.26 ,$6.51 ,$74.65 ,$74.65 ,$6.64 ,$104.46 ,$108.28 ,$114.65 ,$95.54 ,$89.17 ,$94.27 ,$114.65 ,$108.28 ,$6.51 ,$108.28 ,$14.00 ,$56.00 ,$6.51 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305133,82565,CREATININE BLOOD,300,1 ,$76.85 ,$49.95 ,$5.12 ,$69.17 ,$52.64 ,$5.12 ,$45.03 ,$45.03 ,$5.22 ,$63.02 ,$65.32 ,$69.17 ,$57.64 ,$53.80 ,$56.87 ,$69.17 ,$65.32 ,$5.12 ,$65.32 ,$11.01 ,$56.00 ,$5.12 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305134,85378,D DIMER  QUANT,300,1 ,$235.00 ,$152.75 ,$9.72 ,$211.50 ,$160.98 ,$9.72 ,$137.71 ,$137.71 ,$9.91 ,$192.70 ,$199.75 ,$211.50 ,$176.25 ,$164.50 ,$173.90 ,$211.50 ,$199.75 ,$9.72 ,$199.75 ,$20.90 ,$56.00 ,$9.72 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305135,80051,ELECTROLYTE PANEL,300,1 ,$201.61 ,$131.05 ,$7.01 ,$181.45 ,$138.10 ,$7.01 ,$118.14 ,$118.14 ,$7.15 ,$165.32 ,$171.37 ,$181.45 ,$151.21 ,$141.13 ,$149.19 ,$181.45 ,$171.37 ,$7.01 ,$171.37 ,$15.07 ,$56.00 ,$7.01 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305138,82977,GGT,300,1 ,$112.65 ,$73.22 ,$7.20 ,$101.39 ,$77.17 ,$7.20 ,$66.01 ,$66.01 ,$7.34 ,$92.37 ,$95.75 ,$101.39 ,$84.49 ,$78.86 ,$83.36 ,$101.39 ,$95.75 ,$7.20 ,$95.75 ,$15.48 ,$56.00 ,$7.20 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305141,82947,GLUCOSE FASTING,300,1 ,$63.17 ,$41.06 ,$3.93 ,$56.85 ,$43.27 ,$3.93 ,$37.02 ,$37.02 ,$4.01 ,$51.80 ,$53.69 ,$56.85 ,$47.38 ,$44.22 ,$46.75 ,$56.85 ,$53.69 ,$3.93 ,$53.69 ,$8.45 ,$56.00 ,$3.93 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305143,82951,GLUCOSE TOLERANCE 3HR 100GM,300,1 ,$211.61 ,$137.55 ,$12.87 ,$190.45 ,$144.95 ,$12.87 ,$124.00 ,$124.00 ,$13.13 ,$173.52 ,$179.87 ,$190.45 ,$158.71 ,$148.13 ,$156.59 ,$190.45 ,$179.87 ,$12.87 ,$179.87 ,$27.67 ,$56.00 ,$12.87 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305151,80048,BMP,300,1 ,$266.97 ,$173.53 ,$8.46 ,$240.27 ,$182.87 ,$8.46 ,$156.44 ,$156.44 ,$8.63 ,$218.92 ,$226.92 ,$240.27 ,$200.23 ,$186.88 ,$197.56 ,$240.27 ,$226.92 ,$8.46 ,$226.92 ,$18.19 ,$56.00 ,$8.46 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305153,83615,LDH,300,1 ,$95.80 ,$62.27 ,$6.04 ,$86.22 ,$65.62 ,$6.04 ,$56.14 ,$56.14 ,$6.16 ,$78.56 ,$81.43 ,$86.22 ,$71.85 ,$67.06 ,$70.89 ,$86.22 ,$81.43 ,$6.04 ,$81.43 ,$12.99 ,$56.00 ,$6.04 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305155,83540,IRON,300,1 ,$116.86 ,$75.96 ,$6.47 ,$105.17 ,$80.05 ,$6.47 ,$68.48 ,$68.48 ,$6.60 ,$95.83 ,$99.33 ,$105.17 ,$87.65 ,$81.80 ,$86.48 ,$105.17 ,$99.33 ,$6.47 ,$99.33 ,$13.91 ,$56.00 ,$6.47 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305156,83735,MAGNESIUM,300,1 ,$112.65 ,$73.22 ,$6.70 ,$101.39 ,$77.17 ,$6.70 ,$66.01 ,$66.01 ,$6.83 ,$92.37 ,$95.75 ,$101.39 ,$84.49 ,$78.86 ,$83.36 ,$101.39 ,$95.75 ,$6.70 ,$95.75 ,$14.41 ,$56.00 ,$6.70 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305159,80185,DILANTIN PHENYTOIN TOTAL,300,1 ,$175.00 ,$113.75 ,$13.25 ,$157.50 ,$119.88 ,$13.25 ,$102.55 ,$102.55 ,$13.52 ,$143.50 ,$148.75 ,$157.50 ,$131.25 ,$122.50 ,$129.50 ,$157.50 ,$148.75 ,$13.25 ,$148.75 ,$28.49 ,$56.00 ,$13.25 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305161,84100,PHOSPHORUS SERUM,300,1 ,$103.17 ,$67.06 ,$4.74 ,$92.85 ,$70.67 ,$4.74 ,$60.46 ,$60.46 ,$4.83 ,$84.60 ,$87.69 ,$92.85 ,$77.38 ,$72.22 ,$76.35 ,$92.85 ,$87.69 ,$4.74 ,$87.69 ,$10.19 ,$56.00 ,$4.74 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305163,84132,POTASSIUM SERUM,300,1 ,$61.06 ,$39.69 ,$4.76 ,$56.00 ,$41.83 ,$4.76 ,$35.78 ,$35.78 ,$4.86 ,$50.07 ,$51.90 ,$54.95 ,$45.80 ,$42.74 ,$45.18 ,$54.95 ,$51.90 ,$4.76 ,$51.90 ,$10.23 ,$56.00 ,$4.76 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305165,80329,SALICYLATE,300,1 ,$205.00 ,$133.25 ,$56.00 ,$184.50 ,$140.43 , N/A ,$120.13 ,$120.13 , N/A ,$168.10 ,$174.25 ,$184.50 ,$153.75 ,$143.50 ,$151.70 ,$184.50 ,$174.25 , N/A ,$174.25 , N/A ,$56.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305167,84450,AST SGOT,300,1 ,$102.12 ,$66.38 ,$5.18 ,$91.91 ,$69.95 ,$5.18 ,$59.84 ,$59.84 ,$5.28 ,$83.74 ,$86.80 ,$91.91 ,$76.59 ,$71.48 ,$75.57 ,$91.91 ,$86.80 ,$5.18 ,$86.80 ,$11.14 ,$56.00 ,$5.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305169,84460,ALT SGPT,300,1 ,$93.70 ,$60.91 ,$5.30 ,$84.33 ,$64.18 ,$5.30 ,$54.91 ,$54.91 ,$5.41 ,$76.83 ,$79.65 ,$84.33 ,$70.28 ,$65.59 ,$69.34 ,$84.33 ,$79.65 ,$5.30 ,$79.65 ,$11.40 ,$56.00 ,$5.30 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305170,84478,TRIGLYCERIDES,300,1 ,$109.49 ,$71.17 ,$5.74 ,$98.54 ,$75.00 ,$5.74 ,$64.16 ,$64.16 ,$5.85 ,$89.78 ,$93.07 ,$98.54 ,$82.12 ,$76.64 ,$81.02 ,$98.54 ,$93.07 ,$5.74 ,$93.07 ,$12.34 ,$56.00 ,$5.74 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305171,84295,SODIUM  SERUM,300,1 ,$71.59 ,$46.53 ,$4.81 ,$64.43 ,$49.04 ,$4.81 ,$41.95 ,$41.95 ,$4.91 ,$58.70 ,$60.85 ,$64.43 ,$53.69 ,$50.11 ,$52.98 ,$64.43 ,$60.85 ,$4.81 ,$60.85 ,$10.34 ,$56.00 ,$4.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305177,84520,BUN/UREA NITROGEN,300,1 ,$69.48 ,$45.16 ,$3.95 ,$62.53 ,$47.59 ,$3.95 ,$40.72 ,$40.72 ,$4.03 ,$56.97 ,$59.06 ,$62.53 ,$52.11 ,$48.64 ,$51.42 ,$62.53 ,$59.06 ,$3.95 ,$59.06 ,$8.49 ,$56.00 ,$3.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305179,84550,URIC ACID,300,1 ,$90.54 ,$58.85 ,$4.52 ,$81.49 ,$62.02 ,$4.52 ,$53.06 ,$53.06 ,$4.61 ,$74.24 ,$76.96 ,$81.49 ,$67.91 ,$63.38 ,$67.00 ,$81.49 ,$76.96 ,$4.52 ,$76.96 ,$9.72 ,$56.00 ,$4.52 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305184,83550,IRON BINDING CAPACITY (SERUM),300,1 ,$131.60 ,$85.54 ,$8.74 ,$118.44 ,$90.15 ,$8.74 ,$77.12 ,$77.12 ,$8.91 ,$107.91 ,$111.86 ,$118.44 ,$98.70 ,$92.12 ,$97.38 ,$118.44 ,$111.86 ,$8.74 ,$111.86 ,$18.79 ,$56.00 ,$8.74 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305192,81003,UA WITHOUT MICRO,300,1 ,$90.93 ,$59.10 ,$2.25 ,$81.84 ,$62.29 ,$2.25 ,$53.29 ,$53.29 ,$2.30 ,$74.56 ,$77.29 ,$81.84 ,$68.20 ,$63.65 ,$67.29 ,$81.84 ,$77.29 ,$2.25 ,$77.29 ,$4.84 ,$56.00 ,$2.25 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305309,86308,MONO TEST,300,1 ,$132.22 ,$85.94 ,$5.18 ,$119.00 ,$90.57 ,$5.18 ,$77.48 ,$77.48 ,$5.28 ,$108.42 ,$112.39 ,$119.00 ,$99.17 ,$92.55 ,$97.84 ,$119.00 ,$112.39 ,$5.18 ,$112.39 ,$11.14 ,$56.00 ,$5.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305310,80069,RFP,300,1 ,$285.80 ,$185.77 ,$8.68 ,$257.22 ,$195.77 ,$8.68 ,$167.48 ,$167.48 ,$8.85 ,$234.36 ,$242.93 ,$257.22 ,$214.35 ,$200.06 ,$211.49 ,$257.22 ,$242.93 ,$8.68 ,$242.93 ,$18.66 ,$56.00 ,$8.68 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305311,83036,HGBA1C,300,1 ,$145.28 ,$94.43 ,$9.71 ,$130.75 ,$99.52 ,$9.71 ,$85.13 ,$85.13 ,$9.90 ,$119.13 ,$123.49 ,$130.75 ,$108.96 ,$101.70 ,$107.51 ,$130.75 ,$123.49 ,$9.71 ,$123.49 ,$20.88 ,$56.00 ,$9.71 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305400,81025,PREGNANCY TEST  URINE,300,1 ,$173.10 ,$112.52 ,$8.61 ,$155.79 ,$118.57 ,$8.61 ,$101.44 ,$101.44 ,$8.78 ,$141.94 ,$147.14 ,$155.79 ,$129.83 ,$121.17 ,$128.09 ,$155.79 ,$147.14 ,$8.61 ,$147.14 ,$18.51 ,$56.00 ,$8.61 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305403,81001,UA WITH MICRO,300,1 ,$116.13 ,$75.48 ,$3.17 ,$104.52 ,$79.55 ,$3.17 ,$68.05 ,$68.05 ,$3.23 ,$95.23 ,$98.71 ,$104.52 ,$87.10 ,$81.29 ,$85.94 ,$104.52 ,$98.71 ,$3.17 ,$98.71 ,$6.82 ,$56.00 ,$3.17 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305405,81002,ACETONE URINE,300,1 ,$46.01 ,$29.91 ,$3.48 ,$46.01 ,$31.52 ,$3.48 ,$26.96 ,$26.96 ,$3.55 ,$37.73 ,$39.11 ,$41.41 ,$34.51 ,$32.21 ,$34.05 ,$41.41 ,$39.11 ,$3.48 ,$39.11 ,$7.48 ,$46.01 ,$3.48 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305407,82042,URINE ALB PROT,300,1 ,$47.38 ,$30.80 ,$7.78 ,$47.38 ,$32.46 ,$7.78 ,$27.76 ,$27.76 ,$7.94 ,$38.85 ,$40.27 ,$42.64 ,$35.54 ,$33.17 ,$35.06 ,$42.64 ,$40.27 ,$7.78 ,$40.27 ,$16.73 ,$47.38 ,$7.78 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305415,82009,KETONE SERUM,300,1 ,$69.48 ,$45.16 ,$4.52 ,$62.53 ,$47.59 ,$4.52 ,$40.72 ,$40.72 ,$4.61 ,$56.97 ,$59.06 ,$62.53 ,$52.11 ,$48.64 ,$51.42 ,$62.53 ,$59.06 ,$4.52 ,$59.06 ,$9.72 ,$56.00 ,$4.52 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305429,82945,CSF GLUCOSE,300,1 ,$81.06 ,$52.69 ,$3.93 ,$72.95 ,$55.53 ,$3.93 ,$47.50 ,$47.50 ,$4.01 ,$66.47 ,$68.90 ,$72.95 ,$60.80 ,$56.74 ,$59.98 ,$72.95 ,$68.90 ,$3.93 ,$68.90 ,$8.45 ,$56.00 ,$3.93 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305437,82952,GLUCOSE ADDITIONAL SPEC,300,1 ,$57.90 ,$37.64 ,$3.92 ,$56.00 ,$39.66 ,$3.92 ,$33.93 ,$33.93 ,$4.00 ,$47.48 ,$49.22 ,$52.11 ,$43.43 ,$40.53 ,$42.85 ,$52.11 ,$49.22 ,$3.92 ,$49.22 ,$8.43 ,$56.00 ,$3.92 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305453,82270,OCCULT FECAL BLOOD HEMACULT TEST CARD,300,1 ,$55.80 ,$36.27 ,$4.38 ,$55.80 ,$38.22 ,$4.38 ,$32.70 ,$32.70 ,$4.47 ,$45.76 ,$47.43 ,$50.22 ,$41.85 ,$39.06 ,$41.29 ,$50.22 ,$47.43 ,$4.38 ,$47.43 ,$9.42 ,$55.80 ,$4.38 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305475,87040,CULTURE BLOOD,300,1 ,$286.00 ,$185.90 ,$10.32 ,$257.40 ,$195.91 ,$10.32 ,$167.60 ,$167.60 ,$10.53 ,$234.52 ,$243.10 ,$257.40 ,$214.50 ,$200.20 ,$211.64 ,$257.40 ,$243.10 ,$10.32 ,$243.10 ,$22.19 ,$56.00 ,$10.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305477,87070,CULTURE ROUTINE - SEO,300,1 ,$207.00 ,$134.55 ,$8.62 ,$186.30 ,$141.80 ,$8.62 ,$121.30 ,$121.30 ,$8.79 ,$169.74 ,$175.95 ,$186.30 ,$155.25 ,$144.90 ,$153.18 ,$186.30 ,$175.95 ,$8.62 ,$175.95 ,$18.53 ,$56.00 ,$8.62 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305482,86677,CLOTEST,300,1 ,$230.04 ,$149.53 ,$16.85 ,$207.04 ,$157.58 ,$16.85 ,$134.80 ,$134.80 ,$17.19 ,$188.63 ,$195.53 ,$207.04 ,$172.53 ,$161.03 ,$170.23 ,$207.04 ,$195.53 ,$16.85 ,$195.53 ,$36.23 ,$56.00 ,$16.85 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305483,87205,GRAM STAIN,300,1 ,$121.90 ,$79.24 ,$4.27 ,$109.71 ,$83.50 ,$4.27 ,$71.43 ,$71.43 ,$4.36 ,$99.96 ,$103.62 ,$109.71 ,$91.43 ,$85.33 ,$90.21 ,$109.71 ,$103.62 ,$4.27 ,$103.62 ,$9.18 ,$56.00 ,$4.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305490,82950,GLUCOSE 1HR 50GM POST LOAD,300,1 ,$84.22 ,$54.74 ,$4.75 ,$75.80 ,$57.69 ,$4.75 ,$49.35 ,$49.35 ,$4.85 ,$69.06 ,$71.59 ,$75.80 ,$63.17 ,$58.95 ,$62.32 ,$75.80 ,$71.59 ,$4.75 ,$71.59 ,$10.21 ,$56.00 ,$4.75 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305492,89050,CSF CELL COUNT,300,1 ,$89.23 ,$58.00 ,$4.72 ,$80.31 ,$61.12 ,$4.72 ,$52.29 ,$52.29 ,$4.81 ,$73.17 ,$75.85 ,$80.31 ,$66.92 ,$62.46 ,$66.03 ,$80.31 ,$75.85 ,$4.72 ,$75.85 ,$10.15 ,$56.00 ,$4.72 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305496,36415,.VENIPUNCTURE,300,1 ,$33.00 ,$21.45 ,$3.00 ,$33.00 ,$22.61 ,$3.00 ,$19.34 ,$19.34 ,$3.06 ,$27.06 ,$28.05 ,$29.70 ,$24.75 ,$23.10 ,$24.42 ,$29.70 ,$28.05 ,$3.00 ,$28.05 ,$6.45 ,$33.00 ,$3.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305579,80164,VALPROIC ACID,300,1 ,$172.00 ,$111.80 ,$13.54 ,$154.80 ,$117.82 ,$13.54 ,$100.79 ,$100.79 ,$13.81 ,$141.04 ,$146.20 ,$154.80 ,$129.00 ,$120.40 ,$127.28 ,$154.80 ,$146.20 ,$13.54 ,$146.20 ,$29.11 ,$56.00 ,$13.54 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305581,80156,TEGRETOL CARBAMAZIPINE,300,1 ,$210.00 ,$136.50 ,$14.57 ,$189.00 ,$143.85 ,$14.57 ,$123.06 ,$123.06 ,$14.86 ,$172.20 ,$178.50 ,$189.00 ,$157.50 ,$147.00 ,$155.40 ,$189.00 ,$178.50 ,$14.57 ,$178.50 ,$31.33 ,$56.00 ,$14.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305582,80061,LIPID PANEL,300,1 ,$267.00 ,$173.55 ,$13.39 ,$240.30 ,$182.90 ,$13.39 ,$156.46 ,$156.46 ,$13.66 ,$218.94 ,$226.95 ,$240.30 ,$200.25 ,$186.90 ,$197.58 ,$240.30 ,$226.95 ,$13.39 ,$226.95 ,$28.79 ,$56.00 ,$13.39 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305585,84484,.*TROPONIN I,300,1 ,$205.29 ,$133.44 ,$12.47 ,$184.76 ,$140.62 ,$12.47 ,$120.30 ,$120.30 ,$12.72 ,$168.34 ,$174.50 ,$184.76 ,$153.97 ,$143.70 ,$151.91 ,$184.76 ,$174.50 ,$12.47 ,$174.50 ,$26.81 ,$56.00 ,$12.47 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305601,80076,LIVER FP,300,1 ,$289.13 ,$187.93 ,$8.17 ,$260.22 ,$198.05 ,$8.17 ,$169.43 ,$169.43 ,$8.33 ,$237.09 ,$245.76 ,$260.22 ,$216.85 ,$202.39 ,$213.96 ,$260.22 ,$245.76 ,$8.17 ,$245.76 ,$17.57 ,$56.00 ,$8.17 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305602,80162,DIGOXIN,300,1 ,$154.00 ,$100.10 ,$13.28 ,$138.60 ,$105.49 ,$13.28 ,$90.24 ,$90.24 ,$13.55 ,$126.28 ,$130.90 ,$138.60 ,$115.50 ,$107.80 ,$113.96 ,$138.60 ,$130.90 ,$13.28 ,$130.90 ,$28.55 ,$56.00 ,$13.28 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305607,80053,COMPREHENSIVE,300,1 ,$340.08 ,$221.05 ,$10.56 ,$306.07 ,$232.95 ,$10.56 ,$199.29 ,$199.29 ,$10.77 ,$278.87 ,$289.07 ,$306.07 ,$255.06 ,$238.06 ,$251.66 ,$306.07 ,$289.07 ,$10.56 ,$289.07 ,$22.70 ,$56.00 ,$10.56 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305618,82570,CREATININE CLEARANCE,300,1 ,$93.70 ,$60.91 ,$5.18 ,$84.33 ,$64.18 ,$5.18 ,$54.91 ,$54.91 ,$5.28 ,$76.83 ,$79.65 ,$84.33 ,$70.28 ,$65.59 ,$69.34 ,$84.33 ,$79.65 ,$5.18 ,$79.65 ,$11.14 ,$56.00 ,$5.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305625,84436,T4,300,1 ,$116.86 ,$75.96 ,$6.87 ,$105.17 ,$80.05 ,$6.87 ,$68.48 ,$68.48 ,$7.01 ,$95.83 ,$99.33 ,$105.17 ,$87.65 ,$81.80 ,$86.48 ,$105.17 ,$99.33 ,$6.87 ,$99.33 ,$14.77 ,$56.00 ,$6.87 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305626,84443,TSH 3rd Generation,300,1 ,$186.34 ,$121.12 ,$16.80 ,$167.71 ,$127.64 ,$16.80 ,$109.20 ,$109.20 ,$17.14 ,$152.80 ,$158.39 ,$167.71 ,$139.76 ,$130.44 ,$137.89 ,$167.71 ,$158.39 ,$16.80 ,$158.39 ,$36.12 ,$56.00 ,$16.80 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305641,84703,PREGNANCY TEST  SERUM,300,1 ,$138.97 ,$90.33 ,$7.52 ,$125.07 ,$95.19 ,$7.52 ,$81.44 ,$81.44 ,$7.67 ,$113.96 ,$118.12 ,$125.07 ,$104.23 ,$97.28 ,$102.84 ,$125.07 ,$118.12 ,$7.52 ,$118.12 ,$16.17 ,$56.00 ,$7.52 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305642,84702,PREGNANCY BHCG QUANT,300,1 ,$216.87 ,$140.97 ,$15.05 ,$195.18 ,$148.56 ,$15.05 ,$127.09 ,$127.09 ,$15.35 ,$177.83 ,$184.34 ,$195.18 ,$162.65 ,$151.81 ,$160.48 ,$195.18 ,$184.34 ,$15.05 ,$184.34 ,$32.36 ,$56.00 ,$15.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305689,83690,LIPASE,300,1 ,$150.55 ,$97.86 ,$6.89 ,$135.50 ,$103.13 ,$6.89 ,$88.22 ,$88.22 ,$7.03 ,$123.45 ,$127.97 ,$135.50 ,$112.91 ,$105.39 ,$111.41 ,$135.50 ,$127.97 ,$6.89 ,$127.97 ,$14.81 ,$56.00 ,$6.89 
HSHS HOLY FAMILY HOSPITAL INC (ACU),305692,84153,PSA TOTAL SCREEN,300,1 ,$168.45 ,$109.49 ,$18.39 ,$151.61 ,$115.39 ,$18.39 ,$98.71 ,$98.71 ,$18.76 ,$138.13 ,$143.18 ,$151.61 ,$126.34 ,$117.92 ,$124.65 ,$151.61 ,$143.18 ,$18.39 ,$143.18 ,$39.54 ,$56.00 ,$18.39 
HSHS HOLY FAMILY HOSPITAL INC (ACU),306100,82436,CHLORIDE URINE RANDOM,300,1 ,$57.90 ,$37.64 ,$5.75 ,$56.00 ,$39.66 ,$5.75 ,$33.93 ,$33.93 ,$5.87 ,$47.48 ,$49.22 ,$52.11 ,$43.43 ,$40.53 ,$42.85 ,$52.11 ,$49.22 ,$5.75 ,$49.22 ,$12.36 ,$56.00 ,$5.75 
HSHS HOLY FAMILY HOSPITAL INC (ACU),306194,84156,PROTEIN URINE RANDOM,300,1 ,$98.96 ,$64.32 ,$3.67 ,$89.06 ,$67.79 ,$3.67 ,$57.99 ,$57.99 ,$3.74 ,$81.15 ,$84.12 ,$89.06 ,$74.22 ,$69.27 ,$73.23 ,$89.06 ,$84.12 ,$3.67 ,$84.12 ,$7.89 ,$56.00 ,$3.67 
HSHS HOLY FAMILY HOSPITAL INC (ACU),306403,82340,URINE CALCIUM 24 HR INHOUSE,300,1 ,$102.12 ,$66.38 ,$6.03 ,$91.91 ,$69.95 ,$6.03 ,$59.84 ,$59.84 ,$6.15 ,$83.74 ,$86.80 ,$91.91 ,$76.59 ,$71.48 ,$75.57 ,$91.91 ,$86.80 ,$6.03 ,$86.80 ,$12.96 ,$56.00 ,$6.03 
HSHS HOLY FAMILY HOSPITAL INC (ACU),306896,82271,OCCULT BLOOD EMESIS,300,1 ,$63.17 ,$41.06 ,$5.32 ,$56.85 ,$43.27 ,$5.32 ,$37.02 ,$37.02 ,$5.43 ,$51.80 ,$53.69 ,$56.85 ,$47.38 ,$44.22 ,$46.75 ,$56.85 ,$53.69 ,$5.32 ,$53.69 ,$11.44 ,$56.00 ,$5.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),306995,84112,.AMNISURE ROM TEST,300,1 ,$284.25 ,$184.76 ,$56.00 ,$255.83 ,$194.71 ,$98.11 ,$166.57 ,$166.57 ,$100.07 ,$233.09 ,$241.61 ,$255.83 ,$213.19 ,$198.98 ,$210.35 ,$255.83 ,$241.61 ,$98.11 ,$241.61 ,$210.94 ,$56.00 ,$98.11 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307017,87081,MRSA SCREEN NARES,300,1 ,$148.35 ,$96.43 ,$6.63 ,$133.52 ,$101.62 ,$6.63 ,$86.93 ,$86.93 ,$6.76 ,$121.65 ,$126.10 ,$133.52 ,$111.26 ,$103.85 ,$109.78 ,$133.52 ,$126.10 ,$6.63 ,$126.10 ,$14.25 ,$56.00 ,$6.63 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307019,82607,B12,300,1 ,$190.55 ,$123.86 ,$15.08 ,$171.50 ,$130.53 ,$15.08 ,$111.66 ,$111.66 ,$15.38 ,$156.25 ,$161.97 ,$171.50 ,$142.91 ,$133.39 ,$141.01 ,$171.50 ,$161.97 ,$15.08 ,$161.97 ,$32.42 ,$56.00 ,$15.08 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307020,82746,FOLATE,300,1 ,$162.13 ,$105.38 ,$14.70 ,$145.92 ,$111.06 ,$14.70 ,$95.01 ,$95.01 ,$14.99 ,$132.95 ,$137.81 ,$145.92 ,$121.60 ,$113.49 ,$119.98 ,$145.92 ,$137.81 ,$14.70 ,$137.81 ,$31.61 ,$56.00 ,$14.70 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307038,82043,MICROALBUMIN RANDOM URINE,300,1 ,$96.86 ,$62.96 ,$5.78 ,$87.17 ,$66.35 ,$5.78 ,$56.76 ,$56.76 ,$5.90 ,$79.43 ,$82.33 ,$87.17 ,$72.65 ,$67.80 ,$71.68 ,$87.17 ,$82.33 ,$5.78 ,$82.33 ,$12.43 ,$56.00 ,$5.78 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307042,82140,AMMONIA,300,1 ,$122.12 ,$79.38 ,$14.57 ,$109.91 ,$83.65 ,$14.57 ,$71.56 ,$71.56 ,$14.86 ,$100.14 ,$103.80 ,$109.91 ,$91.59 ,$85.48 ,$90.37 ,$109.91 ,$103.80 ,$14.57 ,$103.80 ,$31.33 ,$56.00 ,$14.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307043,83605,LACTIC ACID,300,1 ,$129.49 ,$84.17 ,$11.57 ,$116.54 ,$88.70 ,$11.57 ,$75.88 ,$75.88 ,$11.80 ,$106.18 ,$110.07 ,$116.54 ,$97.12 ,$90.64 ,$95.82 ,$116.54 ,$110.07 ,$11.57 ,$110.07 ,$24.88 ,$56.00 ,$11.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307045,83630,LEUKOCYTE FECAL LACTOFERRIN GRH,300,1 ,$155.81 ,$101.28 ,$19.70 ,$140.23 ,$106.73 ,$19.70 ,$91.30 ,$91.30 ,$20.09 ,$127.76 ,$132.44 ,$140.23 ,$116.86 ,$109.07 ,$115.30 ,$140.23 ,$132.44 ,$19.70 ,$132.44 ,$42.36 ,$56.00 ,$19.70 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307047,87088,.CULTURE URINE COMPONENT 2 87088,300,1 ,$95.45 ,$62.04 ,$8.09 ,$85.91 ,$65.38 ,$8.09 ,$55.93 ,$55.93 ,$8.25 ,$78.27 ,$81.13 ,$85.91 ,$71.59 ,$66.82 ,$70.63 ,$85.91 ,$81.13 ,$8.09 ,$81.13 ,$17.39 ,$56.00 ,$8.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307053,82570,.P CREATININE OTHER SOURCE,300,1 ,$93.70 ,$60.91 ,$5.18 ,$84.33 ,$64.18 ,$5.18 ,$54.91 ,$54.91 ,$5.28 ,$76.83 ,$79.65 ,$84.33 ,$70.28 ,$65.59 ,$69.34 ,$84.33 ,$79.65 ,$5.18 ,$79.65 ,$11.14 ,$56.00 ,$5.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307056,83880,PRO BNP,300,1 ,$326.36 ,$212.13 ,$39.26 ,$293.72 ,$223.56 ,$39.26 ,$191.25 ,$191.25 ,$40.05 ,$267.62 ,$277.41 ,$293.72 ,$244.77 ,$228.45 ,$241.51 ,$293.72 ,$277.41 ,$39.26 ,$277.41 ,$84.41 ,$56.00 ,$39.26 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307059,85060,PATHOLOGIST PERIPHERAL SMEAR REPORT,300,1 ,$75.00 ,$48.75 ,$43.95 ,$67.50 ,$51.38 , N/A ,$43.95 ,$43.95 , N/A ,$61.50 ,$63.75 ,$67.50 ,$56.25 ,$52.50 ,$55.50 ,$67.50 ,$63.75 , N/A ,$63.75 , N/A ,$56.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307062,82274,OCCULT BLOOD FECAL HEMOSURE,300,1 ,$95.80 ,$62.27 ,$15.92 ,$86.22 ,$65.62 ,$15.92 ,$56.14 ,$56.14 ,$16.24 ,$78.56 ,$81.43 ,$86.22 ,$71.85 ,$67.06 ,$70.89 ,$86.22 ,$81.43 ,$15.92 ,$81.43 ,$34.23 ,$56.00 ,$15.92 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307064,87480,.P CANDIDA NA DIRECT PROBE,300,1 ,$144.90 ,$94.19 ,$20.05 ,$130.41 ,$99.26 ,$20.05 ,$84.91 ,$84.91 ,$20.45 ,$118.82 ,$123.17 ,$130.41 ,$108.68 ,$101.43 ,$107.23 ,$130.41 ,$123.17 ,$20.05 ,$123.17 ,$43.11 ,$56.00 ,$20.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307065,87510,.P GARDNERELLA NA DIRECT PROBE,300,1 ,$144.90 ,$94.19 ,$20.05 ,$130.41 ,$99.26 ,$20.05 ,$84.91 ,$84.91 ,$20.45 ,$118.82 ,$123.17 ,$130.41 ,$108.68 ,$101.43 ,$107.23 ,$130.41 ,$123.17 ,$20.05 ,$123.17 ,$43.11 ,$56.00 ,$20.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307066,87660,.P TRICHOMONAS VAGIN DIRECT PROBE,300,1 ,$144.90 ,$94.19 ,$20.05 ,$130.41 ,$99.26 ,$20.05 ,$84.91 ,$84.91 ,$20.45 ,$118.82 ,$123.17 ,$130.41 ,$108.68 ,$101.43 ,$107.23 ,$130.41 ,$123.17 ,$20.05 ,$123.17 ,$43.11 ,$56.00 ,$20.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307069,87651,GROUP A STREP,300,1 ,$201.25 ,$130.81 ,$35.09 ,$181.13 ,$137.86 ,$35.09 ,$117.93 ,$117.93 ,$35.79 ,$165.03 ,$171.06 ,$181.13 ,$150.94 ,$140.88 ,$148.93 ,$181.13 ,$171.06 ,$35.09 ,$171.06 ,$75.44 ,$56.00 ,$35.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307071,82306,VITAMIN D 25 HYDROXY,300,1 ,$281.09 ,$182.71 ,$29.60 ,$252.98 ,$192.55 ,$29.60 ,$164.72 ,$164.72 ,$30.19 ,$230.49 ,$238.93 ,$252.98 ,$210.82 ,$196.76 ,$208.01 ,$252.98 ,$238.93 ,$29.60 ,$238.93 ,$63.64 ,$56.00 ,$29.60 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307075,87899,.P AGENT NOS ASSAY W OPTICAL OBS,300,1 ,$33.35 ,$21.68 ,$16.07 ,$34.55 ,$22.84 ,$16.07 ,$19.54 ,$19.54 ,$16.39 ,$27.35 ,$28.35 ,$30.02 ,$25.01 ,$23.35 ,$24.68 ,$30.02 ,$28.35 ,$16.07 ,$28.35 ,$34.55 ,$33.35 ,$16.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307077,85046,RETICULOCYTE PANEL,300,1 ,$145.00 ,$94.25 ,$5.57 ,$130.50 ,$99.33 ,$5.57 ,$84.97 ,$84.97 ,$5.68 ,$118.90 ,$123.25 ,$130.50 ,$108.75 ,$101.50 ,$107.30 ,$130.50 ,$123.25 ,$5.57 ,$123.25 ,$11.98 ,$56.00 ,$5.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307080,84146,.PROLACTIN,300,1 ,$206.35 ,$134.13 ,$19.38 ,$185.72 ,$141.35 ,$19.38 ,$120.92 ,$120.92 ,$19.77 ,$169.21 ,$175.40 ,$185.72 ,$154.76 ,$144.45 ,$152.70 ,$185.72 ,$175.40 ,$19.38 ,$175.40 ,$41.67 ,$56.00 ,$19.38 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307082,82626,DHEA Q19894,300,1 ,$83.17 ,$54.06 ,$25.27 ,$74.85 ,$56.97 ,$25.27 ,$48.74 ,$48.74 ,$25.78 ,$68.20 ,$70.69 ,$74.85 ,$62.38 ,$58.22 ,$61.55 ,$74.85 ,$70.69 ,$25.27 ,$70.69 ,$54.33 ,$56.00 ,$25.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307083,87015,.P ID MICROORG CONCENTRATION,300,1 ,$85.10 ,$55.32 ,$6.68 ,$76.59 ,$58.29 ,$6.68 ,$49.87 ,$49.87 ,$6.81 ,$69.78 ,$72.34 ,$76.59 ,$63.83 ,$59.57 ,$62.97 ,$76.59 ,$72.34 ,$6.68 ,$72.34 ,$14.36 ,$56.00 ,$6.68 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307084,87338,STOOL H PYLORI Ag,300,1 ,$194.35 ,$126.33 ,$14.38 ,$174.92 ,$133.13 ,$14.38 ,$113.89 ,$113.89 ,$14.67 ,$159.37 ,$165.20 ,$174.92 ,$145.76 ,$136.05 ,$143.82 ,$174.92 ,$165.20 ,$14.38 ,$165.20 ,$30.92 ,$56.00 ,$14.38 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307085,86235,JO-1 ANTIBODY,300,1 ,$178.44 ,$115.99 ,$17.93 ,$160.60 ,$122.23 ,$17.93 ,$104.57 ,$104.57 ,$18.29 ,$146.32 ,$151.67 ,$160.60 ,$133.83 ,$124.91 ,$132.05 ,$160.60 ,$151.67 ,$17.93 ,$151.67 ,$38.55 ,$56.00 ,$17.93 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307089,G0478,DRUG SCREEN COLLECTION ONLY,300,1 ,$25.00 ,$16.25 ,$14.65 ,$25.00 ,$17.13 , N/A ,$14.65 ,$14.65 , N/A ,$20.50 ,$21.25 ,$22.50 ,$18.75 ,$17.50 ,$18.50 ,$22.50 ,$21.25 , N/A ,$21.25 , N/A ,$25.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307094,84484,TROPONIN I,300,1 ,$215.82 ,$140.28 ,$12.47 ,$194.24 ,$147.84 ,$12.47 ,$126.47 ,$126.47 ,$12.72 ,$176.97 ,$183.45 ,$194.24 ,$161.87 ,$151.07 ,$159.71 ,$194.24 ,$183.45 ,$12.47 ,$183.45 ,$26.81 ,$56.00 ,$12.47 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307101,87086,CULTURE URINE - SEO,300,1 ,$169.00 ,$109.85 ,$8.07 ,$152.10 ,$115.77 ,$8.07 ,$99.03 ,$99.03 ,$8.23 ,$138.58 ,$143.65 ,$152.10 ,$126.75 ,$118.30 ,$125.06 ,$152.10 ,$143.65 ,$8.07 ,$143.65 ,$17.35 ,$56.00 ,$8.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307111,80081,PRENATAL PANEL,300,1 ,$553.88 ,$360.02 ,$56.00 ,$498.49 ,$379.41 ,$74.86 ,$324.57 ,$324.57 ,$76.36 ,$454.18 ,$470.80 ,$498.49 ,$415.41 ,$387.72 ,$409.87 ,$498.49 ,$470.80 ,$74.86 ,$470.80 ,$160.95 ,$56.00 ,$74.86 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307115,N/A,OM DIPSTICK ONLY CARLISLE SYNTEC,300,1 ,$40.00 ,$26.00 ,$23.44 ,$40.00 ,$27.40 , N/A ,$23.44 ,$23.44 , N/A ,$32.80 ,$34.00 ,$36.00 ,$30.00 ,$28.00 ,$29.60 ,$36.00 ,$34.00 , N/A ,$34.00 , N/A ,$40.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307116,82948,POC GLUCOSE ACCUCHECK,300,1 ,$37.95 ,$24.67 ,$5.04 ,$37.95 ,$26.00 ,$5.04 ,$22.24 ,$22.24 ,$5.14 ,$31.12 ,$32.26 ,$34.16 ,$28.46 ,$26.57 ,$28.08 ,$34.16 ,$32.26 ,$5.04 ,$32.26 ,$10.84 ,$37.95 ,$5.04 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307117,87045,HC STOOL CULTURE,300,1 ,$131.10 ,$85.22 ,$9.44 ,$117.99 ,$89.80 ,$9.44 ,$76.82 ,$76.82 ,$9.63 ,$107.50 ,$111.44 ,$117.99 ,$98.33 ,$91.77 ,$97.01 ,$117.99 ,$111.44 ,$9.44 ,$111.44 ,$20.30 ,$56.00 ,$9.44 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307118,87046,HC STOOL CULTURE OTHER SRC,300,1 ,$102.35 ,$66.53 ,$9.44 ,$92.12 ,$70.11 ,$9.44 ,$59.98 ,$59.98 ,$9.63 ,$83.93 ,$87.00 ,$92.12 ,$76.76 ,$71.65 ,$75.74 ,$92.12 ,$87.00 ,$9.44 ,$87.00 ,$20.30 ,$56.00 ,$9.44 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307120,87071,HC CULTURE AEROBIC OTHER QN,300,1 ,$228.00 ,$148.20 ,$9.89 ,$205.20 ,$156.18 ,$9.89 ,$133.61 ,$133.61 ,$10.09 ,$186.96 ,$193.80 ,$205.20 ,$171.00 ,$159.60 ,$168.72 ,$205.20 ,$193.80 ,$9.89 ,$193.80 ,$21.26 ,$56.00 ,$9.89 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307121,87073,HC CULTURE ANAEROBIC OTHER SOURCE QN,300,1 ,$194.35 ,$126.33 ,$9.66 ,$174.92 ,$133.13 ,$9.66 ,$113.89 ,$113.89 ,$9.85 ,$159.37 ,$165.20 ,$174.92 ,$145.76 ,$136.05 ,$143.82 ,$174.92 ,$165.20 ,$9.66 ,$165.20 ,$20.77 ,$56.00 ,$9.66 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307122,87076,HC CULTURE ANAEROBIC ID,300,1 ,$151.80 ,$98.67 ,$8.08 ,$136.62 ,$103.98 ,$8.08 ,$88.95 ,$88.95 ,$8.24 ,$124.48 ,$129.03 ,$136.62 ,$113.85 ,$106.26 ,$112.33 ,$136.62 ,$129.03 ,$8.08 ,$129.03 ,$17.37 ,$56.00 ,$8.08 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307123,87077,HC CULTURE AEROBIC ID ADD,300,1 ,$207.00 ,$134.55 ,$8.08 ,$186.30 ,$141.80 ,$8.08 ,$121.30 ,$121.30 ,$8.24 ,$169.74 ,$175.95 ,$186.30 ,$155.25 ,$144.90 ,$153.18 ,$186.30 ,$175.95 ,$8.08 ,$175.95 ,$17.37 ,$56.00 ,$8.08 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307126,87088,HC CULTURE URINE ID EA ISOL,300,1 ,$95.45 ,$62.04 ,$8.09 ,$85.91 ,$65.38 ,$8.09 ,$55.93 ,$55.93 ,$8.25 ,$78.27 ,$81.13 ,$85.91 ,$71.59 ,$66.82 ,$70.63 ,$85.91 ,$81.13 ,$8.09 ,$81.13 ,$17.39 ,$56.00 ,$8.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307127,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL-90,300,1 ,$65.55 ,$42.61 ,$7.71 ,$59.00 ,$44.90 ,$7.71 ,$38.41 ,$38.41 ,$7.86 ,$53.75 ,$55.72 ,$59.00 ,$49.16 ,$45.89 ,$48.51 ,$59.00 ,$55.72 ,$7.71 ,$55.72 ,$16.58 ,$56.00 ,$7.71 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307128,87102,HC CULTURE FUNGUS OTHER,300,1 ,$203.55 ,$132.31 ,$8.41 ,$183.20 ,$139.43 ,$8.41 ,$119.28 ,$119.28 ,$8.58 ,$166.91 ,$173.02 ,$183.20 ,$152.66 ,$142.49 ,$150.63 ,$183.20 ,$173.02 ,$8.41 ,$173.02 ,$18.08 ,$56.00 ,$8.41 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307129,87106,HC CULTURE FUNGUS ID YEAST,300,1 ,$158.70 ,$103.16 ,$10.32 ,$142.83 ,$108.71 ,$10.32 ,$93.00 ,$93.00 ,$10.53 ,$130.13 ,$134.90 ,$142.83 ,$119.03 ,$111.09 ,$117.44 ,$142.83 ,$134.90 ,$10.32 ,$134.90 ,$22.19 ,$56.00 ,$10.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307130,87147,HC CULTURE TYPE SEROLOGIC,300,1 ,$170.20 ,$110.63 ,$5.18 ,$153.18 ,$116.59 ,$5.18 ,$99.74 ,$99.74 ,$5.28 ,$139.56 ,$144.67 ,$153.18 ,$127.65 ,$119.14 ,$125.95 ,$153.18 ,$144.67 ,$5.18 ,$144.67 ,$11.14 ,$56.00 ,$5.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307131,87149,HC CULTURE TYPING ID NUCLEIC ACID,300,1 ,$75.00 ,$48.75 ,$20.05 ,$67.50 ,$51.38 ,$20.05 ,$43.95 ,$43.95 ,$20.45 ,$61.50 ,$63.75 ,$67.50 ,$56.25 ,$52.50 ,$55.50 ,$67.50 ,$63.75 ,$20.05 ,$63.75 ,$43.11 ,$56.00 ,$20.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307132,87176,HC HOMOGENIZATION TISSUE,300,1 ,$72.45 ,$47.09 ,$5.88 ,$65.21 ,$49.63 ,$5.88 ,$42.46 ,$42.46 ,$6.00 ,$59.41 ,$61.58 ,$65.21 ,$54.34 ,$50.72 ,$53.61 ,$65.21 ,$61.58 ,$5.88 ,$61.58 ,$12.64 ,$56.00 ,$5.88 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307133,87181,HC SENSITIVITY STUDY AGAR,300,1 ,$26.45 ,$17.19 ,$4.75 ,$26.45 ,$18.12 ,$4.75 ,$15.50 ,$15.50 ,$4.85 ,$21.69 ,$22.48 ,$23.81 ,$19.84 ,$18.52 ,$19.57 ,$23.81 ,$22.48 ,$4.75 ,$22.48 ,$10.21 ,$26.45 ,$4.75 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307134,87184,HC SENSITIVITY DISK KB,300,1 ,$93.15 ,$60.55 ,$7.48 ,$83.84 ,$63.81 ,$7.48 ,$54.59 ,$54.59 ,$7.63 ,$76.38 ,$79.18 ,$83.84 ,$69.86 ,$65.21 ,$68.93 ,$83.84 ,$79.18 ,$7.48 ,$79.18 ,$16.08 ,$56.00 ,$7.48 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307135,87185,HC BETA LACTAMAST,300,1 ,$18.00 ,$11.70 ,$4.75 ,$18.00 ,$12.33 ,$4.75 ,$10.55 ,$10.55 ,$4.85 ,$14.76 ,$15.30 ,$16.20 ,$13.50 ,$12.60 ,$13.32 ,$16.20 ,$15.30 ,$4.75 ,$15.30 ,$10.21 ,$18.00 ,$4.75 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307136,87186,HC SENSITIVITY MIC,300,1 ,$188.60 ,$122.59 ,$8.65 ,$169.74 ,$129.19 ,$8.65 ,$110.52 ,$110.52 ,$8.82 ,$154.65 ,$160.31 ,$169.74 ,$141.45 ,$132.02 ,$139.56 ,$169.74 ,$160.31 ,$8.65 ,$160.31 ,$18.60 ,$56.00 ,$8.65 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307138,87206,HC SMEAR ACID FAST/FLUOR,300,1 ,$77.00 ,$50.05 ,$5.39 ,$69.30 ,$52.75 ,$5.39 ,$45.12 ,$45.12 ,$5.50 ,$63.14 ,$65.45 ,$69.30 ,$57.75 ,$53.90 ,$56.98 ,$69.30 ,$65.45 ,$5.39 ,$65.45 ,$11.59 ,$56.00 ,$5.39 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307139,87427,HC SHIGELLA LIKE TOXIN AG,300,1 ,$138.00 ,$89.70 ,$11.98 ,$124.20 ,$94.53 ,$11.98 ,$80.87 ,$80.87 ,$12.22 ,$113.16 ,$117.30 ,$124.20 ,$103.50 ,$96.60 ,$102.12 ,$124.20 ,$117.30 ,$11.98 ,$117.30 ,$25.76 ,$56.00 ,$11.98 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307142,N/A,HF Vitamin D,300,1 ,$15.00 ,$9.75 ,$8.79 ,$15.00 ,$10.28 , N/A ,$8.79 ,$8.79 , N/A ,$12.30 ,$12.75 ,$13.50 ,$11.25 ,$10.50 ,$11.10 ,$13.50 ,$12.75 , N/A ,$12.75 , N/A ,$15.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307143,N/A,HF TSH,300,1 ,$15.00 ,$9.75 ,$8.79 ,$15.00 ,$10.28 , N/A ,$8.79 ,$8.79 , N/A ,$12.30 ,$12.75 ,$13.50 ,$11.25 ,$10.50 ,$11.10 ,$13.50 ,$12.75 , N/A ,$12.75 , N/A ,$15.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307144,N/A,HF PSA,300,1 ,$15.00 ,$9.75 ,$8.79 ,$15.00 ,$10.28 , N/A ,$8.79 ,$8.79 , N/A ,$12.30 ,$12.75 ,$13.50 ,$11.25 ,$10.50 ,$11.10 ,$13.50 ,$12.75 , N/A ,$12.75 , N/A ,$15.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307145,N/A,HF LIPID,300,1 ,$15.00 ,$9.75 ,$8.79 ,$15.00 ,$10.28 , N/A ,$8.79 ,$8.79 , N/A ,$12.30 ,$12.75 ,$13.50 ,$11.25 ,$10.50 ,$11.10 ,$13.50 ,$12.75 , N/A ,$12.75 , N/A ,$15.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307146,N/A,HF A1C,300,1 ,$10.00 ,$6.50 ,$5.86 ,$10.00 ,$6.85 , N/A ,$5.86 ,$5.86 , N/A ,$8.20 ,$8.50 ,$9.00 ,$7.50 ,$7.00 ,$7.40 ,$9.00 ,$8.50 , N/A ,$8.50 , N/A ,$10.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307147,N/A,HF FIT,300,1 ,$15.00 ,$9.75 ,$8.79 ,$15.00 ,$10.28 , N/A ,$8.79 ,$8.79 , N/A ,$12.30 ,$12.75 ,$13.50 ,$11.25 ,$10.50 ,$11.10 ,$13.50 ,$12.75 , N/A ,$12.75 , N/A ,$15.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307345,82728,FERRITIN  IN HOUSE,300,1 ,$161.08 ,$104.70 ,$13.63 ,$144.97 ,$110.34 ,$13.63 ,$94.39 ,$94.39 ,$13.90 ,$132.09 ,$136.92 ,$144.97 ,$120.81 ,$112.76 ,$119.20 ,$144.97 ,$136.92 ,$13.63 ,$136.92 ,$29.30 ,$56.00 ,$13.63 
HSHS HOLY FAMILY HOSPITAL INC (ACU),307347,86140,CRP,300,1 ,$95.00 ,$61.75 ,$5.18 ,$85.50 ,$65.08 ,$5.18 ,$55.67 ,$55.67 ,$5.28 ,$77.90 ,$80.75 ,$85.50 ,$71.25 ,$66.50 ,$70.30 ,$85.50 ,$80.75 ,$5.18 ,$80.75 ,$11.14 ,$56.00 ,$5.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),311108,86611,BARTONELLA HENSELAE,300,1 ,$280.00 ,$182.00 ,$10.18 ,$252.00 ,$191.80 ,$10.18 ,$164.08 ,$164.08 ,$10.38 ,$229.60 ,$238.00 ,$252.00 ,$210.00 ,$196.00 ,$207.20 ,$252.00 ,$238.00 ,$10.18 ,$238.00 ,$21.89 ,$56.00 ,$10.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),3137444,87633,RESP PATH PANEL37444,300,1 ,$476.21 ,$309.54 ,$56.00 ,$896.08 ,$326.20 ,$416.78 ,$279.06 ,$279.06 ,$425.12 ,$390.49 ,$404.78 ,$428.59 ,$357.16 ,$333.35 ,$352.40 ,$428.59 ,$404.78 ,$416.78 ,$404.78 ,$896.08 ,$56.00 ,$416.78 
HSHS HOLY FAMILY HOSPITAL INC (ACU),3139433,87635,COVID-19 (QUEST),300,1 ,$398.00 ,$258.70 ,$56.00 ,$358.20 ,$272.63 , N/A ,$233.23 ,$233.23 , N/A ,$326.36 ,$338.30 ,$358.20 ,$298.50 ,$278.60 ,$294.52 ,$358.20 ,$338.30 , N/A ,$338.30 , N/A ,$56.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),314012,87350,HEPATITIS Be ANTIGEN Q555,300,1 ,$253.00 ,$164.45 ,$11.53 ,$227.70 ,$173.31 ,$11.53 ,$148.26 ,$148.26 ,$11.76 ,$207.46 ,$215.05 ,$227.70 ,$189.75 ,$177.10 ,$187.22 ,$227.70 ,$215.05 ,$11.53 ,$215.05 ,$24.79 ,$56.00 ,$11.53 
HSHS HOLY FAMILY HOSPITAL INC (ACU),314015,86695,HERPES I AND II IgG  SELECT HALL Q6447,300,1 ,$176.29 ,$114.59 ,$13.19 ,$158.66 ,$120.76 ,$13.19 ,$103.31 ,$103.31 ,$13.45 ,$144.56 ,$149.85 ,$158.66 ,$132.22 ,$123.40 ,$130.45 ,$158.66 ,$149.85 ,$13.19 ,$149.85 ,$28.36 ,$56.00 ,$13.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315012,86617,.LYME ANTIBODIES,300,1 ,$124.00 ,$80.60 ,$15.49 ,$111.60 ,$84.94 ,$15.49 ,$72.66 ,$72.66 ,$15.80 ,$101.68 ,$105.40 ,$111.60 ,$93.00 ,$86.80 ,$91.76 ,$111.60 ,$105.40 ,$15.49 ,$105.40 ,$33.30 ,$56.00 ,$15.49 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315015,87491,CHLAMYDIA GC AG APTIMA RNA Q11363,300,1 ,$61.00 ,$39.65 ,$35.09 ,$75.44 ,$41.79 ,$35.09 ,$35.75 ,$35.75 ,$35.79 ,$50.02 ,$51.85 ,$54.90 ,$45.75 ,$42.70 ,$45.14 ,$54.90 ,$51.85 ,$35.09 ,$51.85 ,$75.44 ,$56.00 ,$35.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315022,83520,TRYPTASE Q34484,300,1 ,$305.31 ,$198.45 ,$17.27 ,$274.78 ,$209.14 ,$17.27 ,$178.91 ,$178.91 ,$17.62 ,$250.35 ,$259.51 ,$274.78 ,$228.98 ,$213.72 ,$225.93 ,$274.78 ,$259.51 ,$17.27 ,$259.51 ,$37.13 ,$56.00 ,$17.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315031,85044,.RETICULOCYTE COUNT Q793,300,1 ,$152.00 ,$98.80 ,$4.31 ,$136.80 ,$104.12 ,$4.31 ,$89.07 ,$89.07 ,$4.40 ,$124.64 ,$129.20 ,$136.80 ,$114.00 ,$106.40 ,$112.48 ,$136.80 ,$129.20 ,$4.31 ,$129.20 ,$9.27 ,$56.00 ,$4.31 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315130,86304,CA 125 Q29256,300,1 ,$212.84 ,$138.35 ,$20.81 ,$191.56 ,$145.80 ,$20.81 ,$124.72 ,$124.72 ,$21.23 ,$174.53 ,$180.91 ,$191.56 ,$159.63 ,$148.99 ,$157.50 ,$191.56 ,$180.91 ,$20.81 ,$180.91 ,$44.74 ,$56.00 ,$20.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315166,80198,THEOPHYLLINE Q878,300,1 ,$162.00 ,$105.30 ,$14.14 ,$145.80 ,$110.97 ,$14.14 ,$94.93 ,$94.93 ,$14.42 ,$132.84 ,$137.70 ,$145.80 ,$121.50 ,$113.40 ,$119.88 ,$145.80 ,$137.70 ,$14.14 ,$137.70 ,$30.40 ,$56.00 ,$14.14 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315366,86738,MYCOPLASMA PNEU IgG IgM  Q34127,300,1 ,$658.80 ,$428.22 ,$13.24 ,$592.92 ,$451.28 ,$13.24 ,$386.06 ,$386.06 ,$13.50 ,$540.22 ,$559.98 ,$592.92 ,$494.10 ,$461.16 ,$487.51 ,$592.92 ,$559.98 ,$13.24 ,$559.98 ,$28.47 ,$56.00 ,$13.24 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315390,83945,OXALATE SERUM Q5390,300,1 ,$145.28 ,$94.43 ,$14.45 ,$130.75 ,$99.52 ,$14.45 ,$85.13 ,$85.13 ,$14.74 ,$119.13 ,$123.49 ,$130.75 ,$108.96 ,$101.70 ,$107.51 ,$130.75 ,$123.49 ,$14.45 ,$123.49 ,$31.07 ,$56.00 ,$14.45 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315405,82985,FRUCTOSAMINE Q8340,300,1 ,$75.80 ,$49.27 ,$16.76 ,$68.22 ,$51.92 ,$16.76 ,$44.42 ,$44.42 ,$17.10 ,$62.16 ,$64.43 ,$68.22 ,$56.85 ,$53.06 ,$56.09 ,$68.22 ,$64.43 ,$16.76 ,$64.43 ,$36.03 ,$56.00 ,$16.76 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315425,89051,CELL CT AND DIFF BODY FLUID,300,1 ,$205.54 ,$133.60 ,$5.60 ,$184.99 ,$140.79 ,$5.60 ,$120.45 ,$120.45 ,$5.71 ,$168.54 ,$174.71 ,$184.99 ,$154.16 ,$143.88 ,$152.10 ,$184.99 ,$174.71 ,$5.60 ,$174.71 ,$12.04 ,$56.00 ,$5.60 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315564,82024,ACTH Q211,300,1 ,$283.20 ,$184.08 ,$38.62 ,$254.88 ,$193.99 ,$38.62 ,$165.96 ,$165.96 ,$39.39 ,$232.22 ,$240.72 ,$254.88 ,$212.40 ,$198.24 ,$209.57 ,$254.88 ,$240.72 ,$38.62 ,$240.72 ,$83.03 ,$56.00 ,$38.62 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315570,86160,COMPLEMENT C3  Q351,300,1 ,$330.01 ,$214.51 ,$12.00 ,$297.01 ,$226.06 ,$12.00 ,$193.39 ,$193.39 ,$12.24 ,$270.61 ,$280.51 ,$297.01 ,$247.51 ,$231.01 ,$244.21 ,$297.01 ,$280.51 ,$12.00 ,$280.51 ,$25.80 ,$56.00 ,$12.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315573,82533,CORTISOL SERUM Q367,300,1 ,$136.86 ,$88.96 ,$16.30 ,$123.17 ,$93.75 ,$16.30 ,$80.20 ,$80.20 ,$16.63 ,$112.23 ,$116.33 ,$123.17 ,$102.65 ,$95.80 ,$101.28 ,$123.17 ,$116.33 ,$16.30 ,$116.33 ,$35.05 ,$56.00 ,$16.30 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315585,87230,STOOL C DIFF CULTURE Q91664,300,1 ,$231.15 ,$150.25 ,$19.74 ,$208.04 ,$158.34 ,$19.74 ,$135.45 ,$135.45 ,$20.13 ,$189.54 ,$196.48 ,$208.04 ,$173.36 ,$161.81 ,$171.05 ,$208.04 ,$196.48 ,$19.74 ,$196.48 ,$42.44 ,$56.00 ,$19.74 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315590,89060,CRYSTAL EXAM MISC BODY FLUIDS Q3134,300,1 ,$87.23 ,$56.70 ,$7.33 ,$78.51 ,$59.75 ,$7.33 ,$51.12 ,$51.12 ,$7.48 ,$71.53 ,$74.15 ,$78.51 ,$65.42 ,$61.06 ,$64.55 ,$78.51 ,$74.15 ,$7.33 ,$74.15 ,$15.76 ,$56.00 ,$7.33 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315591,84146,PROLACTIN Q746,300,1 ,$206.35 ,$134.13 ,$19.38 ,$185.72 ,$141.35 ,$19.38 ,$120.92 ,$120.92 ,$19.77 ,$169.21 ,$175.40 ,$185.72 ,$154.76 ,$144.45 ,$152.70 ,$185.72 ,$175.40 ,$19.38 ,$175.40 ,$41.67 ,$56.00 ,$19.38 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315599,82384,CATECHOLAMINES PLASMA Q314,300,1 ,$350.58 ,$227.88 ,$25.25 ,$315.52 ,$240.15 ,$25.25 ,$205.44 ,$205.44 ,$25.76 ,$287.48 ,$297.99 ,$315.52 ,$262.94 ,$245.41 ,$259.43 ,$315.52 ,$297.99 ,$25.25 ,$297.99 ,$54.29 ,$56.00 ,$25.25 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315600,84585,VMA 24 HOUR URINE Q934,300,1 ,$167.39 ,$108.80 ,$15.50 ,$150.65 ,$114.66 ,$15.50 ,$98.09 ,$98.09 ,$15.81 ,$137.26 ,$142.28 ,$150.65 ,$125.54 ,$117.17 ,$123.87 ,$150.65 ,$142.28 ,$15.50 ,$142.28 ,$33.33 ,$56.00 ,$15.50 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315603,86762,RUBELLA AB IGG IGM  Q37673,300,1 ,$111.80 ,$72.67 ,$14.39 ,$100.62 ,$76.58 ,$14.39 ,$65.51 ,$65.51 ,$14.68 ,$91.68 ,$95.03 ,$100.62 ,$83.85 ,$78.26 ,$82.73 ,$100.62 ,$95.03 ,$14.39 ,$95.03 ,$30.94 ,$56.00 ,$14.39 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315606,80178,LITHIUM,300,1 ,$88.00 ,$57.20 ,$6.61 ,$79.20 ,$60.28 ,$6.61 ,$51.57 ,$51.57 ,$6.74 ,$72.16 ,$74.80 ,$79.20 ,$66.00 ,$61.60 ,$65.12 ,$79.20 ,$74.80 ,$6.61 ,$74.80 ,$14.21 ,$56.00 ,$6.61 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315608,86060,ASO Q265,300,1 ,$104.27 ,$67.78 ,$7.30 ,$93.84 ,$71.43 ,$7.30 ,$61.10 ,$61.10 ,$7.45 ,$85.50 ,$88.63 ,$93.84 ,$78.20 ,$72.99 ,$77.16 ,$93.84 ,$88.63 ,$7.30 ,$88.63 ,$15.70 ,$56.00 ,$7.30 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315610,82378,CEA  Q978,300,1 ,$168.45 ,$109.49 ,$18.96 ,$151.61 ,$115.39 ,$18.96 ,$98.71 ,$98.71 ,$19.34 ,$138.13 ,$143.18 ,$151.61 ,$126.34 ,$117.92 ,$124.65 ,$151.61 ,$143.18 ,$18.96 ,$143.18 ,$40.76 ,$56.00 ,$18.96 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315611,83001,FSH Q470,300,1 ,$78.90 ,$51.29 ,$18.58 ,$71.01 ,$54.05 ,$18.58 ,$46.24 ,$46.24 ,$18.95 ,$64.70 ,$67.07 ,$71.01 ,$59.18 ,$55.23 ,$58.39 ,$71.01 ,$67.07 ,$18.58 ,$67.07 ,$39.95 ,$56.00 ,$18.58 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315616,84144,PROGESTERONE SERUM Q745,300,1 ,$178.97 ,$116.33 ,$20.86 ,$161.07 ,$122.59 ,$20.86 ,$104.88 ,$104.88 ,$21.28 ,$146.76 ,$152.12 ,$161.07 ,$134.23 ,$125.28 ,$132.44 ,$161.07 ,$152.12 ,$20.86 ,$152.12 ,$44.85 ,$56.00 ,$20.86 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315619,82785,IGE QUANT Q542,300,1 ,$181.08 ,$117.70 ,$16.46 ,$162.97 ,$124.04 ,$16.46 ,$106.11 ,$106.11 ,$16.79 ,$148.49 ,$153.92 ,$162.97 ,$135.81 ,$126.76 ,$134.00 ,$162.97 ,$153.92 ,$16.46 ,$153.92 ,$35.39 ,$56.00 ,$16.46 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315623,84165,PROTEIN ELECTRO.SERUM Q747,300,1 ,$174.76 ,$113.59 ,$10.74 ,$157.28 ,$119.71 ,$10.74 ,$102.41 ,$102.41 ,$10.95 ,$143.30 ,$148.55 ,$157.28 ,$131.07 ,$122.33 ,$129.32 ,$157.28 ,$148.55 ,$10.74 ,$148.55 ,$23.09 ,$56.00 ,$10.74 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315624,86320,IMMUNO ELECT SERUM Q549,300,1 ,$285.94 ,$185.86 ,$29.92 ,$257.35 ,$195.87 ,$29.92 ,$167.56 ,$167.56 ,$30.52 ,$234.47 ,$243.05 ,$257.35 ,$214.46 ,$200.16 ,$211.60 ,$257.35 ,$243.05 ,$29.92 ,$243.05 ,$64.33 ,$56.00 ,$29.92 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315627,84030,NEWBORN SCREENING,300,1 ,$287.41 ,$186.82 ,$5.50 ,$258.67 ,$196.88 ,$5.50 ,$168.42 ,$168.42 ,$5.61 ,$235.68 ,$244.30 ,$258.67 ,$215.56 ,$201.19 ,$212.68 ,$258.67 ,$244.30 ,$5.50 ,$244.30 ,$11.83 ,$56.00 ,$5.50 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315634,87116,CULTURE AFB Q4554,300,1 ,$175.95 ,$114.37 ,$10.80 ,$158.36 ,$120.53 ,$10.80 ,$103.11 ,$103.11 ,$11.02 ,$144.28 ,$149.56 ,$158.36 ,$131.96 ,$123.17 ,$130.20 ,$158.36 ,$149.56 ,$10.80 ,$149.56 ,$23.22 ,$56.00 ,$10.80 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315657,87340,HEPATITIS B SURFACE AG Q498,300,1 ,$293.25 ,$190.61 ,$10.33 ,$263.93 ,$200.88 ,$10.33 ,$171.84 ,$171.84 ,$10.54 ,$240.47 ,$249.26 ,$263.93 ,$219.94 ,$205.28 ,$217.01 ,$263.93 ,$249.26 ,$10.33 ,$249.26 ,$22.21 ,$56.00 ,$10.33 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315658,86706,HEPATITIS B SURFACE AB EMPLOYEE Q8475,300,1 ,$90.30 ,$58.70 ,$10.74 ,$81.27 ,$61.86 ,$10.74 ,$52.92 ,$52.92 ,$10.95 ,$74.05 ,$76.76 ,$81.27 ,$67.73 ,$63.21 ,$66.82 ,$81.27 ,$76.76 ,$10.74 ,$76.76 ,$23.09 ,$56.00 ,$10.74 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315661,80074,HEP DIAG SURVEY W/CONFIRM Q10306,300,1 ,$342.30 ,$222.50 ,$47.63 ,$308.07 ,$234.48 ,$47.63 ,$200.59 ,$200.59 ,$48.58 ,$280.69 ,$290.96 ,$308.07 ,$256.73 ,$239.61 ,$253.30 ,$308.07 ,$290.96 ,$47.63 ,$290.96 ,$102.40 ,$56.00 ,$47.63 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315674,86335,IMMUNOELECTROPHORESIS 24 HOUR URINE Q213,300,1 ,$244.02 ,$158.61 ,$29.35 ,$219.62 ,$167.15 ,$29.35 ,$143.00 ,$143.00 ,$29.94 ,$200.10 ,$207.42 ,$219.62 ,$183.02 ,$170.81 ,$180.57 ,$219.62 ,$207.42 ,$29.35 ,$207.42 ,$63.10 ,$56.00 ,$29.35 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315677,83655,LEAD ADULT Q599,300,1 ,$113.70 ,$73.91 ,$12.11 ,$102.33 ,$77.88 ,$12.11 ,$66.63 ,$66.63 ,$12.35 ,$93.23 ,$96.65 ,$102.33 ,$85.28 ,$79.59 ,$84.14 ,$102.33 ,$96.65 ,$12.11 ,$96.65 ,$26.04 ,$56.00 ,$12.11 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315680,84560,URIC ACID URINE 24 HOUR Q11321,300,1 ,$69.48 ,$45.16 ,$5.08 ,$62.53 ,$47.59 ,$5.08 ,$40.72 ,$40.72 ,$5.18 ,$56.97 ,$59.06 ,$62.53 ,$52.11 ,$48.64 ,$51.42 ,$62.53 ,$59.06 ,$5.08 ,$59.06 ,$10.92 ,$56.00 ,$5.08 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315681,83497,HIAA 5-HIAA 24-HR URINE Q523,300,1 ,$172.66 ,$112.23 ,$12.90 ,$155.39 ,$118.27 ,$12.90 ,$101.18 ,$101.18 ,$13.16 ,$141.58 ,$146.76 ,$155.39 ,$129.50 ,$120.86 ,$127.77 ,$155.39 ,$146.76 ,$12.90 ,$146.76 ,$27.74 ,$56.00 ,$12.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315692,86762,RUBELLA IGG Q802,300,1 ,$111.80 ,$72.67 ,$14.39 ,$100.62 ,$76.58 ,$14.39 ,$65.51 ,$65.51 ,$14.68 ,$91.68 ,$95.03 ,$100.62 ,$83.85 ,$78.26 ,$82.73 ,$100.62 ,$95.03 ,$14.39 ,$95.03 ,$30.94 ,$56.00 ,$14.39 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315734,84446,VITAMIN E Q931,300,1 ,$92.64 ,$60.22 ,$14.18 ,$83.38 ,$63.46 ,$14.18 ,$54.29 ,$54.29 ,$14.46 ,$75.96 ,$78.74 ,$83.38 ,$69.48 ,$64.85 ,$68.55 ,$83.38 ,$78.74 ,$14.18 ,$78.74 ,$30.49 ,$56.00 ,$14.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315749,82705,FECAL FAT QUALITATIVE Q3967,300,1 ,$90.54 ,$58.85 ,$5.10 ,$81.49 ,$62.02 ,$5.10 ,$53.06 ,$53.06 ,$5.20 ,$74.24 ,$76.96 ,$81.49 ,$67.91 ,$63.38 ,$67.00 ,$81.49 ,$76.96 ,$5.10 ,$76.96 ,$10.97 ,$56.00 ,$5.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315900,82105,AFP TUMOR MARKER Q237,300,1 ,$215.82 ,$140.28 ,$16.77 ,$194.24 ,$147.84 ,$16.77 ,$126.47 ,$126.47 ,$17.11 ,$176.97 ,$183.45 ,$194.24 ,$161.87 ,$151.07 ,$159.71 ,$194.24 ,$183.45 ,$16.77 ,$183.45 ,$36.06 ,$56.00 ,$16.77 
HSHS HOLY FAMILY HOSPITAL INC (ACU),315901,86431,RA TITER Q4418,300,1 ,$94.60 ,$61.49 ,$5.67 ,$85.14 ,$64.80 ,$5.67 ,$55.44 ,$55.44 ,$5.78 ,$77.57 ,$80.41 ,$85.14 ,$70.95 ,$66.22 ,$70.00 ,$85.14 ,$80.41 ,$5.67 ,$80.41 ,$12.19 ,$56.00 ,$5.67 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316002,86255,ANTI MITOCHONDRIAL AB  REFLEX TITER Q259,300,1 ,$503.08 ,$327.00 ,$12.05 ,$452.77 ,$344.61 ,$12.05 ,$294.80 ,$294.80 ,$12.29 ,$412.53 ,$427.62 ,$452.77 ,$377.31 ,$352.16 ,$372.28 ,$452.77 ,$427.62 ,$12.05 ,$427.62 ,$25.91 ,$56.00 ,$12.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316005,86301,CA 19 9  Q4698,300,1 ,$181.67 ,$118.09 ,$20.81 ,$163.50 ,$124.44 ,$20.81 ,$106.46 ,$106.46 ,$21.23 ,$148.97 ,$154.42 ,$163.50 ,$136.25 ,$127.17 ,$134.44 ,$163.50 ,$154.42 ,$20.81 ,$154.42 ,$44.74 ,$56.00 ,$20.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316006,86300,CA 27 29  Q29493,300,1 ,$314.96 ,$204.72 ,$20.81 ,$283.46 ,$215.75 ,$20.81 ,$184.57 ,$184.57 ,$21.23 ,$258.27 ,$267.72 ,$283.46 ,$236.22 ,$220.47 ,$233.07 ,$283.46 ,$267.72 ,$20.81 ,$267.72 ,$44.74 ,$56.00 ,$20.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316010,82390,CERULOPLASMIN Q326,300,1 ,$95.80 ,$62.27 ,$10.74 ,$86.22 ,$65.62 ,$10.74 ,$56.14 ,$56.14 ,$10.95 ,$78.56 ,$81.43 ,$86.22 ,$71.85 ,$67.06 ,$70.89 ,$86.22 ,$81.43 ,$10.74 ,$81.43 ,$23.09 ,$56.00 ,$10.74 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316012,82507,URINE CITRIC ACID Q11315,300,1 ,$297.94 ,$193.66 ,$27.80 ,$268.15 ,$204.09 ,$27.80 ,$174.59 ,$174.59 ,$28.36 ,$244.31 ,$253.25 ,$268.15 ,$223.46 ,$208.56 ,$220.48 ,$268.15 ,$253.25 ,$27.80 ,$253.25 ,$59.77 ,$56.00 ,$27.80 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316014,86160,COMPLEMENT C4 Q353,300,1 ,$330.01 ,$214.51 ,$12.00 ,$297.01 ,$226.06 ,$12.00 ,$193.39 ,$193.39 ,$12.24 ,$270.61 ,$280.51 ,$297.01 ,$247.51 ,$231.01 ,$244.21 ,$297.01 ,$280.51 ,$12.00 ,$280.51 ,$25.80 ,$56.00 ,$12.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316015,86162,COMPLEMENT CH50 Q618,300,1 ,$268.74 ,$174.68 ,$20.32 ,$241.87 ,$184.09 ,$20.32 ,$157.48 ,$157.48 ,$20.73 ,$220.37 ,$228.43 ,$241.87 ,$201.56 ,$188.12 ,$198.87 ,$241.87 ,$228.43 ,$20.32 ,$228.43 ,$43.69 ,$56.00 ,$20.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316017,87252,CULTURE VIRAL Q689,300,1 ,$442.00 ,$287.30 ,$26.07 ,$397.80 ,$302.77 ,$26.07 ,$259.01 ,$259.01 ,$26.59 ,$362.44 ,$375.70 ,$397.80 ,$331.50 ,$309.40 ,$327.08 ,$397.80 ,$375.70 ,$26.07 ,$375.70 ,$56.05 ,$56.00 ,$26.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316018,80158,CYCLOSPORIN  Q15220,300,1 ,$228.00 ,$148.20 ,$18.05 ,$205.20 ,$156.18 ,$18.05 ,$133.61 ,$133.61 ,$18.41 ,$186.96 ,$193.80 ,$205.20 ,$171.00 ,$159.60 ,$168.72 ,$205.20 ,$193.80 ,$18.05 ,$193.80 ,$38.81 ,$56.00 ,$18.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316024,82670,ESTRADIOL Q4021,300,1 ,$230.56 ,$149.86 ,$27.94 ,$207.50 ,$157.93 ,$27.94 ,$135.11 ,$135.11 ,$28.50 ,$189.06 ,$195.98 ,$207.50 ,$172.92 ,$161.39 ,$170.61 ,$207.50 ,$195.98 ,$27.94 ,$195.98 ,$60.07 ,$56.00 ,$27.94 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316025,82672,ESTROGEN Q439,300,1 ,$177.92 ,$115.65 ,$21.70 ,$160.13 ,$121.88 ,$21.70 ,$104.26 ,$104.26 ,$22.13 ,$145.89 ,$151.23 ,$160.13 ,$133.44 ,$124.54 ,$131.66 ,$160.13 ,$151.23 ,$21.70 ,$151.23 ,$46.66 ,$56.00 ,$21.70 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316034,82330,IONIZED CALCIUM Q306,300,1 ,$153.71 ,$99.91 ,$13.68 ,$138.34 ,$105.29 ,$13.68 ,$90.07 ,$90.07 ,$13.95 ,$126.04 ,$130.65 ,$138.34 ,$115.28 ,$107.60 ,$113.75 ,$138.34 ,$130.65 ,$13.68 ,$130.65 ,$29.41 ,$56.00 ,$13.68 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316038,83002,LH Q615 ADULT,300,1 ,$78.90 ,$51.29 ,$18.52 ,$71.01 ,$54.05 ,$18.52 ,$46.24 ,$46.24 ,$18.89 ,$64.70 ,$67.07 ,$71.01 ,$59.18 ,$55.23 ,$58.39 ,$71.01 ,$67.07 ,$18.52 ,$67.07 ,$39.82 ,$56.00 ,$18.52 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316040,84181,.LYME DISEASE W REFLEX WEST BLOT Q6646,300,1 ,$339.00 ,$220.35 ,$17.03 ,$305.10 ,$232.22 ,$17.03 ,$198.65 ,$198.65 ,$17.37 ,$277.98 ,$288.15 ,$305.10 ,$254.25 ,$237.30 ,$250.86 ,$305.10 ,$288.15 ,$17.03 ,$288.15 ,$36.61 ,$56.00 ,$17.03 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316041,83835,METANEPHRINES TOTAL URINE Q14962,300,1 ,$185.29 ,$120.44 ,$16.94 ,$166.76 ,$126.92 ,$16.94 ,$108.58 ,$108.58 ,$17.28 ,$151.94 ,$157.50 ,$166.76 ,$138.97 ,$129.70 ,$137.11 ,$166.76 ,$157.50 ,$16.94 ,$157.50 ,$36.42 ,$56.00 ,$16.94 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316042,86735,MUMPS AB  IgG Q8624,300,1 ,$90.30 ,$58.70 ,$13.05 ,$81.27 ,$61.86 ,$13.05 ,$52.92 ,$52.92 ,$13.31 ,$74.05 ,$76.76 ,$81.27 ,$67.73 ,$63.21 ,$66.82 ,$81.27 ,$76.76 ,$13.05 ,$76.76 ,$28.06 ,$56.00 ,$13.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316045,83970,PARATHYROID HORMONE Q35202,300,1 ,$305.31 ,$198.45 ,$41.28 ,$274.78 ,$209.14 ,$41.28 ,$178.91 ,$178.91 ,$42.11 ,$250.35 ,$259.51 ,$274.78 ,$228.98 ,$213.72 ,$225.93 ,$274.78 ,$259.51 ,$41.28 ,$259.51 ,$88.75 ,$56.00 ,$41.28 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316049,87495,CYTOMEGALOVIRUS AB IgG Q403,300,1 ,$203.55 ,$132.31 ,$30.03 ,$183.20 ,$139.43 ,$30.03 ,$119.28 ,$119.28 ,$30.63 ,$166.91 ,$173.02 ,$183.20 ,$152.66 ,$142.49 ,$150.63 ,$183.20 ,$173.02 ,$30.03 ,$173.02 ,$64.56 ,$56.00 ,$30.03 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316052,86765,RUBEOLA AB IgG  Q964,300,1 ,$150.49 ,$97.82 ,$12.88 ,$135.44 ,$103.09 ,$12.88 ,$88.19 ,$88.19 ,$13.14 ,$123.40 ,$127.92 ,$135.44 ,$112.87 ,$105.34 ,$111.36 ,$135.44 ,$127.92 ,$12.88 ,$127.92 ,$27.69 ,$56.00 ,$12.88 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316055,84480,T3 TOTAL Q859,300,1 ,$146.34 ,$95.12 ,$14.18 ,$131.71 ,$100.24 ,$14.18 ,$85.76 ,$85.76 ,$14.46 ,$120.00 ,$124.39 ,$131.71 ,$109.76 ,$102.44 ,$108.29 ,$131.71 ,$124.39 ,$14.18 ,$124.39 ,$30.49 ,$56.00 ,$14.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316056,84481,T3 FREE Q34429,300,1 ,$300.04 ,$195.03 ,$16.94 ,$270.04 ,$205.53 ,$16.94 ,$175.82 ,$175.82 ,$17.28 ,$246.03 ,$255.03 ,$270.04 ,$225.03 ,$210.03 ,$222.03 ,$270.04 ,$255.03 ,$16.94 ,$255.03 ,$36.42 ,$56.00 ,$16.94 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316058,84403,TESTOSTERONE TOTAL  Q15983,300,1 ,$264.25 ,$171.76 ,$25.81 ,$237.83 ,$181.01 ,$25.81 ,$154.85 ,$154.85 ,$26.33 ,$216.69 ,$224.61 ,$237.83 ,$198.19 ,$184.98 ,$195.55 ,$237.83 ,$224.61 ,$25.81 ,$224.61 ,$55.49 ,$56.00 ,$25.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316059,84402,TESTOSTERONE FREE & TOTAL  Q36170,300,1 ,$175.29 ,$113.94 ,$25.47 ,$157.76 ,$120.07 ,$25.47 ,$102.72 ,$102.72 ,$25.98 ,$143.74 ,$149.00 ,$157.76 ,$131.47 ,$122.70 ,$129.71 ,$157.76 ,$149.00 ,$25.47 ,$149.00 ,$54.76 ,$56.00 ,$25.47 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316064,84466,TRANSFERRIN Q891,300,1 ,$118.96 ,$77.32 ,$12.76 ,$107.06 ,$81.49 ,$12.76 ,$69.71 ,$69.71 ,$13.02 ,$97.55 ,$101.12 ,$107.06 ,$89.22 ,$83.27 ,$88.03 ,$107.06 ,$101.12 ,$12.76 ,$101.12 ,$27.43 ,$56.00 ,$12.76 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316065,86787,VARICELLA AB IgG Q4439,300,1 ,$285.94 ,$185.86 ,$12.88 ,$257.35 ,$195.87 ,$12.88 ,$167.56 ,$167.56 ,$13.14 ,$234.47 ,$243.05 ,$257.35 ,$214.46 ,$200.16 ,$211.60 ,$257.35 ,$243.05 ,$12.88 ,$243.05 ,$27.69 ,$56.00 ,$12.88 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316066,84432,THYROGLOBULIN PANEL Q30278,300,1 ,$188.45 ,$122.49 ,$16.06 ,$169.61 ,$129.09 ,$16.06 ,$110.43 ,$110.43 ,$16.38 ,$154.53 ,$160.18 ,$169.61 ,$141.34 ,$131.92 ,$139.45 ,$169.61 ,$160.18 ,$16.06 ,$160.18 ,$34.53 ,$56.00 ,$16.06 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316068,84590,VITAMIN A Q921,300,1 ,$113.70 ,$73.91 ,$11.61 ,$102.33 ,$77.88 ,$11.61 ,$66.63 ,$66.63 ,$11.84 ,$93.23 ,$96.65 ,$102.33 ,$85.28 ,$79.59 ,$84.14 ,$102.33 ,$96.65 ,$11.61 ,$96.65 ,$24.96 ,$56.00 ,$11.61 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316070,86812,HLA B27 Q528,300,1 ,$378.39 ,$245.95 ,$25.81 ,$340.55 ,$259.20 ,$25.81 ,$221.74 ,$221.74 ,$26.33 ,$310.28 ,$321.63 ,$340.55 ,$283.79 ,$264.87 ,$280.01 ,$340.55 ,$321.63 ,$25.81 ,$321.63 ,$55.49 ,$56.00 ,$25.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316073,80299,LAMICTAL  Q22060,300,1 ,$289.00 ,$187.85 ,$18.64 ,$260.10 ,$197.97 ,$18.64 ,$169.35 ,$169.35 ,$19.01 ,$236.98 ,$245.65 ,$260.10 ,$216.75 ,$202.30 ,$213.86 ,$260.10 ,$245.65 ,$18.64 ,$245.65 ,$40.08 ,$56.00 ,$18.64 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316084,83498,PROGESTERONE 17 HYDROXY Q17180,300,1 ,$267.41 ,$173.82 ,$27.17 ,$240.67 ,$183.18 ,$27.17 ,$156.70 ,$156.70 ,$27.71 ,$219.28 ,$227.30 ,$240.67 ,$200.56 ,$187.19 ,$197.88 ,$240.67 ,$227.30 ,$27.17 ,$227.30 ,$58.42 ,$56.00 ,$27.17 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316097,86780,FTA  ABS Q4112,300,1 ,$163.39 ,$106.20 ,$13.24 ,$147.05 ,$111.92 ,$13.24 ,$95.75 ,$95.75 ,$13.50 ,$133.98 ,$138.88 ,$147.05 ,$122.54 ,$114.37 ,$120.91 ,$147.05 ,$138.88 ,$13.24 ,$138.88 ,$28.47 ,$56.00 ,$13.24 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316099,83090,HOMOCYSTEINE CARDIO Q31789,300,1 ,$209.50 ,$136.18 ,$17.92 ,$188.55 ,$143.51 ,$17.92 ,$122.77 ,$122.77 ,$18.28 ,$171.79 ,$178.08 ,$188.55 ,$157.13 ,$146.65 ,$155.03 ,$188.55 ,$178.08 ,$17.92 ,$178.08 ,$38.53 ,$56.00 ,$17.92 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316102,83890,.HEPATITIS C RNA QUANT CONFIRM Q35645,300,1 ,$489.00 ,$317.85 ,$56.00 ,$440.10 ,$334.97 , N/A ,$286.55 ,$286.55 , N/A ,$400.98 ,$415.65 ,$440.10 ,$366.75 ,$342.30 ,$361.86 ,$440.10 ,$415.65 , N/A ,$415.65 , N/A ,$56.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316112,83986,PH BODY FLUID Q5367,300,1 ,$23.16 ,$15.05 ,$3.58 ,$23.16 ,$15.86 ,$3.58 ,$13.57 ,$13.57 ,$3.65 ,$18.99 ,$19.69 ,$20.84 ,$17.37 ,$16.21 ,$17.14 ,$20.84 ,$19.69 ,$3.58 ,$19.69 ,$7.70 ,$23.16 ,$3.58 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316116,84207,VITAMIN B-6 Q926,300,1 ,$174.76 ,$113.59 ,$28.10 ,$157.28 ,$119.71 ,$28.10 ,$102.41 ,$102.41 ,$28.66 ,$143.30 ,$148.55 ,$157.28 ,$131.07 ,$122.33 ,$129.32 ,$157.28 ,$148.55 ,$28.10 ,$148.55 ,$60.42 ,$56.00 ,$28.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316120,86147,ANTIPHOSPHOLIPID SYNDROME PROFILE Q14890,300,1 ,$864.27 ,$561.78 ,$25.45 ,$777.84 ,$592.03 ,$25.45 ,$506.46 ,$506.46 ,$25.96 ,$708.70 ,$734.63 ,$777.84 ,$648.20 ,$604.99 ,$639.56 ,$777.84 ,$734.63 ,$25.45 ,$734.63 ,$54.72 ,$56.00 ,$25.45 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316122,86804,HEP C AB EMP W/RFX RNA Q8472,300,1 ,$476.21 ,$309.54 ,$15.49 ,$428.59 ,$326.20 ,$15.49 ,$279.06 ,$279.06 ,$15.80 ,$390.49 ,$404.78 ,$428.59 ,$357.16 ,$333.35 ,$352.40 ,$428.59 ,$404.78 ,$15.49 ,$404.78 ,$33.30 ,$56.00 ,$15.49 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316132,85362,FDP PLASMA Q458,300,1 ,$67.00 ,$43.55 ,$6.89 ,$60.30 ,$45.90 ,$6.89 ,$39.26 ,$39.26 ,$7.03 ,$54.94 ,$56.95 ,$60.30 ,$50.25 ,$46.90 ,$49.58 ,$60.30 ,$56.95 ,$6.89 ,$56.95 ,$14.81 ,$56.00 ,$6.89 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316134,83010,HAPTOGLOBIN Q502,300,1 ,$143.18 ,$93.07 ,$12.58 ,$128.86 ,$98.08 ,$12.58 ,$83.90 ,$83.90 ,$12.83 ,$117.41 ,$121.70 ,$128.86 ,$107.39 ,$100.23 ,$105.95 ,$128.86 ,$121.70 ,$12.58 ,$121.70 ,$27.05 ,$56.00 ,$12.58 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316137,82668,ERYTHROPOIETIN Q427,300,1 ,$164.23 ,$106.75 ,$18.79 ,$147.81 ,$112.50 ,$18.79 ,$96.24 ,$96.24 ,$19.17 ,$134.67 ,$139.60 ,$147.81 ,$123.17 ,$114.96 ,$121.53 ,$147.81 ,$139.60 ,$18.79 ,$139.60 ,$40.40 ,$56.00 ,$18.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316156,82941,GASTRIN LEVEL SERUM Q478,300,1 ,$109.49 ,$71.17 ,$17.63 ,$98.54 ,$75.00 ,$17.63 ,$64.16 ,$64.16 ,$17.98 ,$89.78 ,$93.07 ,$98.54 ,$82.12 ,$76.64 ,$81.02 ,$98.54 ,$93.07 ,$17.63 ,$93.07 ,$37.90 ,$56.00 ,$17.63 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316160,82103,ALPHA I ANTITRYPSIN Q235,300,1 ,$127.39 ,$82.80 ,$13.44 ,$114.65 ,$87.26 ,$13.44 ,$74.65 ,$74.65 ,$13.71 ,$104.46 ,$108.28 ,$114.65 ,$95.54 ,$89.17 ,$94.27 ,$114.65 ,$108.28 ,$13.44 ,$108.28 ,$28.90 ,$56.00 ,$13.44 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316164,83874,MYOGLOBIN SERUM Q660,300,1 ,$126.33 ,$82.11 ,$12.92 ,$113.70 ,$86.54 ,$12.92 ,$74.03 ,$74.03 ,$13.18 ,$103.59 ,$107.38 ,$113.70 ,$94.75 ,$88.43 ,$93.48 ,$113.70 ,$107.38 ,$12.92 ,$107.38 ,$27.78 ,$56.00 ,$12.92 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316167,84442,THYROXINE BINDING GLOBULIN Q870,300,1 ,$123.18 ,$80.07 ,$14.78 ,$110.86 ,$84.38 ,$14.78 ,$72.18 ,$72.18 ,$15.08 ,$101.01 ,$104.70 ,$110.86 ,$92.39 ,$86.23 ,$91.15 ,$110.86 ,$104.70 ,$14.78 ,$104.70 ,$31.78 ,$56.00 ,$14.78 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316170,84630,ZINC PLASMA Q945,300,1 ,$127.39 ,$82.80 ,$11.39 ,$114.65 ,$87.26 ,$11.39 ,$74.65 ,$74.65 ,$11.62 ,$104.46 ,$108.28 ,$114.65 ,$95.54 ,$89.17 ,$94.27 ,$114.65 ,$108.28 ,$11.39 ,$108.28 ,$24.49 ,$56.00 ,$11.39 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316171,83020,HEMOGLOBINOPATHY PROFILE Q35489,300,1 ,$145.28 ,$94.43 ,$12.87 ,$130.75 ,$99.52 ,$12.87 ,$85.13 ,$85.13 ,$13.13 ,$119.13 ,$123.49 ,$130.75 ,$108.96 ,$101.70 ,$107.51 ,$130.75 ,$123.49 ,$12.87 ,$123.49 ,$27.67 ,$56.00 ,$12.87 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316174,87328,GIARDIA LAMBIA ANTIGEN STOOL Q8625,300,1 ,$198.95 ,$129.32 ,$13.82 ,$179.06 ,$136.28 ,$13.82 ,$116.58 ,$116.58 ,$14.10 ,$163.14 ,$169.11 ,$179.06 ,$149.21 ,$139.27 ,$147.22 ,$179.06 ,$169.11 ,$13.82 ,$169.11 ,$29.71 ,$56.00 ,$13.82 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316178,84681,C PEPTIDE SERUM Q372,300,1 ,$140.02 ,$91.01 ,$20.81 ,$126.02 ,$95.91 ,$20.81 ,$82.05 ,$82.05 ,$21.23 ,$114.82 ,$119.02 ,$126.02 ,$105.02 ,$98.01 ,$103.61 ,$126.02 ,$119.02 ,$20.81 ,$119.02 ,$44.74 ,$56.00 ,$20.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316182,82525,COPPER SERUM Q363,300,1 ,$181.08 ,$117.70 ,$12.41 ,$162.97 ,$124.04 ,$12.41 ,$106.11 ,$106.11 ,$12.66 ,$148.49 ,$153.92 ,$162.97 ,$135.81 ,$126.76 ,$134.00 ,$162.97 ,$153.92 ,$12.41 ,$153.92 ,$26.68 ,$56.00 ,$12.41 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316183,81241,FACTOR V LEIDEN MUTATION Q17900,300,1 ,$367.48 ,$238.86 ,$56.00 ,$330.73 ,$251.72 ,$73.37 ,$215.34 ,$215.34 ,$74.84 ,$301.33 ,$312.36 ,$330.73 ,$275.61 ,$257.24 ,$271.94 ,$330.73 ,$312.36 ,$73.37 ,$312.36 ,$157.75 ,$56.00 ,$73.37 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316189,86225,ANTI DS DNA AB Q255,300,1 ,$230.04 ,$149.53 ,$13.74 ,$207.04 ,$157.58 ,$13.74 ,$134.80 ,$134.80 ,$14.01 ,$188.63 ,$195.53 ,$207.04 ,$172.53 ,$161.03 ,$170.23 ,$207.04 ,$195.53 ,$13.74 ,$195.53 ,$29.54 ,$56.00 ,$13.74 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316197,83525,INSULIN Q561,300,1 ,$135.81 ,$88.28 ,$11.43 ,$122.23 ,$93.03 ,$11.43 ,$79.58 ,$79.58 ,$11.66 ,$111.36 ,$115.44 ,$122.23 ,$101.86 ,$95.07 ,$100.50 ,$122.23 ,$115.44 ,$11.43 ,$115.44 ,$24.57 ,$56.00 ,$11.43 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316201,83935,OSMOLALITY URINE Q678,300,1 ,$75.80 ,$49.27 ,$6.82 ,$68.22 ,$51.92 ,$6.82 ,$44.42 ,$44.42 ,$6.96 ,$62.16 ,$64.43 ,$68.22 ,$56.85 ,$53.06 ,$56.09 ,$68.22 ,$64.43 ,$6.82 ,$64.43 ,$14.66 ,$56.00 ,$6.82 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316214,85660,HEMOGLOBIN SOLUBILITY Q35489,300,1 ,$57.00 ,$37.05 ,$5.51 ,$56.00 ,$39.05 ,$5.51 ,$33.40 ,$33.40 ,$5.62 ,$46.74 ,$48.45 ,$51.30 ,$42.75 ,$39.90 ,$42.18 ,$51.30 ,$48.45 ,$5.51 ,$48.45 ,$11.85 ,$56.00 ,$5.51 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316215,82784,IMMUNOGLOBULIN IgG QUANT Q543,300,1 ,$151.60 ,$98.54 ,$9.30 ,$136.44 ,$103.85 ,$9.30 ,$88.84 ,$88.84 ,$9.49 ,$124.31 ,$128.86 ,$136.44 ,$113.70 ,$106.12 ,$112.18 ,$136.44 ,$128.86 ,$9.30 ,$128.86 ,$20.00 ,$56.00 ,$9.30 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316217,82232,BETA  2 MICROGLOBULIN  SERUM Q852,300,1 ,$107.38 ,$69.80 ,$16.18 ,$96.64 ,$73.56 ,$16.18 ,$62.92 ,$62.92 ,$16.50 ,$88.05 ,$91.27 ,$96.64 ,$80.54 ,$75.17 ,$79.46 ,$96.64 ,$91.27 ,$16.18 ,$91.27 ,$34.79 ,$56.00 ,$16.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316220,86376,ANTITHYROID MICROSOMAL TPO AB Q7260,300,1 ,$212.84 ,$138.35 ,$14.55 ,$191.56 ,$145.80 ,$14.55 ,$124.72 ,$124.72 ,$14.84 ,$174.53 ,$180.91 ,$191.56 ,$159.63 ,$148.99 ,$157.50 ,$191.56 ,$180.91 ,$14.55 ,$180.91 ,$31.28 ,$56.00 ,$14.55 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316222,82104,ALPHA 1 ANTITRYPSIN PHENO Q853,300,1 ,$153.71 ,$99.91 ,$14.46 ,$138.34 ,$105.29 ,$14.46 ,$90.07 ,$90.07 ,$14.75 ,$126.04 ,$130.65 ,$138.34 ,$115.28 ,$107.60 ,$113.75 ,$138.34 ,$130.65 ,$14.46 ,$130.65 ,$31.09 ,$56.00 ,$14.46 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316223,87536,QUANTATIVE RNA HIV BY PCR Q40085,300,1 ,$654.35 ,$425.33 ,$56.00 ,$588.92 ,$448.23 ,$85.10 ,$383.45 ,$383.45 ,$86.80 ,$536.57 ,$556.20 ,$588.92 ,$490.76 ,$458.05 ,$484.22 ,$588.92 ,$556.20 ,$85.10 ,$556.20 ,$182.97 ,$56.00 ,$85.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316225,86705,HEPATITIS B CORE AB IGM Q4848,300,1 ,$82.77 ,$53.80 ,$11.77 ,$74.49 ,$56.70 ,$11.77 ,$48.50 ,$48.50 ,$12.01 ,$67.87 ,$70.35 ,$74.49 ,$62.08 ,$57.94 ,$61.25 ,$74.49 ,$70.35 ,$11.77 ,$70.35 ,$25.31 ,$56.00 ,$11.77 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316231,83930,OSMOLALITY SERUM Q677,300,1 ,$83.17 ,$54.06 ,$6.61 ,$74.85 ,$56.97 ,$6.61 ,$48.74 ,$48.74 ,$6.74 ,$68.20 ,$70.69 ,$74.85 ,$62.38 ,$58.22 ,$61.55 ,$74.85 ,$70.69 ,$6.61 ,$70.69 ,$14.21 ,$56.00 ,$6.61 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316233,82530,CORTISOL FREE URINE Q11280,300,1 ,$222.14 ,$144.39 ,$16.71 ,$199.93 ,$152.17 ,$16.71 ,$130.17 ,$130.17 ,$17.04 ,$182.15 ,$188.82 ,$199.93 ,$166.61 ,$155.50 ,$164.38 ,$199.93 ,$188.82 ,$16.71 ,$188.82 ,$35.93 ,$56.00 ,$16.71 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316241,83695,LIPOPROTEIN A Q34604,300,1 ,$154.76 ,$100.59 ,$14.32 ,$139.28 ,$106.01 ,$14.32 ,$90.69 ,$90.69 ,$14.61 ,$126.90 ,$131.55 ,$139.28 ,$116.07 ,$108.33 ,$114.52 ,$139.28 ,$131.55 ,$14.32 ,$131.55 ,$30.79 ,$56.00 ,$14.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316248,84445,THYROID STIMULATING IMMUNOGLOB Q30551,300,1 ,$348.47 ,$226.51 ,$50.86 ,$313.62 ,$238.70 ,$50.86 ,$204.20 ,$204.20 ,$51.88 ,$285.75 ,$296.20 ,$313.62 ,$261.35 ,$243.93 ,$257.87 ,$313.62 ,$296.20 ,$50.86 ,$296.20 ,$109.35 ,$56.00 ,$50.86 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316250,86665,.P EPSTEIN BARR VIRUS VCA,300,1 ,$124.70 ,$81.06 ,$18.14 ,$112.23 ,$85.42 ,$18.14 ,$73.07 ,$73.07 ,$18.50 ,$102.25 ,$106.00 ,$112.23 ,$93.53 ,$87.29 ,$92.28 ,$112.23 ,$106.00 ,$18.14 ,$106.00 ,$39.00 ,$56.00 ,$18.14 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316252,86645,CYTOMEGALOVIRUS AB IgM Q96727,300,1 ,$190.27 ,$123.68 ,$16.85 ,$171.24 ,$130.34 ,$16.85 ,$111.50 ,$111.50 ,$17.19 ,$156.02 ,$161.73 ,$171.24 ,$142.70 ,$133.19 ,$140.80 ,$171.24 ,$161.73 ,$16.85 ,$161.73 ,$36.23 ,$56.00 ,$16.85 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316259,83003,GROWTH HORMONE Q521,300,1 ,$166.34 ,$108.12 ,$16.67 ,$149.71 ,$113.94 ,$16.67 ,$97.48 ,$97.48 ,$17.00 ,$136.40 ,$141.39 ,$149.71 ,$124.76 ,$116.44 ,$123.09 ,$149.71 ,$141.39 ,$16.67 ,$141.39 ,$35.84 ,$56.00 ,$16.67 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316260,82088,ALDOSTERONE Q17181,300,1 ,$368.47 ,$239.51 ,$40.75 ,$331.62 ,$252.40 ,$40.75 ,$215.92 ,$215.92 ,$41.57 ,$302.15 ,$313.20 ,$331.62 ,$276.35 ,$257.93 ,$272.67 ,$331.62 ,$313.20 ,$40.75 ,$313.20 ,$87.61 ,$56.00 ,$40.75 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316266,84105,PHOSPHORUS URINE  24 HOUR Q11319,300,1 ,$72.64 ,$47.22 ,$5.78 ,$65.38 ,$49.76 ,$5.78 ,$42.57 ,$42.57 ,$5.90 ,$59.56 ,$61.74 ,$65.38 ,$54.48 ,$50.85 ,$53.75 ,$65.38 ,$61.74 ,$5.78 ,$61.74 ,$12.43 ,$56.00 ,$5.78 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316267,86709,HEPATITIS A AB IgM Q512,300,1 ,$146.20 ,$95.03 ,$11.26 ,$131.58 ,$100.15 ,$11.26 ,$85.67 ,$85.67 ,$11.49 ,$119.88 ,$124.27 ,$131.58 ,$109.65 ,$102.34 ,$108.19 ,$131.58 ,$124.27 ,$11.26 ,$124.27 ,$24.21 ,$56.00 ,$11.26 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316269,82652,VITAMIN D DIHYDROXYCALCITRIOL 125 Q16558,300,1 ,$237.93 ,$154.65 ,$38.50 ,$214.14 ,$162.98 ,$38.50 ,$139.43 ,$139.43 ,$39.27 ,$195.10 ,$202.24 ,$214.14 ,$178.45 ,$166.55 ,$176.07 ,$214.14 ,$202.24 ,$38.50 ,$202.24 ,$82.78 ,$56.00 ,$38.50 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316274,86146,.BETA 2,300,1 ,$153.00 ,$99.45 ,$25.45 ,$137.70 ,$104.81 ,$25.45 ,$89.66 ,$89.66 ,$25.96 ,$125.46 ,$130.05 ,$137.70 ,$114.75 ,$107.10 ,$113.22 ,$137.70 ,$130.05 ,$25.45 ,$130.05 ,$54.72 ,$56.00 ,$25.45 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316282,86141,CRP CARDIAC ULTRA SENSITIVE  Q10124,300,1 ,$103.20 ,$67.08 ,$12.95 ,$92.88 ,$70.69 ,$12.95 ,$60.48 ,$60.48 ,$13.21 ,$84.62 ,$87.72 ,$92.88 ,$77.40 ,$72.24 ,$76.37 ,$92.88 ,$87.72 ,$12.95 ,$87.72 ,$27.84 ,$56.00 ,$12.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316284,83655,LEAD PEDIATRIC Q599,300,1 ,$113.70 ,$73.91 ,$12.11 ,$102.33 ,$77.88 ,$12.11 ,$66.63 ,$66.63 ,$12.35 ,$93.23 ,$96.65 ,$102.33 ,$85.28 ,$79.59 ,$84.14 ,$102.33 ,$96.65 ,$12.11 ,$96.65 ,$26.04 ,$56.00 ,$12.11 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316301,80201,TOPAMAX Q30965 (TOPIRAMATE),300,1 ,$174.00 ,$113.10 ,$11.92 ,$156.60 ,$119.19 ,$11.92 ,$101.96 ,$101.96 ,$12.16 ,$142.68 ,$147.90 ,$156.60 ,$130.50 ,$121.80 ,$128.76 ,$156.60 ,$147.90 ,$11.92 ,$147.90 ,$25.63 ,$56.00 ,$11.92 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316306,82627,DHEA SULFATE Q402,300,1 ,$145.28 ,$94.43 ,$22.23 ,$130.75 ,$99.52 ,$22.23 ,$85.13 ,$85.13 ,$22.67 ,$119.13 ,$123.49 ,$130.75 ,$108.96 ,$101.70 ,$107.51 ,$130.75 ,$123.49 ,$22.23 ,$123.49 ,$47.79 ,$56.00 ,$22.23 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316307,86038,ANA DIRECT WITH REFLEX Q249,300,1 ,$163.39 ,$106.20 ,$12.09 ,$147.05 ,$111.92 ,$12.09 ,$95.75 ,$95.75 ,$12.33 ,$133.98 ,$138.88 ,$147.05 ,$122.54 ,$114.37 ,$120.91 ,$147.05 ,$138.88 ,$12.09 ,$138.88 ,$25.99 ,$56.00 ,$12.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),3163071,86039,.TITER ANA,300,1 ,$50.00 ,$32.50 ,$11.16 ,$50.00 ,$34.25 ,$11.16 ,$29.30 ,$29.30 ,$11.38 ,$41.00 ,$42.50 ,$45.00 ,$37.50 ,$35.00 ,$37.00 ,$45.00 ,$42.50 ,$11.16 ,$42.50 ,$23.99 ,$50.00 ,$11.16 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316316,84166,PROTEIN ELECTROPHORESIS CSF Q749,300,1 ,$174.76 ,$113.59 ,$17.83 ,$157.28 ,$119.71 ,$17.83 ,$102.41 ,$102.41 ,$18.19 ,$143.30 ,$148.55 ,$157.28 ,$131.07 ,$122.33 ,$129.32 ,$157.28 ,$148.55 ,$17.83 ,$148.55 ,$38.33 ,$56.00 ,$17.83 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316328,84238,ACETYLCHOLINE RECEPTOR BINDING Q206,300,1 ,$226.35 ,$147.13 ,$36.57 ,$203.72 ,$155.05 ,$36.57 ,$132.64 ,$132.64 ,$37.30 ,$185.61 ,$192.40 ,$203.72 ,$169.76 ,$158.45 ,$167.50 ,$203.72 ,$192.40 ,$36.57 ,$192.40 ,$78.63 ,$56.00 ,$36.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316332,86698,HISTOPLASMA ANTIBODIES QUANT Q938,300,1 ,$147.27 ,$95.73 ,$13.79 ,$132.54 ,$100.88 ,$13.79 ,$86.30 ,$86.30 ,$14.07 ,$120.76 ,$125.18 ,$132.54 ,$110.45 ,$103.09 ,$108.98 ,$132.54 ,$125.18 ,$13.79 ,$125.18 ,$29.65 ,$56.00 ,$13.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316333,86663,EPSTEIN BAR VIRUS AB EARLY Ag Q15447,300,1 ,$188.12 ,$122.28 ,$13.12 ,$169.31 ,$128.86 ,$13.12 ,$110.24 ,$110.24 ,$13.38 ,$154.26 ,$159.90 ,$169.31 ,$141.09 ,$131.68 ,$139.21 ,$169.31 ,$159.90 ,$13.12 ,$159.90 ,$28.21 ,$56.00 ,$13.12 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316336,81256,HEREDITARY HEMACHROMAT H63D C282Y Q35079,300,1 ,$676.00 ,$439.40 ,$56.00 ,$608.40 ,$463.06 ,$65.36 ,$396.14 ,$396.14 ,$66.67 ,$554.32 ,$574.60 ,$608.40 ,$507.00 ,$473.20 ,$500.24 ,$608.40 ,$574.60 ,$65.36 ,$574.60 ,$140.52 ,$56.00 ,$65.36 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316344,88108,URINE CYTOLOGY Q10676,300,1 ,$523.25 ,$340.11 ,$31.95 ,$470.93 ,$358.43 ,$31.95 ,$306.62 ,$306.62 ,$32.58 ,$429.07 ,$444.76 ,$470.93 ,$392.44 ,$366.28 ,$387.21 ,$470.93 ,$444.76 ,$31.95 ,$444.76 ,$68.68 ,$56.00 ,$31.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316353,86161,C 1 ESTERASE INHIBITOR FUNCTIONAL Q297,300,1 ,$267.67 ,$173.99 ,$12.00 ,$240.90 ,$183.35 ,$12.00 ,$156.85 ,$156.85 ,$12.24 ,$219.49 ,$227.52 ,$240.90 ,$200.75 ,$187.37 ,$198.08 ,$240.90 ,$227.52 ,$12.00 ,$227.52 ,$25.80 ,$56.00 ,$12.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316355,80183,TRILEPTAL OXCARBAZEPINE Q36637,300,1 ,$209.00 ,$135.85 ,$13.25 ,$188.10 ,$143.17 ,$13.25 ,$122.47 ,$122.47 ,$13.52 ,$171.38 ,$177.65 ,$188.10 ,$156.75 ,$146.30 ,$154.66 ,$188.10 ,$177.65 ,$13.25 ,$177.65 ,$28.49 ,$56.00 ,$13.25 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316360,82747,FOLATE RBC  Q467,300,1 ,$133.70 ,$86.91 ,$17.65 ,$120.33 ,$91.58 ,$17.65 ,$78.35 ,$78.35 ,$18.00 ,$109.63 ,$113.65 ,$120.33 ,$100.28 ,$93.59 ,$98.94 ,$120.33 ,$113.65 ,$17.65 ,$113.65 ,$37.95 ,$56.00 ,$17.65 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316361,84425,VITAMIN B1 PLASMA Q90353,300,1 ,$227.40 ,$147.81 ,$21.23 ,$204.66 ,$155.77 ,$21.23 ,$133.26 ,$133.26 ,$21.65 ,$186.47 ,$193.29 ,$204.66 ,$170.55 ,$159.18 ,$168.28 ,$204.66 ,$193.29 ,$21.23 ,$193.29 ,$45.64 ,$56.00 ,$21.23 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316363,83721,LDL DIRECT Q8293,300,1 ,$94.75 ,$61.59 ,$10.50 ,$85.28 ,$64.90 ,$10.50 ,$55.52 ,$55.52 ,$10.71 ,$77.70 ,$80.54 ,$85.28 ,$71.06 ,$66.33 ,$70.12 ,$85.28 ,$80.54 ,$10.50 ,$80.54 ,$22.58 ,$56.00 ,$10.50 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316366,83921,METHYLMALONIC ACID Q91002,300,1 ,$365.32 ,$237.46 ,$21.21 ,$328.79 ,$250.24 ,$21.21 ,$214.08 ,$214.08 ,$21.63 ,$299.56 ,$310.52 ,$328.79 ,$273.99 ,$255.72 ,$270.34 ,$328.79 ,$310.52 ,$21.21 ,$310.52 ,$45.60 ,$56.00 ,$21.21 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316373,86592,RPR WITH REFLEX TO CONFIRM TESTS Q36126,300,1 ,$98.90 ,$64.29 ,$4.27 ,$89.01 ,$67.75 ,$4.27 ,$57.96 ,$57.96 ,$4.36 ,$81.10 ,$84.07 ,$89.01 ,$74.18 ,$69.23 ,$73.19 ,$89.01 ,$84.07 ,$4.27 ,$84.07 ,$9.18 ,$56.00 ,$4.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316378,81240,PROTHROMBIN GENE MUTATION FII PANEL17909,300,1 ,$190.00 ,$123.50 ,$56.00 ,$171.00 ,$130.15 ,$65.69 ,$111.34 ,$111.34 ,$67.00 ,$155.80 ,$161.50 ,$171.00 ,$142.50 ,$133.00 ,$140.60 ,$171.00 ,$161.50 ,$65.69 ,$161.50 ,$141.23 ,$56.00 ,$65.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316380,84244,RENIN PLASMA Q16846,300,1 ,$226.35 ,$147.13 ,$21.99 ,$203.72 ,$155.05 ,$21.99 ,$132.64 ,$132.64 ,$22.43 ,$185.61 ,$192.40 ,$203.72 ,$169.76 ,$158.45 ,$167.50 ,$203.72 ,$192.40 ,$21.99 ,$192.40 ,$47.28 ,$56.00 ,$21.99 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316382,86694,HERPES I AND II IgM Q90849,300,1 ,$169.84 ,$110.40 ,$14.39 ,$152.86 ,$116.34 ,$14.39 ,$99.53 ,$99.53 ,$14.68 ,$139.27 ,$144.36 ,$152.86 ,$127.38 ,$118.89 ,$125.68 ,$152.86 ,$144.36 ,$14.39 ,$144.36 ,$30.94 ,$56.00 ,$14.39 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316383,87255,HERPES CULT WITH TYPING Q2649,300,1 ,$347.30 ,$225.75 ,$33.86 ,$312.57 ,$237.90 ,$33.86 ,$203.52 ,$203.52 ,$34.54 ,$284.79 ,$295.21 ,$312.57 ,$260.48 ,$243.11 ,$257.00 ,$312.57 ,$295.21 ,$33.86 ,$295.21 ,$72.80 ,$56.00 ,$33.86 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316399,86022,.ANTIPLATELET AB IgG INDIRECT Q5341,300,1 ,$416.01 ,$270.41 ,$18.37 ,$374.41 ,$284.97 ,$18.37 ,$243.78 ,$243.78 ,$18.74 ,$341.13 ,$353.61 ,$374.41 ,$312.01 ,$291.21 ,$307.85 ,$374.41 ,$353.61 ,$18.37 ,$353.61 ,$39.50 ,$56.00 ,$18.37 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316403,86684,HIB AB TITER Q35135,300,1 ,$440.74 ,$286.48 ,$15.84 ,$396.67 ,$301.91 ,$15.84 ,$258.27 ,$258.27 ,$16.16 ,$361.41 ,$374.63 ,$396.67 ,$330.56 ,$308.52 ,$326.15 ,$396.67 ,$374.63 ,$15.84 ,$374.63 ,$34.06 ,$56.00 ,$15.84 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316495,86200,CYCLIC CITRULLINATED PEPTIDE Q11173,300,1 ,$82.77 ,$53.80 ,$12.95 ,$74.49 ,$56.70 ,$12.95 ,$48.50 ,$48.50 ,$13.21 ,$67.87 ,$70.35 ,$74.49 ,$62.08 ,$57.94 ,$61.25 ,$74.49 ,$70.35 ,$12.95 ,$70.35 ,$27.84 ,$56.00 ,$12.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316504,85306,PROTEIN S ACTIVITY Q1779,300,1 ,$426.00 ,$276.90 ,$15.32 ,$383.40 ,$291.81 ,$15.32 ,$249.64 ,$249.64 ,$15.63 ,$349.32 ,$362.10 ,$383.40 ,$319.50 ,$298.20 ,$315.24 ,$383.40 ,$362.10 ,$15.32 ,$362.10 ,$32.94 ,$56.00 ,$15.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316893,84482,REVERSE T3 Q967,300,1 ,$372.69 ,$242.25 ,$15.76 ,$335.42 ,$255.29 ,$15.76 ,$218.40 ,$218.40 ,$16.08 ,$305.61 ,$316.79 ,$335.42 ,$279.52 ,$260.88 ,$275.79 ,$335.42 ,$316.79 ,$15.76 ,$316.79 ,$33.88 ,$56.00 ,$15.76 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316908,86337,INSULIN AUTOANTIBODIES Q36178,300,1 ,$500.93 ,$325.60 ,$21.41 ,$450.84 ,$343.14 ,$21.41 ,$293.55 ,$293.55 ,$21.84 ,$410.76 ,$425.79 ,$450.84 ,$375.70 ,$350.65 ,$370.69 ,$450.84 ,$425.79 ,$21.41 ,$425.79 ,$46.03 ,$56.00 ,$21.41 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316910,81291,MTHFR DNA MUTATION ANALYSIS Q17911,300,1 ,$745.17 ,$484.36 ,$56.00 ,$670.65 ,$510.44 ,$65.34 ,$436.67 ,$436.67 ,$66.65 ,$611.04 ,$633.39 ,$670.65 ,$558.88 ,$521.62 ,$551.43 ,$670.65 ,$633.39 ,$65.34 ,$633.39 ,$140.48 ,$56.00 ,$65.34 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316912,82679,ESTRONE Q23244,300,1 ,$161.08 ,$104.70 ,$24.95 ,$144.97 ,$110.34 ,$24.95 ,$94.39 ,$94.39 ,$25.45 ,$132.09 ,$136.92 ,$144.97 ,$120.81 ,$112.76 ,$119.20 ,$144.97 ,$136.92 ,$24.95 ,$136.92 ,$53.64 ,$56.00 ,$24.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316913,80197,TACROLIMUS Q70007,300,1 ,$416.00 ,$270.40 ,$13.73 ,$374.40 ,$284.96 ,$13.73 ,$243.78 ,$243.78 ,$14.00 ,$341.12 ,$353.60 ,$374.40 ,$312.00 ,$291.20 ,$307.84 ,$374.40 ,$353.60 ,$13.73 ,$353.60 ,$29.52 ,$56.00 ,$13.73 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316951,86666,EHRLICHIOSIS IgG IgM PANEL Q34271,300,1 ,"$1,229.76 ",$799.34 ,$10.18 ,"$1,106.78 ",$842.39 ,$10.18 ,$720.64 ,$720.64 ,$10.38 ,"$1,008.40 ","$1,045.30 ","$1,106.78 ",$922.32 ,$860.83 ,$910.02 ,"$1,106.78 ","$1,045.30 ",$10.18 ,"$1,045.30 ",$21.89 ,$56.00 ,$10.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316955,86003,SHRIMP IgE f24 Q2824,300,1 ,$29.02 ,$18.86 ,$5.22 ,$29.02 ,$19.88 ,$5.22 ,$17.01 ,$17.01 ,$5.32 ,$23.80 ,$24.67 ,$26.12 ,$21.77 ,$20.31 ,$21.47 ,$26.12 ,$24.67 ,$5.22 ,$24.67 ,$11.22 ,$29.02 ,$5.22 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316980,87340,.PRENATAL-HBsAg Q498,300,1 ,$293.25 ,$190.61 ,$10.33 ,$263.93 ,$200.88 ,$10.33 ,$171.84 ,$171.84 ,$10.54 ,$240.47 ,$249.26 ,$263.93 ,$219.94 ,$205.28 ,$217.01 ,$263.93 ,$249.26 ,$10.33 ,$249.26 ,$22.21 ,$56.00 ,$10.33 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316983,86704,HEPATITIS B CORE TOTAL Q501,300,1 ,$184.89 ,$120.18 ,$12.05 ,$166.40 ,$126.65 ,$12.05 ,$108.35 ,$108.35 ,$12.29 ,$151.61 ,$157.16 ,$166.40 ,$138.67 ,$129.42 ,$136.82 ,$166.40 ,$157.16 ,$12.05 ,$157.16 ,$25.91 ,$56.00 ,$12.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),316998,82172,APOLIPOPROTEIN B  Q5224,300,1 ,$95.80 ,$62.27 ,$21.09 ,$86.22 ,$65.62 ,$21.09 ,$56.14 ,$56.14 ,$21.51 ,$78.56 ,$81.43 ,$86.22 ,$71.85 ,$67.06 ,$70.89 ,$86.22 ,$81.43 ,$21.09 ,$81.43 ,$45.34 ,$56.00 ,$21.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317002,84270,SEX HORMONE BINDING GLOBULIN Q30740,300,1 ,$78.96 ,$51.32 ,$21.73 ,$71.06 ,$54.09 ,$21.73 ,$46.27 ,$46.27 ,$22.16 ,$64.75 ,$67.12 ,$71.06 ,$59.22 ,$55.27 ,$58.43 ,$71.06 ,$67.12 ,$21.73 ,$67.12 ,$46.72 ,$56.00 ,$21.73 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317020,83519,THYROTROPIN BINDING INHIBITOR Ig Q5738,300,1 ,$128.44 ,$83.49 ,$18.40 ,$115.60 ,$87.98 ,$18.40 ,$75.27 ,$75.27 ,$18.77 ,$105.32 ,$109.17 ,$115.60 ,$96.33 ,$89.91 ,$95.05 ,$115.60 ,$109.17 ,$18.40 ,$109.17 ,$39.56 ,$56.00 ,$18.40 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317031,85303,PROTEIN C ACTIVITY Q1777,300,1 ,$301.00 ,$195.65 ,$13.84 ,$270.90 ,$206.19 ,$13.84 ,$176.39 ,$176.39 ,$14.12 ,$246.82 ,$255.85 ,$270.90 ,$225.75 ,$210.70 ,$222.74 ,$270.90 ,$255.85 ,$13.84 ,$255.85 ,$29.76 ,$56.00 ,$13.84 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317042,87799,BK VIRUS QUANT PCR Q11274,300,1 ,"$1,843.45 ","$1,198.24 ",$42.84 ,"$1,659.11 ","$1,262.76 ",$42.84 ,"$1,080.26 ","$1,080.26 ",$43.70 ,"$1,511.63 ","$1,566.93 ","$1,659.11 ","$1,382.59 ","$1,290.42 ","$1,364.15 ","$1,659.11 ","$1,566.93 ",$42.84 ,"$1,566.93 ",$92.11 ,$56.00 ,$42.84 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317060,80203,ZONISAMIDE Q37852,300,1 ,$178.35 ,$115.93 ,$13.25 ,$160.52 ,$122.17 ,$13.25 ,$104.51 ,$104.51 ,$13.52 ,$146.25 ,$151.60 ,$160.52 ,$133.76 ,$124.85 ,$131.98 ,$160.52 ,$151.60 ,$13.25 ,$151.60 ,$28.49 ,$56.00 ,$13.25 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317320,84252,VITAMIN B2  RIBOFLAVIN Q36399,300,1 ,$430.59 ,$279.88 ,$20.24 ,$387.53 ,$294.95 ,$20.24 ,$252.33 ,$252.33 ,$20.64 ,$353.08 ,$366.00 ,$387.53 ,$322.94 ,$301.41 ,$318.64 ,$387.53 ,$366.00 ,$20.24 ,$366.00 ,$43.52 ,$56.00 ,$20.24 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317324,83993,CALPROTECTIN  FECAL Q16796,300,1 ,$275.83 ,$179.29 ,$19.63 ,$248.25 ,$188.94 ,$19.63 ,$161.64 ,$161.64 ,$20.02 ,$226.18 ,$234.46 ,$248.25 ,$206.87 ,$193.08 ,$204.11 ,$248.25 ,$234.46 ,$19.63 ,$234.46 ,$42.20 ,$56.00 ,$19.63 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317330,83789,TPMT Q18831,300,1 ,"$1,104.37 ",$717.84 ,$24.11 ,$993.93 ,$756.49 ,$24.11 ,$647.16 ,$647.16 ,$24.59 ,$905.58 ,$938.71 ,$993.93 ,$828.28 ,$773.06 ,$817.23 ,$993.93 ,$938.71 ,$24.11 ,$938.71 ,$51.84 ,$56.00 ,$24.11 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317360,87110,CHLAMYDIA TRACHOMATIS CULTURE Q690,300,1 ,$98.90 ,$64.29 ,$19.60 ,$89.01 ,$67.75 ,$19.60 ,$57.96 ,$57.96 ,$19.99 ,$81.10 ,$84.07 ,$89.01 ,$74.18 ,$69.23 ,$73.19 ,$89.01 ,$84.07 ,$19.60 ,$84.07 ,$42.14 ,$56.00 ,$19.60 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317404,87591,.NEISSERIA GONORRHOEAE APT,300,1 ,$127.65 ,$82.97 ,$35.09 ,$114.89 ,$87.44 ,$35.09 ,$74.80 ,$74.80 ,$35.79 ,$104.67 ,$108.50 ,$114.89 ,$95.74 ,$89.36 ,$94.46 ,$114.89 ,$108.50 ,$35.09 ,$108.50 ,$75.44 ,$56.00 ,$35.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317408,85300,ANTITHROMBIN III ACTIVITY Q216,300,1 ,$107.00 ,$69.55 ,$11.85 ,$96.30 ,$73.30 ,$11.85 ,$62.70 ,$62.70 ,$12.09 ,$87.74 ,$90.95 ,$96.30 ,$80.25 ,$74.90 ,$79.18 ,$96.30 ,$90.95 ,$11.85 ,$90.95 ,$25.48 ,$56.00 ,$11.85 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317414,84206,.ASSAY OF PROINSULIN,300,1 ,$154.76 ,$100.59 ,$26.69 ,$139.28 ,$106.01 ,$26.69 ,$90.69 ,$90.69 ,$27.22 ,$126.90 ,$131.55 ,$139.28 ,$116.07 ,$108.33 ,$114.52 ,$139.28 ,$131.55 ,$26.69 ,$131.55 ,$57.38 ,$56.00 ,$26.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317421,82785,.P IGE,300,1 ,$102.12 ,$66.38 ,$16.46 ,$91.91 ,$69.95 ,$16.46 ,$59.84 ,$59.84 ,$16.79 ,$83.74 ,$86.80 ,$91.91 ,$76.59 ,$71.48 ,$75.57 ,$91.91 ,$86.80 ,$16.46 ,$86.80 ,$35.39 ,$56.00 ,$16.46 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317422,86003,.P ALLERGEN SPECIFIC IGE,300,1 ,$60.20 ,$39.13 ,$5.22 ,$56.00 ,$41.24 ,$5.22 ,$35.28 ,$35.28 ,$5.32 ,$49.36 ,$51.17 ,$54.18 ,$45.15 ,$42.14 ,$44.55 ,$54.18 ,$51.17 ,$5.22 ,$51.17 ,$11.22 ,$56.00 ,$5.22 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317429,86021,.P ANTIBODY ID LEUKOCYTE 86021,300,1 ,$146.20 ,$95.03 ,$15.05 ,$131.58 ,$100.15 ,$15.05 ,$85.67 ,$85.67 ,$15.35 ,$119.88 ,$124.27 ,$131.58 ,$109.65 ,$102.34 ,$108.19 ,$131.58 ,$124.27 ,$15.05 ,$124.27 ,$32.36 ,$56.00 ,$15.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317444,84305,IGF 1 Q16293,300,1 ,$241.09 ,$156.71 ,$21.26 ,$216.98 ,$165.15 ,$21.26 ,$141.28 ,$141.28 ,$21.69 ,$197.69 ,$204.93 ,$216.98 ,$180.82 ,$168.76 ,$178.41 ,$216.98 ,$204.93 ,$21.26 ,$204.93 ,$45.71 ,$56.00 ,$21.26 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317446,84255,SELENIUM  Q5507,300,1 ,$217.93 ,$141.65 ,$25.53 ,$196.14 ,$149.28 ,$25.53 ,$127.71 ,$127.71 ,$26.04 ,$178.70 ,$185.24 ,$196.14 ,$163.45 ,$152.55 ,$161.27 ,$196.14 ,$185.24 ,$25.53 ,$185.24 ,$54.89 ,$56.00 ,$25.53 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317467,86334,IMMUNOFIXATION SERUM Q549,300,1 ,$159.09 ,$103.41 ,$22.34 ,$143.18 ,$108.98 ,$22.34 ,$93.23 ,$93.23 ,$22.79 ,$130.45 ,$135.23 ,$143.18 ,$119.32 ,$111.36 ,$117.73 ,$143.18 ,$135.23 ,$22.34 ,$135.23 ,$48.03 ,$56.00 ,$22.34 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317469,84154,.P PSA FREE,300,1 ,$130.55 ,$84.86 ,$18.39 ,$117.50 ,$89.43 ,$18.39 ,$76.50 ,$76.50 ,$18.76 ,$107.05 ,$110.97 ,$117.50 ,$97.91 ,$91.39 ,$96.61 ,$117.50 ,$110.97 ,$18.39 ,$110.97 ,$39.54 ,$56.00 ,$18.39 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317471,83516,.P IMMUNOASSAY NONAB QUAL OR SEMI QUANT,300,1 ,$250.56 ,$162.86 ,$11.53 ,$225.50 ,$171.63 ,$11.53 ,$146.83 ,$146.83 ,$11.76 ,$205.46 ,$212.98 ,$225.50 ,$187.92 ,$175.39 ,$185.41 ,$225.50 ,$212.98 ,$11.53 ,$212.98 ,$24.79 ,$56.00 ,$11.53 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317474,84166,.P CHEMISTRY PROTEIN ELECTRO FRAC,300,1 ,$111.60 ,$72.54 ,$17.83 ,$100.44 ,$76.45 ,$17.83 ,$65.40 ,$65.40 ,$18.19 ,$91.51 ,$94.86 ,$100.44 ,$83.70 ,$78.12 ,$82.58 ,$100.44 ,$94.86 ,$17.83 ,$94.86 ,$38.33 ,$56.00 ,$17.83 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317477,87529,.P HERPES SIMPLEX AMPLIFIED PROBE,300,1 ,$340.40 ,$221.26 ,$35.09 ,$306.36 ,$233.17 ,$35.09 ,$199.47 ,$199.47 ,$35.79 ,$279.13 ,$289.34 ,$306.36 ,$255.30 ,$238.28 ,$251.90 ,$306.36 ,$289.34 ,$35.09 ,$289.34 ,$75.44 ,$56.00 ,$35.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317480,86664,.P EPSTEIN BARR VIRUS NUCLEAR AG,300,1 ,$105.35 ,$68.48 ,$15.29 ,$94.82 ,$72.16 ,$15.29 ,$61.74 ,$61.74 ,$15.60 ,$86.39 ,$89.55 ,$94.82 ,$79.01 ,$73.75 ,$77.96 ,$94.82 ,$89.55 ,$15.29 ,$89.55 ,$32.87 ,$56.00 ,$15.29 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317504,80323,COTININE URINE Q90646,300,1 ,$377.00 ,$245.05 ,$56.00 ,$339.30 ,$258.25 , N/A ,$220.92 ,$220.92 , N/A ,$309.14 ,$320.45 ,$339.30 ,$282.75 ,$263.90 ,$278.98 ,$339.30 ,$320.45 , N/A ,$320.45 , N/A ,$56.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317514,82784,.P GAMMAGLOBULIN IgA IgD IgG IgM,300,1 ,$55.80 ,$36.27 ,$9.30 ,$55.80 ,$38.22 ,$9.30 ,$32.70 ,$32.70 ,$9.49 ,$45.76 ,$47.43 ,$50.22 ,$41.85 ,$39.06 ,$41.29 ,$50.22 ,$47.43 ,$9.30 ,$47.43 ,$20.00 ,$55.80 ,$9.30 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317520,87497,CMV DNA QUANT PCR Q10600,300,1 ,"$1,554.80 ","$1,010.62 ",$42.84 ,"$1,399.32 ","$1,065.04 ",$42.84 ,$911.11 ,$911.11 ,$43.70 ,"$1,274.94 ","$1,321.58 ","$1,399.32 ","$1,166.10 ","$1,088.36 ","$1,150.55 ","$1,399.32 ","$1,321.58 ",$42.84 ,"$1,321.58 ",$92.11 ,$56.00 ,$42.84 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317537,87517,HEPATITIS B VIRAL DNA QUANT PCR Q8369,300,1 ,"$1,340.90 ",$871.59 ,$42.84 ,"$1,206.81 ",$918.52 ,$42.84 ,$785.77 ,$785.77 ,$43.70 ,"$1,099.54 ","$1,139.77 ","$1,206.81 ","$1,005.68 ",$938.63 ,$992.27 ,"$1,206.81 ","$1,139.77 ",$42.84 ,"$1,139.77 ",$92.11 ,$56.00 ,$42.84 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317561,86757,.P ANTIBODY RICKETTSIA,300,1 ,$144.05 ,$93.63 ,$19.35 ,$129.65 ,$98.67 ,$19.35 ,$84.41 ,$84.41 ,$19.74 ,$118.12 ,$122.44 ,$129.65 ,$108.04 ,$100.84 ,$106.60 ,$129.65 ,$122.44 ,$19.35 ,$122.44 ,$41.60 ,$56.00 ,$19.35 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317573,86403,.STREP PNEUMO AG SERUM Q4460,300,1 ,$491.26 ,$319.32 ,$11.54 ,$442.13 ,$336.51 ,$11.54 ,$287.88 ,$287.88 ,$11.77 ,$402.83 ,$417.57 ,$442.13 ,$368.45 ,$343.88 ,$363.53 ,$442.13 ,$417.57 ,$11.54 ,$417.57 ,$24.81 ,$56.00 ,$11.54 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317577,87798,.P AMP NA PROBE NOS AGENT,300,1 ,$680.80 ,$442.52 ,$35.09 ,$612.72 ,$466.35 ,$35.09 ,$398.95 ,$398.95 ,$35.79 ,$558.26 ,$578.68 ,$612.72 ,$510.60 ,$476.56 ,$503.79 ,$612.72 ,$578.68 ,$35.09 ,$578.68 ,$75.44 ,$56.00 ,$35.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317578,86305,HE4 OVARIAN CANCER Q16500,300,1 ,"$1,049.16 ",$681.95 ,$20.81 ,$944.24 ,$718.67 ,$20.81 ,$614.81 ,$614.81 ,$21.23 ,$860.31 ,$891.79 ,$944.24 ,$786.87 ,$734.41 ,$776.38 ,$944.24 ,$891.79 ,$20.81 ,$891.79 ,$44.74 ,$56.00 ,$20.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317584,86611,.P AB BARTONELLA,300,1 ,$154.79 ,$100.61 ,$10.18 ,$139.31 ,$106.03 ,$10.18 ,$90.71 ,$90.71 ,$10.38 ,$126.93 ,$131.57 ,$139.31 ,$116.09 ,$108.35 ,$114.54 ,$139.31 ,$131.57 ,$10.18 ,$131.57 ,$21.89 ,$56.00 ,$10.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317588,86317,.P IA INFECTIOUS AGENT AB QUAN,300,1 ,$20.32 ,$13.21 ,$11.91 ,$32.23 ,$13.92 ,$14.99 ,$11.91 ,$11.91 ,$15.29 ,$16.66 ,$17.27 ,$18.29 ,$15.24 ,$14.22 ,$15.04 ,$18.29 ,$17.27 ,$14.99 ,$17.27 ,$32.23 ,$20.32 ,$14.99 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317665,84392,SULFATE URINE Q11013,300,1 ,$419.01 ,$272.36 ,$5.49 ,$377.11 ,$287.02 ,$5.49 ,$245.54 ,$245.54 ,$5.60 ,$343.59 ,$356.16 ,$377.11 ,$314.26 ,$293.31 ,$310.07 ,$377.11 ,$356.16 ,$5.49 ,$356.16 ,$11.80 ,$56.00 ,$5.49 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317688,87522,HEPATITIS C VIRAL RNA QUANT TMA Q37811,300,1 ,"$1,815.85 ","$1,180.30 ",$42.84 ,"$1,634.27 ","$1,243.86 ",$42.84 ,"$1,064.09 ","$1,064.09 ",$43.70 ,"$1,489.00 ","$1,543.47 ","$1,634.27 ","$1,361.89 ","$1,271.10 ","$1,343.73 ","$1,634.27 ","$1,543.47 ",$42.84 ,"$1,543.47 ",$92.11 ,$56.00 ,$42.84 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317703,83883,.P NEPHELOMETRY EA ANALYTE NES,300,1 ,$276.88 ,$179.97 ,$13.60 ,$249.19 ,$189.66 ,$13.60 ,$162.25 ,$162.25 ,$13.87 ,$227.04 ,$235.35 ,$249.19 ,$207.66 ,$193.82 ,$204.89 ,$249.19 ,$235.35 ,$13.60 ,$235.35 ,$29.24 ,$56.00 ,$13.60 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317706,83527,INSULIN FREE Q36700,300,1 ,$281.09 ,$182.71 ,$12.95 ,$252.98 ,$192.55 ,$12.95 ,$164.72 ,$164.72 ,$13.21 ,$230.49 ,$238.93 ,$252.98 ,$210.82 ,$196.76 ,$208.01 ,$252.98 ,$238.93 ,$12.95 ,$238.93 ,$27.84 ,$56.00 ,$12.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317713,80307,OM DRUG SCREEN 5 QUEST-DOT NIDA 45304N,300,1 ,$40.00 ,$26.00 ,$23.44 ,$86.00 ,$27.40 ,$40.00 ,$23.44 ,$23.44 ,$40.80 ,$32.80 ,$34.00 ,$36.00 ,$30.00 ,$28.00 ,$29.60 ,$36.00 ,$34.00 ,$40.00 ,$34.00 ,$86.00 ,$40.00 ,$40.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317715,81220,CYSTIC FIBROSIS PROFILE Q92068,300,1 ,$423.00 ,$274.95 ,$56.00 ,$909.45 ,$289.76 ,$423.00 ,$247.88 ,$247.88 ,$431.46 ,$346.86 ,$359.55 ,$380.70 ,$317.25 ,$296.10 ,$313.02 ,$380.70 ,$359.55 ,$423.00 ,$359.55 ,$909.45 ,$56.00 ,$423.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317717,86648,.P AB DIPTHERIA,300,1 ,$274.12 ,$178.18 ,$15.21 ,$246.71 ,$187.77 ,$15.21 ,$160.63 ,$160.63 ,$15.51 ,$224.78 ,$233.00 ,$246.71 ,$205.59 ,$191.88 ,$202.85 ,$246.71 ,$233.00 ,$15.21 ,$233.00 ,$32.70 ,$56.00 ,$15.21 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317718,86774,.P AB TETANUS,300,1 ,$274.12 ,$178.18 ,$14.80 ,$246.71 ,$187.77 ,$14.80 ,$160.63 ,$160.63 ,$15.10 ,$224.78 ,$233.00 ,$246.71 ,$205.59 ,$191.88 ,$202.85 ,$246.71 ,$233.00 ,$14.80 ,$233.00 ,$31.82 ,$56.00 ,$14.80 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317721,86316,"CHROMOGRANIN A, ECLIA Q16379",300,1 ,$431.06 ,$280.19 ,$20.81 ,$387.95 ,$295.28 ,$20.81 ,$252.60 ,$252.60 ,$21.23 ,$353.47 ,$366.40 ,$387.95 ,$323.30 ,$301.74 ,$318.98 ,$387.95 ,$366.40 ,$20.81 ,$366.40 ,$44.74 ,$56.00 ,$20.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317722,84597,VITAMIN K Q36585,300,1 ,$421.11 ,$273.72 ,$13.72 ,$379.00 ,$288.46 ,$13.72 ,$246.77 ,$246.77 ,$13.99 ,$345.31 ,$357.94 ,$379.00 ,$315.83 ,$294.78 ,$311.62 ,$379.00 ,$357.94 ,$13.72 ,$357.94 ,$29.50 ,$56.00 ,$13.72 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317723,81206,BCR ABL1 GENE ARR QN PCR Q91065,300,1 ,$842.00 ,$547.30 ,$56.00 ,$757.80 ,$576.77 ,$163.96 ,$493.41 ,$493.41 ,$167.24 ,$690.44 ,$715.70 ,$757.80 ,$631.50 ,$589.40 ,$623.08 ,$757.80 ,$715.70 ,$163.96 ,$715.70 ,$352.51 ,$56.00 ,$163.96 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317725,80184,PHENOBARB Q708,300,1 ,$138.00 ,$89.70 ,$15.30 ,$124.20 ,$94.53 ,$15.30 ,$80.87 ,$80.87 ,$15.61 ,$113.16 ,$117.30 ,$124.20 ,$103.50 ,$96.60 ,$102.12 ,$124.20 ,$117.30 ,$15.30 ,$117.30 ,$32.90 ,$56.00 ,$15.30 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317726,86361,LYMPHOCYTE SUBSET CD4 PANEL Q8360,300,1 ,$184.89 ,$120.18 ,$26.78 ,$166.40 ,$126.65 ,$26.78 ,$108.35 ,$108.35 ,$27.32 ,$151.61 ,$157.16 ,$166.40 ,$138.67 ,$129.42 ,$136.82 ,$166.40 ,$157.16 ,$26.78 ,$157.16 ,$57.58 ,$56.00 ,$26.78 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317746,87075,.P CULT ANAEROBIC W ISOLATION,300,1 ,$161.00 ,$104.65 ,$9.47 ,$144.90 ,$110.29 ,$9.47 ,$94.35 ,$94.35 ,$9.66 ,$132.02 ,$136.85 ,$144.90 ,$120.75 ,$112.70 ,$119.14 ,$144.90 ,$136.85 ,$9.47 ,$136.85 ,$20.36 ,$56.00 ,$9.47 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317750,86747,.P PARVOVIRUS,300,1 ,$104.27 ,$67.78 ,$15.03 ,$93.84 ,$71.43 ,$15.03 ,$61.10 ,$61.10 ,$15.33 ,$85.50 ,$88.63 ,$93.84 ,$78.20 ,$72.99 ,$77.16 ,$93.84 ,$88.63 ,$15.03 ,$88.63 ,$32.31 ,$56.00 ,$15.03 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317752,82677,.P ESTRIOL,300,1 ,$145.28 ,$94.43 ,$24.18 ,$130.75 ,$99.52 ,$24.18 ,$85.13 ,$85.13 ,$24.66 ,$119.13 ,$123.49 ,$130.75 ,$108.96 ,$101.70 ,$107.51 ,$130.75 ,$123.49 ,$24.18 ,$123.49 ,$51.99 ,$56.00 ,$24.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317754,86336,.P INHIBIN A,300,1 ,$226.82 ,$147.43 ,$15.59 ,$204.14 ,$155.37 ,$15.59 ,$132.92 ,$132.92 ,$15.90 ,$185.99 ,$192.80 ,$204.14 ,$170.12 ,$158.77 ,$167.85 ,$204.14 ,$192.80 ,$15.59 ,$192.80 ,$33.52 ,$56.00 ,$15.59 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317757,87177,.P OVA AND PARASITES DIRECT SMEAR,300,1 ,$74.75 ,$48.59 ,$8.90 ,$67.28 ,$51.20 ,$8.90 ,$43.80 ,$43.80 ,$9.08 ,$61.30 ,$63.54 ,$67.28 ,$56.06 ,$52.33 ,$55.32 ,$67.28 ,$63.54 ,$8.90 ,$63.54 ,$19.14 ,$56.00 ,$8.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317758,87209,.P COMPLEX SPECIAL STAIN,300,1 ,$155.25 ,$100.91 ,$17.98 ,$139.73 ,$106.35 ,$17.98 ,$90.98 ,$90.98 ,$18.34 ,$127.31 ,$131.96 ,$139.73 ,$116.44 ,$108.68 ,$114.89 ,$139.73 ,$131.96 ,$17.98 ,$131.96 ,$38.66 ,$56.00 ,$17.98 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317760,84080,.P PHOSPHATASE ISOENZYMES,300,1 ,$124.23 ,$80.75 ,$14.78 ,$111.81 ,$85.10 ,$14.78 ,$72.80 ,$72.80 ,$15.08 ,$101.87 ,$105.60 ,$111.81 ,$93.17 ,$86.96 ,$91.93 ,$111.81 ,$105.60 ,$14.78 ,$105.60 ,$31.78 ,$56.00 ,$14.78 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317761,86593,.P SYPHILLIS QUANT,300,1 ,$31.17 ,$20.26 ,$4.40 ,$31.17 ,$21.35 ,$4.40 ,$18.27 ,$18.27 ,$4.49 ,$25.56 ,$26.49 ,$28.05 ,$23.38 ,$21.82 ,$23.07 ,$28.05 ,$26.49 ,$4.40 ,$26.49 ,$9.46 ,$31.17 ,$4.40 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317772,82397,.P CHEMILUMINESCENT ASSAY,300,1 ,$78.96 ,$51.32 ,$14.12 ,$71.06 ,$54.09 ,$14.12 ,$46.27 ,$46.27 ,$14.40 ,$64.75 ,$67.12 ,$71.06 ,$59.22 ,$55.27 ,$58.43 ,$71.06 ,$67.12 ,$14.12 ,$67.12 ,$30.36 ,$56.00 ,$14.12 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317795,88175,SJB - PAP THIN PREP REFLEX HPV,310,1 ,$127.65 ,$82.97 ,$26.61 ,$114.89 ,$87.44 ,$26.61 ,$74.80 ,$74.80 ,$27.14 ,$104.67 ,$108.50 ,$114.89 ,$95.74 ,$89.36 ,$94.46 ,$114.89 ,$108.50 ,$26.61 ,$108.50 ,$57.21 ,$56.00 ,$26.61 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317797,82542,THIOPURINE METABOLITES Q917451,300,1 ,"$1,085.42 ",$705.52 ,$24.09 ,$976.88 ,$743.51 ,$24.09 ,$636.06 ,$636.06 ,$24.57 ,$890.04 ,$922.61 ,$976.88 ,$814.07 ,$759.79 ,$803.21 ,$976.88 ,$922.61 ,$24.09 ,$922.61 ,$51.79 ,$56.00 ,$24.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317798,87661,TRICHOMONAS VAG RNA QUAL TMA Q19550,300,1 ,$542.80 ,$352.82 ,$35.09 ,$488.52 ,$371.82 ,$35.09 ,$318.08 ,$318.08 ,$35.79 ,$445.10 ,$461.38 ,$488.52 ,$407.10 ,$379.96 ,$401.67 ,$488.52 ,$461.38 ,$35.09 ,$461.38 ,$75.44 ,$56.00 ,$35.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317800,81374,HLA-B51 Q16775,300,1 ,$187.50 ,$121.88 ,$56.00 ,$168.75 ,$128.44 ,$74.33 ,$109.88 ,$109.88 ,$75.82 ,$153.75 ,$159.38 ,$168.75 ,$140.63 ,$131.25 ,$138.75 ,$168.75 ,$159.38 ,$74.33 ,$159.38 ,$159.81 ,$56.00 ,$74.33 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317802,84140,PREGNENOLONE LC MS MS Q31493,300,1 ,$266.35 ,$173.13 ,$20.67 ,$239.72 ,$182.45 ,$20.67 ,$156.08 ,$156.08 ,$21.08 ,$218.41 ,$226.40 ,$239.72 ,$199.76 ,$186.45 ,$197.10 ,$239.72 ,$226.40 ,$20.67 ,$226.40 ,$44.44 ,$56.00 ,$20.67 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317805,81503,OVA 1 Q16991,300,1 ,"$1,865.88 ","$1,212.82 ",$56.00 ,"$1,679.29 ","$1,278.13 ", N/A ,"$1,093.41 ","$1,093.41 ", N/A ,"$1,530.02 ","$1,586.00 ","$1,679.29 ","$1,399.41 ","$1,306.12 ","$1,380.75 ","$1,679.29 ","$1,586.00 ", N/A ,"$1,586.00 ","$1,119.53 ",$56.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317813,84591,VITAMIN B-3 Q91029,300,1 ,$542.18 ,$352.42 ,$17.06 ,$487.96 ,$371.39 ,$17.06 ,$317.72 ,$317.72 ,$17.40 ,$444.59 ,$460.85 ,$487.96 ,$406.64 ,$379.53 ,$401.21 ,$487.96 ,$460.85 ,$17.06 ,$460.85 ,$36.68 ,$56.00 ,$17.06 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317820,81420,QNATAL ADVANCED Q92777,300,1 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317835,85246,VON WILLEBRAND FACTOR ANTIGEN Q4919,300,1 ,$378.00 ,$245.70 ,$22.94 ,$340.20 ,$258.93 ,$22.94 ,$221.51 ,$221.51 ,$23.40 ,$309.96 ,$321.30 ,$340.20 ,$283.50 ,$264.60 ,$279.72 ,$340.20 ,$321.30 ,$22.94 ,$321.30 ,$49.32 ,$56.00 ,$22.94 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317850,86148,PHOS SERINE AB IGG IGM Q36595,300,1 ,$527.81 ,$343.08 ,$16.07 ,$475.03 ,$361.55 ,$16.07 ,$309.30 ,$309.30 ,$16.39 ,$432.80 ,$448.64 ,$475.03 ,$395.86 ,$369.47 ,$390.58 ,$475.03 ,$448.64 ,$16.07 ,$448.64 ,$34.55 ,$56.00 ,$16.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317859,87389,HIV 1/2 AG AND AB 4TH GEN Q91431,300,1 ,$273.70 ,$177.91 ,$24.08 ,$246.33 ,$187.48 ,$24.08 ,$160.39 ,$160.39 ,$24.56 ,$224.43 ,$232.65 ,$246.33 ,$205.28 ,$191.59 ,$202.54 ,$246.33 ,$232.65 ,$24.08 ,$232.65 ,$51.77 ,$56.00 ,$24.08 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317861,82465,LIPOPROTEIN ELEC Q35436,300,1 ,$132.65 ,$86.22 ,$4.35 ,$119.39 ,$90.87 ,$4.35 ,$77.73 ,$77.73 ,$4.44 ,$108.77 ,$112.75 ,$119.39 ,$99.49 ,$92.86 ,$98.16 ,$119.39 ,$112.75 ,$4.35 ,$112.75 ,$9.35 ,$56.00 ,$4.35 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317863,86355,T & B CELL Q39588,300,1 ,$331.09 ,$215.21 ,$37.73 ,$297.98 ,$226.80 ,$37.73 ,$194.02 ,$194.02 ,$38.48 ,$271.49 ,$281.43 ,$297.98 ,$248.32 ,$231.76 ,$245.01 ,$297.98 ,$281.43 ,$37.73 ,$281.43 ,$81.12 ,$56.00 ,$37.73 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317868,82107,ALPHA-FETOPROTEIN AND AFP-L3 Q19529,300,1 ,$165.29 ,$107.44 ,$56.00 ,$148.76 ,$113.22 ,$64.41 ,$96.86 ,$96.86 ,$65.70 ,$135.54 ,$140.50 ,$148.76 ,$123.97 ,$115.70 ,$122.31 ,$148.76 ,$140.50 ,$64.41 ,$140.50 ,$138.48 ,$56.00 ,$64.41 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317872,87103,"CULTURE FUNGUS, BLOOD Q4606",300,1 ,$182.85 ,$118.85 ,$20.46 ,$164.57 ,$125.25 ,$20.46 ,$107.15 ,$107.15 ,$20.87 ,$149.94 ,$155.42 ,$164.57 ,$137.14 ,$128.00 ,$135.31 ,$164.57 ,$155.42 ,$20.46 ,$155.42 ,$43.99 ,$56.00 ,$20.46 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317873,88112,PATH 88112 CELLULAR ENHANCE,310,1 ,$166.75 ,$108.39 ,$47.27 ,$150.08 ,$114.22 ,$47.27 ,$97.72 ,$97.72 ,$48.22 ,$136.74 ,$141.74 ,$150.08 ,$125.06 ,$116.73 ,$123.40 ,$150.08 ,$141.74 ,$47.27 ,$141.74 ,$101.64 ,$56.00 ,$47.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317879,82610,CYSTATIN C Q10570,300,1 ,$356.89 ,$231.98 ,$18.52 ,$321.20 ,$244.47 ,$18.52 ,$209.14 ,$209.14 ,$18.89 ,$292.65 ,$303.36 ,$321.20 ,$267.67 ,$249.82 ,$264.10 ,$321.20 ,$303.36 ,$18.52 ,$303.36 ,$39.82 ,$56.00 ,$18.52 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317927,87632,RESPRITORY VIRUS PCR IV Q91233,300,1 ,"$4,324.00 ","$2,810.60 ",$56.00 ,"$3,891.60 ","$2,961.94 ",$218.06 ,"$2,533.86 ","$2,533.86 ",$222.42 ,"$3,545.68 ","$3,675.40 ","$3,891.60 ","$3,243.00 ","$3,026.80 ","$3,199.76 ","$3,891.60 ","$3,675.40 ",$218.06 ,"$3,675.40 ",$468.83 ,$56.00 ,$218.06 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317938,86800,THYROGLOBULIN ANTIBODIES Q267,300,1 ,$18.27 ,$11.88 ,$10.71 ,$34.21 ,$12.52 ,$15.91 ,$10.71 ,$10.71 ,$16.23 ,$14.98 ,$15.53 ,$16.44 ,$13.70 ,$12.79 ,$13.52 ,$16.44 ,$15.53 ,$15.91 ,$15.53 ,$34.21 ,$18.27 ,$15.91 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317951,82180,VITAMIN C Q929,300,1 ,$21.00 ,$13.65 ,$9.89 ,$21.26 ,$14.39 ,$9.89 ,$12.31 ,$12.31 ,$10.09 ,$17.22 ,$17.85 ,$18.90 ,$15.75 ,$14.70 ,$15.54 ,$18.90 ,$17.85 ,$9.89 ,$17.85 ,$21.26 ,$21.00 ,$9.89 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317959,85240,VON WILLEBRAND COMP PANEL Q19790,300,1 ,$635.00 ,$412.75 ,$17.90 ,$571.50 ,$434.98 ,$17.90 ,$372.11 ,$372.11 ,$18.26 ,$520.70 ,$539.75 ,$571.50 ,$476.25 ,$444.50 ,$469.90 ,$571.50 ,$539.75 ,$17.90 ,$539.75 ,$38.49 ,$56.00 ,$17.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317968,81404,BETA GLOBIN COMPLETE Q14974,300,1 ,$532.85 ,$346.35 ,$56.00 ,$479.57 ,$365.00 , N/A ,$312.25 ,$312.25 , N/A ,$436.94 ,$452.92 ,$479.57 ,$399.64 ,$373.00 ,$394.31 ,$479.57 ,$452.92 , N/A ,$452.92 ,$319.71 ,$56.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317974,82239,BILE ACIDE TOTAL Q14801,300,1 ,$29.48 ,$19.16 ,$17.12 ,$36.81 ,$20.19 ,$17.12 ,$17.28 ,$17.28 ,$17.46 ,$24.17 ,$25.06 ,$26.53 ,$22.11 ,$20.64 ,$21.82 ,$26.53 ,$25.06 ,$17.12 ,$25.06 ,$36.81 ,$29.48 ,$17.12 
HSHS HOLY FAMILY HOSPITAL INC (ACU),317997,86644,CMV AB IGG/IGM Q6732,300,1 ,$61.27 ,$39.83 ,$14.39 ,$56.00 ,$41.97 ,$14.39 ,$35.90 ,$35.90 ,$14.68 ,$50.24 ,$52.08 ,$55.14 ,$45.95 ,$42.89 ,$45.34 ,$55.14 ,$52.08 ,$14.39 ,$52.08 ,$30.94 ,$56.00 ,$14.39 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318000,88305,PATH 88305 LEVEL IV GROSS & MICRO,310,1 ,$192.05 ,$124.83 ,$47.27 ,$172.85 ,$131.55 ,$47.27 ,$112.54 ,$112.54 ,$48.22 ,$157.48 ,$163.24 ,$172.85 ,$144.04 ,$134.44 ,$142.12 ,$172.85 ,$163.24 ,$47.27 ,$163.24 ,$101.64 ,$56.00 ,$47.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318001,88307,PATH 88307 LEVEL V GROSS & MICRO,310,1 ,$213.90 ,$139.04 ,$56.00 ,$582.28 ,$146.52 ,$270.83 ,$125.35 ,$125.35 ,$276.24 ,$175.40 ,$181.82 ,$192.51 ,$160.43 ,$149.73 ,$158.29 ,$192.51 ,$181.82 ,$270.83 ,$181.82 ,$582.28 ,$56.00 ,$270.83 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318002,88304,PATH 88304 LEVEL III GROSS & MICRO,310,1 ,$192.05 ,$124.83 ,$47.27 ,$172.85 ,$131.55 ,$47.27 ,$112.54 ,$112.54 ,$48.22 ,$157.48 ,$163.24 ,$172.85 ,$144.04 ,$134.44 ,$142.12 ,$172.85 ,$163.24 ,$47.27 ,$163.24 ,$101.64 ,$56.00 ,$47.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318003,88342,PATH 88342 IM CYTO CHEM,310,1 ,$562.35 ,$365.53 ,$56.00 ,$506.12 ,$385.21 ,$137.13 ,$329.54 ,$329.54 ,$139.87 ,$461.13 ,$478.00 ,$506.12 ,$421.76 ,$393.65 ,$416.14 ,$506.12 ,$478.00 ,$137.13 ,$478.00 ,$294.83 ,$56.00 ,$137.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318004,88302,PATH 88302 LEVEL II GROSS & MICRO,310,1 ,$93.15 ,$60.55 ,$21.97 ,$83.84 ,$63.81 ,$21.97 ,$54.59 ,$54.59 ,$22.41 ,$76.38 ,$79.18 ,$83.84 ,$69.86 ,$65.21 ,$68.93 ,$83.84 ,$79.18 ,$21.97 ,$79.18 ,$47.23 ,$56.00 ,$21.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318006,88311,PATH 88311 DECALCIFICATION,310,1 ,$69.00 ,$44.85 ,$40.43 ,$62.10 ,$47.27 , N/A ,$40.43 ,$40.43 , N/A ,$56.58 ,$58.65 ,$62.10 ,$51.75 ,$48.30 ,$51.06 ,$62.10 ,$58.65 , N/A ,$58.65 , N/A ,$56.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318007,88312,PATH 88312 SPECIAL STAINS GROUP I,310,1 ,$218.50 ,$142.03 ,$47.27 ,$196.65 ,$149.67 ,$47.27 ,$128.04 ,$128.04 ,$48.22 ,$179.17 ,$185.73 ,$196.65 ,$163.88 ,$152.95 ,$161.69 ,$196.65 ,$185.73 ,$47.27 ,$185.73 ,$101.64 ,$56.00 ,$47.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318008,88173,PATH 88173 FINE NEEDLE ASPIR,310,1 ,$211.60 ,$137.54 ,$47.27 ,$190.44 ,$144.95 ,$47.27 ,$124.00 ,$124.00 ,$48.22 ,$173.51 ,$179.86 ,$190.44 ,$158.70 ,$148.12 ,$156.58 ,$190.44 ,$179.86 ,$47.27 ,$179.86 ,$101.64 ,$56.00 ,$47.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318009,88313,PATH 88313 SPECIAL STAINS GRP II,310,1 ,$178.25 ,$115.86 ,$31.95 ,$160.43 ,$122.10 ,$31.95 ,$104.45 ,$104.45 ,$32.58 ,$146.17 ,$151.51 ,$160.43 ,$133.69 ,$124.78 ,$131.91 ,$160.43 ,$151.51 ,$31.95 ,$151.51 ,$68.68 ,$56.00 ,$31.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318010,88309,PATH 88309 LEVEL VI GROSS & MICRO,310,1 ,$315.10 ,$204.82 ,$56.00 ,"$1,290.66 ",$215.84 ,$600.31 ,$184.65 ,$184.65 ,$612.31 ,$258.38 ,$267.84 ,$283.59 ,$236.33 ,$220.57 ,$233.17 ,$283.59 ,$267.84 ,$600.31 ,$267.84 ,"$1,290.66 ",$56.00 ,$600.31 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318013,88360,PATH 88360 TUMOR IHC,310,1 ,$362.25 ,$235.46 ,$56.00 ,$326.03 ,$248.14 ,$137.13 ,$212.28 ,$212.28 ,$139.87 ,$297.05 ,$307.91 ,$326.03 ,$271.69 ,$253.58 ,$268.07 ,$326.03 ,$307.91 ,$137.13 ,$307.91 ,$294.83 ,$56.00 ,$137.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318021,88341,PATH 88341 IM CYTO CHEM ADDTL SL,310,1 ,$281.75 ,$183.14 ,$56.00 ,$253.58 ,$193.00 , N/A ,$165.11 ,$165.11 , N/A ,$231.04 ,$239.49 ,$253.58 ,$211.31 ,$197.23 ,$208.50 ,$253.58 ,$239.49 , N/A ,$239.49 , N/A ,$56.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),318100,N/A,PATH SPECIMEN PENDING,310,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),3187486,87486,CPT CODE 87486,300,1 ,$400.00 ,$260.00 ,$35.09 ,$360.00 ,$274.00 ,$35.09 ,$234.40 ,$234.40 ,$35.79 ,$328.00 ,$340.00 ,$360.00 ,$300.00 ,$280.00 ,$296.00 ,$360.00 ,$340.00 ,$35.09 ,$340.00 ,$75.44 ,$56.00 ,$35.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),3187581,87581,CPT CODE 87581,300,1 ,$400.00 ,$260.00 ,$35.09 ,$360.00 ,$274.00 ,$35.09 ,$234.40 ,$234.40 ,$35.79 ,$328.00 ,$340.00 ,$360.00 ,$300.00 ,$280.00 ,$296.00 ,$360.00 ,$340.00 ,$35.09 ,$340.00 ,$75.44 ,$56.00 ,$35.09 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319002,86803,HEPATITIS C AB REFLEX TO HCV W/REFLUX,300,1 ,$16.12 ,$10.48 ,$9.45 ,$30.68 ,$11.04 ,$14.27 ,$9.45 ,$9.45 ,$14.56 ,$13.22 ,$13.70 ,$14.51 ,$12.09 ,$11.28 ,$11.93 ,$14.51 ,$13.70 ,$14.27 ,$13.70 ,$30.68 ,$16.12 ,$14.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319006,83704,CARDIO LIPOPROTEIN FRACTION ION MOBILITY,300,1 ,$94.92 ,$61.70 ,$34.19 ,$85.43 ,$65.02 ,$34.19 ,$55.62 ,$55.62 ,$34.87 ,$77.83 ,$80.68 ,$85.43 ,$71.19 ,$66.44 ,$70.24 ,$85.43 ,$80.68 ,$34.19 ,$80.68 ,$73.51 ,$56.00 ,$34.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319021,82553,CK-2 (CKMB) Q17581,300,1 ,$17.62 ,$11.45 ,$10.33 ,$24.83 ,$12.07 ,$11.55 ,$10.33 ,$10.33 ,$11.78 ,$14.45 ,$14.98 ,$15.86 ,$13.22 ,$12.33 ,$13.04 ,$15.86 ,$14.98 ,$11.55 ,$14.98 ,$24.83 ,$17.62 ,$11.55 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319022,81162,BRACA COMPREHENSIVE Q91863,300,1 ,$58.05 ,$37.73 ,$34.02 ,$124.81 ,$39.76 ,$58.05 ,$34.02 ,$34.02 ,$59.21 ,$47.60 ,$49.34 ,$52.25 ,$43.54 ,$40.64 ,$42.96 ,$52.25 ,$49.34 ,$58.05 ,$49.34 ,$124.81 ,$56.00 ,$58.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319025,86008,MILK COMPONENT Q91403,300,1 ,$46.26 ,$30.07 ,$17.93 ,$46.26 ,$31.69 ,$17.93 ,$27.11 ,$27.11 ,$18.29 ,$37.93 ,$39.32 ,$41.63 ,$34.70 ,$32.38 ,$34.23 ,$41.63 ,$39.32 ,$17.93 ,$39.32 ,$38.55 ,$46.26 ,$17.93 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319040,82365,STONE ANALYSIS,300,1 ,$40.80 ,$26.52 ,$12.90 ,$40.80 ,$27.95 ,$12.90 ,$23.91 ,$23.91 ,$13.16 ,$33.46 ,$34.68 ,$36.72 ,$30.60 ,$28.56 ,$30.19 ,$36.72 ,$34.68 ,$12.90 ,$34.68 ,$27.74 ,$40.80 ,$12.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319042,86618,LYME AB W/REFLEX TO WESTERN BLOT Q6646,300,1 ,$219.50 ,$142.68 ,$17.03 ,$197.55 ,$150.36 ,$17.03 ,$128.63 ,$128.63 ,$17.37 ,$179.99 ,$186.58 ,$197.55 ,$164.63 ,$153.65 ,$162.43 ,$197.55 ,$186.58 ,$17.03 ,$186.58 ,$36.61 ,$56.00 ,$17.03 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319052,84145,PROCALCITONIN Q16265,300,1 ,$315.84 ,$205.30 ,$27.22 ,$284.26 ,$216.35 ,$27.22 ,$185.08 ,$185.08 ,$27.76 ,$258.99 ,$268.46 ,$284.26 ,$236.88 ,$221.09 ,$233.72 ,$284.26 ,$268.46 ,$27.22 ,$268.46 ,$58.52 ,$56.00 ,$27.22 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319055,86480,QUANTIFERON PLUS Q36971,300,1 ,$109.65 ,$71.27 ,$56.00 ,$133.26 ,$75.11 ,$61.98 ,$64.25 ,$64.25 ,$63.22 ,$89.91 ,$93.20 ,$98.69 ,$82.24 ,$76.76 ,$81.14 ,$98.69 ,$93.20 ,$61.98 ,$93.20 ,$133.26 ,$56.00 ,$61.98 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319056,82247,BILLIRUBIN BODY FLUID Q93806,300,1 ,$234.90 ,$152.69 ,$5.02 ,$211.41 ,$160.91 ,$5.02 ,$137.65 ,$137.65 ,$5.12 ,$192.62 ,$199.67 ,$211.41 ,$176.18 ,$164.43 ,$173.83 ,$211.41 ,$199.67 ,$5.02 ,$199.67 ,$10.79 ,$56.00 ,$5.02 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319062,82955,G-6-P-D Q500,300,1 ,$17.43 ,$11.33 ,$9.70 ,$20.86 ,$11.94 ,$9.70 ,$10.21 ,$10.21 ,$9.89 ,$14.29 ,$14.82 ,$15.69 ,$13.07 ,$12.20 ,$12.90 ,$15.69 ,$14.82 ,$9.70 ,$14.82 ,$20.86 ,$17.43 ,$9.70 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319064,85210,FACTOR II ACTIVITY,300,1 ,$240.00 ,$156.00 ,$12.98 ,$216.00 ,$164.40 ,$12.98 ,$140.64 ,$140.64 ,$13.24 ,$196.80 ,$204.00 ,$216.00 ,$180.00 ,$168.00 ,$177.60 ,$216.00 ,$204.00 ,$12.98 ,$204.00 ,$27.91 ,$56.00 ,$12.98 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319074,81539,4K SCORE,300,1 ,$29.00 ,$18.85 ,$16.99 ,$62.35 ,$19.87 ,$29.00 ,$16.99 ,$16.99 ,$29.58 ,$23.78 ,$24.65 ,$26.10 ,$21.75 ,$20.30 ,$21.46 ,$26.10 ,$24.65 ,$29.00 ,$24.65 ,$62.35 ,$29.00 ,$29.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319077,84155,PROTEIN C&S RFLX AG Q7942,300,1 ,$90.00 ,$58.50 ,$3.67 ,$81.00 ,$61.65 ,$3.67 ,$52.74 ,$52.74 ,$3.74 ,$73.80 ,$76.50 ,$81.00 ,$67.50 ,$63.00 ,$66.60 ,$81.00 ,$76.50 ,$3.67 ,$76.50 ,$7.89 ,$56.00 ,$3.67 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319086,85613,..LUPUS ANTI COAGULANT Q7079,300,1 ,$629.00 ,$408.85 ,$9.58 ,$566.10 ,$430.87 ,$9.58 ,$368.59 ,$368.59 ,$9.77 ,$515.78 ,$534.65 ,$566.10 ,$471.75 ,$440.30 ,$465.46 ,$566.10 ,$534.65 ,$9.58 ,$534.65 ,$20.60 ,$56.00 ,$9.58 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319095,81270,JAK2 CASCADE,300,1 ,$294.00 ,$191.10 ,$56.00 ,$264.60 ,$201.39 ,$91.66 ,$172.28 ,$172.28 ,$93.49 ,$241.08 ,$249.90 ,$264.60 ,$220.50 ,$205.80 ,$217.56 ,$264.60 ,$249.90 ,$91.66 ,$249.90 ,$197.07 ,$56.00 ,$91.66 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319098,83918,"ORGANIS ACIDS URINE, COMP & QUANT",300,1 ,$75.00 ,$48.75 ,$23.60 ,$67.50 ,$51.38 ,$23.60 ,$43.95 ,$43.95 ,$24.07 ,$61.50 ,$63.75 ,$67.50 ,$56.25 ,$52.50 ,$55.50 ,$67.50 ,$63.75 ,$23.60 ,$63.75 ,$50.74 ,$56.00 ,$23.60 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319109,80169,EVEROLIMUS Q18883,300,1 ,$240.00 ,$156.00 ,$13.73 ,$216.00 ,$164.40 ,$13.73 ,$140.64 ,$140.64 ,$14.00 ,$196.80 ,$204.00 ,$216.00 ,$180.00 ,$168.00 ,$177.60 ,$216.00 ,$204.00 ,$13.73 ,$204.00 ,$29.52 ,$56.00 ,$13.73 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319110,G0480,CLOBAZAM Q30283,300,1 ,$541.50 ,$351.98 ,$56.00 ,$487.35 ,$370.93 ,$114.43 ,$317.32 ,$317.32 ,$116.72 ,$444.03 ,$460.28 ,$487.35 ,$406.13 ,$379.05 ,$400.71 ,$487.35 ,$460.28 ,$114.43 ,$460.28 ,$246.02 ,$56.00 ,$114.43 
HSHS HOLY FAMILY HOSPITAL INC (ACU),319129,86343,SULFAMETHOXAZOLE Q19590,300,1 ,$268.50 ,$174.53 ,$12.46 ,$241.65 ,$183.92 ,$12.46 ,$157.34 ,$157.34 ,$12.71 ,$220.17 ,$228.23 ,$241.65 ,$201.38 ,$187.95 ,$198.69 ,$241.65 ,$228.23 ,$12.46 ,$228.23 ,$26.79 ,$56.00 ,$12.46 
HSHS HOLY FAMILY HOSPITAL INC (ACU),3194955,86341,ENCEPHALITIS ANTIBODY EVALUATION PANEL,300,1 ,$60.00 ,$39.00 ,$23.57 ,$56.00 ,$41.10 ,$23.57 ,$35.16 ,$35.16 ,$24.04 ,$49.20 ,$51.00 ,$54.00 ,$45.00 ,$42.00 ,$44.40 ,$54.00 ,$51.00 ,$23.57 ,$51.00 ,$50.68 ,$56.00 ,$23.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325501,86900,.BB TYPE,300,1 ,$85.00 ,$55.25 ,$49.81 ,$224.01 ,$58.23 ,$104.19 ,$49.81 ,$49.81 ,$106.27 ,$69.70 ,$72.25 ,$76.50 ,$63.75 ,$59.50 ,$62.90 ,$76.50 ,$72.25 ,$104.19 ,$72.25 ,$224.01 ,$56.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325503,86901,.BB RH FACTOR,300,1 ,$57.00 ,$37.05 ,$31.95 ,$68.68 ,$39.05 ,$31.95 ,$33.40 ,$33.40 ,$32.58 ,$46.74 ,$48.45 ,$51.30 ,$42.75 ,$39.90 ,$42.18 ,$51.30 ,$48.45 ,$31.95 ,$48.45 ,$68.68 ,$56.00 ,$31.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325507,86850,BB ANTIBODY SCREEN,300,1 ,$112.00 ,$72.80 ,$47.27 ,$101.64 ,$76.72 ,$47.27 ,$65.63 ,$65.63 ,$48.22 ,$91.84 ,$95.20 ,$100.80 ,$84.00 ,$78.40 ,$82.88 ,$100.80 ,$95.20 ,$47.27 ,$95.20 ,$101.64 ,$56.00 ,$47.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325509,86880,BB COOMBS DIRECT,300,1 ,$101.00 ,$65.65 ,$31.95 ,$90.90 ,$69.19 ,$31.95 ,$59.19 ,$59.19 ,$32.58 ,$82.82 ,$85.85 ,$90.90 ,$75.75 ,$70.70 ,$74.74 ,$90.90 ,$85.85 ,$31.95 ,$85.85 ,$68.68 ,$56.00 ,$31.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325513,86922,BB CROSSMATCH,390,1 ,$131.00 ,$85.15 ,$76.77 ,$294.83 ,$89.74 ,$137.13 ,$76.77 ,$76.77 ,$139.87 ,$107.42 ,$111.35 ,$117.90 ,$98.25 ,$91.70 ,$96.94 ,$117.90 ,$111.35 ,$137.13 ,$111.35 ,$294.83 ,$131.00 ,$137.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325521,P9016,BBB RBC LR,390,1 ,$845.00 ,$549.25 ,$188.35 ,$760.50 ,$578.83 ,$188.35 ,$495.17 ,$495.17 ,$192.12 ,$692.90 ,$718.25 ,$760.50 ,$633.75 ,$591.50 ,$625.30 ,$760.50 ,$718.25 ,$188.35 ,$718.25 ,$404.95 ,$272.00 ,$188.35 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325527,P9040,BBB RBC IRRADIATED LR,390,1 ,"$1,065.00 ",$692.25 ,$262.76 ,$958.50 ,$729.53 ,$262.76 ,$624.09 ,$624.09 ,$268.02 ,$873.30 ,$905.25 ,$958.50 ,$798.75 ,$745.50 ,$788.10 ,$958.50 ,$905.25 ,$262.76 ,$905.25 ,$564.93 ,$272.00 ,$262.76 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325530,86870,.ANTIBODY ID REF LAB,390,1 ,$159.00 ,$103.35 ,$93.17 ,$582.28 ,$108.92 ,$270.83 ,$93.17 ,$93.17 ,$276.24 ,$130.38 ,$135.15 ,$143.10 ,$119.25 ,$111.30 ,$117.66 ,$143.10 ,$135.15 ,$270.83 ,$135.15 ,$582.28 ,$159.00 ,$270.83 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325547,86971,BBB TREAT RBC WITH ENZYMES,390,1 ,$185.00 ,$120.25 ,$108.41 ,$582.28 ,$126.73 ,$270.83 ,$108.41 ,$108.41 ,$276.24 ,$151.70 ,$157.25 ,$166.50 ,$138.75 ,$129.50 ,$136.90 ,$166.50 ,$157.25 ,$270.83 ,$157.25 ,$582.28 ,$185.00 ,$270.83 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325550,P9059,BBB PLASMA,390,1 ,$266.00 ,$172.90 ,$75.91 ,$266.00 ,$182.21 ,$75.91 ,$155.88 ,$155.88 ,$77.43 ,$218.12 ,$226.10 ,$239.40 ,$199.50 ,$186.20 ,$196.84 ,$239.40 ,$226.10 ,$75.91 ,$226.10 ,$163.21 ,$266.00 ,$75.91 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325564,86905,.P ANTIGEN TYPE,390,1 ,$75.00 ,$48.75 ,$43.95 ,$582.28 ,$51.38 ,$270.83 ,$43.95 ,$43.95 ,$276.24 ,$61.50 ,$63.75 ,$67.50 ,$56.25 ,$52.50 ,$55.50 ,$67.50 ,$63.75 ,$270.83 ,$63.75 ,$582.28 ,$75.00 ,$270.83 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325574,86902,.P ANTIGEN TYPE,390,1 ,$75.00 ,$48.75 ,$43.95 ,$582.28 ,$51.38 ,$270.83 ,$43.95 ,$43.95 ,$276.24 ,$61.50 ,$63.75 ,$67.50 ,$56.25 ,$52.50 ,$55.50 ,$67.50 ,$63.75 ,$270.83 ,$63.75 ,$582.28 ,$75.00 ,$270.83 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325580,86978,BBB  ADSORPTION STROMA,390,1 ,$200.00 ,$130.00 ,$31.95 ,$200.00 ,$137.00 ,$31.95 ,$117.20 ,$117.20 ,$32.58 ,$164.00 ,$170.00 ,$180.00 ,$150.00 ,$140.00 ,$148.00 ,$180.00 ,$170.00 ,$31.95 ,$170.00 ,$68.68 ,$200.00 ,$31.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325582,86860,BBB AB ELUTION/ELU W/ LISS (90409),390,1 ,$112.00 ,$72.80 ,$65.63 ,$294.83 ,$76.72 ,$137.13 ,$65.63 ,$65.63 ,$139.87 ,$91.84 ,$95.20 ,$100.80 ,$84.00 ,$78.40 ,$82.88 ,$100.80 ,$95.20 ,$137.13 ,$95.20 ,$294.83 ,$112.00 ,$137.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),325589,P9035,BBB PLATELET SINGLE DONOR,390,1 ,"$2,076.00 ","$1,349.40 ",$272.00 ,"$1,868.40 ","$1,422.06 ",$499.61 ,"$1,216.54 ","$1,216.54 ",$509.60 ,"$1,702.32 ","$1,764.60 ","$1,868.40 ","$1,557.00 ","$1,453.20 ","$1,536.24 ","$1,868.40 ","$1,764.60 ",$499.61 ,"$1,764.60 ","$1,074.16 ",$272.00 ,$499.61 
HSHS HOLY FAMILY HOSPITAL INC (ACU),330019,96119,NEUROPSY TESTING HRLY,420,1 ,$488.00 ,$317.20 ,$169.00 ,$439.20 ,$334.28 , N/A ,$285.97 ,$285.97 , N/A ,$400.16 ,$414.80 ,$439.20 ,$366.00 ,$341.60 ,$361.12 ,$439.20 ,$414.80 , N/A ,$414.80 , N/A ,$169.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),343400,93798,CARDIAC REHAB - INITIAL EVALUATION,943,1 ,$226.00 ,$146.90 ,$105.14 ,$226.06 ,$154.81 ,$105.14 ,$132.44 ,$132.44 ,$107.25 ,$185.32 ,$192.10 ,$203.40 ,$169.50 ,$158.20 ,$167.24 ,$203.40 ,$192.10 ,$105.14 ,$192.10 ,$226.06 ,$142.00 ,$105.14 
HSHS HOLY FAMILY HOSPITAL INC (ACU),343405,93798,CARDIAC REHAB - PHASE II,943,1 ,$219.00 ,$142.35 ,$105.14 ,$226.06 ,$150.02 ,$105.14 ,$128.33 ,$128.33 ,$107.25 ,$179.58 ,$186.15 ,$197.10 ,$164.25 ,$153.30 ,$162.06 ,$197.10 ,$186.15 ,$105.14 ,$186.15 ,$226.06 ,$142.00 ,$105.14 
HSHS HOLY FAMILY HOSPITAL INC (ACU),353011,93017,STRESS TEST TECH FEE,482,1 ,"$1,028.00 ",$668.20 ,$241.86 ,$947.00 ,$704.18 ,$241.86 ,$602.41 ,$602.41 ,$246.70 ,$842.96 ,$873.80 ,$925.20 ,$771.00 ,$719.60 ,$760.72 ,$925.20 ,$873.80 ,$241.86 ,$873.80 ,$520.00 ,$947.00 ,$241.86 
HSHS HOLY FAMILY HOSPITAL INC (ACU),353012,93016,STRESS TEST-PHYS SUPERVISION,482,1 ,$106.00 ,$68.90 ,$62.12 ,$106.00 ,$72.61 , N/A ,$62.12 ,$62.12 , N/A ,$86.92 ,$90.10 ,$95.40 ,$79.50 ,$74.20 ,$78.44 ,$95.40 ,$90.10 , N/A ,$90.10 , N/A ,$106.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),353013,93018,STRESS TEST-PHYS INTER & REPORT,482,1 ,$79.00 ,$51.35 ,$46.29 ,$79.00 ,$54.12 , N/A ,$46.29 ,$46.29 , N/A ,$64.78 ,$67.15 ,$71.10 ,$59.25 ,$55.30 ,$58.46 ,$71.10 ,$67.15 , N/A ,$67.15 , N/A ,$79.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),355902,93005,EKG,730,1 ,$306.00 ,$198.90 ,$52.57 ,$306.00 ,$209.61 ,$52.57 ,$179.32 ,$179.32 ,$53.62 ,$250.92 ,$260.10 ,$275.40 ,$229.50 ,$214.20 ,$226.44 ,$275.40 ,$260.10 ,$52.57 ,$260.10 ,$113.02 ,$306.00 ,$52.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),355903,93041,EKG-LEAD 2 RYTHM STRIP,730,1 ,$229.00 ,$148.85 ,$52.57 ,$229.00 ,$156.87 ,$52.57 ,$134.19 ,$134.19 ,$53.62 ,$187.78 ,$194.65 ,$206.10 ,$171.75 ,$160.30 ,$169.46 ,$206.10 ,$194.65 ,$52.57 ,$194.65 ,$113.02 ,$229.00 ,$52.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),355921,93225,HOLTER MONITOR W/INTERPRETATION,731,1 ,"$1,750.00 ","$1,137.50 ",$104.19 ,"$1,575.00 ","$1,198.75 ",$104.19 ,"$1,025.50 ","$1,025.50 ",$106.27 ,"$1,435.00 ","$1,487.50 ","$1,575.00 ","$1,312.50 ","$1,225.00 ","$1,295.00 ","$1,575.00 ","$1,487.50 ",$104.19 ,"$1,487.50 ",$224.01 ,$710.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),355923,93226,HOLTER MONITOR SCANNING ANALYSIS,731,1 ,$511.00 ,$332.15 ,$104.19 ,$511.00 ,$350.04 ,$104.19 ,$299.45 ,$299.45 ,$106.27 ,$419.02 ,$434.35 ,$459.90 ,$383.25 ,$357.70 ,$378.14 ,$459.90 ,$434.35 ,$104.19 ,$434.35 ,$224.01 ,$511.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),355928,N/A,PULMONARY PHASE III,731,1 ,$35.20 ,$22.88 ,$20.63 ,$35.20 ,$24.11 , N/A ,$20.63 ,$20.63 , N/A ,$28.86 ,$29.92 ,$31.68 ,$26.40 ,$24.64 ,$26.05 ,$31.68 ,$29.92 , N/A ,$29.92 , N/A ,$35.20 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),355929,93668,PAD REHAH PER SESSION,480,1 ,$173.00 ,$112.45 ,$52.57 ,$173.00 ,$118.51 ,$52.57 ,$101.38 ,$101.38 ,$53.62 ,$141.86 ,$147.05 ,$155.70 ,$129.75 ,$121.10 ,$128.02 ,$155.70 ,$147.05 ,$52.57 ,$147.05 ,$113.02 ,$173.00 ,$52.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),400010,71046,HBO OM-CHEST XRAY 2-VIEW,320,1 ,$118.00 ,$76.70 ,$69.15 ,$163.97 ,$80.83 ,$76.27 ,$69.15 ,$69.15 ,$77.79 ,$96.76 ,$100.30 ,$106.20 ,$88.50 ,$82.60 ,$87.32 ,$106.20 ,$100.30 ,$76.27 ,$100.30 ,$163.97 ,$118.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401009,23350,XR INJECT FOR SHOULDER ARTHROGRAM/CT/MRI,320,1 ,$312.00 ,$202.80 ,$182.83 ,$312.00 ,$213.72 , N/A ,$182.83 ,$182.83 , N/A ,$255.84 ,$265.20 ,$280.80 ,$234.00 ,$218.40 ,$230.88 ,$280.80 ,$265.20 , N/A ,$265.20 , N/A ,$312.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401015,76496,XR FLOUROSCOPIC PROCEDURE,320,1 ,$742.00 ,$482.30 ,$76.27 ,$667.80 ,$508.27 ,$76.27 ,$434.81 ,$434.81 ,$77.79 ,$608.44 ,$630.70 ,$667.80 ,$556.50 ,$519.40 ,$549.08 ,$667.80 ,$630.70 ,$76.27 ,$630.70 ,$163.97 ,$473.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401019,73060,XR HUMERUS RT 2 VIEWS,320,1 ,$415.00 ,$269.75 ,$76.27 ,$415.00 ,$284.28 ,$76.27 ,$243.19 ,$243.19 ,$77.79 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$76.27 ,$352.75 ,$163.97 ,$415.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401020,73060,XR HUMERUS LT 2 VIEWS,320,1 ,$398.12 ,$258.78 ,$76.27 ,$398.12 ,$272.71 ,$76.27 ,$233.30 ,$233.30 ,$77.79 ,$326.46 ,$338.40 ,$358.31 ,$298.59 ,$278.68 ,$294.61 ,$358.31 ,$338.40 ,$76.27 ,$338.40 ,$163.97 ,$398.12 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401021,73590,XR LEG TIBIA W/FIB RT,320,1 ,$415.00 ,$269.75 ,$76.27 ,$415.00 ,$284.28 ,$76.27 ,$243.19 ,$243.19 ,$77.79 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$76.27 ,$352.75 ,$163.97 ,$415.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401023,77065,MAMMOGRAM DX UNILATERAL LT W ICAD,401,1 ,$506.00 ,$328.90 ,$89.07 ,$455.40 ,$346.61 ,$89.07 ,$296.52 ,$296.52 ,$90.85 ,$414.92 ,$430.10 ,$455.40 ,$379.50 ,$354.20 ,$374.44 ,$455.40 ,$430.10 ,$89.07 ,$430.10 ,$191.50 ,$169.00 ,$89.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401024,73600,XR ANKLE 2-VIEWS RT,320,1 ,$408.00 ,$265.20 ,$76.27 ,$408.00 ,$279.48 ,$76.27 ,$239.09 ,$239.09 ,$77.79 ,$334.56 ,$346.80 ,$367.20 ,$306.00 ,$285.60 ,$301.92 ,$367.20 ,$346.80 ,$76.27 ,$346.80 ,$163.97 ,$408.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401031,73610,XR ANKLE RT 3 VIEWS,320,1 ,$445.00 ,$289.25 ,$76.27 ,$445.00 ,$304.83 ,$76.27 ,$260.77 ,$260.77 ,$77.79 ,$364.90 ,$378.25 ,$400.50 ,$333.75 ,$311.50 ,$329.30 ,$400.50 ,$378.25 ,$76.27 ,$378.25 ,$163.97 ,$445.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401033,73560,XR KNEE 2 VIEWS RT,320,1 ,$465.00 ,$302.25 ,$76.27 ,$465.00 ,$318.53 ,$76.27 ,$272.49 ,$272.49 ,$77.79 ,$381.30 ,$395.25 ,$418.50 ,$348.75 ,$325.50 ,$344.10 ,$418.50 ,$395.25 ,$76.27 ,$395.25 ,$163.97 ,$465.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401035,73562,XR KNEE 3 VIEWS RT,320,1 ,$473.00 ,$307.45 ,$76.27 ,$473.00 ,$324.01 ,$76.27 ,$277.18 ,$277.18 ,$77.79 ,$387.86 ,$402.05 ,$425.70 ,$354.75 ,$331.10 ,$350.02 ,$425.70 ,$402.05 ,$76.27 ,$402.05 ,$163.97 ,$473.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401037,73564,XR KNEE 4 VIEWS RT,320,1 ,$546.00 ,$354.90 ,$107.10 ,$491.40 ,$374.01 ,$107.10 ,$319.96 ,$319.96 ,$109.25 ,$447.72 ,$464.10 ,$491.40 ,$409.50 ,$382.20 ,$404.04 ,$491.40 ,$464.10 ,$107.10 ,$464.10 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401039,73080,XR ELBOW RT 3 VIEWS,320,1 ,$415.00 ,$269.75 ,$76.27 ,$415.00 ,$284.28 ,$76.27 ,$243.19 ,$243.19 ,$77.79 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$76.27 ,$352.75 ,$163.97 ,$415.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401041,73100,XR WRIST 2 VIEWS RT,320,1 ,$408.00 ,$265.20 ,$76.27 ,$408.00 ,$279.48 ,$76.27 ,$239.09 ,$239.09 ,$77.79 ,$334.56 ,$346.80 ,$367.20 ,$306.00 ,$285.60 ,$301.92 ,$367.20 ,$346.80 ,$76.27 ,$346.80 ,$163.97 ,$408.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401043,73110,XR WRIST 3 VIEW RT,320,1 ,$473.00 ,$307.45 ,$76.27 ,$473.00 ,$324.01 ,$76.27 ,$277.18 ,$277.18 ,$77.79 ,$387.86 ,$402.05 ,$425.70 ,$354.75 ,$331.10 ,$350.02 ,$425.70 ,$402.05 ,$76.27 ,$402.05 ,$163.97 ,$473.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401045,73040,XR ARTHROGRAM SHOULDER RT,320,1 ,"$1,220.00 ",$793.00 ,$364.90 ,"$1,098.00 ",$835.70 ,$364.90 ,$714.92 ,$714.92 ,$372.19 ,"$1,000.40 ","$1,037.00 ","$1,098.00 ",$915.00 ,$854.00 ,$902.80 ,"$1,098.00 ","$1,037.00 ",$364.90 ,"$1,037.00 ",$784.53 ,$473.00 ,$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401049,73000,XR CLAVICLE RT 2 VIEWS,320,1 ,$378.00 ,$245.70 ,$76.27 ,$378.00 ,$258.93 ,$76.27 ,$221.51 ,$221.51 ,$77.79 ,$309.96 ,$321.30 ,$340.20 ,$283.50 ,$264.60 ,$279.72 ,$340.20 ,$321.30 ,$76.27 ,$321.30 ,$163.97 ,$378.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401051,73070,XR ELBOW 2 VIEW RT,320,1 ,$239.00 ,$155.35 ,$76.27 ,$239.00 ,$163.72 ,$76.27 ,$140.05 ,$140.05 ,$77.79 ,$195.98 ,$203.15 ,$215.10 ,$179.25 ,$167.30 ,$176.86 ,$215.10 ,$203.15 ,$76.27 ,$203.15 ,$163.97 ,$239.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401053,73552,XR FEMUR RT 2 VIEWS,320,1 ,$415.00 ,$269.75 ,$76.27 ,$415.00 ,$284.28 ,$76.27 ,$243.19 ,$243.19 ,$77.79 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$76.27 ,$352.75 ,$163.97 ,$415.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401055,73620,XR FOOT 2 VIEW RT,320,1 ,$408.00 ,$265.20 ,$76.27 ,$408.00 ,$279.48 ,$76.27 ,$239.09 ,$239.09 ,$77.79 ,$334.56 ,$346.80 ,$367.20 ,$306.00 ,$285.60 ,$301.92 ,$367.20 ,$346.80 ,$76.27 ,$346.80 ,$163.97 ,$408.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401057,73630,XR FOOT 3 VIEWS RT,320,1 ,$473.00 ,$307.45 ,$76.27 ,$473.00 ,$324.01 ,$76.27 ,$277.18 ,$277.18 ,$77.79 ,$387.86 ,$402.05 ,$425.70 ,$354.75 ,$331.10 ,$350.02 ,$425.70 ,$402.05 ,$76.27 ,$402.05 ,$163.97 ,$473.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401058,73630,XR FOOT 3 VIEWS LT,320,1 ,$453.42 ,$294.72 ,$76.27 ,$453.42 ,$310.59 ,$76.27 ,$265.70 ,$265.70 ,$77.79 ,$371.80 ,$385.41 ,$408.08 ,$340.07 ,$317.39 ,$335.53 ,$408.08 ,$385.41 ,$76.27 ,$385.41 ,$163.97 ,$453.42 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401059,73090,XR FOREARM RT 2 VIEWS,320,1 ,$408.00 ,$265.20 ,$76.27 ,$408.00 ,$279.48 ,$76.27 ,$239.09 ,$239.09 ,$77.79 ,$334.56 ,$346.80 ,$367.20 ,$306.00 ,$285.60 ,$301.92 ,$367.20 ,$346.80 ,$76.27 ,$346.80 ,$163.97 ,$408.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401061,73120,XR HAND 2 VIEW RT,320,1 ,$408.00 ,$265.20 ,$107.10 ,$408.00 ,$279.48 ,$107.10 ,$239.09 ,$239.09 ,$109.25 ,$334.56 ,$346.80 ,$367.20 ,$306.00 ,$285.60 ,$301.92 ,$367.20 ,$346.80 ,$107.10 ,$346.80 ,$230.27 ,$408.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401063,73130,XR HAND 3 VIEWS RT,320,1 ,$445.00 ,$289.25 ,$76.27 ,$445.00 ,$304.83 ,$76.27 ,$260.77 ,$260.77 ,$77.79 ,$364.90 ,$378.25 ,$400.50 ,$333.75 ,$311.50 ,$329.30 ,$400.50 ,$378.25 ,$76.27 ,$378.25 ,$163.97 ,$445.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401065,73502,XR HIP AP W/LAT RT,320,1 ,$445.00 ,$289.25 ,$76.27 ,$445.00 ,$304.83 ,$76.27 ,$260.77 ,$260.77 ,$77.79 ,$364.90 ,$378.25 ,$400.50 ,$333.75 ,$311.50 ,$329.30 ,$400.50 ,$378.25 ,$76.27 ,$378.25 ,$163.97 ,$445.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401069,72220,XR SACRUM & COCCYX 2 VIEWS,320,1 ,$415.00 ,$269.75 ,$76.27 ,$415.00 ,$284.28 ,$76.27 ,$243.19 ,$243.19 ,$77.79 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$76.27 ,$352.75 ,$163.97 ,$415.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),401074,73030,XR SHOULDER RT 2 VIEWS,320,1 ,$457.00 ,$297.05 ,$76.27 ,$457.00 ,$313.05 ,$76.27 ,$267.80 ,$267.80 ,$77.79 ,$374.74 ,$388.45 ,$411.30 ,$342.75 ,$319.90 ,$338.18 ,$411.30 ,$388.45 ,$76.27 ,$388.45 ,$163.97 ,$457.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406007,77002,XR NEEDLE PLACEMENT,320,1 ,$172.00 ,$111.80 ,$100.79 ,$172.00 ,$117.82 , N/A ,$100.79 ,$100.79 , N/A ,$141.04 ,$146.20 ,$154.80 ,$129.00 ,$120.40 ,$127.28 ,$154.80 ,$146.20 , N/A ,$146.20 , N/A ,$172.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406009,72114,XR LUMBAR SP/FLEX / EXT,320,1 ,$696.00 ,$452.40 ,$107.10 ,$626.40 ,$476.76 ,$107.10 ,$407.86 ,$407.86 ,$109.25 ,$570.72 ,$591.60 ,$626.40 ,$522.00 ,$487.20 ,$515.04 ,$626.40 ,$591.60 ,$107.10 ,$591.60 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406016,72082,XR SCOLIOSIS SURVEY,320,1 ,$633.00 ,$411.45 ,$107.10 ,$569.70 ,$433.61 ,$107.10 ,$370.94 ,$370.94 ,$109.25 ,$519.06 ,$538.05 ,$569.70 ,$474.75 ,$443.10 ,$468.42 ,$569.70 ,$538.05 ,$107.10 ,$538.05 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406019,74230,XR VIDEO FLUOROSCOPY,320,1 ,$772.00 ,$501.80 ,$174.13 ,$694.80 ,$528.82 ,$174.13 ,$452.39 ,$452.39 ,$177.61 ,$633.04 ,$656.20 ,$694.80 ,$579.00 ,$540.40 ,$571.28 ,$694.80 ,$656.20 ,$174.13 ,$656.20 ,$374.38 ,$473.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406022,74019,XR ABDOMEN UPRIGHT,320,1 ,$495.00 ,$321.75 ,$107.10 ,$473.00 ,$339.08 ,$107.10 ,$290.07 ,$290.07 ,$109.25 ,$405.90 ,$420.75 ,$445.50 ,$371.25 ,$346.50 ,$366.30 ,$445.50 ,$420.75 ,$107.10 ,$420.75 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406025,72052,XR C-SPINE FLEX EX,320,1 ,$696.00 ,$452.40 ,$107.10 ,$626.40 ,$476.76 ,$107.10 ,$407.86 ,$407.86 ,$109.25 ,$570.72 ,$591.60 ,$626.40 ,$522.00 ,$487.20 ,$515.04 ,$626.40 ,$591.60 ,$107.10 ,$591.60 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406026,72050,XR C-SPINE OBLIQUE 5 VIEWS,320,1 ,$696.00 ,$452.40 ,$107.10 ,$626.40 ,$476.76 ,$107.10 ,$407.86 ,$407.86 ,$109.25 ,$570.72 ,$591.60 ,$626.40 ,$522.00 ,$487.20 ,$515.04 ,$626.40 ,$591.60 ,$107.10 ,$591.60 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406027,72040,XR C-SPINE AP  LAT,320,1 ,$415.00 ,$269.75 ,$76.27 ,$415.00 ,$284.28 ,$76.27 ,$243.19 ,$243.19 ,$77.79 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$76.27 ,$352.75 ,$163.97 ,$415.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406030,71045,XR CHEST 1 VIEW,320,1 ,$400.00 ,$260.00 ,$76.27 ,$400.00 ,$274.00 ,$76.27 ,$234.40 ,$234.40 ,$77.79 ,$328.00 ,$340.00 ,$360.00 ,$300.00 ,$280.00 ,$296.00 ,$360.00 ,$340.00 ,$76.27 ,$340.00 ,$163.97 ,$400.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406037,74220,XR ESOPHAGEAL STDY,320,1 ,$772.00 ,$501.80 ,$174.13 ,$694.80 ,$528.82 ,$174.13 ,$452.39 ,$452.39 ,$177.61 ,$633.04 ,$656.20 ,$694.80 ,$579.00 ,$540.40 ,$571.28 ,$694.80 ,$656.20 ,$174.13 ,$656.20 ,$374.38 ,$473.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406060,74018,XR KUB,320,1 ,$435.00 ,$282.75 ,$76.27 ,$435.00 ,$297.98 ,$76.27 ,$254.91 ,$254.91 ,$77.79 ,$356.70 ,$369.75 ,$391.50 ,$326.25 ,$304.50 ,$321.90 ,$391.50 ,$369.75 ,$76.27 ,$369.75 ,$163.97 ,$435.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406064,74270,XR LOWER GI,320,1 ,"$1,094.00 ",$711.10 ,$174.13 ,$984.60 ,$749.39 ,$174.13 ,$641.08 ,$641.08 ,$177.61 ,$897.08 ,$929.90 ,$984.60 ,$820.50 ,$765.80 ,$809.56 ,$984.60 ,$929.90 ,$174.13 ,$929.90 ,$374.38 ,$473.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406065,74280,XR LOWER GI W/AIR,320,1 ,"$1,369.00 ",$889.85 ,$174.13 ,"$1,232.10 ",$937.77 ,$174.13 ,$802.23 ,$802.23 ,$177.61 ,"$1,122.58 ","$1,163.65 ","$1,232.10 ","$1,026.75 ",$958.30 ,"$1,013.06 ","$1,232.10 ","$1,163.65 ",$174.13 ,"$1,163.65 ",$374.38 ,$473.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406066,70110,XR MANDIBLE,320,1 ,$415.00 ,$269.75 ,$107.10 ,$415.00 ,$284.28 ,$107.10 ,$243.19 ,$243.19 ,$109.25 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$107.10 ,$352.75 ,$230.27 ,$415.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406068,70160,XR NASAL BONES,320,1 ,$415.00 ,$269.75 ,$76.27 ,$415.00 ,$284.28 ,$76.27 ,$243.19 ,$243.19 ,$77.79 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$76.27 ,$352.75 ,$163.97 ,$415.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406069,70030,XR FOREIGN BODY EYE,320,1 ,$435.00 ,$282.75 ,$76.27 ,$435.00 ,$297.98 ,$76.27 ,$254.91 ,$254.91 ,$77.79 ,$356.70 ,$369.75 ,$391.50 ,$326.25 ,$304.50 ,$321.90 ,$391.50 ,$369.75 ,$76.27 ,$369.75 ,$163.97 ,$435.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406070,70200,XR ORBITS,320,1 ,$415.00 ,$269.75 ,$107.10 ,$415.00 ,$284.28 ,$107.10 ,$243.19 ,$243.19 ,$109.25 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$107.10 ,$352.75 ,$230.27 ,$415.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406071,73650,XR OSCALCIS HEEL,320,1 ,$378.00 ,$245.70 ,$76.27 ,$378.00 ,$258.93 ,$76.27 ,$221.51 ,$221.51 ,$77.79 ,$309.96 ,$321.30 ,$340.20 ,$283.50 ,$264.60 ,$279.72 ,$340.20 ,$321.30 ,$76.27 ,$321.30 ,$163.97 ,$378.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406073,72170,XR PELVIS,320,1 ,$408.00 ,$265.20 ,$107.10 ,$408.00 ,$279.48 ,$107.10 ,$239.09 ,$239.09 ,$109.25 ,$334.56 ,$346.80 ,$367.20 ,$306.00 ,$285.60 ,$301.92 ,$367.20 ,$346.80 ,$107.10 ,$346.80 ,$230.27 ,$408.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406074,71100,XR RIBS UNILATERAL 3 VIEWS,320,1 ,$447.00 ,$290.55 ,$76.27 ,$447.00 ,$306.20 ,$76.27 ,$261.94 ,$261.94 ,$77.79 ,$366.54 ,$379.95 ,$402.30 ,$335.25 ,$312.90 ,$330.78 ,$402.30 ,$379.95 ,$76.27 ,$379.95 ,$163.97 ,$447.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406075,71110,XR RIBS BILATERAL 6 VIEWS,320,1 ,$559.00 ,$363.35 ,$107.10 ,$503.10 ,$382.92 ,$107.10 ,$327.57 ,$327.57 ,$109.25 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$107.10 ,$475.15 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406076,72200,XR SACROILIAC JNTS 3 VIEWS,320,1 ,$378.00 ,$245.70 ,$107.10 ,$378.00 ,$258.93 ,$107.10 ,$221.51 ,$221.51 ,$109.25 ,$309.96 ,$321.30 ,$340.20 ,$283.50 ,$264.60 ,$279.72 ,$340.20 ,$321.30 ,$107.10 ,$321.30 ,$230.27 ,$378.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406077,73010,XR SCAPULA 2 VIEWS,320,1 ,$415.00 ,$269.75 ,$107.10 ,$415.00 ,$284.28 ,$107.10 ,$243.19 ,$243.19 ,$109.25 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$107.10 ,$352.75 ,$230.27 ,$415.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406081,70220,XR SINUSES 3 VIEW,320,1 ,$521.00 ,$338.65 ,$76.27 ,$473.00 ,$356.89 ,$76.27 ,$305.31 ,$305.31 ,$77.79 ,$427.22 ,$442.85 ,$468.90 ,$390.75 ,$364.70 ,$385.54 ,$468.90 ,$442.85 ,$76.27 ,$442.85 ,$163.97 ,$473.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406085,72072,XR DORSAL SPINE W/SWIMMERS,320,1 ,$447.00 ,$290.55 ,$107.10 ,$447.00 ,$306.20 ,$107.10 ,$261.94 ,$261.94 ,$109.25 ,$366.54 ,$379.95 ,$402.30 ,$335.25 ,$312.90 ,$330.78 ,$402.30 ,$379.95 ,$107.10 ,$379.95 ,$230.27 ,$447.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406086,72110,XR LUMBAR SP/OBLIQ,320,1 ,$825.00 ,$536.25 ,$107.10 ,$742.50 ,$565.13 ,$107.10 ,$483.45 ,$483.45 ,$109.25 ,$676.50 ,$701.25 ,$742.50 ,$618.75 ,$577.50 ,$610.50 ,$742.50 ,$701.25 ,$107.10 ,$701.25 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406087,72100,XR LUMBAR SP/AP  LAT,320,1 ,$521.00 ,$338.65 ,$107.10 ,$473.00 ,$356.89 ,$107.10 ,$305.31 ,$305.31 ,$109.25 ,$427.22 ,$442.85 ,$468.90 ,$390.75 ,$364.70 ,$385.54 ,$468.90 ,$442.85 ,$107.10 ,$442.85 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406091,71111,XR RIBS BILATERAL W/1 VIEW CHEST,320,1 ,$681.00 ,$442.65 ,$107.10 ,$612.90 ,$466.49 ,$107.10 ,$399.07 ,$399.07 ,$109.25 ,$558.42 ,$578.85 ,$612.90 ,$510.75 ,$476.70 ,$503.94 ,$612.90 ,$578.85 ,$107.10 ,$578.85 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406092,74246,XR UPPER GI W/AIR,320,1 ,"$1,192.00 ",$774.80 ,$174.13 ,"$1,072.80 ",$816.52 ,$174.13 ,$698.51 ,$698.51 ,$177.61 ,$977.44 ,"$1,013.20 ","$1,072.80 ",$894.00 ,$834.40 ,$882.08 ,"$1,072.80 ","$1,013.20 ",$174.13 ,"$1,013.20 ",$374.38 ,$473.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406093,74250,XR SMALL BOWEL SERIES,320,1 ,$848.00 ,$551.20 ,$174.13 ,$763.20 ,$580.88 ,$174.13 ,$496.93 ,$496.93 ,$177.61 ,$695.36 ,$720.80 ,$763.20 ,$636.00 ,$593.60 ,$627.52 ,$763.20 ,$720.80 ,$174.13 ,$720.80 ,$374.38 ,$473.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406098,77067,MAMMOGRAM W/ICAD SCREENING,403,1 ,$419.00 ,$272.35 ,$94.15 ,$377.10 ,$287.02 ,$94.15 ,$245.53 ,$245.53 ,$96.03 ,$343.58 ,$356.15 ,$377.10 ,$314.25 ,$293.30 ,$310.06 ,$377.10 ,$356.15 ,$94.15 ,$356.15 ,$202.42 ,$169.00 ,$94.15 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406099,70360,XR NECK SOFT TISSU,320,1 ,$435.00 ,$282.75 ,$76.27 ,$435.00 ,$297.98 ,$76.27 ,$254.91 ,$254.91 ,$77.79 ,$356.70 ,$369.75 ,$391.50 ,$326.25 ,$304.50 ,$321.90 ,$391.50 ,$369.75 ,$76.27 ,$369.75 ,$163.97 ,$435.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406100,71048,XR CHEST 4 VIEW,320,1 ,$500.00 ,$325.00 ,$107.10 ,$473.00 ,$342.50 ,$107.10 ,$293.00 ,$293.00 ,$109.25 ,$410.00 ,$425.00 ,$450.00 ,$375.00 ,$350.00 ,$370.00 ,$450.00 ,$425.00 ,$107.10 ,$425.00 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406102,73521,XR PELVIS W/HIPS,320,1 ,$633.00 ,$411.45 ,$107.10 ,$569.70 ,$433.61 ,$107.10 ,$370.94 ,$370.94 ,$109.25 ,$519.06 ,$538.05 ,$569.70 ,$474.75 ,$443.10 ,$468.42 ,$569.70 ,$538.05 ,$107.10 ,$538.05 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406103,73522,XR PELVIS ONE HIP,320,1 ,$229.00 ,$148.85 ,$107.10 ,$230.27 ,$156.87 ,$107.10 ,$134.19 ,$134.19 ,$109.25 ,$187.78 ,$194.65 ,$206.10 ,$171.75 ,$160.30 ,$169.46 ,$206.10 ,$194.65 ,$107.10 ,$194.65 ,$230.27 ,$229.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406108,73660,XR TOES 3 VIEWS,320,1 ,$378.00 ,$245.70 ,$76.27 ,$378.00 ,$258.93 ,$76.27 ,$221.51 ,$221.51 ,$77.79 ,$309.96 ,$321.30 ,$340.20 ,$283.50 ,$264.60 ,$279.72 ,$340.20 ,$321.30 ,$76.27 ,$321.30 ,$163.97 ,$378.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406109,74300,XR CHOLANGIOGRAM-OPERAT,320,1 ,$904.00 ,$587.60 ,$473.00 ,$813.60 ,$619.24 , N/A ,$529.74 ,$529.74 , N/A ,$741.28 ,$768.40 ,$813.60 ,$678.00 ,$632.80 ,$668.96 ,$813.60 ,$768.40 , N/A ,$768.40 , N/A ,$473.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406110,74328,XR ERCP,320,1 ,"$1,380.00 ",$897.00 ,$473.00 ,"$1,242.00 ",$945.30 , N/A ,$808.68 ,$808.68 , N/A ,"$1,131.60 ","$1,173.00 ","$1,242.00 ","$1,035.00 ",$966.00 ,"$1,021.20 ","$1,242.00 ","$1,173.00 ", N/A ,"$1,173.00 ", N/A ,$473.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406115,77072,XR BONE AGE STUDY,320,1 ,$370.00 ,$240.50 ,$107.10 ,$370.00 ,$253.45 ,$107.10 ,$216.82 ,$216.82 ,$109.25 ,$303.40 ,$314.50 ,$333.00 ,$277.50 ,$259.00 ,$273.80 ,$333.00 ,$314.50 ,$107.10 ,$314.50 ,$230.27 ,$370.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406117,77074,XR BONE SURVEY,320,1 ,$633.00 ,$411.45 ,$107.10 ,$569.70 ,$433.61 ,$107.10 ,$370.94 ,$370.94 ,$109.25 ,$519.06 ,$538.05 ,$569.70 ,$474.75 ,$443.10 ,$468.42 ,$569.70 ,$538.05 ,$107.10 ,$538.05 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406120,74249,UGI W/SM BOWEL EXP CODE,320,1 ,"$1,609.00 ","$1,045.85 ",$473.00 ,"$1,448.10 ","$1,102.17 ", N/A ,$942.87 ,$942.87 , N/A ,"$1,319.38 ","$1,367.65 ","$1,448.10 ","$1,206.75 ","$1,126.30 ","$1,190.66 ","$1,448.10 ","$1,367.65 ", N/A ,"$1,367.65 ", N/A ,$473.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406121,73140,XR FINGERS 3 VIEWS,320,1 ,$378.00 ,$245.70 ,$76.27 ,$378.00 ,$258.93 ,$76.27 ,$221.51 ,$221.51 ,$77.79 ,$309.96 ,$321.30 ,$340.20 ,$283.50 ,$264.60 ,$279.72 ,$340.20 ,$321.30 ,$76.27 ,$321.30 ,$163.97 ,$378.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406123,71101,XR RIBS UNI W/1 VIEW CHEST,320,1 ,$521.00 ,$338.65 ,$107.10 ,$473.00 ,$356.89 ,$107.10 ,$305.31 ,$305.31 ,$109.25 ,$427.22 ,$442.85 ,$468.90 ,$390.75 ,$364.70 ,$385.54 ,$468.90 ,$442.85 ,$107.10 ,$442.85 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406124,19281,MAMMOGRAM LOCALIZATION,320,1 ,$856.00 ,$556.40 ,$473.00 ,"$1,253.29 ",$586.36 ,$582.93 ,$501.62 ,$501.62 ,$594.58 ,$701.92 ,$727.60 ,$770.40 ,$642.00 ,$599.20 ,$633.44 ,$770.40 ,$727.60 ,$582.93 ,$727.60 ,"$1,253.29 ",$473.00 ,$582.93 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406133,77066,MAMMOGRAM DX BILATERAL W ICAD,401,1 ,$676.00 ,$439.40 ,$113.47 ,$608.40 ,$463.06 ,$113.47 ,$396.14 ,$396.14 ,$115.74 ,$554.32 ,$574.60 ,$608.40 ,$507.00 ,$473.20 ,$500.24 ,$608.40 ,$574.60 ,$113.47 ,$574.60 ,$243.96 ,$169.00 ,$113.47 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406135,77080,XR BONE DENSITY-DEXA SPINE,320,1 ,$630.00 ,$409.50 ,$107.10 ,$567.00 ,$431.55 ,$107.10 ,$369.18 ,$369.18 ,$109.25 ,$516.60 ,$535.50 ,$567.00 ,$472.50 ,$441.00 ,$466.20 ,$567.00 ,$535.50 ,$107.10 ,$535.50 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406136,77081,XR BONE DENSITY-DEXA EXTREMITY,320,1 ,$687.00 ,$446.55 ,$76.27 ,$618.30 ,$470.60 ,$76.27 ,$402.58 ,$402.58 ,$77.79 ,$563.34 ,$583.95 ,$618.30 ,$515.25 ,$480.90 ,$508.38 ,$618.30 ,$583.95 ,$76.27 ,$583.95 ,$163.97 ,$473.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406168,73030,XR SHOULDER TRAUMA 3 VIEW LT,320,1 ,$437.93 ,$284.65 ,$76.27 ,$437.93 ,$299.98 ,$76.27 ,$256.63 ,$256.63 ,$77.79 ,$359.10 ,$372.24 ,$394.14 ,$328.45 ,$306.55 ,$324.07 ,$394.14 ,$372.24 ,$76.27 ,$372.24 ,$163.97 ,$437.93 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406178,77063,MAMMOGRAM SCREENING WITH TOMO AND I/CAD,403,1 ,$117.00 ,$76.05 ,$23.72 ,$117.00 ,$80.15 ,$23.72 ,$68.56 ,$68.56 ,$24.19 ,$95.94 ,$99.45 ,$105.30 ,$87.75 ,$81.90 ,$86.58 ,$105.30 ,$99.45 ,$23.72 ,$99.45 ,$51.00 ,$117.00 ,$23.72 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406183,71046,HBO OM-CHEST XRAY 2-VIEW - CARLISLE SYN,320,1 ,$90.00 ,$58.50 ,$52.74 ,$163.97 ,$61.65 ,$76.27 ,$52.74 ,$52.74 ,$77.79 ,$73.80 ,$76.50 ,$81.00 ,$67.50 ,$63.00 ,$66.60 ,$81.00 ,$76.50 ,$76.27 ,$76.50 ,$163.97 ,$90.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406185,72070,XR DORSAL SPINE 2 VIEWS,320,1 ,$415.00 ,$269.75 ,$107.10 ,$415.00 ,$284.28 ,$107.10 ,$243.19 ,$243.19 ,$109.25 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$107.10 ,$352.75 ,$230.27 ,$415.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406186,72070,XR THORACIC SPINE 3 VIEWS,320,1 ,$398.12 ,$258.78 ,$107.10 ,$398.12 ,$272.71 ,$107.10 ,$233.30 ,$233.30 ,$109.25 ,$326.46 ,$338.40 ,$358.31 ,$298.59 ,$278.68 ,$294.61 ,$358.31 ,$338.40 ,$107.10 ,$338.40 ,$230.27 ,$398.12 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406221,72020,XR C-SPINE CROSS TABLE LATERAL,320,1 ,$415.00 ,$269.75 ,$76.27 ,$415.00 ,$284.28 ,$76.27 ,$243.19 ,$243.19 ,$77.79 ,$340.30 ,$352.75 ,$373.50 ,$311.25 ,$290.50 ,$307.10 ,$373.50 ,$352.75 ,$76.27 ,$352.75 ,$163.97 ,$415.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406222,74022,XR ABDOMEN ACUTE W/PA CHEST,320,1 ,$729.00 ,$473.85 ,$107.10 ,$656.10 ,$499.37 ,$107.10 ,$427.19 ,$427.19 ,$109.25 ,$597.78 ,$619.65 ,$656.10 ,$546.75 ,$510.30 ,$539.46 ,$656.10 ,$619.65 ,$107.10 ,$619.65 ,$230.27 ,$473.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),406225,27093,XR INJECTION HIP ARTHROGRAM,320,1 ,$312.00 ,$202.80 ,$182.83 ,$312.00 ,$213.72 , N/A ,$182.83 ,$182.83 , N/A ,$255.84 ,$265.20 ,$280.80 ,$234.00 ,$218.40 ,$230.88 ,$280.80 ,$265.20 , N/A ,$265.20 , N/A ,$312.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416200,70498,CT CAROTID ANGIOGRAPHY,350,1 ,"$3,293.00 ","$2,140.45 ",$174.13 ,"$2,963.70 ","$2,255.71 ",$174.13 ,"$1,929.70 ","$1,929.70 ",$177.61 ,"$2,700.26 ","$2,799.05 ","$2,963.70 ","$2,469.75 ","$2,305.10 ","$2,436.82 ","$2,963.70 ","$2,799.05 ",$174.13 ,"$2,799.05 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416201,70450,CT BRAIN WITHOUT CONTRAST,350,1 ,"$2,281.00 ","$1,482.65 ",$107.10 ,"$2,052.90 ","$1,562.49 ",$107.10 ,"$1,336.67 ","$1,336.67 ",$109.25 ,"$1,870.42 ","$1,938.85 ","$2,052.90 ","$1,710.75 ","$1,596.70 ","$1,687.94 ","$2,052.90 ","$1,938.85 ",$107.10 ,"$1,938.85 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416202,74178,CT ABDOMEN/PELVIS W & W/O CONTRAST,350,1 ,"$6,310.00 ","$4,101.50 ",$364.90 ,"$5,679.00 ","$4,322.35 ",$364.90 ,"$3,697.66 ","$3,697.66 ",$372.19 ,"$5,174.20 ","$5,363.50 ","$5,679.00 ","$4,732.50 ","$4,417.00 ","$4,669.40 ","$5,679.00 ","$5,363.50 ",$364.90 ,"$5,363.50 ",$784.53 ,$701.00 ,$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416203,70481,CT IAC/ORBITS WITH CONTRASTNTRAST,350,1 ,"$2,873.00 ","$1,867.45 ",$174.13 ,"$2,585.70 ","$1,968.01 ",$174.13 ,"$1,683.58 ","$1,683.58 ",$177.61 ,"$2,355.86 ","$2,442.05 ","$2,585.70 ","$2,154.75 ","$2,011.10 ","$2,126.02 ","$2,585.70 ","$2,442.05 ",$174.13 ,"$2,442.05 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416204,70482,CT IAC/ORBITS W/O / WITH CONTRAST,350,1 ,"$3,227.00 ","$2,097.55 ",$174.13 ,"$2,904.30 ","$2,210.50 ",$174.13 ,"$1,891.02 ","$1,891.02 ",$177.61 ,"$2,646.14 ","$2,742.95 ","$2,904.30 ","$2,420.25 ","$2,258.90 ","$2,387.98 ","$2,904.30 ","$2,742.95 ",$174.13 ,"$2,742.95 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416205,70470,CT BRAIN WITH / W/O CONTRAST,350,1 ,"$3,227.00 ","$2,097.55 ",$174.13 ,"$2,904.30 ","$2,210.50 ",$174.13 ,"$1,891.02 ","$1,891.02 ",$177.61 ,"$2,646.14 ","$2,742.95 ","$2,904.30 ","$2,420.25 ","$2,258.90 ","$2,387.98 ","$2,904.30 ","$2,742.95 ",$174.13 ,"$2,742.95 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416206,73200,CT UPPER EXTREMITY W/O CONTRASTST,350,1 ,"$1,985.00 ","$1,290.25 ",$107.10 ,"$1,786.50 ","$1,359.73 ",$107.10 ,"$1,163.21 ","$1,163.21 ",$109.25 ,"$1,627.70 ","$1,687.25 ","$1,786.50 ","$1,488.75 ","$1,389.50 ","$1,468.90 ","$1,786.50 ","$1,687.25 ",$107.10 ,"$1,687.25 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416207,70486,CT FACIAL BONES,350,1 ,"$2,177.00 ","$1,415.05 ",$107.10 ,"$1,959.30 ","$1,491.25 ",$107.10 ,"$1,275.72 ","$1,275.72 ",$109.25 ,"$1,785.14 ","$1,850.45 ","$1,959.30 ","$1,632.75 ","$1,523.90 ","$1,610.98 ","$1,959.30 ","$1,850.45 ",$107.10 ,"$1,850.45 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416208,73201,CT UPPER EXTREMITY WITH CONTRAST ONLY,350,1 ,"$2,743.00 ","$1,782.95 ",$364.90 ,"$2,468.70 ","$1,878.96 ",$364.90 ,"$1,607.40 ","$1,607.40 ",$372.19 ,"$2,249.26 ","$2,331.55 ","$2,468.70 ","$2,057.25 ","$1,920.10 ","$2,029.82 ","$2,468.70 ","$2,331.55 ",$364.90 ,"$2,331.55 ",$784.53 ,$701.00 ,$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416210,71260,CT CHEST WITH CONTRAST,350,1 ,"$2,743.00 ","$1,782.95 ",$174.13 ,"$2,468.70 ","$1,878.96 ",$174.13 ,"$1,607.40 ","$1,607.40 ",$177.61 ,"$2,249.26 ","$2,331.55 ","$2,468.70 ","$2,057.25 ","$1,920.10 ","$2,029.82 ","$2,468.70 ","$2,331.55 ",$174.13 ,"$2,331.55 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416211,71250,CT CHEST NON-CONTRAST,350,1 ,"$2,268.00 ","$1,474.20 ",$107.10 ,"$2,041.20 ","$1,553.58 ",$107.10 ,"$1,329.05 ","$1,329.05 ",$109.25 ,"$1,859.76 ","$1,927.80 ","$2,041.20 ","$1,701.00 ","$1,587.60 ","$1,678.32 ","$2,041.20 ","$1,927.80 ",$107.10 ,"$1,927.80 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416212,73700,CT LOWER EXTREMITY W/O CONTRAST,350,1 ,"$1,985.00 ","$1,290.25 ",$107.10 ,"$1,786.50 ","$1,359.73 ",$107.10 ,"$1,163.21 ","$1,163.21 ",$109.25 ,"$1,627.70 ","$1,687.25 ","$1,786.50 ","$1,488.75 ","$1,389.50 ","$1,468.90 ","$1,786.50 ","$1,687.25 ",$107.10 ,"$1,687.25 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416214,70490,CT SOFT TISSUE NECK W/O CONTRAST,350,1 ,"$2,078.00 ","$1,350.70 ",$107.10 ,"$1,870.20 ","$1,423.43 ",$107.10 ,"$1,217.71 ","$1,217.71 ",$109.25 ,"$1,703.96 ","$1,766.30 ","$1,870.20 ","$1,558.50 ","$1,454.60 ","$1,537.72 ","$1,870.20 ","$1,766.30 ",$107.10 ,"$1,766.30 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416215,72194,CT PELVIS W/O / WITH CONTRAST,350,1 ,"$2,943.00 ","$1,912.95 ",$174.13 ,"$2,648.70 ","$2,015.96 ",$174.13 ,"$1,724.60 ","$1,724.60 ",$177.61 ,"$2,413.26 ","$2,501.55 ","$2,648.70 ","$2,207.25 ","$2,060.10 ","$2,177.82 ","$2,648.70 ","$2,501.55 ",$174.13 ,"$2,501.55 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416216,72192,CT PELVIS W/O CONTRAST,350,1 ,"$2,066.00 ","$1,342.90 ",$107.10 ,"$1,859.40 ","$1,415.21 ",$107.10 ,"$1,210.68 ","$1,210.68 ",$109.25 ,"$1,694.12 ","$1,756.10 ","$1,859.40 ","$1,549.50 ","$1,446.20 ","$1,528.84 ","$1,859.40 ","$1,756.10 ",$107.10 ,"$1,756.10 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416217,72128,CT THORACIC SPINE W/O CONTRAST,350,1 ,"$2,707.00 ","$1,759.55 ",$107.10 ,"$2,436.30 ","$1,854.30 ",$107.10 ,"$1,586.30 ","$1,586.30 ",$109.25 ,"$2,219.74 ","$2,300.95 ","$2,436.30 ","$2,030.25 ","$1,894.90 ","$2,003.18 ","$2,436.30 ","$2,300.95 ",$107.10 ,"$2,300.95 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416219,70492,CT SOFT TISSUE NECK W/O / WITH CONTRAST,350,1 ,"$3,227.00 ","$2,097.55 ",$174.13 ,"$2,904.30 ","$2,210.50 ",$174.13 ,"$1,891.02 ","$1,891.02 ",$177.61 ,"$2,646.14 ","$2,742.95 ","$2,904.30 ","$2,420.25 ","$2,258.90 ","$2,387.98 ","$2,904.30 ","$2,742.95 ",$174.13 ,"$2,742.95 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416220,74170,CT ABDOMEN WITH / W/O CONTRAST,350,1 ,"$3,081.00 ","$2,002.65 ",$174.13 ,"$2,772.90 ","$2,110.49 ",$174.13 ,"$1,805.47 ","$1,805.47 ",$177.61 ,"$2,526.42 ","$2,618.85 ","$2,772.90 ","$2,310.75 ","$2,156.70 ","$2,279.94 ","$2,772.90 ","$2,618.85 ",$174.13 ,"$2,618.85 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416221,72193,CT PELVIS WITH CONTRAST,350,1 ,"$2,620.00 ","$1,703.00 ",$174.13 ,"$2,358.00 ","$1,794.70 ",$174.13 ,"$1,535.32 ","$1,535.32 ",$177.61 ,"$2,148.40 ","$2,227.00 ","$2,358.00 ","$1,965.00 ","$1,834.00 ","$1,938.80 ","$2,358.00 ","$2,227.00 ",$174.13 ,"$2,227.00 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416222,74150,CT ABDOMEN W/O CONTRAST,350,1 ,"$2,164.00 ","$1,406.60 ",$107.10 ,"$1,947.60 ","$1,482.34 ",$107.10 ,"$1,268.10 ","$1,268.10 ",$109.25 ,"$1,774.48 ","$1,839.40 ","$1,947.60 ","$1,623.00 ","$1,514.80 ","$1,601.36 ","$1,947.60 ","$1,839.40 ",$107.10 ,"$1,839.40 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416223,71270,CT CHEST W/O / WITH CONTRAST,350,1 ,"$3,081.00 ","$2,002.65 ",$174.13 ,"$2,772.90 ","$2,110.49 ",$174.13 ,"$1,805.47 ","$1,805.47 ",$177.61 ,"$2,526.42 ","$2,618.85 ","$2,772.90 ","$2,310.75 ","$2,156.70 ","$2,279.94 ","$2,772.90 ","$2,618.85 ",$174.13 ,"$2,618.85 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416225,70491,CT SOFT TISSUE NECK WITH CONTRAST,350,1 ,"$2,873.00 ","$1,867.45 ",$174.13 ,"$2,585.70 ","$1,968.01 ",$174.13 ,"$1,683.58 ","$1,683.58 ",$177.61 ,"$2,355.86 ","$2,442.05 ","$2,585.70 ","$2,154.75 ","$2,011.10 ","$2,126.02 ","$2,585.70 ","$2,442.05 ",$174.13 ,"$2,442.05 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416226,75635,CT LOWER EXT ANGIO AND AORTA,350,1 ,"$3,147.00 ","$2,045.55 ",$174.13 ,"$2,832.30 ","$2,155.70 ",$174.13 ,"$1,844.14 ","$1,844.14 ",$177.61 ,"$2,580.54 ","$2,674.95 ","$2,832.30 ","$2,360.25 ","$2,202.90 ","$2,328.78 ","$2,832.30 ","$2,674.95 ",$174.13 ,"$2,674.95 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416230,73701,CT LOW EXT WITH CONTRAST ONLY,350,1 ,"$2,743.00 ","$1,782.95 ",$174.13 ,"$2,468.70 ","$1,878.96 ",$174.13 ,"$1,607.40 ","$1,607.40 ",$177.61 ,"$2,249.26 ","$2,331.55 ","$2,468.70 ","$2,057.25 ","$1,920.10 ","$2,029.82 ","$2,468.70 ","$2,331.55 ",$174.13 ,"$2,331.55 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416231,70460,CT BRAIN WITH CONTRAST ONLY,350,1 ,"$2,873.00 ","$1,867.45 ",$174.13 ,"$2,585.70 ","$1,968.01 ",$174.13 ,"$1,683.58 ","$1,683.58 ",$177.61 ,"$2,355.86 ","$2,442.05 ","$2,585.70 ","$2,154.75 ","$2,011.10 ","$2,126.02 ","$2,585.70 ","$2,442.05 ",$174.13 ,"$2,442.05 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416232,71275,CT CHEST ANGIOGRAM (PE),350,1 ,"$3,003.00 ","$1,951.95 ",$174.13 ,"$2,702.70 ","$2,057.06 ",$174.13 ,"$1,759.76 ","$1,759.76 ",$177.61 ,"$2,462.46 ","$2,552.55 ","$2,702.70 ","$2,252.25 ","$2,102.10 ","$2,222.22 ","$2,702.70 ","$2,552.55 ",$174.13 ,"$2,552.55 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416233,74176,CT ABD/PEL W/O CONTRAST,350,1 ,"$4,648.00 ","$3,021.20 ",$222.69 ,"$4,183.20 ","$3,183.88 ",$222.69 ,"$2,723.73 ","$2,723.73 ",$227.15 ,"$3,811.36 ","$3,950.80 ","$4,183.20 ","$3,486.00 ","$3,253.60 ","$3,439.52 ","$4,183.20 ","$3,950.80 ",$222.69 ,"$3,950.80 ",$478.79 ,$701.00 ,$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416234,70496,CT CIRCLE OF WILLIS,350,1 ,"$3,293.00 ","$2,140.45 ",$174.13 ,"$2,963.70 ","$2,255.71 ",$174.13 ,"$1,929.70 ","$1,929.70 ",$177.61 ,"$2,700.26 ","$2,799.05 ","$2,963.70 ","$2,469.75 ","$2,305.10 ","$2,436.82 ","$2,963.70 ","$2,799.05 ",$174.13 ,"$2,799.05 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416245,72125,CT CERVICAL SPINE W/O CONTRAST,350,1 ,"$2,941.00 ","$1,911.65 ",$107.10 ,"$2,646.90 ","$2,014.59 ",$107.10 ,"$1,723.43 ","$1,723.43 ",$109.25 ,"$2,411.62 ","$2,499.85 ","$2,646.90 ","$2,205.75 ","$2,058.70 ","$2,176.34 ","$2,646.90 ","$2,499.85 ",$107.10 ,"$2,499.85 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416250,72131,CT LUMBAR SPINE W/O CONTRAST,350,1 ,"$2,707.00 ","$1,759.55 ",$107.10 ,"$2,436.30 ","$1,854.30 ",$107.10 ,"$1,586.30 ","$1,586.30 ",$109.25 ,"$2,219.74 ","$2,300.95 ","$2,436.30 ","$2,030.25 ","$1,894.90 ","$2,003.18 ","$2,436.30 ","$2,300.95 ",$107.10 ,"$2,300.95 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416251,72132,CT LUMBAR SPINE WITH CONTRAST,350,1 ,"$2,743.00 ","$1,782.95 ",$364.90 ,"$2,468.70 ","$1,878.96 ",$364.90 ,"$1,607.40 ","$1,607.40 ",$372.19 ,"$2,249.26 ","$2,331.55 ","$2,468.70 ","$2,057.25 ","$1,920.10 ","$2,029.82 ","$2,468.70 ","$2,331.55 ",$364.90 ,"$2,331.55 ",$784.53 ,$701.00 ,$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416265,74160,CT ABDOMEN WITH CONTRAST ONLY,350,1 ,"$2,743.00 ","$1,782.95 ",$174.13 ,"$2,468.70 ","$1,878.96 ",$174.13 ,"$1,607.40 ","$1,607.40 ",$177.61 ,"$2,249.26 ","$2,331.55 ","$2,468.70 ","$2,057.25 ","$1,920.10 ","$2,029.82 ","$2,468.70 ","$2,331.55 ",$174.13 ,"$2,331.55 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416266,70480,CT IAC/ORBITS W/O CONTRAST,350,1 ,"$2,177.00 ","$1,415.05 ",$107.10 ,"$1,959.30 ","$1,491.25 ",$107.10 ,"$1,275.72 ","$1,275.72 ",$109.25 ,"$1,785.14 ","$1,850.45 ","$1,959.30 ","$1,632.75 ","$1,523.90 ","$1,610.98 ","$1,959.30 ","$1,850.45 ",$107.10 ,"$1,850.45 ",$230.27 ,$701.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416301,70551,MRI BRAIN W/O CONTRAST,610,1 ,"$3,568.00 ","$2,319.20 ",$222.69 ,"$3,211.20 ","$2,444.08 ",$222.69 ,"$2,090.85 ","$2,090.85 ",$227.15 ,"$2,925.76 ","$3,032.80 ","$3,211.20 ","$2,676.00 ","$2,497.60 ","$2,640.32 ","$3,211.20 ","$3,032.80 ",$222.69 ,"$3,032.80 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416302,74181,MRI ABDOMEN,610,1 ,"$3,255.00 ","$2,115.75 ",$222.69 ,"$2,929.50 ","$2,229.68 ",$222.69 ,"$1,907.43 ","$1,907.43 ",$227.15 ,"$2,669.10 ","$2,766.75 ","$2,929.50 ","$2,441.25 ","$2,278.50 ","$2,408.70 ","$2,929.50 ","$2,766.75 ",$222.69 ,"$2,766.75 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416304,72141,MRI C-SP W/O CONTRAST,610,1 ,"$3,703.00 ","$2,406.95 ",$222.69 ,"$3,332.70 ","$2,536.56 ",$222.69 ,"$2,169.96 ","$2,169.96 ",$227.15 ,"$3,036.46 ","$3,147.55 ","$3,332.70 ","$2,777.25 ","$2,592.10 ","$2,740.22 ","$3,332.70 ","$3,147.55 ",$222.69 ,"$3,147.55 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416305,72146,MRI T-SP W/O CONTRAST,610,1 ,"$3,402.00 ","$2,211.30 ",$222.69 ,"$3,061.80 ","$2,330.37 ",$222.69 ,"$1,993.57 ","$1,993.57 ",$227.15 ,"$2,789.64 ","$2,891.70 ","$3,061.80 ","$2,551.50 ","$2,381.40 ","$2,517.48 ","$3,061.80 ","$2,891.70 ",$222.69 ,"$2,891.70 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416306,72148,MRI L-SP W/O CONTRAST,610,1 ,"$3,402.00 ","$2,211.30 ",$222.69 ,"$3,061.80 ","$2,330.37 ",$222.69 ,"$1,993.57 ","$1,993.57 ",$227.15 ,"$2,789.64 ","$2,891.70 ","$3,061.80 ","$2,551.50 ","$2,381.40 ","$2,517.48 ","$3,061.80 ","$2,891.70 ",$222.69 ,"$2,891.70 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416307,72142,MRI C-SP W/CONTRAST,610,1 ,"$3,711.00 ","$2,412.15 ",$364.90 ,"$3,339.90 ","$2,542.04 ",$364.90 ,"$2,174.65 ","$2,174.65 ",$372.19 ,"$3,043.02 ","$3,154.35 ","$3,339.90 ","$2,783.25 ","$2,597.70 ","$2,746.14 ","$3,339.90 ","$3,154.35 ",$364.90 ,"$3,154.35 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416310,73721,MRI LOWER EXT JOINT,610,1 ,"$3,566.00 ","$2,317.90 ",$222.69 ,"$3,209.40 ","$2,442.71 ",$222.69 ,"$2,089.68 ","$2,089.68 ",$227.15 ,"$2,924.12 ","$3,031.10 ","$3,209.40 ","$2,674.50 ","$2,496.20 ","$2,638.84 ","$3,209.40 ","$3,031.10 ",$222.69 ,"$3,031.10 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416311,73221,MRI UPPER EXT JOINT,610,1 ,"$3,566.00 ","$2,317.90 ",$222.69 ,"$3,209.40 ","$2,442.71 ",$222.69 ,"$2,089.68 ","$2,089.68 ",$227.15 ,"$2,924.12 ","$3,031.10 ","$3,209.40 ","$2,674.50 ","$2,496.20 ","$2,638.84 ","$3,209.40 ","$3,031.10 ",$222.69 ,"$3,031.10 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416312,70553,MRI IACS WO / W/CONTRAST,610,1 ,"$4,730.00 ","$3,074.50 ",$364.90 ,"$4,257.00 ","$3,240.05 ",$364.90 ,"$2,771.78 ","$2,771.78 ",$372.19 ,"$3,878.60 ","$4,020.50 ","$4,257.00 ","$3,547.50 ","$3,311.00 ","$3,500.20 ","$4,257.00 ","$4,020.50 ",$364.90 ,"$4,020.50 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416314,70540,MRI ORBITS/FACIAL/NECK W/O CONTRAST,610,1 ,"$3,242.00 ","$2,107.30 ",$222.69 ,"$2,917.80 ","$2,220.77 ",$222.69 ,"$1,899.81 ","$1,899.81 ",$227.15 ,"$2,658.44 ","$2,755.70 ","$2,917.80 ","$2,431.50 ","$2,269.40 ","$2,399.08 ","$2,917.80 ","$2,755.70 ",$222.69 ,"$2,755.70 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416315,70553,MRI BRAIN WITH / WITHOUT CONTRAST,610,1 ,"$4,592.43 ","$2,985.08 ",$364.90 ,"$4,133.19 ","$3,145.81 ",$364.90 ,"$2,691.16 ","$2,691.16 ",$372.19 ,"$3,765.79 ","$3,903.57 ","$4,133.19 ","$3,444.32 ","$3,214.70 ","$3,398.40 ","$4,133.19 ","$3,903.57 ",$364.90 ,"$3,903.57 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416317,72156,MRI C-SPINE W/O / WITH CONTRAST,610,1 ,"$4,684.00 ","$3,044.60 ",$364.90 ,"$4,215.60 ","$3,208.54 ",$364.90 ,"$2,744.82 ","$2,744.82 ",$372.19 ,"$3,840.88 ","$3,981.40 ","$4,215.60 ","$3,513.00 ","$3,278.80 ","$3,466.16 ","$4,215.60 ","$3,981.40 ",$364.90 ,"$3,981.40 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416318,72157,MRI T-SPINE W/O / WITH CONTRAST,610,1 ,"$4,511.00 ","$2,932.15 ",$364.90 ,"$4,059.90 ","$3,090.04 ",$364.90 ,"$2,643.45 ","$2,643.45 ",$372.19 ,"$3,699.02 ","$3,834.35 ","$4,059.90 ","$3,383.25 ","$3,157.70 ","$3,338.14 ","$4,059.90 ","$3,834.35 ",$364.90 ,"$3,834.35 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416319,72158,MRI L-SPINE W/O / WITH CONTRAST,610,1 ,"$4,511.00 ","$2,932.15 ",$364.90 ,"$4,059.90 ","$3,090.04 ",$364.90 ,"$2,643.45 ","$2,643.45 ",$372.19 ,"$3,699.02 ","$3,834.35 ","$4,059.90 ","$3,383.25 ","$3,157.70 ","$3,338.14 ","$4,059.90 ","$3,834.35 ",$364.90 ,"$3,834.35 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416321,73720,MRI LOWER EXT NONJOINT W/O  WITH CONTRA,610,1 ,"$4,511.00 ","$2,932.15 ",$364.90 ,"$4,059.90 ","$3,090.04 ",$364.90 ,"$2,643.45 ","$2,643.45 ",$372.19 ,"$3,699.02 ","$3,834.35 ","$4,059.90 ","$3,383.25 ","$3,157.70 ","$3,338.14 ","$4,059.90 ","$3,834.35 ",$364.90 ,"$3,834.35 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416324,70543,MRI ORBIT/FACIAL/NECK W/O / WITH CONTRAS,610,1 ,"$4,730.00 ","$3,074.50 ",$364.90 ,"$4,257.00 ","$3,240.05 ",$364.90 ,"$2,771.78 ","$2,771.78 ",$372.19 ,"$3,878.60 ","$4,020.50 ","$4,257.00 ","$3,547.50 ","$3,311.00 ","$3,500.20 ","$4,257.00 ","$4,020.50 ",$364.90 ,"$4,020.50 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416325,71551,MRI CHEST WITH CONTRAST,610,1 ,"$3,418.00 ","$2,221.70 ",$650.59 ,"$3,076.20 ","$2,341.33 ",$650.59 ,"$2,002.95 ","$2,002.95 ",$663.60 ,"$2,802.76 ","$2,905.30 ","$3,076.20 ","$2,563.50 ","$2,392.60 ","$2,529.32 ","$3,076.20 ","$2,905.30 ",$650.59 ,"$2,905.30 ","$1,398.77 ","$1,306.00 ",$650.59 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416328,72197,MRI PELVIS W/O / WITH CONTRAST,610,1 ,"$4,315.00 ","$2,804.75 ",$364.90 ,"$3,883.50 ","$2,955.78 ",$364.90 ,"$2,528.59 ","$2,528.59 ",$372.19 ,"$3,538.30 ","$3,667.75 ","$3,883.50 ","$3,236.25 ","$3,020.50 ","$3,193.10 ","$3,883.50 ","$3,667.75 ",$364.90 ,"$3,667.75 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416329,73218,MRI UPPER EXT NONJOINT W/O CONTRAST,610,1 ,"$3,402.00 ","$2,211.30 ",$222.69 ,"$3,061.80 ","$2,330.37 ",$222.69 ,"$1,993.57 ","$1,993.57 ",$227.15 ,"$2,789.64 ","$2,891.70 ","$3,061.80 ","$2,551.50 ","$2,381.40 ","$2,517.48 ","$3,061.80 ","$2,891.70 ",$222.69 ,"$2,891.70 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416332,73222,MRI UPPER EXT JOINT WITH CONTRAST,610,1 ,"$3,574.00 ","$2,323.10 ",$650.59 ,"$3,216.60 ","$2,448.19 ",$650.59 ,"$2,094.36 ","$2,094.36 ",$663.60 ,"$2,930.68 ","$3,037.90 ","$3,216.60 ","$2,680.50 ","$2,501.80 ","$2,644.76 ","$3,216.60 ","$3,037.90 ",$650.59 ,"$3,037.90 ","$1,398.77 ","$1,306.00 ",$650.59 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416333,73223,MRI UPPER EXT JOINT W/O / WITH CONTRAST,610,1 ,"$4,511.00 ","$2,932.15 ",$364.90 ,"$4,059.90 ","$3,090.04 ",$364.90 ,"$2,643.45 ","$2,643.45 ",$372.19 ,"$3,699.02 ","$3,834.35 ","$4,059.90 ","$3,383.25 ","$3,157.70 ","$3,338.14 ","$4,059.90 ","$3,834.35 ",$364.90 ,"$3,834.35 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416334,73718,MRI LOWER EXT NONJOINT W/O CONTRAST,610,1 ,"$3,402.00 ","$2,211.30 ",$222.69 ,"$3,061.80 ","$2,330.37 ",$222.69 ,"$1,993.57 ","$1,993.57 ",$227.15 ,"$2,789.64 ","$2,891.70 ","$3,061.80 ","$2,551.50 ","$2,381.40 ","$2,517.48 ","$3,061.80 ","$2,891.70 ",$222.69 ,"$2,891.70 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416336,73722,MRI LOWER EXT WITH CONTRAST,610,1 ,"$3,574.00 ","$2,323.10 ",$650.59 ,"$3,216.60 ","$2,448.19 ",$650.59 ,"$2,094.36 ","$2,094.36 ",$663.60 ,"$2,930.68 ","$3,037.90 ","$3,216.60 ","$2,680.50 ","$2,501.80 ","$2,644.76 ","$3,216.60 ","$3,037.90 ",$650.59 ,"$3,037.90 ","$1,398.77 ","$1,306.00 ",$650.59 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416337,73723,MRI LOWER EXT W/O  WITH CONTRAST,610,1 ,"$4,511.00 ","$2,932.15 ",$364.90 ,"$4,059.90 ","$3,090.04 ",$364.90 ,"$2,643.45 ","$2,643.45 ",$372.19 ,"$3,699.02 ","$3,834.35 ","$4,059.90 ","$3,383.25 ","$3,157.70 ","$3,338.14 ","$4,059.90 ","$3,834.35 ",$364.90 ,"$3,834.35 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416339,74183,MRI ABDOMEN W/O  WITH CONTRAST,610,1 ,"$4,315.00 ","$2,804.75 ",$364.90 ,"$3,883.50 ","$2,955.78 ",$364.90 ,"$2,528.59 ","$2,528.59 ",$372.19 ,"$3,538.30 ","$3,667.75 ","$3,883.50 ","$3,236.25 ","$3,020.50 ","$3,193.10 ","$3,883.50 ","$3,667.75 ",$364.90 ,"$3,667.75 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416341,70488,CT MAXIOFACIAL WITH / W/O CONTRAST,350,1 ,"$2,548.00 ","$1,656.20 ",$174.13 ,"$2,293.20 ","$1,745.38 ",$174.13 ,"$1,493.13 ","$1,493.13 ",$177.61 ,"$2,089.36 ","$2,165.80 ","$2,293.20 ","$1,911.00 ","$1,783.60 ","$1,885.52 ","$2,293.20 ","$2,165.80 ",$174.13 ,"$2,165.80 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416342,74175,CT ABD ANGIOGRAM,350,1 ,"$2,714.00 ","$1,764.10 ",$174.13 ,"$2,442.60 ","$1,859.09 ",$174.13 ,"$1,590.40 ","$1,590.40 ",$177.61 ,"$2,225.48 ","$2,306.90 ","$2,442.60 ","$2,035.50 ","$1,899.80 ","$2,008.36 ","$2,442.60 ","$2,306.90 ",$174.13 ,"$2,306.90 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416343,73706,CT LOWER EXTREMITY ANGIOGRAM W/O AORTA,350,1 ,"$3,147.00 ","$2,045.55 ",$174.13 ,"$2,832.30 ","$2,155.70 ",$174.13 ,"$1,844.14 ","$1,844.14 ",$177.61 ,"$2,580.54 ","$2,674.95 ","$2,832.30 ","$2,360.25 ","$2,202.90 ","$2,328.78 ","$2,832.30 ","$2,674.95 ",$174.13 ,"$2,674.95 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416344,75571,CT HRT W/O DYE W/CA TEST,350,1 ,$147.00 ,$95.55 ,$76.27 ,$163.97 ,$100.70 ,$76.27 ,$86.14 ,$86.14 ,$77.79 ,$120.54 ,$124.95 ,$132.30 ,$110.25 ,$102.90 ,$108.78 ,$132.30 ,$124.95 ,$76.27 ,$124.95 ,$163.97 ,$147.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416345,72191,CT ANGIOGRAM PELVIS,350,1 ,"$2,714.00 ","$1,764.10 ",$174.13 ,"$2,442.60 ","$1,859.09 ",$174.13 ,"$1,590.40 ","$1,590.40 ",$177.61 ,"$2,225.48 ","$2,306.90 ","$2,442.60 ","$2,035.50 ","$1,899.80 ","$2,008.36 ","$2,442.60 ","$2,306.90 ",$174.13 ,"$2,306.90 ",$374.38 ,$701.00 ,$174.13 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416346,74174,CT ABD/PELVIS  ANGIOGRAM,350,1 ,"$4,051.00 ","$2,633.15 ",$364.90 ,"$3,645.90 ","$2,774.94 ",$364.90 ,"$2,373.89 ","$2,373.89 ",$372.19 ,"$3,321.82 ","$3,443.35 ","$3,645.90 ","$3,038.25 ","$2,835.70 ","$2,997.74 ","$3,645.90 ","$3,443.35 ",$364.90 ,"$3,443.35 ",$784.53 ,$701.00 ,$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416350,G0297,CT CHEST LOW DOSE SCREENING,350,1 ,$241.00 ,$156.65 ,$76.27 ,$241.00 ,$165.09 ,$76.27 ,$141.23 ,$141.23 ,$77.79 ,$197.62 ,$204.85 ,$216.90 ,$180.75 ,$168.70 ,$178.34 ,$216.90 ,$204.85 ,$76.27 ,$204.85 ,$163.97 ,$241.00 ,$76.27 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416405,70544,MRA HEAD W/O CONTRAST,610,1 ,"$3,242.00 ","$2,107.30 ",$222.69 ,"$2,917.80 ","$2,220.77 ",$222.69 ,"$1,899.81 ","$1,899.81 ",$227.15 ,"$2,658.44 ","$2,755.70 ","$2,917.80 ","$2,431.50 ","$2,269.40 ","$2,399.08 ","$2,917.80 ","$2,755.70 ",$222.69 ,"$2,755.70 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416407,70546,MRA HEAD W/O / WITH CONTRAST,610,1 ,"$4,730.00 ","$3,074.50 ",$364.90 ,"$4,257.00 ","$3,240.05 ",$364.90 ,"$2,771.78 ","$2,771.78 ",$372.19 ,"$3,878.60 ","$4,020.50 ","$4,257.00 ","$3,547.50 ","$3,311.00 ","$3,500.20 ","$4,257.00 ","$4,020.50 ",$364.90 ,"$4,020.50 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416408,70547,MRA NECK WITHOUT CONTRAST,610,1 ,"$3,242.00 ","$2,107.30 ",$222.69 ,"$2,917.80 ","$2,220.77 ",$222.69 ,"$1,899.81 ","$1,899.81 ",$227.15 ,"$2,658.44 ","$2,755.70 ","$2,917.80 ","$2,431.50 ","$2,269.40 ","$2,399.08 ","$2,917.80 ","$2,755.70 ",$222.69 ,"$2,755.70 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416410,70549,MRA NECK W/O / WITH CONTRAST,610,1 ,"$4,730.00 ","$3,074.50 ",$364.90 ,"$4,257.00 ","$3,240.05 ",$364.90 ,"$2,771.78 ","$2,771.78 ",$372.19 ,"$3,878.60 ","$4,020.50 ","$4,257.00 ","$3,547.50 ","$3,311.00 ","$3,500.20 ","$4,257.00 ","$4,020.50 ",$364.90 ,"$4,020.50 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416411,C8901,MRA ABDOMEN W/O CONTRAST,610,1 ,"$2,689.00 ","$1,747.85 ",$222.69 ,"$2,420.10 ","$1,841.97 ",$222.69 ,"$1,575.75 ","$1,575.75 ",$227.15 ,"$2,204.98 ","$2,285.65 ","$2,420.10 ","$2,016.75 ","$1,882.30 ","$1,989.86 ","$2,420.10 ","$2,285.65 ",$222.69 ,"$2,285.65 ",$478.79 ,"$1,306.00 ",$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416412,C8900,MRA ABDOMENT WITH CONTRAST,610,1 ,"$3,418.00 ","$2,221.70 ",$364.90 ,"$3,076.20 ","$2,341.33 ",$364.90 ,"$2,002.95 ","$2,002.95 ",$372.19 ,"$2,802.76 ","$2,905.30 ","$3,076.20 ","$2,563.50 ","$2,392.60 ","$2,529.32 ","$3,076.20 ","$2,905.30 ",$364.90 ,"$2,905.30 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416414,C8918,MRA PELVIS WITH CONTRAST,610,1 ,"$3,108.00 ","$2,020.20 ",$364.90 ,"$2,797.20 ","$2,128.98 ",$364.90 ,"$1,821.29 ","$1,821.29 ",$372.19 ,"$2,548.56 ","$2,641.80 ","$2,797.20 ","$2,331.00 ","$2,175.60 ","$2,299.92 ","$2,797.20 ","$2,641.80 ",$364.90 ,"$2,641.80 ",$784.53 ,"$1,306.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),416432,74177,CT ABD/PEL W CONTRAST ONLY,350,1 ,"$5,594.00 ","$3,636.10 ",$364.90 ,"$5,034.60 ","$3,831.89 ",$364.90 ,"$3,278.08 ","$3,278.08 ",$372.19 ,"$4,587.08 ","$4,754.90 ","$5,034.60 ","$4,195.50 ","$3,915.80 ","$4,139.56 ","$5,034.60 ","$4,754.90 ",$364.90 ,"$4,754.90 ",$784.53 ,$701.00 ,$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426301,78306,NUC BONE SKELETAL (WB),340,1 ,"$1,795.00 ","$1,166.75 ",$351.79 ,"$1,615.50 ","$1,229.58 ",$351.79 ,"$1,051.87 ","$1,051.87 ",$358.82 ,"$1,471.90 ","$1,525.75 ","$1,615.50 ","$1,346.25 ","$1,256.50 ","$1,328.30 ","$1,615.50 ","$1,525.75 ",$351.79 ,"$1,525.75 ",$756.34 ,"$1,088.00 ",$351.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426307,78227,NUC LIVER-BILLI PATEN,340,1 ,"$2,157.00 ","$1,402.05 ",$451.02 ,"$1,941.30 ","$1,477.55 ",$451.02 ,"$1,264.00 ","$1,264.00 ",$460.04 ,"$1,768.74 ","$1,833.45 ","$1,941.30 ","$1,617.75 ","$1,509.90 ","$1,596.18 ","$1,941.30 ","$1,833.45 ",$451.02 ,"$1,833.45 ",$969.70 ,"$1,088.00 ",$451.02 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426308,78580,NUC LUNG PERFUSION,340,1 ,"$1,399.00 ",$909.35 ,$351.79 ,"$1,259.10 ",$958.32 ,$351.79 ,$819.81 ,$819.81 ,$358.82 ,"$1,147.18 ","$1,189.15 ","$1,259.10 ","$1,049.25 ",$979.30 ,"$1,035.26 ","$1,259.10 ","$1,189.15 ",$351.79 ,"$1,189.15 ",$756.34 ,"$1,088.00 ",$351.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426311,78707,NUC RENAL STATIC,340,1 ,"$2,203.00 ","$1,431.95 ",$451.02 ,"$1,982.70 ","$1,509.06 ",$451.02 ,"$1,290.96 ","$1,290.96 ",$460.04 ,"$1,806.46 ","$1,872.55 ","$1,982.70 ","$1,652.25 ","$1,542.10 ","$1,630.22 ","$1,982.70 ","$1,872.55 ",$451.02 ,"$1,872.55 ",$969.70 ,"$1,088.00 ",$451.02 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426313,78070,NUC PARATHYROID SCAN,340,1 ,"$1,599.00 ","$1,039.35 ",$351.79 ,"$1,439.10 ","$1,095.32 ",$351.79 ,$937.01 ,$937.01 ,$358.82 ,"$1,311.18 ","$1,359.15 ","$1,439.10 ","$1,199.25 ","$1,119.30 ","$1,183.26 ","$1,439.10 ","$1,359.15 ",$351.79 ,"$1,359.15 ",$756.34 ,"$1,088.00 ",$351.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426320,78264,NUC GASTRIC EMPTYING,340,1 ,"$1,762.00 ","$1,145.30 ",$351.79 ,"$1,585.80 ","$1,206.97 ",$351.79 ,"$1,032.53 ","$1,032.53 ",$358.82 ,"$1,444.84 ","$1,497.70 ","$1,585.80 ","$1,321.50 ","$1,233.40 ","$1,303.88 ","$1,585.80 ","$1,497.70 ",$351.79 ,"$1,497.70 ",$756.34 ,"$1,088.00 ",$351.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426321,78582,NUC LUNG PERF & VENT,340,1 ,"$2,195.00 ","$1,426.75 ",$451.02 ,"$1,975.50 ","$1,503.58 ",$451.02 ,"$1,286.27 ","$1,286.27 ",$460.04 ,"$1,799.90 ","$1,865.75 ","$1,975.50 ","$1,646.25 ","$1,536.50 ","$1,624.30 ","$1,975.50 ","$1,865.75 ",$451.02 ,"$1,865.75 ",$969.70 ,"$1,088.00 ",$451.02 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426323,78300,NUC JOINT SCAN LIMITED,340,1 ,"$1,795.00 ","$1,166.75 ",$351.79 ,"$1,615.50 ","$1,229.58 ",$351.79 ,"$1,051.87 ","$1,051.87 ",$358.82 ,"$1,471.90 ","$1,525.75 ","$1,615.50 ","$1,346.25 ","$1,256.50 ","$1,328.30 ","$1,615.50 ","$1,525.75 ",$351.79 ,"$1,525.75 ",$756.34 ,"$1,088.00 ",$351.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426327,78708,NUC RENAL WITH LASIX,340,1 ,"$2,203.00 ","$1,431.95 ",$451.02 ,"$1,982.70 ","$1,509.06 ",$451.02 ,"$1,290.96 ","$1,290.96 ",$460.04 ,"$1,806.46 ","$1,872.55 ","$1,982.70 ","$1,652.25 ","$1,542.10 ","$1,630.22 ","$1,982.70 ","$1,872.55 ",$451.02 ,"$1,872.55 ",$969.70 ,"$1,088.00 ",$451.02 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426328,A9500,NUC CARDIOLITE 1 DOSE,343,1 ,$279.00 ,$181.35 ,$163.49 ,$251.10 ,$191.12 , N/A ,$163.49 ,$163.49 , N/A ,$228.78 ,$237.15 ,$251.10 ,$209.25 ,$195.30 ,$206.46 ,$251.10 ,$237.15 , N/A ,$237.15 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426329,A9503,NUC TC99MDP PER MCI,343,1 ,$168.00 ,$109.20 ,$98.45 ,$151.20 ,$115.08 , N/A ,$98.45 ,$98.45 , N/A ,$137.76 ,$142.80 ,$151.20 ,$126.00 ,$117.60 ,$124.32 ,$151.20 ,$142.80 , N/A ,$142.80 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426331,78315,NUC BONE SCAN 3 PHASE (LIMITED),340,1 ,"$1,795.00 ","$1,166.75 ",$351.79 ,"$1,615.50 ","$1,229.58 ",$351.79 ,"$1,051.87 ","$1,051.87 ",$358.82 ,"$1,471.90 ","$1,525.75 ","$1,615.50 ","$1,346.25 ","$1,256.50 ","$1,328.30 ","$1,615.50 ","$1,525.75 ",$351.79 ,"$1,525.75 ",$756.34 ,"$1,088.00 ",$351.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426333,78472,NUC MUGA MYOCARDIAL EF,340,1 ,"$2,073.00 ","$1,347.45 ",$351.79 ,"$1,865.70 ","$1,420.01 ",$351.79 ,"$1,214.78 ","$1,214.78 ",$358.82 ,"$1,699.86 ","$1,762.05 ","$1,865.70 ","$1,554.75 ","$1,451.10 ","$1,534.02 ","$1,865.70 ","$1,762.05 ",$351.79 ,"$1,762.05 ",$756.34 ,"$1,088.00 ",$351.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426334,A9561,NUC HDP PER MCI,343,1 ,$89.00 ,$57.85 ,$52.15 ,$80.10 ,$60.97 , N/A ,$52.15 ,$52.15 , N/A ,$72.98 ,$75.65 ,$80.10 ,$66.75 ,$62.30 ,$65.86 ,$80.10 ,$75.65 , N/A ,$75.65 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426337,A9540,NUC TC99 MAA PERVIAL,343,1 ,$90.00 ,$58.50 ,$52.74 ,$81.00 ,$61.65 , N/A ,$52.74 ,$52.74 , N/A ,$73.80 ,$76.50 ,$81.00 ,$67.50 ,$63.00 ,$66.60 ,$81.00 ,$76.50 , N/A ,$76.50 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426339,A9537,NUC TC99 CHOLETEC PERVIAL,343,1 ,$121.00 ,$78.65 ,$70.91 ,$108.90 ,$82.89 , N/A ,$70.91 ,$70.91 , N/A ,$99.22 ,$102.85 ,$108.90 ,$90.75 ,$84.70 ,$89.54 ,$108.90 ,$102.85 , N/A ,$102.85 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426340,78452,NUC SPECT IMAGING MULTI REST & STRESS,340,1 ,"$5,299.00 ","$3,444.35 ","$1,088.00 ","$4,769.10 ","$3,629.82 ","$1,215.70 ","$3,105.21 ","$3,105.21 ","$1,240.02 ","$4,345.18 ","$4,504.15 ","$4,769.10 ","$3,974.25 ","$3,709.30 ","$3,921.26 ","$4,769.10 ","$4,504.15 ","$1,215.70 ","$4,504.15 ","$2,613.77 ","$1,088.00 ","$1,215.70 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),426343,A9567,NUC TC99 DTPA PERVIAL,343,1 ,$89.00 ,$57.85 ,$52.15 ,$80.10 ,$60.97 , N/A ,$52.15 ,$52.15 , N/A ,$72.98 ,$75.65 ,$80.10 ,$66.75 ,$62.30 ,$65.86 ,$80.10 ,$75.65 , N/A ,$75.65 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426349,93976,SONO RENAL ART DOPPLAR,921,1 ,"$1,414.00 ",$919.10 ,$107.10 ,"$1,272.60 ",$968.59 ,$107.10 ,$828.60 ,$828.60 ,$109.25 ,"$1,159.48 ","$1,201.90 ","$1,272.60 ","$1,060.50 ",$989.80 ,"$1,046.36 ","$1,272.60 ","$1,201.90 ",$107.10 ,"$1,201.90 ",$230.27 ,$604.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426351,76700,SONO ABDOMINAL (COMPL),402,1 ,"$1,250.00 ",$812.50 ,$107.10 ,"$1,125.00 ",$856.25 ,$107.10 ,$732.50 ,$732.50 ,$109.25 ,"$1,025.00 ","$1,062.50 ","$1,125.00 ",$937.50 ,$875.00 ,$925.00 ,"$1,125.00 ","$1,062.50 ",$107.10 ,"$1,062.50 ",$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426352,93978,SONO ABDOMINAL AORTA,921,1 ,"$1,414.00 ",$919.10 ,$222.69 ,"$1,272.60 ",$968.59 ,$222.69 ,$828.60 ,$828.60 ,$227.15 ,"$1,159.48 ","$1,201.90 ","$1,272.60 ","$1,060.50 ",$989.80 ,"$1,046.36 ","$1,272.60 ","$1,201.90 ",$222.69 ,"$1,201.90 ",$478.79 ,$604.00 ,$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426353,76705,SONO GALLBLADDER,402,1 ,"$1,135.00 ",$737.75 ,$107.10 ,"$1,021.50 ",$777.48 ,$107.10 ,$665.11 ,$665.11 ,$109.25 ,$930.70 ,$964.75 ,"$1,021.50 ",$851.25 ,$794.50 ,$839.90 ,"$1,021.50 ",$964.75 ,$107.10 ,$964.75 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426356,76770,SONO RENAL,402,1 ,"$1,135.00 ",$737.75 ,$107.10 ,"$1,021.50 ",$777.48 ,$107.10 ,$665.11 ,$665.11 ,$109.25 ,$930.70 ,$964.75 ,"$1,021.50 ",$851.25 ,$794.50 ,$839.90 ,"$1,021.50 ",$964.75 ,$107.10 ,$964.75 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426360,76815,SONO OB LIMITED,402,1 ,$750.00 ,$487.50 ,$107.10 ,$675.00 ,$513.75 ,$107.10 ,$439.50 ,$439.50 ,$109.25 ,$615.00 ,$637.50 ,$675.00 ,$562.50 ,$525.00 ,$555.00 ,$675.00 ,$637.50 ,$107.10 ,$637.50 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426361,76882,SONO SUPERFICIAL STRUCTURE,402,1 ,$888.00 ,$577.20 ,$107.10 ,$799.20 ,$608.28 ,$107.10 ,$520.37 ,$520.37 ,$109.25 ,$728.16 ,$754.80 ,$799.20 ,$666.00 ,$621.60 ,$657.12 ,$799.20 ,$754.80 ,$107.10 ,$754.80 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426363,76857,SONO BLADDER,402,1 ,"$1,135.00 ",$737.75 ,$107.10 ,"$1,021.50 ",$777.48 ,$107.10 ,$665.11 ,$665.11 ,$109.25 ,$930.70 ,$964.75 ,"$1,021.50 ",$851.25 ,$794.50 ,$839.90 ,"$1,021.50 ",$964.75 ,$107.10 ,$964.75 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426366,76856,SONO PELVIC,402,1 ,"$1,250.00 ",$812.50 ,$107.10 ,"$1,125.00 ",$856.25 ,$107.10 ,$732.50 ,$732.50 ,$109.25 ,"$1,025.00 ","$1,062.50 ","$1,125.00 ",$937.50 ,$875.00 ,$925.00 ,"$1,125.00 ","$1,062.50 ",$107.10 ,"$1,062.50 ",$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426368,76805,SONO OB COMPLETE,402,1 ,"$1,049.00 ",$681.85 ,$107.10 ,$944.10 ,$718.57 ,$107.10 ,$614.71 ,$614.71 ,$109.25 ,$860.18 ,$891.65 ,$944.10 ,$786.75 ,$734.30 ,$776.26 ,$944.10 ,$891.65 ,$107.10 ,$891.65 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426369,76641,SONO BREAST - RT,402,1 ,$868.00 ,$564.20 ,$107.10 ,$781.20 ,$594.58 ,$107.10 ,$508.65 ,$508.65 ,$109.25 ,$711.76 ,$737.80 ,$781.20 ,$651.00 ,$607.60 ,$642.32 ,$781.20 ,$737.80 ,$107.10 ,$737.80 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426370,76536,SONO SOFT TISSUE HEAD/NECK,402,1 ,"$1,053.00 ",$684.45 ,$107.10 ,$947.70 ,$721.31 ,$107.10 ,$617.06 ,$617.06 ,$109.25 ,$863.46 ,$895.05 ,$947.70 ,$789.75 ,$737.10 ,$779.22 ,$947.70 ,$895.05 ,$107.10 ,$895.05 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426372,93971,SONO DOPPLER UNILATERAL EXT VENOUS,921,1 ,"$1,121.00 ",$728.65 ,$107.10 ,"$1,008.90 ",$767.89 ,$107.10 ,$656.91 ,$656.91 ,$109.25 ,$919.22 ,$952.85 ,"$1,008.90 ",$840.75 ,$784.70 ,$829.54 ,"$1,008.90 ",$952.85 ,$107.10 ,$952.85 ,$230.27 ,$604.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426375,76870,SONO TESTICULAR,402,1 ,$975.00 ,$633.75 ,$107.10 ,$877.50 ,$667.88 ,$107.10 ,$571.35 ,$571.35 ,$109.25 ,$799.50 ,$828.75 ,$877.50 ,$731.25 ,$682.50 ,$721.50 ,$877.50 ,$828.75 ,$107.10 ,$828.75 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426376,93880,SONO CAROTID DOPPLER W/COLOR,921,1 ,$996.00 ,$647.40 ,$222.69 ,$896.40 ,$682.26 ,$222.69 ,$583.66 ,$583.66 ,$227.15 ,$816.72 ,$846.60 ,$896.40 ,$747.00 ,$697.20 ,$737.04 ,$896.40 ,$846.60 ,$222.69 ,$846.60 ,$478.79 ,$604.00 ,$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426377,93925,SONO ARTERIAL DOPPLER LOWER BIL,921,1 ,"$1,556.00 ","$1,011.40 ",$222.69 ,"$1,400.40 ","$1,065.86 ",$222.69 ,$911.82 ,$911.82 ,$227.15 ,"$1,275.92 ","$1,322.60 ","$1,400.40 ","$1,167.00 ","$1,089.20 ","$1,151.44 ","$1,400.40 ","$1,322.60 ",$222.69 ,"$1,322.60 ",$478.79 ,$604.00 ,$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426378,93970,SONO DOPPLER BILAT EXT VENOUS,921,1 ,"$1,556.00 ","$1,011.40 ",$222.69 ,"$1,400.40 ","$1,065.86 ",$222.69 ,$911.82 ,$911.82 ,$227.15 ,"$1,275.92 ","$1,322.60 ","$1,400.40 ","$1,167.00 ","$1,089.20 ","$1,151.44 ","$1,400.40 ","$1,322.60 ",$222.69 ,"$1,322.60 ",$478.79 ,$604.00 ,$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426379,93306,SONO ECHOCARDIOGRAM,480,1 ,"$2,565.00 ","$1,667.25 ",$460.20 ,"$2,308.50 ","$1,757.03 ",$460.20 ,"$1,503.09 ","$1,503.09 ",$469.40 ,"$2,103.30 ","$2,180.25 ","$2,308.50 ","$1,923.75 ","$1,795.50 ","$1,898.10 ","$2,308.50 ","$2,180.25 ",$460.20 ,"$2,180.25 ",$989.43 ,"$1,468.00 ",$460.20 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426380,76830,SONO TRANSVAGINAL,402,1 ,$888.00 ,$577.20 ,$107.10 ,$799.20 ,$608.28 ,$107.10 ,$520.37 ,$520.37 ,$109.25 ,$728.16 ,$754.80 ,$799.20 ,$666.00 ,$621.60 ,$657.12 ,$799.20 ,$754.80 ,$107.10 ,$754.80 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426382,76942,SONO GUIDANCE FOR NEEDLE PLACEMENT,402,1 ,$974.00 ,$633.10 ,$332.00 ,$876.60 ,$667.19 , N/A ,$570.76 ,$570.76 , N/A ,$798.68 ,$827.90 ,$876.60 ,$730.50 ,$681.80 ,$720.76 ,$876.60 ,$827.90 , N/A ,$827.90 , N/A ,$332.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426384,19083,SONO-BREAST BIOPSY,402,1 ,"$4,158.00 ","$2,702.70 ",$332.00 ,"$3,742.20 ","$2,848.23 ","$1,311.66 ","$2,436.59 ","$2,436.59 ","$1,337.89 ","$3,409.56 ","$3,534.30 ","$3,742.20 ","$3,118.50 ","$2,910.60 ","$3,076.92 ","$3,742.20 ","$3,534.30 ","$1,311.66 ","$3,534.30 ","$2,820.06 ",$332.00 ,"$1,311.66 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),426385,76819,SONO OB BIOPHYSICAL PROFILE,402,1 ,$888.00 ,$577.20 ,$107.10 ,$799.20 ,$608.28 ,$107.10 ,$520.37 ,$520.37 ,$109.25 ,$728.16 ,$754.80 ,$799.20 ,$666.00 ,$621.60 ,$657.12 ,$799.20 ,$754.80 ,$107.10 ,$754.80 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426386,76810,SONO OB COMPL MULT GESTATION,402,1 ,$391.00 ,$254.15 ,$229.13 ,$351.90 ,$267.84 , N/A ,$229.13 ,$229.13 , N/A ,$320.62 ,$332.35 ,$351.90 ,$293.25 ,$273.70 ,$289.34 ,$351.90 ,$332.35 , N/A ,$332.35 , N/A ,$332.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426389,76816,SONO OB FOLLOW UP,402,1 ,$884.00 ,$574.60 ,$107.10 ,$795.60 ,$605.54 ,$107.10 ,$518.02 ,$518.02 ,$109.25 ,$724.88 ,$751.40 ,$795.60 ,$663.00 ,$618.80 ,$654.16 ,$795.60 ,$751.40 ,$107.10 ,$751.40 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426393,49083,SONO PARACENTESIS,402,1 ,"$2,410.00 ","$1,566.50 ",$332.00 ,"$2,169.00 ","$1,650.85 ",$751.03 ,"$1,412.26 ","$1,412.26 ",$766.05 ,"$1,976.20 ","$2,048.50 ","$2,169.00 ","$1,807.50 ","$1,687.00 ","$1,783.40 ","$2,169.00 ","$2,048.50 ",$751.03 ,"$2,048.50 ","$1,614.70 ",$332.00 ,$751.03 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426395,10005,SONO FINE NEEDLE ASPIRATION,761,1 ,"$2,628.00 ","$1,708.20 ",$582.93 ,"$2,365.20 ","$1,800.18 ",$582.93 ,"$1,540.01 ","$1,540.01 ",$594.58 ,"$2,154.96 ","$2,233.80 ","$2,365.20 ","$1,971.00 ","$1,839.60 ","$1,944.72 ","$2,365.20 ","$2,233.80 ",$582.93 ,"$2,233.80 ","$1,253.29 ","$1,387.58 ",$582.93 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426396,76817,SONO OB TRANSVAGINAL,402,1 ,$854.00 ,$555.10 ,$107.10 ,$768.60 ,$584.99 ,$107.10 ,$500.44 ,$500.44 ,$109.25 ,$700.28 ,$725.90 ,$768.60 ,$640.50 ,$597.80 ,$631.96 ,$768.60 ,$725.90 ,$107.10 ,$725.90 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426397,93922,SONO ABI BILATERAL,921,1 ,$574.00 ,$373.10 ,$104.19 ,$574.00 ,$393.19 ,$104.19 ,$336.36 ,$336.36 ,$106.27 ,$470.68 ,$487.90 ,$516.60 ,$430.50 ,$401.80 ,$424.76 ,$516.60 ,$487.90 ,$104.19 ,$487.90 ,$224.01 ,$574.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426419,76706,SONO ABDOMINAL AORTA SCREENING,402,1 ,$888.00 ,$577.20 ,$107.10 ,$799.20 ,$608.28 ,$107.10 ,$520.37 ,$520.37 ,$109.25 ,$728.16 ,$754.80 ,$799.20 ,$666.00 ,$621.60 ,$657.12 ,$799.20 ,$754.80 ,$107.10 ,$754.80 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426421,93923,SONO ARTERIAL DOPPLER SEG PRESSURES,921,1 ,"$1,190.00 ",$773.50 ,$132.21 ,"$1,071.00 ",$815.15 ,$132.21 ,$697.34 ,$697.34 ,$134.85 ,$975.80 ,"$1,011.50 ","$1,071.00 ",$892.50 ,$833.00 ,$880.60 ,"$1,071.00 ","$1,011.50 ",$132.21 ,"$1,011.50 ",$284.25 ,$604.00 ,$132.21 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426422,78226,NUC HEPATOBILIARY IMAGING,340,1 ,"$2,157.00 ","$1,402.05 ",$351.79 ,"$1,941.30 ","$1,477.55 ",$351.79 ,"$1,264.00 ","$1,264.00 ",$358.82 ,"$1,768.74 ","$1,833.45 ","$1,941.30 ","$1,617.75 ","$1,509.90 ","$1,596.18 ","$1,941.30 ","$1,833.45 ",$351.79 ,"$1,833.45 ",$756.34 ,"$1,088.00 ",$351.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426423,76801,SONO OB EARLY GESTATION,402,1 ,"$1,049.00 ",$681.85 ,$107.10 ,$944.10 ,$718.57 ,$107.10 ,$614.71 ,$614.71 ,$109.25 ,$860.18 ,$891.65 ,$944.10 ,$786.75 ,$734.30 ,$776.26 ,$944.10 ,$891.65 ,$107.10 ,$891.65 ,$230.27 ,$332.00 ,$107.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426428,51798,SONO BLADDER POST VOID VOLUME,402,1 ,$440.00 ,$286.00 ,$52.57 ,$396.00 ,$301.40 ,$52.57 ,$257.84 ,$257.84 ,$53.62 ,$360.80 ,$374.00 ,$396.00 ,$330.00 ,$308.00 ,$325.60 ,$396.00 ,$374.00 ,$52.57 ,$374.00 ,$113.02 ,$332.00 ,$52.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426429,C8929,SONO ECHO W/WO CONTRAST,402,1 ,"$3,772.00 ","$2,451.80 ",$332.00 ,"$3,394.80 ","$2,583.82 ",$650.59 ,"$2,210.39 ","$2,210.39 ",$663.60 ,"$3,093.04 ","$3,206.20 ","$3,394.80 ","$2,829.00 ","$2,640.40 ","$2,791.28 ","$3,394.80 ","$3,206.20 ",$650.59 ,"$3,206.20 ","$1,398.77 ",$332.00 ,$650.59 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426431,93350,SONO ECHO STRESS,340,1 ,"$1,780.00 ","$1,157.00 ",$460.20 ,"$1,602.00 ","$1,219.30 ",$460.20 ,"$1,043.08 ","$1,043.08 ",$469.40 ,"$1,459.60 ","$1,513.00 ","$1,602.00 ","$1,335.00 ","$1,246.00 ","$1,317.20 ","$1,602.00 ","$1,513.00 ",$460.20 ,"$1,513.00 ",$989.43 ,"$1,088.00 ",$460.20 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426433,93321,SONO ECHO LIMITED,921,1 ,$593.00 ,$385.45 ,$347.50 ,$593.00 ,$406.21 , N/A ,$347.50 ,$347.50 , N/A ,$486.26 ,$504.05 ,$533.70 ,$444.75 ,$415.10 ,$438.82 ,$533.70 ,$504.05 , N/A ,$504.05 , N/A ,$593.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426434,93352,SONO ECHO STRESS ADD ON CONTRAST,921,1 ,$225.00 ,$146.25 ,$131.85 ,$225.00 ,$154.13 , N/A ,$131.85 ,$131.85 , N/A ,$184.50 ,$191.25 ,$202.50 ,$168.75 ,$157.50 ,$166.50 ,$202.50 ,$191.25 , N/A ,$191.25 , N/A ,$225.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426435,C8924,SONO ECHO LIMITED WITH CONTRAST,480,1 ,"$1,158.00 ",$752.70 ,$364.90 ,"$1,158.00 ",$793.23 ,$364.90 ,$678.59 ,$678.59 ,$372.19 ,$949.56 ,$984.30 ,"$1,042.20 ",$868.50 ,$810.60 ,$856.92 ,"$1,042.20 ",$984.30 ,$364.90 ,$984.30 ,$784.53 ,"$1,158.00 ",$364.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),426436,93308,SONO ECHO 2D W/WO M MODE LTD,480,1 ,$452.00 ,$293.80 ,$222.69 ,$478.79 ,$309.62 ,$222.69 ,$264.87 ,$264.87 ,$227.15 ,$370.64 ,$384.20 ,$406.80 ,$339.00 ,$316.40 ,$334.48 ,$406.80 ,$384.20 ,$222.69 ,$384.20 ,$478.79 ,$452.00 ,$222.69 
HSHS HOLY FAMILY HOSPITAL INC (ACU),428001,78195,NUC MED LYMPH NODE IMAGING,340,1 ,"$3,126.00 ","$2,031.90 ",$451.02 ,"$2,813.40 ","$2,141.31 ",$451.02 ,"$1,831.84 ","$1,831.84 ",$460.04 ,"$2,563.32 ","$2,657.10 ","$2,813.40 ","$2,344.50 ","$2,188.20 ","$2,313.24 ","$2,813.40 ","$2,657.10 ",$451.02 ,"$2,657.10 ",$969.70 ,"$1,088.00 ",$451.02 
HSHS HOLY FAMILY HOSPITAL INC (ACU),45080003,59409,HC DELIVERY VAGINAL,450,1 ,"$7,661.00 ","$4,979.65 ",$809.00 ,"$6,894.90 ","$5,247.79 ","$2,387.18 ","$4,489.35 ","$4,489.35 ","$2,434.93 ","$6,282.02 ","$6,511.85 ","$6,894.90 ","$5,745.75 ","$5,362.70 ","$5,669.14 ","$6,894.90 ","$6,511.85 ","$2,387.18 ","$6,511.85 ","$5,132.45 ",$809.00 ,"$2,387.18 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),492534,N/A,D5W 100ML IVPB,258,1 ,$23.00 ,$14.95 ,$12.14 ,$20.70 ,$15.76 , N/A ,$13.48 ,$13.48 , N/A ,$18.86 ,$19.55 ,$20.70 ,$17.25 ,$16.10 ,$17.02 ,$20.70 ,$19.55 , N/A ,$19.55 , N/A ,$12.14 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50505,N/A,BLOOD ADMINISTRATION IPC,391,1 ,$557.00 ,$362.05 ,$272.00 ,$501.30 ,$381.55 , N/A ,$326.40 ,$326.40 , N/A ,$456.74 ,$473.45 ,$501.30 ,$417.75 ,$389.90 ,$412.18 ,$501.30 ,$473.45 , N/A ,$473.45 , N/A ,$272.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50600,G0379,OBSERV-1ST HOUR,762,1 ,$393.80 ,$255.97 ,$230.77 ,$393.80 ,$269.75 , N/A ,$230.77 ,$230.77 , N/A ,$322.92 ,$334.73 ,$354.42 ,$295.35 ,$275.66 ,$291.41 ,$354.42 ,$334.73 , N/A ,$334.73 , N/A ,$393.80 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50601,G0378,OBSERV-EACH ADDITIONAL HOUR,762,1 ,$40.00 ,$26.00 ,$23.44 ,$40.00 ,$27.40 , N/A ,$23.44 ,$23.44 , N/A ,$32.80 ,$34.00 ,$36.00 ,$30.00 ,$28.00 ,$29.60 ,$36.00 ,$34.00 , N/A ,$34.00 , N/A ,$40.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50610,N/A,OBSERV INIT HR FOLLOW EXT REC,762,1 ,$27.50 ,$17.88 ,$16.12 ,$27.50 ,$18.84 , N/A ,$16.12 ,$16.12 , N/A ,$22.55 ,$23.38 ,$24.75 ,$20.63 ,$19.25 ,$20.35 ,$24.75 ,$23.38 , N/A ,$23.38 , N/A ,$27.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50620,N/A,IPC EXT REC INIT HOUR,710,1 ,$302.00 ,$196.30 ,$159.46 ,$271.80 ,$206.87 , N/A ,$176.97 ,$176.97 , N/A ,$247.64 ,$256.70 ,$271.80 ,$226.50 ,$211.40 ,$223.48 ,$271.80 ,$256.70 , N/A ,$256.70 , N/A ,$159.46 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50621,N/A,IPC EXT REC EACH ADDTL HR,710,1 ,$28.89 ,$18.78 ,$15.25 ,$26.00 ,$19.79 , N/A ,$16.93 ,$16.93 , N/A ,$23.69 ,$24.56 ,$26.00 ,$21.67 ,$20.22 ,$21.38 ,$26.00 ,$24.56 , N/A ,$24.56 , N/A ,$15.25 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50630,G0379,OBS INIT HR TELE,762,1 ,$393.80 ,$255.97 ,$230.77 ,$393.80 ,$269.75 , N/A ,$230.77 ,$230.77 , N/A ,$322.92 ,$334.73 ,$354.42 ,$295.35 ,$275.66 ,$291.41 ,$354.42 ,$334.73 , N/A ,$334.73 , N/A ,$393.80 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50631,G0378,OBS ADDTL HR TELE,762,1 ,$40.00 ,$26.00 ,$23.44 ,$40.00 ,$27.40 , N/A ,$23.44 ,$23.44 , N/A ,$32.80 ,$34.00 ,$36.00 ,$30.00 ,$28.00 ,$29.60 ,$36.00 ,$34.00 , N/A ,$34.00 , N/A ,$40.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50640,G0379,OBS INIT HR ISOL,762,1 ,$393.80 ,$255.97 ,$230.77 ,$393.80 ,$269.75 , N/A ,$230.77 ,$230.77 , N/A ,$322.92 ,$334.73 ,$354.42 ,$295.35 ,$275.66 ,$291.41 ,$354.42 ,$334.73 , N/A ,$334.73 , N/A ,$393.80 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50641,G0378,OBS ADDTL HR ISOL,762,1 ,$40.00 ,$26.00 ,$23.44 ,$40.00 ,$27.40 , N/A ,$23.44 ,$23.44 , N/A ,$32.80 ,$34.00 ,$36.00 ,$30.00 ,$28.00 ,$29.60 ,$36.00 ,$34.00 , N/A ,$34.00 , N/A ,$40.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50801,96360,IV HYDRATION INIT HOUR,260,1 ,$376.00 ,$244.40 ,$175.58 ,$377.50 ,$257.56 ,$175.58 ,$220.34 ,$220.34 ,$179.09 ,$308.32 ,$319.60 ,$338.40 ,$282.00 ,$263.20 ,$278.24 ,$338.40 ,$319.60 ,$175.58 ,$319.60 ,$377.50 ,$217.00 ,$175.58 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50802,96361,IV HYDRATION EA ADDTL HOUR,260,1 ,$152.00 ,$98.80 ,$36.42 ,$152.00 ,$104.12 ,$36.42 ,$89.07 ,$89.07 ,$37.15 ,$124.64 ,$129.20 ,$136.80 ,$114.00 ,$106.40 ,$112.48 ,$136.80 ,$129.20 ,$36.42 ,$129.20 ,$78.30 ,$152.00 ,$36.42 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50803,96365,IV INFUSION INIT HOUR,260,1 ,$341.00 ,$221.65 ,$175.58 ,$377.50 ,$233.59 ,$175.58 ,$199.83 ,$199.83 ,$179.09 ,$279.62 ,$289.85 ,$306.90 ,$255.75 ,$238.70 ,$252.34 ,$306.90 ,$289.85 ,$175.58 ,$289.85 ,$377.50 ,$217.00 ,$175.58 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50804,96366,IV INFUSION EA ADDTL HOUR,260,1 ,$148.00 ,$96.20 ,$36.42 ,$148.00 ,$101.38 ,$36.42 ,$86.73 ,$86.73 ,$37.15 ,$121.36 ,$125.80 ,$133.20 ,$111.00 ,$103.60 ,$109.52 ,$133.20 ,$125.80 ,$36.42 ,$125.80 ,$78.30 ,$148.00 ,$36.42 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50805,96367,IV INFUSION EA SEQUENTIAL HOUR,260,1 ,$186.00 ,$120.90 ,$57.79 ,$186.00 ,$127.41 ,$57.79 ,$109.00 ,$109.00 ,$58.94 ,$152.52 ,$158.10 ,$167.40 ,$139.50 ,$130.20 ,$137.64 ,$167.40 ,$158.10 ,$57.79 ,$158.10 ,$124.24 ,$186.00 ,$57.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50806,96368,IV INFUSION CONCURRENT,260,1 ,$186.00 ,$120.90 ,$109.00 ,$186.00 ,$127.41 , N/A ,$109.00 ,$109.00 , N/A ,$152.52 ,$158.10 ,$167.40 ,$139.50 ,$130.20 ,$137.64 ,$167.40 ,$158.10 , N/A ,$158.10 , N/A ,$186.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50807,96372,"INJECTION, SC/IM",940,1 ,$128.00 ,$83.20 ,$57.79 ,$128.00 ,$87.68 ,$57.79 ,$75.01 ,$75.01 ,$58.94 ,$104.96 ,$108.80 ,$115.20 ,$96.00 ,$89.60 ,$94.72 ,$115.20 ,$108.80 ,$57.79 ,$108.80 ,$124.24 ,$128.00 ,$57.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50808,96374,INJECTION IVP INIT,940,1 ,$277.00 ,$180.05 ,$142.00 ,$377.50 ,$189.75 ,$175.58 ,$162.32 ,$162.32 ,$179.09 ,$227.14 ,$235.45 ,$249.30 ,$207.75 ,$193.90 ,$204.98 ,$249.30 ,$235.45 ,$175.58 ,$235.45 ,$377.50 ,$142.00 ,$175.58 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50809,96375,INJECTION IVP EA SUBSEQUENT DRUG,940,1 ,$172.00 ,$111.80 ,$36.42 ,$154.80 ,$117.82 ,$36.42 ,$100.79 ,$100.79 ,$37.15 ,$141.04 ,$146.20 ,$154.80 ,$129.00 ,$120.40 ,$127.28 ,$154.80 ,$146.20 ,$36.42 ,$146.20 ,$78.30 ,$142.00 ,$36.42 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50810,96376,INJECTION IVP REPEAT DRUG,940,1 ,$172.00 ,$111.80 ,$100.79 ,$154.80 ,$117.82 , N/A ,$100.79 ,$100.79 , N/A ,$141.04 ,$146.20 ,$154.80 ,$129.00 ,$120.40 ,$127.28 ,$154.80 ,$146.20 , N/A ,$146.20 , N/A ,$142.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),50812,36569,PICC W/O SQ PORT OVER 5 YEARS,361,1 ,"$1,329.00 ",$863.85 ,$778.79 ,"$3,351.22 ",$910.37 ,"$1,558.71 ",$778.79 ,$778.79 ,"$1,589.88 ","$1,089.78 ","$1,129.65 ","$1,196.10 ",$996.75 ,$930.30 ,$983.46 ,"$1,196.10 ","$1,129.65 ","$1,558.71 ","$1,129.65 ","$3,351.22 ","$1,329.00 ","$1,558.71 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),50820,90471,FLU VACCINE ADMIN,771,1 ,$97.00 ,$63.05 ,$56.84 ,$124.24 ,$66.45 ,$57.79 ,$56.84 ,$56.84 ,$58.94 ,$79.54 ,$82.45 ,$87.30 ,$72.75 ,$67.90 ,$71.78 ,$87.30 ,$82.45 ,$57.79 ,$82.45 ,$124.24 , N/A ,$57.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),51000147,P9612,HC STRAIGHT CATH FOR URINE SPECIMEN,450,1 ,$161.30 ,$104.85 ,$3.00 ,$161.30 ,$110.49 ,$3.00 ,$94.52 ,$94.52 ,$3.06 ,$132.27 ,$137.11 ,$145.17 ,$120.98 ,$112.91 ,$119.36 ,$145.17 ,$137.11 ,$3.00 ,$137.11 ,$6.45 ,$161.30 ,$3.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),554813,N/A,D5 1/2NS 1000ML+20MEQ KCL,258,1 ,$18.00 ,$11.70 ,$9.50 ,$16.20 ,$12.33 , N/A ,$10.55 ,$10.55 , N/A ,$14.76 ,$15.30 ,$16.20 ,$13.50 ,$12.60 ,$13.32 ,$16.20 ,$15.30 , N/A ,$15.30 , N/A ,$9.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),554822,N/A,D5NS 1000ML + 20MEQ KCL (PREMIX),258,1 ,$30.00 ,$19.50 ,$15.84 ,$27.00 ,$20.55 , N/A ,$17.58 ,$17.58 , N/A ,$24.60 ,$25.50 ,$27.00 ,$22.50 ,$21.00 ,$22.20 ,$27.00 ,$25.50 , N/A ,$25.50 , N/A ,$15.84 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),554922,N/A,D5 1/4NS 1000ML,258,1 ,$15.00 ,$9.75 ,$7.92 ,$13.50 ,$10.28 , N/A ,$8.79 ,$8.79 , N/A ,$12.30 ,$12.75 ,$13.50 ,$11.25 ,$10.50 ,$11.10 ,$13.50 ,$12.75 , N/A ,$12.75 , N/A ,$7.92 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),554923,N/A,D5 1/2NS 1000 ML,258,1 ,$17.00 ,$11.05 ,$8.98 ,$15.30 ,$11.65 , N/A ,$9.96 ,$9.96 , N/A ,$13.94 ,$14.45 ,$15.30 ,$12.75 ,$11.90 ,$12.58 ,$15.30 ,$14.45 , N/A ,$14.45 , N/A ,$8.98 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),554924,N/A,D5 1/2NS 500ML 792603,258,1 ,$17.00 ,$11.05 ,$8.98 ,$15.30 ,$11.65 , N/A ,$9.96 ,$9.96 , N/A ,$13.94 ,$14.45 ,$15.30 ,$12.75 ,$11.90 ,$12.58 ,$15.30 ,$14.45 , N/A ,$14.45 , N/A ,$8.98 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),554927,N/A,D5NS 1000 ML  794109,258,1 ,$48.00 ,$31.20 ,$25.34 ,$43.20 ,$32.88 , N/A ,$28.13 ,$28.13 , N/A ,$39.36 ,$40.80 ,$43.20 ,$36.00 ,$33.60 ,$35.52 ,$43.20 ,$40.80 , N/A ,$40.80 , N/A ,$25.34 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),554928,N/A,D5W  250 ML                7922-02,258,1 ,$12.00 ,$7.80 ,$6.34 ,$10.80 ,$8.22 , N/A ,$7.03 ,$7.03 , N/A ,$9.84 ,$10.20 ,$10.80 ,$9.00 ,$8.40 ,$8.88 ,$10.80 ,$10.20 , N/A ,$10.20 , N/A ,$6.34 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),554930,N/A,D5W 1000 ML,258,1 ,$16.00 ,$10.40 ,$8.45 ,$14.40 ,$10.96 , N/A ,$9.38 ,$9.38 , N/A ,$13.12 ,$13.60 ,$14.40 ,$12.00 ,$11.20 ,$11.84 ,$14.40 ,$13.60 , N/A ,$13.60 , N/A ,$8.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),554943,N/A,OSMITROL (MANNITOL) 20% : 500ML PREMIX,258,1 ,$71.00 ,$46.15 ,$37.49 ,$63.90 ,$48.64 , N/A ,$41.61 ,$41.61 , N/A ,$58.22 ,$60.35 ,$63.90 ,$53.25 ,$49.70 ,$52.54 ,$63.90 ,$60.35 , N/A ,$60.35 , N/A ,$37.49 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),555356,N/A,STERILE WATER FOR IRRIGATION 1000ML,258,1 ,$11.00 ,$7.15 ,$5.81 ,$9.90 ,$7.54 , N/A ,$6.45 ,$6.45 , N/A ,$9.02 ,$9.35 ,$9.90 ,$8.25 ,$7.70 ,$8.14 ,$9.90 ,$9.35 , N/A ,$9.35 , N/A ,$5.81 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581010,94644,CONTINUOUS AEROSOL TREATMENT,410,1 ,$344.00 ,$223.60 ,$104.19 ,$309.60 ,$235.64 ,$104.19 ,$201.58 ,$201.58 ,$106.27 ,$282.08 ,$292.40 ,$309.60 ,$258.00 ,$240.80 ,$254.56 ,$309.60 ,$292.40 ,$104.19 ,$292.40 ,$224.01 ,$142.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581011,94640,AEROSOL RX ROUTINE 1ST,410,1 ,$137.00 ,$89.05 ,$80.28 ,$377.95 ,$93.85 ,$175.79 ,$80.28 ,$80.28 ,$179.31 ,$112.34 ,$116.45 ,$123.30 ,$102.75 ,$95.90 ,$101.38 ,$123.30 ,$116.45 ,$175.79 ,$116.45 ,$377.95 ,$137.00 ,$175.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581060,94668,CP & PD TREATMENT,410,1 ,$137.00 ,$89.05 ,$80.28 ,$224.01 ,$93.85 ,$104.19 ,$80.28 ,$80.28 ,$106.27 ,$112.34 ,$116.45 ,$123.30 ,$102.75 ,$95.90 ,$101.38 ,$123.30 ,$116.45 ,$104.19 ,$116.45 ,$224.01 ,$137.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581250,N/A,OXYGEN THERAPY - BID,270,1 ,$120.00 ,$78.00 ,$63.36 ,$108.00 ,$82.20 , N/A ,$70.32 ,$70.32 , N/A ,$98.40 ,$102.00 ,$108.00 ,$90.00 ,$84.00 ,$88.80 ,$108.00 ,$102.00 , N/A ,$102.00 , N/A ,$63.36 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581306,94002,VENTILATOR FIRST DAY,410,1 ,$967.00 ,$628.55 ,$142.00 ,$954.40 ,$662.40 ,$443.90 ,$566.66 ,$566.66 ,$452.78 ,$792.94 ,$821.95 ,$870.30 ,$725.25 ,$676.90 ,$715.58 ,$870.30 ,$821.95 ,$443.90 ,$821.95 ,$954.40 ,$142.00 ,$443.90 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581332,94761,PULSE OXIMETERY MULTIPLE DETERMINATION,510,1 ,$129.00 ,$83.85 ,$68.11 ,$116.10 ,$88.37 , N/A ,$75.59 ,$75.59 , N/A ,$105.78 ,$109.65 ,$116.10 ,$96.75 ,$90.30 ,$95.46 ,$116.10 ,$109.65 , N/A ,$109.65 , N/A ,$68.11 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581333,94760,PULSE OXIMETRY SINGLE DETERMINATION,460,1 ,$55.00 ,$35.75 ,$32.23 ,$55.00 ,$37.68 , N/A ,$32.23 ,$32.23 , N/A ,$45.10 ,$46.75 ,$49.50 ,$41.25 ,$38.50 ,$40.70 ,$49.50 ,$46.75 , N/A ,$46.75 , N/A ,$55.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581336,G0239,PULMONARY REHAB VISIT MULTIPLE PATEINT,410,1 ,$135.00 ,$87.75 ,$31.95 ,$135.00 ,$92.48 ,$31.95 ,$79.11 ,$79.11 ,$32.58 ,$110.70 ,$114.75 ,$121.50 ,$101.25 ,$94.50 ,$99.90 ,$121.50 ,$114.75 ,$31.95 ,$114.75 ,$68.68 ,$135.00 ,$31.95 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581338,36600,ARTERIAL PUNCTURE,410,1 ,$79.00 ,$51.35 ,$46.29 ,$224.01 ,$54.12 ,$104.19 ,$46.29 ,$46.29 ,$106.27 ,$64.78 ,$67.15 ,$71.10 ,$59.25 ,$55.30 ,$58.46 ,$71.10 ,$67.15 ,$104.19 ,$67.15 ,$224.01 ,$79.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581339,94799,INCENTIVE SPIROMETERY TREATMENT,410,1 ,$200.00 ,$130.00 ,$117.20 ,$284.25 ,$137.00 ,$132.21 ,$117.20 ,$117.20 ,$134.85 ,$164.00 ,$170.00 ,$180.00 ,$150.00 ,$140.00 ,$148.00 ,$180.00 ,$170.00 ,$132.21 ,$170.00 ,$284.25 ,$142.00 ,$132.21 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581340,94660,CPAP/BIPAP SETUP,410,1 ,$580.00 ,$377.00 ,$142.00 ,$522.00 ,$397.30 ,$175.79 ,$339.88 ,$339.88 ,$179.31 ,$475.60 ,$493.00 ,$522.00 ,$435.00 ,$406.00 ,$429.20 ,$522.00 ,$493.00 ,$175.79 ,$493.00 ,$377.95 ,$142.00 ,$175.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581344,94010,PFT - SPIROMETRY W/O BRONCHO,460,1 ,$283.00 ,$183.95 ,$132.21 ,$284.25 ,$193.86 ,$132.21 ,$165.84 ,$165.84 ,$134.85 ,$232.06 ,$240.55 ,$254.70 ,$212.25 ,$198.10 ,$209.42 ,$254.70 ,$240.55 ,$132.21 ,$240.55 ,$284.25 ,$263.00 ,$132.21 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581345,94726,PFT PLETHYSMOGRAPHY,460,1 ,$437.00 ,$284.05 ,$241.86 ,$520.00 ,$299.35 ,$241.86 ,$256.08 ,$256.08 ,$246.70 ,$358.34 ,$371.45 ,$393.30 ,$327.75 ,$305.90 ,$323.38 ,$393.30 ,$371.45 ,$241.86 ,$371.45 ,$520.00 ,$263.00 ,$241.86 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581346,94729,PFT DIFFUSION TEST BY GAS,460,1 ,$437.00 ,$284.05 ,$256.08 ,$393.30 ,$299.35 , N/A ,$256.08 ,$256.08 , N/A ,$358.34 ,$371.45 ,$393.30 ,$327.75 ,$305.90 ,$323.38 ,$393.30 ,$371.45 , N/A ,$371.45 , N/A ,$263.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),581356,94060,PFT - BRONCHOSPASM EVAL: SPIROMETRY,460,1 ,$472.00 ,$306.80 ,$241.86 ,$520.00 ,$323.32 ,$241.86 ,$276.59 ,$276.59 ,$246.70 ,$387.04 ,$401.20 ,$424.80 ,$354.00 ,$330.40 ,$349.28 ,$424.80 ,$401.20 ,$241.86 ,$401.20 ,$520.00 ,$263.00 ,$241.86 
HSHS HOLY FAMILY HOSPITAL INC (ACU),582008,98960,SELF MANAGEMENT EDUCATION,410,1 ,$140.00 ,$91.00 ,$82.04 ,$140.00 ,$95.90 , N/A ,$82.04 ,$82.04 , N/A ,$114.80 ,$119.00 ,$126.00 ,$105.00 ,$98.00 ,$103.60 ,$126.00 ,$119.00 , N/A ,$119.00 , N/A ,$140.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),591000,95811,SLEEP STUDY WITH CPAP,740,1 ,"$4,957.00 ","$3,222.05 ",$868.59 ,"$4,461.30 ","$3,395.55 ",$868.59 ,"$2,904.80 ","$2,904.80 ",$885.96 ,"$4,064.74 ","$4,213.45 ","$4,461.30 ","$3,717.75 ","$3,469.90 ","$3,668.18 ","$4,461.30 ","$4,213.45 ",$868.59 ,"$4,213.45 ","$1,867.47 ","$3,170.00 ",$868.59 
HSHS HOLY FAMILY HOSPITAL INC (ACU),591100,95810,SLEEP STUDY W/O CPAP,740,1 ,"$4,507.00 ","$2,929.55 ",$868.59 ,"$4,056.30 ","$3,087.30 ",$868.59 ,"$2,641.10 ","$2,641.10 ",$885.96 ,"$3,695.74 ","$3,830.95 ","$4,056.30 ","$3,380.25 ","$3,154.90 ","$3,335.18 ","$4,056.30 ","$3,830.95 ",$868.59 ,"$3,830.95 ","$1,867.47 ","$3,170.00 ",$868.59 
HSHS HOLY FAMILY HOSPITAL INC (ACU),591200,95805,SLEEP STUDY-LATENCY TEST,740,1 ,"$4,097.00 ","$2,663.05 ",$464.05 ,"$3,687.30 ","$2,806.45 ",$464.05 ,"$2,400.84 ","$2,400.84 ",$473.33 ,"$3,359.54 ","$3,482.45 ","$3,687.30 ","$3,072.75 ","$2,867.90 ","$3,031.78 ","$3,687.30 ","$3,482.45 ",$464.05 ,"$3,482.45 ",$997.71 ,"$3,170.00 ",$464.05 
HSHS HOLY FAMILY HOSPITAL INC (ACU),591355,G0399,HOME SLEEP STUDY,740,1 ,$901.00 ,$585.65 ,$132.21 ,$901.00 ,$617.19 ,$132.21 ,$527.99 ,$527.99 ,$134.85 ,$738.82 ,$765.85 ,$810.90 ,$675.75 ,$630.70 ,$666.74 ,$810.90 ,$765.85 ,$132.21 ,$765.85 ,$284.25 ,$901.00 ,$132.21 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609004,97112,PT-NEURO RE-EDUCATION PER 15 MIN,420,1 ,$103.00 ,$66.95 ,$35.55 ,$103.00 ,$70.56 ,$35.55 ,$60.36 ,$60.36 ,$36.26 ,$84.46 ,$87.55 ,$92.70 ,$77.25 ,$72.10 ,$76.22 ,$92.70 ,$87.55 ,$35.55 ,$87.55 ,$76.43 ,$103.00 ,$35.55 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609006,97542,PT-WHEELCHAIR TRAING PER 15 MIN,420,1 ,$115.00 ,$74.75 ,$33.48 ,$115.00 ,$78.78 ,$33.48 ,$67.39 ,$67.39 ,$34.15 ,$94.30 ,$97.75 ,$103.50 ,$86.25 ,$80.50 ,$85.10 ,$103.50 ,$97.75 ,$33.48 ,$97.75 ,$71.98 ,$115.00 ,$33.48 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609022,97750,PT-PHYSICAL PERFORMANCE TEST,420,1 ,$124.00 ,$80.60 ,$35.11 ,$124.00 ,$84.94 ,$35.11 ,$72.66 ,$72.66 ,$35.81 ,$101.68 ,$105.40 ,$111.60 ,$93.00 ,$86.80 ,$91.76 ,$111.60 ,$105.40 ,$35.11 ,$105.40 ,$75.49 ,$124.00 ,$35.11 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609023,97032,PT-E-STIM MANUAL PER 15 MIN,420,1 ,$110.00 ,$71.50 ,$15.07 ,$110.00 ,$75.35 ,$15.07 ,$64.46 ,$64.46 ,$15.37 ,$90.20 ,$93.50 ,$99.00 ,$82.50 ,$77.00 ,$81.40 ,$99.00 ,$93.50 ,$15.07 ,$93.50 ,$32.40 ,$110.00 ,$15.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609027,97016,PT-VASOPNEUMATIC PER 15 MIN,420,1 ,$109.00 ,$70.85 ,$12.54 ,$109.00 ,$74.67 ,$12.54 ,$63.87 ,$63.87 ,$12.79 ,$89.38 ,$92.65 ,$98.10 ,$81.75 ,$76.30 ,$80.66 ,$98.10 ,$92.65 ,$12.54 ,$92.65 ,$26.96 ,$109.00 ,$12.54 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609036,97110,"PT-THERAPEUTIC EXERCISE I, PER 15 MIN",420,1 ,$113.00 ,$73.45 ,$31.04 ,$113.00 ,$77.41 ,$31.04 ,$66.22 ,$66.22 ,$31.66 ,$92.66 ,$96.05 ,$101.70 ,$84.75 ,$79.10 ,$83.62 ,$101.70 ,$96.05 ,$31.04 ,$96.05 ,$66.74 ,$113.00 ,$31.04 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609041,97140,"PT-MANUAL THERAPY, PER 15 MIN",420,1 ,$116.00 ,$75.40 ,$28.62 ,$116.00 ,$79.46 ,$28.62 ,$67.98 ,$67.98 ,$29.19 ,$95.12 ,$98.60 ,$104.40 ,$87.00 ,$81.20 ,$85.84 ,$104.40 ,$98.60 ,$28.62 ,$98.60 ,$61.53 ,$116.00 ,$28.62 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609053,97530,PT-PHYSICAL FUNCTION,420,1 ,$126.00 ,$81.90 ,$39.49 ,$126.00 ,$86.31 ,$39.49 ,$73.84 ,$73.84 ,$40.28 ,$103.32 ,$107.10 ,$113.40 ,$94.50 ,$88.20 ,$93.24 ,$113.40 ,$107.10 ,$39.49 ,$107.10 ,$84.90 ,$126.00 ,$39.49 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609058,97116,PT-GAIT TRAINING PER 15 MIN.,420,1 ,$105.00 ,$68.25 ,$30.70 ,$105.00 ,$71.93 ,$30.70 ,$61.53 ,$61.53 ,$31.31 ,$86.10 ,$89.25 ,$94.50 ,$78.75 ,$73.50 ,$77.70 ,$94.50 ,$89.25 ,$30.70 ,$89.25 ,$66.01 ,$105.00 ,$30.70 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609066,97035,"PT-ULTRASOUND I, PER 15 MIN",420,1 ,$98.00 ,$63.70 ,$14.64 ,$98.00 ,$67.13 ,$14.64 ,$57.43 ,$57.43 ,$14.93 ,$80.36 ,$83.30 ,$88.20 ,$73.50 ,$68.60 ,$72.52 ,$88.20 ,$83.30 ,$14.64 ,$83.30 ,$31.48 ,$98.00 ,$14.64 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609067,97537,PT-COMM/WORK REINTEGRATION,420,1 ,$118.00 ,$76.70 ,$33.14 ,$118.00 ,$80.83 ,$33.14 ,$69.15 ,$69.15 ,$33.80 ,$96.76 ,$100.30 ,$106.20 ,$88.50 ,$82.60 ,$87.32 ,$106.20 ,$100.30 ,$33.14 ,$100.30 ,$71.25 ,$118.00 ,$33.14 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609075,N/A,PT SCREEN PINNACLE,420,1 ,$75.00 ,$48.75 ,$43.95 ,$75.00 ,$51.38 , N/A ,$43.95 ,$43.95 , N/A ,$61.50 ,$63.75 ,$67.50 ,$56.25 ,$52.50 ,$55.50 ,$67.50 ,$63.75 , N/A ,$63.75 , N/A ,$75.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609081,N/A,PT SCREEN GRH,420,1 ,$133.75 ,$86.94 ,$78.38 ,$133.75 ,$91.62 , N/A ,$78.38 ,$78.38 , N/A ,$109.68 ,$113.69 ,$120.38 ,$100.31 ,$93.63 ,$98.98 ,$120.38 ,$113.69 , N/A ,$113.69 , N/A ,$133.75 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609086,97161,PT-EVALUATION LOW COMPLEX 20 MIN,420,1 ,$291.00 ,$189.15 ,$86.40 ,$261.90 ,$199.34 ,$86.40 ,$170.53 ,$170.53 ,$88.13 ,$238.62 ,$247.35 ,$261.90 ,$218.25 ,$203.70 ,$215.34 ,$261.90 ,$247.35 ,$86.40 ,$247.35 ,$185.76 ,$169.00 ,$86.40 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609087,97162,PT-EVALUATION MOD COMPLEX 30 MIN,420,1 ,$583.00 ,$378.95 ,$86.40 ,$524.70 ,$399.36 ,$86.40 ,$341.64 ,$341.64 ,$88.13 ,$478.06 ,$495.55 ,$524.70 ,$437.25 ,$408.10 ,$431.42 ,$524.70 ,$495.55 ,$86.40 ,$495.55 ,$185.76 ,$169.00 ,$86.40 
HSHS HOLY FAMILY HOSPITAL INC (ACU),609203,97014,PT-E-STIM UNATTENDED,420,1 ,$97.00 ,$63.05 ,$56.84 ,$97.00 ,$66.45 , N/A ,$56.84 ,$56.84 , N/A ,$79.54 ,$82.45 ,$87.30 ,$72.75 ,$67.90 ,$71.78 ,$87.30 ,$82.45 , N/A ,$82.45 , N/A ,$97.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),619506,92611,ST-EVAL-SWALLOW BY VIDEO,440,1 ,$447.00 ,$290.55 ,$94.28 ,$402.30 ,$306.20 ,$94.28 ,$261.94 ,$261.94 ,$96.17 ,$366.54 ,$379.95 ,$402.30 ,$335.25 ,$312.90 ,$330.78 ,$402.30 ,$379.95 ,$94.28 ,$379.95 ,$202.70 ,$169.00 ,$94.28 
HSHS HOLY FAMILY HOSPITAL INC (ACU),619513,92610,ST-SWALLOW EVALUATION,440,1 ,$336.00 ,$218.40 ,$88.26 ,$302.40 ,$230.16 ,$88.26 ,$196.90 ,$196.90 ,$90.03 ,$275.52 ,$285.60 ,$302.40 ,$252.00 ,$235.20 ,$248.64 ,$302.40 ,$285.60 ,$88.26 ,$285.60 ,$189.76 ,$169.00 ,$88.26 
HSHS HOLY FAMILY HOSPITAL INC (ACU),619531,92507,ST-TREATMENT-SPEECH/LANG/VOICE,440,1 ,$266.00 ,$172.90 ,$80.52 ,$239.40 ,$182.21 ,$80.52 ,$155.88 ,$155.88 ,$82.13 ,$218.12 ,$226.10 ,$239.40 ,$199.50 ,$186.20 ,$196.84 ,$239.40 ,$226.10 ,$80.52 ,$226.10 ,$173.12 ,$169.00 ,$80.52 
HSHS HOLY FAMILY HOSPITAL INC (ACU),619533,92526,ST-TREATMENT SWALLOWING DYSFUNCTION/ORAL,440,1 ,$234.00 ,$152.10 ,$88.41 ,$210.60 ,$160.29 ,$88.41 ,$137.12 ,$137.12 ,$90.18 ,$191.88 ,$198.90 ,$210.60 ,$175.50 ,$163.80 ,$173.16 ,$210.60 ,$198.90 ,$88.41 ,$198.90 ,$190.08 ,$169.00 ,$88.41 
HSHS HOLY FAMILY HOSPITAL INC (ACU),619551,92523,ST-EVAL SPEECH LANG,440,1 ,$409.00 ,$265.85 ,$169.00 ,$421.62 ,$280.17 ,$196.10 ,$239.67 ,$239.67 ,$200.02 ,$335.38 ,$347.65 ,$368.10 ,$306.75 ,$286.30 ,$302.66 ,$368.10 ,$347.65 ,$196.10 ,$347.65 ,$421.62 ,$169.00 ,$196.10 
HSHS HOLY FAMILY HOSPITAL INC (ACU),619552,92522,ST-EVAL SPEECH,440,1 ,$218.00 ,$141.70 ,$94.35 ,$202.85 ,$149.33 ,$94.35 ,$127.75 ,$127.75 ,$96.24 ,$178.76 ,$185.30 ,$196.20 ,$163.50 ,$152.60 ,$161.32 ,$196.20 ,$185.30 ,$94.35 ,$185.30 ,$202.85 ,$169.00 ,$94.35 
HSHS HOLY FAMILY HOSPITAL INC (ACU),619554,92524,ST-EVAL VOICE,440,1 ,$296.00 ,$192.40 ,$92.32 ,$266.40 ,$202.76 ,$92.32 ,$173.46 ,$173.46 ,$94.17 ,$242.72 ,$251.60 ,$266.40 ,$222.00 ,$207.20 ,$219.04 ,$266.40 ,$251.60 ,$92.32 ,$251.60 ,$198.49 ,$169.00 ,$92.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),641022,97165,OT-EVAL LOW COMPLEX 30 MIN,430,1 ,$309.00 ,$200.85 ,$91.49 ,$278.10 ,$211.67 ,$91.49 ,$181.07 ,$181.07 ,$93.32 ,$253.38 ,$262.65 ,$278.10 ,$231.75 ,$216.30 ,$228.66 ,$278.10 ,$262.65 ,$91.49 ,$262.65 ,$196.70 ,$169.00 ,$91.49 
HSHS HOLY FAMILY HOSPITAL INC (ACU),641023,97166,OT-EVAL MED COMPLEX 45MIN,430,1 ,$618.00 ,$401.70 ,$91.15 ,$556.20 ,$423.33 ,$91.15 ,$362.15 ,$362.15 ,$92.97 ,$506.76 ,$525.30 ,$556.20 ,$463.50 ,$432.60 ,$457.32 ,$556.20 ,$525.30 ,$91.15 ,$525.30 ,$195.97 ,$169.00 ,$91.15 
HSHS HOLY FAMILY HOSPITAL INC (ACU),642003,97018,OT-PARAFFIN BATH,430,1 ,$79.00 ,$51.35 ,$6.18 ,$79.00 ,$54.12 ,$6.18 ,$46.29 ,$46.29 ,$6.30 ,$64.78 ,$67.15 ,$71.10 ,$59.25 ,$55.30 ,$58.46 ,$71.10 ,$67.15 ,$6.18 ,$67.15 ,$13.29 ,$79.00 ,$6.18 
HSHS HOLY FAMILY HOSPITAL INC (ACU),645005,97535,OT-INDIVIDUAL DAILY LIVING SKILLS/15 MIN,430,1 ,$126.00 ,$81.90 ,$34.43 ,$126.00 ,$86.31 ,$34.43 ,$73.84 ,$73.84 ,$35.12 ,$103.32 ,$107.10 ,$113.40 ,$94.50 ,$88.20 ,$93.24 ,$113.40 ,$107.10 ,$34.43 ,$107.10 ,$74.02 ,$126.00 ,$34.43 
HSHS HOLY FAMILY HOSPITAL INC (ACU),680069,N/A,SYRINGE TOOMEY 70CC,270,1 ,$3.50 ,$2.28 ,$1.85 ,$3.15 ,$2.40 , N/A ,$2.05 ,$2.05 , N/A ,$2.87 ,$2.98 ,$3.15 ,$2.63 ,$2.45 ,$2.59 ,$3.15 ,$2.98 , N/A ,$2.98 , N/A ,$1.85 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),680945,N/A,SPECULUM VAG MED DISP (59000),270,1 ,$3.88 ,$2.52 ,$2.05 ,$3.49 ,$2.66 , N/A ,$2.27 ,$2.27 , N/A ,$3.18 ,$3.30 ,$3.49 ,$2.91 ,$2.72 ,$2.87 ,$3.49 ,$3.30 , N/A ,$3.30 , N/A ,$2.05 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),681025,N/A,TRAY IRRIGATION PISTON SYR 60ML STRL,270,1 ,$3.30 ,$2.15 ,$1.74 ,$2.97 ,$2.26 , N/A ,$1.93 ,$1.93 , N/A ,$2.71 ,$2.81 ,$2.97 ,$2.48 ,$2.31 ,$2.44 ,$2.97 ,$2.81 , N/A ,$2.81 , N/A ,$1.74 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),682027,N/A,KIT STAPLE REMOVAL,270,1 ,$6.17 ,$4.01 ,$3.26 ,$5.55 ,$4.23 , N/A ,$3.62 ,$3.62 , N/A ,$5.06 ,$5.24 ,$5.55 ,$4.63 ,$4.32 ,$4.57 ,$5.55 ,$5.24 , N/A ,$5.24 , N/A ,$3.26 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),684294,N/A,"STRIP CLOSURE SKIN 1/4""X3"" STERI-STRIP",270,1 ,$1.56 ,$1.01 ,$0.82 ,$1.40 ,$1.07 , N/A ,$0.91 ,$0.91 , N/A ,$1.28 ,$1.33 ,$1.40 ,$1.17 ,$1.09 ,$1.15 ,$1.40 ,$1.33 , N/A ,$1.33 , N/A ,$0.82 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),684483,N/A,VALVE ANTI-REFLUX SUMP SALEM,270,1 ,$13.50 ,$8.78 ,$7.13 ,$12.15 ,$9.25 , N/A ,$7.91 ,$7.91 , N/A ,$11.07 ,$11.48 ,$12.15 ,$10.13 ,$9.45 ,$9.99 ,$12.15 ,$11.48 , N/A ,$11.48 , N/A ,$7.13 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),684691,N/A,TUBE SALEM SUMP 12FR NG,270,1 ,$3.31 ,$2.15 ,$1.75 ,$2.98 ,$2.27 , N/A ,$1.94 ,$1.94 , N/A ,$2.71 ,$2.81 ,$2.98 ,$2.48 ,$2.32 ,$2.45 ,$2.98 ,$2.81 , N/A ,$2.81 , N/A ,$1.75 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),685026,N/A,KIT CATHETER PEDI 5FR,270,1 ,$11.70 ,$7.61 ,$6.18 ,$10.53 ,$8.01 , N/A ,$6.86 ,$6.86 , N/A ,$9.59 ,$9.95 ,$10.53 ,$8.78 ,$8.19 ,$8.66 ,$10.53 ,$9.95 , N/A ,$9.95 , N/A ,$6.18 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),685233,N/A,KIT IV START W/ EXT SET,270,1 ,$8.67 ,$5.64 ,$4.58 ,$7.80 ,$5.94 , N/A ,$5.08 ,$5.08 , N/A ,$7.11 ,$7.37 ,$7.80 ,$6.50 ,$6.07 ,$6.42 ,$7.80 ,$7.37 , N/A ,$7.37 , N/A ,$4.58 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),685237,N/A,TUBING SECONDARY IV,270,1 ,$2.10 ,$1.37 ,$1.11 ,$1.89 ,$1.44 , N/A ,$1.23 ,$1.23 , N/A ,$1.72 ,$1.79 ,$1.89 ,$1.58 ,$1.47 ,$1.55 ,$1.89 ,$1.79 , N/A ,$1.79 , N/A ,$1.11 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),685252,N/A,CATHETER NL 10FR 5CC SILICONE,270,1 ,$10.23 ,$6.65 ,$5.40 ,$9.21 ,$7.01 , N/A ,$5.99 ,$5.99 , N/A ,$8.39 ,$8.70 ,$9.21 ,$7.67 ,$7.16 ,$7.57 ,$9.21 ,$8.70 , N/A ,$8.70 , N/A ,$5.40 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690023,N/A,"DRAIN PENROSE 1/4""",270,1 ,$2.19 ,$1.42 ,$1.16 ,$1.97 ,$1.50 , N/A ,$1.28 ,$1.28 , N/A ,$1.80 ,$1.86 ,$1.97 ,$1.64 ,$1.53 ,$1.62 ,$1.97 ,$1.86 , N/A ,$1.86 , N/A ,$1.16 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690029,N/A,MASTISOL STERILE 3CC VIAL,270,1 ,$4.74 ,$3.08 ,$2.50 ,$4.27 ,$3.25 , N/A ,$2.78 ,$2.78 , N/A ,$3.89 ,$4.03 ,$4.27 ,$3.56 ,$3.32 ,$3.51 ,$4.27 ,$4.03 , N/A ,$4.03 , N/A ,$2.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690030,N/A,"NEEDLE POWERLOCK 20GX1""",270,1 ,$45.57 ,$29.62 ,$24.06 ,$41.01 ,$31.22 , N/A ,$26.70 ,$26.70 , N/A ,$37.37 ,$38.73 ,$41.01 ,$34.18 ,$31.90 ,$33.72 ,$41.01 ,$38.73 , N/A ,$38.73 , N/A ,$24.06 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690031,N/A,"NEEDLE POWERLOCK 20GX1.5""",270,1 ,$12.34 ,$8.02 ,$6.52 ,$11.11 ,$8.45 , N/A ,$7.23 ,$7.23 , N/A ,$10.12 ,$10.49 ,$11.11 ,$9.26 ,$8.64 ,$9.13 ,$11.11 ,$10.49 , N/A ,$10.49 , N/A ,$6.52 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690032,N/A,PAD MAXI,270,1 ,$9.59 ,$6.23 ,$5.06 ,$8.63 ,$6.57 , N/A ,$5.62 ,$5.62 , N/A ,$7.86 ,$8.15 ,$8.63 ,$7.19 ,$6.71 ,$7.10 ,$8.63 ,$8.15 , N/A ,$8.15 , N/A ,$5.06 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690033,N/A,PAD SANITARY BLADDER CONTROL,270,1 ,$0.60 ,$0.39 ,$0.32 ,$0.54 ,$0.41 , N/A ,$0.35 ,$0.35 , N/A ,$0.49 ,$0.51 ,$0.54 ,$0.45 ,$0.42 ,$0.44 ,$0.54 ,$0.51 , N/A ,$0.51 , N/A ,$0.32 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690034,N/A,EXTENSION SET MICROBORE W/ REM CLAVE,270,1 ,$8.22 ,$5.34 ,$4.34 ,$7.40 ,$5.63 , N/A ,$4.82 ,$4.82 , N/A ,$6.74 ,$6.99 ,$7.40 ,$6.17 ,$5.75 ,$6.08 ,$7.40 ,$6.99 , N/A ,$6.99 , N/A ,$4.34 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690037,N/A,SODIUM CHLORIDE .9% POUR BTL 1000CC,270,1 ,$8.02 ,$5.21 ,$4.23 ,$7.22 ,$5.49 , N/A ,$4.70 ,$4.70 , N/A ,$6.58 ,$6.82 ,$7.22 ,$6.02 ,$5.61 ,$5.93 ,$7.22 ,$6.82 , N/A ,$6.82 , N/A ,$4.23 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690038,N/A,SODIUM CHLORIDE .9% POUR BTL 500CC,270,1 ,$9.00 ,$5.85 ,$4.75 ,$8.10 ,$6.17 , N/A ,$5.27 ,$5.27 , N/A ,$7.38 ,$7.65 ,$8.10 ,$6.75 ,$6.30 ,$6.66 ,$8.10 ,$7.65 , N/A ,$7.65 , N/A ,$4.75 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690039,N/A,STERILE WATER 1000ML POUR BOTTLE,270,1 ,$7.10 ,$4.62 ,$3.75 ,$6.39 ,$4.86 , N/A ,$4.16 ,$4.16 , N/A ,$5.82 ,$6.04 ,$6.39 ,$5.33 ,$4.97 ,$5.25 ,$6.39 ,$6.04 , N/A ,$6.04 , N/A ,$3.75 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690040,N/A,STRAINER URINE CALCULI,270,1 ,$2.00 ,$1.30 ,$1.06 ,$1.80 ,$1.37 , N/A ,$1.17 ,$1.17 , N/A ,$1.64 ,$1.70 ,$1.80 ,$1.50 ,$1.40 ,$1.48 ,$1.80 ,$1.70 , N/A ,$1.70 , N/A ,$1.06 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690044,N/A,URINAL DELUXE W/COVER,270,1 ,$1.01 ,$0.66 ,$0.53 ,$0.91 ,$0.69 , N/A ,$0.59 ,$0.59 , N/A ,$0.83 ,$0.86 ,$0.91 ,$0.76 ,$0.71 ,$0.75 ,$0.91 ,$0.86 , N/A ,$0.86 , N/A ,$0.53 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690046,N/A,SENSOR SPO2 PEDS OXIMAX,270,1 ,$19.97 ,$12.98 ,$10.54 ,$17.97 ,$13.68 , N/A ,$11.70 ,$11.70 , N/A ,$16.38 ,$16.97 ,$17.97 ,$14.98 ,$13.98 ,$14.78 ,$17.97 ,$16.97 , N/A ,$16.97 , N/A ,$10.54 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690047,N/A,SENSOR SPO2 INFANT OXIMAX,270,1 ,$47.20 ,$30.68 ,$24.92 ,$42.48 ,$32.33 , N/A ,$27.66 ,$27.66 , N/A ,$38.70 ,$40.12 ,$42.48 ,$35.40 ,$33.04 ,$34.93 ,$42.48 ,$40.12 , N/A ,$40.12 , N/A ,$24.92 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690057,N/A,PORTA CATH NEEDLE 20G X .75,270,1 ,$9.94 ,$6.46 ,$5.25 ,$8.95 ,$6.81 , N/A ,$5.82 ,$5.82 , N/A ,$8.15 ,$8.45 ,$8.95 ,$7.46 ,$6.96 ,$7.36 ,$8.95 ,$8.45 , N/A ,$8.45 , N/A ,$5.25 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690058,N/A,PORTA CATH NEEDLE 19G X .75,270,1 ,$9.94 ,$6.46 ,$5.25 ,$8.95 ,$6.81 , N/A ,$5.82 ,$5.82 , N/A ,$8.15 ,$8.45 ,$8.95 ,$7.46 ,$6.96 ,$7.36 ,$8.95 ,$8.45 , N/A ,$8.45 , N/A ,$5.25 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690203,N/A,NEONATAL spo2 SENSOR PORTABLE,270,1 ,$27.75 ,$18.04 ,$14.65 ,$24.98 ,$19.01 , N/A ,$16.26 ,$16.26 , N/A ,$22.76 ,$23.59 ,$24.98 ,$20.81 ,$19.43 ,$20.54 ,$24.98 ,$23.59 , N/A ,$23.59 , N/A ,$14.65 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690233,N/A,TUBING MAGNESIUM ORANGE,270,1 ,$52.00 ,$33.80 ,$27.46 ,$46.80 ,$35.62 , N/A ,$30.47 ,$30.47 , N/A ,$42.64 ,$44.20 ,$46.80 ,$39.00 ,$36.40 ,$38.48 ,$46.80 ,$44.20 , N/A ,$44.20 , N/A ,$27.46 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690236,N/A,STERILE WATER IRR 2000ML,270,1 ,$19.09 ,$12.41 ,$10.08 ,$17.18 ,$13.08 , N/A ,$11.19 ,$11.19 , N/A ,$15.65 ,$16.23 ,$17.18 ,$14.32 ,$13.36 ,$14.13 ,$17.18 ,$16.23 , N/A ,$16.23 , N/A ,$10.08 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690500,N/A,IV TUBING,270,1 ,$35.00 ,$22.75 ,$18.48 ,$31.50 ,$23.98 , N/A ,$20.51 ,$20.51 , N/A ,$28.70 ,$29.75 ,$31.50 ,$26.25 ,$24.50 ,$25.90 ,$31.50 ,$29.75 , N/A ,$29.75 , N/A ,$18.48 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690503,N/A,ACTIVAC CANISTER W/GEL,270,1 ,$199.34 ,$129.57 ,$105.25 ,$179.41 ,$136.55 , N/A ,$116.81 ,$116.81 , N/A ,$163.46 ,$169.44 ,$179.41 ,$149.51 ,$139.54 ,$147.51 ,$179.41 ,$169.44 , N/A ,$169.44 , N/A ,$105.25 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690507,N/A,STETHOSCOPE DISPOSABLE,270,1 ,$6.87 ,$4.47 ,$3.63 ,$6.18 ,$4.71 , N/A ,$4.03 ,$4.03 , N/A ,$5.63 ,$5.84 ,$6.18 ,$5.15 ,$4.81 ,$5.08 ,$6.18 ,$5.84 , N/A ,$5.84 , N/A ,$3.63 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690516,A6234,DRESSING AQUACEL FOAM 4X4,270,1 ,$5.58 ,$3.63 ,$2.95 ,$5.02 ,$3.82 , N/A ,$3.27 ,$3.27 , N/A ,$4.58 ,$4.74 ,$5.02 ,$4.19 ,$3.91 ,$4.13 ,$5.02 ,$4.74 , N/A ,$4.74 , N/A ,$2.95 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690517,A6234,"DRESSING AQUACEL HEEL FOAM 8X5.5""",270,1 ,$17.51 ,$11.38 ,$9.25 ,$15.76 ,$11.99 , N/A ,$10.26 ,$10.26 , N/A ,$14.36 ,$14.88 ,$15.76 ,$13.13 ,$12.26 ,$12.96 ,$15.76 ,$14.88 , N/A ,$14.88 , N/A ,$9.25 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690518,A6234,DRESSING AQUACEL SACRAL FOAM 8X7,270,1 ,$13.00 ,$8.45 ,$6.86 ,$11.70 ,$8.91 , N/A ,$7.62 ,$7.62 , N/A ,$10.66 ,$11.05 ,$11.70 ,$9.75 ,$9.10 ,$9.62 ,$11.70 ,$11.05 , N/A ,$11.05 , N/A ,$6.86 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690520,N/A,PAD CHAIR SENSOR 30-DAY,270,1 ,$36.38 ,$23.65 ,$19.21 ,$32.74 ,$24.92 , N/A ,$21.32 ,$21.32 , N/A ,$29.83 ,$30.92 ,$32.74 ,$27.29 ,$25.47 ,$26.92 ,$32.74 ,$30.92 , N/A ,$30.92 , N/A ,$19.21 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690525,A6197,DRESSING AQUACEL AG 3.5X6,270,1 ,$68.60 ,$44.59 ,$36.22 ,$61.74 ,$46.99 , N/A ,$40.20 ,$40.20 , N/A ,$56.25 ,$58.31 ,$61.74 ,$51.45 ,$48.02 ,$50.76 ,$61.74 ,$58.31 , N/A ,$58.31 , N/A ,$36.22 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690527,N/A,DRESSING GRANUFOAM SM WOUND VAC,270,1 ,$85.57 ,$55.62 ,$45.18 ,$77.01 ,$58.62 , N/A ,$50.14 ,$50.14 , N/A ,$70.17 ,$72.73 ,$77.01 ,$64.18 ,$59.90 ,$63.32 ,$77.01 ,$72.73 , N/A ,$72.73 , N/A ,$45.18 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690528,N/A,DRESSING GRANUFOAM MED WOUND VAC,270,1 ,$112.68 ,$73.24 ,$59.50 ,$101.41 ,$77.19 , N/A ,$66.03 ,$66.03 , N/A ,$92.40 ,$95.78 ,$101.41 ,$84.51 ,$78.88 ,$83.38 ,$101.41 ,$95.78 , N/A ,$95.78 , N/A ,$59.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690702,N/A,"TRAY, DRESSING CHANGE CENTRAL LINE",270,1 ,$41.25 ,$26.81 ,$21.78 ,$37.13 ,$28.26 , N/A ,$24.17 ,$24.17 , N/A ,$33.83 ,$35.06 ,$37.13 ,$30.94 ,$28.88 ,$30.53 ,$37.13 ,$35.06 , N/A ,$35.06 , N/A ,$21.78 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690826,N/A,HANDLE LARYNGOSCOPE FLEXICARE,270,1 ,$21.63 ,$14.06 ,$11.42 ,$19.47 ,$14.82 , N/A ,$12.68 ,$12.68 , N/A ,$17.74 ,$18.39 ,$19.47 ,$16.22 ,$15.14 ,$16.01 ,$19.47 ,$18.39 , N/A ,$18.39 , N/A ,$11.42 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690903,N/A,"TROCAR, CHEST TUBE 32FR",270,1 ,$13.40 ,$8.71 ,$7.08 ,$12.06 ,$9.18 , N/A ,$7.85 ,$7.85 , N/A ,$10.99 ,$11.39 ,$12.06 ,$10.05 ,$9.38 ,$9.92 ,$12.06 ,$11.39 , N/A ,$11.39 , N/A ,$7.08 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690911,N/A,"ALUMINUM FINGER SPLINT 1-1/2""",270,1 ,$2.20 ,$1.43 ,$1.16 ,$1.98 ,$1.51 , N/A ,$1.29 ,$1.29 , N/A ,$1.80 ,$1.87 ,$1.98 ,$1.65 ,$1.54 ,$1.63 ,$1.98 ,$1.87 , N/A ,$1.87 , N/A ,$1.16 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690912,N/A,"ALUMINUM FINGER SPLINT 3-5/8""",270,1 ,$2.13 ,$1.38 ,$1.12 ,$1.92 ,$1.46 , N/A ,$1.25 ,$1.25 , N/A ,$1.75 ,$1.81 ,$1.92 ,$1.60 ,$1.49 ,$1.58 ,$1.92 ,$1.81 , N/A ,$1.81 , N/A ,$1.12 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690913,N/A,"ALUMINUM FINGER SPLINT 4-5/8""",270,1 ,$2.09 ,$1.36 ,$1.10 ,$1.88 ,$1.43 , N/A ,$1.22 ,$1.22 , N/A ,$1.71 ,$1.78 ,$1.88 ,$1.57 ,$1.46 ,$1.55 ,$1.88 ,$1.78 , N/A ,$1.78 , N/A ,$1.10 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690917,N/A,AIRWAY NASAL 20FR,270,1 ,$5.49 ,$3.57 ,$2.90 ,$4.94 ,$3.76 , N/A ,$3.22 ,$3.22 , N/A ,$4.50 ,$4.67 ,$4.94 ,$4.12 ,$3.84 ,$4.06 ,$4.94 ,$4.67 , N/A ,$4.67 , N/A ,$2.90 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690922,N/A,SCALPEL SAFETY #11 BLADE,270,1 ,$4.41 ,$2.87 ,$2.33 ,$3.97 ,$3.02 , N/A ,$2.58 ,$2.58 , N/A ,$3.62 ,$3.75 ,$3.97 ,$3.31 ,$3.09 ,$3.26 ,$3.97 ,$3.75 , N/A ,$3.75 , N/A ,$2.33 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690925,N/A,"FINGER PROTECTOR PADDED 3.5""",270,1 ,$15.00 ,$9.75 ,$7.92 ,$13.50 ,$10.28 , N/A ,$8.79 ,$8.79 , N/A ,$12.30 ,$12.75 ,$13.50 ,$11.25 ,$10.50 ,$11.10 ,$13.50 ,$12.75 , N/A ,$12.75 , N/A ,$7.92 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690944,N/A,WATER TRAP FOR DPM7,270,1 ,$43.97 ,$28.58 ,$23.22 ,$39.57 ,$30.12 , N/A ,$25.77 ,$25.77 , N/A ,$36.06 ,$37.37 ,$39.57 ,$32.98 ,$30.78 ,$32.54 ,$39.57 ,$37.37 , N/A ,$37.37 , N/A ,$23.22 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690945,N/A,"SAMPLING LINE, ADULT 2.5M (DPM7)",270,1 ,$17.59 ,$11.43 ,$9.29 ,$15.83 ,$12.05 , N/A ,$10.31 ,$10.31 , N/A ,$14.42 ,$14.95 ,$15.83 ,$13.19 ,$12.31 ,$13.02 ,$15.83 ,$14.95 , N/A ,$14.95 , N/A ,$9.29 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),690946,N/A,"AIRWAY ADAPTER, STRAIGHT (DPM7)",270,1 ,$55.50 ,$36.08 ,$29.30 ,$49.95 ,$38.02 , N/A ,$32.52 ,$32.52 , N/A ,$45.51 ,$47.18 ,$49.95 ,$41.63 ,$38.85 ,$41.07 ,$49.95 ,$47.18 , N/A ,$47.18 , N/A ,$29.30 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691001,N/A,AMBU BAG PEDS DISP (RESUSCITATOR),270,1 ,$71.66 ,$46.58 ,$37.84 ,$64.49 ,$49.09 , N/A ,$41.99 ,$41.99 , N/A ,$58.76 ,$60.91 ,$64.49 ,$53.75 ,$50.16 ,$53.03 ,$64.49 ,$60.91 , N/A ,$60.91 , N/A ,$37.84 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691003,N/A,MASK CPAP MEDIUM (CARDIO),270,1 ,$51.00 ,$33.15 ,$26.93 ,$45.90 ,$34.94 , N/A ,$29.89 ,$29.89 , N/A ,$41.82 ,$43.35 ,$45.90 ,$38.25 ,$35.70 ,$37.74 ,$45.90 ,$43.35 , N/A ,$43.35 , N/A ,$26.93 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691005,N/A,DETECTOR CO2 PEDIATRIC,270,1 ,$20.12 ,$13.08 ,$10.62 ,$18.11 ,$13.78 , N/A ,$11.79 ,$11.79 , N/A ,$16.50 ,$17.10 ,$18.11 ,$15.09 ,$14.08 ,$14.89 ,$18.11 ,$17.10 , N/A ,$17.10 , N/A ,$10.62 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691006,C1713,PEEK KNOTLESS ANCHOR SYSTEM,278,1 ,"$1,275.00 ",$828.75 ,$747.15 ,"$1,147.50 ",$873.38 , N/A ,$747.15 ,$747.15 , N/A ,"$1,045.50 ","$1,083.75 ","$1,147.50 ",$956.25 ,$892.50 ,$943.50 ,"$1,147.50 ","$1,083.75 ", N/A ,"$1,083.75 ", N/A ,$765.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691008,N/A,SUTURE TAPE VIOLET,270,1 ,$300.00 ,$195.00 ,$158.40 ,$270.00 ,$205.50 , N/A ,$175.80 ,$175.80 , N/A ,$246.00 ,$255.00 ,$270.00 ,$225.00 ,$210.00 ,$222.00 ,$270.00 ,$255.00 , N/A ,$255.00 , N/A ,$158.40 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691009,N/A,SUTURE TAPE CO-BRALD,270,1 ,$300.00 ,$195.00 ,$158.40 ,$270.00 ,$205.50 , N/A ,$175.80 ,$175.80 , N/A ,$246.00 ,$255.00 ,$270.00 ,$225.00 ,$210.00 ,$222.00 ,$270.00 ,$255.00 , N/A ,$255.00 , N/A ,$158.40 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691019,N/A,SPACER,270,1 ,$12.21 ,$7.94 ,$6.45 ,$10.99 ,$8.36 , N/A ,$7.16 ,$7.16 , N/A ,$10.01 ,$10.38 ,$10.99 ,$9.16 ,$8.55 ,$9.04 ,$10.99 ,$10.38 , N/A ,$10.38 , N/A ,$6.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691020,N/A,VENTILATOR CIRCUITS,270,1 ,$54.67 ,$35.54 ,$28.87 ,$49.20 ,$37.45 , N/A ,$32.04 ,$32.04 , N/A ,$44.83 ,$46.47 ,$49.20 ,$41.00 ,$38.27 ,$40.46 ,$49.20 ,$46.47 , N/A ,$46.47 , N/A ,$28.87 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691161,N/A,SLING ARM XL,270,1 ,$6.87 ,$4.47 ,$3.63 ,$6.18 ,$4.71 , N/A ,$4.03 ,$4.03 , N/A ,$5.63 ,$5.84 ,$6.18 ,$5.15 ,$4.81 ,$5.08 ,$6.18 ,$5.84 , N/A ,$5.84 , N/A ,$3.63 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691303,N/A,AMBU BAG ADULT (RESUSCITATOR),270,1 ,$83.36 ,$54.18 ,$44.01 ,$75.02 ,$57.10 , N/A ,$48.85 ,$48.85 , N/A ,$68.36 ,$70.86 ,$75.02 ,$62.52 ,$58.35 ,$61.69 ,$75.02 ,$70.86 , N/A ,$70.86 , N/A ,$44.01 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691304,N/A,DETECTOR CO2 ADULT,270,1 ,$20.22 ,$13.14 ,$10.68 ,$18.20 ,$13.85 , N/A ,$11.85 ,$11.85 , N/A ,$16.58 ,$17.19 ,$18.20 ,$15.17 ,$14.15 ,$14.96 ,$18.20 ,$17.19 , N/A ,$17.19 , N/A ,$10.68 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691402,N/A,KUMAR CHOLANGIOGRAPHY CATHETER,270,1 ,$104.70 ,$68.06 ,$55.28 ,$94.23 ,$71.72 , N/A ,$61.35 ,$61.35 , N/A ,$85.85 ,$89.00 ,$94.23 ,$78.53 ,$73.29 ,$77.48 ,$94.23 ,$89.00 , N/A ,$89.00 , N/A ,$55.28 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691403,N/A,LAPROSCOPIC SUCTION,270,1 ,$148.53 ,$96.54 ,$78.42 ,$133.68 ,$101.74 , N/A ,$87.04 ,$87.04 , N/A ,$121.79 ,$126.25 ,$133.68 ,$111.40 ,$103.97 ,$109.91 ,$133.68 ,$126.25 , N/A ,$126.25 , N/A ,$78.42 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691404,N/A,SUTURE VICRYL 4/0 SH,270,1 ,$7.67 ,$4.99 ,$4.05 ,$6.90 ,$5.25 , N/A ,$4.49 ,$4.49 , N/A ,$6.29 ,$6.52 ,$6.90 ,$5.75 ,$5.37 ,$5.68 ,$6.90 ,$6.52 , N/A ,$6.52 , N/A ,$4.05 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691416,N/A,SUTURE PDS 0 CT-1,270,1 ,$9.30 ,$6.05 ,$4.91 ,$8.37 ,$6.37 , N/A ,$5.45 ,$5.45 , N/A ,$7.63 ,$7.91 ,$8.37 ,$6.98 ,$6.51 ,$6.88 ,$8.37 ,$7.91 , N/A ,$7.91 , N/A ,$4.91 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691418,N/A,THERMAL ABLASION CATHETER KIT,270,1 ,"$3,975.00 ","$2,583.75 ","$2,098.80 ","$3,577.50 ","$2,722.88 ", N/A ,"$2,329.35 ","$2,329.35 ", N/A ,"$3,259.50 ","$3,378.75 ","$3,577.50 ","$2,981.25 ","$2,782.50 ","$2,941.50 ","$3,577.50 ","$3,378.75 ", N/A ,"$3,378.75 ", N/A ,"$2,098.80 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691419,C1771,BLADDER SLING,278,1 ,"$3,130.38 ","$2,034.75 ","$1,834.40 ","$2,817.34 ","$2,144.31 ", N/A ,"$1,834.40 ","$1,834.40 ", N/A ,"$2,566.91 ","$2,660.82 ","$2,817.34 ","$2,347.79 ","$2,191.27 ","$2,316.48 ","$2,817.34 ","$2,660.82 ", N/A ,"$2,660.82 ", N/A ,"$1,878.23 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691423,N/A,RELOAD 60MM LINEAR STAPLER,270,1 ,$315.27 ,$204.93 ,$166.46 ,$283.74 ,$215.96 , N/A ,$184.75 ,$184.75 , N/A ,$258.52 ,$267.98 ,$283.74 ,$236.45 ,$220.69 ,$233.30 ,$283.74 ,$267.98 , N/A ,$267.98 , N/A ,$166.46 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691425,N/A,SUTURE 4-0 VICRYL PS-2 (12/BX),270,1 ,$9.16 ,$5.95 ,$4.84 ,$8.24 ,$6.27 , N/A ,$5.37 ,$5.37 , N/A ,$7.51 ,$7.79 ,$8.24 ,$6.87 ,$6.41 ,$6.78 ,$8.24 ,$7.79 , N/A ,$7.79 , N/A ,$4.84 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691428,N/A,SUTURE VICRYL 0 CT-2,270,1 ,$3.83 ,$2.49 ,$2.02 ,$3.45 ,$2.62 , N/A ,$2.24 ,$2.24 , N/A ,$3.14 ,$3.26 ,$3.45 ,$2.87 ,$2.68 ,$2.83 ,$3.45 ,$3.26 , N/A ,$3.26 , N/A ,$2.02 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691431,N/A,SUTURE VICRYL 4/0 PS-2,270,1 ,$17.50 ,$11.38 ,$9.24 ,$15.75 ,$11.99 , N/A ,$10.26 ,$10.26 , N/A ,$14.35 ,$14.88 ,$15.75 ,$13.13 ,$12.25 ,$12.95 ,$15.75 ,$14.88 , N/A ,$14.88 , N/A ,$9.24 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691444,N/A,DRAPE TOWEL OR WHITE ADH STRIP,270,1 ,$2.64 ,$1.72 ,$1.39 ,$2.38 ,$1.81 , N/A ,$1.55 ,$1.55 , N/A ,$2.16 ,$2.24 ,$2.38 ,$1.98 ,$1.85 ,$1.95 ,$2.38 ,$2.24 , N/A ,$2.24 , N/A ,$1.39 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691445,N/A,SUTURE PROLENE 4/0 PS-2,270,1 ,$20.30 ,$13.20 ,$10.72 ,$18.27 ,$13.91 , N/A ,$11.90 ,$11.90 , N/A ,$16.65 ,$17.26 ,$18.27 ,$15.23 ,$14.21 ,$15.02 ,$18.27 ,$17.26 , N/A ,$17.26 , N/A ,$10.72 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691446,N/A,SUTURE MONOCRYL 3/0 18 PS-2 UND MONO,270,1 ,$32.10 ,$20.87 ,$16.95 ,$28.89 ,$21.99 , N/A ,$18.81 ,$18.81 , N/A ,$26.32 ,$27.29 ,$28.89 ,$24.08 ,$22.47 ,$23.75 ,$28.89 ,$27.29 , N/A ,$27.29 , N/A ,$16.95 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691447,N/A,SUTURE MONOCRYL 4/0 18 PS-2 UNDYED,270,1 ,$11.44 ,$7.44 ,$6.04 ,$10.30 ,$7.84 , N/A ,$6.70 ,$6.70 , N/A ,$9.38 ,$9.72 ,$10.30 ,$8.58 ,$8.01 ,$8.47 ,$10.30 ,$9.72 , N/A ,$9.72 , N/A ,$6.04 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691452,N/A,LIGASURE 5mm BLUNT,270,1 ,"$1,236.68 ",$803.84 ,$652.97 ,"$1,113.01 ",$847.13 , N/A ,$724.69 ,$724.69 , N/A ,"$1,014.08 ","$1,051.18 ","$1,113.01 ",$927.51 ,$865.68 ,$915.14 ,"$1,113.01 ","$1,051.18 ", N/A ,"$1,051.18 ", N/A ,$652.97 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691453,N/A,"INDIA INK, SPOT MARKER",270,1 ,$108.00 ,$70.20 ,$57.02 ,$97.20 ,$73.98 , N/A ,$63.29 ,$63.29 , N/A ,$88.56 ,$91.80 ,$97.20 ,$81.00 ,$75.60 ,$79.92 ,$97.20 ,$91.80 , N/A ,$91.80 , N/A ,$57.02 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691454,N/A,SUTURE ETHILON 5/0 PC-3,270,1 ,$17.85 ,$11.60 ,$9.42 ,$16.07 ,$12.23 , N/A ,$10.46 ,$10.46 , N/A ,$14.64 ,$15.17 ,$16.07 ,$13.39 ,$12.50 ,$13.21 ,$16.07 ,$15.17 , N/A ,$15.17 , N/A ,$9.42 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691458,N/A,HEADREST SLOTTED RICHARD-TYPE,270,1 ,$56.50 ,$36.73 ,$29.83 ,$50.85 ,$38.70 , N/A ,$33.11 ,$33.11 , N/A ,$46.33 ,$48.03 ,$50.85 ,$42.38 ,$39.55 ,$41.81 ,$50.85 ,$48.03 , N/A ,$48.03 , N/A ,$29.83 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691459,N/A,SUTURE VICRYL 0 PLUS VIO UR-6,270,1 ,$4.90 ,$3.19 ,$2.59 ,$4.41 ,$3.36 , N/A ,$2.87 ,$2.87 , N/A ,$4.02 ,$4.17 ,$4.41 ,$3.68 ,$3.43 ,$3.63 ,$4.41 ,$4.17 , N/A ,$4.17 , N/A ,$2.59 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691460,N/A,SUTURE ETHILON 3/0 MONO PS-1,270,1 ,$9.77 ,$6.35 ,$5.16 ,$8.79 ,$6.69 , N/A ,$5.73 ,$5.73 , N/A ,$8.01 ,$8.30 ,$8.79 ,$7.33 ,$6.84 ,$7.23 ,$8.79 ,$8.30 , N/A ,$8.30 , N/A ,$5.16 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691463,A4264,ADIANA,278,1 ,"$1,950.00 ","$1,267.50 ","$1,142.70 ","$1,755.00 ","$1,335.75 ", N/A ,"$1,142.70 ","$1,142.70 ", N/A ,"$1,599.00 ","$1,657.50 ","$1,755.00 ","$1,462.50 ","$1,365.00 ","$1,443.00 ","$1,755.00 ","$1,657.50 ", N/A ,"$1,657.50 ", N/A ,"$1,170.00 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691464,N/A,"SUTURE VICRYL 0 36"" PLS UND CTX COATED",270,1 ,$8.15 ,$5.30 ,$4.30 ,$7.34 ,$5.58 , N/A ,$4.78 ,$4.78 , N/A ,$6.68 ,$6.93 ,$7.34 ,$6.11 ,$5.71 ,$6.03 ,$7.34 ,$6.93 , N/A ,$6.93 , N/A ,$4.30 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691466,N/A,SCISSORS LAPROSCOPIC DISP,270,1 ,$270.00 ,$175.50 ,$142.56 ,$243.00 ,$184.95 , N/A ,$158.22 ,$158.22 , N/A ,$221.40 ,$229.50 ,$243.00 ,$202.50 ,$189.00 ,$199.80 ,$243.00 ,$229.50 , N/A ,$229.50 , N/A ,$142.56 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691469,N/A,SUTURE PROLENE 0 CT-1,270,1 ,$5.81 ,$3.78 ,$3.07 ,$5.23 ,$3.98 , N/A ,$3.40 ,$3.40 , N/A ,$4.76 ,$4.94 ,$5.23 ,$4.36 ,$4.07 ,$4.30 ,$5.23 ,$4.94 , N/A ,$4.94 , N/A ,$3.07 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691492,N/A,SUTURE SILK 4/0 SH,270,1 ,$22.70 ,$14.76 ,$11.99 ,$20.43 ,$15.55 , N/A ,$13.30 ,$13.30 , N/A ,$18.61 ,$19.30 ,$20.43 ,$17.03 ,$15.89 ,$16.80 ,$20.43 ,$19.30 , N/A ,$19.30 , N/A ,$11.99 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691493,N/A,SUTURE PROLENE 3/0 PS-1,270,1 ,$16.30 ,$10.60 ,$8.61 ,$14.67 ,$11.17 , N/A ,$9.55 ,$9.55 , N/A ,$13.37 ,$13.86 ,$14.67 ,$12.23 ,$11.41 ,$12.06 ,$14.67 ,$13.86 , N/A ,$13.86 , N/A ,$8.61 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691501,N/A,TROCAR 5MM ADVANCED FIXATION 5MM X 100MM,270,1 ,$51.00 ,$33.15 ,$26.93 ,$45.90 ,$34.94 , N/A ,$29.89 ,$29.89 , N/A ,$41.82 ,$43.35 ,$45.90 ,$38.25 ,$35.70 ,$37.74 ,$45.90 ,$43.35 , N/A ,$43.35 , N/A ,$26.93 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691505,N/A,SUTURE VICRYL 0 CT-1,270,1 ,$7.76 ,$5.04 ,$4.10 ,$6.98 ,$5.32 , N/A ,$4.55 ,$4.55 , N/A ,$6.36 ,$6.60 ,$6.98 ,$5.82 ,$5.43 ,$5.74 ,$6.98 ,$6.60 , N/A ,$6.60 , N/A ,$4.10 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691507,N/A,SUTURE PROLENE 2/0 MO-6,270,1 ,$11.00 ,$7.15 ,$5.81 ,$9.90 ,$7.54 , N/A ,$6.45 ,$6.45 , N/A ,$9.02 ,$9.35 ,$9.90 ,$8.25 ,$7.70 ,$8.14 ,$9.90 ,$9.35 , N/A ,$9.35 , N/A ,$5.81 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691509,N/A,DELETE - SUTURE ETHILON 4/0 PS-2,270,1 ,$7.51 ,$4.88 ,$3.97 ,$6.76 ,$5.14 , N/A ,$4.40 ,$4.40 , N/A ,$6.16 ,$6.38 ,$6.76 ,$5.63 ,$5.26 ,$5.56 ,$6.76 ,$6.38 , N/A ,$6.38 , N/A ,$3.97 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691510,N/A,SUTURE VICRY 0 LIGAPAK LIGATING REEL,270,1 ,$5.21 ,$3.39 ,$2.75 ,$4.69 ,$3.57 , N/A ,$3.05 ,$3.05 , N/A ,$4.27 ,$4.43 ,$4.69 ,$3.91 ,$3.65 ,$3.86 ,$4.69 ,$4.43 , N/A ,$4.43 , N/A ,$2.75 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691523,N/A,"NEEDLE SPINAL TUOHY  20G X 6"" (25/CS)",270,1 ,$31.70 ,$20.61 ,$16.74 ,$28.53 ,$21.71 , N/A ,$18.58 ,$18.58 , N/A ,$25.99 ,$26.95 ,$28.53 ,$23.78 ,$22.19 ,$23.46 ,$28.53 ,$26.95 , N/A ,$26.95 , N/A ,$16.74 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691525,N/A,SUTURE VICRYL 3/0 PS-2,270,1 ,$18.19 ,$11.82 ,$9.60 ,$16.37 ,$12.46 , N/A ,$10.66 ,$10.66 , N/A ,$14.92 ,$15.46 ,$16.37 ,$13.64 ,$12.73 ,$13.46 ,$16.37 ,$15.46 , N/A ,$15.46 , N/A ,$9.60 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691527,N/A,SUTURE VICRYL 0 CT-1 MULTIPACK,270,1 ,$28.84 ,$18.75 ,$15.23 ,$25.96 ,$19.76 , N/A ,$16.90 ,$16.90 , N/A ,$23.65 ,$24.51 ,$25.96 ,$21.63 ,$20.19 ,$21.34 ,$25.96 ,$24.51 , N/A ,$24.51 , N/A ,$15.23 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691528,N/A,TROCAR 12MMX100MM SYS KII,270,1 ,$85.47 ,$55.56 ,$45.13 ,$76.92 ,$58.55 , N/A ,$50.09 ,$50.09 , N/A ,$70.09 ,$72.65 ,$76.92 ,$64.10 ,$59.83 ,$63.25 ,$76.92 ,$72.65 , N/A ,$72.65 , N/A ,$45.13 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691529,N/A,SUTURE VICRYL 3/0 SH,270,1 ,$7.36 ,$4.78 ,$3.89 ,$6.62 ,$5.04 , N/A ,$4.31 ,$4.31 , N/A ,$6.04 ,$6.26 ,$6.62 ,$5.52 ,$5.15 ,$5.45 ,$6.62 ,$6.26 , N/A ,$6.26 , N/A ,$3.89 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691541,N/A,SUTURE VICRYL 2/0 LIGAPACK LIGATING,270,1 ,$7.80 ,$5.07 ,$4.12 ,$7.02 ,$5.34 , N/A ,$4.57 ,$4.57 , N/A ,$6.40 ,$6.63 ,$7.02 ,$5.85 ,$5.46 ,$5.77 ,$7.02 ,$6.63 , N/A ,$6.63 , N/A ,$4.12 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691546,N/A,SUTURE CHROMIC 2/0 SURGICAL GUT CT-1,270,1 ,$13.87 ,$9.02 ,$7.32 ,$12.48 ,$9.50 , N/A ,$8.13 ,$8.13 , N/A ,$11.37 ,$11.79 ,$12.48 ,$10.40 ,$9.71 ,$10.26 ,$12.48 ,$11.79 , N/A ,$11.79 , N/A ,$7.32 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691548,N/A,SUTURE NUROLON 0 MO-7,270,1 ,$94.14 ,$61.19 ,$49.71 ,$84.73 ,$64.49 , N/A ,$55.17 ,$55.17 , N/A ,$77.19 ,$80.02 ,$84.73 ,$70.61 ,$65.90 ,$69.66 ,$84.73 ,$80.02 , N/A ,$80.02 , N/A ,$49.71 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691551,N/A,SLEEVE FOR TROCAR 5MM NEW APPLIED,270,1 ,$24.00 ,$15.60 ,$12.67 ,$21.60 ,$16.44 , N/A ,$14.06 ,$14.06 , N/A ,$19.68 ,$20.40 ,$21.60 ,$18.00 ,$16.80 ,$17.76 ,$21.60 ,$20.40 , N/A ,$20.40 , N/A ,$12.67 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691552,N/A,SUTURE VICRYL 4/0 PC-5,270,1 ,$16.60 ,$10.79 ,$8.76 ,$14.94 ,$11.37 , N/A ,$9.73 ,$9.73 , N/A ,$13.61 ,$14.11 ,$14.94 ,$12.45 ,$11.62 ,$12.28 ,$14.94 ,$14.11 , N/A ,$14.11 , N/A ,$8.76 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691554,N/A,SUTURE SILK 2/0 SH,270,1 ,$2.73 ,$1.77 ,$1.44 ,$2.46 ,$1.87 , N/A ,$1.60 ,$1.60 , N/A ,$2.24 ,$2.32 ,$2.46 ,$2.05 ,$1.91 ,$2.02 ,$2.46 ,$2.32 , N/A ,$2.32 , N/A ,$1.44 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691559,N/A,SUTURE PROLENE 0 MO-6,270,1 ,$11.50 ,$7.48 ,$6.07 ,$10.35 ,$7.88 , N/A ,$6.74 ,$6.74 , N/A ,$9.43 ,$9.78 ,$10.35 ,$8.63 ,$8.05 ,$8.51 ,$10.35 ,$9.78 , N/A ,$9.78 , N/A ,$6.07 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691563,N/A,PLUMEPEN ELECTROSURGICAL PENCIL,270,1 ,$67.25 ,$43.71 ,$35.51 ,$60.53 ,$46.07 , N/A ,$39.41 ,$39.41 , N/A ,$55.15 ,$57.16 ,$60.53 ,$50.44 ,$47.08 ,$49.77 ,$60.53 ,$57.16 , N/A ,$57.16 , N/A ,$35.51 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691568,N/A,SUTURE SILK 2/0 TIES,270,1 ,$10.28 ,$6.68 ,$5.43 ,$9.25 ,$7.04 , N/A ,$6.02 ,$6.02 , N/A ,$8.43 ,$8.74 ,$9.25 ,$7.71 ,$7.20 ,$7.61 ,$9.25 ,$8.74 , N/A ,$8.74 , N/A ,$5.43 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691581,N/A,SUTURE ETHILON 6/0 BLK MONO PC-1,270,1 ,$18.33 ,$11.91 ,$9.68 ,$16.50 ,$12.56 , N/A ,$10.74 ,$10.74 , N/A ,$15.03 ,$15.58 ,$16.50 ,$13.75 ,$12.83 ,$13.56 ,$16.50 ,$15.58 , N/A ,$15.58 , N/A ,$9.68 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691600,N/A,ESOPHAGIAL TEMP PROBES,270,1 ,$16.20 ,$10.53 ,$8.55 ,$14.58 ,$11.10 , N/A ,$9.49 ,$9.49 , N/A ,$13.28 ,$13.77 ,$14.58 ,$12.15 ,$11.34 ,$11.99 ,$14.58 ,$13.77 , N/A ,$13.77 , N/A ,$8.55 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691601,N/A,SKIN TEMP PROBES,270,1 ,$15.00 ,$9.75 ,$7.92 ,$13.50 ,$10.28 , N/A ,$8.79 ,$8.79 , N/A ,$12.30 ,$12.75 ,$13.50 ,$11.25 ,$10.50 ,$11.10 ,$13.50 ,$12.75 , N/A ,$12.75 , N/A ,$7.92 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691623,N/A,SUTURE CHROMIC 2/0 SH,270,1 ,$8.41 ,$5.47 ,$4.44 ,$7.57 ,$5.76 , N/A ,$4.93 ,$4.93 , N/A ,$6.90 ,$7.15 ,$7.57 ,$6.31 ,$5.89 ,$6.22 ,$7.57 ,$7.15 , N/A ,$7.15 , N/A ,$4.44 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691630,N/A,MALYUGIN RING,270,1 ,$525.00 ,$341.25 ,$277.20 ,$472.50 ,$359.63 , N/A ,$307.65 ,$307.65 , N/A ,$430.50 ,$446.25 ,$472.50 ,$393.75 ,$367.50 ,$388.50 ,$472.50 ,$446.25 , N/A ,$446.25 , N/A ,$277.20 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691634,N/A,TX1 TISSUE REMOVAL SYSTEM,270,1 ,"$2,067.00 ","$1,343.55 ","$1,091.38 ","$1,860.30 ","$1,415.90 ", N/A ,"$1,211.26 ","$1,211.26 ", N/A ,"$1,694.94 ","$1,756.95 ","$1,860.30 ","$1,550.25 ","$1,446.90 ","$1,529.58 ","$1,860.30 ","$1,756.95 ", N/A ,"$1,756.95 ", N/A ,"$1,091.38 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691649,N/A,SUTURE ETHILON 3/0 FS-1,270,1 ,$6.40 ,$4.16 ,$3.38 ,$5.76 ,$4.38 , N/A ,$3.75 ,$3.75 , N/A ,$5.25 ,$5.44 ,$5.76 ,$4.80 ,$4.48 ,$4.74 ,$5.76 ,$5.44 , N/A ,$5.44 , N/A ,$3.38 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691653,N/A,TUBE TRACH ORAL RAE 4.5 CUFFED,270,1 ,$14.80 ,$9.62 ,$7.81 ,$13.32 ,$10.14 , N/A ,$8.67 ,$8.67 , N/A ,$12.14 ,$12.58 ,$13.32 ,$11.10 ,$10.36 ,$10.95 ,$13.32 ,$12.58 , N/A ,$12.58 , N/A ,$7.81 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691659,N/A,"TOWEL OR, BLUE 4-PACK STERILE",270,1 ,$4.31 ,$2.80 ,$2.28 ,$3.88 ,$2.95 , N/A ,$2.53 ,$2.53 , N/A ,$3.53 ,$3.66 ,$3.88 ,$3.23 ,$3.02 ,$3.19 ,$3.88 ,$3.66 , N/A ,$3.66 , N/A ,$2.28 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691660,N/A,BLADE SURGICAL #10,270,1 ,$1.00 ,$0.65 ,$0.53 ,$0.90 ,$0.69 , N/A ,$0.59 ,$0.59 , N/A ,$0.82 ,$0.85 ,$0.90 ,$0.75 ,$0.70 ,$0.74 ,$0.90 ,$0.85 , N/A ,$0.85 , N/A ,$0.53 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691667,N/A,SUTURE 3-0 CHROMIC GUT SH-1,270,1 ,$12.10 ,$7.87 ,$6.39 ,$10.89 ,$8.29 , N/A ,$7.09 ,$7.09 , N/A ,$9.92 ,$10.29 ,$10.89 ,$9.08 ,$8.47 ,$8.95 ,$10.89 ,$10.29 , N/A ,$10.29 , N/A ,$6.39 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691675,N/A,PATIENT POSITIONING SYSTEM PIGAZZI,270,1 ,$310.17 ,$201.61 ,$163.77 ,$279.15 ,$212.47 , N/A ,$181.76 ,$181.76 , N/A ,$254.34 ,$263.64 ,$279.15 ,$232.63 ,$217.12 ,$229.53 ,$279.15 ,$263.64 , N/A ,$263.64 , N/A ,$163.77 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691676,N/A,LAP SPONGE COUNTER BAG 11X14,270,1 ,$1.20 ,$0.78 ,$0.63 ,$1.08 ,$0.82 , N/A ,$0.70 ,$0.70 , N/A ,$0.98 ,$1.02 ,$1.08 ,$0.90 ,$0.84 ,$0.89 ,$1.08 ,$1.02 , N/A ,$1.02 , N/A ,$0.63 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691678,N/A,BLADE SURGICAL #15 STERILE,270,1 ,$1.00 ,$0.65 ,$0.53 ,$0.90 ,$0.69 , N/A ,$0.59 ,$0.59 , N/A ,$0.82 ,$0.85 ,$0.90 ,$0.75 ,$0.70 ,$0.74 ,$0.90 ,$0.85 , N/A ,$0.85 , N/A ,$0.53 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691681,N/A,SUTURE SILK 3/0 PS-2,270,1 ,$12.80 ,$8.32 ,$6.76 ,$11.52 ,$8.77 , N/A ,$7.50 ,$7.50 , N/A ,$10.50 ,$10.88 ,$11.52 ,$9.60 ,$8.96 ,$9.47 ,$11.52 ,$10.88 , N/A ,$10.88 , N/A ,$6.76 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691689,N/A,SUTURE VICRYL 2/0 SH,270,1 ,$6.79 ,$4.41 ,$3.59 ,$6.11 ,$4.65 , N/A ,$3.98 ,$3.98 , N/A ,$5.57 ,$5.77 ,$6.11 ,$5.09 ,$4.75 ,$5.02 ,$6.11 ,$5.77 , N/A ,$5.77 , N/A ,$3.59 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691690,N/A,"NEEDLE BLUNT TIP 16GX1.5""",270,1 ,$7.77 ,$5.05 ,$4.10 ,$6.99 ,$5.32 , N/A ,$4.55 ,$4.55 , N/A ,$6.37 ,$6.60 ,$6.99 ,$5.83 ,$5.44 ,$5.75 ,$6.99 ,$6.60 , N/A ,$6.60 , N/A ,$4.10 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691693,N/A,GAS SAMPLING LINE,270,1 ,$2.30 ,$1.50 ,$1.21 ,$2.07 ,$1.58 , N/A ,$1.35 ,$1.35 , N/A ,$1.89 ,$1.96 ,$2.07 ,$1.73 ,$1.61 ,$1.70 ,$2.07 ,$1.96 , N/A ,$1.96 , N/A ,$1.21 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691695,N/A,CLIP APPLIER 5MM ETHICON,270,1 ,$354.19 ,$230.22 ,$187.01 ,$318.77 ,$242.62 , N/A ,$207.56 ,$207.56 , N/A ,$290.44 ,$301.06 ,$318.77 ,$265.64 ,$247.93 ,$262.10 ,$318.77 ,$301.06 , N/A ,$301.06 , N/A ,$187.01 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691696,N/A,SPECIMEN RETRIEVAL BAG ETHICON,270,1 ,$136.15 ,$88.50 ,$71.89 ,$122.54 ,$93.26 , N/A ,$79.78 ,$79.78 , N/A ,$111.64 ,$115.73 ,$122.54 ,$102.11 ,$95.31 ,$100.75 ,$122.54 ,$115.73 , N/A ,$115.73 , N/A ,$71.89 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691698,N/A,"TOURNIQUET CUFF SLEEVE 30""",270,1 ,$13.80 ,$8.97 ,$7.29 ,$12.42 ,$9.45 , N/A ,$8.09 ,$8.09 , N/A ,$11.32 ,$11.73 ,$12.42 ,$10.35 ,$9.66 ,$10.21 ,$12.42 ,$11.73 , N/A ,$11.73 , N/A ,$7.29 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691699,N/A,"TOURNIQUET CUFF SLEEVE 12""",270,1 ,$8.40 ,$5.46 ,$4.44 ,$7.56 ,$5.75 , N/A ,$4.92 ,$4.92 , N/A ,$6.89 ,$7.14 ,$7.56 ,$6.30 ,$5.88 ,$6.22 ,$7.56 ,$7.14 , N/A ,$7.14 , N/A ,$4.44 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691707,N/A,SUTURE ETHILON 4/0 P-3,270,1 ,$31.82 ,$20.68 ,$16.80 ,$28.64 ,$21.80 , N/A ,$18.65 ,$18.65 , N/A ,$26.09 ,$27.05 ,$28.64 ,$23.87 ,$22.27 ,$23.55 ,$28.64 ,$27.05 , N/A ,$27.05 , N/A ,$16.80 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691710,N/A,"PADDING CAST WEBRIL 6""X12FT STERILE",270,1 ,$9.76 ,$6.34 ,$5.15 ,$8.78 ,$6.69 , N/A ,$5.72 ,$5.72 , N/A ,$8.00 ,$8.30 ,$8.78 ,$7.32 ,$6.83 ,$7.22 ,$8.78 ,$8.30 , N/A ,$8.30 , N/A ,$5.15 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691732,N/A,SUTURE VICRYL 3/0 PLUS,270,1 ,$5.20 ,$3.38 ,$2.75 ,$4.68 ,$3.56 , N/A ,$3.05 ,$3.05 , N/A ,$4.26 ,$4.42 ,$4.68 ,$3.90 ,$3.64 ,$3.85 ,$4.68 ,$4.42 , N/A ,$4.42 , N/A ,$2.75 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691742,N/A,MANIFOLD 4-PART,270,1 ,$43.20 ,$28.08 ,$22.81 ,$38.88 ,$29.59 , N/A ,$25.32 ,$25.32 , N/A ,$35.42 ,$36.72 ,$38.88 ,$32.40 ,$30.24 ,$31.97 ,$38.88 ,$36.72 , N/A ,$36.72 , N/A ,$22.81 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691743,N/A,SUTURE VICRYL 4/0 P-3,270,1 ,$10.30 ,$6.70 ,$5.44 ,$9.27 ,$7.06 , N/A ,$6.04 ,$6.04 , N/A ,$8.45 ,$8.76 ,$9.27 ,$7.73 ,$7.21 ,$7.62 ,$9.27 ,$8.76 , N/A ,$8.76 , N/A ,$5.44 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691745,N/A,"PROBE APC, 2.3mm DIA 220cm SIDE FIRE",270,1 ,$674.85 ,$438.65 ,$356.32 ,$607.37 ,$462.27 , N/A ,$395.46 ,$395.46 , N/A ,$553.38 ,$573.62 ,$607.37 ,$506.14 ,$472.40 ,$499.39 ,$607.37 ,$573.62 , N/A ,$573.62 , N/A ,$356.32 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691748,N/A,SNARE 13MM HEXAGONAL,270,1 ,$39.00 ,$25.35 ,$20.59 ,$35.10 ,$26.72 , N/A ,$22.85 ,$22.85 , N/A ,$31.98 ,$33.15 ,$35.10 ,$29.25 ,$27.30 ,$28.86 ,$35.10 ,$33.15 , N/A ,$33.15 , N/A ,$20.59 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691752,N/A,NEEDLE SUTURE #5 MAYO 1/2 CIRCLE,270,1 ,$10.00 ,$6.50 ,$5.28 ,$9.00 ,$6.85 , N/A ,$5.86 ,$5.86 , N/A ,$8.20 ,$8.50 ,$9.00 ,$7.50 ,$7.00 ,$7.40 ,$9.00 ,$8.50 , N/A ,$8.50 , N/A ,$5.28 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691764,N/A,UTERINE MANIPULATOR CUP - MEDIUM,270,1 ,$226.91 ,$147.49 ,$119.81 ,$204.22 ,$155.43 , N/A ,$132.97 ,$132.97 , N/A ,$186.07 ,$192.87 ,$204.22 ,$170.18 ,$158.84 ,$167.91 ,$204.22 ,$192.87 , N/A ,$192.87 , N/A ,$119.81 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691766,N/A,"DRAPE, LAP CHOLE",270,1 ,$29.28 ,$19.03 ,$15.46 ,$26.35 ,$20.06 , N/A ,$17.16 ,$17.16 , N/A ,$24.01 ,$24.89 ,$26.35 ,$21.96 ,$20.50 ,$21.67 ,$26.35 ,$24.89 , N/A ,$24.89 , N/A ,$15.46 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691777,N/A,DISTAL ATTACHMENT DISPOSABLE,270,1 ,$88.70 ,$57.66 ,$46.83 ,$79.83 ,$60.76 , N/A ,$51.98 ,$51.98 , N/A ,$72.73 ,$75.40 ,$79.83 ,$66.53 ,$62.09 ,$65.64 ,$79.83 ,$75.40 , N/A ,$75.40 , N/A ,$46.83 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691778,N/A,"BANDAGE COBAN 1""X5 YD",270,1 ,$1.60 ,$1.04 ,$0.84 ,$1.44 ,$1.10 , N/A ,$0.94 ,$0.94 , N/A ,$1.31 ,$1.36 ,$1.44 ,$1.20 ,$1.12 ,$1.18 ,$1.44 ,$1.36 , N/A ,$1.36 , N/A ,$0.84 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691811,N/A,DRAPE C-ARM UNIVERSAL 42X74,270,1 ,$10.58 ,$6.88 ,$5.59 ,$9.52 ,$7.25 , N/A ,$6.20 ,$6.20 , N/A ,$8.68 ,$8.99 ,$9.52 ,$7.94 ,$7.41 ,$7.83 ,$9.52 ,$8.99 , N/A ,$8.99 , N/A ,$5.59 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691820,N/A,SNARE 10MM POLYPECTOMY,270,1 ,$26.25 ,$17.06 ,$13.86 ,$23.63 ,$17.98 , N/A ,$15.38 ,$15.38 , N/A ,$21.53 ,$22.31 ,$23.63 ,$19.69 ,$18.38 ,$19.43 ,$23.63 ,$22.31 , N/A ,$22.31 , N/A ,$13.86 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691828,N/A,"PADDING UNDERCAST 3"" WEBRIL NS",270,1 ,$1.80 ,$1.17 ,$0.95 ,$1.62 ,$1.23 , N/A ,$1.05 ,$1.05 , N/A ,$1.48 ,$1.53 ,$1.62 ,$1.35 ,$1.26 ,$1.33 ,$1.62 ,$1.53 , N/A ,$1.53 , N/A ,$0.95 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691835,N/A,"BANDAGE COBAN 3""X5YD STERILE",270,1 ,$4.37 ,$2.84 ,$2.31 ,$3.93 ,$2.99 , N/A ,$2.56 ,$2.56 , N/A ,$3.58 ,$3.71 ,$3.93 ,$3.28 ,$3.06 ,$3.23 ,$3.93 ,$3.71 , N/A ,$3.71 , N/A ,$2.31 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691837,N/A,COLPOTMIZER CUP SZ 3.5cm,270,1 ,$314.50 ,$204.43 ,$166.06 ,$283.05 ,$215.43 , N/A ,$184.30 ,$184.30 , N/A ,$257.89 ,$267.33 ,$283.05 ,$235.88 ,$220.15 ,$232.73 ,$283.05 ,$267.33 , N/A ,$267.33 , N/A ,$166.06 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691852,N/A,DRAPE BUTTOCK W/ FLUID LOSS,270,1 ,$6.98 ,$4.54 ,$3.69 ,$6.28 ,$4.78 , N/A ,$4.09 ,$4.09 , N/A ,$5.72 ,$5.93 ,$6.28 ,$5.24 ,$4.89 ,$5.17 ,$6.28 ,$5.93 , N/A ,$5.93 , N/A ,$3.69 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691862,N/A,VESSEL LOOPS WHITE MAXI,270,1 ,$7.23 ,$4.70 ,$3.82 ,$6.51 ,$4.95 , N/A ,$4.24 ,$4.24 , N/A ,$5.93 ,$6.15 ,$6.51 ,$5.42 ,$5.06 ,$5.35 ,$6.51 ,$6.15 , N/A ,$6.15 , N/A ,$3.82 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691864,N/A,"BLADE, LONG MEDIUM 31X9MM",270,1 ,$75.12 ,$48.83 ,$39.66 ,$67.61 ,$51.46 , N/A ,$44.02 ,$44.02 , N/A ,$61.60 ,$63.85 ,$67.61 ,$56.34 ,$52.58 ,$55.59 ,$67.61 ,$63.85 , N/A ,$63.85 , N/A ,$39.66 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691910,N/A,"MAYO STAND COVER 23"" W",270,1 ,$2.38 ,$1.55 ,$1.26 ,$2.14 ,$1.63 , N/A ,$1.39 ,$1.39 , N/A ,$1.95 ,$2.02 ,$2.14 ,$1.79 ,$1.67 ,$1.76 ,$2.14 ,$2.02 , N/A ,$2.02 , N/A ,$1.26 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),691937,N/A,"NET, RESCUE, ENDOCHOICE",270,1 ,$255.00 ,$165.75 ,$134.64 ,$229.50 ,$174.68 , N/A ,$149.43 ,$149.43 , N/A ,$209.10 ,$216.75 ,$229.50 ,$191.25 ,$178.50 ,$188.70 ,$229.50 ,$216.75 , N/A ,$216.75 , N/A ,$134.64 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692000,N/A,SENSOR SPO2 NEONAT/ADULT OXIMAX,270,1 ,$47.44 ,$30.84 ,$25.05 ,$42.70 ,$32.50 , N/A ,$27.80 ,$27.80 , N/A ,$38.90 ,$40.32 ,$42.70 ,$35.58 ,$33.21 ,$35.11 ,$42.70 ,$40.32 , N/A ,$40.32 , N/A ,$25.05 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692013,N/A,"SUTURE, PLIABILIZED, MONO, BLK, 5.0",270,1 ,$8.95 ,$5.82 ,$4.73 ,$8.06 ,$6.13 , N/A ,$5.24 ,$5.24 , N/A ,$7.34 ,$7.61 ,$8.06 ,$6.71 ,$6.27 ,$6.62 ,$8.06 ,$7.61 , N/A ,$7.61 , N/A ,$4.73 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692037,N/A,SUTURE MONOSOF 3/0 P-14 ETHILON PS-1,270,1 ,$8.16 ,$5.30 ,$4.31 ,$7.34 ,$5.59 , N/A ,$4.78 ,$4.78 , N/A ,$6.69 ,$6.94 ,$7.34 ,$6.12 ,$5.71 ,$6.04 ,$7.34 ,$6.94 , N/A ,$6.94 , N/A ,$4.31 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692039,N/A,SUTURE ETHILON 4/0 PS-2,270,1 ,$16.10 ,$10.47 ,$8.50 ,$14.49 ,$11.03 , N/A ,$9.43 ,$9.43 , N/A ,$13.20 ,$13.69 ,$14.49 ,$12.08 ,$11.27 ,$11.91 ,$14.49 ,$13.69 , N/A ,$13.69 , N/A ,$8.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692043,N/A,SUTURE ETHILON 5/0 PS-3,270,1 ,$7.34 ,$4.77 ,$3.88 ,$6.61 ,$5.03 , N/A ,$4.30 ,$4.30 , N/A ,$6.02 ,$6.24 ,$6.61 ,$5.51 ,$5.14 ,$5.43 ,$6.61 ,$6.24 , N/A ,$6.24 , N/A ,$3.88 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692044,N/A,SUTURE ETHILON 6/0 PS-3,270,1 ,$14.92 ,$9.70 ,$7.88 ,$13.43 ,$10.22 , N/A ,$8.74 ,$8.74 , N/A ,$12.23 ,$12.68 ,$13.43 ,$11.19 ,$10.44 ,$11.04 ,$13.43 ,$12.68 , N/A ,$12.68 , N/A ,$7.88 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692160,N/A,SUTURE VICRYL 8X18 VIOLET CT-2,270,1 ,$28.15 ,$18.30 ,$14.86 ,$25.34 ,$19.28 , N/A ,$16.50 ,$16.50 , N/A ,$23.08 ,$23.93 ,$25.34 ,$21.11 ,$19.71 ,$20.83 ,$25.34 ,$23.93 , N/A ,$23.93 , N/A ,$14.86 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692166,N/A,SUTURE 5-0 SURGIPRO P-12,270,1 ,$28.50 ,$18.53 ,$15.05 ,$25.65 ,$19.52 , N/A ,$16.70 ,$16.70 , N/A ,$23.37 ,$24.23 ,$25.65 ,$21.38 ,$19.95 ,$21.09 ,$25.65 ,$24.23 , N/A ,$24.23 , N/A ,$15.05 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692172,N/A,SUTURE 4-0 ETHILON,270,1 ,$14.30 ,$9.30 ,$7.55 ,$12.87 ,$9.80 , N/A ,$8.38 ,$8.38 , N/A ,$11.73 ,$12.16 ,$12.87 ,$10.73 ,$10.01 ,$10.58 ,$12.87 ,$12.16 , N/A ,$12.16 , N/A ,$7.55 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692186,N/A,SUTURE 6-0 VICRYL PC-3 UNDYED,270,1 ,$19.03 ,$12.37 ,$10.05 ,$17.13 ,$13.04 , N/A ,$11.15 ,$11.15 , N/A ,$15.60 ,$16.18 ,$17.13 ,$14.27 ,$13.32 ,$14.08 ,$17.13 ,$16.18 , N/A ,$16.18 , N/A ,$10.05 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692216,N/A,SUTURE VICRYL 4/0 FS-2,270,1 ,$5.14 ,$3.34 ,$2.71 ,$4.63 ,$3.52 , N/A ,$3.01 ,$3.01 , N/A ,$4.21 ,$4.37 ,$4.63 ,$3.86 ,$3.60 ,$3.80 ,$4.63 ,$4.37 , N/A ,$4.37 , N/A ,$2.71 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692218,N/A,SUTURE 1 PROLENE,270,1 ,$7.70 ,$5.01 ,$4.07 ,$6.93 ,$5.27 , N/A ,$4.51 ,$4.51 , N/A ,$6.31 ,$6.55 ,$6.93 ,$5.78 ,$5.39 ,$5.70 ,$6.93 ,$6.55 , N/A ,$6.55 , N/A ,$4.07 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692237,N/A,SUTURE 4-0 MONOCRYL UNDYED MONOFILAMENT,270,1 ,$11.75 ,$7.64 ,$6.20 ,$10.58 ,$8.05 , N/A ,$6.89 ,$6.89 , N/A ,$9.64 ,$9.99 ,$10.58 ,$8.81 ,$8.23 ,$8.70 ,$10.58 ,$9.99 , N/A ,$9.99 , N/A ,$6.20 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692258,N/A,"SUTURE 6-0 MONOSOF P-13 18""",270,1 ,$9.80 ,$6.37 ,$5.17 ,$8.82 ,$6.71 , N/A ,$5.74 ,$5.74 , N/A ,$8.04 ,$8.33 ,$8.82 ,$7.35 ,$6.86 ,$7.25 ,$8.82 ,$8.33 , N/A ,$8.33 , N/A ,$5.17 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692270,N/A,SUTURE 4-0 MONOCRYL SH,270,1 ,$4.64 ,$3.02 ,$2.45 ,$4.18 ,$3.18 , N/A ,$2.72 ,$2.72 , N/A ,$3.80 ,$3.94 ,$4.18 ,$3.48 ,$3.25 ,$3.43 ,$4.18 ,$3.94 , N/A ,$3.94 , N/A ,$2.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692302,N/A,SUTURE 1 VICRYL CT-1 TAPER,270,1 ,$5.70 ,$3.71 ,$3.01 ,$5.13 ,$3.90 , N/A ,$3.34 ,$3.34 , N/A ,$4.67 ,$4.85 ,$5.13 ,$4.28 ,$3.99 ,$4.22 ,$5.13 ,$4.85 , N/A ,$4.85 , N/A ,$3.01 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692374,N/A,DELETE - SUTURE VICRYL 2/0 CT-1,270,1 ,$7.31 ,$4.75 ,$3.86 ,$6.58 ,$5.01 , N/A ,$4.28 ,$4.28 , N/A ,$5.99 ,$6.21 ,$6.58 ,$5.48 ,$5.12 ,$5.41 ,$6.58 ,$6.21 , N/A ,$6.21 , N/A ,$3.86 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692376,N/A,SUTURE VICRYL 3/0 36 CT-1 COATED,270,1 ,$7.87 ,$5.12 ,$4.16 ,$7.08 ,$5.39 , N/A ,$4.61 ,$4.61 , N/A ,$6.45 ,$6.69 ,$7.08 ,$5.90 ,$5.51 ,$5.82 ,$7.08 ,$6.69 , N/A ,$6.69 , N/A ,$4.16 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692382,N/A,"SUTURE NYLON, 2.0, PS-2",270,1 ,$7.34 ,$4.77 ,$3.88 ,$6.61 ,$5.03 , N/A ,$4.30 ,$4.30 , N/A ,$6.02 ,$6.24 ,$6.61 ,$5.51 ,$5.14 ,$5.43 ,$6.61 ,$6.24 , N/A ,$6.24 , N/A ,$3.88 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),692384,N/A,"SUTURE, PROLENE, 3-0",270,1 ,$12.32 ,$8.01 ,$6.51 ,$11.09 ,$8.44 , N/A ,$7.22 ,$7.22 , N/A ,$10.10 ,$10.47 ,$11.09 ,$9.24 ,$8.62 ,$9.12 ,$11.09 ,$10.47 , N/A ,$10.47 , N/A ,$6.51 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693004,N/A,TRI-FUNNEL PEG TUBE SZ 16 FR (G-TUBE),270,1 ,$150.00 ,$97.50 ,$79.20 ,$135.00 ,$102.75 , N/A ,$87.90 ,$87.90 , N/A ,$123.00 ,$127.50 ,$135.00 ,$112.50 ,$105.00 ,$111.00 ,$135.00 ,$127.50 , N/A ,$127.50 , N/A ,$79.20 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693008,C2625,BILIARY STENT 5cm 10fr,278,1 ,$270.48 ,$175.81 ,$158.50 ,$243.43 ,$185.28 , N/A ,$158.50 ,$158.50 , N/A ,$221.79 ,$229.91 ,$243.43 ,$202.86 ,$189.34 ,$200.16 ,$243.43 ,$229.91 , N/A ,$229.91 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693016,C1781,MESH VENTRALEX LARGE CIRCLE HERNIA PATCH,278,1 ,"$1,798.80 ","$1,169.22 ","$1,054.10 ","$1,618.92 ","$1,232.18 ", N/A ,"$1,054.10 ","$1,054.10 ", N/A ,"$1,475.02 ","$1,528.98 ","$1,618.92 ","$1,349.10 ","$1,259.16 ","$1,331.11 ","$1,618.92 ","$1,528.98 ", N/A ,"$1,528.98 ", N/A ,"$1,079.28 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693040,N/A,"PROBE APC, 2.3mm DIA 220cm LENGTH",270,1 ,$641.85 ,$417.20 ,$338.90 ,$577.67 ,$439.67 , N/A ,$376.12 ,$376.12 , N/A ,$526.32 ,$545.57 ,$577.67 ,$481.39 ,$449.30 ,$474.97 ,$577.67 ,$545.57 , N/A ,$545.57 , N/A ,$338.90 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693044,N/A,"PROVISC, .85ml",270,1 ,$126.00 ,$81.90 ,$66.53 ,$113.40 ,$86.31 , N/A ,$73.84 ,$73.84 , N/A ,$103.32 ,$107.10 ,$113.40 ,$94.50 ,$88.20 ,$93.24 ,$113.40 ,$107.10 , N/A ,$107.10 , N/A ,$66.53 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693047,C1769,"GUIDEWIRE URO, 150CM",278,1 ,$92.98 ,$60.44 ,$54.49 ,$83.68 ,$63.69 , N/A ,$54.49 ,$54.49 , N/A ,$76.24 ,$79.03 ,$83.68 ,$69.74 ,$65.09 ,$68.81 ,$83.68 ,$79.03 , N/A ,$79.03 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693050,C1781,"MESH PLUG PER FIX, LARGE",278,1 ,$426.30 ,$277.10 ,$249.81 ,$383.67 ,$292.02 , N/A ,$249.81 ,$249.81 , N/A ,$349.57 ,$362.36 ,$383.67 ,$319.73 ,$298.41 ,$315.46 ,$383.67 ,$362.36 , N/A ,$362.36 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693051,C1781,"MESH PLUG PER FIX, MEDIUM",278,1 ,$417.90 ,$271.64 ,$244.89 ,$376.11 ,$286.26 , N/A ,$244.89 ,$244.89 , N/A ,$342.68 ,$355.22 ,$376.11 ,$313.43 ,$292.53 ,$309.25 ,$376.11 ,$355.22 , N/A ,$355.22 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693052,C1781,"MESH PLUG PER FIX, XLRG",278,1 ,$513.00 ,$333.45 ,$300.62 ,$461.70 ,$351.41 , N/A ,$300.62 ,$300.62 , N/A ,$420.66 ,$436.05 ,$461.70 ,$384.75 ,$359.10 ,$379.62 ,$461.70 ,$436.05 , N/A ,$436.05 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693056,N/A,ABSORBA TACK 30,270,1 ,"$1,742.50 ","$1,132.63 ",$920.04 ,"$1,568.25 ","$1,193.61 ", N/A ,"$1,021.11 ","$1,021.11 ", N/A ,"$1,428.85 ","$1,481.13 ","$1,568.25 ","$1,306.88 ","$1,219.75 ","$1,289.45 ","$1,568.25 ","$1,481.13 ", N/A ,"$1,481.13 ", N/A ,$920.04 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693057,N/A,"CATHETER 24FR, 30CC 3-WAY",270,1 ,$48.80 ,$31.72 ,$25.77 ,$43.92 ,$33.43 , N/A ,$28.60 ,$28.60 , N/A ,$40.02 ,$41.48 ,$43.92 ,$36.60 ,$34.16 ,$36.11 ,$43.92 ,$41.48 , N/A ,$41.48 , N/A ,$25.77 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693070,N/A,CUTTER ECHELON RELOAD 60mm,270,1 ,$363.52 ,$236.29 ,$191.94 ,$327.17 ,$249.01 , N/A ,$213.02 ,$213.02 , N/A ,$298.09 ,$308.99 ,$327.17 ,$272.64 ,$254.46 ,$269.00 ,$327.17 ,$308.99 , N/A ,$308.99 , N/A ,$191.94 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693072,N/A,RETRIEVAL BALLOON EXTRACTOR 9-12 MM,270,1 ,$426.00 ,$276.90 ,$224.93 ,$383.40 ,$291.81 , N/A ,$249.64 ,$249.64 , N/A ,$349.32 ,$362.10 ,$383.40 ,$319.50 ,$298.20 ,$315.24 ,$383.40 ,$362.10 , N/A ,$362.10 , N/A ,$224.93 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693074,N/A,RETRIEVAL BALLOON EXTRACTOR 12-15MM,270,1 ,$426.00 ,$276.90 ,$224.93 ,$383.40 ,$291.81 , N/A ,$249.64 ,$249.64 , N/A ,$349.32 ,$362.10 ,$383.40 ,$319.50 ,$298.20 ,$315.24 ,$383.40 ,$362.10 , N/A ,$362.10 , N/A ,$224.93 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693075,C2625,STENT 7FR 5CM,278,1 ,$270.48 ,$175.81 ,$158.50 ,$243.43 ,$185.28 , N/A ,$158.50 ,$158.50 , N/A ,$221.79 ,$229.91 ,$243.43 ,$202.86 ,$189.34 ,$200.16 ,$243.43 ,$229.91 , N/A ,$229.91 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693086,N/A,NOVASURE DEVICE,270,1 ,"$3,357.67 ","$2,182.49 ","$1,772.85 ","$3,021.90 ","$2,300.00 ", N/A ,"$1,967.59 ","$1,967.59 ", N/A ,"$2,753.29 ","$2,854.02 ","$3,021.90 ","$2,518.25 ","$2,350.37 ","$2,484.68 ","$3,021.90 ","$2,854.02 ", N/A ,"$2,854.02 ", N/A ,"$1,772.85 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693099,N/A,BRUSH CYTOLOGY CELLEBRITY 2.0MMX1.9OD,270,1 ,$30.36 ,$19.73 ,$16.03 ,$27.32 ,$20.80 , N/A ,$17.79 ,$17.79 , N/A ,$24.90 ,$25.81 ,$27.32 ,$22.77 ,$21.25 ,$22.47 ,$27.32 ,$25.81 , N/A ,$25.81 , N/A ,$16.03 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693106,N/A,ARISTA HEMOSTATIC AGENT,270,1 ,$612.00 ,$397.80 ,$323.14 ,$550.80 ,$419.22 , N/A ,$358.63 ,$358.63 , N/A ,$501.84 ,$520.20 ,$550.80 ,$459.00 ,$428.40 ,$452.88 ,$550.80 ,$520.20 , N/A ,$520.20 , N/A ,$323.14 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693107,N/A,ARISTA FLEXTIP APPLICATOR,270,1 ,$112.20 ,$72.93 ,$59.24 ,$100.98 ,$76.86 , N/A ,$65.75 ,$65.75 , N/A ,$92.00 ,$95.37 ,$100.98 ,$84.15 ,$78.54 ,$83.03 ,$100.98 ,$95.37 , N/A ,$95.37 , N/A ,$59.24 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693108,N/A,ARISTA RIGIDTIP APPLICATOR,270,1 ,$150.00 ,$97.50 ,$79.20 ,$135.00 ,$102.75 , N/A ,$87.90 ,$87.90 , N/A ,$123.00 ,$127.50 ,$135.00 ,$112.50 ,$105.00 ,$111.00 ,$135.00 ,$127.50 , N/A ,$127.50 , N/A ,$79.20 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693109,N/A,PLUME FILTRATION DEVICE,270,1 ,$80.39 ,$52.25 ,$42.45 ,$72.35 ,$55.07 , N/A ,$47.11 ,$47.11 , N/A ,$65.92 ,$68.33 ,$72.35 ,$60.29 ,$56.27 ,$59.49 ,$72.35 ,$68.33 , N/A ,$68.33 , N/A ,$42.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693118,N/A,LIGASURE IMPACT,270,1 ,"$2,373.77 ","$1,542.95 ","$1,253.35 ","$2,136.39 ","$1,626.03 ", N/A ,"$1,391.03 ","$1,391.03 ", N/A ,"$1,946.49 ","$2,017.70 ","$2,136.39 ","$1,780.33 ","$1,661.64 ","$1,756.59 ","$2,136.39 ","$2,017.70 ", N/A ,"$2,017.70 ", N/A ,"$1,253.35 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693138,C1769,HYDRATOME RX 44 X 30 CM (GUIDEWIRE),278,1 ,"$1,170.00 ",$760.50 ,$685.62 ,"$1,053.00 ",$801.45 , N/A ,$685.62 ,$685.62 , N/A ,$959.40 ,$994.50 ,"$1,053.00 ",$877.50 ,$819.00 ,$865.80 ,"$1,053.00 ",$994.50 , N/A ,$994.50 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693139,N/A,GOLD PROBE INJECTION CATHETER 7FR,270,1 ,$593.40 ,$385.71 ,$313.32 ,$534.06 ,$406.48 , N/A ,$347.73 ,$347.73 , N/A ,$486.59 ,$504.39 ,$534.06 ,$445.05 ,$415.38 ,$439.12 ,$534.06 ,$504.39 , N/A ,$504.39 , N/A ,$313.32 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693140,N/A,PEG PULL SAFETY 20 FR,270,1 ,$456.00 ,$296.40 ,$240.77 ,$410.40 ,$312.36 , N/A ,$267.22 ,$267.22 , N/A ,$373.92 ,$387.60 ,$410.40 ,$342.00 ,$319.20 ,$337.44 ,$410.40 ,$387.60 , N/A ,$387.60 , N/A ,$240.77 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693166,C1781,"MESH LIGHT PLUG PER FIX, MED",278,1 ,"$1,041.00 ",$676.65 ,$610.03 ,$936.90 ,$713.09 , N/A ,$610.03 ,$610.03 , N/A ,$853.62 ,$884.85 ,$936.90 ,$780.75 ,$728.70 ,$770.34 ,$936.90 ,$884.85 , N/A ,$884.85 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693168,C1769,HYDRATOME RX 44 X 20 CM (GUIDEWIRE),278,1 ,"$1,170.00 ",$760.50 ,$685.62 ,"$1,053.00 ",$801.45 , N/A ,$685.62 ,$685.62 , N/A ,$959.40 ,$994.50 ,"$1,053.00 ",$877.50 ,$819.00 ,$865.80 ,"$1,053.00 ",$994.50 , N/A ,$994.50 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693175,N/A,"SUTURE, V-LOC 180",270,1 ,$56.70 ,$36.86 ,$29.94 ,$51.03 ,$38.84 , N/A ,$33.23 ,$33.23 , N/A ,$46.49 ,$48.20 ,$51.03 ,$42.53 ,$39.69 ,$41.96 ,$51.03 ,$48.20 , N/A ,$48.20 , N/A ,$29.94 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693176,C1781,MESH SURG PROGRIP 15X10,278,1 ,"$1,149.48 ",$747.16 ,$673.60 ,"$1,034.53 ",$787.39 , N/A ,$673.60 ,$673.60 , N/A ,$942.57 ,$977.06 ,"$1,034.53 ",$862.11 ,$804.64 ,$850.62 ,"$1,034.53 ",$977.06 , N/A ,$977.06 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),693177,N/A,"WOUND VAC, NEGATIVE PRESSURE",270,1 ,"$1,158.30 ",$752.90 ,$611.58 ,"$1,042.47 ",$793.44 , N/A ,$678.76 ,$678.76 , N/A ,$949.81 ,$984.56 ,"$1,042.47 ",$868.73 ,$810.81 ,$857.14 ,"$1,042.47 ",$984.56 , N/A ,$984.56 , N/A ,$611.58 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694004,N/A,AMBU BAG INFANT (RESUSCITATOR),270,1 ,$66.04 ,$42.93 ,$34.87 ,$59.44 ,$45.24 , N/A ,$38.70 ,$38.70 , N/A ,$54.15 ,$56.13 ,$59.44 ,$49.53 ,$46.23 ,$48.87 ,$59.44 ,$56.13 , N/A ,$56.13 , N/A ,$34.87 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694026,N/A,SLING ARM SMALL,270,1 ,$6.87 ,$4.47 ,$3.63 ,$6.18 ,$4.71 , N/A ,$4.03 ,$4.03 , N/A ,$5.63 ,$5.84 ,$6.18 ,$5.15 ,$4.81 ,$5.08 ,$6.18 ,$5.84 , N/A ,$5.84 , N/A ,$3.63 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694055,N/A,"SPLINT, MAS-ALLEN HAND",270,1 ,$34.40 ,$22.36 ,$18.16 ,$30.96 ,$23.56 , N/A ,$20.16 ,$20.16 , N/A ,$28.21 ,$29.24 ,$30.96 ,$25.80 ,$24.08 ,$25.46 ,$30.96 ,$29.24 , N/A ,$29.24 , N/A ,$18.16 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694070,N/A,POST OP SHOE MEN LARGE,270,1 ,$9.15 ,$5.95 ,$4.83 ,$8.24 ,$6.27 , N/A ,$5.36 ,$5.36 , N/A ,$7.50 ,$7.78 ,$8.24 ,$6.86 ,$6.41 ,$6.77 ,$8.24 ,$7.78 , N/A ,$7.78 , N/A ,$4.83 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694071,N/A,POST OP SHOE MEN MEDIUM,270,1 ,$9.15 ,$5.95 ,$4.83 ,$8.24 ,$6.27 , N/A ,$5.36 ,$5.36 , N/A ,$7.50 ,$7.78 ,$8.24 ,$6.86 ,$6.41 ,$6.77 ,$8.24 ,$7.78 , N/A ,$7.78 , N/A ,$4.83 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694072,N/A,POST OP SHOE MEN SMALL,270,1 ,$9.03 ,$5.87 ,$4.77 ,$8.13 ,$6.19 , N/A ,$5.29 ,$5.29 , N/A ,$7.40 ,$7.68 ,$8.13 ,$6.77 ,$6.32 ,$6.68 ,$8.13 ,$7.68 , N/A ,$7.68 , N/A ,$4.77 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694073,N/A,POST OP SHOE WOMEN LARGE,270,1 ,$25.25 ,$16.41 ,$13.33 ,$22.73 ,$17.30 , N/A ,$14.80 ,$14.80 , N/A ,$20.71 ,$21.46 ,$22.73 ,$18.94 ,$17.68 ,$18.69 ,$22.73 ,$21.46 , N/A ,$21.46 , N/A ,$13.33 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694074,N/A,POST OP SHOE WOMEN MEDIUM,270,1 ,$20.40 ,$13.26 ,$10.77 ,$18.36 ,$13.97 , N/A ,$11.95 ,$11.95 , N/A ,$16.73 ,$17.34 ,$18.36 ,$15.30 ,$14.28 ,$15.10 ,$18.36 ,$17.34 , N/A ,$17.34 , N/A ,$10.77 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694077,N/A,CERVICAL COLLAR FOAM MED,270,1 ,$15.40 ,$10.01 ,$8.13 ,$13.86 ,$10.55 , N/A ,$9.02 ,$9.02 , N/A ,$12.63 ,$13.09 ,$13.86 ,$11.55 ,$10.78 ,$11.40 ,$13.86 ,$13.09 , N/A ,$13.09 , N/A ,$8.13 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694110,N/A,DRAIN CHEST PLEUREVAC DRY,270,1 ,$125.30 ,$81.45 ,$66.16 ,$112.77 ,$85.83 , N/A ,$73.43 ,$73.43 , N/A ,$102.75 ,$106.51 ,$112.77 ,$93.98 ,$87.71 ,$92.72 ,$112.77 ,$106.51 , N/A ,$106.51 , N/A ,$66.16 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694111,N/A,"OSTOMY 4X4 WAFER 2-1/4""",270,1 ,$1.62 ,$1.05 ,$0.86 ,$1.46 ,$1.11 , N/A ,$0.95 ,$0.95 , N/A ,$1.33 ,$1.38 ,$1.46 ,$1.22 ,$1.13 ,$1.20 ,$1.46 ,$1.38 , N/A ,$1.38 , N/A ,$0.86 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694115,N/A,"BOLUS, ROTH NET, FOOD",270,1 ,$315.00 ,$204.75 ,$166.32 ,$283.50 ,$215.78 , N/A ,$184.59 ,$184.59 , N/A ,$258.30 ,$267.75 ,$283.50 ,$236.25 ,$220.50 ,$233.10 ,$283.50 ,$267.75 , N/A ,$267.75 , N/A ,$166.32 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694125,N/A,AIRWAY OROPHARYNGEAL 80MM SM ADULT,270,1 ,$2.20 ,$1.43 ,$1.16 ,$1.98 ,$1.51 , N/A ,$1.29 ,$1.29 , N/A ,$1.80 ,$1.87 ,$1.98 ,$1.65 ,$1.54 ,$1.63 ,$1.98 ,$1.87 , N/A ,$1.87 , N/A ,$1.16 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694143,N/A,URINE LEG BAG,270,1 ,$6.11 ,$3.97 ,$3.23 ,$5.50 ,$4.19 , N/A ,$3.58 ,$3.58 , N/A ,$5.01 ,$5.19 ,$5.50 ,$4.58 ,$4.28 ,$4.52 ,$5.50 ,$5.19 , N/A ,$5.19 , N/A ,$3.23 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694144,N/A,URINE BAG PEDIATRIC,270,1 ,$2.60 ,$1.69 ,$1.37 ,$2.34 ,$1.78 , N/A ,$1.52 ,$1.52 , N/A ,$2.13 ,$2.21 ,$2.34 ,$1.95 ,$1.82 ,$1.92 ,$2.34 ,$2.21 , N/A ,$2.21 , N/A ,$1.37 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694145,N/A,URINE DRAIN BAG 4000CC,270,1 ,$11.05 ,$7.18 ,$5.83 ,$9.95 ,$7.57 , N/A ,$6.48 ,$6.48 , N/A ,$9.06 ,$9.39 ,$9.95 ,$8.29 ,$7.74 ,$8.18 ,$9.95 ,$9.39 , N/A ,$9.39 , N/A ,$5.83 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694146,N/A,BAG DRAIN URINE 2000ML LF,270,1 ,$7.74 ,$5.03 ,$4.09 ,$6.97 ,$5.30 , N/A ,$4.54 ,$4.54 , N/A ,$6.35 ,$6.58 ,$6.97 ,$5.81 ,$5.42 ,$5.73 ,$6.97 ,$6.58 , N/A ,$6.58 , N/A ,$4.09 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694170,N/A,TRAY FOLEY LF 16FR 5CC,270,1 ,$21.30 ,$13.85 ,$11.25 ,$19.17 ,$14.59 , N/A ,$12.48 ,$12.48 , N/A ,$17.47 ,$18.11 ,$19.17 ,$15.98 ,$14.91 ,$15.76 ,$19.17 ,$18.11 , N/A ,$18.11 , N/A ,$11.25 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694181,N/A,PACK OBSTETRICAL,270,1 ,$38.25 ,$24.86 ,$20.20 ,$34.43 ,$26.20 , N/A ,$22.41 ,$22.41 , N/A ,$31.37 ,$32.51 ,$34.43 ,$28.69 ,$26.78 ,$28.31 ,$34.43 ,$32.51 , N/A ,$32.51 , N/A ,$20.20 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694193,N/A,"T-TUBE GOODE, MICROGEL",270,1 ,$126.00 ,$81.90 ,$66.53 ,$113.40 ,$86.31 , N/A ,$73.84 ,$73.84 , N/A ,$103.32 ,$107.10 ,$113.40 ,$94.50 ,$88.20 ,$93.24 ,$113.40 ,$107.10 , N/A ,$107.10 , N/A ,$66.53 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694218,N/A,"BRACE ANKLE REG 9.5"" AIR GEL",270,1 ,$23.69 ,$15.40 ,$12.51 ,$21.32 ,$16.23 , N/A ,$13.88 ,$13.88 , N/A ,$19.43 ,$20.14 ,$21.32 ,$17.77 ,$16.58 ,$17.53 ,$21.32 ,$20.14 , N/A ,$20.14 , N/A ,$12.51 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694219,N/A,"BRACE ANKLE TRAINER MED 9""",270,1 ,$23.69 ,$15.40 ,$12.51 ,$21.32 ,$16.23 , N/A ,$13.88 ,$13.88 , N/A ,$19.43 ,$20.14 ,$21.32 ,$17.77 ,$16.58 ,$17.53 ,$21.32 ,$20.14 , N/A ,$20.14 , N/A ,$12.51 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694220,N/A,"BRACE ANKLE SMALL 8 1/2"" HEIGHT",270,1 ,$23.70 ,$15.41 ,$12.51 ,$21.33 ,$16.23 , N/A ,$13.89 ,$13.89 , N/A ,$19.43 ,$20.15 ,$21.33 ,$17.78 ,$16.59 ,$17.54 ,$21.33 ,$20.15 , N/A ,$20.15 , N/A ,$12.51 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694224,C1776,"DRILL, MINI SUTURE TAK",278,1 ,$750.00 ,$487.50 ,$439.50 ,$675.00 ,$513.75 , N/A ,$439.50 ,$439.50 , N/A ,$615.00 ,$637.50 ,$675.00 ,$562.50 ,$525.00 ,$555.00 ,$675.00 ,$637.50 , N/A ,$637.50 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694225,N/A,"SURGICEL 4X8""",270,1 ,$180.46 ,$117.30 ,$95.28 ,$162.41 ,$123.62 , N/A ,$105.75 ,$105.75 , N/A ,$147.98 ,$153.39 ,$162.41 ,$135.35 ,$126.32 ,$133.54 ,$162.41 ,$153.39 , N/A ,$153.39 , N/A ,$95.28 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694229,C1776,"KIT, DX FIBERTAK",278,1 ,"$1,179.00 ",$766.35 ,$690.89 ,"$1,061.10 ",$807.62 , N/A ,$690.89 ,$690.89 , N/A ,$966.78 ,"$1,002.15 ","$1,061.10 ",$884.25 ,$825.30 ,$872.46 ,"$1,061.10 ","$1,002.15 ", N/A ,"$1,002.15 ", N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694230,N/A,"HYDROGEL, SKINTEGRITY 4oz TUBE",270,1 ,$13.04 ,$8.48 ,$6.89 ,$11.74 ,$8.93 , N/A ,$7.64 ,$7.64 , N/A ,$10.69 ,$11.08 ,$11.74 ,$9.78 ,$9.13 ,$9.65 ,$11.74 ,$11.08 , N/A ,$11.08 , N/A ,$6.89 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694231,C1713,"SUTURE ANCHOR, MINI BIO COMPOSITE",278,1 ,"$1,395.00 ",$906.75 ,$817.47 ,"$1,255.50 ",$955.58 , N/A ,$817.47 ,$817.47 , N/A ,"$1,143.90 ","$1,185.75 ","$1,255.50 ","$1,046.25 ",$976.50 ,"$1,032.30 ","$1,255.50 ","$1,185.75 ", N/A ,"$1,185.75 ", N/A ,$837.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694232,C1713,"SUTURE ANCHOR, DX FIBERTAK",278,1 ,"$1,824.00 ","$1,185.60 ","$1,068.86 ","$1,641.60 ","$1,249.44 ", N/A ,"$1,068.86 ","$1,068.86 ", N/A ,"$1,495.68 ","$1,550.40 ","$1,641.60 ","$1,368.00 ","$1,276.80 ","$1,349.76 ","$1,641.60 ","$1,550.40 ", N/A ,"$1,550.40 ", N/A ,"$1,094.40 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694238,N/A,STOCKING ANTI-EMB THIGH LRG/REG TED HOSE,270,1 ,$20.50 ,$13.33 ,$10.82 ,$18.45 ,$14.04 , N/A ,$12.01 ,$12.01 , N/A ,$16.81 ,$17.43 ,$18.45 ,$15.38 ,$14.35 ,$15.17 ,$18.45 ,$17.43 , N/A ,$17.43 , N/A ,$10.82 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694248,N/A,SUTURE PROLENE 2-0 sh,270,1 ,$11.76 ,$7.64 ,$6.21 ,$10.58 ,$8.06 , N/A ,$6.89 ,$6.89 , N/A ,$9.64 ,$10.00 ,$10.58 ,$8.82 ,$8.23 ,$8.70 ,$10.58 ,$10.00 , N/A ,$10.00 , N/A ,$6.21 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694263,N/A,PROTECTOR HEEL/ELBOW 1 PAIR,270,1 ,$13.02 ,$8.46 ,$6.87 ,$11.72 ,$8.92 , N/A ,$7.63 ,$7.63 , N/A ,$10.68 ,$11.07 ,$11.72 ,$9.77 ,$9.11 ,$9.63 ,$11.72 ,$11.07 , N/A ,$11.07 , N/A ,$6.87 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694264,N/A,STOCKING ANTI-EMB KNEE LRG/SHORT TED,270,1 ,$35.60 ,$23.14 ,$18.80 ,$32.04 ,$24.39 , N/A ,$20.86 ,$20.86 , N/A ,$29.19 ,$30.26 ,$32.04 ,$26.70 ,$24.92 ,$26.34 ,$32.04 ,$30.26 , N/A ,$30.26 , N/A ,$18.80 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694287,N/A,MAJOR PACK,270,1 ,$303.95 ,$197.57 ,$160.49 ,$273.56 ,$208.21 , N/A ,$178.11 ,$178.11 , N/A ,$249.24 ,$258.36 ,$273.56 ,$227.96 ,$212.77 ,$224.92 ,$273.56 ,$258.36 , N/A ,$258.36 , N/A ,$160.49 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694288,N/A,GYN PACK,270,1 ,$183.93 ,$119.55 ,$97.12 ,$165.54 ,$125.99 , N/A ,$107.78 ,$107.78 , N/A ,$150.82 ,$156.34 ,$165.54 ,$137.95 ,$128.75 ,$136.11 ,$165.54 ,$156.34 , N/A ,$156.34 , N/A ,$97.12 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694297,N/A,"STRIP CLOSURE SKIN 1"" STERI-STRIP",270,1 ,$4.87 ,$3.17 ,$2.57 ,$4.38 ,$3.34 , N/A ,$2.85 ,$2.85 , N/A ,$3.99 ,$4.14 ,$4.38 ,$3.65 ,$3.41 ,$3.60 ,$4.38 ,$4.14 , N/A ,$4.14 , N/A ,$2.57 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694300,N/A,"PACK, CYSTO",270,1 ,$29.65 ,$19.27 ,$15.66 ,$26.69 ,$20.31 , N/A ,$17.37 ,$17.37 , N/A ,$24.31 ,$25.20 ,$26.69 ,$22.24 ,$20.76 ,$21.94 ,$26.69 ,$25.20 , N/A ,$25.20 , N/A ,$15.66 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694307,N/A,LIMB HOLDER DISPOSABLE,270,1 ,$17.82 ,$11.58 ,$9.41 ,$16.04 ,$12.21 , N/A ,$10.44 ,$10.44 , N/A ,$14.61 ,$15.15 ,$16.04 ,$13.37 ,$12.47 ,$13.19 ,$16.04 ,$15.15 , N/A ,$15.15 , N/A ,$9.41 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694309,N/A,CATHETER CHOLANGIOGRAM 7.5FR 2.5MM,270,1 ,$71.77 ,$46.65 ,$37.89 ,$64.59 ,$49.16 , N/A ,$42.06 ,$42.06 , N/A ,$58.85 ,$61.00 ,$64.59 ,$53.83 ,$50.24 ,$53.11 ,$64.59 ,$61.00 , N/A ,$61.00 , N/A ,$37.89 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694315,N/A,"SPONGE PEANUT 3/8""",270,1 ,$14.40 ,$9.36 ,$7.60 ,$12.96 ,$9.86 , N/A ,$8.44 ,$8.44 , N/A ,$11.81 ,$12.24 ,$12.96 ,$10.80 ,$10.08 ,$10.66 ,$12.96 ,$12.24 , N/A ,$12.24 , N/A ,$7.60 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694322,N/A,NEEDLE SPINAL 20GA X 3-1/2IN,270,1 ,$3.07 ,$2.00 ,$1.62 ,$2.76 ,$2.10 , N/A ,$1.80 ,$1.80 , N/A ,$2.52 ,$2.61 ,$2.76 ,$2.30 ,$2.15 ,$2.27 ,$2.76 ,$2.61 , N/A ,$2.61 , N/A ,$1.62 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694325,N/A,"NEEDLE SPINAL 18GX3.5""",270,1 ,$3.07 ,$2.00 ,$1.62 ,$2.76 ,$2.10 , N/A ,$1.80 ,$1.80 , N/A ,$2.52 ,$2.61 ,$2.76 ,$2.30 ,$2.15 ,$2.27 ,$2.76 ,$2.61 , N/A ,$2.61 , N/A ,$1.62 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694326,N/A,"NEEDLE SPINAL 18GX3""",270,1 ,$3.88 ,$2.52 ,$2.05 ,$3.49 ,$2.66 , N/A ,$2.27 ,$2.27 , N/A ,$3.18 ,$3.30 ,$3.49 ,$2.91 ,$2.72 ,$2.87 ,$3.49 ,$3.30 , N/A ,$3.30 , N/A ,$2.05 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694330,N/A,"NEEDLE SPINAL 22GX3""",270,1 ,$3.14 ,$2.04 ,$1.66 ,$2.83 ,$2.15 , N/A ,$1.84 ,$1.84 , N/A ,$2.57 ,$2.67 ,$2.83 ,$2.36 ,$2.20 ,$2.32 ,$2.83 ,$2.67 , N/A ,$2.67 , N/A ,$1.66 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694331,N/A,SCD CALF,270,1 ,$70.86 ,$46.06 ,$37.41 ,$63.77 ,$48.54 , N/A ,$41.52 ,$41.52 , N/A ,$58.11 ,$60.23 ,$63.77 ,$53.15 ,$49.60 ,$52.44 ,$63.77 ,$60.23 , N/A ,$60.23 , N/A ,$37.41 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694342,N/A,SCD XL CALF,270,1 ,$128.46 ,$83.50 ,$67.83 ,$115.61 ,$88.00 , N/A ,$75.28 ,$75.28 , N/A ,$105.34 ,$109.19 ,$115.61 ,$96.35 ,$89.92 ,$95.06 ,$115.61 ,$109.19 , N/A ,$109.19 , N/A ,$67.83 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694356,N/A,TRAY LUMBAR PUNCTURE ADULT 20G,270,1 ,$35.20 ,$22.88 ,$18.59 ,$31.68 ,$24.11 , N/A ,$20.63 ,$20.63 , N/A ,$28.86 ,$29.92 ,$31.68 ,$26.40 ,$24.64 ,$26.05 ,$31.68 ,$29.92 , N/A ,$29.92 , N/A ,$18.59 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694361,N/A,CERVICAL COLLAR FOAM LG,270,1 ,$15.40 ,$10.01 ,$8.13 ,$13.86 ,$10.55 , N/A ,$9.02 ,$9.02 , N/A ,$12.63 ,$13.09 ,$13.86 ,$11.55 ,$10.78 ,$11.40 ,$13.86 ,$13.09 , N/A ,$13.09 , N/A ,$8.13 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694431,N/A,STAPLER SKIN INSORB ABSORBABLE,270,1 ,$131.77 ,$85.65 ,$69.57 ,$118.59 ,$90.26 , N/A ,$77.22 ,$77.22 , N/A ,$108.05 ,$112.00 ,$118.59 ,$98.83 ,$92.24 ,$97.51 ,$118.59 ,$112.00 , N/A ,$112.00 , N/A ,$69.57 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694447,N/A,STAPLER SKIN 35 WIDE STR DISP,270,1 ,$29.33 ,$19.06 ,$15.49 ,$26.40 ,$20.09 , N/A ,$17.19 ,$17.19 , N/A ,$24.05 ,$24.93 ,$26.40 ,$22.00 ,$20.53 ,$21.70 ,$26.40 ,$24.93 , N/A ,$24.93 , N/A ,$15.49 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694457,N/A,"TUBING SUCTION 3/16""X10'",270,1 ,$1.33 ,$0.86 ,$0.70 ,$1.20 ,$0.91 , N/A ,$0.78 ,$0.78 , N/A ,$1.09 ,$1.13 ,$1.20 ,$1.00 ,$0.93 ,$0.98 ,$1.20 ,$1.13 , N/A ,$1.13 , N/A ,$0.70 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694458,N/A,ELECTRODE QUIK-COMBO PADS ADULT RTS,270,1 ,$105.00 ,$68.25 ,$55.44 ,$94.50 ,$71.93 , N/A ,$61.53 ,$61.53 , N/A ,$86.10 ,$89.25 ,$94.50 ,$78.75 ,$73.50 ,$77.70 ,$94.50 ,$89.25 , N/A ,$89.25 , N/A ,$55.44 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694459,N/A,CAUTERY PENCIL ELECTROSURGICAL,270,1 ,$10.80 ,$7.02 ,$5.70 ,$9.72 ,$7.40 , N/A ,$6.33 ,$6.33 , N/A ,$8.86 ,$9.18 ,$9.72 ,$8.10 ,$7.56 ,$7.99 ,$9.72 ,$9.18 , N/A ,$9.18 , N/A ,$5.70 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694465,N/A,STAPLER SKIN 15 WIDE STR DISP,270,1 ,$14.89 ,$9.68 ,$7.86 ,$13.40 ,$10.20 , N/A ,$8.73 ,$8.73 , N/A ,$12.21 ,$12.66 ,$13.40 ,$11.17 ,$10.42 ,$11.02 ,$13.40 ,$12.66 , N/A ,$12.66 , N/A ,$7.86 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694477,N/A,PACK C-SECTION PAK II,270,1 ,$386.43 ,$251.18 ,$204.04 ,$347.79 ,$264.70 , N/A ,$226.45 ,$226.45 , N/A ,$316.87 ,$328.47 ,$347.79 ,$289.82 ,$270.50 ,$285.96 ,$347.79 ,$328.47 , N/A ,$328.47 , N/A ,$204.04 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694490,N/A,VISCOAT,270,1 ,$189.00 ,$122.85 ,$99.79 ,$170.10 ,$129.47 , N/A ,$110.75 ,$110.75 , N/A ,$154.98 ,$160.65 ,$170.10 ,$141.75 ,$132.30 ,$139.86 ,$170.10 ,$160.65 , N/A ,$160.65 , N/A ,$99.79 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694494,N/A,POST OP SHOE WOMEN SMALL,270,1 ,$24.57 ,$15.97 ,$12.97 ,$22.11 ,$16.83 , N/A ,$14.40 ,$14.40 , N/A ,$20.15 ,$20.88 ,$22.11 ,$18.43 ,$17.20 ,$18.18 ,$22.11 ,$20.88 , N/A ,$20.88 , N/A ,$12.97 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694497,N/A,PACK ORTHO LOW EXTREMITY,270,1 ,$143.96 ,$93.57 ,$76.01 ,$129.56 ,$98.61 , N/A ,$84.36 ,$84.36 , N/A ,$118.05 ,$122.37 ,$129.56 ,$107.97 ,$100.77 ,$106.53 ,$129.56 ,$122.37 , N/A ,$122.37 , N/A ,$76.01 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694503,N/A,PHACO PAK,270,1 ,$261.00 ,$169.65 ,$137.81 ,$234.90 ,$178.79 , N/A ,$152.95 ,$152.95 , N/A ,$214.02 ,$221.85 ,$234.90 ,$195.75 ,$182.70 ,$193.14 ,$234.90 ,$221.85 , N/A ,$221.85 , N/A ,$137.81 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694515,N/A,"2"" ORTHO GLASS",270,1 ,$19.30 ,$12.55 ,$10.19 ,$17.37 ,$13.22 , N/A ,$11.31 ,$11.31 , N/A ,$15.83 ,$16.41 ,$17.37 ,$14.48 ,$13.51 ,$14.28 ,$17.37 ,$16.41 , N/A ,$16.41 , N/A ,$10.19 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694517,N/A,"3"" ORTHO GLASS",270,1 ,$21.00 ,$13.65 ,$11.09 ,$18.90 ,$14.39 , N/A ,$12.31 ,$12.31 , N/A ,$17.22 ,$17.85 ,$18.90 ,$15.75 ,$14.70 ,$15.54 ,$18.90 ,$17.85 , N/A ,$17.85 , N/A ,$11.09 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694518,N/A,"4"" ORTHO GLASS",270,1 ,$28.00 ,$18.20 ,$14.78 ,$25.20 ,$19.18 , N/A ,$16.41 ,$16.41 , N/A ,$22.96 ,$23.80 ,$25.20 ,$21.00 ,$19.60 ,$20.72 ,$25.20 ,$23.80 , N/A ,$23.80 , N/A ,$14.78 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694521,N/A,"5"" ORTHO GLASS",270,1 ,$40.00 ,$26.00 ,$21.12 ,$36.00 ,$27.40 , N/A ,$23.44 ,$23.44 , N/A ,$32.80 ,$34.00 ,$36.00 ,$30.00 ,$28.00 ,$29.60 ,$36.00 ,$34.00 , N/A ,$34.00 , N/A ,$21.12 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694522,N/A,"6"" ORTHO GLASS",270,1 ,$44.00 ,$28.60 ,$23.23 ,$39.60 ,$30.14 , N/A ,$25.78 ,$25.78 , N/A ,$36.08 ,$37.40 ,$39.60 ,$33.00 ,$30.80 ,$32.56 ,$39.60 ,$37.40 , N/A ,$37.40 , N/A ,$23.23 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694523,N/A,"KNEE IMMOBILIZER UNIVERSAL LNGTH 19""",270,1 ,$38.56 ,$25.06 ,$20.36 ,$34.70 ,$26.41 , N/A ,$22.60 ,$22.60 , N/A ,$31.62 ,$32.78 ,$34.70 ,$28.92 ,$26.99 ,$28.53 ,$34.70 ,$32.78 , N/A ,$32.78 , N/A ,$20.36 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694524,N/A,"KNEE IMMOBILIZER LARGE LENGTH 24""",270,1 ,$69.30 ,$45.05 ,$36.59 ,$62.37 ,$47.47 , N/A ,$40.61 ,$40.61 , N/A ,$56.83 ,$58.91 ,$62.37 ,$51.98 ,$48.51 ,$51.28 ,$62.37 ,$58.91 , N/A ,$58.91 , N/A ,$36.59 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694544,N/A,CATHETER FOLEY COUDE 18FR 10ML LATEX,270,1 ,$33.90 ,$22.04 ,$17.90 ,$30.51 ,$23.22 , N/A ,$19.87 ,$19.87 , N/A ,$27.80 ,$28.82 ,$30.51 ,$25.43 ,$23.73 ,$25.09 ,$30.51 ,$28.82 , N/A ,$28.82 , N/A ,$17.90 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694554,N/A,"TROCAR, CHEST TUBE 28FR",270,1 ,$36.42 ,$23.67 ,$19.23 ,$32.78 ,$24.95 , N/A ,$21.34 ,$21.34 , N/A ,$29.86 ,$30.96 ,$32.78 ,$27.32 ,$25.49 ,$26.95 ,$32.78 ,$30.96 , N/A ,$30.96 , N/A ,$19.23 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694555,N/A,"TROCAR, CHEST TUBE 20FR",270,1 ,$36.42 ,$23.67 ,$19.23 ,$32.78 ,$24.95 , N/A ,$21.34 ,$21.34 , N/A ,$29.86 ,$30.96 ,$32.78 ,$27.32 ,$25.49 ,$26.95 ,$32.78 ,$30.96 , N/A ,$30.96 , N/A ,$19.23 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694575,V2632,LENS INTRAOCULAR,276,1 ,$450.00 ,$292.50 ,$263.70 ,$405.00 ,$308.25 , N/A ,$263.70 ,$263.70 , N/A ,$369.00 ,$382.50 ,$405.00 ,$337.50 ,$315.00 ,$333.00 ,$405.00 ,$382.50 , N/A ,$382.50 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694602,N/A,SPLINT WRIST UNIV COCK UP RT,270,1 ,$21.40 ,$13.91 ,$11.30 ,$19.26 ,$14.66 , N/A ,$12.54 ,$12.54 , N/A ,$17.55 ,$18.19 ,$19.26 ,$16.05 ,$14.98 ,$15.84 ,$19.26 ,$18.19 , N/A ,$18.19 , N/A ,$11.30 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694608,N/A,PAD MAXI LONG,270,1 ,$2.48 ,$1.61 ,$1.31 ,$2.23 ,$1.70 , N/A ,$1.45 ,$1.45 , N/A ,$2.03 ,$2.11 ,$2.23 ,$1.86 ,$1.74 ,$1.84 ,$2.23 ,$2.11 , N/A ,$2.11 , N/A ,$1.31 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694616,N/A,KIRSCHNER WIRES .045,270,1 ,$66.00 ,$42.90 ,$34.85 ,$59.40 ,$45.21 , N/A ,$38.68 ,$38.68 , N/A ,$54.12 ,$56.10 ,$59.40 ,$49.50 ,$46.20 ,$48.84 ,$59.40 ,$56.10 , N/A ,$56.10 , N/A ,$34.85 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694638,N/A,"CATHETER URETERAL 8F, CONE TIP",270,1 ,$21.77 ,$14.15 ,$11.49 ,$19.59 ,$14.91 , N/A ,$12.76 ,$12.76 , N/A ,$17.85 ,$18.50 ,$19.59 ,$16.33 ,$15.24 ,$16.11 ,$19.59 ,$18.50 , N/A ,$18.50 , N/A ,$11.49 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694647,N/A,CATHETER FOLEY 22FR 30CC NL BALLOON,270,1 ,$21.10 ,$13.72 ,$11.14 ,$18.99 ,$14.45 , N/A ,$12.36 ,$12.36 , N/A ,$17.30 ,$17.94 ,$18.99 ,$15.83 ,$14.77 ,$15.61 ,$18.99 ,$17.94 , N/A ,$17.94 , N/A ,$11.14 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694653,N/A,SWABSTICK POVIDONE-IODINE TRIPLES,270,1 ,$0.37 ,$0.24 ,$0.20 ,$0.33 ,$0.25 , N/A ,$0.22 ,$0.22 , N/A ,$0.30 ,$0.31 ,$0.33 ,$0.28 ,$0.26 ,$0.27 ,$0.33 ,$0.31 , N/A ,$0.31 , N/A ,$0.20 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694654,N/A,"CATHETER, 3 WAY 18FR/30CC",270,1 ,$34.30 ,$22.30 ,$18.11 ,$30.87 ,$23.50 , N/A ,$20.10 ,$20.10 , N/A ,$28.13 ,$29.16 ,$30.87 ,$25.73 ,$24.01 ,$25.38 ,$30.87 ,$29.16 , N/A ,$29.16 , N/A ,$18.11 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694660,N/A,CATHETER FOLEY 22FR/30CC 3WAY,270,1 ,$21.29 ,$13.84 ,$11.24 ,$19.16 ,$14.58 , N/A ,$12.48 ,$12.48 , N/A ,$17.46 ,$18.10 ,$19.16 ,$15.97 ,$14.90 ,$15.75 ,$19.16 ,$18.10 , N/A ,$18.10 , N/A ,$11.24 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694668,N/A,"BANDAGE COBAN 4"" STERILE",270,1 ,$4.78 ,$3.11 ,$2.52 ,$4.30 ,$3.27 , N/A ,$2.80 ,$2.80 , N/A ,$3.92 ,$4.06 ,$4.30 ,$3.59 ,$3.35 ,$3.54 ,$4.30 ,$4.06 , N/A ,$4.06 , N/A ,$2.52 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694699,N/A,CATHETER FOLEY COUDE 18FR/10CC LTX,270,1 ,$15.40 ,$10.01 ,$8.13 ,$13.86 ,$10.55 , N/A ,$9.02 ,$9.02 , N/A ,$12.63 ,$13.09 ,$13.86 ,$11.55 ,$10.78 ,$11.40 ,$13.86 ,$13.09 , N/A ,$13.09 , N/A ,$8.13 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694710,N/A,SPLINT WRIST UNIV COCK UP LT,270,1 ,$13.17 ,$8.56 ,$6.95 ,$11.85 ,$9.02 , N/A ,$7.72 ,$7.72 , N/A ,$10.80 ,$11.19 ,$11.85 ,$9.88 ,$9.22 ,$9.75 ,$11.85 ,$11.19 , N/A ,$11.19 , N/A ,$6.95 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694713,N/A,SUPPORT BRIEF MEDIUM,270,1 ,$55.00 ,$35.75 ,$29.04 ,$49.50 ,$37.68 , N/A ,$32.23 ,$32.23 , N/A ,$45.10 ,$46.75 ,$49.50 ,$41.25 ,$38.50 ,$40.70 ,$49.50 ,$46.75 , N/A ,$46.75 , N/A ,$29.04 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694749,N/A,SURGICEL 2X3 HEMOSTAT,270,1 ,$176.76 ,$114.89 ,$93.33 ,$159.08 ,$121.08 , N/A ,$103.58 ,$103.58 , N/A ,$144.94 ,$150.25 ,$159.08 ,$132.57 ,$123.73 ,$130.80 ,$159.08 ,$150.25 , N/A ,$150.25 , N/A ,$93.33 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694751,N/A,SHOULDER IMMOBILIZER LARGE,270,1 ,$27.50 ,$17.88 ,$14.52 ,$24.75 ,$18.84 , N/A ,$16.12 ,$16.12 , N/A ,$22.55 ,$23.38 ,$24.75 ,$20.63 ,$19.25 ,$20.35 ,$24.75 ,$23.38 , N/A ,$23.38 , N/A ,$14.52 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694753,N/A,SLING ARM MEDIUM,270,1 ,$7.68 ,$4.99 ,$4.06 ,$6.91 ,$5.26 , N/A ,$4.50 ,$4.50 , N/A ,$6.30 ,$6.53 ,$6.91 ,$5.76 ,$5.38 ,$5.68 ,$6.91 ,$6.53 , N/A ,$6.53 , N/A ,$4.06 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694754,N/A,SLING ARM LARGE,270,1 ,$6.87 ,$4.47 ,$3.63 ,$6.18 ,$4.71 , N/A ,$4.03 ,$4.03 , N/A ,$5.63 ,$5.84 ,$6.18 ,$5.15 ,$4.81 ,$5.08 ,$6.18 ,$5.84 , N/A ,$5.84 , N/A ,$3.63 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694764,N/A,LINER SUCTION CANISTER - LG (1500CC),270,1 ,$3.19 ,$2.07 ,$1.68 ,$2.87 ,$2.19 , N/A ,$1.87 ,$1.87 , N/A ,$2.62 ,$2.71 ,$2.87 ,$2.39 ,$2.23 ,$2.36 ,$2.87 ,$2.71 , N/A ,$2.71 , N/A ,$1.68 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694765,N/A,YANKAUER SUCTION DISP,270,1 ,$0.78 ,$0.51 ,$0.41 ,$0.70 ,$0.53 , N/A ,$0.46 ,$0.46 , N/A ,$0.64 ,$0.66 ,$0.70 ,$0.59 ,$0.55 ,$0.58 ,$0.70 ,$0.66 , N/A ,$0.66 , N/A ,$0.41 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694773,N/A,LINER SUCTION CANISTER  - XLG (3000 CC),270,1 ,$4.20 ,$2.73 ,$2.22 ,$3.78 ,$2.88 , N/A ,$2.46 ,$2.46 , N/A ,$3.44 ,$3.57 ,$3.78 ,$3.15 ,$2.94 ,$3.11 ,$3.78 ,$3.57 , N/A ,$3.57 , N/A ,$2.22 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694775,N/A,MORGAN THERAPEUTIC LENS  AE-1695(12/CS),270,1 ,$93.75 ,$60.94 ,$49.50 ,$84.38 ,$64.22 , N/A ,$54.94 ,$54.94 , N/A ,$76.88 ,$79.69 ,$84.38 ,$70.31 ,$65.63 ,$69.38 ,$84.38 ,$79.69 , N/A ,$79.69 , N/A ,$49.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694776,N/A,MORGAN DELIVERY SET AE-1696,270,1 ,$17.50 ,$11.38 ,$9.24 ,$15.75 ,$11.99 , N/A ,$10.26 ,$10.26 , N/A ,$14.35 ,$14.88 ,$15.75 ,$13.13 ,$12.25 ,$12.95 ,$15.75 ,$14.88 , N/A ,$14.88 , N/A ,$9.24 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694791,N/A,"DRAIN ROUND 9fr 1/8"" W/TROCAR",270,1 ,$46.40 ,$30.16 ,$24.50 ,$41.76 ,$31.78 , N/A ,$27.19 ,$27.19 , N/A ,$38.05 ,$39.44 ,$41.76 ,$34.80 ,$32.48 ,$34.34 ,$41.76 ,$39.44 , N/A ,$39.44 , N/A ,$24.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694807,N/A,DRAIN WOUND FLAT 10MM (JP DRAIN),270,1 ,$49.30 ,$32.05 ,$26.03 ,$44.37 ,$33.77 , N/A ,$28.89 ,$28.89 , N/A ,$40.43 ,$41.91 ,$44.37 ,$36.98 ,$34.51 ,$36.48 ,$44.37 ,$41.91 , N/A ,$41.91 , N/A ,$26.03 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694808,N/A,DRAIN WOUND 100ML 7MM (JP DRAIN),270,1 ,$49.30 ,$32.05 ,$26.03 ,$44.37 ,$33.77 , N/A ,$28.89 ,$28.89 , N/A ,$40.43 ,$41.91 ,$44.37 ,$36.98 ,$34.51 ,$36.48 ,$44.37 ,$41.91 , N/A ,$41.91 , N/A ,$26.03 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694809,N/A,FORCEPS BIOPSY RADIAL JAW 3 HOT,270,1 ,$105.00 ,$68.25 ,$55.44 ,$94.50 ,$71.93 , N/A ,$61.53 ,$61.53 , N/A ,$86.10 ,$89.25 ,$94.50 ,$78.75 ,$73.50 ,$77.70 ,$94.50 ,$89.25 , N/A ,$89.25 , N/A ,$55.44 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694810,N/A,IRRIGATION SET TUR Y-TYPE,270,1 ,$11.94 ,$7.76 ,$6.30 ,$10.75 ,$8.18 , N/A ,$7.00 ,$7.00 , N/A ,$9.79 ,$10.15 ,$10.75 ,$8.96 ,$8.36 ,$8.84 ,$10.75 ,$10.15 , N/A ,$10.15 , N/A ,$6.30 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694815,N/A,TRAY THORACOSTOMY W/O CATHETER,270,1 ,$42.36 ,$27.53 ,$22.37 ,$38.12 ,$29.02 , N/A ,$24.82 ,$24.82 , N/A ,$34.74 ,$36.01 ,$38.12 ,$31.77 ,$29.65 ,$31.35 ,$38.12 ,$36.01 , N/A ,$36.01 , N/A ,$22.37 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694823,N/A,CATHETER FOLEY 22FR 10CC LTX,270,1 ,$4.60 ,$2.99 ,$2.43 ,$4.14 ,$3.15 , N/A ,$2.70 ,$2.70 , N/A ,$3.77 ,$3.91 ,$4.14 ,$3.45 ,$3.22 ,$3.40 ,$4.14 ,$3.91 , N/A ,$3.91 , N/A ,$2.43 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694833,N/A,CATHETER FOLEY 24FR 30CC LTX,270,1 ,$9.76 ,$6.34 ,$5.15 ,$8.78 ,$6.69 , N/A ,$5.72 ,$5.72 , N/A ,$8.00 ,$8.30 ,$8.78 ,$7.32 ,$6.83 ,$7.22 ,$8.78 ,$8.30 , N/A ,$8.30 , N/A ,$5.15 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694841,N/A,"BINDER ABDOMINAL, 12"" 4-PANEL 30-45"" S/M",270,1 ,$21.30 ,$13.85 ,$11.25 ,$19.17 ,$14.59 , N/A ,$12.48 ,$12.48 , N/A ,$17.47 ,$18.11 ,$19.17 ,$15.98 ,$14.91 ,$15.76 ,$19.17 ,$18.11 , N/A ,$18.11 , N/A ,$11.25 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694858,N/A,AIRWAY OROPHARYNGEAL 100MM ADULT,270,1 ,$2.30 ,$1.50 ,$1.21 ,$2.07 ,$1.58 , N/A ,$1.35 ,$1.35 , N/A ,$1.89 ,$1.96 ,$2.07 ,$1.73 ,$1.61 ,$1.70 ,$2.07 ,$1.96 , N/A ,$1.96 , N/A ,$1.21 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694862,N/A,DRAPE TOWEL LRG STERI 17X23,270,1 ,$2.40 ,$1.56 ,$1.27 ,$2.16 ,$1.64 , N/A ,$1.41 ,$1.41 , N/A ,$1.97 ,$2.04 ,$2.16 ,$1.80 ,$1.68 ,$1.78 ,$2.16 ,$2.04 , N/A ,$2.04 , N/A ,$1.27 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694896,N/A,ANTI FOG KIT,270,1 ,$10.82 ,$7.03 ,$5.71 ,$9.74 ,$7.41 , N/A ,$6.34 ,$6.34 , N/A ,$8.87 ,$9.20 ,$9.74 ,$8.12 ,$7.57 ,$8.01 ,$9.74 ,$9.20 , N/A ,$9.20 , N/A ,$5.71 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694904,N/A,NEEDLE SCLEARA 23G 4MM,270,1 ,$87.00 ,$56.55 ,$45.94 ,$78.30 ,$59.60 , N/A ,$50.98 ,$50.98 , N/A ,$71.34 ,$73.95 ,$78.30 ,$65.25 ,$60.90 ,$64.38 ,$78.30 ,$73.95 , N/A ,$73.95 , N/A ,$45.94 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694913,N/A,SCOPE WARMER,270,1 ,$19.50 ,$12.68 ,$10.30 ,$17.55 ,$13.36 , N/A ,$11.43 ,$11.43 , N/A ,$15.99 ,$16.58 ,$17.55 ,$14.63 ,$13.65 ,$14.43 ,$17.55 ,$16.58 , N/A ,$16.58 , N/A ,$10.30 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694916,N/A,NEEDLE SCLEARA 25G 2.3MM,270,1 ,$87.00 ,$56.55 ,$45.94 ,$78.30 ,$59.60 , N/A ,$50.98 ,$50.98 , N/A ,$71.34 ,$73.95 ,$78.30 ,$65.25 ,$60.90 ,$64.38 ,$78.30 ,$73.95 , N/A ,$73.95 , N/A ,$45.94 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694925,N/A,TUBING INSUFLOW INSUFFLATION,270,1 ,$180.00 ,$117.00 ,$95.04 ,$162.00 ,$123.30 , N/A ,$105.48 ,$105.48 , N/A ,$147.60 ,$153.00 ,$162.00 ,$135.00 ,$126.00 ,$133.20 ,$162.00 ,$153.00 , N/A ,$153.00 , N/A ,$95.04 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694927,N/A,TUBING HIGH FLOW INSUFFLATION,270,1 ,$23.35 ,$15.18 ,$12.33 ,$21.02 ,$15.99 , N/A ,$13.68 ,$13.68 , N/A ,$19.15 ,$19.85 ,$21.02 ,$17.51 ,$16.35 ,$17.28 ,$21.02 ,$19.85 , N/A ,$19.85 , N/A ,$12.33 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694951,N/A,STOPCOCK 4 WAY,270,1 ,$1.46 ,$0.95 ,$0.77 ,$1.31 ,$1.00 , N/A ,$0.86 ,$0.86 , N/A ,$1.20 ,$1.24 ,$1.31 ,$1.10 ,$1.02 ,$1.08 ,$1.31 ,$1.24 , N/A ,$1.24 , N/A ,$0.77 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),694955,N/A,APPLIER CLIP LAPAROSCOPIC 10MM,270,1 ,$217.47 ,$141.36 ,$114.82 ,$195.72 ,$148.97 , N/A ,$127.44 ,$127.44 , N/A ,$178.33 ,$184.85 ,$195.72 ,$163.10 ,$152.23 ,$160.93 ,$195.72 ,$184.85 , N/A ,$184.85 , N/A ,$114.82 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695002,A6197,DRESSING AQUACEL AG 4X5,270,1 ,$20.93 ,$13.60 ,$11.05 ,$18.84 ,$14.34 , N/A ,$12.27 ,$12.27 , N/A ,$17.16 ,$17.79 ,$18.84 ,$15.70 ,$14.65 ,$15.49 ,$18.84 ,$17.79 , N/A ,$17.79 , N/A ,$11.05 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695012,N/A,VASELINE TUBES 1oz,270,1 ,$1.10 ,$0.72 ,$0.58 ,$0.99 ,$0.75 , N/A ,$0.64 ,$0.64 , N/A ,$0.90 ,$0.94 ,$0.99 ,$0.83 ,$0.77 ,$0.81 ,$0.99 ,$0.94 , N/A ,$0.94 , N/A ,$0.58 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695018,N/A,IUPC,270,1 ,$87.00 ,$56.55 ,$45.94 ,$78.30 ,$59.60 , N/A ,$50.98 ,$50.98 , N/A ,$71.34 ,$73.95 ,$78.30 ,$65.25 ,$60.90 ,$64.38 ,$78.30 ,$73.95 , N/A ,$73.95 , N/A ,$45.94 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695069,N/A,"DRAPE PELVIC PAROSCOPY POUCH 112X124""",270,1 ,$136.10 ,$88.47 ,$71.86 ,$122.49 ,$93.23 , N/A ,$79.75 ,$79.75 , N/A ,$111.60 ,$115.69 ,$122.49 ,$102.08 ,$95.27 ,$100.71 ,$122.49 ,$115.69 , N/A ,$115.69 , N/A ,$71.86 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695072,N/A,HEEL LIFT BOOTS SMOOTH,270,1 ,$92.50 ,$60.13 ,$48.84 ,$83.25 ,$63.36 , N/A ,$54.21 ,$54.21 , N/A ,$75.85 ,$78.63 ,$83.25 ,$69.38 ,$64.75 ,$68.45 ,$83.25 ,$78.63 , N/A ,$78.63 , N/A ,$48.84 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695077,N/A,NEEDLE SPINAL SPROTT 24G X 3 1/2,270,1 ,$29.50 ,$19.18 ,$15.58 ,$26.55 ,$20.21 , N/A ,$17.29 ,$17.29 , N/A ,$24.19 ,$25.08 ,$26.55 ,$22.13 ,$20.65 ,$21.83 ,$26.55 ,$25.08 , N/A ,$25.08 , N/A ,$15.58 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695098,A6237,DRESSING CALCIUM ALGINATE,270,1 ,$7.95 ,$5.17 ,$4.20 ,$7.16 ,$5.45 , N/A ,$4.66 ,$4.66 , N/A ,$6.52 ,$6.76 ,$7.16 ,$5.96 ,$5.57 ,$5.88 ,$7.16 ,$6.76 , N/A ,$6.76 , N/A ,$4.20 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695100,A6237,"DRESSING CALCIUM ALGINATE 12"" ROPE",270,1 ,$17.10 ,$11.12 ,$9.03 ,$15.39 ,$11.71 , N/A ,$10.02 ,$10.02 , N/A ,$14.02 ,$14.54 ,$15.39 ,$12.83 ,$11.97 ,$12.65 ,$15.39 ,$14.54 , N/A ,$14.54 , N/A ,$9.03 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695103,N/A,APPLIER CLIP LIGACLIP MED,270,1 ,$139.67 ,$90.79 ,$73.75 ,$125.70 ,$95.67 , N/A ,$81.85 ,$81.85 , N/A ,$114.53 ,$118.72 ,$125.70 ,$104.75 ,$97.77 ,$103.36 ,$125.70 ,$118.72 , N/A ,$118.72 , N/A ,$73.75 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695113,N/A,APPLICATOR CHLORAPREP ORANGE 26ML,270,1 ,$21.40 ,$13.91 ,$11.30 ,$19.26 ,$14.66 , N/A ,$12.54 ,$12.54 , N/A ,$17.55 ,$18.19 ,$19.26 ,$16.05 ,$14.98 ,$15.84 ,$19.26 ,$18.19 , N/A ,$18.19 , N/A ,$11.30 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695123,N/A,SET PRIMARY IV W/ 3 CLAVE PRTS 100IN,270,1 ,$12.21 ,$7.94 ,$6.45 ,$10.99 ,$8.36 , N/A ,$7.16 ,$7.16 , N/A ,$10.01 ,$10.38 ,$10.99 ,$9.16 ,$8.55 ,$9.04 ,$10.99 ,$10.38 , N/A ,$10.38 , N/A ,$6.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695159,N/A,POLYP TRAP SUCTION SINGLE,270,1 ,$9.00 ,$5.85 ,$4.75 ,$8.10 ,$6.17 , N/A ,$5.27 ,$5.27 , N/A ,$7.38 ,$7.65 ,$8.10 ,$6.75 ,$6.30 ,$6.66 ,$8.10 ,$7.65 , N/A ,$7.65 , N/A ,$4.75 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695160,N/A,POLYP TRAP SUCTION,270,1 ,$15.00 ,$9.75 ,$7.92 ,$13.50 ,$10.28 , N/A ,$8.79 ,$8.79 , N/A ,$12.30 ,$12.75 ,$13.50 ,$11.25 ,$10.50 ,$11.10 ,$13.50 ,$12.75 , N/A ,$12.75 , N/A ,$7.92 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695183,N/A,BLANKET FULL BODY WARMING,270,1 ,$14.08 ,$9.15 ,$7.43 ,$12.67 ,$9.64 , N/A ,$8.25 ,$8.25 , N/A ,$11.55 ,$11.97 ,$12.67 ,$10.56 ,$9.86 ,$10.42 ,$12.67 ,$11.97 , N/A ,$11.97 , N/A ,$7.43 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695188,N/A,TROCAR 5MM Z-THREAD BLADELESS,270,1 ,$51.00 ,$33.15 ,$26.93 ,$45.90 ,$34.94 , N/A ,$29.89 ,$29.89 , N/A ,$41.82 ,$43.35 ,$45.90 ,$38.25 ,$35.70 ,$37.74 ,$45.90 ,$43.35 , N/A ,$43.35 , N/A ,$26.93 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695189,N/A,TROCAR 11MM X 100MM NON BLADED,270,1 ,$144.80 ,$94.12 ,$76.45 ,$130.32 ,$99.19 , N/A ,$84.85 ,$84.85 , N/A ,$118.74 ,$123.08 ,$130.32 ,$108.60 ,$101.36 ,$107.15 ,$130.32 ,$123.08 , N/A ,$123.08 , N/A ,$76.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695190,N/A,TROCAR BALOON GELPORT 12X100,270,1 ,$81.00 ,$52.65 ,$42.77 ,$72.90 ,$55.49 , N/A ,$47.47 ,$47.47 , N/A ,$66.42 ,$68.85 ,$72.90 ,$60.75 ,$56.70 ,$59.94 ,$72.90 ,$68.85 , N/A ,$68.85 , N/A ,$42.77 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695198,N/A,VIAGUARD SUCTION CONVERTOR W/YANK,270,1 ,$44.90 ,$29.19 ,$23.71 ,$40.41 ,$30.76 , N/A ,$26.31 ,$26.31 , N/A ,$36.82 ,$38.17 ,$40.41 ,$33.68 ,$31.43 ,$33.23 ,$40.41 ,$38.17 , N/A ,$38.17 , N/A ,$23.71 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695205,N/A,SPLINT THUMB LEWIN-STERN,270,1 ,$42.00 ,$27.30 ,$22.18 ,$37.80 ,$28.77 , N/A ,$24.61 ,$24.61 , N/A ,$34.44 ,$35.70 ,$37.80 ,$31.50 ,$29.40 ,$31.08 ,$37.80 ,$35.70 , N/A ,$35.70 , N/A ,$22.18 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695209,N/A,RHINO ROCKET 4.5CM INFLATABLE,270,1 ,$112.50 ,$73.13 ,$59.40 ,$101.25 ,$77.06 , N/A ,$65.93 ,$65.93 , N/A ,$92.25 ,$95.63 ,$101.25 ,$84.38 ,$78.75 ,$83.25 ,$101.25 ,$95.63 , N/A ,$95.63 , N/A ,$59.40 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695211,N/A,DISSECTOR ENDOPATH 5MM,270,1 ,$38.64 ,$25.12 ,$20.40 ,$34.78 ,$26.47 , N/A ,$22.64 ,$22.64 , N/A ,$31.68 ,$32.84 ,$34.78 ,$28.98 ,$27.05 ,$28.59 ,$34.78 ,$32.84 , N/A ,$32.84 , N/A ,$20.40 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695220,N/A,RHINO ROCKET 5.5CM INFLATABLE,270,1 ,$106.80 ,$69.42 ,$56.39 ,$96.12 ,$73.16 , N/A ,$62.58 ,$62.58 , N/A ,$87.58 ,$90.78 ,$96.12 ,$80.10 ,$74.76 ,$79.03 ,$96.12 ,$90.78 , N/A ,$90.78 , N/A ,$56.39 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695221,N/A,RHINO ROCKET 7.5CM INFLATABLE,270,1 ,$110.10 ,$71.57 ,$58.13 ,$99.09 ,$75.42 , N/A ,$64.52 ,$64.52 , N/A ,$90.28 ,$93.59 ,$99.09 ,$82.58 ,$77.07 ,$81.47 ,$99.09 ,$93.59 , N/A ,$93.59 , N/A ,$58.13 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695237,N/A,TUBING SECONDARY IV,270,1 ,$2.10 ,$1.37 ,$1.11 ,$1.89 ,$1.44 , N/A ,$1.23 ,$1.23 , N/A ,$1.72 ,$1.79 ,$1.89 ,$1.58 ,$1.47 ,$1.55 ,$1.89 ,$1.79 , N/A ,$1.79 , N/A ,$1.11 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695240,N/A,TRAY EPIDURAL/SPINAL 27GA SPROTTE,270,1 ,$107.32 ,$69.76 ,$56.67 ,$96.59 ,$73.51 , N/A ,$62.89 ,$62.89 , N/A ,$88.00 ,$91.22 ,$96.59 ,$80.49 ,$75.12 ,$79.42 ,$96.59 ,$91.22 , N/A ,$91.22 , N/A ,$56.67 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695242,N/A,PUMP PAIN,270,1 ,$705.00 ,$458.25 ,$372.24 ,$634.50 ,$482.93 , N/A ,$413.13 ,$413.13 , N/A ,$578.10 ,$599.25 ,$634.50 ,$528.75 ,$493.50 ,$521.70 ,$634.50 ,$599.25 , N/A ,$599.25 , N/A ,$372.24 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695256,N/A,"BANDAGE ELASTIC 6""X11YD NS",270,1 ,$6.89 ,$4.48 ,$3.64 ,$6.20 ,$4.72 , N/A ,$4.04 ,$4.04 , N/A ,$5.65 ,$5.86 ,$6.20 ,$5.17 ,$4.82 ,$5.10 ,$6.20 ,$5.86 , N/A ,$5.86 , N/A ,$3.64 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695257,N/A,SAFETOUCH COLLECT SYSTEM W/ TISSUE TRAP,270,1 ,$31.75 ,$20.64 ,$16.76 ,$28.58 ,$21.75 , N/A ,$18.61 ,$18.61 , N/A ,$26.04 ,$26.99 ,$28.58 ,$23.81 ,$22.23 ,$23.50 ,$28.58 ,$26.99 , N/A ,$26.99 , N/A ,$16.76 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695259,N/A,DISPOSABLE COLLECTION SET,270,1 ,$18.00 ,$11.70 ,$9.50 ,$16.20 ,$12.33 , N/A ,$10.55 ,$10.55 , N/A ,$14.76 ,$15.30 ,$16.20 ,$13.50 ,$12.60 ,$13.32 ,$16.20 ,$15.30 , N/A ,$15.30 , N/A ,$9.50 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695261,N/A,CURETTE 10 MM CURVED,270,1 ,$13.90 ,$9.04 ,$7.34 ,$12.51 ,$9.52 , N/A ,$8.15 ,$8.15 , N/A ,$11.40 ,$11.82 ,$12.51 ,$10.43 ,$9.73 ,$10.29 ,$12.51 ,$11.82 , N/A ,$11.82 , N/A ,$7.34 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695285,N/A,TUBING PRIMARY IV W/ 2 CLAVE PORTS,270,1 ,$12.75 ,$8.29 ,$6.73 ,$11.48 ,$8.73 , N/A ,$7.47 ,$7.47 , N/A ,$10.46 ,$10.84 ,$11.48 ,$9.56 ,$8.93 ,$9.44 ,$11.48 ,$10.84 , N/A ,$10.84 , N/A ,$6.73 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695286,N/A,TUBING BLOOD PLUMSET,270,1 ,$37.27 ,$24.23 ,$19.68 ,$33.54 ,$25.53 , N/A ,$21.84 ,$21.84 , N/A ,$30.56 ,$31.68 ,$33.54 ,$27.95 ,$26.09 ,$27.58 ,$33.54 ,$31.68 , N/A ,$31.68 , N/A ,$19.68 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695287,N/A,TUBING PRIMARY PLUMSET (NITRO),270,1 ,$34.70 ,$22.56 ,$18.32 ,$31.23 ,$23.77 , N/A ,$20.33 ,$20.33 , N/A ,$28.45 ,$29.50 ,$31.23 ,$26.03 ,$24.29 ,$25.68 ,$31.23 ,$29.50 , N/A ,$29.50 , N/A ,$18.32 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695293,N/A,PLUM ANES SET EPIDURAL,270,1 ,$18.18 ,$11.82 ,$9.60 ,$16.36 ,$12.45 , N/A ,$10.65 ,$10.65 , N/A ,$14.91 ,$15.45 ,$16.36 ,$13.64 ,$12.73 ,$13.45 ,$16.36 ,$15.45 , N/A ,$15.45 , N/A ,$9.60 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695299,N/A,NEONATAL/ADULT DATASCOPE SPO2 SENSOR,270,1 ,$28.13 ,$18.28 ,$14.85 ,$25.32 ,$19.27 , N/A ,$16.48 ,$16.48 , N/A ,$23.07 ,$23.91 ,$25.32 ,$21.10 ,$19.69 ,$20.82 ,$25.32 ,$23.91 , N/A ,$23.91 , N/A ,$14.85 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695301,N/A,FORCEPS BIOPSY WITH NEEDLE (COLD),270,1 ,$44.90 ,$29.19 ,$23.71 ,$40.41 ,$30.76 , N/A ,$26.31 ,$26.31 , N/A ,$36.82 ,$38.17 ,$40.41 ,$33.68 ,$31.43 ,$33.23 ,$40.41 ,$38.17 , N/A ,$38.17 , N/A ,$23.71 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695310,N/A,SENSOR SPO2 PEDIATRIC (NELLCOR),270,1 ,$42.90 ,$27.89 ,$22.65 ,$38.61 ,$29.39 , N/A ,$25.14 ,$25.14 , N/A ,$35.18 ,$36.47 ,$38.61 ,$32.18 ,$30.03 ,$31.75 ,$38.61 ,$36.47 , N/A ,$36.47 , N/A ,$22.65 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695314,N/A,SENSOR QUATRO BIS MONITOR ADULT,270,1 ,$55.50 ,$36.08 ,$29.30 ,$49.95 ,$38.02 , N/A ,$32.52 ,$32.52 , N/A ,$45.51 ,$47.18 ,$49.95 ,$41.63 ,$38.85 ,$41.07 ,$49.95 ,$47.18 , N/A ,$47.18 , N/A ,$29.30 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695343,N/A,SNARE POLYPECTOMY ROTATABLE 13mm,270,1 ,$70.50 ,$45.83 ,$37.22 ,$63.45 ,$48.29 , N/A ,$41.31 ,$41.31 , N/A ,$57.81 ,$59.93 ,$63.45 ,$52.88 ,$49.35 ,$52.17 ,$63.45 ,$59.93 , N/A ,$59.93 , N/A ,$37.22 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695350,N/A,CUTTER LINEAR RELOAD 75mm,270,1 ,$178.90 ,$116.29 ,$94.46 ,$161.01 ,$122.55 , N/A ,$104.84 ,$104.84 , N/A ,$146.70 ,$152.07 ,$161.01 ,$134.18 ,$125.23 ,$132.39 ,$161.01 ,$152.07 , N/A ,$152.07 , N/A ,$94.46 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695352,N/A,SNARE 11MM OVAL MICRO-MINI,270,1 ,$41.40 ,$26.91 ,$21.86 ,$37.26 ,$28.36 , N/A ,$24.26 ,$24.26 , N/A ,$33.95 ,$35.19 ,$37.26 ,$31.05 ,$28.98 ,$30.64 ,$37.26 ,$35.19 , N/A ,$35.19 , N/A ,$21.86 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695355,N/A,STAPLER PROXIMATE 75mm,270,1 ,$335.49 ,$218.07 ,$177.14 ,$301.94 ,$229.81 , N/A ,$196.60 ,$196.60 , N/A ,$275.10 ,$285.17 ,$301.94 ,$251.62 ,$234.84 ,$248.26 ,$301.94 ,$285.17 , N/A ,$285.17 , N/A ,$177.14 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695365,N/A,LOCKING DEVICE RAPID EXCHANGE,270,1 ,$33.00 ,$21.45 ,$17.42 ,$29.70 ,$22.61 , N/A ,$19.34 ,$19.34 , N/A ,$27.06 ,$28.05 ,$29.70 ,$24.75 ,$23.10 ,$24.42 ,$29.70 ,$28.05 , N/A ,$28.05 , N/A ,$17.42 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695368,N/A,COLD SNARE OVAL THIN WIRE 10MM D,270,1 ,$19.80 ,$12.87 ,$10.45 ,$17.82 ,$13.56 , N/A ,$11.60 ,$11.60 , N/A ,$16.24 ,$16.83 ,$17.82 ,$14.85 ,$13.86 ,$14.65 ,$17.82 ,$16.83 , N/A ,$16.83 , N/A ,$10.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695390,N/A,ADHESIVE SKIN DERMABOND,270,1 ,$47.65 ,$30.97 ,$25.16 ,$42.89 ,$32.64 , N/A ,$27.92 ,$27.92 , N/A ,$39.07 ,$40.50 ,$42.89 ,$35.74 ,$33.36 ,$35.26 ,$42.89 ,$40.50 , N/A ,$40.50 , N/A ,$25.16 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695399,C1713,"STAPLE, COMPRESSIVE",278,1 ,"$3,945.00 ","$2,564.25 ","$2,311.77 ","$3,550.50 ","$2,702.33 ", N/A ,"$2,311.77 ","$2,311.77 ", N/A ,"$3,234.90 ","$3,353.25 ","$3,550.50 ","$2,958.75 ","$2,761.50 ","$2,919.30 ","$3,550.50 ","$3,353.25 ", N/A ,"$3,353.25 ", N/A ,"$2,367.00 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695406,N/A,TRAY SUTURE SET,270,1 ,$33.90 ,$22.04 ,$17.90 ,$30.51 ,$23.22 , N/A ,$19.87 ,$19.87 , N/A ,$27.80 ,$28.82 ,$30.51 ,$25.43 ,$23.73 ,$25.09 ,$30.51 ,$28.82 , N/A ,$28.82 , N/A ,$17.90 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695410,N/A,STAPLER 60MM,270,1 ,$210.18 ,$136.62 ,$110.98 ,$189.16 ,$143.97 , N/A ,$123.17 ,$123.17 , N/A ,$172.35 ,$178.65 ,$189.16 ,$157.64 ,$147.13 ,$155.53 ,$189.16 ,$178.65 , N/A ,$178.65 , N/A ,$110.98 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695417,N/A,BLADE FULL RADIUS 9X5X25.5,270,1 ,$21.00 ,$13.65 ,$11.09 ,$18.90 ,$14.39 , N/A ,$12.31 ,$12.31 , N/A ,$17.22 ,$17.85 ,$18.90 ,$15.75 ,$14.70 ,$15.54 ,$18.90 ,$17.85 , N/A ,$17.85 , N/A ,$11.09 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695423,N/A,STAPLER EEA 28MM,270,1 ,"$2,300.40 ","$1,495.26 ","$1,214.61 ","$2,070.36 ","$1,575.77 ", N/A ,"$1,348.03 ","$1,348.03 ", N/A ,"$1,886.33 ","$1,955.34 ","$2,070.36 ","$1,725.30 ","$1,610.28 ","$1,702.30 ","$2,070.36 ","$1,955.34 ", N/A ,"$1,955.34 ", N/A ,"$1,214.61 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695429,N/A,RESOLUTION CLIP - ROTATABLE (10/BX),270,1 ,$657.00 ,$427.05 ,$346.90 ,$591.30 ,$450.05 , N/A ,$385.00 ,$385.00 , N/A ,$538.74 ,$558.45 ,$591.30 ,$492.75 ,$459.90 ,$486.18 ,$591.30 ,$558.45 , N/A ,$558.45 , N/A ,$346.90 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695430,N/A,GOWN ADULT (BAIR PAWS),270,1 ,$28.02 ,$18.21 ,$14.79 ,$25.22 ,$19.19 , N/A ,$16.42 ,$16.42 , N/A ,$22.98 ,$23.82 ,$25.22 ,$21.02 ,$19.61 ,$20.73 ,$25.22 ,$23.82 , N/A ,$23.82 , N/A ,$14.79 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695431,N/A,GOWN ADULT XLG (BEAR PAWS),270,1 ,$39.42 ,$25.62 ,$20.81 ,$35.48 ,$27.00 , N/A ,$23.10 ,$23.10 , N/A ,$32.32 ,$33.51 ,$35.48 ,$29.57 ,$27.59 ,$29.17 ,$35.48 ,$33.51 , N/A ,$33.51 , N/A ,$20.81 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695438,N/A,BLADE PINAPPLE BURR 4MM X 8MM,270,1 ,$28.89 ,$18.78 ,$15.25 ,$26.00 ,$19.79 , N/A ,$16.93 ,$16.93 , N/A ,$23.69 ,$24.56 ,$26.00 ,$21.67 ,$20.22 ,$21.38 ,$26.00 ,$24.56 , N/A ,$24.56 , N/A ,$15.25 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695514,N/A,HANDLE PIECE DISPOSABLE - SINGLE,270,1 ,"$3,000.00 ","$1,950.00 ","$1,584.00 ","$2,700.00 ","$2,055.00 ", N/A ,"$1,758.00 ","$1,758.00 ", N/A ,"$2,460.00 ","$2,550.00 ","$2,700.00 ","$2,250.00 ","$2,100.00 ","$2,220.00 ","$2,700.00 ","$2,550.00 ", N/A ,"$2,550.00 ", N/A ,"$1,584.00 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695534,N/A,DILATOR BALLOON CRE 15-16.5-18mm,270,1 ,$516.00 ,$335.40 ,$272.45 ,$464.40 ,$353.46 , N/A ,$302.38 ,$302.38 , N/A ,$423.12 ,$438.60 ,$464.40 ,$387.00 ,$361.20 ,$381.84 ,$464.40 ,$438.60 , N/A ,$438.60 , N/A ,$272.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695535,N/A,DILATOR BALLOON CRE 12-13.5-15mm,270,1 ,$516.00 ,$335.40 ,$272.45 ,$464.40 ,$353.46 , N/A ,$302.38 ,$302.38 , N/A ,$423.12 ,$438.60 ,$464.40 ,$387.00 ,$361.20 ,$381.84 ,$464.40 ,$438.60 , N/A ,$438.60 , N/A ,$272.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695536,N/A,DILATOR BALLOON CRE 10-11-12mm,270,1 ,$516.00 ,$335.40 ,$272.45 ,$464.40 ,$353.46 , N/A ,$302.38 ,$302.38 , N/A ,$423.12 ,$438.60 ,$464.40 ,$387.00 ,$361.20 ,$381.84 ,$464.40 ,$438.60 , N/A ,$438.60 , N/A ,$272.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695584,N/A,CUTTER LINEAR FLEX45,270,1 ,$727.15 ,$472.65 ,$383.94 ,$654.44 ,$498.10 , N/A ,$426.11 ,$426.11 , N/A ,$596.26 ,$618.08 ,$654.44 ,$545.36 ,$509.01 ,$538.09 ,$654.44 ,$618.08 , N/A ,$618.08 , N/A ,$383.94 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695586,N/A,STAPLE LINEAR RELOAD 2.5,270,1 ,$415.44 ,$270.04 ,$219.35 ,$373.90 ,$284.58 , N/A ,$243.45 ,$243.45 , N/A ,$340.66 ,$353.12 ,$373.90 ,$311.58 ,$290.81 ,$307.43 ,$373.90 ,$353.12 , N/A ,$353.12 , N/A ,$219.35 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695587,N/A,STAPLE LINEAR RELOAD 3.5,270,1 ,$417.54 ,$271.40 ,$220.46 ,$375.79 ,$286.01 , N/A ,$244.68 ,$244.68 , N/A ,$342.38 ,$354.91 ,$375.79 ,$313.16 ,$292.28 ,$308.98 ,$375.79 ,$354.91 , N/A ,$354.91 , N/A ,$220.46 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695597,N/A,DELETE - CUTTER ECHELON RELOAD 60mm,270,1 ,$391.29 ,$254.34 ,$206.60 ,$352.16 ,$268.03 , N/A ,$229.30 ,$229.30 , N/A ,$320.86 ,$332.60 ,$352.16 ,$293.47 ,$273.90 ,$289.55 ,$352.16 ,$332.60 , N/A ,$332.60 , N/A ,$206.60 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695598,N/A,"CUTTER, LINEAR FLEX 60",270,1 ,$875.13 ,$568.83 ,$462.07 ,$787.62 ,$599.46 , N/A ,$512.83 ,$512.83 , N/A ,$717.61 ,$743.86 ,$787.62 ,$656.35 ,$612.59 ,$647.60 ,$787.62 ,$743.86 , N/A ,$743.86 , N/A ,$462.07 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695611,C1769,"K-WIRE, 3.0MM, ASNIS MICRO",278,1 ,$76.80 ,$49.92 ,$45.00 ,$69.12 ,$52.61 , N/A ,$45.00 ,$45.00 , N/A ,$62.98 ,$65.28 ,$69.12 ,$57.60 ,$53.76 ,$56.83 ,$69.12 ,$65.28 , N/A ,$65.28 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695612,C1713,"COUNTERSINK, 3.0MM ASNIS MICRO, CANNULAT",278,1 ,$556.80 ,$361.92 ,$326.28 ,$501.12 ,$381.41 , N/A ,$326.28 ,$326.28 , N/A ,$456.58 ,$473.28 ,$501.12 ,$417.60 ,$389.76 ,$412.03 ,$501.12 ,$473.28 , N/A ,$473.28 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695614,C1769,"K-WIRE, 2.0MM, ASNIS MICRO",278,1 ,$113.58 ,$73.83 ,$66.56 ,$102.22 ,$77.80 , N/A ,$66.56 ,$66.56 , N/A ,$93.14 ,$96.54 ,$102.22 ,$85.19 ,$79.51 ,$84.05 ,$102.22 ,$96.54 , N/A ,$96.54 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695615,C1713,"COUNTERSINK, 2.0MM ASNIS MICRO, CANNULAT",278,1 ,$885.63 ,$575.66 ,$518.98 ,$797.07 ,$606.66 , N/A ,$518.98 ,$518.98 , N/A ,$726.22 ,$752.79 ,$797.07 ,$664.22 ,$619.94 ,$655.37 ,$797.07 ,$752.79 , N/A ,$752.79 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695617,C1713,SCREW 2.0MM ASNIS MICRO CANN 12/5MM,278,1 ,$655.44 ,$426.04 ,$384.09 ,$589.90 ,$448.98 , N/A ,$384.09 ,$384.09 , N/A ,$537.46 ,$557.12 ,$589.90 ,$491.58 ,$458.81 ,$485.03 ,$589.90 ,$557.12 , N/A ,$557.12 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695631,N/A,DILATOR BALLOON CRE 18/19,270,1 ,$516.00 ,$335.40 ,$272.45 ,$464.40 ,$353.46 , N/A ,$302.38 ,$302.38 , N/A ,$423.12 ,$438.60 ,$464.40 ,$387.00 ,$361.20 ,$381.84 ,$464.40 ,$438.60 , N/A ,$438.60 , N/A ,$272.45 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695640,C2617,CONTOUR URETERAL STENT 2X24,278,1 ,$282.81 ,$183.83 ,$165.73 ,$254.53 ,$193.72 , N/A ,$165.73 ,$165.73 , N/A ,$231.90 ,$240.39 ,$254.53 ,$212.11 ,$197.97 ,$209.28 ,$254.53 ,$240.39 , N/A ,$240.39 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695641,C2617,CONTOUR URETERAL STENT 2X26,278,1 ,$284.91 ,$185.19 ,$166.96 ,$256.42 ,$195.16 , N/A ,$166.96 ,$166.96 , N/A ,$233.63 ,$242.17 ,$256.42 ,$213.68 ,$199.44 ,$210.83 ,$256.42 ,$242.17 , N/A ,$242.17 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),695800,N/A,PEP THERAPY SYSTEM RC CORNET CURAPLE,270,1 ,$89.85 ,$58.40 ,$47.44 ,$80.87 ,$61.55 , N/A ,$52.65 ,$52.65 , N/A ,$73.68 ,$76.37 ,$80.87 ,$67.39 ,$62.90 ,$66.49 ,$80.87 ,$76.37 , N/A ,$76.37 , N/A ,$47.44 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),697010,C1713,SCREW 3.0MM ASNIS MICRO CANNULATED,278,1 ,$492.66 ,$320.23 ,$288.70 ,$443.39 ,$337.47 , N/A ,$288.70 ,$288.70 , N/A ,$403.98 ,$418.76 ,$443.39 ,$369.50 ,$344.86 ,$364.57 ,$443.39 ,$418.76 , N/A ,$418.76 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),697012,N/A,"BUTTON, LOW PROFILE, 18FR, 2.4",270,1 ,$483.00 ,$313.95 ,$255.02 ,$434.70 ,$330.86 , N/A ,$283.04 ,$283.04 , N/A ,$396.06 ,$410.55 ,$434.70 ,$362.25 ,$338.10 ,$357.42 ,$434.70 ,$410.55 , N/A ,$410.55 , N/A ,$255.02 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),697015,N/A,"BUTTON, LOW PROFILE, 24FR, 3.4",270,1 ,$483.00 ,$313.95 ,$255.02 ,$434.70 ,$330.86 , N/A ,$283.04 ,$283.04 , N/A ,$396.06 ,$410.55 ,$434.70 ,$362.25 ,$338.10 ,$357.42 ,$434.70 ,$410.55 , N/A ,$410.55 , N/A ,$255.02 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698000,N/A,MASK LARYNGEAL AIRWAY SZ.3 (LMA),270,1 ,$18.25 ,$11.86 ,$9.64 ,$16.43 ,$12.50 , N/A ,$10.69 ,$10.69 , N/A ,$14.97 ,$15.51 ,$16.43 ,$13.69 ,$12.78 ,$13.51 ,$16.43 ,$15.51 , N/A ,$15.51 , N/A ,$9.64 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698001,N/A,MASK LARYNGEAL SZ 4 ADULT (LMA),270,1 ,$18.50 ,$12.03 ,$9.77 ,$16.65 ,$12.67 , N/A ,$10.84 ,$10.84 , N/A ,$15.17 ,$15.73 ,$16.65 ,$13.88 ,$12.95 ,$13.69 ,$16.65 ,$15.73 , N/A ,$15.73 , N/A ,$9.77 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698002,N/A,MASK LARYNGEAL SZ 5 ADULT (LMA),270,1 ,$18.25 ,$11.86 ,$9.64 ,$16.43 ,$12.50 , N/A ,$10.69 ,$10.69 , N/A ,$14.97 ,$15.51 ,$16.43 ,$13.69 ,$12.78 ,$13.51 ,$16.43 ,$15.51 , N/A ,$15.51 , N/A ,$9.64 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698007,N/A,MAX CORE BIOPSY INSTRUMENT 18G X 20CM,270,1 ,"$1,231.52 ",$800.49 ,$650.24 ,"$1,108.37 ",$843.59 , N/A ,$721.67 ,$721.67 , N/A ,"$1,009.85 ","$1,046.79 ","$1,108.37 ",$923.64 ,$862.06 ,$911.32 ,"$1,108.37 ","$1,046.79 ", N/A ,"$1,046.79 ", N/A ,$650.24 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698008,V2632,LENS TORIC INTRAOCULAR,276,1 ,"$1,560.00 ","$1,014.00 ",$914.16 ,"$1,404.00 ","$1,068.60 ", N/A ,$914.16 ,$914.16 , N/A ,"$1,279.20 ","$1,326.00 ","$1,404.00 ","$1,170.00 ","$1,092.00 ","$1,154.40 ","$1,404.00 ","$1,326.00 ", N/A ,"$1,326.00 ", N/A ,$936.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698009,N/A,"GEL, ORISE, WITH NEEDLE",270,1 ,$585.00 ,$380.25 ,$308.88 ,$526.50 ,$400.73 , N/A ,$342.81 ,$342.81 , N/A ,$479.70 ,$497.25 ,$526.50 ,$438.75 ,$409.50 ,$432.90 ,$526.50 ,$497.25 , N/A ,$497.25 , N/A ,$308.88 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698010,N/A,STATLOCK STABILIZATON DEVICE PICC,270,1 ,$20.73 ,$13.47 ,$10.95 ,$18.66 ,$14.20 , N/A ,$12.15 ,$12.15 , N/A ,$17.00 ,$17.62 ,$18.66 ,$15.55 ,$14.51 ,$15.34 ,$18.66 ,$17.62 , N/A ,$17.62 , N/A ,$10.95 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698011,V2632,LENS PAN OPTIX,276,1 ,"$3,060.00 ","$1,989.00 ","$1,793.16 ","$2,754.00 ","$2,096.10 ", N/A ,"$1,793.16 ","$1,793.16 ", N/A ,"$2,509.20 ","$2,601.00 ","$2,754.00 ","$2,295.00 ","$2,142.00 ","$2,264.40 ","$2,754.00 ","$2,601.00 ", N/A ,"$2,601.00 ", N/A ,"$1,836.00 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698012,N/A,IMPLANT SIZER RTS SIZE 1-4,270,1 ,"$1,485.00 ",$965.25 ,$784.08 ,"$1,336.50 ","$1,017.23 ", N/A ,$870.21 ,$870.21 , N/A ,"$1,217.70 ","$1,262.25 ","$1,336.50 ","$1,113.75 ","$1,039.50 ","$1,098.90 ","$1,336.50 ","$1,262.25 ", N/A ,"$1,262.25 ", N/A ,$784.08 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698013,N/A,IMPLANT W/ GROMMETS,270,1 ,"$8,985.00 ","$5,840.25 ","$4,744.08 ","$8,086.50 ","$6,154.73 ", N/A ,"$5,265.21 ","$5,265.21 ", N/A ,"$7,367.70 ","$7,637.25 ","$8,086.50 ","$6,738.75 ","$6,289.50 ","$6,648.90 ","$8,086.50 ","$7,637.25 ", N/A ,"$7,637.25 ", N/A ,"$4,744.08 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698026,N/A,TUBE ENDOTRACH CUFF 5.5MM,270,1 ,$5.10 ,$3.32 ,$2.69 ,$4.59 ,$3.49 , N/A ,$2.99 ,$2.99 , N/A ,$4.18 ,$4.34 ,$4.59 ,$3.83 ,$3.57 ,$3.77 ,$4.59 ,$4.34 , N/A ,$4.34 , N/A ,$2.69 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698028,N/A,TUBE ENDOTRACH CUFF 6.5MM,270,1 ,$5.10 ,$3.32 ,$2.69 ,$4.59 ,$3.49 , N/A ,$2.99 ,$2.99 , N/A ,$4.18 ,$4.34 ,$4.59 ,$3.83 ,$3.57 ,$3.77 ,$4.59 ,$4.34 , N/A ,$4.34 , N/A ,$2.69 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698031,N/A,CIRCUIT BREATHING ADULT,270,1 ,$11.34 ,$7.37 ,$5.99 ,$10.21 ,$7.77 , N/A ,$6.65 ,$6.65 , N/A ,$9.30 ,$9.64 ,$10.21 ,$8.51 ,$7.94 ,$8.39 ,$10.21 ,$9.64 , N/A ,$9.64 , N/A ,$5.99 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698038,N/A,TUBE ENDOTRACH CUFF 7.0MM,270,1 ,$6.84 ,$4.45 ,$3.61 ,$6.16 ,$4.69 , N/A ,$4.01 ,$4.01 , N/A ,$5.61 ,$5.81 ,$6.16 ,$5.13 ,$4.79 ,$5.06 ,$6.16 ,$5.81 , N/A ,$5.81 , N/A ,$3.61 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698039,N/A,TUBE ENDOTRACH CUFF 7.5MM,270,1 ,$4.30 ,$2.80 ,$2.27 ,$3.87 ,$2.95 , N/A ,$2.52 ,$2.52 , N/A ,$3.53 ,$3.66 ,$3.87 ,$3.23 ,$3.01 ,$3.18 ,$3.87 ,$3.66 , N/A ,$3.66 , N/A ,$2.27 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698040,N/A,TUBE ENDOTRACH CUFF 8.0MM MURPHY,270,1 ,$6.84 ,$4.45 ,$3.61 ,$6.16 ,$4.69 , N/A ,$4.01 ,$4.01 , N/A ,$5.61 ,$5.81 ,$6.16 ,$5.13 ,$4.79 ,$5.06 ,$6.16 ,$5.81 , N/A ,$5.81 , N/A ,$3.61 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698048,N/A,ET TUBE HOLDER,270,1 ,$13.05 ,$8.48 ,$6.89 ,$11.75 ,$8.94 , N/A ,$7.65 ,$7.65 , N/A ,$10.70 ,$11.09 ,$11.75 ,$9.79 ,$9.14 ,$9.66 ,$11.75 ,$11.09 , N/A ,$11.09 , N/A ,$6.89 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698051,N/A,"SHEATH, #3, COPILOT",270,1 ,$30.00 ,$19.50 ,$15.84 ,$27.00 ,$20.55 , N/A ,$17.58 ,$17.58 , N/A ,$24.60 ,$25.50 ,$27.00 ,$22.50 ,$21.00 ,$22.20 ,$27.00 ,$25.50 , N/A ,$25.50 , N/A ,$15.84 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698052,N/A,"SHEATH, #4, COPILOT",270,1 ,$36.00 ,$23.40 ,$19.01 ,$32.40 ,$24.66 , N/A ,$21.10 ,$21.10 , N/A ,$29.52 ,$30.60 ,$32.40 ,$27.00 ,$25.20 ,$26.64 ,$32.40 ,$30.60 , N/A ,$30.60 , N/A ,$19.01 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698053,N/A,"BOUGIE, COPILOT",270,1 ,$15.00 ,$9.75 ,$7.92 ,$13.50 ,$10.28 , N/A ,$8.79 ,$8.79 , N/A ,$12.30 ,$12.75 ,$13.50 ,$11.25 ,$10.50 ,$11.10 ,$13.50 ,$12.75 , N/A ,$12.75 , N/A ,$7.92 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698063,N/A,TUBE ET 4.5MM UNCUFFED PED'S,270,1 ,$3.40 ,$2.21 ,$1.80 ,$3.06 ,$2.33 , N/A ,$1.99 ,$1.99 , N/A ,$2.79 ,$2.89 ,$3.06 ,$2.55 ,$2.38 ,$2.52 ,$3.06 ,$2.89 , N/A ,$2.89 , N/A ,$1.80 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698071,N/A,INFLATION DEVICE ONCORE 26,270,1 ,$210.00 ,$136.50 ,$110.88 ,$189.00 ,$143.85 , N/A ,$123.06 ,$123.06 , N/A ,$172.20 ,$178.50 ,$189.00 ,$157.50 ,$147.00 ,$155.40 ,$189.00 ,$178.50 , N/A ,$178.50 , N/A ,$110.88 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698087,N/A,KIT CATHETER CVC MULTI LUMEN 7FR,270,1 ,$304.56 ,$197.96 ,$160.81 ,$274.10 ,$208.62 , N/A ,$178.47 ,$178.47 , N/A ,$249.74 ,$258.88 ,$274.10 ,$228.42 ,$213.19 ,$225.37 ,$274.10 ,$258.88 , N/A ,$258.88 , N/A ,$160.81 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698106,C1726,"BALLOON DILATORS 12, 13.5 / 15",270,1 ,$598.20 ,$388.83 ,$315.85 ,$538.38 ,$409.77 , N/A ,$350.55 ,$350.55 , N/A ,$490.52 ,$508.47 ,$538.38 ,$448.65 ,$418.74 ,$442.67 ,$538.38 ,$508.47 , N/A ,$508.47 , N/A ,$315.85 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698803,C1713,"RING, CAPSULAR TENSION",278,1 ,$900.00 ,$585.00 ,$527.40 ,$810.00 ,$616.50 , N/A ,$527.40 ,$527.40 , N/A ,$738.00 ,$765.00 ,$810.00 ,$675.00 ,$630.00 ,$666.00 ,$810.00 ,$765.00 , N/A ,$765.00 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698804,V2632,LENS RESTOR,276,1 ,"$2,760.00 ","$1,794.00 ","$1,617.36 ","$2,484.00 ","$1,890.60 ", N/A ,"$1,617.36 ","$1,617.36 ", N/A ,"$2,263.20 ","$2,346.00 ","$2,484.00 ","$2,070.00 ","$1,932.00 ","$2,042.40 ","$2,484.00 ","$2,346.00 ", N/A ,"$2,346.00 ", N/A ,"$1,656.00 ", N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698807,N/A,CATHETER EXTERNAL FEMALE,270,1 ,$19.77 ,$12.85 ,$10.44 ,$17.79 ,$13.54 , N/A ,$11.59 ,$11.59 , N/A ,$16.21 ,$16.80 ,$17.79 ,$14.83 ,$13.84 ,$14.63 ,$17.79 ,$16.80 , N/A ,$16.80 , N/A ,$10.44 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),698809,N/A,NEEDLE GUIDE ENDOCAVITY,270,1 ,$45.62 ,$29.65 ,$24.09 ,$41.06 ,$31.25 , N/A ,$26.73 ,$26.73 , N/A ,$37.41 ,$38.78 ,$41.06 ,$34.22 ,$31.93 ,$33.76 ,$41.06 ,$38.78 , N/A ,$38.78 , N/A ,$24.09 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),699997,N/A,COAPTATE,270,1 ,"$1,096.98 ",$713.04 ,$579.21 ,$987.28 ,$751.43 , N/A ,$642.83 ,$642.83 , N/A ,$899.52 ,$932.43 ,$987.28 ,$822.74 ,$767.89 ,$811.77 ,$987.28 ,$932.43 , N/A ,$932.43 , N/A ,$579.21 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),699998,N/A,NEEDLE INJECTION FOR COAPTATE,270,1 ,$132.54 ,$86.15 ,$69.98 ,$119.29 ,$90.79 , N/A ,$77.67 ,$77.67 , N/A ,$108.68 ,$112.66 ,$119.29 ,$99.41 ,$92.78 ,$98.08 ,$119.29 ,$112.66 , N/A ,$112.66 , N/A ,$69.98 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),71000,36430,BLOOD ADMINISTRATION IFS,391,1 ,$557.00 ,$362.05 ,$272.00 ,$797.24 ,$381.55 ,$370.81 ,$326.40 ,$326.40 ,$378.23 ,$456.74 ,$473.45 ,$501.30 ,$417.75 ,$389.90 ,$412.18 ,$501.30 ,$473.45 ,$370.81 ,$473.45 ,$797.24 ,$272.00 ,$370.81 
HSHS HOLY FAMILY HOSPITAL INC (ACU),713000,97803,MEDICAL NUTRITION THERAPY-15 MIN (REASSE,942,1 ,$47.00 ,$30.55 ,$27.54 ,$70.37 ,$32.20 ,$27.82 ,$27.54 ,$27.54 ,$27.82 ,$38.54 ,$39.95 ,$42.30 ,$35.25 ,$32.90 ,$34.78 ,$42.30 ,$39.95 ,$27.82 ,$39.95 ,$70.37 ,$47.00 ,$27.82 
HSHS HOLY FAMILY HOSPITAL INC (ACU),714000,97802,MEDICAL NUTRITION THERAPY 15 MIN INITIAL,942,1 ,$47.00 ,$30.55 ,$27.54 ,$80.95 ,$32.20 ,$32.00 ,$27.54 ,$27.54 ,$32.00 ,$38.54 ,$39.95 ,$42.30 ,$35.25 ,$32.90 ,$34.78 ,$42.30 ,$39.95 ,$32.00 ,$39.95 ,$80.95 ,$47.00 ,$32.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),72022,96413,CHEMO BY IV INF FIRST 16 MIN UP TO 1 HR,335,1 ,$605.00 ,$393.25 ,$295.85 ,$636.09 ,$414.43 ,$295.85 ,$354.53 ,$354.53 ,$301.77 ,$496.10 ,$514.25 ,$544.50 ,$453.75 ,$423.50 ,$447.70 ,$544.50 ,$514.25 ,$295.85 ,$514.25 ,$636.09 ,$605.00 ,$295.85 
HSHS HOLY FAMILY HOSPITAL INC (ACU),72023,96415,CHEMO INFUSION EA ADTL HOUR UP TO 8 HRS,335,1 ,$202.00 ,$131.30 ,$57.79 ,$202.00 ,$138.37 ,$57.79 ,$118.37 ,$118.37 ,$58.94 ,$165.64 ,$171.70 ,$181.80 ,$151.50 ,$141.40 ,$149.48 ,$181.80 ,$171.70 ,$57.79 ,$171.70 ,$124.24 ,$202.00 ,$57.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),72034,96401,CHEMO BY SQ/IM NON-HORMONAL ANTINEOPLAST,331,1 ,$202.00 ,$131.30 ,$57.79 ,$202.00 ,$138.37 ,$57.79 ,$118.37 ,$118.37 ,$58.94 ,$165.64 ,$171.70 ,$181.80 ,$151.50 ,$141.40 ,$149.48 ,$181.80 ,$171.70 ,$57.79 ,$171.70 ,$124.24 ,$202.00 ,$57.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),72070,96523,PORT FLUSH,940,1 ,$161.00 ,$104.65 ,$52.57 ,$144.90 ,$110.29 ,$52.57 ,$94.35 ,$94.35 ,$53.62 ,$132.02 ,$136.85 ,$144.90 ,$120.75 ,$112.70 ,$119.14 ,$144.90 ,$136.85 ,$52.57 ,$136.85 ,$113.02 ,$142.00 ,$52.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),72071,36591,INFUSAPORT BLOOD DRAW,940,1 ,$209.00 ,$135.85 ,$104.19 ,$224.01 ,$143.17 ,$104.19 ,$122.47 ,$122.47 ,$106.27 ,$171.38 ,$177.65 ,$188.10 ,$156.75 ,$146.30 ,$154.66 ,$188.10 ,$177.65 ,$104.19 ,$177.65 ,$224.01 ,$142.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),72072,36592,BLOOD DRAW-PERIPH OR CENTRAL VENOUS ACCE,940,1 ,$209.00 ,$135.85 ,$104.19 ,$224.01 ,$143.17 ,$104.19 ,$122.47 ,$122.47 ,$106.27 ,$171.38 ,$177.65 ,$188.10 ,$156.75 ,$146.30 ,$154.66 ,$188.10 ,$177.65 ,$104.19 ,$177.65 ,$224.01 ,$142.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),74012,95115,ALLERGY INJECTION SINGLE,940,1 ,$121.00 ,$78.65 ,$36.42 ,$121.00 ,$82.89 ,$36.42 ,$70.91 ,$70.91 ,$37.15 ,$99.22 ,$102.85 ,$108.90 ,$90.75 ,$84.70 ,$89.54 ,$108.90 ,$102.85 ,$36.42 ,$102.85 ,$78.30 ,$121.00 ,$36.42 
HSHS HOLY FAMILY HOSPITAL INC (ACU),74013,95117,ALLERGY INJECTION MULTIPLE,940,1 ,$190.00 ,$123.50 ,$36.42 ,$171.00 ,$130.15 ,$36.42 ,$111.34 ,$111.34 ,$37.15 ,$155.80 ,$161.50 ,$171.00 ,$142.50 ,$133.00 ,$140.60 ,$171.00 ,$161.50 ,$36.42 ,$161.50 ,$78.30 ,$142.00 ,$36.42 
HSHS HOLY FAMILY HOSPITAL INC (ACU),750030,G0108,"DSME INDIVIDUAL, PER 30 MIN",942,1 ,$40.00 ,$26.00 ,$23.44 ,$122.42 ,$27.40 ,$56.94 ,$23.44 ,$23.44 ,$58.08 ,$32.80 ,$34.00 ,$36.00 ,$30.00 ,$28.00 ,$29.60 ,$36.00 ,$34.00 ,$56.94 ,$34.00 ,$122.42 ,$40.00 ,$56.94 
HSHS HOLY FAMILY HOSPITAL INC (ACU),750031,98961,"DSME 2-4 PATIENTS, PER 30 MIN",942,1 ,$28.00 ,$18.20 ,$16.41 ,$28.00 ,$19.18 , N/A ,$16.41 ,$16.41 , N/A ,$22.96 ,$23.80 ,$25.20 ,$21.00 ,$19.60 ,$20.72 ,$25.20 ,$23.80 , N/A ,$23.80 , N/A ,$28.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),77014,99211,IFS PICC LINE REMOVAL,761,1 ,$242.00 ,$157.30 ,$127.78 ,$217.80 ,$165.77 , N/A ,$141.81 ,$141.81 , N/A ,$198.44 ,$205.70 ,$217.80 ,$181.50 ,$169.40 ,$179.08 ,$217.80 ,$205.70 , N/A ,$205.70 , N/A ,$127.78 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),80030,N/A,AM-OUT OF DISTRICT,540,1 ,$278.00 ,$180.70 ,$162.91 ,$278.00 ,$190.43 , N/A ,$162.91 ,$162.91 , N/A ,$227.96 ,$236.30 ,$250.20 ,$208.50 ,$194.60 ,$205.72 ,$250.20 ,$236.30 , N/A ,$236.30 , N/A ,$278.00 ,$278.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),80040,N/A,AM-BODY REMOVAL,540,1 ,$169.00 ,$109.85 ,$99.03 ,$169.00 ,$115.77 , N/A ,$99.03 ,$99.03 , N/A ,$138.58 ,$143.65 ,$152.10 ,$126.75 ,$118.30 ,$125.06 ,$152.10 ,$143.65 , N/A ,$143.65 , N/A ,$169.00 ,$169.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),80100,A0425,AM-MILEAGE-PER MILE TO GRH,540,1 ,$25.00 ,$16.25 ,$14.65 ,$25.00 ,$17.13 , N/A ,$14.65 ,$14.65 , N/A ,$20.50 ,$21.25 ,$22.50 ,$18.75 ,$17.50 ,$18.50 ,$22.50 ,$21.25 , N/A ,$21.25 , N/A ,$25.00 ,$25.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),80101,A0425,AM-MILEAGE-PER MILE FROM GRH,540,1 ,$25.00 ,$16.25 ,$14.65 ,$25.00 ,$17.13 , N/A ,$14.65 ,$14.65 , N/A ,$20.50 ,$21.25 ,$22.50 ,$18.75 ,$17.50 ,$18.50 ,$22.50 ,$21.25 , N/A ,$21.25 , N/A ,$25.00 ,$25.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),80200,A0422,AM-OXYGEN,540,1 ,$45.00 ,$29.25 ,$26.37 ,$45.00 ,$30.83 , N/A ,$26.37 ,$26.37 , N/A ,$36.90 ,$38.25 ,$40.50 ,$33.75 ,$31.50 ,$33.30 ,$40.50 ,$38.25 , N/A ,$38.25 , N/A ,$45.00 ,$45.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),80500,A0998,AM-RESPOND AND TREAT NO TRANSPORT,540,1 ,$960.00 ,$624.00 ,$350.00 ,$947.00 ,$657.60 , N/A ,$562.56 ,$562.56 , N/A ,$787.20 ,$816.00 ,$864.00 ,$720.00 ,$672.00 ,$710.40 ,$864.00 ,$816.00 , N/A ,$816.00 , N/A ,$947.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),82001,A0428,BLS NON EMERGENCY TO GRH,540,1 ,$705.00 ,$458.25 ,$350.00 ,$705.00 ,$482.93 , N/A ,$413.13 ,$413.13 , N/A ,$578.10 ,$599.25 ,$634.50 ,$528.75 ,$493.50 ,$521.70 ,$634.50 ,$599.25 , N/A ,$599.25 , N/A ,$705.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),82009,A0434,SCT SPECIALTY CARE TRANSPORT,540,1 ,"$1,848.00 ","$1,201.20 ",$350.00 ,"$1,663.20 ","$1,265.88 ", N/A ,"$1,082.93 ","$1,082.93 ", N/A ,"$1,515.36 ","$1,570.80 ","$1,663.20 ","$1,386.00 ","$1,293.60 ","$1,367.52 ","$1,663.20 ","$1,570.80 ", N/A ,"$1,570.80 ", N/A ,$947.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),82010,A0429,BLS EMERGENCY TO GRH,540,1 ,"$1,248.00 ",$811.20 ,$350.00 ,"$1,123.20 ",$854.88 , N/A ,$731.33 ,$731.33 , N/A ,"$1,023.36 ","$1,060.80 ","$1,123.20 ",$936.00 ,$873.60 ,$923.52 ,"$1,123.20 ","$1,060.80 ", N/A ,"$1,060.80 ", N/A ,$947.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),82101,A0426,ALS 1 NON EMERGENCY TO GRH,540,1 ,$960.00 ,$624.00 ,$350.00 ,$947.00 ,$657.60 , N/A ,$562.56 ,$562.56 , N/A ,$787.20 ,$816.00 ,$864.00 ,$720.00 ,$672.00 ,$710.40 ,$864.00 ,$816.00 , N/A ,$816.00 , N/A ,$947.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),82110,A0427,ALS 1 EMERGENCY TO GRH,540,1 ,"$1,520.00 ",$988.00 ,$350.00 ,"$1,368.00 ","$1,041.20 ", N/A ,$890.72 ,$890.72 , N/A ,"$1,246.40 ","$1,292.00 ","$1,368.00 ","$1,140.00 ","$1,064.00 ","$1,124.80 ","$1,368.00 ","$1,292.00 ", N/A ,"$1,292.00 ", N/A ,$947.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),82201,A0433,ALS 2 TO GRH,540,1 ,"$1,673.00 ","$1,087.45 ",$350.00 ,"$1,505.70 ","$1,146.01 ", N/A ,$980.38 ,$980.38 , N/A ,"$1,371.86 ","$1,422.05 ","$1,505.70 ","$1,254.75 ","$1,171.10 ","$1,238.02 ","$1,505.70 ","$1,422.05 ", N/A ,"$1,422.05 ", N/A ,$947.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),83001,A0428,BLS NON EMERGENCY FROM GRH,540,1 ,$705.00 ,$458.25 ,$350.00 ,$705.00 ,$482.93 , N/A ,$413.13 ,$413.13 , N/A ,$578.10 ,$599.25 ,$634.50 ,$528.75 ,$493.50 ,$521.70 ,$634.50 ,$599.25 , N/A ,$599.25 , N/A ,$705.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),83010,A0429,BLS EMERGENCY FROM GRH,540,1 ,"$1,248.00 ",$811.20 ,$350.00 ,"$1,123.20 ",$854.88 , N/A ,$731.33 ,$731.33 , N/A ,"$1,023.36 ","$1,060.80 ","$1,123.20 ",$936.00 ,$873.60 ,$923.52 ,"$1,123.20 ","$1,060.80 ", N/A ,"$1,060.80 ", N/A ,$947.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),83101,A0426,ALS 1 NON EMERGENCY FROM GRH,540,1 ,$960.00 ,$624.00 ,$350.00 ,$947.00 ,$657.60 , N/A ,$562.56 ,$562.56 , N/A ,$787.20 ,$816.00 ,$864.00 ,$720.00 ,$672.00 ,$710.40 ,$864.00 ,$816.00 , N/A ,$816.00 , N/A ,$947.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),83110,A0427,ALS 1 EMERGENCY FROM GRH,540,1 ,"$1,520.00 ",$988.00 ,$350.00 ,"$1,368.00 ","$1,041.20 ", N/A ,$890.72 ,$890.72 , N/A ,"$1,246.40 ","$1,292.00 ","$1,368.00 ","$1,140.00 ","$1,064.00 ","$1,124.80 ","$1,368.00 ","$1,292.00 ", N/A ,"$1,292.00 ", N/A ,$947.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),83201,A0433,ALS 2 FROM GRH,540,1 ,"$1,673.00 ","$1,087.45 ",$350.00 ,"$1,505.70 ","$1,146.01 ", N/A ,$980.38 ,$980.38 , N/A ,"$1,371.86 ","$1,422.05 ","$1,505.70 ","$1,254.75 ","$1,171.10 ","$1,238.02 ","$1,505.70 ","$1,422.05 ", N/A ,"$1,422.05 ", N/A ,$947.00 ,$350.00 
HSHS HOLY FAMILY HOSPITAL INC (ACU),90001,99281,ER-LEVEL I,450,1 ,$244.00 ,$158.60 ,$66.53 ,$244.00 ,$167.14 ,$66.53 ,$142.98 ,$142.98 ,$67.86 ,$200.08 ,$207.40 ,$219.60 ,$183.00 ,$170.80 ,$180.56 ,$219.60 ,$207.40 ,$66.53 ,$207.40 ,$143.04 ,$244.00 ,$66.53 
HSHS HOLY FAMILY HOSPITAL INC (ACU),90002,99282,ER-LEVEL II,450,1 ,$403.00 ,$261.95 ,$122.28 ,$403.00 ,$276.06 ,$122.28 ,$236.16 ,$236.16 ,$124.72 ,$330.46 ,$342.55 ,$362.70 ,$302.25 ,$282.10 ,$298.22 ,$362.70 ,$342.55 ,$122.28 ,$342.55 ,$262.90 ,$403.00 ,$122.28 
HSHS HOLY FAMILY HOSPITAL INC (ACU),90003,99283,ER-LEVEL III,450,1 ,$641.00 ,$416.65 ,$213.42 ,$641.00 ,$439.09 ,$213.42 ,$375.63 ,$375.63 ,$217.69 ,$525.62 ,$544.85 ,$576.90 ,$480.75 ,$448.70 ,$474.34 ,$576.90 ,$544.85 ,$213.42 ,$544.85 ,$458.86 ,$641.00 ,$213.42 
HSHS HOLY FAMILY HOSPITAL INC (ACU),90004,99284,ER LEVEL IV,450,1 ,"$1,023.00 ",$664.95 ,$336.17 ,"$1,023.00 ",$700.76 ,$336.17 ,$599.48 ,$599.48 ,$342.89 ,$838.86 ,$869.55 ,$920.70 ,$767.25 ,$716.10 ,$757.02 ,$920.70 ,$869.55 ,$336.17 ,$869.55 ,$722.77 ,"$1,023.00 ",$336.17 
HSHS HOLY FAMILY HOSPITAL INC (ACU),90005,99285,ER LEVEL V,450,1 ,"$1,506.00 ",$978.90 ,$482.11 ,"$1,506.00 ","$1,031.61 ",$482.11 ,$882.52 ,$882.52 ,$491.75 ,"$1,234.92 ","$1,280.10 ","$1,355.40 ","$1,129.50 ","$1,054.20 ","$1,114.44 ","$1,355.40 ","$1,280.10 ",$482.11 ,"$1,280.10 ","$1,036.54 ","$1,506.00 ",$482.11 
HSHS HOLY FAMILY HOSPITAL INC (ACU),90006,99291,ER-LEVEL VI-CRITICAL CARE,450,1 ,"$2,158.00 ","$1,402.70 ",$637.06 ,"$2,011.00 ","$1,478.23 ",$637.06 ,"$1,264.59 ","$1,264.59 ",$649.80 ,"$1,769.56 ","$1,834.30 ","$1,942.20 ","$1,618.50 ","$1,510.60 ","$1,596.92 ","$1,942.20 ","$1,834.30 ",$637.06 ,"$1,834.30 ","$1,369.68 ","$2,011.00 ",$637.06 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93010,96368,IV INFUSION CONCURRENT,260,1 ,$186.00 ,$120.90 ,$109.00 ,$186.00 ,$127.41 , N/A ,$109.00 ,$109.00 , N/A ,$152.52 ,$158.10 ,$167.40 ,$139.50 ,$130.20 ,$137.64 ,$167.40 ,$158.10 , N/A ,$158.10 , N/A ,$186.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93011,96367,IV INFUSION EACH SEQ UP TO 1 HOUR,260,1 ,$186.00 ,$120.90 ,$57.79 ,$186.00 ,$127.41 ,$57.79 ,$109.00 ,$109.00 ,$58.94 ,$152.52 ,$158.10 ,$167.40 ,$139.50 ,$130.20 ,$137.64 ,$167.40 ,$158.10 ,$57.79 ,$158.10 ,$124.24 ,$186.00 ,$57.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93019,96375,"IV PUSH, SEQUENTIAL (NEW)",260,1 ,$172.00 ,$111.80 ,$36.42 ,$172.00 ,$117.82 ,$36.42 ,$100.79 ,$100.79 ,$37.15 ,$141.04 ,$146.20 ,$154.80 ,$129.00 ,$120.40 ,$127.28 ,$154.80 ,$146.20 ,$36.42 ,$146.20 ,$78.30 ,$172.00 ,$36.42 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93020,96376,"IV DRUG, EACH OR REPEATED",260,1 ,$172.00 ,$111.80 ,$100.79 ,$172.00 ,$117.82 , N/A ,$100.79 ,$100.79 , N/A ,$141.04 ,$146.20 ,$154.80 ,$129.00 ,$120.40 ,$127.28 ,$154.80 ,$146.20 , N/A ,$146.20 , N/A ,$172.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93059,10060,ER-I & D SMALL ABSCESS,450,1 ,$492.00 ,$319.80 ,$166.97 ,$492.00 ,$337.02 ,$166.97 ,$288.31 ,$288.31 ,$170.31 ,$403.44 ,$418.20 ,$442.80 ,$369.00 ,$344.40 ,$364.08 ,$442.80 ,$418.20 ,$166.97 ,$418.20 ,$358.99 ,$492.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93061,10061,ER-DRAIN OF ABSCESS-COMPLICATED,450,1 ,$492.00 ,$319.80 ,$288.31 ,$656.45 ,$337.02 ,$305.32 ,$288.31 ,$288.31 ,$311.43 ,$403.44 ,$418.20 ,$442.80 ,$369.00 ,$344.40 ,$364.08 ,$442.80 ,$418.20 ,$305.32 ,$418.20 ,$656.45 ,$492.00 ,$305.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93075,10080,ER-DRAIN OF PILON CYST-SIMPLE,450,1 ,$492.00 ,$319.80 ,$288.31 ,"$1,253.29 ",$337.02 ,$582.93 ,$288.31 ,$288.31 ,$594.58 ,$403.44 ,$418.20 ,$442.80 ,$369.00 ,$344.40 ,$364.08 ,$442.80 ,$418.20 ,$582.93 ,$418.20 ,"$1,253.29 ",$492.00 ,$582.93 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93120,10120,ER-FOREIGN BODY-SIMPLE WITH INCISION,450,1 ,$928.00 ,$603.20 ,$305.32 ,$835.20 ,$635.68 ,$305.32 ,$543.81 ,$543.81 ,$311.43 ,$760.96 ,$788.80 ,$835.20 ,$696.00 ,$649.60 ,$686.72 ,$835.20 ,$788.80 ,$305.32 ,$788.80 ,$656.45 ,$809.00 ,$305.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93160,10160,ER-PUNCTURE ASPIRATION,450,1 ,$492.00 ,$319.80 ,$288.31 ,$656.45 ,$337.02 ,$305.32 ,$288.31 ,$288.31 ,$311.43 ,$403.44 ,$418.20 ,$442.80 ,$369.00 ,$344.40 ,$364.08 ,$442.80 ,$418.20 ,$305.32 ,$418.20 ,$656.45 ,$492.00 ,$305.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93430,11730,"ER-NAIL AVULSION, SINGLE",450,1 ,$299.00 ,$194.35 ,$166.97 ,$358.99 ,$204.82 ,$166.97 ,$175.21 ,$175.21 ,$170.31 ,$245.18 ,$254.15 ,$269.10 ,$224.25 ,$209.30 ,$221.26 ,$269.10 ,$254.15 ,$166.97 ,$254.15 ,$358.99 ,$299.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93435,27810,ER-CLOSED TX BIMAL FX WITH MANIPULATIO,450,1 ,"$1,488.00 ",$967.20 ,$809.00 ,"$2,784.70 ","$1,019.28 ","$1,295.21 ",$871.97 ,$871.97 ,"$1,321.11 ","$1,220.16 ","$1,264.80 ","$1,339.20 ","$1,116.00 ","$1,041.60 ","$1,101.12 ","$1,339.20 ","$1,264.80 ","$1,295.21 ","$1,264.80 ","$2,784.70 ",$809.00 ,"$1,295.21 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),93471,27265,ER-REDUCTION HIP PROSTHESIS DISL W/O ANE,450,1 ,$514.00 ,$334.10 ,$206.07 ,$514.00 ,$352.09 ,$206.07 ,$301.20 ,$301.20 ,$210.19 ,$421.48 ,$436.90 ,$462.60 ,$385.50 ,$359.80 ,$380.36 ,$462.60 ,$436.90 ,$206.07 ,$436.90 ,$443.04 ,$514.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93501,49082,ER ABD PARACENTESIS,450,1 ,"$2,410.00 ","$1,566.50 ",$751.03 ,"$2,169.00 ","$1,650.85 ",$751.03 ,"$1,412.26 ","$1,412.26 ",$766.05 ,"$1,976.20 ","$2,048.50 ","$2,169.00 ","$1,807.50 ","$1,687.00 ","$1,783.40 ","$2,169.00 ","$2,048.50 ",$751.03 ,"$2,048.50 ","$1,614.70 ",$809.00 ,$751.03 
HSHS HOLY FAMILY HOSPITAL INC (ACU),93520,51700,BLADDER IRRIGATION,450,1 ,$286.00 ,$185.90 ,$167.60 ,$482.61 ,$195.91 ,$224.47 ,$167.60 ,$167.60 ,$228.96 ,$234.52 ,$243.10 ,$257.40 ,$214.50 ,$200.20 ,$211.64 ,$257.40 ,$243.10 ,$224.47 ,$243.10 ,$482.61 ,$286.00 ,$224.47 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94001,51701,ER-STRAIGHT CATHERIZATION,761,1 ,$209.00 ,$135.85 ,$104.19 ,$224.01 ,$143.17 ,$104.19 ,$122.47 ,$122.47 ,$106.27 ,$171.38 ,$177.65 ,$188.10 ,$156.75 ,$146.30 ,$154.66 ,$188.10 ,$177.65 ,$104.19 ,$177.65 ,$224.01 ,$110.35 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94007,96372,INJECTION NON-VACCINE,260,1 ,$128.00 ,$83.20 ,$57.79 ,$128.00 ,$87.68 ,$57.79 ,$75.01 ,$75.01 ,$58.94 ,$104.96 ,$108.80 ,$115.20 ,$96.00 ,$89.60 ,$94.72 ,$115.20 ,$108.80 ,$57.79 ,$108.80 ,$124.24 ,$128.00 ,$57.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94008,96374,IV PUSH,260,1 ,$277.00 ,$180.05 ,$162.32 ,$377.50 ,$189.75 ,$175.58 ,$162.32 ,$162.32 ,$179.09 ,$227.14 ,$235.45 ,$249.30 ,$207.75 ,$193.90 ,$204.98 ,$249.30 ,$235.45 ,$175.58 ,$235.45 ,$377.50 ,$217.00 ,$175.58 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94009,96360,INFUSION HYDRATION 31MIN TO 1ST HOUR,260,1 ,$376.00 ,$244.40 ,$175.58 ,$377.50 ,$257.56 ,$175.58 ,$220.34 ,$220.34 ,$179.09 ,$308.32 ,$319.60 ,$338.40 ,$282.00 ,$263.20 ,$278.24 ,$338.40 ,$319.60 ,$175.58 ,$319.60 ,$377.50 ,$217.00 ,$175.58 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94011,12011,ER-LACERATION-SIMPLE UP TO 2.5 CM,450,1 ,$351.00 ,$228.15 ,$166.97 ,$358.99 ,$240.44 ,$166.97 ,$205.69 ,$205.69 ,$170.31 ,$287.82 ,$298.35 ,$315.90 ,$263.25 ,$245.70 ,$259.74 ,$315.90 ,$298.35 ,$166.97 ,$298.35 ,$358.99 ,$351.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94012,51702,ER-BLADDER CATH (FOLEY) SIMPLE,761,1 ,$317.00 ,$206.05 ,$104.19 ,$285.30 ,$217.15 ,$104.19 ,$185.76 ,$185.76 ,$106.27 ,$259.94 ,$269.45 ,$285.30 ,$237.75 ,$221.90 ,$234.58 ,$285.30 ,$269.45 ,$104.19 ,$269.45 ,$224.01 ,$167.38 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94013,12013,ER-LACERATION-SIMPLE-2.6 TO 5.0 CM,450,1 ,$385.00 ,$250.25 ,$166.97 ,$385.00 ,$263.73 ,$166.97 ,$225.61 ,$225.61 ,$170.31 ,$315.70 ,$327.25 ,$346.50 ,$288.75 ,$269.50 ,$284.90 ,$346.50 ,$327.25 ,$166.97 ,$327.25 ,$358.99 ,$385.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94014,12014,ER-LACERATION-SIMPLE-5.1 TO 7.5 CM,450,1 ,$422.00 ,$274.30 ,$166.97 ,$422.00 ,$289.07 ,$166.97 ,$247.29 ,$247.29 ,$170.31 ,$346.04 ,$358.70 ,$379.80 ,$316.50 ,$295.40 ,$312.28 ,$379.80 ,$358.70 ,$166.97 ,$358.70 ,$358.99 ,$422.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94015,12015,ER-REPAIR-SIMPLE-7.6-12.5 CM,450,1 ,$459.00 ,$298.35 ,$166.97 ,$459.00 ,$314.42 ,$166.97 ,$268.97 ,$268.97 ,$170.31 ,$376.38 ,$390.15 ,$413.10 ,$344.25 ,$321.30 ,$339.66 ,$413.10 ,$390.15 ,$166.97 ,$390.15 ,$358.99 ,$459.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94017,12017,ER-REPAIR-SIMPLE-20.1-30.0 CM,450,1 ,$459.00 ,$298.35 ,$268.97 ,$656.45 ,$314.42 ,$305.32 ,$268.97 ,$268.97 ,$311.43 ,$376.38 ,$390.15 ,$413.10 ,$344.25 ,$321.30 ,$339.66 ,$413.10 ,$390.15 ,$305.32 ,$390.15 ,$656.45 ,$459.00 ,$305.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94019,90471,"ER-INJECTION VACCINE, 1ST",771,1 ,$97.00 ,$63.05 ,$56.84 ,$124.24 ,$66.45 ,$57.79 ,$56.84 ,$56.84 ,$58.94 ,$79.54 ,$82.45 ,$87.30 ,$72.75 ,$67.90 ,$71.78 ,$87.30 ,$82.45 ,$57.79 ,$82.45 ,$124.24 , N/A ,$57.79 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94022,90472,INJECTION EACH ADD VACCINE,771,1 ,$97.00 ,$63.05 ,$56.84 ,$87.30 ,$66.45 , N/A ,$56.84 ,$56.84 , N/A ,$79.54 ,$82.45 ,$87.30 ,$72.75 ,$67.90 ,$71.78 ,$87.30 ,$82.45 , N/A ,$82.45 , N/A , N/A , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94500,16000,"ER-BURN, MINOR TREATMENT W/O ANESTH",450,1 ,$299.00 ,$194.35 ,$166.97 ,$358.99 ,$204.82 ,$166.97 ,$175.21 ,$175.21 ,$170.31 ,$245.18 ,$254.15 ,$269.10 ,$224.25 ,$209.30 ,$221.26 ,$269.10 ,$254.15 ,$166.97 ,$254.15 ,$358.99 ,$299.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),94520,16020,"ER-BURN,DRESSING AND/OR DEBRIDEMENT,SMAL",450,1 ,$521.00 ,$338.65 ,$166.97 ,$521.00 ,$356.89 ,$166.97 ,$305.31 ,$305.31 ,$170.31 ,$427.22 ,$442.85 ,$468.90 ,$390.75 ,$364.70 ,$385.54 ,$468.90 ,$442.85 ,$166.97 ,$442.85 ,$358.99 ,$521.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95000,Q3014,TELEHEALTH ORIGINATING SITE FACILITY FEE,780,1 ,$40.00 ,$26.00 ,$21.12 ,$57.30 ,$27.40 ,$26.65 ,$23.44 ,$23.44 ,$27.18 ,$32.80 ,$34.00 ,$36.00 ,$30.00 ,$28.00 ,$29.60 ,$36.00 ,$34.00 ,$26.65 ,$34.00 ,$57.30 ,$21.12 ,$26.65 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95020,20520,"ER-FB-REMOVAL MUSCLE AND/OR TENDON,SIMPL",450,1 ,"$1,474.00 ",$958.10 ,$809.00 ,"$2,820.06 ","$1,009.69 ","$1,311.66 ",$863.76 ,$863.76 ,"$1,337.89 ","$1,208.68 ","$1,252.90 ","$1,326.60 ","$1,105.50 ","$1,031.80 ","$1,090.76 ","$1,326.60 ","$1,252.90 ","$1,311.66 ","$1,252.90 ","$2,820.06 ",$809.00 ,"$1,311.66 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),95105,20605,"ER-ARTHROCENTESIS, MEDIUM JOINT",450,1 ,$861.00 ,$559.65 ,$250.15 ,$809.00 ,$589.79 ,$250.15 ,$504.55 ,$504.55 ,$255.15 ,$706.02 ,$731.85 ,$774.90 ,$645.75 ,$602.70 ,$637.14 ,$774.90 ,$731.85 ,$250.15 ,$731.85 ,$537.82 ,$809.00 ,$250.15 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95110,20610,"ER-ARTHROCENTESIS, LARGE JOINT",450,1 ,$861.00 ,$559.65 ,$250.15 ,$809.00 ,$589.79 ,$250.15 ,$504.55 ,$504.55 ,$255.15 ,$706.02 ,$731.85 ,$774.90 ,$645.75 ,$602.70 ,$637.14 ,$774.90 ,$731.85 ,$250.15 ,$731.85 ,$537.82 ,$809.00 ,$250.15 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95150,23650,ER-TX OF CLOSED SHOULDER DISLOC W/O ANES,450,1 ,$559.00 ,$363.35 ,$206.07 ,$559.00 ,$382.92 ,$206.07 ,$327.57 ,$327.57 ,$210.19 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$206.07 ,$475.15 ,$443.04 ,$559.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95170,24600,"ER-TX CLOSED ELBOW DIS, W/O ANESTH",450,1 ,$559.00 ,$363.35 ,$206.07 ,$559.00 ,$382.92 ,$206.07 ,$327.57 ,$327.57 ,$210.19 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$206.07 ,$475.15 ,$443.04 ,$559.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95179,24640,"ER-SUBLUXATION, RADIAL HEAD (CHILD)",450,1 ,$559.00 ,$363.35 ,$206.07 ,$559.00 ,$382.92 ,$206.07 ,$327.57 ,$327.57 ,$210.19 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$206.07 ,$475.15 ,$443.04 ,$559.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95180,24605,"ER-TX CLOSED ELBOW DIS, WITH ANESTH",450,1 ,"$5,160.00 ","$3,354.00 ",$809.00 ,"$4,644.00 ","$3,534.60 ","$1,295.21 ","$3,023.76 ","$3,023.76 ","$1,321.11 ","$4,231.20 ","$4,386.00 ","$4,644.00 ","$3,870.00 ","$3,612.00 ","$3,818.40 ","$4,644.00 ","$4,386.00 ","$1,295.21 ","$4,386.00 ","$2,784.70 ",$809.00 ,"$1,295.21 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),95185,26770,ER-CLOSED TX IP JOINT DISLOC WITH MANIPU,450,1 ,$559.00 ,$363.35 ,$206.07 ,$559.00 ,$382.92 ,$206.07 ,$327.57 ,$327.57 ,$210.19 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$206.07 ,$475.15 ,$443.04 ,$559.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95188,25560,"ER-TREAT FX, RADIUS & ULNA",450,1 ,$559.00 ,$363.35 ,$206.07 ,$559.00 ,$382.92 ,$206.07 ,$327.57 ,$327.57 ,$210.19 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$206.07 ,$475.15 ,$443.04 ,$559.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95190,27250,"ER-TX CLOSED HIP DISLOCATION, W/O ANESTH",450,1 ,$821.00 ,$533.65 ,$206.07 ,$809.00 ,$562.39 ,$206.07 ,$481.11 ,$481.11 ,$210.19 ,$673.22 ,$697.85 ,$738.90 ,$615.75 ,$574.70 ,$607.54 ,$738.90 ,$697.85 ,$206.07 ,$697.85 ,$443.04 ,$809.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95192,25605,"ER DISTAL RADIAL FX, WITH MANIPULATION",450,1 ,"$1,619.00 ","$1,052.35 ",$809.00 ,"$2,784.70 ","$1,109.02 ","$1,295.21 ",$948.73 ,$948.73 ,"$1,321.11 ","$1,327.58 ","$1,376.15 ","$1,457.10 ","$1,214.25 ","$1,133.30 ","$1,198.06 ","$1,457.10 ","$1,376.15 ","$1,295.21 ","$1,376.15 ","$2,784.70 ",$809.00 ,"$1,295.21 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),95194,26600,"METACARPAL FX, EACH BONE, W/O MANIPULATN",450,1 ,$559.00 ,$363.35 ,$206.07 ,$559.00 ,$382.92 ,$206.07 ,$327.57 ,$327.57 ,$210.19 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$206.07 ,$475.15 ,$443.04 ,$559.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95202,26725,"PHALANGEAL SHAFT FX, EACH W MANIPULATION",450,1 ,$559.00 ,$363.35 ,$206.07 ,$559.00 ,$382.92 ,$206.07 ,$327.57 ,$327.57 ,$210.19 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$206.07 ,$475.15 ,$443.04 ,$559.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95203,26750,"ER-DISTAL PHALANGEAL FX, EACH",450,1 ,$559.00 ,$363.35 ,$206.07 ,$559.00 ,$382.92 ,$206.07 ,$327.57 ,$327.57 ,$210.19 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$206.07 ,$475.15 ,$443.04 ,$559.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95215,27760,ER-CLOSED TX MED MALL FX W/O MANIPULATIO,450,1 ,$559.00 ,$363.35 ,$206.07 ,$559.00 ,$382.92 ,$206.07 ,$327.57 ,$327.57 ,$210.19 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$206.07 ,$475.15 ,$443.04 ,$559.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95223,27840,"ER-ANKLE DISLOCATION, W/O ANESTH",450,1 ,"$1,619.00 ","$1,052.35 ",$206.07 ,"$1,457.10 ","$1,109.02 ",$206.07 ,$948.73 ,$948.73 ,$210.19 ,"$1,327.58 ","$1,376.15 ","$1,457.10 ","$1,214.25 ","$1,133.30 ","$1,198.06 ","$1,457.10 ","$1,376.15 ",$206.07 ,"$1,376.15 ",$443.04 ,$809.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95226,43752,ER-NASAL GASTRIC TUBE INSERTION,450,1 ,$430.00 ,$279.50 ,$251.98 ,$747.01 ,$294.55 ,$347.45 ,$251.98 ,$251.98 ,$354.40 ,$352.60 ,$365.50 ,$387.00 ,$322.50 ,$301.00 ,$318.20 ,$387.00 ,$365.50 ,$347.45 ,$365.50 ,$747.01 ,$430.00 ,$347.45 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95236,28470,"ER-METATARSAL FX, EACH, W/O MANIPULATION",450,1 ,$559.00 ,$363.35 ,$206.07 ,$559.00 ,$382.92 ,$206.07 ,$327.57 ,$327.57 ,$210.19 ,$458.38 ,$475.15 ,$503.10 ,$419.25 ,$391.30 ,$413.66 ,$503.10 ,$475.15 ,$206.07 ,$475.15 ,$443.04 ,$559.00 ,$206.07 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95305,29105,ER-SPLINT LONG ARM,450,1 ,$360.00 ,$234.00 ,$127.80 ,$360.00 ,$246.60 ,$127.80 ,$210.96 ,$210.96 ,$130.36 ,$295.20 ,$306.00 ,$324.00 ,$270.00 ,$252.00 ,$266.40 ,$324.00 ,$306.00 ,$127.80 ,$306.00 ,$274.77 ,$360.00 ,$127.80 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95326,29126,"ER-SPLINT-SHORT ARM, DYNAMIC",450,1 ,$358.00 ,$232.70 ,$104.19 ,$358.00 ,$245.23 ,$104.19 ,$209.79 ,$209.79 ,$106.27 ,$293.56 ,$304.30 ,$322.20 ,$268.50 ,$250.60 ,$264.92 ,$322.20 ,$304.30 ,$104.19 ,$304.30 ,$224.01 ,$358.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95330,29130,ER-SPLINT FINGER,450,1 ,$358.00 ,$232.70 ,$52.57 ,$358.00 ,$245.23 ,$52.57 ,$209.79 ,$209.79 ,$53.62 ,$293.56 ,$304.30 ,$322.20 ,$268.50 ,$250.60 ,$264.92 ,$322.20 ,$304.30 ,$52.57 ,$304.30 ,$113.02 ,$358.00 ,$52.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95332,29125,ER-SPLINT SHORT ARM,450,1 ,$360.00 ,$234.00 ,$104.19 ,$360.00 ,$246.60 ,$104.19 ,$210.96 ,$210.96 ,$106.27 ,$295.20 ,$306.00 ,$324.00 ,$270.00 ,$252.00 ,$266.40 ,$324.00 ,$306.00 ,$104.19 ,$306.00 ,$224.01 ,$360.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95515,29515,ER-SPLINT SHORT LEG,450,1 ,$439.00 ,$285.35 ,$127.80 ,$439.00 ,$300.72 ,$127.80 ,$257.25 ,$257.25 ,$130.36 ,$359.98 ,$373.15 ,$395.10 ,$329.25 ,$307.30 ,$324.86 ,$395.10 ,$373.15 ,$127.80 ,$373.15 ,$274.77 ,$439.00 ,$127.80 
HSHS HOLY FAMILY HOSPITAL INC (ACU),95532,29505,ER-SPLINT LONG LEG,450,1 ,$358.00 ,$232.70 ,$127.80 ,$358.00 ,$245.23 ,$127.80 ,$209.79 ,$209.79 ,$130.36 ,$293.56 ,$304.30 ,$322.20 ,$268.50 ,$250.60 ,$264.92 ,$322.20 ,$304.30 ,$127.80 ,$304.30 ,$274.77 ,$358.00 ,$127.80 
HSHS HOLY FAMILY HOSPITAL INC (ACU),96030,30300,ER-FOREIGN BODY REMOVAL-INTRANASAL,450,1 ,$226.00 ,$146.90 ,$104.19 ,$226.00 ,$154.81 ,$104.19 ,$132.44 ,$132.44 ,$106.27 ,$185.32 ,$192.10 ,$203.40 ,$169.50 ,$158.20 ,$167.24 ,$203.40 ,$192.10 ,$104.19 ,$192.10 ,$224.01 ,$226.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),96101,30901,"ER-ANT NASAL BLEED, SIMPLE",450,1 ,$317.00 ,$206.05 ,$104.19 ,$317.00 ,$217.15 ,$104.19 ,$185.76 ,$185.76 ,$106.27 ,$259.94 ,$269.45 ,$285.30 ,$237.75 ,$221.90 ,$234.58 ,$285.30 ,$269.45 ,$104.19 ,$269.45 ,$224.01 ,$317.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),96150,31500,"ER-INTUBATION, ENDOTRACHEAL",450,1 ,$763.00 ,$495.95 ,$194.60 ,$763.00 ,$522.66 ,$194.60 ,$447.12 ,$447.12 ,$198.49 ,$625.66 ,$648.55 ,$686.70 ,$572.25 ,$534.10 ,$564.62 ,$686.70 ,$648.55 ,$194.60 ,$648.55 ,$418.39 ,$763.00 ,$194.60 
HSHS HOLY FAMILY HOSPITAL INC (ACU),96220,32551,"ER-TUBE, THORACOSTOMY",450,1 ,"$1,874.00 ","$1,218.10 ",$809.00 ,"$3,351.22 ","$1,283.69 ","$1,558.71 ","$1,098.16 ","$1,098.16 ","$1,589.88 ","$1,536.68 ","$1,592.90 ","$1,686.60 ","$1,405.50 ","$1,311.80 ","$1,386.76 ","$1,686.60 ","$1,592.90 ","$1,558.71 ","$1,592.90 ","$3,351.22 ",$809.00 ,"$1,558.71 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),96389,36556,ER-INSERT VENOUS CATH OVER AGE 5,450,1 ,"$3,768.00 ","$2,449.20 ",$809.00 ,"$3,391.20 ","$2,581.08 ","$1,558.71 ","$2,208.05 ","$2,208.05 ","$1,589.88 ","$3,089.76 ","$3,202.80 ","$3,391.20 ","$2,826.00 ","$2,637.60 ","$2,788.32 ","$3,391.20 ","$3,202.80 ","$1,558.71 ","$3,202.80 ","$3,351.22 ",$809.00 ,"$1,558.71 "
HSHS HOLY FAMILY HOSPITAL INC (ACU),98102,64402,ER-FACIAL NERVE BLOCK,450,1 ,$863.00 ,$560.95 ,$505.72 ,$809.00 ,$591.16 , N/A ,$505.72 ,$505.72 , N/A ,$707.66 ,$733.55 ,$776.70 ,$647.25 ,$604.10 ,$638.62 ,$776.70 ,$733.55 , N/A ,$733.55 , N/A ,$809.00 , N/A 
HSHS HOLY FAMILY HOSPITAL INC (ACU),98103,64450,ER-DIGITAL NERVE BLOCK,450,1 ,"$1,256.00 ",$816.40 ,$597.30 ,"$1,284.19 ",$860.36 ,$597.30 ,$736.02 ,$736.02 ,$609.24 ,"$1,029.92 ","$1,067.60 ","$1,130.40 ",$942.00 ,$879.20 ,$929.44 ,"$1,130.40 ","$1,067.60 ",$597.30 ,"$1,067.60 ","$1,284.19 ",$809.00 ,$597.30 
HSHS HOLY FAMILY HOSPITAL INC (ACU),98570,62270,"ER-SPINAL PUNCTURE, LUMBAR",450,1 ,"$1,815.00 ","$1,179.75 ",$597.30 ,"$1,633.50 ","$1,243.28 ",$597.30 ,"$1,063.59 ","$1,063.59 ",$609.24 ,"$1,488.30 ","$1,542.75 ","$1,633.50 ","$1,361.25 ","$1,270.50 ","$1,343.10 ","$1,633.50 ","$1,542.75 ",$597.30 ,"$1,542.75 ","$1,284.19 ",$809.00 ,$597.30 
HSHS HOLY FAMILY HOSPITAL INC (ACU),98605,65205,"ER-FOREIGN BODY, SIMPLE-EYE",450,1 ,$463.00 ,$300.95 ,$104.19 ,$463.00 ,$317.16 ,$104.19 ,$271.32 ,$271.32 ,$106.27 ,$379.66 ,$393.55 ,$416.70 ,$347.25 ,$324.10 ,$342.62 ,$416.70 ,$393.55 ,$104.19 ,$393.55 ,$224.01 ,$463.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),98610,65210,"ER-FOREIGN BODY, EMBEDDED-EYE CONJUNC",450,1 ,$510.00 ,$331.50 ,$298.86 ,$747.01 ,$349.35 ,$347.45 ,$298.86 ,$298.86 ,$354.40 ,$418.20 ,$433.50 ,$459.00 ,$382.50 ,$357.00 ,$377.40 ,$459.00 ,$433.50 ,$347.45 ,$433.50 ,$747.01 ,$510.00 ,$347.45 
HSHS HOLY FAMILY HOSPITAL INC (ACU),98620,65220,ER-CORNEAL FOREIGN BODY,450,1 ,$278.00 ,$180.70 ,$162.91 ,$747.01 ,$190.43 ,$347.45 ,$162.91 ,$162.91 ,$354.40 ,$227.96 ,$236.30 ,$250.20 ,$208.50 ,$194.60 ,$205.72 ,$250.20 ,$236.30 ,$347.45 ,$236.30 ,$747.01 ,$278.00 ,$347.45 
HSHS HOLY FAMILY HOSPITAL INC (ACU),98700,69200,ER-REMOVAL FOREING BODY-EAR,450,1 ,$226.00 ,$146.90 ,$104.19 ,$226.00 ,$154.81 ,$104.19 ,$132.44 ,$132.44 ,$106.27 ,$185.32 ,$192.10 ,$203.40 ,$169.50 ,$158.20 ,$167.24 ,$203.40 ,$192.10 ,$104.19 ,$192.10 ,$224.01 ,$226.00 ,$104.19 
HSHS HOLY FAMILY HOSPITAL INC (ACU),98701,69210,ER-EAR LAVAGE (CERUMEN) W/ INSTRUMENTS,450,1 ,$226.00 ,$146.90 ,$52.57 ,$226.00 ,$154.81 ,$52.57 ,$132.44 ,$132.44 ,$53.62 ,$185.32 ,$192.10 ,$203.40 ,$169.50 ,$158.20 ,$167.24 ,$203.40 ,$192.10 ,$52.57 ,$192.10 ,$113.02 ,$226.00 ,$52.57 
HSHS HOLY FAMILY HOSPITAL INC (ACU),99250,92950,ER CPR,450,1 ,$688.00 ,$447.20 ,$241.86 ,$688.00 ,$471.28 ,$241.86 ,$403.17 ,$403.17 ,$246.70 ,$564.16 ,$584.80 ,$619.20 ,$516.00 ,$481.60 ,$509.12 ,$619.20 ,$584.80 ,$241.86 ,$584.80 ,$520.00 ,$688.00 ,$241.86 
HSHS HOLY FAMILY HOSPITAL INC (ACU),99401,12001,ER-LACERATION-SIMPLE-UP TO 2.5 CM,450,1 ,$324.00 ,$210.60 ,$166.97 ,$358.99 ,$221.94 ,$166.97 ,$189.86 ,$189.86 ,$170.31 ,$265.68 ,$275.40 ,$291.60 ,$243.00 ,$226.80 ,$239.76 ,$291.60 ,$275.40 ,$166.97 ,$275.40 ,$358.99 ,$324.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),99402,12002,ER-LACERATION-SIMPLE-2.6 TO 7.5 CM,450,1 ,$356.00 ,$231.40 ,$166.97 ,$358.99 ,$243.86 ,$166.97 ,$208.62 ,$208.62 ,$170.31 ,$291.92 ,$302.60 ,$320.40 ,$267.00 ,$249.20 ,$263.44 ,$320.40 ,$302.60 ,$166.97 ,$302.60 ,$358.99 ,$356.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),99404,12004,ER-LACERATION-SIMPLE-7.6 TO 12.5 CM,450,1 ,$391.00 ,$254.15 ,$166.97 ,$391.00 ,$267.84 ,$166.97 ,$229.13 ,$229.13 ,$170.31 ,$320.62 ,$332.35 ,$351.90 ,$293.25 ,$273.70 ,$289.34 ,$351.90 ,$332.35 ,$166.97 ,$332.35 ,$358.99 ,$391.00 ,$166.97 
HSHS HOLY FAMILY HOSPITAL INC (ACU),99405,12005,ER-LACERATION-SIMPLE-12.6-20.CM,450,1 ,$430.00 ,$279.50 ,$251.98 ,$656.45 ,$294.55 ,$305.32 ,$251.98 ,$251.98 ,$311.43 ,$352.60 ,$365.50 ,$387.00 ,$322.50 ,$301.00 ,$318.20 ,$387.00 ,$365.50 ,$305.32 ,$365.50 ,$656.45 ,$430.00 ,$305.32 
HSHS HOLY FAMILY HOSPITAL INC (ACU),99980,96365,IV INFUSION FIRST 16 MIN UP TO 1 HR,260,1 ,$341.00 ,$221.65 ,$175.58 ,$377.50 ,$233.59 ,$175.58 ,$199.83 ,$199.83 ,$179.09 ,$279.62 ,$289.85 ,$306.90 ,$255.75 ,$238.70 ,$252.34 ,$306.90 ,$289.85 ,$175.58 ,$289.85 ,$377.50 ,$217.00 ,$175.58 
HSHS HOLY FAMILY HOSPITAL INC (ACU),99981,96366,IV INFUSION EACH ADTL 31 MIN,260,1 ,$148.00 ,$96.20 ,$36.42 ,$148.00 ,$101.38 ,$36.42 ,$86.73 ,$86.73 ,$37.15 ,$121.36 ,$125.80 ,$133.20 ,$111.00 ,$103.60 ,$109.52 ,$133.20 ,$125.80 ,$36.42 ,$125.80 ,$78.30 ,$148.00 ,$36.42