ST. FRANCIS 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 HSHS , Aetna MCR , BC EXCHANGE , BC MEDICARE , BCBS OF ILLINOIS PPO , BLUE CROSS BLUE SHIELD IL HMO , BLUE CROSS BLUE SHIELD IPA IL , BLUE CROSS SIHCA , CIGNA , CLEAR SPRING HEALTH MEDICARE ADV , CONSOCIATE GROUP , CURRENT HEALTH SOLUTIONS ," ESSENCE, L.L.P. ", FIRST HEALTH NETWORK , HEALTH ALLIANCE MEDICAL PLAN EXCHANGE ," HEALTH ALLIANCE MEDICAL PLANS, INC. ", HEALTH ALLIANCE MEDICARE , HEALTH ALLIANCE PPO , HEALTHLINK , HEALTHLINK CASINO QUEEN , HEALTHLINK PPO , HFN , HOPETRUST , HUMANA MEDICARE , ILLINOIS BREAST AND CERVICAL CANCER PROGRAM , MERIDIAN HMO MCD , MOLINA MEDICAID , MOLINA MEDICARE , MULTIPLAN , PHYSICIANS HEALTH ASSOCIATION OF IL BCBS HMO , PROVIDER NETWORK OF AMERICA , ST CLAIR COUNTY HOUSING AUTHORITY , UHC CATERPILLAR , UNITED HEALTH ALL PAYOR , UNITED HEALTH CARE MEDICARE , WELLFIRST ST. FRANCIS HOSPITAL - ACUTE,12000001,N/A,HC DAILY SERVICE GENERAL,120,1 ,"$1,121.00 ",$728.65 ,$728.65 ,"$1,121.00 ",$807.12 ,$609.82 , Inpt Medicare ,"$1,584.25 ", Inpt Medicare ,"$1,821.04 ","$1,821.04 ","$1,821.04 ","$1,821.04 ",$941.64 , Inpt Medicare ,$952.85 ,$840.75 , Inpt Medicare ,$840.75 ,"$1,162.00 ","$1,162.00 ", Inpt Medicare ,"$1,162.00 ",$946.00 ,$946.00 ,$946.00 ,"$1,008.90 ", Inpt Medicare +150% , Inpt Medicare , N/A , Inpt Medicaid , Inpt Medicaid + 5% , Inpt Medicare +10% ,$952.85 ,"$1,821.04 ","$1,008.90 ",$946.00 ,$896.80 ,$896.80 , Inpt Medicare ,$728.65 ST. FRANCIS HOSPITAL - ACUTE,12000002,N/A,HC DAILY SERVICE SWING BED,120,1 ,$348.00 ,$226.20 ,$226.20 ,$348.00 ,$250.56 ,$189.31 , Inpt Medicare ,"$1,584.25 ", Inpt Medicare ,"$1,821.04 ","$1,821.04 ","$1,821.04 ","$1,821.04 ",$292.32 , Inpt Medicare ,$295.80 ,$261.00 , Inpt Medicare ,$261.00 ,"$1,162.00 ","$1,162.00 ", Inpt Medicare ,"$1,162.00 ",$946.00 ,$946.00 ,$946.00 ,$313.20 , Inpt Medicare +150% , Inpt Medicare , N/A , Inpt Medicaid , Inpt Medicaid + 5% , Inpt Medicare +10% ,$295.80 ,"$1,821.04 ",$313.20 ,$946.00 ,$278.40 ,$278.40 , Inpt Medicare ,$226.20 ST. FRANCIS HOSPITAL - ACUTE,12000006,N/A,HC DAILY SERVICE W/TELEMETRY,120,1 ,"$1,530.00 ",$994.50 ,$994.50 ,"$1,530.00 ","$1,101.60 ",$832.32 , Inpt Medicare ,"$1,584.25 ", Inpt Medicare ,"$1,821.04 ","$1,821.04 ","$1,821.04 ","$1,821.04 ","$1,285.20 ", Inpt Medicare ,"$1,300.50 ","$1,147.50 ", Inpt Medicare ,"$1,147.50 ","$1,162.00 ","$1,162.00 ", Inpt Medicare ,"$1,162.00 ",$946.00 ,$946.00 ,$946.00 ,"$1,377.00 ", Inpt Medicare +150% , Inpt Medicare , N/A , Inpt Medicaid , Inpt Medicaid + 5% , Inpt Medicare +10% ,"$1,300.50 ","$1,821.04 ","$1,377.00 ",$946.00 ,"$1,224.00 ","$1,224.00 ", Inpt Medicare ,$994.50 ST. FRANCIS HOSPITAL - ACUTE,12200001,N/A,HC DAILY SERVICE OBSTETRICS,122,1 ,"$1,121.00 ",$728.65 ,$728.65 ,"$1,121.00 ",$807.12 ,$609.82 , Inpt Medicare ,"$1,584.25 ", Inpt Medicare ,"$1,821.04 ","$1,821.04 ","$1,821.04 ","$1,821.04 ",$941.64 , Inpt Medicare ,$952.85 ,$840.75 , Inpt Medicare ,$840.75 ,"$1,162.00 ","$1,162.00 ", Inpt Medicare ,"$1,162.00 ",$946.00 ,$946.00 ,$946.00 ,"$1,008.90 ", Inpt Medicare +150% , Inpt Medicare , N/A , Inpt Medicaid , Inpt Medicaid + 5% , Inpt Medicare +10% ,$952.85 ,"$1,821.04 ","$1,008.90 ",$946.00 ,$896.80 ,$896.80 , Inpt Medicare ,$728.65 ST. FRANCIS HOSPITAL - ACUTE,12500001,N/A,HC DAILY HOSPICE ACUTE CARE,125,1 ,$849.00 ,$551.85 ,$551.85 ,$849.00 ,$611.28 ,$461.86 , Inpt Medicare ,"$1,584.25 ", Inpt Medicare ,"$1,821.04 ","$1,821.04 ","$1,821.04 ","$1,821.04 ",$713.16 , Inpt Medicare ,$721.65 ,$636.75 , Inpt Medicare ,$636.75 ,"$1,162.00 ","$1,162.00 ", Inpt Medicare ,"$1,162.00 ",$946.00 ,$946.00 ,$946.00 ,$764.10 , Inpt Medicare +150% , Inpt Medicare , N/A , Inpt Medicaid , Inpt Medicaid + 5% , Inpt Medicare +10% ,$721.65 ,"$1,821.04 ",$764.10 ,$946.00 ,$679.20 ,$679.20 , Inpt Medicare ,$551.85 ST. FRANCIS HOSPITAL - ACUTE,17100001,N/A,HC DAILY INFANT SERVICE LEV 1,171,1 ,$550.00 ,$357.50 ,$357.50 ,$550.00 ,$396.00 ,$299.20 , Inpt Medicare ,"$1,584.25 ", Inpt Medicare ,"$1,821.04 ","$1,821.04 ","$1,821.04 ","$1,821.04 ",$462.00 , Inpt Medicare ,$467.50 ,$412.50 , Inpt Medicare ,$412.50 ,"$1,162.00 ","$1,162.00 ", Inpt Medicare ,"$1,162.00 ",$279.00 ,$279.00 ,$279.00 ,$495.00 , Inpt Medicare +150% , Inpt Medicare , N/A , Inpt Medicaid , Inpt Medicaid + 5% , Inpt Medicare +10% ,$467.50 ,"$1,821.04 ",$495.00 ,$279.00 ,$440.00 ,$440.00 , Inpt Medicare ,$357.50 ST. FRANCIS HOSPITAL - ACUTE,20000001,N/A,HC DAILY SERVICE ICU,200,1 ,"$2,352.00 ","$1,528.80 ","$1,528.80 ","$2,352.00 ","$1,693.44 ","$1,279.49 ", Inpt Medicare ,"$1,584.25 ", Inpt Medicare ,"$1,821.04 ","$1,821.04 ","$1,821.04 ","$1,821.04 ","$1,975.68 ", Inpt Medicare ,"$1,999.20 ","$1,764.00 ", Inpt Medicare ,"$1,764.00 ","$1,162.00 ","$1,162.00 ", Inpt Medicare ,"$1,162.00 ","$1,837.00 ","$1,837.00 ","$1,837.00 ","$2,116.80 ", Inpt Medicare +150% , Inpt Medicare , N/A , Inpt Medicaid , Inpt Medicaid + 5% , Inpt Medicare +10% ,"$1,999.20 ","$1,821.04 ","$2,116.80 ","$1,837.00 ","$1,881.60 ","$1,881.60 ", Inpt Medicare ,"$1,528.80 " ST. FRANCIS HOSPITAL - ACUTE,23100003,N/A,HC ADVANCED NURSING CARE,231,1 ,$245.00 ,$159.25 ,$56.35 ,$245.00 ,$176.40 ,$133.28 ,$56.35 ,$136.76 ,$56.35 ,$146.36 ,$146.36 ,$146.36 ,$146.36 ,$205.80 ,$56.35 ,$208.25 ,$205.80 ,$56.35 ,$183.75 ,$196.00 ,$196.00 ,$56.35 ,$196.00 ,$205.80 ,$205.80 ,$205.80 ,$220.50 ,$140.88 ,$56.35 ,$245.00 , N/A , N/A ,$61.99 ,$208.25 ,$146.36 ,$220.50 ,$205.80 ,$196.00 ,$196.00 ,$56.35 ,$159.25 ST. FRANCIS HOSPITAL - ACUTE,26000000,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$429.00 ,$278.85 ,$98.67 ,$429.00 ,$308.88 ,$233.38 ,$98.67 ,$239.47 ,$98.67 ,$256.28 ,$256.28 ,$256.28 ,$256.28 ,$360.36 ,$98.67 ,$364.65 ,$360.36 ,$98.67 ,$321.75 ,$343.20 ,$343.20 ,$98.67 ,$343.20 ,$360.36 ,$360.36 ,$360.36 ,$386.10 ,$246.68 ,$98.67 ,$429.00 ,$300.07 ,$330.08 ,$108.54 ,$364.65 ,$256.28 ,$386.10 ,$360.36 ,$343.20 ,$343.20 ,$98.67 ,$278.85 ST. FRANCIS HOSPITAL - ACUTE,26000001,96361,HC HYDRATION THERAPY EA ADDL HR,260,1 ,$283.00 ,$183.95 ,$65.09 ,$516.01 ,$203.76 ,$153.95 ,$65.09 ,$157.97 ,$65.09 ,$169.06 ,$169.06 ,$169.06 ,$169.06 ,$237.72 ,$65.09 ,$240.55 ,$237.72 ,$65.09 ,$212.25 ,$226.40 ,$226.40 ,$65.09 ,$226.40 ,$237.72 ,$237.72 ,$237.72 ,$254.70 ,$162.73 ,$65.09 ,$283.00 ,$469.10 ,$516.01 ,$71.60 ,$240.55 ,$169.06 ,$254.70 ,$237.72 ,$226.40 ,$226.40 ,$65.09 ,$183.95 ST. FRANCIS HOSPITAL - ACUTE,26000002,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$429.00 ,$278.85 ,$98.67 ,$429.00 ,$308.88 ,$233.38 ,$98.67 ,$239.47 ,$98.67 ,$256.28 ,$256.28 ,$256.28 ,$256.28 ,$360.36 ,$98.67 ,$364.65 ,$360.36 ,$98.67 ,$321.75 ,$343.20 ,$343.20 ,$98.67 ,$343.20 ,$360.36 ,$360.36 ,$360.36 ,$386.10 ,$246.68 ,$98.67 ,$429.00 ,$300.07 ,$330.08 ,$108.54 ,$364.65 ,$256.28 ,$386.10 ,$360.36 ,$343.20 ,$343.20 ,$98.67 ,$278.85 ST. FRANCIS HOSPITAL - ACUTE,26000003,96366,HC INFUSION THERAPY EA ADDL HR,260,1 ,$283.00 ,$183.95 ,$65.09 ,$516.01 ,$203.76 ,$153.95 ,$65.09 ,$157.97 ,$65.09 ,$169.06 ,$169.06 ,$169.06 ,$169.06 ,$237.72 ,$65.09 ,$240.55 ,$237.72 ,$65.09 ,$212.25 ,$226.40 ,$226.40 ,$65.09 ,$226.40 ,$237.72 ,$237.72 ,$237.72 ,$254.70 ,$162.73 ,$65.09 ,$283.00 ,$469.10 ,$516.01 ,$71.60 ,$240.55 ,$169.06 ,$254.70 ,$237.72 ,$226.40 ,$226.40 ,$65.09 ,$183.95 ST. FRANCIS HOSPITAL - ACUTE,26000004,96367,HC IV INF ADDL SEQ INIT HR,260,1 ,$283.00 ,$183.95 ,$65.09 ,$330.08 ,$203.76 ,$153.95 ,$65.09 ,$157.97 ,$65.09 ,$169.06 ,$169.06 ,$169.06 ,$169.06 ,$237.72 ,$65.09 ,$240.55 ,$237.72 ,$65.09 ,$212.25 ,$226.40 ,$226.40 ,$65.09 ,$226.40 ,$237.72 ,$237.72 ,$237.72 ,$254.70 ,$162.73 ,$65.09 ,$283.00 ,$300.07 ,$330.08 ,$71.60 ,$240.55 ,$169.06 ,$254.70 ,$237.72 ,$226.40 ,$226.40 ,$65.09 ,$183.95 ST. FRANCIS HOSPITAL - ACUTE,26000005,96368,HC INFUS CONCURRENT,260,1 ,$283.00 ,$183.95 ,$65.09 ,$330.08 ,$203.76 ,$153.95 ,$65.09 ,$157.97 ,$65.09 ,$169.06 ,$169.06 ,$169.06 ,$169.06 ,$237.72 ,$65.09 ,$240.55 ,$237.72 ,$65.09 ,$212.25 ,$226.40 ,$226.40 ,$65.09 ,$226.40 ,$237.72 ,$237.72 ,$237.72 ,$254.70 ,$162.73 ,$65.09 ,$283.00 ,$300.07 ,$330.08 ,$71.60 ,$240.55 ,$169.06 ,$254.70 ,$237.72 ,$226.40 ,$226.40 ,$65.09 ,$183.95 ST. FRANCIS HOSPITAL - ACUTE,26000010,96370,HC IV INFUSION THERPAY/PROPH SUBQ EA ADDL HR,260,1 ,$202.00 ,$131.30 ,$46.46 ,$516.01 ,$145.44 ,$109.89 ,$46.46 ,$112.76 ,$46.46 ,$120.67 ,$120.67 ,$120.67 ,$120.67 ,$169.68 ,$46.46 ,$171.70 ,$169.68 ,$46.46 ,$151.50 ,$161.60 ,$161.60 ,$46.46 ,$161.60 ,$169.68 ,$169.68 ,$169.68 ,$181.80 ,$116.15 ,$46.46 ,$202.00 ,$469.10 ,$516.01 ,$51.11 ,$171.70 ,$120.67 ,$181.80 ,$169.68 ,$161.60 ,$161.60 ,$46.46 ,$131.30 ST. FRANCIS HOSPITAL - ACUTE,26000011,96371,HC IV INFUSION THERPAY/PROPH SUBQ SECOND LOCATION,260,1 ,$256.00 ,$166.40 ,$58.88 ,$330.08 ,$184.32 ,$139.26 ,$58.88 ,$142.90 ,$58.88 ,$152.93 ,$152.93 ,$152.93 ,$152.93 ,$215.04 ,$58.88 ,$217.60 ,$215.04 ,$58.88 ,$192.00 ,$204.80 ,$204.80 ,$58.88 ,$204.80 ,$215.04 ,$215.04 ,$215.04 ,$230.40 ,$147.20 ,$58.88 ,$256.00 ,$300.07 ,$330.08 ,$64.77 ,$217.60 ,$152.93 ,$230.40 ,$215.04 ,$204.80 ,$204.80 ,$58.88 ,$166.40 ST. FRANCIS HOSPITAL - ACUTE,26000012,96369,HC INFUSION THERAPY/PROPHLAXIS INIT <1HR,260,1 ,$471.00 ,$306.15 ,$108.33 ,$471.00 ,$339.12 ,$256.22 ,$108.33 ,$262.91 ,$108.33 ,$281.38 ,$281.38 ,$281.38 ,$281.38 ,$395.64 ,$108.33 ,$400.35 ,$395.64 ,$108.33 ,$353.25 ,$376.80 ,$376.80 ,$108.33 ,$376.80 ,$395.64 ,$395.64 ,$395.64 ,$423.90 ,$270.83 ,$108.33 ,$471.00 ,$300.07 ,$330.08 ,$119.16 ,$400.35 ,$281.38 ,$423.90 ,$395.64 ,$376.80 ,$376.80 ,$108.33 ,$306.15 ST. FRANCIS HOSPITAL - ACUTE,27000008,N/A,HC CONTAINER DRAINAGE,270,1 ,$36.00 ,$23.40 ,$8.28 ,$36.00 ,$25.92 ,$19.58 ,$8.28 ,$20.10 ,$8.28 ,$21.51 ,$21.51 ,$21.51 ,$21.51 ,$30.24 ,$8.28 ,$30.60 ,$30.24 ,$8.28 ,$27.00 ,$28.80 ,$28.80 ,$8.28 ,$28.80 ,$30.24 ,$30.24 ,$30.24 ,$32.40 ,$20.70 ,$8.28 ,$36.00 , N/A , N/A ,$9.11 ,$30.60 ,$21.51 ,$32.40 ,$30.24 ,$28.80 ,$28.80 ,$8.28 ,$23.40 ST. FRANCIS HOSPITAL - ACUTE,27000027,N/A,HC TRAY AMNIOCENTESIS,270,1 ,$128.00 ,$83.20 ,$29.44 ,$128.00 ,$92.16 ,$69.63 ,$29.44 ,$71.45 ,$29.44 ,$76.47 ,$76.47 ,$76.47 ,$76.47 ,$107.52 ,$29.44 ,$108.80 ,$107.52 ,$29.44 ,$96.00 ,$102.40 ,$102.40 ,$29.44 ,$102.40 ,$107.52 ,$107.52 ,$107.52 ,$115.20 ,$73.60 ,$29.44 ,$128.00 , N/A , N/A ,$32.38 ,$108.80 ,$76.47 ,$115.20 ,$107.52 ,$102.40 ,$102.40 ,$29.44 ,$83.20 ST. FRANCIS HOSPITAL - ACUTE,27000052,N/A,HC KIT CPM MACHINE,270,1 ,$53.00 ,$34.45 ,$12.19 ,$53.00 ,$38.16 ,$28.83 ,$12.19 ,$29.58 ,$12.19 ,$31.66 ,$31.66 ,$31.66 ,$31.66 ,$44.52 ,$12.19 ,$45.05 ,$44.52 ,$12.19 ,$39.75 ,$42.40 ,$42.40 ,$12.19 ,$42.40 ,$44.52 ,$44.52 ,$44.52 ,$47.70 ,$30.48 ,$12.19 ,$53.00 , N/A , N/A ,$13.41 ,$45.05 ,$31.66 ,$47.70 ,$44.52 ,$42.40 ,$42.40 ,$12.19 ,$34.45 ST. FRANCIS HOSPITAL - ACUTE,27100075,N/A,HC IPPB CIRCUITS,271,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 , N/A , N/A ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,27100080,N/A,HC LARYNGEAL MASK AIRWAY,272,1 ,$91.00 ,$59.15 ,$20.93 ,$91.00 ,$65.52 ,$49.50 ,$20.93 ,$50.80 ,$20.93 ,$54.36 ,$54.36 ,$54.36 ,$54.36 ,$76.44 ,$20.93 ,$77.35 ,$76.44 ,$20.93 ,$68.25 ,$72.80 ,$72.80 ,$20.93 ,$72.80 ,$76.44 ,$76.44 ,$76.44 ,$81.90 ,$52.33 ,$20.93 ,$91.00 , N/A , N/A ,$23.02 ,$77.35 ,$54.36 ,$81.90 ,$76.44 ,$72.80 ,$72.80 ,$20.93 ,$59.15 ST. FRANCIS HOSPITAL - ACUTE,27100106,N/A,HC OXYGEN DAILY,271,1 ,$189.00 ,$122.85 ,$43.47 ,$189.00 ,$136.08 ,$102.82 ,$43.47 ,$105.50 ,$43.47 ,$112.91 ,$112.91 ,$112.91 ,$112.91 ,$158.76 ,$43.47 ,$160.65 ,$158.76 ,$43.47 ,$141.75 ,$151.20 ,$151.20 ,$43.47 ,$151.20 ,$158.76 ,$158.76 ,$158.76 ,$170.10 ,$108.68 ,$43.47 ,$189.00 , N/A , N/A ,$47.82 ,$160.65 ,$112.91 ,$170.10 ,$158.76 ,$151.20 ,$151.20 ,$43.47 ,$122.85 ST. FRANCIS HOSPITAL - ACUTE,27100107,N/A,HC OXYGEN HOURLY,271,1 ,$24.00 ,$15.60 ,$5.52 ,$24.00 ,$17.28 ,$13.06 ,$5.52 ,$13.40 ,$5.52 ,$14.34 ,$14.34 ,$14.34 ,$14.34 ,$20.16 ,$5.52 ,$20.40 ,$20.16 ,$5.52 ,$18.00 ,$19.20 ,$19.20 ,$5.52 ,$19.20 ,$20.16 ,$20.16 ,$20.16 ,$21.60 ,$13.80 ,$5.52 ,$24.00 , N/A , N/A ,$6.07 ,$20.40 ,$14.34 ,$21.60 ,$20.16 ,$19.20 ,$19.20 ,$5.52 ,$15.60 ST. FRANCIS HOSPITAL - ACUTE,27100108,N/A,HC OXYGEN HOOD DAILY,271,1 ,$100.00 ,$65.00 ,$23.00 ,$100.00 ,$72.00 ,$54.40 ,$23.00 ,$55.82 ,$23.00 ,$59.74 ,$59.74 ,$59.74 ,$59.74 ,$84.00 ,$23.00 ,$85.00 ,$84.00 ,$23.00 ,$75.00 ,$80.00 ,$80.00 ,$23.00 ,$80.00 ,$84.00 ,$84.00 ,$84.00 ,$90.00 ,$57.50 ,$23.00 ,$100.00 , N/A , N/A ,$25.30 ,$85.00 ,$59.74 ,$90.00 ,$84.00 ,$80.00 ,$80.00 ,$23.00 ,$65.00 ST. FRANCIS HOSPITAL - ACUTE,27100110,N/A,HC OXYGEN/AEROSAL MASK,271,1 ,$47.00 ,$30.55 ,$10.81 ,$47.00 ,$33.84 ,$25.57 ,$10.81 ,$26.24 ,$10.81 ,$28.08 ,$28.08 ,$28.08 ,$28.08 ,$39.48 ,$10.81 ,$39.95 ,$39.48 ,$10.81 ,$35.25 ,$37.60 ,$37.60 ,$10.81 ,$37.60 ,$39.48 ,$39.48 ,$39.48 ,$42.30 ,$27.03 ,$10.81 ,$47.00 , N/A , N/A ,$11.89 ,$39.95 ,$28.08 ,$42.30 ,$39.48 ,$37.60 ,$37.60 ,$10.81 ,$30.55 ST. FRANCIS HOSPITAL - ACUTE,27100114,N/A,HC PEAK FLOWMETER,271,1 ,$29.00 ,$18.85 ,$6.67 ,$29.00 ,$20.88 ,$15.78 ,$6.67 ,$16.19 ,$6.67 ,$17.32 ,$17.32 ,$17.32 ,$17.32 ,$24.36 ,$6.67 ,$24.65 ,$24.36 ,$6.67 ,$21.75 ,$23.20 ,$23.20 ,$6.67 ,$23.20 ,$24.36 ,$24.36 ,$24.36 ,$26.10 ,$16.68 ,$6.67 ,$29.00 , N/A , N/A ,$7.34 ,$24.65 ,$17.32 ,$26.10 ,$24.36 ,$23.20 ,$23.20 ,$6.67 ,$18.85 ST. FRANCIS HOSPITAL - ACUTE,27100120,N/A,HC CAST SHOE,271,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 , N/A , N/A ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,27100136,N/A,HC FINGER SPLINT,271,1 ,$13.00 ,$8.45 ,$2.99 ,$13.00 ,$9.36 ,$7.07 ,$2.99 ,$7.26 ,$2.99 ,$7.77 ,$7.77 ,$7.77 ,$7.77 ,$10.92 ,$2.99 ,$11.05 ,$10.92 ,$2.99 ,$9.75 ,$10.40 ,$10.40 ,$2.99 ,$10.40 ,$10.92 ,$10.92 ,$10.92 ,$11.70 ,$7.48 ,$2.99 ,$13.00 , N/A , N/A ,$3.29 ,$11.05 ,$7.77 ,$11.70 ,$10.92 ,$10.40 ,$10.40 ,$2.99 ,$8.45 ST. FRANCIS HOSPITAL - ACUTE,27100159,N/A,HC TUBE GAUZE,271,1 ,$37.00 ,$24.05 ,$8.51 ,$37.00 ,$26.64 ,$20.13 ,$8.51 ,$20.65 ,$8.51 ,$22.10 ,$22.10 ,$22.10 ,$22.10 ,$31.08 ,$8.51 ,$31.45 ,$31.08 ,$8.51 ,$27.75 ,$29.60 ,$29.60 ,$8.51 ,$29.60 ,$31.08 ,$31.08 ,$31.08 ,$33.30 ,$21.28 ,$8.51 ,$37.00 , N/A , N/A ,$9.36 ,$31.45 ,$22.10 ,$33.30 ,$31.08 ,$29.60 ,$29.60 ,$8.51 ,$24.05 ST. FRANCIS HOSPITAL - ACUTE,27100182,N/A,HC HAND SPLINT,271,1 ,$76.00 ,$49.40 ,$17.48 ,$76.00 ,$54.72 ,$41.34 ,$17.48 ,$42.42 ,$17.48 ,$45.40 ,$45.40 ,$45.40 ,$45.40 ,$63.84 ,$17.48 ,$64.60 ,$63.84 ,$17.48 ,$57.00 ,$60.80 ,$60.80 ,$17.48 ,$60.80 ,$63.84 ,$63.84 ,$63.84 ,$68.40 ,$43.70 ,$17.48 ,$76.00 , N/A , N/A ,$19.23 ,$64.60 ,$45.40 ,$68.40 ,$63.84 ,$60.80 ,$60.80 ,$17.48 ,$49.40 ST. FRANCIS HOSPITAL - ACUTE,27100187,N/A,HC BAG DRAINAGE,271,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27100188,N/A,HC SLING ARM,271,1 ,$96.00 ,$62.40 ,$22.08 ,$96.00 ,$69.12 ,$52.22 ,$22.08 ,$53.59 ,$22.08 ,$57.35 ,$57.35 ,$57.35 ,$57.35 ,$80.64 ,$22.08 ,$81.60 ,$80.64 ,$22.08 ,$72.00 ,$76.80 ,$76.80 ,$22.08 ,$76.80 ,$80.64 ,$80.64 ,$80.64 ,$86.40 ,$55.20 ,$22.08 ,$96.00 , N/A , N/A ,$24.29 ,$81.60 ,$57.35 ,$86.40 ,$80.64 ,$76.80 ,$76.80 ,$22.08 ,$62.40 ST. FRANCIS HOSPITAL - ACUTE,27100204,N/A,HC CIRCUIT BREATHING,271,1 ,$43.00 ,$27.95 ,$9.89 ,$43.00 ,$30.96 ,$23.39 ,$9.89 ,$24.00 ,$9.89 ,$25.69 ,$25.69 ,$25.69 ,$25.69 ,$36.12 ,$9.89 ,$36.55 ,$36.12 ,$9.89 ,$32.25 ,$34.40 ,$34.40 ,$9.89 ,$34.40 ,$36.12 ,$36.12 ,$36.12 ,$38.70 ,$24.73 ,$9.89 ,$43.00 , N/A , N/A ,$10.88 ,$36.55 ,$25.69 ,$38.70 ,$36.12 ,$34.40 ,$34.40 ,$9.89 ,$27.95 ST. FRANCIS HOSPITAL - ACUTE,27100207,N/A,HC DRESSING BANDAGE ELASTIC,271,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27100209,N/A,HC ENEMA BAG,271,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27100211,N/A,HC PAD DEFIBRILLATOR,271,1 ,$54.00 ,$35.10 ,$12.42 ,$54.00 ,$38.88 ,$29.38 ,$12.42 ,$30.14 ,$12.42 ,$32.26 ,$32.26 ,$32.26 ,$32.26 ,$45.36 ,$12.42 ,$45.90 ,$45.36 ,$12.42 ,$40.50 ,$43.20 ,$43.20 ,$12.42 ,$43.20 ,$45.36 ,$45.36 ,$45.36 ,$48.60 ,$31.05 ,$12.42 ,$54.00 , N/A , N/A ,$13.66 ,$45.90 ,$32.26 ,$48.60 ,$45.36 ,$43.20 ,$43.20 ,$12.42 ,$35.10 ST. FRANCIS HOSPITAL - ACUTE,27100215,N/A,HC RESTRAINT ANY TYPE,271,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 , N/A , N/A ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,27100218,N/A,HC SET IV BLOOD ADMINISTRATION,271,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 , N/A , N/A ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,27100221,N/A,HC SET IV PCA,271,1 ,$165.00 ,$107.25 ,$37.95 ,$165.00 ,$118.80 ,$89.76 ,$37.95 ,$92.10 ,$37.95 ,$98.57 ,$98.57 ,$98.57 ,$98.57 ,$138.60 ,$37.95 ,$140.25 ,$138.60 ,$37.95 ,$123.75 ,$132.00 ,$132.00 ,$37.95 ,$132.00 ,$138.60 ,$138.60 ,$138.60 ,$148.50 ,$94.88 ,$37.95 ,$165.00 , N/A , N/A ,$41.75 ,$140.25 ,$98.57 ,$148.50 ,$138.60 ,$132.00 ,$132.00 ,$37.95 ,$107.25 ST. FRANCIS HOSPITAL - ACUTE,27100222,N/A,HC SET OSTOMY IRRIGATION,271,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 , N/A , N/A ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,27100223,N/A,HC SHELL/SHIELD BREAST,271,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27100225,N/A,HC SPLINT KNEE,271,1 ,$148.00 ,$96.20 ,$34.04 ,$148.00 ,$106.56 ,$80.51 ,$34.04 ,$82.61 ,$34.04 ,$88.42 ,$88.42 ,$88.42 ,$88.42 ,$124.32 ,$34.04 ,$125.80 ,$124.32 ,$34.04 ,$111.00 ,$118.40 ,$118.40 ,$34.04 ,$118.40 ,$124.32 ,$124.32 ,$124.32 ,$133.20 ,$85.10 ,$34.04 ,$148.00 , N/A , N/A ,$37.44 ,$125.80 ,$88.42 ,$133.20 ,$124.32 ,$118.40 ,$118.40 ,$34.04 ,$96.20 ST. FRANCIS HOSPITAL - ACUTE,27100231,N/A,HC TUBING DRAINAGE,271,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27100234,N/A,HC MASK BIPAP,271,1 ,$152.00 ,$98.80 ,$34.96 ,$152.00 ,$109.44 ,$82.69 ,$34.96 ,$84.85 ,$34.96 ,$90.80 ,$90.80 ,$90.80 ,$90.80 ,$127.68 ,$34.96 ,$129.20 ,$127.68 ,$34.96 ,$114.00 ,$121.60 ,$121.60 ,$34.96 ,$121.60 ,$127.68 ,$127.68 ,$127.68 ,$136.80 ,$87.40 ,$34.96 ,$152.00 , N/A , N/A ,$38.46 ,$129.20 ,$90.80 ,$136.80 ,$127.68 ,$121.60 ,$121.60 ,$34.96 ,$98.80 ST. FRANCIS HOSPITAL - ACUTE,27100239,N/A,HC TUBING OXYGEN,271,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 , N/A , N/A ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,27100256,N/A,HC ELECTRODE FETAL SCALP,271,1 ,$209.00 ,$135.85 ,$48.07 ,$209.00 ,$150.48 ,$113.70 ,$48.07 ,$116.66 ,$48.07 ,$124.86 ,$124.86 ,$124.86 ,$124.86 ,$175.56 ,$48.07 ,$177.65 ,$175.56 ,$48.07 ,$156.75 ,$167.20 ,$167.20 ,$48.07 ,$167.20 ,$175.56 ,$175.56 ,$175.56 ,$188.10 ,$120.18 ,$48.07 ,$209.00 , N/A , N/A ,$52.88 ,$177.65 ,$124.86 ,$188.10 ,$175.56 ,$167.20 ,$167.20 ,$48.07 ,$135.85 ST. FRANCIS HOSPITAL - ACUTE,27100261,N/A,HC PAD K PAD,271,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27100273,N/A,HC SPLINT OCL CUSTOM,271,1 ,$51.00 ,$33.15 ,$11.73 ,$51.00 ,$36.72 ,$27.74 ,$11.73 ,$28.47 ,$11.73 ,$30.47 ,$30.47 ,$30.47 ,$30.47 ,$42.84 ,$11.73 ,$43.35 ,$42.84 ,$11.73 ,$38.25 ,$40.80 ,$40.80 ,$11.73 ,$40.80 ,$42.84 ,$42.84 ,$42.84 ,$45.90 ,$29.33 ,$11.73 ,$51.00 , N/A , N/A ,$12.90 ,$43.35 ,$30.47 ,$45.90 ,$42.84 ,$40.80 ,$40.80 ,$11.73 ,$33.15 ST. FRANCIS HOSPITAL - ACUTE,27100282,N/A,HC PACK HOT/ COLD SMALL,271,1 ,$13.00 ,$8.45 ,$2.99 ,$13.00 ,$9.36 ,$7.07 ,$2.99 ,$7.26 ,$2.99 ,$7.77 ,$7.77 ,$7.77 ,$7.77 ,$10.92 ,$2.99 ,$11.05 ,$10.92 ,$2.99 ,$9.75 ,$10.40 ,$10.40 ,$2.99 ,$10.40 ,$10.92 ,$10.92 ,$10.92 ,$11.70 ,$7.48 ,$2.99 ,$13.00 , N/A , N/A ,$3.29 ,$11.05 ,$7.77 ,$11.70 ,$10.92 ,$10.40 ,$10.40 ,$2.99 ,$8.45 ST. FRANCIS HOSPITAL - ACUTE,27100290,A4467,HC GARMENT ELASTIC,271,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 , N/A , N/A ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,27100291,L3650,HC IMMOBILIZER SHOULDER ADB RESTR,271,1 ,$60.00 ,$39.00 ,$13.80 ,$60.00 ,$43.20 ,$32.64 ,$13.80 ,$33.49 ,$13.80 ,$35.84 ,$35.84 ,$35.84 ,$35.84 ,$50.40 ,$13.80 ,$51.00 ,$50.40 ,$13.80 ,$45.00 ,$48.00 ,$48.00 ,$13.80 ,$48.00 ,$50.40 ,$50.40 ,$50.40 ,$54.00 ,$34.50 ,$13.80 ,$60.00 , N/A , N/A ,$15.18 ,$51.00 ,$35.84 ,$54.00 ,$50.40 ,$48.00 ,$48.00 ,$13.80 ,$39.00 ST. FRANCIS HOSPITAL - ACUTE,27100325,N/A,HC SPACER MDI,271,1 ,$16.00 ,$10.40 ,$3.68 ,$16.00 ,$11.52 ,$8.70 ,$3.68 ,$8.93 ,$3.68 ,$9.56 ,$9.56 ,$9.56 ,$9.56 ,$13.44 ,$3.68 ,$13.60 ,$13.44 ,$3.68 ,$12.00 ,$12.80 ,$12.80 ,$3.68 ,$12.80 ,$13.44 ,$13.44 ,$13.44 ,$14.40 ,$9.20 ,$3.68 ,$16.00 , N/A , N/A ,$4.05 ,$13.60 ,$9.56 ,$14.40 ,$13.44 ,$12.80 ,$12.80 ,$3.68 ,$10.40 ST. FRANCIS HOSPITAL - ACUTE,27100326,N/A,HC STOCKING ANTIEMBOLISM,271,1 ,$75.00 ,$48.75 ,$17.25 ,$75.00 ,$54.00 ,$40.80 ,$17.25 ,$41.87 ,$17.25 ,$44.81 ,$44.81 ,$44.81 ,$44.81 ,$63.00 ,$17.25 ,$63.75 ,$63.00 ,$17.25 ,$56.25 ,$60.00 ,$60.00 ,$17.25 ,$60.00 ,$63.00 ,$63.00 ,$63.00 ,$67.50 ,$43.13 ,$17.25 ,$75.00 , N/A , N/A ,$18.98 ,$63.75 ,$44.81 ,$67.50 ,$63.00 ,$60.00 ,$60.00 ,$17.25 ,$48.75 ST. FRANCIS HOSPITAL - ACUTE,27100483,N/A,HC BOTTLE HUMIDITY,271,1 ,$17.00 ,$11.05 ,$3.91 ,$17.00 ,$12.24 ,$9.25 ,$3.91 ,$9.49 ,$3.91 ,$10.16 ,$10.16 ,$10.16 ,$10.16 ,$14.28 ,$3.91 ,$14.45 ,$14.28 ,$3.91 ,$12.75 ,$13.60 ,$13.60 ,$3.91 ,$13.60 ,$14.28 ,$14.28 ,$14.28 ,$15.30 ,$9.78 ,$3.91 ,$17.00 , N/A , N/A ,$4.30 ,$14.45 ,$10.16 ,$15.30 ,$14.28 ,$13.60 ,$13.60 ,$3.91 ,$11.05 ST. FRANCIS HOSPITAL - ACUTE,27100484,N/A,HC ROLL CAST FIBERGLASS,271,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 , N/A , N/A ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,27100485,N/A,HC ROLL CAST PLASTER,271,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27100491,N/A,HC PROTECTANT SKIN,271,1 ,$10.00 ,$6.50 ,$2.30 ,$10.00 ,$7.20 ,$5.44 ,$2.30 ,$5.58 ,$2.30 ,$5.97 ,$5.97 ,$5.97 ,$5.97 ,$8.40 ,$2.30 ,$8.50 ,$8.40 ,$2.30 ,$7.50 ,$8.00 ,$8.00 ,$2.30 ,$8.00 ,$8.40 ,$8.40 ,$8.40 ,$9.00 ,$5.75 ,$2.30 ,$10.00 , N/A , N/A ,$2.53 ,$8.50 ,$5.97 ,$9.00 ,$8.40 ,$8.00 ,$8.00 ,$2.30 ,$6.50 ST. FRANCIS HOSPITAL - ACUTE,27100493,N/A,HC PAD SENSOR,271,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 , N/A , N/A ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,27100495,N/A,HC SPLITTER PILL,271,1 ,$34.00 ,$22.10 ,$7.82 ,$34.00 ,$24.48 ,$18.50 ,$7.82 ,$18.98 ,$7.82 ,$20.31 ,$20.31 ,$20.31 ,$20.31 ,$28.56 ,$7.82 ,$28.90 ,$28.56 ,$7.82 ,$25.50 ,$27.20 ,$27.20 ,$7.82 ,$27.20 ,$28.56 ,$28.56 ,$28.56 ,$30.60 ,$19.55 ,$7.82 ,$34.00 , N/A , N/A ,$8.60 ,$28.90 ,$20.31 ,$30.60 ,$28.56 ,$27.20 ,$27.20 ,$7.82 ,$22.10 ST. FRANCIS HOSPITAL - ACUTE,27100497,N/A,HC STRAP CATHETER,271,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27200035,C1729,HC CATHETER DRAINAGE PLEUREX,272,1 ,$221.00 ,$143.65 ,$50.83 ,$221.00 ,$159.12 ,$120.22 ,$50.83 ,$123.36 ,$50.83 ,$132.03 ,$132.03 ,$132.03 ,$132.03 ,$185.64 ,$50.83 ,$187.85 ,$185.64 ,$50.83 ,$165.75 ,$176.80 ,$176.80 ,$50.83 ,$176.80 ,$185.64 ,$185.64 ,$185.64 ,$198.90 ,$127.08 ,$50.83 ,$221.00 , N/A , N/A ,$55.91 ,$187.85 ,$132.03 ,$198.90 ,$185.64 ,$176.80 ,$176.80 ,$50.83 ,$143.65 ST. FRANCIS HOSPITAL - ACUTE,27200075,C1758,HC CATHETER URETERAL,272,1 ,$91.00 ,$59.15 ,$20.93 ,$91.00 ,$65.52 ,$49.50 ,$20.93 ,$50.80 ,$20.93 ,$54.36 ,$54.36 ,$54.36 ,$54.36 ,$76.44 ,$20.93 ,$77.35 ,$76.44 ,$20.93 ,$68.25 ,$72.80 ,$72.80 ,$20.93 ,$72.80 ,$76.44 ,$76.44 ,$76.44 ,$81.90 ,$52.33 ,$20.93 ,$91.00 , N/A , N/A ,$23.02 ,$77.35 ,$54.36 ,$81.90 ,$76.44 ,$72.80 ,$72.80 ,$20.93 ,$59.15 ST. FRANCIS HOSPITAL - ACUTE,27200200,N/A,HC ABDOMINAL BINDERS,272,1 ,$55.00 ,$35.75 ,$12.65 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 , N/A , N/A ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,27200226,N/A,HC ADHESIVE DERMABOND,272,1 ,$69.00 ,$44.85 ,$15.87 ,$69.00 ,$49.68 ,$37.54 ,$15.87 ,$38.52 ,$15.87 ,$41.22 ,$41.22 ,$41.22 ,$41.22 ,$57.96 ,$15.87 ,$58.65 ,$57.96 ,$15.87 ,$51.75 ,$55.20 ,$55.20 ,$15.87 ,$55.20 ,$57.96 ,$57.96 ,$57.96 ,$62.10 ,$39.68 ,$15.87 ,$69.00 , N/A , N/A ,$17.46 ,$58.65 ,$41.22 ,$62.10 ,$57.96 ,$55.20 ,$55.20 ,$15.87 ,$44.85 ST. FRANCIS HOSPITAL - ACUTE,27200236,N/A,HC AIRWAY NASO-PHARYNGEAL,272,1 ,$47.00 ,$30.55 ,$10.81 ,$47.00 ,$33.84 ,$25.57 ,$10.81 ,$26.24 ,$10.81 ,$28.08 ,$28.08 ,$28.08 ,$28.08 ,$39.48 ,$10.81 ,$39.95 ,$39.48 ,$10.81 ,$35.25 ,$37.60 ,$37.60 ,$10.81 ,$37.60 ,$39.48 ,$39.48 ,$39.48 ,$42.30 ,$27.03 ,$10.81 ,$47.00 , N/A , N/A ,$11.89 ,$39.95 ,$28.08 ,$42.30 ,$39.48 ,$37.60 ,$37.60 ,$10.81 ,$30.55 ST. FRANCIS HOSPITAL - ACUTE,27200290,N/A,HC BAG BILE,272,1 ,$43.00 ,$27.95 ,$9.89 ,$43.00 ,$30.96 ,$23.39 ,$9.89 ,$24.00 ,$9.89 ,$25.69 ,$25.69 ,$25.69 ,$25.69 ,$36.12 ,$9.89 ,$36.55 ,$36.12 ,$9.89 ,$32.25 ,$34.40 ,$34.40 ,$9.89 ,$34.40 ,$36.12 ,$36.12 ,$36.12 ,$38.70 ,$24.73 ,$9.89 ,$43.00 , N/A , N/A ,$10.88 ,$36.55 ,$25.69 ,$38.70 ,$36.12 ,$34.40 ,$34.40 ,$9.89 ,$27.95 ST. FRANCIS HOSPITAL - ACUTE,27200502,N/A,HC BLADE SAW,272,1 ,$25.00 ,$16.25 ,$5.75 ,$25.00 ,$18.00 ,$13.60 ,$5.75 ,$13.96 ,$5.75 ,$14.94 ,$14.94 ,$14.94 ,$14.94 ,$21.00 ,$5.75 ,$21.25 ,$21.00 ,$5.75 ,$18.75 ,$20.00 ,$20.00 ,$5.75 ,$20.00 ,$21.00 ,$21.00 ,$21.00 ,$22.50 ,$14.38 ,$5.75 ,$25.00 , N/A , N/A ,$6.33 ,$21.25 ,$14.94 ,$22.50 ,$21.00 ,$20.00 ,$20.00 ,$5.75 ,$16.25 ST. FRANCIS HOSPITAL - ACUTE,27200571,N/A,HC BREAST PUMP KIT,272,1 ,$51.00 ,$33.15 ,$11.73 ,$51.00 ,$36.72 ,$27.74 ,$11.73 ,$28.47 ,$11.73 ,$30.47 ,$30.47 ,$30.47 ,$30.47 ,$42.84 ,$11.73 ,$43.35 ,$42.84 ,$11.73 ,$38.25 ,$40.80 ,$40.80 ,$11.73 ,$40.80 ,$42.84 ,$42.84 ,$42.84 ,$45.90 ,$29.33 ,$11.73 ,$51.00 , N/A , N/A ,$12.90 ,$43.35 ,$30.47 ,$45.90 ,$42.84 ,$40.80 ,$40.80 ,$11.73 ,$33.15 ST. FRANCIS HOSPITAL - ACUTE,27200832,N/A,HC CATH TRAY WITH FOLEY,272,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 , N/A , N/A ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,27200849,N/A,HC CATHETER - FOLEY,272,1 ,$231.00 ,$150.15 ,$53.13 ,$231.00 ,$166.32 ,$125.66 ,$53.13 ,$128.94 ,$53.13 ,$138.00 ,$138.00 ,$138.00 ,$138.00 ,$194.04 ,$53.13 ,$196.35 ,$194.04 ,$53.13 ,$173.25 ,$184.80 ,$184.80 ,$53.13 ,$184.80 ,$194.04 ,$194.04 ,$194.04 ,$207.90 ,$132.83 ,$53.13 ,$231.00 , N/A , N/A ,$58.44 ,$196.35 ,$138.00 ,$207.90 ,$194.04 ,$184.80 ,$184.80 ,$53.13 ,$150.15 ST. FRANCIS HOSPITAL - ACUTE,27201077,N/A,HC DIS INCENTIVE SPIROMETER,272,1 ,$114.00 ,$74.10 ,$26.22 ,$114.00 ,$82.08 ,$62.02 ,$26.22 ,$63.63 ,$26.22 ,$68.10 ,$68.10 ,$68.10 ,$68.10 ,$95.76 ,$26.22 ,$96.90 ,$95.76 ,$26.22 ,$85.50 ,$91.20 ,$91.20 ,$26.22 ,$91.20 ,$95.76 ,$95.76 ,$95.76 ,$102.60 ,$65.55 ,$26.22 ,$114.00 , N/A , N/A ,$28.84 ,$96.90 ,$68.10 ,$102.60 ,$95.76 ,$91.20 ,$91.20 ,$26.22 ,$74.10 ST. FRANCIS HOSPITAL - ACUTE,27201157,N/A,HC DRSG ADAPTIC 3X3 PK,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27201252,N/A,HC EPIDURAL TRAY,272,1 ,$230.00 ,$149.50 ,$52.90 ,$230.00 ,$165.60 ,$125.12 ,$52.90 ,$128.39 ,$52.90 ,$137.40 ,$137.40 ,$137.40 ,$137.40 ,$193.20 ,$52.90 ,$195.50 ,$193.20 ,$52.90 ,$172.50 ,$184.00 ,$184.00 ,$52.90 ,$184.00 ,$193.20 ,$193.20 ,$193.20 ,$207.00 ,$132.25 ,$52.90 ,$230.00 , N/A , N/A ,$58.19 ,$195.50 ,$137.40 ,$207.00 ,$193.20 ,$184.00 ,$184.00 ,$52.90 ,$149.50 ST. FRANCIS HOSPITAL - ACUTE,27201282,N/A,HC FEEDING TUBE,272,1 ,$53.00 ,$34.45 ,$12.19 ,$53.00 ,$38.16 ,$28.83 ,$12.19 ,$29.58 ,$12.19 ,$31.66 ,$31.66 ,$31.66 ,$31.66 ,$44.52 ,$12.19 ,$45.05 ,$44.52 ,$12.19 ,$39.75 ,$42.40 ,$42.40 ,$12.19 ,$42.40 ,$44.52 ,$44.52 ,$44.52 ,$47.70 ,$30.48 ,$12.19 ,$53.00 , N/A , N/A ,$13.41 ,$45.05 ,$31.66 ,$47.70 ,$44.52 ,$42.40 ,$42.40 ,$12.19 ,$34.45 ST. FRANCIS HOSPITAL - ACUTE,27201315,N/A,HC FLUTTER VALVE EQUIPMENT,272,1 ,$115.00 ,$74.75 ,$26.45 ,$115.00 ,$82.80 ,$62.56 ,$26.45 ,$64.19 ,$26.45 ,$68.70 ,$68.70 ,$68.70 ,$68.70 ,$96.60 ,$26.45 ,$97.75 ,$96.60 ,$26.45 ,$86.25 ,$92.00 ,$92.00 ,$26.45 ,$92.00 ,$96.60 ,$96.60 ,$96.60 ,$103.50 ,$66.13 ,$26.45 ,$115.00 , N/A , N/A ,$29.10 ,$97.75 ,$68.70 ,$103.50 ,$96.60 ,$92.00 ,$92.00 ,$26.45 ,$74.75 ST. FRANCIS HOSPITAL - ACUTE,27201319,N/A,HC FOLEY CATH W/URINE METER,272,1 ,$51.00 ,$33.15 ,$11.73 ,$51.00 ,$36.72 ,$27.74 ,$11.73 ,$28.47 ,$11.73 ,$30.47 ,$30.47 ,$30.47 ,$30.47 ,$42.84 ,$11.73 ,$43.35 ,$42.84 ,$11.73 ,$38.25 ,$40.80 ,$40.80 ,$11.73 ,$40.80 ,$42.84 ,$42.84 ,$42.84 ,$45.90 ,$29.33 ,$11.73 ,$51.00 , N/A , N/A ,$12.90 ,$43.35 ,$30.47 ,$45.90 ,$42.84 ,$40.80 ,$40.80 ,$11.73 ,$33.15 ST. FRANCIS HOSPITAL - ACUTE,27201502,N/A,HC KIT DRAINAGE,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27201713,N/A,HC NEEDLE SPINAL,272,1 ,$60.00 ,$39.00 ,$13.80 ,$60.00 ,$43.20 ,$32.64 ,$13.80 ,$33.49 ,$13.80 ,$35.84 ,$35.84 ,$35.84 ,$35.84 ,$50.40 ,$13.80 ,$51.00 ,$50.40 ,$13.80 ,$45.00 ,$48.00 ,$48.00 ,$13.80 ,$48.00 ,$50.40 ,$50.40 ,$50.40 ,$54.00 ,$34.50 ,$13.80 ,$60.00 , N/A , N/A ,$15.18 ,$51.00 ,$35.84 ,$54.00 ,$50.40 ,$48.00 ,$48.00 ,$13.80 ,$39.00 ST. FRANCIS HOSPITAL - ACUTE,27201799,N/A,HC PACKING - WOUND,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27201938,N/A,HC PULSE OXIMETER PROBE DISP,272,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 , N/A , N/A ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,27202018,N/A,HC SENSOR ADULT ADHESIVE,272,1 ,$108.00 ,$70.20 ,$24.84 ,$108.00 ,$77.76 ,$58.75 ,$24.84 ,$60.29 ,$24.84 ,$64.52 ,$64.52 ,$64.52 ,$64.52 ,$90.72 ,$24.84 ,$91.80 ,$90.72 ,$24.84 ,$81.00 ,$86.40 ,$86.40 ,$24.84 ,$86.40 ,$90.72 ,$90.72 ,$90.72 ,$97.20 ,$62.10 ,$24.84 ,$108.00 , N/A , N/A ,$27.32 ,$91.80 ,$64.52 ,$97.20 ,$90.72 ,$86.40 ,$86.40 ,$24.84 ,$70.20 ST. FRANCIS HOSPITAL - ACUTE,27202033,N/A,HC SET IV SECONDARY,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27202120,N/A,HC STAPLER SKIN,272,1 ,$107.00 ,$69.55 ,$24.61 ,$107.00 ,$77.04 ,$58.21 ,$24.61 ,$59.73 ,$24.61 ,$63.92 ,$63.92 ,$63.92 ,$63.92 ,$89.88 ,$24.61 ,$90.95 ,$89.88 ,$24.61 ,$80.25 ,$85.60 ,$85.60 ,$24.61 ,$85.60 ,$89.88 ,$89.88 ,$89.88 ,$96.30 ,$61.53 ,$24.61 ,$107.00 , N/A , N/A ,$27.07 ,$90.95 ,$63.92 ,$96.30 ,$89.88 ,$85.60 ,$85.60 ,$24.61 ,$69.55 ST. FRANCIS HOSPITAL - ACUTE,27202600,N/A,HC SUTURE,272,1 ,$155.00 ,$100.75 ,$35.65 ,$155.00 ,$111.60 ,$84.32 ,$35.65 ,$86.52 ,$35.65 ,$92.60 ,$92.60 ,$92.60 ,$92.60 ,$130.20 ,$35.65 ,$131.75 ,$130.20 ,$35.65 ,$116.25 ,$124.00 ,$124.00 ,$35.65 ,$124.00 ,$130.20 ,$130.20 ,$130.20 ,$139.50 ,$89.13 ,$35.65 ,$155.00 , N/A , N/A ,$39.22 ,$131.75 ,$92.60 ,$139.50 ,$130.20 ,$124.00 ,$124.00 ,$35.65 ,$100.75 ST. FRANCIS HOSPITAL - ACUTE,27202743,N/A,HC TRAY CATH,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27202786,N/A,HC TRAY PERI-CERV BLOCK,272,1 ,$250.00 ,$162.50 ,$57.50 ,$250.00 ,$180.00 ,$136.00 ,$57.50 ,$139.55 ,$57.50 ,$149.35 ,$149.35 ,$149.35 ,$149.35 ,$210.00 ,$57.50 ,$212.50 ,$210.00 ,$57.50 ,$187.50 ,$200.00 ,$200.00 ,$57.50 ,$200.00 ,$210.00 ,$210.00 ,$210.00 ,$225.00 ,$143.75 ,$57.50 ,$250.00 , N/A , N/A ,$63.25 ,$212.50 ,$149.35 ,$225.00 ,$210.00 ,$200.00 ,$200.00 ,$57.50 ,$162.50 ST. FRANCIS HOSPITAL - ACUTE,27203103,N/A,HC DRSG PRIMAPORE,272,1 ,$12.00 ,$7.80 ,$2.76 ,$12.00 ,$8.64 ,$6.53 ,$2.76 ,$6.70 ,$2.76 ,$7.17 ,$7.17 ,$7.17 ,$7.17 ,$10.08 ,$2.76 ,$10.20 ,$10.08 ,$2.76 ,$9.00 ,$9.60 ,$9.60 ,$2.76 ,$9.60 ,$10.08 ,$10.08 ,$10.08 ,$10.80 ,$6.90 ,$2.76 ,$12.00 , N/A , N/A ,$3.04 ,$10.20 ,$7.17 ,$10.80 ,$10.08 ,$9.60 ,$9.60 ,$2.76 ,$7.80 ST. FRANCIS HOSPITAL - ACUTE,27203503,N/A,HC CANNULA NASAL HEATED HI FLOW,272,1 ,$185.00 ,$120.25 ,$42.55 ,$185.00 ,$133.20 ,$100.64 ,$42.55 ,$103.27 ,$42.55 ,$110.52 ,$110.52 ,$110.52 ,$110.52 ,$155.40 ,$42.55 ,$157.25 ,$155.40 ,$42.55 ,$138.75 ,$148.00 ,$148.00 ,$42.55 ,$148.00 ,$155.40 ,$155.40 ,$155.40 ,$166.50 ,$106.38 ,$42.55 ,$185.00 , N/A , N/A ,$46.81 ,$157.25 ,$110.52 ,$166.50 ,$155.40 ,$148.00 ,$148.00 ,$42.55 ,$120.25 ST. FRANCIS HOSPITAL - ACUTE,27203509,N/A,HC CATHETER FOLEY 3W,272,1 ,$245.00 ,$159.25 ,$56.35 ,$245.00 ,$176.40 ,$133.28 ,$56.35 ,$136.76 ,$56.35 ,$146.36 ,$146.36 ,$146.36 ,$146.36 ,$205.80 ,$56.35 ,$208.25 ,$205.80 ,$56.35 ,$183.75 ,$196.00 ,$196.00 ,$56.35 ,$196.00 ,$205.80 ,$205.80 ,$205.80 ,$220.50 ,$140.88 ,$56.35 ,$245.00 , N/A , N/A ,$61.99 ,$208.25 ,$146.36 ,$220.50 ,$205.80 ,$196.00 ,$196.00 ,$56.35 ,$159.25 ST. FRANCIS HOSPITAL - ACUTE,27203511,N/A,HC BAG LEG URINARY,272,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 , N/A , N/A ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,27203519,A6223,HC DRESSING XEROFORM,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27203521,A6234,HC DRESSING DUODERM <16 SQ CM,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27203526,A6266,HC PACKING GAUZE IODOFORM,272,1 ,$13.00 ,$8.45 ,$2.99 ,$13.00 ,$9.36 ,$7.07 ,$2.99 ,$7.26 ,$2.99 ,$7.77 ,$7.77 ,$7.77 ,$7.77 ,$10.92 ,$2.99 ,$11.05 ,$10.92 ,$2.99 ,$9.75 ,$10.40 ,$10.40 ,$2.99 ,$10.40 ,$10.92 ,$10.92 ,$10.92 ,$11.70 ,$7.48 ,$2.99 ,$13.00 , N/A , N/A ,$3.29 ,$11.05 ,$7.77 ,$11.70 ,$10.92 ,$10.40 ,$10.40 ,$2.99 ,$8.45 ST. FRANCIS HOSPITAL - ACUTE,27203528,A6403,HC DRESSING KERLIX SPONGE >16 AND <48 SQ CM,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27203531,C1751,HC CATHETER CV TRIPLE-LUMEN,272,1 ,$302.00 ,$196.30 ,$69.46 ,$302.00 ,$217.44 ,$164.29 ,$69.46 ,$168.58 ,$69.46 ,$180.41 ,$180.41 ,$180.41 ,$180.41 ,$253.68 ,$69.46 ,$256.70 ,$253.68 ,$69.46 ,$226.50 ,$241.60 ,$241.60 ,$69.46 ,$241.60 ,$253.68 ,$253.68 ,$253.68 ,$271.80 ,$173.65 ,$69.46 ,$302.00 , N/A , N/A ,$76.41 ,$256.70 ,$180.41 ,$271.80 ,$253.68 ,$241.60 ,$241.60 ,$69.46 ,$196.30 ST. FRANCIS HOSPITAL - ACUTE,27203535,N/A,HC TRAY LUMBAR PUNCTURE,272,1 ,$263.00 ,$170.95 ,$60.49 ,$263.00 ,$189.36 ,$143.07 ,$60.49 ,$146.81 ,$60.49 ,$157.12 ,$157.12 ,$157.12 ,$157.12 ,$220.92 ,$60.49 ,$223.55 ,$220.92 ,$60.49 ,$197.25 ,$210.40 ,$210.40 ,$60.49 ,$210.40 ,$220.92 ,$220.92 ,$220.92 ,$236.70 ,$151.23 ,$60.49 ,$263.00 , N/A , N/A ,$66.54 ,$223.55 ,$157.12 ,$236.70 ,$220.92 ,$210.40 ,$210.40 ,$60.49 ,$170.95 ST. FRANCIS HOSPITAL - ACUTE,27203538,N/A,HC KIT ARTERIAL LINE,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27203557,N/A,HC CATHETER INTRAUTERINE,272,1 ,$346.00 ,$224.90 ,$79.58 ,$346.00 ,$249.12 ,$188.22 ,$79.58 ,$193.14 ,$79.58 ,$206.70 ,$206.70 ,$206.70 ,$206.70 ,$290.64 ,$79.58 ,$294.10 ,$290.64 ,$79.58 ,$259.50 ,$276.80 ,$276.80 ,$79.58 ,$276.80 ,$290.64 ,$290.64 ,$290.64 ,$311.40 ,$198.95 ,$79.58 ,$346.00 , N/A , N/A ,$87.54 ,$294.10 ,$206.70 ,$311.40 ,$290.64 ,$276.80 ,$276.80 ,$79.58 ,$224.90 ST. FRANCIS HOSPITAL - ACUTE,27203558,N/A,HC EXTRACTOR,272,1 ,$225.00 ,$146.25 ,$51.75 ,$225.00 ,$162.00 ,$122.40 ,$51.75 ,$125.60 ,$51.75 ,$134.42 ,$134.42 ,$134.42 ,$134.42 ,$189.00 ,$51.75 ,$191.25 ,$189.00 ,$51.75 ,$168.75 ,$180.00 ,$180.00 ,$51.75 ,$180.00 ,$189.00 ,$189.00 ,$189.00 ,$202.50 ,$129.38 ,$51.75 ,$225.00 , N/A , N/A ,$56.93 ,$191.25 ,$134.42 ,$202.50 ,$189.00 ,$180.00 ,$180.00 ,$51.75 ,$146.25 ST. FRANCIS HOSPITAL - ACUTE,27203560,N/A,HC CATHETER IV,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27203562,N/A,HC CATHETER SUCTION,272,1 ,$134.00 ,$87.10 ,$30.82 ,$134.00 ,$96.48 ,$72.90 ,$30.82 ,$74.80 ,$30.82 ,$80.05 ,$80.05 ,$80.05 ,$80.05 ,$112.56 ,$30.82 ,$113.90 ,$112.56 ,$30.82 ,$100.50 ,$107.20 ,$107.20 ,$30.82 ,$107.20 ,$112.56 ,$112.56 ,$112.56 ,$120.60 ,$77.05 ,$30.82 ,$134.00 , N/A , N/A ,$33.90 ,$113.90 ,$80.05 ,$120.60 ,$112.56 ,$107.20 ,$107.20 ,$30.82 ,$87.10 ST. FRANCIS HOSPITAL - ACUTE,27203575,N/A,HC DRESSING TELFA,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27203576,N/A,HC DRESSING V.A.C.,272,1 ,$78.00 ,$50.70 ,$17.94 ,$78.00 ,$56.16 ,$42.43 ,$17.94 ,$43.54 ,$17.94 ,$46.60 ,$46.60 ,$46.60 ,$46.60 ,$65.52 ,$17.94 ,$66.30 ,$65.52 ,$17.94 ,$58.50 ,$62.40 ,$62.40 ,$17.94 ,$62.40 ,$65.52 ,$65.52 ,$65.52 ,$70.20 ,$44.85 ,$17.94 ,$78.00 , N/A , N/A ,$19.73 ,$66.30 ,$46.60 ,$70.20 ,$65.52 ,$62.40 ,$62.40 ,$17.94 ,$50.70 ST. FRANCIS HOSPITAL - ACUTE,27203586,N/A,HC SALEM SUMP,272,1 ,$62.00 ,$40.30 ,$14.26 ,$62.00 ,$44.64 ,$33.73 ,$14.26 ,$34.61 ,$14.26 ,$37.04 ,$37.04 ,$37.04 ,$37.04 ,$52.08 ,$14.26 ,$52.70 ,$52.08 ,$14.26 ,$46.50 ,$49.60 ,$49.60 ,$14.26 ,$49.60 ,$52.08 ,$52.08 ,$52.08 ,$55.80 ,$35.65 ,$14.26 ,$62.00 , N/A , N/A ,$15.69 ,$52.70 ,$37.04 ,$55.80 ,$52.08 ,$49.60 ,$49.60 ,$14.26 ,$40.30 ST. FRANCIS HOSPITAL - ACUTE,27203591,N/A,HC TRAP SPECIMEN,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27203597,N/A,HC TUBING ANY,272,1 ,$57.00 ,$37.05 ,$13.11 ,$57.00 ,$41.04 ,$31.01 ,$13.11 ,$31.82 ,$13.11 ,$34.05 ,$34.05 ,$34.05 ,$34.05 ,$47.88 ,$13.11 ,$48.45 ,$47.88 ,$13.11 ,$42.75 ,$45.60 ,$45.60 ,$13.11 ,$45.60 ,$47.88 ,$47.88 ,$47.88 ,$51.30 ,$32.78 ,$13.11 ,$57.00 , N/A , N/A ,$14.42 ,$48.45 ,$34.05 ,$51.30 ,$47.88 ,$45.60 ,$45.60 ,$13.11 ,$37.05 ST. FRANCIS HOSPITAL - ACUTE,27203612,N/A,HC KIT TRACHEOSTOMY CARE,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27203626,N/A,HC TUBE ENDOTRACH,272,1 ,$89.00 ,$57.85 ,$20.47 ,$89.00 ,$64.08 ,$48.42 ,$20.47 ,$49.68 ,$20.47 ,$53.17 ,$53.17 ,$53.17 ,$53.17 ,$74.76 ,$20.47 ,$75.65 ,$74.76 ,$20.47 ,$66.75 ,$71.20 ,$71.20 ,$20.47 ,$71.20 ,$74.76 ,$74.76 ,$74.76 ,$80.10 ,$51.18 ,$20.47 ,$89.00 , N/A , N/A ,$22.52 ,$75.65 ,$53.17 ,$80.10 ,$74.76 ,$71.20 ,$71.20 ,$20.47 ,$57.85 ST. FRANCIS HOSPITAL - ACUTE,27203703,C1751,HC CATHETER PICC,272,1 ,$420.00 ,$273.00 ,$96.60 ,$420.00 ,$302.40 ,$228.48 ,$96.60 ,$234.44 ,$96.60 ,$250.91 ,$250.91 ,$250.91 ,$250.91 ,$352.80 ,$96.60 ,$357.00 ,$352.80 ,$96.60 ,$315.00 ,$336.00 ,$336.00 ,$96.60 ,$336.00 ,$352.80 ,$352.80 ,$352.80 ,$378.00 ,$241.50 ,$96.60 ,$420.00 , N/A , N/A ,$106.26 ,$357.00 ,$250.91 ,$378.00 ,$352.80 ,$336.00 ,$336.00 ,$96.60 ,$273.00 ST. FRANCIS HOSPITAL - ACUTE,27203827,C1894,HC INTRODUCER/SHEATH/CATH,272,1 ,$90.00 ,$58.50 ,$20.70 ,$90.00 ,$64.80 ,$48.96 ,$20.70 ,$50.24 ,$20.70 ,$53.77 ,$53.77 ,$53.77 ,$53.77 ,$75.60 ,$20.70 ,$76.50 ,$75.60 ,$20.70 ,$67.50 ,$72.00 ,$72.00 ,$20.70 ,$72.00 ,$75.60 ,$75.60 ,$75.60 ,$81.00 ,$51.75 ,$20.70 ,$90.00 , N/A , N/A ,$22.77 ,$76.50 ,$53.77 ,$81.00 ,$75.60 ,$72.00 ,$72.00 ,$20.70 ,$58.50 ST. FRANCIS HOSPITAL - ACUTE,27203841,N/A,HC BALLOON DILATOR CERVICAL,272,1 ,$126.00 ,$81.90 ,$28.98 ,$126.00 ,$90.72 ,$68.54 ,$28.98 ,$70.33 ,$28.98 ,$75.27 ,$75.27 ,$75.27 ,$75.27 ,$105.84 ,$28.98 ,$107.10 ,$105.84 ,$28.98 ,$94.50 ,$100.80 ,$100.80 ,$28.98 ,$100.80 ,$105.84 ,$105.84 ,$105.84 ,$113.40 ,$72.45 ,$28.98 ,$126.00 , N/A , N/A ,$31.88 ,$107.10 ,$75.27 ,$113.40 ,$105.84 ,$100.80 ,$100.80 ,$28.98 ,$81.90 ST. FRANCIS HOSPITAL - ACUTE,27203847,N/A,HC NEEDLE INTRAOSSEOUS,272,1 ,$133.00 ,$86.45 ,$30.59 ,$133.00 ,$95.76 ,$72.35 ,$30.59 ,$74.24 ,$30.59 ,$79.45 ,$79.45 ,$79.45 ,$79.45 ,$111.72 ,$30.59 ,$113.05 ,$111.72 ,$30.59 ,$99.75 ,$106.40 ,$106.40 ,$30.59 ,$106.40 ,$111.72 ,$111.72 ,$111.72 ,$119.70 ,$76.48 ,$30.59 ,$133.00 , N/A , N/A ,$33.65 ,$113.05 ,$79.45 ,$119.70 ,$111.72 ,$106.40 ,$106.40 ,$30.59 ,$86.45 ST. FRANCIS HOSPITAL - ACUTE,27203871,N/A,HC NASAL RHINO ROCKET,272,1 ,$151.00 ,$98.15 ,$34.73 ,$151.00 ,$108.72 ,$82.14 ,$34.73 ,$84.29 ,$34.73 ,$90.21 ,$90.21 ,$90.21 ,$90.21 ,$126.84 ,$34.73 ,$128.35 ,$126.84 ,$34.73 ,$113.25 ,$120.80 ,$120.80 ,$34.73 ,$120.80 ,$126.84 ,$126.84 ,$126.84 ,$135.90 ,$86.83 ,$34.73 ,$151.00 , N/A , N/A ,$38.20 ,$128.35 ,$90.21 ,$135.90 ,$126.84 ,$120.80 ,$120.80 ,$34.73 ,$98.15 ST. FRANCIS HOSPITAL - ACUTE,27204594,N/A,HC SPONGE GELFOAM,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27204596,N/A,HC SUCTION TIP,272,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 , N/A , N/A ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,27204603,N/A,HC TRAY UMBILICAL CATH,272,1 ,$165.00 ,$107.25 ,$37.95 ,$165.00 ,$118.80 ,$89.76 ,$37.95 ,$92.10 ,$37.95 ,$98.57 ,$98.57 ,$98.57 ,$98.57 ,$138.60 ,$37.95 ,$140.25 ,$138.60 ,$37.95 ,$123.75 ,$132.00 ,$132.00 ,$37.95 ,$132.00 ,$138.60 ,$138.60 ,$138.60 ,$148.50 ,$94.88 ,$37.95 ,$165.00 , N/A , N/A ,$41.75 ,$140.25 ,$98.57 ,$148.50 ,$138.60 ,$132.00 ,$132.00 ,$37.95 ,$107.25 ST. FRANCIS HOSPITAL - ACUTE,27204607,N/A,HC TUBE NASOGASTRIC,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27204612,N/A,HC TUBING EXTENSION,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27204615,N/A,HC TUBING Y,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27204622,N/A,HC MARKER BIOPSY SITE,272,1 ,$211.00 ,$137.15 ,$48.53 ,$211.00 ,$151.92 ,$114.78 ,$48.53 ,$117.78 ,$48.53 ,$126.05 ,$126.05 ,$126.05 ,$126.05 ,$177.24 ,$48.53 ,$179.35 ,$177.24 ,$48.53 ,$158.25 ,$168.80 ,$168.80 ,$48.53 ,$168.80 ,$177.24 ,$177.24 ,$177.24 ,$189.90 ,$121.33 ,$48.53 ,$211.00 , N/A , N/A ,$53.38 ,$179.35 ,$126.05 ,$189.90 ,$177.24 ,$168.80 ,$168.80 ,$48.53 ,$137.15 ST. FRANCIS HOSPITAL - ACUTE,27204654,N/A,HC BAG RESUSCITATE INFANT,272,1 ,$53.00 ,$34.45 ,$12.19 ,$53.00 ,$38.16 ,$28.83 ,$12.19 ,$29.58 ,$12.19 ,$31.66 ,$31.66 ,$31.66 ,$31.66 ,$44.52 ,$12.19 ,$45.05 ,$44.52 ,$12.19 ,$39.75 ,$42.40 ,$42.40 ,$12.19 ,$42.40 ,$44.52 ,$44.52 ,$44.52 ,$47.70 ,$30.48 ,$12.19 ,$53.00 , N/A , N/A ,$13.41 ,$45.05 ,$31.66 ,$47.70 ,$44.52 ,$42.40 ,$42.40 ,$12.19 ,$34.45 ST. FRANCIS HOSPITAL - ACUTE,27204655,N/A,HC BAG RESUSCITATE PEDIATRIC,272,1 ,$53.00 ,$34.45 ,$12.19 ,$53.00 ,$38.16 ,$28.83 ,$12.19 ,$29.58 ,$12.19 ,$31.66 ,$31.66 ,$31.66 ,$31.66 ,$44.52 ,$12.19 ,$45.05 ,$44.52 ,$12.19 ,$39.75 ,$42.40 ,$42.40 ,$12.19 ,$42.40 ,$44.52 ,$44.52 ,$44.52 ,$47.70 ,$30.48 ,$12.19 ,$53.00 , N/A , N/A ,$13.41 ,$45.05 ,$31.66 ,$47.70 ,$44.52 ,$42.40 ,$42.40 ,$12.19 ,$34.45 ST. FRANCIS HOSPITAL - ACUTE,27204656,N/A,HC BAG RESUSCITOR,272,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 , N/A , N/A ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,27204657,N/A,HC CANISTER V.A.C.,272,1 ,$65.00 ,$42.25 ,$14.95 ,$65.00 ,$46.80 ,$35.36 ,$14.95 ,$36.28 ,$14.95 ,$38.83 ,$38.83 ,$38.83 ,$38.83 ,$54.60 ,$14.95 ,$55.25 ,$54.60 ,$14.95 ,$48.75 ,$52.00 ,$52.00 ,$14.95 ,$52.00 ,$54.60 ,$54.60 ,$54.60 ,$58.50 ,$37.38 ,$14.95 ,$65.00 , N/A , N/A ,$16.45 ,$55.25 ,$38.83 ,$58.50 ,$54.60 ,$52.00 ,$52.00 ,$14.95 ,$42.25 ST. FRANCIS HOSPITAL - ACUTE,27204692,N/A,HC MASK NON-REBREATHER ADULT,272,1 ,$13.00 ,$8.45 ,$2.99 ,$13.00 ,$9.36 ,$7.07 ,$2.99 ,$7.26 ,$2.99 ,$7.77 ,$7.77 ,$7.77 ,$7.77 ,$10.92 ,$2.99 ,$11.05 ,$10.92 ,$2.99 ,$9.75 ,$10.40 ,$10.40 ,$2.99 ,$10.40 ,$10.92 ,$10.92 ,$10.92 ,$11.70 ,$7.48 ,$2.99 ,$13.00 , N/A , N/A ,$3.29 ,$11.05 ,$7.77 ,$11.70 ,$10.92 ,$10.40 ,$10.40 ,$2.99 ,$8.45 ST. FRANCIS HOSPITAL - ACUTE,27204771,N/A,HC BLADE LARYNGOSCOPE,272,1 ,$39.00 ,$25.35 ,$8.97 ,$39.00 ,$28.08 ,$21.22 ,$8.97 ,$21.77 ,$8.97 ,$23.30 ,$23.30 ,$23.30 ,$23.30 ,$32.76 ,$8.97 ,$33.15 ,$32.76 ,$8.97 ,$29.25 ,$31.20 ,$31.20 ,$8.97 ,$31.20 ,$32.76 ,$32.76 ,$32.76 ,$35.10 ,$22.43 ,$8.97 ,$39.00 , N/A , N/A ,$9.87 ,$33.15 ,$23.30 ,$35.10 ,$32.76 ,$31.20 ,$31.20 ,$8.97 ,$25.35 ST. FRANCIS HOSPITAL - ACUTE,27204869,N/A,HC IV ANGIOCATH,272,1 ,$59.00 ,$38.35 ,$13.57 ,$59.00 ,$42.48 ,$32.10 ,$13.57 ,$32.93 ,$13.57 ,$35.25 ,$35.25 ,$35.25 ,$35.25 ,$49.56 ,$13.57 ,$50.15 ,$49.56 ,$13.57 ,$44.25 ,$47.20 ,$47.20 ,$13.57 ,$47.20 ,$49.56 ,$49.56 ,$49.56 ,$53.10 ,$33.93 ,$13.57 ,$59.00 , N/A , N/A ,$14.93 ,$50.15 ,$35.25 ,$53.10 ,$49.56 ,$47.20 ,$47.20 ,$13.57 ,$38.35 ST. FRANCIS HOSPITAL - ACUTE,27204901,N/A,HC KIT IRRIGATION PISTON SYRINGE,272,1 ,$50.00 ,$32.50 ,$11.50 ,$50.00 ,$36.00 ,$27.20 ,$11.50 ,$27.91 ,$11.50 ,$29.87 ,$29.87 ,$29.87 ,$29.87 ,$42.00 ,$11.50 ,$42.50 ,$42.00 ,$11.50 ,$37.50 ,$40.00 ,$40.00 ,$11.50 ,$40.00 ,$42.00 ,$42.00 ,$42.00 ,$45.00 ,$28.75 ,$11.50 ,$50.00 , N/A , N/A ,$12.65 ,$42.50 ,$29.87 ,$45.00 ,$42.00 ,$40.00 ,$40.00 ,$11.50 ,$32.50 ST. FRANCIS HOSPITAL - ACUTE,27204937,N/A,HC NEEDLE NERVE BLOCK STIMULATING,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27204957,N/A,HC BARRIER PROTECTANT SENSI-CARE,272,1 ,$34.00 ,$22.10 ,$7.82 ,$34.00 ,$24.48 ,$18.50 ,$7.82 ,$18.98 ,$7.82 ,$20.31 ,$20.31 ,$20.31 ,$20.31 ,$28.56 ,$7.82 ,$28.90 ,$28.56 ,$7.82 ,$25.50 ,$27.20 ,$27.20 ,$7.82 ,$27.20 ,$28.56 ,$28.56 ,$28.56 ,$30.60 ,$19.55 ,$7.82 ,$34.00 , N/A , N/A ,$8.60 ,$28.90 ,$20.31 ,$30.60 ,$28.56 ,$27.20 ,$27.20 ,$7.82 ,$22.10 ST. FRANCIS HOSPITAL - ACUTE,27204966,N/A,HC OSTOMY POUCH,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27204968,N/A,HC OSTOMY PASTE,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27204969,N/A,HC OSTOMY STOMAHESIVE POWDER,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27205010,N/A,HC VALVE ANTI-REFLUX SALEM,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205028,N/A,HC STAPLE REMOVER SKIN,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205029,N/A,HC STATLOCK DEVICE FOLEY,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205033,N/A,HC STOPCOCK 4 WAY,272,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 , N/A , N/A ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,27205049,N/A,HC TAPE MEDIPORE,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27205058,N/A,HC TRAY FOLEY,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205063,N/A,HC TRAY SUTURE REMOVAL,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205083,N/A,HC TUBING BLOOD WARMING,272,1 ,$15.00 ,$9.75 ,$3.45 ,$15.00 ,$10.80 ,$8.16 ,$3.45 ,$8.37 ,$3.45 ,$8.96 ,$8.96 ,$8.96 ,$8.96 ,$12.60 ,$3.45 ,$12.75 ,$12.60 ,$3.45 ,$11.25 ,$12.00 ,$12.00 ,$3.45 ,$12.00 ,$12.60 ,$12.60 ,$12.60 ,$13.50 ,$8.63 ,$3.45 ,$15.00 , N/A , N/A ,$3.80 ,$12.75 ,$8.96 ,$13.50 ,$12.60 ,$12.00 ,$12.00 ,$3.45 ,$9.75 ST. FRANCIS HOSPITAL - ACUTE,27205084,N/A,HC TUBING FEEDING KANGAROO,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205095,N/A,HC WEDGE WAFFLE,272,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 , N/A , N/A ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,27205105,N/A,HC DRESSING NASAL RHINO ROCKET RAPID,272,1 ,$86.00 ,$55.90 ,$19.78 ,$86.00 ,$61.92 ,$46.78 ,$19.78 ,$48.01 ,$19.78 ,$51.38 ,$51.38 ,$51.38 ,$51.38 ,$72.24 ,$19.78 ,$73.10 ,$72.24 ,$19.78 ,$64.50 ,$68.80 ,$68.80 ,$19.78 ,$68.80 ,$72.24 ,$72.24 ,$72.24 ,$77.40 ,$49.45 ,$19.78 ,$86.00 , N/A , N/A ,$21.76 ,$73.10 ,$51.38 ,$77.40 ,$72.24 ,$68.80 ,$68.80 ,$19.78 ,$55.90 ST. FRANCIS HOSPITAL - ACUTE,27205115,N/A,HC DRESSING AQUACEL AG,272,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 , N/A , N/A ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,27205125,N/A,HC CATHETER NASAL,272,1 ,$177.00 ,$115.05 ,$40.71 ,$177.00 ,$127.44 ,$96.29 ,$40.71 ,$98.80 ,$40.71 ,$105.74 ,$105.74 ,$105.74 ,$105.74 ,$148.68 ,$40.71 ,$150.45 ,$148.68 ,$40.71 ,$132.75 ,$141.60 ,$141.60 ,$40.71 ,$141.60 ,$148.68 ,$148.68 ,$148.68 ,$159.30 ,$101.78 ,$40.71 ,$177.00 , N/A , N/A ,$44.78 ,$150.45 ,$105.74 ,$159.30 ,$148.68 ,$141.60 ,$141.60 ,$40.71 ,$115.05 ST. FRANCIS HOSPITAL - ACUTE,27205181,N/A,HC STRYKER AIR 2 MATTRESS OVERLAY,272,1 ,$85.00 ,$55.25 ,$19.55 ,$85.00 ,$61.20 ,$46.24 ,$19.55 ,$47.45 ,$19.55 ,$50.78 ,$50.78 ,$50.78 ,$50.78 ,$71.40 ,$19.55 ,$72.25 ,$71.40 ,$19.55 ,$63.75 ,$68.00 ,$68.00 ,$19.55 ,$68.00 ,$71.40 ,$71.40 ,$71.40 ,$76.50 ,$48.88 ,$19.55 ,$85.00 , N/A , N/A ,$21.51 ,$72.25 ,$50.78 ,$76.50 ,$71.40 ,$68.00 ,$68.00 ,$19.55 ,$55.25 ST. FRANCIS HOSPITAL - ACUTE,27205275,N/A,HC ADAPTER CPAP,272,1 ,$27.00 ,$17.55 ,$6.21 ,$27.00 ,$19.44 ,$14.69 ,$6.21 ,$15.07 ,$6.21 ,$16.13 ,$16.13 ,$16.13 ,$16.13 ,$22.68 ,$6.21 ,$22.95 ,$22.68 ,$6.21 ,$20.25 ,$21.60 ,$21.60 ,$6.21 ,$21.60 ,$22.68 ,$22.68 ,$22.68 ,$24.30 ,$15.53 ,$6.21 ,$27.00 , N/A , N/A ,$6.83 ,$22.95 ,$16.13 ,$24.30 ,$22.68 ,$21.60 ,$21.60 ,$6.21 ,$17.55 ST. FRANCIS HOSPITAL - ACUTE,27205283,N/A,HC AIRWAY ORAL NASAL,272,1 ,$10.00 ,$6.50 ,$2.30 ,$10.00 ,$7.20 ,$5.44 ,$2.30 ,$5.58 ,$2.30 ,$5.97 ,$5.97 ,$5.97 ,$5.97 ,$8.40 ,$2.30 ,$8.50 ,$8.40 ,$2.30 ,$7.50 ,$8.00 ,$8.00 ,$2.30 ,$8.00 ,$8.40 ,$8.40 ,$8.40 ,$9.00 ,$5.75 ,$2.30 ,$10.00 , N/A , N/A ,$2.53 ,$8.50 ,$5.97 ,$9.00 ,$8.40 ,$8.00 ,$8.00 ,$2.30 ,$6.50 ST. FRANCIS HOSPITAL - ACUTE,27205287,N/A,HC BAG TUBING,272,1 ,$146.00 ,$94.90 ,$33.58 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 , N/A , N/A ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,27205288,N/A,HC BANDAGE ADHESIVE,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205291,N/A,HC BARRIER OSTOMY OINTMENT,270,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205294,N/A,HC SWAB BETADINE,270,1 ,$3.00 ,$1.95 ,$0.69 ,$3.00 ,$2.16 ,$1.63 ,$0.69 ,$1.67 ,$0.69 ,$1.79 ,$1.79 ,$1.79 ,$1.79 ,$2.52 ,$0.69 ,$2.55 ,$2.52 ,$0.69 ,$2.25 ,$2.40 ,$2.40 ,$0.69 ,$2.40 ,$2.52 ,$2.52 ,$2.52 ,$2.70 ,$1.73 ,$0.69 ,$3.00 , N/A , N/A ,$0.76 ,$2.55 ,$1.79 ,$2.70 ,$2.52 ,$2.40 ,$2.40 ,$0.69 ,$1.95 ST. FRANCIS HOSPITAL - ACUTE,27205298,N/A,HC CATHETER FOLEY COUDE,272,1 ,$241.00 ,$156.65 ,$55.43 ,$241.00 ,$173.52 ,$131.10 ,$55.43 ,$134.53 ,$55.43 ,$143.97 ,$143.97 ,$143.97 ,$143.97 ,$202.44 ,$55.43 ,$204.85 ,$202.44 ,$55.43 ,$180.75 ,$192.80 ,$192.80 ,$55.43 ,$192.80 ,$202.44 ,$202.44 ,$202.44 ,$216.90 ,$138.58 ,$55.43 ,$241.00 , N/A , N/A ,$60.97 ,$204.85 ,$143.97 ,$216.90 ,$202.44 ,$192.80 ,$192.80 ,$55.43 ,$156.65 ST. FRANCIS HOSPITAL - ACUTE,27205300,N/A,HC CAUTERY PEN LOW TEMP,272,1 ,$39.00 ,$25.35 ,$8.97 ,$39.00 ,$28.08 ,$21.22 ,$8.97 ,$21.77 ,$8.97 ,$23.30 ,$23.30 ,$23.30 ,$23.30 ,$32.76 ,$8.97 ,$33.15 ,$32.76 ,$8.97 ,$29.25 ,$31.20 ,$31.20 ,$8.97 ,$31.20 ,$32.76 ,$32.76 ,$32.76 ,$35.10 ,$22.43 ,$8.97 ,$39.00 , N/A , N/A ,$9.87 ,$33.15 ,$23.30 ,$35.10 ,$32.76 ,$31.20 ,$31.20 ,$8.97 ,$25.35 ST. FRANCIS HOSPITAL - ACUTE,27205301,N/A,HC CLEANSER WOUND,272,1 ,$51.00 ,$33.15 ,$11.73 ,$51.00 ,$36.72 ,$27.74 ,$11.73 ,$28.47 ,$11.73 ,$30.47 ,$30.47 ,$30.47 ,$30.47 ,$42.84 ,$11.73 ,$43.35 ,$42.84 ,$11.73 ,$38.25 ,$40.80 ,$40.80 ,$11.73 ,$40.80 ,$42.84 ,$42.84 ,$42.84 ,$45.90 ,$29.33 ,$11.73 ,$51.00 , N/A , N/A ,$12.90 ,$43.35 ,$30.47 ,$45.90 ,$42.84 ,$40.80 ,$40.80 ,$11.73 ,$33.15 ST. FRANCIS HOSPITAL - ACUTE,27205306,N/A,HC ELECTRODE NONINVASIVE PACING PAD,272,1 ,$70.00 ,$45.50 ,$16.10 ,$70.00 ,$50.40 ,$38.08 ,$16.10 ,$39.07 ,$16.10 ,$41.82 ,$41.82 ,$41.82 ,$41.82 ,$58.80 ,$16.10 ,$59.50 ,$58.80 ,$16.10 ,$52.50 ,$56.00 ,$56.00 ,$16.10 ,$56.00 ,$58.80 ,$58.80 ,$58.80 ,$63.00 ,$40.25 ,$16.10 ,$70.00 , N/A , N/A ,$17.71 ,$59.50 ,$41.82 ,$63.00 ,$58.80 ,$56.00 ,$56.00 ,$16.10 ,$45.50 ST. FRANCIS HOSPITAL - ACUTE,27205310,N/A,HC KIT ENEMA,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205317,N/A,HC NEEDLE NON-CORING,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205318,N/A,HC NEEDLE ANGLED,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205324,N/A,HC PAD ABDOMNINAL,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205334,N/A,HC TRAY ENT,272,1 ,$64.00 ,$41.60 ,$14.72 ,$64.00 ,$46.08 ,$34.82 ,$14.72 ,$35.72 ,$14.72 ,$38.23 ,$38.23 ,$38.23 ,$38.23 ,$53.76 ,$14.72 ,$54.40 ,$53.76 ,$14.72 ,$48.00 ,$51.20 ,$51.20 ,$14.72 ,$51.20 ,$53.76 ,$53.76 ,$53.76 ,$57.60 ,$36.80 ,$14.72 ,$64.00 , N/A , N/A ,$16.19 ,$54.40 ,$38.23 ,$57.60 ,$53.76 ,$51.20 ,$51.20 ,$14.72 ,$41.60 ST. FRANCIS HOSPITAL - ACUTE,27205335,N/A,HC TRAY EPISIOTOMY,272,1 ,$48.00 ,$31.20 ,$11.04 ,$48.00 ,$34.56 ,$26.11 ,$11.04 ,$26.79 ,$11.04 ,$28.68 ,$28.68 ,$28.68 ,$28.68 ,$40.32 ,$11.04 ,$40.80 ,$40.32 ,$11.04 ,$36.00 ,$38.40 ,$38.40 ,$11.04 ,$38.40 ,$40.32 ,$40.32 ,$40.32 ,$43.20 ,$27.60 ,$11.04 ,$48.00 , N/A , N/A ,$12.14 ,$40.80 ,$28.68 ,$43.20 ,$40.32 ,$38.40 ,$38.40 ,$11.04 ,$31.20 ST. FRANCIS HOSPITAL - ACUTE,27205339,N/A,HC KIT DRESSING,272,1 ,$25.53 ,$16.59 ,$5.87 ,$25.53 ,$18.38 ,$13.89 ,$5.87 ,$14.25 ,$5.87 ,$15.25 ,$15.25 ,$15.25 ,$15.25 ,$21.45 ,$5.87 ,$21.70 ,$21.45 ,$5.87 ,$19.15 ,$20.42 ,$20.42 ,$5.87 ,$20.42 ,$21.45 ,$21.45 ,$21.45 ,$22.98 ,$14.68 ,$5.87 ,$25.53 , N/A , N/A ,$6.46 ,$21.70 ,$15.25 ,$22.98 ,$21.45 ,$20.42 ,$20.42 ,$5.87 ,$16.59 ST. FRANCIS HOSPITAL - ACUTE,27205341,N/A,HC DRESSING BANDAGE ACE DOUBLE,272,1 ,$43.00 ,$27.95 ,$9.89 ,$43.00 ,$30.96 ,$23.39 ,$9.89 ,$24.00 ,$9.89 ,$25.69 ,$25.69 ,$25.69 ,$25.69 ,$36.12 ,$9.89 ,$36.55 ,$36.12 ,$9.89 ,$32.25 ,$34.40 ,$34.40 ,$9.89 ,$34.40 ,$36.12 ,$36.12 ,$36.12 ,$38.70 ,$24.73 ,$9.89 ,$43.00 , N/A , N/A ,$10.88 ,$36.55 ,$25.69 ,$38.70 ,$36.12 ,$34.40 ,$34.40 ,$9.89 ,$27.95 ST. FRANCIS HOSPITAL - ACUTE,27205342,N/A,HC DRESSING TEGADERM,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205345,N/A,HC DRESSING GAUZE STRETCH,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205387,N/A,HC IRRIGATION SOL W/WATER/SODIUM CHLORIDE,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27205391,N/A,HC DRESSING AQUACEL FOAM/FLAT,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27260409,N/A,HC CONNECTOR T-TUBE,272,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 , N/A , N/A ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,27400006,L0150,HC PHILADELPHA COLLAR,274,1 ,$136.00 ,$88.40 ,$31.28 ,$136.00 ,$97.92 ,$73.98 ,$31.28 ,$75.92 ,$31.28 ,$81.25 ,$81.25 ,$81.25 ,$81.25 ,$114.24 ,$31.28 ,$115.60 ,$114.24 ,$31.28 ,$102.00 ,$108.80 ,$108.80 ,$31.28 ,$108.80 ,$114.24 ,$114.24 ,$114.24 ,$122.40 ,$78.20 ,$31.28 ,$136.00 , N/A , N/A ,$34.41 ,$115.60 ,$81.25 ,$122.40 ,$114.24 ,$108.80 ,$108.80 ,$31.28 ,$88.40 ST. FRANCIS HOSPITAL - ACUTE,27400044,L3908,HC COCK UP WRIST SPLINT/FIT AND ADJ,274,1 ,$78.00 ,$50.70 ,$17.94 ,$78.00 ,$56.16 ,$42.43 ,$17.94 ,$43.54 ,$17.94 ,$46.60 ,$46.60 ,$46.60 ,$46.60 ,$65.52 ,$17.94 ,$66.30 ,$65.52 ,$17.94 ,$58.50 ,$62.40 ,$62.40 ,$17.94 ,$62.40 ,$65.52 ,$65.52 ,$65.52 ,$70.20 ,$44.85 ,$17.94 ,$78.00 , N/A , N/A ,$19.73 ,$66.30 ,$46.60 ,$70.20 ,$65.52 ,$62.40 ,$62.40 ,$17.94 ,$50.70 ST. FRANCIS HOSPITAL - ACUTE,27400128,L1930,HC AFO ANKLE BRACE CUSTOM,274,1 ,$187.00 ,$121.55 ,$43.01 ,$187.00 ,$134.64 ,$101.73 ,$43.01 ,$104.38 ,$43.01 ,$111.71 ,$111.71 ,$111.71 ,$111.71 ,$157.08 ,$43.01 ,$158.95 ,$157.08 ,$43.01 ,$140.25 ,$149.60 ,$149.60 ,$43.01 ,$149.60 ,$157.08 ,$157.08 ,$157.08 ,$168.30 ,$107.53 ,$43.01 ,$187.00 , N/A , N/A ,$47.31 ,$158.95 ,$111.71 ,$168.30 ,$157.08 ,$149.60 ,$149.60 ,$43.01 ,$121.55 ST. FRANCIS HOSPITAL - ACUTE,27800553,A4648,HC TISSUE MARKER IMPLANTABLE,278,1 ,$238.00 ,$154.70 ,$54.74 ,$238.00 ,$171.36 ,$129.47 ,$54.74 ,$132.85 ,$54.74 ,$142.18 ,$142.18 ,$142.18 ,$142.18 ,$199.92 ,$54.74 ,$202.30 ,$199.92 ,$54.74 ,$178.50 ,$190.40 ,$190.40 ,$54.74 ,$190.40 ,$199.92 ,$199.92 ,$199.92 ,$214.20 ,$136.85 ,$54.74 ,$238.00 , N/A , N/A ,$60.21 ,$202.30 ,$142.18 ,$214.20 ,$199.92 ,$190.40 ,$190.40 ,$54.74 ,$154.70 ST. FRANCIS HOSPITAL - ACUTE,28000001,G0498,HC CHEMO IV W/PUMP EXTENDED,280,1 ,$814.00 ,$529.10 ,$187.22 ,$814.00 ,$586.08 ,$442.82 ,$187.22 ,$454.37 ,$187.22 ,$486.28 ,$486.28 ,$486.28 ,$486.28 ,$683.76 ,$187.22 ,$691.90 ,$683.76 ,$187.22 ,$610.50 ,$651.20 ,$651.20 ,$187.22 ,$651.20 ,$683.76 ,$683.76 ,$683.76 ,$732.60 ,$468.05 ,$187.22 ,$814.00 ,$469.10 ,$516.01 ,$205.94 ,$691.90 ,$486.28 ,$732.60 ,$683.76 ,$651.20 ,$651.20 ,$187.22 ,$529.10 ST. FRANCIS HOSPITAL - ACUTE,30000009,36416,HC CAPILLARY COLLECTION,300,1 ,$32.00 ,$20.80 ,$7.36 ,$32.00 ,$23.04 ,$17.41 ,$7.36 ,$17.86 ,$7.36 ,$19.12 ,$19.12 ,$19.12 ,$19.12 ,$26.88 ,$7.36 ,$27.20 ,$26.88 ,$7.36 ,$24.00 ,$25.60 ,$25.60 ,$7.36 ,$25.60 ,$26.88 ,$26.88 ,$26.88 ,$28.80 ,$18.40 ,$7.36 ,$32.00 , N/A , N/A ,$8.10 ,$27.20 ,$19.12 ,$28.80 ,$26.88 ,$25.60 ,$25.60 ,$7.36 ,$20.80 ST. FRANCIS HOSPITAL - ACUTE,30000010,36415,HC VENIPUNCTURE,300,1 ,$26.00 ,$16.90 ,$2.26 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 , N/A , N/A ,$5.98 , N/A ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$3.00 ,$2.26 ,$2.49 ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,30000015,36600,HC ARTERIAL PUNCTURE,300,1 ,$70.00 ,$45.50 ,$16.10 ,$70.00 ,$50.40 ,$38.08 ,$16.10 ,$39.07 ,$16.10 ,$41.82 ,$41.82 ,$41.82 ,$41.82 ,$58.80 ,$16.10 ,$59.50 ,$58.80 ,$16.10 ,$52.50 ,$56.00 ,$56.00 ,$16.10 ,$56.00 ,$58.80 ,$58.80 ,$58.80 ,$63.00 ,$40.25 ,$16.10 ,$70.00 ,$46.49 ,$51.14 ,$17.71 ,$59.50 ,$41.82 ,$63.00 ,$58.80 ,$56.00 ,$56.00 ,$16.10 ,$45.50 ST. FRANCIS HOSPITAL - ACUTE,30000016,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$142.00 ,$92.30 ,$32.66 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$46.49 ,$51.14 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30000206,80307,HC DRUG SCREEN PANEL 9,300,1 ,$103.00 ,$66.95 ,$23.69 ,$103.00 ,$74.16 ,$56.03 ,$23.69 ,$57.49 ,$23.69 ,$61.53 ,$61.53 ,$61.53 ,$61.53 ,$86.52 ,$23.69 ,$87.55 ,$86.52 ,$23.69 ,$77.25 ,$82.40 ,$82.40 ,$23.69 ,$82.40 ,$86.52 ,$86.52 ,$86.52 ,$92.70 ,$59.23 ,$23.69 ,$103.00 ,$29.09 ,$32.00 ,$26.06 ,$87.55 ,$61.53 ,$92.70 ,$86.52 ,$82.40 ,$82.40 ,$23.69 ,$66.95 ST. FRANCIS HOSPITAL - ACUTE,30000213,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$168.00 ,$109.20 ,$38.64 ,$168.00 ,$120.96 ,$91.39 ,$38.64 ,$93.78 ,$38.64 ,$100.36 ,$100.36 ,$100.36 ,$100.36 ,$141.12 ,$38.64 ,$142.80 ,$141.12 ,$38.64 ,$126.00 ,$134.40 ,$134.40 ,$38.64 ,$134.40 ,$141.12 ,$141.12 ,$141.12 ,$151.20 ,$96.60 ,$38.64 ,$168.00 ,$46.49 ,$51.14 ,$42.50 ,$142.80 ,$100.36 ,$151.20 ,$141.12 ,$134.40 ,$134.40 ,$38.64 ,$109.20 ST. FRANCIS HOSPITAL - ACUTE,30000218,86927,HC FFP THAWING EACH UNIT,300,1 ,$83.00 ,$53.95 ,$19.09 ,$83.00 ,$59.76 ,$45.15 ,$19.09 ,$46.33 ,$19.09 ,$49.58 ,$49.58 ,$49.58 ,$49.58 ,$69.72 ,$19.09 ,$70.55 ,$69.72 ,$19.09 ,$62.25 ,$66.40 ,$66.40 ,$19.09 ,$66.40 ,$69.72 ,$69.72 ,$69.72 ,$74.70 ,$47.73 ,$19.09 ,$83.00 ,$39.07 ,$42.98 ,$21.00 ,$70.55 ,$49.58 ,$74.70 ,$69.72 ,$66.40 ,$66.40 ,$19.09 ,$53.95 ST. FRANCIS HOSPITAL - ACUTE,30000219,86970,HC RBC PRETREAT CHEM,300,1 ,$125.00 ,$81.25 ,$28.75 ,$125.00 ,$90.00 ,$68.00 ,$28.75 ,$69.78 ,$28.75 ,$74.68 ,$74.68 ,$74.68 ,$74.68 ,$105.00 ,$28.75 ,$106.25 ,$105.00 ,$28.75 ,$93.75 ,$100.00 ,$100.00 ,$28.75 ,$100.00 ,$105.00 ,$105.00 ,$105.00 ,$112.50 ,$71.88 ,$28.75 ,$125.00 ,$39.07 ,$42.98 ,$31.63 ,$106.25 ,$74.68 ,$112.50 ,$105.00 ,$100.00 ,$100.00 ,$28.75 ,$81.25 ST. FRANCIS HOSPITAL - ACUTE,30000221,86999,HC TRANSFUSION UNLISTED PROCEDURE,300,1 ,$85.00 ,$55.25 ,$19.55 ,$85.00 ,$61.20 ,$46.24 ,$19.55 ,$47.45 ,$19.55 ,$50.78 ,$50.78 ,$50.78 ,$50.78 ,$71.40 ,$19.55 ,$72.25 ,$71.40 ,$19.55 ,$63.75 ,$68.00 ,$68.00 ,$19.55 ,$68.00 ,$71.40 ,$71.40 ,$71.40 ,$76.50 ,$48.88 ,$19.55 ,$85.00 ,$39.07 ,$42.98 ,$21.51 ,$72.25 ,$50.78 ,$76.50 ,$71.40 ,$68.00 ,$68.00 ,$19.55 ,$55.25 ST. FRANCIS HOSPITAL - ACUTE,30000223,89051,HC CELL CT BODY FLUID W/DIFF,300,1 ,$222.00 ,$144.30 ,$30.87 ,$222.00 ,$159.84 ,$120.77 ,$51.06 ,$123.92 ,$51.06 ,$132.62 ,$132.62 ,$132.62 ,$132.62 ,$186.48 ,$51.06 ,$188.70 ,$186.48 ,$51.06 ,$166.50 ,$177.60 ,$177.60 ,$51.06 ,$177.60 ,$186.48 ,$186.48 ,$186.48 ,$199.80 ,$127.65 ,$51.06 ,$222.00 ,$30.87 ,$33.96 ,$56.17 ,$188.70 ,$132.62 ,$199.80 ,$186.48 ,$177.60 ,$177.60 ,$51.06 ,$144.30 ST. FRANCIS HOSPITAL - ACUTE,30000242,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$168.00 ,$109.20 ,$38.64 ,$168.00 ,$120.96 ,$91.39 ,$38.64 ,$93.78 ,$38.64 ,$100.36 ,$100.36 ,$100.36 ,$100.36 ,$141.12 ,$38.64 ,$142.80 ,$141.12 ,$38.64 ,$126.00 ,$134.40 ,$134.40 ,$38.64 ,$134.40 ,$141.12 ,$141.12 ,$141.12 ,$151.20 ,$96.60 ,$38.64 ,$168.00 ,$46.49 ,$51.14 ,$42.50 ,$142.80 ,$100.36 ,$151.20 ,$141.12 ,$134.40 ,$134.40 ,$38.64 ,$109.20 ST. FRANCIS HOSPITAL - ACUTE,30002013,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$142.00 ,$92.30 ,$32.66 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$46.49 ,$51.14 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30002017,89055,HC LEUKO ASSESS STOOL QN/SEMI,300,1 ,$44.00 ,$28.60 ,$6.71 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$6.71 ,$7.38 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30002018,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$69.00 ,$44.85 ,$15.87 ,$69.00 ,$49.68 ,$37.54 ,$15.87 ,$38.52 ,$15.87 ,$41.22 ,$41.22 ,$41.22 ,$41.22 ,$57.96 ,$15.87 ,$58.65 ,$57.96 ,$15.87 ,$51.75 ,$55.20 ,$55.20 ,$15.87 ,$55.20 ,$57.96 ,$57.96 ,$57.96 ,$62.10 ,$39.68 ,$15.87 ,$69.00 ,$30.87 ,$33.96 ,$17.46 ,$58.65 ,$41.22 ,$62.10 ,$57.96 ,$55.20 ,$55.20 ,$15.87 ,$44.85 ST. FRANCIS HOSPITAL - ACUTE,30002022,80306,HC DRUG SCREEN SGL CLASS PRESUMPTIVE INSTRMNT,300,1 ,$287.00 ,$186.55 ,$10.81 ,$287.00 ,$206.64 ,$156.13 ,$66.01 ,$160.20 ,$66.01 ,$171.45 ,$171.45 ,$171.45 ,$171.45 ,$241.08 ,$66.01 ,$243.95 ,$241.08 ,$66.01 ,$215.25 ,$229.60 ,$229.60 ,$66.01 ,$229.60 ,$241.08 ,$241.08 ,$241.08 ,$258.30 ,$165.03 ,$66.01 ,$287.00 ,$10.81 ,$11.89 ,$72.61 ,$243.95 ,$171.45 ,$258.30 ,$241.08 ,$229.60 ,$229.60 ,$66.01 ,$186.55 ST. FRANCIS HOSPITAL - ACUTE,30002023,N/A,HC TOX SCREEN CHAIN OF CUSTODY URINE,300,1 ,$29.00 ,$18.85 ,$6.67 ,$29.00 ,$20.88 ,$15.78 ,$6.67 ,$16.19 ,$6.67 ,$17.32 ,$17.32 ,$17.32 ,$17.32 ,$24.36 ,$6.67 ,$24.65 ,$24.36 ,$6.67 ,$21.75 ,$23.20 ,$23.20 ,$6.67 ,$23.20 ,$24.36 ,$24.36 ,$24.36 ,$26.10 ,$16.68 ,$6.67 ,$29.00 , N/A , N/A ,$7.34 ,$24.65 ,$17.32 ,$26.10 ,$24.36 ,$23.20 ,$23.20 ,$6.67 ,$18.85 ST. FRANCIS HOSPITAL - ACUTE,30002024,N/A,HC TOX SCREEN CHAIN OF CUSTODY ALCOHOL,300,1 ,$47.00 ,$30.55 ,$10.81 ,$47.00 ,$33.84 ,$25.57 ,$10.81 ,$26.24 ,$10.81 ,$28.08 ,$28.08 ,$28.08 ,$28.08 ,$39.48 ,$10.81 ,$39.95 ,$39.48 ,$10.81 ,$35.25 ,$37.60 ,$37.60 ,$10.81 ,$37.60 ,$39.48 ,$39.48 ,$39.48 ,$42.30 ,$27.03 ,$10.81 ,$47.00 , N/A , N/A ,$11.89 ,$39.95 ,$28.08 ,$42.30 ,$39.48 ,$37.60 ,$37.60 ,$10.81 ,$30.55 ST. FRANCIS HOSPITAL - ACUTE,30040115,99001,HC SPECIMEN HAND/CONVEY OTHER,300,1 ,$43.00 ,$27.95 ,$9.89 ,$43.00 ,$30.96 ,$23.39 ,$9.89 ,$24.00 ,$9.89 ,$25.69 ,$25.69 ,$25.69 ,$25.69 ,$36.12 ,$9.89 ,$36.55 ,$36.12 ,$9.89 ,$32.25 ,$34.40 ,$34.40 ,$9.89 ,$34.40 ,$36.12 ,$36.12 ,$36.12 ,$38.70 ,$24.73 ,$9.89 ,$43.00 , N/A , N/A ,$10.88 ,$36.55 ,$25.69 ,$38.70 ,$36.12 ,$34.40 ,$34.40 ,$9.89 ,$27.95 ST. FRANCIS HOSPITAL - ACUTE,30100101,80048,HC BASIC METABOLIC PANEL,301,1 ,$238.00 ,$154.70 ,$8.46 ,$238.00 ,$171.36 ,$129.47 ,$54.74 ,$132.85 ,$54.74 ,$142.18 ,$142.18 ,$142.18 ,$142.18 ,$199.92 ,$54.74 ,$202.30 ,$199.92 ,$54.74 ,$178.50 ,$190.40 ,$190.40 ,$54.74 ,$190.40 ,$199.92 ,$199.92 ,$199.92 ,$214.20 ,$136.85 ,$54.74 ,$8.46 ,$9.86 ,$10.85 ,$60.21 ,$202.30 ,$142.18 ,$214.20 ,$199.92 ,$190.40 ,$190.40 ,$54.74 ,$154.70 ST. FRANCIS HOSPITAL - ACUTE,30100103,80051,HC ELECTROLYTE PANEL,301,1 ,$184.00 ,$119.60 ,$9.86 ,$184.00 ,$132.48 ,$100.10 ,$42.32 ,$102.71 ,$42.32 ,$109.92 ,$109.92 ,$109.92 ,$109.92 ,$154.56 ,$42.32 ,$156.40 ,$154.56 ,$42.32 ,$138.00 ,$147.20 ,$147.20 ,$42.32 ,$147.20 ,$154.56 ,$154.56 ,$154.56 ,$165.60 ,$105.80 ,$42.32 ,$184.00 ,$9.86 ,$10.85 ,$46.55 ,$156.40 ,$109.92 ,$165.60 ,$154.56 ,$147.20 ,$147.20 ,$42.32 ,$119.60 ST. FRANCIS HOSPITAL - ACUTE,30100104,80053,HC COMPREHENSIVE METABOL PANEL,301,1 ,$288.00 ,$187.20 ,$9.86 ,$288.00 ,$207.36 ,$156.67 ,$66.24 ,$160.76 ,$66.24 ,$172.05 ,$172.05 ,$172.05 ,$172.05 ,$241.92 ,$66.24 ,$244.80 ,$241.92 ,$66.24 ,$216.00 ,$230.40 ,$230.40 ,$66.24 ,$230.40 ,$241.92 ,$241.92 ,$241.92 ,$259.20 ,$165.60 ,$66.24 ,$10.56 ,$9.86 ,$10.85 ,$72.86 ,$244.80 ,$172.05 ,$259.20 ,$241.92 ,$230.40 ,$230.40 ,$66.24 ,$187.20 ST. FRANCIS HOSPITAL - ACUTE,30100107,80061,HC LIPID PANEL,301,1 ,$135.00 ,$87.75 ,$9.86 ,$135.00 ,$97.20 ,$73.44 ,$31.05 ,$75.36 ,$31.05 ,$80.65 ,$80.65 ,$80.65 ,$80.65 ,$113.40 ,$31.05 ,$114.75 ,$113.40 ,$31.05 ,$101.25 ,$108.00 ,$108.00 ,$31.05 ,$108.00 ,$113.40 ,$113.40 ,$113.40 ,$121.50 ,$77.63 ,$31.05 ,$135.00 ,$9.86 ,$10.85 ,$34.16 ,$114.75 ,$80.65 ,$121.50 ,$113.40 ,$108.00 ,$108.00 ,$31.05 ,$87.75 ST. FRANCIS HOSPITAL - ACUTE,30100108,80069,HC RENAL PANEL,301,1 ,$248.00 ,$161.20 ,$9.86 ,$248.00 ,$178.56 ,$134.91 ,$57.04 ,$138.43 ,$57.04 ,$148.16 ,$148.16 ,$148.16 ,$148.16 ,$208.32 ,$57.04 ,$210.80 ,$208.32 ,$57.04 ,$186.00 ,$198.40 ,$198.40 ,$57.04 ,$198.40 ,$208.32 ,$208.32 ,$208.32 ,$223.20 ,$142.60 ,$57.04 ,$248.00 ,$9.86 ,$10.85 ,$62.74 ,$210.80 ,$148.16 ,$223.20 ,$208.32 ,$198.40 ,$198.40 ,$57.04 ,$161.20 ST. FRANCIS HOSPITAL - ACUTE,30100110,80076,HC LIVER (HEPATIC) PANEL,301,1 ,$218.00 ,$141.70 ,$9.86 ,$218.00 ,$156.96 ,$118.59 ,$50.14 ,$121.69 ,$50.14 ,$130.23 ,$130.23 ,$130.23 ,$130.23 ,$183.12 ,$50.14 ,$185.30 ,$183.12 ,$50.14 ,$163.50 ,$174.40 ,$174.40 ,$50.14 ,$174.40 ,$183.12 ,$183.12 ,$183.12 ,$196.20 ,$125.35 ,$50.14 ,$218.00 ,$9.86 ,$10.85 ,$55.15 ,$185.30 ,$130.23 ,$196.20 ,$183.12 ,$174.40 ,$174.40 ,$50.14 ,$141.70 ST. FRANCIS HOSPITAL - ACUTE,30100116,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$173.00 ,$112.45 ,$12.41 ,$173.00 ,$124.56 ,$94.11 ,$39.79 ,$96.57 ,$39.79 ,$103.35 ,$103.35 ,$103.35 ,$103.35 ,$145.32 ,$39.79 ,$147.05 ,$145.32 ,$39.79 ,$129.75 ,$138.40 ,$138.40 ,$39.79 ,$138.40 ,$145.32 ,$145.32 ,$145.32 ,$155.70 ,$99.48 ,$39.79 ,$173.00 ,$12.41 ,$13.65 ,$43.77 ,$147.05 ,$103.35 ,$155.70 ,$145.32 ,$138.40 ,$138.40 ,$39.79 ,$112.45 ST. FRANCIS HOSPITAL - ACUTE,30100120,80162,HC DIGOXIN LEVELS,301,1 ,$173.00 ,$112.45 ,$12.41 ,$173.00 ,$124.56 ,$94.11 ,$39.79 ,$96.57 ,$39.79 ,$103.35 ,$103.35 ,$103.35 ,$103.35 ,$145.32 ,$39.79 ,$147.05 ,$145.32 ,$39.79 ,$129.75 ,$138.40 ,$138.40 ,$39.79 ,$138.40 ,$145.32 ,$145.32 ,$145.32 ,$155.70 ,$99.48 ,$39.79 ,$173.00 ,$12.41 ,$13.65 ,$43.77 ,$147.05 ,$103.35 ,$155.70 ,$145.32 ,$138.40 ,$138.40 ,$39.79 ,$112.45 ST. FRANCIS HOSPITAL - ACUTE,30100121,80164,HC VALPROIC ACID,301,1 ,$147.00 ,$95.55 ,$12.41 ,$147.00 ,$105.84 ,$79.97 ,$33.81 ,$82.06 ,$33.81 ,$87.82 ,$87.82 ,$87.82 ,$87.82 ,$123.48 ,$33.81 ,$124.95 ,$123.48 ,$33.81 ,$110.25 ,$117.60 ,$117.60 ,$33.81 ,$117.60 ,$123.48 ,$123.48 ,$123.48 ,$132.30 ,$84.53 ,$33.81 ,$147.00 ,$12.41 ,$13.65 ,$37.19 ,$124.95 ,$87.82 ,$132.30 ,$123.48 ,$117.60 ,$117.60 ,$33.81 ,$95.55 ST. FRANCIS HOSPITAL - ACUTE,30100124,80170,HC GENTAMICIN,301,1 ,$173.00 ,$112.45 ,$12.41 ,$173.00 ,$124.56 ,$94.11 ,$39.79 ,$96.57 ,$39.79 ,$103.35 ,$103.35 ,$103.35 ,$103.35 ,$145.32 ,$39.79 ,$147.05 ,$145.32 ,$39.79 ,$129.75 ,$138.40 ,$138.40 ,$39.79 ,$138.40 ,$145.32 ,$145.32 ,$145.32 ,$155.70 ,$99.48 ,$39.79 ,$173.00 ,$12.41 ,$13.65 ,$43.77 ,$147.05 ,$103.35 ,$155.70 ,$145.32 ,$138.40 ,$138.40 ,$39.79 ,$112.45 ST. FRANCIS HOSPITAL - ACUTE,30100127,80178,HC LITHIUM,301,1 ,$173.00 ,$112.45 ,$12.41 ,$173.00 ,$124.56 ,$94.11 ,$39.79 ,$96.57 ,$39.79 ,$103.35 ,$103.35 ,$103.35 ,$103.35 ,$145.32 ,$39.79 ,$147.05 ,$145.32 ,$39.79 ,$129.75 ,$138.40 ,$138.40 ,$39.79 ,$138.40 ,$145.32 ,$145.32 ,$145.32 ,$155.70 ,$99.48 ,$39.79 ,$173.00 ,$12.41 ,$13.65 ,$43.77 ,$147.05 ,$103.35 ,$155.70 ,$145.32 ,$138.40 ,$138.40 ,$39.79 ,$112.45 ST. FRANCIS HOSPITAL - ACUTE,30100130,80185,HC PHENYTOIN TOTAL,301,1 ,$173.00 ,$112.45 ,$12.41 ,$173.00 ,$124.56 ,$94.11 ,$39.79 ,$96.57 ,$39.79 ,$103.35 ,$103.35 ,$103.35 ,$103.35 ,$145.32 ,$39.79 ,$147.05 ,$145.32 ,$39.79 ,$129.75 ,$138.40 ,$138.40 ,$39.79 ,$138.40 ,$145.32 ,$145.32 ,$145.32 ,$155.70 ,$99.48 ,$39.79 ,$173.00 ,$12.41 ,$13.65 ,$43.77 ,$147.05 ,$103.35 ,$155.70 ,$145.32 ,$138.40 ,$138.40 ,$39.79 ,$112.45 ST. FRANCIS HOSPITAL - ACUTE,30100138,80198,HC THEOPHYLLINE,301,1 ,$173.00 ,$112.45 ,$12.41 ,$173.00 ,$124.56 ,$94.11 ,$39.79 ,$96.57 ,$39.79 ,$103.35 ,$103.35 ,$103.35 ,$103.35 ,$145.32 ,$39.79 ,$147.05 ,$145.32 ,$39.79 ,$129.75 ,$138.40 ,$138.40 ,$39.79 ,$138.40 ,$145.32 ,$145.32 ,$145.32 ,$155.70 ,$99.48 ,$39.79 ,$173.00 ,$12.41 ,$13.65 ,$43.77 ,$147.05 ,$103.35 ,$155.70 ,$145.32 ,$138.40 ,$138.40 ,$39.79 ,$112.45 ST. FRANCIS HOSPITAL - ACUTE,30100141,80202,HC VANCOMYCIN,301,1 ,$204.00 ,$132.60 ,$12.41 ,$204.00 ,$146.88 ,$110.98 ,$46.92 ,$113.87 ,$46.92 ,$121.87 ,$121.87 ,$121.87 ,$121.87 ,$171.36 ,$46.92 ,$173.40 ,$171.36 ,$46.92 ,$153.00 ,$163.20 ,$163.20 ,$46.92 ,$163.20 ,$171.36 ,$171.36 ,$171.36 ,$183.60 ,$117.30 ,$46.92 ,$204.00 ,$12.41 ,$13.65 ,$51.61 ,$173.40 ,$121.87 ,$183.60 ,$171.36 ,$163.20 ,$163.20 ,$46.92 ,$132.60 ST. FRANCIS HOSPITAL - ACUTE,30100158,82010,HC ACETONE KETONES SERUM QN,301,1 ,$50.00 ,$32.50 ,$10.81 ,$50.00 ,$36.00 ,$27.20 ,$11.50 ,$27.91 ,$11.50 ,$29.87 ,$29.87 ,$29.87 ,$29.87 ,$42.00 ,$11.50 ,$42.50 ,$42.00 ,$11.50 ,$37.50 ,$40.00 ,$40.00 ,$11.50 ,$40.00 ,$42.00 ,$42.00 ,$42.00 ,$45.00 ,$28.75 ,$11.50 ,$50.00 ,$10.81 ,$11.89 ,$12.65 ,$42.50 ,$29.87 ,$45.00 ,$42.00 ,$40.00 ,$40.00 ,$11.50 ,$32.50 ST. FRANCIS HOSPITAL - ACUTE,30100165,82040,HC ALBUMIN SERUM,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100168,82043,HC MICROALBUMIN URINE QN,301,1 ,$125.00 ,$81.25 ,$3.86 ,$125.00 ,$90.00 ,$68.00 ,$28.75 ,$69.78 ,$28.75 ,$74.68 ,$74.68 ,$74.68 ,$74.68 ,$105.00 ,$28.75 ,$106.25 ,$105.00 ,$28.75 ,$93.75 ,$100.00 ,$100.00 ,$28.75 ,$100.00 ,$105.00 ,$105.00 ,$105.00 ,$112.50 ,$71.88 ,$28.75 ,$125.00 ,$3.86 ,$4.25 ,$31.63 ,$106.25 ,$74.68 ,$112.50 ,$105.00 ,$100.00 ,$100.00 ,$28.75 ,$81.25 ST. FRANCIS HOSPITAL - ACUTE,30100186,82140,HC AMMONIA,301,1 ,$205.00 ,$133.25 ,$10.81 ,$205.00 ,$147.60 ,$111.52 ,$47.15 ,$114.43 ,$47.15 ,$122.47 ,$122.47 ,$122.47 ,$122.47 ,$172.20 ,$47.15 ,$174.25 ,$172.20 ,$47.15 ,$153.75 ,$164.00 ,$164.00 ,$47.15 ,$164.00 ,$172.20 ,$172.20 ,$172.20 ,$184.50 ,$117.88 ,$47.15 ,$205.00 ,$10.81 ,$11.89 ,$51.87 ,$174.25 ,$122.47 ,$184.50 ,$172.20 ,$164.00 ,$164.00 ,$47.15 ,$133.25 ST. FRANCIS HOSPITAL - ACUTE,30100188,82150,HC AMYLASE,301,1 ,$146.00 ,$94.90 ,$10.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$10.81 ,$11.89 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100202,82247,HC BILIRUBIN TOTAL,301,1 ,$100.00 ,$65.00 ,$4.81 ,$100.00 ,$72.00 ,$54.40 ,$23.00 ,$55.82 ,$23.00 ,$59.74 ,$59.74 ,$59.74 ,$59.74 ,$84.00 ,$23.00 ,$85.00 ,$84.00 ,$23.00 ,$75.00 ,$80.00 ,$80.00 ,$23.00 ,$80.00 ,$84.00 ,$84.00 ,$84.00 ,$90.00 ,$57.50 ,$23.00 ,$100.00 ,$4.81 ,$5.29 ,$25.30 ,$85.00 ,$59.74 ,$90.00 ,$84.00 ,$80.00 ,$80.00 ,$23.00 ,$65.00 ST. FRANCIS HOSPITAL - ACUTE,30100203,82248,HC BILIRUBIN DIRECT,301,1 ,$83.00 ,$53.95 ,$4.81 ,$83.00 ,$59.76 ,$45.15 ,$19.09 ,$46.33 ,$19.09 ,$49.58 ,$49.58 ,$49.58 ,$49.58 ,$69.72 ,$19.09 ,$70.55 ,$69.72 ,$19.09 ,$62.25 ,$66.40 ,$66.40 ,$19.09 ,$66.40 ,$69.72 ,$69.72 ,$69.72 ,$74.70 ,$47.73 ,$19.09 ,$83.00 ,$4.81 ,$5.29 ,$21.00 ,$70.55 ,$49.58 ,$74.70 ,$69.72 ,$66.40 ,$66.40 ,$19.09 ,$53.95 ST. FRANCIS HOSPITAL - ACUTE,30100214,82310,HC CALCIUM,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100216,82340,HC CALCIUM URINE QN TIMED,301,1 ,$146.00 ,$94.90 ,$10.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$10.81 ,$11.89 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100222,82374,HC BICARBONATE,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100225,82375,HC CARBOXYHEMOGLOBIN,301,1 ,$205.00 ,$133.25 ,$10.81 ,$205.00 ,$147.60 ,$111.52 ,$47.15 ,$114.43 ,$47.15 ,$122.47 ,$122.47 ,$122.47 ,$122.47 ,$172.20 ,$47.15 ,$174.25 ,$172.20 ,$47.15 ,$153.75 ,$164.00 ,$164.00 ,$47.15 ,$164.00 ,$172.20 ,$172.20 ,$172.20 ,$184.50 ,$117.88 ,$47.15 ,$205.00 ,$10.81 ,$11.89 ,$51.87 ,$174.25 ,$122.47 ,$184.50 ,$172.20 ,$164.00 ,$164.00 ,$47.15 ,$133.25 ST. FRANCIS HOSPITAL - ACUTE,30100237,82435,HC CHLORIDE,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100238,82436,HC CHLORIDE URINE,301,1 ,$146.00 ,$94.90 ,$4.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$4.81 ,$5.29 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100241,82465,HC CHOLESTEROL,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100259,82550,HC CREATINE KINASE (CPK) TOTAL,301,1 ,$171.00 ,$111.15 ,$4.81 ,$171.00 ,$123.12 ,$93.02 ,$39.33 ,$95.45 ,$39.33 ,$102.16 ,$102.16 ,$102.16 ,$102.16 ,$143.64 ,$39.33 ,$145.35 ,$143.64 ,$39.33 ,$128.25 ,$136.80 ,$136.80 ,$39.33 ,$136.80 ,$143.64 ,$143.64 ,$143.64 ,$153.90 ,$98.33 ,$39.33 ,$171.00 ,$4.81 ,$5.29 ,$43.26 ,$145.35 ,$102.16 ,$153.90 ,$143.64 ,$136.80 ,$136.80 ,$39.33 ,$111.15 ST. FRANCIS HOSPITAL - ACUTE,30100261,82553,HC CREATINE KINASE MB FRAC,301,1 ,$239.00 ,$155.35 ,$10.81 ,$239.00 ,$172.08 ,$130.02 ,$54.97 ,$133.41 ,$54.97 ,$142.78 ,$142.78 ,$142.78 ,$142.78 ,$200.76 ,$54.97 ,$203.15 ,$200.76 ,$54.97 ,$179.25 ,$191.20 ,$191.20 ,$54.97 ,$191.20 ,$200.76 ,$200.76 ,$200.76 ,$215.10 ,$137.43 ,$54.97 ,$239.00 ,$10.81 ,$11.89 ,$60.47 ,$203.15 ,$142.78 ,$215.10 ,$200.76 ,$191.20 ,$191.20 ,$54.97 ,$155.35 ST. FRANCIS HOSPITAL - ACUTE,30100262,82565,HC CREATININE,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$5.12 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100264,82570,HC CREATININE OTH SOURCE,301,1 ,$146.00 ,$94.90 ,$4.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$4.81 ,$5.29 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100266,82575,HC CREATININE CLEARANCE,301,1 ,$246.00 ,$159.90 ,$10.81 ,$246.00 ,$177.12 ,$133.82 ,$56.58 ,$137.32 ,$56.58 ,$146.96 ,$146.96 ,$146.96 ,$146.96 ,$206.64 ,$56.58 ,$209.10 ,$206.64 ,$56.58 ,$184.50 ,$196.80 ,$196.80 ,$56.58 ,$196.80 ,$206.64 ,$206.64 ,$206.64 ,$221.40 ,$141.45 ,$56.58 ,$246.00 ,$10.81 ,$11.89 ,$62.24 ,$209.10 ,$146.96 ,$221.40 ,$206.64 ,$196.80 ,$196.80 ,$56.58 ,$159.90 ST. FRANCIS HOSPITAL - ACUTE,30100290,82728,HC FERRITIN,301,1 ,$172.00 ,$111.80 ,$10.81 ,$172.00 ,$123.84 ,$93.57 ,$39.56 ,$96.01 ,$39.56 ,$102.75 ,$102.75 ,$102.75 ,$102.75 ,$144.48 ,$39.56 ,$146.20 ,$144.48 ,$39.56 ,$129.00 ,$137.60 ,$137.60 ,$39.56 ,$137.60 ,$144.48 ,$144.48 ,$144.48 ,$154.80 ,$98.90 ,$39.56 ,$172.00 ,$10.81 ,$11.89 ,$43.52 ,$146.20 ,$102.75 ,$154.80 ,$144.48 ,$137.60 ,$137.60 ,$39.56 ,$111.80 ST. FRANCIS HOSPITAL - ACUTE,30100305,82800,HC BLOOD GAS PH,301,1 ,$142.00 ,$92.30 ,$10.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$10.81 ,$11.89 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30100307,82805,HC BLOOD GASES W/O2 SAT,301,1 ,$272.00 ,$176.80 ,$10.81 ,$272.00 ,$195.84 ,$147.97 ,$62.56 ,$151.83 ,$62.56 ,$162.49 ,$162.49 ,$162.49 ,$162.49 ,$228.48 ,$62.56 ,$231.20 ,$228.48 ,$62.56 ,$204.00 ,$217.60 ,$217.60 ,$62.56 ,$217.60 ,$228.48 ,$228.48 ,$228.48 ,$244.80 ,$156.40 ,$62.56 ,$272.00 ,$10.81 ,$11.89 ,$68.82 ,$231.20 ,$162.49 ,$244.80 ,$228.48 ,$217.60 ,$217.60 ,$62.56 ,$176.80 ST. FRANCIS HOSPITAL - ACUTE,30100311,82945,HC GLUCOSE BODY FLUID,301,1 ,$83.00 ,$53.95 ,$4.81 ,$83.00 ,$59.76 ,$45.15 ,$19.09 ,$46.33 ,$19.09 ,$49.58 ,$49.58 ,$49.58 ,$49.58 ,$69.72 ,$19.09 ,$70.55 ,$69.72 ,$19.09 ,$62.25 ,$66.40 ,$66.40 ,$19.09 ,$66.40 ,$69.72 ,$69.72 ,$69.72 ,$74.70 ,$47.73 ,$19.09 ,$83.00 ,$4.81 ,$5.29 ,$21.00 ,$70.55 ,$49.58 ,$74.70 ,$69.72 ,$66.40 ,$66.40 ,$19.09 ,$53.95 ST. FRANCIS HOSPITAL - ACUTE,30100312,82947,HC GLUCOSE,301,1 ,$83.00 ,$53.95 ,$4.81 ,$83.00 ,$59.76 ,$45.15 ,$19.09 ,$46.33 ,$19.09 ,$49.58 ,$49.58 ,$49.58 ,$49.58 ,$69.72 ,$19.09 ,$70.55 ,$69.72 ,$19.09 ,$62.25 ,$66.40 ,$66.40 ,$19.09 ,$66.40 ,$69.72 ,$69.72 ,$69.72 ,$74.70 ,$47.73 ,$19.09 ,$83.00 ,$4.81 ,$5.29 ,$21.00 ,$70.55 ,$49.58 ,$74.70 ,$69.72 ,$66.40 ,$66.40 ,$19.09 ,$53.95 ST. FRANCIS HOSPITAL - ACUTE,30100313,82950,HC GLUCOSE SCREEN,301,1 ,$108.00 ,$70.20 ,$4.81 ,$108.00 ,$77.76 ,$58.75 ,$24.84 ,$60.29 ,$24.84 ,$64.52 ,$64.52 ,$64.52 ,$64.52 ,$90.72 ,$24.84 ,$91.80 ,$90.72 ,$24.84 ,$81.00 ,$86.40 ,$86.40 ,$24.84 ,$86.40 ,$90.72 ,$90.72 ,$90.72 ,$97.20 ,$62.10 ,$24.84 ,$108.00 ,$4.81 ,$5.29 ,$27.32 ,$91.80 ,$64.52 ,$97.20 ,$90.72 ,$86.40 ,$86.40 ,$24.84 ,$70.20 ST. FRANCIS HOSPITAL - ACUTE,30100314,82951,HC GLUCOSE TOLERANCE,301,1 ,$168.00 ,$109.20 ,$10.81 ,$168.00 ,$120.96 ,$91.39 ,$38.64 ,$93.78 ,$38.64 ,$100.36 ,$100.36 ,$100.36 ,$100.36 ,$141.12 ,$38.64 ,$142.80 ,$141.12 ,$38.64 ,$126.00 ,$134.40 ,$134.40 ,$38.64 ,$134.40 ,$141.12 ,$141.12 ,$141.12 ,$151.20 ,$96.60 ,$38.64 ,$168.00 ,$10.81 ,$11.89 ,$42.50 ,$142.80 ,$100.36 ,$151.20 ,$141.12 ,$134.40 ,$134.40 ,$38.64 ,$109.20 ST. FRANCIS HOSPITAL - ACUTE,30100315,82952,HC GLUCOSE TOLERANCE ADDL SPEC,301,1 ,$61.00 ,$39.65 ,$10.81 ,$61.00 ,$43.92 ,$33.18 ,$14.03 ,$34.05 ,$14.03 ,$36.44 ,$36.44 ,$36.44 ,$36.44 ,$51.24 ,$14.03 ,$51.85 ,$51.24 ,$14.03 ,$45.75 ,$48.80 ,$48.80 ,$14.03 ,$48.80 ,$51.24 ,$51.24 ,$51.24 ,$54.90 ,$35.08 ,$14.03 ,$61.00 ,$10.81 ,$11.89 ,$15.43 ,$51.85 ,$36.44 ,$54.90 ,$51.24 ,$48.80 ,$48.80 ,$14.03 ,$39.65 ST. FRANCIS HOSPITAL - ACUTE,30100319,82977,HC GGT/GGTP,301,1 ,$142.00 ,$92.30 ,$4.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$4.81 ,$5.29 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30100337,83036,HC GLYCOSYLATED HGB,301,1 ,$188.00 ,$122.20 ,$10.81 ,$188.00 ,$135.36 ,$102.27 ,$43.24 ,$104.94 ,$43.24 ,$112.31 ,$112.31 ,$112.31 ,$112.31 ,$157.92 ,$43.24 ,$159.80 ,$157.92 ,$43.24 ,$141.00 ,$150.40 ,$150.40 ,$43.24 ,$150.40 ,$157.92 ,$157.92 ,$157.92 ,$169.20 ,$108.10 ,$43.24 ,$188.00 ,$10.81 ,$11.89 ,$47.56 ,$159.80 ,$112.31 ,$169.20 ,$157.92 ,$150.40 ,$150.40 ,$43.24 ,$122.20 ST. FRANCIS HOSPITAL - ACUTE,30100338,83050,HC METHEMOGLOBIN,301,1 ,$205.00 ,$133.25 ,$10.81 ,$205.00 ,$147.60 ,$111.52 ,$47.15 ,$114.43 ,$47.15 ,$122.47 ,$122.47 ,$122.47 ,$122.47 ,$172.20 ,$47.15 ,$174.25 ,$172.20 ,$47.15 ,$153.75 ,$164.00 ,$164.00 ,$47.15 ,$164.00 ,$172.20 ,$172.20 ,$172.20 ,$184.50 ,$117.88 ,$47.15 ,$205.00 ,$10.81 ,$11.89 ,$51.87 ,$174.25 ,$122.47 ,$184.50 ,$172.20 ,$164.00 ,$164.00 ,$47.15 ,$133.25 ST. FRANCIS HOSPITAL - ACUTE,30100393,83540,HC IRON TOTAL,301,1 ,$142.00 ,$92.30 ,$4.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$4.81 ,$5.29 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30100394,83550,HC IRON BINDING CAPACITY,301,1 ,$288.00 ,$187.20 ,$10.81 ,$288.00 ,$207.36 ,$156.67 ,$66.24 ,$160.76 ,$66.24 ,$172.05 ,$172.05 ,$172.05 ,$172.05 ,$241.92 ,$66.24 ,$244.80 ,$241.92 ,$66.24 ,$216.00 ,$230.40 ,$230.40 ,$66.24 ,$230.40 ,$241.92 ,$241.92 ,$241.92 ,$259.20 ,$165.60 ,$66.24 ,$288.00 ,$10.81 ,$11.89 ,$72.86 ,$244.80 ,$172.05 ,$259.20 ,$241.92 ,$230.40 ,$230.40 ,$66.24 ,$187.20 ST. FRANCIS HOSPITAL - ACUTE,30100396,83605,HC LACTATE/LACTIC ACID,301,1 ,$211.00 ,$137.15 ,$10.81 ,$211.00 ,$151.92 ,$114.78 ,$48.53 ,$117.78 ,$48.53 ,$126.05 ,$126.05 ,$126.05 ,$126.05 ,$177.24 ,$48.53 ,$179.35 ,$177.24 ,$48.53 ,$158.25 ,$168.80 ,$168.80 ,$48.53 ,$168.80 ,$177.24 ,$177.24 ,$177.24 ,$189.90 ,$121.33 ,$48.53 ,$211.00 ,$10.81 ,$11.89 ,$53.38 ,$179.35 ,$126.05 ,$189.90 ,$177.24 ,$168.80 ,$168.80 ,$48.53 ,$137.15 ST. FRANCIS HOSPITAL - ACUTE,30100397,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$142.00 ,$92.30 ,$4.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$4.81 ,$5.29 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30100409,83690,HC LIPASE,301,1 ,$142.00 ,$92.30 ,$4.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$4.81 ,$5.29 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30100415,83718,HC CHOLESTEROL HDL,301,1 ,$111.00 ,$72.15 ,$10.81 ,$111.00 ,$79.92 ,$60.38 ,$25.53 ,$61.96 ,$25.53 ,$66.31 ,$66.31 ,$66.31 ,$66.31 ,$93.24 ,$25.53 ,$94.35 ,$93.24 ,$25.53 ,$83.25 ,$88.80 ,$88.80 ,$25.53 ,$88.80 ,$93.24 ,$93.24 ,$93.24 ,$99.90 ,$63.83 ,$25.53 ,$111.00 ,$10.81 ,$11.89 ,$28.08 ,$94.35 ,$66.31 ,$99.90 ,$93.24 ,$88.80 ,$88.80 ,$25.53 ,$72.15 ST. FRANCIS HOSPITAL - ACUTE,30100416,83721,HC CHOLESTEROL LDL,301,1 ,$111.00 ,$72.15 ,$10.81 ,$111.00 ,$79.92 ,$60.38 ,$25.53 ,$61.96 ,$25.53 ,$66.31 ,$66.31 ,$66.31 ,$66.31 ,$93.24 ,$25.53 ,$94.35 ,$93.24 ,$25.53 ,$83.25 ,$88.80 ,$88.80 ,$25.53 ,$88.80 ,$93.24 ,$93.24 ,$93.24 ,$99.90 ,$63.83 ,$25.53 ,$111.00 ,$10.81 ,$11.89 ,$28.08 ,$94.35 ,$66.31 ,$99.90 ,$93.24 ,$88.80 ,$88.80 ,$25.53 ,$72.15 ST. FRANCIS HOSPITAL - ACUTE,30100417,83735,HC MAGNESIUM,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100438,83880,HC BNP NATRIURETIC PEPTIDE,301,1 ,$263.00 ,$170.95 ,$29.09 ,$263.00 ,$189.36 ,$143.07 ,$60.49 ,$146.81 ,$60.49 ,$157.12 ,$157.12 ,$157.12 ,$157.12 ,$220.92 ,$60.49 ,$223.55 ,$220.92 ,$60.49 ,$197.25 ,$210.40 ,$210.40 ,$60.49 ,$210.40 ,$220.92 ,$220.92 ,$220.92 ,$236.70 ,$151.23 ,$60.49 ,$263.00 ,$29.09 ,$32.00 ,$66.54 ,$223.55 ,$157.12 ,$236.70 ,$220.92 ,$210.40 ,$210.40 ,$60.49 ,$170.95 ST. FRANCIS HOSPITAL - ACUTE,30100673,83986,HC PH BODY FLUID,301,1 ,$9.00 ,$5.85 ,$2.07 ,$9.00 ,$6.48 ,$4.90 ,$2.07 ,$5.02 ,$2.07 ,$5.38 ,$5.38 ,$5.38 ,$5.38 ,$7.56 ,$2.07 ,$7.65 ,$7.56 ,$2.07 ,$6.75 ,$7.20 ,$7.20 ,$2.07 ,$7.20 ,$7.56 ,$7.56 ,$7.56 ,$8.10 ,$5.18 ,$2.07 ,$9.00 ,$4.81 ,$5.29 ,$2.28 ,$7.65 ,$5.38 ,$8.10 ,$7.56 ,$7.20 ,$7.20 ,$2.07 ,$5.85 ST. FRANCIS HOSPITAL - ACUTE,30100679,84075,HC ALKALINE PHOSPHATASE,301,1 ,$142.00 ,$92.30 ,$4.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$4.81 ,$5.29 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30100684,84100,HC PHOSPHORUS,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100685,84105,HC PHOSPHORUS URINE,301,1 ,$146.00 ,$94.90 ,$4.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$4.81 ,$5.29 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100688,84112,HC PLACENTAL ALPHA MICROGLOBULIN,301,1 ,$226.00 ,$146.90 ,$29.09 ,$226.00 ,$162.72 ,$122.94 ,$51.98 ,$126.15 ,$51.98 ,$135.01 ,$135.01 ,$135.01 ,$135.01 ,$189.84 ,$51.98 ,$192.10 ,$189.84 ,$51.98 ,$169.50 ,$180.80 ,$180.80 ,$51.98 ,$180.80 ,$189.84 ,$189.84 ,$189.84 ,$203.40 ,$129.95 ,$51.98 ,$226.00 ,$29.09 ,$32.00 ,$57.18 ,$192.10 ,$135.01 ,$203.40 ,$189.84 ,$180.80 ,$180.80 ,$51.98 ,$146.90 ST. FRANCIS HOSPITAL - ACUTE,30100691,84132,HC POTASSIUM,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100694,84133,HC POTASSIUM URINE,301,1 ,$146.00 ,$94.90 ,$4.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$4.81 ,$5.29 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100698,84153,HC PSA TOTAL,301,1 ,$155.00 ,$100.75 ,$10.81 ,$155.00 ,$111.60 ,$84.32 ,$35.65 ,$86.52 ,$35.65 ,$92.60 ,$92.60 ,$92.60 ,$92.60 ,$130.20 ,$35.65 ,$131.75 ,$130.20 ,$35.65 ,$116.25 ,$124.00 ,$124.00 ,$35.65 ,$124.00 ,$130.20 ,$130.20 ,$130.20 ,$139.50 ,$89.13 ,$35.65 ,$155.00 ,$10.81 ,$11.89 ,$39.22 ,$131.75 ,$92.60 ,$139.50 ,$130.20 ,$124.00 ,$124.00 ,$35.65 ,$100.75 ST. FRANCIS HOSPITAL - ACUTE,30100700,84155,HC PROTEIN TOTAL,301,1 ,$24.00 ,$15.60 ,$4.81 ,$24.00 ,$17.28 ,$13.06 ,$5.52 ,$13.40 ,$5.52 ,$14.34 ,$14.34 ,$14.34 ,$14.34 ,$20.16 ,$5.52 ,$20.40 ,$20.16 ,$5.52 ,$18.00 ,$19.20 ,$19.20 ,$5.52 ,$19.20 ,$20.16 ,$20.16 ,$20.16 ,$21.60 ,$13.80 ,$5.52 ,$24.00 ,$4.81 ,$5.29 ,$6.07 ,$20.40 ,$14.34 ,$21.60 ,$20.16 ,$19.20 ,$19.20 ,$5.52 ,$15.60 ST. FRANCIS HOSPITAL - ACUTE,30100701,84156,HC PROTEIN TOTAL URINE,301,1 ,$146.00 ,$94.90 ,$4.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$4.81 ,$5.29 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100703,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$118.00 ,$76.70 ,$4.81 ,$118.00 ,$84.96 ,$64.19 ,$27.14 ,$65.87 ,$27.14 ,$70.49 ,$70.49 ,$70.49 ,$70.49 ,$99.12 ,$27.14 ,$100.30 ,$99.12 ,$27.14 ,$88.50 ,$94.40 ,$94.40 ,$27.14 ,$94.40 ,$99.12 ,$99.12 ,$99.12 ,$106.20 ,$67.85 ,$27.14 ,$118.00 ,$4.81 ,$5.29 ,$29.85 ,$100.30 ,$70.49 ,$106.20 ,$99.12 ,$94.40 ,$94.40 ,$27.14 ,$76.70 ST. FRANCIS HOSPITAL - ACUTE,30100721,84295,HC SODIUM,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100724,84300,HC SODIUM URINE,301,1 ,$146.00 ,$94.90 ,$4.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$4.81 ,$5.29 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100730,84315,HC SPEC GRAVITY NON UR,301,1 ,$34.00 ,$22.10 ,$4.81 ,$34.00 ,$24.48 ,$18.50 ,$7.82 ,$18.98 ,$7.82 ,$20.31 ,$20.31 ,$20.31 ,$20.31 ,$28.56 ,$7.82 ,$28.90 ,$28.56 ,$7.82 ,$25.50 ,$27.20 ,$27.20 ,$7.82 ,$27.20 ,$28.56 ,$28.56 ,$28.56 ,$30.60 ,$19.55 ,$7.82 ,$34.00 ,$4.81 ,$5.29 ,$8.60 ,$28.90 ,$20.31 ,$30.60 ,$28.56 ,$27.20 ,$27.20 ,$7.82 ,$22.10 ST. FRANCIS HOSPITAL - ACUTE,30100740,84439,HC T4 FREE,301,1 ,$118.00 ,$76.70 ,$14.55 ,$118.00 ,$84.96 ,$64.19 ,$27.14 ,$65.87 ,$27.14 ,$70.49 ,$70.49 ,$70.49 ,$70.49 ,$99.12 ,$27.14 ,$100.30 ,$99.12 ,$27.14 ,$88.50 ,$94.40 ,$94.40 ,$27.14 ,$94.40 ,$99.12 ,$99.12 ,$99.12 ,$106.20 ,$67.85 ,$27.14 ,$118.00 ,$14.55 ,$16.01 ,$29.85 ,$100.30 ,$70.49 ,$106.20 ,$99.12 ,$94.40 ,$94.40 ,$27.14 ,$76.70 ST. FRANCIS HOSPITAL - ACUTE,30100743,84443,HC THYROID STIMULATING HORM,301,1 ,$146.00 ,$94.90 ,$14.55 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$14.55 ,$16.01 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100746,84450,HC AST,301,1 ,$142.00 ,$92.30 ,$4.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$4.81 ,$5.29 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30100747,84460,HC ALT,301,1 ,$142.00 ,$92.30 ,$4.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$4.81 ,$5.29 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30100750,84478,HC TRIGLYCERIDES,301,1 ,$112.00 ,$72.80 ,$4.81 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100758,84484,HC TROPONIN QN,301,1 ,$255.00 ,$165.75 ,$10.81 ,$255.00 ,$183.60 ,$138.72 ,$58.65 ,$142.34 ,$58.65 ,$152.34 ,$152.34 ,$152.34 ,$152.34 ,$214.20 ,$58.65 ,$216.75 ,$214.20 ,$58.65 ,$191.25 ,$204.00 ,$204.00 ,$58.65 ,$204.00 ,$214.20 ,$214.20 ,$214.20 ,$229.50 ,$146.63 ,$58.65 ,$255.00 ,$10.81 ,$11.89 ,$64.52 ,$216.75 ,$152.34 ,$229.50 ,$214.20 ,$204.00 ,$204.00 ,$58.65 ,$165.75 ST. FRANCIS HOSPITAL - ACUTE,30100761,84520,HC BUN,301,1 ,$112.00 ,$72.80 ,$3.95 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$3.95 ,$4.81 ,$5.29 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30100764,84540,HC UREA URINE,301,1 ,$146.00 ,$94.90 ,$4.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$4.81 ,$5.29 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100765,84550,HC URIC ACID,301,1 ,$142.00 ,$92.30 ,$4.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$4.81 ,$5.29 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30100766,84560,HC URIC ACID OTH SRC,301,1 ,$146.00 ,$94.90 ,$4.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$4.81 ,$5.29 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30100767,84578,HC UROBILINOGEN,301,1 ,$32.00 ,$20.80 ,$2.43 ,$32.00 ,$23.04 ,$17.41 ,$7.36 ,$17.86 ,$7.36 ,$19.12 ,$19.12 ,$19.12 ,$19.12 ,$26.88 ,$7.36 ,$27.20 ,$26.88 ,$7.36 ,$24.00 ,$25.60 ,$25.60 ,$7.36 ,$25.60 ,$26.88 ,$26.88 ,$26.88 ,$28.80 ,$18.40 ,$7.36 ,$32.00 ,$2.43 ,$2.67 ,$8.10 ,$27.20 ,$19.12 ,$28.80 ,$26.88 ,$25.60 ,$25.60 ,$7.36 ,$20.80 ST. FRANCIS HOSPITAL - ACUTE,30100802,84702,HC HCG QN,301,1 ,$223.00 ,$144.95 ,$14.55 ,$223.00 ,$160.56 ,$121.31 ,$51.29 ,$124.48 ,$51.29 ,$133.22 ,$133.22 ,$133.22 ,$133.22 ,$187.32 ,$51.29 ,$189.55 ,$187.32 ,$51.29 ,$167.25 ,$178.40 ,$178.40 ,$51.29 ,$178.40 ,$187.32 ,$187.32 ,$187.32 ,$200.70 ,$128.23 ,$51.29 ,$223.00 ,$14.55 ,$16.01 ,$56.42 ,$189.55 ,$133.22 ,$200.70 ,$187.32 ,$178.40 ,$178.40 ,$51.29 ,$144.95 ST. FRANCIS HOSPITAL - ACUTE,30100810,88720,HC BILICHECK TEST,301,1 ,$47.00 ,$30.55 ,$4.81 ,$47.00 ,$33.84 ,$25.57 ,$10.81 ,$26.24 ,$10.81 ,$28.08 ,$28.08 ,$28.08 ,$28.08 ,$39.48 ,$10.81 ,$39.95 ,$39.48 ,$10.81 ,$35.25 ,$37.60 ,$37.60 ,$10.81 ,$37.60 ,$39.48 ,$39.48 ,$39.48 ,$42.30 ,$27.03 ,$10.81 ,$47.00 ,$4.81 ,$5.29 ,$11.89 ,$39.95 ,$28.08 ,$42.30 ,$39.48 ,$37.60 ,$37.60 ,$10.81 ,$30.55 ST. FRANCIS HOSPITAL - ACUTE,30101023,G0103,HC PSA ANNUAL SCREENING,301,1 ,$236.00 ,$153.40 ,$10.81 ,$236.00 ,$169.92 ,$128.38 ,$54.28 ,$131.74 ,$54.28 ,$140.99 ,$140.99 ,$140.99 ,$140.99 ,$198.24 ,$54.28 ,$200.60 ,$198.24 ,$54.28 ,$177.00 ,$188.80 ,$188.80 ,$54.28 ,$188.80 ,$198.24 ,$198.24 ,$198.24 ,$212.40 ,$135.70 ,$54.28 ,$236.00 ,$10.81 ,$11.89 ,$59.71 ,$200.60 ,$140.99 ,$212.40 ,$198.24 ,$188.80 ,$188.80 ,$54.28 ,$153.40 ST. FRANCIS HOSPITAL - ACUTE,30101089,80150,HC AMIKACIN - 90,301,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 ,$12.41 ,$13.65 ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,30101094,80158,HC CYCLOSPORINE - 90,301,1 ,$73.00 ,$47.45 ,$12.41 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 ,$12.41 ,$13.65 ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,30101095,80159,HC CLOZAPINE - 90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$12.41 ,$13.65 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101099,80168,HC ETHOSUXIMIDE - 90,301,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 ,$12.41 ,$13.65 ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,30101100,80169,HC EVEROLIMUS - 90,301,1 ,$85.00 ,$55.25 ,$12.41 ,$85.00 ,$61.20 ,$46.24 ,$19.55 ,$47.45 ,$19.55 ,$50.78 ,$50.78 ,$50.78 ,$50.78 ,$71.40 ,$19.55 ,$72.25 ,$71.40 ,$19.55 ,$63.75 ,$68.00 ,$68.00 ,$19.55 ,$68.00 ,$71.40 ,$71.40 ,$71.40 ,$76.50 ,$48.88 ,$19.55 ,$85.00 ,$12.41 ,$13.65 ,$21.51 ,$72.25 ,$50.78 ,$76.50 ,$71.40 ,$68.00 ,$68.00 ,$19.55 ,$55.25 ST. FRANCIS HOSPITAL - ACUTE,30101102,80171,HC GABAPENTIN PLASMA - 90,301,1 ,$59.00 ,$38.35 ,$12.41 ,$59.00 ,$42.48 ,$32.10 ,$13.57 ,$32.93 ,$13.57 ,$35.25 ,$35.25 ,$35.25 ,$35.25 ,$49.56 ,$13.57 ,$50.15 ,$49.56 ,$13.57 ,$44.25 ,$47.20 ,$47.20 ,$13.57 ,$47.20 ,$49.56 ,$49.56 ,$49.56 ,$53.10 ,$33.93 ,$13.57 ,$59.00 ,$12.41 ,$13.65 ,$14.93 ,$50.15 ,$35.25 ,$53.10 ,$49.56 ,$47.20 ,$47.20 ,$13.57 ,$38.35 ST. FRANCIS HOSPITAL - ACUTE,30101104,80175,HC LAMOTRIGINE - 90,301,1 ,$59.00 ,$38.35 ,$12.41 ,$59.00 ,$42.48 ,$32.10 ,$13.57 ,$32.93 ,$13.57 ,$35.25 ,$35.25 ,$35.25 ,$35.25 ,$49.56 ,$13.57 ,$50.15 ,$49.56 ,$13.57 ,$44.25 ,$47.20 ,$47.20 ,$13.57 ,$47.20 ,$49.56 ,$49.56 ,$49.56 ,$53.10 ,$33.93 ,$13.57 ,$59.00 ,$12.41 ,$13.65 ,$14.93 ,$50.15 ,$35.25 ,$53.10 ,$49.56 ,$47.20 ,$47.20 ,$13.57 ,$38.35 ST. FRANCIS HOSPITAL - ACUTE,30101106,80177,HC LEVETIRACETAM - 90,301,1 ,$66.00 ,$42.90 ,$12.41 ,$66.00 ,$47.52 ,$35.90 ,$15.18 ,$36.84 ,$15.18 ,$39.43 ,$39.43 ,$39.43 ,$39.43 ,$55.44 ,$15.18 ,$56.10 ,$55.44 ,$15.18 ,$49.50 ,$52.80 ,$52.80 ,$15.18 ,$52.80 ,$55.44 ,$55.44 ,$55.44 ,$59.40 ,$37.95 ,$15.18 ,$66.00 ,$12.41 ,$13.65 ,$16.70 ,$56.10 ,$39.43 ,$59.40 ,$55.44 ,$52.80 ,$52.80 ,$15.18 ,$42.90 ST. FRANCIS HOSPITAL - ACUTE,30101109,80183,HC OXCARBAZEPINE - 90,301,1 ,$75.00 ,$48.75 ,$12.41 ,$75.00 ,$54.00 ,$40.80 ,$17.25 ,$41.87 ,$17.25 ,$44.81 ,$44.81 ,$44.81 ,$44.81 ,$63.00 ,$17.25 ,$63.75 ,$63.00 ,$17.25 ,$56.25 ,$60.00 ,$60.00 ,$17.25 ,$60.00 ,$63.00 ,$63.00 ,$63.00 ,$67.50 ,$43.13 ,$17.25 ,$75.00 ,$12.41 ,$13.65 ,$18.98 ,$63.75 ,$44.81 ,$67.50 ,$63.00 ,$60.00 ,$60.00 ,$17.25 ,$48.75 ST. FRANCIS HOSPITAL - ACUTE,30101110,80184,HC PHENOBARBITAL - 90,301,1 ,$20.00 ,$13.00 ,$4.60 ,$20.00 ,$14.40 ,$10.88 ,$4.60 ,$11.16 ,$4.60 ,$11.95 ,$11.95 ,$11.95 ,$11.95 ,$16.80 ,$4.60 ,$17.00 ,$16.80 ,$4.60 ,$15.00 ,$16.00 ,$16.00 ,$4.60 ,$16.00 ,$16.80 ,$16.80 ,$16.80 ,$18.00 ,$11.50 ,$4.60 ,$20.00 ,$12.41 ,$13.65 ,$5.06 ,$17.00 ,$11.95 ,$18.00 ,$16.80 ,$16.00 ,$16.00 ,$4.60 ,$13.00 ST. FRANCIS HOSPITAL - ACUTE,30101115,80188,HC PRIMIDONE - 90,301,1 ,$20.00 ,$13.00 ,$4.60 ,$20.00 ,$14.40 ,$10.88 ,$4.60 ,$11.16 ,$4.60 ,$11.95 ,$11.95 ,$11.95 ,$11.95 ,$16.80 ,$4.60 ,$17.00 ,$16.80 ,$4.60 ,$15.00 ,$16.00 ,$16.00 ,$4.60 ,$16.00 ,$16.80 ,$16.80 ,$16.80 ,$18.00 ,$11.50 ,$4.60 ,$20.00 ,$12.41 ,$13.65 ,$5.06 ,$17.00 ,$11.95 ,$18.00 ,$16.80 ,$16.00 ,$16.00 ,$4.60 ,$13.00 ST. FRANCIS HOSPITAL - ACUTE,30101116,80192,HC PROCAINEAMIDE - 90,301,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 ,$12.41 ,$13.65 ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,30101117,80194,HC QUINIDINE - 90,301,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 ,$12.41 ,$13.65 ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,30101118,80195,HC RAPAMYCIN (SIROLIMUS) - 90,301,1 ,$65.00 ,$42.25 ,$12.41 ,$65.00 ,$46.80 ,$35.36 ,$14.95 ,$36.28 ,$14.95 ,$38.83 ,$38.83 ,$38.83 ,$38.83 ,$54.60 ,$14.95 ,$55.25 ,$54.60 ,$14.95 ,$48.75 ,$52.00 ,$52.00 ,$14.95 ,$52.00 ,$54.60 ,$54.60 ,$54.60 ,$58.50 ,$37.38 ,$14.95 ,$65.00 ,$12.41 ,$13.65 ,$16.45 ,$55.25 ,$38.83 ,$58.50 ,$54.60 ,$52.00 ,$52.00 ,$14.95 ,$42.25 ST. FRANCIS HOSPITAL - ACUTE,30101119,80197,HC TACROLIMUS - 90,301,1 ,$169.00 ,$109.85 ,$12.41 ,$169.00 ,$121.68 ,$91.94 ,$38.87 ,$94.34 ,$38.87 ,$100.96 ,$100.96 ,$100.96 ,$100.96 ,$141.96 ,$38.87 ,$143.65 ,$141.96 ,$38.87 ,$126.75 ,$135.20 ,$135.20 ,$38.87 ,$135.20 ,$141.96 ,$141.96 ,$141.96 ,$152.10 ,$97.18 ,$38.87 ,$169.00 ,$12.41 ,$13.65 ,$42.76 ,$143.65 ,$100.96 ,$152.10 ,$141.96 ,$135.20 ,$135.20 ,$38.87 ,$109.85 ST. FRANCIS HOSPITAL - ACUTE,30101124,80201,HC TOPIRAMATE - 90,301,1 ,$47.00 ,$30.55 ,$10.81 ,$47.00 ,$33.84 ,$25.57 ,$10.81 ,$26.24 ,$10.81 ,$28.08 ,$28.08 ,$28.08 ,$28.08 ,$39.48 ,$10.81 ,$39.95 ,$39.48 ,$10.81 ,$35.25 ,$37.60 ,$37.60 ,$10.81 ,$37.60 ,$39.48 ,$39.48 ,$39.48 ,$42.30 ,$27.03 ,$10.81 ,$47.00 ,$12.41 ,$13.65 ,$11.89 ,$39.95 ,$28.08 ,$42.30 ,$39.48 ,$37.60 ,$37.60 ,$10.81 ,$30.55 ST. FRANCIS HOSPITAL - ACUTE,30101131,80299,HC THERAPEUTIC DRUG OTHER - 90,301,1 ,$65.00 ,$42.25 ,$12.41 ,$65.00 ,$46.80 ,$35.36 ,$14.95 ,$36.28 ,$14.95 ,$38.83 ,$38.83 ,$38.83 ,$38.83 ,$54.60 ,$14.95 ,$55.25 ,$54.60 ,$14.95 ,$48.75 ,$52.00 ,$52.00 ,$14.95 ,$52.00 ,$54.60 ,$54.60 ,$54.60 ,$58.50 ,$37.38 ,$14.95 ,$65.00 ,$12.41 ,$13.65 ,$16.45 ,$55.25 ,$38.83 ,$58.50 ,$54.60 ,$52.00 ,$52.00 ,$14.95 ,$42.25 ST. FRANCIS HOSPITAL - ACUTE,30101134,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T1,301,1 ,$155.00 ,$100.75 ,$29.09 ,$155.00 ,$111.60 ,$84.32 ,$35.65 ,$86.52 ,$35.65 ,$92.60 ,$92.60 ,$92.60 ,$92.60 ,$130.20 ,$35.65 ,$131.75 ,$130.20 ,$35.65 ,$116.25 ,$124.00 ,$124.00 ,$35.65 ,$124.00 ,$130.20 ,$130.20 ,$130.20 ,$139.50 ,$89.13 ,$35.65 ,$155.00 ,$29.09 ,$32.00 ,$39.22 ,$131.75 ,$92.60 ,$139.50 ,$130.20 ,$124.00 ,$124.00 ,$35.65 ,$100.75 ST. FRANCIS HOSPITAL - ACUTE,30101135,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T2,301,1 ,$206.00 ,$133.90 ,$29.09 ,$206.00 ,$148.32 ,$112.06 ,$47.38 ,$114.99 ,$47.38 ,$123.06 ,$123.06 ,$123.06 ,$123.06 ,$173.04 ,$47.38 ,$175.10 ,$173.04 ,$47.38 ,$154.50 ,$164.80 ,$164.80 ,$47.38 ,$164.80 ,$173.04 ,$173.04 ,$173.04 ,$185.40 ,$118.45 ,$47.38 ,$206.00 ,$29.09 ,$32.00 ,$52.12 ,$175.10 ,$123.06 ,$185.40 ,$173.04 ,$164.80 ,$164.80 ,$47.38 ,$133.90 ST. FRANCIS HOSPITAL - ACUTE,30101136,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T3,301,1 ,$301.00 ,$195.65 ,$29.09 ,$301.00 ,$216.72 ,$163.74 ,$69.23 ,$168.02 ,$69.23 ,$179.82 ,$179.82 ,$179.82 ,$179.82 ,$252.84 ,$69.23 ,$255.85 ,$252.84 ,$69.23 ,$225.75 ,$240.80 ,$240.80 ,$69.23 ,$240.80 ,$252.84 ,$252.84 ,$252.84 ,$270.90 ,$173.08 ,$69.23 ,$301.00 ,$29.09 ,$32.00 ,$76.15 ,$255.85 ,$179.82 ,$270.90 ,$252.84 ,$240.80 ,$240.80 ,$69.23 ,$195.65 ST. FRANCIS HOSPITAL - ACUTE,30101140,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T1-90,301,1 ,$155.00 ,$100.75 ,$29.09 ,$155.00 ,$111.60 ,$84.32 ,$35.65 ,$86.52 ,$35.65 ,$92.60 ,$92.60 ,$92.60 ,$92.60 ,$130.20 ,$35.65 ,$131.75 ,$130.20 ,$35.65 ,$116.25 ,$124.00 ,$124.00 ,$35.65 ,$124.00 ,$130.20 ,$130.20 ,$130.20 ,$139.50 ,$89.13 ,$35.65 ,$155.00 ,$29.09 ,$32.00 ,$39.22 ,$131.75 ,$92.60 ,$139.50 ,$130.20 ,$124.00 ,$124.00 ,$35.65 ,$100.75 ST. FRANCIS HOSPITAL - ACUTE,30101141,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T2-90,301,1 ,$59.00 ,$38.35 ,$13.57 ,$59.00 ,$42.48 ,$32.10 ,$13.57 ,$32.93 ,$13.57 ,$35.25 ,$35.25 ,$35.25 ,$35.25 ,$49.56 ,$13.57 ,$50.15 ,$49.56 ,$13.57 ,$44.25 ,$47.20 ,$47.20 ,$13.57 ,$47.20 ,$49.56 ,$49.56 ,$49.56 ,$53.10 ,$33.93 ,$13.57 ,$59.00 ,$29.09 ,$32.00 ,$14.93 ,$50.15 ,$35.25 ,$53.10 ,$49.56 ,$47.20 ,$47.20 ,$13.57 ,$38.35 ST. FRANCIS HOSPITAL - ACUTE,30101146,80323,HC NICOTINE - 90,301,1 ,$51.00 ,$33.15 ,$11.73 ,$51.00 ,$36.72 ,$27.74 ,$11.73 ,$28.47 ,$11.73 ,$30.47 ,$30.47 ,$30.47 ,$30.47 ,$42.84 ,$11.73 ,$43.35 ,$42.84 ,$11.73 ,$38.25 ,$40.80 ,$40.80 ,$11.73 ,$40.80 ,$42.84 ,$42.84 ,$42.84 ,$45.90 ,$29.33 ,$11.73 ,$51.00 ,$29.09 ,$32.00 ,$12.90 ,$43.35 ,$30.47 ,$45.90 ,$42.84 ,$40.80 ,$40.80 ,$11.73 ,$33.15 ST. FRANCIS HOSPITAL - ACUTE,30101148,80327,HC ANABOLIC STERIODS 1-2 - 90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$29.09 ,$32.00 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101151,80349,HC CANNABINOIDS NATURAL -90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$10.81 ,$11.89 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101153,80359,HC METHYLENEDIOXYAMPHETAMINES MDA MDEA MDMA -90,301,1 ,$127.00 ,$82.55 ,$10.81 ,$127.00 ,$91.44 ,$69.09 ,$29.21 ,$70.89 ,$29.21 ,$75.87 ,$75.87 ,$75.87 ,$75.87 ,$106.68 ,$29.21 ,$107.95 ,$106.68 ,$29.21 ,$95.25 ,$101.60 ,$101.60 ,$29.21 ,$101.60 ,$106.68 ,$106.68 ,$106.68 ,$114.30 ,$73.03 ,$29.21 ,$127.00 ,$10.81 ,$11.89 ,$32.13 ,$107.95 ,$75.87 ,$114.30 ,$106.68 ,$101.60 ,$101.60 ,$29.21 ,$82.55 ST. FRANCIS HOSPITAL - ACUTE,30101158,82024,HC ACTH -90,301,1 ,$212.00 ,$137.80 ,$25.29 ,$212.00 ,$152.64 ,$115.33 ,$48.76 ,$118.34 ,$48.76 ,$126.65 ,$126.65 ,$126.65 ,$126.65 ,$178.08 ,$48.76 ,$180.20 ,$178.08 ,$48.76 ,$159.00 ,$169.60 ,$169.60 ,$48.76 ,$169.60 ,$178.08 ,$178.08 ,$178.08 ,$190.80 ,$121.90 ,$48.76 ,$212.00 ,$25.29 ,$27.82 ,$53.64 ,$180.20 ,$126.65 ,$190.80 ,$178.08 ,$169.60 ,$169.60 ,$48.76 ,$137.80 ST. FRANCIS HOSPITAL - ACUTE,30101162,82085,HC ALDOLASE-90,301,1 ,$58.00 ,$37.70 ,$10.81 ,$58.00 ,$41.76 ,$31.55 ,$13.34 ,$32.38 ,$13.34 ,$34.65 ,$34.65 ,$34.65 ,$34.65 ,$48.72 ,$13.34 ,$49.30 ,$48.72 ,$13.34 ,$43.50 ,$46.40 ,$46.40 ,$13.34 ,$46.40 ,$48.72 ,$48.72 ,$48.72 ,$52.20 ,$33.35 ,$13.34 ,$58.00 ,$10.81 ,$11.89 ,$14.67 ,$49.30 ,$34.65 ,$52.20 ,$48.72 ,$46.40 ,$46.40 ,$13.34 ,$37.70 ST. FRANCIS HOSPITAL - ACUTE,30101163,82088,HC ALDOSTERONE-90,301,1 ,$227.00 ,$147.55 ,$25.29 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 ,$25.29 ,$27.82 ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,30101164,82103,HC ALPHA-1 ANTITRYPSIN TOTAL-90,301,1 ,$87.00 ,$56.55 ,$10.81 ,$87.00 ,$62.64 ,$47.33 ,$20.01 ,$48.56 ,$20.01 ,$51.97 ,$51.97 ,$51.97 ,$51.97 ,$73.08 ,$20.01 ,$73.95 ,$73.08 ,$20.01 ,$65.25 ,$69.60 ,$69.60 ,$20.01 ,$69.60 ,$73.08 ,$73.08 ,$73.08 ,$78.30 ,$50.03 ,$20.01 ,$87.00 ,$10.81 ,$11.89 ,$22.01 ,$73.95 ,$51.97 ,$78.30 ,$73.08 ,$69.60 ,$69.60 ,$20.01 ,$56.55 ST. FRANCIS HOSPITAL - ACUTE,30101165,82104,HC ALPHA-1 ANTITRYPSIN PHENO-90,301,1 ,$165.00 ,$107.25 ,$10.81 ,$165.00 ,$118.80 ,$89.76 ,$37.95 ,$92.10 ,$37.95 ,$98.57 ,$98.57 ,$98.57 ,$98.57 ,$138.60 ,$37.95 ,$140.25 ,$138.60 ,$37.95 ,$123.75 ,$132.00 ,$132.00 ,$37.95 ,$132.00 ,$138.60 ,$138.60 ,$138.60 ,$148.50 ,$94.88 ,$37.95 ,$165.00 ,$10.81 ,$11.89 ,$41.75 ,$140.25 ,$98.57 ,$148.50 ,$138.60 ,$132.00 ,$132.00 ,$37.95 ,$107.25 ST. FRANCIS HOSPITAL - ACUTE,30101166,82105,HC ALPHA FETOPROTEIN SERUM-90,301,1 ,$92.00 ,$59.80 ,$10.81 ,$92.00 ,$66.24 ,$50.05 ,$21.16 ,$51.35 ,$21.16 ,$54.96 ,$54.96 ,$54.96 ,$54.96 ,$77.28 ,$21.16 ,$78.20 ,$77.28 ,$21.16 ,$69.00 ,$73.60 ,$73.60 ,$21.16 ,$73.60 ,$77.28 ,$77.28 ,$77.28 ,$82.80 ,$52.90 ,$21.16 ,$92.00 ,$10.81 ,$11.89 ,$23.28 ,$78.20 ,$54.96 ,$82.80 ,$77.28 ,$73.60 ,$73.60 ,$21.16 ,$59.80 ST. FRANCIS HOSPITAL - ACUTE,30101169,82108,HC ALUMINUM-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$13.18 ,$14.50 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101172,82131,HC AMINO ACID QN SINGLE-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$10.81 ,$11.89 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101175,82139,HC AMINO ACIDS 6+ QN CSF-90,301,1 ,$121.00 ,$78.65 ,$10.81 ,$121.00 ,$87.12 ,$65.82 ,$27.83 ,$67.54 ,$27.83 ,$72.29 ,$72.29 ,$72.29 ,$72.29 ,$101.64 ,$27.83 ,$102.85 ,$101.64 ,$27.83 ,$90.75 ,$96.80 ,$96.80 ,$27.83 ,$96.80 ,$101.64 ,$101.64 ,$101.64 ,$108.90 ,$69.58 ,$27.83 ,$121.00 ,$10.81 ,$11.89 ,$30.61 ,$102.85 ,$72.29 ,$108.90 ,$101.64 ,$96.80 ,$96.80 ,$27.83 ,$78.65 ST. FRANCIS HOSPITAL - ACUTE,30101176,82140,HC AMMONIA-90,301,1 ,$55.00 ,$35.75 ,$10.81 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 ,$10.81 ,$11.89 ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,30101178,82157,HC ANDROSTENEDIONE-90,301,1 ,$102.00 ,$66.30 ,$23.46 ,$102.00 ,$73.44 ,$55.49 ,$23.46 ,$56.94 ,$23.46 ,$60.93 ,$60.93 ,$60.93 ,$60.93 ,$85.68 ,$23.46 ,$86.70 ,$85.68 ,$23.46 ,$76.50 ,$81.60 ,$81.60 ,$23.46 ,$81.60 ,$85.68 ,$85.68 ,$85.68 ,$91.80 ,$58.65 ,$23.46 ,$102.00 ,$25.29 ,$27.82 ,$25.81 ,$86.70 ,$60.93 ,$91.80 ,$85.68 ,$81.60 ,$81.60 ,$23.46 ,$66.30 ST. FRANCIS HOSPITAL - ACUTE,30101179,82164,HC ANGIOTENSIN 1 ENZYME (ACE)-90,301,1 ,$46.00 ,$29.90 ,$10.58 ,$46.00 ,$33.12 ,$25.02 ,$10.58 ,$25.68 ,$10.58 ,$27.48 ,$27.48 ,$27.48 ,$27.48 ,$38.64 ,$10.58 ,$39.10 ,$38.64 ,$10.58 ,$34.50 ,$36.80 ,$36.80 ,$10.58 ,$36.80 ,$38.64 ,$38.64 ,$38.64 ,$41.40 ,$26.45 ,$10.58 ,$46.00 ,$10.81 ,$11.89 ,$11.64 ,$39.10 ,$27.48 ,$41.40 ,$38.64 ,$36.80 ,$36.80 ,$10.58 ,$29.90 ST. FRANCIS HOSPITAL - ACUTE,30101180,82172,HC APOLIPOPROTEIN SERUM-90,301,1 ,$37.00 ,$24.05 ,$8.51 ,$37.00 ,$26.64 ,$20.13 ,$8.51 ,$20.65 ,$8.51 ,$22.10 ,$22.10 ,$22.10 ,$22.10 ,$31.08 ,$8.51 ,$31.45 ,$31.08 ,$8.51 ,$27.75 ,$29.60 ,$29.60 ,$8.51 ,$29.60 ,$31.08 ,$31.08 ,$31.08 ,$33.30 ,$21.28 ,$8.51 ,$37.00 ,$10.81 ,$11.89 ,$9.36 ,$31.45 ,$22.10 ,$33.30 ,$31.08 ,$29.60 ,$29.60 ,$8.51 ,$24.05 ST. FRANCIS HOSPITAL - ACUTE,30101181,82175,HC ARSENIC-90,301,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$13.18 ,$14.50 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101182,82180,HC VITAMIN C (ASCORBIC ACID)-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$10.81 ,$11.89 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101184,82232,HC BETA 2 MICROGLOBULIN-90,301,1 ,$62.00 ,$40.30 ,$14.26 ,$62.00 ,$44.64 ,$33.73 ,$14.26 ,$34.61 ,$14.26 ,$37.04 ,$37.04 ,$37.04 ,$37.04 ,$52.08 ,$14.26 ,$52.70 ,$52.08 ,$14.26 ,$46.50 ,$49.60 ,$49.60 ,$14.26 ,$49.60 ,$52.08 ,$52.08 ,$52.08 ,$55.80 ,$35.65 ,$14.26 ,$62.00 ,$25.29 ,$27.82 ,$15.69 ,$52.70 ,$37.04 ,$55.80 ,$52.08 ,$49.60 ,$49.60 ,$14.26 ,$40.30 ST. FRANCIS HOSPITAL - ACUTE,30101185,82239,HC BILE ACID TOTAL-90,301,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$10.81 ,$11.89 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30101186,82247,HC BILIRUBIN TOTAL-90,301,1 ,$37.00 ,$24.05 ,$4.81 ,$37.00 ,$26.64 ,$20.13 ,$8.51 ,$20.65 ,$8.51 ,$22.10 ,$22.10 ,$22.10 ,$22.10 ,$31.08 ,$8.51 ,$31.45 ,$31.08 ,$8.51 ,$27.75 ,$29.60 ,$29.60 ,$8.51 ,$29.60 ,$31.08 ,$31.08 ,$31.08 ,$33.30 ,$21.28 ,$8.51 ,$37.00 ,$4.81 ,$5.29 ,$9.36 ,$31.45 ,$22.10 ,$33.30 ,$31.08 ,$29.60 ,$29.60 ,$8.51 ,$24.05 ST. FRANCIS HOSPITAL - ACUTE,30101188,82270,HC OCCULT BLOOD FECAL SCRN,301,1 ,$61.00 ,$39.65 ,$4.81 ,$61.00 ,$43.92 ,$33.18 ,$14.03 ,$34.05 ,$14.03 ,$36.44 ,$36.44 ,$36.44 ,$36.44 ,$51.24 ,$14.03 ,$51.85 ,$51.24 ,$14.03 ,$45.75 ,$48.80 ,$48.80 ,$14.03 ,$48.80 ,$51.24 ,$51.24 ,$51.24 ,$54.90 ,$35.08 ,$14.03 ,$61.00 ,$4.81 ,$5.29 ,$15.43 ,$51.85 ,$36.44 ,$54.90 ,$51.24 ,$48.80 ,$48.80 ,$14.03 ,$39.65 ST. FRANCIS HOSPITAL - ACUTE,30101191,82271,HC OCCULT BLOOD GASTRIC,301,1 ,$50.00 ,$32.50 ,$4.81 ,$50.00 ,$36.00 ,$27.20 ,$11.50 ,$27.91 ,$11.50 ,$29.87 ,$29.87 ,$29.87 ,$29.87 ,$42.00 ,$11.50 ,$42.50 ,$42.00 ,$11.50 ,$37.50 ,$40.00 ,$40.00 ,$11.50 ,$40.00 ,$42.00 ,$42.00 ,$42.00 ,$45.00 ,$28.75 ,$11.50 ,$50.00 ,$4.81 ,$5.29 ,$12.65 ,$42.50 ,$29.87 ,$45.00 ,$42.00 ,$40.00 ,$40.00 ,$11.50 ,$32.50 ST. FRANCIS HOSPITAL - ACUTE,30101196,82300,HC CADMIUM-90,301,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$13.18 ,$14.50 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101197,82306,HC VITAMIN D 25 OH-90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$29.09 ,$32.00 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101199,82308,HC CALCITONIN-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$25.29 ,$27.82 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101203,82340,HC CALCIUM URINE QN TIMED-90,301,1 ,$55.00 ,$35.75 ,$10.81 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 ,$10.81 ,$11.89 ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,30101205,82365,HC CALCULUS ANLYS INFRARED-90,301,1 ,$88.00 ,$57.20 ,$10.81 ,$88.00 ,$63.36 ,$47.87 ,$20.24 ,$49.12 ,$20.24 ,$52.57 ,$52.57 ,$52.57 ,$52.57 ,$73.92 ,$20.24 ,$74.80 ,$73.92 ,$20.24 ,$66.00 ,$70.40 ,$70.40 ,$20.24 ,$70.40 ,$73.92 ,$73.92 ,$73.92 ,$79.20 ,$50.60 ,$20.24 ,$88.00 ,$10.81 ,$11.89 ,$22.26 ,$74.80 ,$52.57 ,$79.20 ,$73.92 ,$70.40 ,$70.40 ,$20.24 ,$57.20 ST. FRANCIS HOSPITAL - ACUTE,30101209,82379,HC CARNITINE TOTAL AND FREE QN-90,301,1 ,$159.00 ,$103.35 ,$10.81 ,$159.00 ,$114.48 ,$86.50 ,$36.57 ,$88.75 ,$36.57 ,$94.99 ,$94.99 ,$94.99 ,$94.99 ,$133.56 ,$36.57 ,$135.15 ,$133.56 ,$36.57 ,$119.25 ,$127.20 ,$127.20 ,$36.57 ,$127.20 ,$133.56 ,$133.56 ,$133.56 ,$143.10 ,$91.43 ,$36.57 ,$159.00 ,$10.81 ,$11.89 ,$40.23 ,$135.15 ,$94.99 ,$143.10 ,$133.56 ,$127.20 ,$127.20 ,$36.57 ,$103.35 ST. FRANCIS HOSPITAL - ACUTE,30101210,82380,HC CAROTENE-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$10.81 ,$11.89 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101211,82384,HC CATECHOLAMINE FRACTION-90,301,1 ,$67.00 ,$43.55 ,$15.41 ,$67.00 ,$48.24 ,$36.45 ,$15.41 ,$37.40 ,$15.41 ,$40.03 ,$40.03 ,$40.03 ,$40.03 ,$56.28 ,$15.41 ,$56.95 ,$56.28 ,$15.41 ,$50.25 ,$53.60 ,$53.60 ,$15.41 ,$53.60 ,$56.28 ,$56.28 ,$56.28 ,$60.30 ,$38.53 ,$15.41 ,$67.00 ,$25.29 ,$27.82 ,$16.95 ,$56.95 ,$40.03 ,$60.30 ,$56.28 ,$53.60 ,$53.60 ,$15.41 ,$43.55 ST. FRANCIS HOSPITAL - ACUTE,30101212,82390,HC CERULOPLASMIN-90,301,1 ,$84.00 ,$54.60 ,$10.81 ,$84.00 ,$60.48 ,$45.70 ,$19.32 ,$46.89 ,$19.32 ,$50.18 ,$50.18 ,$50.18 ,$50.18 ,$70.56 ,$19.32 ,$71.40 ,$70.56 ,$19.32 ,$63.00 ,$67.20 ,$67.20 ,$19.32 ,$67.20 ,$70.56 ,$70.56 ,$70.56 ,$75.60 ,$48.30 ,$19.32 ,$84.00 ,$10.81 ,$11.89 ,$21.25 ,$71.40 ,$50.18 ,$75.60 ,$70.56 ,$67.20 ,$67.20 ,$19.32 ,$54.60 ST. FRANCIS HOSPITAL - ACUTE,30101213,82397,HC CHEMILUMINESCENT ASSAY-90,301,1 ,$34.00 ,$22.10 ,$7.82 ,$34.00 ,$24.48 ,$18.50 ,$7.82 ,$18.98 ,$7.82 ,$20.31 ,$20.31 ,$20.31 ,$20.31 ,$28.56 ,$7.82 ,$28.90 ,$28.56 ,$7.82 ,$25.50 ,$27.20 ,$27.20 ,$7.82 ,$27.20 ,$28.56 ,$28.56 ,$28.56 ,$30.60 ,$19.55 ,$7.82 ,$34.00 ,$10.81 ,$11.89 ,$8.60 ,$28.90 ,$20.31 ,$30.60 ,$28.56 ,$27.20 ,$27.20 ,$7.82 ,$22.10 ST. FRANCIS HOSPITAL - ACUTE,30101218,82495,HC CHROMIUM SERUM-90,301,1 ,$87.00 ,$56.55 ,$13.18 ,$87.00 ,$62.64 ,$47.33 ,$20.01 ,$48.56 ,$20.01 ,$51.97 ,$51.97 ,$51.97 ,$51.97 ,$73.08 ,$20.01 ,$73.95 ,$73.08 ,$20.01 ,$65.25 ,$69.60 ,$69.60 ,$20.01 ,$69.60 ,$73.08 ,$73.08 ,$73.08 ,$78.30 ,$50.03 ,$20.01 ,$87.00 ,$13.18 ,$14.50 ,$22.01 ,$73.95 ,$51.97 ,$78.30 ,$73.08 ,$69.60 ,$69.60 ,$20.01 ,$56.55 ST. FRANCIS HOSPITAL - ACUTE,30101219,82507,HC CITRATE-90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$10.81 ,$11.89 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101220,82523,HC COLLAGEN CROSS LINKS ANY METHOD-90,301,1 ,$191.00 ,$124.15 ,$16.68 ,$191.00 ,$137.52 ,$103.90 ,$43.93 ,$106.62 ,$43.93 ,$114.10 ,$114.10 ,$114.10 ,$114.10 ,$160.44 ,$43.93 ,$162.35 ,$160.44 ,$43.93 ,$143.25 ,$152.80 ,$152.80 ,$43.93 ,$152.80 ,$160.44 ,$160.44 ,$160.44 ,$171.90 ,$109.83 ,$43.93 ,$191.00 ,$16.68 ,$18.35 ,$48.32 ,$162.35 ,$114.10 ,$171.90 ,$160.44 ,$152.80 ,$152.80 ,$43.93 ,$124.15 ST. FRANCIS HOSPITAL - ACUTE,30101221,82525,HC COPPER-90,301,1 ,$71.00 ,$46.15 ,$13.18 ,$71.00 ,$51.12 ,$38.62 ,$16.33 ,$39.63 ,$16.33 ,$42.42 ,$42.42 ,$42.42 ,$42.42 ,$59.64 ,$16.33 ,$60.35 ,$59.64 ,$16.33 ,$53.25 ,$56.80 ,$56.80 ,$16.33 ,$56.80 ,$59.64 ,$59.64 ,$59.64 ,$63.90 ,$40.83 ,$16.33 ,$71.00 ,$13.18 ,$14.50 ,$17.96 ,$60.35 ,$42.42 ,$63.90 ,$59.64 ,$56.80 ,$56.80 ,$16.33 ,$46.15 ST. FRANCIS HOSPITAL - ACUTE,30101222,82530,HC CORTISOL FREE-90,301,1 ,$142.00 ,$92.30 ,$10.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$10.81 ,$11.89 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30101223,82533,HC CORTISOL TOTAL-90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$25.29 ,$27.82 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101224,82542,HC CHROMO SPECTROMETRY -90,301,1 ,$110.00 ,$71.50 ,$10.81 ,$110.00 ,$79.20 ,$59.84 ,$25.30 ,$61.40 ,$25.30 ,$65.71 ,$65.71 ,$65.71 ,$65.71 ,$92.40 ,$25.30 ,$93.50 ,$92.40 ,$25.30 ,$82.50 ,$88.00 ,$88.00 ,$25.30 ,$88.00 ,$92.40 ,$92.40 ,$92.40 ,$99.00 ,$63.25 ,$25.30 ,$110.00 ,$10.81 ,$11.89 ,$27.83 ,$93.50 ,$65.71 ,$99.00 ,$92.40 ,$88.00 ,$88.00 ,$25.30 ,$71.50 ST. FRANCIS HOSPITAL - ACUTE,30101225,82550,HC CREATINE KINASE (CPK) TOTAL-90,301,1 ,$171.00 ,$111.15 ,$4.81 ,$171.00 ,$123.12 ,$93.02 ,$39.33 ,$95.45 ,$39.33 ,$102.16 ,$102.16 ,$102.16 ,$102.16 ,$143.64 ,$39.33 ,$145.35 ,$143.64 ,$39.33 ,$128.25 ,$136.80 ,$136.80 ,$39.33 ,$136.80 ,$143.64 ,$143.64 ,$143.64 ,$153.90 ,$98.33 ,$39.33 ,$171.00 ,$4.81 ,$5.29 ,$43.26 ,$145.35 ,$102.16 ,$153.90 ,$143.64 ,$136.80 ,$136.80 ,$39.33 ,$111.15 ST. FRANCIS HOSPITAL - ACUTE,30101226,82552,HC CREATINE KINASE (CPK) ISO-90,301,1 ,$52.00 ,$33.80 ,$10.81 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 ,$10.81 ,$11.89 ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,30101231,82570,HC CREATININE OTH SOURCE-90,301,1 ,$146.00 ,$94.90 ,$4.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$4.81 ,$5.29 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30101233,82595,HC CRYOGLOBULIN QL OR SQN-90,301,1 ,$88.00 ,$57.20 ,$10.81 ,$88.00 ,$63.36 ,$47.87 ,$20.24 ,$49.12 ,$20.24 ,$52.57 ,$52.57 ,$52.57 ,$52.57 ,$73.92 ,$20.24 ,$74.80 ,$73.92 ,$20.24 ,$66.00 ,$70.40 ,$70.40 ,$20.24 ,$70.40 ,$73.92 ,$73.92 ,$73.92 ,$79.20 ,$50.60 ,$20.24 ,$88.00 ,$10.81 ,$11.89 ,$22.26 ,$74.80 ,$52.57 ,$79.20 ,$73.92 ,$70.40 ,$70.40 ,$20.24 ,$57.20 ST. FRANCIS HOSPITAL - ACUTE,30101238,82627,HC DHEA SULFATE-90,301,1 ,$156.00 ,$101.40 ,$25.29 ,$156.00 ,$112.32 ,$84.86 ,$35.88 ,$87.08 ,$35.88 ,$93.19 ,$93.19 ,$93.19 ,$93.19 ,$131.04 ,$35.88 ,$132.60 ,$131.04 ,$35.88 ,$117.00 ,$124.80 ,$124.80 ,$35.88 ,$124.80 ,$131.04 ,$131.04 ,$131.04 ,$140.40 ,$89.70 ,$35.88 ,$156.00 ,$25.29 ,$27.82 ,$39.47 ,$132.60 ,$93.19 ,$140.40 ,$131.04 ,$124.80 ,$124.80 ,$35.88 ,$101.40 ST. FRANCIS HOSPITAL - ACUTE,30101240,82652,HC VITAMIN D (1 25 DIHYDROXY)-90,301,1 ,$255.00 ,$165.75 ,$29.09 ,$255.00 ,$183.60 ,$138.72 ,$58.65 ,$142.34 ,$58.65 ,$152.34 ,$152.34 ,$152.34 ,$152.34 ,$214.20 ,$58.65 ,$216.75 ,$214.20 ,$58.65 ,$191.25 ,$204.00 ,$204.00 ,$58.65 ,$204.00 ,$214.20 ,$214.20 ,$214.20 ,$229.50 ,$146.63 ,$58.65 ,$255.00 ,$29.09 ,$32.00 ,$64.52 ,$216.75 ,$152.34 ,$229.50 ,$214.20 ,$204.00 ,$204.00 ,$58.65 ,$165.75 ST. FRANCIS HOSPITAL - ACUTE,30101241,82656,HC ELASTASE PANCREATIC EL1 FECAL QL OR SQN-90,301,1 ,$67.00 ,$43.55 ,$10.81 ,$67.00 ,$48.24 ,$36.45 ,$15.41 ,$37.40 ,$15.41 ,$40.03 ,$40.03 ,$40.03 ,$40.03 ,$56.28 ,$15.41 ,$56.95 ,$56.28 ,$15.41 ,$50.25 ,$53.60 ,$53.60 ,$15.41 ,$53.60 ,$56.28 ,$56.28 ,$56.28 ,$60.30 ,$38.53 ,$15.41 ,$67.00 ,$10.81 ,$11.89 ,$16.95 ,$56.95 ,$40.03 ,$60.30 ,$56.28 ,$53.60 ,$53.60 ,$15.41 ,$43.55 ST. FRANCIS HOSPITAL - ACUTE,30101242,82657,HC ENZYME ACT NONRAD SUBS-90,301,1 ,$79.00 ,$51.35 ,$10.81 ,$79.00 ,$56.88 ,$42.98 ,$18.17 ,$44.10 ,$18.17 ,$47.19 ,$47.19 ,$47.19 ,$47.19 ,$66.36 ,$18.17 ,$67.15 ,$66.36 ,$18.17 ,$59.25 ,$63.20 ,$63.20 ,$18.17 ,$63.20 ,$66.36 ,$66.36 ,$66.36 ,$71.10 ,$45.43 ,$18.17 ,$79.00 ,$10.81 ,$11.89 ,$19.99 ,$67.15 ,$47.19 ,$71.10 ,$66.36 ,$63.20 ,$63.20 ,$18.17 ,$51.35 ST. FRANCIS HOSPITAL - ACUTE,30101245,82668,HC ERYTHROPOIETIN-90,301,1 ,$207.00 ,$134.55 ,$10.81 ,$207.00 ,$149.04 ,$112.61 ,$47.61 ,$115.55 ,$47.61 ,$123.66 ,$123.66 ,$123.66 ,$123.66 ,$173.88 ,$47.61 ,$175.95 ,$173.88 ,$47.61 ,$155.25 ,$165.60 ,$165.60 ,$47.61 ,$165.60 ,$173.88 ,$173.88 ,$173.88 ,$186.30 ,$119.03 ,$47.61 ,$207.00 ,$10.81 ,$11.89 ,$52.37 ,$175.95 ,$123.66 ,$186.30 ,$173.88 ,$165.60 ,$165.60 ,$47.61 ,$134.55 ST. FRANCIS HOSPITAL - ACUTE,30101246,82670,HC ESTRADIOL-90,301,1 ,$120.00 ,$78.00 ,$25.29 ,$120.00 ,$86.40 ,$65.28 ,$27.60 ,$66.98 ,$27.60 ,$71.69 ,$71.69 ,$71.69 ,$71.69 ,$100.80 ,$27.60 ,$102.00 ,$100.80 ,$27.60 ,$90.00 ,$96.00 ,$96.00 ,$27.60 ,$96.00 ,$100.80 ,$100.80 ,$100.80 ,$108.00 ,$69.00 ,$27.60 ,$120.00 ,$25.29 ,$27.82 ,$30.36 ,$102.00 ,$71.69 ,$108.00 ,$100.80 ,$96.00 ,$96.00 ,$27.60 ,$78.00 ST. FRANCIS HOSPITAL - ACUTE,30101247,82670,HC ESTRADIOL FREE-90,301,1 ,$87.00 ,$56.55 ,$20.01 ,$87.00 ,$62.64 ,$47.33 ,$20.01 ,$48.56 ,$20.01 ,$51.97 ,$51.97 ,$51.97 ,$51.97 ,$73.08 ,$20.01 ,$73.95 ,$73.08 ,$20.01 ,$65.25 ,$69.60 ,$69.60 ,$20.01 ,$69.60 ,$73.08 ,$73.08 ,$73.08 ,$78.30 ,$50.03 ,$20.01 ,$87.00 ,$25.29 ,$27.82 ,$22.01 ,$73.95 ,$51.97 ,$78.30 ,$73.08 ,$69.60 ,$69.60 ,$20.01 ,$56.55 ST. FRANCIS HOSPITAL - ACUTE,30101249,82672,HC ESTROGEN TOTAL-90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$25.29 ,$27.82 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101250,82677,HC ESTRIOL-90,301,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 ,$25.29 ,$27.82 ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,30101251,82679,HC ESTRONE-90,301,1 ,$99.00 ,$64.35 ,$22.77 ,$99.00 ,$71.28 ,$53.86 ,$22.77 ,$55.26 ,$22.77 ,$59.14 ,$59.14 ,$59.14 ,$59.14 ,$83.16 ,$22.77 ,$84.15 ,$83.16 ,$22.77 ,$74.25 ,$79.20 ,$79.20 ,$22.77 ,$79.20 ,$83.16 ,$83.16 ,$83.16 ,$89.10 ,$56.93 ,$22.77 ,$99.00 ,$25.29 ,$27.82 ,$25.05 ,$84.15 ,$59.14 ,$89.10 ,$83.16 ,$79.20 ,$79.20 ,$22.77 ,$64.35 ST. FRANCIS HOSPITAL - ACUTE,30101253,82705,HC FECAL FAT QUALITATIVE-90,301,1 ,$24.00 ,$15.60 ,$4.81 ,$24.00 ,$17.28 ,$13.06 ,$5.52 ,$13.40 ,$5.52 ,$14.34 ,$14.34 ,$14.34 ,$14.34 ,$20.16 ,$5.52 ,$20.40 ,$20.16 ,$5.52 ,$18.00 ,$19.20 ,$19.20 ,$5.52 ,$19.20 ,$20.16 ,$20.16 ,$20.16 ,$21.60 ,$13.80 ,$5.52 ,$24.00 ,$4.81 ,$5.29 ,$6.07 ,$20.40 ,$14.34 ,$21.60 ,$20.16 ,$19.20 ,$19.20 ,$5.52 ,$15.60 ST. FRANCIS HOSPITAL - ACUTE,30101256,82728,HC FERRITIN-90,301,1 ,$11.00 ,$7.15 ,$2.53 ,$11.89 ,$7.92 ,$5.98 ,$2.53 ,$6.14 ,$2.53 ,$6.57 ,$6.57 ,$6.57 ,$6.57 ,$9.24 ,$2.53 ,$9.35 ,$9.24 ,$2.53 ,$8.25 ,$8.80 ,$8.80 ,$2.53 ,$8.80 ,$9.24 ,$9.24 ,$9.24 ,$9.90 ,$6.33 ,$2.53 ,$11.00 ,$10.81 ,$11.89 ,$2.78 ,$9.35 ,$6.57 ,$9.90 ,$9.24 ,$8.80 ,$8.80 ,$2.53 ,$7.15 ST. FRANCIS HOSPITAL - ACUTE,30101259,82747,HC FOLIC ACID RBC-90,301,1 ,$128.00 ,$83.20 ,$6.71 ,$128.00 ,$92.16 ,$69.63 ,$29.44 ,$71.45 ,$29.44 ,$76.47 ,$76.47 ,$76.47 ,$76.47 ,$107.52 ,$29.44 ,$108.80 ,$107.52 ,$29.44 ,$96.00 ,$102.40 ,$102.40 ,$29.44 ,$102.40 ,$107.52 ,$107.52 ,$107.52 ,$115.20 ,$73.60 ,$29.44 ,$128.00 ,$6.71 ,$7.38 ,$32.38 ,$108.80 ,$76.47 ,$115.20 ,$107.52 ,$102.40 ,$102.40 ,$29.44 ,$83.20 ST. FRANCIS HOSPITAL - ACUTE,30101262,82784,HC GAMMAGLOBULIN-90,301,1 ,$51.00 ,$33.15 ,$10.81 ,$51.00 ,$36.72 ,$27.74 ,$11.73 ,$28.47 ,$11.73 ,$30.47 ,$30.47 ,$30.47 ,$30.47 ,$42.84 ,$11.73 ,$43.35 ,$42.84 ,$11.73 ,$38.25 ,$40.80 ,$40.80 ,$11.73 ,$40.80 ,$42.84 ,$42.84 ,$42.84 ,$45.90 ,$29.33 ,$11.73 ,$51.00 ,$10.81 ,$11.89 ,$12.90 ,$43.35 ,$30.47 ,$45.90 ,$42.84 ,$40.80 ,$40.80 ,$11.73 ,$33.15 ST. FRANCIS HOSPITAL - ACUTE,30101265,82787,HC IMMUNOGLOBULIN SUBCLASSES-90,301,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$16.68 ,$18.35 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101268,82941,HC GASTRIN-90,301,1 ,$108.00 ,$70.20 ,$24.84 ,$108.00 ,$77.76 ,$58.75 ,$24.84 ,$60.29 ,$24.84 ,$64.52 ,$64.52 ,$64.52 ,$64.52 ,$90.72 ,$24.84 ,$91.80 ,$90.72 ,$24.84 ,$81.00 ,$86.40 ,$86.40 ,$24.84 ,$86.40 ,$90.72 ,$90.72 ,$90.72 ,$97.20 ,$62.10 ,$24.84 ,$108.00 ,$25.29 ,$27.82 ,$27.32 ,$91.80 ,$64.52 ,$97.20 ,$90.72 ,$86.40 ,$86.40 ,$24.84 ,$70.20 ST. FRANCIS HOSPITAL - ACUTE,30101273,82948,HC GLUCOSE BLOOD REAGENT STRIP,301,1 ,$42.00 ,$27.30 ,$2.43 ,$42.00 ,$30.24 ,$22.85 ,$9.66 ,$23.44 ,$9.66 ,$25.09 ,$25.09 ,$25.09 ,$25.09 ,$35.28 ,$9.66 ,$35.70 ,$35.28 ,$9.66 ,$31.50 ,$33.60 ,$33.60 ,$9.66 ,$33.60 ,$35.28 ,$35.28 ,$35.28 ,$37.80 ,$24.15 ,$9.66 ,$42.00 ,$2.43 ,$2.67 ,$10.63 ,$35.70 ,$25.09 ,$37.80 ,$35.28 ,$33.60 ,$33.60 ,$9.66 ,$27.30 ST. FRANCIS HOSPITAL - ACUTE,30101274,82955,HC G6PD ENZYME QN-90,301,1 ,$52.00 ,$33.80 ,$10.81 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 ,$10.81 ,$11.89 ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,30101275,82977,HC GGT/GGTP-90,301,1 ,$37.00 ,$24.05 ,$4.81 ,$37.00 ,$26.64 ,$20.13 ,$8.51 ,$20.65 ,$8.51 ,$22.10 ,$22.10 ,$22.10 ,$22.10 ,$31.08 ,$8.51 ,$31.45 ,$31.08 ,$8.51 ,$27.75 ,$29.60 ,$29.60 ,$8.51 ,$29.60 ,$31.08 ,$31.08 ,$31.08 ,$33.30 ,$21.28 ,$8.51 ,$37.00 ,$4.81 ,$5.29 ,$9.36 ,$31.45 ,$22.10 ,$33.30 ,$31.08 ,$29.60 ,$29.60 ,$8.51 ,$24.05 ST. FRANCIS HOSPITAL - ACUTE,30101276,82985,HC FRUCTOSAMINE-90,301,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$10.81 ,$11.89 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101279,83003,HC GROWTH HORMONE (HGH)-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$25.29 ,$27.82 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101281,83010,HC HAPTOGLOBIN-90,301,1 ,$71.00 ,$46.15 ,$10.81 ,$71.00 ,$51.12 ,$38.62 ,$16.33 ,$39.63 ,$16.33 ,$42.42 ,$42.42 ,$42.42 ,$42.42 ,$59.64 ,$16.33 ,$60.35 ,$59.64 ,$16.33 ,$53.25 ,$56.80 ,$56.80 ,$16.33 ,$56.80 ,$59.64 ,$59.64 ,$59.64 ,$63.90 ,$40.83 ,$16.33 ,$71.00 ,$10.81 ,$11.89 ,$17.96 ,$60.35 ,$42.42 ,$63.90 ,$59.64 ,$56.80 ,$56.80 ,$16.33 ,$46.15 ST. FRANCIS HOSPITAL - ACUTE,30101282,83013,HC H PYLORI BREATH TEST-90,301,1 ,$162.00 ,$105.30 ,$29.09 ,$162.00 ,$116.64 ,$88.13 ,$37.26 ,$90.43 ,$37.26 ,$96.78 ,$96.78 ,$96.78 ,$96.78 ,$136.08 ,$37.26 ,$137.70 ,$136.08 ,$37.26 ,$121.50 ,$129.60 ,$129.60 ,$37.26 ,$129.60 ,$136.08 ,$136.08 ,$136.08 ,$145.80 ,$93.15 ,$37.26 ,$162.00 ,$29.09 ,$32.00 ,$40.99 ,$137.70 ,$96.78 ,$145.80 ,$136.08 ,$129.60 ,$129.60 ,$37.26 ,$105.30 ST. FRANCIS HOSPITAL - ACUTE,30101283,83018,HC HEAVY METAL QN EACH-90,301,1 ,$63.00 ,$40.95 ,$13.18 ,$63.00 ,$45.36 ,$34.27 ,$14.49 ,$35.17 ,$14.49 ,$37.64 ,$37.64 ,$37.64 ,$37.64 ,$52.92 ,$14.49 ,$53.55 ,$52.92 ,$14.49 ,$47.25 ,$50.40 ,$50.40 ,$14.49 ,$50.40 ,$52.92 ,$52.92 ,$52.92 ,$56.70 ,$36.23 ,$14.49 ,$63.00 ,$13.18 ,$14.50 ,$15.94 ,$53.55 ,$37.64 ,$56.70 ,$52.92 ,$50.40 ,$50.40 ,$14.49 ,$40.95 ST. FRANCIS HOSPITAL - ACUTE,30101285,83021,HC HEMOGLOBIN FRACT QN-90,301,1 ,$11.00 ,$7.15 ,$2.53 ,$11.23 ,$7.92 ,$5.98 ,$2.53 ,$6.14 ,$2.53 ,$6.57 ,$6.57 ,$6.57 ,$6.57 ,$9.24 ,$2.53 ,$9.35 ,$9.24 ,$2.53 ,$8.25 ,$8.80 ,$8.80 ,$2.53 ,$8.80 ,$9.24 ,$9.24 ,$9.24 ,$9.90 ,$6.33 ,$2.53 ,$11.00 ,$10.21 ,$11.23 ,$2.78 ,$9.35 ,$6.57 ,$9.90 ,$9.24 ,$8.80 ,$8.80 ,$2.53 ,$7.15 ST. FRANCIS HOSPITAL - ACUTE,30101294,83497,HC HYDROXYINDOLACET 5 (HIAA)-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$14.55 ,$16.01 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101295,83498,HC HYDROXYPROGESTERONE 17D-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$25.29 ,$27.82 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101297,83516,HC MLT NON INFECT QL/SQ-90,301,1 ,$91.00 ,$59.15 ,$9.68 ,$91.00 ,$65.52 ,$49.50 ,$20.93 ,$50.80 ,$20.93 ,$54.36 ,$54.36 ,$54.36 ,$54.36 ,$76.44 ,$20.93 ,$77.35 ,$76.44 ,$20.93 ,$68.25 ,$72.80 ,$72.80 ,$20.93 ,$72.80 ,$76.44 ,$76.44 ,$76.44 ,$81.90 ,$52.33 ,$20.93 ,$91.00 ,$9.68 ,$10.65 ,$23.02 ,$77.35 ,$54.36 ,$81.90 ,$76.44 ,$72.80 ,$72.80 ,$20.93 ,$59.15 ST. FRANCIS HOSPITAL - ACUTE,30101300,83516,HC MLT NON INFECT QL/SQ TTG-90,301,1 ,$44.00 ,$28.60 ,$9.68 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$9.68 ,$10.65 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101302,83519,HC QN RIA-90,301,1 ,$139.00 ,$90.35 ,$9.68 ,$139.00 ,$100.08 ,$75.62 ,$31.97 ,$77.59 ,$31.97 ,$83.04 ,$83.04 ,$83.04 ,$83.04 ,$116.76 ,$31.97 ,$118.15 ,$116.76 ,$31.97 ,$104.25 ,$111.20 ,$111.20 ,$31.97 ,$111.20 ,$116.76 ,$116.76 ,$116.76 ,$125.10 ,$79.93 ,$31.97 ,$139.00 ,$9.68 ,$10.65 ,$35.17 ,$118.15 ,$83.04 ,$125.10 ,$116.76 ,$111.20 ,$111.20 ,$31.97 ,$90.35 ST. FRANCIS HOSPITAL - ACUTE,30101303,83520,HC IMMUNOASSAY QN OTHER-90,301,1 ,$33.00 ,$21.45 ,$7.59 ,$33.00 ,$23.76 ,$17.95 ,$7.59 ,$18.42 ,$7.59 ,$19.71 ,$19.71 ,$19.71 ,$19.71 ,$27.72 ,$7.59 ,$28.05 ,$27.72 ,$7.59 ,$24.75 ,$26.40 ,$26.40 ,$7.59 ,$26.40 ,$27.72 ,$27.72 ,$27.72 ,$29.70 ,$18.98 ,$7.59 ,$33.00 ,$9.68 ,$10.65 ,$8.35 ,$28.05 ,$19.71 ,$29.70 ,$27.72 ,$26.40 ,$26.40 ,$7.59 ,$21.45 ST. FRANCIS HOSPITAL - ACUTE,30101306,83520,HC IMMUNOASSAY QN ENZYME-90,301,1 ,$275.00 ,$178.75 ,$9.68 ,$275.00 ,$198.00 ,$149.60 ,$63.25 ,$153.51 ,$63.25 ,$164.29 ,$164.29 ,$164.29 ,$164.29 ,$231.00 ,$63.25 ,$233.75 ,$231.00 ,$63.25 ,$206.25 ,$220.00 ,$220.00 ,$63.25 ,$220.00 ,$231.00 ,$231.00 ,$231.00 ,$247.50 ,$158.13 ,$63.25 ,$275.00 ,$9.68 ,$10.65 ,$69.58 ,$233.75 ,$164.29 ,$247.50 ,$231.00 ,$220.00 ,$220.00 ,$63.25 ,$178.75 ST. FRANCIS HOSPITAL - ACUTE,30101307,83525,HC INSULIN TOTAL-90,301,1 ,$63.00 ,$40.95 ,$14.49 ,$63.00 ,$45.36 ,$34.27 ,$14.49 ,$35.17 ,$14.49 ,$37.64 ,$37.64 ,$37.64 ,$37.64 ,$52.92 ,$14.49 ,$53.55 ,$52.92 ,$14.49 ,$47.25 ,$50.40 ,$50.40 ,$14.49 ,$50.40 ,$52.92 ,$52.92 ,$52.92 ,$56.70 ,$36.23 ,$14.49 ,$63.00 ,$14.55 ,$16.01 ,$15.94 ,$53.55 ,$37.64 ,$56.70 ,$52.92 ,$50.40 ,$50.40 ,$14.49 ,$40.95 ST. FRANCIS HOSPITAL - ACUTE,30101310,83586,HC KETOSTEROIDS (17-KS)-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$14.55 ,$16.01 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101312,83615,HC LACTATE DEHYDRO (LDH)-90,301,1 ,$22.00 ,$14.30 ,$4.81 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$4.81 ,$5.29 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101313,83625,HC LDH ISOENZYMES-90,301,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$10.81 ,$11.89 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101316,83655,HC LEAD-90,301,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$13.18 ,$14.50 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101325,80335,HC ANTIDEPRESSANTS TRYCLIC 1-2 -90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$29.09 ,$32.00 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101326,83735,HC MAGNESIUM-90,301,1 ,$55.00 ,$35.75 ,$4.81 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 ,$4.81 ,$5.29 ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,30101327,83785,HC MANGANESE-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$13.18 ,$14.50 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101329,83825,HC MERCURY-90,301,1 ,$52.00 ,$33.80 ,$11.96 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 ,$13.18 ,$14.50 ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,30101330,83835,HC METANEPHRINES-90,301,1 ,$99.00 ,$64.35 ,$22.77 ,$99.00 ,$71.28 ,$53.86 ,$22.77 ,$55.26 ,$22.77 ,$59.14 ,$59.14 ,$59.14 ,$59.14 ,$83.16 ,$22.77 ,$84.15 ,$83.16 ,$22.77 ,$74.25 ,$79.20 ,$79.20 ,$22.77 ,$79.20 ,$83.16 ,$83.16 ,$83.16 ,$89.10 ,$56.93 ,$22.77 ,$99.00 ,$25.29 ,$27.82 ,$25.05 ,$84.15 ,$59.14 ,$89.10 ,$83.16 ,$79.20 ,$79.20 ,$22.77 ,$64.35 ST. FRANCIS HOSPITAL - ACUTE,30101334,83874,HC MYOGLOBIN-90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$10.81 ,$11.89 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101337,83883,HC NEPHELOMETRY EA ANALYTE-90,301,1 ,$116.00 ,$75.40 ,$16.68 ,$116.00 ,$83.52 ,$63.10 ,$26.68 ,$64.75 ,$26.68 ,$69.30 ,$69.30 ,$69.30 ,$69.30 ,$97.44 ,$26.68 ,$98.60 ,$97.44 ,$26.68 ,$87.00 ,$92.80 ,$92.80 ,$26.68 ,$92.80 ,$97.44 ,$97.44 ,$97.44 ,$104.40 ,$66.70 ,$26.68 ,$116.00 ,$16.68 ,$18.35 ,$29.35 ,$98.60 ,$69.30 ,$104.40 ,$97.44 ,$92.80 ,$92.80 ,$26.68 ,$75.40 ST. FRANCIS HOSPITAL - ACUTE,30101339,83915,HC NUCLEOTIDASE 5 -90,301,1 ,$65.00 ,$42.25 ,$10.81 ,$65.00 ,$46.80 ,$35.36 ,$14.95 ,$36.28 ,$14.95 ,$38.83 ,$38.83 ,$38.83 ,$38.83 ,$54.60 ,$14.95 ,$55.25 ,$54.60 ,$14.95 ,$48.75 ,$52.00 ,$52.00 ,$14.95 ,$52.00 ,$54.60 ,$54.60 ,$54.60 ,$58.50 ,$37.38 ,$14.95 ,$65.00 ,$10.81 ,$11.89 ,$16.45 ,$55.25 ,$38.83 ,$58.50 ,$54.60 ,$52.00 ,$52.00 ,$14.95 ,$42.25 ST. FRANCIS HOSPITAL - ACUTE,30101341,83918,HC ORGANIC ACIDS QN-90,301,1 ,$146.00 ,$94.90 ,$13.18 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$13.18 ,$14.50 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30101345,83945,HC OXALATE-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$10.81 ,$11.89 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101348,83986,HC PH BODY FLUID NOT BLOOD-90,301,1 ,$9.00 ,$5.85 ,$2.07 ,$9.00 ,$6.48 ,$4.90 ,$2.07 ,$5.02 ,$2.07 ,$5.38 ,$5.38 ,$5.38 ,$5.38 ,$7.56 ,$2.07 ,$7.65 ,$7.56 ,$2.07 ,$6.75 ,$7.20 ,$7.20 ,$2.07 ,$7.20 ,$7.56 ,$7.56 ,$7.56 ,$8.10 ,$5.18 ,$2.07 ,$9.00 ,$4.81 ,$5.29 ,$2.28 ,$7.65 ,$5.38 ,$8.10 ,$7.56 ,$7.20 ,$7.20 ,$2.07 ,$5.85 ST. FRANCIS HOSPITAL - ACUTE,30101351,83993,HC CALPROTECTIN STOOL-90,301,1 ,$108.00 ,$70.20 ,$10.81 ,$108.00 ,$77.76 ,$58.75 ,$24.84 ,$60.29 ,$24.84 ,$64.52 ,$64.52 ,$64.52 ,$64.52 ,$90.72 ,$24.84 ,$91.80 ,$90.72 ,$24.84 ,$81.00 ,$86.40 ,$86.40 ,$24.84 ,$86.40 ,$90.72 ,$90.72 ,$90.72 ,$97.20 ,$62.10 ,$24.84 ,$108.00 ,$10.81 ,$11.89 ,$27.32 ,$91.80 ,$64.52 ,$97.20 ,$90.72 ,$86.40 ,$86.40 ,$24.84 ,$70.20 ST. FRANCIS HOSPITAL - ACUTE,30101352,84030,HC NEWBORN SCREEN PKU-90,301,1 ,$156.00 ,$101.40 ,$4.81 ,$156.00 ,$112.32 ,$84.86 ,$35.88 ,$87.08 ,$35.88 ,$93.19 ,$93.19 ,$93.19 ,$93.19 ,$131.04 ,$35.88 ,$132.60 ,$131.04 ,$35.88 ,$117.00 ,$124.80 ,$124.80 ,$35.88 ,$124.80 ,$131.04 ,$131.04 ,$131.04 ,$140.40 ,$89.70 ,$35.88 ,$156.00 ,$4.81 ,$5.29 ,$39.47 ,$132.60 ,$93.19 ,$140.40 ,$131.04 ,$124.80 ,$124.80 ,$35.88 ,$101.40 ST. FRANCIS HOSPITAL - ACUTE,30101353,84066,HC PHOSPHATASE ACID PROSTATIC-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$10.81 ,$11.89 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101354,84075,HC ALKALINE PHOSPHATASE-90,301,1 ,$25.00 ,$16.25 ,$4.81 ,$25.00 ,$18.00 ,$13.60 ,$5.75 ,$13.96 ,$5.75 ,$14.94 ,$14.94 ,$14.94 ,$14.94 ,$21.00 ,$5.75 ,$21.25 ,$21.00 ,$5.75 ,$18.75 ,$20.00 ,$20.00 ,$5.75 ,$20.00 ,$21.00 ,$21.00 ,$21.00 ,$22.50 ,$14.38 ,$5.75 ,$25.00 ,$4.81 ,$5.29 ,$6.33 ,$21.25 ,$14.94 ,$22.50 ,$21.00 ,$20.00 ,$20.00 ,$5.75 ,$16.25 ST. FRANCIS HOSPITAL - ACUTE,30101356,84080,HC ALK PHOS ISOENZ-90,301,1 ,$98.00 ,$63.70 ,$10.81 ,$98.00 ,$70.56 ,$53.31 ,$22.54 ,$54.70 ,$22.54 ,$58.55 ,$58.55 ,$58.55 ,$58.55 ,$82.32 ,$22.54 ,$83.30 ,$82.32 ,$22.54 ,$73.50 ,$78.40 ,$78.40 ,$22.54 ,$78.40 ,$82.32 ,$82.32 ,$82.32 ,$88.20 ,$56.35 ,$22.54 ,$98.00 ,$10.81 ,$11.89 ,$24.79 ,$83.30 ,$58.55 ,$88.20 ,$82.32 ,$78.40 ,$78.40 ,$22.54 ,$63.70 ST. FRANCIS HOSPITAL - ACUTE,30101358,84105,HC PHOSPHORUS URINE-90,301,1 ,$55.00 ,$35.75 ,$4.81 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 ,$4.81 ,$5.29 ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,30101364,84133,HC POTASSIUM URINE-90,301,1 ,$55.00 ,$35.75 ,$4.81 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 ,$4.81 ,$5.29 ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,30101369,84145,HC PROCALCITONIN (PCT)-90,301,1 ,$123.00 ,$79.95 ,$25.29 ,$123.00 ,$88.56 ,$66.91 ,$28.29 ,$68.66 ,$28.29 ,$73.48 ,$73.48 ,$73.48 ,$73.48 ,$103.32 ,$28.29 ,$104.55 ,$103.32 ,$28.29 ,$92.25 ,$98.40 ,$98.40 ,$28.29 ,$98.40 ,$103.32 ,$103.32 ,$103.32 ,$110.70 ,$70.73 ,$28.29 ,$123.00 ,$25.29 ,$27.82 ,$31.12 ,$104.55 ,$73.48 ,$110.70 ,$103.32 ,$98.40 ,$98.40 ,$28.29 ,$79.95 ST. FRANCIS HOSPITAL - ACUTE,30101370,84153,HC PSA TOTAL-90,301,1 ,$51.00 ,$33.15 ,$10.81 ,$51.00 ,$36.72 ,$27.74 ,$11.73 ,$28.47 ,$11.73 ,$30.47 ,$30.47 ,$30.47 ,$30.47 ,$42.84 ,$11.73 ,$43.35 ,$42.84 ,$11.73 ,$38.25 ,$40.80 ,$40.80 ,$11.73 ,$40.80 ,$42.84 ,$42.84 ,$42.84 ,$45.90 ,$29.33 ,$11.73 ,$51.00 ,$10.81 ,$11.89 ,$12.90 ,$43.35 ,$30.47 ,$45.90 ,$42.84 ,$40.80 ,$40.80 ,$11.73 ,$33.15 ST. FRANCIS HOSPITAL - ACUTE,30101371,84154,HC PSA FREE-90,301,1 ,$125.00 ,$81.25 ,$10.81 ,$125.00 ,$90.00 ,$68.00 ,$28.75 ,$69.78 ,$28.75 ,$74.68 ,$74.68 ,$74.68 ,$74.68 ,$105.00 ,$28.75 ,$106.25 ,$105.00 ,$28.75 ,$93.75 ,$100.00 ,$100.00 ,$28.75 ,$100.00 ,$105.00 ,$105.00 ,$105.00 ,$112.50 ,$71.88 ,$28.75 ,$125.00 ,$10.81 ,$11.89 ,$31.63 ,$106.25 ,$74.68 ,$112.50 ,$105.00 ,$100.00 ,$100.00 ,$28.75 ,$81.25 ST. FRANCIS HOSPITAL - ACUTE,30101382,84206,HC PROINSULIN-90,301,1 ,$156.00 ,$101.40 ,$25.29 ,$156.00 ,$112.32 ,$84.86 ,$35.88 ,$87.08 ,$35.88 ,$93.19 ,$93.19 ,$93.19 ,$93.19 ,$131.04 ,$35.88 ,$132.60 ,$131.04 ,$35.88 ,$117.00 ,$124.80 ,$124.80 ,$35.88 ,$124.80 ,$131.04 ,$131.04 ,$131.04 ,$140.40 ,$89.70 ,$35.88 ,$156.00 ,$25.29 ,$27.82 ,$39.47 ,$132.60 ,$93.19 ,$140.40 ,$131.04 ,$124.80 ,$124.80 ,$35.88 ,$101.40 ST. FRANCIS HOSPITAL - ACUTE,30101383,84207,HC VITAMIN B6-90,301,1 ,$117.00 ,$76.05 ,$10.81 ,$117.00 ,$84.24 ,$63.65 ,$26.91 ,$65.31 ,$26.91 ,$69.90 ,$69.90 ,$69.90 ,$69.90 ,$98.28 ,$26.91 ,$99.45 ,$98.28 ,$26.91 ,$87.75 ,$93.60 ,$93.60 ,$26.91 ,$93.60 ,$98.28 ,$98.28 ,$98.28 ,$105.30 ,$67.28 ,$26.91 ,$117.00 ,$10.81 ,$11.89 ,$29.60 ,$99.45 ,$69.90 ,$105.30 ,$98.28 ,$93.60 ,$93.60 ,$26.91 ,$76.05 ST. FRANCIS HOSPITAL - ACUTE,30101387,84244,HC RENIN-90,301,1 ,$135.00 ,$87.75 ,$25.29 ,$135.00 ,$97.20 ,$73.44 ,$31.05 ,$75.36 ,$31.05 ,$80.65 ,$80.65 ,$80.65 ,$80.65 ,$113.40 ,$31.05 ,$114.75 ,$113.40 ,$31.05 ,$101.25 ,$108.00 ,$108.00 ,$31.05 ,$108.00 ,$113.40 ,$113.40 ,$113.40 ,$121.50 ,$77.63 ,$31.05 ,$135.00 ,$25.29 ,$27.82 ,$34.16 ,$114.75 ,$80.65 ,$121.50 ,$113.40 ,$108.00 ,$108.00 ,$31.05 ,$87.75 ST. FRANCIS HOSPITAL - ACUTE,30101388,84255,HC SELENIUM-90,301,1 ,$52.00 ,$33.80 ,$10.81 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 ,$10.81 ,$11.89 ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,30101390,84270,HC SEX HORMONE BIND GLOB-90,301,1 ,$52.00 ,$33.80 ,$10.81 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 ,$10.81 ,$11.89 ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,30101392,84260,HC SEROTONIN-90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$25.29 ,$27.82 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101394,84300,HC SODIUM URINE-90,301,1 ,$55.00 ,$35.75 ,$4.81 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 ,$4.81 ,$5.29 ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,30101395,84302,HC SODIUM OTHER FLUID-90,301,1 ,$44.00 ,$28.60 ,$4.81 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$4.81 ,$5.29 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101396,84305,HC SOMATOMEDIN-90,301,1 ,$114.00 ,$74.10 ,$25.29 ,$114.00 ,$82.08 ,$62.02 ,$26.22 ,$63.63 ,$26.22 ,$68.10 ,$68.10 ,$68.10 ,$68.10 ,$95.76 ,$26.22 ,$96.90 ,$95.76 ,$26.22 ,$85.50 ,$91.20 ,$91.20 ,$26.22 ,$91.20 ,$95.76 ,$95.76 ,$95.76 ,$102.60 ,$65.55 ,$26.22 ,$114.00 ,$25.29 ,$27.82 ,$28.84 ,$96.90 ,$68.10 ,$102.60 ,$95.76 ,$91.20 ,$91.20 ,$26.22 ,$74.10 ST. FRANCIS HOSPITAL - ACUTE,30101398,84311,HC SPECTROPHOTOMETRY-90,301,1 ,$9.00 ,$5.85 ,$2.07 ,$11.89 ,$6.48 ,$4.90 ,$2.07 ,$5.02 ,$2.07 ,$5.38 ,$5.38 ,$5.38 ,$5.38 ,$7.56 ,$2.07 ,$7.65 ,$7.56 ,$2.07 ,$6.75 ,$7.20 ,$7.20 ,$2.07 ,$7.20 ,$7.56 ,$7.56 ,$7.56 ,$8.10 ,$5.18 ,$2.07 ,$9.00 ,$10.81 ,$11.89 ,$2.28 ,$7.65 ,$5.38 ,$8.10 ,$7.56 ,$7.20 ,$7.20 ,$2.07 ,$5.85 ST. FRANCIS HOSPITAL - ACUTE,30101399,84311,HC SPECTROPHOTOMETRY FECAL-90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$10.81 ,$11.89 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101402,84376,HC SUGARS SINGLE QL-90,301,1 ,$22.00 ,$14.30 ,$4.81 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$4.81 ,$5.29 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101405,84392,HC SULFATE URINE-90,301,1 ,$55.00 ,$35.75 ,$3.86 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 ,$3.86 ,$4.25 ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,30101406,84402,HC TESTOSTERONE FREE-90,301,1 ,$72.00 ,$46.80 ,$16.56 ,$72.00 ,$51.84 ,$39.17 ,$16.56 ,$40.19 ,$16.56 ,$43.01 ,$43.01 ,$43.01 ,$43.01 ,$60.48 ,$16.56 ,$61.20 ,$60.48 ,$16.56 ,$54.00 ,$57.60 ,$57.60 ,$16.56 ,$57.60 ,$60.48 ,$60.48 ,$60.48 ,$64.80 ,$41.40 ,$16.56 ,$72.00 ,$25.29 ,$27.82 ,$18.22 ,$61.20 ,$43.01 ,$64.80 ,$60.48 ,$57.60 ,$57.60 ,$16.56 ,$46.80 ST. FRANCIS HOSPITAL - ACUTE,30101407,84403,HC TESTOSTERONE TOTAL-90,301,1 ,$101.00 ,$65.65 ,$23.23 ,$101.00 ,$72.72 ,$54.94 ,$23.23 ,$56.38 ,$23.23 ,$60.34 ,$60.34 ,$60.34 ,$60.34 ,$84.84 ,$23.23 ,$85.85 ,$84.84 ,$23.23 ,$75.75 ,$80.80 ,$80.80 ,$23.23 ,$80.80 ,$84.84 ,$84.84 ,$84.84 ,$90.90 ,$58.08 ,$23.23 ,$101.00 ,$25.29 ,$27.82 ,$25.55 ,$85.85 ,$60.34 ,$90.90 ,$84.84 ,$80.80 ,$80.80 ,$23.23 ,$65.65 ST. FRANCIS HOSPITAL - ACUTE,30101408,84425,HC VITAMIN B1-90,301,1 ,$92.00 ,$59.80 ,$10.81 ,$92.00 ,$66.24 ,$50.05 ,$21.16 ,$51.35 ,$21.16 ,$54.96 ,$54.96 ,$54.96 ,$54.96 ,$77.28 ,$21.16 ,$78.20 ,$77.28 ,$21.16 ,$69.00 ,$73.60 ,$73.60 ,$21.16 ,$73.60 ,$77.28 ,$77.28 ,$77.28 ,$82.80 ,$52.90 ,$21.16 ,$92.00 ,$10.81 ,$11.89 ,$23.28 ,$78.20 ,$54.96 ,$82.80 ,$77.28 ,$73.60 ,$73.60 ,$21.16 ,$59.80 ST. FRANCIS HOSPITAL - ACUTE,30101410,84432,HC THYROGLOBULIN-90,301,1 ,$85.00 ,$55.25 ,$19.55 ,$85.00 ,$61.20 ,$46.24 ,$19.55 ,$47.45 ,$19.55 ,$50.78 ,$50.78 ,$50.78 ,$50.78 ,$71.40 ,$19.55 ,$72.25 ,$71.40 ,$19.55 ,$63.75 ,$68.00 ,$68.00 ,$19.55 ,$68.00 ,$71.40 ,$71.40 ,$71.40 ,$76.50 ,$48.88 ,$19.55 ,$85.00 ,$25.29 ,$27.82 ,$21.51 ,$72.25 ,$50.78 ,$76.50 ,$71.40 ,$68.00 ,$68.00 ,$19.55 ,$55.25 ST. FRANCIS HOSPITAL - ACUTE,30101415,84442,HC THYROXINE BIND GLOB-90,301,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$14.55 ,$16.01 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30101417,84445,HC THYROID STIM IMMUNO GLOB-90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$25.29 ,$27.82 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101418,84446,HC VITAMIN E-90,301,1 ,$78.00 ,$50.70 ,$10.81 ,$78.00 ,$56.16 ,$42.43 ,$17.94 ,$43.54 ,$17.94 ,$46.60 ,$46.60 ,$46.60 ,$46.60 ,$65.52 ,$17.94 ,$66.30 ,$65.52 ,$17.94 ,$58.50 ,$62.40 ,$62.40 ,$17.94 ,$62.40 ,$65.52 ,$65.52 ,$65.52 ,$70.20 ,$44.85 ,$17.94 ,$78.00 ,$10.81 ,$11.89 ,$19.73 ,$66.30 ,$46.60 ,$70.20 ,$65.52 ,$62.40 ,$62.40 ,$17.94 ,$50.70 ST. FRANCIS HOSPITAL - ACUTE,30101419,84460,HC ALT-90,301,1 ,$37.00 ,$24.05 ,$4.81 ,$37.00 ,$26.64 ,$20.13 ,$8.51 ,$20.65 ,$8.51 ,$22.10 ,$22.10 ,$22.10 ,$22.10 ,$31.08 ,$8.51 ,$31.45 ,$31.08 ,$8.51 ,$27.75 ,$29.60 ,$29.60 ,$8.51 ,$29.60 ,$31.08 ,$31.08 ,$31.08 ,$33.30 ,$21.28 ,$8.51 ,$37.00 ,$4.81 ,$5.29 ,$9.36 ,$31.45 ,$22.10 ,$33.30 ,$31.08 ,$29.60 ,$29.60 ,$8.51 ,$24.05 ST. FRANCIS HOSPITAL - ACUTE,30101422,84479,HC T3 UPTAKE-90,301,1 ,$37.00 ,$24.05 ,$8.51 ,$37.00 ,$26.64 ,$20.13 ,$8.51 ,$20.65 ,$8.51 ,$22.10 ,$22.10 ,$22.10 ,$22.10 ,$31.08 ,$8.51 ,$31.45 ,$31.08 ,$8.51 ,$27.75 ,$29.60 ,$29.60 ,$8.51 ,$29.60 ,$31.08 ,$31.08 ,$31.08 ,$33.30 ,$21.28 ,$8.51 ,$37.00 ,$14.55 ,$16.01 ,$9.36 ,$31.45 ,$22.10 ,$33.30 ,$31.08 ,$29.60 ,$29.60 ,$8.51 ,$24.05 ST. FRANCIS HOSPITAL - ACUTE,30101423,84480,HC T3 TOTAL-90,301,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$14.55 ,$16.01 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101425,84482,HC T3 REVERSE-90,301,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$14.55 ,$16.01 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30101434,84560,HC URIC ACID OTH SRC-90,301,1 ,$22.00 ,$14.30 ,$4.81 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$4.81 ,$5.29 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101435,84585,HC VANILLYLMAND AC (VMA)-90,301,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$25.29 ,$27.82 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101437,84588,HC VASOPRESSIN (ADH)-90,301,1 ,$139.00 ,$90.35 ,$25.29 ,$139.00 ,$100.08 ,$75.62 ,$31.97 ,$77.59 ,$31.97 ,$83.04 ,$83.04 ,$83.04 ,$83.04 ,$116.76 ,$31.97 ,$118.15 ,$116.76 ,$31.97 ,$104.25 ,$111.20 ,$111.20 ,$31.97 ,$111.20 ,$116.76 ,$116.76 ,$116.76 ,$125.10 ,$79.93 ,$31.97 ,$139.00 ,$25.29 ,$27.82 ,$35.17 ,$118.15 ,$83.04 ,$125.10 ,$116.76 ,$111.20 ,$111.20 ,$31.97 ,$90.35 ST. FRANCIS HOSPITAL - ACUTE,30101438,84590,HC VITAMIN A-90,301,1 ,$82.00 ,$53.30 ,$10.81 ,$82.00 ,$59.04 ,$44.61 ,$18.86 ,$45.77 ,$18.86 ,$48.99 ,$48.99 ,$48.99 ,$48.99 ,$68.88 ,$18.86 ,$69.70 ,$68.88 ,$18.86 ,$61.50 ,$65.60 ,$65.60 ,$18.86 ,$65.60 ,$68.88 ,$68.88 ,$68.88 ,$73.80 ,$47.15 ,$18.86 ,$82.00 ,$10.81 ,$11.89 ,$20.75 ,$69.70 ,$48.99 ,$73.80 ,$68.88 ,$65.60 ,$65.60 ,$18.86 ,$53.30 ST. FRANCIS HOSPITAL - ACUTE,30101440,84597,HC VITAMIN K-90,301,1 ,$55.00 ,$35.75 ,$10.81 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 ,$10.81 ,$11.89 ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,30101442,84630,HC ZINC-90,301,1 ,$67.00 ,$43.55 ,$13.18 ,$67.00 ,$48.24 ,$36.45 ,$15.41 ,$37.40 ,$15.41 ,$40.03 ,$40.03 ,$40.03 ,$40.03 ,$56.28 ,$15.41 ,$56.95 ,$56.28 ,$15.41 ,$50.25 ,$53.60 ,$53.60 ,$15.41 ,$53.60 ,$56.28 ,$56.28 ,$56.28 ,$60.30 ,$38.53 ,$15.41 ,$67.00 ,$13.18 ,$14.50 ,$16.95 ,$56.95 ,$40.03 ,$60.30 ,$56.28 ,$53.60 ,$53.60 ,$15.41 ,$43.55 ST. FRANCIS HOSPITAL - ACUTE,30101443,84681,HC C PEPTIDE-90,301,1 ,$72.00 ,$46.80 ,$10.81 ,$72.00 ,$51.84 ,$39.17 ,$16.56 ,$40.19 ,$16.56 ,$43.01 ,$43.01 ,$43.01 ,$43.01 ,$60.48 ,$16.56 ,$61.20 ,$60.48 ,$16.56 ,$54.00 ,$57.60 ,$57.60 ,$16.56 ,$57.60 ,$60.48 ,$60.48 ,$60.48 ,$64.80 ,$41.40 ,$16.56 ,$72.00 ,$10.81 ,$11.89 ,$18.22 ,$61.20 ,$43.01 ,$64.80 ,$60.48 ,$57.60 ,$57.60 ,$16.56 ,$46.80 ST. FRANCIS HOSPITAL - ACUTE,30101444,84702,HC HCG QN-90,301,1 ,$96.00 ,$62.40 ,$14.55 ,$96.00 ,$69.12 ,$52.22 ,$22.08 ,$53.59 ,$22.08 ,$57.35 ,$57.35 ,$57.35 ,$57.35 ,$80.64 ,$22.08 ,$81.60 ,$80.64 ,$22.08 ,$72.00 ,$76.80 ,$76.80 ,$22.08 ,$76.80 ,$80.64 ,$80.64 ,$80.64 ,$86.40 ,$55.20 ,$22.08 ,$96.00 ,$14.55 ,$16.01 ,$24.29 ,$81.60 ,$57.35 ,$86.40 ,$80.64 ,$76.80 ,$76.80 ,$22.08 ,$62.40 ST. FRANCIS HOSPITAL - ACUTE,30101457,G0480,HC DRUG SCRN DEFNT 1-7 CLS T3-90,301,1 ,$147.00 ,$95.55 ,$29.09 ,$147.00 ,$105.84 ,$79.97 ,$33.81 ,$82.06 ,$33.81 ,$87.82 ,$87.82 ,$87.82 ,$87.82 ,$123.48 ,$33.81 ,$124.95 ,$123.48 ,$33.81 ,$110.25 ,$117.60 ,$117.60 ,$33.81 ,$117.60 ,$123.48 ,$123.48 ,$123.48 ,$132.30 ,$84.53 ,$33.81 ,$147.00 ,$29.09 ,$32.00 ,$37.19 ,$124.95 ,$87.82 ,$132.30 ,$123.48 ,$117.60 ,$117.60 ,$33.81 ,$95.55 ST. FRANCIS HOSPITAL - ACUTE,30101464,82272,HC OCCULT BLOOD FECAL DIAG,301,1 ,$50.00 ,$32.50 ,$4.81 ,$50.00 ,$36.00 ,$27.20 ,$11.50 ,$27.91 ,$11.50 ,$29.87 ,$29.87 ,$29.87 ,$29.87 ,$42.00 ,$11.50 ,$42.50 ,$42.00 ,$11.50 ,$37.50 ,$40.00 ,$40.00 ,$11.50 ,$40.00 ,$42.00 ,$42.00 ,$42.00 ,$45.00 ,$28.75 ,$11.50 ,$50.00 ,$4.81 ,$5.29 ,$12.65 ,$42.50 ,$29.87 ,$45.00 ,$42.00 ,$40.00 ,$40.00 ,$11.50 ,$32.50 ST. FRANCIS HOSPITAL - ACUTE,30101465,83921,HC ORGANIC ACIDS QN SINGLE-90,301,1 ,$219.00 ,$142.35 ,$10.81 ,$219.00 ,$157.68 ,$119.14 ,$50.37 ,$122.25 ,$50.37 ,$130.83 ,$130.83 ,$130.83 ,$130.83 ,$183.96 ,$50.37 ,$186.15 ,$183.96 ,$50.37 ,$164.25 ,$175.20 ,$175.20 ,$50.37 ,$175.20 ,$183.96 ,$183.96 ,$183.96 ,$197.10 ,$125.93 ,$50.37 ,$219.00 ,$10.81 ,$11.89 ,$55.41 ,$186.15 ,$130.83 ,$197.10 ,$183.96 ,$175.20 ,$175.20 ,$50.37 ,$142.35 ST. FRANCIS HOSPITAL - ACUTE,30101476,82610,HC CYSTATIN C -90,301,1 ,$86.00 ,$55.90 ,$10.81 ,$86.00 ,$61.92 ,$46.78 ,$19.78 ,$48.01 ,$19.78 ,$51.38 ,$51.38 ,$51.38 ,$51.38 ,$72.24 ,$19.78 ,$73.10 ,$72.24 ,$19.78 ,$64.50 ,$68.80 ,$68.80 ,$19.78 ,$68.80 ,$72.24 ,$72.24 ,$72.24 ,$77.40 ,$49.45 ,$19.78 ,$86.00 ,$10.81 ,$11.89 ,$21.76 ,$73.10 ,$51.38 ,$77.40 ,$72.24 ,$68.80 ,$68.80 ,$19.78 ,$55.90 ST. FRANCIS HOSPITAL - ACUTE,30101509,82330,HC CALCIUM IONIZED STAT -90,301,1 ,$99.00 ,$64.35 ,$10.81 ,$99.00 ,$71.28 ,$53.86 ,$22.77 ,$55.26 ,$22.77 ,$59.14 ,$59.14 ,$59.14 ,$59.14 ,$83.16 ,$22.77 ,$84.15 ,$83.16 ,$22.77 ,$74.25 ,$79.20 ,$79.20 ,$22.77 ,$79.20 ,$83.16 ,$83.16 ,$83.16 ,$89.10 ,$56.93 ,$22.77 ,$99.00 ,$10.81 ,$11.89 ,$25.05 ,$84.15 ,$59.14 ,$89.10 ,$83.16 ,$79.20 ,$79.20 ,$22.77 ,$64.35 ST. FRANCIS HOSPITAL - ACUTE,30101524,83721,HC CHOLESTEROL LDL,301,1 ,$111.00 ,$72.15 ,$10.81 ,$111.00 ,$79.92 ,$60.38 ,$25.53 ,$61.96 ,$25.53 ,$66.31 ,$66.31 ,$66.31 ,$66.31 ,$93.24 ,$25.53 ,$94.35 ,$93.24 ,$25.53 ,$83.25 ,$88.80 ,$88.80 ,$25.53 ,$88.80 ,$93.24 ,$93.24 ,$93.24 ,$99.90 ,$63.83 ,$25.53 ,$111.00 ,$10.81 ,$11.89 ,$28.08 ,$94.35 ,$66.31 ,$99.90 ,$93.24 ,$88.80 ,$88.80 ,$25.53 ,$72.15 ST. FRANCIS HOSPITAL - ACUTE,30101525,82465,HC CHOLESTEROL -90,301,1 ,$37.00 ,$24.05 ,$4.81 ,$37.00 ,$26.64 ,$20.13 ,$8.51 ,$20.65 ,$8.51 ,$22.10 ,$22.10 ,$22.10 ,$22.10 ,$31.08 ,$8.51 ,$31.45 ,$31.08 ,$8.51 ,$27.75 ,$29.60 ,$29.60 ,$8.51 ,$29.60 ,$31.08 ,$31.08 ,$31.08 ,$33.30 ,$21.28 ,$8.51 ,$37.00 ,$4.81 ,$5.29 ,$9.36 ,$31.45 ,$22.10 ,$33.30 ,$31.08 ,$29.60 ,$29.60 ,$8.51 ,$24.05 ST. FRANCIS HOSPITAL - ACUTE,30101526,82947,HC GLUCOSE -90,301,1 ,$37.00 ,$24.05 ,$4.81 ,$37.00 ,$26.64 ,$20.13 ,$8.51 ,$20.65 ,$8.51 ,$22.10 ,$22.10 ,$22.10 ,$22.10 ,$31.08 ,$8.51 ,$31.45 ,$31.08 ,$8.51 ,$27.75 ,$29.60 ,$29.60 ,$8.51 ,$29.60 ,$31.08 ,$31.08 ,$31.08 ,$33.30 ,$21.28 ,$8.51 ,$37.00 ,$4.81 ,$5.29 ,$9.36 ,$31.45 ,$22.10 ,$33.30 ,$31.08 ,$29.60 ,$29.60 ,$8.51 ,$24.05 ST. FRANCIS HOSPITAL - ACUTE,30101527,84450,HC AST -90,301,1 ,$37.00 ,$24.05 ,$4.81 ,$37.00 ,$26.64 ,$20.13 ,$8.51 ,$20.65 ,$8.51 ,$22.10 ,$22.10 ,$22.10 ,$22.10 ,$31.08 ,$8.51 ,$31.45 ,$31.08 ,$8.51 ,$27.75 ,$29.60 ,$29.60 ,$8.51 ,$29.60 ,$31.08 ,$31.08 ,$31.08 ,$33.30 ,$21.28 ,$8.51 ,$37.00 ,$4.81 ,$5.29 ,$9.36 ,$31.45 ,$22.10 ,$33.30 ,$31.08 ,$29.60 ,$29.60 ,$8.51 ,$24.05 ST. FRANCIS HOSPITAL - ACUTE,30101543,80074,HC HEPATITIS PANEL ACUTE,301,1 ,$222.00 ,$144.30 ,$9.86 ,$222.00 ,$159.84 ,$120.77 ,$51.06 ,$123.92 ,$51.06 ,$132.62 ,$132.62 ,$132.62 ,$132.62 ,$186.48 ,$51.06 ,$188.70 ,$186.48 ,$51.06 ,$166.50 ,$177.60 ,$177.60 ,$51.06 ,$177.60 ,$186.48 ,$186.48 ,$186.48 ,$199.80 ,$127.65 ,$51.06 ,$222.00 ,$9.86 ,$10.85 ,$56.17 ,$188.70 ,$132.62 ,$199.80 ,$186.48 ,$177.60 ,$177.60 ,$51.06 ,$144.30 ST. FRANCIS HOSPITAL - ACUTE,30101549,80184,HC PHENOBARBITAL,301,1 ,$60.00 ,$39.00 ,$12.41 ,$60.00 ,$43.20 ,$32.64 ,$13.80 ,$33.49 ,$13.80 ,$35.84 ,$35.84 ,$35.84 ,$35.84 ,$50.40 ,$13.80 ,$51.00 ,$50.40 ,$13.80 ,$45.00 ,$48.00 ,$48.00 ,$13.80 ,$48.00 ,$50.40 ,$50.40 ,$50.40 ,$54.00 ,$34.50 ,$13.80 ,$60.00 ,$12.41 ,$13.65 ,$15.18 ,$51.00 ,$35.84 ,$54.00 ,$50.40 ,$48.00 ,$48.00 ,$13.80 ,$39.00 ST. FRANCIS HOSPITAL - ACUTE,30101552,80200,HC TOBRAMYCIN,301,1 ,$104.00 ,$67.60 ,$12.41 ,$104.00 ,$74.88 ,$56.58 ,$23.92 ,$58.05 ,$23.92 ,$62.13 ,$62.13 ,$62.13 ,$62.13 ,$87.36 ,$23.92 ,$88.40 ,$87.36 ,$23.92 ,$78.00 ,$83.20 ,$83.20 ,$23.92 ,$83.20 ,$87.36 ,$87.36 ,$87.36 ,$93.60 ,$59.80 ,$23.92 ,$104.00 ,$12.41 ,$13.65 ,$26.31 ,$88.40 ,$62.13 ,$93.60 ,$87.36 ,$83.20 ,$83.20 ,$23.92 ,$67.60 ST. FRANCIS HOSPITAL - ACUTE,30101553,80299,HC THERAPEUTIC DRUG OTHER,301,1 ,$123.00 ,$79.95 ,$12.41 ,$123.00 ,$88.56 ,$66.91 ,$28.29 ,$68.66 ,$28.29 ,$73.48 ,$73.48 ,$73.48 ,$73.48 ,$103.32 ,$28.29 ,$104.55 ,$103.32 ,$28.29 ,$92.25 ,$98.40 ,$98.40 ,$28.29 ,$98.40 ,$103.32 ,$103.32 ,$103.32 ,$110.70 ,$70.73 ,$28.29 ,$123.00 ,$12.41 ,$13.65 ,$31.12 ,$104.55 ,$73.48 ,$110.70 ,$103.32 ,$98.40 ,$98.40 ,$28.29 ,$79.95 ST. FRANCIS HOSPITAL - ACUTE,30101555,81479,HC IDH GENE MUTATION ASSAY - 90,301,1 ,$25.00 ,$16.25 ,$13.96 ,$42.19 ,$18.00 ,$13.60 , N/A ,$13.96 , N/A ,$14.94 ,$14.94 ,$14.94 ,$14.94 ,$21.00 , N/A ,$21.25 ,$21.00 , N/A ,$18.75 ,$20.00 ,$20.00 , N/A ,$20.00 ,$21.00 ,$21.00 ,$21.00 ,$22.50 , N/A , N/A ,$25.00 ,$38.35 ,$42.19 , N/A ,$21.25 ,$14.94 ,$22.50 ,$21.00 ,$20.00 ,$20.00 , N/A ,$16.25 ST. FRANCIS HOSPITAL - ACUTE,30101556,82042,HC ALBUMIN OTHER SOURCE,301,1 ,$45.00 ,$29.25 ,$4.81 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$4.81 ,$5.29 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30101559,82150,HC AMYLASE,301,1 ,$146.00 ,$94.90 ,$10.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 ,$10.81 ,$11.89 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,30101564,82306,HC VITAMIN D 25 OH,301,1 ,$248.00 ,$161.20 ,$29.09 ,$248.00 ,$178.56 ,$134.91 ,$57.04 ,$138.43 ,$57.04 ,$148.16 ,$148.16 ,$148.16 ,$148.16 ,$208.32 ,$57.04 ,$210.80 ,$208.32 ,$57.04 ,$186.00 ,$198.40 ,$198.40 ,$57.04 ,$198.40 ,$208.32 ,$208.32 ,$208.32 ,$223.20 ,$142.60 ,$57.04 ,$248.00 ,$29.09 ,$32.00 ,$62.74 ,$210.80 ,$148.16 ,$223.20 ,$208.32 ,$198.40 ,$198.40 ,$57.04 ,$161.20 ST. FRANCIS HOSPITAL - ACUTE,30101568,82378,HC CARBINOEMBRYONIC AG (CEA),301,1 ,$84.00 ,$54.60 ,$10.81 ,$84.00 ,$60.48 ,$45.70 ,$19.32 ,$46.89 ,$19.32 ,$50.18 ,$50.18 ,$50.18 ,$50.18 ,$70.56 ,$19.32 ,$71.40 ,$70.56 ,$19.32 ,$63.00 ,$67.20 ,$67.20 ,$19.32 ,$67.20 ,$70.56 ,$70.56 ,$70.56 ,$75.60 ,$48.30 ,$19.32 ,$84.00 ,$10.81 ,$11.89 ,$21.25 ,$71.40 ,$50.18 ,$75.60 ,$70.56 ,$67.20 ,$67.20 ,$19.32 ,$54.60 ST. FRANCIS HOSPITAL - ACUTE,30101571,82533,HC CORTISOL TOTAL,301,1 ,$104.00 ,$67.60 ,$23.92 ,$104.00 ,$74.88 ,$56.58 ,$23.92 ,$58.05 ,$23.92 ,$62.13 ,$62.13 ,$62.13 ,$62.13 ,$87.36 ,$23.92 ,$88.40 ,$87.36 ,$23.92 ,$78.00 ,$83.20 ,$83.20 ,$23.92 ,$83.20 ,$87.36 ,$87.36 ,$87.36 ,$93.60 ,$59.80 ,$23.92 ,$104.00 ,$25.29 ,$27.82 ,$26.31 ,$88.40 ,$62.13 ,$93.60 ,$87.36 ,$83.20 ,$83.20 ,$23.92 ,$67.60 ST. FRANCIS HOSPITAL - ACUTE,30101573,82607,HC VITAMIN B12,301,1 ,$71.00 ,$46.15 ,$14.55 ,$71.00 ,$51.12 ,$38.62 ,$16.33 ,$39.63 ,$16.33 ,$42.42 ,$42.42 ,$42.42 ,$42.42 ,$59.64 ,$16.33 ,$60.35 ,$59.64 ,$16.33 ,$53.25 ,$56.80 ,$56.80 ,$16.33 ,$56.80 ,$59.64 ,$59.64 ,$59.64 ,$63.90 ,$40.83 ,$16.33 ,$71.00 ,$14.55 ,$16.01 ,$17.96 ,$60.35 ,$42.42 ,$63.90 ,$59.64 ,$56.80 ,$56.80 ,$16.33 ,$46.15 ST. FRANCIS HOSPITAL - ACUTE,30101574,82670,HC ESTRADIOL,301,1 ,$120.00 ,$78.00 ,$25.29 ,$120.00 ,$86.40 ,$65.28 ,$27.60 ,$66.98 ,$27.60 ,$71.69 ,$71.69 ,$71.69 ,$71.69 ,$100.80 ,$27.60 ,$102.00 ,$100.80 ,$27.60 ,$90.00 ,$96.00 ,$96.00 ,$27.60 ,$96.00 ,$100.80 ,$100.80 ,$100.80 ,$108.00 ,$69.00 ,$27.60 ,$120.00 ,$25.29 ,$27.82 ,$30.36 ,$102.00 ,$71.69 ,$108.00 ,$100.80 ,$96.00 ,$96.00 ,$27.60 ,$78.00 ST. FRANCIS HOSPITAL - ACUTE,30101576,82731,HC FETAL FIBRONECTIN,301,1 ,$376.00 ,$244.40 ,$29.09 ,$376.00 ,$270.72 ,$204.54 ,$86.48 ,$209.88 ,$86.48 ,$224.62 ,$224.62 ,$224.62 ,$224.62 ,$315.84 ,$86.48 ,$319.60 ,$315.84 ,$86.48 ,$282.00 ,$300.80 ,$300.80 ,$86.48 ,$300.80 ,$315.84 ,$315.84 ,$315.84 ,$338.40 ,$216.20 ,$86.48 ,$376.00 ,$29.09 ,$32.00 ,$95.13 ,$319.60 ,$224.62 ,$338.40 ,$315.84 ,$300.80 ,$300.80 ,$86.48 ,$244.40 ST. FRANCIS HOSPITAL - ACUTE,30101577,82746,HC FOLIC ACID SERUM,301,1 ,$75.00 ,$48.75 ,$10.81 ,$75.00 ,$54.00 ,$40.80 ,$17.25 ,$41.87 ,$17.25 ,$44.81 ,$44.81 ,$44.81 ,$44.81 ,$63.00 ,$17.25 ,$63.75 ,$63.00 ,$17.25 ,$56.25 ,$60.00 ,$60.00 ,$17.25 ,$60.00 ,$63.00 ,$63.00 ,$63.00 ,$67.50 ,$43.13 ,$17.25 ,$75.00 ,$10.81 ,$11.89 ,$18.98 ,$63.75 ,$44.81 ,$67.50 ,$63.00 ,$60.00 ,$60.00 ,$17.25 ,$48.75 ST. FRANCIS HOSPITAL - ACUTE,30101579,82784,HC GAMMAGLOBULIN,301,1 ,$51.00 ,$33.15 ,$10.81 ,$51.00 ,$36.72 ,$27.74 ,$11.73 ,$28.47 ,$11.73 ,$30.47 ,$30.47 ,$30.47 ,$30.47 ,$42.84 ,$11.73 ,$43.35 ,$42.84 ,$11.73 ,$38.25 ,$40.80 ,$40.80 ,$11.73 ,$40.80 ,$42.84 ,$42.84 ,$42.84 ,$45.90 ,$29.33 ,$11.73 ,$51.00 ,$10.81 ,$11.89 ,$12.90 ,$43.35 ,$30.47 ,$45.90 ,$42.84 ,$40.80 ,$40.80 ,$11.73 ,$33.15 ST. FRANCIS HOSPITAL - ACUTE,30101580,82785,HC GAMMAGLOBULIN IGE,301,1 ,$107.00 ,$69.55 ,$10.81 ,$107.00 ,$77.04 ,$58.21 ,$24.61 ,$59.73 ,$24.61 ,$63.92 ,$63.92 ,$63.92 ,$63.92 ,$89.88 ,$24.61 ,$90.95 ,$89.88 ,$24.61 ,$80.25 ,$85.60 ,$85.60 ,$24.61 ,$85.60 ,$89.88 ,$89.88 ,$89.88 ,$96.30 ,$61.53 ,$24.61 ,$107.00 ,$10.81 ,$11.89 ,$27.07 ,$90.95 ,$63.92 ,$96.30 ,$89.88 ,$85.60 ,$85.60 ,$24.61 ,$69.55 ST. FRANCIS HOSPITAL - ACUTE,30101581,82945,HC GLUCOSE BODY FLUID,301,1 ,$83.00 ,$53.95 ,$4.81 ,$83.00 ,$59.76 ,$45.15 ,$19.09 ,$46.33 ,$19.09 ,$49.58 ,$49.58 ,$49.58 ,$49.58 ,$69.72 ,$19.09 ,$70.55 ,$69.72 ,$19.09 ,$62.25 ,$66.40 ,$66.40 ,$19.09 ,$66.40 ,$69.72 ,$69.72 ,$69.72 ,$74.70 ,$47.73 ,$19.09 ,$83.00 ,$4.81 ,$5.29 ,$21.00 ,$70.55 ,$49.58 ,$74.70 ,$69.72 ,$66.40 ,$66.40 ,$19.09 ,$53.95 ST. FRANCIS HOSPITAL - ACUTE,30101585,83001,HC FSH,301,1 ,$113.00 ,$73.45 ,$25.29 ,$113.00 ,$81.36 ,$61.47 ,$25.99 ,$63.08 ,$25.99 ,$67.51 ,$67.51 ,$67.51 ,$67.51 ,$94.92 ,$25.99 ,$96.05 ,$94.92 ,$25.99 ,$84.75 ,$90.40 ,$90.40 ,$25.99 ,$90.40 ,$94.92 ,$94.92 ,$94.92 ,$101.70 ,$64.98 ,$25.99 ,$113.00 ,$25.29 ,$27.82 ,$28.59 ,$96.05 ,$67.51 ,$101.70 ,$94.92 ,$90.40 ,$90.40 ,$25.99 ,$73.45 ST. FRANCIS HOSPITAL - ACUTE,30101586,83002,HC LUTEINIZING HORMONE (LH),301,1 ,$122.00 ,$79.30 ,$25.29 ,$122.00 ,$87.84 ,$66.37 ,$28.06 ,$68.10 ,$28.06 ,$72.88 ,$72.88 ,$72.88 ,$72.88 ,$102.48 ,$28.06 ,$103.70 ,$102.48 ,$28.06 ,$91.50 ,$97.60 ,$97.60 ,$28.06 ,$97.60 ,$102.48 ,$102.48 ,$102.48 ,$109.80 ,$70.15 ,$28.06 ,$122.00 ,$25.29 ,$27.82 ,$30.87 ,$103.70 ,$72.88 ,$109.80 ,$102.48 ,$97.60 ,$97.60 ,$28.06 ,$79.30 ST. FRANCIS HOSPITAL - ACUTE,30101591,83090,HC HOMOCYSTEINE,301,1 ,$119.00 ,$77.35 ,$25.29 ,$119.00 ,$85.68 ,$64.74 ,$27.37 ,$66.43 ,$27.37 ,$71.09 ,$71.09 ,$71.09 ,$71.09 ,$99.96 ,$27.37 ,$101.15 ,$99.96 ,$27.37 ,$89.25 ,$95.20 ,$95.20 ,$27.37 ,$95.20 ,$99.96 ,$99.96 ,$99.96 ,$107.10 ,$68.43 ,$27.37 ,$119.00 ,$25.29 ,$27.82 ,$30.11 ,$101.15 ,$71.09 ,$107.10 ,$99.96 ,$95.20 ,$95.20 ,$27.37 ,$77.35 ST. FRANCIS HOSPITAL - ACUTE,30101594,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$142.00 ,$92.30 ,$4.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$4.81 ,$5.29 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30101597,83874,HC MYOGLOBIN,301,1 ,$117.00 ,$76.05 ,$10.81 ,$117.00 ,$84.24 ,$63.65 ,$26.91 ,$65.31 ,$26.91 ,$69.90 ,$69.90 ,$69.90 ,$69.90 ,$98.28 ,$26.91 ,$99.45 ,$98.28 ,$26.91 ,$87.75 ,$93.60 ,$93.60 ,$26.91 ,$93.60 ,$98.28 ,$98.28 ,$98.28 ,$105.30 ,$67.28 ,$26.91 ,$117.00 ,$10.81 ,$11.89 ,$29.60 ,$99.45 ,$69.90 ,$105.30 ,$98.28 ,$93.60 ,$93.60 ,$26.91 ,$76.05 ST. FRANCIS HOSPITAL - ACUTE,30101598,83930,HC OSMOLALITY BLOOD,301,1 ,$79.00 ,$51.35 ,$4.81 ,$79.00 ,$56.88 ,$42.98 ,$18.17 ,$44.10 ,$18.17 ,$47.19 ,$47.19 ,$47.19 ,$47.19 ,$66.36 ,$18.17 ,$67.15 ,$66.36 ,$18.17 ,$59.25 ,$63.20 ,$63.20 ,$18.17 ,$63.20 ,$66.36 ,$66.36 ,$66.36 ,$71.10 ,$45.43 ,$18.17 ,$79.00 ,$4.81 ,$5.29 ,$19.99 ,$67.15 ,$47.19 ,$71.10 ,$66.36 ,$63.20 ,$63.20 ,$18.17 ,$51.35 ST. FRANCIS HOSPITAL - ACUTE,30101599,83935,HC OSMOLALITY URINE,301,1 ,$91.00 ,$59.15 ,$4.81 ,$91.00 ,$65.52 ,$49.50 ,$20.93 ,$50.80 ,$20.93 ,$54.36 ,$54.36 ,$54.36 ,$54.36 ,$76.44 ,$20.93 ,$77.35 ,$76.44 ,$20.93 ,$68.25 ,$72.80 ,$72.80 ,$20.93 ,$72.80 ,$76.44 ,$76.44 ,$76.44 ,$81.90 ,$52.33 ,$20.93 ,$91.00 ,$4.81 ,$5.29 ,$23.02 ,$77.35 ,$54.36 ,$81.90 ,$76.44 ,$72.80 ,$72.80 ,$20.93 ,$59.15 ST. FRANCIS HOSPITAL - ACUTE,30101600,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$81.00 ,$52.65 ,$18.63 ,$81.00 ,$58.32 ,$44.06 ,$18.63 ,$45.21 ,$18.63 ,$48.39 ,$48.39 ,$48.39 ,$48.39 ,$68.04 ,$18.63 ,$68.85 ,$68.04 ,$18.63 ,$60.75 ,$64.80 ,$64.80 ,$18.63 ,$64.80 ,$68.04 ,$68.04 ,$68.04 ,$72.90 ,$46.58 ,$18.63 ,$81.00 ,$25.29 ,$27.82 ,$20.49 ,$68.85 ,$48.39 ,$72.90 ,$68.04 ,$64.80 ,$64.80 ,$18.63 ,$52.65 ST. FRANCIS HOSPITAL - ACUTE,30101605,84134,HC PREALBUMIN,301,1 ,$71.00 ,$46.15 ,$10.81 ,$71.00 ,$51.12 ,$38.62 ,$16.33 ,$39.63 ,$16.33 ,$42.42 ,$42.42 ,$42.42 ,$42.42 ,$59.64 ,$16.33 ,$60.35 ,$59.64 ,$16.33 ,$53.25 ,$56.80 ,$56.80 ,$16.33 ,$56.80 ,$59.64 ,$59.64 ,$59.64 ,$63.90 ,$40.83 ,$16.33 ,$71.00 ,$10.81 ,$11.89 ,$17.96 ,$60.35 ,$42.42 ,$63.90 ,$59.64 ,$56.80 ,$56.80 ,$16.33 ,$46.15 ST. FRANCIS HOSPITAL - ACUTE,30101606,84144,HC PROGESTERONE,301,1 ,$108.00 ,$70.20 ,$14.55 ,$108.00 ,$77.76 ,$58.75 ,$24.84 ,$60.29 ,$24.84 ,$64.52 ,$64.52 ,$64.52 ,$64.52 ,$90.72 ,$24.84 ,$91.80 ,$90.72 ,$24.84 ,$81.00 ,$86.40 ,$86.40 ,$24.84 ,$86.40 ,$90.72 ,$90.72 ,$90.72 ,$97.20 ,$62.10 ,$24.84 ,$108.00 ,$14.55 ,$16.01 ,$27.32 ,$91.80 ,$64.52 ,$97.20 ,$90.72 ,$86.40 ,$86.40 ,$24.84 ,$70.20 ST. FRANCIS HOSPITAL - ACUTE,30101608,84146,HC PROLACTIN,301,1 ,$131.00 ,$85.15 ,$25.29 ,$131.00 ,$94.32 ,$71.26 ,$30.13 ,$73.12 ,$30.13 ,$78.26 ,$78.26 ,$78.26 ,$78.26 ,$110.04 ,$30.13 ,$111.35 ,$110.04 ,$30.13 ,$98.25 ,$104.80 ,$104.80 ,$30.13 ,$104.80 ,$110.04 ,$110.04 ,$110.04 ,$117.90 ,$75.33 ,$30.13 ,$131.00 ,$25.29 ,$27.82 ,$33.14 ,$111.35 ,$78.26 ,$117.90 ,$110.04 ,$104.80 ,$104.80 ,$30.13 ,$85.15 ST. FRANCIS HOSPITAL - ACUTE,30101611,84155,HC PROTEIN TOTAL,301,1 ,$24.00 ,$15.60 ,$4.81 ,$24.00 ,$17.28 ,$13.06 ,$5.52 ,$13.40 ,$5.52 ,$14.34 ,$14.34 ,$14.34 ,$14.34 ,$20.16 ,$5.52 ,$20.40 ,$20.16 ,$5.52 ,$18.00 ,$19.20 ,$19.20 ,$5.52 ,$19.20 ,$20.16 ,$20.16 ,$20.16 ,$21.60 ,$13.80 ,$5.52 ,$24.00 ,$4.81 ,$5.29 ,$6.07 ,$20.40 ,$14.34 ,$21.60 ,$20.16 ,$19.20 ,$19.20 ,$5.52 ,$15.60 ST. FRANCIS HOSPITAL - ACUTE,30101612,84156,HC PROTEIN TOTAL URINE,301,1 ,$23.00 ,$14.95 ,$4.81 ,$23.00 ,$16.56 ,$12.51 ,$5.29 ,$12.84 ,$5.29 ,$13.74 ,$13.74 ,$13.74 ,$13.74 ,$19.32 ,$5.29 ,$19.55 ,$19.32 ,$5.29 ,$17.25 ,$18.40 ,$18.40 ,$5.29 ,$18.40 ,$19.32 ,$19.32 ,$19.32 ,$20.70 ,$13.23 ,$5.29 ,$23.00 ,$4.81 ,$5.29 ,$5.82 ,$19.55 ,$13.74 ,$20.70 ,$19.32 ,$18.40 ,$18.40 ,$5.29 ,$14.95 ST. FRANCIS HOSPITAL - ACUTE,30101613,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$118.00 ,$76.70 ,$4.81 ,$118.00 ,$84.96 ,$64.19 ,$27.14 ,$65.87 ,$27.14 ,$70.49 ,$70.49 ,$70.49 ,$70.49 ,$99.12 ,$27.14 ,$100.30 ,$99.12 ,$27.14 ,$88.50 ,$94.40 ,$94.40 ,$27.14 ,$94.40 ,$99.12 ,$99.12 ,$99.12 ,$106.20 ,$67.85 ,$27.14 ,$118.00 ,$4.81 ,$5.29 ,$29.85 ,$100.30 ,$70.49 ,$106.20 ,$99.12 ,$94.40 ,$94.40 ,$27.14 ,$76.70 ST. FRANCIS HOSPITAL - ACUTE,30101614,84165,HC PROTEIN ELECTROPHORESIS,301,1 ,$69.00 ,$44.85 ,$10.81 ,$69.00 ,$49.68 ,$37.54 ,$15.87 ,$38.52 ,$15.87 ,$41.22 ,$41.22 ,$41.22 ,$41.22 ,$57.96 ,$15.87 ,$58.65 ,$57.96 ,$15.87 ,$51.75 ,$55.20 ,$55.20 ,$15.87 ,$55.20 ,$57.96 ,$57.96 ,$57.96 ,$62.10 ,$39.68 ,$15.87 ,$69.00 ,$10.81 ,$11.89 ,$17.46 ,$58.65 ,$41.22 ,$62.10 ,$57.96 ,$55.20 ,$55.20 ,$15.87 ,$44.85 ST. FRANCIS HOSPITAL - ACUTE,30101615,84166,HC PROTEIN EP OTH FLUID,301,1 ,$84.00 ,$54.60 ,$10.81 ,$84.00 ,$60.48 ,$45.70 ,$19.32 ,$46.89 ,$19.32 ,$50.18 ,$50.18 ,$50.18 ,$50.18 ,$70.56 ,$19.32 ,$71.40 ,$70.56 ,$19.32 ,$63.00 ,$67.20 ,$67.20 ,$19.32 ,$67.20 ,$70.56 ,$70.56 ,$70.56 ,$75.60 ,$48.30 ,$19.32 ,$84.00 ,$10.81 ,$11.89 ,$21.25 ,$71.40 ,$50.18 ,$75.60 ,$70.56 ,$67.20 ,$67.20 ,$19.32 ,$54.60 ST. FRANCIS HOSPITAL - ACUTE,30101620,84436,HC THYROXINE (T-4) TOTAL,301,1 ,$92.00 ,$59.80 ,$14.55 ,$92.00 ,$66.24 ,$50.05 ,$21.16 ,$51.35 ,$21.16 ,$54.96 ,$54.96 ,$54.96 ,$54.96 ,$77.28 ,$21.16 ,$78.20 ,$77.28 ,$21.16 ,$69.00 ,$73.60 ,$73.60 ,$21.16 ,$73.60 ,$77.28 ,$77.28 ,$77.28 ,$82.80 ,$52.90 ,$21.16 ,$92.00 ,$14.55 ,$16.01 ,$23.28 ,$78.20 ,$54.96 ,$82.80 ,$77.28 ,$73.60 ,$73.60 ,$21.16 ,$59.80 ST. FRANCIS HOSPITAL - ACUTE,30101622,84466,HC TRANSFERRIN,301,1 ,$142.00 ,$92.30 ,$10.81 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 ,$10.81 ,$11.89 ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,30101624,84480,HC T3 TOTAL,301,1 ,$94.00 ,$61.10 ,$14.55 ,$94.00 ,$67.68 ,$51.14 ,$21.62 ,$52.47 ,$21.62 ,$56.16 ,$56.16 ,$56.16 ,$56.16 ,$78.96 ,$21.62 ,$79.90 ,$78.96 ,$21.62 ,$70.50 ,$75.20 ,$75.20 ,$21.62 ,$75.20 ,$78.96 ,$78.96 ,$78.96 ,$84.60 ,$54.05 ,$21.62 ,$94.00 ,$14.55 ,$16.01 ,$23.78 ,$79.90 ,$56.16 ,$84.60 ,$78.96 ,$75.20 ,$75.20 ,$21.62 ,$61.10 ST. FRANCIS HOSPITAL - ACUTE,30101625,84481,HC T3 FREE,301,1 ,$94.00 ,$61.10 ,$14.55 ,$94.00 ,$67.68 ,$51.14 ,$21.62 ,$52.47 ,$21.62 ,$56.16 ,$56.16 ,$56.16 ,$56.16 ,$78.96 ,$21.62 ,$79.90 ,$78.96 ,$21.62 ,$70.50 ,$75.20 ,$75.20 ,$21.62 ,$75.20 ,$78.96 ,$78.96 ,$78.96 ,$84.60 ,$54.05 ,$21.62 ,$94.00 ,$14.55 ,$16.01 ,$23.78 ,$79.90 ,$56.16 ,$84.60 ,$78.96 ,$75.20 ,$75.20 ,$21.62 ,$61.10 ST. FRANCIS HOSPITAL - ACUTE,30101642,84999,HC OSMOLALITY FECAL-90,301,1 ,$22.00 ,$14.30 ,$10.81 ,$22.00 ,$15.84 ,$11.97 , N/A ,$12.28 , N/A ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 , N/A ,$18.70 ,$18.48 , N/A ,$16.50 ,$17.60 ,$17.60 , N/A ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 , N/A , N/A ,$22.00 ,$10.81 ,$11.89 , N/A ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 , N/A ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30101643,81596,HC CHRONIC HEP C VIRUS ASSAYS-90,301,1 ,$293.00 ,$190.45 ,$38.35 ,$293.00 ,$210.96 ,$159.39 ,$67.39 ,$163.55 ,$67.39 ,$175.04 ,$175.04 ,$175.04 ,$175.04 ,$246.12 ,$67.39 ,$249.05 ,$246.12 ,$67.39 ,$219.75 ,$234.40 ,$234.40 ,$67.39 ,$234.40 ,$246.12 ,$246.12 ,$246.12 ,$263.70 ,$168.48 ,$67.39 ,$293.00 ,$38.35 ,$42.19 ,$74.13 ,$249.05 ,$175.04 ,$263.70 ,$246.12 ,$234.40 ,$234.40 ,$67.39 ,$190.45 ST. FRANCIS HOSPITAL - ACUTE,30101664,80307,HC DRUG SCREEN UMBILICAL CORD-90,301,1 ,$23.00 ,$14.95 ,$5.29 ,$32.00 ,$16.56 ,$12.51 ,$5.29 ,$12.84 ,$5.29 ,$13.74 ,$13.74 ,$13.74 ,$13.74 ,$19.32 ,$5.29 ,$19.55 ,$19.32 ,$5.29 ,$17.25 ,$18.40 ,$18.40 ,$5.29 ,$18.40 ,$19.32 ,$19.32 ,$19.32 ,$20.70 ,$13.23 ,$5.29 ,$23.00 ,$29.09 ,$32.00 ,$5.82 ,$19.55 ,$13.74 ,$20.70 ,$19.32 ,$18.40 ,$18.40 ,$5.29 ,$14.95 ST. FRANCIS HOSPITAL - ACUTE,30101665,80307,HC DRUG SCREEN MECONIUM-90,301,1 ,$14.00 ,$9.10 ,$3.22 ,$32.00 ,$10.08 ,$7.62 ,$3.22 ,$7.81 ,$3.22 ,$8.36 ,$8.36 ,$8.36 ,$8.36 ,$11.76 ,$3.22 ,$11.90 ,$11.76 ,$3.22 ,$10.50 ,$11.20 ,$11.20 ,$3.22 ,$11.20 ,$11.76 ,$11.76 ,$11.76 ,$12.60 ,$8.05 ,$3.22 ,$14.00 ,$29.09 ,$32.00 ,$3.54 ,$11.90 ,$8.36 ,$12.60 ,$11.76 ,$11.20 ,$11.20 ,$3.22 ,$9.10 ST. FRANCIS HOSPITAL - ACUTE,30101668,83550,HC IRON BINDING CAPACITY -90,301,1 ,$110.00 ,$71.50 ,$10.81 ,$110.00 ,$79.20 ,$59.84 ,$25.30 ,$61.40 ,$25.30 ,$65.71 ,$65.71 ,$65.71 ,$65.71 ,$92.40 ,$25.30 ,$93.50 ,$92.40 ,$25.30 ,$82.50 ,$88.00 ,$88.00 ,$25.30 ,$88.00 ,$92.40 ,$92.40 ,$92.40 ,$99.00 ,$63.25 ,$25.30 ,$110.00 ,$10.81 ,$11.89 ,$27.83 ,$93.50 ,$65.71 ,$99.00 ,$92.40 ,$88.00 ,$88.00 ,$25.30 ,$71.50 ST. FRANCIS HOSPITAL - ACUTE,30101702,81479,HC MUTATION ANALYSIS MYD88-90,301,1 ,$463.00 ,$300.95 ,$38.35 ,$463.00 ,$333.36 ,$251.87 , N/A ,$258.45 , N/A ,$276.60 ,$276.60 ,$276.60 ,$276.60 ,$388.92 , N/A ,$393.55 ,$388.92 , N/A ,$347.25 ,$370.40 ,$370.40 , N/A ,$370.40 ,$388.92 ,$388.92 ,$388.92 ,$416.70 , N/A , N/A ,$463.00 ,$38.35 ,$42.19 , N/A ,$393.55 ,$276.60 ,$416.70 ,$388.92 ,$370.40 ,$370.40 , N/A ,$300.95 ST. FRANCIS HOSPITAL - ACUTE,30200163,86308,HC HETEROPHILE SCR MONO,302,1 ,$265.00 ,$172.25 ,$9.68 ,$265.00 ,$190.80 ,$144.16 ,$60.95 ,$147.92 ,$60.95 ,$158.31 ,$158.31 ,$158.31 ,$158.31 ,$222.60 ,$60.95 ,$225.25 ,$222.60 ,$60.95 ,$198.75 ,$212.00 ,$212.00 ,$60.95 ,$212.00 ,$222.60 ,$222.60 ,$222.60 ,$238.50 ,$152.38 ,$60.95 ,$265.00 ,$9.68 ,$10.65 ,$67.05 ,$225.25 ,$158.31 ,$238.50 ,$222.60 ,$212.00 ,$212.00 ,$60.95 ,$172.25 ST. FRANCIS HOSPITAL - ACUTE,30200542,86703,HC HIV 1 HIV 2 AB SGL ASSAY,302,1 ,$344.00 ,$223.60 ,$9.68 ,$344.00 ,$247.68 ,$187.14 ,$79.12 ,$192.02 ,$79.12 ,$205.51 ,$205.51 ,$205.51 ,$205.51 ,$288.96 ,$79.12 ,$292.40 ,$288.96 ,$79.12 ,$258.00 ,$275.20 ,$275.20 ,$79.12 ,$275.20 ,$288.96 ,$288.96 ,$288.96 ,$309.60 ,$197.80 ,$79.12 ,$344.00 ,$9.68 ,$10.65 ,$87.03 ,$292.40 ,$205.51 ,$309.60 ,$288.96 ,$275.20 ,$275.20 ,$79.12 ,$223.60 ST. FRANCIS HOSPITAL - ACUTE,30200562,86880,HC COOMBS DIRECT,302,1 ,$119.00 ,$77.35 ,$9.68 ,$119.00 ,$85.68 ,$64.74 ,$27.37 ,$66.43 ,$27.37 ,$71.09 ,$71.09 ,$71.09 ,$71.09 ,$99.96 ,$27.37 ,$101.15 ,$99.96 ,$27.37 ,$89.25 ,$95.20 ,$95.20 ,$27.37 ,$95.20 ,$99.96 ,$99.96 ,$99.96 ,$107.10 ,$68.43 ,$27.37 ,$119.00 ,$9.68 ,$10.65 ,$30.11 ,$101.15 ,$71.09 ,$107.10 ,$99.96 ,$95.20 ,$95.20 ,$27.37 ,$77.35 ST. FRANCIS HOSPITAL - ACUTE,30200563,86885,HC INDIRECT COOMBS,302,1 ,$183.00 ,$118.95 ,$9.68 ,$183.00 ,$131.76 ,$99.55 ,$42.09 ,$102.15 ,$42.09 ,$109.32 ,$109.32 ,$109.32 ,$109.32 ,$153.72 ,$42.09 ,$155.55 ,$153.72 ,$42.09 ,$137.25 ,$146.40 ,$146.40 ,$42.09 ,$146.40 ,$153.72 ,$153.72 ,$153.72 ,$164.70 ,$105.23 ,$42.09 ,$183.00 ,$9.68 ,$10.65 ,$46.30 ,$155.55 ,$109.32 ,$164.70 ,$153.72 ,$146.40 ,$146.40 ,$42.09 ,$118.95 ST. FRANCIS HOSPITAL - ACUTE,30200564,86890,HC AUTOLOGOUS PROCESSING FEE,302,1 ,$123.00 ,$79.95 ,$28.29 ,$123.00 ,$88.56 ,$66.91 ,$28.29 ,$68.66 ,$28.29 ,$73.48 ,$73.48 ,$73.48 ,$73.48 ,$103.32 ,$28.29 ,$104.55 ,$103.32 ,$28.29 ,$92.25 ,$98.40 ,$98.40 ,$28.29 ,$98.40 ,$103.32 ,$103.32 ,$103.32 ,$110.70 ,$70.73 ,$28.29 ,$123.00 ,$39.07 ,$42.98 ,$31.12 ,$104.55 ,$73.48 ,$110.70 ,$103.32 ,$98.40 ,$98.40 ,$28.29 ,$79.95 ST. FRANCIS HOSPITAL - ACUTE,30200565,86900,HC BLOOD TYPING ABO,302,1 ,$63.00 ,$40.95 ,$6.00 ,$63.00 ,$45.36 ,$34.27 ,$14.49 ,$35.17 ,$14.49 ,$37.64 ,$37.64 ,$37.64 ,$37.64 ,$52.92 ,$14.49 ,$53.55 ,$52.92 ,$14.49 ,$47.25 ,$50.40 ,$50.40 ,$14.49 ,$50.40 ,$52.92 ,$52.92 ,$52.92 ,$56.70 ,$36.23 ,$14.49 ,$63.00 ,$6.00 ,$6.60 ,$15.94 ,$53.55 ,$37.64 ,$56.70 ,$52.92 ,$50.40 ,$50.40 ,$14.49 ,$40.95 ST. FRANCIS HOSPITAL - ACUTE,30200566,86901,HC BLOOD TYPING RH,302,1 ,$90.00 ,$58.50 ,$6.00 ,$90.00 ,$64.80 ,$48.96 ,$20.70 ,$50.24 ,$20.70 ,$53.77 ,$53.77 ,$53.77 ,$53.77 ,$75.60 ,$20.70 ,$76.50 ,$75.60 ,$20.70 ,$67.50 ,$72.00 ,$72.00 ,$20.70 ,$72.00 ,$75.60 ,$75.60 ,$75.60 ,$81.00 ,$51.75 ,$20.70 ,$90.00 ,$6.00 ,$6.60 ,$22.77 ,$76.50 ,$53.77 ,$81.00 ,$75.60 ,$72.00 ,$72.00 ,$20.70 ,$58.50 ST. FRANCIS HOSPITAL - ACUTE,30200568,86905,HC RBC ANTIGEN OTHER THAN ABO OR RH(D) EACH,302,1 ,$102.00 ,$66.30 ,$6.00 ,$102.00 ,$73.44 ,$55.49 ,$23.46 ,$56.94 ,$23.46 ,$60.93 ,$60.93 ,$60.93 ,$60.93 ,$85.68 ,$23.46 ,$86.70 ,$85.68 ,$23.46 ,$76.50 ,$81.60 ,$81.60 ,$23.46 ,$81.60 ,$85.68 ,$85.68 ,$85.68 ,$91.80 ,$58.65 ,$23.46 ,$102.00 ,$6.00 ,$6.60 ,$25.81 ,$86.70 ,$60.93 ,$91.80 ,$85.68 ,$81.60 ,$81.60 ,$23.46 ,$66.30 ST. FRANCIS HOSPITAL - ACUTE,30200569,86920,HC CROSSMATCH IMMEDIATE SPIN,302,1 ,$154.00 ,$100.10 ,$6.00 ,$154.00 ,$110.88 ,$83.78 ,$35.42 ,$85.96 ,$35.42 ,$92.00 ,$92.00 ,$92.00 ,$92.00 ,$129.36 ,$35.42 ,$130.90 ,$129.36 ,$35.42 ,$115.50 ,$123.20 ,$123.20 ,$35.42 ,$123.20 ,$129.36 ,$129.36 ,$129.36 ,$138.60 ,$88.55 ,$35.42 ,$154.00 ,$6.00 ,$6.60 ,$38.96 ,$130.90 ,$92.00 ,$138.60 ,$129.36 ,$123.20 ,$123.20 ,$35.42 ,$100.10 ST. FRANCIS HOSPITAL - ACUTE,30200571,86922,HC CROSSMATCH AHG,302,1 ,$29.00 ,$18.85 ,$6.67 ,$42.98 ,$20.88 ,$15.78 ,$6.67 ,$16.19 ,$6.67 ,$17.32 ,$17.32 ,$17.32 ,$17.32 ,$24.36 ,$6.67 ,$24.65 ,$24.36 ,$6.67 ,$21.75 ,$23.20 ,$23.20 ,$6.67 ,$23.20 ,$24.36 ,$24.36 ,$24.36 ,$26.10 ,$16.68 ,$6.67 ,$29.00 ,$39.07 ,$42.98 ,$7.34 ,$24.65 ,$17.32 ,$26.10 ,$24.36 ,$23.20 ,$23.20 ,$6.67 ,$18.85 ST. FRANCIS HOSPITAL - ACUTE,30200844,86001,HC RAST ALLERGEN IGG QN SQ EA-90,302,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$9.68 ,$10.65 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30200845,86003,HC RAST ALLERGEN IGE QN SQ EA-90,302,1 ,$20.00 ,$13.00 ,$4.60 ,$20.00 ,$14.40 ,$10.88 ,$4.60 ,$11.16 ,$4.60 ,$11.95 ,$11.95 ,$11.95 ,$11.95 ,$16.80 ,$4.60 ,$17.00 ,$16.80 ,$4.60 ,$15.00 ,$16.00 ,$16.00 ,$4.60 ,$16.00 ,$16.80 ,$16.80 ,$16.80 ,$18.00 ,$11.50 ,$4.60 ,$20.00 ,$9.68 ,$10.65 ,$5.06 ,$17.00 ,$11.95 ,$18.00 ,$16.80 ,$16.00 ,$16.00 ,$4.60 ,$13.00 ST. FRANCIS HOSPITAL - ACUTE,30200847,86021,HC LEUKO AB ID-90,302,1 ,$89.00 ,$57.85 ,$9.68 ,$89.00 ,$64.08 ,$48.42 ,$20.47 ,$49.68 ,$20.47 ,$53.17 ,$53.17 ,$53.17 ,$53.17 ,$74.76 ,$20.47 ,$75.65 ,$74.76 ,$20.47 ,$66.75 ,$71.20 ,$71.20 ,$20.47 ,$71.20 ,$74.76 ,$74.76 ,$74.76 ,$80.10 ,$51.18 ,$20.47 ,$89.00 ,$9.68 ,$10.65 ,$22.52 ,$75.65 ,$53.17 ,$80.10 ,$74.76 ,$71.20 ,$71.20 ,$20.47 ,$57.85 ST. FRANCIS HOSPITAL - ACUTE,30200851,86022,HC PLATELET AB ID-90,302,1 ,$62.00 ,$40.30 ,$9.68 ,$62.00 ,$44.64 ,$33.73 ,$14.26 ,$34.61 ,$14.26 ,$37.04 ,$37.04 ,$37.04 ,$37.04 ,$52.08 ,$14.26 ,$52.70 ,$52.08 ,$14.26 ,$46.50 ,$49.60 ,$49.60 ,$14.26 ,$49.60 ,$52.08 ,$52.08 ,$52.08 ,$55.80 ,$35.65 ,$14.26 ,$62.00 ,$9.68 ,$10.65 ,$15.69 ,$52.70 ,$37.04 ,$55.80 ,$52.08 ,$49.60 ,$49.60 ,$14.26 ,$40.30 ST. FRANCIS HOSPITAL - ACUTE,30200859,86039,HC ANA TITER-90,302,1 ,$59.00 ,$38.35 ,$9.68 ,$59.00 ,$42.48 ,$32.10 ,$13.57 ,$32.93 ,$13.57 ,$35.25 ,$35.25 ,$35.25 ,$35.25 ,$49.56 ,$13.57 ,$50.15 ,$49.56 ,$13.57 ,$44.25 ,$47.20 ,$47.20 ,$13.57 ,$47.20 ,$49.56 ,$49.56 ,$49.56 ,$53.10 ,$33.93 ,$13.57 ,$59.00 ,$9.68 ,$10.65 ,$14.93 ,$50.15 ,$35.25 ,$53.10 ,$49.56 ,$47.20 ,$47.20 ,$13.57 ,$38.35 ST. FRANCIS HOSPITAL - ACUTE,30200861,86140,HC C-REACTIVE PROTEIN-90,302,1 ,$147.00 ,$95.55 ,$9.68 ,$147.00 ,$105.84 ,$79.97 ,$33.81 ,$82.06 ,$33.81 ,$87.82 ,$87.82 ,$87.82 ,$87.82 ,$123.48 ,$33.81 ,$124.95 ,$123.48 ,$33.81 ,$110.25 ,$117.60 ,$117.60 ,$33.81 ,$117.60 ,$123.48 ,$123.48 ,$123.48 ,$132.30 ,$84.53 ,$33.81 ,$147.00 ,$9.68 ,$10.65 ,$37.19 ,$124.95 ,$87.82 ,$132.30 ,$123.48 ,$117.60 ,$117.60 ,$33.81 ,$95.55 ST. FRANCIS HOSPITAL - ACUTE,30200862,86140,HC C-REACTIVE PROTEIN,302,1 ,$147.00 ,$95.55 ,$9.68 ,$147.00 ,$105.84 ,$79.97 ,$33.81 ,$82.06 ,$33.81 ,$87.82 ,$87.82 ,$87.82 ,$87.82 ,$123.48 ,$33.81 ,$124.95 ,$123.48 ,$33.81 ,$110.25 ,$117.60 ,$117.60 ,$33.81 ,$117.60 ,$123.48 ,$123.48 ,$123.48 ,$132.30 ,$84.53 ,$33.81 ,$147.00 ,$9.68 ,$10.65 ,$37.19 ,$124.95 ,$87.82 ,$132.30 ,$123.48 ,$117.60 ,$117.60 ,$33.81 ,$95.55 ST. FRANCIS HOSPITAL - ACUTE,30200864,86146,HC BETA 2 GLYCO AB-90,302,1 ,$89.00 ,$57.85 ,$10.81 ,$89.00 ,$64.08 ,$48.42 ,$20.47 ,$49.68 ,$20.47 ,$53.17 ,$53.17 ,$53.17 ,$53.17 ,$74.76 ,$20.47 ,$75.65 ,$74.76 ,$20.47 ,$66.75 ,$71.20 ,$71.20 ,$20.47 ,$71.20 ,$74.76 ,$74.76 ,$74.76 ,$80.10 ,$51.18 ,$20.47 ,$89.00 ,$10.81 ,$11.89 ,$22.52 ,$75.65 ,$53.17 ,$80.10 ,$74.76 ,$71.20 ,$71.20 ,$20.47 ,$57.85 ST. FRANCIS HOSPITAL - ACUTE,30200865,86147,HC CARDIOLIPIN AB EA-90,302,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$16.68 ,$18.35 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30200866,86148,HC ANTI-PHOSPHATIDYLSERINE AB-90,302,1 ,$55.00 ,$35.75 ,$10.81 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 ,$10.81 ,$11.89 ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,30200868,86157,HC COLD AGGLUTININ TITER-90,302,1 ,$65.00 ,$42.25 ,$9.68 ,$65.00 ,$46.80 ,$35.36 ,$14.95 ,$36.28 ,$14.95 ,$38.83 ,$38.83 ,$38.83 ,$38.83 ,$54.60 ,$14.95 ,$55.25 ,$54.60 ,$14.95 ,$48.75 ,$52.00 ,$52.00 ,$14.95 ,$52.00 ,$54.60 ,$54.60 ,$54.60 ,$58.50 ,$37.38 ,$14.95 ,$65.00 ,$9.68 ,$10.65 ,$16.45 ,$55.25 ,$38.83 ,$58.50 ,$54.60 ,$52.00 ,$52.00 ,$14.95 ,$42.25 ST. FRANCIS HOSPITAL - ACUTE,30200869,86160,HC COMPLEMENT AG EA-90,302,1 ,$45.00 ,$29.25 ,$9.68 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$9.68 ,$10.65 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30200871,86162,HC COMPLEMENT TOTAL-90,302,1 ,$261.00 ,$169.65 ,$9.68 ,$261.00 ,$187.92 ,$141.98 ,$60.03 ,$145.69 ,$60.03 ,$155.92 ,$155.92 ,$155.92 ,$155.92 ,$219.24 ,$60.03 ,$221.85 ,$219.24 ,$60.03 ,$195.75 ,$208.80 ,$208.80 ,$60.03 ,$208.80 ,$219.24 ,$219.24 ,$219.24 ,$234.90 ,$150.08 ,$60.03 ,$261.00 ,$9.68 ,$10.65 ,$66.03 ,$221.85 ,$155.92 ,$234.90 ,$219.24 ,$208.80 ,$208.80 ,$60.03 ,$169.65 ST. FRANCIS HOSPITAL - ACUTE,30200873,86200,HC CCP AB-90,302,1 ,$138.00 ,$89.70 ,$9.68 ,$138.00 ,$99.36 ,$75.07 ,$31.74 ,$77.03 ,$31.74 ,$82.44 ,$82.44 ,$82.44 ,$82.44 ,$115.92 ,$31.74 ,$117.30 ,$115.92 ,$31.74 ,$103.50 ,$110.40 ,$110.40 ,$31.74 ,$110.40 ,$115.92 ,$115.92 ,$115.92 ,$124.20 ,$79.35 ,$31.74 ,$138.00 ,$9.68 ,$10.65 ,$34.91 ,$117.30 ,$82.44 ,$124.20 ,$115.92 ,$110.40 ,$110.40 ,$31.74 ,$89.70 ST. FRANCIS HOSPITAL - ACUTE,30200878,86255,HC FLUOR AB SCR-90,302,1 ,$183.00 ,$118.95 ,$16.68 ,$183.00 ,$131.76 ,$99.55 ,$42.09 ,$102.15 ,$42.09 ,$109.32 ,$109.32 ,$109.32 ,$109.32 ,$153.72 ,$42.09 ,$155.55 ,$153.72 ,$42.09 ,$137.25 ,$146.40 ,$146.40 ,$42.09 ,$146.40 ,$153.72 ,$153.72 ,$153.72 ,$164.70 ,$105.23 ,$42.09 ,$183.00 ,$16.68 ,$18.35 ,$46.30 ,$155.55 ,$109.32 ,$164.70 ,$153.72 ,$146.40 ,$146.40 ,$42.09 ,$118.95 ST. FRANCIS HOSPITAL - ACUTE,30200879,86256,HC FLUOR AB TITER-90,302,1 ,$234.00 ,$152.10 ,$16.68 ,$234.00 ,$168.48 ,$127.30 ,$53.82 ,$130.62 ,$53.82 ,$139.79 ,$139.79 ,$139.79 ,$139.79 ,$196.56 ,$53.82 ,$198.90 ,$196.56 ,$53.82 ,$175.50 ,$187.20 ,$187.20 ,$53.82 ,$187.20 ,$196.56 ,$196.56 ,$196.56 ,$210.60 ,$134.55 ,$53.82 ,$234.00 ,$16.68 ,$18.35 ,$59.20 ,$198.90 ,$139.79 ,$210.60 ,$196.56 ,$187.20 ,$187.20 ,$53.82 ,$152.10 ST. FRANCIS HOSPITAL - ACUTE,30200880,86300,HC TUMOR AG CA 15-3 (27.29)-90,302,1 ,$242.00 ,$157.30 ,$25.65 ,$242.00 ,$174.24 ,$131.65 ,$55.66 ,$135.08 ,$55.66 ,$144.57 ,$144.57 ,$144.57 ,$144.57 ,$203.28 ,$55.66 ,$205.70 ,$203.28 ,$55.66 ,$181.50 ,$193.60 ,$193.60 ,$55.66 ,$193.60 ,$203.28 ,$203.28 ,$203.28 ,$217.80 ,$139.15 ,$55.66 ,$242.00 ,$25.65 ,$28.22 ,$61.23 ,$205.70 ,$144.57 ,$217.80 ,$203.28 ,$193.60 ,$193.60 ,$55.66 ,$157.30 ST. FRANCIS HOSPITAL - ACUTE,30200881,86301,HC TUMOR AG CA 19-9 -90,302,1 ,$298.00 ,$193.70 ,$25.65 ,$298.00 ,$214.56 ,$162.11 ,$68.54 ,$166.34 ,$68.54 ,$178.03 ,$178.03 ,$178.03 ,$178.03 ,$250.32 ,$68.54 ,$253.30 ,$250.32 ,$68.54 ,$223.50 ,$238.40 ,$238.40 ,$68.54 ,$238.40 ,$250.32 ,$250.32 ,$250.32 ,$268.20 ,$171.35 ,$68.54 ,$298.00 ,$25.65 ,$28.22 ,$75.39 ,$253.30 ,$178.03 ,$268.20 ,$250.32 ,$238.40 ,$238.40 ,$68.54 ,$193.70 ST. FRANCIS HOSPITAL - ACUTE,30200883,86305,HC HE4 OVARIAN CANCER-90,302,1 ,$446.00 ,$289.90 ,$25.65 ,$446.00 ,$321.12 ,$242.62 ,$102.58 ,$248.96 ,$102.58 ,$266.44 ,$266.44 ,$266.44 ,$266.44 ,$374.64 ,$102.58 ,$379.10 ,$374.64 ,$102.58 ,$334.50 ,$356.80 ,$356.80 ,$102.58 ,$356.80 ,$374.64 ,$374.64 ,$374.64 ,$401.40 ,$256.45 ,$102.58 ,$446.00 ,$25.65 ,$28.22 ,$112.84 ,$379.10 ,$266.44 ,$401.40 ,$374.64 ,$356.80 ,$356.80 ,$102.58 ,$289.90 ST. FRANCIS HOSPITAL - ACUTE,30200887,86635,HC COCCIDIOIDES AB-90,302,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$16.68 ,$18.35 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30200888,86638,HC Q FEVER AB-90,302,1 ,$53.00 ,$34.45 ,$12.19 ,$53.00 ,$38.16 ,$28.83 ,$12.19 ,$29.58 ,$12.19 ,$31.66 ,$31.66 ,$31.66 ,$31.66 ,$44.52 ,$12.19 ,$45.05 ,$44.52 ,$12.19 ,$39.75 ,$42.40 ,$42.40 ,$12.19 ,$42.40 ,$44.52 ,$44.52 ,$44.52 ,$47.70 ,$30.48 ,$12.19 ,$53.00 ,$16.68 ,$18.35 ,$13.41 ,$45.05 ,$31.66 ,$47.70 ,$44.52 ,$42.40 ,$42.40 ,$12.19 ,$34.45 ST. FRANCIS HOSPITAL - ACUTE,30200890,86644,HC CMV AB-90,302,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$16.68 ,$18.35 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30200892,86648,HC DIPTHERIA-90,302,1 ,$54.00 ,$35.10 ,$12.42 ,$54.00 ,$38.88 ,$29.38 ,$12.42 ,$30.14 ,$12.42 ,$32.26 ,$32.26 ,$32.26 ,$32.26 ,$45.36 ,$12.42 ,$45.90 ,$45.36 ,$12.42 ,$40.50 ,$43.20 ,$43.20 ,$12.42 ,$43.20 ,$45.36 ,$45.36 ,$45.36 ,$48.60 ,$31.05 ,$12.42 ,$54.00 ,$16.68 ,$18.35 ,$13.66 ,$45.90 ,$32.26 ,$48.60 ,$45.36 ,$43.20 ,$43.20 ,$12.42 ,$35.10 ST. FRANCIS HOSPITAL - ACUTE,30200899,86664,HC EBV NUCLEAR AG-90,302,1 ,$83.00 ,$53.95 ,$16.68 ,$83.00 ,$59.76 ,$45.15 ,$19.09 ,$46.33 ,$19.09 ,$49.58 ,$49.58 ,$49.58 ,$49.58 ,$69.72 ,$19.09 ,$70.55 ,$69.72 ,$19.09 ,$62.25 ,$66.40 ,$66.40 ,$19.09 ,$66.40 ,$69.72 ,$69.72 ,$69.72 ,$74.70 ,$47.73 ,$19.09 ,$83.00 ,$16.68 ,$18.35 ,$21.00 ,$70.55 ,$49.58 ,$74.70 ,$69.72 ,$66.40 ,$66.40 ,$19.09 ,$53.95 ST. FRANCIS HOSPITAL - ACUTE,30200900,86665,HC EBV VIRAL CAP-90,302,1 ,$83.00 ,$53.95 ,$16.68 ,$83.00 ,$59.76 ,$45.15 ,$19.09 ,$46.33 ,$19.09 ,$49.58 ,$49.58 ,$49.58 ,$49.58 ,$69.72 ,$19.09 ,$70.55 ,$69.72 ,$19.09 ,$62.25 ,$66.40 ,$66.40 ,$19.09 ,$66.40 ,$69.72 ,$69.72 ,$69.72 ,$74.70 ,$47.73 ,$19.09 ,$83.00 ,$16.68 ,$18.35 ,$21.00 ,$70.55 ,$49.58 ,$74.70 ,$69.72 ,$66.40 ,$66.40 ,$19.09 ,$53.95 ST. FRANCIS HOSPITAL - ACUTE,30200901,86666,HC EHRLICHIA AB-90,302,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$16.68 ,$18.35 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30200903,86671,HC FUNGUS AB NOS-90,302,1 ,$178.00 ,$115.70 ,$9.68 ,$178.00 ,$128.16 ,$96.83 ,$40.94 ,$99.36 ,$40.94 ,$106.34 ,$106.34 ,$106.34 ,$106.34 ,$149.52 ,$40.94 ,$151.30 ,$149.52 ,$40.94 ,$133.50 ,$142.40 ,$142.40 ,$40.94 ,$142.40 ,$149.52 ,$149.52 ,$149.52 ,$160.20 ,$102.35 ,$40.94 ,$178.00 ,$9.68 ,$10.65 ,$45.03 ,$151.30 ,$106.34 ,$160.20 ,$149.52 ,$142.40 ,$142.40 ,$40.94 ,$115.70 ST. FRANCIS HOSPITAL - ACUTE,30200912,86695,HC HERPES SIMPLEX AB I-90,302,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$16.68 ,$18.35 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30200913,86696,HC HERPES SIMPLEX AB II-90,302,1 ,$45.00 ,$29.25 ,$9.68 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$9.68 ,$10.65 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30200914,86698,HC HISTOPLASMA AB-90,302,1 ,$96.00 ,$62.40 ,$16.68 ,$96.00 ,$69.12 ,$52.22 ,$22.08 ,$53.59 ,$22.08 ,$57.35 ,$57.35 ,$57.35 ,$57.35 ,$80.64 ,$22.08 ,$81.60 ,$80.64 ,$22.08 ,$72.00 ,$76.80 ,$76.80 ,$22.08 ,$76.80 ,$80.64 ,$80.64 ,$80.64 ,$86.40 ,$55.20 ,$22.08 ,$96.00 ,$16.68 ,$18.35 ,$24.29 ,$81.60 ,$57.35 ,$86.40 ,$80.64 ,$76.80 ,$76.80 ,$22.08 ,$62.40 ST. FRANCIS HOSPITAL - ACUTE,30200923,86707,HC HEP B E AB-90,302,1 ,$45.00 ,$29.25 ,$9.68 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$9.68 ,$10.65 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30200924,86708,HC HEP A AB TOTAL-90,302,1 ,$95.00 ,$61.75 ,$9.68 ,$95.00 ,$68.40 ,$51.68 ,$21.85 ,$53.03 ,$21.85 ,$56.75 ,$56.75 ,$56.75 ,$56.75 ,$79.80 ,$21.85 ,$80.75 ,$79.80 ,$21.85 ,$71.25 ,$76.00 ,$76.00 ,$21.85 ,$76.00 ,$79.80 ,$79.80 ,$79.80 ,$85.50 ,$54.63 ,$21.85 ,$95.00 ,$9.68 ,$10.65 ,$24.04 ,$80.75 ,$56.75 ,$85.50 ,$79.80 ,$76.00 ,$76.00 ,$21.85 ,$61.75 ST. FRANCIS HOSPITAL - ACUTE,30200925,86709,HC HEP A AB IGM-90,302,1 ,$89.00 ,$57.85 ,$9.68 ,$89.00 ,$64.08 ,$48.42 ,$20.47 ,$49.68 ,$20.47 ,$53.17 ,$53.17 ,$53.17 ,$53.17 ,$74.76 ,$20.47 ,$75.65 ,$74.76 ,$20.47 ,$66.75 ,$71.20 ,$71.20 ,$20.47 ,$71.20 ,$74.76 ,$74.76 ,$74.76 ,$80.10 ,$51.18 ,$20.47 ,$89.00 ,$9.68 ,$10.65 ,$22.52 ,$75.65 ,$53.17 ,$80.10 ,$74.76 ,$71.20 ,$71.20 ,$20.47 ,$57.85 ST. FRANCIS HOSPITAL - ACUTE,30200926,86710,HC INFLUENZA AB-90,302,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 ,$9.68 ,$10.65 ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,30200932,86738,HC MYCOPLASMA AB-90,302,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$16.68 ,$18.35 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30200935,86747,HC PARVOVIRUS AB-90,302,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$16.68 ,$18.35 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30200943,86774,HC TETANUS AB-90,302,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$16.68 ,$18.35 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30200944,86777,HC TOXOPLASMA AB-90,302,1 ,$100.00 ,$65.00 ,$16.68 ,$100.00 ,$72.00 ,$54.40 ,$23.00 ,$55.82 ,$23.00 ,$59.74 ,$59.74 ,$59.74 ,$59.74 ,$84.00 ,$23.00 ,$85.00 ,$84.00 ,$23.00 ,$75.00 ,$80.00 ,$80.00 ,$23.00 ,$80.00 ,$84.00 ,$84.00 ,$84.00 ,$90.00 ,$57.50 ,$23.00 ,$100.00 ,$16.68 ,$18.35 ,$25.30 ,$85.00 ,$59.74 ,$90.00 ,$84.00 ,$80.00 ,$80.00 ,$23.00 ,$65.00 ST. FRANCIS HOSPITAL - ACUTE,30200945,86778,HC TOXOPLASMA AB IGM-90,302,1 ,$100.00 ,$65.00 ,$16.68 ,$100.00 ,$72.00 ,$54.40 ,$23.00 ,$55.82 ,$23.00 ,$59.74 ,$59.74 ,$59.74 ,$59.74 ,$84.00 ,$23.00 ,$85.00 ,$84.00 ,$23.00 ,$75.00 ,$80.00 ,$80.00 ,$23.00 ,$80.00 ,$84.00 ,$84.00 ,$84.00 ,$90.00 ,$57.50 ,$23.00 ,$100.00 ,$16.68 ,$18.35 ,$25.30 ,$85.00 ,$59.74 ,$90.00 ,$84.00 ,$80.00 ,$80.00 ,$23.00 ,$65.00 ST. FRANCIS HOSPITAL - ACUTE,30200946,86780,HC TREPONEMA P AB CONFIRM-90,302,1 ,$65.00 ,$42.25 ,$14.95 ,$65.00 ,$46.80 ,$35.36 ,$14.95 ,$36.28 ,$14.95 ,$38.83 ,$38.83 ,$38.83 ,$38.83 ,$54.60 ,$14.95 ,$55.25 ,$54.60 ,$14.95 ,$48.75 ,$52.00 ,$52.00 ,$14.95 ,$52.00 ,$54.60 ,$54.60 ,$54.60 ,$58.50 ,$37.38 ,$14.95 ,$65.00 ,$16.68 ,$18.35 ,$16.45 ,$55.25 ,$38.83 ,$58.50 ,$54.60 ,$52.00 ,$52.00 ,$14.95 ,$42.25 ST. FRANCIS HOSPITAL - ACUTE,30200948,86787,HC VARICELLA ZOSTER AB-90,302,1 ,$45.00 ,$29.25 ,$9.68 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$9.68 ,$10.65 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30200949,86788,HC WEST NILE VIRUS AB IGM-90,302,1 ,$38.00 ,$24.70 ,$8.74 ,$38.00 ,$27.36 ,$20.67 ,$8.74 ,$21.21 ,$8.74 ,$22.70 ,$22.70 ,$22.70 ,$22.70 ,$31.92 ,$8.74 ,$32.30 ,$31.92 ,$8.74 ,$28.50 ,$30.40 ,$30.40 ,$8.74 ,$30.40 ,$31.92 ,$31.92 ,$31.92 ,$34.20 ,$21.85 ,$8.74 ,$38.00 ,$16.68 ,$18.35 ,$9.61 ,$32.30 ,$22.70 ,$34.20 ,$31.92 ,$30.40 ,$30.40 ,$8.74 ,$24.70 ST. FRANCIS HOSPITAL - ACUTE,30200950,86789,HC WEST NILE AB-90,302,1 ,$38.00 ,$24.70 ,$8.74 ,$38.00 ,$27.36 ,$20.67 ,$8.74 ,$21.21 ,$8.74 ,$22.70 ,$22.70 ,$22.70 ,$22.70 ,$31.92 ,$8.74 ,$32.30 ,$31.92 ,$8.74 ,$28.50 ,$30.40 ,$30.40 ,$8.74 ,$30.40 ,$31.92 ,$31.92 ,$31.92 ,$34.20 ,$21.85 ,$8.74 ,$38.00 ,$16.68 ,$18.35 ,$9.61 ,$32.30 ,$22.70 ,$34.20 ,$31.92 ,$30.40 ,$30.40 ,$8.74 ,$24.70 ST. FRANCIS HOSPITAL - ACUTE,30200953,86800,HC THYROGLOBULIN AB-90,302,1 ,$22.00 ,$14.30 ,$5.06 ,$27.82 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$25.29 ,$27.82 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30200960,86812,HC HLA TYPING SINGLE A/B/C-90,302,1 ,$275.00 ,$178.75 ,$39.07 ,$275.00 ,$198.00 ,$149.60 ,$63.25 ,$153.51 ,$63.25 ,$164.29 ,$164.29 ,$164.29 ,$164.29 ,$231.00 ,$63.25 ,$233.75 ,$231.00 ,$63.25 ,$206.25 ,$220.00 ,$220.00 ,$63.25 ,$220.00 ,$231.00 ,$231.00 ,$231.00 ,$247.50 ,$158.13 ,$63.25 ,$275.00 ,$39.07 ,$42.98 ,$69.58 ,$233.75 ,$164.29 ,$247.50 ,$231.00 ,$220.00 ,$220.00 ,$63.25 ,$178.75 ST. FRANCIS HOSPITAL - ACUTE,30200966,86850,HC AB SCREEN-90,302,1 ,$90.00 ,$58.50 ,$9.68 ,$90.00 ,$64.80 ,$48.96 ,$20.70 ,$50.24 ,$20.70 ,$53.77 ,$53.77 ,$53.77 ,$53.77 ,$75.60 ,$20.70 ,$76.50 ,$75.60 ,$20.70 ,$67.50 ,$72.00 ,$72.00 ,$20.70 ,$72.00 ,$75.60 ,$75.60 ,$75.60 ,$81.00 ,$51.75 ,$20.70 ,$90.00 ,$9.68 ,$10.65 ,$22.77 ,$76.50 ,$53.77 ,$81.00 ,$75.60 ,$72.00 ,$72.00 ,$20.70 ,$58.50 ST. FRANCIS HOSPITAL - ACUTE,30200970,86860,HC ELUTION-90,302,1 ,$204.00 ,$132.60 ,$9.68 ,$204.00 ,$146.88 ,$110.98 ,$46.92 ,$113.87 ,$46.92 ,$121.87 ,$121.87 ,$121.87 ,$121.87 ,$171.36 ,$46.92 ,$173.40 ,$171.36 ,$46.92 ,$153.00 ,$163.20 ,$163.20 ,$46.92 ,$163.20 ,$171.36 ,$171.36 ,$171.36 ,$183.60 ,$117.30 ,$46.92 ,$204.00 ,$9.68 ,$10.65 ,$51.61 ,$173.40 ,$121.87 ,$183.60 ,$171.36 ,$163.20 ,$163.20 ,$46.92 ,$132.60 ST. FRANCIS HOSPITAL - ACUTE,30200974,86870,HC RBC AB ID PANEL-90,302,1 ,$159.00 ,$103.35 ,$9.68 ,$159.00 ,$114.48 ,$86.50 ,$36.57 ,$88.75 ,$36.57 ,$94.99 ,$94.99 ,$94.99 ,$94.99 ,$133.56 ,$36.57 ,$135.15 ,$133.56 ,$36.57 ,$119.25 ,$127.20 ,$127.20 ,$36.57 ,$127.20 ,$133.56 ,$133.56 ,$133.56 ,$143.10 ,$91.43 ,$36.57 ,$159.00 ,$9.68 ,$10.65 ,$40.23 ,$135.15 ,$94.99 ,$143.10 ,$133.56 ,$127.20 ,$127.20 ,$36.57 ,$103.35 ST. FRANCIS HOSPITAL - ACUTE,30200976,86880,HC COOMBS DIRECT-90,302,1 ,$119.00 ,$77.35 ,$9.68 ,$119.00 ,$85.68 ,$64.74 ,$27.37 ,$66.43 ,$27.37 ,$71.09 ,$71.09 ,$71.09 ,$71.09 ,$99.96 ,$27.37 ,$101.15 ,$99.96 ,$27.37 ,$89.25 ,$95.20 ,$95.20 ,$27.37 ,$95.20 ,$99.96 ,$99.96 ,$99.96 ,$107.10 ,$68.43 ,$27.37 ,$119.00 ,$9.68 ,$10.65 ,$30.11 ,$101.15 ,$71.09 ,$107.10 ,$99.96 ,$95.20 ,$95.20 ,$27.37 ,$77.35 ST. FRANCIS HOSPITAL - ACUTE,30200978,86886,HC INDIRECT TITER-90,302,1 ,$148.00 ,$96.20 ,$9.68 ,$148.00 ,$106.56 ,$80.51 ,$34.04 ,$82.61 ,$34.04 ,$88.42 ,$88.42 ,$88.42 ,$88.42 ,$124.32 ,$34.04 ,$125.80 ,$124.32 ,$34.04 ,$111.00 ,$118.40 ,$118.40 ,$34.04 ,$118.40 ,$124.32 ,$124.32 ,$124.32 ,$133.20 ,$85.10 ,$34.04 ,$148.00 ,$9.68 ,$10.65 ,$37.44 ,$125.80 ,$88.42 ,$133.20 ,$124.32 ,$118.40 ,$118.40 ,$34.04 ,$96.20 ST. FRANCIS HOSPITAL - ACUTE,30200981,86900,HC BLOOD TYPING ABO-90,302,1 ,$63.00 ,$40.95 ,$6.00 ,$63.00 ,$45.36 ,$34.27 ,$14.49 ,$35.17 ,$14.49 ,$37.64 ,$37.64 ,$37.64 ,$37.64 ,$52.92 ,$14.49 ,$53.55 ,$52.92 ,$14.49 ,$47.25 ,$50.40 ,$50.40 ,$14.49 ,$50.40 ,$52.92 ,$52.92 ,$52.92 ,$56.70 ,$36.23 ,$14.49 ,$63.00 ,$6.00 ,$6.60 ,$15.94 ,$53.55 ,$37.64 ,$56.70 ,$52.92 ,$50.40 ,$50.40 ,$14.49 ,$40.95 ST. FRANCIS HOSPITAL - ACUTE,30200983,86901,HC BLOOD TYPING RH-90,302,1 ,$90.00 ,$58.50 ,$6.00 ,$90.00 ,$64.80 ,$48.96 ,$20.70 ,$50.24 ,$20.70 ,$53.77 ,$53.77 ,$53.77 ,$53.77 ,$75.60 ,$20.70 ,$76.50 ,$75.60 ,$20.70 ,$67.50 ,$72.00 ,$72.00 ,$20.70 ,$72.00 ,$75.60 ,$75.60 ,$75.60 ,$81.00 ,$51.75 ,$20.70 ,$90.00 ,$6.00 ,$6.60 ,$22.77 ,$76.50 ,$53.77 ,$81.00 ,$75.60 ,$72.00 ,$72.00 ,$20.70 ,$58.50 ST. FRANCIS HOSPITAL - ACUTE,30200998,86906,HC RH PHENOTYPE COMPLETE-90,302,1 ,$102.00 ,$66.30 ,$6.00 ,$102.00 ,$73.44 ,$55.49 ,$23.46 ,$56.94 ,$23.46 ,$60.93 ,$60.93 ,$60.93 ,$60.93 ,$85.68 ,$23.46 ,$86.70 ,$85.68 ,$23.46 ,$76.50 ,$81.60 ,$81.60 ,$23.46 ,$81.60 ,$85.68 ,$85.68 ,$85.68 ,$91.80 ,$58.65 ,$23.46 ,$102.00 ,$6.00 ,$6.60 ,$25.81 ,$86.70 ,$60.93 ,$91.80 ,$85.68 ,$81.60 ,$81.60 ,$23.46 ,$66.30 ST. FRANCIS HOSPITAL - ACUTE,30201001,86940,HC HEOLYSIN AGG AUTO SCREEN-90,302,1 ,$104.00 ,$67.60 ,$16.68 ,$104.00 ,$74.88 ,$56.58 ,$23.92 ,$58.05 ,$23.92 ,$62.13 ,$62.13 ,$62.13 ,$62.13 ,$87.36 ,$23.92 ,$88.40 ,$87.36 ,$23.92 ,$78.00 ,$83.20 ,$83.20 ,$23.92 ,$83.20 ,$87.36 ,$87.36 ,$87.36 ,$93.60 ,$59.80 ,$23.92 ,$104.00 ,$16.68 ,$18.35 ,$26.31 ,$88.40 ,$62.13 ,$93.60 ,$87.36 ,$83.20 ,$83.20 ,$23.92 ,$67.60 ST. FRANCIS HOSPITAL - ACUTE,30201003,86970,HC RBC PRETREAT CHEM-90,302,1 ,$125.00 ,$81.25 ,$28.75 ,$125.00 ,$90.00 ,$68.00 ,$28.75 ,$69.78 ,$28.75 ,$74.68 ,$74.68 ,$74.68 ,$74.68 ,$105.00 ,$28.75 ,$106.25 ,$105.00 ,$28.75 ,$93.75 ,$100.00 ,$100.00 ,$28.75 ,$100.00 ,$105.00 ,$105.00 ,$105.00 ,$112.50 ,$71.88 ,$28.75 ,$125.00 ,$39.07 ,$42.98 ,$31.63 ,$106.25 ,$74.68 ,$112.50 ,$105.00 ,$100.00 ,$100.00 ,$28.75 ,$81.25 ST. FRANCIS HOSPITAL - ACUTE,30201005,86971,HC RBC PRETREAT ENZYME-90,302,1 ,$56.00 ,$36.40 ,$12.88 ,$56.00 ,$40.32 ,$30.46 ,$12.88 ,$31.26 ,$12.88 ,$33.45 ,$33.45 ,$33.45 ,$33.45 ,$47.04 ,$12.88 ,$47.60 ,$47.04 ,$12.88 ,$42.00 ,$44.80 ,$44.80 ,$12.88 ,$44.80 ,$47.04 ,$47.04 ,$47.04 ,$50.40 ,$32.20 ,$12.88 ,$56.00 ,$39.07 ,$42.98 ,$14.17 ,$47.60 ,$33.45 ,$50.40 ,$47.04 ,$44.80 ,$44.80 ,$12.88 ,$36.40 ST. FRANCIS HOSPITAL - ACUTE,30201007,86972,HC RBC PRETREAT DENSITY SEP-90,302,1 ,$131.00 ,$85.15 ,$30.13 ,$131.00 ,$94.32 ,$71.26 ,$30.13 ,$73.12 ,$30.13 ,$78.26 ,$78.26 ,$78.26 ,$78.26 ,$110.04 ,$30.13 ,$111.35 ,$110.04 ,$30.13 ,$98.25 ,$104.80 ,$104.80 ,$30.13 ,$104.80 ,$110.04 ,$110.04 ,$110.04 ,$117.90 ,$75.33 ,$30.13 ,$131.00 ,$39.07 ,$42.98 ,$33.14 ,$111.35 ,$78.26 ,$117.90 ,$110.04 ,$104.80 ,$104.80 ,$30.13 ,$85.15 ST. FRANCIS HOSPITAL - ACUTE,30201016,86977,HC RBC PRETREAT NEUTRAL SERUM INHIBIT-90,302,1 ,$125.00 ,$81.25 ,$28.75 ,$125.00 ,$90.00 ,$68.00 ,$28.75 ,$69.78 ,$28.75 ,$74.68 ,$74.68 ,$74.68 ,$74.68 ,$105.00 ,$28.75 ,$106.25 ,$105.00 ,$28.75 ,$93.75 ,$100.00 ,$100.00 ,$28.75 ,$100.00 ,$105.00 ,$105.00 ,$105.00 ,$112.50 ,$71.88 ,$28.75 ,$125.00 ,$39.07 ,$42.98 ,$31.63 ,$106.25 ,$74.68 ,$112.50 ,$105.00 ,$100.00 ,$100.00 ,$28.75 ,$81.25 ST. FRANCIS HOSPITAL - ACUTE,30201020,86978,HC RBC PRETREAT ABSOR-90,302,1 ,$102.00 ,$66.30 ,$6.00 ,$102.00 ,$73.44 ,$55.49 ,$23.46 ,$56.94 ,$23.46 ,$60.93 ,$60.93 ,$60.93 ,$60.93 ,$85.68 ,$23.46 ,$86.70 ,$85.68 ,$23.46 ,$76.50 ,$81.60 ,$81.60 ,$23.46 ,$81.60 ,$85.68 ,$85.68 ,$85.68 ,$91.80 ,$58.65 ,$23.46 ,$102.00 ,$6.00 ,$6.60 ,$25.81 ,$86.70 ,$60.93 ,$91.80 ,$85.68 ,$81.60 ,$81.60 ,$23.46 ,$66.30 ST. FRANCIS HOSPITAL - ACUTE,30201022,87801,HC INFECT MLT ORG AMP-90,302,1 ,$245.00 ,$159.25 ,$7.72 ,$245.00 ,$176.40 ,$133.28 ,$56.35 ,$136.76 ,$56.35 ,$146.36 ,$146.36 ,$146.36 ,$146.36 ,$205.80 ,$56.35 ,$208.25 ,$205.80 ,$56.35 ,$183.75 ,$196.00 ,$196.00 ,$56.35 ,$196.00 ,$205.80 ,$205.80 ,$205.80 ,$220.50 ,$140.88 ,$56.35 ,$245.00 ,$7.72 ,$8.49 ,$61.99 ,$208.25 ,$146.36 ,$220.50 ,$205.80 ,$196.00 ,$196.00 ,$56.35 ,$159.25 ST. FRANCIS HOSPITAL - ACUTE,30201025,86316,HC TUMOR AG OTHER AG QN-90,302,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$10.81 ,$11.89 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30201026,86317,HC INFECTIOUS AB QN-90,302,1 ,$7.00 ,$4.55 ,$1.61 ,$18.35 ,$5.04 ,$3.81 ,$1.61 ,$3.91 ,$1.61 ,$4.18 ,$4.18 ,$4.18 ,$4.18 ,$5.88 ,$1.61 ,$5.95 ,$5.88 ,$1.61 ,$5.25 ,$5.60 ,$5.60 ,$1.61 ,$5.60 ,$5.88 ,$5.88 ,$5.88 ,$6.30 ,$4.03 ,$1.61 ,$7.00 ,$16.68 ,$18.35 ,$1.77 ,$5.95 ,$4.18 ,$6.30 ,$5.88 ,$5.60 ,$5.60 ,$1.61 ,$4.55 ST. FRANCIS HOSPITAL - ACUTE,30201028,86329,HC IMMUNODIFFUSION NOS-90,302,1 ,$98.00 ,$63.70 ,$16.68 ,$98.00 ,$70.56 ,$53.31 ,$22.54 ,$54.70 ,$22.54 ,$58.55 ,$58.55 ,$58.55 ,$58.55 ,$82.32 ,$22.54 ,$83.30 ,$82.32 ,$22.54 ,$73.50 ,$78.40 ,$78.40 ,$22.54 ,$78.40 ,$82.32 ,$82.32 ,$82.32 ,$88.20 ,$56.35 ,$22.54 ,$98.00 ,$16.68 ,$18.35 ,$24.79 ,$83.30 ,$58.55 ,$88.20 ,$82.32 ,$78.40 ,$78.40 ,$22.54 ,$63.70 ST. FRANCIS HOSPITAL - ACUTE,30201031,86334,HC IMMUNOFIX ELECTRO SERUM -90,302,1 ,$227.00 ,$147.55 ,$16.68 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 ,$16.68 ,$18.35 ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,30201033,86336,HC INHIBIN A-90,302,1 ,$65.00 ,$42.25 ,$10.81 ,$65.00 ,$46.80 ,$35.36 ,$14.95 ,$36.28 ,$14.95 ,$38.83 ,$38.83 ,$38.83 ,$38.83 ,$54.60 ,$14.95 ,$55.25 ,$54.60 ,$14.95 ,$48.75 ,$52.00 ,$52.00 ,$14.95 ,$52.00 ,$54.60 ,$54.60 ,$54.60 ,$58.50 ,$37.38 ,$14.95 ,$65.00 ,$10.81 ,$11.89 ,$16.45 ,$55.25 ,$38.83 ,$58.50 ,$54.60 ,$52.00 ,$52.00 ,$14.95 ,$42.25 ST. FRANCIS HOSPITAL - ACUTE,30201034,86337,HC INSULIN AB-90,302,1 ,$181.00 ,$117.65 ,$25.29 ,$181.00 ,$130.32 ,$98.46 ,$41.63 ,$101.03 ,$41.63 ,$108.13 ,$108.13 ,$108.13 ,$108.13 ,$152.04 ,$41.63 ,$153.85 ,$152.04 ,$41.63 ,$135.75 ,$144.80 ,$144.80 ,$41.63 ,$144.80 ,$152.04 ,$152.04 ,$152.04 ,$162.90 ,$104.08 ,$41.63 ,$181.00 ,$25.29 ,$27.82 ,$45.79 ,$153.85 ,$108.13 ,$162.90 ,$152.04 ,$144.80 ,$144.80 ,$41.63 ,$117.65 ST. FRANCIS HOSPITAL - ACUTE,30201035,86340,HC INTRINSIC FACTOR AB-90,302,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$25.29 ,$27.82 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30201036,86341,HC ISLET CELL AB-90,302,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$16.68 ,$18.35 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30201041,86356,HC MOL ANTIGEN QN EA-90,302,1 ,$342.00 ,$222.30 ,$16.68 ,$342.00 ,$246.24 ,$186.05 ,$78.66 ,$190.90 ,$78.66 ,$204.31 ,$204.31 ,$204.31 ,$204.31 ,$287.28 ,$78.66 ,$290.70 ,$287.28 ,$78.66 ,$256.50 ,$273.60 ,$273.60 ,$78.66 ,$273.60 ,$287.28 ,$287.28 ,$287.28 ,$307.80 ,$196.65 ,$78.66 ,$342.00 ,$16.68 ,$18.35 ,$86.53 ,$290.70 ,$204.31 ,$307.80 ,$287.28 ,$273.60 ,$273.60 ,$78.66 ,$222.30 ST. FRANCIS HOSPITAL - ACUTE,30201043,86359,HC T CELLS TOTAL COUNT-90,302,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$16.68 ,$18.35 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30201045,86360,HC ABS T CELLS CD4 CD8 RATIO-90,302,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$16.68 ,$18.35 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30201047,86376,HC MICROSOMAL AB-90,302,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$25.29 ,$27.82 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30201052,86431,HC RHEUMATOID FACTOR QN-90,302,1 ,$241.00 ,$156.65 ,$9.68 ,$241.00 ,$173.52 ,$131.10 ,$55.43 ,$134.53 ,$55.43 ,$143.97 ,$143.97 ,$143.97 ,$143.97 ,$202.44 ,$55.43 ,$204.85 ,$202.44 ,$55.43 ,$180.75 ,$192.80 ,$192.80 ,$55.43 ,$192.80 ,$202.44 ,$202.44 ,$202.44 ,$216.90 ,$138.58 ,$55.43 ,$241.00 ,$9.68 ,$10.65 ,$60.97 ,$204.85 ,$143.97 ,$216.90 ,$202.44 ,$192.80 ,$192.80 ,$55.43 ,$156.65 ST. FRANCIS HOSPITAL - ACUTE,30201055,86603,HC ADENOVIRUS AB-90,302,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$16.68 ,$18.35 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30201056,86606,HC ASPERGILLUS AB-90,302,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$16.68 ,$18.35 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30201058,86611,HC BARTONELLA SCREEN AB-90,302,1 ,$45.00 ,$29.25 ,$10.35 ,$45.00 ,$32.40 ,$24.48 ,$10.35 ,$25.12 ,$10.35 ,$26.88 ,$26.88 ,$26.88 ,$26.88 ,$37.80 ,$10.35 ,$38.25 ,$37.80 ,$10.35 ,$33.75 ,$36.00 ,$36.00 ,$10.35 ,$36.00 ,$37.80 ,$37.80 ,$37.80 ,$40.50 ,$25.88 ,$10.35 ,$45.00 ,$16.68 ,$18.35 ,$11.39 ,$38.25 ,$26.88 ,$40.50 ,$37.80 ,$36.00 ,$36.00 ,$10.35 ,$29.25 ST. FRANCIS HOSPITAL - ACUTE,30201060,86612,HC BLASTOMYCES AB-90,302,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$16.68 ,$18.35 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30201062,86617,HC LYME DISEASE AB CONFIRM-90,302,1 ,$115.00 ,$74.75 ,$16.68 ,$115.00 ,$82.80 ,$62.56 ,$26.45 ,$64.19 ,$26.45 ,$68.70 ,$68.70 ,$68.70 ,$68.70 ,$96.60 ,$26.45 ,$97.75 ,$96.60 ,$26.45 ,$86.25 ,$92.00 ,$92.00 ,$26.45 ,$92.00 ,$96.60 ,$96.60 ,$96.60 ,$103.50 ,$66.13 ,$26.45 ,$115.00 ,$16.68 ,$18.35 ,$29.10 ,$97.75 ,$68.70 ,$103.50 ,$96.60 ,$92.00 ,$92.00 ,$26.45 ,$74.75 ST. FRANCIS HOSPITAL - ACUTE,30201063,86618,HC LYME AB-90,302,1 ,$117.00 ,$76.05 ,$16.68 ,$117.00 ,$84.24 ,$63.65 ,$26.91 ,$65.31 ,$26.91 ,$69.90 ,$69.90 ,$69.90 ,$69.90 ,$98.28 ,$26.91 ,$99.45 ,$98.28 ,$26.91 ,$87.75 ,$93.60 ,$93.60 ,$26.91 ,$93.60 ,$98.28 ,$98.28 ,$98.28 ,$105.30 ,$67.28 ,$26.91 ,$117.00 ,$16.68 ,$18.35 ,$29.60 ,$99.45 ,$69.90 ,$105.30 ,$98.28 ,$93.60 ,$93.60 ,$26.91 ,$76.05 ST. FRANCIS HOSPITAL - ACUTE,30201088,86008,HC ALLERGEN IGE QN/SEMI-QN RECOMB/COMP EA-90,302,1 ,$6.00 ,$3.90 ,$1.38 ,$10.65 ,$4.32 ,$3.26 ,$1.38 ,$3.35 ,$1.38 ,$3.58 ,$3.58 ,$3.58 ,$3.58 ,$5.04 ,$1.38 ,$5.10 ,$5.04 ,$1.38 ,$4.50 ,$4.80 ,$4.80 ,$1.38 ,$4.80 ,$5.04 ,$5.04 ,$5.04 ,$5.40 ,$3.45 ,$1.38 ,$6.00 ,$9.68 ,$10.65 ,$1.52 ,$5.10 ,$3.58 ,$5.40 ,$5.04 ,$4.80 ,$4.80 ,$1.38 ,$3.90 ST. FRANCIS HOSPITAL - ACUTE,30201093,86003,HC ALLERGEN IGE QN EA,302,1 ,$30.00 ,$19.50 ,$6.90 ,$30.00 ,$21.60 ,$16.32 ,$6.90 ,$16.75 ,$6.90 ,$17.92 ,$17.92 ,$17.92 ,$17.92 ,$25.20 ,$6.90 ,$25.50 ,$25.20 ,$6.90 ,$22.50 ,$24.00 ,$24.00 ,$6.90 ,$24.00 ,$25.20 ,$25.20 ,$25.20 ,$27.00 ,$17.25 ,$6.90 ,$30.00 ,$9.68 ,$10.65 ,$7.59 ,$25.50 ,$17.92 ,$27.00 ,$25.20 ,$24.00 ,$24.00 ,$6.90 ,$19.50 ST. FRANCIS HOSPITAL - ACUTE,30201094,86038,HC ANA SCREEN,302,1 ,$185.00 ,$120.25 ,$9.68 ,$185.00 ,$133.20 ,$100.64 ,$42.55 ,$103.27 ,$42.55 ,$110.52 ,$110.52 ,$110.52 ,$110.52 ,$155.40 ,$42.55 ,$157.25 ,$155.40 ,$42.55 ,$138.75 ,$148.00 ,$148.00 ,$42.55 ,$148.00 ,$155.40 ,$155.40 ,$155.40 ,$166.50 ,$106.38 ,$42.55 ,$185.00 ,$9.68 ,$10.65 ,$46.81 ,$157.25 ,$110.52 ,$166.50 ,$155.40 ,$148.00 ,$148.00 ,$42.55 ,$120.25 ST. FRANCIS HOSPITAL - ACUTE,30201095,86060,HC ASO,302,1 ,$147.00 ,$95.55 ,$9.68 ,$147.00 ,$105.84 ,$79.97 ,$33.81 ,$82.06 ,$33.81 ,$87.82 ,$87.82 ,$87.82 ,$87.82 ,$123.48 ,$33.81 ,$124.95 ,$123.48 ,$33.81 ,$110.25 ,$117.60 ,$117.60 ,$33.81 ,$117.60 ,$123.48 ,$123.48 ,$123.48 ,$132.30 ,$84.53 ,$33.81 ,$147.00 ,$9.68 ,$10.65 ,$37.19 ,$124.95 ,$87.82 ,$132.30 ,$123.48 ,$117.60 ,$117.60 ,$33.81 ,$95.55 ST. FRANCIS HOSPITAL - ACUTE,30201096,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$65.00 ,$42.25 ,$9.68 ,$65.00 ,$46.80 ,$35.36 ,$14.95 ,$36.28 ,$14.95 ,$38.83 ,$38.83 ,$38.83 ,$38.83 ,$54.60 ,$14.95 ,$55.25 ,$54.60 ,$14.95 ,$48.75 ,$52.00 ,$52.00 ,$14.95 ,$52.00 ,$54.60 ,$54.60 ,$54.60 ,$58.50 ,$37.38 ,$14.95 ,$65.00 ,$9.68 ,$10.65 ,$16.45 ,$55.25 ,$38.83 ,$58.50 ,$54.60 ,$52.00 ,$52.00 ,$14.95 ,$42.25 ST. FRANCIS HOSPITAL - ACUTE,30201097,86147,HC CARDIOLIPIN AB EA,302,1 ,$126.00 ,$81.90 ,$16.68 ,$126.00 ,$90.72 ,$68.54 ,$28.98 ,$70.33 ,$28.98 ,$75.27 ,$75.27 ,$75.27 ,$75.27 ,$105.84 ,$28.98 ,$107.10 ,$105.84 ,$28.98 ,$94.50 ,$100.80 ,$100.80 ,$28.98 ,$100.80 ,$105.84 ,$105.84 ,$105.84 ,$113.40 ,$72.45 ,$28.98 ,$126.00 ,$16.68 ,$18.35 ,$31.88 ,$107.10 ,$75.27 ,$113.40 ,$105.84 ,$100.80 ,$100.80 ,$28.98 ,$81.90 ST. FRANCIS HOSPITAL - ACUTE,30201098,86225,HC DNA DOUBLE STRAND AB,302,1 ,$298.00 ,$193.70 ,$9.68 ,$298.00 ,$214.56 ,$162.11 ,$68.54 ,$166.34 ,$68.54 ,$178.03 ,$178.03 ,$178.03 ,$178.03 ,$250.32 ,$68.54 ,$253.30 ,$250.32 ,$68.54 ,$223.50 ,$238.40 ,$238.40 ,$68.54 ,$238.40 ,$250.32 ,$250.32 ,$250.32 ,$268.20 ,$171.35 ,$68.54 ,$298.00 ,$9.68 ,$10.65 ,$75.39 ,$253.30 ,$178.03 ,$268.20 ,$250.32 ,$238.40 ,$238.40 ,$68.54 ,$193.70 ST. FRANCIS HOSPITAL - ACUTE,30201099,86235,HC ENA AB,302,1 ,$107.00 ,$69.55 ,$16.68 ,$107.00 ,$77.04 ,$58.21 ,$24.61 ,$59.73 ,$24.61 ,$63.92 ,$63.92 ,$63.92 ,$63.92 ,$89.88 ,$24.61 ,$90.95 ,$89.88 ,$24.61 ,$80.25 ,$85.60 ,$85.60 ,$24.61 ,$85.60 ,$89.88 ,$89.88 ,$89.88 ,$96.30 ,$61.53 ,$24.61 ,$107.00 ,$16.68 ,$18.35 ,$27.07 ,$90.95 ,$63.92 ,$96.30 ,$89.88 ,$85.60 ,$85.60 ,$24.61 ,$69.55 ST. FRANCIS HOSPITAL - ACUTE,30201101,86304,HC TUMOR AG CA 125,302,1 ,$298.00 ,$193.70 ,$25.65 ,$298.00 ,$214.56 ,$162.11 ,$68.54 ,$166.34 ,$68.54 ,$178.03 ,$178.03 ,$178.03 ,$178.03 ,$250.32 ,$68.54 ,$253.30 ,$250.32 ,$68.54 ,$223.50 ,$238.40 ,$238.40 ,$68.54 ,$238.40 ,$250.32 ,$250.32 ,$250.32 ,$268.20 ,$171.35 ,$68.54 ,$298.00 ,$25.65 ,$28.22 ,$75.39 ,$253.30 ,$178.03 ,$268.20 ,$250.32 ,$238.40 ,$238.40 ,$68.54 ,$193.70 ST. FRANCIS HOSPITAL - ACUTE,30201102,86334,HC IMMUNOFIX ELECTRO SERUM,302,1 ,$227.00 ,$147.55 ,$16.68 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 ,$16.68 ,$18.35 ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,30201103,86335,HC IMMUNOFIX ELECTRO OTH,302,1 ,$227.00 ,$147.55 ,$16.68 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 ,$16.68 ,$18.35 ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,30201104,86359,HC T CELLS TOTAL COUNT,302,1 ,$75.00 ,$48.75 ,$16.68 ,$75.00 ,$54.00 ,$40.80 ,$17.25 ,$41.87 ,$17.25 ,$44.81 ,$44.81 ,$44.81 ,$44.81 ,$63.00 ,$17.25 ,$63.75 ,$63.00 ,$17.25 ,$56.25 ,$60.00 ,$60.00 ,$17.25 ,$60.00 ,$63.00 ,$63.00 ,$63.00 ,$67.50 ,$43.13 ,$17.25 ,$75.00 ,$16.68 ,$18.35 ,$18.98 ,$63.75 ,$44.81 ,$67.50 ,$63.00 ,$60.00 ,$60.00 ,$17.25 ,$48.75 ST. FRANCIS HOSPITAL - ACUTE,30201105,86360,HC ABS T CELLS CD4 CD8 RATIO,302,1 ,$143.00 ,$92.95 ,$16.68 ,$143.00 ,$102.96 ,$77.79 ,$32.89 ,$79.82 ,$32.89 ,$85.43 ,$85.43 ,$85.43 ,$85.43 ,$120.12 ,$32.89 ,$121.55 ,$120.12 ,$32.89 ,$107.25 ,$114.40 ,$114.40 ,$32.89 ,$114.40 ,$120.12 ,$120.12 ,$120.12 ,$128.70 ,$82.23 ,$32.89 ,$143.00 ,$16.68 ,$18.35 ,$36.18 ,$121.55 ,$85.43 ,$128.70 ,$120.12 ,$114.40 ,$114.40 ,$32.89 ,$92.95 ST. FRANCIS HOSPITAL - ACUTE,30201106,86376,HC MICROSOMAL AB,302,1 ,$319.00 ,$207.35 ,$25.29 ,$319.00 ,$229.68 ,$173.54 ,$73.37 ,$178.07 ,$73.37 ,$190.57 ,$190.57 ,$190.57 ,$190.57 ,$267.96 ,$73.37 ,$271.15 ,$267.96 ,$73.37 ,$239.25 ,$255.20 ,$255.20 ,$73.37 ,$255.20 ,$267.96 ,$267.96 ,$267.96 ,$287.10 ,$183.43 ,$73.37 ,$319.00 ,$25.29 ,$27.82 ,$80.71 ,$271.15 ,$190.57 ,$287.10 ,$267.96 ,$255.20 ,$255.20 ,$73.37 ,$207.35 ST. FRANCIS HOSPITAL - ACUTE,30201108,86431,HC RHEUMATOID FACTOR QN,302,1 ,$241.00 ,$156.65 ,$9.68 ,$241.00 ,$173.52 ,$131.10 ,$55.43 ,$134.53 ,$55.43 ,$143.97 ,$143.97 ,$143.97 ,$143.97 ,$202.44 ,$55.43 ,$204.85 ,$202.44 ,$55.43 ,$180.75 ,$192.80 ,$192.80 ,$55.43 ,$192.80 ,$202.44 ,$202.44 ,$202.44 ,$216.90 ,$138.58 ,$55.43 ,$241.00 ,$9.68 ,$10.65 ,$60.97 ,$204.85 ,$143.97 ,$216.90 ,$202.44 ,$192.80 ,$192.80 ,$55.43 ,$156.65 ST. FRANCIS HOSPITAL - ACUTE,30201109,86480,HC TB QUANTIFERON GOLD,302,1 ,$266.00 ,$172.90 ,$16.68 ,$266.00 ,$191.52 ,$144.70 ,$61.18 ,$148.48 ,$61.18 ,$158.91 ,$158.91 ,$158.91 ,$158.91 ,$223.44 ,$61.18 ,$226.10 ,$223.44 ,$61.18 ,$199.50 ,$212.80 ,$212.80 ,$61.18 ,$212.80 ,$223.44 ,$223.44 ,$223.44 ,$239.40 ,$152.95 ,$61.18 ,$266.00 ,$16.68 ,$18.35 ,$67.30 ,$226.10 ,$158.91 ,$239.40 ,$223.44 ,$212.80 ,$212.80 ,$61.18 ,$172.90 ST. FRANCIS HOSPITAL - ACUTE,30201110,86592,HC SYPHILIS VDRL RPR QL,302,1 ,$145.00 ,$94.25 ,$9.68 ,$145.00 ,$104.40 ,$78.88 ,$33.35 ,$80.94 ,$33.35 ,$86.62 ,$86.62 ,$86.62 ,$86.62 ,$121.80 ,$33.35 ,$123.25 ,$121.80 ,$33.35 ,$108.75 ,$116.00 ,$116.00 ,$33.35 ,$116.00 ,$121.80 ,$121.80 ,$121.80 ,$130.50 ,$83.38 ,$33.35 ,$145.00 ,$9.68 ,$10.65 ,$36.69 ,$123.25 ,$86.62 ,$130.50 ,$121.80 ,$116.00 ,$116.00 ,$33.35 ,$94.25 ST. FRANCIS HOSPITAL - ACUTE,30201111,86593,HC SYPHILIS VDRL RPR QN,302,1 ,$53.00 ,$34.45 ,$9.68 ,$53.00 ,$38.16 ,$28.83 ,$12.19 ,$29.58 ,$12.19 ,$31.66 ,$31.66 ,$31.66 ,$31.66 ,$44.52 ,$12.19 ,$45.05 ,$44.52 ,$12.19 ,$39.75 ,$42.40 ,$42.40 ,$12.19 ,$42.40 ,$44.52 ,$44.52 ,$44.52 ,$47.70 ,$30.48 ,$12.19 ,$53.00 ,$9.68 ,$10.65 ,$13.41 ,$45.05 ,$31.66 ,$47.70 ,$44.52 ,$42.40 ,$42.40 ,$12.19 ,$34.45 ST. FRANCIS HOSPITAL - ACUTE,30201112,86606,HC ASPERGILLUS AB,302,1 ,$68.00 ,$44.20 ,$15.64 ,$68.00 ,$48.96 ,$36.99 ,$15.64 ,$37.96 ,$15.64 ,$40.62 ,$40.62 ,$40.62 ,$40.62 ,$57.12 ,$15.64 ,$57.80 ,$57.12 ,$15.64 ,$51.00 ,$54.40 ,$54.40 ,$15.64 ,$54.40 ,$57.12 ,$57.12 ,$57.12 ,$61.20 ,$39.10 ,$15.64 ,$68.00 ,$16.68 ,$18.35 ,$17.20 ,$57.80 ,$40.62 ,$61.20 ,$57.12 ,$54.40 ,$54.40 ,$15.64 ,$44.20 ST. FRANCIS HOSPITAL - ACUTE,30201113,86612,HC BLASTOMYCES AB,302,1 ,$68.00 ,$44.20 ,$15.64 ,$68.00 ,$48.96 ,$36.99 ,$15.64 ,$37.96 ,$15.64 ,$40.62 ,$40.62 ,$40.62 ,$40.62 ,$57.12 ,$15.64 ,$57.80 ,$57.12 ,$15.64 ,$51.00 ,$54.40 ,$54.40 ,$15.64 ,$54.40 ,$57.12 ,$57.12 ,$57.12 ,$61.20 ,$39.10 ,$15.64 ,$68.00 ,$16.68 ,$18.35 ,$17.20 ,$57.80 ,$40.62 ,$61.20 ,$57.12 ,$54.40 ,$54.40 ,$15.64 ,$44.20 ST. FRANCIS HOSPITAL - ACUTE,30201115,86635,HC COCCIDIOIDES AB,302,1 ,$68.00 ,$44.20 ,$15.64 ,$68.00 ,$48.96 ,$36.99 ,$15.64 ,$37.96 ,$15.64 ,$40.62 ,$40.62 ,$40.62 ,$40.62 ,$57.12 ,$15.64 ,$57.80 ,$57.12 ,$15.64 ,$51.00 ,$54.40 ,$54.40 ,$15.64 ,$54.40 ,$57.12 ,$57.12 ,$57.12 ,$61.20 ,$39.10 ,$15.64 ,$68.00 ,$16.68 ,$18.35 ,$17.20 ,$57.80 ,$40.62 ,$61.20 ,$57.12 ,$54.40 ,$54.40 ,$15.64 ,$44.20 ST. FRANCIS HOSPITAL - ACUTE,30201116,86641,HC CRYPTOCOCCAL AB,302,1 ,$222.00 ,$144.30 ,$16.68 ,$222.00 ,$159.84 ,$120.77 ,$51.06 ,$123.92 ,$51.06 ,$132.62 ,$132.62 ,$132.62 ,$132.62 ,$186.48 ,$51.06 ,$188.70 ,$186.48 ,$51.06 ,$166.50 ,$177.60 ,$177.60 ,$51.06 ,$177.60 ,$186.48 ,$186.48 ,$186.48 ,$199.80 ,$127.65 ,$51.06 ,$222.00 ,$16.68 ,$18.35 ,$56.17 ,$188.70 ,$132.62 ,$199.80 ,$186.48 ,$177.60 ,$177.60 ,$51.06 ,$144.30 ST. FRANCIS HOSPITAL - ACUTE,30201117,86644,HC CMV AB,302,1 ,$132.00 ,$85.80 ,$16.68 ,$132.00 ,$95.04 ,$71.81 ,$30.36 ,$73.68 ,$30.36 ,$78.86 ,$78.86 ,$78.86 ,$78.86 ,$110.88 ,$30.36 ,$112.20 ,$110.88 ,$30.36 ,$99.00 ,$105.60 ,$105.60 ,$30.36 ,$105.60 ,$110.88 ,$110.88 ,$110.88 ,$118.80 ,$75.90 ,$30.36 ,$132.00 ,$16.68 ,$18.35 ,$33.40 ,$112.20 ,$78.86 ,$118.80 ,$110.88 ,$105.60 ,$105.60 ,$30.36 ,$85.80 ST. FRANCIS HOSPITAL - ACUTE,30201118,86645,HC CMV AB IGM,302,1 ,$132.00 ,$85.80 ,$16.68 ,$132.00 ,$95.04 ,$71.81 ,$30.36 ,$73.68 ,$30.36 ,$78.86 ,$78.86 ,$78.86 ,$78.86 ,$110.88 ,$30.36 ,$112.20 ,$110.88 ,$30.36 ,$99.00 ,$105.60 ,$105.60 ,$30.36 ,$105.60 ,$110.88 ,$110.88 ,$110.88 ,$118.80 ,$75.90 ,$30.36 ,$132.00 ,$16.68 ,$18.35 ,$33.40 ,$112.20 ,$78.86 ,$118.80 ,$110.88 ,$105.60 ,$105.60 ,$30.36 ,$85.80 ST. FRANCIS HOSPITAL - ACUTE,30201119,86677,HC H PYLORI AB,302,1 ,$338.00 ,$219.70 ,$16.68 ,$338.00 ,$243.36 ,$183.87 ,$77.74 ,$188.67 ,$77.74 ,$201.92 ,$201.92 ,$201.92 ,$201.92 ,$283.92 ,$77.74 ,$287.30 ,$283.92 ,$77.74 ,$253.50 ,$270.40 ,$270.40 ,$77.74 ,$270.40 ,$283.92 ,$283.92 ,$283.92 ,$304.20 ,$194.35 ,$77.74 ,$338.00 ,$16.68 ,$18.35 ,$85.51 ,$287.30 ,$201.92 ,$304.20 ,$283.92 ,$270.40 ,$270.40 ,$77.74 ,$219.70 ST. FRANCIS HOSPITAL - ACUTE,30201120,86698,HC HISTOPLASMA AB,302,1 ,$96.00 ,$62.40 ,$16.68 ,$96.00 ,$69.12 ,$52.22 ,$22.08 ,$53.59 ,$22.08 ,$57.35 ,$57.35 ,$57.35 ,$57.35 ,$80.64 ,$22.08 ,$81.60 ,$80.64 ,$22.08 ,$72.00 ,$76.80 ,$76.80 ,$22.08 ,$76.80 ,$80.64 ,$80.64 ,$80.64 ,$86.40 ,$55.20 ,$22.08 ,$96.00 ,$16.68 ,$18.35 ,$24.29 ,$81.60 ,$57.35 ,$86.40 ,$80.64 ,$76.80 ,$76.80 ,$22.08 ,$62.40 ST. FRANCIS HOSPITAL - ACUTE,30201121,86704,HC HEP CORE AB,302,1 ,$52.00 ,$33.80 ,$9.68 ,$52.00 ,$37.44 ,$28.29 ,$11.96 ,$29.03 ,$11.96 ,$31.06 ,$31.06 ,$31.06 ,$31.06 ,$43.68 ,$11.96 ,$44.20 ,$43.68 ,$11.96 ,$39.00 ,$41.60 ,$41.60 ,$11.96 ,$41.60 ,$43.68 ,$43.68 ,$43.68 ,$46.80 ,$29.90 ,$11.96 ,$52.00 ,$9.68 ,$10.65 ,$13.16 ,$44.20 ,$31.06 ,$46.80 ,$43.68 ,$41.60 ,$41.60 ,$11.96 ,$33.80 ST. FRANCIS HOSPITAL - ACUTE,30201122,86705,HC HEP B CORE IGM,302,1 ,$189.00 ,$122.85 ,$9.68 ,$189.00 ,$136.08 ,$102.82 ,$43.47 ,$105.50 ,$43.47 ,$112.91 ,$112.91 ,$112.91 ,$112.91 ,$158.76 ,$43.47 ,$160.65 ,$158.76 ,$43.47 ,$141.75 ,$151.20 ,$151.20 ,$43.47 ,$151.20 ,$158.76 ,$158.76 ,$158.76 ,$170.10 ,$108.68 ,$43.47 ,$189.00 ,$9.68 ,$10.65 ,$47.82 ,$160.65 ,$112.91 ,$170.10 ,$158.76 ,$151.20 ,$151.20 ,$43.47 ,$122.85 ST. FRANCIS HOSPITAL - ACUTE,30201123,86706,HC HEP B SURFACE AB,302,1 ,$238.00 ,$154.70 ,$9.68 ,$238.00 ,$171.36 ,$129.47 ,$54.74 ,$132.85 ,$54.74 ,$142.18 ,$142.18 ,$142.18 ,$142.18 ,$199.92 ,$54.74 ,$202.30 ,$199.92 ,$54.74 ,$178.50 ,$190.40 ,$190.40 ,$54.74 ,$190.40 ,$199.92 ,$199.92 ,$199.92 ,$214.20 ,$136.85 ,$54.74 ,$238.00 ,$9.68 ,$10.65 ,$60.21 ,$202.30 ,$142.18 ,$214.20 ,$199.92 ,$190.40 ,$190.40 ,$54.74 ,$154.70 ST. FRANCIS HOSPITAL - ACUTE,30201126,86735,HC MUMPS AB,302,1 ,$144.00 ,$93.60 ,$9.68 ,$144.00 ,$103.68 ,$78.34 ,$33.12 ,$80.38 ,$33.12 ,$86.03 ,$86.03 ,$86.03 ,$86.03 ,$120.96 ,$33.12 ,$122.40 ,$120.96 ,$33.12 ,$108.00 ,$115.20 ,$115.20 ,$33.12 ,$115.20 ,$120.96 ,$120.96 ,$120.96 ,$129.60 ,$82.80 ,$33.12 ,$144.00 ,$9.68 ,$10.65 ,$36.43 ,$122.40 ,$86.03 ,$129.60 ,$120.96 ,$115.20 ,$115.20 ,$33.12 ,$93.60 ST. FRANCIS HOSPITAL - ACUTE,30201127,86762,HC RUBELLA AB,302,1 ,$148.00 ,$96.20 ,$9.68 ,$148.00 ,$106.56 ,$80.51 ,$34.04 ,$82.61 ,$34.04 ,$88.42 ,$88.42 ,$88.42 ,$88.42 ,$124.32 ,$34.04 ,$125.80 ,$124.32 ,$34.04 ,$111.00 ,$118.40 ,$118.40 ,$34.04 ,$118.40 ,$124.32 ,$124.32 ,$124.32 ,$133.20 ,$85.10 ,$34.04 ,$148.00 ,$9.68 ,$10.65 ,$37.44 ,$125.80 ,$88.42 ,$133.20 ,$124.32 ,$118.40 ,$118.40 ,$34.04 ,$96.20 ST. FRANCIS HOSPITAL - ACUTE,30201128,86765,HC RUBEOLA AB,302,1 ,$138.00 ,$89.70 ,$9.68 ,$138.00 ,$99.36 ,$75.07 ,$31.74 ,$77.03 ,$31.74 ,$82.44 ,$82.44 ,$82.44 ,$82.44 ,$115.92 ,$31.74 ,$117.30 ,$115.92 ,$31.74 ,$103.50 ,$110.40 ,$110.40 ,$31.74 ,$110.40 ,$115.92 ,$115.92 ,$115.92 ,$124.20 ,$79.35 ,$31.74 ,$138.00 ,$9.68 ,$10.65 ,$34.91 ,$117.30 ,$82.44 ,$124.20 ,$115.92 ,$110.40 ,$110.40 ,$31.74 ,$89.70 ST. FRANCIS HOSPITAL - ACUTE,30201130,86787,HC VARICELLA ZOSTER AB,302,1 ,$112.00 ,$72.80 ,$9.68 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$9.68 ,$10.65 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,30201131,86800,HC THYROGLOBULIN AB,302,1 ,$89.00 ,$57.85 ,$20.47 ,$89.00 ,$64.08 ,$48.42 ,$20.47 ,$49.68 ,$20.47 ,$53.17 ,$53.17 ,$53.17 ,$53.17 ,$74.76 ,$20.47 ,$75.65 ,$74.76 ,$20.47 ,$66.75 ,$71.20 ,$71.20 ,$20.47 ,$71.20 ,$74.76 ,$74.76 ,$74.76 ,$80.10 ,$51.18 ,$20.47 ,$89.00 ,$25.29 ,$27.82 ,$22.52 ,$75.65 ,$53.17 ,$80.10 ,$74.76 ,$71.20 ,$71.20 ,$20.47 ,$57.85 ST. FRANCIS HOSPITAL - ACUTE,30201132,86803,HC HEP C AB,302,1 ,$189.00 ,$122.85 ,$16.68 ,$189.00 ,$136.08 ,$102.82 ,$43.47 ,$105.50 ,$43.47 ,$112.91 ,$112.91 ,$112.91 ,$112.91 ,$158.76 ,$43.47 ,$160.65 ,$158.76 ,$43.47 ,$141.75 ,$151.20 ,$151.20 ,$43.47 ,$151.20 ,$158.76 ,$158.76 ,$158.76 ,$170.10 ,$108.68 ,$43.47 ,$189.00 ,$16.68 ,$18.35 ,$47.82 ,$160.65 ,$112.91 ,$170.10 ,$158.76 ,$151.20 ,$151.20 ,$43.47 ,$122.85 ST. FRANCIS HOSPITAL - ACUTE,30201134,86902,HC RBC AG SCR RGT SERUM T1-90,302,1 ,$102.00 ,$66.30 ,$6.00 ,$102.00 ,$73.44 ,$55.49 ,$23.46 ,$56.94 ,$23.46 ,$60.93 ,$60.93 ,$60.93 ,$60.93 ,$85.68 ,$23.46 ,$86.70 ,$85.68 ,$23.46 ,$76.50 ,$81.60 ,$81.60 ,$23.46 ,$81.60 ,$85.68 ,$85.68 ,$85.68 ,$91.80 ,$58.65 ,$23.46 ,$102.00 ,$6.00 ,$6.60 ,$25.81 ,$86.70 ,$60.93 ,$91.80 ,$85.68 ,$81.60 ,$81.60 ,$23.46 ,$66.30 ST. FRANCIS HOSPITAL - ACUTE,30201135,86902,HC RBC AG SCR RGT SERUM T2-90,302,1 ,$159.00 ,$103.35 ,$6.00 ,$159.00 ,$114.48 ,$86.50 ,$36.57 ,$88.75 ,$36.57 ,$94.99 ,$94.99 ,$94.99 ,$94.99 ,$133.56 ,$36.57 ,$135.15 ,$133.56 ,$36.57 ,$119.25 ,$127.20 ,$127.20 ,$36.57 ,$127.20 ,$133.56 ,$133.56 ,$133.56 ,$143.10 ,$91.43 ,$36.57 ,$159.00 ,$6.00 ,$6.60 ,$40.23 ,$135.15 ,$94.99 ,$143.10 ,$133.56 ,$127.20 ,$127.20 ,$36.57 ,$103.35 ST. FRANCIS HOSPITAL - ACUTE,30201136,86902,HC RBC AG SCR RGT SERUM T3-90,302,1 ,$227.00 ,$147.55 ,$6.00 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 ,$6.00 ,$6.60 ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,30201137,86902,HC RBC AG SCR RGT SERUM T4-90,302,1 ,$340.00 ,$221.00 ,$6.00 ,$340.00 ,$244.80 ,$184.96 ,$78.20 ,$189.79 ,$78.20 ,$203.12 ,$203.12 ,$203.12 ,$203.12 ,$285.60 ,$78.20 ,$289.00 ,$285.60 ,$78.20 ,$255.00 ,$272.00 ,$272.00 ,$78.20 ,$272.00 ,$285.60 ,$285.60 ,$285.60 ,$306.00 ,$195.50 ,$78.20 ,$340.00 ,$6.00 ,$6.60 ,$86.02 ,$289.00 ,$203.12 ,$306.00 ,$285.60 ,$272.00 ,$272.00 ,$78.20 ,$221.00 ST. FRANCIS HOSPITAL - ACUTE,30201138,86905,HC RBC AG TYPING NON ABO/RH T1-90,302,1 ,$102.00 ,$66.30 ,$6.00 ,$102.00 ,$73.44 ,$55.49 ,$23.46 ,$56.94 ,$23.46 ,$60.93 ,$60.93 ,$60.93 ,$60.93 ,$85.68 ,$23.46 ,$86.70 ,$85.68 ,$23.46 ,$76.50 ,$81.60 ,$81.60 ,$23.46 ,$81.60 ,$85.68 ,$85.68 ,$85.68 ,$91.80 ,$58.65 ,$23.46 ,$102.00 ,$6.00 ,$6.60 ,$25.81 ,$86.70 ,$60.93 ,$91.80 ,$85.68 ,$81.60 ,$81.60 ,$23.46 ,$66.30 ST. FRANCIS HOSPITAL - ACUTE,30201139,86905,HC RBC AG TYPING NON ABO/RH T2-90,302,1 ,$159.00 ,$103.35 ,$6.00 ,$159.00 ,$114.48 ,$86.50 ,$36.57 ,$88.75 ,$36.57 ,$94.99 ,$94.99 ,$94.99 ,$94.99 ,$133.56 ,$36.57 ,$135.15 ,$133.56 ,$36.57 ,$119.25 ,$127.20 ,$127.20 ,$36.57 ,$127.20 ,$133.56 ,$133.56 ,$133.56 ,$143.10 ,$91.43 ,$36.57 ,$159.00 ,$6.00 ,$6.60 ,$40.23 ,$135.15 ,$94.99 ,$143.10 ,$133.56 ,$127.20 ,$127.20 ,$36.57 ,$103.35 ST. FRANCIS HOSPITAL - ACUTE,30201140,86905,HC RBC AG TYPING NON ABO/RH T3-90,302,1 ,$227.00 ,$147.55 ,$6.00 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 ,$6.00 ,$6.60 ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,30201141,86905,HC RBC AG TYPING NON ABO/RH T4-90,302,1 ,$340.00 ,$221.00 ,$6.00 ,$340.00 ,$244.80 ,$184.96 ,$78.20 ,$189.79 ,$78.20 ,$203.12 ,$203.12 ,$203.12 ,$203.12 ,$285.60 ,$78.20 ,$289.00 ,$285.60 ,$78.20 ,$255.00 ,$272.00 ,$272.00 ,$78.20 ,$272.00 ,$285.60 ,$285.60 ,$285.60 ,$306.00 ,$195.50 ,$78.20 ,$340.00 ,$6.00 ,$6.60 ,$86.02 ,$289.00 ,$203.12 ,$306.00 ,$285.60 ,$272.00 ,$272.00 ,$78.20 ,$221.00 ST. FRANCIS HOSPITAL - ACUTE,30201147,86870,HC RBC AB ID PANEL SERUM-90,302,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$9.68 ,$10.65 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30201163,87427,HC SHIGA-LIKE TOXIN -90,302,1 ,$36.00 ,$23.40 ,$8.28 ,$36.00 ,$25.92 ,$19.58 ,$8.28 ,$20.10 ,$8.28 ,$21.51 ,$21.51 ,$21.51 ,$21.51 ,$30.24 ,$8.28 ,$30.60 ,$30.24 ,$8.28 ,$27.00 ,$28.80 ,$28.80 ,$8.28 ,$28.80 ,$30.24 ,$30.24 ,$30.24 ,$32.40 ,$20.70 ,$8.28 ,$36.00 ,$9.68 ,$10.65 ,$9.11 ,$30.60 ,$21.51 ,$32.40 ,$30.24 ,$28.80 ,$28.80 ,$8.28 ,$23.40 ST. FRANCIS HOSPITAL - ACUTE,30500103,85007,HC BLOOD COUNT MAN DIFF WBC,305,1 ,$42.00 ,$27.30 ,$6.71 ,$42.00 ,$30.24 ,$22.85 ,$9.66 ,$23.44 ,$9.66 ,$25.09 ,$25.09 ,$25.09 ,$25.09 ,$35.28 ,$9.66 ,$35.70 ,$35.28 ,$9.66 ,$31.50 ,$33.60 ,$33.60 ,$9.66 ,$33.60 ,$35.28 ,$35.28 ,$35.28 ,$37.80 ,$24.15 ,$9.66 ,$42.00 ,$6.71 ,$7.38 ,$10.63 ,$35.70 ,$25.09 ,$37.80 ,$35.28 ,$33.60 ,$33.60 ,$9.66 ,$27.30 ST. FRANCIS HOSPITAL - ACUTE,30500104,85014,HC HEMATOCRIT,305,1 ,$32.00 ,$20.80 ,$2.37 ,$32.00 ,$23.04 ,$17.41 ,$7.36 ,$17.86 ,$7.36 ,$19.12 ,$19.12 ,$19.12 ,$19.12 ,$26.88 ,$7.36 ,$27.20 ,$26.88 ,$7.36 ,$24.00 ,$25.60 ,$25.60 ,$7.36 ,$25.60 ,$26.88 ,$26.88 ,$26.88 ,$28.80 ,$18.40 ,$7.36 ,$2.37 ,$6.71 ,$7.38 ,$8.10 ,$27.20 ,$19.12 ,$28.80 ,$26.88 ,$25.60 ,$25.60 ,$7.36 ,$20.80 ST. FRANCIS HOSPITAL - ACUTE,30500106,85018,HC HGB,305,1 ,$32.00 ,$20.80 ,$2.37 ,$32.00 ,$23.04 ,$17.41 ,$7.36 ,$17.86 ,$7.36 ,$19.12 ,$19.12 ,$19.12 ,$19.12 ,$26.88 ,$7.36 ,$27.20 ,$26.88 ,$7.36 ,$24.00 ,$25.60 ,$25.60 ,$7.36 ,$25.60 ,$26.88 ,$26.88 ,$26.88 ,$28.80 ,$18.40 ,$7.36 ,$2.37 ,$6.71 ,$7.38 ,$8.10 ,$27.20 ,$19.12 ,$28.80 ,$26.88 ,$25.60 ,$25.60 ,$7.36 ,$20.80 ST. FRANCIS HOSPITAL - ACUTE,30500107,85025,HC CBC AUTO W/AUTO DIFF,305,1 ,$154.00 ,$100.10 ,$6.71 ,$154.00 ,$110.88 ,$83.78 ,$35.42 ,$85.96 ,$35.42 ,$92.00 ,$92.00 ,$92.00 ,$92.00 ,$129.36 ,$35.42 ,$130.90 ,$129.36 ,$35.42 ,$115.50 ,$123.20 ,$123.20 ,$35.42 ,$123.20 ,$129.36 ,$129.36 ,$129.36 ,$138.60 ,$88.55 ,$35.42 ,$7.77 ,$6.71 ,$7.38 ,$38.96 ,$130.90 ,$92.00 ,$138.60 ,$129.36 ,$123.20 ,$123.20 ,$35.42 ,$100.10 ST. FRANCIS HOSPITAL - ACUTE,30500108,85027,HC CBC W/O DIFF,305,1 ,$124.00 ,$80.60 ,$6.47 ,$124.00 ,$89.28 ,$67.46 ,$28.52 ,$69.22 ,$28.52 ,$74.08 ,$74.08 ,$74.08 ,$74.08 ,$104.16 ,$28.52 ,$105.40 ,$104.16 ,$28.52 ,$93.00 ,$99.20 ,$99.20 ,$28.52 ,$99.20 ,$104.16 ,$104.16 ,$104.16 ,$111.60 ,$71.30 ,$28.52 ,$6.47 ,$6.71 ,$7.38 ,$31.37 ,$105.40 ,$74.08 ,$111.60 ,$104.16 ,$99.20 ,$99.20 ,$28.52 ,$80.60 ST. FRANCIS HOSPITAL - ACUTE,30500112,85048,HC BLOOD COUNT LEUKO AUTO,305,1 ,$32.00 ,$20.80 ,$6.71 ,$32.00 ,$23.04 ,$17.41 ,$7.36 ,$17.86 ,$7.36 ,$19.12 ,$19.12 ,$19.12 ,$19.12 ,$26.88 ,$7.36 ,$27.20 ,$26.88 ,$7.36 ,$24.00 ,$25.60 ,$25.60 ,$7.36 ,$25.60 ,$26.88 ,$26.88 ,$26.88 ,$28.80 ,$18.40 ,$7.36 ,$32.00 ,$6.71 ,$7.38 ,$8.10 ,$27.20 ,$19.12 ,$28.80 ,$26.88 ,$25.60 ,$25.60 ,$7.36 ,$20.80 ST. FRANCIS HOSPITAL - ACUTE,30500113,85049,HC PLATELET COUNT AUTO,305,1 ,$70.00 ,$45.50 ,$6.71 ,$70.00 ,$50.40 ,$38.08 ,$16.10 ,$39.07 ,$16.10 ,$41.82 ,$41.82 ,$41.82 ,$41.82 ,$58.80 ,$16.10 ,$59.50 ,$58.80 ,$16.10 ,$52.50 ,$56.00 ,$56.00 ,$16.10 ,$56.00 ,$58.80 ,$58.80 ,$58.80 ,$63.00 ,$40.25 ,$16.10 ,$70.00 ,$6.71 ,$7.38 ,$17.71 ,$59.50 ,$41.82 ,$63.00 ,$58.80 ,$56.00 ,$56.00 ,$16.10 ,$45.50 ST. FRANCIS HOSPITAL - ACUTE,30500175,85379,HC D DIMER QN,305,1 ,$135.00 ,$87.75 ,$11.64 ,$135.00 ,$97.20 ,$73.44 ,$31.05 ,$75.36 ,$31.05 ,$80.65 ,$80.65 ,$80.65 ,$80.65 ,$113.40 ,$31.05 ,$114.75 ,$113.40 ,$31.05 ,$101.25 ,$108.00 ,$108.00 ,$31.05 ,$108.00 ,$113.40 ,$113.40 ,$113.40 ,$121.50 ,$77.63 ,$31.05 ,$135.00 ,$11.64 ,$12.80 ,$34.16 ,$114.75 ,$80.65 ,$121.50 ,$113.40 ,$108.00 ,$108.00 ,$31.05 ,$87.75 ST. FRANCIS HOSPITAL - ACUTE,30500176,85384,HC FIBRINOGEN,305,1 ,$204.00 ,$132.60 ,$3.92 ,$204.00 ,$146.88 ,$110.98 ,$46.92 ,$113.87 ,$46.92 ,$121.87 ,$121.87 ,$121.87 ,$121.87 ,$171.36 ,$46.92 ,$173.40 ,$171.36 ,$46.92 ,$153.00 ,$163.20 ,$163.20 ,$46.92 ,$163.20 ,$171.36 ,$171.36 ,$171.36 ,$183.60 ,$117.30 ,$46.92 ,$204.00 ,$3.92 ,$4.31 ,$51.61 ,$173.40 ,$121.87 ,$183.60 ,$171.36 ,$163.20 ,$163.20 ,$46.92 ,$132.60 ST. FRANCIS HOSPITAL - ACUTE,30500187,85520,HC HEPARIN ASSAY,305,1 ,$155.00 ,$100.75 ,$11.64 ,$155.00 ,$111.60 ,$84.32 ,$35.65 ,$86.52 ,$35.65 ,$92.60 ,$92.60 ,$92.60 ,$92.60 ,$130.20 ,$35.65 ,$131.75 ,$130.20 ,$35.65 ,$116.25 ,$124.00 ,$124.00 ,$35.65 ,$124.00 ,$130.20 ,$130.20 ,$130.20 ,$139.50 ,$89.13 ,$35.65 ,$155.00 ,$11.64 ,$12.80 ,$39.22 ,$131.75 ,$92.60 ,$139.50 ,$130.20 ,$124.00 ,$124.00 ,$35.65 ,$100.75 ST. FRANCIS HOSPITAL - ACUTE,30500196,85610,HC PROTHROMBIN TIME (PT),305,1 ,$70.00 ,$45.50 ,$3.92 ,$70.00 ,$50.40 ,$38.08 ,$16.10 ,$39.07 ,$16.10 ,$41.82 ,$41.82 ,$41.82 ,$41.82 ,$58.80 ,$16.10 ,$59.50 ,$58.80 ,$16.10 ,$52.50 ,$56.00 ,$56.00 ,$16.10 ,$56.00 ,$58.80 ,$58.80 ,$58.80 ,$63.00 ,$40.25 ,$16.10 ,$70.00 ,$3.92 ,$4.31 ,$17.71 ,$59.50 ,$41.82 ,$63.00 ,$58.80 ,$56.00 ,$56.00 ,$16.10 ,$45.50 ST. FRANCIS HOSPITAL - ACUTE,30500205,85652,HC SED RATE AUTO,305,1 ,$75.00 ,$48.75 ,$6.71 ,$75.00 ,$54.00 ,$40.80 ,$17.25 ,$41.87 ,$17.25 ,$44.81 ,$44.81 ,$44.81 ,$44.81 ,$63.00 ,$17.25 ,$63.75 ,$63.00 ,$17.25 ,$56.25 ,$60.00 ,$60.00 ,$17.25 ,$60.00 ,$63.00 ,$63.00 ,$63.00 ,$67.50 ,$43.13 ,$17.25 ,$75.00 ,$6.71 ,$7.38 ,$18.98 ,$63.75 ,$44.81 ,$67.50 ,$63.00 ,$60.00 ,$60.00 ,$17.25 ,$48.75 ST. FRANCIS HOSPITAL - ACUTE,30500211,85730,HC PTT,305,1 ,$116.00 ,$75.40 ,$3.92 ,$116.00 ,$83.52 ,$63.10 ,$26.68 ,$64.75 ,$26.68 ,$69.30 ,$69.30 ,$69.30 ,$69.30 ,$97.44 ,$26.68 ,$98.60 ,$97.44 ,$26.68 ,$87.00 ,$92.80 ,$92.80 ,$26.68 ,$92.80 ,$97.44 ,$97.44 ,$97.44 ,$104.40 ,$66.70 ,$26.68 ,$116.00 ,$3.92 ,$4.31 ,$29.35 ,$98.60 ,$69.30 ,$104.40 ,$97.44 ,$92.80 ,$92.80 ,$26.68 ,$75.40 ST. FRANCIS HOSPITAL - ACUTE,30500234,85014,HC HEMATOCRIT-90,305,1 ,$10.00 ,$6.50 ,$2.30 ,$10.00 ,$7.20 ,$5.44 ,$2.30 ,$5.58 ,$2.30 ,$5.97 ,$5.97 ,$5.97 ,$5.97 ,$8.40 ,$2.30 ,$8.50 ,$8.40 ,$2.30 ,$7.50 ,$8.00 ,$8.00 ,$2.30 ,$8.00 ,$8.40 ,$8.40 ,$8.40 ,$9.00 ,$5.75 ,$2.30 ,$2.37 ,$6.71 ,$7.38 ,$2.53 ,$8.50 ,$5.97 ,$9.00 ,$8.40 ,$8.00 ,$8.00 ,$2.30 ,$6.50 ST. FRANCIS HOSPITAL - ACUTE,30500238,85018,HC HGB-90,305,1 ,$10.00 ,$6.50 ,$2.30 ,$10.00 ,$7.20 ,$5.44 ,$2.30 ,$5.58 ,$2.30 ,$5.97 ,$5.97 ,$5.97 ,$5.97 ,$8.40 ,$2.30 ,$8.50 ,$8.40 ,$2.30 ,$7.50 ,$8.00 ,$8.00 ,$2.30 ,$8.00 ,$8.40 ,$8.40 ,$8.40 ,$9.00 ,$5.75 ,$2.30 ,$2.37 ,$6.71 ,$7.38 ,$2.53 ,$8.50 ,$5.97 ,$9.00 ,$8.40 ,$8.00 ,$8.00 ,$2.30 ,$6.50 ST. FRANCIS HOSPITAL - ACUTE,30500244,85041,HC BLOOD COUNT RBC AUTO-90,305,1 ,$10.00 ,$6.50 ,$2.30 ,$10.00 ,$7.20 ,$5.44 ,$2.30 ,$5.58 ,$2.30 ,$5.97 ,$5.97 ,$5.97 ,$5.97 ,$8.40 ,$2.30 ,$8.50 ,$8.40 ,$2.30 ,$7.50 ,$8.00 ,$8.00 ,$2.30 ,$8.00 ,$8.40 ,$8.40 ,$8.40 ,$9.00 ,$5.75 ,$2.30 ,$10.00 ,$6.71 ,$7.38 ,$2.53 ,$8.50 ,$5.97 ,$9.00 ,$8.40 ,$8.00 ,$8.00 ,$2.30 ,$6.50 ST. FRANCIS HOSPITAL - ACUTE,30500249,85210,HC FACTOR II-90,305,1 ,$88.00 ,$57.20 ,$3.92 ,$88.00 ,$63.36 ,$47.87 ,$20.24 ,$49.12 ,$20.24 ,$52.57 ,$52.57 ,$52.57 ,$52.57 ,$73.92 ,$20.24 ,$74.80 ,$73.92 ,$20.24 ,$66.00 ,$70.40 ,$70.40 ,$20.24 ,$70.40 ,$73.92 ,$73.92 ,$73.92 ,$79.20 ,$50.60 ,$20.24 ,$88.00 ,$3.92 ,$4.31 ,$22.26 ,$74.80 ,$52.57 ,$79.20 ,$73.92 ,$70.40 ,$70.40 ,$20.24 ,$57.20 ST. FRANCIS HOSPITAL - ACUTE,30500250,85220,HC FACTOR V-90,305,1 ,$88.00 ,$57.20 ,$11.64 ,$88.00 ,$63.36 ,$47.87 ,$20.24 ,$49.12 ,$20.24 ,$52.57 ,$52.57 ,$52.57 ,$52.57 ,$73.92 ,$20.24 ,$74.80 ,$73.92 ,$20.24 ,$66.00 ,$70.40 ,$70.40 ,$20.24 ,$70.40 ,$73.92 ,$73.92 ,$73.92 ,$79.20 ,$50.60 ,$20.24 ,$88.00 ,$11.64 ,$12.80 ,$22.26 ,$74.80 ,$52.57 ,$79.20 ,$73.92 ,$70.40 ,$70.40 ,$20.24 ,$57.20 ST. FRANCIS HOSPITAL - ACUTE,30500251,85230,HC FACTOR VII-90,305,1 ,$82.00 ,$53.30 ,$11.64 ,$82.00 ,$59.04 ,$44.61 ,$18.86 ,$45.77 ,$18.86 ,$48.99 ,$48.99 ,$48.99 ,$48.99 ,$68.88 ,$18.86 ,$69.70 ,$68.88 ,$18.86 ,$61.50 ,$65.60 ,$65.60 ,$18.86 ,$65.60 ,$68.88 ,$68.88 ,$68.88 ,$73.80 ,$47.15 ,$18.86 ,$82.00 ,$11.64 ,$12.80 ,$20.75 ,$69.70 ,$48.99 ,$73.80 ,$68.88 ,$65.60 ,$65.60 ,$18.86 ,$53.30 ST. FRANCIS HOSPITAL - ACUTE,30500252,85240,HC FACTOR VIII AHG-90,305,1 ,$222.00 ,$144.30 ,$11.64 ,$222.00 ,$159.84 ,$120.77 ,$51.06 ,$123.92 ,$51.06 ,$132.62 ,$132.62 ,$132.62 ,$132.62 ,$186.48 ,$51.06 ,$188.70 ,$186.48 ,$51.06 ,$166.50 ,$177.60 ,$177.60 ,$51.06 ,$177.60 ,$186.48 ,$186.48 ,$186.48 ,$199.80 ,$127.65 ,$51.06 ,$222.00 ,$11.64 ,$12.80 ,$56.17 ,$188.70 ,$132.62 ,$199.80 ,$186.48 ,$177.60 ,$177.60 ,$51.06 ,$144.30 ST. FRANCIS HOSPITAL - ACUTE,30500253,85245,HC FACTOR VIII VW RISTO-90,305,1 ,$57.00 ,$37.05 ,$11.64 ,$57.00 ,$41.04 ,$31.01 ,$13.11 ,$31.82 ,$13.11 ,$34.05 ,$34.05 ,$34.05 ,$34.05 ,$47.88 ,$13.11 ,$48.45 ,$47.88 ,$13.11 ,$42.75 ,$45.60 ,$45.60 ,$13.11 ,$45.60 ,$47.88 ,$47.88 ,$47.88 ,$51.30 ,$32.78 ,$13.11 ,$57.00 ,$11.64 ,$12.80 ,$14.42 ,$48.45 ,$34.05 ,$51.30 ,$47.88 ,$45.60 ,$45.60 ,$13.11 ,$37.05 ST. FRANCIS HOSPITAL - ACUTE,30500254,85246,HC FACTOR VIII VW AG-90,305,1 ,$80.00 ,$52.00 ,$11.64 ,$80.00 ,$57.60 ,$43.52 ,$18.40 ,$44.66 ,$18.40 ,$47.79 ,$47.79 ,$47.79 ,$47.79 ,$67.20 ,$18.40 ,$68.00 ,$67.20 ,$18.40 ,$60.00 ,$64.00 ,$64.00 ,$18.40 ,$64.00 ,$67.20 ,$67.20 ,$67.20 ,$72.00 ,$46.00 ,$18.40 ,$80.00 ,$11.64 ,$12.80 ,$20.24 ,$68.00 ,$47.79 ,$72.00 ,$67.20 ,$64.00 ,$64.00 ,$18.40 ,$52.00 ST. FRANCIS HOSPITAL - ACUTE,30500256,85250,HC FACTOR IX-90,305,1 ,$72.00 ,$46.80 ,$11.64 ,$72.00 ,$51.84 ,$39.17 ,$16.56 ,$40.19 ,$16.56 ,$43.01 ,$43.01 ,$43.01 ,$43.01 ,$60.48 ,$16.56 ,$61.20 ,$60.48 ,$16.56 ,$54.00 ,$57.60 ,$57.60 ,$16.56 ,$57.60 ,$60.48 ,$60.48 ,$60.48 ,$64.80 ,$41.40 ,$16.56 ,$72.00 ,$11.64 ,$12.80 ,$18.22 ,$61.20 ,$43.01 ,$64.80 ,$60.48 ,$57.60 ,$57.60 ,$16.56 ,$46.80 ST. FRANCIS HOSPITAL - ACUTE,30500257,85260,HC FACTOR X-90,305,1 ,$88.00 ,$57.20 ,$11.64 ,$88.00 ,$63.36 ,$47.87 ,$20.24 ,$49.12 ,$20.24 ,$52.57 ,$52.57 ,$52.57 ,$52.57 ,$73.92 ,$20.24 ,$74.80 ,$73.92 ,$20.24 ,$66.00 ,$70.40 ,$70.40 ,$20.24 ,$70.40 ,$73.92 ,$73.92 ,$73.92 ,$79.20 ,$50.60 ,$20.24 ,$88.00 ,$11.64 ,$12.80 ,$22.26 ,$74.80 ,$52.57 ,$79.20 ,$73.92 ,$70.40 ,$70.40 ,$20.24 ,$57.20 ST. FRANCIS HOSPITAL - ACUTE,30500258,85270,HC FACTOR XI-90,305,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$11.64 ,$12.80 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30500260,85291,HC FACTOR XII-90,305,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$11.64 ,$12.80 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30500262,85301,HC ANTITHROMBIN III AG-90,305,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$11.64 ,$12.80 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30500263,85302,HC PROTEIN C AG-90,305,1 ,$80.00 ,$52.00 ,$11.64 ,$80.00 ,$57.60 ,$43.52 ,$18.40 ,$44.66 ,$18.40 ,$47.79 ,$47.79 ,$47.79 ,$47.79 ,$67.20 ,$18.40 ,$68.00 ,$67.20 ,$18.40 ,$60.00 ,$64.00 ,$64.00 ,$18.40 ,$64.00 ,$67.20 ,$67.20 ,$67.20 ,$72.00 ,$46.00 ,$18.40 ,$80.00 ,$11.64 ,$12.80 ,$20.24 ,$68.00 ,$47.79 ,$72.00 ,$67.20 ,$64.00 ,$64.00 ,$18.40 ,$52.00 ST. FRANCIS HOSPITAL - ACUTE,30500264,85303,HC PROTEIN C ACTIVITY-90,305,1 ,$130.00 ,$84.50 ,$11.64 ,$130.00 ,$93.60 ,$70.72 ,$29.90 ,$72.57 ,$29.90 ,$77.66 ,$77.66 ,$77.66 ,$77.66 ,$109.20 ,$29.90 ,$110.50 ,$109.20 ,$29.90 ,$97.50 ,$104.00 ,$104.00 ,$29.90 ,$104.00 ,$109.20 ,$109.20 ,$109.20 ,$117.00 ,$74.75 ,$29.90 ,$130.00 ,$11.64 ,$12.80 ,$32.89 ,$110.50 ,$77.66 ,$117.00 ,$109.20 ,$104.00 ,$104.00 ,$29.90 ,$84.50 ST. FRANCIS HOSPITAL - ACUTE,30500265,85305,HC PROTEIN S TOTAL-90,305,1 ,$77.00 ,$50.05 ,$11.64 ,$77.00 ,$55.44 ,$41.89 ,$17.71 ,$42.98 ,$17.71 ,$46.00 ,$46.00 ,$46.00 ,$46.00 ,$64.68 ,$17.71 ,$65.45 ,$64.68 ,$17.71 ,$57.75 ,$61.60 ,$61.60 ,$17.71 ,$61.60 ,$64.68 ,$64.68 ,$64.68 ,$69.30 ,$44.28 ,$17.71 ,$77.00 ,$11.64 ,$12.80 ,$19.48 ,$65.45 ,$46.00 ,$69.30 ,$64.68 ,$61.60 ,$61.60 ,$17.71 ,$50.05 ST. FRANCIS HOSPITAL - ACUTE,30500266,85306,HC PROTEIN S FREE-90,305,1 ,$75.00 ,$48.75 ,$11.64 ,$75.00 ,$54.00 ,$40.80 ,$17.25 ,$41.87 ,$17.25 ,$44.81 ,$44.81 ,$44.81 ,$44.81 ,$63.00 ,$17.25 ,$63.75 ,$63.00 ,$17.25 ,$56.25 ,$60.00 ,$60.00 ,$17.25 ,$60.00 ,$63.00 ,$63.00 ,$63.00 ,$67.50 ,$43.13 ,$17.25 ,$75.00 ,$11.64 ,$12.80 ,$18.98 ,$63.75 ,$44.81 ,$67.50 ,$63.00 ,$60.00 ,$60.00 ,$17.25 ,$48.75 ST. FRANCIS HOSPITAL - ACUTE,30500267,85307,HC ACTIVATED PROTEIN C RESIST-90,305,1 ,$50.00 ,$32.50 ,$10.81 ,$50.00 ,$36.00 ,$27.20 ,$11.50 ,$27.91 ,$11.50 ,$29.87 ,$29.87 ,$29.87 ,$29.87 ,$42.00 ,$11.50 ,$42.50 ,$42.00 ,$11.50 ,$37.50 ,$40.00 ,$40.00 ,$11.50 ,$40.00 ,$42.00 ,$42.00 ,$42.00 ,$45.00 ,$28.75 ,$11.50 ,$50.00 ,$10.81 ,$11.89 ,$12.65 ,$42.50 ,$29.87 ,$45.00 ,$42.00 ,$40.00 ,$40.00 ,$11.50 ,$32.50 ST. FRANCIS HOSPITAL - ACUTE,30500289,85597,HC PLATELET NEUTRALIZATION-90,305,1 ,$124.00 ,$80.60 ,$11.64 ,$124.00 ,$89.28 ,$67.46 ,$28.52 ,$69.22 ,$28.52 ,$74.08 ,$74.08 ,$74.08 ,$74.08 ,$104.16 ,$28.52 ,$105.40 ,$104.16 ,$28.52 ,$93.00 ,$99.20 ,$99.20 ,$28.52 ,$99.20 ,$104.16 ,$104.16 ,$104.16 ,$111.60 ,$71.30 ,$28.52 ,$124.00 ,$11.64 ,$12.80 ,$31.37 ,$105.40 ,$74.08 ,$111.60 ,$104.16 ,$99.20 ,$99.20 ,$28.52 ,$80.60 ST. FRANCIS HOSPITAL - ACUTE,30500290,85598,HC HEXAGN NEUTRALIZATION PHOSPH-90,305,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$11.64 ,$12.80 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30500297,85613,HC RUSSELL VIPER VENOM SCR T1-90,305,1 ,$60.00 ,$39.00 ,$11.64 ,$60.00 ,$43.20 ,$32.64 ,$13.80 ,$33.49 ,$13.80 ,$35.84 ,$35.84 ,$35.84 ,$35.84 ,$50.40 ,$13.80 ,$51.00 ,$50.40 ,$13.80 ,$45.00 ,$48.00 ,$48.00 ,$13.80 ,$48.00 ,$50.40 ,$50.40 ,$50.40 ,$54.00 ,$34.50 ,$13.80 ,$60.00 ,$11.64 ,$12.80 ,$15.18 ,$51.00 ,$35.84 ,$54.00 ,$50.40 ,$48.00 ,$48.00 ,$13.80 ,$39.00 ST. FRANCIS HOSPITAL - ACUTE,30500304,85670,HC THROMBIN TIME PLASMA-90,305,1 ,$44.00 ,$28.60 ,$3.92 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 ,$3.92 ,$4.31 ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,30500305,85730,HC PTT-90,305,1 ,$49.00 ,$31.85 ,$3.92 ,$49.00 ,$35.28 ,$26.66 ,$11.27 ,$27.35 ,$11.27 ,$29.27 ,$29.27 ,$29.27 ,$29.27 ,$41.16 ,$11.27 ,$41.65 ,$41.16 ,$11.27 ,$36.75 ,$39.20 ,$39.20 ,$11.27 ,$39.20 ,$41.16 ,$41.16 ,$41.16 ,$44.10 ,$28.18 ,$11.27 ,$49.00 ,$3.92 ,$4.31 ,$12.40 ,$41.65 ,$29.27 ,$44.10 ,$41.16 ,$39.20 ,$39.20 ,$11.27 ,$31.85 ST. FRANCIS HOSPITAL - ACUTE,30500310,85810,HC VISCOSITY-90,305,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$10.21 ,$11.23 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30500341,85046,HC BLOOD COUNT RETICULOCYTES AUTO,305,1 ,$85.00 ,$55.25 ,$6.71 ,$85.00 ,$61.20 ,$46.24 ,$19.55 ,$47.45 ,$19.55 ,$50.78 ,$50.78 ,$50.78 ,$50.78 ,$71.40 ,$19.55 ,$72.25 ,$71.40 ,$19.55 ,$63.75 ,$68.00 ,$68.00 ,$19.55 ,$68.00 ,$71.40 ,$71.40 ,$71.40 ,$76.50 ,$48.88 ,$19.55 ,$85.00 ,$6.71 ,$7.38 ,$21.51 ,$72.25 ,$50.78 ,$76.50 ,$71.40 ,$68.00 ,$68.00 ,$19.55 ,$55.25 ST. FRANCIS HOSPITAL - ACUTE,30500829,85300,HC ANTITHROMBIN III ACT,305,1 ,$102.00 ,$66.30 ,$11.64 ,$102.00 ,$73.44 ,$55.49 ,$23.46 ,$56.94 ,$23.46 ,$60.93 ,$60.93 ,$60.93 ,$60.93 ,$85.68 ,$23.46 ,$86.70 ,$85.68 ,$23.46 ,$76.50 ,$81.60 ,$81.60 ,$23.46 ,$81.60 ,$85.68 ,$85.68 ,$85.68 ,$91.80 ,$58.65 ,$23.46 ,$102.00 ,$11.64 ,$12.80 ,$25.81 ,$86.70 ,$60.93 ,$91.80 ,$85.68 ,$81.60 ,$81.60 ,$23.46 ,$66.30 ST. FRANCIS HOSPITAL - ACUTE,30500832,85460,HC FETAL HGB KLEIHAUER BETKE,305,1 ,$210.00 ,$136.50 ,$10.21 ,$210.00 ,$151.20 ,$114.24 ,$48.30 ,$117.22 ,$48.30 ,$125.45 ,$125.45 ,$125.45 ,$125.45 ,$176.40 ,$48.30 ,$178.50 ,$176.40 ,$48.30 ,$157.50 ,$168.00 ,$168.00 ,$48.30 ,$168.00 ,$176.40 ,$176.40 ,$176.40 ,$189.00 ,$120.75 ,$48.30 ,$210.00 ,$10.21 ,$11.23 ,$53.13 ,$178.50 ,$125.45 ,$189.00 ,$176.40 ,$168.00 ,$168.00 ,$48.30 ,$136.50 ST. FRANCIS HOSPITAL - ACUTE,30500833,85520,HC HEPARIN ASSAY,305,1 ,$75.00 ,$48.75 ,$11.64 ,$75.00 ,$54.00 ,$40.80 ,$17.25 ,$41.87 ,$17.25 ,$44.81 ,$44.81 ,$44.81 ,$44.81 ,$63.00 ,$17.25 ,$63.75 ,$63.00 ,$17.25 ,$56.25 ,$60.00 ,$60.00 ,$17.25 ,$60.00 ,$63.00 ,$63.00 ,$63.00 ,$67.50 ,$43.13 ,$17.25 ,$75.00 ,$11.64 ,$12.80 ,$18.98 ,$63.75 ,$44.81 ,$67.50 ,$63.00 ,$60.00 ,$60.00 ,$17.25 ,$48.75 ST. FRANCIS HOSPITAL - ACUTE,30600102,87040,HC BLOOD CULTURE,306,1 ,$389.00 ,$252.85 ,$25.65 ,$389.00 ,$280.08 ,$211.62 ,$89.47 ,$217.14 ,$89.47 ,$232.39 ,$232.39 ,$232.39 ,$232.39 ,$326.76 ,$89.47 ,$330.65 ,$326.76 ,$89.47 ,$291.75 ,$311.20 ,$311.20 ,$89.47 ,$311.20 ,$326.76 ,$326.76 ,$326.76 ,$350.10 ,$223.68 ,$89.47 ,$389.00 ,$25.65 ,$28.22 ,$98.42 ,$330.65 ,$232.39 ,$350.10 ,$326.76 ,$311.20 ,$311.20 ,$89.47 ,$252.85 ST. FRANCIS HOSPITAL - ACUTE,30600174,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$121.00 ,$78.65 ,$7.72 ,$121.00 ,$87.12 ,$65.82 ,$27.83 ,$67.54 ,$27.83 ,$72.29 ,$72.29 ,$72.29 ,$72.29 ,$101.64 ,$27.83 ,$102.85 ,$101.64 ,$27.83 ,$90.75 ,$96.80 ,$96.80 ,$27.83 ,$96.80 ,$101.64 ,$101.64 ,$101.64 ,$108.90 ,$69.58 ,$27.83 ,$121.00 ,$7.72 ,$8.49 ,$30.61 ,$102.85 ,$72.29 ,$108.90 ,$101.64 ,$96.80 ,$96.80 ,$27.83 ,$78.65 ST. FRANCIS HOSPITAL - ACUTE,30600176,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$110.00 ,$71.50 ,$7.72 ,$110.00 ,$79.20 ,$59.84 ,$25.30 ,$61.40 ,$25.30 ,$65.71 ,$65.71 ,$65.71 ,$65.71 ,$92.40 ,$25.30 ,$93.50 ,$92.40 ,$25.30 ,$82.50 ,$88.00 ,$88.00 ,$25.30 ,$88.00 ,$92.40 ,$92.40 ,$92.40 ,$99.00 ,$63.25 ,$25.30 ,$110.00 ,$7.72 ,$8.49 ,$27.83 ,$93.50 ,$65.71 ,$99.00 ,$92.40 ,$88.00 ,$88.00 ,$25.30 ,$71.50 ST. FRANCIS HOSPITAL - ACUTE,30600237,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$526.00 ,$341.90 ,$9.68 ,$526.00 ,$378.72 ,$286.14 ,$120.98 ,$293.61 ,$120.98 ,$314.23 ,$314.23 ,$314.23 ,$314.23 ,$441.84 ,$120.98 ,$447.10 ,$441.84 ,$120.98 ,$394.50 ,$420.80 ,$420.80 ,$120.98 ,$420.80 ,$441.84 ,$441.84 ,$441.84 ,$473.40 ,$302.45 ,$120.98 ,$526.00 ,$9.68 ,$10.65 ,$133.08 ,$447.10 ,$314.23 ,$473.40 ,$441.84 ,$420.80 ,$420.80 ,$120.98 ,$341.90 ST. FRANCIS HOSPITAL - ACUTE,30600269,87807,HC QL RSV,306,1 ,$483.00 ,$313.95 ,$7.72 ,$483.00 ,$347.76 ,$262.75 ,$111.09 ,$269.61 ,$111.09 ,$288.54 ,$288.54 ,$288.54 ,$288.54 ,$405.72 ,$111.09 ,$410.55 ,$405.72 ,$111.09 ,$362.25 ,$386.40 ,$386.40 ,$111.09 ,$386.40 ,$405.72 ,$405.72 ,$405.72 ,$434.70 ,$277.73 ,$111.09 ,$483.00 ,$7.72 ,$8.49 ,$122.20 ,$410.55 ,$288.54 ,$434.70 ,$405.72 ,$386.40 ,$386.40 ,$111.09 ,$313.95 ST. FRANCIS HOSPITAL - ACUTE,30600270,87880,HC OPTICAL STREP,306,1 ,$254.00 ,$165.10 ,$7.72 ,$254.00 ,$182.88 ,$138.18 ,$58.42 ,$141.78 ,$58.42 ,$151.74 ,$151.74 ,$151.74 ,$151.74 ,$213.36 ,$58.42 ,$215.90 ,$213.36 ,$58.42 ,$190.50 ,$203.20 ,$203.20 ,$58.42 ,$203.20 ,$213.36 ,$213.36 ,$213.36 ,$228.60 ,$146.05 ,$58.42 ,$254.00 ,$7.72 ,$8.49 ,$64.26 ,$215.90 ,$151.74 ,$228.60 ,$213.36 ,$203.20 ,$203.20 ,$58.42 ,$165.10 ST. FRANCIS HOSPITAL - ACUTE,30600283,87804,HC QL INFLUENZA A/B,306,1 ,$325.00 ,$211.25 ,$7.72 ,$325.00 ,$234.00 ,$176.80 ,$74.75 ,$181.42 ,$74.75 ,$194.16 ,$194.16 ,$194.16 ,$194.16 ,$273.00 ,$74.75 ,$276.25 ,$273.00 ,$74.75 ,$243.75 ,$260.00 ,$260.00 ,$74.75 ,$260.00 ,$273.00 ,$273.00 ,$273.00 ,$292.50 ,$186.88 ,$74.75 ,$325.00 ,$7.72 ,$8.49 ,$82.23 ,$276.25 ,$194.16 ,$292.50 ,$273.00 ,$260.00 ,$260.00 ,$74.75 ,$211.25 ST. FRANCIS HOSPITAL - ACUTE,30600303,87176,HC HOMOGENIZATION TISSUE,306,1 ,$80.00 ,$52.00 ,$7.72 ,$80.00 ,$57.60 ,$43.52 ,$18.40 ,$44.66 ,$18.40 ,$47.79 ,$47.79 ,$47.79 ,$47.79 ,$67.20 ,$18.40 ,$68.00 ,$67.20 ,$18.40 ,$60.00 ,$64.00 ,$64.00 ,$18.40 ,$64.00 ,$67.20 ,$67.20 ,$67.20 ,$72.00 ,$46.00 ,$18.40 ,$80.00 ,$7.72 ,$8.49 ,$20.24 ,$68.00 ,$47.79 ,$72.00 ,$67.20 ,$64.00 ,$64.00 ,$18.40 ,$52.00 ST. FRANCIS HOSPITAL - ACUTE,30600332,87651,HC INFECT AMP (GRP A STREP),306,1 ,$99.00 ,$64.35 ,$22.77 ,$99.00 ,$71.28 ,$53.86 ,$22.77 ,$55.26 ,$22.77 ,$59.14 ,$59.14 ,$59.14 ,$59.14 ,$83.16 ,$22.77 ,$84.15 ,$83.16 ,$22.77 ,$74.25 ,$79.20 ,$79.20 ,$22.77 ,$79.20 ,$83.16 ,$83.16 ,$83.16 ,$89.10 ,$56.93 ,$22.77 ,$99.00 ,$25.65 ,$28.22 ,$25.05 ,$84.15 ,$59.14 ,$89.10 ,$83.16 ,$79.20 ,$79.20 ,$22.77 ,$64.35 ST. FRANCIS HOSPITAL - ACUTE,30600333,87808,HC TRICHOMONAS VAGINITIS OPTICAL,306,1 ,$165.00 ,$107.25 ,$7.72 ,$165.00 ,$118.80 ,$89.76 ,$37.95 ,$92.10 ,$37.95 ,$98.57 ,$98.57 ,$98.57 ,$98.57 ,$138.60 ,$37.95 ,$140.25 ,$138.60 ,$37.95 ,$123.75 ,$132.00 ,$132.00 ,$37.95 ,$132.00 ,$138.60 ,$138.60 ,$138.60 ,$148.50 ,$94.88 ,$37.95 ,$165.00 ,$7.72 ,$8.49 ,$41.75 ,$140.25 ,$98.57 ,$148.50 ,$138.60 ,$132.00 ,$132.00 ,$37.95 ,$107.25 ST. FRANCIS HOSPITAL - ACUTE,30600353,87015,HC CONCENTRATION INFECTIOUS AGENT-90,306,1 ,$23.00 ,$14.95 ,$5.29 ,$23.00 ,$16.56 ,$12.51 ,$5.29 ,$12.84 ,$5.29 ,$13.74 ,$13.74 ,$13.74 ,$13.74 ,$19.32 ,$5.29 ,$19.55 ,$19.32 ,$5.29 ,$17.25 ,$18.40 ,$18.40 ,$5.29 ,$18.40 ,$19.32 ,$19.32 ,$19.32 ,$20.70 ,$13.23 ,$5.29 ,$23.00 ,$7.72 ,$8.49 ,$5.82 ,$19.55 ,$13.74 ,$20.70 ,$19.32 ,$18.40 ,$18.40 ,$5.29 ,$14.95 ST. FRANCIS HOSPITAL - ACUTE,30600360,87081,HC CULTURE SCR PRESUMP PATHOGENS T1,306,1 ,$241.00 ,$156.65 ,$7.72 ,$241.00 ,$173.52 ,$131.10 ,$55.43 ,$134.53 ,$55.43 ,$143.97 ,$143.97 ,$143.97 ,$143.97 ,$202.44 ,$55.43 ,$204.85 ,$202.44 ,$55.43 ,$180.75 ,$192.80 ,$192.80 ,$55.43 ,$192.80 ,$202.44 ,$202.44 ,$202.44 ,$216.90 ,$138.58 ,$55.43 ,$241.00 ,$7.72 ,$8.49 ,$60.97 ,$204.85 ,$143.97 ,$216.90 ,$202.44 ,$192.80 ,$192.80 ,$55.43 ,$156.65 ST. FRANCIS HOSPITAL - ACUTE,30600366,87109,HC CULTURE MYCOPLASMA-90,306,1 ,$65.00 ,$42.25 ,$14.95 ,$65.00 ,$46.80 ,$35.36 ,$14.95 ,$36.28 ,$14.95 ,$38.83 ,$38.83 ,$38.83 ,$38.83 ,$54.60 ,$14.95 ,$55.25 ,$54.60 ,$14.95 ,$48.75 ,$52.00 ,$52.00 ,$14.95 ,$52.00 ,$54.60 ,$54.60 ,$54.60 ,$58.50 ,$37.38 ,$14.95 ,$65.00 ,$25.65 ,$28.22 ,$16.45 ,$55.25 ,$38.83 ,$58.50 ,$54.60 ,$52.00 ,$52.00 ,$14.95 ,$42.25 ST. FRANCIS HOSPITAL - ACUTE,30600367,87110,HC CULTURE CHLAMYDIA-90,306,1 ,$156.00 ,$101.40 ,$7.72 ,$156.00 ,$112.32 ,$84.86 ,$35.88 ,$87.08 ,$35.88 ,$93.19 ,$93.19 ,$93.19 ,$93.19 ,$131.04 ,$35.88 ,$132.60 ,$131.04 ,$35.88 ,$117.00 ,$124.80 ,$124.80 ,$35.88 ,$124.80 ,$131.04 ,$131.04 ,$131.04 ,$140.40 ,$89.70 ,$35.88 ,$156.00 ,$7.72 ,$8.49 ,$39.47 ,$132.60 ,$93.19 ,$140.40 ,$131.04 ,$124.80 ,$124.80 ,$35.88 ,$101.40 ST. FRANCIS HOSPITAL - ACUTE,30600370,87140,HC CULTURE TYPE IF EA ANTISERUM-90,306,1 ,$84.00 ,$54.60 ,$19.32 ,$84.00 ,$60.48 ,$45.70 ,$19.32 ,$46.89 ,$19.32 ,$50.18 ,$50.18 ,$50.18 ,$50.18 ,$70.56 ,$19.32 ,$71.40 ,$70.56 ,$19.32 ,$63.00 ,$67.20 ,$67.20 ,$19.32 ,$67.20 ,$70.56 ,$70.56 ,$70.56 ,$75.60 ,$48.30 ,$19.32 ,$84.00 ,$25.65 ,$28.22 ,$21.25 ,$71.40 ,$50.18 ,$75.60 ,$70.56 ,$67.20 ,$67.20 ,$19.32 ,$54.60 ST. FRANCIS HOSPITAL - ACUTE,30600380,87177,HC SMEAR OVA PARASITE CONC/ID-90,306,1 ,$72.00 ,$46.80 ,$7.72 ,$72.00 ,$51.84 ,$39.17 ,$16.56 ,$40.19 ,$16.56 ,$43.01 ,$43.01 ,$43.01 ,$43.01 ,$60.48 ,$16.56 ,$61.20 ,$60.48 ,$16.56 ,$54.00 ,$57.60 ,$57.60 ,$16.56 ,$57.60 ,$60.48 ,$60.48 ,$60.48 ,$64.80 ,$41.40 ,$16.56 ,$72.00 ,$7.72 ,$8.49 ,$18.22 ,$61.20 ,$43.01 ,$64.80 ,$60.48 ,$57.60 ,$57.60 ,$16.56 ,$46.80 ST. FRANCIS HOSPITAL - ACUTE,30600397,87207,HC SPECIAL STAIN INCL BODIES/PARASITES-90,306,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$7.72 ,$8.49 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30600399,87209,HC OVA AND PARASITE W/STAIN-90,306,1 ,$72.00 ,$46.80 ,$16.56 ,$72.00 ,$51.84 ,$39.17 ,$16.56 ,$40.19 ,$16.56 ,$43.01 ,$43.01 ,$43.01 ,$43.01 ,$60.48 ,$16.56 ,$61.20 ,$60.48 ,$16.56 ,$54.00 ,$57.60 ,$57.60 ,$16.56 ,$57.60 ,$60.48 ,$60.48 ,$60.48 ,$64.80 ,$41.40 ,$16.56 ,$72.00 ,$25.65 ,$28.22 ,$18.22 ,$61.20 ,$43.01 ,$64.80 ,$60.48 ,$57.60 ,$57.60 ,$16.56 ,$46.80 ST. FRANCIS HOSPITAL - ACUTE,30600405,87254,HC VIRUS ISOL SHELL ID-90,306,1 ,$165.00 ,$107.25 ,$25.65 ,$165.00 ,$118.80 ,$89.76 ,$37.95 ,$92.10 ,$37.95 ,$98.57 ,$98.57 ,$98.57 ,$98.57 ,$138.60 ,$37.95 ,$140.25 ,$138.60 ,$37.95 ,$123.75 ,$132.00 ,$132.00 ,$37.95 ,$132.00 ,$138.60 ,$138.60 ,$138.60 ,$148.50 ,$94.88 ,$37.95 ,$165.00 ,$25.65 ,$28.22 ,$41.75 ,$140.25 ,$98.57 ,$148.50 ,$138.60 ,$132.00 ,$132.00 ,$37.95 ,$107.25 ST. FRANCIS HOSPITAL - ACUTE,30600413,87290,HC IF VARICELLA ZOETER AG-90,306,1 ,$50.00 ,$32.50 ,$9.68 ,$50.00 ,$36.00 ,$27.20 ,$11.50 ,$27.91 ,$11.50 ,$29.87 ,$29.87 ,$29.87 ,$29.87 ,$42.00 ,$11.50 ,$42.50 ,$42.00 ,$11.50 ,$37.50 ,$40.00 ,$40.00 ,$11.50 ,$40.00 ,$42.00 ,$42.00 ,$42.00 ,$45.00 ,$28.75 ,$11.50 ,$50.00 ,$9.68 ,$10.65 ,$12.65 ,$42.50 ,$29.87 ,$45.00 ,$42.00 ,$40.00 ,$40.00 ,$11.50 ,$32.50 ST. FRANCIS HOSPITAL - ACUTE,30600414,87299,HC ANTIBODY DETECT IF NOS-90,306,1 ,$50.00 ,$32.50 ,$9.68 ,$50.00 ,$36.00 ,$27.20 ,$11.50 ,$27.91 ,$11.50 ,$29.87 ,$29.87 ,$29.87 ,$29.87 ,$42.00 ,$11.50 ,$42.50 ,$42.00 ,$11.50 ,$37.50 ,$40.00 ,$40.00 ,$11.50 ,$40.00 ,$42.00 ,$42.00 ,$42.00 ,$45.00 ,$28.75 ,$11.50 ,$50.00 ,$9.68 ,$10.65 ,$12.65 ,$42.50 ,$29.87 ,$45.00 ,$42.00 ,$40.00 ,$40.00 ,$11.50 ,$32.50 ST. FRANCIS HOSPITAL - ACUTE,30600423,87341,HC EIA QL HEPATITIS B AG NEUT-90,306,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$9.68 ,$10.65 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30600424,87350,HC HEPATITIS BE AG QL-90,306,1 ,$72.00 ,$46.80 ,$9.68 ,$72.00 ,$51.84 ,$39.17 ,$16.56 ,$40.19 ,$16.56 ,$43.01 ,$43.01 ,$43.01 ,$43.01 ,$60.48 ,$16.56 ,$61.20 ,$60.48 ,$16.56 ,$54.00 ,$57.60 ,$57.60 ,$16.56 ,$57.60 ,$60.48 ,$60.48 ,$60.48 ,$64.80 ,$41.40 ,$16.56 ,$72.00 ,$9.68 ,$10.65 ,$18.22 ,$61.20 ,$43.01 ,$64.80 ,$60.48 ,$57.60 ,$57.60 ,$16.56 ,$46.80 ST. FRANCIS HOSPITAL - ACUTE,30600426,87385,HC EIA QL HISTOPLASMA AG-90,306,1 ,$60.00 ,$39.00 ,$9.68 ,$60.00 ,$43.20 ,$32.64 ,$13.80 ,$33.49 ,$13.80 ,$35.84 ,$35.84 ,$35.84 ,$35.84 ,$50.40 ,$13.80 ,$51.00 ,$50.40 ,$13.80 ,$45.00 ,$48.00 ,$48.00 ,$13.80 ,$48.00 ,$50.40 ,$50.40 ,$50.40 ,$54.00 ,$34.50 ,$13.80 ,$60.00 ,$9.68 ,$10.65 ,$15.18 ,$51.00 ,$35.84 ,$54.00 ,$50.40 ,$48.00 ,$48.00 ,$13.80 ,$39.00 ST. FRANCIS HOSPITAL - ACUTE,30600438,87491,HC CHLAMYDIA TRACH AMP-90,306,1 ,$110.00 ,$71.50 ,$9.68 ,$110.00 ,$79.20 ,$59.84 ,$25.30 ,$61.40 ,$25.30 ,$65.71 ,$65.71 ,$65.71 ,$65.71 ,$92.40 ,$25.30 ,$93.50 ,$92.40 ,$25.30 ,$82.50 ,$88.00 ,$88.00 ,$25.30 ,$88.00 ,$92.40 ,$92.40 ,$92.40 ,$99.00 ,$63.25 ,$25.30 ,$110.00 ,$9.68 ,$10.65 ,$27.83 ,$93.50 ,$65.71 ,$99.00 ,$92.40 ,$88.00 ,$88.00 ,$25.30 ,$71.50 ST. FRANCIS HOSPITAL - ACUTE,30600442,87496,HC INFECT AMP (CMV) MENI-90,306,1 ,$110.00 ,$71.50 ,$25.30 ,$110.00 ,$79.20 ,$59.84 ,$25.30 ,$61.40 ,$25.30 ,$65.71 ,$65.71 ,$65.71 ,$65.71 ,$92.40 ,$25.30 ,$93.50 ,$92.40 ,$25.30 ,$82.50 ,$88.00 ,$88.00 ,$25.30 ,$88.00 ,$92.40 ,$92.40 ,$92.40 ,$99.00 ,$63.25 ,$25.30 ,$110.00 ,$25.65 ,$28.22 ,$27.83 ,$93.50 ,$65.71 ,$99.00 ,$92.40 ,$88.00 ,$88.00 ,$25.30 ,$71.50 ST. FRANCIS HOSPITAL - ACUTE,30600443,87497,HC CMV QN-90,306,1 ,$122.00 ,$79.30 ,$25.65 ,$122.00 ,$87.84 ,$66.37 ,$28.06 ,$68.10 ,$28.06 ,$72.88 ,$72.88 ,$72.88 ,$72.88 ,$102.48 ,$28.06 ,$103.70 ,$102.48 ,$28.06 ,$91.50 ,$97.60 ,$97.60 ,$28.06 ,$97.60 ,$102.48 ,$102.48 ,$102.48 ,$109.80 ,$70.15 ,$28.06 ,$122.00 ,$25.65 ,$28.22 ,$30.87 ,$103.70 ,$72.88 ,$109.80 ,$102.48 ,$97.60 ,$97.60 ,$28.06 ,$79.30 ST. FRANCIS HOSPITAL - ACUTE,30600448,87517,HC HEPATITIS B QN-90,306,1 ,$85.00 ,$55.25 ,$19.55 ,$85.00 ,$61.20 ,$46.24 ,$19.55 ,$47.45 ,$19.55 ,$50.78 ,$50.78 ,$50.78 ,$50.78 ,$71.40 ,$19.55 ,$72.25 ,$71.40 ,$19.55 ,$63.75 ,$68.00 ,$68.00 ,$19.55 ,$68.00 ,$71.40 ,$71.40 ,$71.40 ,$76.50 ,$48.88 ,$19.55 ,$85.00 ,$25.65 ,$28.22 ,$21.51 ,$72.25 ,$50.78 ,$76.50 ,$71.40 ,$68.00 ,$68.00 ,$19.55 ,$55.25 ST. FRANCIS HOSPITAL - ACUTE,30600451,87522,HC HEPATITIS C QN-90,306,1 ,$347.00 ,$225.55 ,$25.65 ,$347.00 ,$249.84 ,$188.77 ,$79.81 ,$193.70 ,$79.81 ,$207.30 ,$207.30 ,$207.30 ,$207.30 ,$291.48 ,$79.81 ,$294.95 ,$291.48 ,$79.81 ,$260.25 ,$277.60 ,$277.60 ,$79.81 ,$277.60 ,$291.48 ,$291.48 ,$291.48 ,$312.30 ,$199.53 ,$79.81 ,$347.00 ,$25.65 ,$28.22 ,$87.79 ,$294.95 ,$207.30 ,$312.30 ,$291.48 ,$277.60 ,$277.60 ,$79.81 ,$225.55 ST. FRANCIS HOSPITAL - ACUTE,30600453,87529,HC HERPES SIMPLEX AMP-90,306,1 ,$238.00 ,$154.70 ,$25.65 ,$238.00 ,$171.36 ,$129.47 ,$54.74 ,$132.85 ,$54.74 ,$142.18 ,$142.18 ,$142.18 ,$142.18 ,$199.92 ,$54.74 ,$202.30 ,$199.92 ,$54.74 ,$178.50 ,$190.40 ,$190.40 ,$54.74 ,$190.40 ,$199.92 ,$199.92 ,$199.92 ,$214.20 ,$136.85 ,$54.74 ,$238.00 ,$25.65 ,$28.22 ,$60.21 ,$202.30 ,$142.18 ,$214.20 ,$199.92 ,$190.40 ,$190.40 ,$54.74 ,$154.70 ST. FRANCIS HOSPITAL - ACUTE,30600458,87536,HC HIV-1 QN-90,306,1 ,$727.00 ,$472.55 ,$25.65 ,$727.00 ,$523.44 ,$395.49 ,$167.21 ,$405.81 ,$167.21 ,$434.31 ,$434.31 ,$434.31 ,$434.31 ,$610.68 ,$167.21 ,$617.95 ,$610.68 ,$167.21 ,$545.25 ,$581.60 ,$581.60 ,$167.21 ,$581.60 ,$610.68 ,$610.68 ,$610.68 ,$654.30 ,$418.03 ,$167.21 ,$727.00 ,$25.65 ,$28.22 ,$183.93 ,$617.95 ,$434.31 ,$654.30 ,$610.68 ,$581.60 ,$581.60 ,$167.21 ,$472.55 ST. FRANCIS HOSPITAL - ACUTE,30600460,87591,HC NEISSERIA AMP-90,306,1 ,$109.00 ,$70.85 ,$25.07 ,$109.00 ,$78.48 ,$59.30 ,$25.07 ,$60.84 ,$25.07 ,$65.12 ,$65.12 ,$65.12 ,$65.12 ,$91.56 ,$25.07 ,$92.65 ,$91.56 ,$25.07 ,$81.75 ,$87.20 ,$87.20 ,$25.07 ,$87.20 ,$91.56 ,$91.56 ,$91.56 ,$98.10 ,$62.68 ,$25.07 ,$109.00 ,$25.65 ,$28.22 ,$27.58 ,$92.65 ,$65.12 ,$98.10 ,$91.56 ,$87.20 ,$87.20 ,$25.07 ,$70.85 ST. FRANCIS HOSPITAL - ACUTE,30600469,87661,HC TRICHOMONAS VAG AMP PROBE-90,306,1 ,$109.00 ,$70.85 ,$25.07 ,$109.00 ,$78.48 ,$59.30 ,$25.07 ,$60.84 ,$25.07 ,$65.12 ,$65.12 ,$65.12 ,$65.12 ,$91.56 ,$25.07 ,$92.65 ,$91.56 ,$25.07 ,$81.75 ,$87.20 ,$87.20 ,$25.07 ,$87.20 ,$91.56 ,$91.56 ,$91.56 ,$98.10 ,$62.68 ,$25.07 ,$109.00 ,$25.65 ,$28.22 ,$27.58 ,$92.65 ,$65.12 ,$98.10 ,$91.56 ,$87.20 ,$87.20 ,$25.07 ,$70.85 ST. FRANCIS HOSPITAL - ACUTE,30600471,87798,HC INFECT AMP-90,306,1 ,$220.00 ,$143.00 ,$25.65 ,$220.00 ,$158.40 ,$119.68 ,$50.60 ,$122.80 ,$50.60 ,$131.43 ,$131.43 ,$131.43 ,$131.43 ,$184.80 ,$50.60 ,$187.00 ,$184.80 ,$50.60 ,$165.00 ,$176.00 ,$176.00 ,$50.60 ,$176.00 ,$184.80 ,$184.80 ,$184.80 ,$198.00 ,$126.50 ,$50.60 ,$220.00 ,$25.65 ,$28.22 ,$55.66 ,$187.00 ,$131.43 ,$198.00 ,$184.80 ,$176.00 ,$176.00 ,$50.60 ,$143.00 ST. FRANCIS HOSPITAL - ACUTE,30600478,87799,HC INFECT AGENT QN-90,306,1 ,$391.00 ,$254.15 ,$25.65 ,$391.00 ,$281.52 ,$212.70 ,$89.93 ,$218.26 ,$89.93 ,$233.58 ,$233.58 ,$233.58 ,$233.58 ,$328.44 ,$89.93 ,$332.35 ,$328.44 ,$89.93 ,$293.25 ,$312.80 ,$312.80 ,$89.93 ,$312.80 ,$328.44 ,$328.44 ,$328.44 ,$351.90 ,$224.83 ,$89.93 ,$391.00 ,$25.65 ,$28.22 ,$98.92 ,$332.35 ,$233.58 ,$351.90 ,$328.44 ,$312.80 ,$312.80 ,$89.93 ,$254.15 ST. FRANCIS HOSPITAL - ACUTE,30600483,87902,HC GENTOYPE HEP C-90,306,1 ,$271.00 ,$176.15 ,$25.65 ,$271.00 ,$195.12 ,$147.42 ,$62.33 ,$151.27 ,$62.33 ,$161.90 ,$161.90 ,$161.90 ,$161.90 ,$227.64 ,$62.33 ,$230.35 ,$227.64 ,$62.33 ,$203.25 ,$216.80 ,$216.80 ,$62.33 ,$216.80 ,$227.64 ,$227.64 ,$227.64 ,$243.90 ,$155.83 ,$62.33 ,$271.00 ,$25.65 ,$28.22 ,$68.56 ,$230.35 ,$161.90 ,$243.90 ,$227.64 ,$216.80 ,$216.80 ,$62.33 ,$176.15 ST. FRANCIS HOSPITAL - ACUTE,30600490,87272,HC IF CRYPTOSPORIDIUM AG-90,306,1 ,$36.00 ,$23.40 ,$8.28 ,$36.00 ,$25.92 ,$19.58 ,$8.28 ,$20.10 ,$8.28 ,$21.51 ,$21.51 ,$21.51 ,$21.51 ,$30.24 ,$8.28 ,$30.60 ,$30.24 ,$8.28 ,$27.00 ,$28.80 ,$28.80 ,$8.28 ,$28.80 ,$30.24 ,$30.24 ,$30.24 ,$32.40 ,$20.70 ,$8.28 ,$36.00 ,$9.68 ,$10.65 ,$9.11 ,$30.60 ,$21.51 ,$32.40 ,$30.24 ,$28.80 ,$28.80 ,$8.28 ,$23.40 ST. FRANCIS HOSPITAL - ACUTE,30600504,87046,HC STOOL CULTURE ADD ISO-90,306,1 ,$26.00 ,$16.90 ,$5.98 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 ,$7.72 ,$8.49 ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,30600505,87329,HC EIA QL GIARDIA AG-90,306,1 ,$40.00 ,$26.00 ,$9.20 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$9.68 ,$10.65 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30600507,87541,HC INFECT AGT LEGIONELLA PNEUMOPHILA PROBE-90,306,1 ,$97.00 ,$63.05 ,$22.31 ,$97.00 ,$69.84 ,$52.77 ,$22.31 ,$54.15 ,$22.31 ,$57.95 ,$57.95 ,$57.95 ,$57.95 ,$81.48 ,$22.31 ,$82.45 ,$81.48 ,$22.31 ,$72.75 ,$77.60 ,$77.60 ,$22.31 ,$77.60 ,$81.48 ,$81.48 ,$81.48 ,$87.30 ,$55.78 ,$22.31 ,$97.00 ,$25.65 ,$28.22 ,$24.54 ,$82.45 ,$57.95 ,$87.30 ,$81.48 ,$77.60 ,$77.60 ,$22.31 ,$63.05 ST. FRANCIS HOSPITAL - ACUTE,30600519,87070,HC BODY FLUID CULTURE,306,1 ,$389.00 ,$252.85 ,$7.72 ,$389.00 ,$280.08 ,$211.62 ,$89.47 ,$217.14 ,$89.47 ,$232.39 ,$232.39 ,$232.39 ,$232.39 ,$326.76 ,$89.47 ,$330.65 ,$326.76 ,$89.47 ,$291.75 ,$311.20 ,$311.20 ,$89.47 ,$311.20 ,$326.76 ,$326.76 ,$326.76 ,$350.10 ,$223.68 ,$89.47 ,$389.00 ,$7.72 ,$8.49 ,$98.42 ,$330.65 ,$232.39 ,$350.10 ,$326.76 ,$311.20 ,$311.20 ,$89.47 ,$252.85 ST. FRANCIS HOSPITAL - ACUTE,30600522,87075,HC CULTURE ANAEROBIC,306,1 ,$481.00 ,$312.65 ,$7.72 ,$481.00 ,$346.32 ,$261.66 ,$110.63 ,$268.49 ,$110.63 ,$287.35 ,$287.35 ,$287.35 ,$287.35 ,$404.04 ,$110.63 ,$408.85 ,$404.04 ,$110.63 ,$360.75 ,$384.80 ,$384.80 ,$110.63 ,$384.80 ,$404.04 ,$404.04 ,$404.04 ,$432.90 ,$276.58 ,$110.63 ,$481.00 ,$7.72 ,$8.49 ,$121.69 ,$408.85 ,$287.35 ,$432.90 ,$404.04 ,$384.80 ,$384.80 ,$110.63 ,$312.65 ST. FRANCIS HOSPITAL - ACUTE,30600523,87076,HC CULTURE ANAEROBIC ID,306,1 ,$47.00 ,$30.55 ,$7.72 ,$47.00 ,$33.84 ,$25.57 ,$10.81 ,$26.24 ,$10.81 ,$28.08 ,$28.08 ,$28.08 ,$28.08 ,$39.48 ,$10.81 ,$39.95 ,$39.48 ,$10.81 ,$35.25 ,$37.60 ,$37.60 ,$10.81 ,$37.60 ,$39.48 ,$39.48 ,$39.48 ,$42.30 ,$27.03 ,$10.81 ,$47.00 ,$7.72 ,$8.49 ,$11.89 ,$39.95 ,$28.08 ,$42.30 ,$39.48 ,$37.60 ,$37.60 ,$10.81 ,$30.55 ST. FRANCIS HOSPITAL - ACUTE,30600524,87077,HC CULTURE AEROBIC ID ADDL,306,1 ,$47.00 ,$30.55 ,$7.72 ,$47.00 ,$33.84 ,$25.57 ,$10.81 ,$26.24 ,$10.81 ,$28.08 ,$28.08 ,$28.08 ,$28.08 ,$39.48 ,$10.81 ,$39.95 ,$39.48 ,$10.81 ,$35.25 ,$37.60 ,$37.60 ,$10.81 ,$37.60 ,$39.48 ,$39.48 ,$39.48 ,$42.30 ,$27.03 ,$10.81 ,$47.00 ,$7.72 ,$8.49 ,$11.89 ,$39.95 ,$28.08 ,$42.30 ,$39.48 ,$37.60 ,$37.60 ,$10.81 ,$30.55 ST. FRANCIS HOSPITAL - ACUTE,30600526,87081,HC CULTURE SCR PRESUMP PATHOGENS,306,1 ,$241.00 ,$156.65 ,$7.72 ,$241.00 ,$173.52 ,$131.10 ,$55.43 ,$134.53 ,$55.43 ,$143.97 ,$143.97 ,$143.97 ,$143.97 ,$202.44 ,$55.43 ,$204.85 ,$202.44 ,$55.43 ,$180.75 ,$192.80 ,$192.80 ,$55.43 ,$192.80 ,$202.44 ,$202.44 ,$202.44 ,$216.90 ,$138.58 ,$55.43 ,$241.00 ,$7.72 ,$8.49 ,$60.97 ,$204.85 ,$143.97 ,$216.90 ,$202.44 ,$192.80 ,$192.80 ,$55.43 ,$156.65 ST. FRANCIS HOSPITAL - ACUTE,30600527,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$354.00 ,$230.10 ,$7.72 ,$354.00 ,$254.88 ,$192.58 ,$81.42 ,$197.60 ,$81.42 ,$211.48 ,$211.48 ,$211.48 ,$211.48 ,$297.36 ,$81.42 ,$300.90 ,$297.36 ,$81.42 ,$265.50 ,$283.20 ,$283.20 ,$81.42 ,$283.20 ,$297.36 ,$297.36 ,$297.36 ,$318.60 ,$203.55 ,$81.42 ,$354.00 ,$7.72 ,$8.49 ,$89.56 ,$300.90 ,$211.48 ,$318.60 ,$297.36 ,$283.20 ,$283.20 ,$81.42 ,$230.10 ST. FRANCIS HOSPITAL - ACUTE,30600528,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$63.00 ,$40.95 ,$7.72 ,$63.00 ,$45.36 ,$34.27 ,$14.49 ,$35.17 ,$14.49 ,$37.64 ,$37.64 ,$37.64 ,$37.64 ,$52.92 ,$14.49 ,$53.55 ,$52.92 ,$14.49 ,$47.25 ,$50.40 ,$50.40 ,$14.49 ,$50.40 ,$52.92 ,$52.92 ,$52.92 ,$56.70 ,$36.23 ,$14.49 ,$63.00 ,$7.72 ,$8.49 ,$15.94 ,$53.55 ,$37.64 ,$56.70 ,$52.92 ,$50.40 ,$50.40 ,$14.49 ,$40.95 ST. FRANCIS HOSPITAL - ACUTE,30600530,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL,306,1 ,$191.00 ,$124.15 ,$7.72 ,$191.00 ,$137.52 ,$103.90 ,$43.93 ,$106.62 ,$43.93 ,$114.10 ,$114.10 ,$114.10 ,$114.10 ,$160.44 ,$43.93 ,$162.35 ,$160.44 ,$43.93 ,$143.25 ,$152.80 ,$152.80 ,$43.93 ,$152.80 ,$160.44 ,$160.44 ,$160.44 ,$171.90 ,$109.83 ,$43.93 ,$191.00 ,$7.72 ,$8.49 ,$48.32 ,$162.35 ,$114.10 ,$171.90 ,$160.44 ,$152.80 ,$152.80 ,$43.93 ,$124.15 ST. FRANCIS HOSPITAL - ACUTE,30600531,87102,HC CULTURE FUNGUS OTHER,306,1 ,$191.00 ,$124.15 ,$7.72 ,$191.00 ,$137.52 ,$103.90 ,$43.93 ,$106.62 ,$43.93 ,$114.10 ,$114.10 ,$114.10 ,$114.10 ,$160.44 ,$43.93 ,$162.35 ,$160.44 ,$43.93 ,$143.25 ,$152.80 ,$152.80 ,$43.93 ,$152.80 ,$160.44 ,$160.44 ,$160.44 ,$171.90 ,$109.83 ,$43.93 ,$191.00 ,$7.72 ,$8.49 ,$48.32 ,$162.35 ,$114.10 ,$171.90 ,$160.44 ,$152.80 ,$152.80 ,$43.93 ,$124.15 ST. FRANCIS HOSPITAL - ACUTE,30600533,87106,HC CULTURE FUNGUS ID YEAST,306,1 ,$67.00 ,$43.55 ,$7.72 ,$67.00 ,$48.24 ,$36.45 ,$15.41 ,$37.40 ,$15.41 ,$40.03 ,$40.03 ,$40.03 ,$40.03 ,$56.28 ,$15.41 ,$56.95 ,$56.28 ,$15.41 ,$50.25 ,$53.60 ,$53.60 ,$15.41 ,$53.60 ,$56.28 ,$56.28 ,$56.28 ,$60.30 ,$38.53 ,$15.41 ,$67.00 ,$7.72 ,$8.49 ,$16.95 ,$56.95 ,$40.03 ,$60.30 ,$56.28 ,$53.60 ,$53.60 ,$15.41 ,$43.55 ST. FRANCIS HOSPITAL - ACUTE,30600534,87107,HC CULTURE FUNGUS ID MOLD,306,1 ,$99.00 ,$64.35 ,$22.77 ,$99.00 ,$71.28 ,$53.86 ,$22.77 ,$55.26 ,$22.77 ,$59.14 ,$59.14 ,$59.14 ,$59.14 ,$83.16 ,$22.77 ,$84.15 ,$83.16 ,$22.77 ,$74.25 ,$79.20 ,$79.20 ,$22.77 ,$79.20 ,$83.16 ,$83.16 ,$83.16 ,$89.10 ,$56.93 ,$22.77 ,$99.00 ,$25.65 ,$28.22 ,$25.05 ,$84.15 ,$59.14 ,$89.10 ,$83.16 ,$79.20 ,$79.20 ,$22.77 ,$64.35 ST. FRANCIS HOSPITAL - ACUTE,30600535,87116,HC CULTURE AFB/TB/MYCOBACT,306,1 ,$164.00 ,$106.60 ,$25.65 ,$164.00 ,$118.08 ,$89.22 ,$37.72 ,$91.54 ,$37.72 ,$97.97 ,$97.97 ,$97.97 ,$97.97 ,$137.76 ,$37.72 ,$139.40 ,$137.76 ,$37.72 ,$123.00 ,$131.20 ,$131.20 ,$37.72 ,$131.20 ,$137.76 ,$137.76 ,$137.76 ,$147.60 ,$94.30 ,$37.72 ,$164.00 ,$25.65 ,$28.22 ,$41.49 ,$139.40 ,$97.97 ,$147.60 ,$137.76 ,$131.20 ,$131.20 ,$37.72 ,$106.60 ST. FRANCIS HOSPITAL - ACUTE,30600536,87147,HC CULTURE TYPE SEROLOGIC,306,1 ,$37.00 ,$24.05 ,$7.72 ,$37.00 ,$26.64 ,$20.13 ,$8.51 ,$20.65 ,$8.51 ,$22.10 ,$22.10 ,$22.10 ,$22.10 ,$31.08 ,$8.51 ,$31.45 ,$31.08 ,$8.51 ,$27.75 ,$29.60 ,$29.60 ,$8.51 ,$29.60 ,$31.08 ,$31.08 ,$31.08 ,$33.30 ,$21.28 ,$8.51 ,$37.00 ,$7.72 ,$8.49 ,$9.36 ,$31.45 ,$22.10 ,$33.30 ,$31.08 ,$29.60 ,$29.60 ,$8.51 ,$24.05 ST. FRANCIS HOSPITAL - ACUTE,30600537,87149,HC CULTURE TYPING ID NUCLEIC ACID,306,1 ,$335.00 ,$217.75 ,$7.72 ,$335.00 ,$241.20 ,$182.24 ,$77.05 ,$187.00 ,$77.05 ,$200.13 ,$200.13 ,$200.13 ,$200.13 ,$281.40 ,$77.05 ,$284.75 ,$281.40 ,$77.05 ,$251.25 ,$268.00 ,$268.00 ,$77.05 ,$268.00 ,$281.40 ,$281.40 ,$281.40 ,$301.50 ,$192.63 ,$77.05 ,$335.00 ,$7.72 ,$8.49 ,$84.76 ,$284.75 ,$200.13 ,$301.50 ,$281.40 ,$268.00 ,$268.00 ,$77.05 ,$217.75 ST. FRANCIS HOSPITAL - ACUTE,30600538,87153,HC ID NUCLEAR ACID SEQ METH PROF,306,1 ,$214.00 ,$139.10 ,$25.65 ,$214.00 ,$154.08 ,$116.42 ,$49.22 ,$119.45 ,$49.22 ,$127.84 ,$127.84 ,$127.84 ,$127.84 ,$179.76 ,$49.22 ,$181.90 ,$179.76 ,$49.22 ,$160.50 ,$171.20 ,$171.20 ,$49.22 ,$171.20 ,$179.76 ,$179.76 ,$179.76 ,$192.60 ,$123.05 ,$49.22 ,$214.00 ,$25.65 ,$28.22 ,$54.14 ,$181.90 ,$127.84 ,$192.60 ,$179.76 ,$171.20 ,$171.20 ,$49.22 ,$139.10 ST. FRANCIS HOSPITAL - ACUTE,30600539,87153,HC ID NUCLEAR ACID SEQ METH ID,306,1 ,$627.00 ,$407.55 ,$25.65 ,$627.00 ,$451.44 ,$341.09 ,$144.21 ,$349.99 ,$144.21 ,$374.57 ,$374.57 ,$374.57 ,$374.57 ,$526.68 ,$144.21 ,$532.95 ,$526.68 ,$144.21 ,$470.25 ,$501.60 ,$501.60 ,$144.21 ,$501.60 ,$526.68 ,$526.68 ,$526.68 ,$564.30 ,$360.53 ,$144.21 ,$627.00 ,$25.65 ,$28.22 ,$158.63 ,$532.95 ,$374.57 ,$564.30 ,$526.68 ,$501.60 ,$501.60 ,$144.21 ,$407.55 ST. FRANCIS HOSPITAL - ACUTE,30600541,87172,HC PINWORM EXAM,306,1 ,$62.00 ,$40.30 ,$7.72 ,$62.00 ,$44.64 ,$33.73 ,$14.26 ,$34.61 ,$14.26 ,$37.04 ,$37.04 ,$37.04 ,$37.04 ,$52.08 ,$14.26 ,$52.70 ,$52.08 ,$14.26 ,$46.50 ,$49.60 ,$49.60 ,$14.26 ,$49.60 ,$52.08 ,$52.08 ,$52.08 ,$55.80 ,$35.65 ,$14.26 ,$62.00 ,$7.72 ,$8.49 ,$15.69 ,$52.70 ,$37.04 ,$55.80 ,$52.08 ,$49.60 ,$49.60 ,$14.26 ,$40.30 ST. FRANCIS HOSPITAL - ACUTE,30600544,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$58.00 ,$37.70 ,$7.72 ,$58.00 ,$41.76 ,$31.55 ,$13.34 ,$32.38 ,$13.34 ,$34.65 ,$34.65 ,$34.65 ,$34.65 ,$48.72 ,$13.34 ,$49.30 ,$48.72 ,$13.34 ,$43.50 ,$46.40 ,$46.40 ,$13.34 ,$46.40 ,$48.72 ,$48.72 ,$48.72 ,$52.20 ,$33.35 ,$13.34 ,$58.00 ,$7.72 ,$8.49 ,$14.67 ,$49.30 ,$34.65 ,$52.20 ,$48.72 ,$46.40 ,$46.40 ,$13.34 ,$37.70 ST. FRANCIS HOSPITAL - ACUTE,30600545,87184,HC SENSITIVITY DISK KB,306,1 ,$314.00 ,$204.10 ,$7.72 ,$314.00 ,$226.08 ,$170.82 ,$72.22 ,$175.27 ,$72.22 ,$187.58 ,$187.58 ,$187.58 ,$187.58 ,$263.76 ,$72.22 ,$266.90 ,$263.76 ,$72.22 ,$235.50 ,$251.20 ,$251.20 ,$72.22 ,$251.20 ,$263.76 ,$263.76 ,$263.76 ,$282.60 ,$180.55 ,$72.22 ,$314.00 ,$7.72 ,$8.49 ,$79.44 ,$266.90 ,$187.58 ,$282.60 ,$263.76 ,$251.20 ,$251.20 ,$72.22 ,$204.10 ST. FRANCIS HOSPITAL - ACUTE,30600546,87185,HC BETA LACTAMASE,306,1 ,$42.00 ,$27.30 ,$7.72 ,$42.00 ,$30.24 ,$22.85 ,$9.66 ,$23.44 ,$9.66 ,$25.09 ,$25.09 ,$25.09 ,$25.09 ,$35.28 ,$9.66 ,$35.70 ,$35.28 ,$9.66 ,$31.50 ,$33.60 ,$33.60 ,$9.66 ,$33.60 ,$35.28 ,$35.28 ,$35.28 ,$37.80 ,$24.15 ,$9.66 ,$42.00 ,$7.72 ,$8.49 ,$10.63 ,$35.70 ,$25.09 ,$37.80 ,$35.28 ,$33.60 ,$33.60 ,$9.66 ,$27.30 ST. FRANCIS HOSPITAL - ACUTE,30600547,87186,HC SENSITIVITY MIC,306,1 ,$281.00 ,$182.65 ,$7.72 ,$281.00 ,$202.32 ,$152.86 ,$64.63 ,$156.85 ,$64.63 ,$167.87 ,$167.87 ,$167.87 ,$167.87 ,$236.04 ,$64.63 ,$238.85 ,$236.04 ,$64.63 ,$210.75 ,$224.80 ,$224.80 ,$64.63 ,$224.80 ,$236.04 ,$236.04 ,$236.04 ,$252.90 ,$161.58 ,$64.63 ,$281.00 ,$7.72 ,$8.49 ,$71.09 ,$238.85 ,$167.87 ,$252.90 ,$236.04 ,$224.80 ,$224.80 ,$64.63 ,$182.65 ST. FRANCIS HOSPITAL - ACUTE,30600548,87188,HC MACROTUBE DIL METH 4DRG PNL,306,1 ,$59.00 ,$38.35 ,$7.72 ,$59.00 ,$42.48 ,$32.10 ,$13.57 ,$32.93 ,$13.57 ,$35.25 ,$35.25 ,$35.25 ,$35.25 ,$49.56 ,$13.57 ,$50.15 ,$49.56 ,$13.57 ,$44.25 ,$47.20 ,$47.20 ,$13.57 ,$47.20 ,$49.56 ,$49.56 ,$49.56 ,$53.10 ,$33.93 ,$13.57 ,$59.00 ,$7.72 ,$8.49 ,$14.93 ,$50.15 ,$35.25 ,$53.10 ,$49.56 ,$47.20 ,$47.20 ,$13.57 ,$38.35 ST. FRANCIS HOSPITAL - ACUTE,30600549,87188,HC MACROTUBE DIL METH EA AGNT,306,1 ,$117.00 ,$76.05 ,$7.72 ,$117.00 ,$84.24 ,$63.65 ,$26.91 ,$65.31 ,$26.91 ,$69.90 ,$69.90 ,$69.90 ,$69.90 ,$98.28 ,$26.91 ,$99.45 ,$98.28 ,$26.91 ,$87.75 ,$93.60 ,$93.60 ,$26.91 ,$93.60 ,$98.28 ,$98.28 ,$98.28 ,$105.30 ,$67.28 ,$26.91 ,$117.00 ,$7.72 ,$8.49 ,$29.60 ,$99.45 ,$69.90 ,$105.30 ,$98.28 ,$93.60 ,$93.60 ,$26.91 ,$76.05 ST. FRANCIS HOSPITAL - ACUTE,30600550,87190,HC SENSITIVITY AFB,306,1 ,$24.00 ,$15.60 ,$5.52 ,$24.00 ,$17.28 ,$13.06 ,$5.52 ,$13.40 ,$5.52 ,$14.34 ,$14.34 ,$14.34 ,$14.34 ,$20.16 ,$5.52 ,$20.40 ,$20.16 ,$5.52 ,$18.00 ,$19.20 ,$19.20 ,$5.52 ,$19.20 ,$20.16 ,$20.16 ,$20.16 ,$21.60 ,$13.80 ,$5.52 ,$24.00 ,$7.72 ,$8.49 ,$6.07 ,$20.40 ,$14.34 ,$21.60 ,$20.16 ,$19.20 ,$19.20 ,$5.52 ,$15.60 ST. FRANCIS HOSPITAL - ACUTE,30600552,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$82.00 ,$53.30 ,$7.72 ,$82.00 ,$59.04 ,$44.61 ,$18.86 ,$45.77 ,$18.86 ,$48.99 ,$48.99 ,$48.99 ,$48.99 ,$68.88 ,$18.86 ,$69.70 ,$68.88 ,$18.86 ,$61.50 ,$65.60 ,$65.60 ,$18.86 ,$65.60 ,$68.88 ,$68.88 ,$68.88 ,$73.80 ,$47.15 ,$18.86 ,$82.00 ,$7.72 ,$8.49 ,$20.75 ,$69.70 ,$48.99 ,$73.80 ,$68.88 ,$65.60 ,$65.60 ,$18.86 ,$53.30 ST. FRANCIS HOSPITAL - ACUTE,30600558,87338,HC EIA QL H PYLORI AG STOOL,306,1 ,$294.00 ,$191.10 ,$9.68 ,$294.00 ,$211.68 ,$159.94 ,$67.62 ,$164.11 ,$67.62 ,$175.64 ,$175.64 ,$175.64 ,$175.64 ,$246.96 ,$67.62 ,$249.90 ,$246.96 ,$67.62 ,$220.50 ,$235.20 ,$235.20 ,$67.62 ,$235.20 ,$246.96 ,$246.96 ,$246.96 ,$264.60 ,$169.05 ,$67.62 ,$294.00 ,$9.68 ,$10.65 ,$74.38 ,$249.90 ,$175.64 ,$264.60 ,$246.96 ,$235.20 ,$235.20 ,$67.62 ,$191.10 ST. FRANCIS HOSPITAL - ACUTE,30600559,87340,HC EIA QL HEPATITIS B AG,306,1 ,$165.00 ,$107.25 ,$9.68 ,$165.00 ,$118.80 ,$89.76 ,$37.95 ,$92.10 ,$37.95 ,$98.57 ,$98.57 ,$98.57 ,$98.57 ,$138.60 ,$37.95 ,$140.25 ,$138.60 ,$37.95 ,$123.75 ,$132.00 ,$132.00 ,$37.95 ,$132.00 ,$138.60 ,$138.60 ,$138.60 ,$148.50 ,$94.88 ,$37.95 ,$165.00 ,$9.68 ,$10.65 ,$41.75 ,$140.25 ,$98.57 ,$148.50 ,$138.60 ,$132.00 ,$132.00 ,$37.95 ,$107.25 ST. FRANCIS HOSPITAL - ACUTE,30600561,87389,HC HIV-1 AG W/HIV-1 AND HIV-2 AB,306,1 ,$261.00 ,$169.65 ,$9.68 ,$261.00 ,$187.92 ,$141.98 ,$60.03 ,$145.69 ,$60.03 ,$155.92 ,$155.92 ,$155.92 ,$155.92 ,$219.24 ,$60.03 ,$221.85 ,$219.24 ,$60.03 ,$195.75 ,$208.80 ,$208.80 ,$60.03 ,$208.80 ,$219.24 ,$219.24 ,$219.24 ,$234.90 ,$150.08 ,$60.03 ,$261.00 ,$9.68 ,$10.65 ,$66.03 ,$221.85 ,$155.92 ,$234.90 ,$219.24 ,$208.80 ,$208.80 ,$60.03 ,$169.65 ST. FRANCIS HOSPITAL - ACUTE,30600565,87450,HC EIA QL SGL AG,306,1 ,$62.00 ,$40.30 ,$14.26 ,$62.00 ,$44.64 ,$33.73 ,$14.26 ,$34.61 ,$14.26 ,$37.04 ,$37.04 ,$37.04 ,$37.04 ,$52.08 ,$14.26 ,$52.70 ,$52.08 ,$14.26 ,$46.50 ,$49.60 ,$49.60 ,$14.26 ,$49.60 ,$52.08 ,$52.08 ,$52.08 ,$55.80 ,$35.65 ,$14.26 ,$62.00 , N/A , N/A ,$15.69 ,$52.70 ,$37.04 ,$55.80 ,$52.08 ,$49.60 ,$49.60 ,$14.26 ,$40.30 ST. FRANCIS HOSPITAL - ACUTE,30600566,87480,HC CANDIDA SPECIES DNA SCREEN,306,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 ,$9.68 ,$10.65 ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,30600567,87483,HC INFECT AMP CNS DNA/RNA 14 TARGETS,306,1 ,$354.00 ,$230.10 ,$25.65 ,$354.00 ,$254.88 ,$192.58 ,$81.42 ,$197.60 ,$81.42 ,$211.48 ,$211.48 ,$211.48 ,$211.48 ,$297.36 ,$81.42 ,$300.90 ,$297.36 ,$81.42 ,$265.50 ,$283.20 ,$283.20 ,$81.42 ,$283.20 ,$297.36 ,$297.36 ,$297.36 ,$318.60 ,$203.55 ,$81.42 ,$354.00 ,$25.65 ,$28.22 ,$89.56 ,$300.90 ,$211.48 ,$318.60 ,$297.36 ,$283.20 ,$283.20 ,$81.42 ,$230.10 ST. FRANCIS HOSPITAL - ACUTE,30600568,87486,HC CHLAMYDIA PNEUM AMP PROBE,306,1 ,$148.00 ,$96.20 ,$25.65 ,$148.00 ,$106.56 ,$80.51 ,$34.04 ,$82.61 ,$34.04 ,$88.42 ,$88.42 ,$88.42 ,$88.42 ,$124.32 ,$34.04 ,$125.80 ,$124.32 ,$34.04 ,$111.00 ,$118.40 ,$118.40 ,$34.04 ,$118.40 ,$124.32 ,$124.32 ,$124.32 ,$133.20 ,$85.10 ,$34.04 ,$148.00 ,$25.65 ,$28.22 ,$37.44 ,$125.80 ,$88.42 ,$133.20 ,$124.32 ,$118.40 ,$118.40 ,$34.04 ,$96.20 ST. FRANCIS HOSPITAL - ACUTE,30600570,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$119.00 ,$77.35 ,$9.68 ,$119.00 ,$85.68 ,$64.74 ,$27.37 ,$66.43 ,$27.37 ,$71.09 ,$71.09 ,$71.09 ,$71.09 ,$99.96 ,$27.37 ,$101.15 ,$99.96 ,$27.37 ,$89.25 ,$95.20 ,$95.20 ,$27.37 ,$95.20 ,$99.96 ,$99.96 ,$99.96 ,$107.10 ,$68.43 ,$27.37 ,$119.00 ,$9.68 ,$10.65 ,$30.11 ,$101.15 ,$71.09 ,$107.10 ,$99.96 ,$95.20 ,$95.20 ,$27.37 ,$77.35 ST. FRANCIS HOSPITAL - ACUTE,30600571,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS,306,1 ,$706.00 ,$458.90 ,$25.65 ,$706.00 ,$508.32 ,$384.06 ,$162.38 ,$394.09 ,$162.38 ,$421.76 ,$421.76 ,$421.76 ,$421.76 ,$593.04 ,$162.38 ,$600.10 ,$593.04 ,$162.38 ,$529.50 ,$564.80 ,$564.80 ,$162.38 ,$564.80 ,$593.04 ,$593.04 ,$593.04 ,$635.40 ,$405.95 ,$162.38 ,$706.00 ,$25.65 ,$28.22 ,$178.62 ,$600.10 ,$421.76 ,$635.40 ,$593.04 ,$564.80 ,$564.80 ,$162.38 ,$458.90 ST. FRANCIS HOSPITAL - ACUTE,30600572,87510,HC G VAGINALIS DNA SCREEN,306,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 ,$25.65 ,$28.22 ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,30600573,87581,HC IF AG PROBE MYCOPLASMA PNEUMONIAE,306,1 ,$148.00 ,$96.20 ,$25.65 ,$148.00 ,$106.56 ,$80.51 ,$34.04 ,$82.61 ,$34.04 ,$88.42 ,$88.42 ,$88.42 ,$88.42 ,$124.32 ,$34.04 ,$125.80 ,$124.32 ,$34.04 ,$111.00 ,$118.40 ,$118.40 ,$34.04 ,$118.40 ,$124.32 ,$124.32 ,$124.32 ,$133.20 ,$85.10 ,$34.04 ,$148.00 ,$25.65 ,$28.22 ,$37.44 ,$125.80 ,$88.42 ,$133.20 ,$124.32 ,$118.40 ,$118.40 ,$34.04 ,$96.20 ST. FRANCIS HOSPITAL - ACUTE,30600575,87591,HC NEISSERIA AMP,306,1 ,$119.00 ,$77.35 ,$25.65 ,$119.00 ,$85.68 ,$64.74 ,$27.37 ,$66.43 ,$27.37 ,$71.09 ,$71.09 ,$71.09 ,$71.09 ,$99.96 ,$27.37 ,$101.15 ,$99.96 ,$27.37 ,$89.25 ,$95.20 ,$95.20 ,$27.37 ,$95.20 ,$99.96 ,$99.96 ,$99.96 ,$107.10 ,$68.43 ,$27.37 ,$119.00 ,$25.65 ,$28.22 ,$30.11 ,$101.15 ,$71.09 ,$107.10 ,$99.96 ,$95.20 ,$95.20 ,$27.37 ,$77.35 ST. FRANCIS HOSPITAL - ACUTE,30600576,87624,HC HPV HIGH RISK ALL OTHERS,306,1 ,$310.00 ,$201.50 ,$25.65 ,$310.00 ,$223.20 ,$168.64 ,$71.30 ,$173.04 ,$71.30 ,$185.19 ,$185.19 ,$185.19 ,$185.19 ,$260.40 ,$71.30 ,$263.50 ,$260.40 ,$71.30 ,$232.50 ,$248.00 ,$248.00 ,$71.30 ,$248.00 ,$260.40 ,$260.40 ,$260.40 ,$279.00 ,$178.25 ,$71.30 ,$35.09 ,$25.65 ,$28.22 ,$78.43 ,$263.50 ,$185.19 ,$279.00 ,$260.40 ,$248.00 ,$248.00 ,$71.30 ,$201.50 ST. FRANCIS HOSPITAL - ACUTE,30600577,87633,HC IF AG RESP VIRUS MAP 12-25 TARGETS,306,1 ,"$1,749.00 ","$1,136.85 ",$25.65 ,"$1,749.00 ","$1,259.28 ",$951.46 ,$402.27 ,$976.29 ,$402.27 ,"$1,044.85 ","$1,044.85 ","$1,044.85 ","$1,044.85 ","$1,469.16 ",$402.27 ,"$1,486.65 ","$1,469.16 ",$402.27 ,"$1,311.75 ","$1,399.20 ","$1,399.20 ",$402.27 ,"$1,399.20 ","$1,469.16 ","$1,469.16 ","$1,469.16 ","$1,574.10 ","$1,005.68 ",$402.27 ,"$1,749.00 ",$25.65 ,$28.22 ,$442.50 ,"$1,486.65 ","$1,044.85 ","$1,574.10 ","$1,469.16 ","$1,399.20 ","$1,399.20 ",$402.27 ,"$1,136.85 " ST. FRANCIS HOSPITAL - ACUTE,30600578,87641,HC MRSA AMP,306,1 ,$433.00 ,$281.45 ,$25.65 ,$433.00 ,$311.76 ,$235.55 ,$99.59 ,$241.70 ,$99.59 ,$258.67 ,$258.67 ,$258.67 ,$258.67 ,$363.72 ,$99.59 ,$368.05 ,$363.72 ,$99.59 ,$324.75 ,$346.40 ,$346.40 ,$99.59 ,$346.40 ,$363.72 ,$363.72 ,$363.72 ,$389.70 ,$248.98 ,$99.59 ,$433.00 ,$25.65 ,$28.22 ,$109.55 ,$368.05 ,$258.67 ,$389.70 ,$363.72 ,$346.40 ,$346.40 ,$99.59 ,$281.45 ST. FRANCIS HOSPITAL - ACUTE,30600579,87653,HC INFECT AMP (GRP B STREP),306,1 ,$483.00 ,$313.95 ,$25.65 ,$483.00 ,$347.76 ,$262.75 ,$111.09 ,$269.61 ,$111.09 ,$288.54 ,$288.54 ,$288.54 ,$288.54 ,$405.72 ,$111.09 ,$410.55 ,$405.72 ,$111.09 ,$362.25 ,$386.40 ,$386.40 ,$111.09 ,$386.40 ,$405.72 ,$405.72 ,$405.72 ,$434.70 ,$277.73 ,$111.09 ,$483.00 ,$25.65 ,$28.22 ,$122.20 ,$410.55 ,$288.54 ,$434.70 ,$405.72 ,$386.40 ,$386.40 ,$111.09 ,$313.95 ST. FRANCIS HOSPITAL - ACUTE,30600580,87660,HC TRICHOMONAS DNA SCREEN,306,1 ,$41.00 ,$26.65 ,$9.43 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 ,$25.65 ,$28.22 ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,30600581,87798,HC INFECT AMP,306,1 ,$220.00 ,$143.00 ,$25.65 ,$220.00 ,$158.40 ,$119.68 ,$50.60 ,$122.80 ,$50.60 ,$131.43 ,$131.43 ,$131.43 ,$131.43 ,$184.80 ,$50.60 ,$187.00 ,$184.80 ,$50.60 ,$165.00 ,$176.00 ,$176.00 ,$50.60 ,$176.00 ,$184.80 ,$184.80 ,$184.80 ,$198.00 ,$126.50 ,$50.60 ,$220.00 ,$25.65 ,$28.22 ,$55.66 ,$187.00 ,$131.43 ,$198.00 ,$184.80 ,$176.00 ,$176.00 ,$50.60 ,$143.00 ST. FRANCIS HOSPITAL - ACUTE,30600582,87798,HC INFECT AMP DRUG RESIST TB,306,1 ,$220.00 ,$143.00 ,$25.65 ,$220.00 ,$158.40 ,$119.68 ,$50.60 ,$122.80 ,$50.60 ,$131.43 ,$131.43 ,$131.43 ,$131.43 ,$184.80 ,$50.60 ,$187.00 ,$184.80 ,$50.60 ,$165.00 ,$176.00 ,$176.00 ,$50.60 ,$176.00 ,$184.80 ,$184.80 ,$184.80 ,$198.00 ,$126.50 ,$50.60 ,$220.00 ,$25.65 ,$28.22 ,$55.66 ,$187.00 ,$131.43 ,$198.00 ,$184.80 ,$176.00 ,$176.00 ,$50.60 ,$143.00 ST. FRANCIS HOSPITAL - ACUTE,30600585,87181,HC SENSITIVITY STUDY AGAR ACID FAST,306,1 ,$248.00 ,$161.20 ,$7.72 ,$248.00 ,$178.56 ,$134.91 ,$57.04 ,$138.43 ,$57.04 ,$148.16 ,$148.16 ,$148.16 ,$148.16 ,$208.32 ,$57.04 ,$210.80 ,$208.32 ,$57.04 ,$186.00 ,$198.40 ,$198.40 ,$57.04 ,$198.40 ,$208.32 ,$208.32 ,$208.32 ,$223.20 ,$142.60 ,$57.04 ,$248.00 ,$7.72 ,$8.49 ,$62.74 ,$210.80 ,$148.16 ,$223.20 ,$208.32 ,$198.40 ,$198.40 ,$57.04 ,$161.20 ST. FRANCIS HOSPITAL - ACUTE,30600586,87147,HC CULTURE TYPE SEROLOGIC-91,306,1 ,$41.00 ,$26.65 ,$7.72 ,$41.00 ,$29.52 ,$22.30 ,$9.43 ,$22.89 ,$9.43 ,$24.49 ,$24.49 ,$24.49 ,$24.49 ,$34.44 ,$9.43 ,$34.85 ,$34.44 ,$9.43 ,$30.75 ,$32.80 ,$32.80 ,$9.43 ,$32.80 ,$34.44 ,$34.44 ,$34.44 ,$36.90 ,$23.58 ,$9.43 ,$41.00 ,$7.72 ,$8.49 ,$10.37 ,$34.85 ,$24.49 ,$36.90 ,$34.44 ,$32.80 ,$32.80 ,$9.43 ,$26.65 ST. FRANCIS HOSPITAL - ACUTE,30600587,87186,HC SENSITIVITY MIC MYCOBACTERIA,306,1 ,$803.00 ,$521.95 ,$7.72 ,$803.00 ,$578.16 ,$436.83 ,$184.69 ,$448.23 ,$184.69 ,$479.71 ,$479.71 ,$479.71 ,$479.71 ,$674.52 ,$184.69 ,$682.55 ,$674.52 ,$184.69 ,$602.25 ,$642.40 ,$642.40 ,$184.69 ,$642.40 ,$674.52 ,$674.52 ,$674.52 ,$722.70 ,$461.73 ,$184.69 ,$803.00 ,$7.72 ,$8.49 ,$203.16 ,$682.55 ,$479.71 ,$722.70 ,$674.52 ,$642.40 ,$642.40 ,$184.69 ,$521.95 ST. FRANCIS HOSPITAL - ACUTE,30600608,87045,HC STOOL CULTURE -90,306,1 ,$46.00 ,$29.90 ,$7.72 ,$46.00 ,$33.12 ,$25.02 ,$10.58 ,$25.68 ,$10.58 ,$27.48 ,$27.48 ,$27.48 ,$27.48 ,$38.64 ,$10.58 ,$39.10 ,$38.64 ,$10.58 ,$34.50 ,$36.80 ,$36.80 ,$10.58 ,$36.80 ,$38.64 ,$38.64 ,$38.64 ,$41.40 ,$26.45 ,$10.58 ,$46.00 ,$7.72 ,$8.49 ,$11.64 ,$39.10 ,$27.48 ,$41.40 ,$38.64 ,$36.80 ,$36.80 ,$10.58 ,$29.90 ST. FRANCIS HOSPITAL - ACUTE,30600613,87205,HC URINE FOR EOSINOPHILS-90,306,1 ,$22.00 ,$14.30 ,$5.06 ,$22.00 ,$15.84 ,$11.97 ,$5.06 ,$12.28 ,$5.06 ,$13.14 ,$13.14 ,$13.14 ,$13.14 ,$18.48 ,$5.06 ,$18.70 ,$18.48 ,$5.06 ,$16.50 ,$17.60 ,$17.60 ,$5.06 ,$17.60 ,$18.48 ,$18.48 ,$18.48 ,$19.80 ,$12.65 ,$5.06 ,$22.00 ,$7.72 ,$8.49 ,$5.57 ,$18.70 ,$13.14 ,$19.80 ,$18.48 ,$17.60 ,$17.60 ,$5.06 ,$14.30 ST. FRANCIS HOSPITAL - ACUTE,30600623,87635,HC COVID-19 LAB TEST CDC-90,306,1 ,$398.00 ,$258.70 ,$25.65 ,$398.00 ,$286.56 ,$216.51 ,$91.54 ,$222.16 ,$91.54 ,$237.77 ,$237.77 ,$237.77 ,$237.77 ,$334.32 ,$91.54 ,$338.30 ,$334.32 ,$91.54 ,$298.50 ,$318.40 ,$318.40 ,$91.54 ,$318.40 ,$334.32 ,$334.32 ,$334.32 ,$358.20 ,$228.85 ,$91.54 ,$398.00 ,$25.65 ,$28.22 ,$100.69 ,$338.30 ,$237.77 ,$358.20 ,$334.32 ,$318.40 ,$318.40 ,$91.54 ,$258.70 ST. FRANCIS HOSPITAL - ACUTE,30600626,87220,HC SCABIES- 90,306,1 ,$40.00 ,$26.00 ,$7.72 ,$40.00 ,$28.80 ,$21.76 ,$9.20 ,$22.33 ,$9.20 ,$23.90 ,$23.90 ,$23.90 ,$23.90 ,$33.60 ,$9.20 ,$34.00 ,$33.60 ,$9.20 ,$30.00 ,$32.00 ,$32.00 ,$9.20 ,$32.00 ,$33.60 ,$33.60 ,$33.60 ,$36.00 ,$23.00 ,$9.20 ,$40.00 ,$7.72 ,$8.49 ,$10.12 ,$34.00 ,$23.90 ,$36.00 ,$33.60 ,$32.00 ,$32.00 ,$9.20 ,$26.00 ST. FRANCIS HOSPITAL - ACUTE,30682010,87635,HC COVID-19 LAB TEST NON-CDC-90,306,1 ,$398.00 ,$258.70 ,$25.65 ,$398.00 ,$286.56 ,$216.51 ,$91.54 ,$222.16 ,$91.54 ,$237.77 ,$237.77 ,$237.77 ,$237.77 ,$334.32 ,$91.54 ,$338.30 ,$334.32 ,$91.54 ,$298.50 ,$318.40 ,$318.40 ,$91.54 ,$318.40 ,$334.32 ,$334.32 ,$334.32 ,$358.20 ,$228.85 ,$91.54 ,$398.00 ,$25.65 ,$28.22 ,$100.69 ,$338.30 ,$237.77 ,$358.20 ,$334.32 ,$318.40 ,$318.40 ,$91.54 ,$258.70 ST. FRANCIS HOSPITAL - ACUTE,30682012,87635,HC COVID-19 LAB TEST,306,1 ,$398.00 ,$258.70 ,$25.65 ,$398.00 ,$286.56 ,$216.51 ,$91.54 ,$222.16 ,$91.54 ,$237.77 ,$237.77 ,$237.77 ,$237.77 ,$334.32 ,$91.54 ,$338.30 ,$334.32 ,$91.54 ,$298.50 ,$318.40 ,$318.40 ,$91.54 ,$318.40 ,$334.32 ,$334.32 ,$334.32 ,$358.20 ,$228.85 ,$91.54 ,$398.00 ,$25.65 ,$28.22 ,$100.69 ,$338.30 ,$237.77 ,$358.20 ,$334.32 ,$318.40 ,$318.40 ,$91.54 ,$258.70 ST. FRANCIS HOSPITAL - ACUTE,30700121,81001,HC URINALYSIS AUTO W/MICRO,307,1 ,$96.00 ,$62.40 ,$3.17 ,$96.00 ,$69.12 ,$52.22 ,$22.08 ,$53.59 ,$22.08 ,$57.35 ,$57.35 ,$57.35 ,$57.35 ,$80.64 ,$22.08 ,$81.60 ,$80.64 ,$22.08 ,$72.00 ,$76.80 ,$76.80 ,$22.08 ,$76.80 ,$80.64 ,$80.64 ,$80.64 ,$86.40 ,$55.20 ,$22.08 ,$3.17 ,$3.86 ,$4.25 ,$24.29 ,$81.60 ,$57.35 ,$86.40 ,$80.64 ,$76.80 ,$76.80 ,$22.08 ,$62.40 ST. FRANCIS HOSPITAL - ACUTE,30700125,81003,HC URINALYSIS AUTO W/O MICRO,307,1 ,$36.00 ,$23.40 ,$2.43 ,$36.00 ,$25.92 ,$19.58 ,$8.28 ,$20.10 ,$8.28 ,$21.51 ,$21.51 ,$21.51 ,$21.51 ,$30.24 ,$8.28 ,$30.60 ,$30.24 ,$8.28 ,$27.00 ,$28.80 ,$28.80 ,$8.28 ,$28.80 ,$30.24 ,$30.24 ,$30.24 ,$32.40 ,$20.70 ,$8.28 ,$36.00 ,$2.43 ,$2.67 ,$9.11 ,$30.60 ,$21.51 ,$32.40 ,$30.24 ,$28.80 ,$28.80 ,$8.28 ,$23.40 ST. FRANCIS HOSPITAL - ACUTE,30700127,81005,HC URINALYSIS QL/SEMI QN -90,307,1 ,$46.00 ,$29.90 ,$3.86 ,$46.00 ,$33.12 ,$25.02 ,$10.58 ,$25.68 ,$10.58 ,$27.48 ,$27.48 ,$27.48 ,$27.48 ,$38.64 ,$10.58 ,$39.10 ,$38.64 ,$10.58 ,$34.50 ,$36.80 ,$36.80 ,$10.58 ,$36.80 ,$38.64 ,$38.64 ,$38.64 ,$41.40 ,$26.45 ,$10.58 ,$46.00 ,$3.86 ,$4.25 ,$11.64 ,$39.10 ,$27.48 ,$41.40 ,$38.64 ,$36.80 ,$36.80 ,$10.58 ,$29.90 ST. FRANCIS HOSPITAL - ACUTE,30700128,81025,HC URINE PREGNANCY TEST,307,1 ,$145.00 ,$94.25 ,$3.86 ,$145.00 ,$104.40 ,$78.88 ,$33.35 ,$80.94 ,$33.35 ,$86.62 ,$86.62 ,$86.62 ,$86.62 ,$121.80 ,$33.35 ,$123.25 ,$121.80 ,$33.35 ,$108.75 ,$116.00 ,$116.00 ,$33.35 ,$116.00 ,$121.80 ,$121.80 ,$121.80 ,$130.50 ,$83.38 ,$33.35 ,$8.61 ,$3.86 ,$4.25 ,$36.69 ,$123.25 ,$86.62 ,$130.50 ,$121.80 ,$116.00 ,$116.00 ,$33.35 ,$94.25 ST. FRANCIS HOSPITAL - ACUTE,30700131,81050,HC VOLUME MEASUREMENT URINE,307,1 ,$26.00 ,$16.90 ,$3.86 ,$26.00 ,$18.72 ,$14.14 ,$5.98 ,$14.51 ,$5.98 ,$15.53 ,$15.53 ,$15.53 ,$15.53 ,$21.84 ,$5.98 ,$22.10 ,$21.84 ,$5.98 ,$19.50 ,$20.80 ,$20.80 ,$5.98 ,$20.80 ,$21.84 ,$21.84 ,$21.84 ,$23.40 ,$14.95 ,$5.98 ,$26.00 ,$3.86 ,$4.25 ,$6.58 ,$22.10 ,$15.53 ,$23.40 ,$21.84 ,$20.80 ,$20.80 ,$5.98 ,$16.90 ST. FRANCIS HOSPITAL - ACUTE,31000129,81206,HC BCR/ABL1 GENE MAJOR BP QL/QN DIAG -90,310,1 ,$120.00 ,$78.00 ,$27.60 ,$137.35 ,$86.40 ,$65.28 ,$27.60 ,$66.98 ,$27.60 ,$71.69 ,$71.69 ,$71.69 ,$71.69 ,$100.80 ,$27.60 ,$102.00 ,$100.80 ,$27.60 ,$90.00 ,$96.00 ,$96.00 ,$27.60 ,$96.00 ,$100.80 ,$100.80 ,$100.80 ,$108.00 ,$69.00 ,$27.60 ,$120.00 ,$124.86 ,$137.35 ,$30.36 ,$102.00 ,$71.69 ,$108.00 ,$100.80 ,$96.00 ,$96.00 ,$27.60 ,$78.00 ST. FRANCIS HOSPITAL - ACUTE,31000131,81207,HC BCR/ABL1 GENE MINOR BP DIAG -90,310,1 ,$106.00 ,$68.90 ,$24.38 ,$137.35 ,$76.32 ,$57.66 ,$24.38 ,$59.17 ,$24.38 ,$63.32 ,$63.32 ,$63.32 ,$63.32 ,$89.04 ,$24.38 ,$90.10 ,$89.04 ,$24.38 ,$79.50 ,$84.80 ,$84.80 ,$24.38 ,$84.80 ,$89.04 ,$89.04 ,$89.04 ,$95.40 ,$60.95 ,$24.38 ,$106.00 ,$124.86 ,$137.35 ,$26.82 ,$90.10 ,$63.32 ,$95.40 ,$89.04 ,$84.80 ,$84.80 ,$24.38 ,$68.90 ST. FRANCIS HOSPITAL - ACUTE,31000135,81211,HC BRCA 1 AND 2 SEQ COMMON DUPE/DEL-90,310,1 ,$465.00 ,$302.25 ,$106.95 ,$465.00 ,$334.80 ,$252.96 ,$106.95 ,$259.56 ,$106.95 ,$277.79 ,$277.79 ,$277.79 ,$277.79 ,$390.60 ,$106.95 ,$395.25 ,$390.60 ,$106.95 ,$348.75 ,$372.00 ,$372.00 ,$106.95 ,$372.00 ,$390.60 ,$390.60 ,$390.60 ,$418.50 ,$267.38 ,$106.95 ,$465.00 , N/A , N/A ,$117.65 ,$395.25 ,$277.79 ,$418.50 ,$390.60 ,$372.00 ,$372.00 ,$106.95 ,$302.25 ST. FRANCIS HOSPITAL - ACUTE,31000137,81220,HC CYSTIC FIBROSIS GENE COMMON VARIANTS -90,310,1 ,$79.00 ,$51.35 ,$18.17 ,$79.00 ,$56.88 ,$42.98 ,$18.17 ,$44.10 ,$18.17 ,$47.19 ,$47.19 ,$47.19 ,$47.19 ,$66.36 ,$18.17 ,$67.15 ,$66.36 ,$18.17 ,$59.25 ,$63.20 ,$63.20 ,$18.17 ,$63.20 ,$66.36 ,$66.36 ,$66.36 ,$71.10 ,$45.43 ,$18.17 ,$79.00 ,$38.35 ,$42.19 ,$19.99 ,$67.15 ,$47.19 ,$71.10 ,$66.36 ,$63.20 ,$63.20 ,$18.17 ,$51.35 ST. FRANCIS HOSPITAL - ACUTE,31000143,81240,HC F2 GENE ANAL 20210G A VAR -90,310,1 ,$451.00 ,$293.15 ,$38.35 ,$451.00 ,$324.72 ,$245.34 ,$103.73 ,$251.75 ,$103.73 ,$269.43 ,$269.43 ,$269.43 ,$269.43 ,$378.84 ,$103.73 ,$383.35 ,$378.84 ,$103.73 ,$338.25 ,$360.80 ,$360.80 ,$103.73 ,$360.80 ,$378.84 ,$378.84 ,$378.84 ,$405.90 ,$259.33 ,$103.73 ,$451.00 ,$38.35 ,$42.19 ,$114.10 ,$383.35 ,$269.43 ,$405.90 ,$378.84 ,$360.80 ,$360.80 ,$103.73 ,$293.15 ST. FRANCIS HOSPITAL - ACUTE,31000145,81241,HC F5 GENE ANAL LEIDEN VAR -90,310,1 ,$451.00 ,$293.15 ,$38.35 ,$451.00 ,$324.72 ,$245.34 ,$103.73 ,$251.75 ,$103.73 ,$269.43 ,$269.43 ,$269.43 ,$269.43 ,$378.84 ,$103.73 ,$383.35 ,$378.84 ,$103.73 ,$338.25 ,$360.80 ,$360.80 ,$103.73 ,$360.80 ,$378.84 ,$378.84 ,$378.84 ,$405.90 ,$259.33 ,$103.73 ,$451.00 ,$38.35 ,$42.19 ,$114.10 ,$383.35 ,$269.43 ,$405.90 ,$378.84 ,$360.80 ,$360.80 ,$103.73 ,$293.15 ST. FRANCIS HOSPITAL - ACUTE,31000149,81256,HC HFE GENE ANALYSIS -90,310,1 ,$249.00 ,$161.85 ,$38.35 ,$249.00 ,$179.28 ,$135.46 ,$57.27 ,$138.99 ,$57.27 ,$148.75 ,$148.75 ,$148.75 ,$148.75 ,$209.16 ,$57.27 ,$211.65 ,$209.16 ,$57.27 ,$186.75 ,$199.20 ,$199.20 ,$57.27 ,$199.20 ,$209.16 ,$209.16 ,$209.16 ,$224.10 ,$143.18 ,$57.27 ,$249.00 ,$38.35 ,$42.19 ,$63.00 ,$211.65 ,$148.75 ,$224.10 ,$209.16 ,$199.20 ,$199.20 ,$57.27 ,$161.85 ST. FRANCIS HOSPITAL - ACUTE,31000154,81270,HC JAK2 GENE ANALYSIS-90,310,1 ,$255.00 ,$165.75 ,$38.35 ,$255.00 ,$183.60 ,$138.72 ,$58.65 ,$142.34 ,$58.65 ,$152.34 ,$152.34 ,$152.34 ,$152.34 ,$214.20 ,$58.65 ,$216.75 ,$214.20 ,$58.65 ,$191.25 ,$204.00 ,$204.00 ,$58.65 ,$204.00 ,$214.20 ,$214.20 ,$214.20 ,$229.50 ,$146.63 ,$58.65 ,$255.00 ,$38.35 ,$42.19 ,$64.52 ,$216.75 ,$152.34 ,$229.50 ,$214.20 ,$204.00 ,$204.00 ,$58.65 ,$165.75 ST. FRANCIS HOSPITAL - ACUTE,31000157,81291,HC MTHFR GENE ANALYSIS-90,310,1 ,$83.00 ,$53.95 ,$19.09 ,$83.00 ,$59.76 ,$45.15 ,$19.09 ,$46.33 ,$19.09 ,$49.58 ,$49.58 ,$49.58 ,$49.58 ,$69.72 ,$19.09 ,$70.55 ,$69.72 ,$19.09 ,$62.25 ,$66.40 ,$66.40 ,$19.09 ,$66.40 ,$69.72 ,$69.72 ,$69.72 ,$74.70 ,$47.73 ,$19.09 ,$83.00 ,$38.35 ,$42.19 ,$21.00 ,$70.55 ,$49.58 ,$74.70 ,$69.72 ,$66.40 ,$66.40 ,$19.09 ,$53.95 ST. FRANCIS HOSPITAL - ACUTE,31000171,81332,HC SERPINA 1 GENE ANALYSIS-90,310,1 ,$501.00 ,$325.65 ,$38.35 ,$501.00 ,$360.72 ,$272.54 ,$115.23 ,$279.66 ,$115.23 ,$299.30 ,$299.30 ,$299.30 ,$299.30 ,$420.84 ,$115.23 ,$425.85 ,$420.84 ,$115.23 ,$375.75 ,$400.80 ,$400.80 ,$115.23 ,$400.80 ,$420.84 ,$420.84 ,$420.84 ,$450.90 ,$288.08 ,$115.23 ,$501.00 ,$38.35 ,$42.19 ,$126.75 ,$425.85 ,$299.30 ,$450.90 ,$420.84 ,$400.80 ,$400.80 ,$115.23 ,$325.65 ST. FRANCIS HOSPITAL - ACUTE,31000184,81403,HC MOLECULAR PATH PROC LEVEL 4-90,310,1 ,$285.00 ,$185.25 ,$38.35 ,$285.00 ,$205.20 ,$155.04 , N/A ,$159.09 , N/A ,$170.26 ,$170.26 ,$170.26 ,$170.26 ,$239.40 , N/A ,$242.25 ,$239.40 , N/A ,$213.75 ,$228.00 ,$228.00 , N/A ,$228.00 ,$239.40 ,$239.40 ,$239.40 ,$256.50 , N/A , N/A ,$285.00 ,$38.35 ,$42.19 , N/A ,$242.25 ,$170.26 ,$256.50 ,$239.40 ,$228.00 ,$228.00 , N/A ,$185.25 ST. FRANCIS HOSPITAL - ACUTE,31000191,81479,HC IBD CELIAC UNLISTED MOLECULAR PATH-90,310,1 ,$21.00 ,$13.65 ,$11.72 ,$42.19 ,$15.12 ,$11.42 , N/A ,$11.72 , N/A ,$12.55 ,$12.55 ,$12.55 ,$12.55 ,$17.64 , N/A ,$17.85 ,$17.64 , N/A ,$15.75 ,$16.80 ,$16.80 , N/A ,$16.80 ,$17.64 ,$17.64 ,$17.64 ,$18.90 , N/A , N/A ,$21.00 ,$38.35 ,$42.19 , N/A ,$17.85 ,$12.55 ,$18.90 ,$17.64 ,$16.80 ,$16.80 , N/A ,$13.65 ST. FRANCIS HOSPITAL - ACUTE,31000200,0001U,HC RBC DNA HUMAN GENE ANLYS 35 AG 11 BLOOD GRP-90,310,1 ,$619.00 ,$402.35 ,$38.35 ,$619.00 ,$445.68 ,$336.74 ,$142.37 ,$345.53 ,$142.37 ,$369.79 ,$369.79 ,$369.79 ,$369.79 ,$519.96 ,$142.37 ,$526.15 ,$519.96 ,$142.37 ,$464.25 ,$495.20 ,$495.20 ,$142.37 ,$495.20 ,$519.96 ,$519.96 ,$519.96 ,$557.10 ,$355.93 ,$142.37 ,$619.00 ,$38.35 ,$42.19 ,$156.61 ,$526.15 ,$369.79 ,$557.10 ,$519.96 ,$495.20 ,$495.20 ,$142.37 ,$402.35 ST. FRANCIS HOSPITAL - ACUTE,31000205,81219,HC CALR GENE ANALYSIS EXON 9-90,310,1 ,$318.00 ,$206.70 ,$73.14 ,$318.00 ,$228.96 ,$172.99 ,$73.14 ,$177.51 ,$73.14 ,$189.97 ,$189.97 ,$189.97 ,$189.97 ,$267.12 ,$73.14 ,$270.30 ,$267.12 ,$73.14 ,$238.50 ,$254.40 ,$254.40 ,$73.14 ,$254.40 ,$267.12 ,$267.12 ,$267.12 ,$286.20 ,$182.85 ,$73.14 ,$318.00 ,$124.86 ,$137.35 ,$80.45 ,$270.30 ,$189.97 ,$286.20 ,$267.12 ,$254.40 ,$254.40 ,$73.14 ,$206.70 ST. FRANCIS HOSPITAL - ACUTE,31000208,81402,HC MOLECULAR PATHOLOGY PROC LEVEL 3-90,310,1 ,$227.00 ,$147.55 ,$38.35 ,$227.00 ,$163.44 ,$123.49 , N/A ,$126.71 , N/A ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 , N/A ,$192.95 ,$190.68 , N/A ,$170.25 ,$181.60 ,$181.60 , N/A ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 , N/A , N/A ,$227.00 ,$38.35 ,$42.19 , N/A ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 , N/A ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,31000228,81350,HC UGT1A1 GENE ANALYSIS COM VARIANTS-90,310,1 ,$354.00 ,$230.10 ,$38.35 ,$354.00 ,$254.88 ,$192.58 ,$81.42 ,$197.60 ,$81.42 ,$211.48 ,$211.48 ,$211.48 ,$211.48 ,$297.36 ,$81.42 ,$300.90 ,$297.36 ,$81.42 ,$265.50 ,$283.20 ,$283.20 ,$81.42 ,$283.20 ,$297.36 ,$297.36 ,$297.36 ,$318.60 ,$203.55 ,$81.42 ,$354.00 ,$38.35 ,$42.19 ,$89.56 ,$300.90 ,$211.48 ,$318.60 ,$297.36 ,$283.20 ,$283.20 ,$81.42 ,$230.10 ST. FRANCIS HOSPITAL - ACUTE,31000250,81479,HC MUTATION ANALYSIS CSF3R -90,310,1 ,$182.00 ,$118.30 ,$38.35 ,$182.00 ,$131.04 ,$99.01 , N/A ,$101.59 , N/A ,$108.73 ,$108.73 ,$108.73 ,$108.73 ,$152.88 , N/A ,$154.70 ,$152.88 , N/A ,$136.50 ,$145.60 ,$145.60 , N/A ,$145.60 ,$152.88 ,$152.88 ,$152.88 ,$163.80 , N/A , N/A ,$182.00 ,$38.35 ,$42.19 , N/A ,$154.70 ,$108.73 ,$163.80 ,$152.88 ,$145.60 ,$145.60 , N/A ,$118.30 ST. FRANCIS HOSPITAL - ACUTE,31000254,81212,HC BRCA 1 AND S BREAST/OVARIAN CANCER GENE ANALYSIS-90,310,1 ,$465.00 ,$302.25 ,$106.95 ,$465.00 ,$334.80 ,$252.96 ,$106.95 ,$259.56 ,$106.95 ,$277.79 ,$277.79 ,$277.79 ,$277.79 ,$390.60 ,$106.95 ,$395.25 ,$390.60 ,$106.95 ,$348.75 ,$372.00 ,$372.00 ,$106.95 ,$372.00 ,$390.60 ,$390.60 ,$390.60 ,$418.50 ,$267.38 ,$106.95 ,$465.00 ,$124.86 ,$137.35 ,$117.65 ,$395.25 ,$277.79 ,$418.50 ,$390.60 ,$372.00 ,$372.00 ,$106.95 ,$302.25 ST. FRANCIS HOSPITAL - ACUTE,31000260,89257,HC SPERM IDENTIFICATION FROM ASPIRATION-90,310,1 ,$112.00 ,$72.80 ,$25.76 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$30.87 ,$33.96 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,31000272,81263,HC IGH VAR REG SOMATIC MUTATION ANALYSIS- 90,310,1 ,$391.00 ,$254.15 ,$89.93 ,$391.00 ,$281.52 ,$212.70 ,$89.93 ,$218.26 ,$89.93 ,$233.58 ,$233.58 ,$233.58 ,$233.58 ,$328.44 ,$89.93 ,$332.35 ,$328.44 ,$89.93 ,$293.25 ,$312.80 ,$312.80 ,$89.93 ,$312.80 ,$328.44 ,$328.44 ,$328.44 ,$351.90 ,$224.83 ,$89.93 ,$391.00 ,$354.33 ,$389.76 ,$98.92 ,$332.35 ,$233.58 ,$351.90 ,$328.44 ,$312.80 ,$312.80 ,$89.93 ,$254.15 ST. FRANCIS HOSPITAL - ACUTE,31000276,81479,HC T CELL RECEPTOR EXCISION CIRCLES - 90,310,1 ,$952.00 ,$618.80 ,$38.35 ,$952.00 ,$685.44 ,$517.89 , N/A ,$531.41 , N/A ,$568.72 ,$568.72 ,$568.72 ,$568.72 ,$799.68 , N/A ,$809.20 ,$799.68 , N/A ,$714.00 ,$761.60 ,$761.60 , N/A ,$761.60 ,$799.68 ,$799.68 ,$799.68 ,$856.80 , N/A , N/A ,$952.00 ,$38.35 ,$42.19 , N/A ,$809.20 ,$568.72 ,$856.80 ,$799.68 ,$761.60 ,$761.60 , N/A ,$618.80 ST. FRANCIS HOSPITAL - ACUTE,31100244,88184,HC FLOW CYTO 1ST MARKER-90,311,1 ,$117.00 ,$76.05 ,$26.91 ,$117.00 ,$84.24 ,$63.65 ,$26.91 ,$65.31 ,$26.91 ,$69.90 ,$69.90 ,$69.90 ,$69.90 ,$98.28 ,$26.91 ,$99.45 ,$98.28 ,$26.91 ,$87.75 ,$93.60 ,$93.60 ,$26.91 ,$93.60 ,$98.28 ,$98.28 ,$98.28 ,$105.30 ,$67.28 ,$26.91 ,$117.00 ,$33.96 ,$37.36 ,$29.60 ,$99.45 ,$69.90 ,$105.30 ,$98.28 ,$93.60 ,$93.60 ,$26.91 ,$76.05 ST. FRANCIS HOSPITAL - ACUTE,31100246,88185,HC FLOW CYTO EA ADD MARKER-90,311,1 ,$118.00 ,$76.70 ,$27.14 ,$118.00 ,$84.96 ,$64.19 ,$27.14 ,$65.87 ,$27.14 ,$70.49 ,$70.49 ,$70.49 ,$70.49 ,$99.12 ,$27.14 ,$100.30 ,$99.12 ,$27.14 ,$88.50 ,$94.40 ,$94.40 ,$27.14 ,$94.40 ,$99.12 ,$99.12 ,$99.12 ,$106.20 ,$67.85 ,$27.14 ,$118.00 ,$33.96 ,$37.36 ,$29.85 ,$100.30 ,$70.49 ,$106.20 ,$99.12 ,$94.40 ,$94.40 ,$27.14 ,$76.70 ST. FRANCIS HOSPITAL - ACUTE,31100249,88188,HC FLOW CYTO INT 9-15 MARKERS-90,311,1 ,$118.00 ,$76.70 ,$27.14 ,$118.00 ,$84.96 ,$64.19 ,$27.14 ,$65.87 ,$27.14 ,$70.49 ,$70.49 ,$70.49 ,$70.49 ,$99.12 ,$27.14 ,$100.30 ,$99.12 ,$27.14 ,$88.50 ,$94.40 ,$94.40 ,$27.14 ,$94.40 ,$99.12 ,$99.12 ,$99.12 ,$106.20 ,$67.85 ,$27.14 ,$118.00 ,$30.87 ,$33.96 ,$29.85 ,$100.30 ,$70.49 ,$106.20 ,$99.12 ,$94.40 ,$94.40 ,$27.14 ,$76.70 ST. FRANCIS HOSPITAL - ACUTE,31100262,88271,HC MCG DNA PROBE(BCR/ABL)-90,311,1 ,$74.00 ,$48.10 ,$17.02 ,$74.00 ,$53.28 ,$40.26 ,$17.02 ,$41.31 ,$17.02 ,$44.21 ,$44.21 ,$44.21 ,$44.21 ,$62.16 ,$17.02 ,$62.90 ,$62.16 ,$17.02 ,$55.50 ,$59.20 ,$59.20 ,$17.02 ,$59.20 ,$62.16 ,$62.16 ,$62.16 ,$66.60 ,$42.55 ,$17.02 ,$74.00 ,$38.35 ,$42.19 ,$18.72 ,$62.90 ,$44.21 ,$66.60 ,$62.16 ,$59.20 ,$59.20 ,$17.02 ,$48.10 ST. FRANCIS HOSPITAL - ACUTE,31100271,88275,HC MCG INTER INSIT BCR/ABL 100-90,311,1 ,$140.00 ,$91.00 ,$32.20 ,$140.00 ,$100.80 ,$76.16 ,$32.20 ,$78.15 ,$32.20 ,$83.64 ,$83.64 ,$83.64 ,$83.64 ,$117.60 ,$32.20 ,$119.00 ,$117.60 ,$32.20 ,$105.00 ,$112.00 ,$112.00 ,$32.20 ,$112.00 ,$117.60 ,$117.60 ,$117.60 ,$126.00 ,$80.50 ,$32.20 ,$140.00 ,$38.35 ,$42.19 ,$35.42 ,$119.00 ,$83.64 ,$126.00 ,$117.60 ,$112.00 ,$112.00 ,$32.20 ,$91.00 ST. FRANCIS HOSPITAL - ACUTE,31100283,88120,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC-90,311,1 ,$407.00 ,$264.55 ,$33.96 ,$407.00 ,$293.04 ,$221.41 ,$93.61 ,$227.19 ,$93.61 ,$243.14 ,$243.14 ,$243.14 ,$243.14 ,$341.88 ,$93.61 ,$345.95 ,$341.88 ,$93.61 ,$305.25 ,$325.60 ,$325.60 ,$93.61 ,$325.60 ,$341.88 ,$341.88 ,$341.88 ,$366.30 ,$234.03 ,$93.61 ,$407.00 ,$33.96 ,$37.36 ,$102.97 ,$345.95 ,$243.14 ,$366.30 ,$341.88 ,$325.60 ,$325.60 ,$93.61 ,$264.55 ST. FRANCIS HOSPITAL - ACUTE,31100291,88125,HC CYTOPATH FORENSIC,311,1 ,$110.00 ,$71.50 ,$25.30 ,$110.00 ,$79.20 ,$59.84 ,$25.30 ,$61.40 ,$25.30 ,$65.71 ,$65.71 ,$65.71 ,$65.71 ,$92.40 ,$25.30 ,$93.50 ,$92.40 ,$25.30 ,$82.50 ,$88.00 ,$88.00 ,$25.30 ,$88.00 ,$92.40 ,$92.40 ,$92.40 ,$99.00 ,$63.25 ,$25.30 ,$110.00 ,$30.87 ,$33.96 ,$27.83 ,$93.50 ,$65.71 ,$99.00 ,$92.40 ,$88.00 ,$88.00 ,$25.30 ,$71.50 ST. FRANCIS HOSPITAL - ACUTE,31100293,88175,HC CYTOPATH PAP DIAG INIT/REDO,311,1 ,$167.00 ,$108.55 ,$20.26 ,$167.00 ,$120.24 ,$90.85 ,$38.41 ,$93.22 ,$38.41 ,$99.77 ,$99.77 ,$99.77 ,$99.77 ,$140.28 ,$38.41 ,$141.95 ,$140.28 ,$38.41 ,$125.25 ,$133.60 ,$133.60 ,$38.41 ,$133.60 ,$140.28 ,$140.28 ,$140.28 ,$150.30 ,$96.03 ,$38.41 ,$20.26 ,$22.38 ,$24.62 ,$42.25 ,$141.95 ,$99.77 ,$150.30 ,$140.28 ,$133.60 ,$133.60 ,$38.41 ,$108.55 ST. FRANCIS HOSPITAL - ACUTE,31100294,88184,HC FLOW CYTO 1ST MARKER,311,1 ,$117.00 ,$76.05 ,$26.91 ,$117.00 ,$84.24 ,$63.65 ,$26.91 ,$65.31 ,$26.91 ,$69.90 ,$69.90 ,$69.90 ,$69.90 ,$98.28 ,$26.91 ,$99.45 ,$98.28 ,$26.91 ,$87.75 ,$93.60 ,$93.60 ,$26.91 ,$93.60 ,$98.28 ,$98.28 ,$98.28 ,$105.30 ,$67.28 ,$26.91 ,$117.00 ,$33.96 ,$37.36 ,$29.60 ,$99.45 ,$69.90 ,$105.30 ,$98.28 ,$93.60 ,$93.60 ,$26.91 ,$76.05 ST. FRANCIS HOSPITAL - ACUTE,31100295,88185,HC FLOW CYTO EA ADD MARKER,311,1 ,$101.00 ,$65.65 ,$23.23 ,$101.00 ,$72.72 ,$54.94 ,$23.23 ,$56.38 ,$23.23 ,$60.34 ,$60.34 ,$60.34 ,$60.34 ,$84.84 ,$23.23 ,$85.85 ,$84.84 ,$23.23 ,$75.75 ,$80.80 ,$80.80 ,$23.23 ,$80.80 ,$84.84 ,$84.84 ,$84.84 ,$90.90 ,$58.08 ,$23.23 ,$101.00 ,$33.96 ,$37.36 ,$25.55 ,$85.85 ,$60.34 ,$90.90 ,$84.84 ,$80.80 ,$80.80 ,$23.23 ,$65.65 ST. FRANCIS HOSPITAL - ACUTE,31100299,88104,HC CYTOPATH FLD SMEAR,311,1 ,$99.00 ,$64.35 ,$22.77 ,$99.00 ,$71.28 ,$53.86 ,$22.77 ,$55.26 ,$22.77 ,$59.14 ,$59.14 ,$59.14 ,$59.14 ,$83.16 ,$22.77 ,$84.15 ,$83.16 ,$22.77 ,$74.25 ,$79.20 ,$79.20 ,$22.77 ,$79.20 ,$83.16 ,$83.16 ,$83.16 ,$89.10 ,$56.93 ,$22.77 ,$99.00 ,$30.87 ,$33.96 ,$25.05 ,$84.15 ,$59.14 ,$89.10 ,$83.16 ,$79.20 ,$79.20 ,$22.77 ,$64.35 ST. FRANCIS HOSPITAL - ACUTE,31100300,88106,HC CYTOPATH FLUID SIMP FILTER,311,1 ,$92.00 ,$59.80 ,$21.16 ,$92.00 ,$66.24 ,$50.05 ,$21.16 ,$51.35 ,$21.16 ,$54.96 ,$54.96 ,$54.96 ,$54.96 ,$77.28 ,$21.16 ,$78.20 ,$77.28 ,$21.16 ,$69.00 ,$73.60 ,$73.60 ,$21.16 ,$73.60 ,$77.28 ,$77.28 ,$77.28 ,$82.80 ,$52.90 ,$21.16 ,$92.00 ,$30.87 ,$33.96 ,$23.28 ,$78.20 ,$54.96 ,$82.80 ,$77.28 ,$73.60 ,$73.60 ,$21.16 ,$59.80 ST. FRANCIS HOSPITAL - ACUTE,31100301,88175,HC CYTOPATH PAP SCREEN INIT/REDO,311,1 ,$167.00 ,$108.55 ,$20.26 ,$167.00 ,$120.24 ,$90.85 ,$38.41 ,$93.22 ,$38.41 ,$99.77 ,$99.77 ,$99.77 ,$99.77 ,$140.28 ,$38.41 ,$141.95 ,$140.28 ,$38.41 ,$125.25 ,$133.60 ,$133.60 ,$38.41 ,$133.60 ,$140.28 ,$140.28 ,$140.28 ,$150.30 ,$96.03 ,$38.41 ,$20.26 ,$22.38 ,$24.62 ,$42.25 ,$141.95 ,$99.77 ,$150.30 ,$140.28 ,$133.60 ,$133.60 ,$38.41 ,$108.55 ST. FRANCIS HOSPITAL - ACUTE,31100310,88121,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC COMP ASSIST-90,311,1 ,$407.00 ,$264.55 ,$33.96 ,$407.00 ,$293.04 ,$221.41 ,$93.61 ,$227.19 ,$93.61 ,$243.14 ,$243.14 ,$243.14 ,$243.14 ,$341.88 ,$93.61 ,$345.95 ,$341.88 ,$93.61 ,$305.25 ,$325.60 ,$325.60 ,$93.61 ,$325.60 ,$341.88 ,$341.88 ,$341.88 ,$366.30 ,$234.03 ,$93.61 ,$407.00 ,$33.96 ,$37.36 ,$102.97 ,$345.95 ,$243.14 ,$366.30 ,$341.88 ,$325.60 ,$325.60 ,$93.61 ,$264.55 ST. FRANCIS HOSPITAL - ACUTE,31200272,88346,HC IF DIRECT-90,312,1 ,$124.00 ,$80.60 ,$28.52 ,$124.00 ,$89.28 ,$67.46 ,$28.52 ,$69.22 ,$28.52 ,$74.08 ,$74.08 ,$74.08 ,$74.08 ,$104.16 ,$28.52 ,$105.40 ,$104.16 ,$28.52 ,$93.00 ,$99.20 ,$99.20 ,$28.52 ,$99.20 ,$104.16 ,$104.16 ,$104.16 ,$111.60 ,$71.30 ,$28.52 ,$124.00 ,$30.87 ,$33.96 ,$31.37 ,$105.40 ,$74.08 ,$111.60 ,$104.16 ,$99.20 ,$99.20 ,$28.52 ,$80.60 ST. FRANCIS HOSPITAL - ACUTE,31200274,88350,HC IMMUNOFLUOR PER SPEC EA ADDN SINGLE STAIN-90,312,1 ,$124.00 ,$80.60 ,$28.52 ,$124.00 ,$89.28 ,$67.46 ,$28.52 ,$69.22 ,$28.52 ,$74.08 ,$74.08 ,$74.08 ,$74.08 ,$104.16 ,$28.52 ,$105.40 ,$104.16 ,$28.52 ,$93.00 ,$99.20 ,$99.20 ,$28.52 ,$99.20 ,$104.16 ,$104.16 ,$104.16 ,$111.60 ,$71.30 ,$28.52 ,$124.00 ,$30.87 ,$33.96 ,$31.37 ,$105.40 ,$74.08 ,$111.60 ,$104.16 ,$99.20 ,$99.20 ,$28.52 ,$80.60 ST. FRANCIS HOSPITAL - ACUTE,31200293,88332,HC CONSULT PATH SURG ADDL FROZEN,312,1 ,$162.00 ,$105.30 ,$24.31 ,$162.00 ,$116.64 ,$88.13 ,$37.26 ,$90.43 ,$37.26 ,$96.78 ,$96.78 ,$96.78 ,$96.78 ,$136.08 ,$37.26 ,$137.70 ,$136.08 ,$37.26 ,$121.50 ,$129.60 ,$129.60 ,$37.26 ,$129.60 ,$136.08 ,$136.08 ,$136.08 ,$145.80 ,$93.15 ,$37.26 ,$24.31 ,$30.87 ,$33.96 ,$40.99 ,$137.70 ,$96.78 ,$145.80 ,$136.08 ,$129.60 ,$129.60 ,$37.26 ,$105.30 ST. FRANCIS HOSPITAL - ACUTE,31200294,88331,HC CONSULT PATH SURG W/FROZEN,312,1 ,$288.00 ,$187.20 ,$30.87 ,$288.00 ,$207.36 ,$156.67 ,$66.24 ,$160.76 ,$66.24 ,$172.05 ,$172.05 ,$172.05 ,$172.05 ,$241.92 ,$66.24 ,$244.80 ,$241.92 ,$66.24 ,$216.00 ,$230.40 ,$230.40 ,$66.24 ,$230.40 ,$241.92 ,$241.92 ,$241.92 ,$259.20 ,$165.60 ,$66.24 ,$36.68 ,$30.87 ,$33.96 ,$72.86 ,$244.80 ,$172.05 ,$259.20 ,$241.92 ,$230.40 ,$230.40 ,$66.24 ,$187.20 ST. FRANCIS HOSPITAL - ACUTE,31200295,88323,HC CONSULT/SLIDE PREP,312,1 ,$200.00 ,$130.00 ,$30.87 ,$200.00 ,$144.00 ,$108.80 ,$46.00 ,$111.64 ,$46.00 ,$119.48 ,$119.48 ,$119.48 ,$119.48 ,$168.00 ,$46.00 ,$170.00 ,$168.00 ,$46.00 ,$150.00 ,$160.00 ,$160.00 ,$46.00 ,$160.00 ,$168.00 ,$168.00 ,$168.00 ,$180.00 ,$115.00 ,$46.00 ,$200.00 ,$30.87 ,$33.96 ,$50.60 ,$170.00 ,$119.48 ,$180.00 ,$168.00 ,$160.00 ,$160.00 ,$46.00 ,$130.00 ST. FRANCIS HOSPITAL - ACUTE,31200296,88311,HC DECALCIFICATION,312,1 ,$70.00 ,$45.50 ,$16.10 ,$70.00 ,$50.40 ,$38.08 ,$16.10 ,$39.07 ,$16.10 ,$41.82 ,$41.82 ,$41.82 ,$41.82 ,$58.80 ,$16.10 ,$59.50 ,$58.80 ,$16.10 ,$52.50 ,$56.00 ,$56.00 ,$16.10 ,$56.00 ,$58.80 ,$58.80 ,$58.80 ,$63.00 ,$40.25 ,$16.10 ,$70.00 ,$30.87 ,$33.96 ,$17.71 ,$59.50 ,$41.82 ,$63.00 ,$58.80 ,$56.00 ,$56.00 ,$16.10 ,$45.50 ST. FRANCIS HOSPITAL - ACUTE,31200297,88302,HC GROSS AND MICRO LEVEL II,312,1 ,$237.00 ,$154.05 ,$30.87 ,$237.00 ,$170.64 ,$128.93 ,$54.51 ,$132.29 ,$54.51 ,$141.58 ,$141.58 ,$141.58 ,$141.58 ,$199.08 ,$54.51 ,$201.45 ,$199.08 ,$54.51 ,$177.75 ,$189.60 ,$189.60 ,$54.51 ,$189.60 ,$199.08 ,$199.08 ,$199.08 ,$213.30 ,$136.28 ,$54.51 ,$237.00 ,$30.87 ,$33.96 ,$59.96 ,$201.45 ,$141.58 ,$213.30 ,$199.08 ,$189.60 ,$189.60 ,$54.51 ,$154.05 ST. FRANCIS HOSPITAL - ACUTE,31200298,88304,HC GROSS AND MICRO LEVEL III,312,1 ,$289.00 ,$187.85 ,$30.87 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 ,$30.87 ,$33.96 ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,31200299,88305,HC GROSS AND MICRO LEVEL IV,312,1 ,$358.00 ,$232.70 ,$30.87 ,$358.00 ,$257.76 ,$194.75 ,$82.34 ,$199.84 ,$82.34 ,$213.87 ,$213.87 ,$213.87 ,$213.87 ,$300.72 ,$82.34 ,$304.30 ,$300.72 ,$82.34 ,$268.50 ,$286.40 ,$286.40 ,$82.34 ,$286.40 ,$300.72 ,$300.72 ,$300.72 ,$322.20 ,$205.85 ,$82.34 ,$33.68 ,$30.87 ,$33.96 ,$90.57 ,$304.30 ,$213.87 ,$322.20 ,$300.72 ,$286.40 ,$286.40 ,$82.34 ,$232.70 ST. FRANCIS HOSPITAL - ACUTE,31200300,88307,HC GROSS AND MICRO LEVEL V,312,1 ,$762.00 ,$495.30 ,$33.96 ,$762.00 ,$548.64 ,$414.53 ,$175.26 ,$425.35 ,$175.26 ,$455.22 ,$455.22 ,$455.22 ,$455.22 ,$640.08 ,$175.26 ,$647.70 ,$640.08 ,$175.26 ,$571.50 ,$609.60 ,$609.60 ,$175.26 ,$609.60 ,$640.08 ,$640.08 ,$640.08 ,$685.80 ,$438.15 ,$175.26 ,$203.41 ,$33.96 ,$37.36 ,$192.79 ,$647.70 ,$455.22 ,$685.80 ,$640.08 ,$609.60 ,$609.60 ,$175.26 ,$495.30 ST. FRANCIS HOSPITAL - ACUTE,31200301,88309,HC GROSS AND MICRO LEVEL VI,312,1 ,"$1,099.00 ",$714.35 ,$33.96 ,"$1,099.00 ",$791.28 ,$597.86 ,$252.77 ,$613.46 ,$252.77 ,$656.54 ,$656.54 ,$656.54 ,$656.54 ,$923.16 ,$252.77 ,$934.15 ,$923.16 ,$252.77 ,$824.25 ,$879.20 ,$879.20 ,$252.77 ,$879.20 ,$923.16 ,$923.16 ,$923.16 ,$989.10 ,$631.93 ,$252.77 ,"$1,099.00 ",$33.96 ,$37.36 ,$278.05 ,$934.15 ,$656.54 ,$989.10 ,$923.16 ,$879.20 ,$879.20 ,$252.77 ,$714.35 ST. FRANCIS HOSPITAL - ACUTE,31200302,88300,HC GROSS ONLY LEVEL I,312,1 ,$113.00 ,$73.45 ,$25.99 ,$113.00 ,$81.36 ,$61.47 ,$25.99 ,$63.08 ,$25.99 ,$67.51 ,$67.51 ,$67.51 ,$67.51 ,$94.92 ,$25.99 ,$96.05 ,$94.92 ,$25.99 ,$84.75 ,$90.40 ,$90.40 ,$25.99 ,$90.40 ,$94.92 ,$94.92 ,$94.92 ,$101.70 ,$64.98 ,$25.99 ,$113.00 ,$30.87 ,$33.96 ,$28.59 ,$96.05 ,$67.51 ,$101.70 ,$94.92 ,$90.40 ,$90.40 ,$25.99 ,$73.45 ST. FRANCIS HOSPITAL - ACUTE,31200303,88312,HC SPECIAL STAIN I,312,1 ,$96.00 ,$62.40 ,$22.08 ,$96.00 ,$69.12 ,$52.22 ,$22.08 ,$53.59 ,$22.08 ,$57.35 ,$57.35 ,$57.35 ,$57.35 ,$80.64 ,$22.08 ,$81.60 ,$80.64 ,$22.08 ,$72.00 ,$76.80 ,$76.80 ,$22.08 ,$76.80 ,$80.64 ,$80.64 ,$80.64 ,$86.40 ,$55.20 ,$22.08 ,$96.00 ,$30.87 ,$33.96 ,$24.29 ,$81.60 ,$57.35 ,$86.40 ,$80.64 ,$76.80 ,$76.80 ,$22.08 ,$62.40 ST. FRANCIS HOSPITAL - ACUTE,31200304,88313,HC SPECIAL STAIN II,312,1 ,$77.00 ,$50.05 ,$17.71 ,$77.00 ,$55.44 ,$41.89 ,$17.71 ,$42.98 ,$17.71 ,$46.00 ,$46.00 ,$46.00 ,$46.00 ,$64.68 ,$17.71 ,$65.45 ,$64.68 ,$17.71 ,$57.75 ,$61.60 ,$61.60 ,$17.71 ,$61.60 ,$64.68 ,$64.68 ,$64.68 ,$69.30 ,$44.28 ,$17.71 ,$77.00 ,$30.87 ,$33.96 ,$19.48 ,$65.45 ,$46.00 ,$69.30 ,$64.68 ,$61.60 ,$61.60 ,$17.71 ,$50.05 ST. FRANCIS HOSPITAL - ACUTE,31200305,88342,HC IMMUNOHISOCHEMIST EA AB REPEAT,312,1 ,$314.00 ,$204.10 ,$30.87 ,$314.00 ,$226.08 ,$170.82 ,$72.22 ,$175.27 ,$72.22 ,$187.58 ,$187.58 ,$187.58 ,$187.58 ,$263.76 ,$72.22 ,$266.90 ,$263.76 ,$72.22 ,$235.50 ,$251.20 ,$251.20 ,$72.22 ,$251.20 ,$263.76 ,$263.76 ,$263.76 ,$282.60 ,$180.55 ,$72.22 ,$73.43 ,$30.87 ,$33.96 ,$79.44 ,$266.90 ,$187.58 ,$282.60 ,$263.76 ,$251.20 ,$251.20 ,$72.22 ,$204.10 ST. FRANCIS HOSPITAL - ACUTE,31200306,88344,HC IMMUNOHISTOCHEM EA AB STAIN,312,1 ,$707.00 ,$459.55 ,$30.87 ,$707.00 ,$509.04 ,$384.61 ,$162.61 ,$394.65 ,$162.61 ,$422.36 ,$422.36 ,$422.36 ,$422.36 ,$593.88 ,$162.61 ,$600.95 ,$593.88 ,$162.61 ,$530.25 ,$565.60 ,$565.60 ,$162.61 ,$565.60 ,$593.88 ,$593.88 ,$593.88 ,$636.30 ,$406.53 ,$162.61 ,$707.00 ,$30.87 ,$33.96 ,$178.87 ,$600.95 ,$422.36 ,$636.30 ,$593.88 ,$565.60 ,$565.60 ,$162.61 ,$459.55 ST. FRANCIS HOSPITAL - ACUTE,31200307,88341,HC IMMUNOHISOCHEMIS EA AD SGL STN,312,1 ,$283.00 ,$183.95 ,$30.87 ,$283.00 ,$203.76 ,$153.95 ,$65.09 ,$157.97 ,$65.09 ,$169.06 ,$169.06 ,$169.06 ,$169.06 ,$237.72 ,$65.09 ,$240.55 ,$237.72 ,$65.09 ,$212.25 ,$226.40 ,$226.40 ,$65.09 ,$226.40 ,$237.72 ,$237.72 ,$237.72 ,$254.70 ,$162.73 ,$65.09 ,$67.12 ,$30.87 ,$33.96 ,$71.60 ,$240.55 ,$169.06 ,$254.70 ,$237.72 ,$226.40 ,$226.40 ,$65.09 ,$183.95 ST. FRANCIS HOSPITAL - ACUTE,31200308,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$171.00 ,$111.15 ,$33.96 ,$171.00 ,$123.12 ,$93.02 ,$39.33 ,$95.45 ,$39.33 ,$102.16 ,$102.16 ,$102.16 ,$102.16 ,$143.64 ,$39.33 ,$145.35 ,$143.64 ,$39.33 ,$128.25 ,$136.80 ,$136.80 ,$39.33 ,$136.80 ,$143.64 ,$143.64 ,$143.64 ,$153.90 ,$98.33 ,$39.33 ,$171.00 ,$33.96 ,$37.36 ,$43.26 ,$145.35 ,$102.16 ,$153.90 ,$143.64 ,$136.80 ,$136.80 ,$39.33 ,$111.15 ST. FRANCIS HOSPITAL - ACUTE,31200309,88363,HC EXAM ARCHIVE TISS MOL ANLYS,312,1 ,$25.00 ,$16.25 ,$5.75 ,$33.96 ,$18.00 ,$13.60 ,$5.75 ,$13.96 ,$5.75 ,$14.94 ,$14.94 ,$14.94 ,$14.94 ,$21.00 ,$5.75 ,$21.25 ,$21.00 ,$5.75 ,$18.75 ,$20.00 ,$20.00 ,$5.75 ,$20.00 ,$21.00 ,$21.00 ,$21.00 ,$22.50 ,$14.38 ,$5.75 ,$25.00 ,$30.87 ,$33.96 ,$6.33 ,$21.25 ,$14.94 ,$22.50 ,$21.00 ,$20.00 ,$20.00 ,$5.75 ,$16.25 ST. FRANCIS HOSPITAL - ACUTE,32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$172.00 ,$111.80 ,$39.56 ,$172.00 ,$123.84 ,$93.57 ,$39.56 ,$96.01 ,$39.56 ,$102.75 ,$102.75 ,$102.75 ,$102.75 ,$144.48 ,$39.56 ,$146.20 ,$144.48 ,$39.56 ,$129.00 ,$137.60 ,$137.60 ,$39.56 ,$137.60 ,$144.48 ,$144.48 ,$144.48 ,$154.80 ,$98.90 ,$39.56 ,$172.00 , N/A , N/A ,$43.52 ,$146.20 ,$102.75 ,$154.80 ,$144.48 ,$137.60 ,$137.60 ,$39.56 ,$111.80 ST. FRANCIS HOSPITAL - ACUTE,32000011,25246,HC ARTHROGRAM INJ WRIST,320,1 ,$172.00 ,$111.80 ,$39.56 ,$366.26 ,$123.84 ,$93.57 ,$39.56 ,$96.01 ,$39.56 ,$102.75 ,$102.75 ,$102.75 ,$102.75 ,$144.48 ,$39.56 ,$146.20 ,$144.48 ,$39.56 ,$129.00 ,$137.60 ,$137.60 ,$39.56 ,$137.60 ,$144.48 ,$144.48 ,$144.48 ,$154.80 ,$98.90 ,$39.56 ,$172.00 ,$332.96 ,$366.26 ,$43.52 ,$146.20 ,$102.75 ,$154.80 ,$144.48 ,$137.60 ,$137.60 ,$39.56 ,$111.80 ST. FRANCIS HOSPITAL - ACUTE,32000012,27093,HC INJ ARTHROGRAM HIP W/O,320,1 ,$181.00 ,$117.65 ,$41.63 ,$366.26 ,$130.32 ,$98.46 ,$41.63 ,$101.03 ,$41.63 ,$108.13 ,$108.13 ,$108.13 ,$108.13 ,$152.04 ,$41.63 ,$153.85 ,$152.04 ,$41.63 ,$135.75 ,$144.80 ,$144.80 ,$41.63 ,$144.80 ,$152.04 ,$152.04 ,$152.04 ,$162.90 ,$104.08 ,$41.63 ,$181.00 ,$332.96 ,$366.26 ,$45.79 ,$153.85 ,$108.13 ,$162.90 ,$152.04 ,$144.80 ,$144.80 ,$41.63 ,$117.65 ST. FRANCIS HOSPITAL - ACUTE,32000015,27369,HC ARTHROGRAM INJ KNEE,320,1 ,$373.00 ,$242.45 ,$85.79 ,$373.00 ,$268.56 ,$202.91 ,$85.79 ,$208.21 ,$85.79 ,$222.83 ,$222.83 ,$222.83 ,$222.83 ,$313.32 ,$85.79 ,$317.05 ,$313.32 ,$85.79 ,$279.75 ,$298.40 ,$298.40 ,$85.79 ,$298.40 ,$313.32 ,$313.32 ,$313.32 ,$335.70 ,$214.48 ,$85.79 ,$373.00 , N/A , N/A ,$94.37 ,$317.05 ,$222.83 ,$335.70 ,$313.32 ,$298.40 ,$298.40 ,$85.79 ,$242.45 ST. FRANCIS HOSPITAL - ACUTE,32000019,32551,HC CHEST TUBE INSERTION 32551,320,1 ,$752.00 ,$488.80 ,$172.96 ,$752.00 ,$541.44 ,$409.09 ,$172.96 ,$419.77 ,$172.96 ,$449.24 ,$449.24 ,$449.24 ,$449.24 ,$631.68 ,$172.96 ,$639.20 ,$631.68 ,$172.96 ,$564.00 ,$601.60 ,$601.60 ,$172.96 ,$601.60 ,$631.68 ,$631.68 ,$631.68 ,$676.80 ,$432.40 ,$172.96 ,$752.00 ,$663.48 ,$729.83 ,$190.26 ,$639.20 ,$449.24 ,$676.80 ,$631.68 ,$601.60 ,$601.60 ,$172.96 ,$488.80 ST. FRANCIS HOSPITAL - ACUTE,32000026,36000,HC IV START > 3YR OLD,320,1 ,$48.00 ,$31.20 ,$11.04 ,$294.28 ,$34.56 ,$26.11 ,$11.04 ,$26.79 ,$11.04 ,$28.68 ,$28.68 ,$28.68 ,$28.68 ,$40.32 ,$11.04 ,$40.80 ,$40.32 ,$11.04 ,$36.00 ,$38.40 ,$38.40 ,$11.04 ,$38.40 ,$40.32 ,$40.32 ,$40.32 ,$43.20 ,$27.60 ,$11.04 ,$48.00 ,$267.53 ,$294.28 ,$12.14 ,$40.80 ,$28.68 ,$43.20 ,$40.32 ,$38.40 ,$38.40 ,$11.04 ,$31.20 ST. FRANCIS HOSPITAL - ACUTE,32000029,36410,HC VENIPUNCTURE > AGE 3 REQUIR MD,320,1 ,$245.00 ,$159.25 ,$46.49 ,$245.00 ,$176.40 ,$133.28 ,$56.35 ,$136.76 ,$56.35 ,$146.36 ,$146.36 ,$146.36 ,$146.36 ,$205.80 ,$56.35 ,$208.25 ,$205.80 ,$56.35 ,$183.75 ,$196.00 ,$196.00 ,$56.35 ,$196.00 ,$205.80 ,$205.80 ,$205.80 ,$220.50 ,$140.88 ,$56.35 ,$245.00 ,$46.49 ,$51.14 ,$61.99 ,$208.25 ,$146.36 ,$220.50 ,$205.80 ,$196.00 ,$196.00 ,$56.35 ,$159.25 ST. FRANCIS HOSPITAL - ACUTE,32000030,36598,HC CONTRAST INJ CV CATH W/FLUORO,320,1 ,$357.00 ,$232.05 ,$82.11 ,"$1,795.74 ",$257.04 ,$194.21 ,$82.11 ,$199.28 ,$82.11 ,$213.27 ,$213.27 ,$213.27 ,$213.27 ,$299.88 ,$82.11 ,$303.45 ,$299.88 ,$82.11 ,$267.75 ,$285.60 ,$285.60 ,$82.11 ,$285.60 ,$299.88 ,$299.88 ,$299.88 ,$321.30 ,$205.28 ,$82.11 ,$357.00 ,"$1,632.49 ","$1,795.74 ",$90.32 ,$303.45 ,$213.27 ,$321.30 ,$299.88 ,$285.60 ,$285.60 ,$82.11 ,$232.05 ST. FRANCIS HOSPITAL - ACUTE,32000035,43752,HC PLACE TUBE NASOGASTRIC,320,1 ,$156.00 ,$101.40 ,$35.88 ,$635.26 ,$112.32 ,$84.86 ,$35.88 ,$87.08 ,$35.88 ,$93.19 ,$93.19 ,$93.19 ,$93.19 ,$131.04 ,$35.88 ,$132.60 ,$131.04 ,$35.88 ,$117.00 ,$124.80 ,$124.80 ,$35.88 ,$124.80 ,$131.04 ,$131.04 ,$131.04 ,$140.40 ,$89.70 ,$35.88 ,$156.00 ,$577.51 ,$635.26 ,$39.47 ,$132.60 ,$93.19 ,$140.40 ,$131.04 ,$124.80 ,$124.80 ,$35.88 ,$101.40 ST. FRANCIS HOSPITAL - ACUTE,32000061,49451,HC RPLC DUODEN/JEJUN TB FLUORO,320,1 ,$321.00 ,$208.65 ,$73.83 ,$635.26 ,$231.12 ,$174.62 ,$73.83 ,$179.18 ,$73.83 ,$191.77 ,$191.77 ,$191.77 ,$191.77 ,$269.64 ,$73.83 ,$272.85 ,$269.64 ,$73.83 ,$240.75 ,$256.80 ,$256.80 ,$73.83 ,$256.80 ,$269.64 ,$269.64 ,$269.64 ,$288.90 ,$184.58 ,$73.83 ,$321.00 ,$577.51 ,$635.26 ,$81.21 ,$272.85 ,$191.77 ,$288.90 ,$269.64 ,$256.80 ,$256.80 ,$73.83 ,$208.65 ST. FRANCIS HOSPITAL - ACUTE,32000062,49452,HC RPLC GASTRO-JEJUN TB FLUORO,361,1 ,$321.00 ,$208.65 ,$73.83 ,$635.26 ,$231.12 ,$174.62 ,$73.83 ,$179.18 ,$73.83 ,$205.92 ,$205.92 ,$205.92 ,$205.92 ,$269.64 ,$73.83 ,$272.85 ,$269.64 ,$73.83 ,$240.75 ,$256.80 ,$256.80 ,$73.83 ,$256.80 ,$269.64 ,$269.64 ,$269.64 ,$288.90 ,$184.58 ,$73.83 ,$321.00 ,$577.51 ,$635.26 ,$81.21 ,$272.85 ,$205.92 ,$288.90 ,$269.64 ,$256.80 ,$256.80 ,$73.83 ,$208.65 ST. FRANCIS HOSPITAL - ACUTE,32000063,49465,HC INJ CNTR W/FLUOR EVAL G/D/J TB,320,1 ,$374.00 ,$243.10 ,$86.02 ,$374.00 ,$269.28 ,$203.46 ,$86.02 ,$208.77 ,$86.02 ,$223.43 ,$223.43 ,$223.43 ,$223.43 ,$314.16 ,$86.02 ,$317.90 ,$314.16 ,$86.02 ,$280.50 ,$299.20 ,$299.20 ,$86.02 ,$299.20 ,$314.16 ,$314.16 ,$314.16 ,$336.60 ,$215.05 ,$86.02 ,$374.00 ,$332.96 ,$366.26 ,$94.62 ,$317.90 ,$223.43 ,$336.60 ,$314.16 ,$299.20 ,$299.20 ,$86.02 ,$243.10 ST. FRANCIS HOSPITAL - ACUTE,32000085,51600,HC INJ CYSTOGRAM,320,1 ,$172.00 ,$111.80 ,$39.56 ,$366.26 ,$123.84 ,$93.57 ,$39.56 ,$96.01 ,$39.56 ,$102.75 ,$102.75 ,$102.75 ,$102.75 ,$144.48 ,$39.56 ,$146.20 ,$144.48 ,$39.56 ,$129.00 ,$137.60 ,$137.60 ,$39.56 ,$137.60 ,$144.48 ,$144.48 ,$144.48 ,$154.80 ,$98.90 ,$39.56 ,$172.00 ,$332.96 ,$366.26 ,$43.52 ,$146.20 ,$102.75 ,$154.80 ,$144.48 ,$137.60 ,$137.60 ,$39.56 ,$111.80 ST. FRANCIS HOSPITAL - ACUTE,32000086,51610,HC INJ URETHROCYSTOGRAM RETRO,320,1 ,$112.00 ,$72.80 ,$25.76 ,$366.26 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$332.96 ,$366.26 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,32000087,58340,HC CATH/INTRO SALINE/CONTRAST SIS,320,1 ,$172.00 ,$111.80 ,$39.56 ,$366.26 ,$123.84 ,$93.57 ,$39.56 ,$96.01 ,$39.56 ,$102.75 ,$102.75 ,$102.75 ,$102.75 ,$144.48 ,$39.56 ,$146.20 ,$144.48 ,$39.56 ,$129.00 ,$137.60 ,$137.60 ,$39.56 ,$137.60 ,$144.48 ,$144.48 ,$144.48 ,$154.80 ,$98.90 ,$39.56 ,$172.00 ,$332.96 ,$366.26 ,$43.52 ,$146.20 ,$102.75 ,$154.80 ,$144.48 ,$137.60 ,$137.60 ,$39.56 ,$111.80 ST. FRANCIS HOSPITAL - ACUTE,32000098,70030,HC XRAY EYE (FOREIGN BODY),320,1 ,$686.00 ,$445.90 ,$53.38 ,$686.00 ,$493.92 ,$373.18 ,$157.78 ,$382.93 ,$157.78 ,$409.82 ,$409.82 ,$409.82 ,$409.82 ,$576.24 ,$157.78 ,$583.10 ,$576.24 ,$157.78 ,$514.50 ,$548.80 ,$548.80 ,$157.78 ,$548.80 ,$576.24 ,$576.24 ,$576.24 ,$617.40 ,$394.45 ,$157.78 ,$686.00 ,$53.38 ,$58.72 ,$173.56 ,$583.10 ,$409.82 ,$617.40 ,$576.24 ,$548.80 ,$548.80 ,$157.78 ,$445.90 ST. FRANCIS HOSPITAL - ACUTE,32000100,70110,HC MANDIBLE MIN 4 VIEWS,320,1 ,"$1,034.00 ",$672.10 ,$53.38 ,"$1,034.00 ",$744.48 ,$562.50 ,$237.82 ,$577.18 ,$237.82 ,$617.71 ,$617.71 ,$617.71 ,$617.71 ,$868.56 ,$237.82 ,$878.90 ,$868.56 ,$237.82 ,$775.50 ,$827.20 ,$827.20 ,$237.82 ,$827.20 ,$868.56 ,$868.56 ,$868.56 ,$930.60 ,$594.55 ,$237.82 ,"$1,034.00 ",$53.38 ,$58.72 ,$261.60 ,$878.90 ,$617.71 ,$930.60 ,$868.56 ,$827.20 ,$827.20 ,$237.82 ,$672.10 ST. FRANCIS HOSPITAL - ACUTE,32000104,70150,HC FACIAL BONES MIN 3 VIEWS,320,1 ,$781.00 ,$507.65 ,$53.38 ,$781.00 ,$562.32 ,$424.86 ,$179.63 ,$435.95 ,$179.63 ,$466.57 ,$466.57 ,$466.57 ,$466.57 ,$656.04 ,$179.63 ,$663.85 ,$656.04 ,$179.63 ,$585.75 ,$624.80 ,$624.80 ,$179.63 ,$624.80 ,$656.04 ,$656.04 ,$656.04 ,$702.90 ,$449.08 ,$179.63 ,$781.00 ,$53.38 ,$58.72 ,$197.59 ,$663.85 ,$466.57 ,$702.90 ,$656.04 ,$624.80 ,$624.80 ,$179.63 ,$507.65 ST. FRANCIS HOSPITAL - ACUTE,32000105,70160,HC NASAL BONES MIN 3 VIEWS,320,1 ,$479.00 ,$311.35 ,$53.38 ,$479.00 ,$344.88 ,$260.58 ,$110.17 ,$267.38 ,$110.17 ,$286.15 ,$286.15 ,$286.15 ,$286.15 ,$402.36 ,$110.17 ,$407.15 ,$402.36 ,$110.17 ,$359.25 ,$383.20 ,$383.20 ,$110.17 ,$383.20 ,$402.36 ,$402.36 ,$402.36 ,$431.10 ,$275.43 ,$110.17 ,$479.00 ,$53.38 ,$58.72 ,$121.19 ,$407.15 ,$286.15 ,$431.10 ,$402.36 ,$383.20 ,$383.20 ,$110.17 ,$311.35 ST. FRANCIS HOSPITAL - ACUTE,32000106,70200,HC XRAY ORBITS (EYE) (MIN 4 V),320,1 ,$781.00 ,$507.65 ,$53.38 ,$781.00 ,$562.32 ,$424.86 ,$179.63 ,$435.95 ,$179.63 ,$466.57 ,$466.57 ,$466.57 ,$466.57 ,$656.04 ,$179.63 ,$663.85 ,$656.04 ,$179.63 ,$585.75 ,$624.80 ,$624.80 ,$179.63 ,$624.80 ,$656.04 ,$656.04 ,$656.04 ,$702.90 ,$449.08 ,$179.63 ,$781.00 ,$53.38 ,$58.72 ,$197.59 ,$663.85 ,$466.57 ,$702.90 ,$656.04 ,$624.80 ,$624.80 ,$179.63 ,$507.65 ST. FRANCIS HOSPITAL - ACUTE,32000107,70210,HC XRAY SINUS WATERS VIEW,320,1 ,$280.00 ,$182.00 ,$53.38 ,$280.00 ,$201.60 ,$152.32 ,$64.40 ,$156.30 ,$64.40 ,$167.27 ,$167.27 ,$167.27 ,$167.27 ,$235.20 ,$64.40 ,$238.00 ,$235.20 ,$64.40 ,$210.00 ,$224.00 ,$224.00 ,$64.40 ,$224.00 ,$235.20 ,$235.20 ,$235.20 ,$252.00 ,$161.00 ,$64.40 ,$280.00 ,$53.38 ,$58.72 ,$70.84 ,$238.00 ,$167.27 ,$252.00 ,$235.20 ,$224.00 ,$224.00 ,$64.40 ,$182.00 ST. FRANCIS HOSPITAL - ACUTE,32000108,70220,HC SINUSES MIN 3 VIEWS,320,1 ,$781.00 ,$507.65 ,$53.38 ,$781.00 ,$562.32 ,$424.86 ,$179.63 ,$435.95 ,$179.63 ,$466.57 ,$466.57 ,$466.57 ,$466.57 ,$656.04 ,$179.63 ,$663.85 ,$656.04 ,$179.63 ,$585.75 ,$624.80 ,$624.80 ,$179.63 ,$624.80 ,$656.04 ,$656.04 ,$656.04 ,$702.90 ,$449.08 ,$179.63 ,$781.00 ,$53.38 ,$58.72 ,$197.59 ,$663.85 ,$466.57 ,$702.90 ,$656.04 ,$624.80 ,$624.80 ,$179.63 ,$507.65 ST. FRANCIS HOSPITAL - ACUTE,32000110,70250,HC SKULL LESS THAN 4 VIEWS,320,1 ,$479.00 ,$311.35 ,$53.38 ,$479.00 ,$344.88 ,$260.58 ,$110.17 ,$267.38 ,$110.17 ,$286.15 ,$286.15 ,$286.15 ,$286.15 ,$402.36 ,$110.17 ,$407.15 ,$402.36 ,$110.17 ,$359.25 ,$383.20 ,$383.20 ,$110.17 ,$383.20 ,$402.36 ,$402.36 ,$402.36 ,$431.10 ,$275.43 ,$110.17 ,$479.00 ,$53.38 ,$58.72 ,$121.19 ,$407.15 ,$286.15 ,$431.10 ,$402.36 ,$383.20 ,$383.20 ,$110.17 ,$311.35 ST. FRANCIS HOSPITAL - ACUTE,32000112,70260,HC SKULL MIN 4 VIEWS,320,1 ,$797.00 ,$518.05 ,$53.38 ,$797.00 ,$573.84 ,$433.57 ,$183.31 ,$444.89 ,$183.31 ,$476.13 ,$476.13 ,$476.13 ,$476.13 ,$669.48 ,$183.31 ,$677.45 ,$669.48 ,$183.31 ,$597.75 ,$637.60 ,$637.60 ,$183.31 ,$637.60 ,$669.48 ,$669.48 ,$669.48 ,$717.30 ,$458.28 ,$183.31 ,$797.00 ,$53.38 ,$58.72 ,$201.64 ,$677.45 ,$476.13 ,$717.30 ,$669.48 ,$637.60 ,$637.60 ,$183.31 ,$518.05 ST. FRANCIS HOSPITAL - ACUTE,32000113,70330,HC TEMPOROMANDIBULAR JOINTS BILAT,320,1 ,$781.00 ,$507.65 ,$53.38 ,$781.00 ,$562.32 ,$424.86 ,$179.63 ,$435.95 ,$179.63 ,$466.57 ,$466.57 ,$466.57 ,$466.57 ,$656.04 ,$179.63 ,$663.85 ,$656.04 ,$179.63 ,$585.75 ,$624.80 ,$624.80 ,$179.63 ,$624.80 ,$656.04 ,$656.04 ,$656.04 ,$702.90 ,$449.08 ,$179.63 ,$781.00 ,$53.38 ,$58.72 ,$197.59 ,$663.85 ,$466.57 ,$702.90 ,$656.04 ,$624.80 ,$624.80 ,$179.63 ,$507.65 ST. FRANCIS HOSPITAL - ACUTE,32000114,70336,HC MRI TMJ,320,1 ,"$3,446.00 ","$2,239.90 ",$224.25 ,"$3,446.00 ","$2,481.12 ","$1,874.62 ",$792.58 ,"$1,923.56 ",$792.58 ,"$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,894.64 ",$792.58 ,"$2,929.10 ","$2,894.64 ",$792.58 ,"$2,584.50 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,756.80 ","$2,894.64 ","$2,894.64 ","$2,894.64 ","$3,101.40 ","$1,981.45 ",$792.58 ,"$3,446.00 ",$224.25 ,$246.68 ,$871.84 ,"$2,929.10 ","$2,058.64 ","$3,101.40 ","$2,894.64 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,239.90 " ST. FRANCIS HOSPITAL - ACUTE,32000116,70360,HC XRAY NECK SOFT TISSUE,320,1 ,$138.00 ,$89.70 ,$31.74 ,$138.00 ,$99.36 ,$75.07 ,$31.74 ,$77.03 ,$31.74 ,$82.44 ,$82.44 ,$82.44 ,$82.44 ,$115.92 ,$31.74 ,$117.30 ,$115.92 ,$31.74 ,$103.50 ,$110.40 ,$110.40 ,$31.74 ,$110.40 ,$115.92 ,$115.92 ,$115.92 ,$124.20 ,$79.35 ,$31.74 ,$138.00 ,$53.38 ,$58.72 ,$34.91 ,$117.30 ,$82.44 ,$124.20 ,$115.92 ,$110.40 ,$110.40 ,$31.74 ,$89.70 ST. FRANCIS HOSPITAL - ACUTE,32000121,71045,HC XR CHEST 1V,320,1 ,$351.00 ,$228.15 ,$17.56 ,$351.00 ,$252.72 ,$190.94 ,$80.73 ,$195.93 ,$80.73 ,$209.69 ,$209.69 ,$209.69 ,$209.69 ,$294.84 ,$80.73 ,$298.35 ,$294.84 ,$80.73 ,$263.25 ,$280.80 ,$280.80 ,$80.73 ,$280.80 ,$294.84 ,$294.84 ,$294.84 ,$315.90 ,$201.83 ,$80.73 ,$17.56 ,$53.38 ,$58.72 ,$88.80 ,$298.35 ,$209.69 ,$315.90 ,$294.84 ,$280.80 ,$280.80 ,$80.73 ,$228.15 ST. FRANCIS HOSPITAL - ACUTE,32000127,71046,HC XR CHEST 2V,320,1 ,$441.00 ,$286.65 ,$23.18 ,$441.00 ,$317.52 ,$239.90 ,$101.43 ,$246.17 ,$101.43 ,$263.45 ,$263.45 ,$263.45 ,$263.45 ,$370.44 ,$101.43 ,$374.85 ,$370.44 ,$101.43 ,$330.75 ,$352.80 ,$352.80 ,$101.43 ,$352.80 ,$370.44 ,$370.44 ,$370.44 ,$396.90 ,$253.58 ,$101.43 ,$23.18 ,$53.38 ,$58.72 ,$111.57 ,$374.85 ,$263.45 ,$396.90 ,$370.44 ,$352.80 ,$352.80 ,$101.43 ,$286.65 ST. FRANCIS HOSPITAL - ACUTE,32000130,71047,HC XR CHEST 2V W/LORDOTIC,320,1 ,$441.00 ,$286.65 ,$53.38 ,$441.00 ,$317.52 ,$239.90 ,$101.43 ,$246.17 ,$101.43 ,$263.45 ,$263.45 ,$263.45 ,$263.45 ,$370.44 ,$101.43 ,$374.85 ,$370.44 ,$101.43 ,$330.75 ,$352.80 ,$352.80 ,$101.43 ,$352.80 ,$370.44 ,$370.44 ,$370.44 ,$396.90 ,$253.58 ,$101.43 ,$441.00 ,$53.38 ,$58.72 ,$111.57 ,$374.85 ,$263.45 ,$396.90 ,$370.44 ,$352.80 ,$352.80 ,$101.43 ,$286.65 ST. FRANCIS HOSPITAL - ACUTE,32000133,71048,HC XR CHEST 4+V,320,1 ,$485.00 ,$315.25 ,$53.38 ,$485.00 ,$349.20 ,$263.84 ,$111.55 ,$270.73 ,$111.55 ,$289.74 ,$289.74 ,$289.74 ,$289.74 ,$407.40 ,$111.55 ,$412.25 ,$407.40 ,$111.55 ,$363.75 ,$388.00 ,$388.00 ,$111.55 ,$388.00 ,$407.40 ,$407.40 ,$407.40 ,$436.50 ,$278.88 ,$111.55 ,$485.00 ,$53.38 ,$58.72 ,$122.71 ,$412.25 ,$289.74 ,$436.50 ,$407.40 ,$388.00 ,$388.00 ,$111.55 ,$315.25 ST. FRANCIS HOSPITAL - ACUTE,32000135,71046,HC XR CHEST SPECIAL VIEWS,320,1 ,$441.00 ,$286.65 ,$23.18 ,$441.00 ,$317.52 ,$239.90 ,$101.43 ,$246.17 ,$101.43 ,$263.45 ,$263.45 ,$263.45 ,$263.45 ,$370.44 ,$101.43 ,$374.85 ,$370.44 ,$101.43 ,$330.75 ,$352.80 ,$352.80 ,$101.43 ,$352.80 ,$370.44 ,$370.44 ,$370.44 ,$396.90 ,$253.58 ,$101.43 ,$23.18 ,$53.38 ,$58.72 ,$111.57 ,$374.85 ,$263.45 ,$396.90 ,$370.44 ,$352.80 ,$352.80 ,$101.43 ,$286.65 ST. FRANCIS HOSPITAL - ACUTE,32000137,71100,HC XR RIBS 2V UNI,320,1 ,$479.00 ,$311.35 ,$53.38 ,$479.00 ,$344.88 ,$260.58 ,$110.17 ,$267.38 ,$110.17 ,$286.15 ,$286.15 ,$286.15 ,$286.15 ,$402.36 ,$110.17 ,$407.15 ,$402.36 ,$110.17 ,$359.25 ,$383.20 ,$383.20 ,$110.17 ,$383.20 ,$402.36 ,$402.36 ,$402.36 ,$431.10 ,$275.43 ,$110.17 ,$479.00 ,$53.38 ,$58.72 ,$121.19 ,$407.15 ,$286.15 ,$431.10 ,$402.36 ,$383.20 ,$383.20 ,$110.17 ,$311.35 ST. FRANCIS HOSPITAL - ACUTE,32000138,71101,HC XR RIBS W/CXR 3+V UNI,320,1 ,$665.00 ,$432.25 ,$53.38 ,$665.00 ,$478.80 ,$361.76 ,$152.95 ,$371.20 ,$152.95 ,$397.27 ,$397.27 ,$397.27 ,$397.27 ,$558.60 ,$152.95 ,$565.25 ,$558.60 ,$152.95 ,$498.75 ,$532.00 ,$532.00 ,$152.95 ,$532.00 ,$558.60 ,$558.60 ,$558.60 ,$598.50 ,$382.38 ,$152.95 ,$665.00 ,$53.38 ,$58.72 ,$168.25 ,$565.25 ,$397.27 ,$598.50 ,$558.60 ,$532.00 ,$532.00 ,$152.95 ,$432.25 ST. FRANCIS HOSPITAL - ACUTE,32000139,71110,HC XR RIBS 3 V BIL,320,1 ,$781.00 ,$507.65 ,$53.38 ,$781.00 ,$562.32 ,$424.86 ,$179.63 ,$435.95 ,$179.63 ,$466.57 ,$466.57 ,$466.57 ,$466.57 ,$656.04 ,$179.63 ,$663.85 ,$656.04 ,$179.63 ,$585.75 ,$624.80 ,$624.80 ,$179.63 ,$624.80 ,$656.04 ,$656.04 ,$656.04 ,$702.90 ,$449.08 ,$179.63 ,$781.00 ,$53.38 ,$58.72 ,$197.59 ,$663.85 ,$466.57 ,$702.90 ,$656.04 ,$624.80 ,$624.80 ,$179.63 ,$507.65 ST. FRANCIS HOSPITAL - ACUTE,32000140,71111,HC XR RIBS W/CXR 4+V BI,320,1 ,$781.00 ,$507.65 ,$53.38 ,$781.00 ,$562.32 ,$424.86 ,$179.63 ,$435.95 ,$179.63 ,$466.57 ,$466.57 ,$466.57 ,$466.57 ,$656.04 ,$179.63 ,$663.85 ,$656.04 ,$179.63 ,$585.75 ,$624.80 ,$624.80 ,$179.63 ,$624.80 ,$656.04 ,$656.04 ,$656.04 ,$702.90 ,$449.08 ,$179.63 ,$781.00 ,$53.38 ,$58.72 ,$197.59 ,$663.85 ,$466.57 ,$702.90 ,$656.04 ,$624.80 ,$624.80 ,$179.63 ,$507.65 ST. FRANCIS HOSPITAL - ACUTE,32000141,71120,HC XR STERNUM 2+V,320,1 ,$479.00 ,$311.35 ,$53.38 ,$479.00 ,$344.88 ,$260.58 ,$110.17 ,$267.38 ,$110.17 ,$286.15 ,$286.15 ,$286.15 ,$286.15 ,$402.36 ,$110.17 ,$407.15 ,$402.36 ,$110.17 ,$359.25 ,$383.20 ,$383.20 ,$110.17 ,$383.20 ,$402.36 ,$402.36 ,$402.36 ,$431.10 ,$275.43 ,$110.17 ,$479.00 ,$53.38 ,$58.72 ,$121.19 ,$407.15 ,$286.15 ,$431.10 ,$402.36 ,$383.20 ,$383.20 ,$110.17 ,$311.35 ST. FRANCIS HOSPITAL - ACUTE,32000142,71130,HC XR STERNOCLAVIC JT 3+V,320,1 ,$634.00 ,$412.10 ,$53.38 ,$634.00 ,$456.48 ,$344.90 ,$145.82 ,$353.90 ,$145.82 ,$378.75 ,$378.75 ,$378.75 ,$378.75 ,$532.56 ,$145.82 ,$538.90 ,$532.56 ,$145.82 ,$475.50 ,$507.20 ,$507.20 ,$145.82 ,$507.20 ,$532.56 ,$532.56 ,$532.56 ,$570.60 ,$364.55 ,$145.82 ,$634.00 ,$53.38 ,$58.72 ,$160.40 ,$538.90 ,$378.75 ,$570.60 ,$532.56 ,$507.20 ,$507.20 ,$145.82 ,$412.10 ST. FRANCIS HOSPITAL - ACUTE,32000144,71250,HC CT CHEST W/O CONTRAST,350,1 ,"$2,513.00 ","$1,633.45 ",$133.17 ,"$2,513.00 ","$1,809.36 ","$1,367.07 ",$577.99 ,"$1,402.76 ",$577.99 ,"$1,501.27 ","$1,501.27 ","$1,501.27 ","$1,501.27 ","$2,110.92 ",$577.99 ,"$2,136.05 ","$2,110.92 ",$577.99 ,"$1,884.75 ","$2,010.40 ","$2,010.40 ",$577.99 ,"$2,010.40 ","$2,110.92 ","$2,110.92 ","$2,110.92 ","$2,261.70 ","$1,444.98 ",$577.99 ,"$2,513.00 ",$133.17 ,$146.49 ,$635.79 ,"$2,136.05 ","$1,501.27 ","$2,261.70 ","$2,110.92 ","$2,010.40 ","$2,010.40 ",$577.99 ,"$1,633.45 " ST. FRANCIS HOSPITAL - ACUTE,32000146,71260,HC CT CHEST W/CONTRAST,350,1 ,"$3,031.00 ","$1,970.15 ",$133.17 ,"$3,031.00 ","$2,182.32 ","$1,648.86 ",$697.13 ,"$1,691.90 ",$697.13 ,"$1,810.72 ","$1,810.72 ","$1,810.72 ","$1,810.72 ","$2,546.04 ",$697.13 ,"$2,576.35 ","$2,546.04 ",$697.13 ,"$2,273.25 ","$2,424.80 ","$2,424.80 ",$697.13 ,"$2,424.80 ","$2,546.04 ","$2,546.04 ","$2,546.04 ","$2,727.90 ","$1,742.83 ",$697.13 ,"$3,031.00 ",$133.17 ,$146.49 ,$766.84 ,"$2,576.35 ","$1,810.72 ","$2,727.90 ","$2,546.04 ","$2,424.80 ","$2,424.80 ",$697.13 ,"$1,970.15 " ST. FRANCIS HOSPITAL - ACUTE,32000148,71270,HC CT CHEST W AND W/O CONTRAST,350,1 ,"$3,333.00 ","$2,166.45 ",$133.17 ,"$3,333.00 ","$2,399.76 ","$1,813.15 ",$766.59 ,"$1,860.48 ",$766.59 ,"$1,991.13 ","$1,991.13 ","$1,991.13 ","$1,991.13 ","$2,799.72 ",$766.59 ,"$2,833.05 ","$2,799.72 ",$766.59 ,"$2,499.75 ","$2,666.40 ","$2,666.40 ",$766.59 ,"$2,666.40 ","$2,799.72 ","$2,799.72 ","$2,799.72 ","$2,999.70 ","$1,916.48 ",$766.59 ,"$3,333.00 ",$133.17 ,$146.49 ,$843.25 ,"$2,833.05 ","$1,991.13 ","$2,999.70 ","$2,799.72 ","$2,666.40 ","$2,666.40 ",$766.59 ,"$2,166.45 " ST. FRANCIS HOSPITAL - ACUTE,32000150,71275,HC CTA CHEST W AND W/O CONTRAST,350,1 ,"$3,820.00 ","$2,483.00 ",$300.96 ,"$3,820.00 ","$2,750.40 ","$2,078.08 ",$878.60 ,"$2,132.32 ",$878.60 ,"$2,282.07 ","$2,282.07 ","$2,282.07 ","$2,282.07 ","$3,208.80 ",$878.60 ,"$3,247.00 ","$3,208.80 ",$878.60 ,"$2,865.00 ","$3,056.00 ","$3,056.00 ",$878.60 ,"$3,056.00 ","$3,208.80 ","$3,208.80 ","$3,208.80 ","$3,438.00 ","$2,196.50 ",$878.60 ,"$3,820.00 ",$300.96 ,$331.06 ,$966.46 ,"$3,247.00 ","$2,282.07 ","$3,438.00 ","$3,208.80 ","$3,056.00 ","$3,056.00 ",$878.60 ,"$2,483.00 " ST. FRANCIS HOSPITAL - ACUTE,32000151,71550,HC MRI CHEST W/O CON,610,1 ,"$3,446.00 ","$2,239.90 ",$456.75 ,"$3,446.00 ","$2,481.12 ","$1,874.62 ",$792.58 ,"$1,923.56 ",$792.58 ,"$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,894.64 ",$792.58 ,"$2,929.10 ","$2,894.64 ",$792.58 ,"$2,584.50 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,756.80 ","$2,894.64 ","$2,894.64 ","$2,894.64 ","$3,101.40 ","$1,981.45 ",$792.58 ,"$3,446.00 ",$456.75 ,$502.43 ,$871.84 ,"$2,929.10 ","$2,058.64 ","$3,101.40 ","$2,894.64 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,239.90 " ST. FRANCIS HOSPITAL - ACUTE,32000152,71551,HC MRI CHEST W/CONTRAST,610,1 ,"$3,673.00 ","$2,387.45 ",$456.75 ,"$3,673.00 ","$2,644.56 ","$1,998.11 ",$844.79 ,"$2,050.27 ",$844.79 ,"$2,194.25 ","$2,194.25 ","$2,194.25 ","$2,194.25 ","$3,085.32 ",$844.79 ,"$3,122.05 ","$3,085.32 ",$844.79 ,"$2,754.75 ","$2,938.40 ","$2,938.40 ",$844.79 ,"$2,938.40 ","$3,085.32 ","$3,085.32 ","$3,085.32 ","$3,305.70 ","$2,111.98 ",$844.79 ,"$3,673.00 ",$456.75 ,$502.43 ,$929.27 ,"$3,122.05 ","$2,194.25 ","$3,305.70 ","$3,085.32 ","$2,938.40 ","$2,938.40 ",$844.79 ,"$2,387.45 " ST. FRANCIS HOSPITAL - ACUTE,32000153,71552,HC MRI CHEST W AND W/O CONTRAST,610,1 ,"$3,919.00 ","$2,547.35 ",$456.75 ,"$3,919.00 ","$2,821.68 ","$2,131.94 ",$901.37 ,"$2,187.59 ",$901.37 ,"$2,341.21 ","$2,341.21 ","$2,341.21 ","$2,341.21 ","$3,291.96 ",$901.37 ,"$3,331.15 ","$3,291.96 ",$901.37 ,"$2,939.25 ","$3,135.20 ","$3,135.20 ",$901.37 ,"$3,135.20 ","$3,291.96 ","$3,291.96 ","$3,291.96 ","$3,527.10 ","$2,253.43 ",$901.37 ,"$3,919.00 ",$456.75 ,$502.43 ,$991.51 ,"$3,331.15 ","$2,341.21 ","$3,527.10 ","$3,291.96 ","$3,135.20 ","$3,135.20 ",$901.37 ,"$2,547.35 " ST. FRANCIS HOSPITAL - ACUTE,32000155,72020,HC XR SPINE 1V ANY LEVEL,320,1 ,$179.00 ,$116.35 ,$41.17 ,$179.00 ,$128.88 ,$97.38 ,$41.17 ,$99.92 ,$41.17 ,$106.93 ,$106.93 ,$106.93 ,$106.93 ,$150.36 ,$41.17 ,$152.15 ,$150.36 ,$41.17 ,$134.25 ,$143.20 ,$143.20 ,$41.17 ,$143.20 ,$150.36 ,$150.36 ,$150.36 ,$161.10 ,$102.93 ,$41.17 ,$179.00 ,$53.38 ,$58.72 ,$45.29 ,$152.15 ,$106.93 ,$161.10 ,$150.36 ,$143.20 ,$143.20 ,$41.17 ,$116.35 ST. FRANCIS HOSPITAL - ACUTE,32000164,72040,HC XR C-SPINE 2-3V,320,1 ,$487.00 ,$316.55 ,$53.38 ,$487.00 ,$350.64 ,$264.93 ,$112.01 ,$271.84 ,$112.01 ,$290.93 ,$290.93 ,$290.93 ,$290.93 ,$409.08 ,$112.01 ,$413.95 ,$409.08 ,$112.01 ,$365.25 ,$389.60 ,$389.60 ,$112.01 ,$389.60 ,$409.08 ,$409.08 ,$409.08 ,$438.30 ,$280.03 ,$112.01 ,$487.00 ,$53.38 ,$58.72 ,$123.21 ,$413.95 ,$290.93 ,$438.30 ,$409.08 ,$389.60 ,$389.60 ,$112.01 ,$316.55 ST. FRANCIS HOSPITAL - ACUTE,32000168,72050,HC XR C-SPINE 4-5 VIEW,320,1 ,$781.00 ,$507.65 ,$53.38 ,$781.00 ,$562.32 ,$424.86 ,$179.63 ,$435.95 ,$179.63 ,$466.57 ,$466.57 ,$466.57 ,$466.57 ,$656.04 ,$179.63 ,$663.85 ,$656.04 ,$179.63 ,$585.75 ,$624.80 ,$624.80 ,$179.63 ,$624.80 ,$656.04 ,$656.04 ,$656.04 ,$702.90 ,$449.08 ,$179.63 ,$781.00 ,$53.38 ,$58.72 ,$197.59 ,$663.85 ,$466.57 ,$702.90 ,$656.04 ,$624.80 ,$624.80 ,$179.63 ,$507.65 ST. FRANCIS HOSPITAL - ACUTE,32000170,72052,HC XR C-SPINE 6+ VIEWS,320,1 ,"$1,094.00 ",$711.10 ,$53.38 ,"$1,094.00 ",$787.68 ,$595.14 ,$251.62 ,$610.67 ,$251.62 ,$653.56 ,$653.56 ,$653.56 ,$653.56 ,$918.96 ,$251.62 ,$929.90 ,$918.96 ,$251.62 ,$820.50 ,$875.20 ,$875.20 ,$251.62 ,$875.20 ,$918.96 ,$918.96 ,$918.96 ,$984.60 ,$629.05 ,$251.62 ,"$1,094.00 ",$53.38 ,$58.72 ,$276.78 ,$929.90 ,$653.56 ,$984.60 ,$918.96 ,$875.20 ,$875.20 ,$251.62 ,$711.10 ST. FRANCIS HOSPITAL - ACUTE,32000172,72070,HC XR T-SPINE 2V,320,1 ,$420.00 ,$273.00 ,$53.38 ,$420.00 ,$302.40 ,$228.48 ,$96.60 ,$234.44 ,$96.60 ,$250.91 ,$250.91 ,$250.91 ,$250.91 ,$352.80 ,$96.60 ,$357.00 ,$352.80 ,$96.60 ,$315.00 ,$336.00 ,$336.00 ,$96.60 ,$336.00 ,$352.80 ,$352.80 ,$352.80 ,$378.00 ,$241.50 ,$96.60 ,$420.00 ,$53.38 ,$58.72 ,$106.26 ,$357.00 ,$250.91 ,$378.00 ,$352.80 ,$336.00 ,$336.00 ,$96.60 ,$273.00 ST. FRANCIS HOSPITAL - ACUTE,32000174,72072,HC XR T-SPINE 3V,320,1 ,$470.00 ,$305.50 ,$53.38 ,$470.00 ,$338.40 ,$255.68 ,$108.10 ,$262.35 ,$108.10 ,$280.78 ,$280.78 ,$280.78 ,$280.78 ,$394.80 ,$108.10 ,$399.50 ,$394.80 ,$108.10 ,$352.50 ,$376.00 ,$376.00 ,$108.10 ,$376.00 ,$394.80 ,$394.80 ,$394.80 ,$423.00 ,$270.25 ,$108.10 ,$470.00 ,$53.38 ,$58.72 ,$118.91 ,$399.50 ,$280.78 ,$423.00 ,$394.80 ,$376.00 ,$376.00 ,$108.10 ,$305.50 ST. FRANCIS HOSPITAL - ACUTE,32000178,72100,HC XR L-SPINE 2-3V,320,1 ,$487.00 ,$316.55 ,$53.38 ,$487.00 ,$350.64 ,$264.93 ,$112.01 ,$271.84 ,$112.01 ,$290.93 ,$290.93 ,$290.93 ,$290.93 ,$409.08 ,$112.01 ,$413.95 ,$409.08 ,$112.01 ,$365.25 ,$389.60 ,$389.60 ,$112.01 ,$389.60 ,$409.08 ,$409.08 ,$409.08 ,$438.30 ,$280.03 ,$112.01 ,$487.00 ,$53.38 ,$58.72 ,$123.21 ,$413.95 ,$290.93 ,$438.30 ,$409.08 ,$389.60 ,$389.60 ,$112.01 ,$316.55 ST. FRANCIS HOSPITAL - ACUTE,32000181,72110,HC XR L-SPINE 4+V,320,1 ,$996.00 ,$647.40 ,$53.38 ,$996.00 ,$717.12 ,$541.82 ,$229.08 ,$555.97 ,$229.08 ,$595.01 ,$595.01 ,$595.01 ,$595.01 ,$836.64 ,$229.08 ,$846.60 ,$836.64 ,$229.08 ,$747.00 ,$796.80 ,$796.80 ,$229.08 ,$796.80 ,$836.64 ,$836.64 ,$836.64 ,$896.40 ,$572.70 ,$229.08 ,$996.00 ,$53.38 ,$58.72 ,$251.99 ,$846.60 ,$595.01 ,$896.40 ,$836.64 ,$796.80 ,$796.80 ,$229.08 ,$647.40 ST. FRANCIS HOSPITAL - ACUTE,32000184,72114,HC XR L-SPINE CMPL W/BEND MIN 6 VIEW,320,1 ,"$1,237.00 ",$804.05 ,$53.38 ,"$1,237.00 ",$890.64 ,$672.93 ,$284.51 ,$690.49 ,$284.51 ,$738.98 ,$738.98 ,$738.98 ,$738.98 ,"$1,039.08 ",$284.51 ,"$1,051.45 ","$1,039.08 ",$284.51 ,$927.75 ,$989.60 ,$989.60 ,$284.51 ,$989.60 ,"$1,039.08 ","$1,039.08 ","$1,039.08 ","$1,113.30 ",$711.28 ,$284.51 ,"$1,237.00 ",$53.38 ,$58.72 ,$312.96 ,"$1,051.45 ",$738.98 ,"$1,113.30 ","$1,039.08 ",$989.60 ,$989.60 ,$284.51 ,$804.05 ST. FRANCIS HOSPITAL - ACUTE,32000186,72170,HC XR PELVIS 1-2V,320,1 ,$479.00 ,$311.35 ,$53.38 ,$479.00 ,$344.88 ,$260.58 ,$110.17 ,$267.38 ,$110.17 ,$286.15 ,$286.15 ,$286.15 ,$286.15 ,$402.36 ,$110.17 ,$407.15 ,$402.36 ,$110.17 ,$359.25 ,$383.20 ,$383.20 ,$110.17 ,$383.20 ,$402.36 ,$402.36 ,$402.36 ,$431.10 ,$275.43 ,$110.17 ,$479.00 ,$53.38 ,$58.72 ,$121.19 ,$407.15 ,$286.15 ,$431.10 ,$402.36 ,$383.20 ,$383.20 ,$110.17 ,$311.35 ST. FRANCIS HOSPITAL - ACUTE,32000189,72190,HC XR PELVIS CMPL 3+V,320,1 ,$856.00 ,$556.40 ,$53.38 ,$856.00 ,$616.32 ,$465.66 ,$196.88 ,$477.82 ,$196.88 ,$511.37 ,$511.37 ,$511.37 ,$511.37 ,$719.04 ,$196.88 ,$727.60 ,$719.04 ,$196.88 ,$642.00 ,$684.80 ,$684.80 ,$196.88 ,$684.80 ,$719.04 ,$719.04 ,$719.04 ,$770.40 ,$492.20 ,$196.88 ,$856.00 ,$53.38 ,$58.72 ,$216.57 ,$727.60 ,$511.37 ,$770.40 ,$719.04 ,$684.80 ,$684.80 ,$196.88 ,$556.40 ST. FRANCIS HOSPITAL - ACUTE,32000190,72202,HC XR SACROILI JT 3+V,320,1 ,$634.00 ,$412.10 ,$53.38 ,$634.00 ,$456.48 ,$344.90 ,$145.82 ,$353.90 ,$145.82 ,$378.75 ,$378.75 ,$378.75 ,$378.75 ,$532.56 ,$145.82 ,$538.90 ,$532.56 ,$145.82 ,$475.50 ,$507.20 ,$507.20 ,$145.82 ,$507.20 ,$532.56 ,$532.56 ,$532.56 ,$570.60 ,$364.55 ,$145.82 ,$634.00 ,$53.38 ,$58.72 ,$160.40 ,$538.90 ,$378.75 ,$570.60 ,$532.56 ,$507.20 ,$507.20 ,$145.82 ,$412.10 ST. FRANCIS HOSPITAL - ACUTE,32000191,72220,HC XR SACRUM/COCCYX 2+V,320,1 ,$479.00 ,$311.35 ,$53.38 ,$479.00 ,$344.88 ,$260.58 ,$110.17 ,$267.38 ,$110.17 ,$286.15 ,$286.15 ,$286.15 ,$286.15 ,$402.36 ,$110.17 ,$407.15 ,$402.36 ,$110.17 ,$359.25 ,$383.20 ,$383.20 ,$110.17 ,$383.20 ,$402.36 ,$402.36 ,$402.36 ,$431.10 ,$275.43 ,$110.17 ,$479.00 ,$53.38 ,$58.72 ,$121.19 ,$407.15 ,$286.15 ,$431.10 ,$402.36 ,$383.20 ,$383.20 ,$110.17 ,$311.35 ST. FRANCIS HOSPITAL - ACUTE,32000201,73000,HC XRAY CLAVICLE,320,1 ,$461.00 ,$299.65 ,$53.38 ,$461.00 ,$331.92 ,$250.78 ,$106.03 ,$257.33 ,$106.03 ,$275.40 ,$275.40 ,$275.40 ,$275.40 ,$387.24 ,$106.03 ,$391.85 ,$387.24 ,$106.03 ,$345.75 ,$368.80 ,$368.80 ,$106.03 ,$368.80 ,$387.24 ,$387.24 ,$387.24 ,$414.90 ,$265.08 ,$106.03 ,$461.00 ,$53.38 ,$58.72 ,$116.63 ,$391.85 ,$275.40 ,$414.90 ,$387.24 ,$368.80 ,$368.80 ,$106.03 ,$299.65 ST. FRANCIS HOSPITAL - ACUTE,32000201,73000,HC XRAY CLAVICLE,320,1 ,$911.00 ,$592.15 ,$53.38 ,$911.00 ,$655.92 ,$495.58 ,$209.53 ,$508.52 ,$209.53 ,$544.23 ,$544.23 ,$544.23 ,$544.23 ,$765.24 ,$209.53 ,$774.35 ,$765.24 ,$209.53 ,$683.25 ,$728.80 ,$728.80 ,$209.53 ,$728.80 ,$765.24 ,$765.24 ,$765.24 ,$819.90 ,$523.83 ,$209.53 ,$911.00 ,$53.38 ,$58.72 ,$230.48 ,$774.35 ,$544.23 ,$819.90 ,$765.24 ,$728.80 ,$728.80 ,$209.53 ,$592.15 ST. FRANCIS HOSPITAL - ACUTE,32000204,73010,HC XRAY SCAPULA,320,1 ,$479.00 ,$311.35 ,$53.38 ,$479.00 ,$344.88 ,$260.58 ,$110.17 ,$267.38 ,$110.17 ,$286.15 ,$286.15 ,$286.15 ,$286.15 ,$402.36 ,$110.17 ,$407.15 ,$402.36 ,$110.17 ,$359.25 ,$383.20 ,$383.20 ,$110.17 ,$383.20 ,$402.36 ,$402.36 ,$402.36 ,$431.10 ,$275.43 ,$110.17 ,$479.00 ,$53.38 ,$58.72 ,$121.19 ,$407.15 ,$286.15 ,$431.10 ,$402.36 ,$383.20 ,$383.20 ,$110.17 ,$311.35 ST. FRANCIS HOSPITAL - ACUTE,32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$314.00 ,$204.10 ,$53.38 ,$314.00 ,$226.08 ,$170.82 ,$72.22 ,$175.27 ,$72.22 ,$187.58 ,$187.58 ,$187.58 ,$187.58 ,$263.76 ,$72.22 ,$266.90 ,$263.76 ,$72.22 ,$235.50 ,$251.20 ,$251.20 ,$72.22 ,$251.20 ,$263.76 ,$263.76 ,$263.76 ,$282.60 ,$180.55 ,$72.22 ,$314.00 ,$53.38 ,$58.72 ,$79.44 ,$266.90 ,$187.58 ,$282.60 ,$263.76 ,$251.20 ,$251.20 ,$72.22 ,$204.10 ST. FRANCIS HOSPITAL - ACUTE,32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$539.00 ,$350.35 ,$53.38 ,$539.00 ,$388.08 ,$293.22 ,$123.97 ,$300.87 ,$123.97 ,$322.00 ,$322.00 ,$322.00 ,$322.00 ,$452.76 ,$123.97 ,$458.15 ,$452.76 ,$123.97 ,$404.25 ,$431.20 ,$431.20 ,$123.97 ,$431.20 ,$452.76 ,$452.76 ,$452.76 ,$485.10 ,$309.93 ,$123.97 ,$539.00 ,$53.38 ,$58.72 ,$136.37 ,$458.15 ,$322.00 ,$485.10 ,$452.76 ,$431.20 ,$431.20 ,$123.97 ,$350.35 ST. FRANCIS HOSPITAL - ACUTE,32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$947.00 ,$615.55 ,$53.38 ,$947.00 ,$681.84 ,$515.17 ,$217.81 ,$528.62 ,$217.81 ,$565.74 ,$565.74 ,$565.74 ,$565.74 ,$795.48 ,$217.81 ,$804.95 ,$795.48 ,$217.81 ,$710.25 ,$757.60 ,$757.60 ,$217.81 ,$757.60 ,$795.48 ,$795.48 ,$795.48 ,$852.30 ,$544.53 ,$217.81 ,$947.00 ,$53.38 ,$58.72 ,$239.59 ,$804.95 ,$565.74 ,$852.30 ,$795.48 ,$757.60 ,$757.60 ,$217.81 ,$615.55 ST. FRANCIS HOSPITAL - ACUTE,32000212,73040,HC XRAY SHOULDER ARTHRO,320,1 ,"$1,018.00 ",$661.70 ,$234.14 ,"$1,018.00 ",$732.96 ,$553.79 ,$234.14 ,$568.25 ,$234.14 ,$608.15 ,$608.15 ,$608.15 ,$608.15 ,$855.12 ,$234.14 ,$865.30 ,$855.12 ,$234.14 ,$763.50 ,$814.40 ,$814.40 ,$234.14 ,$814.40 ,$855.12 ,$855.12 ,$855.12 ,$916.20 ,$585.35 ,$234.14 ,"$1,018.00 ",$304.16 ,$334.58 ,$257.55 ,$865.30 ,$608.15 ,$916.20 ,$855.12 ,$814.40 ,$814.40 ,$234.14 ,$661.70 ST. FRANCIS HOSPITAL - ACUTE,32000213,73050,HC XR AC JOINTS BI W/W/O WTS,320,1 ,$634.00 ,$412.10 ,$53.38 ,$634.00 ,$456.48 ,$344.90 ,$145.82 ,$353.90 ,$145.82 ,$378.75 ,$378.75 ,$378.75 ,$378.75 ,$532.56 ,$145.82 ,$538.90 ,$532.56 ,$145.82 ,$475.50 ,$507.20 ,$507.20 ,$145.82 ,$507.20 ,$532.56 ,$532.56 ,$532.56 ,$570.60 ,$364.55 ,$145.82 ,$634.00 ,$53.38 ,$58.72 ,$160.40 ,$538.90 ,$378.75 ,$570.60 ,$532.56 ,$507.20 ,$507.20 ,$145.82 ,$412.10 ST. FRANCIS HOSPITAL - ACUTE,32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$483.00 ,$313.95 ,$53.38 ,$483.00 ,$347.76 ,$262.75 ,$111.09 ,$269.61 ,$111.09 ,$288.54 ,$288.54 ,$288.54 ,$288.54 ,$405.72 ,$111.09 ,$410.55 ,$405.72 ,$111.09 ,$362.25 ,$386.40 ,$386.40 ,$111.09 ,$386.40 ,$405.72 ,$405.72 ,$405.72 ,$434.70 ,$277.73 ,$111.09 ,$483.00 ,$53.38 ,$58.72 ,$122.20 ,$410.55 ,$288.54 ,$434.70 ,$405.72 ,$386.40 ,$386.40 ,$111.09 ,$313.95 ST. FRANCIS HOSPITAL - ACUTE,32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$862.00 ,$560.30 ,$53.38 ,$862.00 ,$620.64 ,$468.93 ,$198.26 ,$481.17 ,$198.26 ,$514.96 ,$514.96 ,$514.96 ,$514.96 ,$724.08 ,$198.26 ,$732.70 ,$724.08 ,$198.26 ,$646.50 ,$689.60 ,$689.60 ,$198.26 ,$689.60 ,$724.08 ,$724.08 ,$724.08 ,$775.80 ,$495.65 ,$198.26 ,$862.00 ,$53.38 ,$58.72 ,$218.09 ,$732.70 ,$514.96 ,$775.80 ,$724.08 ,$689.60 ,$689.60 ,$198.26 ,$560.30 ST. FRANCIS HOSPITAL - ACUTE,32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$314.00 ,$204.10 ,$53.38 ,$314.00 ,$226.08 ,$170.82 ,$72.22 ,$175.27 ,$72.22 ,$187.58 ,$187.58 ,$187.58 ,$187.58 ,$263.76 ,$72.22 ,$266.90 ,$263.76 ,$72.22 ,$235.50 ,$251.20 ,$251.20 ,$72.22 ,$251.20 ,$263.76 ,$263.76 ,$263.76 ,$282.60 ,$180.55 ,$72.22 ,$314.00 ,$53.38 ,$58.72 ,$79.44 ,$266.90 ,$187.58 ,$282.60 ,$263.76 ,$251.20 ,$251.20 ,$72.22 ,$204.10 ST. FRANCIS HOSPITAL - ACUTE,32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$484.00 ,$314.60 ,$53.38 ,$484.00 ,$348.48 ,$263.30 ,$111.32 ,$270.17 ,$111.32 ,$289.14 ,$289.14 ,$289.14 ,$289.14 ,$406.56 ,$111.32 ,$411.40 ,$406.56 ,$111.32 ,$363.00 ,$387.20 ,$387.20 ,$111.32 ,$387.20 ,$406.56 ,$406.56 ,$406.56 ,$435.60 ,$278.30 ,$111.32 ,$484.00 ,$53.38 ,$58.72 ,$122.45 ,$411.40 ,$289.14 ,$435.60 ,$406.56 ,$387.20 ,$387.20 ,$111.32 ,$314.60 ST. FRANCIS HOSPITAL - ACUTE,32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$957.00 ,$622.05 ,$53.38 ,$957.00 ,$689.04 ,$520.61 ,$220.11 ,$534.20 ,$220.11 ,$571.71 ,$571.71 ,$571.71 ,$571.71 ,$803.88 ,$220.11 ,$813.45 ,$803.88 ,$220.11 ,$717.75 ,$765.60 ,$765.60 ,$220.11 ,$765.60 ,$803.88 ,$803.88 ,$803.88 ,$861.30 ,$550.28 ,$220.11 ,$957.00 ,$53.38 ,$58.72 ,$242.12 ,$813.45 ,$571.71 ,$861.30 ,$803.88 ,$765.60 ,$765.60 ,$220.11 ,$622.05 ST. FRANCIS HOSPITAL - ACUTE,32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$314.00 ,$204.10 ,$53.38 ,$314.00 ,$226.08 ,$170.82 ,$72.22 ,$175.27 ,$72.22 ,$187.58 ,$187.58 ,$187.58 ,$187.58 ,$263.76 ,$72.22 ,$266.90 ,$263.76 ,$72.22 ,$235.50 ,$251.20 ,$251.20 ,$72.22 ,$251.20 ,$263.76 ,$263.76 ,$263.76 ,$282.60 ,$180.55 ,$72.22 ,$314.00 ,$53.38 ,$58.72 ,$79.44 ,$266.90 ,$187.58 ,$282.60 ,$263.76 ,$251.20 ,$251.20 ,$72.22 ,$204.10 ST. FRANCIS HOSPITAL - ACUTE,32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$628.00 ,$408.20 ,$53.38 ,$628.00 ,$452.16 ,$341.63 ,$144.44 ,$350.55 ,$144.44 ,$375.17 ,$375.17 ,$375.17 ,$375.17 ,$527.52 ,$144.44 ,$533.80 ,$527.52 ,$144.44 ,$471.00 ,$502.40 ,$502.40 ,$144.44 ,$502.40 ,$527.52 ,$527.52 ,$527.52 ,$565.20 ,$361.10 ,$144.44 ,$628.00 ,$53.38 ,$58.72 ,$158.88 ,$533.80 ,$375.17 ,$565.20 ,$527.52 ,$502.40 ,$502.40 ,$144.44 ,$408.20 ST. FRANCIS HOSPITAL - ACUTE,32000226,73092,HC XRAY INFANT UP EXTRM MIN 2V,320,1 ,$456.00 ,$296.40 ,$53.38 ,$456.00 ,$328.32 ,$248.06 ,$104.88 ,$254.54 ,$104.88 ,$272.41 ,$272.41 ,$272.41 ,$272.41 ,$383.04 ,$104.88 ,$387.60 ,$383.04 ,$104.88 ,$342.00 ,$364.80 ,$364.80 ,$104.88 ,$364.80 ,$383.04 ,$383.04 ,$383.04 ,$410.40 ,$262.20 ,$104.88 ,$456.00 ,$53.38 ,$58.72 ,$115.37 ,$387.60 ,$272.41 ,$410.40 ,$383.04 ,$364.80 ,$364.80 ,$104.88 ,$296.40 ST. FRANCIS HOSPITAL - ACUTE,32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$314.00 ,$204.10 ,$53.38 ,$314.00 ,$226.08 ,$170.82 ,$72.22 ,$175.27 ,$72.22 ,$187.58 ,$187.58 ,$187.58 ,$187.58 ,$263.76 ,$72.22 ,$266.90 ,$263.76 ,$72.22 ,$235.50 ,$251.20 ,$251.20 ,$72.22 ,$251.20 ,$263.76 ,$263.76 ,$263.76 ,$282.60 ,$180.55 ,$72.22 ,$314.00 ,$53.38 ,$58.72 ,$79.44 ,$266.90 ,$187.58 ,$282.60 ,$263.76 ,$251.20 ,$251.20 ,$72.22 ,$204.10 ST. FRANCIS HOSPITAL - ACUTE,32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$474.00 ,$308.10 ,$53.38 ,$474.00 ,$341.28 ,$257.86 ,$109.02 ,$264.59 ,$109.02 ,$283.17 ,$283.17 ,$283.17 ,$283.17 ,$398.16 ,$109.02 ,$402.90 ,$398.16 ,$109.02 ,$355.50 ,$379.20 ,$379.20 ,$109.02 ,$379.20 ,$398.16 ,$398.16 ,$398.16 ,$426.60 ,$272.55 ,$109.02 ,$474.00 ,$53.38 ,$58.72 ,$119.92 ,$402.90 ,$283.17 ,$426.60 ,$398.16 ,$379.20 ,$379.20 ,$109.02 ,$308.10 ST. FRANCIS HOSPITAL - ACUTE,32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$947.00 ,$615.55 ,$53.38 ,$947.00 ,$681.84 ,$515.17 ,$217.81 ,$528.62 ,$217.81 ,$565.74 ,$565.74 ,$565.74 ,$565.74 ,$795.48 ,$217.81 ,$804.95 ,$795.48 ,$217.81 ,$710.25 ,$757.60 ,$757.60 ,$217.81 ,$757.60 ,$795.48 ,$795.48 ,$795.48 ,$852.30 ,$544.53 ,$217.81 ,$947.00 ,$53.38 ,$58.72 ,$239.59 ,$804.95 ,$565.74 ,$852.30 ,$795.48 ,$757.60 ,$757.60 ,$217.81 ,$615.55 ST. FRANCIS HOSPITAL - ACUTE,32000236,73115,HC XRAY WRIST ARTHRO,320,1 ,"$1,018.00 ",$661.70 ,$234.14 ,"$1,018.00 ",$732.96 ,$553.79 ,$234.14 ,$568.25 ,$234.14 ,$608.15 ,$608.15 ,$608.15 ,$608.15 ,$855.12 ,$234.14 ,$865.30 ,$855.12 ,$234.14 ,$763.50 ,$814.40 ,$814.40 ,$234.14 ,$814.40 ,$855.12 ,$855.12 ,$855.12 ,$916.20 ,$585.35 ,$234.14 ,"$1,018.00 ",$304.16 ,$334.58 ,$257.55 ,$865.30 ,$608.15 ,$916.20 ,$855.12 ,$814.40 ,$814.40 ,$234.14 ,$661.70 ST. FRANCIS HOSPITAL - ACUTE,32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$320.00 ,$208.00 ,$53.38 ,$320.00 ,$230.40 ,$174.08 ,$73.60 ,$178.62 ,$73.60 ,$191.17 ,$191.17 ,$191.17 ,$191.17 ,$268.80 ,$73.60 ,$272.00 ,$268.80 ,$73.60 ,$240.00 ,$256.00 ,$256.00 ,$73.60 ,$256.00 ,$268.80 ,$268.80 ,$268.80 ,$288.00 ,$184.00 ,$73.60 ,$320.00 ,$53.38 ,$58.72 ,$80.96 ,$272.00 ,$191.17 ,$288.00 ,$268.80 ,$256.00 ,$256.00 ,$73.60 ,$208.00 ST. FRANCIS HOSPITAL - ACUTE,32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$486.00 ,$315.90 ,$53.38 ,$486.00 ,$349.92 ,$264.38 ,$111.78 ,$271.29 ,$111.78 ,$290.34 ,$290.34 ,$290.34 ,$290.34 ,$408.24 ,$111.78 ,$413.10 ,$408.24 ,$111.78 ,$364.50 ,$388.80 ,$388.80 ,$111.78 ,$388.80 ,$408.24 ,$408.24 ,$408.24 ,$437.40 ,$279.45 ,$111.78 ,$486.00 ,$53.38 ,$58.72 ,$122.96 ,$413.10 ,$290.34 ,$437.40 ,$408.24 ,$388.80 ,$388.80 ,$111.78 ,$315.90 ST. FRANCIS HOSPITAL - ACUTE,32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$345.00 ,$224.25 ,$53.38 ,$345.00 ,$248.40 ,$187.68 ,$79.35 ,$192.58 ,$79.35 ,$206.10 ,$206.10 ,$206.10 ,$206.10 ,$289.80 ,$79.35 ,$293.25 ,$289.80 ,$79.35 ,$258.75 ,$276.00 ,$276.00 ,$79.35 ,$276.00 ,$289.80 ,$289.80 ,$289.80 ,$310.50 ,$198.38 ,$79.35 ,$345.00 ,$53.38 ,$58.72 ,$87.29 ,$293.25 ,$206.10 ,$310.50 ,$289.80 ,$276.00 ,$276.00 ,$79.35 ,$224.25 ST. FRANCIS HOSPITAL - ACUTE,32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$681.00 ,$442.65 ,$53.38 ,$681.00 ,$490.32 ,$370.46 ,$156.63 ,$380.13 ,$156.63 ,$406.83 ,$406.83 ,$406.83 ,$406.83 ,$572.04 ,$156.63 ,$578.85 ,$572.04 ,$156.63 ,$510.75 ,$544.80 ,$544.80 ,$156.63 ,$544.80 ,$572.04 ,$572.04 ,$572.04 ,$612.90 ,$391.58 ,$156.63 ,$681.00 ,$53.38 ,$58.72 ,$172.29 ,$578.85 ,$406.83 ,$612.90 ,$572.04 ,$544.80 ,$544.80 ,$156.63 ,$442.65 ST. FRANCIS HOSPITAL - ACUTE,32000241,73140,HC XRAY FINGER MIN 2 VIEWS,320,1 ,$314.00 ,$204.10 ,$53.38 ,$314.00 ,$226.08 ,$170.82 ,$72.22 ,$175.27 ,$72.22 ,$187.58 ,$187.58 ,$187.58 ,$187.58 ,$263.76 ,$72.22 ,$266.90 ,$263.76 ,$72.22 ,$235.50 ,$251.20 ,$251.20 ,$72.22 ,$251.20 ,$263.76 ,$263.76 ,$263.76 ,$282.60 ,$180.55 ,$72.22 ,$314.00 ,$53.38 ,$58.72 ,$79.44 ,$266.90 ,$187.58 ,$282.60 ,$263.76 ,$251.20 ,$251.20 ,$72.22 ,$204.10 ST. FRANCIS HOSPITAL - ACUTE,32000252,73525,HC XRAY HIP ARTHRGRPHY,320,1 ,"$1,018.00 ",$661.70 ,$234.14 ,"$1,018.00 ",$732.96 ,$553.79 ,$234.14 ,$568.25 ,$234.14 ,$608.15 ,$608.15 ,$608.15 ,$608.15 ,$855.12 ,$234.14 ,$865.30 ,$855.12 ,$234.14 ,$763.50 ,$814.40 ,$814.40 ,$234.14 ,$814.40 ,$855.12 ,$855.12 ,$855.12 ,$916.20 ,$585.35 ,$234.14 ,"$1,018.00 ",$304.16 ,$334.58 ,$257.55 ,$865.30 ,$608.15 ,$916.20 ,$855.12 ,$814.40 ,$814.40 ,$234.14 ,$661.70 ST. FRANCIS HOSPITAL - ACUTE,32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$318.00 ,$206.70 ,$53.38 ,$318.00 ,$228.96 ,$172.99 ,$73.14 ,$177.51 ,$73.14 ,$189.97 ,$189.97 ,$189.97 ,$189.97 ,$267.12 ,$73.14 ,$270.30 ,$267.12 ,$73.14 ,$238.50 ,$254.40 ,$254.40 ,$73.14 ,$254.40 ,$267.12 ,$267.12 ,$267.12 ,$286.20 ,$182.85 ,$73.14 ,$318.00 ,$53.38 ,$58.72 ,$80.45 ,$270.30 ,$189.97 ,$286.20 ,$267.12 ,$254.40 ,$254.40 ,$73.14 ,$206.70 ST. FRANCIS HOSPITAL - ACUTE,32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$628.00 ,$408.20 ,$53.38 ,$628.00 ,$452.16 ,$341.63 ,$144.44 ,$350.55 ,$144.44 ,$375.17 ,$375.17 ,$375.17 ,$375.17 ,$527.52 ,$144.44 ,$533.80 ,$527.52 ,$144.44 ,$471.00 ,$502.40 ,$502.40 ,$144.44 ,$502.40 ,$527.52 ,$527.52 ,$527.52 ,$565.20 ,$361.10 ,$144.44 ,$628.00 ,$53.38 ,$58.72 ,$158.88 ,$533.80 ,$375.17 ,$565.20 ,$527.52 ,$502.40 ,$502.40 ,$144.44 ,$408.20 ST. FRANCIS HOSPITAL - ACUTE,32000263,73562,HC XRAY KNEE (3 V),320,1 ,$482.00 ,$313.30 ,$53.38 ,$482.00 ,$347.04 ,$262.21 ,$110.86 ,$269.05 ,$110.86 ,$287.95 ,$287.95 ,$287.95 ,$287.95 ,$404.88 ,$110.86 ,$409.70 ,$404.88 ,$110.86 ,$361.50 ,$385.60 ,$385.60 ,$110.86 ,$385.60 ,$404.88 ,$404.88 ,$404.88 ,$433.80 ,$277.15 ,$110.86 ,$482.00 ,$53.38 ,$58.72 ,$121.95 ,$409.70 ,$287.95 ,$433.80 ,$404.88 ,$385.60 ,$385.60 ,$110.86 ,$313.30 ST. FRANCIS HOSPITAL - ACUTE,32000263,73562,HC XRAY KNEE (3 V),320,1 ,$815.00 ,$529.75 ,$53.38 ,$815.00 ,$586.80 ,$443.36 ,$187.45 ,$454.93 ,$187.45 ,$486.88 ,$486.88 ,$486.88 ,$486.88 ,$684.60 ,$187.45 ,$692.75 ,$684.60 ,$187.45 ,$611.25 ,$652.00 ,$652.00 ,$187.45 ,$652.00 ,$684.60 ,$684.60 ,$684.60 ,$733.50 ,$468.63 ,$187.45 ,$815.00 ,$53.38 ,$58.72 ,$206.20 ,$692.75 ,$486.88 ,$733.50 ,$684.60 ,$652.00 ,$652.00 ,$187.45 ,$529.75 ST. FRANCIS HOSPITAL - ACUTE,32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$653.00 ,$424.45 ,$53.38 ,$653.00 ,$470.16 ,$355.23 ,$150.19 ,$364.50 ,$150.19 ,$390.10 ,$390.10 ,$390.10 ,$390.10 ,$548.52 ,$150.19 ,$555.05 ,$548.52 ,$150.19 ,$489.75 ,$522.40 ,$522.40 ,$150.19 ,$522.40 ,$548.52 ,$548.52 ,$548.52 ,$587.70 ,$375.48 ,$150.19 ,$653.00 ,$53.38 ,$58.72 ,$165.21 ,$555.05 ,$390.10 ,$587.70 ,$548.52 ,$522.40 ,$522.40 ,$150.19 ,$424.45 ST. FRANCIS HOSPITAL - ACUTE,32000267,73565,HC XR KNEE STAND,320,1 ,$211.00 ,$137.15 ,$48.53 ,$211.00 ,$151.92 ,$114.78 ,$48.53 ,$117.78 ,$48.53 ,$126.05 ,$126.05 ,$126.05 ,$126.05 ,$177.24 ,$48.53 ,$179.35 ,$177.24 ,$48.53 ,$158.25 ,$168.80 ,$168.80 ,$48.53 ,$168.80 ,$177.24 ,$177.24 ,$177.24 ,$189.90 ,$121.33 ,$48.53 ,$211.00 ,$53.38 ,$58.72 ,$53.38 ,$179.35 ,$126.05 ,$189.90 ,$177.24 ,$168.80 ,$168.80 ,$48.53 ,$137.15 ST. FRANCIS HOSPITAL - ACUTE,32000268,73580,HC XRAY KNEE ARTHRO,320,1 ,$886.00 ,$575.90 ,$203.78 ,$886.00 ,$637.92 ,$481.98 ,$203.78 ,$494.57 ,$203.78 ,$529.30 ,$529.30 ,$529.30 ,$529.30 ,$744.24 ,$203.78 ,$753.10 ,$744.24 ,$203.78 ,$664.50 ,$708.80 ,$708.80 ,$203.78 ,$708.80 ,$744.24 ,$744.24 ,$744.24 ,$797.40 ,$509.45 ,$203.78 ,$886.00 ,$304.16 ,$334.58 ,$224.16 ,$753.10 ,$529.30 ,$797.40 ,$744.24 ,$708.80 ,$708.80 ,$203.78 ,$575.90 ST. FRANCIS HOSPITAL - ACUTE,32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$337.00 ,$219.05 ,$53.38 ,$337.00 ,$242.64 ,$183.33 ,$77.51 ,$188.11 ,$77.51 ,$201.32 ,$201.32 ,$201.32 ,$201.32 ,$283.08 ,$77.51 ,$286.45 ,$283.08 ,$77.51 ,$252.75 ,$269.60 ,$269.60 ,$77.51 ,$269.60 ,$283.08 ,$283.08 ,$283.08 ,$303.30 ,$193.78 ,$77.51 ,$337.00 ,$53.38 ,$58.72 ,$85.26 ,$286.45 ,$201.32 ,$303.30 ,$283.08 ,$269.60 ,$269.60 ,$77.51 ,$219.05 ST. FRANCIS HOSPITAL - ACUTE,32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$674.00 ,$438.10 ,$53.38 ,$674.00 ,$485.28 ,$366.66 ,$155.02 ,$376.23 ,$155.02 ,$402.65 ,$402.65 ,$402.65 ,$402.65 ,$566.16 ,$155.02 ,$572.90 ,$566.16 ,$155.02 ,$505.50 ,$539.20 ,$539.20 ,$155.02 ,$539.20 ,$566.16 ,$566.16 ,$566.16 ,$606.60 ,$387.55 ,$155.02 ,$674.00 ,$53.38 ,$58.72 ,$170.52 ,$572.90 ,$402.65 ,$606.60 ,$566.16 ,$539.20 ,$539.20 ,$155.02 ,$438.10 ST. FRANCIS HOSPITAL - ACUTE,32000272,73592,HC XRAY INFANT LO EXTRM MIN 2V,320,1 ,$479.00 ,$311.35 ,$53.38 ,$479.00 ,$344.88 ,$260.58 ,$110.17 ,$267.38 ,$110.17 ,$286.15 ,$286.15 ,$286.15 ,$286.15 ,$402.36 ,$110.17 ,$407.15 ,$402.36 ,$110.17 ,$359.25 ,$383.20 ,$383.20 ,$110.17 ,$383.20 ,$402.36 ,$402.36 ,$402.36 ,$431.10 ,$275.43 ,$110.17 ,$479.00 ,$53.38 ,$58.72 ,$121.19 ,$407.15 ,$286.15 ,$431.10 ,$402.36 ,$383.20 ,$383.20 ,$110.17 ,$311.35 ST. FRANCIS HOSPITAL - ACUTE,32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$314.00 ,$204.10 ,$53.38 ,$314.00 ,$226.08 ,$170.82 ,$72.22 ,$175.27 ,$72.22 ,$187.58 ,$187.58 ,$187.58 ,$187.58 ,$263.76 ,$72.22 ,$266.90 ,$263.76 ,$72.22 ,$235.50 ,$251.20 ,$251.20 ,$72.22 ,$251.20 ,$263.76 ,$263.76 ,$263.76 ,$282.60 ,$180.55 ,$72.22 ,$314.00 ,$53.38 ,$58.72 ,$79.44 ,$266.90 ,$187.58 ,$282.60 ,$263.76 ,$251.20 ,$251.20 ,$72.22 ,$204.10 ST. FRANCIS HOSPITAL - ACUTE,32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$484.00 ,$314.60 ,$53.38 ,$484.00 ,$348.48 ,$263.30 ,$111.32 ,$270.17 ,$111.32 ,$289.14 ,$289.14 ,$289.14 ,$289.14 ,$406.56 ,$111.32 ,$411.40 ,$406.56 ,$111.32 ,$363.00 ,$387.20 ,$387.20 ,$111.32 ,$387.20 ,$406.56 ,$406.56 ,$406.56 ,$435.60 ,$278.30 ,$111.32 ,$484.00 ,$53.38 ,$58.72 ,$122.45 ,$411.40 ,$289.14 ,$435.60 ,$406.56 ,$387.20 ,$387.20 ,$111.32 ,$314.60 ST. FRANCIS HOSPITAL - ACUTE,32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$957.00 ,$622.05 ,$53.38 ,$957.00 ,$689.04 ,$520.61 ,$220.11 ,$534.20 ,$220.11 ,$571.71 ,$571.71 ,$571.71 ,$571.71 ,$803.88 ,$220.11 ,$813.45 ,$803.88 ,$220.11 ,$717.75 ,$765.60 ,$765.60 ,$220.11 ,$765.60 ,$803.88 ,$803.88 ,$803.88 ,$861.30 ,$550.28 ,$220.11 ,$957.00 ,$53.38 ,$58.72 ,$242.12 ,$813.45 ,$571.71 ,$861.30 ,$803.88 ,$765.60 ,$765.60 ,$220.11 ,$622.05 ST. FRANCIS HOSPITAL - ACUTE,32000279,73620,HC XRAY FOOT (2 V),320,1 ,$318.00 ,$206.70 ,$53.38 ,$318.00 ,$228.96 ,$172.99 ,$73.14 ,$177.51 ,$73.14 ,$189.97 ,$189.97 ,$189.97 ,$189.97 ,$267.12 ,$73.14 ,$270.30 ,$267.12 ,$73.14 ,$238.50 ,$254.40 ,$254.40 ,$73.14 ,$254.40 ,$267.12 ,$267.12 ,$267.12 ,$286.20 ,$182.85 ,$73.14 ,$318.00 ,$53.38 ,$58.72 ,$80.45 ,$270.30 ,$189.97 ,$286.20 ,$267.12 ,$254.40 ,$254.40 ,$73.14 ,$206.70 ST. FRANCIS HOSPITAL - ACUTE,32000279,73620,HC XRAY FOOT (2 V),320,1 ,$628.00 ,$408.20 ,$53.38 ,$628.00 ,$452.16 ,$341.63 ,$144.44 ,$350.55 ,$144.44 ,$375.17 ,$375.17 ,$375.17 ,$375.17 ,$527.52 ,$144.44 ,$533.80 ,$527.52 ,$144.44 ,$471.00 ,$502.40 ,$502.40 ,$144.44 ,$502.40 ,$527.52 ,$527.52 ,$527.52 ,$565.20 ,$361.10 ,$144.44 ,$628.00 ,$53.38 ,$58.72 ,$158.88 ,$533.80 ,$375.17 ,$565.20 ,$527.52 ,$502.40 ,$502.40 ,$144.44 ,$408.20 ST. FRANCIS HOSPITAL - ACUTE,32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$484.00 ,$314.60 ,$53.38 ,$484.00 ,$348.48 ,$263.30 ,$111.32 ,$270.17 ,$111.32 ,$289.14 ,$289.14 ,$289.14 ,$289.14 ,$406.56 ,$111.32 ,$411.40 ,$406.56 ,$111.32 ,$363.00 ,$387.20 ,$387.20 ,$111.32 ,$387.20 ,$406.56 ,$406.56 ,$406.56 ,$435.60 ,$278.30 ,$111.32 ,$484.00 ,$53.38 ,$58.72 ,$122.45 ,$411.40 ,$289.14 ,$435.60 ,$406.56 ,$387.20 ,$387.20 ,$111.32 ,$314.60 ST. FRANCIS HOSPITAL - ACUTE,32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$957.00 ,$622.05 ,$53.38 ,$957.00 ,$689.04 ,$520.61 ,$220.11 ,$534.20 ,$220.11 ,$571.71 ,$571.71 ,$571.71 ,$571.71 ,$803.88 ,$220.11 ,$813.45 ,$803.88 ,$220.11 ,$717.75 ,$765.60 ,$765.60 ,$220.11 ,$765.60 ,$803.88 ,$803.88 ,$803.88 ,$861.30 ,$550.28 ,$220.11 ,$957.00 ,$53.38 ,$58.72 ,$242.12 ,$813.45 ,$571.71 ,$861.30 ,$803.88 ,$765.60 ,$765.60 ,$220.11 ,$622.05 ST. FRANCIS HOSPITAL - ACUTE,32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$318.00 ,$206.70 ,$53.38 ,$318.00 ,$228.96 ,$172.99 ,$73.14 ,$177.51 ,$73.14 ,$189.97 ,$189.97 ,$189.97 ,$189.97 ,$267.12 ,$73.14 ,$270.30 ,$267.12 ,$73.14 ,$238.50 ,$254.40 ,$254.40 ,$73.14 ,$254.40 ,$267.12 ,$267.12 ,$267.12 ,$286.20 ,$182.85 ,$73.14 ,$318.00 ,$53.38 ,$58.72 ,$80.45 ,$270.30 ,$189.97 ,$286.20 ,$267.12 ,$254.40 ,$254.40 ,$73.14 ,$206.70 ST. FRANCIS HOSPITAL - ACUTE,32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$628.00 ,$408.20 ,$53.38 ,$628.00 ,$452.16 ,$341.63 ,$144.44 ,$350.55 ,$144.44 ,$375.17 ,$375.17 ,$375.17 ,$375.17 ,$527.52 ,$144.44 ,$533.80 ,$527.52 ,$144.44 ,$471.00 ,$502.40 ,$502.40 ,$144.44 ,$502.40 ,$527.52 ,$527.52 ,$527.52 ,$565.20 ,$361.10 ,$144.44 ,$628.00 ,$53.38 ,$58.72 ,$158.88 ,$533.80 ,$375.17 ,$565.20 ,$527.52 ,$502.40 ,$502.40 ,$144.44 ,$408.20 ST. FRANCIS HOSPITAL - ACUTE,32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$314.00 ,$204.10 ,$53.38 ,$314.00 ,$226.08 ,$170.82 ,$72.22 ,$175.27 ,$72.22 ,$187.58 ,$187.58 ,$187.58 ,$187.58 ,$263.76 ,$72.22 ,$266.90 ,$263.76 ,$72.22 ,$235.50 ,$251.20 ,$251.20 ,$72.22 ,$251.20 ,$263.76 ,$263.76 ,$263.76 ,$282.60 ,$180.55 ,$72.22 ,$314.00 ,$53.38 ,$58.72 ,$79.44 ,$266.90 ,$187.58 ,$282.60 ,$263.76 ,$251.20 ,$251.20 ,$72.22 ,$204.10 ST. FRANCIS HOSPITAL - ACUTE,32000289,74018,HC XRAY ABDOMEN 1V,320,1 ,$414.00 ,$269.10 ,$53.38 ,$414.00 ,$298.08 ,$225.22 ,$95.22 ,$231.09 ,$95.22 ,$247.32 ,$247.32 ,$247.32 ,$247.32 ,$347.76 ,$95.22 ,$351.90 ,$347.76 ,$95.22 ,$310.50 ,$331.20 ,$331.20 ,$95.22 ,$331.20 ,$347.76 ,$347.76 ,$347.76 ,$372.60 ,$238.05 ,$95.22 ,$414.00 ,$53.38 ,$58.72 ,$104.74 ,$351.90 ,$247.32 ,$372.60 ,$347.76 ,$331.20 ,$331.20 ,$95.22 ,$269.10 ST. FRANCIS HOSPITAL - ACUTE,32000294,74019,HC XRAY ABDOMEN AP AND LAT (2 V OR 3 V),320,1 ,$549.00 ,$356.85 ,$53.38 ,$549.00 ,$395.28 ,$298.66 ,$126.27 ,$306.45 ,$126.27 ,$327.97 ,$327.97 ,$327.97 ,$327.97 ,$461.16 ,$126.27 ,$466.65 ,$461.16 ,$126.27 ,$411.75 ,$439.20 ,$439.20 ,$126.27 ,$439.20 ,$461.16 ,$461.16 ,$461.16 ,$494.10 ,$315.68 ,$126.27 ,$549.00 ,$53.38 ,$58.72 ,$138.90 ,$466.65 ,$327.97 ,$494.10 ,$461.16 ,$439.20 ,$439.20 ,$126.27 ,$356.85 ST. FRANCIS HOSPITAL - ACUTE,32000298,74022,HC XRAY ABDOMEN AP/DECUB/ERECT/CXR,320,1 ,$527.00 ,$342.55 ,$53.38 ,$527.00 ,$379.44 ,$286.69 ,$121.21 ,$294.17 ,$121.21 ,$314.83 ,$314.83 ,$314.83 ,$314.83 ,$442.68 ,$121.21 ,$447.95 ,$442.68 ,$121.21 ,$395.25 ,$421.60 ,$421.60 ,$121.21 ,$421.60 ,$442.68 ,$442.68 ,$442.68 ,$474.30 ,$303.03 ,$121.21 ,$527.00 ,$53.38 ,$58.72 ,$133.33 ,$447.95 ,$314.83 ,$474.30 ,$442.68 ,$421.60 ,$421.60 ,$121.21 ,$342.55 ST. FRANCIS HOSPITAL - ACUTE,32000300,74220,HC XRAY ESOPHAGUS,320,1 ,$810.00 ,$526.50 ,$53.38 ,$810.00 ,$583.20 ,$440.64 ,$186.30 ,$452.14 ,$186.30 ,$483.89 ,$483.89 ,$483.89 ,$483.89 ,$680.40 ,$186.30 ,$688.50 ,$680.40 ,$186.30 ,$607.50 ,$648.00 ,$648.00 ,$186.30 ,$648.00 ,$680.40 ,$680.40 ,$680.40 ,$729.00 ,$465.75 ,$186.30 ,$810.00 ,$53.38 ,$58.72 ,$204.93 ,$688.50 ,$483.89 ,$729.00 ,$680.40 ,$648.00 ,$648.00 ,$186.30 ,$526.50 ST. FRANCIS HOSPITAL - ACUTE,32000301,74230,HC VIDEO FLUORO SWALLOWING,320,1 ,$810.00 ,$526.50 ,$117.38 ,$810.00 ,$583.20 ,$440.64 ,$186.30 ,$452.14 ,$186.30 ,$483.89 ,$483.89 ,$483.89 ,$483.89 ,$680.40 ,$186.30 ,$688.50 ,$680.40 ,$186.30 ,$607.50 ,$648.00 ,$648.00 ,$186.30 ,$648.00 ,$680.40 ,$680.40 ,$680.40 ,$729.00 ,$465.75 ,$186.30 ,$810.00 ,$117.38 ,$129.12 ,$204.93 ,$688.50 ,$483.89 ,$729.00 ,$680.40 ,$648.00 ,$648.00 ,$186.30 ,$526.50 ST. FRANCIS HOSPITAL - ACUTE,32000302,74240,HC XRAY UPPER GI TRACT,320,1 ,$987.00 ,$641.55 ,$117.38 ,$987.00 ,$710.64 ,$536.93 ,$227.01 ,$550.94 ,$227.01 ,$589.63 ,$589.63 ,$589.63 ,$589.63 ,$829.08 ,$227.01 ,$838.95 ,$829.08 ,$227.01 ,$740.25 ,$789.60 ,$789.60 ,$227.01 ,$789.60 ,$829.08 ,$829.08 ,$829.08 ,$888.30 ,$567.53 ,$227.01 ,$987.00 ,$117.38 ,$129.12 ,$249.71 ,$838.95 ,$589.63 ,$888.30 ,$829.08 ,$789.60 ,$789.60 ,$227.01 ,$641.55 ST. FRANCIS HOSPITAL - ACUTE,32000304,74245,HC UPPER GI\SMALL BOWEL SGL,320,1 ,"$1,304.00 ",$847.60 ,$299.92 ,"$1,304.00 ",$938.88 ,$709.38 ,$299.92 ,$727.89 ,$299.92 ,$779.01 ,$779.01 ,$779.01 ,$779.01 ,"$1,095.36 ",$299.92 ,"$1,108.40 ","$1,095.36 ",$299.92 ,$978.00 ,"$1,043.20 ","$1,043.20 ",$299.92 ,"$1,043.20 ","$1,095.36 ","$1,095.36 ","$1,095.36 ","$1,173.60 ",$749.80 ,$299.92 ,"$1,304.00 ", N/A , N/A ,$329.91 ,"$1,108.40 ",$779.01 ,"$1,173.60 ","$1,095.36 ","$1,043.20 ","$1,043.20 ",$299.92 ,$847.60 ST. FRANCIS HOSPITAL - ACUTE,32000306,74246,HC UPPER GI TRACT - NO KUB,320,1 ,$906.00 ,$588.90 ,$117.38 ,$906.00 ,$652.32 ,$492.86 ,$208.38 ,$505.73 ,$208.38 ,$541.24 ,$541.24 ,$541.24 ,$541.24 ,$761.04 ,$208.38 ,$770.10 ,$761.04 ,$208.38 ,$679.50 ,$724.80 ,$724.80 ,$208.38 ,$724.80 ,$761.04 ,$761.04 ,$761.04 ,$815.40 ,$520.95 ,$208.38 ,$906.00 ,$117.38 ,$129.12 ,$229.22 ,$770.10 ,$541.24 ,$815.40 ,$761.04 ,$724.80 ,$724.80 ,$208.38 ,$588.90 ST. FRANCIS HOSPITAL - ACUTE,32000308,74247,HC UPPER GI W/KUB DBL CONTRAST,320,1 ,$982.00 ,$638.30 ,$225.86 ,$982.00 ,$707.04 ,$534.21 ,$225.86 ,$548.15 ,$225.86 ,$586.65 ,$586.65 ,$586.65 ,$586.65 ,$824.88 ,$225.86 ,$834.70 ,$824.88 ,$225.86 ,$736.50 ,$785.60 ,$785.60 ,$225.86 ,$785.60 ,$824.88 ,$824.88 ,$824.88 ,$883.80 ,$564.65 ,$225.86 ,$982.00 , N/A , N/A ,$248.45 ,$834.70 ,$586.65 ,$883.80 ,$824.88 ,$785.60 ,$785.60 ,$225.86 ,$638.30 ST. FRANCIS HOSPITAL - ACUTE,32000311,74250,HC XRAY SMALL BOWEL,320,1 ,$810.00 ,$526.50 ,$117.38 ,$810.00 ,$583.20 ,$440.64 ,$186.30 ,$452.14 ,$186.30 ,$483.89 ,$483.89 ,$483.89 ,$483.89 ,$680.40 ,$186.30 ,$688.50 ,$680.40 ,$186.30 ,$607.50 ,$648.00 ,$648.00 ,$186.30 ,$648.00 ,$680.40 ,$680.40 ,$680.40 ,$729.00 ,$465.75 ,$186.30 ,$810.00 ,$117.38 ,$129.12 ,$204.93 ,$688.50 ,$483.89 ,$729.00 ,$680.40 ,$648.00 ,$648.00 ,$186.30 ,$526.50 ST. FRANCIS HOSPITAL - ACUTE,32000315,74270,HC XRAY COLON BARIUM,320,1 ,$994.00 ,$646.10 ,$117.38 ,$994.00 ,$715.68 ,$540.74 ,$228.62 ,$554.85 ,$228.62 ,$593.82 ,$593.82 ,$593.82 ,$593.82 ,$834.96 ,$228.62 ,$844.90 ,$834.96 ,$228.62 ,$745.50 ,$795.20 ,$795.20 ,$228.62 ,$795.20 ,$834.96 ,$834.96 ,$834.96 ,$894.60 ,$571.55 ,$228.62 ,$994.00 ,$117.38 ,$129.12 ,$251.48 ,$844.90 ,$593.82 ,$894.60 ,$834.96 ,$795.20 ,$795.20 ,$228.62 ,$646.10 ST. FRANCIS HOSPITAL - ACUTE,32000318,74270,HC XRAY BARM ENEMA/COLSTMY,320,1 ,$994.00 ,$646.10 ,$117.38 ,$994.00 ,$715.68 ,$540.74 ,$228.62 ,$554.85 ,$228.62 ,$593.82 ,$593.82 ,$593.82 ,$593.82 ,$834.96 ,$228.62 ,$844.90 ,$834.96 ,$228.62 ,$745.50 ,$795.20 ,$795.20 ,$228.62 ,$795.20 ,$834.96 ,$834.96 ,$834.96 ,$894.60 ,$571.55 ,$228.62 ,$994.00 ,$117.38 ,$129.12 ,$251.48 ,$844.90 ,$593.82 ,$894.60 ,$834.96 ,$795.20 ,$795.20 ,$228.62 ,$646.10 ST. FRANCIS HOSPITAL - ACUTE,32000319,74270,HC XRAY BARM ENEMA WATER SOL,320,1 ,$994.00 ,$646.10 ,$117.38 ,$994.00 ,$715.68 ,$540.74 ,$228.62 ,$554.85 ,$228.62 ,$593.82 ,$593.82 ,$593.82 ,$593.82 ,$834.96 ,$228.62 ,$844.90 ,$834.96 ,$228.62 ,$745.50 ,$795.20 ,$795.20 ,$228.62 ,$795.20 ,$834.96 ,$834.96 ,$834.96 ,$894.60 ,$571.55 ,$228.62 ,$994.00 ,$117.38 ,$129.12 ,$251.48 ,$844.90 ,$593.82 ,$894.60 ,$834.96 ,$795.20 ,$795.20 ,$228.62 ,$646.10 ST. FRANCIS HOSPITAL - ACUTE,32000323,74300,HC CHOLANGIOGRAPHY OPERATIVE,320,1 ,"$1,207.00 ",$784.55 ,$277.61 ,"$1,207.00 ",$869.04 ,$656.61 ,$277.61 ,$673.75 ,$277.61 ,$721.06 ,$721.06 ,$721.06 ,$721.06 ,"$1,013.88 ",$277.61 ,"$1,025.95 ","$1,013.88 ",$277.61 ,$905.25 ,$965.60 ,$965.60 ,$277.61 ,$965.60 ,"$1,013.88 ","$1,013.88 ","$1,013.88 ","$1,086.30 ",$694.03 ,$277.61 ,"$1,207.00 ",$304.16 ,$334.58 ,$305.37 ,"$1,025.95 ",$721.06 ,"$1,086.30 ","$1,013.88 ",$965.60 ,$965.60 ,$277.61 ,$784.55 ST. FRANCIS HOSPITAL - ACUTE,32000339,74420,HC XRAY UROGRAM RETROGRADE,320,1 ,$676.00 ,$439.40 ,$155.48 ,$676.00 ,$486.72 ,$367.74 ,$155.48 ,$377.34 ,$155.48 ,$403.84 ,$403.84 ,$403.84 ,$403.84 ,$567.84 ,$155.48 ,$574.60 ,$567.84 ,$155.48 ,$507.00 ,$540.80 ,$540.80 ,$155.48 ,$540.80 ,$567.84 ,$567.84 ,$567.84 ,$608.40 ,$388.70 ,$155.48 ,$676.00 ,$332.96 ,$366.26 ,$171.03 ,$574.60 ,$403.84 ,$608.40 ,$567.84 ,$540.80 ,$540.80 ,$155.48 ,$439.40 ST. FRANCIS HOSPITAL - ACUTE,32000343,74430,HC CYSTOGRAM 3+ VIEWS,320,1 ,$733.00 ,$476.45 ,$168.59 ,$733.00 ,$527.76 ,$398.75 ,$168.59 ,$409.16 ,$168.59 ,$437.89 ,$437.89 ,$437.89 ,$437.89 ,$615.72 ,$168.59 ,$623.05 ,$615.72 ,$168.59 ,$549.75 ,$586.40 ,$586.40 ,$168.59 ,$586.40 ,$615.72 ,$615.72 ,$615.72 ,$659.70 ,$421.48 ,$168.59 ,$733.00 ,$304.16 ,$334.58 ,$185.45 ,$623.05 ,$437.89 ,$659.70 ,$615.72 ,$586.40 ,$586.40 ,$168.59 ,$476.45 ST. FRANCIS HOSPITAL - ACUTE,32000344,74450,HC CYSTOURETHROGRAM RETROGRADE,320,1 ,$676.00 ,$439.40 ,$155.48 ,$676.00 ,$486.72 ,$367.74 ,$155.48 ,$377.34 ,$155.48 ,$403.84 ,$403.84 ,$403.84 ,$403.84 ,$567.84 ,$155.48 ,$574.60 ,$567.84 ,$155.48 ,$507.00 ,$540.80 ,$540.80 ,$155.48 ,$540.80 ,$567.84 ,$567.84 ,$567.84 ,$608.40 ,$388.70 ,$155.48 ,$676.00 ,$304.16 ,$334.58 ,$171.03 ,$574.60 ,$403.84 ,$608.40 ,$567.84 ,$540.80 ,$540.80 ,$155.48 ,$439.40 ST. FRANCIS HOSPITAL - ACUTE,32000346,74455,HC XRAY VOID CYSTOURETHGRAM,320,1 ,$919.00 ,$597.35 ,$211.37 ,$919.00 ,$661.68 ,$499.94 ,$211.37 ,$512.99 ,$211.37 ,$549.01 ,$549.01 ,$549.01 ,$549.01 ,$771.96 ,$211.37 ,$781.15 ,$771.96 ,$211.37 ,$689.25 ,$735.20 ,$735.20 ,$211.37 ,$735.20 ,$771.96 ,$771.96 ,$771.96 ,$827.10 ,$528.43 ,$211.37 ,$919.00 ,$304.16 ,$334.58 ,$232.51 ,$781.15 ,$549.01 ,$827.10 ,$771.96 ,$735.20 ,$735.20 ,$211.37 ,$597.35 ST. FRANCIS HOSPITAL - ACUTE,32000354,74740,HC XRAY HYSTEROSALPINGOGRAP,320,1 ,"$1,023.00 ",$664.95 ,$235.29 ,"$1,023.00 ",$736.56 ,$556.51 ,$235.29 ,$571.04 ,$235.29 ,$611.14 ,$611.14 ,$611.14 ,$611.14 ,$859.32 ,$235.29 ,$869.55 ,$859.32 ,$235.29 ,$767.25 ,$818.40 ,$818.40 ,$235.29 ,$818.40 ,$859.32 ,$859.32 ,$859.32 ,$920.70 ,$588.23 ,$235.29 ,"$1,023.00 ",$304.16 ,$334.58 ,$258.82 ,$869.55 ,$611.14 ,$920.70 ,$859.32 ,$818.40 ,$818.40 ,$235.29 ,$664.95 ST. FRANCIS HOSPITAL - ACUTE,32000445,75989,HC GUID FOR PERC DRAIN ABSCESS,320,1 ,"$2,160.00 ","$1,404.00 ",$304.16 ,"$2,160.00 ","$1,555.20 ","$1,175.04 ",$496.80 ,"$1,205.71 ",$496.80 ,"$1,290.38 ","$1,290.38 ","$1,290.38 ","$1,290.38 ","$1,814.40 ",$496.80 ,"$1,836.00 ","$1,814.40 ",$496.80 ,"$1,620.00 ","$1,728.00 ","$1,728.00 ",$496.80 ,"$1,728.00 ","$1,814.40 ","$1,814.40 ","$1,814.40 ","$1,944.00 ","$1,242.00 ",$496.80 ,"$2,160.00 ",$304.16 ,$334.58 ,$546.48 ,"$1,836.00 ","$1,290.38 ","$1,944.00 ","$1,814.40 ","$1,728.00 ","$1,728.00 ",$496.80 ,"$1,404.00 " ST. FRANCIS HOSPITAL - ACUTE,32000447,76000,HC FLUOROSCOPY UP TO 1 HR 76000,320,1 ,"$1,098.00 ",$713.70 ,$53.38 ,"$1,098.00 ",$790.56 ,$597.31 ,$252.54 ,$612.90 ,$252.54 ,$655.95 ,$655.95 ,$655.95 ,$655.95 ,$922.32 ,$252.54 ,$933.30 ,$922.32 ,$252.54 ,$823.50 ,$878.40 ,$878.40 ,$252.54 ,$878.40 ,$922.32 ,$922.32 ,$922.32 ,$988.20 ,$631.35 ,$252.54 ,"$1,098.00 ",$53.38 ,$58.72 ,$277.79 ,$933.30 ,$655.95 ,$988.20 ,$922.32 ,$878.40 ,$878.40 ,$252.54 ,$713.70 ST. FRANCIS HOSPITAL - ACUTE,32000464,76010,HC BABYGRAM,320,1 ,$395.00 ,$256.75 ,$53.38 ,$395.00 ,$284.40 ,$214.88 ,$90.85 ,$220.49 ,$90.85 ,$235.97 ,$235.97 ,$235.97 ,$235.97 ,$331.80 ,$90.85 ,$335.75 ,$331.80 ,$90.85 ,$296.25 ,$316.00 ,$316.00 ,$90.85 ,$316.00 ,$331.80 ,$331.80 ,$331.80 ,$355.50 ,$227.13 ,$90.85 ,$395.00 ,$53.38 ,$58.72 ,$99.94 ,$335.75 ,$235.97 ,$355.50 ,$331.80 ,$316.00 ,$316.00 ,$90.85 ,$256.75 ST. FRANCIS HOSPITAL - ACUTE,32000467,76098,HC RADIOLOGICAL EXAM SURG SPEC,320,1 ,$146.00 ,$94.90 ,$28.81 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$28.81 ,$53.38 ,$58.72 ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,32000475,77001,HC FLUORO CV ACCESS PLACEMENT,320,1 ,$460.00 ,$299.00 ,$105.80 ,$460.00 ,$331.20 ,$250.24 ,$105.80 ,$256.77 ,$105.80 ,$274.80 ,$274.80 ,$274.80 ,$274.80 ,$386.40 ,$105.80 ,$391.00 ,$386.40 ,$105.80 ,$345.00 ,$368.00 ,$368.00 ,$105.80 ,$368.00 ,$386.40 ,$386.40 ,$386.40 ,$414.00 ,$264.50 ,$105.80 ,$460.00 ,$304.16 ,$334.58 ,$116.38 ,$391.00 ,$274.80 ,$414.00 ,$386.40 ,$368.00 ,$368.00 ,$105.80 ,$299.00 ST. FRANCIS HOSPITAL - ACUTE,32000476,77002,HC FLUORO NEEDLE PLACEMENT,320,1 ,$523.00 ,$339.95 ,$120.29 ,$523.00 ,$376.56 ,$284.51 ,$120.29 ,$291.94 ,$120.29 ,$312.44 ,$312.44 ,$312.44 ,$312.44 ,$439.32 ,$120.29 ,$444.55 ,$439.32 ,$120.29 ,$392.25 ,$418.40 ,$418.40 ,$120.29 ,$418.40 ,$439.32 ,$439.32 ,$439.32 ,$470.70 ,$300.73 ,$120.29 ,$523.00 ,$304.16 ,$334.58 ,$132.32 ,$444.55 ,$312.44 ,$470.70 ,$439.32 ,$418.40 ,$418.40 ,$120.29 ,$339.95 ST. FRANCIS HOSPITAL - ACUTE,32000481,77003,HC FLUORO NEEDLE LOCALIZATION,320,1 ,$460.00 ,$299.00 ,$105.80 ,$460.00 ,$331.20 ,$250.24 ,$105.80 ,$256.77 ,$105.80 ,$274.80 ,$274.80 ,$274.80 ,$274.80 ,$386.40 ,$105.80 ,$391.00 ,$386.40 ,$105.80 ,$345.00 ,$368.00 ,$368.00 ,$105.80 ,$368.00 ,$386.40 ,$386.40 ,$386.40 ,$414.00 ,$264.50 ,$105.80 ,$460.00 ,$304.16 ,$334.58 ,$116.38 ,$391.00 ,$274.80 ,$414.00 ,$386.40 ,$368.00 ,$368.00 ,$105.80 ,$299.00 ST. FRANCIS HOSPITAL - ACUTE,32000489,19281,HC MAMM GUIDE NDL PLACEMENT,320,1 ,"$1,342.00 ",$872.30 ,$114.53 ,"$1,342.00 ",$966.24 ,$730.05 ,$308.66 ,$749.10 ,$308.66 ,$801.71 ,$801.71 ,$801.71 ,$801.71 ,"$1,127.28 ",$308.66 ,"$1,140.70 ","$1,127.28 ",$308.66 ,"$1,006.50 ","$1,073.60 ","$1,073.60 ",$308.66 ,"$1,073.60 ","$1,127.28 ","$1,127.28 ","$1,127.28 ","$1,207.80 ",$771.65 ,$308.66 ,$264.15 ,$114.53 ,$125.98 ,$339.53 ,"$1,140.70 ",$801.71 ,"$1,207.80 ","$1,127.28 ","$1,073.60 ","$1,073.60 ",$308.66 ,$872.30 ST. FRANCIS HOSPITAL - ACUTE,32000490,77053,HC GALACTOGRAM SINGLE DUCT,320,1 ,"$1,096.00 ",$712.40 ,$41.18 ,"$1,096.00 ",$789.12 ,$596.22 ,$252.08 ,$611.79 ,$252.08 ,$654.75 ,$654.75 ,$654.75 ,$654.75 ,$920.64 ,$252.08 ,$931.60 ,$920.64 ,$252.08 ,$822.00 ,$876.80 ,$876.80 ,$252.08 ,$876.80 ,$920.64 ,$920.64 ,$920.64 ,$986.40 ,$630.20 ,$252.08 ,$41.18 ,$304.16 ,$334.58 ,$277.29 ,$931.60 ,$654.75 ,$986.40 ,$920.64 ,$876.80 ,$876.80 ,$252.08 ,$712.40 ST. FRANCIS HOSPITAL - ACUTE,32000491,77054,HC GALACTOGRAM MULTI DUCT,320,1 ,"$1,096.00 ",$712.40 ,$252.08 ,"$1,096.00 ",$789.12 ,$596.22 ,$252.08 ,$611.79 ,$252.08 ,$654.75 ,$654.75 ,$654.75 ,$654.75 ,$920.64 ,$252.08 ,$931.60 ,$920.64 ,$252.08 ,$822.00 ,$876.80 ,$876.80 ,$252.08 ,$876.80 ,$920.64 ,$920.64 ,$920.64 ,$986.40 ,$630.20 ,$252.08 ,"$1,096.00 ",$304.16 ,$334.58 ,$277.29 ,$931.60 ,$654.75 ,$986.40 ,$920.64 ,$876.80 ,$876.80 ,$252.08 ,$712.40 ST. FRANCIS HOSPITAL - ACUTE,32000492,77073,HC BONE LENGTH STUDIES,320,1 ,$452.00 ,$293.80 ,$53.38 ,$452.00 ,$325.44 ,$245.89 ,$103.96 ,$252.31 ,$103.96 ,$270.02 ,$270.02 ,$270.02 ,$270.02 ,$379.68 ,$103.96 ,$384.20 ,$379.68 ,$103.96 ,$339.00 ,$361.60 ,$361.60 ,$103.96 ,$361.60 ,$379.68 ,$379.68 ,$379.68 ,$406.80 ,$259.90 ,$103.96 ,$452.00 ,$53.38 ,$58.72 ,$114.36 ,$384.20 ,$270.02 ,$406.80 ,$379.68 ,$361.60 ,$361.60 ,$103.96 ,$293.80 ST. FRANCIS HOSPITAL - ACUTE,32000494,77075,HC BONE SURVEY COMPLETE,320,1 ,"$1,412.00 ",$917.80 ,$53.38 ,"$1,412.00 ","$1,016.64 ",$768.13 ,$324.76 ,$788.18 ,$324.76 ,$843.53 ,$843.53 ,$843.53 ,$843.53 ,"$1,186.08 ",$324.76 ,"$1,200.20 ","$1,186.08 ",$324.76 ,"$1,059.00 ","$1,129.60 ","$1,129.60 ",$324.76 ,"$1,129.60 ","$1,186.08 ","$1,186.08 ","$1,186.08 ","$1,270.80 ",$811.90 ,$324.76 ,"$1,412.00 ",$53.38 ,$58.72 ,$357.24 ,"$1,200.20 ",$843.53 ,"$1,270.80 ","$1,186.08 ","$1,129.60 ","$1,129.60 ",$324.76 ,$917.80 ST. FRANCIS HOSPITAL - ACUTE,32000495,77076,HC OSSEOUS SURVEY INFANT,320,1 ,$406.00 ,$263.90 ,$53.38 ,$406.00 ,$292.32 ,$220.86 ,$93.38 ,$226.63 ,$93.38 ,$242.54 ,$242.54 ,$242.54 ,$242.54 ,$341.04 ,$93.38 ,$345.10 ,$341.04 ,$93.38 ,$304.50 ,$324.80 ,$324.80 ,$93.38 ,$324.80 ,$341.04 ,$341.04 ,$341.04 ,$365.40 ,$233.45 ,$93.38 ,$406.00 ,$53.38 ,$58.72 ,$102.72 ,$345.10 ,$242.54 ,$365.40 ,$341.04 ,$324.80 ,$324.80 ,$93.38 ,$263.90 ST. FRANCIS HOSPITAL - ACUTE,32000500,76000,HC FLUOROSCOPY UP TO 1 HR SNIFF DIAPHRM,320,1 ,"$1,098.00 ",$713.70 ,$53.38 ,"$1,098.00 ",$790.56 ,$597.31 ,$252.54 ,$612.90 ,$252.54 ,$655.95 ,$655.95 ,$655.95 ,$655.95 ,$922.32 ,$252.54 ,$933.30 ,$922.32 ,$252.54 ,$823.50 ,$878.40 ,$878.40 ,$252.54 ,$878.40 ,$922.32 ,$922.32 ,$922.32 ,$988.20 ,$631.35 ,$252.54 ,"$1,098.00 ",$53.38 ,$58.72 ,$277.79 ,$933.30 ,$655.95 ,$988.20 ,$922.32 ,$878.40 ,$878.40 ,$252.54 ,$713.70 ST. FRANCIS HOSPITAL - ACUTE,32000504,20550,HC INJ SINGLE TENDON/LIGAMENT,320,1 ,$626.00 ,$406.90 ,$143.98 ,$626.00 ,$450.72 ,$340.54 ,$143.98 ,$349.43 ,$143.98 ,$373.97 ,$373.97 ,$373.97 ,$373.97 ,$525.84 ,$143.98 ,$532.10 ,$525.84 ,$143.98 ,$469.50 ,$500.80 ,$500.80 ,$143.98 ,$500.80 ,$525.84 ,$525.84 ,$525.84 ,$563.40 ,$359.95 ,$143.98 ,$626.00 ,$310.46 ,$341.51 ,$158.38 ,$532.10 ,$373.97 ,$563.40 ,$525.84 ,$500.80 ,$500.80 ,$143.98 ,$406.90 ST. FRANCIS HOSPITAL - ACUTE,32000504,20550,HC INJ SINGLE TENDON/LIGAMENT,320,1 ,$938.00 ,$609.70 ,$215.74 ,$938.00 ,$675.36 ,$510.27 ,$215.74 ,$523.59 ,$215.74 ,$560.36 ,$560.36 ,$560.36 ,$560.36 ,$787.92 ,$215.74 ,$797.30 ,$787.92 ,$215.74 ,$703.50 ,$750.40 ,$750.40 ,$215.74 ,$750.40 ,$787.92 ,$787.92 ,$787.92 ,$844.20 ,$539.35 ,$215.74 ,$938.00 ,$310.46 ,$341.51 ,$237.31 ,$797.30 ,$560.36 ,$844.20 ,$787.92 ,$750.40 ,$750.40 ,$215.74 ,$609.70 ST. FRANCIS HOSPITAL - ACUTE,32000505,20552,HC INJ TRIGGER PT 1-2 MUSCLE(S),320,1 ,$549.00 ,$356.85 ,$126.27 ,$549.00 ,$395.28 ,$298.66 ,$126.27 ,$306.45 ,$126.27 ,$327.97 ,$327.97 ,$327.97 ,$327.97 ,$461.16 ,$126.27 ,$466.65 ,$461.16 ,$126.27 ,$411.75 ,$439.20 ,$439.20 ,$126.27 ,$439.20 ,$461.16 ,$461.16 ,$461.16 ,$494.10 ,$315.68 ,$126.27 ,$549.00 ,$310.46 ,$341.51 ,$138.90 ,$466.65 ,$327.97 ,$494.10 ,$461.16 ,$439.20 ,$439.20 ,$126.27 ,$356.85 ST. FRANCIS HOSPITAL - ACUTE,32000509,77072,HC BONE AGE STUDIES,320,1 ,$211.00 ,$137.15 ,$48.53 ,$211.00 ,$151.92 ,$114.78 ,$48.53 ,$117.78 ,$48.53 ,$126.05 ,$126.05 ,$126.05 ,$126.05 ,$177.24 ,$48.53 ,$179.35 ,$177.24 ,$48.53 ,$158.25 ,$168.80 ,$168.80 ,$48.53 ,$168.80 ,$177.24 ,$177.24 ,$177.24 ,$189.90 ,$121.33 ,$48.53 ,$211.00 ,$53.38 ,$58.72 ,$53.38 ,$179.35 ,$126.05 ,$189.90 ,$177.24 ,$168.80 ,$168.80 ,$48.53 ,$137.15 ST. FRANCIS HOSPITAL - ACUTE,32000530,32554,HC THORACENTESIS W/O IMAGING 32554,320,1 ,$752.00 ,$488.80 ,$172.96 ,$752.00 ,$541.44 ,$409.09 ,$172.96 ,$419.77 ,$172.96 ,$449.24 ,$449.24 ,$449.24 ,$449.24 ,$631.68 ,$172.96 ,$639.20 ,$631.68 ,$172.96 ,$564.00 ,$601.60 ,$601.60 ,$172.96 ,$601.60 ,$631.68 ,$631.68 ,$631.68 ,$676.80 ,$432.40 ,$172.96 ,$752.00 ,$663.48 ,$729.83 ,$190.26 ,$639.20 ,$449.24 ,$676.80 ,$631.68 ,$601.60 ,$601.60 ,$172.96 ,$488.80 ST. FRANCIS HOSPITAL - ACUTE,32000531,32555,HC THORACENTESIS W IMAGING 32555,320,1 ,$827.00 ,$537.55 ,$190.21 ,$827.00 ,$595.44 ,$449.89 ,$190.21 ,$461.63 ,$190.21 ,$494.05 ,$494.05 ,$494.05 ,$494.05 ,$694.68 ,$190.21 ,$702.95 ,$694.68 ,$190.21 ,$620.25 ,$661.60 ,$661.60 ,$190.21 ,$661.60 ,$694.68 ,$694.68 ,$694.68 ,$744.30 ,$475.53 ,$190.21 ,$827.00 ,$663.48 ,$729.83 ,$209.23 ,$702.95 ,$494.05 ,$744.30 ,$694.68 ,$661.60 ,$661.60 ,$190.21 ,$537.55 ST. FRANCIS HOSPITAL - ACUTE,32000542,20551,HC INJ TENDON ORIGIN,320,1 ,$626.00 ,$406.90 ,$143.98 ,$626.00 ,$450.72 ,$340.54 ,$143.98 ,$349.43 ,$143.98 ,$373.97 ,$373.97 ,$373.97 ,$373.97 ,$525.84 ,$143.98 ,$532.10 ,$525.84 ,$143.98 ,$469.50 ,$500.80 ,$500.80 ,$143.98 ,$500.80 ,$525.84 ,$525.84 ,$525.84 ,$563.40 ,$359.95 ,$143.98 ,$626.00 ,$310.46 ,$341.51 ,$158.38 ,$532.10 ,$373.97 ,$563.40 ,$525.84 ,$500.80 ,$500.80 ,$143.98 ,$406.90 ST. FRANCIS HOSPITAL - ACUTE,32000543,72074,HC XR T-SPINE 4 + VIEWS,320,1 ,$855.00 ,$555.75 ,$53.38 ,$855.00 ,$615.60 ,$465.12 ,$196.65 ,$477.26 ,$196.65 ,$510.78 ,$510.78 ,$510.78 ,$510.78 ,$718.20 ,$196.65 ,$726.75 ,$718.20 ,$196.65 ,$641.25 ,$684.00 ,$684.00 ,$196.65 ,$684.00 ,$718.20 ,$718.20 ,$718.20 ,$769.50 ,$491.63 ,$196.65 ,$855.00 ,$53.38 ,$58.72 ,$216.32 ,$726.75 ,$510.78 ,$769.50 ,$718.20 ,$684.00 ,$684.00 ,$196.65 ,$555.75 ST. FRANCIS HOSPITAL - ACUTE,32000556,77071,HC XR JOINT STRESS BY PHYS,320,1 ,$416.00 ,$270.40 ,$95.68 ,$416.00 ,$299.52 ,$226.30 ,$95.68 ,$232.21 ,$95.68 ,$248.52 ,$248.52 ,$248.52 ,$248.52 ,$349.44 ,$95.68 ,$353.60 ,$349.44 ,$95.68 ,$312.00 ,$332.80 ,$332.80 ,$95.68 ,$332.80 ,$349.44 ,$349.44 ,$349.44 ,$374.40 ,$239.20 ,$95.68 ,$416.00 , N/A , N/A ,$105.25 ,$353.60 ,$248.52 ,$374.40 ,$349.44 ,$332.80 ,$332.80 ,$95.68 ,$270.40 ST. FRANCIS HOSPITAL - ACUTE,32000567,70100,HC XR MANDIBLE 1-3 VIEW,320,1 ,$746.00 ,$484.90 ,$53.38 ,$746.00 ,$537.12 ,$405.82 ,$171.58 ,$416.42 ,$171.58 ,$445.66 ,$445.66 ,$445.66 ,$445.66 ,$626.64 ,$171.58 ,$634.10 ,$626.64 ,$171.58 ,$559.50 ,$596.80 ,$596.80 ,$171.58 ,$596.80 ,$626.64 ,$626.64 ,$626.64 ,$671.40 ,$428.95 ,$171.58 ,$746.00 ,$53.38 ,$58.72 ,$188.74 ,$634.10 ,$445.66 ,$671.40 ,$626.64 ,$596.80 ,$596.80 ,$171.58 ,$484.90 ST. FRANCIS HOSPITAL - ACUTE,32000570,72081,HC XR SPINE/CERV SCOLIOSIS 1 VW,320,1 ,$479.00 ,$311.35 ,$53.38 ,$479.00 ,$344.88 ,$260.58 ,$110.17 ,$267.38 ,$110.17 ,$286.15 ,$286.15 ,$286.15 ,$286.15 ,$402.36 ,$110.17 ,$407.15 ,$402.36 ,$110.17 ,$359.25 ,$383.20 ,$383.20 ,$110.17 ,$383.20 ,$402.36 ,$402.36 ,$402.36 ,$431.10 ,$275.43 ,$110.17 ,$479.00 ,$53.38 ,$58.72 ,$121.19 ,$407.15 ,$286.15 ,$431.10 ,$402.36 ,$383.20 ,$383.20 ,$110.17 ,$311.35 ST. FRANCIS HOSPITAL - ACUTE,32000571,72082,HC XR SPINE/CERV SCOLIOSIS 2-3VW,320,1 ,$527.00 ,$342.55 ,$53.38 ,$527.00 ,$379.44 ,$286.69 ,$121.21 ,$294.17 ,$121.21 ,$314.83 ,$314.83 ,$314.83 ,$314.83 ,$442.68 ,$121.21 ,$447.95 ,$442.68 ,$121.21 ,$395.25 ,$421.60 ,$421.60 ,$121.21 ,$421.60 ,$442.68 ,$442.68 ,$442.68 ,$474.30 ,$303.03 ,$121.21 ,$527.00 ,$53.38 ,$58.72 ,$133.33 ,$447.95 ,$314.83 ,$474.30 ,$442.68 ,$421.60 ,$421.60 ,$121.21 ,$342.55 ST. FRANCIS HOSPITAL - ACUTE,32000574,73501,HC XR HIP W/PELVIS UNI 1VIEW,320,1 ,$373.00 ,$242.45 ,$53.38 ,$373.00 ,$268.56 ,$202.91 ,$85.79 ,$208.21 ,$85.79 ,$222.83 ,$222.83 ,$222.83 ,$222.83 ,$313.32 ,$85.79 ,$317.05 ,$313.32 ,$85.79 ,$279.75 ,$298.40 ,$298.40 ,$85.79 ,$298.40 ,$313.32 ,$313.32 ,$313.32 ,$335.70 ,$214.48 ,$85.79 ,$373.00 ,$53.38 ,$58.72 ,$94.37 ,$317.05 ,$222.83 ,$335.70 ,$313.32 ,$298.40 ,$298.40 ,$85.79 ,$242.45 ST. FRANCIS HOSPITAL - ACUTE,32000575,73502,HC XR HIP W/PELVIS UNI 2-3VWS,320,1 ,$634.00 ,$412.10 ,$53.38 ,$634.00 ,$456.48 ,$344.90 ,$145.82 ,$353.90 ,$145.82 ,$378.75 ,$378.75 ,$378.75 ,$378.75 ,$532.56 ,$145.82 ,$538.90 ,$532.56 ,$145.82 ,$475.50 ,$507.20 ,$507.20 ,$145.82 ,$507.20 ,$532.56 ,$532.56 ,$532.56 ,$570.60 ,$364.55 ,$145.82 ,$634.00 ,$53.38 ,$58.72 ,$160.40 ,$538.90 ,$378.75 ,$570.60 ,$532.56 ,$507.20 ,$507.20 ,$145.82 ,$412.10 ST. FRANCIS HOSPITAL - ACUTE,32000577,73521,HC XR HIP W/PELVIS BIL 2 VIEWS,320,1 ,$425.00 ,$276.25 ,$53.38 ,$425.00 ,$306.00 ,$231.20 ,$97.75 ,$237.24 ,$97.75 ,$253.90 ,$253.90 ,$253.90 ,$253.90 ,$357.00 ,$97.75 ,$361.25 ,$357.00 ,$97.75 ,$318.75 ,$340.00 ,$340.00 ,$97.75 ,$340.00 ,$357.00 ,$357.00 ,$357.00 ,$382.50 ,$244.38 ,$97.75 ,$425.00 ,$53.38 ,$58.72 ,$107.53 ,$361.25 ,$253.90 ,$382.50 ,$357.00 ,$340.00 ,$340.00 ,$97.75 ,$276.25 ST. FRANCIS HOSPITAL - ACUTE,32000578,73522,HC XR HIP W/PELVIS BIL 3-4VIEWS,320,1 ,$950.00 ,$617.50 ,$53.38 ,$950.00 ,$684.00 ,$516.80 ,$218.50 ,$530.29 ,$218.50 ,$567.53 ,$567.53 ,$567.53 ,$567.53 ,$798.00 ,$218.50 ,$807.50 ,$798.00 ,$218.50 ,$712.50 ,$760.00 ,$760.00 ,$218.50 ,$760.00 ,$798.00 ,$798.00 ,$798.00 ,$855.00 ,$546.25 ,$218.50 ,$950.00 ,$53.38 ,$58.72 ,$240.35 ,$807.50 ,$567.53 ,$855.00 ,$798.00 ,$760.00 ,$760.00 ,$218.50 ,$617.50 ST. FRANCIS HOSPITAL - ACUTE,32000579,73523,HC XR HIP W/PELVIS BIL 5+VIEWS,320,1 ,"$1,162.00 ",$755.30 ,$53.38 ,"$1,162.00 ",$836.64 ,$632.13 ,$267.26 ,$648.63 ,$267.26 ,$694.18 ,$694.18 ,$694.18 ,$694.18 ,$976.08 ,$267.26 ,$987.70 ,$976.08 ,$267.26 ,$871.50 ,$929.60 ,$929.60 ,$267.26 ,$929.60 ,$976.08 ,$976.08 ,$976.08 ,"$1,045.80 ",$668.15 ,$267.26 ,"$1,162.00 ",$53.38 ,$58.72 ,$293.99 ,$987.70 ,$694.18 ,"$1,045.80 ",$976.08 ,$929.60 ,$929.60 ,$267.26 ,$755.30 ST. FRANCIS HOSPITAL - ACUTE,32000580,73551,HC XR FEMUR 1VIEW,320,1 ,$234.00 ,$152.10 ,$53.38 ,$234.00 ,$168.48 ,$127.30 ,$53.82 ,$130.62 ,$53.82 ,$139.79 ,$139.79 ,$139.79 ,$139.79 ,$196.56 ,$53.82 ,$198.90 ,$196.56 ,$53.82 ,$175.50 ,$187.20 ,$187.20 ,$53.82 ,$187.20 ,$196.56 ,$196.56 ,$196.56 ,$210.60 ,$134.55 ,$53.82 ,$234.00 ,$53.38 ,$58.72 ,$59.20 ,$198.90 ,$139.79 ,$210.60 ,$196.56 ,$187.20 ,$187.20 ,$53.82 ,$152.10 ST. FRANCIS HOSPITAL - ACUTE,32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$502.00 ,$326.30 ,$53.38 ,$502.00 ,$361.44 ,$273.09 ,$115.46 ,$280.22 ,$115.46 ,$299.89 ,$299.89 ,$299.89 ,$299.89 ,$421.68 ,$115.46 ,$426.70 ,$421.68 ,$115.46 ,$376.50 ,$401.60 ,$401.60 ,$115.46 ,$401.60 ,$421.68 ,$421.68 ,$421.68 ,$451.80 ,$288.65 ,$115.46 ,$502.00 ,$53.38 ,$58.72 ,$127.01 ,$426.70 ,$299.89 ,$451.80 ,$421.68 ,$401.60 ,$401.60 ,$115.46 ,$326.30 ST. FRANCIS HOSPITAL - ACUTE,32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$995.00 ,$646.75 ,$53.38 ,$995.00 ,$716.40 ,$541.28 ,$228.85 ,$555.41 ,$228.85 ,$594.41 ,$594.41 ,$594.41 ,$594.41 ,$835.80 ,$228.85 ,$845.75 ,$835.80 ,$228.85 ,$746.25 ,$796.00 ,$796.00 ,$228.85 ,$796.00 ,$835.80 ,$835.80 ,$835.80 ,$895.50 ,$572.13 ,$228.85 ,$995.00 ,$53.38 ,$58.72 ,$251.74 ,$845.75 ,$594.41 ,$895.50 ,$835.80 ,$796.00 ,$796.00 ,$228.85 ,$646.75 ST. FRANCIS HOSPITAL - ACUTE,32000589,74019,HC XR ABDOMEN 2V,320,1 ,$522.00 ,$339.30 ,$53.38 ,$522.00 ,$375.84 ,$283.97 ,$120.06 ,$291.38 ,$120.06 ,$311.84 ,$311.84 ,$311.84 ,$311.84 ,$438.48 ,$120.06 ,$443.70 ,$438.48 ,$120.06 ,$391.50 ,$417.60 ,$417.60 ,$120.06 ,$417.60 ,$438.48 ,$438.48 ,$438.48 ,$469.80 ,$300.15 ,$120.06 ,$522.00 ,$53.38 ,$58.72 ,$132.07 ,$443.70 ,$311.84 ,$469.80 ,$438.48 ,$417.60 ,$417.60 ,$120.06 ,$339.30 ST. FRANCIS HOSPITAL - ACUTE,32000595,76000,HC FLUOROSCOPY >1HR,320,1 ,"$1,098.00 ",$713.70 ,$53.38 ,"$1,098.00 ",$790.56 ,$597.31 ,$252.54 ,$612.90 ,$252.54 ,$655.95 ,$655.95 ,$655.95 ,$655.95 ,$922.32 ,$252.54 ,$933.30 ,$922.32 ,$252.54 ,$823.50 ,$878.40 ,$878.40 ,$252.54 ,$878.40 ,$922.32 ,$922.32 ,$922.32 ,$988.20 ,$631.35 ,$252.54 ,"$1,098.00 ",$53.38 ,$58.72 ,$277.79 ,$933.30 ,$655.95 ,$988.20 ,$922.32 ,$878.40 ,$878.40 ,$252.54 ,$713.70 ST. FRANCIS HOSPITAL - ACUTE,32000605,71045,HC XR CHEST 1V W/PICC INS,320,1 ,$371.00 ,$241.15 ,$17.56 ,$371.00 ,$267.12 ,$201.82 ,$85.33 ,$207.09 ,$85.33 ,$221.64 ,$221.64 ,$221.64 ,$221.64 ,$311.64 ,$85.33 ,$315.35 ,$311.64 ,$85.33 ,$278.25 ,$296.80 ,$296.80 ,$85.33 ,$296.80 ,$311.64 ,$311.64 ,$311.64 ,$333.90 ,$213.33 ,$85.33 ,$17.56 ,$53.38 ,$58.72 ,$93.86 ,$315.35 ,$221.64 ,$333.90 ,$311.64 ,$296.80 ,$296.80 ,$85.33 ,$241.15 ST. FRANCIS HOSPITAL - ACUTE,32000611,G1004,HC RAD AUC CDSM NATL DECISION SUPPORT COMPANY,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000612,74248,HC XRAY SMALL INTESTINE FOLLOW THRU STUDY,320,1 ,"$1,230.00 ",$799.50 ,$53.38 ,"$1,230.00 ",$885.60 ,$669.12 ,$282.90 ,$686.59 ,$282.90 ,$734.80 ,$734.80 ,$734.80 ,$734.80 ,"$1,033.20 ",$282.90 ,"$1,045.50 ","$1,033.20 ",$282.90 ,$922.50 ,$984.00 ,$984.00 ,$282.90 ,$984.00 ,"$1,033.20 ","$1,033.20 ","$1,033.20 ","$1,107.00 ",$707.25 ,$282.90 ,"$1,230.00 ",$53.38 ,$58.72 ,$311.19 ,"$1,045.50 ",$734.80 ,"$1,107.00 ","$1,033.20 ",$984.00 ,$984.00 ,$282.90 ,$799.50 ST. FRANCIS HOSPITAL - ACUTE,32000613,G1002,HC RAD AUC CDSM MEDCURRENT,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000614,G1003,HC RAD AUC CDSM MEDICALIS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000615,G1005,HC RAD AUC CDSM NATIONAL IMAGING ASSOCIATES,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000616,G1006,HC RAD AUC CDSM TEST APPROPRIATE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000617,G1007,HC RAD AUC CDSM AIM SPECIALTY HEALTH,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000618,G1008,HC RAD AUC CDSM CRANBERRY PEAK,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000619,G1009,HC RAD AUC CDSM SAGE HEALTH MGMT SOLUTIONS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000620,G1010,HC RAD AUC CDSM STANSON,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000621,G1011,HC RAD AUC CDSM QUALIFIED TOOL NOS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000622,G1000,HC RAD AUC CDSM APPLIED PATHWAYS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,32000623,G1001,HC RAD AUC CDSM EVICORE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,33100001,96405,HC CHEMO IV INTRALESION UP TO 7 LESIONS,331,1 ,$536.00 ,$348.40 ,$123.28 ,$536.00 ,$385.92 ,$291.58 ,$123.28 ,$299.20 ,$123.28 ,$320.21 ,$320.21 ,$320.21 ,$320.21 ,$450.24 ,$123.28 ,$455.60 ,$450.24 ,$123.28 ,$402.00 ,$428.80 ,$428.80 ,$123.28 ,$428.80 ,$450.24 ,$450.24 ,$450.24 ,$482.40 ,$308.20 ,$123.28 ,$536.00 ,$294.07 ,$323.48 ,$135.61 ,$455.60 ,$320.21 ,$482.40 ,$450.24 ,$428.80 ,$428.80 ,$123.28 ,$348.40 ST. FRANCIS HOSPITAL - ACUTE,33100002,96406,HC CHEMO IV INTRALESION >7 LESIONS,331,1 ,$499.00 ,$324.35 ,$114.77 ,$499.00 ,$359.28 ,$271.46 ,$114.77 ,$278.54 ,$114.77 ,$298.10 ,$298.10 ,$298.10 ,$298.10 ,$419.16 ,$114.77 ,$424.15 ,$419.16 ,$114.77 ,$374.25 ,$399.20 ,$399.20 ,$114.77 ,$399.20 ,$419.16 ,$419.16 ,$419.16 ,$449.10 ,$286.93 ,$114.77 ,$499.00 ,$294.07 ,$323.48 ,$126.25 ,$424.15 ,$298.10 ,$449.10 ,$419.16 ,$399.20 ,$399.20 ,$114.77 ,$324.35 ST. FRANCIS HOSPITAL - ACUTE,33100003,96420,HC CHEMO IV INTRA ART PUSH TECH,331,1 ,$328.00 ,$213.20 ,$75.44 ,$328.00 ,$236.16 ,$178.43 ,$75.44 ,$183.09 ,$75.44 ,$195.95 ,$195.95 ,$195.95 ,$195.95 ,$275.52 ,$75.44 ,$278.80 ,$275.52 ,$75.44 ,$246.00 ,$262.40 ,$262.40 ,$75.44 ,$262.40 ,$275.52 ,$275.52 ,$275.52 ,$295.20 ,$188.60 ,$75.44 ,$328.00 , N/A , N/A ,$82.98 ,$278.80 ,$195.95 ,$295.20 ,$275.52 ,$262.40 ,$262.40 ,$75.44 ,$213.20 ST. FRANCIS HOSPITAL - ACUTE,33500002,96401,HC CHEMO SQ/IM NON ANTI-NEOPLAST,335,1 ,$259.00 ,$168.35 ,$59.57 ,$259.00 ,$186.48 ,$140.90 ,$59.57 ,$144.57 ,$59.57 ,$154.73 ,$154.73 ,$154.73 ,$154.73 ,$217.56 ,$59.57 ,$220.15 ,$217.56 ,$59.57 ,$194.25 ,$207.20 ,$207.20 ,$59.57 ,$207.20 ,$217.56 ,$217.56 ,$217.56 ,$233.10 ,$148.93 ,$59.57 ,$259.00 , N/A , N/A ,$65.53 ,$220.15 ,$154.73 ,$233.10 ,$217.56 ,$207.20 ,$207.20 ,$59.57 ,$168.35 ST. FRANCIS HOSPITAL - ACUTE,33500003,96409,HC CHEMO IV PUSH SINGLE/INIT,335,1 ,$371.00 ,$241.15 ,$85.33 ,$371.00 ,$267.12 ,$201.82 ,$85.33 ,$207.09 ,$85.33 ,$221.64 ,$221.64 ,$221.64 ,$221.64 ,$311.64 ,$85.33 ,$315.35 ,$311.64 ,$85.33 ,$278.25 ,$296.80 ,$296.80 ,$85.33 ,$296.80 ,$311.64 ,$311.64 ,$311.64 ,$333.90 ,$213.33 ,$85.33 ,$371.00 , N/A , N/A ,$93.86 ,$315.35 ,$221.64 ,$333.90 ,$311.64 ,$296.80 ,$296.80 ,$85.33 ,$241.15 ST. FRANCIS HOSPITAL - ACUTE,33500004,96411,HC CHEMO IV PUSH ADDL DRUG,335,1 ,$328.00 ,$213.20 ,$75.44 ,$328.00 ,$236.16 ,$178.43 ,$75.44 ,$183.09 ,$75.44 ,$195.95 ,$195.95 ,$195.95 ,$195.95 ,$275.52 ,$75.44 ,$278.80 ,$275.52 ,$75.44 ,$246.00 ,$262.40 ,$262.40 ,$75.44 ,$262.40 ,$275.52 ,$275.52 ,$275.52 ,$295.20 ,$188.60 ,$75.44 ,$328.00 , N/A , N/A ,$82.98 ,$278.80 ,$195.95 ,$295.20 ,$275.52 ,$262.40 ,$262.40 ,$75.44 ,$213.20 ST. FRANCIS HOSPITAL - ACUTE,33500005,96413,HC CHEMO IV INFUSION SGL/INIT<1H,335,1 ,$483.00 ,$313.95 ,$111.09 ,$483.00 ,$347.76 ,$262.75 ,$111.09 ,$269.61 ,$111.09 ,$288.54 ,$288.54 ,$288.54 ,$288.54 ,$405.72 ,$111.09 ,$410.55 ,$405.72 ,$111.09 ,$362.25 ,$386.40 ,$386.40 ,$111.09 ,$386.40 ,$405.72 ,$405.72 ,$405.72 ,$434.70 ,$277.73 ,$111.09 ,$483.00 ,$300.07 ,$330.08 ,$122.20 ,$410.55 ,$288.54 ,$434.70 ,$405.72 ,$386.40 ,$386.40 ,$111.09 ,$313.95 ST. FRANCIS HOSPITAL - ACUTE,33500006,96415,HC CHEMO IV INFUSION ADDL HR,335,1 ,$333.00 ,$216.45 ,$76.59 ,$516.01 ,$239.76 ,$181.15 ,$76.59 ,$185.88 ,$76.59 ,$198.93 ,$198.93 ,$198.93 ,$198.93 ,$279.72 ,$76.59 ,$283.05 ,$279.72 ,$76.59 ,$249.75 ,$266.40 ,$266.40 ,$76.59 ,$266.40 ,$279.72 ,$279.72 ,$279.72 ,$299.70 ,$191.48 ,$76.59 ,$333.00 ,$469.10 ,$516.01 ,$84.25 ,$283.05 ,$198.93 ,$299.70 ,$279.72 ,$266.40 ,$266.40 ,$76.59 ,$216.45 ST. FRANCIS HOSPITAL - ACUTE,33500007,96416,HC CHEMO ADMIN INTRAV INFUS >8HR,335,1 ,"$2,703.00 ","$1,756.95 ",$469.10 ,"$2,703.00 ","$1,946.16 ","$1,470.43 ",$621.69 ,"$1,508.81 ",$621.69 ,"$1,614.77 ","$1,614.77 ","$1,614.77 ","$1,614.77 ","$2,270.52 ",$621.69 ,"$2,297.55 ","$2,270.52 ",$621.69 ,"$2,027.25 ","$2,162.40 ","$2,162.40 ",$621.69 ,"$2,162.40 ","$2,270.52 ","$2,270.52 ","$2,270.52 ","$2,432.70 ","$1,554.23 ",$621.69 ,"$2,703.00 ",$469.10 ,$516.01 ,$683.86 ,"$2,297.55 ","$1,614.77 ","$2,432.70 ","$2,270.52 ","$2,162.40 ","$2,162.40 ",$621.69 ,"$1,756.95 " ST. FRANCIS HOSPITAL - ACUTE,33500008,96417,HC CHEMO IV INFUSION EA ADDL <1H,335,1 ,$333.00 ,$216.45 ,$76.59 ,$333.00 ,$239.76 ,$181.15 ,$76.59 ,$185.88 ,$76.59 ,$198.93 ,$198.93 ,$198.93 ,$198.93 ,$279.72 ,$76.59 ,$283.05 ,$279.72 ,$76.59 ,$249.75 ,$266.40 ,$266.40 ,$76.59 ,$266.40 ,$279.72 ,$279.72 ,$279.72 ,$299.70 ,$191.48 ,$76.59 ,$333.00 ,$300.07 ,$330.08 ,$84.25 ,$283.05 ,$198.93 ,$299.70 ,$279.72 ,$266.40 ,$266.40 ,$76.59 ,$216.45 ST. FRANCIS HOSPITAL - ACUTE,33500009,96422,HC CHEMO ADMIN INTRA-ARTR INFUS<1HR,335,1 ,$483.00 ,$313.95 ,$111.09 ,$483.00 ,$347.76 ,$262.75 ,$111.09 ,$269.61 ,$111.09 ,$288.54 ,$288.54 ,$288.54 ,$288.54 ,$405.72 ,$111.09 ,$410.55 ,$405.72 ,$111.09 ,$362.25 ,$386.40 ,$386.40 ,$111.09 ,$386.40 ,$405.72 ,$405.72 ,$405.72 ,$434.70 ,$277.73 ,$111.09 ,$483.00 ,$300.07 ,$330.08 ,$122.20 ,$410.55 ,$288.54 ,$434.70 ,$405.72 ,$386.40 ,$386.40 ,$111.09 ,$313.95 ST. FRANCIS HOSPITAL - ACUTE,33500010,96423,HC CHEMO ADMN INTR-ARTR EA ADD HR,335,1 ,$333.00 ,$216.45 ,$76.59 ,$516.01 ,$239.76 ,$181.15 ,$76.59 ,$185.88 ,$76.59 ,$198.93 ,$198.93 ,$198.93 ,$198.93 ,$279.72 ,$76.59 ,$283.05 ,$279.72 ,$76.59 ,$249.75 ,$266.40 ,$266.40 ,$76.59 ,$266.40 ,$279.72 ,$279.72 ,$279.72 ,$299.70 ,$191.48 ,$76.59 ,$333.00 ,$469.10 ,$516.01 ,$84.25 ,$283.05 ,$198.93 ,$299.70 ,$279.72 ,$266.40 ,$266.40 ,$76.59 ,$216.45 ST. FRANCIS HOSPITAL - ACUTE,33500011,96446,HC CHEMO PERITONEAL CAVITY,335,1 ,$499.00 ,$324.35 ,$114.77 ,$499.00 ,$359.28 ,$271.46 ,$114.77 ,$278.54 ,$114.77 ,$298.10 ,$298.10 ,$298.10 ,$298.10 ,$419.16 ,$114.77 ,$424.15 ,$419.16 ,$114.77 ,$374.25 ,$399.20 ,$399.20 ,$114.77 ,$399.20 ,$419.16 ,$419.16 ,$419.16 ,$449.10 ,$286.93 ,$114.77 ,$499.00 ,$300.07 ,$330.08 ,$126.25 ,$424.15 ,$298.10 ,$449.10 ,$419.16 ,$399.20 ,$399.20 ,$114.77 ,$324.35 ST. FRANCIS HOSPITAL - ACUTE,33500012,96450,HC CHEMO CNS,335,1 ,"$1,092.00 ",$709.80 ,$251.16 ,"$1,092.00 ",$786.24 ,$594.05 ,$251.16 ,$609.55 ,$251.16 ,$652.36 ,$652.36 ,$652.36 ,$652.36 ,$917.28 ,$251.16 ,$928.20 ,$917.28 ,$251.16 ,$819.00 ,$873.60 ,$873.60 ,$251.16 ,$873.60 ,$917.28 ,$917.28 ,$917.28 ,$982.80 ,$627.90 ,$251.16 ,"$1,092.00 ",$469.10 ,$516.01 ,$276.28 ,$928.20 ,$652.36 ,$982.80 ,$917.28 ,$873.60 ,$873.60 ,$251.16 ,$709.80 ST. FRANCIS HOSPITAL - ACUTE,33500013,96402,HC CHEMOTHERAPY INJECTION-HORMONAL ANTI-NEO,335,1 ,$259.00 ,$168.35 ,$59.57 ,$259.00 ,$186.48 ,$140.90 ,$59.57 ,$144.57 ,$59.57 ,$154.73 ,$154.73 ,$154.73 ,$154.73 ,$217.56 ,$59.57 ,$220.15 ,$217.56 ,$59.57 ,$194.25 ,$207.20 ,$207.20 ,$59.57 ,$207.20 ,$217.56 ,$217.56 ,$217.56 ,$233.10 ,$148.93 ,$59.57 ,$259.00 , N/A , N/A ,$65.53 ,$220.15 ,$154.73 ,$233.10 ,$217.56 ,$207.20 ,$207.20 ,$59.57 ,$168.35 ST. FRANCIS HOSPITAL - ACUTE,33500014,96521,HC REFILLING/MAINTENANCE PORTABLE PUMP,335,1 ,$573.00 ,$372.45 ,$114.53 ,$573.00 ,$412.56 ,$311.71 ,$131.79 ,$319.85 ,$131.79 ,$342.31 ,$342.31 ,$342.31 ,$342.31 ,$481.32 ,$131.79 ,$487.05 ,$481.32 ,$131.79 ,$429.75 ,$458.40 ,$458.40 ,$131.79 ,$458.40 ,$481.32 ,$481.32 ,$481.32 ,$515.70 ,$329.48 ,$131.79 ,$573.00 ,$114.53 ,$125.98 ,$144.97 ,$487.05 ,$342.31 ,$515.70 ,$481.32 ,$458.40 ,$458.40 ,$131.79 ,$372.45 ST. FRANCIS HOSPITAL - ACUTE,33500027,96425,HC CHEMO INTRA-ART PROLONGED INFUSION W/PUMP,335,1 ,"$1,009.00 ",$655.85 ,$232.07 ,"$1,009.00 ",$726.48 ,$548.90 ,$232.07 ,$563.22 ,$232.07 ,$602.78 ,$602.78 ,$602.78 ,$602.78 ,$847.56 ,$232.07 ,$857.65 ,$847.56 ,$232.07 ,$756.75 ,$807.20 ,$807.20 ,$232.07 ,$807.20 ,$847.56 ,$847.56 ,$847.56 ,$908.10 ,$580.18 ,$232.07 ,"$1,009.00 ",$469.10 ,$516.01 ,$255.28 ,$857.65 ,$602.78 ,$908.10 ,$847.56 ,$807.20 ,$807.20 ,$232.07 ,$655.85 ST. FRANCIS HOSPITAL - ACUTE,33500028,96440,HC CHEMO ADMIN PLEURAL CAVITY W/THORACENTESIS,335,1 ,$536.00 ,$348.40 ,$123.28 ,$729.83 ,$385.92 ,$291.58 ,$123.28 ,$299.20 ,$123.28 ,$320.21 ,$320.21 ,$320.21 ,$320.21 ,$450.24 ,$123.28 ,$455.60 ,$450.24 ,$123.28 ,$402.00 ,$428.80 ,$428.80 ,$123.28 ,$428.80 ,$450.24 ,$450.24 ,$450.24 ,$482.40 ,$308.20 ,$123.28 ,$536.00 ,$663.48 ,$729.83 ,$135.61 ,$455.60 ,$320.21 ,$482.40 ,$450.24 ,$428.80 ,$428.80 ,$123.28 ,$348.40 ST. FRANCIS HOSPITAL - ACUTE,33500029,96522,HC PUMP MAINT SYSTEMIC,335,1 ,$573.00 ,$372.45 ,$114.53 ,$573.00 ,$412.56 ,$311.71 ,$131.79 ,$319.85 ,$131.79 ,$342.31 ,$342.31 ,$342.31 ,$342.31 ,$481.32 ,$131.79 ,$487.05 ,$481.32 ,$131.79 ,$429.75 ,$458.40 ,$458.40 ,$131.79 ,$458.40 ,$481.32 ,$481.32 ,$481.32 ,$515.70 ,$329.48 ,$131.79 ,$573.00 ,$114.53 ,$125.98 ,$144.97 ,$487.05 ,$342.31 ,$515.70 ,$481.32 ,$458.40 ,$458.40 ,$131.79 ,$372.45 ST. FRANCIS HOSPITAL - ACUTE,34000006,78013,HC NM THYROID SCAN,340,1 ,$564.00 ,$366.60 ,$129.72 ,$564.00 ,$406.08 ,$306.82 ,$129.72 ,$314.82 ,$129.72 ,$336.93 ,$336.93 ,$336.93 ,$336.93 ,$473.76 ,$129.72 ,$479.40 ,$473.76 ,$129.72 ,$423.00 ,$451.20 ,$451.20 ,$129.72 ,$451.20 ,$473.76 ,$473.76 ,$473.76 ,$507.60 ,$324.30 ,$129.72 ,$564.00 ,$403.61 ,$443.97 ,$142.69 ,$479.40 ,$336.93 ,$507.60 ,$473.76 ,$451.20 ,$451.20 ,$129.72 ,$366.60 ST. FRANCIS HOSPITAL - ACUTE,34000009,78070,HC PARATHRYOID IMAGING 78070,340,1 ,"$1,219.00 ",$792.35 ,$280.37 ,"$1,219.00 ",$877.68 ,$663.14 ,$280.37 ,$680.45 ,$280.37 ,$728.23 ,$728.23 ,$728.23 ,$728.23 ,"$1,023.96 ",$280.37 ,"$1,036.15 ","$1,023.96 ",$280.37 ,$914.25 ,$975.20 ,$975.20 ,$280.37 ,$975.20 ,"$1,023.96 ","$1,023.96 ","$1,023.96 ","$1,097.10 ",$700.93 ,$280.37 ,"$1,219.00 ",$360.21 ,$396.23 ,$308.41 ,"$1,036.15 ",$728.23 ,"$1,097.10 ","$1,023.96 ",$975.20 ,$975.20 ,$280.37 ,$792.35 ST. FRANCIS HOSPITAL - ACUTE,34000014,78195,HC LYMPH NODE IMAGING,340,1 ,"$2,205.00 ","$1,433.25 ",$403.61 ,"$2,205.00 ","$1,587.60 ","$1,199.52 ",$507.15 ,"$1,230.83 ",$507.15 ,"$1,317.27 ","$1,317.27 ","$1,317.27 ","$1,317.27 ","$1,852.20 ",$507.15 ,"$1,874.25 ","$1,852.20 ",$507.15 ,"$1,653.75 ","$1,764.00 ","$1,764.00 ",$507.15 ,"$1,764.00 ","$1,852.20 ","$1,852.20 ","$1,852.20 ","$1,984.50 ","$1,267.88 ",$507.15 ,"$2,205.00 ",$403.61 ,$443.97 ,$557.87 ,"$1,874.25 ","$1,317.27 ","$1,984.50 ","$1,852.20 ","$1,764.00 ","$1,764.00 ",$507.15 ,"$1,433.25 " ST. FRANCIS HOSPITAL - ACUTE,34000017,78205,HC LIVER IMAGING SPECT,340,1 ,"$1,405.00 ",$913.25 ,$323.15 ,"$1,405.00 ","$1,011.60 ",$764.32 ,$323.15 ,$784.27 ,$323.15 ,$839.35 ,$839.35 ,$839.35 ,$839.35 ,"$1,180.20 ",$323.15 ,"$1,194.25 ","$1,180.20 ",$323.15 ,"$1,053.75 ","$1,124.00 ","$1,124.00 ",$323.15 ,"$1,124.00 ","$1,180.20 ","$1,180.20 ","$1,180.20 ","$1,264.50 ",$807.88 ,$323.15 ,"$1,405.00 ", N/A , N/A ,$355.47 ,"$1,194.25 ",$839.35 ,"$1,264.50 ","$1,180.20 ","$1,124.00 ","$1,124.00 ",$323.15 ,$913.25 ST. FRANCIS HOSPITAL - ACUTE,34000018,78206,HC LIVER IMAGING SPECT FLOW,340,1 ,"$1,405.00 ",$913.25 ,$323.15 ,"$1,405.00 ","$1,011.60 ",$764.32 ,$323.15 ,$784.27 ,$323.15 ,$839.35 ,$839.35 ,$839.35 ,$839.35 ,"$1,180.20 ",$323.15 ,"$1,194.25 ","$1,180.20 ",$323.15 ,"$1,053.75 ","$1,124.00 ","$1,124.00 ",$323.15 ,"$1,124.00 ","$1,180.20 ","$1,180.20 ","$1,180.20 ","$1,264.50 ",$807.88 ,$323.15 ,"$1,405.00 ", N/A , N/A ,$355.47 ,"$1,194.25 ",$839.35 ,"$1,264.50 ","$1,180.20 ","$1,124.00 ","$1,124.00 ",$323.15 ,$913.25 ST. FRANCIS HOSPITAL - ACUTE,34000019,78215,HC LIVER SPLEEN STATIC,340,1 ,"$1,405.00 ",$913.25 ,$323.15 ,"$1,405.00 ","$1,011.60 ",$764.32 ,$323.15 ,$784.27 ,$323.15 ,$839.35 ,$839.35 ,$839.35 ,$839.35 ,"$1,180.20 ",$323.15 ,"$1,194.25 ","$1,180.20 ",$323.15 ,"$1,053.75 ","$1,124.00 ","$1,124.00 ",$323.15 ,"$1,124.00 ","$1,180.20 ","$1,180.20 ","$1,180.20 ","$1,264.50 ",$807.88 ,$323.15 ,"$1,405.00 ",$360.21 ,$396.23 ,$355.47 ,"$1,194.25 ",$839.35 ,"$1,264.50 ","$1,180.20 ","$1,124.00 ","$1,124.00 ",$323.15 ,$913.25 ST. FRANCIS HOSPITAL - ACUTE,34000022,78226,HC HEPATOBILIARY SCAN,340,1 ,"$1,424.00 ",$925.60 ,$327.52 ,"$1,424.00 ","$1,025.28 ",$774.66 ,$327.52 ,$794.88 ,$327.52 ,$850.70 ,$850.70 ,$850.70 ,$850.70 ,"$1,196.16 ",$327.52 ,"$1,210.40 ","$1,196.16 ",$327.52 ,"$1,068.00 ","$1,139.20 ","$1,139.20 ",$327.52 ,"$1,139.20 ","$1,196.16 ","$1,196.16 ","$1,196.16 ","$1,281.60 ",$818.80 ,$327.52 ,"$1,424.00 ",$403.61 ,$443.97 ,$360.27 ,"$1,210.40 ",$850.70 ,"$1,281.60 ","$1,196.16 ","$1,139.20 ","$1,139.20 ",$327.52 ,$925.60 ST. FRANCIS HOSPITAL - ACUTE,34000026,78264,HC GASTRIC EMPTYING STUDY,340,1 ,"$1,026.00 ",$666.90 ,$235.98 ,"$1,026.00 ",$738.72 ,$558.14 ,$235.98 ,$572.71 ,$235.98 ,$612.93 ,$612.93 ,$612.93 ,$612.93 ,$861.84 ,$235.98 ,$872.10 ,$861.84 ,$235.98 ,$769.50 ,$820.80 ,$820.80 ,$235.98 ,$820.80 ,$861.84 ,$861.84 ,$861.84 ,$923.40 ,$589.95 ,$235.98 ,"$1,026.00 ",$403.61 ,$443.97 ,$259.58 ,$872.10 ,$612.93 ,$923.40 ,$861.84 ,$820.80 ,$820.80 ,$235.98 ,$666.90 ST. FRANCIS HOSPITAL - ACUTE,34000027,78278,HC GI BLEED SCAN,340,1 ,"$1,258.00 ",$817.70 ,$289.34 ,"$1,258.00 ",$905.76 ,$684.35 ,$289.34 ,$702.22 ,$289.34 ,$751.53 ,$751.53 ,$751.53 ,$751.53 ,"$1,056.72 ",$289.34 ,"$1,069.30 ","$1,056.72 ",$289.34 ,$943.50 ,"$1,006.40 ","$1,006.40 ",$289.34 ,"$1,006.40 ","$1,056.72 ","$1,056.72 ","$1,056.72 ","$1,132.20 ",$723.35 ,$289.34 ,"$1,258.00 ",$403.61 ,$443.97 ,$318.27 ,"$1,069.30 ",$751.53 ,"$1,132.20 ","$1,056.72 ","$1,006.40 ","$1,006.40 ",$289.34 ,$817.70 ST. FRANCIS HOSPITAL - ACUTE,34000028,78290,HC SM BOWEL MECKEL'S SCAN,340,1 ,"$1,040.00 ",$676.00 ,$239.20 ,"$1,040.00 ",$748.80 ,$565.76 ,$239.20 ,$580.53 ,$239.20 ,$621.30 ,$621.30 ,$621.30 ,$621.30 ,$873.60 ,$239.20 ,$884.00 ,$873.60 ,$239.20 ,$780.00 ,$832.00 ,$832.00 ,$239.20 ,$832.00 ,$873.60 ,$873.60 ,$873.60 ,$936.00 ,$598.00 ,$239.20 ,"$1,040.00 ",$360.21 ,$396.23 ,$263.12 ,$884.00 ,$621.30 ,$936.00 ,$873.60 ,$832.00 ,$832.00 ,$239.20 ,$676.00 ST. FRANCIS HOSPITAL - ACUTE,34000029,78300,HC BONE SCAN LIMITED,340,1 ,"$1,444.00 ",$938.60 ,$332.12 ,"$1,444.00 ","$1,039.68 ",$785.54 ,$332.12 ,$806.04 ,$332.12 ,$862.65 ,$862.65 ,$862.65 ,$862.65 ,"$1,212.96 ",$332.12 ,"$1,227.40 ","$1,212.96 ",$332.12 ,"$1,083.00 ","$1,155.20 ","$1,155.20 ",$332.12 ,"$1,155.20 ","$1,212.96 ","$1,212.96 ","$1,212.96 ","$1,299.60 ",$830.30 ,$332.12 ,"$1,444.00 ",$360.21 ,$396.23 ,$365.33 ,"$1,227.40 ",$862.65 ,"$1,299.60 ","$1,212.96 ","$1,155.20 ","$1,155.20 ",$332.12 ,$938.60 ST. FRANCIS HOSPITAL - ACUTE,34000030,78305,HC BONE SCAN MULTIPLE,340,1 ,"$1,444.00 ",$938.60 ,$332.12 ,"$1,444.00 ","$1,039.68 ",$785.54 ,$332.12 ,$806.04 ,$332.12 ,$862.65 ,$862.65 ,$862.65 ,$862.65 ,"$1,212.96 ",$332.12 ,"$1,227.40 ","$1,212.96 ",$332.12 ,"$1,083.00 ","$1,155.20 ","$1,155.20 ",$332.12 ,"$1,155.20 ","$1,212.96 ","$1,212.96 ","$1,212.96 ","$1,299.60 ",$830.30 ,$332.12 ,"$1,444.00 ",$360.21 ,$396.23 ,$365.33 ,"$1,227.40 ",$862.65 ,"$1,299.60 ","$1,212.96 ","$1,155.20 ","$1,155.20 ",$332.12 ,$938.60 ST. FRANCIS HOSPITAL - ACUTE,34000031,78306,HC BONE SCAN WHOLE BODY,340,1 ,"$1,444.00 ",$938.60 ,$332.12 ,"$1,444.00 ","$1,039.68 ",$785.54 ,$332.12 ,$806.04 ,$332.12 ,$862.65 ,$862.65 ,$862.65 ,$862.65 ,"$1,212.96 ",$332.12 ,"$1,227.40 ","$1,212.96 ",$332.12 ,"$1,083.00 ","$1,155.20 ","$1,155.20 ",$332.12 ,"$1,155.20 ","$1,212.96 ","$1,212.96 ","$1,212.96 ","$1,299.60 ",$830.30 ,$332.12 ,"$1,444.00 ",$360.21 ,$396.23 ,$365.33 ,"$1,227.40 ",$862.65 ,"$1,299.60 ","$1,212.96 ","$1,155.20 ","$1,155.20 ",$332.12 ,$938.60 ST. FRANCIS HOSPITAL - ACUTE,34000033,78315,HC BONE SCAN/3 PHASE,340,1 ,"$1,444.00 ",$938.60 ,$332.12 ,"$1,444.00 ","$1,039.68 ",$785.54 ,$332.12 ,$806.04 ,$332.12 ,$862.65 ,$862.65 ,$862.65 ,$862.65 ,"$1,212.96 ",$332.12 ,"$1,227.40 ","$1,212.96 ",$332.12 ,"$1,083.00 ","$1,155.20 ","$1,155.20 ",$332.12 ,"$1,155.20 ","$1,212.96 ","$1,212.96 ","$1,212.96 ","$1,299.60 ",$830.30 ,$332.12 ,"$1,444.00 ",$360.21 ,$396.23 ,$365.33 ,"$1,227.40 ",$862.65 ,"$1,299.60 ","$1,212.96 ","$1,155.20 ","$1,155.20 ",$332.12 ,$938.60 ST. FRANCIS HOSPITAL - ACUTE,34000034,78320,HC BONE SPECT,340,1 ,"$2,331.00 ","$1,515.15 ",$536.13 ,"$2,331.00 ","$1,678.32 ","$1,268.06 ",$536.13 ,"$1,301.16 ",$536.13 ,"$1,392.54 ","$1,392.54 ","$1,392.54 ","$1,392.54 ","$1,958.04 ",$536.13 ,"$1,981.35 ","$1,958.04 ",$536.13 ,"$1,748.25 ","$1,864.80 ","$1,864.80 ",$536.13 ,"$1,864.80 ","$1,958.04 ","$1,958.04 ","$1,958.04 ","$2,097.90 ","$1,340.33 ",$536.13 ,"$2,331.00 ", N/A , N/A ,$589.74 ,"$1,981.35 ","$1,392.54 ","$2,097.90 ","$1,958.04 ","$1,864.80 ","$1,864.80 ",$536.13 ,"$1,515.15 " ST. FRANCIS HOSPITAL - ACUTE,34000035,78451,HC HT MUSCLE IMAGE SPECT SINGLE,340,1 ,"$3,976.00 ","$2,584.40 ",$403.61 ,"$3,976.00 ","$2,862.72 ","$2,162.94 ",$914.48 ,"$2,219.40 ",$914.48 ,"$2,375.26 ","$2,375.26 ","$2,375.26 ","$2,375.26 ","$3,339.84 ",$914.48 ,"$3,379.60 ","$3,339.84 ",$914.48 ,"$2,982.00 ","$3,180.80 ","$3,180.80 ",$914.48 ,"$3,180.80 ","$3,339.84 ","$3,339.84 ","$3,339.84 ","$3,578.40 ","$2,286.20 ",$914.48 ,"$3,976.00 ",$403.61 ,$443.97 ,"$1,005.93 ","$3,379.60 ","$2,375.26 ","$3,578.40 ","$3,339.84 ","$3,180.80 ","$3,180.80 ",$914.48 ,"$2,584.40 " ST. FRANCIS HOSPITAL - ACUTE,34000037,78452,HC HT MUSCLE IMAGE SPECT MULTI,340,1 ,"$5,055.00 ","$3,285.75 ",$883.69 ,"$5,055.00 ","$3,639.60 ","$2,749.92 ","$1,162.65 ","$2,821.70 ","$1,162.65 ","$3,019.86 ","$3,019.86 ","$3,019.86 ","$3,019.86 ","$4,246.20 ","$1,162.65 ","$4,296.75 ","$4,246.20 ","$1,162.65 ","$3,791.25 ","$4,044.00 ","$4,044.00 ","$1,162.65 ","$4,044.00 ","$4,246.20 ","$4,246.20 ","$4,246.20 ","$4,549.50 ","$2,906.63 ","$1,162.65 ","$5,055.00 ",$883.69 ,$972.06 ,"$1,278.92 ","$4,296.75 ","$3,019.86 ","$4,549.50 ","$4,246.20 ","$4,044.00 ","$4,044.00 ","$1,162.65 ","$3,285.75 " ST. FRANCIS HOSPITAL - ACUTE,34000044,78472,HC MUGA RESTING SGL,340,1 ,"$1,258.00 ",$817.70 ,$289.34 ,"$1,258.00 ",$905.76 ,$684.35 ,$289.34 ,$702.22 ,$289.34 ,$751.53 ,$751.53 ,$751.53 ,$751.53 ,"$1,056.72 ",$289.34 ,"$1,069.30 ","$1,056.72 ",$289.34 ,$943.50 ,"$1,006.40 ","$1,006.40 ",$289.34 ,"$1,006.40 ","$1,056.72 ","$1,056.72 ","$1,056.72 ","$1,132.20 ",$723.35 ,$289.34 ,"$1,258.00 ",$360.21 ,$396.23 ,$318.27 ,"$1,069.30 ",$751.53 ,"$1,132.20 ","$1,056.72 ","$1,006.40 ","$1,006.40 ",$289.34 ,$817.70 ST. FRANCIS HOSPITAL - ACUTE,34000047,78580,HC LUNG PERFUS,340,1 ,"$2,110.00 ","$1,371.50 ",$403.61 ,"$2,110.00 ","$1,519.20 ","$1,147.84 ",$485.30 ,"$1,177.80 ",$485.30 ,"$1,260.51 ","$1,260.51 ","$1,260.51 ","$1,260.51 ","$1,772.40 ",$485.30 ,"$1,793.50 ","$1,772.40 ",$485.30 ,"$1,582.50 ","$1,688.00 ","$1,688.00 ",$485.30 ,"$1,688.00 ","$1,772.40 ","$1,772.40 ","$1,772.40 ","$1,899.00 ","$1,213.25 ",$485.30 ,"$2,110.00 ",$403.61 ,$443.97 ,$533.83 ,"$1,793.50 ","$1,260.51 ","$1,899.00 ","$1,772.40 ","$1,688.00 ","$1,688.00 ",$485.30 ,"$1,371.50 " ST. FRANCIS HOSPITAL - ACUTE,34000048,78582,HC LUNG SCAN-VENT/PERF,340,1 ,"$3,193.00 ","$2,075.45 ",$403.61 ,"$3,193.00 ","$2,298.96 ","$1,736.99 ",$734.39 ,"$1,782.33 ",$734.39 ,"$1,907.50 ","$1,907.50 ","$1,907.50 ","$1,907.50 ","$2,682.12 ",$734.39 ,"$2,714.05 ","$2,682.12 ",$734.39 ,"$2,394.75 ","$2,554.40 ","$2,554.40 ",$734.39 ,"$2,554.40 ","$2,682.12 ","$2,682.12 ","$2,682.12 ","$2,873.70 ","$1,835.98 ",$734.39 ,"$3,193.00 ",$403.61 ,$443.97 ,$807.83 ,"$2,714.05 ","$1,907.50 ","$2,873.70 ","$2,682.12 ","$2,554.40 ","$2,554.40 ",$734.39 ,"$2,075.45 " ST. FRANCIS HOSPITAL - ACUTE,34000060,78700,HC KIDNEY SCAN,340,1 ,$955.00 ,$620.75 ,$219.65 ,$955.00 ,$687.60 ,$519.52 ,$219.65 ,$533.08 ,$219.65 ,$570.52 ,$570.52 ,$570.52 ,$570.52 ,$802.20 ,$219.65 ,$811.75 ,$802.20 ,$219.65 ,$716.25 ,$764.00 ,$764.00 ,$219.65 ,$764.00 ,$802.20 ,$802.20 ,$802.20 ,$859.50 ,$549.13 ,$219.65 ,$955.00 ,$360.21 ,$396.23 ,$241.62 ,$811.75 ,$570.52 ,$859.50 ,$802.20 ,$764.00 ,$764.00 ,$219.65 ,$620.75 ST. FRANCIS HOSPITAL - ACUTE,34000061,78701,HC KIDNEY SCAN W/FLOW,340,1 ,"$1,461.00 ",$949.65 ,$336.03 ,"$1,461.00 ","$1,051.92 ",$794.78 ,$336.03 ,$815.53 ,$336.03 ,$872.80 ,$872.80 ,$872.80 ,$872.80 ,"$1,227.24 ",$336.03 ,"$1,241.85 ","$1,227.24 ",$336.03 ,"$1,095.75 ","$1,168.80 ","$1,168.80 ",$336.03 ,"$1,168.80 ","$1,227.24 ","$1,227.24 ","$1,227.24 ","$1,314.90 ",$840.08 ,$336.03 ,"$1,461.00 ",$360.21 ,$396.23 ,$369.63 ,"$1,241.85 ",$872.80 ,"$1,314.90 ","$1,227.24 ","$1,168.80 ","$1,168.80 ",$336.03 ,$949.65 ST. FRANCIS HOSPITAL - ACUTE,34000063,78708,HC KIDNEY W/PHARMACLGCL INTER,340,1 ,"$1,461.00 ",$949.65 ,$336.03 ,"$1,461.00 ","$1,051.92 ",$794.78 ,$336.03 ,$815.53 ,$336.03 ,$872.80 ,$872.80 ,$872.80 ,$872.80 ,"$1,227.24 ",$336.03 ,"$1,241.85 ","$1,227.24 ",$336.03 ,"$1,095.75 ","$1,168.80 ","$1,168.80 ",$336.03 ,"$1,168.80 ","$1,227.24 ","$1,227.24 ","$1,227.24 ","$1,314.90 ",$840.08 ,$336.03 ,"$1,461.00 ",$360.21 ,$396.23 ,$369.63 ,"$1,241.85 ",$872.80 ,"$1,314.90 ","$1,227.24 ","$1,168.80 ","$1,168.80 ",$336.03 ,$949.65 ST. FRANCIS HOSPITAL - ACUTE,34000065,78709,HC KIDNEY W AND W/O PHARM INTERVEN,340,1 ,"$2,107.00 ","$1,369.55 ",$360.21 ,"$2,107.00 ","$1,517.04 ","$1,146.21 ",$484.61 ,"$1,176.13 ",$484.61 ,"$1,258.72 ","$1,258.72 ","$1,258.72 ","$1,258.72 ","$1,769.88 ",$484.61 ,"$1,790.95 ","$1,769.88 ",$484.61 ,"$1,580.25 ","$1,685.60 ","$1,685.60 ",$484.61 ,"$1,685.60 ","$1,769.88 ","$1,769.88 ","$1,769.88 ","$1,896.30 ","$1,211.53 ",$484.61 ,"$2,107.00 ",$360.21 ,$396.23 ,$533.07 ,"$1,790.95 ","$1,258.72 ","$1,896.30 ","$1,769.88 ","$1,685.60 ","$1,685.60 ",$484.61 ,"$1,369.55 " ST. FRANCIS HOSPITAL - ACUTE,34000068,78800,HC TUMOR LOCAL LIMITED,340,1 ,"$2,547.00 ","$1,655.55 ",$403.61 ,"$2,547.00 ","$1,833.84 ","$1,385.57 ",$585.81 ,"$1,421.74 ",$585.81 ,"$1,521.58 ","$1,521.58 ","$1,521.58 ","$1,521.58 ","$2,139.48 ",$585.81 ,"$2,164.95 ","$2,139.48 ",$585.81 ,"$1,910.25 ","$2,037.60 ","$2,037.60 ",$585.81 ,"$2,037.60 ","$2,139.48 ","$2,139.48 ","$2,139.48 ","$2,292.30 ","$1,464.53 ",$585.81 ,"$2,547.00 ",$403.61 ,$443.97 ,$644.39 ,"$2,164.95 ","$1,521.58 ","$2,292.30 ","$2,139.48 ","$2,037.60 ","$2,037.60 ",$585.81 ,"$1,655.55 " ST. FRANCIS HOSPITAL - ACUTE,34000069,78801,HC TUMOR LOCAL MULTIPLE,340,1 ,"$2,852.00 ","$1,853.80 ",$403.61 ,"$2,852.00 ","$2,053.44 ","$1,551.49 ",$655.96 ,"$1,591.99 ",$655.96 ,"$1,703.78 ","$1,703.78 ","$1,703.78 ","$1,703.78 ","$2,395.68 ",$655.96 ,"$2,424.20 ","$2,395.68 ",$655.96 ,"$2,139.00 ","$2,281.60 ","$2,281.60 ",$655.96 ,"$2,281.60 ","$2,395.68 ","$2,395.68 ","$2,395.68 ","$2,566.80 ","$1,639.90 ",$655.96 ,"$2,852.00 ",$403.61 ,$443.97 ,$721.56 ,"$2,424.20 ","$1,703.78 ","$2,566.80 ","$2,395.68 ","$2,281.60 ","$2,281.60 ",$655.96 ,"$1,853.80 " ST. FRANCIS HOSPITAL - ACUTE,34000070,78802,HC TUMOR IMAGE-WHOLE BODY-1 DAY,340,1 ,"$3,606.00 ","$2,343.90 ",$829.38 ,"$3,606.00 ","$2,596.32 ","$1,961.66 ",$829.38 ,"$2,012.87 ",$829.38 ,"$2,154.22 ","$2,154.22 ","$2,154.22 ","$2,154.22 ","$3,029.04 ",$829.38 ,"$3,065.10 ","$3,029.04 ",$829.38 ,"$2,704.50 ","$2,884.80 ","$2,884.80 ",$829.38 ,"$2,884.80 ","$3,029.04 ","$3,029.04 ","$3,029.04 ","$3,245.40 ","$2,073.45 ",$829.38 ,"$3,606.00 ",$883.69 ,$972.06 ,$912.32 ,"$3,065.10 ","$2,154.22 ","$3,245.40 ","$3,029.04 ","$2,884.80 ","$2,884.80 ",$829.38 ,"$2,343.90 " ST. FRANCIS HOSPITAL - ACUTE,34000071,78803,HC TUMOR IMAGING (SPECT),340,1 ,"$3,606.00 ","$2,343.90 ",$829.38 ,"$3,606.00 ","$2,596.32 ","$1,961.66 ",$829.38 ,"$2,012.87 ",$829.38 ,"$2,154.22 ","$2,154.22 ","$2,154.22 ","$2,154.22 ","$3,029.04 ",$829.38 ,"$3,065.10 ","$3,029.04 ",$829.38 ,"$2,704.50 ","$2,884.80 ","$2,884.80 ",$829.38 ,"$2,884.80 ","$3,029.04 ","$3,029.04 ","$3,029.04 ","$3,245.40 ","$2,073.45 ",$829.38 ,"$3,606.00 ",$883.69 ,$972.06 ,$912.32 ,"$3,065.10 ","$2,154.22 ","$3,245.40 ","$3,029.04 ","$2,884.80 ","$2,884.80 ",$829.38 ,"$2,343.90 " ST. FRANCIS HOSPITAL - ACUTE,34000077,78804,HC TUMOR/INF-WHOLE BODY-MULT DAY,340,1 ,"$3,606.00 ","$2,343.90 ",$829.38 ,"$3,606.00 ","$2,596.32 ","$1,961.66 ",$829.38 ,"$2,012.87 ",$829.38 ,"$2,154.22 ","$2,154.22 ","$2,154.22 ","$2,154.22 ","$3,029.04 ",$829.38 ,"$3,065.10 ","$3,029.04 ",$829.38 ,"$2,704.50 ","$2,884.80 ","$2,884.80 ",$829.38 ,"$2,884.80 ","$3,029.04 ","$3,029.04 ","$3,029.04 ","$3,245.40 ","$2,073.45 ",$829.38 ,"$3,606.00 ",$883.69 ,$972.06 ,$912.32 ,"$3,065.10 ","$2,154.22 ","$3,245.40 ","$3,029.04 ","$2,884.80 ","$2,884.80 ",$829.38 ,"$2,343.90 " ST. FRANCIS HOSPITAL - ACUTE,34000079,78805,HC WBC LIMITED,340,1 ,"$2,547.00 ","$1,655.55 ",$585.81 ,"$2,547.00 ","$1,833.84 ","$1,385.57 ",$585.81 ,"$1,421.74 ",$585.81 ,"$1,521.58 ","$1,521.58 ","$1,521.58 ","$1,521.58 ","$2,139.48 ",$585.81 ,"$2,164.95 ","$2,139.48 ",$585.81 ,"$1,910.25 ","$2,037.60 ","$2,037.60 ",$585.81 ,"$2,037.60 ","$2,139.48 ","$2,139.48 ","$2,139.48 ","$2,292.30 ","$1,464.53 ",$585.81 ,"$2,547.00 ", N/A , N/A ,$644.39 ,"$2,164.95 ","$1,521.58 ","$2,292.30 ","$2,139.48 ","$2,037.60 ","$2,037.60 ",$585.81 ,"$1,655.55 " ST. FRANCIS HOSPITAL - ACUTE,34000080,78806,HC WBC WHOLE BODY,340,1 ,"$3,606.00 ","$2,343.90 ",$829.38 ,"$3,606.00 ","$2,596.32 ","$1,961.66 ",$829.38 ,"$2,012.87 ",$829.38 ,"$2,154.22 ","$2,154.22 ","$2,154.22 ","$2,154.22 ","$3,029.04 ",$829.38 ,"$3,065.10 ","$3,029.04 ",$829.38 ,"$2,704.50 ","$2,884.80 ","$2,884.80 ",$829.38 ,"$2,884.80 ","$3,029.04 ","$3,029.04 ","$3,029.04 ","$3,245.40 ","$2,073.45 ",$829.38 ,"$3,606.00 ", N/A , N/A ,$912.32 ,"$3,065.10 ","$2,154.22 ","$3,245.40 ","$3,029.04 ","$2,884.80 ","$2,884.80 ",$829.38 ,"$2,343.90 " ST. FRANCIS HOSPITAL - ACUTE,34000090,78597,HC PULM PERF DIFF W/IMG,340,1 ,"$3,149.00 ","$2,046.85 ",$403.61 ,"$3,149.00 ","$2,267.28 ","$1,713.06 ",$724.27 ,"$1,757.77 ",$724.27 ,"$1,881.21 ","$1,881.21 ","$1,881.21 ","$1,881.21 ","$2,645.16 ",$724.27 ,"$2,676.65 ","$2,645.16 ",$724.27 ,"$2,361.75 ","$2,519.20 ","$2,519.20 ",$724.27 ,"$2,519.20 ","$2,645.16 ","$2,645.16 ","$2,645.16 ","$2,834.10 ","$1,810.68 ",$724.27 ,"$3,149.00 ",$403.61 ,$443.97 ,$796.70 ,"$2,676.65 ","$1,881.21 ","$2,834.10 ","$2,645.16 ","$2,519.20 ","$2,519.20 ",$724.27 ,"$2,046.85 " ST. FRANCIS HOSPITAL - ACUTE,34000091,78598,HC NM PULM VENT AND PERF DIFF W/IMG,340,1 ,"$2,110.00 ","$1,371.50 ",$403.61 ,"$2,110.00 ","$1,519.20 ","$1,147.84 ",$485.30 ,"$1,177.80 ",$485.30 ,"$1,260.51 ","$1,260.51 ","$1,260.51 ","$1,260.51 ","$1,772.40 ",$485.30 ,"$1,793.50 ","$1,772.40 ",$485.30 ,"$1,582.50 ","$1,688.00 ","$1,688.00 ",$485.30 ,"$1,688.00 ","$1,772.40 ","$1,772.40 ","$1,772.40 ","$1,899.00 ","$1,213.25 ",$485.30 ,"$2,110.00 ",$403.61 ,$443.97 ,$533.83 ,"$1,793.50 ","$1,260.51 ","$1,899.00 ","$1,772.40 ","$1,688.00 ","$1,688.00 ",$485.30 ,"$1,371.50 " ST. FRANCIS HOSPITAL - ACUTE,34000092,78227,HC NM HEPATOBILIARY DUCTS W/PHARM,340,1 ,"$2,310.00 ","$1,501.50 ",$403.61 ,"$2,310.00 ","$1,663.20 ","$1,256.64 ",$531.30 ,"$1,289.44 ",$531.30 ,"$1,379.99 ","$1,379.99 ","$1,379.99 ","$1,379.99 ","$1,940.40 ",$531.30 ,"$1,963.50 ","$1,940.40 ",$531.30 ,"$1,732.50 ","$1,848.00 ","$1,848.00 ",$531.30 ,"$1,848.00 ","$1,940.40 ","$1,940.40 ","$1,940.40 ","$2,079.00 ","$1,328.25 ",$531.30 ,"$2,310.00 ",$403.61 ,$443.97 ,$584.43 ,"$1,963.50 ","$1,379.99 ","$2,079.00 ","$1,940.40 ","$1,848.00 ","$1,848.00 ",$531.30 ,"$1,501.50 " ST. FRANCIS HOSPITAL - ACUTE,34000093,78071,HC PARATHYROID IMG W/SPECT 78071,340,1 ,"$1,341.00 ",$871.65 ,$308.43 ,"$1,341.00 ",$965.52 ,$729.50 ,$308.43 ,$748.55 ,$308.43 ,$801.11 ,$801.11 ,$801.11 ,$801.11 ,"$1,126.44 ",$308.43 ,"$1,139.85 ","$1,126.44 ",$308.43 ,"$1,005.75 ","$1,072.80 ","$1,072.80 ",$308.43 ,"$1,072.80 ","$1,126.44 ","$1,126.44 ","$1,126.44 ","$1,206.90 ",$771.08 ,$308.43 ,"$1,341.00 ",$360.21 ,$396.23 ,$339.27 ,"$1,139.85 ",$801.11 ,"$1,206.90 ","$1,126.44 ","$1,072.80 ","$1,072.80 ",$308.43 ,$871.65 ST. FRANCIS HOSPITAL - ACUTE,34100032,78494,HC MUGA RESTING W/SPECT,341,1 ,"$1,241.00 ",$806.65 ,$285.43 ,"$1,241.00 ",$893.52 ,$675.10 ,$285.43 ,$692.73 ,$285.43 ,$741.37 ,$741.37 ,$741.37 ,$741.37 ,"$1,042.44 ",$285.43 ,"$1,054.85 ","$1,042.44 ",$285.43 ,$930.75 ,$992.80 ,$992.80 ,$285.43 ,$992.80 ,"$1,042.44 ","$1,042.44 ","$1,042.44 ","$1,116.90 ",$713.58 ,$285.43 ,"$1,241.00 ",$883.69 ,$972.06 ,$313.97 ,"$1,054.85 ",$741.37 ,"$1,116.90 ","$1,042.44 ",$992.80 ,$992.80 ,$285.43 ,$806.65 ST. FRANCIS HOSPITAL - ACUTE,34300002,A9500,HC DIAGNUCLIDE CARDIO UP TO 40MCI,343,1 ,$355.00 ,$230.75 ,$81.65 ,$355.00 ,$255.60 ,$193.12 ,$81.65 ,$198.16 ,$81.65 ,$212.08 ,$212.08 ,$212.08 ,$212.08 ,$298.20 ,$81.65 ,$301.75 ,$298.20 ,$81.65 ,$266.25 ,$284.00 ,$284.00 ,$81.65 ,$284.00 ,$298.20 ,$298.20 ,$298.20 ,$319.50 ,$204.13 ,$81.65 ,$355.00 , N/A , N/A ,$89.82 ,$301.75 ,$212.08 ,$319.50 ,$298.20 ,$284.00 ,$284.00 ,$81.65 ,$230.75 ST. FRANCIS HOSPITAL - ACUTE,34300004,A9503,HC DIAGNUCLIDE MDP UP TO 30MCI,343,1 ,$79.00 ,$51.35 ,$18.17 ,$79.00 ,$56.88 ,$42.98 ,$18.17 ,$44.10 ,$18.17 ,$47.19 ,$47.19 ,$47.19 ,$47.19 ,$66.36 ,$18.17 ,$67.15 ,$66.36 ,$18.17 ,$59.25 ,$63.20 ,$63.20 ,$18.17 ,$63.20 ,$66.36 ,$66.36 ,$66.36 ,$71.10 ,$45.43 ,$18.17 ,$79.00 , N/A , N/A ,$19.99 ,$67.15 ,$47.19 ,$71.10 ,$66.36 ,$63.20 ,$63.20 ,$18.17 ,$51.35 ST. FRANCIS HOSPITAL - ACUTE,34300006,A9505,HC DIAGNUCLIDE THALL 201 PER MCI,343,1 ,$393.00 ,$255.45 ,$90.39 ,$393.00 ,$282.96 ,$213.79 ,$90.39 ,$219.37 ,$90.39 ,$234.78 ,$234.78 ,$234.78 ,$234.78 ,$330.12 ,$90.39 ,$334.05 ,$330.12 ,$90.39 ,$294.75 ,$314.40 ,$314.40 ,$90.39 ,$314.40 ,$330.12 ,$330.12 ,$330.12 ,$353.70 ,$225.98 ,$90.39 ,$393.00 , N/A , N/A ,$99.43 ,$334.05 ,$234.78 ,$353.70 ,$330.12 ,$314.40 ,$314.40 ,$90.39 ,$255.45 ST. FRANCIS HOSPITAL - ACUTE,34300009,A9512,HC TECHNETIUM TC99 PERTECH PER MCI,343,1 ,$2.20 ,$1.43 ,$0.51 ,$2.20 ,$1.58 ,$1.20 ,$0.51 ,$1.23 ,$0.51 ,$1.31 ,$1.31 ,$1.31 ,$1.31 ,$1.85 ,$0.51 ,$1.87 ,$1.85 ,$0.51 ,$1.65 ,$1.76 ,$1.76 ,$0.51 ,$1.76 ,$1.85 ,$1.85 ,$1.85 ,$1.98 ,$1.28 ,$0.51 ,$2.20 , N/A , N/A ,$0.56 ,$1.87 ,$1.31 ,$1.98 ,$1.85 ,$1.76 ,$1.76 ,$0.51 ,$1.43 ST. FRANCIS HOSPITAL - ACUTE,34300010,A9516,HC DIAGNUCLIDE I123 CAPS 100 MICR,343,1 ,$112.00 ,$72.80 ,$25.76 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 , N/A , N/A ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,34300014,A9528,HC DIAGNUCLIDE I131 NECK/CHST,343,1 ,$68.00 ,$44.20 ,$15.64 ,$68.00 ,$48.96 ,$36.99 ,$15.64 ,$37.96 ,$15.64 ,$40.62 ,$40.62 ,$40.62 ,$40.62 ,$57.12 ,$15.64 ,$57.80 ,$57.12 ,$15.64 ,$51.00 ,$54.40 ,$54.40 ,$15.64 ,$54.40 ,$57.12 ,$57.12 ,$57.12 ,$61.20 ,$39.10 ,$15.64 ,$68.00 , N/A , N/A ,$17.20 ,$57.80 ,$40.62 ,$61.20 ,$57.12 ,$54.40 ,$54.40 ,$15.64 ,$44.20 ST. FRANCIS HOSPITAL - ACUTE,34300015,A9530,HC THERAPEUTIC ISOTOPE SOLUTION PER MCI,343,1 ,$38.00 ,$24.70 ,$8.74 ,$336.93 ,$27.36 ,$20.67 ,$8.74 ,$21.21 ,$8.74 ,$22.70 ,$22.70 ,$22.70 ,$22.70 ,$31.92 ,$8.74 ,$32.30 ,$31.92 ,$8.74 ,$28.50 ,$30.40 ,$30.40 ,$8.74 ,$30.40 ,$31.92 ,$31.92 ,$31.92 ,$34.20 ,$21.85 ,$8.74 ,$38.00 ,$306.30 ,$336.93 ,$9.61 ,$32.30 ,$22.70 ,$34.20 ,$31.92 ,$30.40 ,$30.40 ,$8.74 ,$24.70 ST. FRANCIS HOSPITAL - ACUTE,34300016,A9537,HC DIAGNUCLIDE CHOLETEC HEPAT PER DOSE,343,1 ,$123.00 ,$79.95 ,$28.29 ,$123.00 ,$88.56 ,$66.91 ,$28.29 ,$68.66 ,$28.29 ,$73.48 ,$73.48 ,$73.48 ,$73.48 ,$103.32 ,$28.29 ,$104.55 ,$103.32 ,$28.29 ,$92.25 ,$98.40 ,$98.40 ,$28.29 ,$98.40 ,$103.32 ,$103.32 ,$103.32 ,$110.70 ,$70.73 ,$28.29 ,$123.00 , N/A , N/A ,$31.12 ,$104.55 ,$73.48 ,$110.70 ,$103.32 ,$98.40 ,$98.40 ,$28.29 ,$79.95 ST. FRANCIS HOSPITAL - ACUTE,34300018,A9540,HC DIAGNUCLIDE MAA LUNG SCAN PER DOSE<10MCI,343,1 ,$559.00 ,$363.35 ,$128.57 ,$559.00 ,$402.48 ,$304.10 ,$128.57 ,$312.03 ,$128.57 ,$333.95 ,$333.95 ,$333.95 ,$333.95 ,$469.56 ,$128.57 ,$475.15 ,$469.56 ,$128.57 ,$419.25 ,$447.20 ,$447.20 ,$128.57 ,$447.20 ,$469.56 ,$469.56 ,$469.56 ,$503.10 ,$321.43 ,$128.57 ,$559.00 , N/A , N/A ,$141.43 ,$475.15 ,$333.95 ,$503.10 ,$469.56 ,$447.20 ,$447.20 ,$128.57 ,$363.35 ST. FRANCIS HOSPITAL - ACUTE,34300019,A9540,HC DIAGNUCLIDE MAA LUNG SCAN PER DOSE<10MCI,343,1 ,$559.00 ,$363.35 ,$128.57 ,$559.00 ,$402.48 ,$304.10 ,$128.57 ,$312.03 ,$128.57 ,$333.95 ,$333.95 ,$333.95 ,$333.95 ,$469.56 ,$128.57 ,$475.15 ,$469.56 ,$128.57 ,$419.25 ,$447.20 ,$447.20 ,$128.57 ,$447.20 ,$469.56 ,$469.56 ,$469.56 ,$503.10 ,$321.43 ,$128.57 ,$559.00 , N/A , N/A ,$141.43 ,$475.15 ,$333.95 ,$503.10 ,$469.56 ,$447.20 ,$447.20 ,$128.57 ,$363.35 ST. FRANCIS HOSPITAL - ACUTE,34300020,A9541,HC DIAGNUCLIDE SULFUR COLLOID UP TO 20MCI,343,1 ,$926.00 ,$601.90 ,$212.98 ,$926.00 ,$666.72 ,$503.74 ,$212.98 ,$516.89 ,$212.98 ,$553.19 ,$553.19 ,$553.19 ,$553.19 ,$777.84 ,$212.98 ,$787.10 ,$777.84 ,$212.98 ,$694.50 ,$740.80 ,$740.80 ,$212.98 ,$740.80 ,$777.84 ,$777.84 ,$777.84 ,$833.40 ,$532.45 ,$212.98 ,$926.00 , N/A , N/A ,$234.28 ,$787.10 ,$553.19 ,$833.40 ,$777.84 ,$740.80 ,$740.80 ,$212.98 ,$601.90 ST. FRANCIS HOSPITAL - ACUTE,34300024,A9547,HC DIAGNUCLIDE IN OXINE .5 MCI,343,1 ,"$1,061.00 ",$689.65 ,$244.03 ,"$1,061.00 ",$763.92 ,$577.18 ,$244.03 ,$592.25 ,$244.03 ,$633.84 ,$633.84 ,$633.84 ,$633.84 ,$891.24 ,$244.03 ,$901.85 ,$891.24 ,$244.03 ,$795.75 ,$848.80 ,$848.80 ,$244.03 ,$848.80 ,$891.24 ,$891.24 ,$891.24 ,$954.90 ,$610.08 ,$244.03 ,"$1,061.00 ", N/A , N/A ,$268.43 ,$901.85 ,$633.84 ,$954.90 ,$891.24 ,$848.80 ,$848.80 ,$244.03 ,$689.65 ST. FRANCIS HOSPITAL - ACUTE,34300028,A9551,HC DIAGNUCLIDE DMSA,343,1 ,"$1,789.00 ","$1,162.85 ",$411.47 ,"$1,789.00 ","$1,288.08 ",$973.22 ,$411.47 ,$998.62 ,$411.47 ,"$1,068.75 ","$1,068.75 ","$1,068.75 ","$1,068.75 ","$1,502.76 ",$411.47 ,"$1,520.65 ","$1,502.76 ",$411.47 ,"$1,341.75 ","$1,431.20 ","$1,431.20 ",$411.47 ,"$1,431.20 ","$1,502.76 ","$1,502.76 ","$1,502.76 ","$1,610.10 ","$1,028.68 ",$411.47 ,"$1,789.00 ", N/A , N/A ,$452.62 ,"$1,520.65 ","$1,068.75 ","$1,610.10 ","$1,502.76 ","$1,431.20 ","$1,431.20 ",$411.47 ,"$1,162.85 " ST. FRANCIS HOSPITAL - ACUTE,34300029,A9552,HC DIAGNUCLIDE 18FDG,343,1 ,$950.00 ,$617.50 ,$218.50 ,$950.00 ,$684.00 ,$516.80 ,$218.50 ,$530.29 ,$218.50 ,$567.53 ,$567.53 ,$567.53 ,$567.53 ,$798.00 ,$218.50 ,$807.50 ,$798.00 ,$218.50 ,$712.50 ,$760.00 ,$760.00 ,$218.50 ,$760.00 ,$798.00 ,$798.00 ,$798.00 ,$855.00 ,$546.25 ,$218.50 ,$950.00 , N/A , N/A ,$240.35 ,$807.50 ,$567.53 ,$855.00 ,$798.00 ,$760.00 ,$760.00 ,$218.50 ,$617.50 ST. FRANCIS HOSPITAL - ACUTE,34300033,A9558,HC DIAGNUCLIDE XE133 10 MCI,343,1 ,$649.00 ,$421.85 ,$149.27 ,$649.00 ,$467.28 ,$353.06 ,$149.27 ,$362.27 ,$149.27 ,$387.71 ,$387.71 ,$387.71 ,$387.71 ,$545.16 ,$149.27 ,$551.65 ,$545.16 ,$149.27 ,$486.75 ,$519.20 ,$519.20 ,$149.27 ,$519.20 ,$545.16 ,$545.16 ,$545.16 ,$584.10 ,$373.18 ,$149.27 ,$649.00 , N/A , N/A ,$164.20 ,$551.65 ,$387.71 ,$584.10 ,$545.16 ,$519.20 ,$519.20 ,$149.27 ,$421.85 ST. FRANCIS HOSPITAL - ACUTE,34300035,A9560,HC TC99M GI BLD MUGA UP TO 30MCI,343,1 ,$768.00 ,$499.20 ,$176.64 ,$768.00 ,$552.96 ,$417.79 ,$176.64 ,$428.70 ,$176.64 ,$458.80 ,$458.80 ,$458.80 ,$458.80 ,$645.12 ,$176.64 ,$652.80 ,$645.12 ,$176.64 ,$576.00 ,$614.40 ,$614.40 ,$176.64 ,$614.40 ,$645.12 ,$645.12 ,$645.12 ,$691.20 ,$441.60 ,$176.64 ,$768.00 , N/A , N/A ,$194.30 ,$652.80 ,$458.80 ,$691.20 ,$645.12 ,$614.40 ,$614.40 ,$176.64 ,$499.20 ST. FRANCIS HOSPITAL - ACUTE,34300036,A9560,HC RBC TAG KIT WITH TC99,343,1 ,$768.00 ,$499.20 ,$176.64 ,$768.00 ,$552.96 ,$417.79 ,$176.64 ,$428.70 ,$176.64 ,$458.80 ,$458.80 ,$458.80 ,$458.80 ,$645.12 ,$176.64 ,$652.80 ,$645.12 ,$176.64 ,$576.00 ,$614.40 ,$614.40 ,$176.64 ,$614.40 ,$645.12 ,$645.12 ,$645.12 ,$691.20 ,$441.60 ,$176.64 ,$768.00 , N/A , N/A ,$194.30 ,$652.80 ,$458.80 ,$691.20 ,$645.12 ,$614.40 ,$614.40 ,$176.64 ,$499.20 ST. FRANCIS HOSPITAL - ACUTE,34300037,A9562,HC DIAG NUCLDE MAG 3 PER DOSE,343,1 ,$871.00 ,$566.15 ,$200.33 ,$871.00 ,$627.12 ,$473.82 ,$200.33 ,$486.19 ,$200.33 ,$520.34 ,$520.34 ,$520.34 ,$520.34 ,$731.64 ,$200.33 ,$740.35 ,$731.64 ,$200.33 ,$653.25 ,$696.80 ,$696.80 ,$200.33 ,$696.80 ,$731.64 ,$731.64 ,$731.64 ,$783.90 ,$500.83 ,$200.33 ,$871.00 , N/A , N/A ,$220.36 ,$740.35 ,$520.34 ,$783.90 ,$731.64 ,$696.80 ,$696.80 ,$200.33 ,$566.15 ST. FRANCIS HOSPITAL - ACUTE,34300038,A9572,HC DIAGNUCLIDE OCTREOTIDE PER DOSE UP TO 6MCI,343,1 ,"$13,391.00 ","$8,704.15 ","$3,079.93 ","$13,391.00 ","$9,641.52 ","$7,284.70 ","$3,079.93 ","$7,474.86 ","$3,079.93 ","$7,999.78 ","$7,999.78 ","$7,999.78 ","$7,999.78 ","$11,248.44 ","$3,079.93 ","$11,382.35 ","$11,248.44 ","$3,079.93 ","$10,043.25 ","$10,712.80 ","$10,712.80 ","$3,079.93 ","$10,712.80 ","$11,248.44 ","$11,248.44 ","$11,248.44 ","$12,051.90 ","$7,699.83 ","$3,079.93 ","$13,391.00 ", N/A , N/A ,"$3,387.92 ","$11,382.35 ","$7,999.78 ","$12,051.90 ","$11,248.44 ","$10,712.80 ","$10,712.80 ","$3,079.93 ","$8,704.15 " ST. FRANCIS HOSPITAL - ACUTE,34300039,A9582,HC DIAGNUCLIDE I 123 MIBG,343,1 ,"$13,950.00 ","$9,067.50 ","$3,208.50 ","$13,950.00 ","$10,044.00 ","$7,588.80 ","$3,208.50 ","$7,786.89 ","$3,208.50 ","$8,333.73 ","$8,333.73 ","$8,333.73 ","$8,333.73 ","$11,718.00 ","$3,208.50 ","$11,857.50 ","$11,718.00 ","$3,208.50 ","$10,462.50 ","$11,160.00 ","$11,160.00 ","$3,208.50 ","$11,160.00 ","$11,718.00 ","$11,718.00 ","$11,718.00 ","$12,555.00 ","$8,021.25 ","$3,208.50 ","$13,950.00 ", N/A , N/A ,"$3,529.35 ","$11,857.50 ","$8,333.73 ","$12,555.00 ","$11,718.00 ","$11,160.00 ","$11,160.00 ","$3,208.50 ","$9,067.50 " ST. FRANCIS HOSPITAL - ACUTE,34300041,J2805,HC DIAGNUCLIDE CCK,636,1 ,$223.00 ,$144.95 ,$51.29 ,$223.00 ,$160.56 ,$121.31 ,$51.29 ,$124.48 ,$51.29 ,$133.22 ,$133.22 ,$133.22 ,$133.22 ,$187.32 ,$51.29 ,$189.55 ,$187.32 ,$51.29 ,$167.25 ,$178.40 ,$178.40 ,$51.29 ,$178.40 ,$187.32 ,$187.32 ,$187.32 ,$200.70 ,$128.23 ,$51.29 ,$223.00 ,$130.92 ,$144.01 ,$56.42 ,$189.55 ,$133.22 ,$200.70 ,$187.32 ,$178.40 ,$178.40 ,$51.29 ,$144.95 ST. FRANCIS HOSPITAL - ACUTE,34300049,A9509,HC DIAGNUCLIDE I123 CAP PER MILLICURIE,343,1 ,$352.00 ,$228.80 ,$80.96 ,$352.00 ,$253.44 ,$191.49 ,$80.96 ,$196.49 ,$80.96 ,$210.28 ,$210.28 ,$210.28 ,$210.28 ,$295.68 ,$80.96 ,$299.20 ,$295.68 ,$80.96 ,$264.00 ,$281.60 ,$281.60 ,$80.96 ,$281.60 ,$295.68 ,$295.68 ,$295.68 ,$316.80 ,$202.40 ,$80.96 ,$352.00 , N/A , N/A ,$89.06 ,$299.20 ,$210.28 ,$316.80 ,$295.68 ,$281.60 ,$281.60 ,$80.96 ,$228.80 ST. FRANCIS HOSPITAL - ACUTE,34300052,A9539,HC DIAGNUCLIDE DTPA AEROSOL,343,1 ,$302.00 ,$196.30 ,$69.46 ,$302.00 ,$217.44 ,$164.29 ,$69.46 ,$168.58 ,$69.46 ,$180.41 ,$180.41 ,$180.41 ,$180.41 ,$253.68 ,$69.46 ,$256.70 ,$253.68 ,$69.46 ,$226.50 ,$241.60 ,$241.60 ,$69.46 ,$241.60 ,$253.68 ,$253.68 ,$253.68 ,$271.80 ,$173.65 ,$69.46 ,$302.00 , N/A , N/A ,$76.41 ,$256.70 ,$180.41 ,$271.80 ,$253.68 ,$241.60 ,$241.60 ,$69.46 ,$196.30 ST. FRANCIS HOSPITAL - ACUTE,34300058,A9500,HC SESTAMIBI PER STUDY DOSE,343,1 ,$154.00 ,$100.10 ,$35.42 ,$154.00 ,$110.88 ,$83.78 ,$35.42 ,$85.96 ,$35.42 ,$92.00 ,$92.00 ,$92.00 ,$92.00 ,$129.36 ,$35.42 ,$130.90 ,$129.36 ,$35.42 ,$115.50 ,$123.20 ,$123.20 ,$35.42 ,$123.20 ,$129.36 ,$129.36 ,$129.36 ,$138.60 ,$88.55 ,$35.42 ,$154.00 , N/A , N/A ,$38.96 ,$130.90 ,$92.00 ,$138.60 ,$129.36 ,$123.20 ,$123.20 ,$35.42 ,$100.10 ST. FRANCIS HOSPITAL - ACUTE,34300060,A9520,HC DIAGNUCLIDE TC-99 TILMANOCEPT DIAG UP TO 0.5 MCI,343,1 ,"$1,968.00 ","$1,279.20 ",$452.64 ,"$1,968.00 ","$1,416.96 ","$1,070.59 ",$452.64 ,"$1,098.54 ",$452.64 ,"$1,175.68 ","$1,175.68 ","$1,175.68 ","$1,175.68 ","$1,653.12 ",$452.64 ,"$1,672.80 ","$1,653.12 ",$452.64 ,"$1,476.00 ","$1,574.40 ","$1,574.40 ",$452.64 ,"$1,574.40 ","$1,653.12 ","$1,653.12 ","$1,653.12 ","$1,771.20 ","$1,131.60 ",$452.64 ,"$1,968.00 ", N/A , N/A ,$497.90 ,"$1,672.80 ","$1,175.68 ","$1,771.20 ","$1,653.12 ","$1,574.40 ","$1,574.40 ",$452.64 ,"$1,279.20 " ST. FRANCIS HOSPITAL - ACUTE,34300061,A9557,HC DIAGNUCLIDE TC-99 BICISATE PER STUDY UP TO 25MCI,343,1 ,"$2,828.00 ","$1,838.20 ",$650.44 ,"$2,828.00 ","$2,036.16 ","$1,538.43 ",$650.44 ,"$1,578.59 ",$650.44 ,"$1,689.45 ","$1,689.45 ","$1,689.45 ","$1,689.45 ","$2,375.52 ",$650.44 ,"$2,403.80 ","$2,375.52 ",$650.44 ,"$2,121.00 ","$2,262.40 ","$2,262.40 ",$650.44 ,"$2,262.40 ","$2,375.52 ","$2,375.52 ","$2,375.52 ","$2,545.20 ","$1,626.10 ",$650.44 ,"$2,828.00 ", N/A , N/A ,$715.48 ,"$2,403.80 ","$1,689.45 ","$2,545.20 ","$2,375.52 ","$2,262.40 ","$2,262.40 ",$650.44 ,"$1,838.20 " ST. FRANCIS HOSPITAL - ACUTE,34300062,A9562,HC DIAGNUCLIDE TC-99 MERTIATIDE PER STUDY UP TO 15MCI,343,1 ,"$1,144.00 ",$743.60 ,$263.12 ,"$1,144.00 ",$823.68 ,$622.34 ,$263.12 ,$638.58 ,$263.12 ,$683.43 ,$683.43 ,$683.43 ,$683.43 ,$960.96 ,$263.12 ,$972.40 ,$960.96 ,$263.12 ,$858.00 ,$915.20 ,$915.20 ,$263.12 ,$915.20 ,$960.96 ,$960.96 ,$960.96 ,"$1,029.60 ",$657.80 ,$263.12 ,"$1,144.00 ", N/A , N/A ,$289.43 ,$972.40 ,$683.43 ,"$1,029.60 ",$960.96 ,$915.20 ,$915.20 ,$263.12 ,$743.60 ST. FRANCIS HOSPITAL - ACUTE,35000018,47000,HC BX LIVER NEEDLE PERC,350,1 ,"$1,933.00 ","$1,256.45 ",$444.59 ,"$1,933.00 ","$1,391.76 ","$1,051.55 ",$444.59 ,"$1,079.00 ",$444.59 ,"$1,154.77 ","$1,154.77 ","$1,154.77 ","$1,154.77 ","$1,623.72 ",$444.59 ,"$1,643.05 ","$1,623.72 ",$444.59 ,"$1,449.75 ","$1,546.40 ","$1,546.40 ",$444.59 ,"$1,546.40 ","$1,623.72 ","$1,623.72 ","$1,623.72 ","$1,739.70 ","$1,111.48 ",$444.59 ,"$1,933.00 ",$663.48 ,$729.83 ,$489.05 ,"$1,643.05 ","$1,154.77 ","$1,739.70 ","$1,623.72 ","$1,546.40 ","$1,546.40 ",$444.59 ,"$1,256.45 " ST. FRANCIS HOSPITAL - ACUTE,35000036,70450,HC CT HEAD/BRAIN W/O CONTRAST,350,1 ,"$2,313.00 ","$1,503.45 ",$274.06 ,"$2,313.00 ","$1,665.36 ","$1,258.27 ",$531.99 ,"$1,291.12 ",$531.99 ,"$1,381.79 ","$1,381.79 ","$1,381.79 ","$1,381.79 ","$1,942.92 ",$531.99 ,"$1,966.05 ","$1,942.92 ",$531.99 ,"$1,734.75 ","$1,850.40 ","$1,850.40 ",$531.99 ,"$1,850.40 ","$1,942.92 ","$1,942.92 ","$1,942.92 ","$2,081.70 ","$1,329.98 ",$531.99 ,"$2,313.00 ",$274.06 ,$301.47 ,$585.19 ,"$1,966.05 ","$1,381.79 ","$2,081.70 ","$1,942.92 ","$1,850.40 ","$1,850.40 ",$531.99 ,"$1,503.45 " ST. FRANCIS HOSPITAL - ACUTE,35000037,70460,HC CT HEAD/BRAIN W/CONTRAST,350,1 ,"$2,930.00 ","$1,904.50 ",$274.06 ,"$2,930.00 ","$2,109.60 ","$1,593.92 ",$673.90 ,"$1,635.53 ",$673.90 ,"$1,750.38 ","$1,750.38 ","$1,750.38 ","$1,750.38 ","$2,461.20 ",$673.90 ,"$2,490.50 ","$2,461.20 ",$673.90 ,"$2,197.50 ","$2,344.00 ","$2,344.00 ",$673.90 ,"$2,344.00 ","$2,461.20 ","$2,461.20 ","$2,461.20 ","$2,637.00 ","$1,684.75 ",$673.90 ,"$2,930.00 ",$274.06 ,$301.47 ,$741.29 ,"$2,490.50 ","$1,750.38 ","$2,637.00 ","$2,461.20 ","$2,344.00 ","$2,344.00 ",$673.90 ,"$1,904.50 " ST. FRANCIS HOSPITAL - ACUTE,35000038,70470,HC CT HEAD/BRAIN W AND W/O CONTRAST,350,1 ,"$3,223.00 ","$2,094.95 ",$274.06 ,"$3,223.00 ","$2,320.56 ","$1,753.31 ",$741.29 ,"$1,799.08 ",$741.29 ,"$1,925.42 ","$1,925.42 ","$1,925.42 ","$1,925.42 ","$2,707.32 ",$741.29 ,"$2,739.55 ","$2,707.32 ",$741.29 ,"$2,417.25 ","$2,578.40 ","$2,578.40 ",$741.29 ,"$2,578.40 ","$2,707.32 ","$2,707.32 ","$2,707.32 ","$2,900.70 ","$1,853.23 ",$741.29 ,"$3,223.00 ",$274.06 ,$301.47 ,$815.42 ,"$2,739.55 ","$1,925.42 ","$2,900.70 ","$2,707.32 ","$2,578.40 ","$2,578.40 ",$741.29 ,"$2,094.95 " ST. FRANCIS HOSPITAL - ACUTE,35000039,70480,HC CT ORBIT/IAC/EAR W/O CONTRAST,350,1 ,"$2,313.00 ","$1,503.45 ",$133.17 ,"$2,313.00 ","$1,665.36 ","$1,258.27 ",$531.99 ,"$1,291.12 ",$531.99 ,"$1,381.79 ","$1,381.79 ","$1,381.79 ","$1,381.79 ","$1,942.92 ",$531.99 ,"$1,966.05 ","$1,942.92 ",$531.99 ,"$1,734.75 ","$1,850.40 ","$1,850.40 ",$531.99 ,"$1,850.40 ","$1,942.92 ","$1,942.92 ","$1,942.92 ","$2,081.70 ","$1,329.98 ",$531.99 ,"$2,313.00 ",$133.17 ,$146.49 ,$585.19 ,"$1,966.05 ","$1,381.79 ","$2,081.70 ","$1,942.92 ","$1,850.40 ","$1,850.40 ",$531.99 ,"$1,503.45 " ST. FRANCIS HOSPITAL - ACUTE,35000041,70481,HC CT ORBIT/IAC/EAR W/CONTRAST,350,1 ,"$2,930.00 ","$1,904.50 ",$133.17 ,"$2,930.00 ","$2,109.60 ","$1,593.92 ",$673.90 ,"$1,635.53 ",$673.90 ,"$1,750.38 ","$1,750.38 ","$1,750.38 ","$1,750.38 ","$2,461.20 ",$673.90 ,"$2,490.50 ","$2,461.20 ",$673.90 ,"$2,197.50 ","$2,344.00 ","$2,344.00 ",$673.90 ,"$2,344.00 ","$2,461.20 ","$2,461.20 ","$2,461.20 ","$2,637.00 ","$1,684.75 ",$673.90 ,"$2,930.00 ",$133.17 ,$146.49 ,$741.29 ,"$2,490.50 ","$1,750.38 ","$2,637.00 ","$2,461.20 ","$2,344.00 ","$2,344.00 ",$673.90 ,"$1,904.50 " ST. FRANCIS HOSPITAL - ACUTE,35000042,70482,HC CT ORBIT/IAC/EAR W AND W/O CONTRAST,350,1 ,"$2,930.00 ","$1,904.50 ",$133.17 ,"$2,930.00 ","$2,109.60 ","$1,593.92 ",$673.90 ,"$1,635.53 ",$673.90 ,"$1,750.38 ","$1,750.38 ","$1,750.38 ","$1,750.38 ","$2,461.20 ",$673.90 ,"$2,490.50 ","$2,461.20 ",$673.90 ,"$2,197.50 ","$2,344.00 ","$2,344.00 ",$673.90 ,"$2,344.00 ","$2,461.20 ","$2,461.20 ","$2,461.20 ","$2,637.00 ","$1,684.75 ",$673.90 ,"$2,930.00 ",$133.17 ,$146.49 ,$741.29 ,"$2,490.50 ","$1,750.38 ","$2,637.00 ","$2,461.20 ","$2,344.00 ","$2,344.00 ",$673.90 ,"$1,904.50 " ST. FRANCIS HOSPITAL - ACUTE,35000043,70486,HC CT MAX/FACIAL W/O CONTRAST,350,1 ,"$1,940.00 ","$1,261.00 ",$133.17 ,"$1,940.00 ","$1,396.80 ","$1,055.36 ",$446.20 ,"$1,082.91 ",$446.20 ,"$1,158.96 ","$1,158.96 ","$1,158.96 ","$1,158.96 ","$1,629.60 ",$446.20 ,"$1,649.00 ","$1,629.60 ",$446.20 ,"$1,455.00 ","$1,552.00 ","$1,552.00 ",$446.20 ,"$1,552.00 ","$1,629.60 ","$1,629.60 ","$1,629.60 ","$1,746.00 ","$1,115.50 ",$446.20 ,"$1,940.00 ",$133.17 ,$146.49 ,$490.82 ,"$1,649.00 ","$1,158.96 ","$1,746.00 ","$1,629.60 ","$1,552.00 ","$1,552.00 ",$446.20 ,"$1,261.00 " ST. FRANCIS HOSPITAL - ACUTE,35000045,70487,HC CT MAX/FACIAL W/CONTRAST,350,1 ,"$2,134.00 ","$1,387.10 ",$133.17 ,"$2,134.00 ","$1,536.48 ","$1,160.90 ",$490.82 ,"$1,191.20 ",$490.82 ,"$1,274.85 ","$1,274.85 ","$1,274.85 ","$1,274.85 ","$1,792.56 ",$490.82 ,"$1,813.90 ","$1,792.56 ",$490.82 ,"$1,600.50 ","$1,707.20 ","$1,707.20 ",$490.82 ,"$1,707.20 ","$1,792.56 ","$1,792.56 ","$1,792.56 ","$1,920.60 ","$1,227.05 ",$490.82 ,"$2,134.00 ",$133.17 ,$146.49 ,$539.90 ,"$1,813.90 ","$1,274.85 ","$1,920.60 ","$1,792.56 ","$1,707.20 ","$1,707.20 ",$490.82 ,"$1,387.10 " ST. FRANCIS HOSPITAL - ACUTE,35000046,70488,HC CT MAX/FACIAL W AND W/O CONTRAST,350,1 ,"$2,134.00 ","$1,387.10 ",$133.17 ,"$2,134.00 ","$1,536.48 ","$1,160.90 ",$490.82 ,"$1,191.20 ",$490.82 ,"$1,274.85 ","$1,274.85 ","$1,274.85 ","$1,274.85 ","$1,792.56 ",$490.82 ,"$1,813.90 ","$1,792.56 ",$490.82 ,"$1,600.50 ","$1,707.20 ","$1,707.20 ",$490.82 ,"$1,707.20 ","$1,792.56 ","$1,792.56 ","$1,792.56 ","$1,920.60 ","$1,227.05 ",$490.82 ,"$2,134.00 ",$133.17 ,$146.49 ,$539.90 ,"$1,813.90 ","$1,274.85 ","$1,920.60 ","$1,792.56 ","$1,707.20 ","$1,707.20 ",$490.82 ,"$1,387.10 " ST. FRANCIS HOSPITAL - ACUTE,35000047,70490,HC CT NECK SFT TISS W/O CONTRAST,350,1 ,"$2,565.00 ","$1,667.25 ",$133.17 ,"$2,565.00 ","$1,846.80 ","$1,395.36 ",$589.95 ,"$1,431.78 ",$589.95 ,"$1,532.33 ","$1,532.33 ","$1,532.33 ","$1,532.33 ","$2,154.60 ",$589.95 ,"$2,180.25 ","$2,154.60 ",$589.95 ,"$1,923.75 ","$2,052.00 ","$2,052.00 ",$589.95 ,"$2,052.00 ","$2,154.60 ","$2,154.60 ","$2,154.60 ","$2,308.50 ","$1,474.88 ",$589.95 ,"$2,565.00 ",$133.17 ,$146.49 ,$648.95 ,"$2,180.25 ","$1,532.33 ","$2,308.50 ","$2,154.60 ","$2,052.00 ","$2,052.00 ",$589.95 ,"$1,667.25 " ST. FRANCIS HOSPITAL - ACUTE,35000048,70491,HC CT NECK SFT TISS W/CONTRAST,350,1 ,"$3,106.00 ","$2,018.90 ",$133.17 ,"$3,106.00 ","$2,236.32 ","$1,689.66 ",$714.38 ,"$1,733.77 ",$714.38 ,"$1,855.52 ","$1,855.52 ","$1,855.52 ","$1,855.52 ","$2,609.04 ",$714.38 ,"$2,640.10 ","$2,609.04 ",$714.38 ,"$2,329.50 ","$2,484.80 ","$2,484.80 ",$714.38 ,"$2,484.80 ","$2,609.04 ","$2,609.04 ","$2,609.04 ","$2,795.40 ","$1,785.95 ",$714.38 ,"$3,106.00 ",$133.17 ,$146.49 ,$785.82 ,"$2,640.10 ","$1,855.52 ","$2,795.40 ","$2,609.04 ","$2,484.80 ","$2,484.80 ",$714.38 ,"$2,018.90 " ST. FRANCIS HOSPITAL - ACUTE,35000049,70492,HC CT NECK SFT TISS W AND WO CONTRAST,350,1 ,"$4,032.00 ","$2,620.80 ",$133.17 ,"$4,032.00 ","$2,903.04 ","$2,193.41 ",$927.36 ,"$2,250.66 ",$927.36 ,"$2,408.72 ","$2,408.72 ","$2,408.72 ","$2,408.72 ","$3,386.88 ",$927.36 ,"$3,427.20 ","$3,386.88 ",$927.36 ,"$3,024.00 ","$3,225.60 ","$3,225.60 ",$927.36 ,"$3,225.60 ","$3,386.88 ","$3,386.88 ","$3,386.88 ","$3,628.80 ","$2,318.40 ",$927.36 ,"$4,032.00 ",$133.17 ,$146.49 ,"$1,020.10 ","$3,427.20 ","$2,408.72 ","$3,628.80 ","$3,386.88 ","$3,225.60 ","$3,225.60 ",$927.36 ,"$2,620.80 " ST. FRANCIS HOSPITAL - ACUTE,35000050,70496,HC CT ANGIO HEAD W/WO,350,1 ,"$2,999.00 ","$1,949.35 ",$351.01 ,"$2,999.00 ","$2,159.28 ","$1,631.46 ",$689.77 ,"$1,674.04 ",$689.77 ,"$1,791.60 ","$1,791.60 ","$1,791.60 ","$1,791.60 ","$2,519.16 ",$689.77 ,"$2,549.15 ","$2,519.16 ",$689.77 ,"$2,249.25 ","$2,399.20 ","$2,399.20 ",$689.77 ,"$2,399.20 ","$2,519.16 ","$2,519.16 ","$2,519.16 ","$2,699.10 ","$1,724.43 ",$689.77 ,"$2,999.00 ",$351.01 ,$386.11 ,$758.75 ,"$2,549.15 ","$1,791.60 ","$2,699.10 ","$2,519.16 ","$2,399.20 ","$2,399.20 ",$689.77 ,"$1,949.35 " ST. FRANCIS HOSPITAL - ACUTE,35000051,70498,HC CT ANGIO NECK W/WO CONTRAST,350,1 ,"$3,247.00 ","$2,110.55 ",$133.17 ,"$3,247.00 ","$2,337.84 ","$1,766.37 ",$746.81 ,"$1,812.48 ",$746.81 ,"$1,939.76 ","$1,939.76 ","$1,939.76 ","$1,939.76 ","$2,727.48 ",$746.81 ,"$2,759.95 ","$2,727.48 ",$746.81 ,"$2,435.25 ","$2,597.60 ","$2,597.60 ",$746.81 ,"$2,597.60 ","$2,727.48 ","$2,727.48 ","$2,727.48 ","$2,922.30 ","$1,867.03 ",$746.81 ,"$3,247.00 ",$133.17 ,$146.49 ,$821.49 ,"$2,759.95 ","$1,939.76 ","$2,922.30 ","$2,727.48 ","$2,597.60 ","$2,597.60 ",$746.81 ,"$2,110.55 " ST. FRANCIS HOSPITAL - ACUTE,35000052,70540,HC MRI ORBIT/FACE/NECK W/O CON,610,1 ,"$3,617.00 ","$2,351.05 ",$332.25 ,"$3,617.00 ","$2,604.24 ","$1,967.65 ",$831.91 ,"$2,019.01 ",$831.91 ,"$2,160.80 ","$2,160.80 ","$2,160.80 ","$2,160.80 ","$3,038.28 ",$831.91 ,"$3,074.45 ","$3,038.28 ",$831.91 ,"$2,712.75 ","$2,893.60 ","$2,893.60 ",$831.91 ,"$2,893.60 ","$3,038.28 ","$3,038.28 ","$3,038.28 ","$3,255.30 ","$2,079.78 ",$831.91 ,"$3,617.00 ",$332.25 ,$365.48 ,$915.10 ,"$3,074.45 ","$2,160.80 ","$3,255.30 ","$3,038.28 ","$2,893.60 ","$2,893.60 ",$831.91 ,"$2,351.05 " ST. FRANCIS HOSPITAL - ACUTE,35000053,72125,HC CT C-SPINE W/O CONTRAST,350,1 ,"$2,826.00 ","$1,836.90 ",$151.16 ,"$2,826.00 ","$2,034.72 ","$1,537.34 ",$649.98 ,"$1,577.47 ",$649.98 ,"$1,688.25 ","$1,688.25 ","$1,688.25 ","$1,688.25 ","$2,373.84 ",$649.98 ,"$2,402.10 ","$2,373.84 ",$649.98 ,"$2,119.50 ","$2,260.80 ","$2,260.80 ",$649.98 ,"$2,260.80 ","$2,373.84 ","$2,373.84 ","$2,373.84 ","$2,543.40 ","$1,624.95 ",$649.98 ,"$2,826.00 ",$151.16 ,$166.28 ,$714.98 ,"$2,402.10 ","$1,688.25 ","$2,543.40 ","$2,373.84 ","$2,260.80 ","$2,260.80 ",$649.98 ,"$1,836.90 " ST. FRANCIS HOSPITAL - ACUTE,35000055,72126,HC CT C-SPINE W/CONTRAST,350,1 ,"$3,479.00 ","$2,261.35 ",$151.16 ,"$3,479.00 ","$2,504.88 ","$1,892.58 ",$800.17 ,"$1,941.98 ",$800.17 ,"$2,078.35 ","$2,078.35 ","$2,078.35 ","$2,078.35 ","$2,922.36 ",$800.17 ,"$2,957.15 ","$2,922.36 ",$800.17 ,"$2,609.25 ","$2,783.20 ","$2,783.20 ",$800.17 ,"$2,783.20 ","$2,922.36 ","$2,922.36 ","$2,922.36 ","$3,131.10 ","$2,000.43 ",$800.17 ,"$3,479.00 ",$151.16 ,$166.28 ,$880.19 ,"$2,957.15 ","$2,078.35 ","$3,131.10 ","$2,922.36 ","$2,783.20 ","$2,783.20 ",$800.17 ,"$2,261.35 " ST. FRANCIS HOSPITAL - ACUTE,35000056,72127,HC CT C-SPINE W AND W/O CONTRAST,350,1 ,"$3,699.00 ","$2,404.35 ",$151.16 ,"$3,699.00 ","$2,663.28 ","$2,012.26 ",$850.77 ,"$2,064.78 ",$850.77 ,"$2,209.78 ","$2,209.78 ","$2,209.78 ","$2,209.78 ","$3,107.16 ",$850.77 ,"$3,144.15 ","$3,107.16 ",$850.77 ,"$2,774.25 ","$2,959.20 ","$2,959.20 ",$850.77 ,"$2,959.20 ","$3,107.16 ","$3,107.16 ","$3,107.16 ","$3,329.10 ","$2,126.93 ",$850.77 ,"$3,699.00 ",$151.16 ,$166.28 ,$935.85 ,"$3,144.15 ","$2,209.78 ","$3,329.10 ","$3,107.16 ","$2,959.20 ","$2,959.20 ",$850.77 ,"$2,404.35 " ST. FRANCIS HOSPITAL - ACUTE,35000057,72128,HC CT T-SPINE W/O CONTRAST,350,1 ,"$2,110.00 ","$1,371.50 ",$151.16 ,"$2,110.00 ","$1,519.20 ","$1,147.84 ",$485.30 ,"$1,177.80 ",$485.30 ,"$1,260.51 ","$1,260.51 ","$1,260.51 ","$1,260.51 ","$1,772.40 ",$485.30 ,"$1,793.50 ","$1,772.40 ",$485.30 ,"$1,582.50 ","$1,688.00 ","$1,688.00 ",$485.30 ,"$1,688.00 ","$1,772.40 ","$1,772.40 ","$1,772.40 ","$1,899.00 ","$1,213.25 ",$485.30 ,"$2,110.00 ",$151.16 ,$166.28 ,$533.83 ,"$1,793.50 ","$1,260.51 ","$1,899.00 ","$1,772.40 ","$1,688.00 ","$1,688.00 ",$485.30 ,"$1,371.50 " ST. FRANCIS HOSPITAL - ACUTE,35000059,72129,HC CT T-SPINE W/CONTRAST,350,1 ,"$2,891.00 ","$1,879.15 ",$151.16 ,"$2,891.00 ","$2,081.52 ","$1,572.70 ",$664.93 ,"$1,613.76 ",$664.93 ,"$1,727.08 ","$1,727.08 ","$1,727.08 ","$1,727.08 ","$2,428.44 ",$664.93 ,"$2,457.35 ","$2,428.44 ",$664.93 ,"$2,168.25 ","$2,312.80 ","$2,312.80 ",$664.93 ,"$2,312.80 ","$2,428.44 ","$2,428.44 ","$2,428.44 ","$2,601.90 ","$1,662.33 ",$664.93 ,"$2,891.00 ",$151.16 ,$166.28 ,$731.42 ,"$2,457.35 ","$1,727.08 ","$2,601.90 ","$2,428.44 ","$2,312.80 ","$2,312.80 ",$664.93 ,"$1,879.15 " ST. FRANCIS HOSPITAL - ACUTE,35000060,72130,HC CT T-SPINE W AND W/O CONTRAST,350,1 ,"$3,313.00 ","$2,153.45 ",$151.16 ,"$3,313.00 ","$2,385.36 ","$1,802.27 ",$761.99 ,"$1,849.32 ",$761.99 ,"$1,979.19 ","$1,979.19 ","$1,979.19 ","$1,979.19 ","$2,782.92 ",$761.99 ,"$2,816.05 ","$2,782.92 ",$761.99 ,"$2,484.75 ","$2,650.40 ","$2,650.40 ",$761.99 ,"$2,650.40 ","$2,782.92 ","$2,782.92 ","$2,782.92 ","$2,981.70 ","$1,904.98 ",$761.99 ,"$3,313.00 ",$151.16 ,$166.28 ,$838.19 ,"$2,816.05 ","$1,979.19 ","$2,981.70 ","$2,782.92 ","$2,650.40 ","$2,650.40 ",$761.99 ,"$2,153.45 " ST. FRANCIS HOSPITAL - ACUTE,35000061,72131,HC CT L-SPINE W/O CONTRAST,350,1 ,"$2,110.00 ","$1,371.50 ",$151.16 ,"$2,110.00 ","$1,519.20 ","$1,147.84 ",$485.30 ,"$1,177.80 ",$485.30 ,"$1,260.51 ","$1,260.51 ","$1,260.51 ","$1,260.51 ","$1,772.40 ",$485.30 ,"$1,793.50 ","$1,772.40 ",$485.30 ,"$1,582.50 ","$1,688.00 ","$1,688.00 ",$485.30 ,"$1,688.00 ","$1,772.40 ","$1,772.40 ","$1,772.40 ","$1,899.00 ","$1,213.25 ",$485.30 ,"$2,110.00 ",$151.16 ,$166.28 ,$533.83 ,"$1,793.50 ","$1,260.51 ","$1,899.00 ","$1,772.40 ","$1,688.00 ","$1,688.00 ",$485.30 ,"$1,371.50 " ST. FRANCIS HOSPITAL - ACUTE,35000062,72132,HC CT L-SPINE W/CONTRAST,350,1 ,"$2,235.00 ","$1,452.75 ",$151.16 ,"$2,235.00 ","$1,609.20 ","$1,215.84 ",$514.05 ,"$1,247.58 ",$514.05 ,"$1,335.19 ","$1,335.19 ","$1,335.19 ","$1,335.19 ","$1,877.40 ",$514.05 ,"$1,899.75 ","$1,877.40 ",$514.05 ,"$1,676.25 ","$1,788.00 ","$1,788.00 ",$514.05 ,"$1,788.00 ","$1,877.40 ","$1,877.40 ","$1,877.40 ","$2,011.50 ","$1,285.13 ",$514.05 ,"$2,235.00 ",$151.16 ,$166.28 ,$565.46 ,"$1,899.75 ","$1,335.19 ","$2,011.50 ","$1,877.40 ","$1,788.00 ","$1,788.00 ",$514.05 ,"$1,452.75 " ST. FRANCIS HOSPITAL - ACUTE,35000063,72133,HC CT L-SPINE W AND W/O CONTRAST,350,1 ,"$2,435.00 ","$1,582.75 ",$151.16 ,"$2,435.00 ","$1,753.20 ","$1,324.64 ",$560.05 ,"$1,359.22 ",$560.05 ,"$1,454.67 ","$1,454.67 ","$1,454.67 ","$1,454.67 ","$2,045.40 ",$560.05 ,"$2,069.75 ","$2,045.40 ",$560.05 ,"$1,826.25 ","$1,948.00 ","$1,948.00 ",$560.05 ,"$1,948.00 ","$2,045.40 ","$2,045.40 ","$2,045.40 ","$2,191.50 ","$1,400.13 ",$560.05 ,"$2,435.00 ",$151.16 ,$166.28 ,$616.06 ,"$2,069.75 ","$1,454.67 ","$2,191.50 ","$2,045.40 ","$1,948.00 ","$1,948.00 ",$560.05 ,"$1,582.75 " ST. FRANCIS HOSPITAL - ACUTE,35000064,72191,HC CTA PELVIS W AND W/O CONTRAST,350,1 ,"$3,299.00 ","$2,144.35 ",$300.96 ,"$3,299.00 ","$2,375.28 ","$1,794.66 ",$758.77 ,"$1,841.50 ",$758.77 ,"$1,970.82 ","$1,970.82 ","$1,970.82 ","$1,970.82 ","$2,771.16 ",$758.77 ,"$2,804.15 ","$2,771.16 ",$758.77 ,"$2,474.25 ","$2,639.20 ","$2,639.20 ",$758.77 ,"$2,639.20 ","$2,771.16 ","$2,771.16 ","$2,771.16 ","$2,969.10 ","$1,896.93 ",$758.77 ,"$3,299.00 ",$300.96 ,$331.06 ,$834.65 ,"$2,804.15 ","$1,970.82 ","$2,969.10 ","$2,771.16 ","$2,639.20 ","$2,639.20 ",$758.77 ,"$2,144.35 " ST. FRANCIS HOSPITAL - ACUTE,35000065,72192,HC CT PELVIS W/O CONTRAST,350,1 ,"$2,479.00 ","$1,611.35 ",$301.25 ,"$2,479.00 ","$1,784.88 ","$1,348.58 ",$570.17 ,"$1,383.78 ",$570.17 ,"$1,480.95 ","$1,480.95 ","$1,480.95 ","$1,480.95 ","$2,082.36 ",$570.17 ,"$2,107.15 ","$2,082.36 ",$570.17 ,"$1,859.25 ","$1,983.20 ","$1,983.20 ",$570.17 ,"$1,983.20 ","$2,082.36 ","$2,082.36 ","$2,082.36 ","$2,231.10 ","$1,425.43 ",$570.17 ,"$2,479.00 ",$301.25 ,$331.38 ,$627.19 ,"$2,107.15 ","$1,480.95 ","$2,231.10 ","$2,082.36 ","$1,983.20 ","$1,983.20 ",$570.17 ,"$1,611.35 " ST. FRANCIS HOSPITAL - ACUTE,35000066,72193,HC CT PELVIS W/CONTRAST,350,1 ,"$2,706.00 ","$1,758.90 ",$301.25 ,"$2,706.00 ","$1,948.32 ","$1,472.06 ",$622.38 ,"$1,510.49 ",$622.38 ,"$1,616.56 ","$1,616.56 ","$1,616.56 ","$1,616.56 ","$2,273.04 ",$622.38 ,"$2,300.10 ","$2,273.04 ",$622.38 ,"$2,029.50 ","$2,164.80 ","$2,164.80 ",$622.38 ,"$2,164.80 ","$2,273.04 ","$2,273.04 ","$2,273.04 ","$2,435.40 ","$1,555.95 ",$622.38 ,"$2,706.00 ",$301.25 ,$331.38 ,$684.62 ,"$2,300.10 ","$1,616.56 ","$2,435.40 ","$2,273.04 ","$2,164.80 ","$2,164.80 ",$622.38 ,"$1,758.90 " ST. FRANCIS HOSPITAL - ACUTE,35000067,72194,HC CT PELVIS W AND W/O CONTRAST,350,1 ,"$3,204.00 ","$2,082.60 ",$301.25 ,"$3,204.00 ","$2,306.88 ","$1,742.98 ",$736.92 ,"$1,788.47 ",$736.92 ,"$1,914.07 ","$1,914.07 ","$1,914.07 ","$1,914.07 ","$2,691.36 ",$736.92 ,"$2,723.40 ","$2,691.36 ",$736.92 ,"$2,403.00 ","$2,563.20 ","$2,563.20 ",$736.92 ,"$2,563.20 ","$2,691.36 ","$2,691.36 ","$2,691.36 ","$2,883.60 ","$1,842.30 ",$736.92 ,"$3,204.00 ",$301.25 ,$331.38 ,$810.61 ,"$2,723.40 ","$1,914.07 ","$2,883.60 ","$2,691.36 ","$2,563.20 ","$2,563.20 ",$736.92 ,"$2,082.60 " ST. FRANCIS HOSPITAL - ACUTE,35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$2,175.00 ","$1,413.75 ",$133.17 ,"$2,175.00 ","$1,566.00 ","$1,183.20 ",$500.25 ,"$1,214.09 ",$500.25 ,"$1,299.35 ","$1,299.35 ","$1,299.35 ","$1,299.35 ","$1,827.00 ",$500.25 ,"$1,848.75 ","$1,827.00 ",$500.25 ,"$1,631.25 ","$1,740.00 ","$1,740.00 ",$500.25 ,"$1,740.00 ","$1,827.00 ","$1,827.00 ","$1,827.00 ","$1,957.50 ","$1,250.63 ",$500.25 ,"$2,175.00 ",$133.17 ,$146.49 ,$550.28 ,"$1,848.75 ","$1,299.35 ","$1,957.50 ","$1,827.00 ","$1,740.00 ","$1,740.00 ",$500.25 ,"$1,413.75 " ST. FRANCIS HOSPITAL - ACUTE,35000071,73201,HC CT UPPER EXTRM W CONT,350,1 ,"$3,051.00 ","$1,983.15 ",$133.17 ,"$3,051.00 ","$2,196.72 ","$1,659.74 ",$701.73 ,"$1,703.07 ",$701.73 ,"$1,822.67 ","$1,822.67 ","$1,822.67 ","$1,822.67 ","$2,562.84 ",$701.73 ,"$2,593.35 ","$2,562.84 ",$701.73 ,"$2,288.25 ","$2,440.80 ","$2,440.80 ",$701.73 ,"$2,440.80 ","$2,562.84 ","$2,562.84 ","$2,562.84 ","$2,745.90 ","$1,754.33 ",$701.73 ,"$3,051.00 ",$133.17 ,$146.49 ,$771.90 ,"$2,593.35 ","$1,822.67 ","$2,745.90 ","$2,562.84 ","$2,440.80 ","$2,440.80 ",$701.73 ,"$1,983.15 " ST. FRANCIS HOSPITAL - ACUTE,35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$3,051.00 ","$1,983.15 ",$133.17 ,"$3,051.00 ","$2,196.72 ","$1,659.74 ",$701.73 ,"$1,703.07 ",$701.73 ,"$1,822.67 ","$1,822.67 ","$1,822.67 ","$1,822.67 ","$2,562.84 ",$701.73 ,"$2,593.35 ","$2,562.84 ",$701.73 ,"$2,288.25 ","$2,440.80 ","$2,440.80 ",$701.73 ,"$2,440.80 ","$2,562.84 ","$2,562.84 ","$2,562.84 ","$2,745.90 ","$1,754.33 ",$701.73 ,"$3,051.00 ",$133.17 ,$146.49 ,$771.90 ,"$2,593.35 ","$1,822.67 ","$2,745.90 ","$2,562.84 ","$2,440.80 ","$2,440.80 ",$701.73 ,"$1,983.15 " ST. FRANCIS HOSPITAL - ACUTE,35000073,73206,HC CT ANGIO UPPER EXTREM W/WO CONT,350,1 ,"$3,051.00 ","$1,983.15 ",$300.96 ,"$3,051.00 ","$2,196.72 ","$1,659.74 ",$701.73 ,"$1,703.07 ",$701.73 ,"$1,822.67 ","$1,822.67 ","$1,822.67 ","$1,822.67 ","$2,562.84 ",$701.73 ,"$2,593.35 ","$2,562.84 ",$701.73 ,"$2,288.25 ","$2,440.80 ","$2,440.80 ",$701.73 ,"$2,440.80 ","$2,562.84 ","$2,562.84 ","$2,562.84 ","$2,745.90 ","$1,754.33 ",$701.73 ,"$3,051.00 ",$300.96 ,$331.06 ,$771.90 ,"$2,593.35 ","$1,822.67 ","$2,745.90 ","$2,562.84 ","$2,440.80 ","$2,440.80 ",$701.73 ,"$1,983.15 " ST. FRANCIS HOSPITAL - ACUTE,35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$2,364.00 ","$1,536.60 ",$133.17 ,"$2,364.00 ","$1,702.08 ","$1,286.02 ",$543.72 ,"$1,319.58 ",$543.72 ,"$1,412.25 ","$1,412.25 ","$1,412.25 ","$1,412.25 ","$1,985.76 ",$543.72 ,"$2,009.40 ","$1,985.76 ",$543.72 ,"$1,773.00 ","$1,891.20 ","$1,891.20 ",$543.72 ,"$1,891.20 ","$1,985.76 ","$1,985.76 ","$1,985.76 ","$2,127.60 ","$1,359.30 ",$543.72 ,"$2,364.00 ",$133.17 ,$146.49 ,$598.09 ,"$2,009.40 ","$1,412.25 ","$2,127.60 ","$1,985.76 ","$1,891.20 ","$1,891.20 ",$543.72 ,"$1,536.60 " ST. FRANCIS HOSPITAL - ACUTE,35000075,73701,HC CT LOWER EXTREMITY W/CON,350,1 ,"$2,709.00 ","$1,760.85 ",$133.17 ,"$2,709.00 ","$1,950.48 ","$1,473.70 ",$623.07 ,"$1,512.16 ",$623.07 ,"$1,618.36 ","$1,618.36 ","$1,618.36 ","$1,618.36 ","$2,275.56 ",$623.07 ,"$2,302.65 ","$2,275.56 ",$623.07 ,"$2,031.75 ","$2,167.20 ","$2,167.20 ",$623.07 ,"$2,167.20 ","$2,275.56 ","$2,275.56 ","$2,275.56 ","$2,438.10 ","$1,557.68 ",$623.07 ,"$2,709.00 ",$133.17 ,$146.49 ,$685.38 ,"$2,302.65 ","$1,618.36 ","$2,438.10 ","$2,275.56 ","$2,167.20 ","$2,167.20 ",$623.07 ,"$1,760.85 " ST. FRANCIS HOSPITAL - ACUTE,35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$2,039.00 ","$1,325.35 ",$300.96 ,"$2,039.00 ","$1,468.08 ","$1,109.22 ",$468.97 ,"$1,138.17 ",$468.97 ,"$1,218.10 ","$1,218.10 ","$1,218.10 ","$1,218.10 ","$1,712.76 ",$468.97 ,"$1,733.15 ","$1,712.76 ",$468.97 ,"$1,529.25 ","$1,631.20 ","$1,631.20 ",$468.97 ,"$1,631.20 ","$1,712.76 ","$1,712.76 ","$1,712.76 ","$1,835.10 ","$1,172.43 ",$468.97 ,"$2,039.00 ",$300.96 ,$331.06 ,$515.87 ,"$1,733.15 ","$1,218.10 ","$1,835.10 ","$1,712.76 ","$1,631.20 ","$1,631.20 ",$468.97 ,"$1,325.35 " ST. FRANCIS HOSPITAL - ACUTE,35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$2,239.00 ","$1,455.35 ",$300.96 ,"$2,239.00 ","$1,612.08 ","$1,218.02 ",$514.97 ,"$1,249.81 ",$514.97 ,"$1,337.58 ","$1,337.58 ","$1,337.58 ","$1,337.58 ","$1,880.76 ",$514.97 ,"$1,903.15 ","$1,880.76 ",$514.97 ,"$1,679.25 ","$1,791.20 ","$1,791.20 ",$514.97 ,"$1,791.20 ","$1,880.76 ","$1,880.76 ","$1,880.76 ","$2,015.10 ","$1,287.43 ",$514.97 ,"$2,239.00 ",$300.96 ,$331.06 ,$566.47 ,"$1,903.15 ","$1,337.58 ","$2,015.10 ","$1,880.76 ","$1,791.20 ","$1,791.20 ",$514.97 ,"$1,455.35 " ST. FRANCIS HOSPITAL - ACUTE,35000079,74150,HC CT ABD W/O CONTRAST,350,1 ,"$2,393.00 ","$1,555.45 ",$301.25 ,"$2,393.00 ","$1,722.96 ","$1,301.79 ",$550.39 ,"$1,335.77 ",$550.39 ,"$1,429.58 ","$1,429.58 ","$1,429.58 ","$1,429.58 ","$2,010.12 ",$550.39 ,"$2,034.05 ","$2,010.12 ",$550.39 ,"$1,794.75 ","$1,914.40 ","$1,914.40 ",$550.39 ,"$1,914.40 ","$2,010.12 ","$2,010.12 ","$2,010.12 ","$2,153.70 ","$1,375.98 ",$550.39 ,"$2,393.00 ",$301.25 ,$331.38 ,$605.43 ,"$2,034.05 ","$1,429.58 ","$2,153.70 ","$2,010.12 ","$1,914.40 ","$1,914.40 ",$550.39 ,"$1,555.45 " ST. FRANCIS HOSPITAL - ACUTE,35000080,74160,HC CT ABDOMEN W/CONTRAST,350,1 ,"$3,227.00 ","$2,097.55 ",$301.25 ,"$3,227.00 ","$2,323.44 ","$1,755.49 ",$742.21 ,"$1,801.31 ",$742.21 ,"$1,927.81 ","$1,927.81 ","$1,927.81 ","$1,927.81 ","$2,710.68 ",$742.21 ,"$2,742.95 ","$2,710.68 ",$742.21 ,"$2,420.25 ","$2,581.60 ","$2,581.60 ",$742.21 ,"$2,581.60 ","$2,710.68 ","$2,710.68 ","$2,710.68 ","$2,904.30 ","$1,855.53 ",$742.21 ,"$3,227.00 ",$301.25 ,$331.38 ,$816.43 ,"$2,742.95 ","$1,927.81 ","$2,904.30 ","$2,710.68 ","$2,581.60 ","$2,581.60 ",$742.21 ,"$2,097.55 " ST. FRANCIS HOSPITAL - ACUTE,35000081,74170,HC CT ABDOMEN W AND W/O CONTRAST,350,1 ,"$3,528.00 ","$2,293.20 ",$301.25 ,"$3,528.00 ","$2,540.16 ","$1,919.23 ",$811.44 ,"$1,969.33 ",$811.44 ,"$2,107.63 ","$2,107.63 ","$2,107.63 ","$2,107.63 ","$2,963.52 ",$811.44 ,"$2,998.80 ","$2,963.52 ",$811.44 ,"$2,646.00 ","$2,822.40 ","$2,822.40 ",$811.44 ,"$2,822.40 ","$2,963.52 ","$2,963.52 ","$2,963.52 ","$3,175.20 ","$2,028.60 ",$811.44 ,"$3,528.00 ",$301.25 ,$331.38 ,$892.58 ,"$2,998.80 ","$2,107.63 ","$3,175.20 ","$2,963.52 ","$2,822.40 ","$2,822.40 ",$811.44 ,"$2,293.20 " ST. FRANCIS HOSPITAL - ACUTE,35000082,74175,HC CTA ABDOMEN W AND W/O CONTRAST,350,1 ,"$3,499.00 ","$2,274.35 ",$300.96 ,"$3,499.00 ","$2,519.28 ","$1,903.46 ",$804.77 ,"$1,953.14 ",$804.77 ,"$2,090.30 ","$2,090.30 ","$2,090.30 ","$2,090.30 ","$2,939.16 ",$804.77 ,"$2,974.15 ","$2,939.16 ",$804.77 ,"$2,624.25 ","$2,799.20 ","$2,799.20 ",$804.77 ,"$2,799.20 ","$2,939.16 ","$2,939.16 ","$2,939.16 ","$3,149.10 ","$2,011.93 ",$804.77 ,"$3,499.00 ",$300.96 ,$331.06 ,$885.25 ,"$2,974.15 ","$2,090.30 ","$3,149.10 ","$2,939.16 ","$2,799.20 ","$2,799.20 ",$804.77 ,"$2,274.35 " ST. FRANCIS HOSPITAL - ACUTE,35000083,74176,HC CT ABDOMEN/PELVIS W/O CONTRAST,350,1 ,"$4,871.00 ","$3,166.15 ",$301.25 ,"$4,871.00 ","$3,507.12 ","$2,649.82 ","$1,120.33 ","$2,718.99 ","$1,120.33 ","$2,909.94 ","$2,909.94 ","$2,909.94 ","$2,909.94 ","$4,091.64 ","$1,120.33 ","$4,140.35 ","$4,091.64 ","$1,120.33 ","$3,653.25 ","$3,896.80 ","$3,896.80 ","$1,120.33 ","$3,896.80 ","$4,091.64 ","$4,091.64 ","$4,091.64 ","$4,383.90 ","$2,800.83 ","$1,120.33 ","$4,871.00 ",$301.25 ,$331.38 ,"$1,232.36 ","$4,140.35 ","$2,909.94 ","$4,383.90 ","$4,091.64 ","$3,896.80 ","$3,896.80 ","$1,120.33 ","$3,166.15 " ST. FRANCIS HOSPITAL - ACUTE,35000084,74177,HC CT ABDOMEN/PELVIS W/CONTRAST,350,1 ,"$5,932.00 ","$3,855.80 ",$301.25 ,"$5,932.00 ","$4,271.04 ","$3,227.01 ","$1,364.36 ","$3,311.24 ","$1,364.36 ","$3,543.78 ","$3,543.78 ","$3,543.78 ","$3,543.78 ","$4,982.88 ","$1,364.36 ","$5,042.20 ","$4,982.88 ","$1,364.36 ","$4,449.00 ","$4,745.60 ","$4,745.60 ","$1,364.36 ","$4,745.60 ","$4,982.88 ","$4,982.88 ","$4,982.88 ","$5,338.80 ","$3,410.90 ","$1,364.36 ","$5,932.00 ",$301.25 ,$331.38 ,"$1,500.80 ","$5,042.20 ","$3,543.78 ","$5,338.80 ","$4,982.88 ","$4,745.60 ","$4,745.60 ","$1,364.36 ","$3,855.80 " ST. FRANCIS HOSPITAL - ACUTE,35000085,74178,HC CT ABDOMEN/PELVIS W AND W/O CONTR,350,1 ,"$6,301.00 ","$4,095.65 ",$301.25 ,"$6,301.00 ","$4,536.72 ","$3,427.74 ","$1,449.23 ","$3,517.22 ","$1,449.23 ","$3,764.22 ","$3,764.22 ","$3,764.22 ","$3,764.22 ","$5,292.84 ","$1,449.23 ","$5,355.85 ","$5,292.84 ","$1,449.23 ","$4,725.75 ","$5,040.80 ","$5,040.80 ","$1,449.23 ","$5,040.80 ","$5,292.84 ","$5,292.84 ","$5,292.84 ","$5,670.90 ","$3,623.08 ","$1,449.23 ","$6,301.00 ",$301.25 ,$331.38 ,"$1,594.15 ","$5,355.85 ","$3,764.22 ","$5,670.90 ","$5,292.84 ","$5,040.80 ","$5,040.80 ","$1,449.23 ","$4,095.65 " ST. FRANCIS HOSPITAL - ACUTE,35000098,75635,HC CTA ABDOMEN AORTA ILIOFEM RUNOFF,350,1 ,"$3,856.00 ","$2,506.40 ",$300.96 ,"$3,856.00 ","$2,776.32 ","$2,097.66 ",$886.88 ,"$2,152.42 ",$886.88 ,"$2,303.57 ","$2,303.57 ","$2,303.57 ","$2,303.57 ","$3,239.04 ",$886.88 ,"$3,277.60 ","$3,239.04 ",$886.88 ,"$2,892.00 ","$3,084.80 ","$3,084.80 ",$886.88 ,"$3,084.80 ","$3,239.04 ","$3,239.04 ","$3,239.04 ","$3,470.40 ","$2,217.20 ",$886.88 ,"$3,856.00 ",$300.96 ,$331.06 ,$975.57 ,"$3,277.60 ","$2,303.57 ","$3,470.40 ","$3,239.04 ","$3,084.80 ","$3,084.80 ",$886.88 ,"$2,506.40 " ST. FRANCIS HOSPITAL - ACUTE,35000099,76376,HC 3D RENDER CT NOT REQUIRE INDEP,350,1 ,"$1,162.00 ",$755.30 ,$267.26 ,"$1,162.00 ",$836.64 ,$632.13 ,$267.26 ,$648.63 ,$267.26 ,$694.18 ,$694.18 ,$694.18 ,$694.18 ,$976.08 ,$267.26 ,$987.70 ,$976.08 ,$267.26 ,$871.50 ,$929.60 ,$929.60 ,$267.26 ,$929.60 ,$976.08 ,$976.08 ,$976.08 ,"$1,045.80 ",$668.15 ,$267.26 ,"$1,162.00 ", N/A , N/A ,$293.99 ,$987.70 ,$694.18 ,"$1,045.80 ",$976.08 ,$929.60 ,$929.60 ,$267.26 ,$755.30 ST. FRANCIS HOSPITAL - ACUTE,35000100,76377,HC 3D RENDER CT REQUIRES INDEPENDENT,350,1 ,$605.00 ,$393.25 ,$139.15 ,$605.00 ,$435.60 ,$329.12 ,$139.15 ,$337.71 ,$139.15 ,$361.43 ,$361.43 ,$361.43 ,$361.43 ,$508.20 ,$139.15 ,$514.25 ,$508.20 ,$139.15 ,$453.75 ,$484.00 ,$484.00 ,$139.15 ,$484.00 ,$508.20 ,$508.20 ,$508.20 ,$544.50 ,$347.88 ,$139.15 ,$605.00 , N/A , N/A ,$153.07 ,$514.25 ,$361.43 ,$544.50 ,$508.20 ,$484.00 ,$484.00 ,$139.15 ,$393.25 ST. FRANCIS HOSPITAL - ACUTE,35000106,77012,HC CT GUIDED NEEDLE PLACEMENT,350,1 ,"$2,341.00 ","$1,521.65 ",$102.71 ,"$2,341.00 ","$1,685.52 ","$1,273.50 ",$538.43 ,"$1,306.75 ",$538.43 ,"$1,398.51 ","$1,398.51 ","$1,398.51 ","$1,398.51 ","$1,966.44 ",$538.43 ,"$1,989.85 ","$1,966.44 ",$538.43 ,"$1,755.75 ","$1,872.80 ","$1,872.80 ",$538.43 ,"$1,872.80 ","$1,966.44 ","$1,966.44 ","$1,966.44 ","$2,106.90 ","$1,346.08 ",$538.43 ,"$2,341.00 ",$102.71 ,$112.98 ,$592.27 ,"$1,989.85 ","$1,398.51 ","$2,106.90 ","$1,966.44 ","$1,872.80 ","$1,872.80 ",$538.43 ,"$1,521.65 " ST. FRANCIS HOSPITAL - ACUTE,35000111,77014,HC CT GUIDED THRPY PLACEMENT UNENHAN,350,1 ,$490.00 ,$318.50 ,$102.71 ,$490.00 ,$352.80 ,$266.56 ,$112.70 ,$273.52 ,$112.70 ,$292.73 ,$292.73 ,$292.73 ,$292.73 ,$411.60 ,$112.70 ,$416.50 ,$411.60 ,$112.70 ,$367.50 ,$392.00 ,$392.00 ,$112.70 ,$392.00 ,$411.60 ,$411.60 ,$411.60 ,$441.00 ,$281.75 ,$112.70 ,$490.00 ,$102.71 ,$112.98 ,$123.97 ,$416.50 ,$292.73 ,$441.00 ,$411.60 ,$392.00 ,$392.00 ,$112.70 ,$318.50 ST. FRANCIS HOSPITAL - ACUTE,35000120,74174,HC CT ANGIO ABD/PELV W AND WO CONTRAST,350,1 ,"$6,301.00 ","$4,095.65 ",$301.25 ,"$6,301.00 ","$4,536.72 ","$3,427.74 ","$1,449.23 ","$3,517.22 ","$1,449.23 ","$3,764.22 ","$3,764.22 ","$3,764.22 ","$3,764.22 ","$5,292.84 ","$1,449.23 ","$5,355.85 ","$5,292.84 ","$1,449.23 ","$4,725.75 ","$5,040.80 ","$5,040.80 ","$1,449.23 ","$5,040.80 ","$5,292.84 ","$5,292.84 ","$5,292.84 ","$5,670.90 ","$3,623.08 ","$1,449.23 ","$6,301.00 ",$301.25 ,$331.38 ,"$1,594.15 ","$5,355.85 ","$3,764.22 ","$5,670.90 ","$5,292.84 ","$5,040.80 ","$5,040.80 ","$1,449.23 ","$4,095.65 " ST. FRANCIS HOSPITAL - ACUTE,35000150,G0297,HC CT LUNG SCREENING,350,1 ,$419.00 ,$272.35 ,$96.37 ,$419.00 ,$301.68 ,$227.94 ,$96.37 ,$233.89 ,$96.37 ,$250.31 ,$250.31 ,$250.31 ,$250.31 ,$351.96 ,$96.37 ,$356.15 ,$351.96 ,$96.37 ,$314.25 ,$335.20 ,$335.20 ,$96.37 ,$335.20 ,$351.96 ,$351.96 ,$351.96 ,$377.10 ,$240.93 ,$96.37 ,$419.00 ,$133.17 ,$146.49 ,$106.01 ,$356.15 ,$250.31 ,$377.10 ,$351.96 ,$335.20 ,$335.20 ,$96.37 ,$272.35 ST. FRANCIS HOSPITAL - ACUTE,36000025,10021,HC ASP FINE NDL W/O IMAGING GUIDE,360,1 ,$289.00 ,$187.85 ,$66.47 ,$641.73 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$185.39 ,$185.39 ,$185.39 ,$185.39 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$107.91 ,$583.39 ,$641.73 ,$73.12 ,$245.65 ,$185.39 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,36000027,10060,HC I AND D ABSC SMP FAC,360,1 ,$289.00 ,$187.85 ,$66.47 ,$317.01 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$185.39 ,$185.39 ,$185.39 ,$185.39 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 ,$288.19 ,$317.01 ,$73.12 ,$245.65 ,$185.39 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,36000029,10140,HC I AND D HEMATOMA/SEROMA/FLUID,360,1 ,$331.00 ,$215.15 ,$76.13 ,"$1,105.69 ",$238.32 ,$180.06 ,$76.13 ,$184.76 ,$76.13 ,$212.34 ,$212.34 ,$212.34 ,$212.34 ,$278.04 ,$76.13 ,$281.35 ,$278.04 ,$76.13 ,$248.25 ,$264.80 ,$264.80 ,$76.13 ,$264.80 ,$278.04 ,$278.04 ,$278.04 ,$297.90 ,$190.33 ,$76.13 ,$331.00 ,"$1,005.17 ","$1,105.69 ",$83.74 ,$281.35 ,$212.34 ,$297.90 ,$278.04 ,$264.80 ,$264.80 ,$76.13 ,$215.15 ST. FRANCIS HOSPITAL - ACUTE,36000030,10160,HC ASP ABSC/HEMA/CYST/BULLA FAC,360,1 ,$251.00 ,$163.15 ,$57.73 ,$317.01 ,$180.72 ,$136.54 ,$57.73 ,$140.11 ,$57.73 ,$161.02 ,$161.02 ,$161.02 ,$161.02 ,$210.84 ,$57.73 ,$213.35 ,$210.84 ,$57.73 ,$188.25 ,$200.80 ,$200.80 ,$57.73 ,$200.80 ,$210.84 ,$210.84 ,$210.84 ,$225.90 ,$144.33 ,$57.73 ,$251.00 ,$288.19 ,$317.01 ,$63.50 ,$213.35 ,$161.02 ,$225.90 ,$210.84 ,$200.80 ,$200.80 ,$57.73 ,$163.15 ST. FRANCIS HOSPITAL - ACUTE,36000078,19000,HC ASP CYST BREAST,360,1 ,"$1,308.00 ",$850.20 ,$119.12 ,"$1,308.00 ",$941.76 ,$711.55 ,$300.84 ,$730.13 ,$300.84 ,$839.08 ,$839.08 ,$839.08 ,$839.08 ,"$1,098.72 ",$300.84 ,"$1,111.80 ","$1,098.72 ",$300.84 ,$981.00 ,"$1,046.40 ","$1,046.40 ",$300.84 ,"$1,046.40 ","$1,098.72 ","$1,098.72 ","$1,098.72 ","$1,177.20 ",$752.10 ,$300.84 ,$119.12 ,$583.39 ,$641.73 ,$330.92 ,"$1,111.80 ",$839.08 ,"$1,177.20 ","$1,098.72 ","$1,046.40 ","$1,046.40 ",$300.84 ,$850.20 ST. FRANCIS HOSPITAL - ACUTE,36000079,19001,HC ASP CYST BREAST EA ADDL,360,1 ,$654.00 ,$425.10 ,$30.34 ,$654.00 ,$470.88 ,$355.78 ,$150.42 ,$365.06 ,$150.42 ,$419.54 ,$419.54 ,$419.54 ,$419.54 ,$549.36 ,$150.42 ,$555.90 ,$549.36 ,$150.42 ,$490.50 ,$523.20 ,$523.20 ,$150.42 ,$523.20 ,$549.36 ,$549.36 ,$549.36 ,$588.60 ,$376.05 ,$150.42 ,$30.34 ,$583.39 ,$641.73 ,$165.46 ,$555.90 ,$419.54 ,$588.60 ,$549.36 ,$523.20 ,$523.20 ,$150.42 ,$425.10 ST. FRANCIS HOSPITAL - ACUTE,36000081,19030,HC INJECTION GALACTOGRAM,360,1 ,"$1,131.00 ",$735.15 ,$260.13 ,"$1,131.00 ",$814.32 ,$615.26 ,$260.13 ,$631.32 ,$260.13 ,$725.54 ,$725.54 ,$725.54 ,$725.54 ,$950.04 ,$260.13 ,$961.35 ,$950.04 ,$260.13 ,$848.25 ,$904.80 ,$904.80 ,$260.13 ,$904.80 ,$950.04 ,$950.04 ,$950.04 ,"$1,017.90 ",$650.33 ,$260.13 ,"$1,131.00 ", N/A , N/A ,$286.14 ,$961.35 ,$725.54 ,"$1,017.90 ",$950.04 ,$904.80 ,$904.80 ,$260.13 ,$735.15 ST. FRANCIS HOSPITAL - ACUTE,36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$2,806.00 ","$1,823.90 ",$645.38 ,"$2,806.00 ","$2,020.32 ","$1,526.46 ",$645.38 ,"$1,566.31 ",$645.38 ,"$1,800.05 ","$1,800.05 ","$1,800.05 ","$1,800.05 ","$2,357.04 ",$645.38 ,"$2,385.10 ","$2,357.04 ",$645.38 ,"$2,104.50 ","$2,244.80 ","$2,244.80 ",$645.38 ,"$2,244.80 ","$2,357.04 ","$2,357.04 ","$2,357.04 ","$2,525.40 ","$1,613.45 ",$645.38 ,$650.01 ,"$1,182.27 ","$1,300.50 ",$709.92 ,"$2,385.10 ","$1,800.05 ","$2,525.40 ","$2,357.04 ","$2,244.80 ","$2,244.80 ",$645.38 ,"$1,823.90 " ST. FRANCIS HOSPITAL - ACUTE,36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$3,102.00 ","$2,016.30 ",$650.01 ,"$3,102.00 ","$2,233.44 ","$1,687.49 ",$713.46 ,"$1,731.54 ",$713.46 ,"$1,989.93 ","$1,989.93 ","$1,989.93 ","$1,989.93 ","$2,605.68 ",$713.46 ,"$2,636.70 ","$2,605.68 ",$713.46 ,"$2,326.50 ","$2,481.60 ","$2,481.60 ",$713.46 ,"$2,481.60 ","$2,605.68 ","$2,605.68 ","$2,605.68 ","$2,791.80 ","$1,783.65 ",$713.46 ,$650.01 ,"$1,182.27 ","$1,300.50 ",$784.81 ,"$2,636.70 ","$1,989.93 ","$2,791.80 ","$2,605.68 ","$2,481.60 ","$2,481.60 ",$713.46 ,"$2,016.30 " ST. FRANCIS HOSPITAL - ACUTE,36000085,19285,HC PLCMNT NEEDLE LOC WIRE BRST ULTRA,360,1 ,"$2,440.00 ","$1,586.00 ",$114.53 ,"$2,440.00 ","$1,756.80 ","$1,327.36 ",$561.20 ,"$1,362.01 ",$561.20 ,"$1,565.26 ","$1,565.26 ","$1,565.26 ","$1,565.26 ","$2,049.60 ",$561.20 ,"$2,074.00 ","$2,049.60 ",$561.20 ,"$1,830.00 ","$1,952.00 ","$1,952.00 ",$561.20 ,"$1,952.00 ","$2,049.60 ","$2,049.60 ","$2,049.60 ","$2,196.00 ","$1,403.00 ",$561.20 ,$489.83 ,$114.53 ,$125.98 ,$617.32 ,"$2,074.00 ","$1,565.26 ","$2,196.00 ","$2,049.60 ","$1,952.00 ","$1,952.00 ",$561.20 ,"$1,586.00 " ST. FRANCIS HOSPITAL - ACUTE,36000088,20206,HC BX MUSCLE NEEDLE PERC,360,1 ,"$1,417.00 ",$921.05 ,$325.91 ,"$1,417.00 ","$1,020.24 ",$770.85 ,$325.91 ,$790.97 ,$325.91 ,$909.01 ,$909.01 ,$909.01 ,$909.01 ,"$1,190.28 ",$325.91 ,"$1,204.45 ","$1,190.28 ",$325.91 ,"$1,062.75 ","$1,133.60 ","$1,133.60 ",$325.91 ,"$1,133.60 ","$1,190.28 ","$1,190.28 ","$1,190.28 ","$1,275.30 ",$814.78 ,$325.91 ,"$1,417.00 ",$583.39 ,$641.73 ,$358.50 ,"$1,204.45 ",$909.01 ,"$1,275.30 ","$1,190.28 ","$1,133.60 ","$1,133.60 ",$325.91 ,$921.05 ST. FRANCIS HOSPITAL - ACUTE,36000101,29085,HC CAST APPL; HAND AND FOREARM,360,1 ,$376.00 ,$244.40 ,$86.48 ,$376.00 ,$270.72 ,$204.54 ,$86.48 ,$209.88 ,$86.48 ,$241.20 ,$241.20 ,$241.20 ,$241.20 ,$315.84 ,$86.48 ,$319.60 ,$315.84 ,$86.48 ,$282.00 ,$300.80 ,$300.80 ,$86.48 ,$300.80 ,$315.84 ,$315.84 ,$315.84 ,$338.40 ,$216.20 ,$86.48 ,$376.00 ,$311.82 ,$343.00 ,$95.13 ,$319.60 ,$241.20 ,$338.40 ,$315.84 ,$300.80 ,$300.80 ,$86.48 ,$244.40 ST. FRANCIS HOSPITAL - ACUTE,36000109,19084,HC BREAST LOC BX ULTRA ADDN LESION,360,1 ,$690.00 ,$448.50 ,$158.70 ,"$1,300.50 ",$496.80 ,$375.36 ,$158.70 ,$385.16 ,$158.70 ,$442.64 ,$442.64 ,$442.64 ,$442.64 ,$579.60 ,$158.70 ,$586.50 ,$579.60 ,$158.70 ,$517.50 ,$552.00 ,$552.00 ,$158.70 ,$552.00 ,$579.60 ,$579.60 ,$579.60 ,$621.00 ,$396.75 ,$158.70 ,$512.31 ,"$1,182.27 ","$1,300.50 ",$174.57 ,$586.50 ,$442.64 ,$621.00 ,$579.60 ,$552.00 ,$552.00 ,$158.70 ,$448.50 ST. FRANCIS HOSPITAL - ACUTE,36000114,19282,HC BREAST NDL LOC BX ADDN LESION,360,1 ,$860.00 ,$559.00 ,$114.53 ,$860.00 ,$619.20 ,$467.84 ,$197.80 ,$480.05 ,$197.80 ,$551.69 ,$551.69 ,$551.69 ,$551.69 ,$722.40 ,$197.80 ,$731.00 ,$722.40 ,$197.80 ,$645.00 ,$688.00 ,$688.00 ,$197.80 ,$688.00 ,$722.40 ,$722.40 ,$722.40 ,$774.00 ,$494.50 ,$197.80 ,$186.19 ,$114.53 ,$125.98 ,$217.58 ,$731.00 ,$551.69 ,$774.00 ,$722.40 ,$688.00 ,$688.00 ,$197.80 ,$559.00 ST. FRANCIS HOSPITAL - ACUTE,36000123,36556,HC INS CATH CV NON-TUNL >5 YR,360,1 ,$619.00 ,$402.35 ,$142.37 ,"$1,795.74 ",$445.68 ,$336.74 ,$142.37 ,$345.53 ,$142.37 ,$397.09 ,$397.09 ,$397.09 ,$397.09 ,$519.96 ,$142.37 ,$526.15 ,$519.96 ,$142.37 ,$464.25 ,$495.20 ,$495.20 ,$142.37 ,$495.20 ,$519.96 ,$519.96 ,$519.96 ,$557.10 ,$355.93 ,$142.37 ,$619.00 ,"$1,632.49 ","$1,795.74 ",$156.61 ,$526.15 ,$397.09 ,$557.10 ,$519.96 ,$495.20 ,$495.20 ,$142.37 ,$402.35 ST. FRANCIS HOSPITAL - ACUTE,36000131,36568,HC INS CATH PERIPH CV W/O PORT <5,360,1 ,$876.00 ,$569.40 ,$201.48 ,$876.00 ,$630.72 ,$476.54 ,$201.48 ,$488.98 ,$201.48 ,$561.95 ,$561.95 ,$561.95 ,$561.95 ,$735.84 ,$201.48 ,$744.60 ,$735.84 ,$201.48 ,$657.00 ,$700.80 ,$700.80 ,$201.48 ,$700.80 ,$735.84 ,$735.84 ,$735.84 ,$788.40 ,$503.70 ,$201.48 ,$876.00 ,$475.21 ,$522.73 ,$221.63 ,$744.60 ,$561.95 ,$788.40 ,$735.84 ,$700.80 ,$700.80 ,$201.48 ,$569.40 ST. FRANCIS HOSPITAL - ACUTE,36000132,36569,HC INS PER CV CATH W/O PORT 5>,360,1 ,$723.00 ,$469.95 ,$166.29 ,$723.00 ,$520.56 ,$393.31 ,$166.29 ,$403.58 ,$166.29 ,$463.80 ,$463.80 ,$463.80 ,$463.80 ,$607.32 ,$166.29 ,$614.55 ,$607.32 ,$166.29 ,$542.25 ,$578.40 ,$578.40 ,$166.29 ,$578.40 ,$607.32 ,$607.32 ,$607.32 ,$650.70 ,$415.73 ,$166.29 ,$723.00 ,$475.21 ,$522.73 ,$182.92 ,$614.55 ,$463.80 ,$650.70 ,$607.32 ,$578.40 ,$578.40 ,$166.29 ,$469.95 ST. FRANCIS HOSPITAL - ACUTE,36000139,36584,HC REPL PICC W/O PORT/PUMP,360,1 ,"$3,019.00 ","$1,962.35 ",$136.02 ,"$3,019.00 ","$2,173.68 ","$1,642.34 ",$694.37 ,"$1,685.21 ",$694.37 ,"$1,936.69 ","$1,936.69 ","$1,936.69 ","$1,936.69 ","$2,535.96 ",$694.37 ,"$2,566.15 ","$2,535.96 ",$694.37 ,"$2,264.25 ","$2,415.20 ","$2,415.20 ",$694.37 ,"$2,415.20 ","$2,535.96 ","$2,535.96 ","$2,535.96 ","$2,717.10 ","$1,735.93 ",$694.37 ,"$3,019.00 ",$136.02 ,$149.62 ,$763.81 ,"$2,566.15 ","$1,936.69 ","$2,717.10 ","$2,535.96 ","$2,415.20 ","$2,415.20 ",$694.37 ,"$1,962.35 " ST. FRANCIS HOSPITAL - ACUTE,36000157,38220,HC ASP BONE MARROW ONLY,360,1 ,$717.00 ,$466.05 ,$164.91 ,$717.00 ,$516.24 ,$390.05 ,$164.91 ,$400.23 ,$164.91 ,$459.96 ,$459.96 ,$459.96 ,$459.96 ,$602.28 ,$164.91 ,$609.45 ,$602.28 ,$164.91 ,$537.75 ,$573.60 ,$573.60 ,$164.91 ,$573.60 ,$602.28 ,$602.28 ,$602.28 ,$645.30 ,$412.28 ,$164.91 ,$717.00 ,$583.39 ,$641.73 ,$181.40 ,$609.45 ,$459.96 ,$645.30 ,$602.28 ,$573.60 ,$573.60 ,$164.91 ,$466.05 ST. FRANCIS HOSPITAL - ACUTE,36000158,38221,HC BX BONE MARROW ONLY,360,1 ,$808.00 ,$525.20 ,$185.84 ,$808.00 ,$581.76 ,$439.55 ,$185.84 ,$451.03 ,$185.84 ,$518.33 ,$518.33 ,$518.33 ,$518.33 ,$678.72 ,$185.84 ,$686.80 ,$678.72 ,$185.84 ,$606.00 ,$646.40 ,$646.40 ,$185.84 ,$646.40 ,$678.72 ,$678.72 ,$678.72 ,$727.20 ,$464.60 ,$185.84 ,$808.00 ,$583.39 ,$641.73 ,$204.42 ,$686.80 ,$518.33 ,$727.20 ,$678.72 ,$646.40 ,$646.40 ,$185.84 ,$525.20 ST. FRANCIS HOSPITAL - ACUTE,36000159,38505,HC LYMPH NODE BIOPSY SUPERFICIAL,360,1 ,"$2,772.00 ","$1,801.80 ",$618.06 ,"$2,772.00 ","$1,995.84 ","$1,507.97 ",$637.56 ,"$1,547.33 ",$637.56 ,"$1,778.24 ","$1,778.24 ","$1,778.24 ","$1,778.24 ","$2,328.48 ",$637.56 ,"$2,356.20 ","$2,328.48 ",$637.56 ,"$2,079.00 ","$2,217.60 ","$2,217.60 ",$637.56 ,"$2,217.60 ","$2,328.48 ","$2,328.48 ","$2,328.48 ","$2,494.80 ","$1,593.90 ",$637.56 ,"$2,772.00 ",$618.06 ,$679.87 ,$701.32 ,"$2,356.20 ","$1,778.24 ","$2,494.80 ","$2,328.48 ","$2,217.60 ","$2,217.60 ",$637.56 ,"$1,801.80 " ST. FRANCIS HOSPITAL - ACUTE,36000161,38792,HC INJ LYMPH NODE NO IMAGING,360,1 ,"$2,184.00 ","$1,419.60 ",$502.32 ,"$2,184.00 ","$1,572.48 ","$1,188.10 ",$502.32 ,"$1,219.11 ",$502.32 ,"$1,401.04 ","$1,401.04 ","$1,401.04 ","$1,401.04 ","$1,834.56 ",$502.32 ,"$1,856.40 ","$1,834.56 ",$502.32 ,"$1,638.00 ","$1,747.20 ","$1,747.20 ",$502.32 ,"$1,747.20 ","$1,834.56 ","$1,834.56 ","$1,834.56 ","$1,965.60 ","$1,255.80 ",$502.32 ,"$2,184.00 ", N/A , N/A ,$552.55 ,"$1,856.40 ","$1,401.04 ","$1,965.60 ","$1,834.56 ","$1,747.20 ","$1,747.20 ",$502.32 ,"$1,419.60 " ST. FRANCIS HOSPITAL - ACUTE,36000187,54150,HC CIRCUMCISION OP,360,1 ,$761.00 ,$494.65 ,$175.03 ,"$1,581.39 ",$547.92 ,$413.98 ,$175.03 ,$424.79 ,$175.03 ,$488.18 ,$488.18 ,$488.18 ,$488.18 ,$639.24 ,$175.03 ,$646.85 ,$639.24 ,$175.03 ,$570.75 ,$608.80 ,$608.80 ,$175.03 ,$608.80 ,$639.24 ,$639.24 ,$639.24 ,$684.90 ,$437.58 ,$175.03 ,$761.00 ,"$1,437.63 ","$1,581.39 ",$192.53 ,$646.85 ,$488.18 ,$684.90 ,$639.24 ,$608.80 ,$608.80 ,$175.03 ,$494.65 ST. FRANCIS HOSPITAL - ACUTE,36000188,55700,HC BX PROSTATE NEEDLE/PUNCH,360,1 ,$309.00 ,$200.85 ,$71.07 ,"$1,218.22 ",$222.48 ,$168.10 ,$71.07 ,$172.48 ,$71.07 ,$198.22 ,$198.22 ,$198.22 ,$198.22 ,$259.56 ,$71.07 ,$262.65 ,$259.56 ,$71.07 ,$231.75 ,$247.20 ,$247.20 ,$71.07 ,$247.20 ,$259.56 ,$259.56 ,$259.56 ,$278.10 ,$177.68 ,$71.07 ,$309.00 ,"$1,107.47 ","$1,218.22 ",$78.18 ,$262.65 ,$198.22 ,$278.10 ,$259.56 ,$247.20 ,$247.20 ,$71.07 ,$200.85 ST. FRANCIS HOSPITAL - ACUTE,36000194,62270,HC LUMBAR PUNCTURE,360,1 ,$874.00 ,$568.10 ,$201.02 ,$874.00 ,$629.28 ,$475.46 ,$201.02 ,$487.87 ,$201.02 ,$560.67 ,$560.67 ,$560.67 ,$560.67 ,$734.16 ,$201.02 ,$742.90 ,$734.16 ,$201.02 ,$655.50 ,$699.20 ,$699.20 ,$201.02 ,$699.20 ,$734.16 ,$734.16 ,$734.16 ,$786.60 ,$502.55 ,$201.02 ,$874.00 ,$495.52 ,$545.07 ,$221.12 ,$742.90 ,$560.67 ,$786.60 ,$734.16 ,$699.20 ,$699.20 ,$201.02 ,$568.10 ST. FRANCIS HOSPITAL - ACUTE,36000319,20526,HC INJECTION;CARPAL TUNNEL,360,1 ,$232.00 ,$150.80 ,$53.36 ,$341.51 ,$167.04 ,$126.21 ,$53.36 ,$129.50 ,$53.36 ,$148.83 ,$148.83 ,$148.83 ,$148.83 ,$194.88 ,$53.36 ,$197.20 ,$194.88 ,$53.36 ,$174.00 ,$185.60 ,$185.60 ,$53.36 ,$185.60 ,$194.88 ,$194.88 ,$194.88 ,$208.80 ,$133.40 ,$53.36 ,$232.00 ,$310.46 ,$341.51 ,$58.70 ,$197.20 ,$148.83 ,$208.80 ,$194.88 ,$185.60 ,$185.60 ,$53.36 ,$150.80 ST. FRANCIS HOSPITAL - ACUTE,36000326,64405,HC NERVE BLOCK; OCCIPITAL,360,1 ,$157.00 ,$102.05 ,$36.11 ,$463.96 ,$113.04 ,$85.41 ,$36.11 ,$87.64 ,$36.11 ,$100.72 ,$100.72 ,$100.72 ,$100.72 ,$131.88 ,$36.11 ,$133.45 ,$131.88 ,$36.11 ,$117.75 ,$125.60 ,$125.60 ,$36.11 ,$125.60 ,$131.88 ,$131.88 ,$131.88 ,$141.30 ,$90.28 ,$36.11 ,$157.00 ,$421.78 ,$463.96 ,$39.72 ,$133.45 ,$100.72 ,$141.30 ,$131.88 ,$125.60 ,$125.60 ,$36.11 ,$102.05 ST. FRANCIS HOSPITAL - ACUTE,36000327,64445,HC NERVE BLOCK;SCIATIC SINGLE,360,1 ,"$1,763.00 ","$1,145.95 ",$405.49 ,"$1,763.00 ","$1,269.36 ",$959.07 ,$405.49 ,$984.11 ,$405.49 ,"$1,130.96 ","$1,130.96 ","$1,130.96 ","$1,130.96 ","$1,480.92 ",$405.49 ,"$1,498.55 ","$1,480.92 ",$405.49 ,"$1,322.25 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,410.40 ","$1,480.92 ","$1,480.92 ","$1,480.92 ","$1,586.70 ","$1,013.73 ",$405.49 ,"$1,763.00 ",$421.78 ,$463.96 ,$446.04 ,"$1,498.55 ","$1,130.96 ","$1,586.70 ","$1,480.92 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,145.95 " ST. FRANCIS HOSPITAL - ACUTE,36000420,26735,HC TX FX OPEN SHAFT FINGER/THUMB W/INT FIX EACH,360,1 ,"$8,213.00 ","$5,338.45 ","$1,888.99 ","$8,213.00 ","$5,913.36 ","$4,467.87 ","$1,888.99 ","$4,269.94 ","$1,888.99 ","$4,906.45 ","$4,906.45 ","$4,906.45 ","$4,906.45 ","$6,898.92 ","$1,888.99 ","$6,981.05 ","$6,898.92 ","$1,888.99 ","$6,159.75 ","$6,570.40 ","$6,570.40 ","$1,888.99 ","$6,570.40 ","$6,898.92 ","$6,898.92 ","$6,898.92 ","$7,391.70 ","$4,722.48 ","$1,888.99 ","$8,213.00 ","$4,298.77 ","$4,728.65 ","$2,077.89 ","$6,981.05 ","$4,906.45 ","$7,391.70 ","$6,898.92 ","$6,570.40 ","$6,570.40 ","$1,888.99 ","$5,338.45 " ST. FRANCIS HOSPITAL - ACUTE,36000441,37618,HC LIGATION ARTERY EXTREMITY,360,1 ,"$1,478.00 ",$960.70 ,$339.94 ,"$2,173.36 ","$1,064.16 ",$804.03 ,$339.94 ,$825.02 ,$339.94 ,$948.14 ,$948.14 ,$948.14 ,$948.14 ,"$1,241.52 ",$339.94 ,"$1,256.30 ","$1,241.52 ",$339.94 ,"$1,108.50 ","$1,182.40 ","$1,182.40 ",$339.94 ,"$1,182.40 ","$1,241.52 ","$1,241.52 ","$1,241.52 ","$1,330.20 ",$849.85 ,$339.94 ,"$1,478.00 ","$1,975.78 ","$2,173.36 ",$373.93 ,"$1,256.30 ",$948.14 ,"$1,330.20 ","$1,241.52 ","$1,182.40 ","$1,182.40 ",$339.94 ,$960.70 ST. FRANCIS HOSPITAL - ACUTE,36000546,11750,HC REMOVE NAIL BED,360,1 ,"$1,260.00 ",$819.00 ,$289.80 ,"$1,260.00 ",$907.20 ,$685.44 ,$289.80 ,$703.33 ,$289.80 ,$808.29 ,$808.29 ,$808.29 ,$808.29 ,"$1,058.40 ",$289.80 ,"$1,071.00 ","$1,058.40 ",$289.80 ,$945.00 ,"$1,008.00 ","$1,008.00 ",$289.80 ,"$1,008.00 ","$1,058.40 ","$1,058.40 ","$1,058.40 ","$1,134.00 ",$724.50 ,$289.80 ,"$1,260.00 ",$618.06 ,$679.87 ,$318.78 ,"$1,071.00 ",$808.29 ,"$1,134.00 ","$1,058.40 ","$1,008.00 ","$1,008.00 ",$289.80 ,$819.00 ST. FRANCIS HOSPITAL - ACUTE,36060013,N/A,HC OR LEVEL 1 INITIAL 15MIN,360,1 ,$770.00 ,$500.50 ,$177.10 ,$770.00 ,$554.40 ,$418.88 ,$177.10 ,$429.81 ,$177.10 ,$493.96 ,$493.96 ,$493.96 ,$493.96 ,$646.80 ,$177.10 ,$654.50 ,$646.80 ,$177.10 ,$577.50 ,$616.00 ,$616.00 ,$177.10 ,$616.00 ,$646.80 ,$646.80 ,$646.80 ,$693.00 ,$442.75 ,$177.10 ,$770.00 , N/A , N/A ,$194.81 ,$654.50 ,$493.96 ,$693.00 ,$646.80 ,$616.00 ,$616.00 ,$177.10 ,$500.50 ST. FRANCIS HOSPITAL - ACUTE,36060014,N/A,HC OR LEVEL 1 ADDL 15MIN,360,1 ,$382.00 ,$248.30 ,$87.86 ,$382.00 ,$275.04 ,$207.81 ,$87.86 ,$213.23 ,$87.86 ,$245.05 ,$245.05 ,$245.05 ,$245.05 ,$320.88 ,$87.86 ,$324.70 ,$320.88 ,$87.86 ,$286.50 ,$305.60 ,$305.60 ,$87.86 ,$305.60 ,$320.88 ,$320.88 ,$320.88 ,$343.80 ,$219.65 ,$87.86 ,$382.00 , N/A , N/A ,$96.65 ,$324.70 ,$245.05 ,$343.80 ,$320.88 ,$305.60 ,$305.60 ,$87.86 ,$248.30 ST. FRANCIS HOSPITAL - ACUTE,36060015,N/A,HC OR LEVEL 2 INITIAL 15MIN,360,1 ,"$2,710.00 ","$1,761.50 ",$623.30 ,"$2,710.00 ","$1,951.20 ","$1,474.24 ",$623.30 ,"$1,512.72 ",$623.30 ,"$1,738.47 ","$1,738.47 ","$1,738.47 ","$1,738.47 ","$2,276.40 ",$623.30 ,"$2,303.50 ","$2,276.40 ",$623.30 ,"$2,032.50 ","$2,168.00 ","$2,168.00 ",$623.30 ,"$2,168.00 ","$2,276.40 ","$2,276.40 ","$2,276.40 ","$2,439.00 ","$1,558.25 ",$623.30 ,"$2,710.00 ", N/A , N/A ,$685.63 ,"$2,303.50 ","$1,738.47 ","$2,439.00 ","$2,276.40 ","$2,168.00 ","$2,168.00 ",$623.30 ,"$1,761.50 " ST. FRANCIS HOSPITAL - ACUTE,36060016,N/A,HC OR LEVEL 2 ADDL 15MIN,360,1 ,$678.00 ,$440.70 ,$155.94 ,$678.00 ,$488.16 ,$368.83 ,$155.94 ,$378.46 ,$155.94 ,$434.94 ,$434.94 ,$434.94 ,$434.94 ,$569.52 ,$155.94 ,$576.30 ,$569.52 ,$155.94 ,$508.50 ,$542.40 ,$542.40 ,$155.94 ,$542.40 ,$569.52 ,$569.52 ,$569.52 ,$610.20 ,$389.85 ,$155.94 ,$678.00 , N/A , N/A ,$171.53 ,$576.30 ,$434.94 ,$610.20 ,$569.52 ,$542.40 ,$542.40 ,$155.94 ,$440.70 ST. FRANCIS HOSPITAL - ACUTE,36060017,N/A,HC OR LEVEL 3 INITIAL 15MIN,360,1 ,"$2,988.00 ","$1,942.20 ",$687.24 ,"$2,988.00 ","$2,151.36 ","$1,625.47 ",$687.24 ,"$1,667.90 ",$687.24 ,"$1,916.80 ","$1,916.80 ","$1,916.80 ","$1,916.80 ","$2,509.92 ",$687.24 ,"$2,539.80 ","$2,509.92 ",$687.24 ,"$2,241.00 ","$2,390.40 ","$2,390.40 ",$687.24 ,"$2,390.40 ","$2,509.92 ","$2,509.92 ","$2,509.92 ","$2,689.20 ","$1,718.10 ",$687.24 ,"$2,988.00 ", N/A , N/A ,$755.96 ,"$2,539.80 ","$1,916.80 ","$2,689.20 ","$2,509.92 ","$2,390.40 ","$2,390.40 ",$687.24 ,"$1,942.20 " ST. FRANCIS HOSPITAL - ACUTE,36060018,N/A,HC OR LEVEL 3 ADDL 15MIN,360,1 ,$747.00 ,$485.55 ,$171.81 ,$747.00 ,$537.84 ,$406.37 ,$171.81 ,$416.98 ,$171.81 ,$479.20 ,$479.20 ,$479.20 ,$479.20 ,$627.48 ,$171.81 ,$634.95 ,$627.48 ,$171.81 ,$560.25 ,$597.60 ,$597.60 ,$171.81 ,$597.60 ,$627.48 ,$627.48 ,$627.48 ,$672.30 ,$429.53 ,$171.81 ,$747.00 , N/A , N/A ,$188.99 ,$634.95 ,$479.20 ,$672.30 ,$627.48 ,$597.60 ,$597.60 ,$171.81 ,$485.55 ST. FRANCIS HOSPITAL - ACUTE,36060019,N/A,HC OR LEVEL 4 INITIAL 15MIN,360,1 ,"$3,265.00 ","$2,122.25 ",$750.95 ,"$3,265.00 ","$2,350.80 ","$1,776.16 ",$750.95 ,"$1,822.52 ",$750.95 ,"$2,094.50 ","$2,094.50 ","$2,094.50 ","$2,094.50 ","$2,742.60 ",$750.95 ,"$2,775.25 ","$2,742.60 ",$750.95 ,"$2,448.75 ","$2,612.00 ","$2,612.00 ",$750.95 ,"$2,612.00 ","$2,742.60 ","$2,742.60 ","$2,742.60 ","$2,938.50 ","$1,877.38 ",$750.95 ,"$3,265.00 ", N/A , N/A ,$826.05 ,"$2,775.25 ","$2,094.50 ","$2,938.50 ","$2,742.60 ","$2,612.00 ","$2,612.00 ",$750.95 ,"$2,122.25 " ST. FRANCIS HOSPITAL - ACUTE,36060020,N/A,HC OR LEVEL 4 ADDL 15MIN,360,1 ,$816.00 ,$530.40 ,$187.68 ,$816.00 ,$587.52 ,$443.90 ,$187.68 ,$455.49 ,$187.68 ,$523.46 ,$523.46 ,$523.46 ,$523.46 ,$685.44 ,$187.68 ,$693.60 ,$685.44 ,$187.68 ,$612.00 ,$652.80 ,$652.80 ,$187.68 ,$652.80 ,$685.44 ,$685.44 ,$685.44 ,$734.40 ,$469.20 ,$187.68 ,$816.00 , N/A , N/A ,$206.45 ,$693.60 ,$523.46 ,$734.40 ,$685.44 ,$652.80 ,$652.80 ,$187.68 ,$530.40 ST. FRANCIS HOSPITAL - ACUTE,36060021,N/A,HC OR LEVEL 5 INITIAL 15MIN,360,1 ,"$3,542.00 ","$2,302.30 ",$814.66 ,"$3,542.00 ","$2,550.24 ","$1,926.85 ",$814.66 ,"$1,977.14 ",$814.66 ,"$2,272.19 ","$2,272.19 ","$2,272.19 ","$2,272.19 ","$2,975.28 ",$814.66 ,"$3,010.70 ","$2,975.28 ",$814.66 ,"$2,656.50 ","$2,833.60 ","$2,833.60 ",$814.66 ,"$2,833.60 ","$2,975.28 ","$2,975.28 ","$2,975.28 ","$3,187.80 ","$2,036.65 ",$814.66 ,"$3,542.00 ", N/A , N/A ,$896.13 ,"$3,010.70 ","$2,272.19 ","$3,187.80 ","$2,975.28 ","$2,833.60 ","$2,833.60 ",$814.66 ,"$2,302.30 " ST. FRANCIS HOSPITAL - ACUTE,36060022,N/A,HC OR LEVEL 5 ADDL 15MIN,360,1 ,$886.00 ,$575.90 ,$203.78 ,$886.00 ,$637.92 ,$481.98 ,$203.78 ,$494.57 ,$203.78 ,$568.37 ,$568.37 ,$568.37 ,$568.37 ,$744.24 ,$203.78 ,$753.10 ,$744.24 ,$203.78 ,$664.50 ,$708.80 ,$708.80 ,$203.78 ,$708.80 ,$744.24 ,$744.24 ,$744.24 ,$797.40 ,$509.45 ,$203.78 ,$886.00 , N/A , N/A ,$224.16 ,$753.10 ,$568.37 ,$797.40 ,$744.24 ,$708.80 ,$708.80 ,$203.78 ,$575.90 ST. FRANCIS HOSPITAL - ACUTE,36060023,N/A,HC OR LEVEL 6 INITIAL 15MIN,360,1 ,"$3,819.00 ","$2,482.35 ",$878.37 ,"$3,819.00 ","$2,749.68 ","$2,077.54 ",$878.37 ,"$2,131.77 ",$878.37 ,"$2,449.89 ","$2,449.89 ","$2,449.89 ","$2,449.89 ","$3,207.96 ",$878.37 ,"$3,246.15 ","$3,207.96 ",$878.37 ,"$2,864.25 ","$3,055.20 ","$3,055.20 ",$878.37 ,"$3,055.20 ","$3,207.96 ","$3,207.96 ","$3,207.96 ","$3,437.10 ","$2,195.93 ",$878.37 ,"$3,819.00 ", N/A , N/A ,$966.21 ,"$3,246.15 ","$2,449.89 ","$3,437.10 ","$3,207.96 ","$3,055.20 ","$3,055.20 ",$878.37 ,"$2,482.35 " ST. FRANCIS HOSPITAL - ACUTE,36060024,N/A,HC OR LEVEL 6 ADDL 15MIN,360,1 ,$955.00 ,$620.75 ,$219.65 ,$955.00 ,$687.60 ,$519.52 ,$219.65 ,$533.08 ,$219.65 ,$612.63 ,$612.63 ,$612.63 ,$612.63 ,$802.20 ,$219.65 ,$811.75 ,$802.20 ,$219.65 ,$716.25 ,$764.00 ,$764.00 ,$219.65 ,$764.00 ,$802.20 ,$802.20 ,$802.20 ,$859.50 ,$549.13 ,$219.65 ,$955.00 , N/A , N/A ,$241.62 ,$811.75 ,$612.63 ,$859.50 ,$802.20 ,$764.00 ,$764.00 ,$219.65 ,$620.75 ST. FRANCIS HOSPITAL - ACUTE,36080008,64417,HC NERVE BLOCK AXILLARY NERVE,360,1 ,"$1,763.00 ","$1,145.95 ",$405.49 ,"$1,763.00 ","$1,269.36 ",$959.07 ,$405.49 ,$984.11 ,$405.49 ,"$1,130.96 ","$1,130.96 ","$1,130.96 ","$1,130.96 ","$1,480.92 ",$405.49 ,"$1,498.55 ","$1,480.92 ",$405.49 ,"$1,322.25 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,410.40 ","$1,480.92 ","$1,480.92 ","$1,480.92 ","$1,586.70 ","$1,013.73 ",$405.49 ,"$1,763.00 ",$421.78 ,$463.96 ,$446.04 ,"$1,498.55 ","$1,130.96 ","$1,586.70 ","$1,480.92 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,145.95 " ST. FRANCIS HOSPITAL - ACUTE,36080010,64455,HC INJ ANES AGENT DIGITAL NERVES,360,1 ,"$1,763.00 ","$1,145.95 ",$405.49 ,"$1,763.00 ","$1,269.36 ",$959.07 ,$405.49 ,$984.11 ,$405.49 ,"$1,130.96 ","$1,130.96 ","$1,130.96 ","$1,130.96 ","$1,480.92 ",$405.49 ,"$1,498.55 ","$1,480.92 ",$405.49 ,"$1,322.25 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,410.40 ","$1,480.92 ","$1,480.92 ","$1,480.92 ","$1,586.70 ","$1,013.73 ",$405.49 ,"$1,763.00 ",$421.78 ,$463.96 ,$446.04 ,"$1,498.55 ","$1,130.96 ","$1,586.70 ","$1,480.92 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,145.95 " ST. FRANCIS HOSPITAL - ACUTE,36100042,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-BIL,361,1 ,"$1,019.00 ",$662.35 ,$234.37 ,"$1,019.00 ",$733.68 ,$554.34 ,$234.37 ,$568.81 ,$234.37 ,$653.69 ,$653.69 ,$653.69 ,$653.69 ,$855.96 ,$234.37 ,$866.15 ,$855.96 ,$234.37 ,$764.25 ,$815.20 ,$815.20 ,$234.37 ,$815.20 ,$855.96 ,$855.96 ,$855.96 ,$917.10 ,$585.93 ,$234.37 ,"$1,019.00 ",$465.68 ,$512.25 ,$257.81 ,$866.15 ,$653.69 ,$917.10 ,$855.96 ,$815.20 ,$815.20 ,$234.37 ,$662.35 ST. FRANCIS HOSPITAL - ACUTE,36100043,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-BIL,361,1 ,"$1,147.00 ",$745.55 ,$263.81 ,"$1,147.00 ",$825.84 ,$623.97 ,$263.81 ,$640.26 ,$263.81 ,$735.80 ,$735.80 ,$735.80 ,$735.80 ,$963.48 ,$263.81 ,$974.95 ,$963.48 ,$263.81 ,$860.25 ,$917.60 ,$917.60 ,$263.81 ,$917.60 ,$963.48 ,$963.48 ,$963.48 ,"$1,032.30 ",$659.53 ,$263.81 ,"$1,147.00 ",$465.68 ,$512.25 ,$290.19 ,$974.95 ,$735.80 ,"$1,032.30 ",$963.48 ,$917.60 ,$917.60 ,$263.81 ,$745.55 ST. FRANCIS HOSPITAL - ACUTE,36100044,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-BIL,361,1 ,"$1,431.00 ",$930.15 ,$329.13 ,"$1,431.00 ","$1,030.32 ",$778.46 ,$329.13 ,$798.78 ,$329.13 ,$917.99 ,$917.99 ,$917.99 ,$917.99 ,"$1,202.04 ",$329.13 ,"$1,216.35 ","$1,202.04 ",$329.13 ,"$1,073.25 ","$1,144.80 ","$1,144.80 ",$329.13 ,"$1,144.80 ","$1,202.04 ","$1,202.04 ","$1,202.04 ","$1,287.90 ",$822.83 ,$329.13 ,"$1,431.00 ",$465.68 ,$512.25 ,$362.04 ,"$1,216.35 ",$917.99 ,"$1,287.90 ","$1,202.04 ","$1,144.80 ","$1,144.80 ",$329.13 ,$930.15 ST. FRANCIS HOSPITAL - ACUTE,36100063,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-LT,361,1 ,$679.00 ,$441.35 ,$156.17 ,$679.00 ,$488.88 ,$369.38 ,$156.17 ,$379.02 ,$156.17 ,$435.58 ,$435.58 ,$435.58 ,$435.58 ,$570.36 ,$156.17 ,$577.15 ,$570.36 ,$156.17 ,$509.25 ,$543.20 ,$543.20 ,$156.17 ,$543.20 ,$570.36 ,$570.36 ,$570.36 ,$611.10 ,$390.43 ,$156.17 ,$679.00 ,$310.46 ,$341.51 ,$171.79 ,$577.15 ,$435.58 ,$611.10 ,$570.36 ,$543.20 ,$543.20 ,$156.17 ,$441.35 ST. FRANCIS HOSPITAL - ACUTE,36100064,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-RT,361,1 ,$679.00 ,$441.35 ,$156.17 ,$679.00 ,$488.88 ,$369.38 ,$156.17 ,$379.02 ,$156.17 ,$435.58 ,$435.58 ,$435.58 ,$435.58 ,$570.36 ,$156.17 ,$577.15 ,$570.36 ,$156.17 ,$509.25 ,$543.20 ,$543.20 ,$156.17 ,$543.20 ,$570.36 ,$570.36 ,$570.36 ,$611.10 ,$390.43 ,$156.17 ,$679.00 ,$310.46 ,$341.51 ,$171.79 ,$577.15 ,$435.58 ,$611.10 ,$570.36 ,$543.20 ,$543.20 ,$156.17 ,$441.35 ST. FRANCIS HOSPITAL - ACUTE,36100065,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-LT,361,1 ,$765.00 ,$497.25 ,$175.95 ,$765.00 ,$550.80 ,$416.16 ,$175.95 ,$427.02 ,$175.95 ,$490.75 ,$490.75 ,$490.75 ,$490.75 ,$642.60 ,$175.95 ,$650.25 ,$642.60 ,$175.95 ,$573.75 ,$612.00 ,$612.00 ,$175.95 ,$612.00 ,$642.60 ,$642.60 ,$642.60 ,$688.50 ,$439.88 ,$175.95 ,$765.00 ,$310.46 ,$341.51 ,$193.55 ,$650.25 ,$490.75 ,$688.50 ,$642.60 ,$612.00 ,$612.00 ,$175.95 ,$497.25 ST. FRANCIS HOSPITAL - ACUTE,36100066,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-RT,361,1 ,$765.00 ,$497.25 ,$175.95 ,$765.00 ,$550.80 ,$416.16 ,$175.95 ,$427.02 ,$175.95 ,$490.75 ,$490.75 ,$490.75 ,$490.75 ,$642.60 ,$175.95 ,$650.25 ,$642.60 ,$175.95 ,$573.75 ,$612.00 ,$612.00 ,$175.95 ,$612.00 ,$642.60 ,$642.60 ,$642.60 ,$688.50 ,$439.88 ,$175.95 ,$765.00 ,$310.46 ,$341.51 ,$193.55 ,$650.25 ,$490.75 ,$688.50 ,$642.60 ,$612.00 ,$612.00 ,$175.95 ,$497.25 ST. FRANCIS HOSPITAL - ACUTE,36100067,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-LT,361,1 ,$955.00 ,$620.75 ,$219.65 ,$955.00 ,$687.60 ,$519.52 ,$219.65 ,$533.08 ,$219.65 ,$612.63 ,$612.63 ,$612.63 ,$612.63 ,$802.20 ,$219.65 ,$811.75 ,$802.20 ,$219.65 ,$716.25 ,$764.00 ,$764.00 ,$219.65 ,$764.00 ,$802.20 ,$802.20 ,$802.20 ,$859.50 ,$549.13 ,$219.65 ,$955.00 ,$310.46 ,$341.51 ,$241.62 ,$811.75 ,$612.63 ,$859.50 ,$802.20 ,$764.00 ,$764.00 ,$219.65 ,$620.75 ST. FRANCIS HOSPITAL - ACUTE,36100068,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-RT,361,1 ,$955.00 ,$620.75 ,$219.65 ,$955.00 ,$687.60 ,$519.52 ,$219.65 ,$533.08 ,$219.65 ,$612.63 ,$612.63 ,$612.63 ,$612.63 ,$802.20 ,$219.65 ,$811.75 ,$802.20 ,$219.65 ,$716.25 ,$764.00 ,$764.00 ,$219.65 ,$764.00 ,$802.20 ,$802.20 ,$802.20 ,$859.50 ,$549.13 ,$219.65 ,$955.00 ,$310.46 ,$341.51 ,$241.62 ,$811.75 ,$612.63 ,$859.50 ,$802.20 ,$764.00 ,$764.00 ,$219.65 ,$620.75 ST. FRANCIS HOSPITAL - ACUTE,36100106,62326,HC INJ W/CATH LUM/SAC W/O GUIDE,361,1 ,"$1,679.00 ","$1,091.35 ",$386.17 ,"$1,679.00 ","$1,208.88 ",$913.38 ,$386.17 ,$937.22 ,$386.17 ,"$1,077.08 ","$1,077.08 ","$1,077.08 ","$1,077.08 ","$1,410.36 ",$386.17 ,"$1,427.15 ","$1,410.36 ",$386.17 ,"$1,259.25 ","$1,343.20 ","$1,343.20 ",$386.17 ,"$1,343.20 ","$1,410.36 ","$1,410.36 ","$1,410.36 ","$1,511.10 ",$965.43 ,$386.17 ,"$1,679.00 ",$764.95 ,$841.45 ,$424.79 ,"$1,427.15 ","$1,077.08 ","$1,511.10 ","$1,410.36 ","$1,343.20 ","$1,343.20 ",$386.17 ,"$1,091.35 " ST. FRANCIS HOSPITAL - ACUTE,36100146,51720,HC INSTILL ANTICARCINOG BLADDER,361,1 ,$599.00 ,$389.35 ,$137.77 ,"$1,145.13 ",$431.28 ,$325.86 ,$137.77 ,$334.36 ,$137.77 ,$384.26 ,$384.26 ,$384.26 ,$384.26 ,$503.16 ,$137.77 ,$509.15 ,$503.16 ,$137.77 ,$449.25 ,$479.20 ,$479.20 ,$137.77 ,$479.20 ,$503.16 ,$503.16 ,$503.16 ,$539.10 ,$344.43 ,$137.77 ,$599.00 ,"$1,041.03 ","$1,145.13 ",$151.55 ,$509.15 ,$384.26 ,$539.10 ,$503.16 ,$479.20 ,$479.20 ,$137.77 ,$389.35 ST. FRANCIS HOSPITAL - ACUTE,36100235,11102,HC BIOPSY SKIN TANGENTIAL INIT LESN,361,1 ,"$2,100.00 ","$1,365.00 ",$483.00 ,"$2,100.00 ","$1,512.00 ","$1,142.40 ",$483.00 ,"$1,172.22 ",$483.00 ,"$1,347.15 ","$1,347.15 ","$1,347.15 ","$1,347.15 ","$1,764.00 ",$483.00 ,"$1,785.00 ","$1,764.00 ",$483.00 ,"$1,575.00 ","$1,680.00 ","$1,680.00 ",$483.00 ,"$1,680.00 ","$1,764.00 ","$1,764.00 ","$1,764.00 ","$1,890.00 ","$1,207.50 ",$483.00 ,"$2,100.00 ",$618.06 ,$679.87 ,$531.30 ,"$1,785.00 ","$1,347.15 ","$1,890.00 ","$1,764.00 ","$1,680.00 ","$1,680.00 ",$483.00 ,"$1,365.00 " ST. FRANCIS HOSPITAL - ACUTE,36100236,11104,HC BIOPSY SKIN PUNCH INIT LESN,361,1 ,"$2,100.00 ","$1,365.00 ",$483.00 ,"$2,100.00 ","$1,512.00 ","$1,142.40 ",$483.00 ,"$1,172.22 ",$483.00 ,"$1,347.15 ","$1,347.15 ","$1,347.15 ","$1,347.15 ","$1,764.00 ",$483.00 ,"$1,785.00 ","$1,764.00 ",$483.00 ,"$1,575.00 ","$1,680.00 ","$1,680.00 ",$483.00 ,"$1,680.00 ","$1,764.00 ","$1,764.00 ","$1,764.00 ","$1,890.00 ","$1,207.50 ",$483.00 ,"$2,100.00 ",$618.06 ,$679.87 ,$531.30 ,"$1,785.00 ","$1,347.15 ","$1,890.00 ","$1,764.00 ","$1,680.00 ","$1,680.00 ",$483.00 ,"$1,365.00 " ST. FRANCIS HOSPITAL - ACUTE,36100237,11106,HC BIOPSY SKIN INCISIONAL INIT LESN,361,1 ,"$2,100.00 ","$1,365.00 ",$483.00 ,"$2,100.00 ","$1,512.00 ","$1,142.40 ",$483.00 ,"$1,172.22 ",$483.00 ,"$1,347.15 ","$1,347.15 ","$1,347.15 ","$1,347.15 ","$1,764.00 ",$483.00 ,"$1,785.00 ","$1,764.00 ",$483.00 ,"$1,575.00 ","$1,680.00 ","$1,680.00 ",$483.00 ,"$1,680.00 ","$1,764.00 ","$1,764.00 ","$1,764.00 ","$1,890.00 ","$1,207.50 ",$483.00 ,"$2,100.00 ",$618.06 ,$679.87 ,$531.30 ,"$1,785.00 ","$1,347.15 ","$1,890.00 ","$1,764.00 ","$1,680.00 ","$1,680.00 ",$483.00 ,"$1,365.00 " ST. FRANCIS HOSPITAL - ACUTE,36100247,36573,HC INS PER CV CATH W/O PORT W/GUIDANCE 5>,361,1 ,"$4,211.00 ","$2,737.15 ",$475.21 ,"$4,211.00 ","$3,031.92 ","$2,290.78 ",$968.53 ,"$2,350.58 ",$968.53 ,"$2,701.36 ","$2,701.36 ","$2,701.36 ","$2,701.36 ","$3,537.24 ",$968.53 ,"$3,579.35 ","$3,537.24 ",$968.53 ,"$3,158.25 ","$3,368.80 ","$3,368.80 ",$968.53 ,"$3,368.80 ","$3,537.24 ","$3,537.24 ","$3,537.24 ","$3,789.90 ","$2,421.33 ",$968.53 ,"$4,211.00 ",$475.21 ,$522.73 ,"$1,065.38 ","$3,579.35 ","$2,701.36 ","$3,789.90 ","$3,537.24 ","$3,368.80 ","$3,368.80 ",$968.53 ,"$2,737.15 " ST. FRANCIS HOSPITAL - ACUTE,37000013,31500,HC INTUBATION ENDOTRACHEAL,361,1 ,$531.00 ,$345.15 ,$122.13 ,$712.59 ,$382.32 ,$288.86 ,$122.13 ,$296.40 ,$122.13 ,$340.64 ,$340.64 ,$340.64 ,$340.64 ,$446.04 ,$122.13 ,$451.35 ,$446.04 ,$122.13 ,$398.25 ,$424.80 ,$424.80 ,$122.13 ,$424.80 ,$446.04 ,$446.04 ,$446.04 ,$477.90 ,$305.33 ,$122.13 ,$531.00 ,$647.81 ,$712.59 ,$134.34 ,$451.35 ,$340.64 ,$477.90 ,$446.04 ,$424.80 ,$424.80 ,$122.13 ,$345.15 ST. FRANCIS HOSPITAL - ACUTE,37000014,64448,HC FEMORAL NERVE BLOCK CONTINUOUS,370,1 ,"$1,763.00 ","$1,145.95 ",$405.49 ,"$1,763.00 ","$1,269.36 ",$959.07 ,$405.49 ,$984.11 ,$405.49 ,"$1,053.22 ","$1,053.22 ","$1,053.22 ","$1,053.22 ","$1,480.92 ",$405.49 ,"$1,498.55 ","$1,480.92 ",$405.49 ,"$1,322.25 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,410.40 ","$1,480.92 ","$1,480.92 ","$1,480.92 ","$1,586.70 ","$1,013.73 ",$405.49 ,"$1,763.00 ",$421.78 ,$463.96 ,$446.04 ,"$1,498.55 ","$1,053.22 ","$1,586.70 ","$1,480.92 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,145.95 " ST. FRANCIS HOSPITAL - ACUTE,37000017,99153,HC MODERATE SEDATION SAME PHY EA ADDL 15MIN,370,1 ,$242.00 ,$157.30 ,$22.62 ,$242.00 ,$174.24 ,$131.65 ,$55.66 ,$135.08 ,$55.66 ,$144.57 ,$144.57 ,$144.57 ,$144.57 ,$203.28 ,$55.66 ,$205.70 ,$203.28 ,$55.66 ,$181.50 ,$193.60 ,$193.60 ,$55.66 ,$193.60 ,$203.28 ,$203.28 ,$203.28 ,$217.80 ,$139.15 ,$55.66 ,$242.00 ,$22.62 ,$24.88 ,$61.23 ,$205.70 ,$144.57 ,$217.80 ,$203.28 ,$193.60 ,$193.60 ,$55.66 ,$157.30 ST. FRANCIS HOSPITAL - ACUTE,37000020,99157,HC MODERATE SEDATION DIFF PHY EA ADDL 15MIN,370,1 ,$214.00 ,$139.10 ,$22.62 ,$214.00 ,$154.08 ,$116.42 ,$49.22 ,$119.45 ,$49.22 ,$127.84 ,$127.84 ,$127.84 ,$127.84 ,$179.76 ,$49.22 ,$181.90 ,$179.76 ,$49.22 ,$160.50 ,$171.20 ,$171.20 ,$49.22 ,$171.20 ,$179.76 ,$179.76 ,$179.76 ,$192.60 ,$123.05 ,$49.22 ,$200.00 ,$22.62 ,$24.88 ,$54.14 ,$181.90 ,$127.84 ,$192.60 ,$179.76 ,$171.20 ,$171.20 ,$49.22 ,$139.10 ST. FRANCIS HOSPITAL - ACUTE,37000021,64447,HC FEMORAL NERVE BLOCK SINGLE,370,1 ,"$1,763.00 ","$1,145.95 ",$405.49 ,"$1,763.00 ","$1,269.36 ",$959.07 ,$405.49 ,$984.11 ,$405.49 ,"$1,053.22 ","$1,053.22 ","$1,053.22 ","$1,053.22 ","$1,480.92 ",$405.49 ,"$1,498.55 ","$1,480.92 ",$405.49 ,"$1,322.25 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,410.40 ","$1,480.92 ","$1,480.92 ","$1,480.92 ","$1,586.70 ","$1,013.73 ",$405.49 ,"$1,763.00 ",$421.78 ,$463.96 ,$446.04 ,"$1,498.55 ","$1,053.22 ","$1,586.70 ","$1,480.92 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,145.95 " ST. FRANCIS HOSPITAL - ACUTE,37000023,64416,HC INTRASCALENE BLOCK CONTINUOUS,370,1 ,"$1,763.00 ","$1,145.95 ",$405.49 ,"$1,763.00 ","$1,269.36 ",$959.07 ,$405.49 ,$984.11 ,$405.49 ,"$1,053.22 ","$1,053.22 ","$1,053.22 ","$1,053.22 ","$1,480.92 ",$405.49 ,"$1,498.55 ","$1,480.92 ",$405.49 ,"$1,322.25 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,410.40 ","$1,480.92 ","$1,480.92 ","$1,480.92 ","$1,586.70 ","$1,013.73 ",$405.49 ,"$1,763.00 ",$421.78 ,$463.96 ,$446.04 ,"$1,498.55 ","$1,053.22 ","$1,586.70 ","$1,480.92 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,145.95 " ST. FRANCIS HOSPITAL - ACUTE,37000024,N/A,HC EPIDURAL NERVE BLOCK,370,1 ,"$1,763.00 ","$1,145.95 ",$405.49 ,"$1,763.00 ","$1,269.36 ",$959.07 ,$405.49 ,$984.11 ,$405.49 ,"$1,053.22 ","$1,053.22 ","$1,053.22 ","$1,053.22 ","$1,480.92 ",$405.49 ,"$1,498.55 ","$1,480.92 ",$405.49 ,"$1,322.25 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,410.40 ","$1,480.92 ","$1,480.92 ","$1,480.92 ","$1,586.70 ","$1,013.73 ",$405.49 ,"$1,763.00 ", N/A , N/A ,$446.04 ,"$1,498.55 ","$1,053.22 ","$1,586.70 ","$1,480.92 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,145.95 " ST. FRANCIS HOSPITAL - ACUTE,37000061,N/A,HC ANESTHESIA GENERAL INITIAL 15MIN,370,1 ,"$3,174.00 ","$2,063.10 ",$730.02 ,"$3,174.00 ","$2,285.28 ","$1,726.66 ",$730.02 ,"$1,771.73 ",$730.02 ,"$1,896.15 ","$1,896.15 ","$1,896.15 ","$1,896.15 ","$2,666.16 ",$730.02 ,"$2,697.90 ","$2,666.16 ",$730.02 ,"$2,380.50 ","$2,539.20 ","$2,539.20 ",$730.02 ,"$2,539.20 ","$2,666.16 ","$2,666.16 ","$2,666.16 ","$2,856.60 ","$1,825.05 ",$730.02 ,"$3,174.00 ", N/A , N/A ,$803.02 ,"$2,697.90 ","$1,896.15 ","$2,856.60 ","$2,666.16 ","$2,539.20 ","$2,539.20 ",$730.02 ,"$2,063.10 " ST. FRANCIS HOSPITAL - ACUTE,37000062,N/A,HC ANESTHESIA GENERAL ADDL 15MIN,370,1 ,$246.00 ,$159.90 ,$56.58 ,$246.00 ,$177.12 ,$133.82 ,$56.58 ,$137.32 ,$56.58 ,$146.96 ,$146.96 ,$146.96 ,$146.96 ,$206.64 ,$56.58 ,$209.10 ,$206.64 ,$56.58 ,$184.50 ,$196.80 ,$196.80 ,$56.58 ,$196.80 ,$206.64 ,$206.64 ,$206.64 ,$221.40 ,$141.45 ,$56.58 ,$246.00 , N/A , N/A ,$62.24 ,$209.10 ,$146.96 ,$221.40 ,$206.64 ,$196.80 ,$196.80 ,$56.58 ,$159.90 ST. FRANCIS HOSPITAL - ACUTE,37000063,N/A,HC ANESTHESIA REGIONAL BLOCK INITIAL 15MIN,370,1 ,"$3,174.00 ","$2,063.10 ",$730.02 ,"$3,174.00 ","$2,285.28 ","$1,726.66 ",$730.02 ,"$1,771.73 ",$730.02 ,"$1,896.15 ","$1,896.15 ","$1,896.15 ","$1,896.15 ","$2,666.16 ",$730.02 ,"$2,697.90 ","$2,666.16 ",$730.02 ,"$2,380.50 ","$2,539.20 ","$2,539.20 ",$730.02 ,"$2,539.20 ","$2,666.16 ","$2,666.16 ","$2,666.16 ","$2,856.60 ","$1,825.05 ",$730.02 ,"$3,174.00 ", N/A , N/A ,$803.02 ,"$2,697.90 ","$1,896.15 ","$2,856.60 ","$2,666.16 ","$2,539.20 ","$2,539.20 ",$730.02 ,"$2,063.10 " ST. FRANCIS HOSPITAL - ACUTE,37000064,N/A,HC ANESTHESIA REGIONAL BLOCK ADDL 15MIN,370,1 ,$246.00 ,$159.90 ,$56.58 ,$246.00 ,$177.12 ,$133.82 ,$56.58 ,$137.32 ,$56.58 ,$146.96 ,$146.96 ,$146.96 ,$146.96 ,$206.64 ,$56.58 ,$209.10 ,$206.64 ,$56.58 ,$184.50 ,$196.80 ,$196.80 ,$56.58 ,$196.80 ,$206.64 ,$206.64 ,$206.64 ,$221.40 ,$141.45 ,$56.58 ,$246.00 , N/A , N/A ,$62.24 ,$209.10 ,$146.96 ,$221.40 ,$206.64 ,$196.80 ,$196.80 ,$56.58 ,$159.90 ST. FRANCIS HOSPITAL - ACUTE,37000072,99151,HC MODERATE SEDATION SAME PHY <5YR 1ST 15MIN,370,1 ,$918.00 ,$596.70 ,$22.62 ,$918.00 ,$660.96 ,$499.39 ,$211.14 ,$512.43 ,$211.14 ,$548.41 ,$548.41 ,$548.41 ,$548.41 ,$771.12 ,$211.14 ,$780.30 ,$771.12 ,$211.14 ,$688.50 ,$734.40 ,$734.40 ,$211.14 ,$734.40 ,$771.12 ,$771.12 ,$771.12 ,$826.20 ,$527.85 ,$211.14 ,$918.00 ,$22.62 ,$24.88 ,$232.25 ,$780.30 ,$548.41 ,$826.20 ,$771.12 ,$734.40 ,$734.40 ,$211.14 ,$596.70 ST. FRANCIS HOSPITAL - ACUTE,37000073,99152,HC MODERATE SEDATION SAME PHY >5YR 1ST 15MIN,370,1 ,$918.00 ,$596.70 ,$22.62 ,$918.00 ,$660.96 ,$499.39 ,$211.14 ,$512.43 ,$211.14 ,$548.41 ,$548.41 ,$548.41 ,$548.41 ,$771.12 ,$211.14 ,$780.30 ,$771.12 ,$211.14 ,$688.50 ,$734.40 ,$734.40 ,$211.14 ,$734.40 ,$771.12 ,$771.12 ,$771.12 ,$826.20 ,$527.85 ,$211.14 ,$918.00 ,$22.62 ,$24.88 ,$232.25 ,$780.30 ,$548.41 ,$826.20 ,$771.12 ,$734.40 ,$734.40 ,$211.14 ,$596.70 ST. FRANCIS HOSPITAL - ACUTE,37000074,99155,HC MODERATE SEDATION DIFF PHY <5YR 1ST 15MIN,370,1 ,$947.00 ,$615.55 ,$22.62 ,$947.00 ,$681.84 ,$515.17 ,$217.81 ,$528.62 ,$217.81 ,$565.74 ,$565.74 ,$565.74 ,$565.74 ,$795.48 ,$217.81 ,$804.95 ,$795.48 ,$217.81 ,$710.25 ,$757.60 ,$757.60 ,$217.81 ,$757.60 ,$795.48 ,$795.48 ,$795.48 ,$852.30 ,$544.53 ,$217.81 ,$947.00 ,$22.62 ,$24.88 ,$239.59 ,$804.95 ,$565.74 ,$852.30 ,$795.48 ,$757.60 ,$757.60 ,$217.81 ,$615.55 ST. FRANCIS HOSPITAL - ACUTE,37000075,99156,HC MODERATE SEDATION DIFF PHY >5YR 1ST 15MIN,370,1 ,$947.00 ,$615.55 ,$22.62 ,$947.00 ,$681.84 ,$515.17 ,$217.81 ,$528.62 ,$217.81 ,$565.74 ,$565.74 ,$565.74 ,$565.74 ,$795.48 ,$217.81 ,$804.95 ,$795.48 ,$217.81 ,$710.25 ,$757.60 ,$757.60 ,$217.81 ,$757.60 ,$795.48 ,$795.48 ,$795.48 ,$852.30 ,$544.53 ,$217.81 ,$200.00 ,$22.62 ,$24.88 ,$239.59 ,$804.95 ,$565.74 ,$852.30 ,$795.48 ,$757.60 ,$757.60 ,$217.81 ,$615.55 ST. FRANCIS HOSPITAL - ACUTE,37000076,N/A,HC MONITORED ANESTHESIA INITIAL 15 MINS,370,1 ,"$3,174.00 ","$2,063.10 ",$730.02 ,"$3,174.00 ","$2,285.28 ","$1,726.66 ",$730.02 ,"$1,771.73 ",$730.02 ,"$1,896.15 ","$1,896.15 ","$1,896.15 ","$1,896.15 ","$2,666.16 ",$730.02 ,"$2,697.90 ","$2,666.16 ",$730.02 ,"$2,380.50 ","$2,539.20 ","$2,539.20 ",$730.02 ,"$2,539.20 ","$2,666.16 ","$2,666.16 ","$2,666.16 ","$2,856.60 ","$1,825.05 ",$730.02 ,"$3,174.00 ", N/A , N/A ,$803.02 ,"$2,697.90 ","$1,896.15 ","$2,856.60 ","$2,666.16 ","$2,539.20 ","$2,539.20 ",$730.02 ,"$2,063.10 " ST. FRANCIS HOSPITAL - ACUTE,37000077,N/A,HC MONITORED ANESTHESIA ADDL 15 MINS,370,1 ,$246.00 ,$159.90 ,$56.58 ,$246.00 ,$177.12 ,$133.82 ,$56.58 ,$137.32 ,$56.58 ,$146.96 ,$146.96 ,$146.96 ,$146.96 ,$206.64 ,$56.58 ,$209.10 ,$206.64 ,$56.58 ,$184.50 ,$196.80 ,$196.80 ,$56.58 ,$196.80 ,$206.64 ,$206.64 ,$206.64 ,$221.40 ,$141.45 ,$56.58 ,$246.00 , N/A , N/A ,$62.24 ,$209.10 ,$146.96 ,$221.40 ,$206.64 ,$196.80 ,$196.80 ,$56.58 ,$159.90 ST. FRANCIS HOSPITAL - ACUTE,37080001,64415,HC INTRASCALENE BLOCK SINGLE,360,1 ,"$1,763.00 ","$1,145.95 ",$405.49 ,"$1,763.00 ","$1,269.36 ",$959.07 ,$405.49 ,$984.11 ,$405.49 ,"$1,130.96 ","$1,130.96 ","$1,130.96 ","$1,130.96 ","$1,480.92 ",$405.49 ,"$1,498.55 ","$1,480.92 ",$405.49 ,"$1,322.25 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,410.40 ","$1,480.92 ","$1,480.92 ","$1,480.92 ","$1,586.70 ","$1,013.73 ",$405.49 ,"$1,763.00 ",$421.78 ,$463.96 ,$446.04 ,"$1,498.55 ","$1,130.96 ","$1,586.70 ","$1,480.92 ","$1,410.40 ","$1,410.40 ",$405.49 ,"$1,145.95 " ST. FRANCIS HOSPITAL - ACUTE,39000143,86945,HC BLOOD PRODUCT IRRADIATION,390,1 ,$119.00 ,$77.35 ,$6.00 ,$119.00 ,$85.68 ,$64.74 ,$27.37 ,$66.43 ,$27.37 ,$71.09 ,$71.09 ,$71.09 ,$71.09 ,$99.96 ,$27.37 ,$101.15 ,$99.96 ,$27.37 ,$89.25 ,$95.20 ,$95.20 ,$27.37 ,$95.20 ,$99.96 ,$99.96 ,$99.96 ,$107.10 ,$68.43 ,$27.37 ,$119.00 ,$6.00 ,$6.60 ,$30.11 ,$101.15 ,$71.09 ,$107.10 ,$99.96 ,$95.20 ,$95.20 ,$27.37 ,$77.35 ST. FRANCIS HOSPITAL - ACUTE,39000148,P9017,HC FRESH FROZEN PLASMA EA,390,1 ,$112.00 ,$72.80 ,$25.76 ,$700.32 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 ,$636.65 ,$700.32 ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,39000151,P9031,HC PLATELETS LEUKO RD EA UNIT,390,1 ,$161.00 ,$104.65 ,$37.03 ,$700.32 ,$115.92 ,$87.58 ,$37.03 ,$89.87 ,$37.03 ,$96.18 ,$96.18 ,$96.18 ,$96.18 ,$135.24 ,$37.03 ,$136.85 ,$135.24 ,$37.03 ,$120.75 ,$128.80 ,$128.80 ,$37.03 ,$128.80 ,$135.24 ,$135.24 ,$135.24 ,$144.90 ,$92.58 ,$37.03 ,$161.00 ,$636.65 ,$700.32 ,$40.73 ,$136.85 ,$96.18 ,$144.90 ,$135.24 ,$128.80 ,$128.80 ,$37.03 ,$104.65 ST. FRANCIS HOSPITAL - ACUTE,39000152,P9033,HC PLATELETS L/R IRR EA,390,1 ,"$1,169.00 ",$759.85 ,$268.87 ,"$1,169.00 ",$841.68 ,$635.94 ,$268.87 ,$652.54 ,$268.87 ,$698.36 ,$698.36 ,$698.36 ,$698.36 ,$981.96 ,$268.87 ,$993.65 ,$981.96 ,$268.87 ,$876.75 ,$935.20 ,$935.20 ,$268.87 ,$935.20 ,$981.96 ,$981.96 ,$981.96 ,"$1,052.10 ",$672.18 ,$268.87 ,"$1,169.00 ",$636.65 ,$700.32 ,$295.76 ,$993.65 ,$698.36 ,"$1,052.10 ",$981.96 ,$935.20 ,$935.20 ,$268.87 ,$759.85 ST. FRANCIS HOSPITAL - ACUTE,39000157,P9052,HC PLT APHER/PHER L/R HLA EA,390,1 ,"$1,295.00 ",$841.75 ,$297.85 ,"$1,295.00 ",$932.40 ,$704.48 ,$297.85 ,$722.87 ,$297.85 ,$773.63 ,$773.63 ,$773.63 ,$773.63 ,"$1,087.80 ",$297.85 ,"$1,100.75 ","$1,087.80 ",$297.85 ,$971.25 ,"$1,036.00 ","$1,036.00 ",$297.85 ,"$1,036.00 ","$1,087.80 ","$1,087.80 ","$1,087.80 ","$1,165.50 ",$744.63 ,$297.85 ,"$1,295.00 ",$636.65 ,$700.32 ,$327.64 ,"$1,100.75 ",$773.63 ,"$1,165.50 ","$1,087.80 ","$1,036.00 ","$1,036.00 ",$297.85 ,$841.75 ST. FRANCIS HOSPITAL - ACUTE,39000160,P9059,HC PLASMA FROZEN 8-24 HRS EA UNIT,390,1 ,$136.00 ,$88.40 ,$31.28 ,$700.32 ,$97.92 ,$73.98 ,$31.28 ,$75.92 ,$31.28 ,$81.25 ,$81.25 ,$81.25 ,$81.25 ,$114.24 ,$31.28 ,$115.60 ,$114.24 ,$31.28 ,$102.00 ,$108.80 ,$108.80 ,$31.28 ,$108.80 ,$114.24 ,$114.24 ,$114.24 ,$122.40 ,$78.20 ,$31.28 ,$136.00 ,$636.65 ,$700.32 ,$34.41 ,$115.60 ,$81.25 ,$122.40 ,$114.24 ,$108.80 ,$108.80 ,$31.28 ,$88.40 ST. FRANCIS HOSPITAL - ACUTE,39000162,P9012,HC CRYOPRECIPITATE EA UNIT T1,390,1 ,$121.00 ,$78.65 ,$27.83 ,$700.32 ,$87.12 ,$65.82 ,$27.83 ,$67.54 ,$27.83 ,$72.29 ,$72.29 ,$72.29 ,$72.29 ,$101.64 ,$27.83 ,$102.85 ,$101.64 ,$27.83 ,$90.75 ,$96.80 ,$96.80 ,$27.83 ,$96.80 ,$101.64 ,$101.64 ,$101.64 ,$108.90 ,$69.58 ,$27.83 ,$121.00 ,$636.65 ,$700.32 ,$30.61 ,$102.85 ,$72.29 ,$108.90 ,$101.64 ,$96.80 ,$96.80 ,$27.83 ,$78.65 ST. FRANCIS HOSPITAL - ACUTE,39000164,P9016,HC RED CELLS L/R EA T1,390,1 ,"$1,149.00 ",$746.85 ,$264.27 ,"$1,149.00 ",$827.28 ,$625.06 ,$264.27 ,$641.37 ,$264.27 ,$686.41 ,$686.41 ,$686.41 ,$686.41 ,$965.16 ,$264.27 ,$976.65 ,$965.16 ,$264.27 ,$861.75 ,$919.20 ,$919.20 ,$264.27 ,$919.20 ,$965.16 ,$965.16 ,$965.16 ,"$1,034.10 ",$660.68 ,$264.27 ,"$1,149.00 ",$636.65 ,$700.32 ,$290.70 ,$976.65 ,$686.41 ,"$1,034.10 ",$965.16 ,$919.20 ,$919.20 ,$264.27 ,$746.85 ST. FRANCIS HOSPITAL - ACUTE,39000173,P9035,HC PLATELETS PHER L/R EA T1,390,1 ,"$1,112.00 ",$722.80 ,$255.76 ,"$1,112.00 ",$800.64 ,$604.93 ,$255.76 ,$620.72 ,$255.76 ,$664.31 ,$664.31 ,$664.31 ,$664.31 ,$934.08 ,$255.76 ,$945.20 ,$934.08 ,$255.76 ,$834.00 ,$889.60 ,$889.60 ,$255.76 ,$889.60 ,$934.08 ,$934.08 ,$934.08 ,"$1,000.80 ",$639.40 ,$255.76 ,"$1,112.00 ",$636.65 ,$700.32 ,$281.34 ,$945.20 ,$664.31 ,"$1,000.80 ",$934.08 ,$889.60 ,$889.60 ,$255.76 ,$722.80 ST. FRANCIS HOSPITAL - ACUTE,39000179,P9037,HC PLATELETS PHER L/R IRR EA T1,390,1 ,"$1,169.00 ",$759.85 ,$268.87 ,"$1,169.00 ",$841.68 ,$635.94 ,$268.87 ,$652.54 ,$268.87 ,$698.36 ,$698.36 ,$698.36 ,$698.36 ,$981.96 ,$268.87 ,$993.65 ,$981.96 ,$268.87 ,$876.75 ,$935.20 ,$935.20 ,$268.87 ,$935.20 ,$981.96 ,$981.96 ,$981.96 ,"$1,052.10 ",$672.18 ,$268.87 ,"$1,169.00 ",$636.65 ,$700.32 ,$295.76 ,$993.65 ,$698.36 ,"$1,052.10 ",$981.96 ,$935.20 ,$935.20 ,$268.87 ,$759.85 ST. FRANCIS HOSPITAL - ACUTE,39000187,P9040,HC RED CELLS L/R IRR EA T1,390,1 ,"$1,209.00 ",$785.85 ,$278.07 ,"$1,209.00 ",$870.48 ,$657.70 ,$278.07 ,$674.86 ,$278.07 ,$722.26 ,$722.26 ,$722.26 ,$722.26 ,"$1,015.56 ",$278.07 ,"$1,027.65 ","$1,015.56 ",$278.07 ,$906.75 ,$967.20 ,$967.20 ,$278.07 ,$967.20 ,"$1,015.56 ","$1,015.56 ","$1,015.56 ","$1,088.10 ",$695.18 ,$278.07 ,"$1,209.00 ",$636.65 ,$700.32 ,$305.88 ,"$1,027.65 ",$722.26 ,"$1,088.10 ","$1,015.56 ",$967.20 ,$967.20 ,$278.07 ,$785.85 ST. FRANCIS HOSPITAL - ACUTE,39000193,P9054,HC BLOOD L/R DEG WASH EA UN T1,390,1 ,$664.00 ,$431.60 ,$152.72 ,$700.32 ,$478.08 ,$361.22 ,$152.72 ,$370.64 ,$152.72 ,$396.67 ,$396.67 ,$396.67 ,$396.67 ,$557.76 ,$152.72 ,$564.40 ,$557.76 ,$152.72 ,$498.00 ,$531.20 ,$531.20 ,$152.72 ,$531.20 ,$557.76 ,$557.76 ,$557.76 ,$597.60 ,$381.80 ,$152.72 ,$664.00 ,$636.65 ,$700.32 ,$167.99 ,$564.40 ,$396.67 ,$597.60 ,$557.76 ,$531.20 ,$531.20 ,$152.72 ,$431.60 ST. FRANCIS HOSPITAL - ACUTE,39100001,36430,HC BLOOD PROD ADMIN,391,1 ,"$1,420.00 ",$923.00 ,$326.60 ,"$1,420.00 ","$1,022.40 ",$772.48 ,$326.60 ,$792.64 ,$326.60 ,$848.31 ,$848.31 ,$848.31 ,$848.31 ,"$1,192.80 ",$326.60 ,"$1,207.00 ","$1,192.80 ",$326.60 ,"$1,065.00 ","$1,136.00 ","$1,136.00 ",$326.60 ,"$1,136.00 ","$1,192.80 ","$1,192.80 ","$1,192.80 ","$1,278.00 ",$816.50 ,$326.60 ,"$1,420.00 ",$636.65 ,$700.32 ,$359.26 ,"$1,207.00 ",$848.31 ,"$1,278.00 ","$1,192.80 ","$1,136.00 ","$1,136.00 ",$326.60 ,$923.00 ST. FRANCIS HOSPITAL - ACUTE,40100003,77066,HC MAMMOGRAM DIAG BILAT W/CAD,401,1 ,$705.00 ,$458.25 ,$66.26 ,$705.00 ,$507.60 ,$383.52 ,$162.15 ,$393.53 ,$162.15 ,$421.17 ,$421.17 ,$421.17 ,$421.17 ,$592.20 ,$162.15 ,$599.25 ,$592.20 ,$162.15 ,$528.75 ,$564.00 ,$564.00 ,$162.15 ,$564.00 ,$592.20 ,$592.20 ,$592.20 ,$634.50 ,$405.38 ,$162.15 ,$125.55 ,$66.26 ,$72.89 ,$178.37 ,$599.25 ,$421.17 ,$634.50 ,$592.20 ,$564.00 ,$564.00 ,$162.15 ,$458.25 ST. FRANCIS HOSPITAL - ACUTE,40100004,77066,HC MAMMOGRAM DIAG BILAT W/CAD ADDNT VIEW,401,1 ,$705.00 ,$458.25 ,$66.26 ,$705.00 ,$507.60 ,$383.52 ,$162.15 ,$393.53 ,$162.15 ,$421.17 ,$421.17 ,$421.17 ,$421.17 ,$592.20 ,$162.15 ,$599.25 ,$592.20 ,$162.15 ,$528.75 ,$564.00 ,$564.00 ,$162.15 ,$564.00 ,$592.20 ,$592.20 ,$592.20 ,$634.50 ,$405.38 ,$162.15 ,$125.55 ,$66.26 ,$72.89 ,$178.37 ,$599.25 ,$421.17 ,$634.50 ,$592.20 ,$564.00 ,$564.00 ,$162.15 ,$458.25 ST. FRANCIS HOSPITAL - ACUTE,40100005,77066,HC MAMMOGRAM DIAG BILAT W/CAD IMPLANT,401,1 ,$705.00 ,$458.25 ,$66.26 ,$705.00 ,$507.60 ,$383.52 ,$162.15 ,$393.53 ,$162.15 ,$421.17 ,$421.17 ,$421.17 ,$421.17 ,$592.20 ,$162.15 ,$599.25 ,$592.20 ,$162.15 ,$528.75 ,$564.00 ,$564.00 ,$162.15 ,$564.00 ,$592.20 ,$592.20 ,$592.20 ,$634.50 ,$405.38 ,$162.15 ,$125.55 ,$66.26 ,$72.89 ,$178.37 ,$599.25 ,$421.17 ,$634.50 ,$592.20 ,$564.00 ,$564.00 ,$162.15 ,$458.25 ST. FRANCIS HOSPITAL - ACUTE,40100006,77066,HC MAMMOGRAM DIAG W/CAD UPGRADE BIL,401,1 ,$705.00 ,$458.25 ,$66.26 ,$705.00 ,$507.60 ,$383.52 ,$162.15 ,$393.53 ,$162.15 ,$421.17 ,$421.17 ,$421.17 ,$421.17 ,$592.20 ,$162.15 ,$599.25 ,$592.20 ,$162.15 ,$528.75 ,$564.00 ,$564.00 ,$162.15 ,$564.00 ,$592.20 ,$592.20 ,$592.20 ,$634.50 ,$405.38 ,$162.15 ,$125.55 ,$66.26 ,$72.89 ,$178.37 ,$599.25 ,$421.17 ,$634.50 ,$592.20 ,$564.00 ,$564.00 ,$162.15 ,$458.25 ST. FRANCIS HOSPITAL - ACUTE,40100007,77065,HC MAMMOGRAM DIAG UNIL W/CAD,401,1 ,$495.00 ,$321.75 ,$66.26 ,$495.00 ,$356.40 ,$269.28 ,$113.85 ,$276.31 ,$113.85 ,$295.71 ,$295.71 ,$295.71 ,$295.71 ,$415.80 ,$113.85 ,$420.75 ,$415.80 ,$113.85 ,$371.25 ,$396.00 ,$396.00 ,$113.85 ,$396.00 ,$415.80 ,$415.80 ,$415.80 ,$445.50 ,$284.63 ,$113.85 ,$98.55 ,$66.26 ,$72.89 ,$125.24 ,$420.75 ,$295.71 ,$445.50 ,$415.80 ,$396.00 ,$396.00 ,$113.85 ,$321.75 ST. FRANCIS HOSPITAL - ACUTE,40100008,77065,HC MAMMOGRAM DIAG UNIL W/CAD ADDNT VIEW,401,1 ,$495.00 ,$321.75 ,$66.26 ,$495.00 ,$356.40 ,$269.28 ,$113.85 ,$276.31 ,$113.85 ,$295.71 ,$295.71 ,$295.71 ,$295.71 ,$415.80 ,$113.85 ,$420.75 ,$415.80 ,$113.85 ,$371.25 ,$396.00 ,$396.00 ,$113.85 ,$396.00 ,$415.80 ,$415.80 ,$415.80 ,$445.50 ,$284.63 ,$113.85 ,$98.55 ,$66.26 ,$72.89 ,$125.24 ,$420.75 ,$295.71 ,$445.50 ,$415.80 ,$396.00 ,$396.00 ,$113.85 ,$321.75 ST. FRANCIS HOSPITAL - ACUTE,40100009,77065,HC MAMMOGRAM DIAG UNIL W/CAD IMPLANT,401,1 ,$495.00 ,$321.75 ,$66.26 ,$495.00 ,$356.40 ,$269.28 ,$113.85 ,$276.31 ,$113.85 ,$295.71 ,$295.71 ,$295.71 ,$295.71 ,$415.80 ,$113.85 ,$420.75 ,$415.80 ,$113.85 ,$371.25 ,$396.00 ,$396.00 ,$113.85 ,$396.00 ,$415.80 ,$415.80 ,$415.80 ,$445.50 ,$284.63 ,$113.85 ,$98.55 ,$66.26 ,$72.89 ,$125.24 ,$420.75 ,$295.71 ,$445.50 ,$415.80 ,$396.00 ,$396.00 ,$113.85 ,$321.75 ST. FRANCIS HOSPITAL - ACUTE,40100010,77065,HC MAMMOGRAM DIAG UNIL W/CAD UPGRADE,401,1 ,$495.00 ,$321.75 ,$66.26 ,$495.00 ,$356.40 ,$269.28 ,$113.85 ,$276.31 ,$113.85 ,$295.71 ,$295.71 ,$295.71 ,$295.71 ,$415.80 ,$113.85 ,$420.75 ,$415.80 ,$113.85 ,$371.25 ,$396.00 ,$396.00 ,$113.85 ,$396.00 ,$415.80 ,$415.80 ,$415.80 ,$445.50 ,$284.63 ,$113.85 ,$98.55 ,$66.26 ,$72.89 ,$125.24 ,$420.75 ,$295.71 ,$445.50 ,$415.80 ,$396.00 ,$396.00 ,$113.85 ,$321.75 ST. FRANCIS HOSPITAL - ACUTE,40100014,G0279,HC DIAGNOSTIC DIGITAL BREAST TOMOSYTH UNI/BIL,401,1 ,$107.00 ,$69.55 ,$24.61 ,$107.00 ,$77.04 ,$58.21 ,$24.61 ,$59.73 ,$24.61 ,$63.92 ,$63.92 ,$63.92 ,$63.92 ,$89.88 ,$24.61 ,$90.95 ,$89.88 ,$24.61 ,$80.25 ,$85.60 ,$85.60 ,$24.61 ,$85.60 ,$89.88 ,$89.88 ,$89.88 ,$96.30 ,$61.53 ,$24.61 ,$26.25 ,$66.26 ,$72.89 ,$27.07 ,$90.95 ,$63.92 ,$96.30 ,$89.88 ,$85.60 ,$85.60 ,$24.61 ,$69.55 ST. FRANCIS HOSPITAL - ACUTE,40200007,51798,HC US BLADDER SCAN,402,1 ,"$1,004.00 ",$652.60 ,$114.53 ,"$1,004.00 ",$722.88 ,$546.18 ,$230.92 ,$560.43 ,$230.92 ,$599.79 ,$599.79 ,$599.79 ,$599.79 ,$843.36 ,$230.92 ,$853.40 ,$843.36 ,$230.92 ,$753.00 ,$803.20 ,$803.20 ,$230.92 ,$803.20 ,$843.36 ,$843.36 ,$843.36 ,$903.60 ,$577.30 ,$230.92 ,"$1,004.00 ",$114.53 ,$125.98 ,$254.01 ,$853.40 ,$599.79 ,$903.60 ,$843.36 ,$803.20 ,$803.20 ,$230.92 ,$652.60 ST. FRANCIS HOSPITAL - ACUTE,40200013,76536,HC US SOFT TISSUE HEAD/NECK,402,1 ,$903.00 ,$586.95 ,$145.88 ,$903.00 ,$650.16 ,$491.23 ,$207.69 ,$504.05 ,$207.69 ,$539.45 ,$539.45 ,$539.45 ,$539.45 ,$758.52 ,$207.69 ,$767.55 ,$758.52 ,$207.69 ,$677.25 ,$722.40 ,$722.40 ,$207.69 ,$722.40 ,$758.52 ,$758.52 ,$758.52 ,$812.70 ,$519.23 ,$207.69 ,$903.00 ,$145.88 ,$160.47 ,$228.46 ,$767.55 ,$539.45 ,$812.70 ,$758.52 ,$722.40 ,$722.40 ,$207.69 ,$586.95 ST. FRANCIS HOSPITAL - ACUTE,40200014,76604,HC US CHEST,402,1 ,"$1,045.00 ",$679.25 ,$145.88 ,"$1,045.00 ",$752.40 ,$568.48 ,$240.35 ,$583.32 ,$240.35 ,$624.28 ,$624.28 ,$624.28 ,$624.28 ,$877.80 ,$240.35 ,$888.25 ,$877.80 ,$240.35 ,$783.75 ,$836.00 ,$836.00 ,$240.35 ,$836.00 ,$877.80 ,$877.80 ,$877.80 ,$940.50 ,$600.88 ,$240.35 ,"$1,045.00 ",$145.88 ,$160.47 ,$264.39 ,$888.25 ,$624.28 ,$940.50 ,$877.80 ,$836.00 ,$836.00 ,$240.35 ,$679.25 ST. FRANCIS HOSPITAL - ACUTE,40200015,76641,HC US BREAST COMPLETE,402,1 ,"$1,120.00 ",$728.00 ,$74.93 ,"$1,120.00 ",$806.40 ,$609.28 ,$257.60 ,$625.18 ,$257.60 ,$669.09 ,$669.09 ,$669.09 ,$669.09 ,$940.80 ,$257.60 ,$952.00 ,$940.80 ,$257.60 ,$840.00 ,$896.00 ,$896.00 ,$257.60 ,$896.00 ,$940.80 ,$940.80 ,$940.80 ,"$1,008.00 ",$644.00 ,$257.60 ,$74.93 ,$145.88 ,$160.47 ,$283.36 ,$952.00 ,$669.09 ,"$1,008.00 ",$940.80 ,$896.00 ,$896.00 ,$257.60 ,$728.00 ST. FRANCIS HOSPITAL - ACUTE,40200016,76642,HC US BREAST LIMITED,402,1 ,"$1,024.00 ",$665.60 ,$56.93 ,"$1,024.00 ",$737.28 ,$557.06 ,$235.52 ,$571.60 ,$235.52 ,$611.74 ,$611.74 ,$611.74 ,$611.74 ,$860.16 ,$235.52 ,$870.40 ,$860.16 ,$235.52 ,$768.00 ,$819.20 ,$819.20 ,$235.52 ,$819.20 ,$860.16 ,$860.16 ,$860.16 ,$921.60 ,$588.80 ,$235.52 ,$56.93 ,$145.88 ,$160.47 ,$259.07 ,$870.40 ,$611.74 ,$921.60 ,$860.16 ,$819.20 ,$819.20 ,$235.52 ,$665.60 ST. FRANCIS HOSPITAL - ACUTE,40200017,76700,HC US ABDOMEN CMPL,402,1 ,"$1,566.00 ","$1,017.90 ",$145.88 ,"$1,566.00 ","$1,127.52 ",$851.90 ,$360.18 ,$874.14 ,$360.18 ,$935.53 ,$935.53 ,$935.53 ,$935.53 ,"$1,315.44 ",$360.18 ,"$1,331.10 ","$1,315.44 ",$360.18 ,"$1,174.50 ","$1,252.80 ","$1,252.80 ",$360.18 ,"$1,252.80 ","$1,315.44 ","$1,315.44 ","$1,315.44 ","$1,409.40 ",$900.45 ,$360.18 ,"$1,566.00 ",$145.88 ,$160.47 ,$396.20 ,"$1,331.10 ",$935.53 ,"$1,409.40 ","$1,315.44 ","$1,252.80 ","$1,252.80 ",$360.18 ,"$1,017.90 " ST. FRANCIS HOSPITAL - ACUTE,40200018,76705,HC US ABDOMEN LTD,402,1 ,"$1,407.00 ",$914.55 ,$145.88 ,"$1,407.00 ","$1,013.04 ",$765.41 ,$323.61 ,$785.39 ,$323.61 ,$840.54 ,$840.54 ,$840.54 ,$840.54 ,"$1,181.88 ",$323.61 ,"$1,195.95 ","$1,181.88 ",$323.61 ,"$1,055.25 ","$1,125.60 ","$1,125.60 ",$323.61 ,"$1,125.60 ","$1,181.88 ","$1,181.88 ","$1,181.88 ","$1,266.30 ",$809.03 ,$323.61 ,"$1,407.00 ",$145.88 ,$160.47 ,$355.97 ,"$1,195.95 ",$840.54 ,"$1,266.30 ","$1,181.88 ","$1,125.60 ","$1,125.60 ",$323.61 ,$914.55 ST. FRANCIS HOSPITAL - ACUTE,40200019,76770,HC US RETROPERITIONEAL,402,1 ,"$1,424.00 ",$925.60 ,$145.88 ,"$1,424.00 ","$1,025.28 ",$774.66 ,$327.52 ,$794.88 ,$327.52 ,$850.70 ,$850.70 ,$850.70 ,$850.70 ,"$1,196.16 ",$327.52 ,"$1,210.40 ","$1,196.16 ",$327.52 ,"$1,068.00 ","$1,139.20 ","$1,139.20 ",$327.52 ,"$1,139.20 ","$1,196.16 ","$1,196.16 ","$1,196.16 ","$1,281.60 ",$818.80 ,$327.52 ,"$1,424.00 ",$145.88 ,$160.47 ,$360.27 ,"$1,210.40 ",$850.70 ,"$1,281.60 ","$1,196.16 ","$1,139.20 ","$1,139.20 ",$327.52 ,$925.60 ST. FRANCIS HOSPITAL - ACUTE,40200020,76775,HC US RETROPERITONEAL LTD,402,1 ,"$1,109.00 ",$720.85 ,$145.88 ,"$1,109.00 ",$798.48 ,$603.30 ,$255.07 ,$619.04 ,$255.07 ,$662.52 ,$662.52 ,$662.52 ,$662.52 ,$931.56 ,$255.07 ,$942.65 ,$931.56 ,$255.07 ,$831.75 ,$887.20 ,$887.20 ,$255.07 ,$887.20 ,$931.56 ,$931.56 ,$931.56 ,$998.10 ,$637.68 ,$255.07 ,"$1,109.00 ",$145.88 ,$160.47 ,$280.58 ,$942.65 ,$662.52 ,$998.10 ,$931.56 ,$887.20 ,$887.20 ,$255.07 ,$720.85 ST. FRANCIS HOSPITAL - ACUTE,40200021,76776,HC US KIDNEY TRANSPLANT W/DOPPLER,402,1 ,"$1,412.00 ",$917.80 ,$145.88 ,"$1,412.00 ","$1,016.64 ",$768.13 ,$324.76 ,$788.18 ,$324.76 ,$843.53 ,$843.53 ,$843.53 ,$843.53 ,"$1,186.08 ",$324.76 ,"$1,200.20 ","$1,186.08 ",$324.76 ,"$1,059.00 ","$1,129.60 ","$1,129.60 ",$324.76 ,"$1,129.60 ","$1,186.08 ","$1,186.08 ","$1,186.08 ","$1,270.80 ",$811.90 ,$324.76 ,"$1,412.00 ",$145.88 ,$160.47 ,$357.24 ,"$1,200.20 ",$843.53 ,"$1,270.80 ","$1,186.08 ","$1,129.60 ","$1,129.60 ",$324.76 ,$917.80 ST. FRANCIS HOSPITAL - ACUTE,40200023,76801,HC US PREGNANCY <14 WEEKS SGL,402,1 ,"$1,133.00 ",$736.45 ,$94.40 ,"$1,133.00 ",$815.76 ,$616.35 ,$260.59 ,$632.44 ,$260.59 ,$676.85 ,$676.85 ,$676.85 ,$676.85 ,$951.72 ,$260.59 ,$963.05 ,$951.72 ,$260.59 ,$849.75 ,$906.40 ,$906.40 ,$260.59 ,$906.40 ,$951.72 ,$951.72 ,$951.72 ,"$1,019.70 ",$651.48 ,$260.59 ,"$1,133.00 ",$94.40 ,$103.84 ,$286.65 ,$963.05 ,$676.85 ,"$1,019.70 ",$951.72 ,$906.40 ,$906.40 ,$260.59 ,$736.45 ST. FRANCIS HOSPITAL - ACUTE,40200024,76802,HC US PREGNANCY <14 WEEKS ADDL,402,1 ,$435.00 ,$282.75 ,$94.40 ,$435.00 ,$313.20 ,$236.64 ,$100.05 ,$242.82 ,$100.05 ,$259.87 ,$259.87 ,$259.87 ,$259.87 ,$365.40 ,$100.05 ,$369.75 ,$365.40 ,$100.05 ,$326.25 ,$348.00 ,$348.00 ,$100.05 ,$348.00 ,$365.40 ,$365.40 ,$365.40 ,$391.50 ,$250.13 ,$100.05 ,$435.00 ,$94.40 ,$103.84 ,$110.06 ,$369.75 ,$259.87 ,$391.50 ,$365.40 ,$348.00 ,$348.00 ,$100.05 ,$282.75 ST. FRANCIS HOSPITAL - ACUTE,40200025,76805,HC US PREGNANCY >14 WEEKS SGL,402,1 ,$989.00 ,$642.85 ,$94.40 ,$989.00 ,$712.08 ,$538.02 ,$227.47 ,$552.06 ,$227.47 ,$590.83 ,$590.83 ,$590.83 ,$590.83 ,$830.76 ,$227.47 ,$840.65 ,$830.76 ,$227.47 ,$741.75 ,$791.20 ,$791.20 ,$227.47 ,$791.20 ,$830.76 ,$830.76 ,$830.76 ,$890.10 ,$568.68 ,$227.47 ,$989.00 ,$94.40 ,$103.84 ,$250.22 ,$840.65 ,$590.83 ,$890.10 ,$830.76 ,$791.20 ,$791.20 ,$227.47 ,$642.85 ST. FRANCIS HOSPITAL - ACUTE,40200027,76810,HC US PREGNANCY >14 WEEKS ADDL,402,1 ,"$1,509.00 ",$980.85 ,$94.40 ,"$1,509.00 ","$1,086.48 ",$820.90 ,$347.07 ,$842.32 ,$347.07 ,$901.48 ,$901.48 ,$901.48 ,$901.48 ,"$1,267.56 ",$347.07 ,"$1,282.65 ","$1,267.56 ",$347.07 ,"$1,131.75 ","$1,207.20 ","$1,207.20 ",$347.07 ,"$1,207.20 ","$1,267.56 ","$1,267.56 ","$1,267.56 ","$1,358.10 ",$867.68 ,$347.07 ,"$1,509.00 ",$94.40 ,$103.84 ,$381.78 ,"$1,282.65 ",$901.48 ,"$1,358.10 ","$1,267.56 ","$1,207.20 ","$1,207.20 ",$347.07 ,$980.85 ST. FRANCIS HOSPITAL - ACUTE,40200028,76811,HC US PREGNANCY DETAILED SGL,402,1 ,"$1,259.00 ",$818.35 ,$94.40 ,"$1,259.00 ",$906.48 ,$684.90 ,$289.57 ,$702.77 ,$289.57 ,$752.13 ,$752.13 ,$752.13 ,$752.13 ,"$1,057.56 ",$289.57 ,"$1,070.15 ","$1,057.56 ",$289.57 ,$944.25 ,"$1,007.20 ","$1,007.20 ",$289.57 ,"$1,007.20 ","$1,057.56 ","$1,057.56 ","$1,057.56 ","$1,133.10 ",$723.93 ,$289.57 ,"$1,259.00 ",$94.40 ,$103.84 ,$318.53 ,"$1,070.15 ",$752.13 ,"$1,133.10 ","$1,057.56 ","$1,007.20 ","$1,007.20 ",$289.57 ,$818.35 ST. FRANCIS HOSPITAL - ACUTE,40200030,76816,HC US OB GROWTH FOLLOWUP,402,1 ,$719.00 ,$467.35 ,$94.40 ,$719.00 ,$517.68 ,$391.14 ,$165.37 ,$401.35 ,$165.37 ,$429.53 ,$429.53 ,$429.53 ,$429.53 ,$603.96 ,$165.37 ,$611.15 ,$603.96 ,$165.37 ,$539.25 ,$575.20 ,$575.20 ,$165.37 ,$575.20 ,$603.96 ,$603.96 ,$603.96 ,$647.10 ,$413.43 ,$165.37 ,$719.00 ,$94.40 ,$103.84 ,$181.91 ,$611.15 ,$429.53 ,$647.10 ,$603.96 ,$575.20 ,$575.20 ,$165.37 ,$467.35 ST. FRANCIS HOSPITAL - ACUTE,40200031,76815,HC US FETAL HEART BEAT,402,1 ,$646.00 ,$419.90 ,$94.40 ,$646.00 ,$465.12 ,$351.42 ,$148.58 ,$360.60 ,$148.58 ,$385.92 ,$385.92 ,$385.92 ,$385.92 ,$542.64 ,$148.58 ,$549.10 ,$542.64 ,$148.58 ,$484.50 ,$516.80 ,$516.80 ,$148.58 ,$516.80 ,$542.64 ,$542.64 ,$542.64 ,$581.40 ,$371.45 ,$148.58 ,$646.00 ,$94.40 ,$103.84 ,$163.44 ,$549.10 ,$385.92 ,$581.40 ,$542.64 ,$516.80 ,$516.80 ,$148.58 ,$419.90 ST. FRANCIS HOSPITAL - ACUTE,40200032,76817,HC US PREGNANCY TRANSVAGINAL,402,1 ,$456.00 ,$296.40 ,$94.40 ,$456.00 ,$328.32 ,$248.06 ,$104.88 ,$254.54 ,$104.88 ,$272.41 ,$272.41 ,$272.41 ,$272.41 ,$383.04 ,$104.88 ,$387.60 ,$383.04 ,$104.88 ,$342.00 ,$364.80 ,$364.80 ,$104.88 ,$364.80 ,$383.04 ,$383.04 ,$383.04 ,$410.40 ,$262.20 ,$104.88 ,$456.00 ,$94.40 ,$103.84 ,$115.37 ,$387.60 ,$272.41 ,$410.40 ,$383.04 ,$364.80 ,$364.80 ,$104.88 ,$296.40 ST. FRANCIS HOSPITAL - ACUTE,40200034,76819,HC US FETAL BIO PROFILE W/O NST,402,1 ,"$1,166.00 ",$757.90 ,$94.40 ,"$1,166.00 ",$839.52 ,$634.30 ,$268.18 ,$650.86 ,$268.18 ,$696.57 ,$696.57 ,$696.57 ,$696.57 ,$979.44 ,$268.18 ,$991.10 ,$979.44 ,$268.18 ,$874.50 ,$932.80 ,$932.80 ,$268.18 ,$932.80 ,$979.44 ,$979.44 ,$979.44 ,"$1,049.40 ",$670.45 ,$268.18 ,"$1,166.00 ",$94.40 ,$103.84 ,$295.00 ,$991.10 ,$696.57 ,"$1,049.40 ",$979.44 ,$932.80 ,$932.80 ,$268.18 ,$757.90 ST. FRANCIS HOSPITAL - ACUTE,40200036,76820,HC US FETAL DOPLR VELO UMB,402,1 ,$401.00 ,$260.65 ,$92.23 ,$401.00 ,$288.72 ,$218.14 ,$92.23 ,$223.84 ,$92.23 ,$239.56 ,$239.56 ,$239.56 ,$239.56 ,$336.84 ,$92.23 ,$340.85 ,$336.84 ,$92.23 ,$300.75 ,$320.80 ,$320.80 ,$92.23 ,$320.80 ,$336.84 ,$336.84 ,$336.84 ,$360.90 ,$230.58 ,$92.23 ,$401.00 ,$94.40 ,$103.84 ,$101.45 ,$340.85 ,$239.56 ,$360.90 ,$336.84 ,$320.80 ,$320.80 ,$92.23 ,$260.65 ST. FRANCIS HOSPITAL - ACUTE,40200038,76830,HC US TRANSVAGINAL,402,1 ,$815.00 ,$529.75 ,$145.88 ,$815.00 ,$586.80 ,$443.36 ,$187.45 ,$454.93 ,$187.45 ,$486.88 ,$486.88 ,$486.88 ,$486.88 ,$684.60 ,$187.45 ,$692.75 ,$684.60 ,$187.45 ,$611.25 ,$652.00 ,$652.00 ,$187.45 ,$652.00 ,$684.60 ,$684.60 ,$684.60 ,$733.50 ,$468.63 ,$187.45 ,$815.00 ,$145.88 ,$160.47 ,$206.20 ,$692.75 ,$486.88 ,$733.50 ,$684.60 ,$652.00 ,$652.00 ,$187.45 ,$529.75 ST. FRANCIS HOSPITAL - ACUTE,40200039,76831,HC US HYSTEROSONOGRAM,402,1 ,$923.00 ,$599.95 ,$212.29 ,$923.00 ,$664.56 ,$502.11 ,$212.29 ,$515.22 ,$212.29 ,$551.40 ,$551.40 ,$551.40 ,$551.40 ,$775.32 ,$212.29 ,$784.55 ,$775.32 ,$212.29 ,$692.25 ,$738.40 ,$738.40 ,$212.29 ,$738.40 ,$775.32 ,$775.32 ,$775.32 ,$830.70 ,$530.73 ,$212.29 ,$923.00 ,$332.96 ,$366.26 ,$233.52 ,$784.55 ,$551.40 ,$830.70 ,$775.32 ,$738.40 ,$738.40 ,$212.29 ,$599.95 ST. FRANCIS HOSPITAL - ACUTE,40200040,76856,HC US PELVIS NON OB,402,1 ,"$1,166.00 ",$757.90 ,$79.80 ,"$1,166.00 ",$839.52 ,$634.30 ,$268.18 ,$650.86 ,$268.18 ,$696.57 ,$696.57 ,$696.57 ,$696.57 ,$979.44 ,$268.18 ,$991.10 ,$979.44 ,$268.18 ,$874.50 ,$932.80 ,$932.80 ,$268.18 ,$932.80 ,$979.44 ,$979.44 ,$979.44 ,"$1,049.40 ",$670.45 ,$268.18 ,$79.80 ,$145.88 ,$160.47 ,$295.00 ,$991.10 ,$696.57 ,"$1,049.40 ",$979.44 ,$932.80 ,$932.80 ,$268.18 ,$757.90 ST. FRANCIS HOSPITAL - ACUTE,40200041,76857,HC US PELVIS NON-OB LTD,402,1 ,$934.00 ,$607.10 ,$145.88 ,$934.00 ,$672.48 ,$508.10 ,$214.82 ,$521.36 ,$214.82 ,$557.97 ,$557.97 ,$557.97 ,$557.97 ,$784.56 ,$214.82 ,$793.90 ,$784.56 ,$214.82 ,$700.50 ,$747.20 ,$747.20 ,$214.82 ,$747.20 ,$784.56 ,$784.56 ,$784.56 ,$840.60 ,$537.05 ,$214.82 ,$934.00 ,$145.88 ,$160.47 ,$236.30 ,$793.90 ,$557.97 ,$840.60 ,$784.56 ,$747.20 ,$747.20 ,$214.82 ,$607.10 ST. FRANCIS HOSPITAL - ACUTE,40200042,76870,HC US SCROTUM,402,1 ,"$1,166.00 ",$757.90 ,$145.88 ,"$1,166.00 ",$839.52 ,$634.30 ,$268.18 ,$650.86 ,$268.18 ,$696.57 ,$696.57 ,$696.57 ,$696.57 ,$979.44 ,$268.18 ,$991.10 ,$979.44 ,$268.18 ,$874.50 ,$932.80 ,$932.80 ,$268.18 ,$932.80 ,$979.44 ,$979.44 ,$979.44 ,"$1,049.40 ",$670.45 ,$268.18 ,"$1,166.00 ",$145.88 ,$160.47 ,$295.00 ,$991.10 ,$696.57 ,"$1,049.40 ",$979.44 ,$932.80 ,$932.80 ,$268.18 ,$757.90 ST. FRANCIS HOSPITAL - ACUTE,40200043,76872,HC ULTRA BX PROS,402,1 ,"$1,166.00 ",$757.90 ,$145.88 ,"$1,166.00 ",$839.52 ,$634.30 ,$268.18 ,$650.86 ,$268.18 ,$696.57 ,$696.57 ,$696.57 ,$696.57 ,$979.44 ,$268.18 ,$991.10 ,$979.44 ,$268.18 ,$874.50 ,$932.80 ,$932.80 ,$268.18 ,$932.80 ,$979.44 ,$979.44 ,$979.44 ,"$1,049.40 ",$670.45 ,$268.18 ,"$1,166.00 ",$145.88 ,$160.47 ,$295.00 ,$991.10 ,$696.57 ,"$1,049.40 ",$979.44 ,$932.80 ,$932.80 ,$268.18 ,$757.90 ST. FRANCIS HOSPITAL - ACUTE,40200045,76881,HC US EXTREMITY NON VASCULAR COMP,402,1 ,$779.00 ,$506.35 ,$145.88 ,$779.00 ,$560.88 ,$423.78 ,$179.17 ,$434.84 ,$179.17 ,$465.37 ,$465.37 ,$465.37 ,$465.37 ,$654.36 ,$179.17 ,$662.15 ,$654.36 ,$179.17 ,$584.25 ,$623.20 ,$623.20 ,$179.17 ,$623.20 ,$654.36 ,$654.36 ,$654.36 ,$701.10 ,$447.93 ,$179.17 ,$779.00 ,$145.88 ,$160.47 ,$197.09 ,$662.15 ,$465.37 ,$701.10 ,$654.36 ,$623.20 ,$623.20 ,$179.17 ,$506.35 ST. FRANCIS HOSPITAL - ACUTE,40200046,76882,HC US EXTREMITY NON VASCULAR LMTD,402,1 ,$466.00 ,$302.90 ,$107.18 ,$466.00 ,$335.52 ,$253.50 ,$107.18 ,$260.12 ,$107.18 ,$278.39 ,$278.39 ,$278.39 ,$278.39 ,$391.44 ,$107.18 ,$396.10 ,$391.44 ,$107.18 ,$349.50 ,$372.80 ,$372.80 ,$107.18 ,$372.80 ,$391.44 ,$391.44 ,$391.44 ,$419.40 ,$267.95 ,$107.18 ,$466.00 ,$145.88 ,$160.47 ,$117.90 ,$396.10 ,$278.39 ,$419.40 ,$391.44 ,$372.80 ,$372.80 ,$107.18 ,$302.90 ST. FRANCIS HOSPITAL - ACUTE,40200051,76937,HC US GUIDED VASCULAR ACCESS 76937,402,1 ,$147.00 ,$95.55 ,$33.81 ,$147.00 ,$105.84 ,$79.97 ,$33.81 ,$82.06 ,$33.81 ,$87.82 ,$87.82 ,$87.82 ,$87.82 ,$123.48 ,$33.81 ,$124.95 ,$123.48 ,$33.81 ,$110.25 ,$117.60 ,$117.60 ,$33.81 ,$117.60 ,$123.48 ,$123.48 ,$123.48 ,$132.30 ,$84.53 ,$33.81 ,$147.00 ,$106.45 ,$117.10 ,$37.19 ,$124.95 ,$87.82 ,$132.30 ,$123.48 ,$117.60 ,$117.60 ,$33.81 ,$95.55 ST. FRANCIS HOSPITAL - ACUTE,40200053,76942,HC US GUIDED NEEDLE PLCMT,402,1 ,$202.00 ,$131.30 ,$27.31 ,$202.00 ,$145.44 ,$109.89 ,$46.46 ,$112.76 ,$46.46 ,$120.67 ,$120.67 ,$120.67 ,$120.67 ,$169.68 ,$46.46 ,$171.70 ,$169.68 ,$46.46 ,$151.50 ,$161.60 ,$161.60 ,$46.46 ,$161.60 ,$169.68 ,$169.68 ,$169.68 ,$181.80 ,$116.15 ,$46.46 ,$27.31 ,$106.45 ,$117.10 ,$51.11 ,$171.70 ,$120.67 ,$181.80 ,$169.68 ,$161.60 ,$161.60 ,$46.46 ,$131.30 ST. FRANCIS HOSPITAL - ACUTE,40200059,76946,HC US GUIDED AMNIOCENTESIS,402,1 ,"$1,536.00 ",$998.40 ,$106.45 ,"$1,536.00 ","$1,105.92 ",$835.58 ,$353.28 ,$857.40 ,$353.28 ,$917.61 ,$917.61 ,$917.61 ,$917.61 ,"$1,290.24 ",$353.28 ,"$1,305.60 ","$1,290.24 ",$353.28 ,"$1,152.00 ","$1,228.80 ","$1,228.80 ",$353.28 ,"$1,228.80 ","$1,290.24 ","$1,290.24 ","$1,290.24 ","$1,382.40 ",$883.20 ,$353.28 ,"$1,536.00 ",$106.45 ,$117.10 ,$388.61 ,"$1,305.60 ",$917.61 ,"$1,382.40 ","$1,290.24 ","$1,228.80 ","$1,228.80 ",$353.28 ,$998.40 ST. FRANCIS HOSPITAL - ACUTE,40200062,76998,HC US INTRAOPERATIVE,402,1 ,$646.00 ,$419.90 ,$106.45 ,$646.00 ,$465.12 ,$351.42 ,$148.58 ,$360.60 ,$148.58 ,$385.92 ,$385.92 ,$385.92 ,$385.92 ,$542.64 ,$148.58 ,$549.10 ,$542.64 ,$148.58 ,$484.50 ,$516.80 ,$516.80 ,$148.58 ,$516.80 ,$542.64 ,$542.64 ,$542.64 ,$581.40 ,$371.45 ,$148.58 ,$646.00 ,$106.45 ,$117.10 ,$163.44 ,$549.10 ,$385.92 ,$581.40 ,$542.64 ,$516.80 ,$516.80 ,$148.58 ,$419.90 ST. FRANCIS HOSPITAL - ACUTE,40200064,93975,HC DUPLEX ABD/PEL/RETRO CMPL,402,1 ,"$1,716.00 ","$1,115.40 ",$145.88 ,"$1,716.00 ","$1,235.52 ",$933.50 ,$394.68 ,$957.87 ,$394.68 ,"$1,025.14 ","$1,025.14 ","$1,025.14 ","$1,025.14 ","$1,441.44 ",$394.68 ,"$1,458.60 ","$1,441.44 ",$394.68 ,"$1,287.00 ","$1,372.80 ","$1,372.80 ",$394.68 ,"$1,372.80 ","$1,441.44 ","$1,441.44 ","$1,441.44 ","$1,544.40 ",$986.70 ,$394.68 ,"$1,716.00 ",$145.88 ,$160.47 ,$434.15 ,"$1,458.60 ","$1,025.14 ","$1,544.40 ","$1,441.44 ","$1,372.80 ","$1,372.80 ",$394.68 ,"$1,115.40 " ST. FRANCIS HOSPITAL - ACUTE,40200071,93976,HC DUPLEX ABD/PEL/RETRO SCAN LTD AORTA,402,1 ,"$1,089.00 ",$707.85 ,$145.88 ,"$1,089.00 ",$784.08 ,$592.42 ,$250.47 ,$607.88 ,$250.47 ,$650.57 ,$650.57 ,$650.57 ,$650.57 ,$914.76 ,$250.47 ,$925.65 ,$914.76 ,$250.47 ,$816.75 ,$871.20 ,$871.20 ,$250.47 ,$871.20 ,$914.76 ,$914.76 ,$914.76 ,$980.10 ,$626.18 ,$250.47 ,"$1,089.00 ",$145.88 ,$160.47 ,$275.52 ,$925.65 ,$650.57 ,$980.10 ,$914.76 ,$871.20 ,$871.20 ,$250.47 ,$707.85 ST. FRANCIS HOSPITAL - ACUTE,40200073,93978,HC DUPLEX AORTA/IVC/GRAFT CMPL,402,1 ,"$1,544.00 ","$1,003.60 ",$145.88 ,"$1,544.00 ","$1,111.68 ",$839.94 ,$355.12 ,$861.86 ,$355.12 ,$922.39 ,$922.39 ,$922.39 ,$922.39 ,"$1,296.96 ",$355.12 ,"$1,312.40 ","$1,296.96 ",$355.12 ,"$1,158.00 ","$1,235.20 ","$1,235.20 ",$355.12 ,"$1,235.20 ","$1,296.96 ","$1,296.96 ","$1,296.96 ","$1,389.60 ",$887.80 ,$355.12 ,"$1,544.00 ",$145.88 ,$160.47 ,$390.63 ,"$1,312.40 ",$922.39 ,"$1,389.60 ","$1,296.96 ","$1,235.20 ","$1,235.20 ",$355.12 ,"$1,003.60 " ST. FRANCIS HOSPITAL - ACUTE,40200075,76706,HC US AORTA (SCREENING),402,1 ,$998.00 ,$648.70 ,$145.88 ,$998.00 ,$718.56 ,$542.91 ,$229.54 ,$557.08 ,$229.54 ,$596.21 ,$596.21 ,$596.21 ,$596.21 ,$838.32 ,$229.54 ,$848.30 ,$838.32 ,$229.54 ,$748.50 ,$798.40 ,$798.40 ,$229.54 ,$798.40 ,$838.32 ,$838.32 ,$838.32 ,$898.20 ,$573.85 ,$229.54 ,$998.00 ,$145.88 ,$160.47 ,$252.49 ,$848.30 ,$596.21 ,$898.20 ,$838.32 ,$798.40 ,$798.40 ,$229.54 ,$648.70 ST. FRANCIS HOSPITAL - ACUTE,40300003,77067,HC MAMMOGRAM SCREEN DIGI W/CAD,403,1 ,$603.00 ,$391.95 ,$66.26 ,$603.00 ,$434.16 ,$328.03 ,$94.15 ,$336.59 ,$94.15 ,$360.23 ,$360.23 ,$360.23 ,$360.23 ,$506.52 ,$94.15 ,$512.55 ,$506.52 ,$94.15 ,$452.25 ,$482.40 ,$482.40 ,$94.15 ,$482.40 ,$506.52 ,$506.52 ,$506.52 ,$542.70 ,$235.38 ,$94.15 ,$104.18 ,$66.26 ,$72.89 ,$103.57 ,$512.55 ,$360.23 ,$542.70 ,$506.52 ,$482.40 ,$482.40 ,$94.15 ,$391.95 ST. FRANCIS HOSPITAL - ACUTE,40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$603.00 ,$391.95 ,$66.26 ,$603.00 ,$434.16 ,$328.03 ,$94.15 ,$336.59 ,$94.15 ,$360.23 ,$360.23 ,$360.23 ,$360.23 ,$506.52 ,$94.15 ,$512.55 ,$506.52 ,$94.15 ,$452.25 ,$482.40 ,$482.40 ,$94.15 ,$482.40 ,$506.52 ,$506.52 ,$506.52 ,$542.70 ,$235.38 ,$94.15 ,$104.18 ,$66.26 ,$72.89 ,$103.57 ,$512.55 ,$360.23 ,$542.70 ,$506.52 ,$482.40 ,$482.40 ,$94.15 ,$391.95 ST. FRANCIS HOSPITAL - ACUTE,40300006,77063,HC SCREEN DIGITAL BREAST TOMOSYTH BIL,403,1 ,$109.00 ,$70.85 ,$25.07 ,$109.00 ,$78.48 ,$59.30 ,$23.72 ,$60.84 ,$25.07 ,$65.12 ,$65.12 ,$65.12 ,$65.12 ,$91.56 ,$25.07 ,$92.65 ,$91.56 ,$25.07 ,$81.75 ,$87.20 ,$87.20 ,$25.07 ,$87.20 ,$91.56 ,$91.56 ,$91.56 ,$98.10 ,$62.68 ,$25.07 ,$26.25 ,$66.26 ,$72.89 ,$27.58 ,$92.65 ,$65.12 ,$98.10 ,$91.56 ,$87.20 ,$87.20 ,$25.07 ,$70.85 ST. FRANCIS HOSPITAL - ACUTE,40300007,77063,HC SCREEN DIG BREAST TOMO BIL-52,403,1 ,$82.00 ,$53.30 ,$18.86 ,$82.00 ,$59.04 ,$44.61 ,$23.72 ,$45.77 ,$18.86 ,$48.99 ,$48.99 ,$48.99 ,$48.99 ,$68.88 ,$18.86 ,$69.70 ,$68.88 ,$18.86 ,$61.50 ,$65.60 ,$65.60 ,$18.86 ,$65.60 ,$68.88 ,$68.88 ,$68.88 ,$73.80 ,$47.15 ,$18.86 ,$26.25 ,$33.13 ,$36.44 ,$20.75 ,$69.70 ,$48.99 ,$73.80 ,$68.88 ,$65.60 ,$65.60 ,$18.86 ,$53.30 ST. FRANCIS HOSPITAL - ACUTE,41000005,92950,HC CPR,480,1 ,"$1,027.00 ",$667.55 ,$236.21 ,"$1,027.00 ",$739.44 ,$558.69 ,$236.21 ,$573.27 ,$236.21 ,$613.53 ,$613.53 ,$613.53 ,$613.53 ,$862.68 ,$236.21 ,$872.95 ,$862.68 ,$236.21 ,$770.25 ,$821.60 ,$821.60 ,$236.21 ,$821.60 ,$862.68 ,$862.68 ,$862.68 ,$924.30 ,$590.53 ,$236.21 ,"$1,027.00 ",$647.81 ,$712.59 ,$259.83 ,$872.95 ,$613.53 ,$924.30 ,$862.68 ,$821.60 ,$821.60 ,$236.21 ,$667.55 ST. FRANCIS HOSPITAL - ACUTE,41000009,94002,HC VENT MANGMNT INPT/OBS INIT DAY,410,1 ,"$1,550.00 ","$1,007.50 ",$356.50 ,"$1,550.00 ","$1,116.00 ",$843.20 ,$356.50 ,$865.21 ,$356.50 ,$925.97 ,$925.97 ,$925.97 ,$925.97 ,"$1,302.00 ",$356.50 ,"$1,317.50 ","$1,302.00 ",$356.50 ,"$1,162.50 ","$1,240.00 ","$1,240.00 ",$356.50 ,"$1,240.00 ","$1,302.00 ","$1,302.00 ","$1,302.00 ","$1,395.00 ",$891.25 ,$356.50 ,"$1,550.00 ",$702.37 ,$772.61 ,$392.15 ,"$1,317.50 ",$925.97 ,"$1,395.00 ","$1,302.00 ","$1,240.00 ","$1,240.00 ",$356.50 ,"$1,007.50 " ST. FRANCIS HOSPITAL - ACUTE,41000013,94660,HC VENT NONINVAS ADULT INTL DAY,410,1 ,$982.00 ,$638.30 ,$225.86 ,$982.00 ,$707.04 ,$534.21 ,$225.86 ,$548.15 ,$225.86 ,$586.65 ,$586.65 ,$586.65 ,$586.65 ,$824.88 ,$225.86 ,$834.70 ,$824.88 ,$225.86 ,$736.50 ,$785.60 ,$785.60 ,$225.86 ,$785.60 ,$824.88 ,$824.88 ,$824.88 ,$883.80 ,$564.65 ,$225.86 ,$982.00 ,$702.37 ,$772.61 ,$248.45 ,$834.70 ,$586.65 ,$883.80 ,$824.88 ,$785.60 ,$785.60 ,$225.86 ,$638.30 ST. FRANCIS HOSPITAL - ACUTE,41000027,94003,HC VENT MANGMNT INPT/OBS SUBS DAY,410,1 ,"$1,341.00 ",$871.65 ,$308.43 ,"$1,341.00 ",$965.52 ,$729.50 ,$308.43 ,$748.55 ,$308.43 ,$801.11 ,$801.11 ,$801.11 ,$801.11 ,"$1,126.44 ",$308.43 ,"$1,139.85 ","$1,126.44 ",$308.43 ,"$1,005.75 ","$1,072.80 ","$1,072.80 ",$308.43 ,"$1,072.80 ","$1,126.44 ","$1,126.44 ","$1,126.44 ","$1,206.90 ",$771.08 ,$308.43 ,"$1,341.00 ",$702.37 ,$772.61 ,$339.27 ,"$1,139.85 ",$801.11 ,"$1,206.90 ","$1,126.44 ","$1,072.80 ","$1,072.80 ",$308.43 ,$871.65 ST. FRANCIS HOSPITAL - ACUTE,41000029,94660,HC VENT NONINVAS ADLT SUBQ DAY,410,1 ,$414.00 ,$269.10 ,$95.22 ,$772.61 ,$298.08 ,$225.22 ,$95.22 ,$231.09 ,$95.22 ,$247.32 ,$247.32 ,$247.32 ,$247.32 ,$347.76 ,$95.22 ,$351.90 ,$347.76 ,$95.22 ,$310.50 ,$331.20 ,$331.20 ,$95.22 ,$331.20 ,$347.76 ,$347.76 ,$347.76 ,$372.60 ,$238.05 ,$95.22 ,$414.00 ,$702.37 ,$772.61 ,$104.74 ,$351.90 ,$247.32 ,$372.60 ,$347.76 ,$331.20 ,$331.20 ,$95.22 ,$269.10 ST. FRANCIS HOSPITAL - ACUTE,41000034,94640,HC IPPB,410,1 ,$320.00 ,$208.00 ,$73.60 ,$320.00 ,$230.40 ,$174.08 ,$73.60 ,$178.62 ,$73.60 ,$191.17 ,$191.17 ,$191.17 ,$191.17 ,$268.80 ,$73.60 ,$272.00 ,$268.80 ,$73.60 ,$240.00 ,$256.00 ,$256.00 ,$73.60 ,$256.00 ,$268.80 ,$268.80 ,$268.80 ,$288.00 ,$184.00 ,$73.60 ,$320.00 ,$232.62 ,$255.88 ,$80.96 ,$272.00 ,$191.17 ,$288.00 ,$268.80 ,$256.00 ,$256.00 ,$73.60 ,$208.00 ST. FRANCIS HOSPITAL - ACUTE,41000035,94640,HC NEBULIZER TREATMENT EACH,410,1 ,$205.00 ,$133.25 ,$47.15 ,$255.88 ,$147.60 ,$111.52 ,$47.15 ,$114.43 ,$47.15 ,$122.47 ,$122.47 ,$122.47 ,$122.47 ,$172.20 ,$47.15 ,$174.25 ,$172.20 ,$47.15 ,$153.75 ,$164.00 ,$164.00 ,$47.15 ,$164.00 ,$172.20 ,$172.20 ,$172.20 ,$184.50 ,$117.88 ,$47.15 ,$205.00 ,$232.62 ,$255.88 ,$51.87 ,$174.25 ,$122.47 ,$184.50 ,$172.20 ,$164.00 ,$164.00 ,$47.15 ,$133.25 ST. FRANCIS HOSPITAL - ACUTE,41000038,94640,HC AEROSOL GENTR SHORT-TERM,410,1 ,$213.00 ,$138.45 ,$48.99 ,$255.88 ,$153.36 ,$115.87 ,$48.99 ,$118.90 ,$48.99 ,$127.25 ,$127.25 ,$127.25 ,$127.25 ,$178.92 ,$48.99 ,$181.05 ,$178.92 ,$48.99 ,$159.75 ,$170.40 ,$170.40 ,$48.99 ,$170.40 ,$178.92 ,$178.92 ,$178.92 ,$191.70 ,$122.48 ,$48.99 ,$213.00 ,$232.62 ,$255.88 ,$53.89 ,$181.05 ,$127.25 ,$191.70 ,$178.92 ,$170.40 ,$170.40 ,$48.99 ,$138.45 ST. FRANCIS HOSPITAL - ACUTE,41000041,94640,HC MDI/DPI TX INITIAL,410,1 ,$182.00 ,$118.30 ,$41.86 ,$255.88 ,$131.04 ,$99.01 ,$41.86 ,$101.59 ,$41.86 ,$108.73 ,$108.73 ,$108.73 ,$108.73 ,$152.88 ,$41.86 ,$154.70 ,$152.88 ,$41.86 ,$136.50 ,$145.60 ,$145.60 ,$41.86 ,$145.60 ,$152.88 ,$152.88 ,$152.88 ,$163.80 ,$104.65 ,$41.86 ,$182.00 ,$232.62 ,$255.88 ,$46.05 ,$154.70 ,$108.73 ,$163.80 ,$152.88 ,$145.60 ,$145.60 ,$41.86 ,$118.30 ST. FRANCIS HOSPITAL - ACUTE,41000046,94640,HC HIGH EFF NEB AERO EACH,410,1 ,$213.00 ,$138.45 ,$48.99 ,$255.88 ,$153.36 ,$115.87 ,$48.99 ,$118.90 ,$48.99 ,$127.25 ,$127.25 ,$127.25 ,$127.25 ,$178.92 ,$48.99 ,$181.05 ,$178.92 ,$48.99 ,$159.75 ,$170.40 ,$170.40 ,$48.99 ,$170.40 ,$178.92 ,$178.92 ,$178.92 ,$191.70 ,$122.48 ,$48.99 ,$213.00 ,$232.62 ,$255.88 ,$53.89 ,$181.05 ,$127.25 ,$191.70 ,$178.92 ,$170.40 ,$170.40 ,$48.99 ,$138.45 ST. FRANCIS HOSPITAL - ACUTE,41000047,94640,HC HIGH EFF NEB AERO W/INSTR/TEACH DEVICE,410,1 ,$213.00 ,$138.45 ,$48.99 ,$255.88 ,$153.36 ,$115.87 ,$48.99 ,$118.90 ,$48.99 ,$127.25 ,$127.25 ,$127.25 ,$127.25 ,$178.92 ,$48.99 ,$181.05 ,$178.92 ,$48.99 ,$159.75 ,$170.40 ,$170.40 ,$48.99 ,$170.40 ,$178.92 ,$178.92 ,$178.92 ,$191.70 ,$122.48 ,$48.99 ,$213.00 ,$232.62 ,$255.88 ,$53.89 ,$181.05 ,$127.25 ,$191.70 ,$178.92 ,$170.40 ,$170.40 ,$48.99 ,$138.45 ST. FRANCIS HOSPITAL - ACUTE,41000050,94644,HC AEROSOL CONTINUOUS 1ST HR,410,1 ,$736.00 ,$478.40 ,$71.72 ,$736.00 ,$529.92 ,$400.38 ,$169.28 ,$410.84 ,$169.28 ,$439.69 ,$439.69 ,$439.69 ,$439.69 ,$618.24 ,$169.28 ,$625.60 ,$618.24 ,$169.28 ,$552.00 ,$588.80 ,$588.80 ,$169.28 ,$588.80 ,$618.24 ,$618.24 ,$618.24 ,$662.40 ,$423.20 ,$169.28 ,$736.00 ,$71.72 ,$78.89 ,$186.21 ,$625.60 ,$439.69 ,$662.40 ,$618.24 ,$588.80 ,$588.80 ,$169.28 ,$478.40 ST. FRANCIS HOSPITAL - ACUTE,41000051,94645,HC AEROSOL CONTINUOUS ADDL HR,410,1 ,$220.00 ,$143.00 ,$50.60 ,$220.00 ,$158.40 ,$119.68 ,$50.60 ,$122.80 ,$50.60 ,$131.43 ,$131.43 ,$131.43 ,$131.43 ,$184.80 ,$50.60 ,$187.00 ,$184.80 ,$50.60 ,$165.00 ,$176.00 ,$176.00 ,$50.60 ,$176.00 ,$184.80 ,$184.80 ,$184.80 ,$198.00 ,$126.50 ,$50.60 ,$220.00 ,$71.72 ,$78.89 ,$55.66 ,$187.00 ,$131.43 ,$198.00 ,$184.80 ,$176.00 ,$176.00 ,$50.60 ,$143.00 ST. FRANCIS HOSPITAL - ACUTE,41000052,94660,HC CPAP,410,1 ,$782.00 ,$508.30 ,$179.86 ,$782.00 ,$563.04 ,$425.41 ,$179.86 ,$436.51 ,$179.86 ,$467.17 ,$467.17 ,$467.17 ,$467.17 ,$656.88 ,$179.86 ,$664.70 ,$656.88 ,$179.86 ,$586.50 ,$625.60 ,$625.60 ,$179.86 ,$625.60 ,$656.88 ,$656.88 ,$656.88 ,$703.80 ,$449.65 ,$179.86 ,$782.00 ,$702.37 ,$772.61 ,$197.85 ,$664.70 ,$467.17 ,$703.80 ,$656.88 ,$625.60 ,$625.60 ,$179.86 ,$508.30 ST. FRANCIS HOSPITAL - ACUTE,41000057,94664,HC DEMO/EVAL/MDI/NEB DAILY,410,1 ,$240.00 ,$156.00 ,$34.61 ,$240.00 ,$172.80 ,$130.56 ,$55.20 ,$133.97 ,$55.20 ,$143.38 ,$143.38 ,$143.38 ,$143.38 ,$201.60 ,$55.20 ,$204.00 ,$201.60 ,$55.20 ,$180.00 ,$192.00 ,$192.00 ,$55.20 ,$192.00 ,$201.60 ,$201.60 ,$201.60 ,$216.00 ,$138.00 ,$55.20 ,$240.00 ,$34.61 ,$38.07 ,$60.72 ,$204.00 ,$143.38 ,$216.00 ,$201.60 ,$192.00 ,$192.00 ,$55.20 ,$156.00 ST. FRANCIS HOSPITAL - ACUTE,41000058,94667,HC CHEST PHYSIOTHRPY INIT,410,1 ,$163.00 ,$105.95 ,$37.49 ,$255.88 ,$117.36 ,$88.67 ,$37.49 ,$90.99 ,$37.49 ,$97.38 ,$97.38 ,$97.38 ,$97.38 ,$136.92 ,$37.49 ,$138.55 ,$136.92 ,$37.49 ,$122.25 ,$130.40 ,$130.40 ,$37.49 ,$130.40 ,$136.92 ,$136.92 ,$136.92 ,$146.70 ,$93.73 ,$37.49 ,$163.00 ,$232.62 ,$255.88 ,$41.24 ,$138.55 ,$97.38 ,$146.70 ,$136.92 ,$130.40 ,$130.40 ,$37.49 ,$105.95 ST. FRANCIS HOSPITAL - ACUTE,41000059,94667,HC CHEST PHYSIOTHRPY INIT ACAPELLA,410,1 ,$148.00 ,$96.20 ,$34.04 ,$255.88 ,$106.56 ,$80.51 ,$34.04 ,$82.61 ,$34.04 ,$88.42 ,$88.42 ,$88.42 ,$88.42 ,$124.32 ,$34.04 ,$125.80 ,$124.32 ,$34.04 ,$111.00 ,$118.40 ,$118.40 ,$34.04 ,$118.40 ,$124.32 ,$124.32 ,$124.32 ,$133.20 ,$85.10 ,$34.04 ,$148.00 ,$232.62 ,$255.88 ,$37.44 ,$125.80 ,$88.42 ,$133.20 ,$124.32 ,$118.40 ,$118.40 ,$34.04 ,$96.20 ST. FRANCIS HOSPITAL - ACUTE,41000060,94668,HC CHEST PHYSIOTHRPY SUBSQ,410,1 ,$150.00 ,$97.50 ,$34.50 ,$255.88 ,$108.00 ,$81.60 ,$34.50 ,$83.73 ,$34.50 ,$89.61 ,$89.61 ,$89.61 ,$89.61 ,$126.00 ,$34.50 ,$127.50 ,$126.00 ,$34.50 ,$112.50 ,$120.00 ,$120.00 ,$34.50 ,$120.00 ,$126.00 ,$126.00 ,$126.00 ,$135.00 ,$86.25 ,$34.50 ,$150.00 ,$232.62 ,$255.88 ,$37.95 ,$127.50 ,$89.61 ,$135.00 ,$126.00 ,$120.00 ,$120.00 ,$34.50 ,$97.50 ST. FRANCIS HOSPITAL - ACUTE,41000061,94668,HC CHEST PHYSIOTHRPY SUBSQ ACAPELLA,410,1 ,$137.00 ,$89.05 ,$31.51 ,$255.88 ,$98.64 ,$74.53 ,$31.51 ,$76.47 ,$31.51 ,$81.84 ,$81.84 ,$81.84 ,$81.84 ,$115.08 ,$31.51 ,$116.45 ,$115.08 ,$31.51 ,$102.75 ,$109.60 ,$109.60 ,$31.51 ,$109.60 ,$115.08 ,$115.08 ,$115.08 ,$123.30 ,$78.78 ,$31.51 ,$137.00 ,$232.62 ,$255.88 ,$34.66 ,$116.45 ,$81.84 ,$123.30 ,$115.08 ,$109.60 ,$109.60 ,$31.51 ,$89.05 ST. FRANCIS HOSPITAL - ACUTE,41000068,G0237,HC RESP STRENGTH/ENDURANCE 15 MIN,410,1 ,$69.00 ,$44.85 ,$15.87 ,$255.88 ,$49.68 ,$37.54 ,$15.87 ,$38.52 ,$15.87 ,$41.22 ,$41.22 ,$41.22 ,$41.22 ,$57.96 ,$15.87 ,$58.65 ,$57.96 ,$15.87 ,$51.75 ,$55.20 ,$55.20 ,$15.87 ,$55.20 ,$57.96 ,$57.96 ,$57.96 ,$62.10 ,$39.68 ,$15.87 ,$69.00 ,$232.62 ,$255.88 ,$17.46 ,$58.65 ,$41.22 ,$62.10 ,$57.96 ,$55.20 ,$55.20 ,$15.87 ,$44.85 ST. FRANCIS HOSPITAL - ACUTE,41000069,G0238,HC RESP THRP FUNCTION 15 MIN,410,1 ,$69.00 ,$44.85 ,$15.87 ,$255.88 ,$49.68 ,$37.54 ,$15.87 ,$38.52 ,$15.87 ,$41.22 ,$41.22 ,$41.22 ,$41.22 ,$57.96 ,$15.87 ,$58.65 ,$57.96 ,$15.87 ,$51.75 ,$55.20 ,$55.20 ,$15.87 ,$55.20 ,$57.96 ,$57.96 ,$57.96 ,$62.10 ,$39.68 ,$15.87 ,$69.00 ,$232.62 ,$255.88 ,$17.46 ,$58.65 ,$41.22 ,$62.10 ,$57.96 ,$55.20 ,$55.20 ,$15.87 ,$44.85 ST. FRANCIS HOSPITAL - ACUTE,41000070,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$101.00 ,$65.65 ,$2.26 ,$101.00 ,$72.72 ,$54.94 ,$23.23 ,$56.38 ,$23.23 ,$60.34 ,$60.34 ,$60.34 ,$60.34 ,$84.84 ,$23.23 ,$85.85 ,$84.84 ,$23.23 ,$75.75 ,$80.80 ,$80.80 ,$23.23 ,$80.80 ,$84.84 ,$84.84 ,$84.84 ,$90.90 ,$58.08 ,$23.23 ,$101.00 ,$2.26 ,$2.49 ,$25.55 ,$85.85 ,$60.34 ,$90.90 ,$84.84 ,$80.80 ,$80.80 ,$23.23 ,$65.65 ST. FRANCIS HOSPITAL - ACUTE,41000074,94640,HC IPPB SUBSQ,410,1 ,$284.00 ,$184.60 ,$65.32 ,$284.00 ,$204.48 ,$154.50 ,$65.32 ,$158.53 ,$65.32 ,$169.66 ,$169.66 ,$169.66 ,$169.66 ,$238.56 ,$65.32 ,$241.40 ,$238.56 ,$65.32 ,$213.00 ,$227.20 ,$227.20 ,$65.32 ,$227.20 ,$238.56 ,$238.56 ,$238.56 ,$255.60 ,$163.30 ,$65.32 ,$284.00 ,$232.62 ,$255.88 ,$71.85 ,$241.40 ,$169.66 ,$255.60 ,$238.56 ,$227.20 ,$227.20 ,$65.32 ,$184.60 ST. FRANCIS HOSPITAL - ACUTE,41000076,94640,HC NEBULIZER SUBSQ,410,1 ,$167.00 ,$108.55 ,$38.41 ,$255.88 ,$120.24 ,$90.85 ,$38.41 ,$93.22 ,$38.41 ,$99.77 ,$99.77 ,$99.77 ,$99.77 ,$140.28 ,$38.41 ,$141.95 ,$140.28 ,$38.41 ,$125.25 ,$133.60 ,$133.60 ,$38.41 ,$133.60 ,$140.28 ,$140.28 ,$140.28 ,$150.30 ,$96.03 ,$38.41 ,$167.00 ,$232.62 ,$255.88 ,$42.25 ,$141.95 ,$99.77 ,$150.30 ,$140.28 ,$133.60 ,$133.60 ,$38.41 ,$108.55 ST. FRANCIS HOSPITAL - ACUTE,41000083,94660,HC CPAP/BIPAP SUBSQ,410,1 ,$782.00 ,$508.30 ,$179.86 ,$782.00 ,$563.04 ,$425.41 ,$179.86 ,$436.51 ,$179.86 ,$467.17 ,$467.17 ,$467.17 ,$467.17 ,$656.88 ,$179.86 ,$664.70 ,$656.88 ,$179.86 ,$586.50 ,$625.60 ,$625.60 ,$179.86 ,$625.60 ,$656.88 ,$656.88 ,$656.88 ,$703.80 ,$449.65 ,$179.86 ,$782.00 ,$702.37 ,$772.61 ,$197.85 ,$664.70 ,$467.17 ,$703.80 ,$656.88 ,$625.60 ,$625.60 ,$179.86 ,$508.30 ST. FRANCIS HOSPITAL - ACUTE,41000090,94640,HC MDI/DPI INHAL TX SUBSQ,410,1 ,$182.00 ,$118.30 ,$41.86 ,$255.88 ,$131.04 ,$99.01 ,$41.86 ,$101.59 ,$41.86 ,$108.73 ,$108.73 ,$108.73 ,$108.73 ,$152.88 ,$41.86 ,$154.70 ,$152.88 ,$41.86 ,$136.50 ,$145.60 ,$145.60 ,$41.86 ,$145.60 ,$152.88 ,$152.88 ,$152.88 ,$163.80 ,$104.65 ,$41.86 ,$182.00 ,$232.62 ,$255.88 ,$46.05 ,$154.70 ,$108.73 ,$163.80 ,$152.88 ,$145.60 ,$145.60 ,$41.86 ,$118.30 ST. FRANCIS HOSPITAL - ACUTE,42000008,95992,HC CANNALITH REPOSITIONING,420,1 ,$204.00 ,$132.60 ,$46.92 ,$356.52 ,$146.88 ,$110.98 ,$46.92 ,$113.87 ,$46.92 ,$121.87 ,$121.87 ,$121.87 ,$121.87 ,$171.36 ,$46.92 ,$173.40 ,$171.36 ,$46.92 ,$153.00 ,$163.20 ,$163.20 ,$46.92 ,$163.20 ,$171.36 ,$171.36 ,$171.36 ,$183.60 ,$117.30 ,$46.92 ,$204.00 ,$324.11 ,$356.52 ,$51.61 ,$173.40 ,$121.87 ,$183.60 ,$171.36 ,$163.20 ,$163.20 ,$46.92 ,$132.60 ST. FRANCIS HOSPITAL - ACUTE,42000025,97032,HC ELECTRIC STIM EACH 15 MIN,420,1 ,$157.00 ,$102.05 ,$36.11 ,$356.52 ,$113.04 ,$85.41 ,$36.11 ,$87.64 ,$36.11 ,$93.79 ,$93.79 ,$93.79 ,$93.79 ,$131.88 ,$36.11 ,$133.45 ,$131.88 ,$36.11 ,$117.75 ,$125.60 ,$125.60 ,$36.11 ,$125.60 ,$131.88 ,$131.88 ,$131.88 ,$141.30 ,$90.28 ,$36.11 ,$157.00 ,$324.11 ,$356.52 ,$39.72 ,$133.45 ,$93.79 ,$141.30 ,$131.88 ,$125.60 ,$125.60 ,$36.11 ,$102.05 ST. FRANCIS HOSPITAL - ACUTE,42000031,97033,HC IONTOPHORESIS; EA 15 MIN,420,1 ,$173.00 ,$112.45 ,$39.79 ,$356.52 ,$124.56 ,$94.11 ,$39.79 ,$96.57 ,$39.79 ,$103.35 ,$103.35 ,$103.35 ,$103.35 ,$145.32 ,$39.79 ,$147.05 ,$145.32 ,$39.79 ,$129.75 ,$138.40 ,$138.40 ,$39.79 ,$138.40 ,$145.32 ,$145.32 ,$145.32 ,$155.70 ,$99.48 ,$39.79 ,$173.00 ,$324.11 ,$356.52 ,$43.77 ,$147.05 ,$103.35 ,$155.70 ,$145.32 ,$138.40 ,$138.40 ,$39.79 ,$112.45 ST. FRANCIS HOSPITAL - ACUTE,42000033,97035,HC ULTRASOUND EA 15MIN,420,1 ,$196.00 ,$127.40 ,$45.08 ,$356.52 ,$141.12 ,$106.62 ,$45.08 ,$109.41 ,$45.08 ,$117.09 ,$117.09 ,$117.09 ,$117.09 ,$164.64 ,$45.08 ,$166.60 ,$164.64 ,$45.08 ,$147.00 ,$156.80 ,$156.80 ,$45.08 ,$156.80 ,$164.64 ,$164.64 ,$164.64 ,$176.40 ,$112.70 ,$45.08 ,$196.00 ,$324.11 ,$356.52 ,$49.59 ,$166.60 ,$117.09 ,$176.40 ,$164.64 ,$156.80 ,$156.80 ,$45.08 ,$127.40 ST. FRANCIS HOSPITAL - ACUTE,42000037,97110,HC THERA EXER; EA 15 MIN,420,1 ,$176.00 ,$114.40 ,$40.48 ,$356.52 ,$126.72 ,$95.74 ,$40.48 ,$98.24 ,$40.48 ,$105.14 ,$105.14 ,$105.14 ,$105.14 ,$147.84 ,$40.48 ,$149.60 ,$147.84 ,$40.48 ,$132.00 ,$140.80 ,$140.80 ,$40.48 ,$140.80 ,$147.84 ,$147.84 ,$147.84 ,$158.40 ,$101.20 ,$40.48 ,$176.00 ,$324.11 ,$356.52 ,$44.53 ,$149.60 ,$105.14 ,$158.40 ,$147.84 ,$140.80 ,$140.80 ,$40.48 ,$114.40 ST. FRANCIS HOSPITAL - ACUTE,42000045,97112,HC NEUROMUSCULAR RE ED EA 15 MIN,420,1 ,$123.00 ,$79.95 ,$28.29 ,$356.52 ,$88.56 ,$66.91 ,$28.29 ,$68.66 ,$28.29 ,$73.48 ,$73.48 ,$73.48 ,$73.48 ,$103.32 ,$28.29 ,$104.55 ,$103.32 ,$28.29 ,$92.25 ,$98.40 ,$98.40 ,$28.29 ,$98.40 ,$103.32 ,$103.32 ,$103.32 ,$110.70 ,$70.73 ,$28.29 ,$123.00 ,$324.11 ,$356.52 ,$31.12 ,$104.55 ,$73.48 ,$110.70 ,$103.32 ,$98.40 ,$98.40 ,$28.29 ,$79.95 ST. FRANCIS HOSPITAL - ACUTE,42000049,97116,HC AMBULATION GAIT TRAIN EA 15 MIN,420,1 ,$121.00 ,$78.65 ,$27.83 ,$356.52 ,$87.12 ,$65.82 ,$27.83 ,$67.54 ,$27.83 ,$72.29 ,$72.29 ,$72.29 ,$72.29 ,$101.64 ,$27.83 ,$102.85 ,$101.64 ,$27.83 ,$90.75 ,$96.80 ,$96.80 ,$27.83 ,$96.80 ,$101.64 ,$101.64 ,$101.64 ,$108.90 ,$69.58 ,$27.83 ,$121.00 ,$324.11 ,$356.52 ,$30.61 ,$102.85 ,$72.29 ,$108.90 ,$101.64 ,$96.80 ,$96.80 ,$27.83 ,$78.65 ST. FRANCIS HOSPITAL - ACUTE,42000053,97124,HC THERAPEUTIC MASSAGE EA 15 MIN,420,1 ,$168.00 ,$109.20 ,$38.64 ,$356.52 ,$120.96 ,$91.39 ,$38.64 ,$93.78 ,$38.64 ,$100.36 ,$100.36 ,$100.36 ,$100.36 ,$141.12 ,$38.64 ,$142.80 ,$141.12 ,$38.64 ,$126.00 ,$134.40 ,$134.40 ,$38.64 ,$134.40 ,$141.12 ,$141.12 ,$141.12 ,$151.20 ,$96.60 ,$38.64 ,$168.00 ,$324.11 ,$356.52 ,$42.50 ,$142.80 ,$100.36 ,$151.20 ,$141.12 ,$134.40 ,$134.40 ,$38.64 ,$109.20 ST. FRANCIS HOSPITAL - ACUTE,42000056,97140,HC MANUAL THERAPY EA 15 MIN,420,1 ,$177.00 ,$115.05 ,$40.71 ,$356.52 ,$127.44 ,$96.29 ,$40.71 ,$98.80 ,$40.71 ,$105.74 ,$105.74 ,$105.74 ,$105.74 ,$148.68 ,$40.71 ,$150.45 ,$148.68 ,$40.71 ,$132.75 ,$141.60 ,$141.60 ,$40.71 ,$141.60 ,$148.68 ,$148.68 ,$148.68 ,$159.30 ,$101.78 ,$40.71 ,$177.00 ,$324.11 ,$356.52 ,$44.78 ,$150.45 ,$105.74 ,$159.30 ,$148.68 ,$141.60 ,$141.60 ,$40.71 ,$115.05 ST. FRANCIS HOSPITAL - ACUTE,42000065,97530,HC THERAPEUTIC ACTIVITIES EA 15 MIN,420,1 ,$176.00 ,$114.40 ,$40.48 ,$356.52 ,$126.72 ,$95.74 ,$40.48 ,$98.24 ,$40.48 ,$105.14 ,$105.14 ,$105.14 ,$105.14 ,$147.84 ,$40.48 ,$149.60 ,$147.84 ,$40.48 ,$132.00 ,$140.80 ,$140.80 ,$40.48 ,$140.80 ,$147.84 ,$147.84 ,$147.84 ,$158.40 ,$101.20 ,$40.48 ,$176.00 ,$324.11 ,$356.52 ,$44.53 ,$149.60 ,$105.14 ,$158.40 ,$147.84 ,$140.80 ,$140.80 ,$40.48 ,$114.40 ST. FRANCIS HOSPITAL - ACUTE,42000093,97750,HC PHYSICAL PERFORMANCE TST EA 15 MIN,420,1 ,$82.00 ,$53.30 ,$18.86 ,$356.52 ,$59.04 ,$44.61 ,$18.86 ,$45.77 ,$18.86 ,$48.99 ,$48.99 ,$48.99 ,$48.99 ,$68.88 ,$18.86 ,$69.70 ,$68.88 ,$18.86 ,$61.50 ,$65.60 ,$65.60 ,$18.86 ,$65.60 ,$68.88 ,$68.88 ,$68.88 ,$73.80 ,$47.15 ,$18.86 ,$82.00 ,$324.11 ,$356.52 ,$20.75 ,$69.70 ,$48.99 ,$73.80 ,$68.88 ,$65.60 ,$65.60 ,$18.86 ,$53.30 ST. FRANCIS HOSPITAL - ACUTE,42000094,97761,HC PROSTHETIC TRAINING EA 15 MIN,420,1 ,$194.00 ,$126.10 ,$44.62 ,$356.52 ,$139.68 ,$105.54 ,$44.62 ,$108.29 ,$44.62 ,$115.90 ,$115.90 ,$115.90 ,$115.90 ,$162.96 ,$44.62 ,$164.90 ,$162.96 ,$44.62 ,$145.50 ,$155.20 ,$155.20 ,$44.62 ,$155.20 ,$162.96 ,$162.96 ,$162.96 ,$174.60 ,$111.55 ,$44.62 ,$194.00 ,$324.11 ,$356.52 ,$49.08 ,$164.90 ,$115.90 ,$174.60 ,$162.96 ,$155.20 ,$155.20 ,$44.62 ,$126.10 ST. FRANCIS HOSPITAL - ACUTE,42000204,97010,HC HOT/COLD PACK 15MIN,420,1 ,$132.00 ,$85.80 ,$26.48 ,$132.00 ,$95.04 ,$71.81 ,$30.36 ,$73.68 ,$30.36 ,$78.86 ,$78.86 ,$78.86 ,$78.86 ,$110.88 ,$30.36 ,$112.20 ,$110.88 ,$30.36 ,$99.00 ,$105.60 ,$105.60 ,$30.36 ,$105.60 ,$110.88 ,$110.88 ,$110.88 ,$118.80 ,$75.90 ,$30.36 ,$132.00 ,$26.48 ,$29.13 ,$33.40 ,$112.20 ,$78.86 ,$118.80 ,$110.88 ,$105.60 ,$105.60 ,$30.36 ,$85.80 ST. FRANCIS HOSPITAL - ACUTE,42000205,97010,HC HOT/COLD PACK 30MIN,420,1 ,$132.00 ,$85.80 ,$26.48 ,$132.00 ,$95.04 ,$71.81 ,$30.36 ,$73.68 ,$30.36 ,$78.86 ,$78.86 ,$78.86 ,$78.86 ,$110.88 ,$30.36 ,$112.20 ,$110.88 ,$30.36 ,$99.00 ,$105.60 ,$105.60 ,$30.36 ,$105.60 ,$110.88 ,$110.88 ,$110.88 ,$118.80 ,$75.90 ,$30.36 ,$132.00 ,$26.48 ,$29.13 ,$33.40 ,$112.20 ,$78.86 ,$118.80 ,$110.88 ,$105.60 ,$105.60 ,$30.36 ,$85.80 ST. FRANCIS HOSPITAL - ACUTE,42000206,G0283,HC ELECT STIM (UNATTEND) OTHER 15MIN,420,1 ,$173.00 ,$112.45 ,$26.48 ,$173.00 ,$124.56 ,$94.11 ,$39.79 ,$96.57 ,$39.79 ,$103.35 ,$103.35 ,$103.35 ,$103.35 ,$145.32 ,$39.79 ,$147.05 ,$145.32 ,$39.79 ,$129.75 ,$138.40 ,$138.40 ,$39.79 ,$138.40 ,$145.32 ,$145.32 ,$145.32 ,$155.70 ,$99.48 ,$39.79 ,$173.00 ,$26.48 ,$29.13 ,$43.77 ,$147.05 ,$103.35 ,$155.70 ,$145.32 ,$138.40 ,$138.40 ,$39.79 ,$112.45 ST. FRANCIS HOSPITAL - ACUTE,42000207,G0283,HC ELECT STIM (UNATTEND) OTHER 30MIN,420,1 ,$243.00 ,$157.95 ,$26.48 ,$243.00 ,$174.96 ,$132.19 ,$55.89 ,$135.64 ,$55.89 ,$145.17 ,$145.17 ,$145.17 ,$145.17 ,$204.12 ,$55.89 ,$206.55 ,$204.12 ,$55.89 ,$182.25 ,$194.40 ,$194.40 ,$55.89 ,$194.40 ,$204.12 ,$204.12 ,$204.12 ,$218.70 ,$139.73 ,$55.89 ,$243.00 ,$26.48 ,$29.13 ,$61.48 ,$206.55 ,$145.17 ,$218.70 ,$204.12 ,$194.40 ,$194.40 ,$55.89 ,$157.95 ST. FRANCIS HOSPITAL - ACUTE,42000208,G0283,HC ELECT STIM (UNATTEND) OTHER 45MIN,420,1 ,$306.00 ,$198.90 ,$26.48 ,$306.00 ,$220.32 ,$166.46 ,$70.38 ,$170.81 ,$70.38 ,$182.80 ,$182.80 ,$182.80 ,$182.80 ,$257.04 ,$70.38 ,$260.10 ,$257.04 ,$70.38 ,$229.50 ,$244.80 ,$244.80 ,$70.38 ,$244.80 ,$257.04 ,$257.04 ,$257.04 ,$275.40 ,$175.95 ,$70.38 ,$306.00 ,$26.48 ,$29.13 ,$77.42 ,$260.10 ,$182.80 ,$275.40 ,$257.04 ,$244.80 ,$244.80 ,$70.38 ,$198.90 ST. FRANCIS HOSPITAL - ACUTE,42000209,G0283,HC ELECT STIM (UNATTEND) OTHER 60MIN,420,1 ,$370.00 ,$240.50 ,$26.48 ,$370.00 ,$266.40 ,$201.28 ,$85.10 ,$206.53 ,$85.10 ,$221.04 ,$221.04 ,$221.04 ,$221.04 ,$310.80 ,$85.10 ,$314.50 ,$310.80 ,$85.10 ,$277.50 ,$296.00 ,$296.00 ,$85.10 ,$296.00 ,$310.80 ,$310.80 ,$310.80 ,$333.00 ,$212.75 ,$85.10 ,$370.00 ,$26.48 ,$29.13 ,$93.61 ,$314.50 ,$221.04 ,$333.00 ,$310.80 ,$296.00 ,$296.00 ,$85.10 ,$240.50 ST. FRANCIS HOSPITAL - ACUTE,42000210,97016,HC APPLY VASOPNEUMATIC DEVICE 15MIN,420,1 ,$121.00 ,$78.65 ,$26.48 ,$121.00 ,$87.12 ,$65.82 ,$27.83 ,$67.54 ,$27.83 ,$72.29 ,$72.29 ,$72.29 ,$72.29 ,$101.64 ,$27.83 ,$102.85 ,$101.64 ,$27.83 ,$90.75 ,$96.80 ,$96.80 ,$27.83 ,$96.80 ,$101.64 ,$101.64 ,$101.64 ,$108.90 ,$69.58 ,$27.83 ,$121.00 ,$26.48 ,$29.13 ,$30.61 ,$102.85 ,$72.29 ,$108.90 ,$101.64 ,$96.80 ,$96.80 ,$27.83 ,$78.65 ST. FRANCIS HOSPITAL - ACUTE,42000211,97016,HC APPLY VASOPNEUMATIC DEVICE 30MIN,420,1 ,$121.00 ,$78.65 ,$26.48 ,$121.00 ,$87.12 ,$65.82 ,$27.83 ,$67.54 ,$27.83 ,$72.29 ,$72.29 ,$72.29 ,$72.29 ,$101.64 ,$27.83 ,$102.85 ,$101.64 ,$27.83 ,$90.75 ,$96.80 ,$96.80 ,$27.83 ,$96.80 ,$101.64 ,$101.64 ,$101.64 ,$108.90 ,$69.58 ,$27.83 ,$121.00 ,$26.48 ,$29.13 ,$30.61 ,$102.85 ,$72.29 ,$108.90 ,$101.64 ,$96.80 ,$96.80 ,$27.83 ,$78.65 ST. FRANCIS HOSPITAL - ACUTE,42000212,97016,HC APPLY VASOPNEUMATIC DEVICE 45MIN,420,1 ,$121.00 ,$78.65 ,$26.48 ,$121.00 ,$87.12 ,$65.82 ,$27.83 ,$67.54 ,$27.83 ,$72.29 ,$72.29 ,$72.29 ,$72.29 ,$101.64 ,$27.83 ,$102.85 ,$101.64 ,$27.83 ,$90.75 ,$96.80 ,$96.80 ,$27.83 ,$96.80 ,$101.64 ,$101.64 ,$101.64 ,$108.90 ,$69.58 ,$27.83 ,$121.00 ,$26.48 ,$29.13 ,$30.61 ,$102.85 ,$72.29 ,$108.90 ,$101.64 ,$96.80 ,$96.80 ,$27.83 ,$78.65 ST. FRANCIS HOSPITAL - ACUTE,42000213,97016,HC APPLY VASOPNEUMATIC DEVICE 60MIN,420,1 ,$121.00 ,$78.65 ,$26.48 ,$121.00 ,$87.12 ,$65.82 ,$27.83 ,$67.54 ,$27.83 ,$72.29 ,$72.29 ,$72.29 ,$72.29 ,$101.64 ,$27.83 ,$102.85 ,$101.64 ,$27.83 ,$90.75 ,$96.80 ,$96.80 ,$27.83 ,$96.80 ,$101.64 ,$101.64 ,$101.64 ,$108.90 ,$69.58 ,$27.83 ,$121.00 ,$26.48 ,$29.13 ,$30.61 ,$102.85 ,$72.29 ,$108.90 ,$101.64 ,$96.80 ,$96.80 ,$27.83 ,$78.65 ST. FRANCIS HOSPITAL - ACUTE,42000214,97012,HC TRACTION MECHANICAL APPL 15 MIN,420,1 ,$131.00 ,$85.15 ,$26.48 ,$131.00 ,$94.32 ,$71.26 ,$30.13 ,$73.12 ,$30.13 ,$78.26 ,$78.26 ,$78.26 ,$78.26 ,$110.04 ,$30.13 ,$111.35 ,$110.04 ,$30.13 ,$98.25 ,$104.80 ,$104.80 ,$30.13 ,$104.80 ,$110.04 ,$110.04 ,$110.04 ,$117.90 ,$75.33 ,$30.13 ,$131.00 ,$26.48 ,$29.13 ,$33.14 ,$111.35 ,$78.26 ,$117.90 ,$110.04 ,$104.80 ,$104.80 ,$30.13 ,$85.15 ST. FRANCIS HOSPITAL - ACUTE,42000215,97012,HC TRACTION MECHANICAL APPL 30 MIN,420,1 ,$131.00 ,$85.15 ,$26.48 ,$131.00 ,$94.32 ,$71.26 ,$30.13 ,$73.12 ,$30.13 ,$78.26 ,$78.26 ,$78.26 ,$78.26 ,$110.04 ,$30.13 ,$111.35 ,$110.04 ,$30.13 ,$98.25 ,$104.80 ,$104.80 ,$30.13 ,$104.80 ,$110.04 ,$110.04 ,$110.04 ,$117.90 ,$75.33 ,$30.13 ,$131.00 ,$26.48 ,$29.13 ,$33.14 ,$111.35 ,$78.26 ,$117.90 ,$110.04 ,$104.80 ,$104.80 ,$30.13 ,$85.15 ST. FRANCIS HOSPITAL - ACUTE,42010001,G8978,HC MOBILITY CURRENT STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010002,G8979,HC MOBILITY GOAL STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010003,G8980,HC MOBILITY DISCHARGE STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010004,G8981,HC BODY POSITION CURRENT STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010005,G8982,HC BODY POSITION GOAL STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010006,G8983,HC BODY POSITION DISCHARGE STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010007,G8984,HC CARRY CURRENT STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010008,G8985,HC CARRY GOAL STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010009,G8986,HC CARRY DISCHARGE STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010010,G8987,HC SELF CARE CURRENT STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010011,G8988,HC SELF CARE GOAL STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010012,G8989,HC SELF CARE DISCHARGE STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010013,G8990,HC OTHER PT/OT CURRENT STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010014,G8991,HC OTHER PT/OT GOAL STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010015,G8992,HC OTHER PT/OT DISCHARGE STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010016,G8993,HC SUBSEQUENT LIMITATION CURRENT STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010017,G8994,HC SUBSEQUENT LIMITATION GOAL STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42010018,G8995,HC SUBSEQUENT LIMITIATION DISCHARGE STATUS,420,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,42400043,97161,HC PT EVAL LOW COMPLEXITY 15MIN,424,1 ,$229.00 ,$148.85 ,$52.67 ,$356.52 ,$164.88 ,$124.58 ,$52.67 ,$127.83 ,$52.67 ,$136.80 ,$136.80 ,$136.80 ,$136.80 ,$192.36 ,$52.67 ,$194.65 ,$192.36 ,$52.67 ,$171.75 ,$183.20 ,$183.20 ,$52.67 ,$183.20 ,$192.36 ,$192.36 ,$192.36 ,$206.10 ,$131.68 ,$52.67 ,$229.00 ,$324.11 ,$356.52 ,$57.94 ,$194.65 ,$136.80 ,$206.10 ,$192.36 ,$183.20 ,$183.20 ,$52.67 ,$148.85 ST. FRANCIS HOSPITAL - ACUTE,42400044,97161,HC PT EVAL LOW COMPLEXITY 30MIN,424,1 ,$229.00 ,$148.85 ,$52.67 ,$356.52 ,$164.88 ,$124.58 ,$52.67 ,$127.83 ,$52.67 ,$136.80 ,$136.80 ,$136.80 ,$136.80 ,$192.36 ,$52.67 ,$194.65 ,$192.36 ,$52.67 ,$171.75 ,$183.20 ,$183.20 ,$52.67 ,$183.20 ,$192.36 ,$192.36 ,$192.36 ,$206.10 ,$131.68 ,$52.67 ,$229.00 ,$324.11 ,$356.52 ,$57.94 ,$194.65 ,$136.80 ,$206.10 ,$192.36 ,$183.20 ,$183.20 ,$52.67 ,$148.85 ST. FRANCIS HOSPITAL - ACUTE,42400045,97161,HC PT EVAL LOW COMPLEXITY 45MIN,424,1 ,$229.00 ,$148.85 ,$52.67 ,$356.52 ,$164.88 ,$124.58 ,$52.67 ,$127.83 ,$52.67 ,$136.80 ,$136.80 ,$136.80 ,$136.80 ,$192.36 ,$52.67 ,$194.65 ,$192.36 ,$52.67 ,$171.75 ,$183.20 ,$183.20 ,$52.67 ,$183.20 ,$192.36 ,$192.36 ,$192.36 ,$206.10 ,$131.68 ,$52.67 ,$229.00 ,$324.11 ,$356.52 ,$57.94 ,$194.65 ,$136.80 ,$206.10 ,$192.36 ,$183.20 ,$183.20 ,$52.67 ,$148.85 ST. FRANCIS HOSPITAL - ACUTE,42400046,97161,HC PT EVAL LOW COMPLEXITY 60MIN,424,1 ,$229.00 ,$148.85 ,$52.67 ,$356.52 ,$164.88 ,$124.58 ,$52.67 ,$127.83 ,$52.67 ,$136.80 ,$136.80 ,$136.80 ,$136.80 ,$192.36 ,$52.67 ,$194.65 ,$192.36 ,$52.67 ,$171.75 ,$183.20 ,$183.20 ,$52.67 ,$183.20 ,$192.36 ,$192.36 ,$192.36 ,$206.10 ,$131.68 ,$52.67 ,$229.00 ,$324.11 ,$356.52 ,$57.94 ,$194.65 ,$136.80 ,$206.10 ,$192.36 ,$183.20 ,$183.20 ,$52.67 ,$148.85 ST. FRANCIS HOSPITAL - ACUTE,42400055,97162,HC PT EVAL MOD COMPLEXITY 15MIN,424,1 ,$286.00 ,$185.90 ,$65.78 ,$356.52 ,$205.92 ,$155.58 ,$65.78 ,$159.65 ,$65.78 ,$170.86 ,$170.86 ,$170.86 ,$170.86 ,$240.24 ,$65.78 ,$243.10 ,$240.24 ,$65.78 ,$214.50 ,$228.80 ,$228.80 ,$65.78 ,$228.80 ,$240.24 ,$240.24 ,$240.24 ,$257.40 ,$164.45 ,$65.78 ,$286.00 ,$324.11 ,$356.52 ,$72.36 ,$243.10 ,$170.86 ,$257.40 ,$240.24 ,$228.80 ,$228.80 ,$65.78 ,$185.90 ST. FRANCIS HOSPITAL - ACUTE,42400056,97162,HC PT EVAL MOD COMPLEXITY 30MIN,424,1 ,$286.00 ,$185.90 ,$65.78 ,$356.52 ,$205.92 ,$155.58 ,$65.78 ,$159.65 ,$65.78 ,$170.86 ,$170.86 ,$170.86 ,$170.86 ,$240.24 ,$65.78 ,$243.10 ,$240.24 ,$65.78 ,$214.50 ,$228.80 ,$228.80 ,$65.78 ,$228.80 ,$240.24 ,$240.24 ,$240.24 ,$257.40 ,$164.45 ,$65.78 ,$286.00 ,$324.11 ,$356.52 ,$72.36 ,$243.10 ,$170.86 ,$257.40 ,$240.24 ,$228.80 ,$228.80 ,$65.78 ,$185.90 ST. FRANCIS HOSPITAL - ACUTE,42400057,97162,HC PT EVAL MOD COMPLEXITY 45MIN,424,1 ,$286.00 ,$185.90 ,$65.78 ,$356.52 ,$205.92 ,$155.58 ,$65.78 ,$159.65 ,$65.78 ,$170.86 ,$170.86 ,$170.86 ,$170.86 ,$240.24 ,$65.78 ,$243.10 ,$240.24 ,$65.78 ,$214.50 ,$228.80 ,$228.80 ,$65.78 ,$228.80 ,$240.24 ,$240.24 ,$240.24 ,$257.40 ,$164.45 ,$65.78 ,$286.00 ,$324.11 ,$356.52 ,$72.36 ,$243.10 ,$170.86 ,$257.40 ,$240.24 ,$228.80 ,$228.80 ,$65.78 ,$185.90 ST. FRANCIS HOSPITAL - ACUTE,42400058,97162,HC PT EVAL MOD COMPLEXITY 60MIN,424,1 ,$286.00 ,$185.90 ,$65.78 ,$356.52 ,$205.92 ,$155.58 ,$65.78 ,$159.65 ,$65.78 ,$170.86 ,$170.86 ,$170.86 ,$170.86 ,$240.24 ,$65.78 ,$243.10 ,$240.24 ,$65.78 ,$214.50 ,$228.80 ,$228.80 ,$65.78 ,$228.80 ,$240.24 ,$240.24 ,$240.24 ,$257.40 ,$164.45 ,$65.78 ,$286.00 ,$324.11 ,$356.52 ,$72.36 ,$243.10 ,$170.86 ,$257.40 ,$240.24 ,$228.80 ,$228.80 ,$65.78 ,$185.90 ST. FRANCIS HOSPITAL - ACUTE,42400079,97164,HC PT RE-EVAL 15MIN,424,1 ,$195.00 ,$126.75 ,$44.85 ,$356.52 ,$140.40 ,$106.08 ,$44.85 ,$108.85 ,$44.85 ,$116.49 ,$116.49 ,$116.49 ,$116.49 ,$163.80 ,$44.85 ,$165.75 ,$163.80 ,$44.85 ,$146.25 ,$156.00 ,$156.00 ,$44.85 ,$156.00 ,$163.80 ,$163.80 ,$163.80 ,$175.50 ,$112.13 ,$44.85 ,$195.00 ,$324.11 ,$356.52 ,$49.34 ,$165.75 ,$116.49 ,$175.50 ,$163.80 ,$156.00 ,$156.00 ,$44.85 ,$126.75 ST. FRANCIS HOSPITAL - ACUTE,42400080,97164,HC PT RE-EVAL 30MIN,424,1 ,$195.00 ,$126.75 ,$44.85 ,$356.52 ,$140.40 ,$106.08 ,$44.85 ,$108.85 ,$44.85 ,$116.49 ,$116.49 ,$116.49 ,$116.49 ,$163.80 ,$44.85 ,$165.75 ,$163.80 ,$44.85 ,$146.25 ,$156.00 ,$156.00 ,$44.85 ,$156.00 ,$163.80 ,$163.80 ,$163.80 ,$175.50 ,$112.13 ,$44.85 ,$195.00 ,$324.11 ,$356.52 ,$49.34 ,$165.75 ,$116.49 ,$175.50 ,$163.80 ,$156.00 ,$156.00 ,$44.85 ,$126.75 ST. FRANCIS HOSPITAL - ACUTE,42400081,97164,HC PT RE-EVAL 45MIN,424,1 ,$195.00 ,$126.75 ,$44.85 ,$356.52 ,$140.40 ,$106.08 ,$44.85 ,$108.85 ,$44.85 ,$116.49 ,$116.49 ,$116.49 ,$116.49 ,$163.80 ,$44.85 ,$165.75 ,$163.80 ,$44.85 ,$146.25 ,$156.00 ,$156.00 ,$44.85 ,$156.00 ,$163.80 ,$163.80 ,$163.80 ,$175.50 ,$112.13 ,$44.85 ,$195.00 ,$324.11 ,$356.52 ,$49.34 ,$165.75 ,$116.49 ,$175.50 ,$163.80 ,$156.00 ,$156.00 ,$44.85 ,$126.75 ST. FRANCIS HOSPITAL - ACUTE,42400082,97164,HC PT RE-EVAL 60MIN,424,1 ,$195.00 ,$126.75 ,$44.85 ,$356.52 ,$140.40 ,$106.08 ,$44.85 ,$108.85 ,$44.85 ,$116.49 ,$116.49 ,$116.49 ,$116.49 ,$163.80 ,$44.85 ,$165.75 ,$163.80 ,$44.85 ,$146.25 ,$156.00 ,$156.00 ,$44.85 ,$156.00 ,$163.80 ,$163.80 ,$163.80 ,$175.50 ,$112.13 ,$44.85 ,$195.00 ,$324.11 ,$356.52 ,$49.34 ,$165.75 ,$116.49 ,$175.50 ,$163.80 ,$156.00 ,$156.00 ,$44.85 ,$126.75 ST. FRANCIS HOSPITAL - ACUTE,43000016,97535,HC SELF CARE ADL TRAINING EA 15MIN,430,1 ,$155.00 ,$100.75 ,$35.65 ,$567.15 ,$111.60 ,$84.32 ,$35.65 ,$86.52 ,$35.65 ,$92.60 ,$92.60 ,$92.60 ,$92.60 ,$130.20 ,$35.65 ,$131.75 ,$130.20 ,$35.65 ,$116.25 ,$124.00 ,$124.00 ,$35.65 ,$124.00 ,$130.20 ,$130.20 ,$130.20 ,$139.50 ,$89.13 ,$35.65 ,$155.00 ,$515.59 ,$567.15 ,$39.22 ,$131.75 ,$92.60 ,$139.50 ,$130.20 ,$124.00 ,$124.00 ,$35.65 ,$100.75 ST. FRANCIS HOSPITAL - ACUTE,43000027,97760,HC ORTHOTICS FABRICATION EA 15 MIN,430,1 ,$169.00 ,$109.85 ,$38.87 ,$356.52 ,$121.68 ,$91.94 ,$38.87 ,$94.34 ,$38.87 ,$100.96 ,$100.96 ,$100.96 ,$100.96 ,$141.96 ,$38.87 ,$143.65 ,$141.96 ,$38.87 ,$126.75 ,$135.20 ,$135.20 ,$38.87 ,$135.20 ,$141.96 ,$141.96 ,$141.96 ,$152.10 ,$97.18 ,$38.87 ,$169.00 ,$324.11 ,$356.52 ,$42.76 ,$143.65 ,$100.96 ,$152.10 ,$141.96 ,$135.20 ,$135.20 ,$38.87 ,$109.85 ST. FRANCIS HOSPITAL - ACUTE,43000038,97018,HC PARAFFIN BATH THERAPY 15MIN,430,1 ,$101.00 ,$65.65 ,$23.23 ,$101.00 ,$72.72 ,$54.94 ,$23.23 ,$56.38 ,$23.23 ,$60.34 ,$60.34 ,$60.34 ,$60.34 ,$84.84 ,$23.23 ,$85.85 ,$84.84 ,$23.23 ,$75.75 ,$80.80 ,$80.80 ,$23.23 ,$80.80 ,$84.84 ,$84.84 ,$84.84 ,$90.90 ,$58.08 ,$23.23 ,$101.00 ,$26.48 ,$29.13 ,$25.55 ,$85.85 ,$60.34 ,$90.90 ,$84.84 ,$80.80 ,$80.80 ,$23.23 ,$65.65 ST. FRANCIS HOSPITAL - ACUTE,43000039,97018,HC PARAFFIN BATH THERAPY 30MIN,430,1 ,$101.00 ,$65.65 ,$23.23 ,$101.00 ,$72.72 ,$54.94 ,$23.23 ,$56.38 ,$23.23 ,$60.34 ,$60.34 ,$60.34 ,$60.34 ,$84.84 ,$23.23 ,$85.85 ,$84.84 ,$23.23 ,$75.75 ,$80.80 ,$80.80 ,$23.23 ,$80.80 ,$84.84 ,$84.84 ,$84.84 ,$90.90 ,$58.08 ,$23.23 ,$101.00 ,$26.48 ,$29.13 ,$25.55 ,$85.85 ,$60.34 ,$90.90 ,$84.84 ,$80.80 ,$80.80 ,$23.23 ,$65.65 ST. FRANCIS HOSPITAL - ACUTE,43000061,97129,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION INITIAL 15 MIN,430,1 ,$185.00 ,$120.25 ,$26.48 ,$185.00 ,$133.20 ,$100.64 ,$42.55 ,$103.27 ,$42.55 ,$110.52 ,$110.52 ,$110.52 ,$110.52 ,$155.40 ,$42.55 ,$157.25 ,$155.40 ,$42.55 ,$138.75 ,$148.00 ,$148.00 ,$42.55 ,$148.00 ,$155.40 ,$155.40 ,$155.40 ,$166.50 ,$106.38 ,$42.55 ,$185.00 ,$26.48 ,$29.13 ,$46.81 ,$157.25 ,$110.52 ,$166.50 ,$155.40 ,$148.00 ,$148.00 ,$42.55 ,$120.25 ST. FRANCIS HOSPITAL - ACUTE,43000062,97130,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION ADDL 15 MIN,430,1 ,$127.00 ,$82.55 ,$26.48 ,$127.00 ,$91.44 ,$69.09 ,$29.21 ,$70.89 ,$29.21 ,$75.87 ,$75.87 ,$75.87 ,$75.87 ,$106.68 ,$29.21 ,$107.95 ,$106.68 ,$29.21 ,$95.25 ,$101.60 ,$101.60 ,$29.21 ,$101.60 ,$106.68 ,$106.68 ,$106.68 ,$114.30 ,$73.03 ,$29.21 ,$127.00 ,$26.48 ,$29.13 ,$32.13 ,$107.95 ,$75.87 ,$114.30 ,$106.68 ,$101.60 ,$101.60 ,$29.21 ,$82.55 ST. FRANCIS HOSPITAL - ACUTE,43400034,97165,HC OT EVAL LOW COMPLEXITY 15MIN,434,1 ,$265.00 ,$172.25 ,$60.95 ,$567.15 ,$190.80 ,$144.16 ,$60.95 ,$147.92 ,$60.95 ,$158.31 ,$158.31 ,$158.31 ,$158.31 ,$222.60 ,$60.95 ,$225.25 ,$222.60 ,$60.95 ,$198.75 ,$212.00 ,$212.00 ,$60.95 ,$212.00 ,$222.60 ,$222.60 ,$222.60 ,$238.50 ,$152.38 ,$60.95 ,$265.00 ,$515.59 ,$567.15 ,$67.05 ,$225.25 ,$158.31 ,$238.50 ,$222.60 ,$212.00 ,$212.00 ,$60.95 ,$172.25 ST. FRANCIS HOSPITAL - ACUTE,43400035,97165,HC OT EVAL LOW COMPLEXITY 30MIN,434,1 ,$264.00 ,$171.60 ,$60.72 ,$567.15 ,$190.08 ,$143.62 ,$60.72 ,$147.36 ,$60.72 ,$157.71 ,$157.71 ,$157.71 ,$157.71 ,$221.76 ,$60.72 ,$224.40 ,$221.76 ,$60.72 ,$198.00 ,$211.20 ,$211.20 ,$60.72 ,$211.20 ,$221.76 ,$221.76 ,$221.76 ,$237.60 ,$151.80 ,$60.72 ,$264.00 ,$515.59 ,$567.15 ,$66.79 ,$224.40 ,$157.71 ,$237.60 ,$221.76 ,$211.20 ,$211.20 ,$60.72 ,$171.60 ST. FRANCIS HOSPITAL - ACUTE,43400036,97165,HC OT EVAL LOW COMPLEXITY 45MIN,434,1 ,$264.00 ,$171.60 ,$60.72 ,$567.15 ,$190.08 ,$143.62 ,$60.72 ,$147.36 ,$60.72 ,$157.71 ,$157.71 ,$157.71 ,$157.71 ,$221.76 ,$60.72 ,$224.40 ,$221.76 ,$60.72 ,$198.00 ,$211.20 ,$211.20 ,$60.72 ,$211.20 ,$221.76 ,$221.76 ,$221.76 ,$237.60 ,$151.80 ,$60.72 ,$264.00 ,$515.59 ,$567.15 ,$66.79 ,$224.40 ,$157.71 ,$237.60 ,$221.76 ,$211.20 ,$211.20 ,$60.72 ,$171.60 ST. FRANCIS HOSPITAL - ACUTE,43400037,97165,HC OT EVAL LOW COMPLEXITY 60MIN,434,1 ,$264.00 ,$171.60 ,$60.72 ,$567.15 ,$190.08 ,$143.62 ,$60.72 ,$147.36 ,$60.72 ,$157.71 ,$157.71 ,$157.71 ,$157.71 ,$221.76 ,$60.72 ,$224.40 ,$221.76 ,$60.72 ,$198.00 ,$211.20 ,$211.20 ,$60.72 ,$211.20 ,$221.76 ,$221.76 ,$221.76 ,$237.60 ,$151.80 ,$60.72 ,$264.00 ,$515.59 ,$567.15 ,$66.79 ,$224.40 ,$157.71 ,$237.60 ,$221.76 ,$211.20 ,$211.20 ,$60.72 ,$171.60 ST. FRANCIS HOSPITAL - ACUTE,43400046,97166,HC OT EVAL MOD COMPLEXITY 15MIN,434,1 ,$330.00 ,$214.50 ,$75.90 ,$567.15 ,$237.60 ,$179.52 ,$75.90 ,$184.21 ,$75.90 ,$197.14 ,$197.14 ,$197.14 ,$197.14 ,$277.20 ,$75.90 ,$280.50 ,$277.20 ,$75.90 ,$247.50 ,$264.00 ,$264.00 ,$75.90 ,$264.00 ,$277.20 ,$277.20 ,$277.20 ,$297.00 ,$189.75 ,$75.90 ,$330.00 ,$515.59 ,$567.15 ,$83.49 ,$280.50 ,$197.14 ,$297.00 ,$277.20 ,$264.00 ,$264.00 ,$75.90 ,$214.50 ST. FRANCIS HOSPITAL - ACUTE,43400047,97166,HC OT EVAL MOD COMPLEXITY 30MIN,434,1 ,$330.00 ,$214.50 ,$75.90 ,$567.15 ,$237.60 ,$179.52 ,$75.90 ,$184.21 ,$75.90 ,$197.14 ,$197.14 ,$197.14 ,$197.14 ,$277.20 ,$75.90 ,$280.50 ,$277.20 ,$75.90 ,$247.50 ,$264.00 ,$264.00 ,$75.90 ,$264.00 ,$277.20 ,$277.20 ,$277.20 ,$297.00 ,$189.75 ,$75.90 ,$330.00 ,$515.59 ,$567.15 ,$83.49 ,$280.50 ,$197.14 ,$297.00 ,$277.20 ,$264.00 ,$264.00 ,$75.90 ,$214.50 ST. FRANCIS HOSPITAL - ACUTE,43400048,97166,HC OT EVAL MOD COMPLEXITY 45MIN,434,1 ,$330.00 ,$214.50 ,$75.90 ,$567.15 ,$237.60 ,$179.52 ,$75.90 ,$184.21 ,$75.90 ,$197.14 ,$197.14 ,$197.14 ,$197.14 ,$277.20 ,$75.90 ,$280.50 ,$277.20 ,$75.90 ,$247.50 ,$264.00 ,$264.00 ,$75.90 ,$264.00 ,$277.20 ,$277.20 ,$277.20 ,$297.00 ,$189.75 ,$75.90 ,$330.00 ,$515.59 ,$567.15 ,$83.49 ,$280.50 ,$197.14 ,$297.00 ,$277.20 ,$264.00 ,$264.00 ,$75.90 ,$214.50 ST. FRANCIS HOSPITAL - ACUTE,43400049,97166,HC OT EVAL MOD COMPLEXITY 60MIN,434,1 ,$330.00 ,$214.50 ,$75.90 ,$567.15 ,$237.60 ,$179.52 ,$75.90 ,$184.21 ,$75.90 ,$197.14 ,$197.14 ,$197.14 ,$197.14 ,$277.20 ,$75.90 ,$280.50 ,$277.20 ,$75.90 ,$247.50 ,$264.00 ,$264.00 ,$75.90 ,$264.00 ,$277.20 ,$277.20 ,$277.20 ,$297.00 ,$189.75 ,$75.90 ,$330.00 ,$515.59 ,$567.15 ,$83.49 ,$280.50 ,$197.14 ,$297.00 ,$277.20 ,$264.00 ,$264.00 ,$75.90 ,$214.50 ST. FRANCIS HOSPITAL - ACUTE,43400070,97168,HC OT RE-EVAL 15MIN,434,1 ,$172.00 ,$111.80 ,$39.56 ,$567.15 ,$123.84 ,$93.57 ,$39.56 ,$96.01 ,$39.56 ,$102.75 ,$102.75 ,$102.75 ,$102.75 ,$144.48 ,$39.56 ,$146.20 ,$144.48 ,$39.56 ,$129.00 ,$137.60 ,$137.60 ,$39.56 ,$137.60 ,$144.48 ,$144.48 ,$144.48 ,$154.80 ,$98.90 ,$39.56 ,$172.00 ,$515.59 ,$567.15 ,$43.52 ,$146.20 ,$102.75 ,$154.80 ,$144.48 ,$137.60 ,$137.60 ,$39.56 ,$111.80 ST. FRANCIS HOSPITAL - ACUTE,43400071,97168,HC OT RE-EVAL 30MIN,434,1 ,$172.00 ,$111.80 ,$39.56 ,$567.15 ,$123.84 ,$93.57 ,$39.56 ,$96.01 ,$39.56 ,$102.75 ,$102.75 ,$102.75 ,$102.75 ,$144.48 ,$39.56 ,$146.20 ,$144.48 ,$39.56 ,$129.00 ,$137.60 ,$137.60 ,$39.56 ,$137.60 ,$144.48 ,$144.48 ,$144.48 ,$154.80 ,$98.90 ,$39.56 ,$172.00 ,$515.59 ,$567.15 ,$43.52 ,$146.20 ,$102.75 ,$154.80 ,$144.48 ,$137.60 ,$137.60 ,$39.56 ,$111.80 ST. FRANCIS HOSPITAL - ACUTE,43400072,97168,HC OT RE-EVAL 45MIN,434,1 ,$172.00 ,$111.80 ,$39.56 ,$567.15 ,$123.84 ,$93.57 ,$39.56 ,$96.01 ,$39.56 ,$102.75 ,$102.75 ,$102.75 ,$102.75 ,$144.48 ,$39.56 ,$146.20 ,$144.48 ,$39.56 ,$129.00 ,$137.60 ,$137.60 ,$39.56 ,$137.60 ,$144.48 ,$144.48 ,$144.48 ,$154.80 ,$98.90 ,$39.56 ,$172.00 ,$515.59 ,$567.15 ,$43.52 ,$146.20 ,$102.75 ,$154.80 ,$144.48 ,$137.60 ,$137.60 ,$39.56 ,$111.80 ST. FRANCIS HOSPITAL - ACUTE,43400073,97168,HC OT RE-EVAL 60MIN,434,1 ,$172.00 ,$111.80 ,$39.56 ,$567.15 ,$123.84 ,$93.57 ,$39.56 ,$96.01 ,$39.56 ,$102.75 ,$102.75 ,$102.75 ,$102.75 ,$144.48 ,$39.56 ,$146.20 ,$144.48 ,$39.56 ,$129.00 ,$137.60 ,$137.60 ,$39.56 ,$137.60 ,$144.48 ,$144.48 ,$144.48 ,$154.80 ,$98.90 ,$39.56 ,$172.00 ,$515.59 ,$567.15 ,$43.52 ,$146.20 ,$102.75 ,$154.80 ,$144.48 ,$137.60 ,$137.60 ,$39.56 ,$111.80 ST. FRANCIS HOSPITAL - ACUTE,44000000,92507,HC SPEECH THERAPY TREATMENT 15MIN,440,1 ,$284.00 ,$184.60 ,$65.32 ,$284.00 ,$204.48 ,$154.50 ,$65.32 ,$158.53 ,$65.32 ,$169.66 ,$169.66 ,$169.66 ,$169.66 ,$238.56 ,$65.32 ,$241.40 ,$238.56 ,$65.32 ,$213.00 ,$227.20 ,$227.20 ,$65.32 ,$227.20 ,$238.56 ,$238.56 ,$238.56 ,$255.60 ,$163.30 ,$65.32 ,$284.00 ,$239.57 ,$263.53 ,$71.85 ,$241.40 ,$169.66 ,$255.60 ,$238.56 ,$227.20 ,$227.20 ,$65.32 ,$184.60 ST. FRANCIS HOSPITAL - ACUTE,44000001,92507,HC SPEECH THERAPY TREATMENT 30MIN,440,1 ,$284.00 ,$184.60 ,$65.32 ,$284.00 ,$204.48 ,$154.50 ,$65.32 ,$158.53 ,$65.32 ,$169.66 ,$169.66 ,$169.66 ,$169.66 ,$238.56 ,$65.32 ,$241.40 ,$238.56 ,$65.32 ,$213.00 ,$227.20 ,$227.20 ,$65.32 ,$227.20 ,$238.56 ,$238.56 ,$238.56 ,$255.60 ,$163.30 ,$65.32 ,$284.00 ,$239.57 ,$263.53 ,$71.85 ,$241.40 ,$169.66 ,$255.60 ,$238.56 ,$227.20 ,$227.20 ,$65.32 ,$184.60 ST. FRANCIS HOSPITAL - ACUTE,44000002,92507,HC SPEECH THERAPY TREATMENT 45MIN,440,1 ,$284.00 ,$184.60 ,$65.32 ,$284.00 ,$204.48 ,$154.50 ,$65.32 ,$158.53 ,$65.32 ,$169.66 ,$169.66 ,$169.66 ,$169.66 ,$238.56 ,$65.32 ,$241.40 ,$238.56 ,$65.32 ,$213.00 ,$227.20 ,$227.20 ,$65.32 ,$227.20 ,$238.56 ,$238.56 ,$238.56 ,$255.60 ,$163.30 ,$65.32 ,$284.00 ,$239.57 ,$263.53 ,$71.85 ,$241.40 ,$169.66 ,$255.60 ,$238.56 ,$227.20 ,$227.20 ,$65.32 ,$184.60 ST. FRANCIS HOSPITAL - ACUTE,44000003,92507,HC SPEECH THERAPY TREATMENT 60MIN,440,1 ,$284.00 ,$184.60 ,$65.32 ,$284.00 ,$204.48 ,$154.50 ,$65.32 ,$158.53 ,$65.32 ,$169.66 ,$169.66 ,$169.66 ,$169.66 ,$238.56 ,$65.32 ,$241.40 ,$238.56 ,$65.32 ,$213.00 ,$227.20 ,$227.20 ,$65.32 ,$227.20 ,$238.56 ,$238.56 ,$238.56 ,$255.60 ,$163.30 ,$65.32 ,$284.00 ,$239.57 ,$263.53 ,$71.85 ,$241.40 ,$169.66 ,$255.60 ,$238.56 ,$227.20 ,$227.20 ,$65.32 ,$184.60 ST. FRANCIS HOSPITAL - ACUTE,44000009,92526,HC DYSPHAGIA TREATMENT 15MIN,440,1 ,$156.00 ,$101.40 ,$35.88 ,$263.53 ,$112.32 ,$84.86 ,$35.88 ,$87.08 ,$35.88 ,$93.19 ,$93.19 ,$93.19 ,$93.19 ,$131.04 ,$35.88 ,$132.60 ,$131.04 ,$35.88 ,$117.00 ,$124.80 ,$124.80 ,$35.88 ,$124.80 ,$131.04 ,$131.04 ,$131.04 ,$140.40 ,$89.70 ,$35.88 ,$156.00 ,$239.57 ,$263.53 ,$39.47 ,$132.60 ,$93.19 ,$140.40 ,$131.04 ,$124.80 ,$124.80 ,$35.88 ,$101.40 ST. FRANCIS HOSPITAL - ACUTE,44000037,92526,HC SPEECH THERAPY TREATMENT DYSPHAGIA 90MIN,440,1 ,$938.00 ,$609.70 ,$215.74 ,$938.00 ,$675.36 ,$510.27 ,$215.74 ,$523.59 ,$215.74 ,$560.36 ,$560.36 ,$560.36 ,$560.36 ,$787.92 ,$215.74 ,$797.30 ,$787.92 ,$215.74 ,$703.50 ,$750.40 ,$750.40 ,$215.74 ,$750.40 ,$787.92 ,$787.92 ,$787.92 ,$844.20 ,$539.35 ,$215.74 ,$938.00 ,$239.57 ,$263.53 ,$237.31 ,$797.30 ,$560.36 ,$844.20 ,$787.92 ,$750.40 ,$750.40 ,$215.74 ,$609.70 ST. FRANCIS HOSPITAL - ACUTE,44010001,G8996,HC SWALLOW CURRENT STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010002,G8997,HC SWALLOW GOAL STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010003,G8998,HC SWALLOW DISCHARGE STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010004,G8999,HC MOTOR SPEECH CURRENT STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010005,G9186,HC MOTOR SPEECH GOAL STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010006,G9158,HC MOTOR SPEECH DISCHARGE STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010007,G9159,HC LANG COMP CURRENT STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010008,G9160,HC LANG COMP GOAL STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010009,G9161,HC LANG COMP DISCHARGE STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010010,G9162,HC LANG EXPRESS CURRENT STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010011,G9163,HC LANG EXPRESS GOAL STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010012,G9164,HC LANG EXPRESS DISCHARGE STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010013,G9165,HC ATTENTION CURRENT STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010014,G9166,HC ATTENTION GOAL STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010015,G9167,HC ATTENTION DISCHARGE STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010016,G9168,HC MEMORY CURRENT STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010017,G9169,HC MEMORY GOAL STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010018,G9170,HC MEMORY DISCHARGE STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010019,G9171,HC VOICE CURRENT STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010020,G9172,HC VOICE GOAL STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010021,G9173,HC VOICE DISCHARGE STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010022,G9174,HC OTHER SPEECH LANG CURRENT STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010023,G9175,HC OTHER SPEECH LANG GOAL STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44010024,G9176,HC OTHER SPEECH LANG DISCHARGE STATUS,440,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. FRANCIS HOSPITAL - ACUTE,44400017,92610,HC DYSPHAGIA EVALUATION 15MIN,444,1 ,$294.00 ,$191.10 ,$67.62 ,$294.00 ,$211.68 ,$159.94 ,$67.62 ,$164.11 ,$67.62 ,$175.64 ,$175.64 ,$175.64 ,$175.64 ,$246.96 ,$67.62 ,$249.90 ,$246.96 ,$67.62 ,$220.50 ,$235.20 ,$235.20 ,$67.62 ,$235.20 ,$246.96 ,$246.96 ,$246.96 ,$264.60 ,$169.05 ,$67.62 ,$294.00 ,$239.57 ,$263.53 ,$74.38 ,$249.90 ,$175.64 ,$264.60 ,$246.96 ,$235.20 ,$235.20 ,$67.62 ,$191.10 ST. FRANCIS HOSPITAL - ACUTE,44400018,92610,HC DYSPHAGIA EVALUATION 30MIN,444,1 ,$352.00 ,$228.80 ,$80.96 ,$352.00 ,$253.44 ,$191.49 ,$80.96 ,$196.49 ,$80.96 ,$210.28 ,$210.28 ,$210.28 ,$210.28 ,$295.68 ,$80.96 ,$299.20 ,$295.68 ,$80.96 ,$264.00 ,$281.60 ,$281.60 ,$80.96 ,$281.60 ,$295.68 ,$295.68 ,$295.68 ,$316.80 ,$202.40 ,$80.96 ,$352.00 ,$239.57 ,$263.53 ,$89.06 ,$299.20 ,$210.28 ,$316.80 ,$295.68 ,$281.60 ,$281.60 ,$80.96 ,$228.80 ST. FRANCIS HOSPITAL - ACUTE,44400019,92610,HC DYSPHAGIA EVALUATION 45MIN,444,1 ,$423.00 ,$274.95 ,$97.29 ,$423.00 ,$304.56 ,$230.11 ,$97.29 ,$236.12 ,$97.29 ,$252.70 ,$252.70 ,$252.70 ,$252.70 ,$355.32 ,$97.29 ,$359.55 ,$355.32 ,$97.29 ,$317.25 ,$338.40 ,$338.40 ,$97.29 ,$338.40 ,$355.32 ,$355.32 ,$355.32 ,$380.70 ,$243.23 ,$97.29 ,$423.00 ,$239.57 ,$263.53 ,$107.02 ,$359.55 ,$252.70 ,$380.70 ,$355.32 ,$338.40 ,$338.40 ,$97.29 ,$274.95 ST. FRANCIS HOSPITAL - ACUTE,44400020,92610,HC DYSPHAGIA EVALUATION 60MIN,444,1 ,$507.00 ,$329.55 ,$116.61 ,$507.00 ,$365.04 ,$275.81 ,$116.61 ,$283.01 ,$116.61 ,$302.88 ,$302.88 ,$302.88 ,$302.88 ,$425.88 ,$116.61 ,$430.95 ,$425.88 ,$116.61 ,$380.25 ,$405.60 ,$405.60 ,$116.61 ,$405.60 ,$425.88 ,$425.88 ,$425.88 ,$456.30 ,$291.53 ,$116.61 ,$507.00 ,$239.57 ,$263.53 ,$128.27 ,$430.95 ,$302.88 ,$456.30 ,$425.88 ,$405.60 ,$405.60 ,$116.61 ,$329.55 ST. FRANCIS HOSPITAL - ACUTE,44400033,92611,HC DYSPHAGIA EVAL-VIDEO,444,1 ,$280.00 ,$182.00 ,$53.38 ,$280.00 ,$201.60 ,$152.32 ,$64.40 ,$156.30 ,$64.40 ,$167.27 ,$167.27 ,$167.27 ,$167.27 ,$235.20 ,$64.40 ,$238.00 ,$235.20 ,$64.40 ,$210.00 ,$224.00 ,$224.00 ,$64.40 ,$224.00 ,$235.20 ,$235.20 ,$235.20 ,$252.00 ,$161.00 ,$64.40 ,$280.00 ,$53.38 ,$58.72 ,$70.84 ,$238.00 ,$167.27 ,$252.00 ,$235.20 ,$224.00 ,$224.00 ,$64.40 ,$182.00 ST. FRANCIS HOSPITAL - ACUTE,44400042,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 15MIN,444,1 ,$465.00 ,$302.25 ,$106.95 ,$465.00 ,$334.80 ,$252.96 ,$106.95 ,$259.56 ,$106.95 ,$277.79 ,$277.79 ,$277.79 ,$277.79 ,$390.60 ,$106.95 ,$395.25 ,$390.60 ,$106.95 ,$348.75 ,$372.00 ,$372.00 ,$106.95 ,$372.00 ,$390.60 ,$390.60 ,$390.60 ,$418.50 ,$267.38 ,$106.95 ,$465.00 ,$239.57 ,$263.53 ,$117.65 ,$395.25 ,$277.79 ,$418.50 ,$390.60 ,$372.00 ,$372.00 ,$106.95 ,$302.25 ST. FRANCIS HOSPITAL - ACUTE,44400058,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 30MIN,444,1 ,$465.00 ,$302.25 ,$106.95 ,$465.00 ,$334.80 ,$252.96 ,$106.95 ,$259.56 ,$106.95 ,$277.79 ,$277.79 ,$277.79 ,$277.79 ,$390.60 ,$106.95 ,$395.25 ,$390.60 ,$106.95 ,$348.75 ,$372.00 ,$372.00 ,$106.95 ,$372.00 ,$390.60 ,$390.60 ,$390.60 ,$418.50 ,$267.38 ,$106.95 ,$465.00 ,$239.57 ,$263.53 ,$117.65 ,$395.25 ,$277.79 ,$418.50 ,$390.60 ,$372.00 ,$372.00 ,$106.95 ,$302.25 ST. FRANCIS HOSPITAL - ACUTE,44400060,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 60MIN,444,1 ,$465.00 ,$302.25 ,$106.95 ,$465.00 ,$334.80 ,$252.96 ,$106.95 ,$259.56 ,$106.95 ,$277.79 ,$277.79 ,$277.79 ,$277.79 ,$390.60 ,$106.95 ,$395.25 ,$390.60 ,$106.95 ,$348.75 ,$372.00 ,$372.00 ,$106.95 ,$372.00 ,$390.60 ,$390.60 ,$390.60 ,$418.50 ,$267.38 ,$106.95 ,$465.00 ,$239.57 ,$263.53 ,$117.65 ,$395.25 ,$277.79 ,$418.50 ,$390.60 ,$372.00 ,$372.00 ,$106.95 ,$302.25 ST. FRANCIS HOSPITAL - ACUTE,44400086,92610,HC DYSPHAGIA EVALUATION 75MIN,444,1 ,$609.00 ,$395.85 ,$140.07 ,$609.00 ,$438.48 ,$331.30 ,$140.07 ,$339.94 ,$140.07 ,$363.82 ,$363.82 ,$363.82 ,$363.82 ,$511.56 ,$140.07 ,$517.65 ,$511.56 ,$140.07 ,$456.75 ,$487.20 ,$487.20 ,$140.07 ,$487.20 ,$511.56 ,$511.56 ,$511.56 ,$548.10 ,$350.18 ,$140.07 ,$609.00 ,$239.57 ,$263.53 ,$154.08 ,$517.65 ,$363.82 ,$548.10 ,$511.56 ,$487.20 ,$487.20 ,$140.07 ,$395.85 ST. FRANCIS HOSPITAL - ACUTE,44400094,92597,HC VOICE PROST EVAL/FITTING 15MIN,444,1 ,$156.00 ,$101.40 ,$35.88 ,$263.53 ,$112.32 ,$84.86 ,$35.88 ,$87.08 ,$35.88 ,$93.19 ,$93.19 ,$93.19 ,$93.19 ,$131.04 ,$35.88 ,$132.60 ,$131.04 ,$35.88 ,$117.00 ,$124.80 ,$124.80 ,$35.88 ,$124.80 ,$131.04 ,$131.04 ,$131.04 ,$140.40 ,$89.70 ,$35.88 ,$156.00 ,$239.57 ,$263.53 ,$39.47 ,$132.60 ,$93.19 ,$140.40 ,$131.04 ,$124.80 ,$124.80 ,$35.88 ,$101.40 ST. FRANCIS HOSPITAL - ACUTE,44400095,92597,HC VOICE PROST EVAL/FITTING 30MIN,444,1 ,$156.00 ,$101.40 ,$35.88 ,$263.53 ,$112.32 ,$84.86 ,$35.88 ,$87.08 ,$35.88 ,$93.19 ,$93.19 ,$93.19 ,$93.19 ,$131.04 ,$35.88 ,$132.60 ,$131.04 ,$35.88 ,$117.00 ,$124.80 ,$124.80 ,$35.88 ,$124.80 ,$131.04 ,$131.04 ,$131.04 ,$140.40 ,$89.70 ,$35.88 ,$156.00 ,$239.57 ,$263.53 ,$39.47 ,$132.60 ,$93.19 ,$140.40 ,$131.04 ,$124.80 ,$124.80 ,$35.88 ,$101.40 ST. FRANCIS HOSPITAL - ACUTE,44400096,92597,HC VOICE PROST EVAL/FITTING 45MIN,444,1 ,$156.00 ,$101.40 ,$35.88 ,$263.53 ,$112.32 ,$84.86 ,$35.88 ,$87.08 ,$35.88 ,$93.19 ,$93.19 ,$93.19 ,$93.19 ,$131.04 ,$35.88 ,$132.60 ,$131.04 ,$35.88 ,$117.00 ,$124.80 ,$124.80 ,$35.88 ,$124.80 ,$131.04 ,$131.04 ,$131.04 ,$140.40 ,$89.70 ,$35.88 ,$156.00 ,$239.57 ,$263.53 ,$39.47 ,$132.60 ,$93.19 ,$140.40 ,$131.04 ,$124.80 ,$124.80 ,$35.88 ,$101.40 ST. FRANCIS HOSPITAL - ACUTE,44400097,92597,HC VOICE PROST EVAL/FITTING 60MIN,444,1 ,$156.00 ,$101.40 ,$35.88 ,$263.53 ,$112.32 ,$84.86 ,$35.88 ,$87.08 ,$35.88 ,$93.19 ,$93.19 ,$93.19 ,$93.19 ,$131.04 ,$35.88 ,$132.60 ,$131.04 ,$35.88 ,$117.00 ,$124.80 ,$124.80 ,$35.88 ,$124.80 ,$131.04 ,$131.04 ,$131.04 ,$140.40 ,$89.70 ,$35.88 ,$156.00 ,$239.57 ,$263.53 ,$39.47 ,$132.60 ,$93.19 ,$140.40 ,$131.04 ,$124.80 ,$124.80 ,$35.88 ,$101.40 ST. FRANCIS HOSPITAL - ACUTE,45000002,10061,HC I AND D ABSC CMPLX,450,1 ,$331.00 ,$215.15 ,$76.13 ,$331.00 ,$238.32 ,$180.06 ,$76.13 ,$184.76 ,$76.13 ,$197.74 ,$197.74 ,$197.74 ,$197.74 ,$278.04 ,$76.13 ,$281.35 ,$278.04 ,$76.13 ,$248.25 ,$264.80 ,$264.80 ,$76.13 ,$264.80 ,$278.04 ,$278.04 ,$278.04 ,$297.90 ,$190.33 ,$76.13 ,$331.00 , N/A , N/A ,$83.74 ,$281.35 ,$197.74 ,$297.90 ,$278.04 ,$264.80 ,$264.80 ,$76.13 ,$215.15 ST. FRANCIS HOSPITAL - ACUTE,45000003,10080,HC I AND D CYST PILONIDAL SMP,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000004,10081,HC I AND D CYST PILONIDAL CPLX,450,1 ,"$1,770.00 ","$1,150.50 ",$407.10 ,"$1,770.00 ","$1,274.40 ",$962.88 ,$407.10 ,$988.01 ,$407.10 ,"$1,057.40 ","$1,057.40 ","$1,057.40 ","$1,057.40 ","$1,486.80 ",$407.10 ,"$1,504.50 ","$1,486.80 ",$407.10 ,"$1,327.50 ","$1,416.00 ","$1,416.00 ",$407.10 ,"$1,416.00 ","$1,486.80 ","$1,486.80 ","$1,486.80 ","$1,593.00 ","$1,017.75 ",$407.10 ,"$1,770.00 ", N/A , N/A ,$447.81 ,"$1,504.50 ","$1,057.40 ","$1,593.00 ","$1,486.80 ","$1,416.00 ","$1,416.00 ",$407.10 ,"$1,150.50 " ST. FRANCIS HOSPITAL - ACUTE,45000005,10120,HC INCISION/REM FB SUBQ SMP,450,1 ,$245.00 ,$159.25 ,$56.35 ,$245.00 ,$176.40 ,$133.28 ,$56.35 ,$136.76 ,$56.35 ,$146.36 ,$146.36 ,$146.36 ,$146.36 ,$205.80 ,$56.35 ,$208.25 ,$205.80 ,$56.35 ,$183.75 ,$196.00 ,$196.00 ,$56.35 ,$196.00 ,$205.80 ,$205.80 ,$205.80 ,$220.50 ,$140.88 ,$56.35 ,$245.00 , N/A , N/A ,$61.99 ,$208.25 ,$146.36 ,$220.50 ,$205.80 ,$196.00 ,$196.00 ,$56.35 ,$159.25 ST. FRANCIS HOSPITAL - ACUTE,45000009,11730,HC AVULSION NAIL PLATE SINGLE FAC,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000011,11740,HC EVAC HEMATOMA SUBUNGAL,450,1 ,$143.00 ,$92.95 ,$32.89 ,$143.00 ,$102.96 ,$77.79 ,$32.89 ,$79.82 ,$32.89 ,$85.43 ,$85.43 ,$85.43 ,$85.43 ,$120.12 ,$32.89 ,$121.55 ,$120.12 ,$32.89 ,$107.25 ,$114.40 ,$114.40 ,$32.89 ,$114.40 ,$120.12 ,$120.12 ,$120.12 ,$128.70 ,$82.23 ,$32.89 ,$143.00 , N/A , N/A ,$36.18 ,$121.55 ,$85.43 ,$128.70 ,$120.12 ,$114.40 ,$114.40 ,$32.89 ,$92.95 ST. FRANCIS HOSPITAL - ACUTE,45000012,11760,HC REPAIR NAIL BED,450,1 ,$296.00 ,$192.40 ,$68.08 ,$296.00 ,$213.12 ,$161.02 ,$68.08 ,$165.23 ,$68.08 ,$176.83 ,$176.83 ,$176.83 ,$176.83 ,$248.64 ,$68.08 ,$251.60 ,$248.64 ,$68.08 ,$222.00 ,$236.80 ,$236.80 ,$68.08 ,$236.80 ,$248.64 ,$248.64 ,$248.64 ,$266.40 ,$170.20 ,$68.08 ,$296.00 , N/A , N/A ,$74.89 ,$251.60 ,$176.83 ,$266.40 ,$248.64 ,$236.80 ,$236.80 ,$68.08 ,$192.40 ST. FRANCIS HOSPITAL - ACUTE,45000014,12001,HC SIMP S/N/AX/GN/TRK/EXT 2.5CM <,450,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 , N/A , N/A ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,45000015,12002,HC SIMP S/N/AX/GN/TRK/EXT 2.6-7.5,450,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 , N/A , N/A ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,45000016,12004,HC SIMP S/N/AX/GN/TRK/EXT7.6-12.5,450,1 ,$89.00 ,$57.85 ,$20.47 ,$89.00 ,$64.08 ,$48.42 ,$20.47 ,$49.68 ,$20.47 ,$53.17 ,$53.17 ,$53.17 ,$53.17 ,$74.76 ,$20.47 ,$75.65 ,$74.76 ,$20.47 ,$66.75 ,$71.20 ,$71.20 ,$20.47 ,$71.20 ,$74.76 ,$74.76 ,$74.76 ,$80.10 ,$51.18 ,$20.47 ,$89.00 , N/A , N/A ,$22.52 ,$75.65 ,$53.17 ,$80.10 ,$74.76 ,$71.20 ,$71.20 ,$20.47 ,$57.85 ST. FRANCIS HOSPITAL - ACUTE,45000017,12005,HC SIMP S/N/AX/GN/TRK/EXT 12.6-20,450,1 ,$127.00 ,$82.55 ,$29.21 ,$127.00 ,$91.44 ,$69.09 ,$29.21 ,$70.89 ,$29.21 ,$75.87 ,$75.87 ,$75.87 ,$75.87 ,$106.68 ,$29.21 ,$107.95 ,$106.68 ,$29.21 ,$95.25 ,$101.60 ,$101.60 ,$29.21 ,$101.60 ,$106.68 ,$106.68 ,$106.68 ,$114.30 ,$73.03 ,$29.21 ,$127.00 , N/A , N/A ,$32.13 ,$107.95 ,$75.87 ,$114.30 ,$106.68 ,$101.60 ,$101.60 ,$29.21 ,$82.55 ST. FRANCIS HOSPITAL - ACUTE,45000018,12006,HC SIMP S/N/AX/GN/TRK/EXT 20.1-30,450,1 ,$138.00 ,$89.70 ,$31.74 ,$138.00 ,$99.36 ,$75.07 ,$31.74 ,$77.03 ,$31.74 ,$82.44 ,$82.44 ,$82.44 ,$82.44 ,$115.92 ,$31.74 ,$117.30 ,$115.92 ,$31.74 ,$103.50 ,$110.40 ,$110.40 ,$31.74 ,$110.40 ,$115.92 ,$115.92 ,$115.92 ,$124.20 ,$79.35 ,$31.74 ,$138.00 , N/A , N/A ,$34.91 ,$117.30 ,$82.44 ,$124.20 ,$115.92 ,$110.40 ,$110.40 ,$31.74 ,$89.70 ST. FRANCIS HOSPITAL - ACUTE,45000020,12011,HC SIMP F/E/E/N/L/MM 2.5CM OR <,450,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 , N/A , N/A ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,45000021,12013,HC SIMP F/E/E/N/L/MM 2.6CM TO 5CM,450,1 ,$81.00 ,$52.65 ,$18.63 ,$81.00 ,$58.32 ,$44.06 ,$18.63 ,$45.21 ,$18.63 ,$48.39 ,$48.39 ,$48.39 ,$48.39 ,$68.04 ,$18.63 ,$68.85 ,$68.04 ,$18.63 ,$60.75 ,$64.80 ,$64.80 ,$18.63 ,$64.80 ,$68.04 ,$68.04 ,$68.04 ,$72.90 ,$46.58 ,$18.63 ,$81.00 , N/A , N/A ,$20.49 ,$68.85 ,$48.39 ,$72.90 ,$68.04 ,$64.80 ,$64.80 ,$18.63 ,$52.65 ST. FRANCIS HOSPITAL - ACUTE,45000022,12014,HC SIMP F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$89.00 ,$57.85 ,$20.47 ,$89.00 ,$64.08 ,$48.42 ,$20.47 ,$49.68 ,$20.47 ,$53.17 ,$53.17 ,$53.17 ,$53.17 ,$74.76 ,$20.47 ,$75.65 ,$74.76 ,$20.47 ,$66.75 ,$71.20 ,$71.20 ,$20.47 ,$71.20 ,$74.76 ,$74.76 ,$74.76 ,$80.10 ,$51.18 ,$20.47 ,$89.00 , N/A , N/A ,$22.52 ,$75.65 ,$53.17 ,$80.10 ,$74.76 ,$71.20 ,$71.20 ,$20.47 ,$57.85 ST. FRANCIS HOSPITAL - ACUTE,45000023,12015,HC SIMP F/E/E/N/L/MM 7.6 -12.5CM,450,1 ,$97.00 ,$63.05 ,$22.31 ,$97.00 ,$69.84 ,$52.77 ,$22.31 ,$54.15 ,$22.31 ,$57.95 ,$57.95 ,$57.95 ,$57.95 ,$81.48 ,$22.31 ,$82.45 ,$81.48 ,$22.31 ,$72.75 ,$77.60 ,$77.60 ,$22.31 ,$77.60 ,$81.48 ,$81.48 ,$81.48 ,$87.30 ,$55.78 ,$22.31 ,$97.00 , N/A , N/A ,$24.54 ,$82.45 ,$57.95 ,$87.30 ,$81.48 ,$77.60 ,$77.60 ,$22.31 ,$63.05 ST. FRANCIS HOSPITAL - ACUTE,45000029,12031,HC INTRM S/A/T/EXT 2.5CM OR <,450,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 , N/A , N/A ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,45000030,12032,HC INTRM S/A/T/EXT 2.6-7.5CM,450,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 , N/A , N/A ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,45000031,12034,HC INTRM S/A/T/EXT 7.6-12.5CM,450,1 ,$89.00 ,$57.85 ,$20.47 ,$89.00 ,$64.08 ,$48.42 ,$20.47 ,$49.68 ,$20.47 ,$53.17 ,$53.17 ,$53.17 ,$53.17 ,$74.76 ,$20.47 ,$75.65 ,$74.76 ,$20.47 ,$66.75 ,$71.20 ,$71.20 ,$20.47 ,$71.20 ,$74.76 ,$74.76 ,$74.76 ,$80.10 ,$51.18 ,$20.47 ,$89.00 , N/A , N/A ,$22.52 ,$75.65 ,$53.17 ,$80.10 ,$74.76 ,$71.20 ,$71.20 ,$20.47 ,$57.85 ST. FRANCIS HOSPITAL - ACUTE,45000035,12041,HC INTRM N/H/F/GEN 2.5CM OR <,450,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 , N/A , N/A ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,45000036,12042,HC INTRM N/H/F/GEN 2.6-7.5CM,450,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 , N/A , N/A ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,45000037,12044,HC INTRM N/H/F/GEN 7.6-12.5CM,450,1 ,$82.00 ,$53.30 ,$18.86 ,$82.00 ,$59.04 ,$44.61 ,$18.86 ,$45.77 ,$18.86 ,$48.99 ,$48.99 ,$48.99 ,$48.99 ,$68.88 ,$18.86 ,$69.70 ,$68.88 ,$18.86 ,$61.50 ,$65.60 ,$65.60 ,$18.86 ,$65.60 ,$68.88 ,$68.88 ,$68.88 ,$73.80 ,$47.15 ,$18.86 ,$82.00 , N/A , N/A ,$20.75 ,$69.70 ,$48.99 ,$73.80 ,$68.88 ,$65.60 ,$65.60 ,$18.86 ,$53.30 ST. FRANCIS HOSPITAL - ACUTE,45000041,12051,HC INTRM F/E/E/N/L/MM 2.5CM OR <,450,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 , N/A , N/A ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,45000042,12052,HC INTRM F/E/E/N/L/MM 2.6-5.0CM,450,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 , N/A , N/A ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,45000051,13120,HC CMPLX S/A/L 1.1-2.5 CM,450,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 , N/A , N/A ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,45000052,13121,HC CMPLX S/A/L 2.6-7.5 CM,450,1 ,$77.00 ,$50.05 ,$17.71 ,$77.00 ,$55.44 ,$41.89 ,$17.71 ,$42.98 ,$17.71 ,$46.00 ,$46.00 ,$46.00 ,$46.00 ,$64.68 ,$17.71 ,$65.45 ,$64.68 ,$17.71 ,$57.75 ,$61.60 ,$61.60 ,$17.71 ,$61.60 ,$64.68 ,$64.68 ,$64.68 ,$69.30 ,$44.28 ,$17.71 ,$77.00 , N/A , N/A ,$19.48 ,$65.45 ,$46.00 ,$69.30 ,$64.68 ,$61.60 ,$61.60 ,$17.71 ,$50.05 ST. FRANCIS HOSPITAL - ACUTE,45000054,13131,HC CMPLX F/C/C/M/N/A/G/H/F 1.1-2.5 CM,450,1 ,$101.00 ,$65.65 ,$23.23 ,$101.00 ,$72.72 ,$54.94 ,$23.23 ,$56.38 ,$23.23 ,$60.34 ,$60.34 ,$60.34 ,$60.34 ,$84.84 ,$23.23 ,$85.85 ,$84.84 ,$23.23 ,$75.75 ,$80.80 ,$80.80 ,$23.23 ,$80.80 ,$84.84 ,$84.84 ,$84.84 ,$90.90 ,$58.08 ,$23.23 ,$101.00 , N/A , N/A ,$25.55 ,$85.85 ,$60.34 ,$90.90 ,$84.84 ,$80.80 ,$80.80 ,$23.23 ,$65.65 ST. FRANCIS HOSPITAL - ACUTE,45000055,13132,HC CMPLX F/C/C/M/N/A/G/H/F 2.6-7.5 CM,450,1 ,$101.00 ,$65.65 ,$23.23 ,$101.00 ,$72.72 ,$54.94 ,$23.23 ,$56.38 ,$23.23 ,$60.34 ,$60.34 ,$60.34 ,$60.34 ,$84.84 ,$23.23 ,$85.85 ,$84.84 ,$23.23 ,$75.75 ,$80.80 ,$80.80 ,$23.23 ,$80.80 ,$84.84 ,$84.84 ,$84.84 ,$90.90 ,$58.08 ,$23.23 ,$101.00 , N/A , N/A ,$25.55 ,$85.85 ,$60.34 ,$90.90 ,$84.84 ,$80.80 ,$80.80 ,$23.23 ,$65.65 ST. FRANCIS HOSPITAL - ACUTE,45000058,13151,HC CMPLX E/N/E/L 1.1-2.5 CM,450,1 ,$101.00 ,$65.65 ,$23.23 ,$101.00 ,$72.72 ,$54.94 ,$23.23 ,$56.38 ,$23.23 ,$60.34 ,$60.34 ,$60.34 ,$60.34 ,$84.84 ,$23.23 ,$85.85 ,$84.84 ,$23.23 ,$75.75 ,$80.80 ,$80.80 ,$23.23 ,$80.80 ,$84.84 ,$84.84 ,$84.84 ,$90.90 ,$58.08 ,$23.23 ,$101.00 , N/A , N/A ,$25.55 ,$85.85 ,$60.34 ,$90.90 ,$84.84 ,$80.80 ,$80.80 ,$23.23 ,$65.65 ST. FRANCIS HOSPITAL - ACUTE,45000059,13152,HC CMPLX E/N/E/L 2.6-7.5 CM,450,1 ,$101.00 ,$65.65 ,$23.23 ,$101.00 ,$72.72 ,$54.94 ,$23.23 ,$56.38 ,$23.23 ,$60.34 ,$60.34 ,$60.34 ,$60.34 ,$84.84 ,$23.23 ,$85.85 ,$84.84 ,$23.23 ,$75.75 ,$80.80 ,$80.80 ,$23.23 ,$80.80 ,$84.84 ,$84.84 ,$84.84 ,$90.90 ,$58.08 ,$23.23 ,$101.00 , N/A , N/A ,$25.55 ,$85.85 ,$60.34 ,$90.90 ,$84.84 ,$80.80 ,$80.80 ,$23.23 ,$65.65 ST. FRANCIS HOSPITAL - ACUTE,45000061,16000,HC TX BURN 1ST DEGREE INIT,450,1 ,$178.00 ,$115.70 ,$40.94 ,$178.00 ,$128.16 ,$96.83 ,$40.94 ,$99.36 ,$40.94 ,$106.34 ,$106.34 ,$106.34 ,$106.34 ,$149.52 ,$40.94 ,$151.30 ,$149.52 ,$40.94 ,$133.50 ,$142.40 ,$142.40 ,$40.94 ,$142.40 ,$149.52 ,$149.52 ,$149.52 ,$160.20 ,$102.35 ,$40.94 ,$178.00 , N/A , N/A ,$45.03 ,$151.30 ,$106.34 ,$160.20 ,$149.52 ,$142.40 ,$142.40 ,$40.94 ,$115.70 ST. FRANCIS HOSPITAL - ACUTE,45000062,16020,HC DRESS/DEB BURN <5% TOTAL SM,450,1 ,$131.00 ,$85.15 ,$30.13 ,$131.00 ,$94.32 ,$71.26 ,$30.13 ,$73.12 ,$30.13 ,$78.26 ,$78.26 ,$78.26 ,$78.26 ,$110.04 ,$30.13 ,$111.35 ,$110.04 ,$30.13 ,$98.25 ,$104.80 ,$104.80 ,$30.13 ,$104.80 ,$110.04 ,$110.04 ,$110.04 ,$117.90 ,$75.33 ,$30.13 ,$131.00 , N/A , N/A ,$33.14 ,$111.35 ,$78.26 ,$117.90 ,$110.04 ,$104.80 ,$104.80 ,$30.13 ,$85.15 ST. FRANCIS HOSPITAL - ACUTE,45000064,16030,HC DRESS/DEBR BURN >10% TOTAL LRG,450,1 ,$241.00 ,$156.65 ,$55.43 ,$241.00 ,$173.52 ,$131.10 ,$55.43 ,$134.53 ,$55.43 ,$143.97 ,$143.97 ,$143.97 ,$143.97 ,$202.44 ,$55.43 ,$204.85 ,$202.44 ,$55.43 ,$180.75 ,$192.80 ,$192.80 ,$55.43 ,$192.80 ,$202.44 ,$202.44 ,$202.44 ,$216.90 ,$138.58 ,$55.43 ,$241.00 , N/A , N/A ,$60.97 ,$204.85 ,$143.97 ,$216.90 ,$202.44 ,$192.80 ,$192.80 ,$55.43 ,$156.65 ST. FRANCIS HOSPITAL - ACUTE,45000067,17250,HC CAUT CHEM TISSUE GRANULATION,450,1 ,$142.00 ,$92.30 ,$32.66 ,$142.00 ,$102.24 ,$77.25 ,$32.66 ,$79.26 ,$32.66 ,$84.83 ,$84.83 ,$84.83 ,$84.83 ,$119.28 ,$32.66 ,$120.70 ,$119.28 ,$32.66 ,$106.50 ,$113.60 ,$113.60 ,$32.66 ,$113.60 ,$119.28 ,$119.28 ,$119.28 ,$127.80 ,$81.65 ,$32.66 ,$142.00 , N/A , N/A ,$35.93 ,$120.70 ,$84.83 ,$127.80 ,$119.28 ,$113.60 ,$113.60 ,$32.66 ,$92.30 ST. FRANCIS HOSPITAL - ACUTE,45000069,20600,HC ARTHROCENT ASP/INJ JT SMALL,450,1 ,$679.00 ,$441.35 ,$156.17 ,$679.00 ,$488.88 ,$369.38 ,$156.17 ,$379.02 ,$156.17 ,$405.63 ,$405.63 ,$405.63 ,$405.63 ,$570.36 ,$156.17 ,$577.15 ,$570.36 ,$156.17 ,$509.25 ,$543.20 ,$543.20 ,$156.17 ,$543.20 ,$570.36 ,$570.36 ,$570.36 ,$611.10 ,$390.43 ,$156.17 ,$679.00 , N/A , N/A ,$171.79 ,$577.15 ,$405.63 ,$611.10 ,$570.36 ,$543.20 ,$543.20 ,$156.17 ,$441.35 ST. FRANCIS HOSPITAL - ACUTE,45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,$955.00 ,$620.75 ,$219.65 ,$955.00 ,$687.60 ,$519.52 ,$219.65 ,$533.08 ,$219.65 ,$570.52 ,$570.52 ,$570.52 ,$570.52 ,$802.20 ,$219.65 ,$811.75 ,$802.20 ,$219.65 ,$716.25 ,$764.00 ,$764.00 ,$219.65 ,$764.00 ,$802.20 ,$802.20 ,$802.20 ,$859.50 ,$549.13 ,$219.65 ,$955.00 , N/A , N/A ,$241.62 ,$811.75 ,$570.52 ,$859.50 ,$802.20 ,$764.00 ,$764.00 ,$219.65 ,$620.75 ST. FRANCIS HOSPITAL - ACUTE,45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,$955.00 ,$620.75 ,$219.65 ,$955.00 ,$687.60 ,$519.52 ,$219.65 ,$533.08 ,$219.65 ,$570.52 ,$570.52 ,$570.52 ,$570.52 ,$802.20 ,$219.65 ,$811.75 ,$802.20 ,$219.65 ,$716.25 ,$764.00 ,$764.00 ,$219.65 ,$764.00 ,$802.20 ,$802.20 ,$802.20 ,$859.50 ,$549.13 ,$219.65 ,$955.00 , N/A , N/A ,$241.62 ,$811.75 ,$570.52 ,$859.50 ,$802.20 ,$764.00 ,$764.00 ,$219.65 ,$620.75 ST. FRANCIS HOSPITAL - ACUTE,45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,"$1,431.00 ",$930.15 ,$329.13 ,"$1,431.00 ","$1,030.32 ",$778.46 ,$329.13 ,$798.78 ,$329.13 ,$854.88 ,$854.88 ,$854.88 ,$854.88 ,"$1,202.04 ",$329.13 ,"$1,216.35 ","$1,202.04 ",$329.13 ,"$1,073.25 ","$1,144.80 ","$1,144.80 ",$329.13 ,"$1,144.80 ","$1,202.04 ","$1,202.04 ","$1,202.04 ","$1,287.90 ",$822.83 ,$329.13 ,"$1,431.00 ", N/A , N/A ,$362.04 ,"$1,216.35 ",$854.88 ,"$1,287.90 ","$1,202.04 ","$1,144.80 ","$1,144.80 ",$329.13 ,$930.15 ST. FRANCIS HOSPITAL - ACUTE,45000072,20612,HC INJ GANGLION CYST,450,1 ,$405.00 ,$263.25 ,$93.15 ,$405.00 ,$291.60 ,$220.32 ,$93.15 ,$226.07 ,$93.15 ,$241.95 ,$241.95 ,$241.95 ,$241.95 ,$340.20 ,$93.15 ,$344.25 ,$340.20 ,$93.15 ,$303.75 ,$324.00 ,$324.00 ,$93.15 ,$324.00 ,$340.20 ,$340.20 ,$340.20 ,$364.50 ,$232.88 ,$93.15 ,$405.00 , N/A , N/A ,$102.47 ,$344.25 ,$241.95 ,$364.50 ,$340.20 ,$324.00 ,$324.00 ,$93.15 ,$263.25 ST. FRANCIS HOSPITAL - ACUTE,45000072,20612,HC INJ GANGLION CYST,450,1 ,$607.00 ,$394.55 ,$139.61 ,$607.00 ,$437.04 ,$330.21 ,$139.61 ,$338.83 ,$139.61 ,$362.62 ,$362.62 ,$362.62 ,$362.62 ,$509.88 ,$139.61 ,$515.95 ,$509.88 ,$139.61 ,$455.25 ,$485.60 ,$485.60 ,$139.61 ,$485.60 ,$509.88 ,$509.88 ,$509.88 ,$546.30 ,$349.03 ,$139.61 ,$607.00 , N/A , N/A ,$153.57 ,$515.95 ,$362.62 ,$546.30 ,$509.88 ,$485.60 ,$485.60 ,$139.61 ,$394.55 ST. FRANCIS HOSPITAL - ACUTE,45000074,23650,HC TX DISL SHLDR W/MAN CLS,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000075,23655,HC TX DISL SHLDR W/MAN/ANES CLS,450,1 ,$659.00 ,$428.35 ,$151.57 ,$659.00 ,$474.48 ,$358.50 ,$151.57 ,$367.85 ,$151.57 ,$393.69 ,$393.69 ,$393.69 ,$393.69 ,$553.56 ,$151.57 ,$560.15 ,$553.56 ,$151.57 ,$494.25 ,$527.20 ,$527.20 ,$151.57 ,$527.20 ,$553.56 ,$553.56 ,$553.56 ,$593.10 ,$378.93 ,$151.57 ,$659.00 , N/A , N/A ,$166.73 ,$560.15 ,$393.69 ,$593.10 ,$553.56 ,$527.20 ,$527.20 ,$151.57 ,$428.35 ST. FRANCIS HOSPITAL - ACUTE,45000076,24600,HC TX DISL ELBOW W/O ANES CLS,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000082,25605,HC CL TX DIS RADIAL FX/EPIP SEP,450,1 ,"$2,891.00 ","$1,879.15 ",$664.93 ,"$2,891.00 ","$2,081.52 ","$1,572.70 ",$664.93 ,"$1,613.76 ",$664.93 ,"$1,727.08 ","$1,727.08 ","$1,727.08 ","$1,727.08 ","$2,428.44 ",$664.93 ,"$2,457.35 ","$2,428.44 ",$664.93 ,"$2,168.25 ","$2,312.80 ","$2,312.80 ",$664.93 ,"$2,312.80 ","$2,428.44 ","$2,428.44 ","$2,428.44 ","$2,601.90 ","$1,662.33 ",$664.93 ,"$2,891.00 ", N/A , N/A ,$731.42 ,"$2,457.35 ","$1,727.08 ","$2,601.90 ","$2,428.44 ","$2,312.80 ","$2,312.80 ",$664.93 ,"$1,879.15 " ST. FRANCIS HOSPITAL - ACUTE,45000087,26725,HC TX FX PHALANX PROX W/MAN CLS,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000090,26770,HC TX DISL (I-P) HAND W/O ANES,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000091,26951,HC AMPUT FINGER/THUMB SGL CLSR,450,1 ,"$5,282.00 ","$3,433.30 ","$1,214.86 ","$5,282.00 ","$3,803.04 ","$2,873.41 ","$1,214.86 ","$2,948.41 ","$1,214.86 ","$3,155.47 ","$3,155.47 ","$3,155.47 ","$3,155.47 ","$4,436.88 ","$1,214.86 ","$4,489.70 ","$4,436.88 ","$1,214.86 ","$3,961.50 ","$4,225.60 ","$4,225.60 ","$1,214.86 ","$4,225.60 ","$4,436.88 ","$4,436.88 ","$4,436.88 ","$4,753.80 ","$3,037.15 ","$1,214.86 ","$5,282.00 ", N/A , N/A ,"$1,336.35 ","$4,489.70 ","$3,155.47 ","$4,753.80 ","$4,436.88 ","$4,225.60 ","$4,225.60 ","$1,214.86 ","$3,433.30 " ST. FRANCIS HOSPITAL - ACUTE,45000094,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT,450,1 ,$367.00 ,$238.55 ,$84.41 ,$367.00 ,$264.24 ,$199.65 ,$84.41 ,$204.86 ,$84.41 ,$219.25 ,$219.25 ,$219.25 ,$219.25 ,$308.28 ,$84.41 ,$311.95 ,$308.28 ,$84.41 ,$275.25 ,$293.60 ,$293.60 ,$84.41 ,$293.60 ,$308.28 ,$308.28 ,$308.28 ,$330.30 ,$211.03 ,$84.41 ,$367.00 , N/A , N/A ,$92.85 ,$311.95 ,$219.25 ,$330.30 ,$308.28 ,$293.60 ,$293.60 ,$84.41 ,$238.55 ST. FRANCIS HOSPITAL - ACUTE,45000096,27560,HC TX DSL PTLR W/O ANS CL,450,1 ,$267.00 ,$173.55 ,$61.41 ,$267.00 ,$192.24 ,$145.25 ,$61.41 ,$149.04 ,$61.41 ,$159.51 ,$159.51 ,$159.51 ,$159.51 ,$224.28 ,$61.41 ,$226.95 ,$224.28 ,$61.41 ,$200.25 ,$213.60 ,$213.60 ,$61.41 ,$213.60 ,$224.28 ,$224.28 ,$224.28 ,$240.30 ,$153.53 ,$61.41 ,$267.00 , N/A , N/A ,$67.55 ,$226.95 ,$159.51 ,$240.30 ,$224.28 ,$213.60 ,$213.60 ,$61.41 ,$173.55 ST. FRANCIS HOSPITAL - ACUTE,45000097,28190,HC REM FB FOOT SUBQ,450,1 ,$257.00 ,$167.05 ,$59.11 ,$257.00 ,$185.04 ,$139.81 ,$59.11 ,$143.46 ,$59.11 ,$153.53 ,$153.53 ,$153.53 ,$153.53 ,$215.88 ,$59.11 ,$218.45 ,$215.88 ,$59.11 ,$192.75 ,$205.60 ,$205.60 ,$59.11 ,$205.60 ,$215.88 ,$215.88 ,$215.88 ,$231.30 ,$147.78 ,$59.11 ,$257.00 , N/A , N/A ,$65.02 ,$218.45 ,$153.53 ,$231.30 ,$215.88 ,$205.60 ,$205.60 ,$59.11 ,$167.05 ST. FRANCIS HOSPITAL - ACUTE,45000097,28190,HC REM FB FOOT SUBQ,450,1 ,$515.00 ,$334.75 ,$118.45 ,$515.00 ,$370.80 ,$280.16 ,$118.45 ,$287.47 ,$118.45 ,$307.66 ,$307.66 ,$307.66 ,$307.66 ,$432.60 ,$118.45 ,$437.75 ,$432.60 ,$118.45 ,$386.25 ,$412.00 ,$412.00 ,$118.45 ,$412.00 ,$432.60 ,$432.60 ,$432.60 ,$463.50 ,$296.13 ,$118.45 ,$515.00 , N/A , N/A ,$130.30 ,$437.75 ,$307.66 ,$463.50 ,$432.60 ,$412.00 ,$412.00 ,$118.45 ,$334.75 ST. FRANCIS HOSPITAL - ACUTE,45000098,29065,HC APPL CAST ARM LONG,450,1 ,$361.00 ,$234.65 ,$83.03 ,$361.00 ,$259.92 ,$196.38 ,$83.03 ,$201.51 ,$83.03 ,$215.66 ,$215.66 ,$215.66 ,$215.66 ,$303.24 ,$83.03 ,$306.85 ,$303.24 ,$83.03 ,$270.75 ,$288.80 ,$288.80 ,$83.03 ,$288.80 ,$303.24 ,$303.24 ,$303.24 ,$324.90 ,$207.58 ,$83.03 ,$361.00 , N/A , N/A ,$91.33 ,$306.85 ,$215.66 ,$324.90 ,$303.24 ,$288.80 ,$288.80 ,$83.03 ,$234.65 ST. FRANCIS HOSPITAL - ACUTE,45000099,29075,HC CAST APPL; ELBOW TO FINGERS,450,1 ,$500.00 ,$325.00 ,$115.00 ,$500.00 ,$360.00 ,$272.00 ,$115.00 ,$279.10 ,$115.00 ,$298.70 ,$298.70 ,$298.70 ,$298.70 ,$420.00 ,$115.00 ,$425.00 ,$420.00 ,$115.00 ,$375.00 ,$400.00 ,$400.00 ,$115.00 ,$400.00 ,$420.00 ,$420.00 ,$420.00 ,$450.00 ,$287.50 ,$115.00 ,$500.00 , N/A , N/A ,$126.50 ,$425.00 ,$298.70 ,$450.00 ,$420.00 ,$400.00 ,$400.00 ,$115.00 ,$325.00 ST. FRANCIS HOSPITAL - ACUTE,45000100,29105,HC APPL SPLNT ARM LONG,450,1 ,$227.00 ,$147.55 ,$52.21 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 , N/A , N/A ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,45000100,29105,HC APPL SPLNT ARM LONG,450,1 ,$449.00 ,$291.85 ,$103.27 ,$449.00 ,$323.28 ,$244.26 ,$103.27 ,$250.63 ,$103.27 ,$268.23 ,$268.23 ,$268.23 ,$268.23 ,$377.16 ,$103.27 ,$381.65 ,$377.16 ,$103.27 ,$336.75 ,$359.20 ,$359.20 ,$103.27 ,$359.20 ,$377.16 ,$377.16 ,$377.16 ,$404.10 ,$258.18 ,$103.27 ,$449.00 , N/A , N/A ,$113.60 ,$381.65 ,$268.23 ,$404.10 ,$377.16 ,$359.20 ,$359.20 ,$103.27 ,$291.85 ST. FRANCIS HOSPITAL - ACUTE,45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,$227.00 ,$147.55 ,$52.21 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 , N/A , N/A ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,$454.00 ,$295.10 ,$104.42 ,$454.00 ,$326.88 ,$246.98 ,$104.42 ,$253.42 ,$104.42 ,$271.22 ,$271.22 ,$271.22 ,$271.22 ,$381.36 ,$104.42 ,$385.90 ,$381.36 ,$104.42 ,$340.50 ,$363.20 ,$363.20 ,$104.42 ,$363.20 ,$381.36 ,$381.36 ,$381.36 ,$408.60 ,$261.05 ,$104.42 ,$454.00 , N/A , N/A ,$114.86 ,$385.90 ,$271.22 ,$408.60 ,$381.36 ,$363.20 ,$363.20 ,$104.42 ,$295.10 ST. FRANCIS HOSPITAL - ACUTE,45000102,29126,HC APPL SHRT ARM SPLNT DYNAM,450,1 ,$449.00 ,$291.85 ,$103.27 ,$449.00 ,$323.28 ,$244.26 ,$103.27 ,$250.63 ,$103.27 ,$268.23 ,$268.23 ,$268.23 ,$268.23 ,$377.16 ,$103.27 ,$381.65 ,$377.16 ,$103.27 ,$336.75 ,$359.20 ,$359.20 ,$103.27 ,$359.20 ,$377.16 ,$377.16 ,$377.16 ,$404.10 ,$258.18 ,$103.27 ,$449.00 , N/A , N/A ,$113.60 ,$381.65 ,$268.23 ,$404.10 ,$377.16 ,$359.20 ,$359.20 ,$103.27 ,$291.85 ST. FRANCIS HOSPITAL - ACUTE,45000102,29126,HC APPL SHRT ARM SPLNT DYNAM,450,1 ,$454.00 ,$295.10 ,$104.42 ,$454.00 ,$326.88 ,$246.98 ,$104.42 ,$253.42 ,$104.42 ,$271.22 ,$271.22 ,$271.22 ,$271.22 ,$381.36 ,$104.42 ,$385.90 ,$381.36 ,$104.42 ,$340.50 ,$363.20 ,$363.20 ,$104.42 ,$363.20 ,$381.36 ,$381.36 ,$381.36 ,$408.60 ,$261.05 ,$104.42 ,$454.00 , N/A , N/A ,$114.86 ,$385.90 ,$271.22 ,$408.60 ,$381.36 ,$363.20 ,$363.20 ,$104.42 ,$295.10 ST. FRANCIS HOSPITAL - ACUTE,45000103,29130,HC APPL SPLNT FINGER STATIC,450,1 ,$224.00 ,$145.60 ,$51.52 ,$224.00 ,$161.28 ,$121.86 ,$51.52 ,$125.04 ,$51.52 ,$133.82 ,$133.82 ,$133.82 ,$133.82 ,$188.16 ,$51.52 ,$190.40 ,$188.16 ,$51.52 ,$168.00 ,$179.20 ,$179.20 ,$51.52 ,$179.20 ,$188.16 ,$188.16 ,$188.16 ,$201.60 ,$128.80 ,$51.52 ,$224.00 , N/A , N/A ,$56.67 ,$190.40 ,$133.82 ,$201.60 ,$188.16 ,$179.20 ,$179.20 ,$51.52 ,$145.60 ST. FRANCIS HOSPITAL - ACUTE,45000103,29130,HC APPL SPLNT FINGER STATIC,450,1 ,$454.00 ,$295.10 ,$104.42 ,$454.00 ,$326.88 ,$246.98 ,$104.42 ,$253.42 ,$104.42 ,$271.22 ,$271.22 ,$271.22 ,$271.22 ,$381.36 ,$104.42 ,$385.90 ,$381.36 ,$104.42 ,$340.50 ,$363.20 ,$363.20 ,$104.42 ,$363.20 ,$381.36 ,$381.36 ,$381.36 ,$408.60 ,$261.05 ,$104.42 ,$454.00 , N/A , N/A ,$114.86 ,$385.90 ,$271.22 ,$408.60 ,$381.36 ,$363.20 ,$363.20 ,$104.42 ,$295.10 ST. FRANCIS HOSPITAL - ACUTE,45000104,29131,HC APPL FINGER SPLINT DYNAMIC,450,1 ,$224.00 ,$145.60 ,$51.52 ,$224.00 ,$161.28 ,$121.86 ,$51.52 ,$125.04 ,$51.52 ,$133.82 ,$133.82 ,$133.82 ,$133.82 ,$188.16 ,$51.52 ,$190.40 ,$188.16 ,$51.52 ,$168.00 ,$179.20 ,$179.20 ,$51.52 ,$179.20 ,$188.16 ,$188.16 ,$188.16 ,$201.60 ,$128.80 ,$51.52 ,$224.00 , N/A , N/A ,$56.67 ,$190.40 ,$133.82 ,$201.60 ,$188.16 ,$179.20 ,$179.20 ,$51.52 ,$145.60 ST. FRANCIS HOSPITAL - ACUTE,45000105,29240,HC STRAPPING SHLDR,450,1 ,$227.00 ,$147.55 ,$52.21 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 , N/A , N/A ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,45000106,29405,HC APPL CAST SHORT LEG,450,1 ,$526.00 ,$341.90 ,$120.98 ,$526.00 ,$378.72 ,$286.14 ,$120.98 ,$293.61 ,$120.98 ,$314.23 ,$314.23 ,$314.23 ,$314.23 ,$441.84 ,$120.98 ,$447.10 ,$441.84 ,$120.98 ,$394.50 ,$420.80 ,$420.80 ,$120.98 ,$420.80 ,$441.84 ,$441.84 ,$441.84 ,$473.40 ,$302.45 ,$120.98 ,$526.00 , N/A , N/A ,$133.08 ,$447.10 ,$314.23 ,$473.40 ,$441.84 ,$420.80 ,$420.80 ,$120.98 ,$341.90 ST. FRANCIS HOSPITAL - ACUTE,45000107,29505,HC APPL LONG LEG SPLNT,450,1 ,$224.00 ,$145.60 ,$51.52 ,$224.00 ,$161.28 ,$121.86 ,$51.52 ,$125.04 ,$51.52 ,$133.82 ,$133.82 ,$133.82 ,$133.82 ,$188.16 ,$51.52 ,$190.40 ,$188.16 ,$51.52 ,$168.00 ,$179.20 ,$179.20 ,$51.52 ,$179.20 ,$188.16 ,$188.16 ,$188.16 ,$201.60 ,$128.80 ,$51.52 ,$224.00 , N/A , N/A ,$56.67 ,$190.40 ,$133.82 ,$201.60 ,$188.16 ,$179.20 ,$179.20 ,$51.52 ,$145.60 ST. FRANCIS HOSPITAL - ACUTE,45000107,29505,HC APPL LONG LEG SPLNT,450,1 ,$449.00 ,$291.85 ,$103.27 ,$449.00 ,$323.28 ,$244.26 ,$103.27 ,$250.63 ,$103.27 ,$268.23 ,$268.23 ,$268.23 ,$268.23 ,$377.16 ,$103.27 ,$381.65 ,$377.16 ,$103.27 ,$336.75 ,$359.20 ,$359.20 ,$103.27 ,$359.20 ,$377.16 ,$377.16 ,$377.16 ,$404.10 ,$258.18 ,$103.27 ,$449.00 , N/A , N/A ,$113.60 ,$381.65 ,$268.23 ,$404.10 ,$377.16 ,$359.20 ,$359.20 ,$103.27 ,$291.85 ST. FRANCIS HOSPITAL - ACUTE,45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,$224.00 ,$145.60 ,$51.52 ,$224.00 ,$161.28 ,$121.86 ,$51.52 ,$125.04 ,$51.52 ,$133.82 ,$133.82 ,$133.82 ,$133.82 ,$188.16 ,$51.52 ,$190.40 ,$188.16 ,$51.52 ,$168.00 ,$179.20 ,$179.20 ,$51.52 ,$179.20 ,$188.16 ,$188.16 ,$188.16 ,$201.60 ,$128.80 ,$51.52 ,$224.00 , N/A , N/A ,$56.67 ,$190.40 ,$133.82 ,$201.60 ,$188.16 ,$179.20 ,$179.20 ,$51.52 ,$145.60 ST. FRANCIS HOSPITAL - ACUTE,45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,$449.00 ,$291.85 ,$103.27 ,$449.00 ,$323.28 ,$244.26 ,$103.27 ,$250.63 ,$103.27 ,$268.23 ,$268.23 ,$268.23 ,$268.23 ,$377.16 ,$103.27 ,$381.65 ,$377.16 ,$103.27 ,$336.75 ,$359.20 ,$359.20 ,$103.27 ,$359.20 ,$377.16 ,$377.16 ,$377.16 ,$404.10 ,$258.18 ,$103.27 ,$449.00 , N/A , N/A ,$113.60 ,$381.65 ,$268.23 ,$404.10 ,$377.16 ,$359.20 ,$359.20 ,$103.27 ,$291.85 ST. FRANCIS HOSPITAL - ACUTE,45000110,30300,HC REM FB INTRANASAL,450,1 ,$114.00 ,$74.10 ,$26.22 ,$114.00 ,$82.08 ,$62.02 ,$26.22 ,$63.63 ,$26.22 ,$68.10 ,$68.10 ,$68.10 ,$68.10 ,$95.76 ,$26.22 ,$96.90 ,$95.76 ,$26.22 ,$85.50 ,$91.20 ,$91.20 ,$26.22 ,$91.20 ,$95.76 ,$95.76 ,$95.76 ,$102.60 ,$65.55 ,$26.22 ,$114.00 , N/A , N/A ,$28.84 ,$96.90 ,$68.10 ,$102.60 ,$95.76 ,$91.20 ,$91.20 ,$26.22 ,$74.10 ST. FRANCIS HOSPITAL - ACUTE,45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$69.00 ,$44.85 ,$15.87 ,$69.00 ,$49.68 ,$37.54 ,$15.87 ,$38.52 ,$15.87 ,$41.22 ,$41.22 ,$41.22 ,$41.22 ,$57.96 ,$15.87 ,$58.65 ,$57.96 ,$15.87 ,$51.75 ,$55.20 ,$55.20 ,$15.87 ,$55.20 ,$57.96 ,$57.96 ,$57.96 ,$62.10 ,$39.68 ,$15.87 ,$69.00 , N/A , N/A ,$17.46 ,$58.65 ,$41.22 ,$62.10 ,$57.96 ,$55.20 ,$55.20 ,$15.87 ,$44.85 ST. FRANCIS HOSPITAL - ACUTE,45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$136.00 ,$88.40 ,$31.28 ,$136.00 ,$97.92 ,$73.98 ,$31.28 ,$75.92 ,$31.28 ,$81.25 ,$81.25 ,$81.25 ,$81.25 ,$114.24 ,$31.28 ,$115.60 ,$114.24 ,$31.28 ,$102.00 ,$108.80 ,$108.80 ,$31.28 ,$108.80 ,$114.24 ,$114.24 ,$114.24 ,$122.40 ,$78.20 ,$31.28 ,$136.00 , N/A , N/A ,$34.41 ,$115.60 ,$81.25 ,$122.40 ,$114.24 ,$108.80 ,$108.80 ,$31.28 ,$88.40 ST. FRANCIS HOSPITAL - ACUTE,45000112,30903,HC CNTRL NOSEBLEED ANT CPLX,450,1 ,$167.00 ,$108.55 ,$38.41 ,$167.00 ,$120.24 ,$90.85 ,$38.41 ,$93.22 ,$38.41 ,$99.77 ,$99.77 ,$99.77 ,$99.77 ,$140.28 ,$38.41 ,$141.95 ,$140.28 ,$38.41 ,$125.25 ,$133.60 ,$133.60 ,$38.41 ,$133.60 ,$140.28 ,$140.28 ,$140.28 ,$150.30 ,$96.03 ,$38.41 ,$167.00 , N/A , N/A ,$42.25 ,$141.95 ,$99.77 ,$150.30 ,$140.28 ,$133.60 ,$133.60 ,$38.41 ,$108.55 ST. FRANCIS HOSPITAL - ACUTE,45000112,30903,HC CNTRL NOSEBLEED ANT CPLX,450,1 ,$335.00 ,$217.75 ,$77.05 ,$335.00 ,$241.20 ,$182.24 ,$77.05 ,$187.00 ,$77.05 ,$200.13 ,$200.13 ,$200.13 ,$200.13 ,$281.40 ,$77.05 ,$284.75 ,$281.40 ,$77.05 ,$251.25 ,$268.00 ,$268.00 ,$77.05 ,$268.00 ,$281.40 ,$281.40 ,$281.40 ,$301.50 ,$192.63 ,$77.05 ,$335.00 , N/A , N/A ,$84.76 ,$284.75 ,$200.13 ,$301.50 ,$281.40 ,$268.00 ,$268.00 ,$77.05 ,$217.75 ST. FRANCIS HOSPITAL - ACUTE,45000113,30905,HC CNTRL NOSEBLEED POST INIT,450,1 ,$136.00 ,$88.40 ,$31.28 ,$136.00 ,$97.92 ,$73.98 ,$31.28 ,$75.92 ,$31.28 ,$81.25 ,$81.25 ,$81.25 ,$81.25 ,$114.24 ,$31.28 ,$115.60 ,$114.24 ,$31.28 ,$102.00 ,$108.80 ,$108.80 ,$31.28 ,$108.80 ,$114.24 ,$114.24 ,$114.24 ,$122.40 ,$78.20 ,$31.28 ,$136.00 , N/A , N/A ,$34.41 ,$115.60 ,$81.25 ,$122.40 ,$114.24 ,$108.80 ,$108.80 ,$31.28 ,$88.40 ST. FRANCIS HOSPITAL - ACUTE,45000132,36680,HC PLACE NDL INFS INTRAOSSEOUS,450,1 ,$285.00 ,$185.25 ,$65.55 ,$285.00 ,$205.20 ,$155.04 ,$65.55 ,$159.09 ,$65.55 ,$170.26 ,$170.26 ,$170.26 ,$170.26 ,$239.40 ,$65.55 ,$242.25 ,$239.40 ,$65.55 ,$213.75 ,$228.00 ,$228.00 ,$65.55 ,$228.00 ,$239.40 ,$239.40 ,$239.40 ,$256.50 ,$163.88 ,$65.55 ,$285.00 , N/A , N/A ,$72.11 ,$242.25 ,$170.26 ,$256.50 ,$239.40 ,$228.00 ,$228.00 ,$65.55 ,$185.25 ST. FRANCIS HOSPITAL - ACUTE,45000136,40800,HC DRAINAGE MOUTH LESION,450,1 ,$132.00 ,$85.80 ,$30.36 ,$132.00 ,$95.04 ,$71.81 ,$30.36 ,$73.68 ,$30.36 ,$78.86 ,$78.86 ,$78.86 ,$78.86 ,$110.88 ,$30.36 ,$112.20 ,$110.88 ,$30.36 ,$99.00 ,$105.60 ,$105.60 ,$30.36 ,$105.60 ,$110.88 ,$110.88 ,$110.88 ,$118.80 ,$75.90 ,$30.36 ,$132.00 , N/A , N/A ,$33.40 ,$112.20 ,$78.86 ,$118.80 ,$110.88 ,$105.60 ,$105.60 ,$30.36 ,$85.80 ST. FRANCIS HOSPITAL - ACUTE,45000137,40830,HC LAC REPAIR VESTIBULE MOUTH 2.5 CM OR LESS,450,1 ,$554.00 ,$360.10 ,$127.42 ,$554.00 ,$398.88 ,$301.38 ,$127.42 ,$309.24 ,$127.42 ,$330.96 ,$330.96 ,$330.96 ,$330.96 ,$465.36 ,$127.42 ,$470.90 ,$465.36 ,$127.42 ,$415.50 ,$443.20 ,$443.20 ,$127.42 ,$443.20 ,$465.36 ,$465.36 ,$465.36 ,$498.60 ,$318.55 ,$127.42 ,$554.00 , N/A , N/A ,$140.16 ,$470.90 ,$330.96 ,$498.60 ,$465.36 ,$443.20 ,$443.20 ,$127.42 ,$360.10 ST. FRANCIS HOSPITAL - ACUTE,45000138,41250,HC RPR LAC MOUTH/TONGUE <2.5CM,450,1 ,$271.00 ,$176.15 ,$62.33 ,$271.00 ,$195.12 ,$147.42 ,$62.33 ,$151.27 ,$62.33 ,$161.90 ,$161.90 ,$161.90 ,$161.90 ,$227.64 ,$62.33 ,$230.35 ,$227.64 ,$62.33 ,$203.25 ,$216.80 ,$216.80 ,$62.33 ,$216.80 ,$227.64 ,$227.64 ,$227.64 ,$243.90 ,$155.83 ,$62.33 ,$271.00 , N/A , N/A ,$68.56 ,$230.35 ,$161.90 ,$243.90 ,$227.64 ,$216.80 ,$216.80 ,$62.33 ,$176.15 ST. FRANCIS HOSPITAL - ACUTE,45000139,41800,HC DRAIN ABSC/CYST DENTOALVLR,450,1 ,$143.00 ,$92.95 ,$32.89 ,$143.00 ,$102.96 ,$77.79 ,$32.89 ,$79.82 ,$32.89 ,$85.43 ,$85.43 ,$85.43 ,$85.43 ,$120.12 ,$32.89 ,$121.55 ,$120.12 ,$32.89 ,$107.25 ,$114.40 ,$114.40 ,$32.89 ,$114.40 ,$120.12 ,$120.12 ,$120.12 ,$128.70 ,$82.23 ,$32.89 ,$143.00 , N/A , N/A ,$36.18 ,$121.55 ,$85.43 ,$128.70 ,$120.12 ,$114.40 ,$114.40 ,$32.89 ,$92.95 ST. FRANCIS HOSPITAL - ACUTE,45000147,46050,HC I AND D ABSC PERIANAL SUPFIC,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000148,46083,HC INC HEMORRHOID EXTERNAL,450,1 ,$143.00 ,$92.95 ,$32.89 ,$143.00 ,$102.96 ,$77.79 ,$32.89 ,$79.82 ,$32.89 ,$85.43 ,$85.43 ,$85.43 ,$85.43 ,$120.12 ,$32.89 ,$121.55 ,$120.12 ,$32.89 ,$107.25 ,$114.40 ,$114.40 ,$32.89 ,$114.40 ,$120.12 ,$120.12 ,$120.12 ,$128.70 ,$82.23 ,$32.89 ,$143.00 , N/A , N/A ,$36.18 ,$121.55 ,$85.43 ,$128.70 ,$120.12 ,$114.40 ,$114.40 ,$32.89 ,$92.95 ST. FRANCIS HOSPITAL - ACUTE,45000156,51700,HC IRRIG/LAVG/INSTL BLADDER,450,1 ,$328.00 ,$213.20 ,$75.44 ,$328.00 ,$236.16 ,$178.43 ,$75.44 ,$183.09 ,$75.44 ,$195.95 ,$195.95 ,$195.95 ,$195.95 ,$275.52 ,$75.44 ,$278.80 ,$275.52 ,$75.44 ,$246.00 ,$262.40 ,$262.40 ,$75.44 ,$262.40 ,$275.52 ,$275.52 ,$275.52 ,$295.20 ,$188.60 ,$75.44 ,$328.00 , N/A , N/A ,$82.98 ,$278.80 ,$195.95 ,$295.20 ,$275.52 ,$262.40 ,$262.40 ,$75.44 ,$213.20 ST. FRANCIS HOSPITAL - ACUTE,45000163,56405,HC I AND D ABSC VULVA/PERINEAL,450,1 ,$331.00 ,$215.15 ,$76.13 ,$331.00 ,$238.32 ,$180.06 ,$76.13 ,$184.76 ,$76.13 ,$197.74 ,$197.74 ,$197.74 ,$197.74 ,$278.04 ,$76.13 ,$281.35 ,$278.04 ,$76.13 ,$248.25 ,$264.80 ,$264.80 ,$76.13 ,$264.80 ,$278.04 ,$278.04 ,$278.04 ,$297.90 ,$190.33 ,$76.13 ,$331.00 , N/A , N/A ,$83.74 ,$281.35 ,$197.74 ,$297.90 ,$278.04 ,$264.80 ,$264.80 ,$76.13 ,$215.15 ST. FRANCIS HOSPITAL - ACUTE,45000165,58301,HC REM DVC INTRAUTERINE,450,1 ,$134.00 ,$87.10 ,$30.82 ,$134.00 ,$96.48 ,$72.90 ,$30.82 ,$74.80 ,$30.82 ,$80.05 ,$80.05 ,$80.05 ,$80.05 ,$112.56 ,$30.82 ,$113.90 ,$112.56 ,$30.82 ,$100.50 ,$107.20 ,$107.20 ,$30.82 ,$107.20 ,$112.56 ,$112.56 ,$112.56 ,$120.60 ,$77.05 ,$30.82 ,$134.00 , N/A , N/A ,$33.90 ,$113.90 ,$80.05 ,$120.60 ,$112.56 ,$107.20 ,$107.20 ,$30.82 ,$87.10 ST. FRANCIS HOSPITAL - ACUTE,45000168,64400,HC DENTAL BLOCK,450,1 ,$502.00 ,$326.30 ,$115.46 ,$502.00 ,$361.44 ,$273.09 ,$115.46 ,$280.22 ,$115.46 ,$299.89 ,$299.89 ,$299.89 ,$299.89 ,$421.68 ,$115.46 ,$426.70 ,$421.68 ,$115.46 ,$376.50 ,$401.60 ,$401.60 ,$115.46 ,$401.60 ,$421.68 ,$421.68 ,$421.68 ,$451.80 ,$288.65 ,$115.46 ,$502.00 , N/A , N/A ,$127.01 ,$426.70 ,$299.89 ,$451.80 ,$421.68 ,$401.60 ,$401.60 ,$115.46 ,$326.30 ST. FRANCIS HOSPITAL - ACUTE,45000168,64400,HC DENTAL BLOCK,450,1 ,"$1,087.00 ",$706.55 ,$250.01 ,"$1,087.00 ",$782.64 ,$591.33 ,$250.01 ,$606.76 ,$250.01 ,$649.37 ,$649.37 ,$649.37 ,$649.37 ,$913.08 ,$250.01 ,$923.95 ,$913.08 ,$250.01 ,$815.25 ,$869.60 ,$869.60 ,$250.01 ,$869.60 ,$913.08 ,$913.08 ,$913.08 ,$978.30 ,$625.03 ,$250.01 ,"$1,087.00 ", N/A , N/A ,$275.01 ,$923.95 ,$649.37 ,$978.30 ,$913.08 ,$869.60 ,$869.60 ,$250.01 ,$706.55 ST. FRANCIS HOSPITAL - ACUTE,45000169,64999,HC INJECTION FACIAL NERVE,450,1 ,$513.00 ,$333.45 ,$117.99 ,$513.00 ,$369.36 ,$279.07 ,$117.99 ,$286.36 ,$117.99 ,$306.47 ,$306.47 ,$306.47 ,$306.47 ,$430.92 ,$117.99 ,$436.05 ,$430.92 ,$117.99 ,$384.75 ,$410.40 ,$410.40 ,$117.99 ,$410.40 ,$430.92 ,$430.92 ,$430.92 ,$461.70 ,$294.98 ,$117.99 ,$513.00 , N/A , N/A ,$129.79 ,$436.05 ,$306.47 ,$461.70 ,$430.92 ,$410.40 ,$410.40 ,$117.99 ,$333.45 ST. FRANCIS HOSPITAL - ACUTE,45000169,64999,HC INJECTION FACIAL NERVE,450,1 ,"$1,016.00 ",$660.40 ,$233.68 ,"$1,016.00 ",$731.52 ,$552.70 ,$233.68 ,$567.13 ,$233.68 ,$606.96 ,$606.96 ,$606.96 ,$606.96 ,$853.44 ,$233.68 ,$863.60 ,$853.44 ,$233.68 ,$762.00 ,$812.80 ,$812.80 ,$233.68 ,$812.80 ,$853.44 ,$853.44 ,$853.44 ,$914.40 ,$584.20 ,$233.68 ,"$1,016.00 ", N/A , N/A ,$257.05 ,$863.60 ,$606.96 ,$914.40 ,$853.44 ,$812.80 ,$812.80 ,$233.68 ,$660.40 ST. FRANCIS HOSPITAL - ACUTE,45000170,64450,HC INJ ANES NERVE PERIPHERAL,450,1 ,"$1,679.00 ","$1,091.35 ",$386.17 ,"$1,679.00 ","$1,208.88 ",$913.38 ,$386.17 ,$937.22 ,$386.17 ,"$1,003.03 ","$1,003.03 ","$1,003.03 ","$1,003.03 ","$1,410.36 ",$386.17 ,"$1,427.15 ","$1,410.36 ",$386.17 ,"$1,259.25 ","$1,343.20 ","$1,343.20 ",$386.17 ,"$1,343.20 ","$1,410.36 ","$1,410.36 ","$1,410.36 ","$1,511.10 ",$965.43 ,$386.17 ,"$1,679.00 ", N/A , N/A ,$424.79 ,"$1,427.15 ","$1,003.03 ","$1,511.10 ","$1,410.36 ","$1,343.20 ","$1,343.20 ",$386.17 ,"$1,091.35 " ST. FRANCIS HOSPITAL - ACUTE,45000171,65205,HC REM EYE FB CONJUCT SUPER,450,1 ,$69.00 ,$44.85 ,$15.87 ,$69.00 ,$49.68 ,$37.54 ,$15.87 ,$38.52 ,$15.87 ,$41.22 ,$41.22 ,$41.22 ,$41.22 ,$57.96 ,$15.87 ,$58.65 ,$57.96 ,$15.87 ,$51.75 ,$55.20 ,$55.20 ,$15.87 ,$55.20 ,$57.96 ,$57.96 ,$57.96 ,$62.10 ,$39.68 ,$15.87 ,$69.00 , N/A , N/A ,$17.46 ,$58.65 ,$41.22 ,$62.10 ,$57.96 ,$55.20 ,$55.20 ,$15.87 ,$44.85 ST. FRANCIS HOSPITAL - ACUTE,45000173,65220,HC REM FB CORNL W/O SLIT LA,450,1 ,$269.00 ,$174.85 ,$61.87 ,$269.00 ,$193.68 ,$146.34 ,$61.87 ,$150.16 ,$61.87 ,$160.70 ,$160.70 ,$160.70 ,$160.70 ,$225.96 ,$61.87 ,$228.65 ,$225.96 ,$61.87 ,$201.75 ,$215.20 ,$215.20 ,$61.87 ,$215.20 ,$225.96 ,$225.96 ,$225.96 ,$242.10 ,$154.68 ,$61.87 ,$269.00 , N/A , N/A ,$68.06 ,$228.65 ,$160.70 ,$242.10 ,$225.96 ,$215.20 ,$215.20 ,$61.87 ,$174.85 ST. FRANCIS HOSPITAL - ACUTE,45000174,65222,HC REM FB CORNL W/ SLIT LA,450,1 ,$279.00 ,$181.35 ,$64.17 ,$279.00 ,$200.88 ,$151.78 ,$64.17 ,$155.74 ,$64.17 ,$166.67 ,$166.67 ,$166.67 ,$166.67 ,$234.36 ,$64.17 ,$237.15 ,$234.36 ,$64.17 ,$209.25 ,$223.20 ,$223.20 ,$64.17 ,$223.20 ,$234.36 ,$234.36 ,$234.36 ,$251.10 ,$160.43 ,$64.17 ,$279.00 , N/A , N/A ,$70.59 ,$237.15 ,$166.67 ,$251.10 ,$234.36 ,$223.20 ,$223.20 ,$64.17 ,$181.35 ST. FRANCIS HOSPITAL - ACUTE,45000177,67700,HC I AND D ABSCESS EYELID,450,1 ,$319.00 ,$207.35 ,$73.37 ,$319.00 ,$229.68 ,$173.54 ,$73.37 ,$178.07 ,$73.37 ,$190.57 ,$190.57 ,$190.57 ,$190.57 ,$267.96 ,$73.37 ,$271.15 ,$267.96 ,$73.37 ,$239.25 ,$255.20 ,$255.20 ,$73.37 ,$255.20 ,$267.96 ,$267.96 ,$267.96 ,$287.10 ,$183.43 ,$73.37 ,$319.00 , N/A , N/A ,$80.71 ,$271.15 ,$190.57 ,$287.10 ,$267.96 ,$255.20 ,$255.20 ,$73.37 ,$207.35 ST. FRANCIS HOSPITAL - ACUTE,45000178,67938,HC REMOVE EMBEDDED FB EYELID,450,1 ,$155.00 ,$100.75 ,$35.65 ,$155.00 ,$111.60 ,$84.32 ,$35.65 ,$86.52 ,$35.65 ,$92.60 ,$92.60 ,$92.60 ,$92.60 ,$130.20 ,$35.65 ,$131.75 ,$130.20 ,$35.65 ,$116.25 ,$124.00 ,$124.00 ,$35.65 ,$124.00 ,$130.20 ,$130.20 ,$130.20 ,$139.50 ,$89.13 ,$35.65 ,$155.00 , N/A , N/A ,$39.22 ,$131.75 ,$92.60 ,$139.50 ,$130.20 ,$124.00 ,$124.00 ,$35.65 ,$100.75 ST. FRANCIS HOSPITAL - ACUTE,45000181,69200,HC FB REMOVAL EAR,450,1 ,$324.00 ,$210.60 ,$74.52 ,$324.00 ,$233.28 ,$176.26 ,$74.52 ,$180.86 ,$74.52 ,$193.56 ,$193.56 ,$193.56 ,$193.56 ,$272.16 ,$74.52 ,$275.40 ,$272.16 ,$74.52 ,$243.00 ,$259.20 ,$259.20 ,$74.52 ,$259.20 ,$272.16 ,$272.16 ,$272.16 ,$291.60 ,$186.30 ,$74.52 ,$324.00 , N/A , N/A ,$81.97 ,$275.40 ,$193.56 ,$291.60 ,$272.16 ,$259.20 ,$259.20 ,$74.52 ,$210.60 ST. FRANCIS HOSPITAL - ACUTE,45000183,69210,HC REMOVE CERUMEN IMPACTED BY INSTRUMENTATION,450,1 ,$72.00 ,$46.80 ,$16.56 ,$72.00 ,$51.84 ,$39.17 ,$16.56 ,$40.19 ,$16.56 ,$43.01 ,$43.01 ,$43.01 ,$43.01 ,$60.48 ,$16.56 ,$61.20 ,$60.48 ,$16.56 ,$54.00 ,$57.60 ,$57.60 ,$16.56 ,$57.60 ,$60.48 ,$60.48 ,$60.48 ,$64.80 ,$41.40 ,$16.56 ,$72.00 , N/A , N/A ,$18.22 ,$61.20 ,$43.01 ,$64.80 ,$60.48 ,$57.60 ,$57.60 ,$16.56 ,$46.80 ST. FRANCIS HOSPITAL - ACUTE,45000188,99281,HC ER LEVEL 1,450,1 ,$211.00 ,$137.15 ,$48.53 ,$211.00 ,$151.92 ,$114.78 ,$48.53 ,$117.78 ,$48.53 ,$126.05 ,$126.05 ,$126.05 ,$126.05 ,$177.24 ,$48.53 ,$179.35 ,$177.24 ,$48.53 ,$158.25 ,$168.80 ,$168.80 ,$48.53 ,$168.80 ,$177.24 ,$177.24 ,$177.24 ,$189.90 ,$121.33 ,$48.53 ,$211.00 , N/A , N/A ,$53.38 ,$179.35 ,$126.05 ,$189.90 ,$177.24 ,$168.80 ,$168.80 ,$48.53 ,$137.15 ST. FRANCIS HOSPITAL - ACUTE,45000189,99282,HC ER LEVEL 2,450,1 ,$417.00 ,$271.05 ,$95.91 ,$417.00 ,$300.24 ,$226.85 ,$95.91 ,$232.77 ,$95.91 ,$249.12 ,$249.12 ,$249.12 ,$249.12 ,$350.28 ,$95.91 ,$354.45 ,$350.28 ,$95.91 ,$312.75 ,$333.60 ,$333.60 ,$95.91 ,$333.60 ,$350.28 ,$350.28 ,$350.28 ,$375.30 ,$239.78 ,$95.91 ,$417.00 , N/A , N/A ,$105.50 ,$354.45 ,$249.12 ,$375.30 ,$350.28 ,$333.60 ,$333.60 ,$95.91 ,$271.05 ST. FRANCIS HOSPITAL - ACUTE,45000190,99283,HC ER LEVEL 3,450,1 ,$609.00 ,$395.85 ,$140.07 ,$609.00 ,$438.48 ,$331.30 ,$140.07 ,$339.94 ,$140.07 ,$363.82 ,$363.82 ,$363.82 ,$363.82 ,$511.56 ,$140.07 ,$517.65 ,$511.56 ,$140.07 ,$456.75 ,$487.20 ,$487.20 ,$140.07 ,$487.20 ,$511.56 ,$511.56 ,$511.56 ,$548.10 ,$350.18 ,$140.07 ,$609.00 , N/A , N/A ,$154.08 ,$517.65 ,$363.82 ,$548.10 ,$511.56 ,$487.20 ,$487.20 ,$140.07 ,$395.85 ST. FRANCIS HOSPITAL - ACUTE,45000191,99284,HC ER LEVEL 4,450,1 ,$957.00 ,$622.05 ,$134.83 ,$957.00 ,$689.04 ,$520.61 ,$220.11 ,$534.20 ,$220.11 ,$571.71 ,$571.71 ,$571.71 ,$571.71 ,$803.88 ,$220.11 ,$813.45 ,$803.88 ,$220.11 ,$717.75 ,$765.60 ,$765.60 ,$220.11 ,$765.60 ,$803.88 ,$803.88 ,$803.88 ,$861.30 ,$550.28 ,$220.11 ,$957.00 ,$134.83 ,$148.31 ,$242.12 ,$813.45 ,$571.71 ,$861.30 ,$803.88 ,$765.60 ,$765.60 ,$220.11 ,$622.05 ST. FRANCIS HOSPITAL - ACUTE,45000192,99285,HC ER LEVEL 5,450,1 ,"$1,688.00 ","$1,097.20 ",$134.83 ,"$1,688.00 ","$1,215.36 ",$918.27 ,$388.24 ,$942.24 ,$388.24 ,"$1,008.41 ","$1,008.41 ","$1,008.41 ","$1,008.41 ","$1,417.92 ",$388.24 ,"$1,434.80 ","$1,417.92 ",$388.24 ,"$1,266.00 ","$1,350.40 ","$1,350.40 ",$388.24 ,"$1,350.40 ","$1,417.92 ","$1,417.92 ","$1,417.92 ","$1,519.20 ",$970.60 ,$388.24 ,"$1,688.00 ",$134.83 ,$148.31 ,$427.06 ,"$1,434.80 ","$1,008.41 ","$1,519.20 ","$1,417.92 ","$1,350.40 ","$1,350.40 ",$388.24 ,"$1,097.20 " ST. FRANCIS HOSPITAL - ACUTE,45000193,99291,HC CRITICAL CARE 30-74 MIN,450,1 ,"$2,381.00 ","$1,547.65 ",$134.83 ,"$2,381.00 ","$1,714.32 ","$1,295.26 ",$547.63 ,"$1,329.07 ",$547.63 ,"$1,422.41 ","$1,422.41 ","$1,422.41 ","$1,422.41 ","$2,000.04 ",$547.63 ,"$2,023.85 ","$2,000.04 ",$547.63 ,"$1,785.75 ","$1,904.80 ","$1,904.80 ",$547.63 ,"$1,904.80 ","$2,000.04 ","$2,000.04 ","$2,000.04 ","$2,142.90 ","$1,369.08 ",$547.63 ,"$2,381.00 ",$134.83 ,$148.31 ,$602.39 ,"$2,023.85 ","$1,422.41 ","$2,142.90 ","$2,000.04 ","$1,904.80 ","$1,904.80 ",$547.63 ,"$1,547.65 " ST. FRANCIS HOSPITAL - ACUTE,45000195,99292,HC CRITICAL CARE EA ADDN'T 30 MIN,450,1 ,$742.00 ,$482.30 ,$170.66 ,$742.00 ,$534.24 ,$403.65 ,$170.66 ,$414.18 ,$170.66 ,$443.27 ,$443.27 ,$443.27 ,$443.27 ,$623.28 ,$170.66 ,$630.70 ,$623.28 ,$170.66 ,$556.50 ,$593.60 ,$593.60 ,$170.66 ,$593.60 ,$623.28 ,$623.28 ,$623.28 ,$667.80 ,$426.65 ,$170.66 ,$742.00 , N/A , N/A ,$187.73 ,$630.70 ,$443.27 ,$667.80 ,$623.28 ,$593.60 ,$593.60 ,$170.66 ,$482.30 ST. FRANCIS HOSPITAL - ACUTE,45000196,27810,HC TX FX BIM ANKLE W/MAN CLS,450,1 ,$550.00 ,$357.50 ,$126.50 ,$550.00 ,$396.00 ,$299.20 ,$126.50 ,$307.01 ,$126.50 ,$328.57 ,$328.57 ,$328.57 ,$328.57 ,$462.00 ,$126.50 ,$467.50 ,$462.00 ,$126.50 ,$412.50 ,$440.00 ,$440.00 ,$126.50 ,$440.00 ,$462.00 ,$462.00 ,$462.00 ,$495.00 ,$316.25 ,$126.50 ,$550.00 , N/A , N/A ,$139.15 ,$467.50 ,$328.57 ,$495.00 ,$462.00 ,$440.00 ,$440.00 ,$126.50 ,$357.50 ST. FRANCIS HOSPITAL - ACUTE,45000198,21480,HC TX DISL JAW CLS-UNI,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000200,35206,HC RPR VESSEL EXTREM UPR,450,1 ,"$3,343.00 ","$2,172.95 ",$768.89 ,"$3,343.00 ","$2,406.96 ","$1,818.59 ",$768.89 ,"$1,866.06 ",$768.89 ,"$1,997.11 ","$1,997.11 ","$1,997.11 ","$1,997.11 ","$2,808.12 ",$768.89 ,"$2,841.55 ","$2,808.12 ",$768.89 ,"$2,507.25 ","$2,674.40 ","$2,674.40 ",$768.89 ,"$2,674.40 ","$2,808.12 ","$2,808.12 ","$2,808.12 ","$3,008.70 ","$1,922.23 ",$768.89 ,"$3,343.00 ", N/A , N/A ,$845.78 ,"$2,841.55 ","$1,997.11 ","$3,008.70 ","$2,808.12 ","$2,674.40 ","$2,674.40 ",$768.89 ,"$2,172.95 " ST. FRANCIS HOSPITAL - ACUTE,45000204,23931,HC I AND D BURSA ELBOW/ARM,450,1 ,$158.00 ,$102.70 ,$36.34 ,$158.00 ,$113.76 ,$85.95 ,$36.34 ,$88.20 ,$36.34 ,$94.39 ,$94.39 ,$94.39 ,$94.39 ,$132.72 ,$36.34 ,$134.30 ,$132.72 ,$36.34 ,$118.50 ,$126.40 ,$126.40 ,$36.34 ,$126.40 ,$132.72 ,$132.72 ,$132.72 ,$142.20 ,$90.85 ,$36.34 ,$158.00 , N/A , N/A ,$39.97 ,$134.30 ,$94.39 ,$142.20 ,$132.72 ,$126.40 ,$126.40 ,$36.34 ,$102.70 ST. FRANCIS HOSPITAL - ACUTE,45000210,25680,HC CLSD WRIST FX W/MANIP,450,1 ,$248.00 ,$161.20 ,$57.04 ,$248.00 ,$178.56 ,$134.91 ,$57.04 ,$138.43 ,$57.04 ,$148.16 ,$148.16 ,$148.16 ,$148.16 ,$208.32 ,$57.04 ,$210.80 ,$208.32 ,$57.04 ,$186.00 ,$198.40 ,$198.40 ,$57.04 ,$198.40 ,$208.32 ,$208.32 ,$208.32 ,$223.20 ,$142.60 ,$57.04 ,$248.00 , N/A , N/A ,$62.74 ,$210.80 ,$148.16 ,$223.20 ,$208.32 ,$198.40 ,$198.40 ,$57.04 ,$161.20 ST. FRANCIS HOSPITAL - ACUTE,45000214,37195,HC THROMBOLYSIS;CEREB IV,450,1 ,$893.00 ,$580.45 ,$205.39 ,$893.00 ,$642.96 ,$485.79 ,$205.39 ,$498.47 ,$205.39 ,$533.48 ,$533.48 ,$533.48 ,$533.48 ,$750.12 ,$205.39 ,$759.05 ,$750.12 ,$205.39 ,$669.75 ,$714.40 ,$714.40 ,$205.39 ,$714.40 ,$750.12 ,$750.12 ,$750.12 ,$803.70 ,$513.48 ,$205.39 ,$893.00 , N/A , N/A ,$225.93 ,$759.05 ,$533.48 ,$803.70 ,$750.12 ,$714.40 ,$714.40 ,$205.39 ,$580.45 ST. FRANCIS HOSPITAL - ACUTE,45000219,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP,450,1 ,$367.00 ,$238.55 ,$84.41 ,$367.00 ,$264.24 ,$199.65 ,$84.41 ,$204.86 ,$84.41 ,$219.25 ,$219.25 ,$219.25 ,$219.25 ,$308.28 ,$84.41 ,$311.95 ,$308.28 ,$84.41 ,$275.25 ,$293.60 ,$293.60 ,$84.41 ,$293.60 ,$308.28 ,$308.28 ,$308.28 ,$330.30 ,$211.03 ,$84.41 ,$367.00 , N/A , N/A ,$92.85 ,$311.95 ,$219.25 ,$330.30 ,$308.28 ,$293.60 ,$293.60 ,$84.41 ,$238.55 ST. FRANCIS HOSPITAL - ACUTE,45000220,29280,HC STRAPPING HAND/FINGER,450,1 ,$227.00 ,$147.55 ,$52.21 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 , N/A , N/A ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,45000230,26605,HC CLSD METACARPAL FX W/MANIP,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000234,25560,HC RADIUS AND ULNA FX W/O MANIP,450,1 ,$611.00 ,$397.15 ,$140.53 ,$611.00 ,$439.92 ,$332.38 ,$140.53 ,$341.06 ,$140.53 ,$365.01 ,$365.01 ,$365.01 ,$365.01 ,$513.24 ,$140.53 ,$519.35 ,$513.24 ,$140.53 ,$458.25 ,$488.80 ,$488.80 ,$140.53 ,$488.80 ,$513.24 ,$513.24 ,$513.24 ,$549.90 ,$351.33 ,$140.53 ,$611.00 , N/A , N/A ,$154.58 ,$519.35 ,$365.01 ,$549.90 ,$513.24 ,$488.80 ,$488.80 ,$140.53 ,$397.15 ST. FRANCIS HOSPITAL - ACUTE,45000252,20520,HC MUSCLE FB REM W/ INC,450,1 ,$260.00 ,$169.00 ,$59.80 ,$260.00 ,$187.20 ,$141.44 ,$59.80 ,$145.13 ,$59.80 ,$155.32 ,$155.32 ,$155.32 ,$155.32 ,$218.40 ,$59.80 ,$221.00 ,$218.40 ,$59.80 ,$195.00 ,$208.00 ,$208.00 ,$59.80 ,$208.00 ,$218.40 ,$218.40 ,$218.40 ,$234.00 ,$149.50 ,$59.80 ,$260.00 , N/A , N/A ,$65.78 ,$221.00 ,$155.32 ,$234.00 ,$218.40 ,$208.00 ,$208.00 ,$59.80 ,$169.00 ST. FRANCIS HOSPITAL - ACUTE,45000258,29345,HC LONG LEG CAST,450,1 ,$413.00 ,$268.45 ,$94.99 ,$413.00 ,$297.36 ,$224.67 ,$94.99 ,$230.54 ,$94.99 ,$246.73 ,$246.73 ,$246.73 ,$246.73 ,$346.92 ,$94.99 ,$351.05 ,$346.92 ,$94.99 ,$309.75 ,$330.40 ,$330.40 ,$94.99 ,$330.40 ,$346.92 ,$346.92 ,$346.92 ,$371.70 ,$237.48 ,$94.99 ,$413.00 , N/A , N/A ,$104.49 ,$351.05 ,$246.73 ,$371.70 ,$346.92 ,$330.40 ,$330.40 ,$94.99 ,$268.45 ST. FRANCIS HOSPITAL - ACUTE,45000272,20611,HC ARTHROCNT ASP/INJ JT MAJOR W/ ULTRA,450,1 ,"$1,279.00 ",$831.35 ,$294.17 ,"$1,279.00 ",$920.88 ,$695.78 ,$294.17 ,$713.94 ,$294.17 ,$764.07 ,$764.07 ,$764.07 ,$764.07 ,"$1,074.36 ",$294.17 ,"$1,087.15 ","$1,074.36 ",$294.17 ,$959.25 ,"$1,023.20 ","$1,023.20 ",$294.17 ,"$1,023.20 ","$1,074.36 ","$1,074.36 ","$1,074.36 ","$1,151.10 ",$735.43 ,$294.17 ,"$1,279.00 ", N/A , N/A ,$323.59 ,"$1,087.15 ",$764.07 ,"$1,151.10 ","$1,074.36 ","$1,023.20 ","$1,023.20 ",$294.17 ,$831.35 ST. FRANCIS HOSPITAL - ACUTE,45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$113.00 ,$73.45 ,$25.99 ,$113.00 ,$81.36 ,$61.47 ,$25.99 ,$63.08 ,$25.99 ,$67.51 ,$67.51 ,$67.51 ,$67.51 ,$94.92 ,$25.99 ,$96.05 ,$94.92 ,$25.99 ,$84.75 ,$90.40 ,$90.40 ,$25.99 ,$90.40 ,$94.92 ,$94.92 ,$94.92 ,$101.70 ,$64.98 ,$25.99 ,$113.00 , N/A , N/A ,$28.59 ,$96.05 ,$67.51 ,$101.70 ,$94.92 ,$90.40 ,$90.40 ,$25.99 ,$73.45 ST. FRANCIS HOSPITAL - ACUTE,45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$223.00 ,$144.95 ,$51.29 ,$223.00 ,$160.56 ,$121.31 ,$51.29 ,$124.48 ,$51.29 ,$133.22 ,$133.22 ,$133.22 ,$133.22 ,$187.32 ,$51.29 ,$189.55 ,$187.32 ,$51.29 ,$167.25 ,$178.40 ,$178.40 ,$51.29 ,$178.40 ,$187.32 ,$187.32 ,$187.32 ,$200.70 ,$128.23 ,$51.29 ,$223.00 , N/A , N/A ,$56.42 ,$189.55 ,$133.22 ,$200.70 ,$187.32 ,$178.40 ,$178.40 ,$51.29 ,$144.95 ST. FRANCIS HOSPITAL - ACUTE,45000329,27752,HC CLSD TX FX TIBIAL SHAFT W/MANIP,450,1 ,$367.00 ,$238.55 ,$84.41 ,$367.00 ,$264.24 ,$199.65 ,$84.41 ,$204.86 ,$84.41 ,$219.25 ,$219.25 ,$219.25 ,$219.25 ,$308.28 ,$84.41 ,$311.95 ,$308.28 ,$84.41 ,$275.25 ,$293.60 ,$293.60 ,$84.41 ,$293.60 ,$308.28 ,$308.28 ,$308.28 ,$330.30 ,$211.03 ,$84.41 ,$367.00 , N/A , N/A ,$92.85 ,$311.95 ,$219.25 ,$330.30 ,$308.28 ,$293.60 ,$293.60 ,$84.41 ,$238.55 ST. FRANCIS HOSPITAL - ACUTE,45000334,29260,HC STRAPPING ELBOW/WRIST,450,1 ,$227.00 ,$147.55 ,$52.21 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 , N/A , N/A ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,45000335,29530,HC STRAPPING KNEE,450,1 ,$269.00 ,$174.85 ,$61.87 ,$269.00 ,$193.68 ,$146.34 ,$61.87 ,$150.16 ,$61.87 ,$160.70 ,$160.70 ,$160.70 ,$160.70 ,$225.96 ,$61.87 ,$228.65 ,$225.96 ,$61.87 ,$201.75 ,$215.20 ,$215.20 ,$61.87 ,$215.20 ,$225.96 ,$225.96 ,$225.96 ,$242.10 ,$154.68 ,$61.87 ,$269.00 , N/A , N/A ,$68.06 ,$228.65 ,$160.70 ,$242.10 ,$225.96 ,$215.20 ,$215.20 ,$61.87 ,$174.85 ST. FRANCIS HOSPITAL - ACUTE,45000336,29550,HC STRAPPING TOES,450,1 ,$227.00 ,$147.55 ,$52.21 ,$227.00 ,$163.44 ,$123.49 ,$52.21 ,$126.71 ,$52.21 ,$135.61 ,$135.61 ,$135.61 ,$135.61 ,$190.68 ,$52.21 ,$192.95 ,$190.68 ,$52.21 ,$170.25 ,$181.60 ,$181.60 ,$52.21 ,$181.60 ,$190.68 ,$190.68 ,$190.68 ,$204.30 ,$130.53 ,$52.21 ,$227.00 , N/A , N/A ,$57.43 ,$192.95 ,$135.61 ,$204.30 ,$190.68 ,$181.60 ,$181.60 ,$52.21 ,$147.55 ST. FRANCIS HOSPITAL - ACUTE,45000451,69000,HC DRAIN ABSC/HEMA EAR EXT SMP-LT,450,1 ,"$1,243.00 ",$807.95 ,$285.89 ,"$1,243.00 ",$894.96 ,$676.19 ,$285.89 ,$693.84 ,$285.89 ,$742.57 ,$742.57 ,$742.57 ,$742.57 ,"$1,044.12 ",$285.89 ,"$1,056.55 ","$1,044.12 ",$285.89 ,$932.25 ,$994.40 ,$994.40 ,$285.89 ,$994.40 ,"$1,044.12 ","$1,044.12 ","$1,044.12 ","$1,118.70 ",$714.73 ,$285.89 ,"$1,243.00 ", N/A , N/A ,$314.48 ,"$1,056.55 ",$742.57 ,"$1,118.70 ","$1,044.12 ",$994.40 ,$994.40 ,$285.89 ,$807.95 ST. FRANCIS HOSPITAL - ACUTE,45000452,69000,HC DRAIN ABSC/HEMA EAR EXT SMP-RT,450,1 ,"$1,243.00 ",$807.95 ,$285.89 ,"$1,243.00 ",$894.96 ,$676.19 ,$285.89 ,$693.84 ,$285.89 ,$742.57 ,$742.57 ,$742.57 ,$742.57 ,"$1,044.12 ",$285.89 ,"$1,056.55 ","$1,044.12 ",$285.89 ,$932.25 ,$994.40 ,$994.40 ,$285.89 ,$994.40 ,"$1,044.12 ","$1,044.12 ","$1,044.12 ","$1,118.70 ",$714.73 ,$285.89 ,"$1,243.00 ", N/A , N/A ,$314.48 ,"$1,056.55 ",$742.57 ,"$1,118.70 ","$1,044.12 ",$994.40 ,$994.40 ,$285.89 ,$807.95 ST. FRANCIS HOSPITAL - ACUTE,45000457,29365,HC APPL CAST CYCLINDER THIGH TO ANKLE,450,1 ,$593.00 ,$385.45 ,$136.39 ,$593.00 ,$426.96 ,$322.59 ,$136.39 ,$331.01 ,$136.39 ,$354.26 ,$354.26 ,$354.26 ,$354.26 ,$498.12 ,$136.39 ,$504.05 ,$498.12 ,$136.39 ,$444.75 ,$474.40 ,$474.40 ,$136.39 ,$474.40 ,$498.12 ,$498.12 ,$498.12 ,$533.70 ,$340.98 ,$136.39 ,$593.00 , N/A , N/A ,$150.03 ,$504.05 ,$354.26 ,$533.70 ,$498.12 ,$474.40 ,$474.40 ,$136.39 ,$385.45 ST. FRANCIS HOSPITAL - ACUTE,45000493,36600,HC ARTERIAL PUNCTURE,450,1 ,$70.00 ,$45.50 ,$16.10 ,$70.00 ,$50.40 ,$38.08 ,$16.10 ,$39.07 ,$16.10 ,$41.82 ,$41.82 ,$41.82 ,$41.82 ,$58.80 ,$16.10 ,$59.50 ,$58.80 ,$16.10 ,$52.50 ,$56.00 ,$56.00 ,$16.10 ,$56.00 ,$58.80 ,$58.80 ,$58.80 ,$63.00 ,$40.25 ,$16.10 ,$70.00 , N/A , N/A ,$17.71 ,$59.50 ,$41.82 ,$63.00 ,$58.80 ,$56.00 ,$56.00 ,$16.10 ,$45.50 ST. FRANCIS HOSPITAL - ACUTE,45000532,23575,HC TX FX SCAPULA CLOSED W/MANIP W/W/O TRACTION,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45000538,27530,HC TX FX TIBIAL W/O MANIP CLOSED,450,1 ,$698.00 ,$453.70 ,$160.54 ,$698.00 ,$502.56 ,$379.71 ,$160.54 ,$389.62 ,$160.54 ,$416.99 ,$416.99 ,$416.99 ,$416.99 ,$586.32 ,$160.54 ,$593.30 ,$586.32 ,$160.54 ,$523.50 ,$558.40 ,$558.40 ,$160.54 ,$558.40 ,$586.32 ,$586.32 ,$586.32 ,$628.20 ,$401.35 ,$160.54 ,$698.00 , N/A , N/A ,$176.59 ,$593.30 ,$416.99 ,$628.20 ,$586.32 ,$558.40 ,$558.40 ,$160.54 ,$453.70 ST. FRANCIS HOSPITAL - ACUTE,45000548,29425,HC APPLY SHORT LEG CAST WALKING,450,1 ,$408.00 ,$265.20 ,$93.84 ,$408.00 ,$293.76 ,$221.95 ,$93.84 ,$227.75 ,$93.84 ,$243.74 ,$243.74 ,$243.74 ,$243.74 ,$342.72 ,$93.84 ,$346.80 ,$342.72 ,$93.84 ,$306.00 ,$326.40 ,$326.40 ,$93.84 ,$326.40 ,$342.72 ,$342.72 ,$342.72 ,$367.20 ,$234.60 ,$93.84 ,$408.00 , N/A , N/A ,$103.22 ,$346.80 ,$243.74 ,$367.20 ,$342.72 ,$326.40 ,$326.40 ,$93.84 ,$265.20 ST. FRANCIS HOSPITAL - ACUTE,45000569,26705,HC TX DISLOC (M-P) W/ANES CLOSED,450,1 ,$372.00 ,$241.80 ,$85.56 ,$372.00 ,$267.84 ,$202.37 ,$85.56 ,$207.65 ,$85.56 ,$222.23 ,$222.23 ,$222.23 ,$222.23 ,$312.48 ,$85.56 ,$316.20 ,$312.48 ,$85.56 ,$279.00 ,$297.60 ,$297.60 ,$85.56 ,$297.60 ,$312.48 ,$312.48 ,$312.48 ,$334.80 ,$213.90 ,$85.56 ,$372.00 , N/A , N/A ,$94.12 ,$316.20 ,$222.23 ,$334.80 ,$312.48 ,$297.60 ,$297.60 ,$85.56 ,$241.80 ST. FRANCIS HOSPITAL - ACUTE,45000582,25600,HC DISTAL RADIUS W/O MANIP CLOSED - RT,450,1 ,$444.00 ,$288.60 ,$102.12 ,$444.00 ,$319.68 ,$241.54 ,$102.12 ,$247.84 ,$102.12 ,$265.25 ,$265.25 ,$265.25 ,$265.25 ,$372.96 ,$102.12 ,$377.40 ,$372.96 ,$102.12 ,$333.00 ,$355.20 ,$355.20 ,$102.12 ,$355.20 ,$372.96 ,$372.96 ,$372.96 ,$399.60 ,$255.30 ,$102.12 ,$444.00 , N/A , N/A ,$112.33 ,$377.40 ,$265.25 ,$399.60 ,$372.96 ,$355.20 ,$355.20 ,$102.12 ,$288.60 ST. FRANCIS HOSPITAL - ACUTE,45000791,25680,HC TX FX CLOSED WRIST W/MANIP-LT,450,1 ,$248.00 ,$161.20 ,$57.04 ,$248.00 ,$178.56 ,$134.91 ,$57.04 ,$138.43 ,$57.04 ,$148.16 ,$148.16 ,$148.16 ,$148.16 ,$208.32 ,$57.04 ,$210.80 ,$208.32 ,$57.04 ,$186.00 ,$198.40 ,$198.40 ,$57.04 ,$198.40 ,$208.32 ,$208.32 ,$208.32 ,$223.20 ,$142.60 ,$57.04 ,$248.00 , N/A , N/A ,$62.74 ,$210.80 ,$148.16 ,$223.20 ,$208.32 ,$198.40 ,$198.40 ,$57.04 ,$161.20 ST. FRANCIS HOSPITAL - ACUTE,45001162,43830,HC GASTROSTOMY CONSTRUCT G-TUBE OPEN,450,1 ,$945.00 ,$614.25 ,$217.35 ,$945.00 ,$680.40 ,$514.08 ,$217.35 ,$527.50 ,$217.35 ,$564.54 ,$564.54 ,$564.54 ,$564.54 ,$793.80 ,$217.35 ,$803.25 ,$793.80 ,$217.35 ,$708.75 ,$756.00 ,$756.00 ,$217.35 ,$756.00 ,$793.80 ,$793.80 ,$793.80 ,$850.50 ,$543.38 ,$217.35 ,$945.00 , N/A , N/A ,$239.09 ,$803.25 ,$564.54 ,$850.50 ,$793.80 ,$756.00 ,$756.00 ,$217.35 ,$614.25 ST. FRANCIS HOSPITAL - ACUTE,45001265,23545,HC TX ACROMIOCLAVICULAR DISLOC W/MANIP CLOSED,450,1 ,$146.00 ,$94.90 ,$33.58 ,$146.00 ,$105.12 ,$79.42 ,$33.58 ,$81.50 ,$33.58 ,$87.22 ,$87.22 ,$87.22 ,$87.22 ,$122.64 ,$33.58 ,$124.10 ,$122.64 ,$33.58 ,$109.50 ,$116.80 ,$116.80 ,$33.58 ,$116.80 ,$122.64 ,$122.64 ,$122.64 ,$131.40 ,$83.95 ,$33.58 ,$146.00 , N/A , N/A ,$36.94 ,$124.10 ,$87.22 ,$131.40 ,$122.64 ,$116.80 ,$116.80 ,$33.58 ,$94.90 ST. FRANCIS HOSPITAL - ACUTE,45001272,23665,HC TX FX DISLOC SHOULDER HUMERW/MANIP,450,1 ,$267.00 ,$173.55 ,$61.41 ,$267.00 ,$192.24 ,$145.25 ,$61.41 ,$149.04 ,$61.41 ,$159.51 ,$159.51 ,$159.51 ,$159.51 ,$224.28 ,$61.41 ,$226.95 ,$224.28 ,$61.41 ,$200.25 ,$213.60 ,$213.60 ,$61.41 ,$213.60 ,$224.28 ,$224.28 ,$224.28 ,$240.30 ,$153.53 ,$61.41 ,$267.00 , N/A , N/A ,$67.55 ,$226.95 ,$159.51 ,$240.30 ,$224.28 ,$213.60 ,$213.60 ,$61.41 ,$173.55 ST. FRANCIS HOSPITAL - ACUTE,45001273,23675,HC TX FX DISLOC SHOULDER W/PROX HUM W/MANIP,450,1 ,$289.00 ,$187.85 ,$66.47 ,$289.00 ,$208.08 ,$157.22 ,$66.47 ,$161.32 ,$66.47 ,$172.65 ,$172.65 ,$172.65 ,$172.65 ,$242.76 ,$66.47 ,$245.65 ,$242.76 ,$66.47 ,$216.75 ,$231.20 ,$231.20 ,$66.47 ,$231.20 ,$242.76 ,$242.76 ,$242.76 ,$260.10 ,$166.18 ,$66.47 ,$289.00 , N/A , N/A ,$73.12 ,$245.65 ,$172.65 ,$260.10 ,$242.76 ,$231.20 ,$231.20 ,$66.47 ,$187.85 ST. FRANCIS HOSPITAL - ACUTE,45001282,25535,HC TX FX ULNAR CLOSED W/MANIP,450,1 ,$267.00 ,$173.55 ,$61.41 ,$267.00 ,$192.24 ,$145.25 ,$61.41 ,$149.04 ,$61.41 ,$159.51 ,$159.51 ,$159.51 ,$159.51 ,$224.28 ,$61.41 ,$226.95 ,$224.28 ,$61.41 ,$200.25 ,$213.60 ,$213.60 ,$61.41 ,$213.60 ,$224.28 ,$224.28 ,$224.28 ,$240.30 ,$153.53 ,$61.41 ,$267.00 , N/A , N/A ,$67.55 ,$226.95 ,$159.51 ,$240.30 ,$224.28 ,$213.60 ,$213.60 ,$61.41 ,$173.55 ST. FRANCIS HOSPITAL - ACUTE,45001317,67935,HC REPAIR EYELID WOUND FULL THICKNESS,450,1 ,"$2,944.00 ","$1,913.60 ",$677.12 ,"$2,944.00 ","$2,119.68 ","$1,601.54 ",$677.12 ,"$1,643.34 ",$677.12 ,"$1,758.75 ","$1,758.75 ","$1,758.75 ","$1,758.75 ","$2,472.96 ",$677.12 ,"$2,502.40 ","$2,472.96 ",$677.12 ,"$2,208.00 ","$2,355.20 ","$2,355.20 ",$677.12 ,"$2,355.20 ","$2,472.96 ","$2,472.96 ","$2,472.96 ","$2,649.60 ","$1,692.80 ",$677.12 ,"$2,944.00 ", N/A , N/A ,$744.83 ,"$2,502.40 ","$1,758.75 ","$2,649.60 ","$2,472.96 ","$2,355.20 ","$2,355.20 ",$677.12 ,"$1,913.60 " ST. FRANCIS HOSPITAL - ACUTE,45001331,43762,HC REPLACE GASTRO TUBE PERC,450,1 ,$719.00 ,$467.35 ,$165.37 ,$719.00 ,$517.68 ,$391.14 ,$165.37 ,$401.35 ,$165.37 ,$429.53 ,$429.53 ,$429.53 ,$429.53 ,$603.96 ,$165.37 ,$611.15 ,$603.96 ,$165.37 ,$539.25 ,$575.20 ,$575.20 ,$165.37 ,$575.20 ,$603.96 ,$603.96 ,$603.96 ,$647.10 ,$413.43 ,$165.37 ,$719.00 , N/A , N/A ,$181.91 ,$611.15 ,$429.53 ,$647.10 ,$603.96 ,$575.20 ,$575.20 ,$165.37 ,$467.35 ST. FRANCIS HOSPITAL - ACUTE,45001352,26545,HC RECONSTRUCT FINGER JOINT,450,1 ,"$8,213.00 ","$5,338.45 ","$1,888.99 ","$8,213.00 ","$5,913.36 ","$4,467.87 ","$1,888.99 ","$4,584.50 ","$1,888.99 ","$4,906.45 ","$4,906.45 ","$4,906.45 ","$4,906.45 ","$6,898.92 ","$1,888.99 ","$6,981.05 ","$6,898.92 ","$1,888.99 ","$6,159.75 ","$6,570.40 ","$6,570.40 ","$1,888.99 ","$6,570.40 ","$6,898.92 ","$6,898.92 ","$6,898.92 ","$7,391.70 ","$4,722.48 ","$1,888.99 ","$8,213.00 ", N/A , N/A ,"$2,077.89 ","$6,981.05 ","$4,906.45 ","$7,391.70 ","$6,898.92 ","$6,570.40 ","$6,570.40 ","$1,888.99 ","$5,338.45 " ST. FRANCIS HOSPITAL - ACUTE,45080004,23605,HC CLOSED RX PROX HUMERUS FX MANIP,450,1 ,$267.00 ,$173.55 ,$61.41 ,$267.00 ,$192.24 ,$145.25 ,$61.41 ,$149.04 ,$61.41 ,$159.51 ,$159.51 ,$159.51 ,$159.51 ,$224.28 ,$61.41 ,$226.95 ,$224.28 ,$61.41 ,$200.25 ,$213.60 ,$213.60 ,$61.41 ,$213.60 ,$224.28 ,$224.28 ,$224.28 ,$240.30 ,$153.53 ,$61.41 ,$267.00 , N/A , N/A ,$67.55 ,$226.95 ,$159.51 ,$240.30 ,$224.28 ,$213.60 ,$213.60 ,$61.41 ,$173.55 ST. FRANCIS HOSPITAL - ACUTE,46000002,94010,HC SPIROMETRY/PFT PKG,460,1 ,$327.00 ,$212.55 ,$71.72 ,$327.00 ,$235.44 ,$177.89 ,$75.21 ,$182.53 ,$75.21 ,$195.35 ,$195.35 ,$195.35 ,$195.35 ,$274.68 ,$75.21 ,$277.95 ,$274.68 ,$75.21 ,$245.25 ,$261.60 ,$261.60 ,$75.21 ,$261.60 ,$274.68 ,$274.68 ,$274.68 ,$294.30 ,$188.03 ,$75.21 ,$327.00 ,$71.72 ,$78.89 ,$82.73 ,$277.95 ,$195.35 ,$294.30 ,$274.68 ,$261.60 ,$261.60 ,$75.21 ,$212.55 ST. FRANCIS HOSPITAL - ACUTE,46000004,94060,HC SPIROMETRY/PFT PRE AND POST,460,1 ,"$1,006.00 ",$653.90 ,$71.72 ,"$1,006.00 ",$724.32 ,$547.26 ,$231.38 ,$561.55 ,$231.38 ,$600.98 ,$600.98 ,$600.98 ,$600.98 ,$845.04 ,$231.38 ,$855.10 ,$845.04 ,$231.38 ,$754.50 ,$804.80 ,$804.80 ,$231.38 ,$804.80 ,$845.04 ,$845.04 ,$845.04 ,$905.40 ,$578.45 ,$231.38 ,"$1,006.00 ",$71.72 ,$78.89 ,$254.52 ,$855.10 ,$600.98 ,$905.40 ,$845.04 ,$804.80 ,$804.80 ,$231.38 ,$653.90 ST. FRANCIS HOSPITAL - ACUTE,46000013,94726,HC PLETHYSMOGRAPHY,460,1 ,$417.00 ,$271.05 ,$71.72 ,$417.00 ,$300.24 ,$226.85 ,$95.91 ,$232.77 ,$95.91 ,$249.12 ,$249.12 ,$249.12 ,$249.12 ,$350.28 ,$95.91 ,$354.45 ,$350.28 ,$95.91 ,$312.75 ,$333.60 ,$333.60 ,$95.91 ,$333.60 ,$350.28 ,$350.28 ,$350.28 ,$375.30 ,$239.78 ,$95.91 ,$417.00 ,$71.72 ,$78.89 ,$105.50 ,$354.45 ,$249.12 ,$375.30 ,$350.28 ,$333.60 ,$333.60 ,$95.91 ,$271.05 ST. FRANCIS HOSPITAL - ACUTE,46000014,94618,HC WALK TEST 6 MIN,460,1 ,$586.00 ,$380.90 ,$134.78 ,$586.00 ,$421.92 ,$318.78 ,$134.78 ,$327.11 ,$134.78 ,$350.08 ,$350.08 ,$350.08 ,$350.08 ,$492.24 ,$134.78 ,$498.10 ,$492.24 ,$134.78 ,$439.50 ,$468.80 ,$468.80 ,$134.78 ,$468.80 ,$492.24 ,$492.24 ,$492.24 ,$527.40 ,$336.95 ,$134.78 ,$586.00 ,$219.14 ,$241.05 ,$148.26 ,$498.10 ,$350.08 ,$527.40 ,$492.24 ,$468.80 ,$468.80 ,$134.78 ,$380.90 ST. FRANCIS HOSPITAL - ACUTE,46000017,94729,HC CARBON MONOXIDE DIFF (DLCO),460,1 ,$417.00 ,$271.05 ,$71.72 ,$417.00 ,$300.24 ,$226.85 ,$95.91 ,$232.77 ,$95.91 ,$249.12 ,$249.12 ,$249.12 ,$249.12 ,$350.28 ,$95.91 ,$354.45 ,$350.28 ,$95.91 ,$312.75 ,$333.60 ,$333.60 ,$95.91 ,$333.60 ,$350.28 ,$350.28 ,$350.28 ,$375.30 ,$239.78 ,$95.91 ,$417.00 ,$71.72 ,$78.89 ,$105.50 ,$354.45 ,$249.12 ,$375.30 ,$350.28 ,$333.60 ,$333.60 ,$95.91 ,$271.05 ST. FRANCIS HOSPITAL - ACUTE,46000019,94770,HC END TIDAL CO2 EXPIRED GAS DETERMINATION,460,1 ,$62.00 ,$40.30 ,$14.26 ,$241.05 ,$44.64 ,$33.73 ,$14.26 ,$34.61 ,$14.26 ,$37.04 ,$37.04 ,$37.04 ,$37.04 ,$52.08 ,$14.26 ,$52.70 ,$52.08 ,$14.26 ,$46.50 ,$49.60 ,$49.60 ,$14.26 ,$49.60 ,$52.08 ,$52.08 ,$52.08 ,$55.80 ,$35.65 ,$14.26 ,$62.00 ,$219.14 ,$241.05 ,$15.69 ,$52.70 ,$37.04 ,$55.80 ,$52.08 ,$49.60 ,$49.60 ,$14.26 ,$40.30 ST. FRANCIS HOSPITAL - ACUTE,46000021,94760,HC PULSE OX SINGLE,460,1 ,$119.00 ,$77.35 ,$27.37 ,$119.00 ,$85.68 ,$64.74 ,$27.37 ,$66.43 ,$27.37 ,$71.09 ,$71.09 ,$71.09 ,$71.09 ,$99.96 ,$27.37 ,$101.15 ,$99.96 ,$27.37 ,$89.25 ,$95.20 ,$95.20 ,$27.37 ,$95.20 ,$99.96 ,$99.96 ,$99.96 ,$107.10 ,$68.43 ,$27.37 ,$119.00 , N/A , N/A ,$30.11 ,$101.15 ,$71.09 ,$107.10 ,$99.96 ,$95.20 ,$95.20 ,$27.37 ,$77.35 ST. FRANCIS HOSPITAL - ACUTE,46000026,94770,HC ETCO2 INITIAL DAY,460,1 ,$364.00 ,$236.60 ,$83.72 ,$364.00 ,$262.08 ,$198.02 ,$83.72 ,$203.18 ,$83.72 ,$217.45 ,$217.45 ,$217.45 ,$217.45 ,$305.76 ,$83.72 ,$309.40 ,$305.76 ,$83.72 ,$273.00 ,$291.20 ,$291.20 ,$83.72 ,$291.20 ,$305.76 ,$305.76 ,$305.76 ,$327.60 ,$209.30 ,$83.72 ,$364.00 ,$219.14 ,$241.05 ,$92.09 ,$309.40 ,$217.45 ,$327.60 ,$305.76 ,$291.20 ,$291.20 ,$83.72 ,$236.60 ST. FRANCIS HOSPITAL - ACUTE,47100009,92558,HC AUD EVOKED OTOACOUS EMISSIONS SCREENING,471,1 ,$157.00 ,$102.05 ,$36.11 ,$157.00 ,$113.04 ,$85.41 ,$36.11 ,$87.64 ,$36.11 ,$93.79 ,$93.79 ,$93.79 ,$93.79 ,$131.88 ,$36.11 ,$133.45 ,$131.88 ,$36.11 ,$117.75 ,$125.60 ,$125.60 ,$36.11 ,$125.60 ,$131.88 ,$131.88 ,$131.88 ,$141.30 ,$90.28 ,$36.11 ,$157.00 ,$132.40 ,$145.64 ,$39.72 ,$133.45 ,$93.79 ,$141.30 ,$131.88 ,$125.60 ,$125.60 ,$36.11 ,$102.05 ST. FRANCIS HOSPITAL - ACUTE,48200000,93017,HC STRESS TEST TRACING ONLY,482,1 ,"$1,174.00 ",$763.10 ,$270.02 ,"$1,174.00 ",$845.28 ,$638.66 ,$270.02 ,$655.33 ,$270.02 ,$701.35 ,$701.35 ,$701.35 ,$701.35 ,$986.16 ,$270.02 ,$997.90 ,$986.16 ,$270.02 ,$880.50 ,$939.20 ,$939.20 ,$270.02 ,$939.20 ,$986.16 ,$986.16 ,$986.16 ,"$1,056.60 ",$675.05 ,$270.02 ,"$1,174.00 ",$292.76 ,$322.04 ,$297.02 ,$997.90 ,$701.35 ,"$1,056.60 ",$986.16 ,$939.20 ,$939.20 ,$270.02 ,$763.10 ST. FRANCIS HOSPITAL - ACUTE,48300000,93306,HC ECHO/CARDIAC DOP/COLOR FLOW,483,1 ,"$3,129.00 ","$2,033.85 ",$465.30 ,"$3,129.00 ","$2,252.88 ","$1,702.18 ",$719.67 ,"$1,746.61 ",$719.67 ,"$1,869.26 ","$1,869.26 ","$1,869.26 ","$1,869.26 ","$2,628.36 ",$719.67 ,"$2,659.65 ","$2,628.36 ",$719.67 ,"$2,346.75 ","$2,503.20 ","$2,503.20 ",$719.67 ,"$2,503.20 ","$2,628.36 ","$2,628.36 ","$2,628.36 ","$2,816.10 ","$1,799.18 ",$719.67 ,"$3,129.00 ",$465.30 ,$511.83 ,$791.64 ,"$2,659.65 ","$1,869.26 ","$2,816.10 ","$2,628.36 ","$2,503.20 ","$2,503.20 ",$719.67 ,"$2,033.85 " ST. FRANCIS HOSPITAL - ACUTE,48300002,93308,HC ECHO 2D W/W/O M-MODE LTD,483,1 ,$341.00 ,$221.65 ,$78.43 ,$511.83 ,$245.52 ,$185.50 ,$78.43 ,$190.35 ,$78.43 ,$203.71 ,$203.71 ,$203.71 ,$203.71 ,$286.44 ,$78.43 ,$289.85 ,$286.44 ,$78.43 ,$255.75 ,$272.80 ,$272.80 ,$78.43 ,$272.80 ,$286.44 ,$286.44 ,$286.44 ,$306.90 ,$196.08 ,$78.43 ,$341.00 ,$465.30 ,$511.83 ,$86.27 ,$289.85 ,$203.71 ,$306.90 ,$286.44 ,$272.80 ,$272.80 ,$78.43 ,$221.65 ST. FRANCIS HOSPITAL - ACUTE,48300006,93325,HC ECHO COLOR FLOW MAPPING,483,1 ,$826.00 ,$536.90 ,$189.98 ,$826.00 ,$594.72 ,$449.34 ,$189.98 ,$461.07 ,$189.98 ,$493.45 ,$493.45 ,$493.45 ,$493.45 ,$693.84 ,$189.98 ,$702.10 ,$693.84 ,$189.98 ,$619.50 ,$660.80 ,$660.80 ,$189.98 ,$660.80 ,$693.84 ,$693.84 ,$693.84 ,$743.40 ,$474.95 ,$189.98 ,$826.00 ,$465.30 ,$511.83 ,$208.98 ,$702.10 ,$493.45 ,$743.40 ,$693.84 ,$660.80 ,$660.80 ,$189.98 ,$536.90 ST. FRANCIS HOSPITAL - ACUTE,48300010,93321,HC ECHO DOPPLER LMTD,483,1 ,$249.00 ,$161.85 ,$57.27 ,$511.83 ,$179.28 ,$135.46 ,$57.27 ,$138.99 ,$57.27 ,$148.75 ,$148.75 ,$148.75 ,$148.75 ,$209.16 ,$57.27 ,$211.65 ,$209.16 ,$57.27 ,$186.75 ,$199.20 ,$199.20 ,$57.27 ,$199.20 ,$209.16 ,$209.16 ,$209.16 ,$224.10 ,$143.18 ,$57.27 ,$249.00 ,$465.30 ,$511.83 ,$63.00 ,$211.65 ,$148.75 ,$224.10 ,$209.16 ,$199.20 ,$199.20 ,$57.27 ,$161.85 ST. FRANCIS HOSPITAL - ACUTE,48300016,C8924,HC ECHO TTE W/W/O CONT AND W/CONT LIMIT,483,1 ,$457.00 ,$297.05 ,$105.11 ,$511.83 ,$329.04 ,$248.61 ,$105.11 ,$255.10 ,$105.11 ,$273.01 ,$273.01 ,$273.01 ,$273.01 ,$383.88 ,$105.11 ,$388.45 ,$383.88 ,$105.11 ,$342.75 ,$365.60 ,$365.60 ,$105.11 ,$365.60 ,$383.88 ,$383.88 ,$383.88 ,$411.30 ,$262.78 ,$105.11 ,$457.00 ,$465.30 ,$511.83 ,$115.62 ,$388.45 ,$273.01 ,$411.30 ,$383.88 ,$365.60 ,$365.60 ,$105.11 ,$297.05 ST. FRANCIS HOSPITAL - ACUTE,48300019,C8929,HC ECHO TTE 2D W/DOPPLER W/W/O CONT AND W/CONT,483,1 ,"$3,869.00 ","$2,514.85 ",$465.30 ,"$3,869.00 ","$2,785.68 ","$2,104.74 ",$889.87 ,"$2,159.68 ",$889.87 ,"$2,311.34 ","$2,311.34 ","$2,311.34 ","$2,311.34 ","$3,249.96 ",$889.87 ,"$3,288.65 ","$3,249.96 ",$889.87 ,"$2,901.75 ","$3,095.20 ","$3,095.20 ",$889.87 ,"$3,095.20 ","$3,249.96 ","$3,249.96 ","$3,249.96 ","$3,482.10 ","$2,224.68 ",$889.87 ,"$3,869.00 ",$465.30 ,$511.83 ,$978.86 ,"$3,288.65 ","$2,311.34 ","$3,482.10 ","$3,249.96 ","$3,095.20 ","$3,095.20 ",$889.87 ,"$2,514.85 " ST. FRANCIS HOSPITAL - ACUTE,51000045,36593,HC DECLOTTING/ACCESS DEVICE/CATH,510,1 ,$630.00 ,$409.50 ,$114.53 ,$630.00 ,$453.60 ,$342.72 ,$144.90 ,$351.67 ,$144.90 ,$376.36 ,$376.36 ,$376.36 ,$376.36 ,$529.20 ,$144.90 ,$535.50 ,$529.20 ,$144.90 ,$472.50 ,$504.00 ,$504.00 ,$144.90 ,$504.00 ,$529.20 ,$529.20 ,$529.20 ,$567.00 ,$362.25 ,$144.90 ,$630.00 ,$114.53 ,$125.98 ,$159.39 ,$535.50 ,$376.36 ,$567.00 ,$529.20 ,$504.00 ,$504.00 ,$144.90 ,$409.50 ST. FRANCIS HOSPITAL - ACUTE,51000063,96372,HC INJECTION IM/SUBQ,260,1 ,$234.00 ,$152.10 ,$53.82 ,$234.00 ,$168.48 ,$127.30 ,$53.82 ,$130.62 ,$53.82 ,$139.79 ,$139.79 ,$139.79 ,$139.79 ,$196.56 ,$53.82 ,$198.90 ,$196.56 ,$53.82 ,$175.50 ,$187.20 ,$187.20 ,$53.82 ,$187.20 ,$196.56 ,$196.56 ,$196.56 ,$210.60 ,$134.55 ,$53.82 ,$234.00 , N/A , N/A ,$59.20 ,$198.90 ,$139.79 ,$210.60 ,$196.56 ,$187.20 ,$187.20 ,$53.82 ,$152.10 ST. FRANCIS HOSPITAL - ACUTE,51000065,96374,HC INJ IV PUSH SINGL/INITIAL,260,1 ,$245.00 ,$159.25 ,$56.35 ,$245.00 ,$176.40 ,$133.28 ,$56.35 ,$136.76 ,$56.35 ,$146.36 ,$146.36 ,$146.36 ,$146.36 ,$205.80 ,$56.35 ,$208.25 ,$205.80 ,$56.35 ,$183.75 ,$196.00 ,$196.00 ,$56.35 ,$196.00 ,$205.80 ,$205.80 ,$205.80 ,$220.50 ,$140.88 ,$56.35 ,$245.00 , N/A , N/A ,$61.99 ,$208.25 ,$146.36 ,$220.50 ,$205.80 ,$196.00 ,$196.00 ,$56.35 ,$159.25 ST. FRANCIS HOSPITAL - ACUTE,51000066,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$245.00 ,$159.25 ,$56.35 ,$245.00 ,$176.40 ,$133.28 ,$56.35 ,$136.76 ,$56.35 ,$146.36 ,$146.36 ,$146.36 ,$146.36 ,$205.80 ,$56.35 ,$208.25 ,$205.80 ,$56.35 ,$183.75 ,$196.00 ,$196.00 ,$56.35 ,$196.00 ,$205.80 ,$205.80 ,$205.80 ,$220.50 ,$140.88 ,$56.35 ,$245.00 , N/A , N/A ,$61.99 ,$208.25 ,$146.36 ,$220.50 ,$205.80 ,$196.00 ,$196.00 ,$56.35 ,$159.25 ST. FRANCIS HOSPITAL - ACUTE,51000067,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$245.00 ,$159.25 ,$56.35 ,$245.00 ,$176.40 ,$133.28 ,$56.35 ,$136.76 ,$56.35 ,$146.36 ,$146.36 ,$146.36 ,$146.36 ,$205.80 ,$56.35 ,$208.25 ,$205.80 ,$56.35 ,$183.75 ,$196.00 ,$196.00 ,$56.35 ,$196.00 ,$205.80 ,$205.80 ,$205.80 ,$220.50 ,$140.88 ,$56.35 ,$245.00 , N/A , N/A ,$61.99 ,$208.25 ,$146.36 ,$220.50 ,$205.80 ,$196.00 ,$196.00 ,$56.35 ,$159.25 ST. FRANCIS HOSPITAL - ACUTE,51000068,96523,HC IRRIGAT IMPLANT VEN ACCESS DEV,510,1 ,$197.00 ,$128.05 ,$45.31 ,$197.00 ,$141.84 ,$107.17 ,$45.31 ,$109.97 ,$45.31 ,$117.69 ,$117.69 ,$117.69 ,$117.69 ,$165.48 ,$45.31 ,$167.45 ,$165.48 ,$45.31 ,$147.75 ,$157.60 ,$157.60 ,$45.31 ,$157.60 ,$165.48 ,$165.48 ,$165.48 ,$177.30 ,$113.28 ,$45.31 ,$197.00 ,$114.53 ,$125.98 ,$49.84 ,$167.45 ,$117.69 ,$177.30 ,$165.48 ,$157.60 ,$157.60 ,$45.31 ,$128.05 ST. FRANCIS HOSPITAL - ACUTE,51000099,99201,HC CLINIC VISIT BRIEF NEW,510,1 ,$416.00 ,$270.40 ,$49.40 ,$416.00 ,$299.52 ,$226.30 ,$95.68 ,$232.21 ,$95.68 ,$248.52 ,$248.52 ,$248.52 ,$248.52 ,$349.44 ,$95.68 ,$353.60 ,$349.44 ,$95.68 ,$312.00 ,$332.80 ,$332.80 ,$95.68 ,$332.80 ,$349.44 ,$349.44 ,$349.44 ,$374.40 ,$239.20 ,$95.68 ,$49.40 ,$134.83 ,$148.31 ,$105.25 ,$353.60 ,$248.52 ,$374.40 ,$349.44 ,$332.80 ,$332.80 ,$95.68 ,$270.40 ST. FRANCIS HOSPITAL - ACUTE,51000101,99202,HC CLINIC VISIT LIMITED NEW,510,1 ,$440.00 ,$286.00 ,$82.03 ,$440.00 ,$316.80 ,$239.36 ,$101.20 ,$245.61 ,$101.20 ,$262.86 ,$262.86 ,$262.86 ,$262.86 ,$369.60 ,$101.20 ,$374.00 ,$369.60 ,$101.20 ,$330.00 ,$352.00 ,$352.00 ,$101.20 ,$352.00 ,$369.60 ,$369.60 ,$369.60 ,$396.00 ,$253.00 ,$101.20 ,$82.03 ,$134.83 ,$148.31 ,$111.32 ,$374.00 ,$262.86 ,$396.00 ,$369.60 ,$352.00 ,$352.00 ,$101.20 ,$286.00 ST. FRANCIS HOSPITAL - ACUTE,51000104,99203,HC CLINIC VISIT INTERM NEW,510,1 ,$557.00 ,$362.05 ,$116.11 ,$557.00 ,$401.04 ,$303.01 ,$128.11 ,$310.92 ,$128.11 ,$332.75 ,$332.75 ,$332.75 ,$332.75 ,$467.88 ,$128.11 ,$473.45 ,$467.88 ,$128.11 ,$417.75 ,$445.60 ,$445.60 ,$128.11 ,$445.60 ,$467.88 ,$467.88 ,$467.88 ,$501.30 ,$320.28 ,$128.11 ,$116.11 ,$134.83 ,$148.31 ,$140.92 ,$473.45 ,$332.75 ,$501.30 ,$467.88 ,$445.60 ,$445.60 ,$128.11 ,$362.05 ST. FRANCIS HOSPITAL - ACUTE,51000107,99211,HC DRESSING CHANGE/ENEMA MINOR,510,1 ,$627.00 ,$407.55 ,$134.83 ,$627.00 ,$451.44 ,$341.09 ,$144.21 ,$349.99 ,$144.21 ,$374.57 ,$374.57 ,$374.57 ,$374.57 ,$526.68 ,$144.21 ,$532.95 ,$526.68 ,$144.21 ,$470.25 ,$501.60 ,$501.60 ,$144.21 ,$501.60 ,$526.68 ,$526.68 ,$526.68 ,$564.30 ,$360.53 ,$144.21 ,$627.00 ,$134.83 ,$148.31 ,$158.63 ,$532.95 ,$374.57 ,$564.30 ,$526.68 ,$501.60 ,$501.60 ,$144.21 ,$407.55 ST. FRANCIS HOSPITAL - ACUTE,51000109,99204,HC CLINIC VISIT COMPLEX NEW,510,1 ,$744.00 ,$483.60 ,$134.83 ,$744.00 ,$535.68 ,$404.74 ,$171.12 ,$415.30 ,$171.12 ,$444.47 ,$444.47 ,$444.47 ,$444.47 ,$624.96 ,$171.12 ,$632.40 ,$624.96 ,$171.12 ,$558.00 ,$595.20 ,$595.20 ,$171.12 ,$595.20 ,$624.96 ,$624.96 ,$624.96 ,$669.60 ,$427.80 ,$171.12 ,$177.80 ,$134.83 ,$148.31 ,$188.23 ,$632.40 ,$444.47 ,$669.60 ,$624.96 ,$595.20 ,$595.20 ,$171.12 ,$483.60 ST. FRANCIS HOSPITAL - ACUTE,51000114,99211,HC CLINIC VISIT BRIEF EST,510,1 ,$243.00 ,$157.95 ,$55.89 ,$243.00 ,$174.96 ,$132.19 ,$55.89 ,$135.64 ,$55.89 ,$145.17 ,$145.17 ,$145.17 ,$145.17 ,$204.12 ,$55.89 ,$206.55 ,$204.12 ,$55.89 ,$182.25 ,$194.40 ,$194.40 ,$55.89 ,$194.40 ,$204.12 ,$204.12 ,$204.12 ,$218.70 ,$139.73 ,$55.89 ,$243.00 ,$134.83 ,$148.31 ,$61.48 ,$206.55 ,$145.17 ,$218.70 ,$204.12 ,$194.40 ,$194.40 ,$55.89 ,$157.95 ST. FRANCIS HOSPITAL - ACUTE,51000120,99212,HC CLINIC VISIT LIMIT EST,510,1 ,$320.00 ,$208.00 ,$49.03 ,$320.00 ,$230.40 ,$174.08 ,$73.60 ,$178.62 ,$73.60 ,$191.17 ,$191.17 ,$191.17 ,$191.17 ,$268.80 ,$73.60 ,$272.00 ,$268.80 ,$73.60 ,$240.00 ,$256.00 ,$256.00 ,$73.60 ,$256.00 ,$268.80 ,$268.80 ,$268.80 ,$288.00 ,$184.00 ,$73.60 ,$49.03 ,$134.83 ,$148.31 ,$80.96 ,$272.00 ,$191.17 ,$288.00 ,$268.80 ,$256.00 ,$256.00 ,$73.60 ,$208.00 ST. FRANCIS HOSPITAL - ACUTE,51000131,99213,HC CLINIC VISIT INTERM EST,510,1 ,$375.00 ,$243.75 ,$80.55 ,$375.00 ,$270.00 ,$204.00 ,$86.25 ,$209.33 ,$86.25 ,$224.03 ,$224.03 ,$224.03 ,$224.03 ,$315.00 ,$86.25 ,$318.75 ,$315.00 ,$86.25 ,$281.25 ,$300.00 ,$300.00 ,$86.25 ,$300.00 ,$315.00 ,$315.00 ,$315.00 ,$337.50 ,$215.63 ,$86.25 ,$80.55 ,$134.83 ,$148.31 ,$94.88 ,$318.75 ,$224.03 ,$337.50 ,$315.00 ,$300.00 ,$300.00 ,$86.25 ,$243.75 ST. FRANCIS HOSPITAL - ACUTE,51000136,99214,HC CLINIC VISIT COMPLX EST,510,1 ,$585.00 ,$380.25 ,$134.55 ,$585.00 ,$421.20 ,$318.24 ,$134.55 ,$326.55 ,$134.55 ,$349.48 ,$349.48 ,$349.48 ,$349.48 ,$491.40 ,$134.55 ,$497.25 ,$491.40 ,$134.55 ,$438.75 ,$468.00 ,$468.00 ,$134.55 ,$468.00 ,$491.40 ,$491.40 ,$491.40 ,$526.50 ,$336.38 ,$134.55 ,$585.00 ,$134.83 ,$148.31 ,$148.01 ,$497.25 ,$349.48 ,$526.50 ,$491.40 ,$468.00 ,$468.00 ,$134.55 ,$380.25 ST. FRANCIS HOSPITAL - ACUTE,51000139,99215,HC CLINIC VISIT COMPRH EST,510,1 ,$681.00 ,$442.65 ,$134.83 ,$681.00 ,$490.32 ,$370.46 ,$156.63 ,$380.13 ,$156.63 ,$406.83 ,$406.83 ,$406.83 ,$406.83 ,$572.04 ,$156.63 ,$578.85 ,$572.04 ,$156.63 ,$510.75 ,$544.80 ,$544.80 ,$156.63 ,$544.80 ,$572.04 ,$572.04 ,$572.04 ,$612.90 ,$391.58 ,$156.63 ,$681.00 ,$134.83 ,$148.31 ,$172.29 ,$578.85 ,$406.83 ,$612.90 ,$572.04 ,$544.80 ,$544.80 ,$156.63 ,$442.65 ST. FRANCIS HOSPITAL - ACUTE,51000147,P9612,HC CATH FOR SPECIMEN COLLECTION,300,1 ,$112.00 ,$72.80 ,$25.76 ,$112.00 ,$80.64 ,$60.93 ,$25.76 ,$62.52 ,$25.76 ,$66.91 ,$66.91 ,$66.91 ,$66.91 ,$94.08 ,$25.76 ,$95.20 ,$94.08 ,$25.76 ,$84.00 ,$89.60 ,$89.60 ,$25.76 ,$89.60 ,$94.08 ,$94.08 ,$94.08 ,$100.80 ,$64.40 ,$25.76 ,$112.00 , N/A , N/A ,$28.34 ,$95.20 ,$66.91 ,$100.80 ,$94.08 ,$89.60 ,$89.60 ,$25.76 ,$72.80 ST. FRANCIS HOSPITAL - ACUTE,51000171,51701,HC CATH BLADDER NON-INDWELLING,510,1 ,$350.00 ,$227.50 ,$80.50 ,$350.00 ,$252.00 ,$190.40 ,$80.50 ,$195.37 ,$80.50 ,$209.09 ,$209.09 ,$209.09 ,$209.09 ,$294.00 ,$80.50 ,$297.50 ,$294.00 ,$80.50 ,$262.50 ,$280.00 ,$280.00 ,$80.50 ,$280.00 ,$294.00 ,$294.00 ,$294.00 ,$315.00 ,$201.25 ,$80.50 ,$350.00 ,$114.53 ,$125.98 ,$88.55 ,$297.50 ,$209.09 ,$315.00 ,$294.00 ,$280.00 ,$280.00 ,$80.50 ,$227.50 ST. FRANCIS HOSPITAL - ACUTE,51000172,51702,HC CATH BLADDER SMP,510,1 ,$420.00 ,$273.00 ,$96.60 ,$420.00 ,$302.40 ,$228.48 ,$96.60 ,$234.44 ,$96.60 ,$250.91 ,$250.91 ,$250.91 ,$250.91 ,$352.80 ,$96.60 ,$357.00 ,$352.80 ,$96.60 ,$315.00 ,$336.00 ,$336.00 ,$96.60 ,$336.00 ,$352.80 ,$352.80 ,$352.80 ,$378.00 ,$241.50 ,$96.60 ,$420.00 ,$114.53 ,$125.98 ,$106.26 ,$357.00 ,$250.91 ,$378.00 ,$352.80 ,$336.00 ,$336.00 ,$96.60 ,$273.00 ST. FRANCIS HOSPITAL - ACUTE,51000173,51703,HC CATH BLADDER CPLX,510,1 ,$462.00 ,$300.30 ,$106.26 ,$462.00 ,$332.64 ,$251.33 ,$106.26 ,$257.89 ,$106.26 ,$276.00 ,$276.00 ,$276.00 ,$276.00 ,$388.08 ,$106.26 ,$392.70 ,$388.08 ,$106.26 ,$346.50 ,$369.60 ,$369.60 ,$106.26 ,$369.60 ,$388.08 ,$388.08 ,$388.08 ,$415.80 ,$265.65 ,$106.26 ,$462.00 ,$114.53 ,$125.98 ,$116.89 ,$392.70 ,$276.00 ,$415.80 ,$388.08 ,$369.60 ,$369.60 ,$106.26 ,$300.30 ST. FRANCIS HOSPITAL - ACUTE,51000175,94780,HC CARSEAT ANALYSIS FIRST 60MIN,510,1 ,$255.00 ,$165.75 ,$58.65 ,$255.00 ,$183.60 ,$138.72 ,$58.65 ,$142.34 ,$58.65 ,$152.34 ,$152.34 ,$152.34 ,$152.34 ,$214.20 ,$58.65 ,$216.75 ,$214.20 ,$58.65 ,$191.25 ,$204.00 ,$204.00 ,$58.65 ,$204.00 ,$214.20 ,$214.20 ,$214.20 ,$229.50 ,$146.63 ,$58.65 ,$255.00 ,$71.72 ,$78.89 ,$64.52 ,$216.75 ,$152.34 ,$229.50 ,$214.20 ,$204.00 ,$204.00 ,$58.65 ,$165.75 ST. FRANCIS HOSPITAL - ACUTE,51000201,29799,HC REMOVAL REVISION LEGCAST FACILITY,510,1 ,$160.00 ,$104.00 ,$36.80 ,$265.87 ,$115.20 ,$87.04 ,$36.80 ,$89.31 ,$36.80 ,$95.58 ,$95.58 ,$95.58 ,$95.58 ,$134.40 ,$36.80 ,$136.00 ,$134.40 ,$36.80 ,$120.00 ,$128.00 ,$128.00 ,$36.80 ,$128.00 ,$134.40 ,$134.40 ,$134.40 ,$144.00 ,$92.00 ,$36.80 ,$160.00 ,$241.70 ,$265.87 ,$40.48 ,$136.00 ,$95.58 ,$144.00 ,$134.40 ,$128.00 ,$128.00 ,$36.80 ,$104.00 ST. FRANCIS HOSPITAL - ACUTE,51000315,38222,HC BM ASPIRATION (BX/ASP SAME SITE),360,1 ,$808.00 ,$525.20 ,$185.84 ,$808.00 ,$581.76 ,$439.55 ,$185.84 ,$451.03 ,$185.84 ,$518.33 ,$518.33 ,$518.33 ,$518.33 ,$678.72 ,$185.84 ,$686.80 ,$678.72 ,$185.84 ,$606.00 ,$646.40 ,$646.40 ,$185.84 ,$646.40 ,$678.72 ,$678.72 ,$678.72 ,$727.20 ,$464.60 ,$185.84 ,$808.00 ,$583.39 ,$641.73 ,$204.42 ,$686.80 ,$518.33 ,$727.20 ,$678.72 ,$646.40 ,$646.40 ,$185.84 ,$525.20 ST. FRANCIS HOSPITAL - ACUTE,51000320,94781,HC CARSEAT ANALYSIS EA ADDN 30MIN,510,1 ,$127.00 ,$82.55 ,$29.21 ,$127.00 ,$91.44 ,$69.09 ,$29.21 ,$70.89 ,$29.21 ,$75.87 ,$75.87 ,$75.87 ,$75.87 ,$106.68 ,$29.21 ,$107.95 ,$106.68 ,$29.21 ,$95.25 ,$101.60 ,$101.60 ,$29.21 ,$101.60 ,$106.68 ,$106.68 ,$106.68 ,$114.30 ,$73.03 ,$29.21 ,$127.00 ,$71.72 ,$78.89 ,$32.13 ,$107.95 ,$75.87 ,$114.30 ,$106.68 ,$101.60 ,$101.60 ,$29.21 ,$82.55 ST. FRANCIS HOSPITAL - ACUTE,51000463,99201,HC CLINIC VISIT BRIEF NEW -25,510,1 ,$416.00 ,$270.40 ,$49.40 ,$416.00 ,$299.52 ,$226.30 ,$95.68 ,$232.21 ,$95.68 ,$248.52 ,$248.52 ,$248.52 ,$248.52 ,$349.44 ,$95.68 ,$353.60 ,$349.44 ,$95.68 ,$312.00 ,$332.80 ,$332.80 ,$95.68 ,$332.80 ,$349.44 ,$349.44 ,$349.44 ,$374.40 ,$239.20 ,$95.68 ,$49.40 ,$134.83 ,$148.31 ,$105.25 ,$353.60 ,$248.52 ,$374.40 ,$349.44 ,$332.80 ,$332.80 ,$95.68 ,$270.40 ST. FRANCIS HOSPITAL - ACUTE,51000464,99202,HC CLINIC VISIT LIMITED NEW -25,510,1 ,$440.00 ,$286.00 ,$82.03 ,$440.00 ,$316.80 ,$239.36 ,$101.20 ,$245.61 ,$101.20 ,$262.86 ,$262.86 ,$262.86 ,$262.86 ,$369.60 ,$101.20 ,$374.00 ,$369.60 ,$101.20 ,$330.00 ,$352.00 ,$352.00 ,$101.20 ,$352.00 ,$369.60 ,$369.60 ,$369.60 ,$396.00 ,$253.00 ,$101.20 ,$82.03 ,$134.83 ,$148.31 ,$111.32 ,$374.00 ,$262.86 ,$396.00 ,$369.60 ,$352.00 ,$352.00 ,$101.20 ,$286.00 ST. FRANCIS HOSPITAL - ACUTE,51000465,99203,HC CLINIC VISIT INTERM NEW -25,510,1 ,$557.00 ,$362.05 ,$116.11 ,$557.00 ,$401.04 ,$303.01 ,$128.11 ,$310.92 ,$128.11 ,$332.75 ,$332.75 ,$332.75 ,$332.75 ,$467.88 ,$128.11 ,$473.45 ,$467.88 ,$128.11 ,$417.75 ,$445.60 ,$445.60 ,$128.11 ,$445.60 ,$467.88 ,$467.88 ,$467.88 ,$501.30 ,$320.28 ,$128.11 ,$116.11 ,$134.83 ,$148.31 ,$140.92 ,$473.45 ,$332.75 ,$501.30 ,$467.88 ,$445.60 ,$445.60 ,$128.11 ,$362.05 ST. FRANCIS HOSPITAL - ACUTE,51000466,99204,HC CLINIC VISIT COMPLEX NEW -25,510,1 ,$744.00 ,$483.60 ,$134.83 ,$744.00 ,$535.68 ,$404.74 ,$171.12 ,$415.30 ,$171.12 ,$444.47 ,$444.47 ,$444.47 ,$444.47 ,$624.96 ,$171.12 ,$632.40 ,$624.96 ,$171.12 ,$558.00 ,$595.20 ,$595.20 ,$171.12 ,$595.20 ,$624.96 ,$624.96 ,$624.96 ,$669.60 ,$427.80 ,$171.12 ,$177.80 ,$134.83 ,$148.31 ,$188.23 ,$632.40 ,$444.47 ,$669.60 ,$624.96 ,$595.20 ,$595.20 ,$171.12 ,$483.60 ST. FRANCIS HOSPITAL - ACUTE,51000468,99211,HC CLINIC VISIT BRIEF ESTAB -25,510,1 ,$277.00 ,$180.05 ,$63.71 ,$277.00 ,$199.44 ,$150.69 ,$63.71 ,$154.62 ,$63.71 ,$165.48 ,$165.48 ,$165.48 ,$165.48 ,$232.68 ,$63.71 ,$235.45 ,$232.68 ,$63.71 ,$207.75 ,$221.60 ,$221.60 ,$63.71 ,$221.60 ,$232.68 ,$232.68 ,$232.68 ,$249.30 ,$159.28 ,$63.71 ,$277.00 ,$134.83 ,$148.31 ,$70.08 ,$235.45 ,$165.48 ,$249.30 ,$232.68 ,$221.60 ,$221.60 ,$63.71 ,$180.05 ST. FRANCIS HOSPITAL - ACUTE,51000469,99212,HC CLINIC VISIT LIMITED ESTAB -25,510,1 ,$320.00 ,$208.00 ,$49.03 ,$320.00 ,$230.40 ,$174.08 ,$73.60 ,$178.62 ,$73.60 ,$191.17 ,$191.17 ,$191.17 ,$191.17 ,$268.80 ,$73.60 ,$272.00 ,$268.80 ,$73.60 ,$240.00 ,$256.00 ,$256.00 ,$73.60 ,$256.00 ,$268.80 ,$268.80 ,$268.80 ,$288.00 ,$184.00 ,$73.60 ,$49.03 ,$134.83 ,$148.31 ,$80.96 ,$272.00 ,$191.17 ,$288.00 ,$268.80 ,$256.00 ,$256.00 ,$73.60 ,$208.00 ST. FRANCIS HOSPITAL - ACUTE,51000470,99213,HC CLINIC VISIT INTERM EST -25,510,1 ,$375.00 ,$243.75 ,$80.55 ,$375.00 ,$270.00 ,$204.00 ,$86.25 ,$209.33 ,$86.25 ,$224.03 ,$224.03 ,$224.03 ,$224.03 ,$315.00 ,$86.25 ,$318.75 ,$315.00 ,$86.25 ,$281.25 ,$300.00 ,$300.00 ,$86.25 ,$300.00 ,$315.00 ,$315.00 ,$315.00 ,$337.50 ,$215.63 ,$86.25 ,$80.55 ,$134.83 ,$148.31 ,$94.88 ,$318.75 ,$224.03 ,$337.50 ,$315.00 ,$300.00 ,$300.00 ,$86.25 ,$243.75 ST. FRANCIS HOSPITAL - ACUTE,51000471,99214,HC CLINIC VISIT COMPLEX EST -25,510,1 ,$585.00 ,$380.25 ,$134.55 ,$585.00 ,$421.20 ,$318.24 ,$134.55 ,$326.55 ,$134.55 ,$349.48 ,$349.48 ,$349.48 ,$349.48 ,$491.40 ,$134.55 ,$497.25 ,$491.40 ,$134.55 ,$438.75 ,$468.00 ,$468.00 ,$134.55 ,$468.00 ,$491.40 ,$491.40 ,$491.40 ,$526.50 ,$336.38 ,$134.55 ,$585.00 ,$134.83 ,$148.31 ,$148.01 ,$497.25 ,$349.48 ,$526.50 ,$491.40 ,$468.00 ,$468.00 ,$134.55 ,$380.25 ST. FRANCIS HOSPITAL - ACUTE,51000472,99215,HC CLINIC VISIT COMPREH EST -25,510,1 ,$681.00 ,$442.65 ,$134.83 ,$681.00 ,$490.32 ,$370.46 ,$156.63 ,$380.13 ,$156.63 ,$406.83 ,$406.83 ,$406.83 ,$406.83 ,$572.04 ,$156.63 ,$578.85 ,$572.04 ,$156.63 ,$510.75 ,$544.80 ,$544.80 ,$156.63 ,$544.80 ,$572.04 ,$572.04 ,$572.04 ,$612.90 ,$391.58 ,$156.63 ,$681.00 ,$134.83 ,$148.31 ,$172.29 ,$578.85 ,$406.83 ,$612.90 ,$572.04 ,$544.80 ,$544.80 ,$156.63 ,$442.65 ST. FRANCIS HOSPITAL - ACUTE,51001010,99215,HC CLINIC VISIT - MEMORY INITIAL,510,1 ,$439.00 ,$285.35 ,$100.97 ,$439.00 ,$316.08 ,$238.82 ,$100.97 ,$245.05 ,$100.97 ,$262.26 ,$262.26 ,$262.26 ,$262.26 ,$368.76 ,$100.97 ,$373.15 ,$368.76 ,$100.97 ,$329.25 ,$351.20 ,$351.20 ,$100.97 ,$351.20 ,$368.76 ,$368.76 ,$368.76 ,$395.10 ,$252.43 ,$100.97 ,$439.00 ,$134.83 ,$148.31 ,$111.07 ,$373.15 ,$262.26 ,$395.10 ,$368.76 ,$351.20 ,$351.20 ,$100.97 ,$285.35 ST. FRANCIS HOSPITAL - ACUTE,61000000,70543,HC MRI ORBIT/FACE/NECK W AND W/O CON,610,1 ,"$4,419.00 ","$2,872.35 ",$332.25 ,"$4,419.00 ","$3,181.68 ","$2,403.94 ","$1,016.37 ","$2,466.69 ","$1,016.37 ","$2,639.91 ","$2,639.91 ","$2,639.91 ","$2,639.91 ","$3,711.96 ","$1,016.37 ","$3,756.15 ","$3,711.96 ","$1,016.37 ","$3,314.25 ","$3,535.20 ","$3,535.20 ","$1,016.37 ","$3,535.20 ","$3,711.96 ","$3,711.96 ","$3,711.96 ","$3,977.10 ","$2,540.93 ","$1,016.37 ","$4,419.00 ",$332.25 ,$365.48 ,"$1,118.01 ","$3,756.15 ","$2,639.91 ","$3,977.10 ","$3,711.96 ","$3,535.20 ","$3,535.20 ","$1,016.37 ","$2,872.35 " ST. FRANCIS HOSPITAL - ACUTE,61000001,70544,HC MRA HEAD W/O CONTRAST,610,1 ,"$3,579.00 ","$2,326.35 ",$406.76 ,"$3,579.00 ","$2,576.88 ","$1,946.98 ",$823.17 ,"$1,997.80 ",$823.17 ,"$2,138.09 ","$2,138.09 ","$2,138.09 ","$2,138.09 ","$3,006.36 ",$823.17 ,"$3,042.15 ","$3,006.36 ",$823.17 ,"$2,684.25 ","$2,863.20 ","$2,863.20 ",$823.17 ,"$2,863.20 ","$3,006.36 ","$3,006.36 ","$3,006.36 ","$3,221.10 ","$2,057.93 ",$823.17 ,"$3,579.00 ",$406.76 ,$447.44 ,$905.49 ,"$3,042.15 ","$2,138.09 ","$3,221.10 ","$3,006.36 ","$2,863.20 ","$2,863.20 ",$823.17 ,"$2,326.35 " ST. FRANCIS HOSPITAL - ACUTE,61000002,70545,HC MRA HEAD W/CONTRAST,610,1 ,"$4,235.00 ","$2,752.75 ",$406.76 ,"$4,235.00 ","$3,049.20 ","$2,303.84 ",$974.05 ,"$2,363.98 ",$974.05 ,"$2,529.99 ","$2,529.99 ","$2,529.99 ","$2,529.99 ","$3,557.40 ",$974.05 ,"$3,599.75 ","$3,557.40 ",$974.05 ,"$3,176.25 ","$3,388.00 ","$3,388.00 ",$974.05 ,"$3,388.00 ","$3,557.40 ","$3,557.40 ","$3,557.40 ","$3,811.50 ","$2,435.13 ",$974.05 ,"$4,235.00 ",$406.76 ,$447.44 ,"$1,071.46 ","$3,599.75 ","$2,529.99 ","$3,811.50 ","$3,557.40 ","$3,388.00 ","$3,388.00 ",$974.05 ,"$2,752.75 " ST. FRANCIS HOSPITAL - ACUTE,61000003,70546,HC MRA HEAD W AND W/O CONTRAST,610,1 ,"$4,235.00 ","$2,752.75 ",$406.76 ,"$4,235.00 ","$3,049.20 ","$2,303.84 ",$974.05 ,"$2,363.98 ",$974.05 ,"$2,529.99 ","$2,529.99 ","$2,529.99 ","$2,529.99 ","$3,557.40 ",$974.05 ,"$3,599.75 ","$3,557.40 ",$974.05 ,"$3,176.25 ","$3,388.00 ","$3,388.00 ",$974.05 ,"$3,388.00 ","$3,557.40 ","$3,557.40 ","$3,557.40 ","$3,811.50 ","$2,435.13 ",$974.05 ,"$4,235.00 ",$406.76 ,$447.44 ,"$1,071.46 ","$3,599.75 ","$2,529.99 ","$3,811.50 ","$3,557.40 ","$3,388.00 ","$3,388.00 ",$974.05 ,"$2,752.75 " ST. FRANCIS HOSPITAL - ACUTE,61000005,70547,HC MRA NECK W/O CONTRAST,610,1 ,"$3,579.00 ","$2,326.35 ",$406.76 ,"$3,579.00 ","$2,576.88 ","$1,946.98 ",$823.17 ,"$1,997.80 ",$823.17 ,"$2,138.09 ","$2,138.09 ","$2,138.09 ","$2,138.09 ","$3,006.36 ",$823.17 ,"$3,042.15 ","$3,006.36 ",$823.17 ,"$2,684.25 ","$2,863.20 ","$2,863.20 ",$823.17 ,"$2,863.20 ","$3,006.36 ","$3,006.36 ","$3,006.36 ","$3,221.10 ","$2,057.93 ",$823.17 ,"$3,579.00 ",$406.76 ,$447.44 ,$905.49 ,"$3,042.15 ","$2,138.09 ","$3,221.10 ","$3,006.36 ","$2,863.20 ","$2,863.20 ",$823.17 ,"$2,326.35 " ST. FRANCIS HOSPITAL - ACUTE,61000007,70549,HC MRA NECK W AND W/O CONTRAST,610,1 ,"$4,419.00 ","$2,872.35 ",$406.76 ,"$4,419.00 ","$3,181.68 ","$2,403.94 ","$1,016.37 ","$2,466.69 ","$1,016.37 ","$2,639.91 ","$2,639.91 ","$2,639.91 ","$2,639.91 ","$3,711.96 ","$1,016.37 ","$3,756.15 ","$3,711.96 ","$1,016.37 ","$3,314.25 ","$3,535.20 ","$3,535.20 ","$1,016.37 ","$3,535.20 ","$3,711.96 ","$3,711.96 ","$3,711.96 ","$3,977.10 ","$2,540.93 ","$1,016.37 ","$4,419.00 ",$406.76 ,$447.44 ,"$1,118.01 ","$3,756.15 ","$2,639.91 ","$3,977.10 ","$3,711.96 ","$3,535.20 ","$3,535.20 ","$1,016.37 ","$2,872.35 " ST. FRANCIS HOSPITAL - ACUTE,61000008,70551,HC MRI BRAIN W/O CONTRAST,610,1 ,"$3,645.00 ","$2,369.25 ",$372.26 ,"$3,645.00 ","$2,624.40 ","$1,982.88 ",$838.35 ,"$2,034.64 ",$838.35 ,"$2,177.52 ","$2,177.52 ","$2,177.52 ","$2,177.52 ","$3,061.80 ",$838.35 ,"$3,098.25 ","$3,061.80 ",$838.35 ,"$2,733.75 ","$2,916.00 ","$2,916.00 ",$838.35 ,"$2,916.00 ","$3,061.80 ","$3,061.80 ","$3,061.80 ","$3,280.50 ","$2,095.88 ",$838.35 ,"$3,645.00 ",$372.26 ,$409.49 ,$922.19 ,"$3,098.25 ","$2,177.52 ","$3,280.50 ","$3,061.80 ","$2,916.00 ","$2,916.00 ",$838.35 ,"$2,369.25 " ST. FRANCIS HOSPITAL - ACUTE,61000009,70552,HC MRI BRAIN W/CON,610,1 ,"$4,419.00 ","$2,872.35 ",$372.26 ,"$4,419.00 ","$3,181.68 ","$2,403.94 ","$1,016.37 ","$2,466.69 ","$1,016.37 ","$2,639.91 ","$2,639.91 ","$2,639.91 ","$2,639.91 ","$3,711.96 ","$1,016.37 ","$3,756.15 ","$3,711.96 ","$1,016.37 ","$3,314.25 ","$3,535.20 ","$3,535.20 ","$1,016.37 ","$3,535.20 ","$3,711.96 ","$3,711.96 ","$3,711.96 ","$3,977.10 ","$2,540.93 ","$1,016.37 ","$4,419.00 ",$372.26 ,$409.49 ,"$1,118.01 ","$3,756.15 ","$2,639.91 ","$3,977.10 ","$3,711.96 ","$3,535.20 ","$3,535.20 ","$1,016.37 ","$2,872.35 " ST. FRANCIS HOSPITAL - ACUTE,61000010,70553,HC MRI BRAIN W AND W/O CONTRAST,610,1 ,"$4,419.00 ","$2,872.35 ",$372.26 ,"$4,419.00 ","$3,181.68 ","$2,403.94 ","$1,016.37 ","$2,466.69 ","$1,016.37 ","$2,639.91 ","$2,639.91 ","$2,639.91 ","$2,639.91 ","$3,711.96 ","$1,016.37 ","$3,756.15 ","$3,711.96 ","$1,016.37 ","$3,314.25 ","$3,535.20 ","$3,535.20 ","$1,016.37 ","$3,535.20 ","$3,711.96 ","$3,711.96 ","$3,711.96 ","$3,977.10 ","$2,540.93 ","$1,016.37 ","$4,419.00 ",$372.26 ,$409.49 ,"$1,118.01 ","$3,756.15 ","$2,639.91 ","$3,977.10 ","$3,711.96 ","$3,535.20 ","$3,535.20 ","$1,016.37 ","$2,872.35 " ST. FRANCIS HOSPITAL - ACUTE,61000011,72141,HC MRI C-SPINE W/O CONTRAST,610,1 ,"$3,388.00 ","$2,202.20 ",$268.48 ,"$3,388.00 ","$2,439.36 ","$1,843.07 ",$779.24 ,"$1,891.18 ",$779.24 ,"$2,023.99 ","$2,023.99 ","$2,023.99 ","$2,023.99 ","$2,845.92 ",$779.24 ,"$2,879.80 ","$2,845.92 ",$779.24 ,"$2,541.00 ","$2,710.40 ","$2,710.40 ",$779.24 ,"$2,710.40 ","$2,845.92 ","$2,845.92 ","$2,845.92 ","$3,049.20 ","$1,948.10 ",$779.24 ,"$3,388.00 ",$268.48 ,$295.33 ,$857.16 ,"$2,879.80 ","$2,023.99 ","$3,049.20 ","$2,845.92 ","$2,710.40 ","$2,710.40 ",$779.24 ,"$2,202.20 " ST. FRANCIS HOSPITAL - ACUTE,61000012,72142,HC MRI C-SPINE W/CON,610,1 ,"$4,138.00 ","$2,689.70 ",$268.48 ,"$4,138.00 ","$2,979.36 ","$2,251.07 ",$951.74 ,"$2,309.83 ",$951.74 ,"$2,472.04 ","$2,472.04 ","$2,472.04 ","$2,472.04 ","$3,475.92 ",$951.74 ,"$3,517.30 ","$3,475.92 ",$951.74 ,"$3,103.50 ","$3,310.40 ","$3,310.40 ",$951.74 ,"$3,310.40 ","$3,475.92 ","$3,475.92 ","$3,475.92 ","$3,724.20 ","$2,379.35 ",$951.74 ,"$4,138.00 ",$268.48 ,$295.33 ,"$1,046.91 ","$3,517.30 ","$2,472.04 ","$3,724.20 ","$3,475.92 ","$3,310.40 ","$3,310.40 ",$951.74 ,"$2,689.70 " ST. FRANCIS HOSPITAL - ACUTE,61000013,72146,HC MRI T-SPINE W/O CONTRAST,610,1 ,"$3,510.00 ","$2,281.50 ",$268.48 ,"$3,510.00 ","$2,527.20 ","$1,909.44 ",$807.30 ,"$1,959.28 ",$807.30 ,"$2,096.87 ","$2,096.87 ","$2,096.87 ","$2,096.87 ","$2,948.40 ",$807.30 ,"$2,983.50 ","$2,948.40 ",$807.30 ,"$2,632.50 ","$2,808.00 ","$2,808.00 ",$807.30 ,"$2,808.00 ","$2,948.40 ","$2,948.40 ","$2,948.40 ","$3,159.00 ","$2,018.25 ",$807.30 ,"$3,510.00 ",$268.48 ,$295.33 ,$888.03 ,"$2,983.50 ","$2,096.87 ","$3,159.00 ","$2,948.40 ","$2,808.00 ","$2,808.00 ",$807.30 ,"$2,281.50 " ST. FRANCIS HOSPITAL - ACUTE,61000014,72147,HC MRI T-SPINE W/CON,610,1 ,"$4,210.00 ","$2,736.50 ",$268.48 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$268.48 ,$295.33 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000016,72148,HC MRI L-SPINE W/O CONTRAST,610,1 ,"$3,621.00 ","$2,353.65 ",$268.48 ,"$3,621.00 ","$2,607.12 ","$1,969.82 ",$832.83 ,"$2,021.24 ",$832.83 ,"$2,163.19 ","$2,163.19 ","$2,163.19 ","$2,163.19 ","$3,041.64 ",$832.83 ,"$3,077.85 ","$3,041.64 ",$832.83 ,"$2,715.75 ","$2,896.80 ","$2,896.80 ",$832.83 ,"$2,896.80 ","$3,041.64 ","$3,041.64 ","$3,041.64 ","$3,258.90 ","$2,082.08 ",$832.83 ,"$3,621.00 ",$268.48 ,$295.33 ,$916.11 ,"$3,077.85 ","$2,163.19 ","$3,258.90 ","$3,041.64 ","$2,896.80 ","$2,896.80 ",$832.83 ,"$2,353.65 " ST. FRANCIS HOSPITAL - ACUTE,61000017,72149,HC MRI L-SPINE W/CON,610,1 ,"$3,821.00 ","$2,483.65 ",$268.48 ,"$3,821.00 ","$2,751.12 ","$2,078.62 ",$878.83 ,"$2,132.88 ",$878.83 ,"$2,282.67 ","$2,282.67 ","$2,282.67 ","$2,282.67 ","$3,209.64 ",$878.83 ,"$3,247.85 ","$3,209.64 ",$878.83 ,"$2,865.75 ","$3,056.80 ","$3,056.80 ",$878.83 ,"$3,056.80 ","$3,209.64 ","$3,209.64 ","$3,209.64 ","$3,438.90 ","$2,197.08 ",$878.83 ,"$3,821.00 ",$268.48 ,$295.33 ,$966.71 ,"$3,247.85 ","$2,282.67 ","$3,438.90 ","$3,209.64 ","$3,056.80 ","$3,056.80 ",$878.83 ,"$2,483.65 " ST. FRANCIS HOSPITAL - ACUTE,61000018,72156,HC MRI C-SPINE W AND W/O CON,610,1 ,"$4,138.00 ","$2,689.70 ",$268.48 ,"$4,138.00 ","$2,979.36 ","$2,251.07 ",$951.74 ,"$2,309.83 ",$951.74 ,"$2,472.04 ","$2,472.04 ","$2,472.04 ","$2,472.04 ","$3,475.92 ",$951.74 ,"$3,517.30 ","$3,475.92 ",$951.74 ,"$3,103.50 ","$3,310.40 ","$3,310.40 ",$951.74 ,"$3,310.40 ","$3,475.92 ","$3,475.92 ","$3,475.92 ","$3,724.20 ","$2,379.35 ",$951.74 ,"$4,138.00 ",$268.48 ,$295.33 ,"$1,046.91 ","$3,517.30 ","$2,472.04 ","$3,724.20 ","$3,475.92 ","$3,310.40 ","$3,310.40 ",$951.74 ,"$2,689.70 " ST. FRANCIS HOSPITAL - ACUTE,61000019,72157,HC MRI T-SPINE W AND W/O CON,610,1 ,"$4,210.00 ","$2,736.50 ",$268.48 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$268.48 ,$295.33 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000020,72158,HC MRI L-SPINE W AND W/O CON,610,1 ,"$4,210.00 ","$2,736.50 ",$268.48 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$268.48 ,$295.33 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000021,72195,HC MRI PELVIS W/O CON,610,1 ,"$3,446.00 ","$2,239.90 ",$332.25 ,"$3,446.00 ","$2,481.12 ","$1,874.62 ",$792.58 ,"$1,923.56 ",$792.58 ,"$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,894.64 ",$792.58 ,"$2,929.10 ","$2,894.64 ",$792.58 ,"$2,584.50 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,756.80 ","$2,894.64 ","$2,894.64 ","$2,894.64 ","$3,101.40 ","$1,981.45 ",$792.58 ,"$3,446.00 ",$332.25 ,$365.48 ,$871.84 ,"$2,929.10 ","$2,058.64 ","$3,101.40 ","$2,894.64 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,239.90 " ST. FRANCIS HOSPITAL - ACUTE,61000023,72197,HC MRI PELVIS W AND W/O CON,610,1 ,"$4,210.00 ","$2,736.50 ",$332.25 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$332.25 ,$365.48 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000024,73218,HC MRI UPPR EXT NONJOINT W/O CONTRAST,610,1 ,"$3,446.00 ","$2,239.90 ",$332.25 ,"$3,446.00 ","$2,481.12 ","$1,874.62 ",$792.58 ,"$1,923.56 ",$792.58 ,"$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,894.64 ",$792.58 ,"$2,929.10 ","$2,894.64 ",$792.58 ,"$2,584.50 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,756.80 ","$2,894.64 ","$2,894.64 ","$2,894.64 ","$3,101.40 ","$1,981.45 ",$792.58 ,"$3,446.00 ",$332.25 ,$365.48 ,$871.84 ,"$2,929.10 ","$2,058.64 ","$3,101.40 ","$2,894.64 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,239.90 " ST. FRANCIS HOSPITAL - ACUTE,61000026,73220,HC MRI UPPR EXT NONJOINT W AND W/O CONTRAST,610,1 ,"$4,210.00 ","$2,736.50 ",$332.25 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$332.25 ,$365.48 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000027,73221,HC MRI UPPR EXT JOINT W/O CONTRAST,610,1 ,"$3,446.00 ","$2,239.90 ",$224.25 ,"$3,446.00 ","$2,481.12 ","$1,874.62 ",$792.58 ,"$1,923.56 ",$792.58 ,"$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,894.64 ",$792.58 ,"$2,929.10 ","$2,894.64 ",$792.58 ,"$2,584.50 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,756.80 ","$2,894.64 ","$2,894.64 ","$2,894.64 ","$3,101.40 ","$1,981.45 ",$792.58 ,"$3,446.00 ",$224.25 ,$246.68 ,$871.84 ,"$2,929.10 ","$2,058.64 ","$3,101.40 ","$2,894.64 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,239.90 " ST. FRANCIS HOSPITAL - ACUTE,61000028,73222,HC MRI UPPR EXT JOINT W/CONTRAST,610,1 ,"$4,210.00 ","$2,736.50 ",$224.25 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$224.25 ,$246.68 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000029,73223,HC MRI UPPR EXT JOINT W AND W/O CONTRAST,610,1 ,"$4,210.00 ","$2,736.50 ",$224.25 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$224.25 ,$246.68 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000030,73718,HC MRI LE NONJOINT WO CONTRAST,610,1 ,"$3,446.00 ","$2,239.90 ",$332.25 ,"$3,446.00 ","$2,481.12 ","$1,874.62 ",$792.58 ,"$1,923.56 ",$792.58 ,"$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,894.64 ",$792.58 ,"$2,929.10 ","$2,894.64 ",$792.58 ,"$2,584.50 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,756.80 ","$2,894.64 ","$2,894.64 ","$2,894.64 ","$3,101.40 ","$1,981.45 ",$792.58 ,"$3,446.00 ",$332.25 ,$365.48 ,$871.84 ,"$2,929.10 ","$2,058.64 ","$3,101.40 ","$2,894.64 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,239.90 " ST. FRANCIS HOSPITAL - ACUTE,61000032,73719,HC MRI LE NONJOINT W/ CONTRAST,610,1 ,"$4,210.00 ","$2,736.50 ",$332.25 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$332.25 ,$365.48 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000033,73720,HC MRI LE NONJOINT W/WO CONTRAST,610,1 ,"$4,210.00 ","$2,736.50 ",$332.25 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$332.25 ,$365.48 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000034,73721,HC MRI LWR EXT JOINT W/O CONTRAST,610,1 ,"$3,446.00 ","$2,239.90 ",$224.25 ,"$3,446.00 ","$2,481.12 ","$1,874.62 ",$792.58 ,"$1,923.56 ",$792.58 ,"$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,894.64 ",$792.58 ,"$2,929.10 ","$2,894.64 ",$792.58 ,"$2,584.50 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,756.80 ","$2,894.64 ","$2,894.64 ","$2,894.64 ","$3,101.40 ","$1,981.45 ",$792.58 ,"$3,446.00 ",$224.25 ,$246.68 ,$871.84 ,"$2,929.10 ","$2,058.64 ","$3,101.40 ","$2,894.64 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,239.90 " ST. FRANCIS HOSPITAL - ACUTE,61000035,73722,HC MRI LWR EXT JOINT W/CONTRAST,610,1 ,"$3,569.00 ","$2,319.85 ",$224.25 ,"$3,569.00 ","$2,569.68 ","$1,941.54 ",$820.87 ,"$1,992.22 ",$820.87 ,"$2,132.12 ","$2,132.12 ","$2,132.12 ","$2,132.12 ","$2,997.96 ",$820.87 ,"$3,033.65 ","$2,997.96 ",$820.87 ,"$2,676.75 ","$2,855.20 ","$2,855.20 ",$820.87 ,"$2,855.20 ","$2,997.96 ","$2,997.96 ","$2,997.96 ","$3,212.10 ","$2,052.18 ",$820.87 ,"$3,569.00 ",$224.25 ,$246.68 ,$902.96 ,"$3,033.65 ","$2,132.12 ","$3,212.10 ","$2,997.96 ","$2,855.20 ","$2,855.20 ",$820.87 ,"$2,319.85 " ST. FRANCIS HOSPITAL - ACUTE,61000036,73723,HC MRI LWR EXT JOINT W AND W/O CONTRAST,610,1 ,"$4,210.00 ","$2,736.50 ",$224.25 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$224.25 ,$246.68 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000038,74181,HC MRI ABDOMEN W/O CON,610,1 ,"$3,446.00 ","$2,239.90 ",$398.21 ,"$3,446.00 ","$2,481.12 ","$1,874.62 ",$792.58 ,"$1,923.56 ",$792.58 ,"$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,058.64 ","$2,894.64 ",$792.58 ,"$2,929.10 ","$2,894.64 ",$792.58 ,"$2,584.50 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,756.80 ","$2,894.64 ","$2,894.64 ","$2,894.64 ","$3,101.40 ","$1,981.45 ",$792.58 ,"$3,446.00 ",$398.21 ,$438.03 ,$871.84 ,"$2,929.10 ","$2,058.64 ","$3,101.40 ","$2,894.64 ","$2,756.80 ","$2,756.80 ",$792.58 ,"$2,239.90 " ST. FRANCIS HOSPITAL - ACUTE,61000039,74182,HC MRI ABDOMEN W/CON,610,1 ,"$4,210.00 ","$2,736.50 ",$398.21 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$398.21 ,$438.03 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000040,74183,HC MRI ABDOMEN W AND W/O CON,610,1 ,"$4,210.00 ","$2,736.50 ",$398.21 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$398.21 ,$438.03 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000050,C8937,HC MRI BREAST CAD,610,1 ,$76.00 ,$49.40 ,$17.48 ,$76.00 ,$54.72 ,$41.34 ,$17.48 ,$42.42 ,$17.48 ,$45.40 ,$45.40 ,$45.40 ,$45.40 ,$63.84 ,$17.48 ,$64.60 ,$63.84 ,$17.48 ,$57.00 ,$60.80 ,$60.80 ,$17.48 ,$60.80 ,$63.84 ,$63.84 ,$63.84 ,$68.40 ,$43.70 ,$17.48 ,$76.00 , N/A , N/A ,$19.23 ,$64.60 ,$45.40 ,$68.40 ,$63.84 ,$60.80 ,$60.80 ,$17.48 ,$49.40 ST. FRANCIS HOSPITAL - ACUTE,61000051,C8900,HC MRA ABDOMEN W/CONTRAST,610,1 ,"$3,790.00 ","$2,463.50 ",$429.62 ,"$3,790.00 ","$2,728.80 ","$2,061.76 ",$871.70 ,"$2,115.58 ",$871.70 ,"$2,264.15 ","$2,264.15 ","$2,264.15 ","$2,264.15 ","$3,183.60 ",$871.70 ,"$3,221.50 ","$3,183.60 ",$871.70 ,"$2,842.50 ","$3,032.00 ","$3,032.00 ",$871.70 ,"$3,032.00 ","$3,183.60 ","$3,183.60 ","$3,183.60 ","$3,411.00 ","$2,179.25 ",$871.70 ,"$3,790.00 ",$429.62 ,$472.58 ,$958.87 ,"$3,221.50 ","$2,264.15 ","$3,411.00 ","$3,183.60 ","$3,032.00 ","$3,032.00 ",$871.70 ,"$2,463.50 " ST. FRANCIS HOSPITAL - ACUTE,61000052,C8901,HC MRA ABDOMEN W/O CONTRAST,610,1 ,"$3,590.00 ","$2,333.50 ",$429.62 ,"$3,590.00 ","$2,584.80 ","$1,952.96 ",$825.70 ,"$2,003.94 ",$825.70 ,"$2,144.67 ","$2,144.67 ","$2,144.67 ","$2,144.67 ","$3,015.60 ",$825.70 ,"$3,051.50 ","$3,015.60 ",$825.70 ,"$2,692.50 ","$2,872.00 ","$2,872.00 ",$825.70 ,"$2,872.00 ","$3,015.60 ","$3,015.60 ","$3,015.60 ","$3,231.00 ","$2,064.25 ",$825.70 ,"$3,590.00 ",$429.62 ,$472.58 ,$908.27 ,"$3,051.50 ","$2,144.67 ","$3,231.00 ","$3,015.60 ","$2,872.00 ","$2,872.00 ",$825.70 ,"$2,333.50 " ST. FRANCIS HOSPITAL - ACUTE,61000053,C8902,HC MRA ABDOMEN W AND W/O CON,610,1 ,"$4,257.00 ","$2,767.05 ",$429.62 ,"$4,257.00 ","$3,065.04 ","$2,315.81 ",$979.11 ,"$2,376.26 ",$979.11 ,"$2,543.13 ","$2,543.13 ","$2,543.13 ","$2,543.13 ","$3,575.88 ",$979.11 ,"$3,618.45 ","$3,575.88 ",$979.11 ,"$3,192.75 ","$3,405.60 ","$3,405.60 ",$979.11 ,"$3,405.60 ","$3,575.88 ","$3,575.88 ","$3,575.88 ","$3,831.30 ","$2,447.78 ",$979.11 ,"$4,257.00 ",$429.62 ,$472.58 ,"$1,077.02 ","$3,618.45 ","$2,543.13 ","$3,831.30 ","$3,575.88 ","$3,405.60 ","$3,405.60 ",$979.11 ,"$2,767.05 " ST. FRANCIS HOSPITAL - ACUTE,61000056,C8905,HC MRI BREAST UNI W AND W/O CONTRAST,610,1 ,"$3,068.00 ","$1,994.20 ",$332.25 ,"$3,068.00 ","$2,208.96 ","$1,668.99 ",$705.64 ,"$1,712.56 ",$705.64 ,"$1,832.82 ","$1,832.82 ","$1,832.82 ","$1,832.82 ","$2,577.12 ",$705.64 ,"$2,607.80 ","$2,577.12 ",$705.64 ,"$2,301.00 ","$2,454.40 ","$2,454.40 ",$705.64 ,"$2,454.40 ","$2,577.12 ","$2,577.12 ","$2,577.12 ","$2,761.20 ","$1,764.10 ",$705.64 ,"$3,068.00 ",$332.25 ,$365.48 ,$776.20 ,"$2,607.80 ","$1,832.82 ","$2,761.20 ","$2,577.12 ","$2,454.40 ","$2,454.40 ",$705.64 ,"$1,994.20 " ST. FRANCIS HOSPITAL - ACUTE,61000058,77047,HC MRI BREAST BI W/O CON,610,1 ,"$3,068.00 ","$1,994.20 ",$180.67 ,"$3,068.00 ","$2,208.96 ","$1,668.99 ",$705.64 ,"$1,712.56 ",$705.64 ,"$1,832.82 ","$1,832.82 ","$1,832.82 ","$1,832.82 ","$2,577.12 ",$705.64 ,"$2,607.80 ","$2,577.12 ",$705.64 ,"$2,301.00 ","$2,454.40 ","$2,454.40 ",$705.64 ,"$2,454.40 ","$2,577.12 ","$2,577.12 ","$2,577.12 ","$2,761.20 ","$1,764.10 ",$705.64 ,$180.67 ,$332.25 ,$365.48 ,$776.20 ,"$2,607.80 ","$1,832.82 ","$2,761.20 ","$2,577.12 ","$2,454.40 ","$2,454.40 ",$705.64 ,"$1,994.20 " ST. FRANCIS HOSPITAL - ACUTE,61000059,C8908,HC MRI BREAST BI W AND W/O CON,610,1 ,"$4,210.00 ","$2,736.50 ",$332.25 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$332.25 ,$365.48 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000067,C8914,HC MRA LWR EXT W AND W/O CONTRAST,610,1 ,"$4,210.00 ","$2,736.50 ",$429.62 ,"$4,210.00 ","$3,031.20 ","$2,290.24 ",$968.30 ,"$2,350.02 ",$968.30 ,"$2,515.05 ","$2,515.05 ","$2,515.05 ","$2,515.05 ","$3,536.40 ",$968.30 ,"$3,578.50 ","$3,536.40 ",$968.30 ,"$3,157.50 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$3,368.00 ","$3,536.40 ","$3,536.40 ","$3,536.40 ","$3,789.00 ","$2,420.75 ",$968.30 ,"$4,210.00 ",$429.62 ,$472.58 ,"$1,065.13 ","$3,578.50 ","$2,515.05 ","$3,789.00 ","$3,536.40 ","$3,368.00 ","$3,368.00 ",$968.30 ,"$2,736.50 " ST. FRANCIS HOSPITAL - ACUTE,61000070,C8920,HC MRA PELVIS W AND W/O CONTRAST,610,1 ,"$3,430.00 ","$2,229.50 ",$429.62 ,"$3,430.00 ","$2,469.60 ","$1,865.92 ",$788.90 ,"$1,914.63 ",$788.90 ,"$2,049.08 ","$2,049.08 ","$2,049.08 ","$2,049.08 ","$2,881.20 ",$788.90 ,"$2,915.50 ","$2,881.20 ",$788.90 ,"$2,572.50 ","$2,744.00 ","$2,744.00 ",$788.90 ,"$2,744.00 ","$2,881.20 ","$2,881.20 ","$2,881.20 ","$3,087.00 ","$1,972.25 ",$788.90 ,"$3,430.00 ",$429.62 ,$472.58 ,$867.79 ,"$2,915.50 ","$2,049.08 ","$3,087.00 ","$2,881.20 ","$2,744.00 ","$2,744.00 ",$788.90 ,"$2,229.50 " ST. FRANCIS HOSPITAL - ACUTE,61000073,70553,HC MRI BRAIN W AND W/O CONTRAST PITUITARY,610,1 ,"$4,419.00 ","$2,872.35 ",$372.26 ,"$4,419.00 ","$3,181.68 ","$2,403.94 ","$1,016.37 ","$2,466.69 ","$1,016.37 ","$2,639.91 ","$2,639.91 ","$2,639.91 ","$2,639.91 ","$3,711.96 ","$1,016.37 ","$3,756.15 ","$3,711.96 ","$1,016.37 ","$3,314.25 ","$3,535.20 ","$3,535.20 ","$1,016.37 ","$3,535.20 ","$3,711.96 ","$3,711.96 ","$3,711.96 ","$3,977.10 ","$2,540.93 ","$1,016.37 ","$4,419.00 ",$372.26 ,$409.49 ,"$1,118.01 ","$3,756.15 ","$2,639.91 ","$3,977.10 ","$3,711.96 ","$3,535.20 ","$3,535.20 ","$1,016.37 ","$2,872.35 " ST. FRANCIS HOSPITAL - ACUTE,61000076,70542,HC MRI ORBIT/FACE/NECK W/CONTRAST,610,1 ,"$4,213.00 ","$2,738.45 ",$332.25 ,"$4,213.00 ","$3,033.36 ","$2,291.87 ",$968.99 ,"$2,351.70 ",$968.99 ,"$2,516.85 ","$2,516.85 ","$2,516.85 ","$2,516.85 ","$3,538.92 ",$968.99 ,"$3,581.05 ","$3,538.92 ",$968.99 ,"$3,159.75 ","$3,370.40 ","$3,370.40 ",$968.99 ,"$3,370.40 ","$3,538.92 ","$3,538.92 ","$3,538.92 ","$3,791.70 ","$2,422.48 ",$968.99 ,"$4,213.00 ",$332.25 ,$365.48 ,"$1,065.89 ","$3,581.05 ","$2,516.85 ","$3,791.70 ","$3,538.92 ","$3,370.40 ","$3,370.40 ",$968.99 ,"$2,738.45 " ST. FRANCIS HOSPITAL - ACUTE,71000206,N/A,HC PACU RECOVERY INITIAL 15MIN,710,1 ,$368.00 ,$239.20 ,$84.64 ,$368.00 ,$264.96 ,$200.19 ,$84.64 ,$205.42 ,$84.64 ,$219.84 ,$219.84 ,$219.84 ,$219.84 ,$309.12 ,$84.64 ,$312.80 ,$309.12 ,$84.64 ,$276.00 ,$294.40 ,$294.40 ,$84.64 ,$294.40 ,$309.12 ,$309.12 ,$309.12 ,$331.20 ,$211.60 ,$84.64 ,$368.00 , N/A , N/A ,$93.10 ,$312.80 ,$219.84 ,$331.20 ,$309.12 ,$294.40 ,$294.40 ,$84.64 ,$239.20 ST. FRANCIS HOSPITAL - ACUTE,71000207,N/A,HC PACU RECOVERY ADDL 15MIN,710,1 ,$297.00 ,$193.05 ,$68.31 ,$297.00 ,$213.84 ,$161.57 ,$68.31 ,$165.79 ,$68.31 ,$177.43 ,$177.43 ,$177.43 ,$177.43 ,$249.48 ,$68.31 ,$252.45 ,$249.48 ,$68.31 ,$222.75 ,$237.60 ,$237.60 ,$68.31 ,$237.60 ,$249.48 ,$249.48 ,$249.48 ,$267.30 ,$170.78 ,$68.31 ,$297.00 , N/A , N/A ,$75.14 ,$252.45 ,$177.43 ,$267.30 ,$249.48 ,$237.60 ,$237.60 ,$68.31 ,$193.05 ST. FRANCIS HOSPITAL - ACUTE,71000250,N/A,HC PHASE II RECOVERY INIT 15MIN,710,1 ,$124.00 ,$80.60 ,$28.52 ,$124.00 ,$89.28 ,$67.46 ,$28.52 ,$69.22 ,$28.52 ,$74.08 ,$74.08 ,$74.08 ,$74.08 ,$104.16 ,$28.52 ,$105.40 ,$104.16 ,$28.52 ,$93.00 ,$99.20 ,$99.20 ,$28.52 ,$99.20 ,$104.16 ,$104.16 ,$104.16 ,$111.60 ,$71.30 ,$28.52 ,$124.00 , N/A , N/A ,$31.37 ,$105.40 ,$74.08 ,$111.60 ,$104.16 ,$99.20 ,$99.20 ,$28.52 ,$80.60 ST. FRANCIS HOSPITAL - ACUTE,71000251,N/A,HC PHASE II RECOVERY ADDL 15MIN,710,1 ,$63.00 ,$40.95 ,$14.49 ,$63.00 ,$45.36 ,$34.27 ,$14.49 ,$35.17 ,$14.49 ,$37.64 ,$37.64 ,$37.64 ,$37.64 ,$52.92 ,$14.49 ,$53.55 ,$52.92 ,$14.49 ,$47.25 ,$50.40 ,$50.40 ,$14.49 ,$50.40 ,$52.92 ,$52.92 ,$52.92 ,$56.70 ,$36.23 ,$14.49 ,$63.00 , N/A , N/A ,$15.94 ,$53.55 ,$37.64 ,$56.70 ,$52.92 ,$50.40 ,$50.40 ,$14.49 ,$40.95 ST. FRANCIS HOSPITAL - ACUTE,72000023,59070,HC TRANSABDOMINAL AMNIOINFUSION W/US GUIDANCE,720,1 ,$482.00 ,$313.30 ,$110.86 ,$891.86 ,$347.04 ,$262.21 ,$110.86 ,$269.05 ,$110.86 ,$287.95 ,$287.95 ,$287.95 ,$287.95 ,$404.88 ,$110.86 ,$409.70 ,$404.88 ,$110.86 ,$361.50 ,$385.60 ,$385.60 ,$110.86 ,$385.60 ,$404.88 ,$404.88 ,$404.88 ,$433.80 ,$277.15 ,$110.86 ,$482.00 ,$810.78 ,$891.86 ,$121.95 ,$409.70 ,$287.95 ,$433.80 ,$404.88 ,$385.60 ,$385.60 ,$110.86 ,$313.30 ST. FRANCIS HOSPITAL - ACUTE,72100005,N/A,HC LABOR PER HR,721,1 ,$90.00 ,$58.50 ,$20.70 ,$90.00 ,$64.80 ,$48.96 ,$20.70 ,$50.24 ,$20.70 ,$53.77 ,$53.77 ,$53.77 ,$53.77 ,$75.60 ,$20.70 ,$76.50 ,$75.60 ,$20.70 ,$67.50 ,$72.00 ,$72.00 ,$20.70 ,$72.00 ,$75.60 ,$75.60 ,$75.60 ,$81.00 ,$51.75 ,$20.70 ,$90.00 , N/A , N/A ,$22.77 ,$76.50 ,$53.77 ,$81.00 ,$75.60 ,$72.00 ,$72.00 ,$20.70 ,$58.50 ST. FRANCIS HOSPITAL - ACUTE,72200009,N/A,HC DELIVERY,722,1 ,"$2,458.00 ","$1,597.70 ",$565.34 ,"$2,458.00 ","$1,769.76 ","$1,337.15 ",$565.34 ,"$1,372.06 ",$565.34 ,"$1,468.41 ","$1,468.41 ","$1,468.41 ","$1,468.41 ","$2,064.72 ",$565.34 ,"$2,089.30 ","$2,064.72 ",$565.34 ,"$1,843.50 ","$1,966.40 ","$1,966.40 ",$565.34 ,"$1,966.40 ","$2,064.72 ","$2,064.72 ","$2,064.72 ","$2,212.20 ","$1,413.35 ",$565.34 ,"$2,458.00 ", N/A , N/A ,$621.87 ,"$2,089.30 ","$1,468.41 ","$2,212.20 ","$2,064.72 ","$1,966.40 ","$1,966.40 ",$565.34 ,"$1,597.70 " ST. FRANCIS HOSPITAL - ACUTE,72300002,54160,HC CIRCUMCISION,723,1 ,$761.00 ,$494.65 ,$175.03 ,"$1,581.39 ",$547.92 ,$413.98 ,$175.03 ,$424.79 ,$175.03 ,$454.62 ,$454.62 ,$454.62 ,$454.62 ,$639.24 ,$175.03 ,$646.85 ,$639.24 ,$175.03 ,$570.75 ,$608.80 ,$608.80 ,$175.03 ,$608.80 ,$639.24 ,$639.24 ,$639.24 ,$684.90 ,$437.58 ,$175.03 ,$761.00 ,"$1,437.63 ","$1,581.39 ",$192.53 ,$646.85 ,$454.62 ,$684.90 ,$639.24 ,$608.80 ,$608.80 ,$175.03 ,$494.65 ST. FRANCIS HOSPITAL - ACUTE,73000002,93005,HC EKG,730,1 ,$309.00 ,$200.85 ,$24.70 ,$309.00 ,$222.48 ,$168.10 ,$71.07 ,$172.48 ,$71.07 ,$184.60 ,$184.60 ,$184.60 ,$184.60 ,$259.56 ,$71.07 ,$262.65 ,$259.56 ,$71.07 ,$231.75 ,$247.20 ,$247.20 ,$71.07 ,$247.20 ,$259.56 ,$259.56 ,$259.56 ,$278.10 ,$177.68 ,$71.07 ,$309.00 ,$24.70 ,$27.17 ,$78.18 ,$262.65 ,$184.60 ,$278.10 ,$259.56 ,$247.20 ,$247.20 ,$71.07 ,$200.85 ST. FRANCIS HOSPITAL - ACUTE,73000003,93041,HC EKG RHYTHM STRIP TRACING,730,1 ,$55.00 ,$35.75 ,$12.65 ,$55.00 ,$39.60 ,$29.92 ,$12.65 ,$30.70 ,$12.65 ,$32.86 ,$32.86 ,$32.86 ,$32.86 ,$46.20 ,$12.65 ,$46.75 ,$46.20 ,$12.65 ,$41.25 ,$44.00 ,$44.00 ,$12.65 ,$44.00 ,$46.20 ,$46.20 ,$46.20 ,$49.50 ,$31.63 ,$12.65 ,$55.00 ,$24.70 ,$27.17 ,$13.92 ,$46.75 ,$32.86 ,$49.50 ,$46.20 ,$44.00 ,$44.00 ,$12.65 ,$35.75 ST. FRANCIS HOSPITAL - ACUTE,73100000,93225,HC HOLTER MONITOR RECORDING,731,1 ,$811.00 ,$527.15 ,$66.26 ,$811.00 ,$583.92 ,$441.18 ,$186.53 ,$452.70 ,$186.53 ,$484.49 ,$484.49 ,$484.49 ,$484.49 ,$681.24 ,$186.53 ,$689.35 ,$681.24 ,$186.53 ,$608.25 ,$648.80 ,$648.80 ,$186.53 ,$648.80 ,$681.24 ,$681.24 ,$681.24 ,$729.90 ,$466.33 ,$186.53 ,$811.00 ,$66.26 ,$72.89 ,$205.18 ,$689.35 ,$484.49 ,$729.90 ,$681.24 ,$648.80 ,$648.80 ,$186.53 ,$527.15 ST. FRANCIS HOSPITAL - ACUTE,73100002,93226,HC HOLTER SCAN AND REPORT 48 HR,731,1 ,"$1,059.00 ",$688.35 ,$66.26 ,"$1,059.00 ",$762.48 ,$576.10 ,$243.57 ,$591.13 ,$243.57 ,$632.65 ,$632.65 ,$632.65 ,$632.65 ,$889.56 ,$243.57 ,$900.15 ,$889.56 ,$243.57 ,$794.25 ,$847.20 ,$847.20 ,$243.57 ,$847.20 ,$889.56 ,$889.56 ,$889.56 ,$953.10 ,$608.93 ,$243.57 ,"$1,059.00 ",$66.26 ,$72.89 ,$267.93 ,$900.15 ,$632.65 ,$953.10 ,$889.56 ,$847.20 ,$847.20 ,$243.57 ,$688.35 ST. FRANCIS HOSPITAL - ACUTE,73100004,93270,HC CARDIAC EVENT RECORDER,731,1 ,$889.00 ,$577.85 ,$66.26 ,$889.00 ,$640.08 ,$483.62 ,$204.47 ,$496.24 ,$204.47 ,$531.09 ,$531.09 ,$531.09 ,$531.09 ,$746.76 ,$204.47 ,$755.65 ,$746.76 ,$204.47 ,$666.75 ,$711.20 ,$711.20 ,$204.47 ,$711.20 ,$746.76 ,$746.76 ,$746.76 ,$800.10 ,$511.18 ,$204.47 ,$889.00 ,$66.26 ,$72.89 ,$224.92 ,$755.65 ,$531.09 ,$800.10 ,$746.76 ,$711.20 ,$711.20 ,$204.47 ,$577.85 ST. FRANCIS HOSPITAL - ACUTE,74000002,95805,HC MULTIPLE SLEEP LATENCY,740,1 ,"$2,973.00 ","$1,932.45 ",$683.79 ,"$2,973.00 ","$2,140.56 ","$1,617.31 ",$683.79 ,"$1,659.53 ",$683.79 ,"$1,776.07 ","$1,776.07 ","$1,776.07 ","$1,776.07 ","$2,497.32 ",$683.79 ,"$2,527.05 ","$2,497.32 ",$683.79 ,"$2,229.75 ","$2,378.40 ","$2,378.40 ",$683.79 ,"$2,378.40 ","$2,497.32 ","$2,497.32 ","$2,497.32 ","$2,675.70 ","$1,709.48 ",$683.79 ,"$2,973.00 ",$735.92 ,$809.51 ,$752.17 ,"$2,527.05 ","$1,776.07 ","$2,675.70 ","$2,497.32 ","$2,378.40 ","$2,378.40 ",$683.79 ,"$1,932.45 " ST. FRANCIS HOSPITAL - ACUTE,74000003,95806,HC SLEEP STUDY UNATTENDED,740,1 ,"$1,534.00 ",$997.10 ,$352.82 ,"$1,534.00 ","$1,104.48 ",$834.50 ,$352.82 ,$856.28 ,$352.82 ,$916.41 ,$916.41 ,$916.41 ,$916.41 ,"$1,288.56 ",$352.82 ,"$1,303.90 ","$1,288.56 ",$352.82 ,"$1,150.50 ","$1,227.20 ","$1,227.20 ",$352.82 ,"$1,227.20 ","$1,288.56 ","$1,288.56 ","$1,288.56 ","$1,380.60 ",$882.05 ,$352.82 ,"$1,534.00 ",$735.92 ,$809.51 ,$388.10 ,"$1,303.90 ",$916.41 ,"$1,380.60 ","$1,288.56 ","$1,227.20 ","$1,227.20 ",$352.82 ,$997.10 ST. FRANCIS HOSPITAL - ACUTE,74000006,95810,HC SLEEP STUDY,740,1 ,"$4,905.00 ","$3,188.25 ",$735.92 ,"$4,905.00 ","$3,531.60 ","$2,668.32 ","$1,128.15 ","$2,737.97 ","$1,128.15 ","$2,930.25 ","$2,930.25 ","$2,930.25 ","$2,930.25 ","$4,120.20 ","$1,128.15 ","$4,169.25 ","$4,120.20 ","$1,128.15 ","$3,678.75 ","$3,924.00 ","$3,924.00 ","$1,128.15 ","$3,924.00 ","$4,120.20 ","$4,120.20 ","$4,120.20 ","$4,414.50 ","$2,820.38 ","$1,128.15 ","$4,905.00 ",$735.92 ,$809.51 ,"$1,240.97 ","$4,169.25 ","$2,930.25 ","$4,414.50 ","$4,120.20 ","$3,924.00 ","$3,924.00 ","$1,128.15 ","$3,188.25 " ST. FRANCIS HOSPITAL - ACUTE,74000009,95811,HC SLEEP STUDY W/CPAP,740,1 ,"$5,722.00 ","$3,719.30 ",$735.92 ,"$5,722.00 ","$4,119.84 ","$3,112.77 ","$1,316.06 ","$3,194.02 ","$1,316.06 ","$3,418.32 ","$3,418.32 ","$3,418.32 ","$3,418.32 ","$4,806.48 ","$1,316.06 ","$4,863.70 ","$4,806.48 ","$1,316.06 ","$4,291.50 ","$4,577.60 ","$4,577.60 ","$1,316.06 ","$4,577.60 ","$4,806.48 ","$4,806.48 ","$4,806.48 ","$5,149.80 ","$3,290.15 ","$1,316.06 ","$5,722.00 ",$735.92 ,$809.51 ,"$1,447.67 ","$4,863.70 ","$3,418.32 ","$5,149.80 ","$4,806.48 ","$4,577.60 ","$4,577.60 ","$1,316.06 ","$3,719.30 " ST. FRANCIS HOSPITAL - ACUTE,74000014,95816,HC EEG AWAKE/DROWSY,740,1 ,$834.00 ,$542.10 ,$191.82 ,$834.00 ,$600.48 ,$453.70 ,$191.82 ,$465.54 ,$191.82 ,$498.23 ,$498.23 ,$498.23 ,$498.23 ,$700.56 ,$191.82 ,$708.90 ,$700.56 ,$191.82 ,$625.50 ,$667.20 ,$667.20 ,$191.82 ,$667.20 ,$700.56 ,$700.56 ,$700.56 ,$750.60 ,$479.55 ,$191.82 ,$834.00 ,$248.35 ,$273.19 ,$211.00 ,$708.90 ,$498.23 ,$750.60 ,$700.56 ,$667.20 ,$667.20 ,$191.82 ,$542.10 ST. FRANCIS HOSPITAL - ACUTE,74000016,95819,HC EEG AWAKE/ASLEEP,740,1 ,$834.00 ,$542.10 ,$191.82 ,$834.00 ,$600.48 ,$453.70 ,$191.82 ,$465.54 ,$191.82 ,$498.23 ,$498.23 ,$498.23 ,$498.23 ,$700.56 ,$191.82 ,$708.90 ,$700.56 ,$191.82 ,$625.50 ,$667.20 ,$667.20 ,$191.82 ,$667.20 ,$700.56 ,$700.56 ,$700.56 ,$750.60 ,$479.55 ,$191.82 ,$834.00 ,$248.35 ,$273.19 ,$211.00 ,$708.90 ,$498.23 ,$750.60 ,$700.56 ,$667.20 ,$667.20 ,$191.82 ,$542.10 ST. FRANCIS HOSPITAL - ACUTE,74000045,95810,HC SLEEP STUDY PSG 4+ PARAMETERS >6YRS -52,740,1 ,"$4,905.00 ","$3,188.25 ",$367.96 ,"$4,905.00 ","$3,531.60 ","$2,668.32 ","$1,128.15 ","$2,737.97 ","$1,128.15 ","$2,930.25 ","$2,930.25 ","$2,930.25 ","$2,930.25 ","$4,120.20 ","$1,128.15 ","$4,169.25 ","$4,120.20 ","$1,128.15 ","$3,678.75 ","$3,924.00 ","$3,924.00 ","$1,128.15 ","$3,924.00 ","$4,120.20 ","$4,120.20 ","$4,120.20 ","$4,414.50 ","$2,820.38 ","$1,128.15 ","$4,905.00 ",$367.96 ,$404.76 ,"$1,240.97 ","$4,169.25 ","$2,930.25 ","$4,414.50 ","$4,120.20 ","$3,924.00 ","$3,924.00 ","$1,128.15 ","$3,188.25 " ST. FRANCIS HOSPITAL - ACUTE,75000098,49083,HC PARACENTESIS W/IMAGING,750,1 ,$295.00 ,$191.75 ,$67.85 ,$729.83 ,$212.40 ,$160.48 ,$67.85 ,$164.67 ,$67.85 ,$176.23 ,$176.23 ,$176.23 ,$176.23 ,$247.80 ,$67.85 ,$250.75 ,$247.80 ,$67.85 ,$221.25 ,$236.00 ,$236.00 ,$67.85 ,$236.00 ,$247.80 ,$247.80 ,$247.80 ,$265.50 ,$169.63 ,$67.85 ,$295.00 ,$663.48 ,$729.83 ,$74.64 ,$250.75 ,$176.23 ,$265.50 ,$247.80 ,$236.00 ,$236.00 ,$67.85 ,$191.75 ST. FRANCIS HOSPITAL - ACUTE,75001071,43233,HC EGD W/BALLOON DILAT >30MM - 43233,750,1 ,"$3,144.00 ","$2,043.60 ",$723.12 ,"$3,144.00 ","$2,263.68 ","$1,710.34 ",$723.12 ,"$1,754.98 ",$723.12 ,"$1,878.23 ","$1,878.23 ","$1,878.23 ","$1,878.23 ","$2,640.96 ",$723.12 ,"$2,672.40 ","$2,640.96 ",$723.12 ,"$2,358.00 ","$2,515.20 ","$2,515.20 ",$723.12 ,"$2,515.20 ","$2,640.96 ","$2,640.96 ","$2,640.96 ","$2,829.60 ","$1,807.80 ",$723.12 ,"$3,144.00 ","$1,036.10 ","$1,139.71 ",$795.43 ,"$2,672.40 ","$1,878.23 ","$2,829.60 ","$2,640.96 ","$2,515.20 ","$2,515.20 ",$723.12 ,"$2,043.60 " ST. FRANCIS HOSPITAL - ACUTE,75001072,43235,HC EGD W/BRUSH/WASH - 43235,750,1 ,"$2,780.00 ","$1,807.00 ",$639.40 ,"$2,780.00 ","$2,001.60 ","$1,512.32 ",$639.40 ,"$1,551.80 ",$639.40 ,"$1,660.77 ","$1,660.77 ","$1,660.77 ","$1,660.77 ","$2,335.20 ",$639.40 ,"$2,363.00 ","$2,335.20 ",$639.40 ,"$2,085.00 ","$2,224.00 ","$2,224.00 ",$639.40 ,"$2,224.00 ","$2,335.20 ","$2,335.20 ","$2,335.20 ","$2,502.00 ","$1,598.50 ",$639.40 ,"$2,780.00 ",$750.64 ,$825.70 ,$703.34 ,"$2,363.00 ","$1,660.77 ","$2,502.00 ","$2,335.20 ","$2,224.00 ","$2,224.00 ",$639.40 ,"$1,807.00 " ST. FRANCIS HOSPITAL - ACUTE,75001076,43239,HC EGD W/BIOPSY SGL/MULT - 43239,750,1 ,"$2,780.00 ","$1,807.00 ",$639.40 ,"$2,780.00 ","$2,001.60 ","$1,512.32 ",$639.40 ,"$1,551.80 ",$639.40 ,"$1,660.77 ","$1,660.77 ","$1,660.77 ","$1,660.77 ","$2,335.20 ",$639.40 ,"$2,363.00 ","$2,335.20 ",$639.40 ,"$2,085.00 ","$2,224.00 ","$2,224.00 ",$639.40 ,"$2,224.00 ","$2,335.20 ","$2,335.20 ","$2,335.20 ","$2,502.00 ","$1,598.50 ",$639.40 ,"$2,780.00 ",$750.64 ,$825.70 ,$703.34 ,"$2,363.00 ","$1,660.77 ","$2,502.00 ","$2,335.20 ","$2,224.00 ","$2,224.00 ",$639.40 ,"$1,807.00 " ST. FRANCIS HOSPITAL - ACUTE,75001081,43245,HC EGD W/DILAT STRICTURE - 43245,750,1 ,"$2,994.00 ","$1,946.10 ",$688.62 ,"$2,994.00 ","$2,155.68 ","$1,628.74 ",$688.62 ,"$1,671.25 ",$688.62 ,"$1,788.62 ","$1,788.62 ","$1,788.62 ","$1,788.62 ","$2,514.96 ",$688.62 ,"$2,544.90 ","$2,514.96 ",$688.62 ,"$2,245.50 ","$2,395.20 ","$2,395.20 ",$688.62 ,"$2,395.20 ","$2,514.96 ","$2,514.96 ","$2,514.96 ","$2,694.60 ","$1,721.55 ",$688.62 ,"$2,994.00 ","$1,036.10 ","$1,139.71 ",$757.48 ,"$2,544.90 ","$1,788.62 ","$2,694.60 ","$2,514.96 ","$2,395.20 ","$2,395.20 ",$688.62 ,"$1,946.10 " ST. FRANCIS HOSPITAL - ACUTE,75001082,43246,HC EGD W/PLACEMENT G-TUBE - 43246,750,1 ,"$1,781.00 ","$1,157.65 ",$409.63 ,"$1,781.00 ","$1,282.32 ",$968.86 ,$409.63 ,$994.15 ,$409.63 ,"$1,063.97 ","$1,063.97 ","$1,063.97 ","$1,063.97 ","$1,496.04 ",$409.63 ,"$1,513.85 ","$1,496.04 ",$409.63 ,"$1,335.75 ","$1,424.80 ","$1,424.80 ",$409.63 ,"$1,424.80 ","$1,496.04 ","$1,496.04 ","$1,496.04 ","$1,602.90 ","$1,024.08 ",$409.63 ,"$1,781.00 ","$1,036.10 ","$1,139.71 ",$450.59 ,"$1,513.85 ","$1,063.97 ","$1,602.90 ","$1,496.04 ","$1,424.80 ","$1,424.80 ",$409.63 ,"$1,157.65 " ST. FRANCIS HOSPITAL - ACUTE,75001083,43247,HC EGD W/FB REMOVAL - 43247,750,1 ,"$3,282.00 ","$2,133.30 ",$754.86 ,"$3,282.00 ","$2,363.04 ","$1,785.41 ",$754.86 ,"$1,832.01 ",$754.86 ,"$1,960.67 ","$1,960.67 ","$1,960.67 ","$1,960.67 ","$2,756.88 ",$754.86 ,"$2,789.70 ","$2,756.88 ",$754.86 ,"$2,461.50 ","$2,625.60 ","$2,625.60 ",$754.86 ,"$2,625.60 ","$2,756.88 ","$2,756.88 ","$2,756.88 ","$2,953.80 ","$1,887.15 ",$754.86 ,"$3,282.00 ","$1,036.10 ","$1,139.71 ",$830.35 ,"$2,789.70 ","$1,960.67 ","$2,953.80 ","$2,756.88 ","$2,625.60 ","$2,625.60 ",$754.86 ,"$2,133.30 " ST. FRANCIS HOSPITAL - ACUTE,75001084,43248,HC EGD W/INSERT GUIDEWIRE - 43248,750,1 ,"$2,797.00 ","$1,818.05 ",$643.31 ,"$2,797.00 ","$2,013.84 ","$1,521.57 ",$643.31 ,"$1,561.29 ",$643.31 ,"$1,670.93 ","$1,670.93 ","$1,670.93 ","$1,670.93 ","$2,349.48 ",$643.31 ,"$2,377.45 ","$2,349.48 ",$643.31 ,"$2,097.75 ","$2,237.60 ","$2,237.60 ",$643.31 ,"$2,237.60 ","$2,349.48 ","$2,349.48 ","$2,349.48 ","$2,517.30 ","$1,608.28 ",$643.31 ,"$2,797.00 ","$1,036.10 ","$1,139.71 ",$707.64 ,"$2,377.45 ","$1,670.93 ","$2,517.30 ","$2,349.48 ","$2,237.60 ","$2,237.60 ",$643.31 ,"$1,818.05 " ST. FRANCIS HOSPITAL - ACUTE,75001085,43249,HC EGD W/BALLOON DILAT <30MM - 43249,750,1 ,"$3,144.00 ","$2,043.60 ",$723.12 ,"$3,144.00 ","$2,263.68 ","$1,710.34 ",$723.12 ,"$1,754.98 ",$723.12 ,"$1,878.23 ","$1,878.23 ","$1,878.23 ","$1,878.23 ","$2,640.96 ",$723.12 ,"$2,672.40 ","$2,640.96 ",$723.12 ,"$2,358.00 ","$2,515.20 ","$2,515.20 ",$723.12 ,"$2,515.20 ","$2,640.96 ","$2,640.96 ","$2,640.96 ","$2,829.60 ","$1,807.80 ",$723.12 ,"$3,144.00 ","$1,036.10 ","$1,139.71 ",$795.43 ,"$2,672.40 ","$1,878.23 ","$2,829.60 ","$2,640.96 ","$2,515.20 ","$2,515.20 ",$723.12 ,"$2,043.60 " ST. FRANCIS HOSPITAL - ACUTE,75001086,43250,HC EGD W/REMOVAL TUMOR/POLYP/LESN HOT BIOPSY - 43250,750,1 ,"$3,144.00 ","$2,043.60 ",$723.12 ,"$3,144.00 ","$2,263.68 ","$1,710.34 ",$723.12 ,"$1,754.98 ",$723.12 ,"$1,878.23 ","$1,878.23 ","$1,878.23 ","$1,878.23 ","$2,640.96 ",$723.12 ,"$2,672.40 ","$2,640.96 ",$723.12 ,"$2,358.00 ","$2,515.20 ","$2,515.20 ",$723.12 ,"$2,515.20 ","$2,640.96 ","$2,640.96 ","$2,640.96 ","$2,829.60 ","$1,807.80 ",$723.12 ,"$3,144.00 ","$1,036.10 ","$1,139.71 ",$795.43 ,"$2,672.40 ","$1,878.23 ","$2,829.60 ","$2,640.96 ","$2,515.20 ","$2,515.20 ",$723.12 ,"$2,043.60 " ST. FRANCIS HOSPITAL - ACUTE,75001087,43251,HC EGD W/REMOVAL TUMOR/POLYP/LESN SNARE TECH - 43251,750,1 ,"$2,780.00 ","$1,807.00 ",$639.40 ,"$2,780.00 ","$2,001.60 ","$1,512.32 ",$639.40 ,"$1,551.80 ",$639.40 ,"$1,660.77 ","$1,660.77 ","$1,660.77 ","$1,660.77 ","$2,335.20 ",$639.40 ,"$2,363.00 ","$2,335.20 ",$639.40 ,"$2,085.00 ","$2,224.00 ","$2,224.00 ",$639.40 ,"$2,224.00 ","$2,335.20 ","$2,335.20 ","$2,335.20 ","$2,502.00 ","$1,598.50 ",$639.40 ,"$2,780.00 ","$1,036.10 ","$1,139.71 ",$703.34 ,"$2,363.00 ","$1,660.77 ","$2,502.00 ","$2,335.20 ","$2,224.00 ","$2,224.00 ",$639.40 ,"$1,807.00 " ST. FRANCIS HOSPITAL - ACUTE,75001106,43450,HC ESOPHAGUS DILATION UNGUIDED SGL/MULT PASS - 43450,750,1 ,"$2,647.00 ","$1,720.55 ",$608.81 ,"$2,647.00 ","$1,905.84 ","$1,439.97 ",$608.81 ,"$1,477.56 ",$608.81 ,"$1,581.32 ","$1,581.32 ","$1,581.32 ","$1,581.32 ","$2,223.48 ",$608.81 ,"$2,249.95 ","$2,223.48 ",$608.81 ,"$1,985.25 ","$2,117.60 ","$2,117.60 ",$608.81 ,"$2,117.60 ","$2,223.48 ","$2,223.48 ","$2,223.48 ","$2,382.30 ","$1,522.03 ",$608.81 ,"$2,647.00 ",$662.83 ,$729.11 ,$669.69 ,"$2,249.95 ","$1,581.32 ","$2,382.30 ","$2,223.48 ","$2,117.60 ","$2,117.60 ",$608.81 ,"$1,720.55 " ST. FRANCIS HOSPITAL - ACUTE,75001126,44389,HC COLONOSCOPY STOMA W/BX SGL/MULT - 44389,750,1 ,"$4,832.00 ","$3,140.80 ",$719.59 ,"$4,832.00 ","$3,479.04 ","$2,628.61 ","$1,111.36 ","$2,697.22 ","$1,111.36 ","$2,886.64 ","$2,886.64 ","$2,886.64 ","$2,886.64 ","$4,058.88 ","$1,111.36 ","$4,107.20 ","$4,058.88 ","$1,111.36 ","$3,624.00 ","$3,865.60 ","$3,865.60 ","$1,111.36 ","$3,865.60 ","$4,058.88 ","$4,058.88 ","$4,058.88 ","$4,348.80 ","$2,778.40 ","$1,111.36 ","$4,832.00 ",$719.59 ,$791.55 ,"$1,222.50 ","$4,107.20 ","$2,886.64 ","$4,348.80 ","$4,058.88 ","$3,865.60 ","$3,865.60 ","$1,111.36 ","$3,140.80 " ST. FRANCIS HOSPITAL - ACUTE,75001129,44392,HC COLONOSCOPY STOMA W/REM TUMOR HOT BX - 44392,750,1 ,"$5,141.00 ","$3,341.65 ",$800.81 ,"$5,141.00 ","$3,701.52 ","$2,796.70 ","$1,182.43 ","$2,869.71 ","$1,182.43 ","$3,071.23 ","$3,071.23 ","$3,071.23 ","$3,071.23 ","$4,318.44 ","$1,182.43 ","$4,369.85 ","$4,318.44 ","$1,182.43 ","$3,855.75 ","$4,112.80 ","$4,112.80 ","$1,182.43 ","$4,112.80 ","$4,318.44 ","$4,318.44 ","$4,318.44 ","$4,626.90 ","$2,956.08 ","$1,182.43 ","$5,141.00 ",$800.81 ,$880.89 ,"$1,300.67 ","$4,369.85 ","$3,071.23 ","$4,626.90 ","$4,318.44 ","$4,112.80 ","$4,112.80 ","$1,182.43 ","$3,341.65 " ST. FRANCIS HOSPITAL - ACUTE,75001130,44394,HC COLONOSCOPY STOMA W/REM TUMOR SNARE TECH - 44394,750,1 ,"$2,644.00 ","$1,718.60 ",$608.12 ,"$2,644.00 ","$1,903.68 ","$1,438.34 ",$608.12 ,"$1,475.88 ",$608.12 ,"$1,579.53 ","$1,579.53 ","$1,579.53 ","$1,579.53 ","$2,220.96 ",$608.12 ,"$2,247.40 ","$2,220.96 ",$608.12 ,"$1,983.00 ","$2,115.20 ","$2,115.20 ",$608.12 ,"$2,115.20 ","$2,220.96 ","$2,220.96 ","$2,220.96 ","$2,379.60 ","$1,520.30 ",$608.12 ,"$2,644.00 ",$800.81 ,$880.89 ,$668.93 ,"$2,247.40 ","$1,579.53 ","$2,379.60 ","$2,220.96 ","$2,115.20 ","$2,115.20 ",$608.12 ,"$1,718.60 " ST. FRANCIS HOSPITAL - ACUTE,75001139,45300,HC PROCTOSIGMOIDOSCOPY RIGID DX W/W/O SPECIMEN - 45300,750,1 ,$753.00 ,$489.45 ,$173.19 ,$753.00 ,$542.16 ,$409.63 ,$173.19 ,$420.32 ,$173.19 ,$449.84 ,$449.84 ,$449.84 ,$449.84 ,$632.52 ,$173.19 ,$640.05 ,$632.52 ,$173.19 ,$564.75 ,$602.40 ,$602.40 ,$173.19 ,$602.40 ,$632.52 ,$632.52 ,$632.52 ,$677.70 ,$432.98 ,$173.19 ,$753.00 ,$629.11 ,$692.02 ,$190.51 ,$640.05 ,$449.84 ,$677.70 ,$632.52 ,$602.40 ,$602.40 ,$173.19 ,$489.45 ST. FRANCIS HOSPITAL - ACUTE,75001140,45307,HC PROCTOSIGMOIDOSCOPY RIGID W/FB REMOVAL - 45307,750,1 ,$753.00 ,$489.45 ,$173.19 ,$839.49 ,$542.16 ,$409.63 ,$173.19 ,$420.32 ,$173.19 ,$449.84 ,$449.84 ,$449.84 ,$449.84 ,$632.52 ,$173.19 ,$640.05 ,$632.52 ,$173.19 ,$564.75 ,$602.40 ,$602.40 ,$173.19 ,$602.40 ,$632.52 ,$632.52 ,$632.52 ,$677.70 ,$432.98 ,$173.19 ,$753.00 ,$763.17 ,$839.49 ,$190.51 ,$640.05 ,$449.84 ,$677.70 ,$632.52 ,$602.40 ,$602.40 ,$173.19 ,$489.45 ST. FRANCIS HOSPITAL - ACUTE,75001157,45378,HC COLONOSCOPY DX W/SPECIMEN BRUSH/WASH - 45378,750,1 ,"$4,285.00 ","$2,785.25 ",$650.90 ,"$4,285.00 ","$3,085.20 ","$2,331.04 ",$985.55 ,"$2,391.89 ",$985.55 ,"$2,559.86 ","$2,559.86 ","$2,559.86 ","$2,559.86 ","$3,599.40 ",$985.55 ,"$3,642.25 ","$3,599.40 ",$985.55 ,"$3,213.75 ","$3,428.00 ","$3,428.00 ",$985.55 ,"$3,428.00 ","$3,599.40 ","$3,599.40 ","$3,599.40 ","$3,856.50 ","$2,463.88 ",$985.55 ,"$4,285.00 ",$650.90 ,$715.99 ,"$1,084.11 ","$3,642.25 ","$2,559.86 ","$3,856.50 ","$3,599.40 ","$3,428.00 ","$3,428.00 ",$985.55 ,"$2,785.25 " ST. FRANCIS HOSPITAL - ACUTE,75001159,45380,HC COLONOSCOPY W/BIOPSY SGL/MULT - 45380,750,1 ,"$4,832.00 ","$3,140.80 ",$650.90 ,"$4,832.00 ","$3,479.04 ","$2,628.61 ","$1,111.36 ","$2,697.22 ","$1,111.36 ","$2,886.64 ","$2,886.64 ","$2,886.64 ","$2,886.64 ","$4,058.88 ","$1,111.36 ","$4,107.20 ","$4,058.88 ","$1,111.36 ","$3,624.00 ","$3,865.60 ","$3,865.60 ","$1,111.36 ","$3,865.60 ","$4,058.88 ","$4,058.88 ","$4,058.88 ","$4,348.80 ","$2,778.40 ","$1,111.36 ","$4,832.00 ",$650.90 ,$715.99 ,"$1,222.50 ","$4,107.20 ","$2,886.64 ","$4,348.80 ","$4,058.88 ","$3,865.60 ","$3,865.60 ","$1,111.36 ","$3,140.80 " ST. FRANCIS HOSPITAL - ACUTE,75001160,45381,HC COLONOSCOPY W/SUBMUCOSAL INJ - 45381,750,1 ,"$5,141.00 ","$3,341.65 ",$800.81 ,"$5,141.00 ","$3,701.52 ","$2,796.70 ","$1,182.43 ","$2,869.71 ","$1,182.43 ","$3,071.23 ","$3,071.23 ","$3,071.23 ","$3,071.23 ","$4,318.44 ","$1,182.43 ","$4,369.85 ","$4,318.44 ","$1,182.43 ","$3,855.75 ","$4,112.80 ","$4,112.80 ","$1,182.43 ","$4,112.80 ","$4,318.44 ","$4,318.44 ","$4,318.44 ","$4,626.90 ","$2,956.08 ","$1,182.43 ","$5,141.00 ",$800.81 ,$880.89 ,"$1,300.67 ","$4,369.85 ","$3,071.23 ","$4,626.90 ","$4,318.44 ","$4,112.80 ","$4,112.80 ","$1,182.43 ","$3,341.65 " ST. FRANCIS HOSPITAL - ACUTE,75001161,45382,HC COLONOSCOPY W/CONTROL BLEEDING - 45382,750,1 ,"$4,832.00 ","$3,140.80 ",$800.81 ,"$4,832.00 ","$3,479.04 ","$2,628.61 ","$1,111.36 ","$2,697.22 ","$1,111.36 ","$2,886.64 ","$2,886.64 ","$2,886.64 ","$2,886.64 ","$4,058.88 ","$1,111.36 ","$4,107.20 ","$4,058.88 ","$1,111.36 ","$3,624.00 ","$3,865.60 ","$3,865.60 ","$1,111.36 ","$3,865.60 ","$4,058.88 ","$4,058.88 ","$4,058.88 ","$4,348.80 ","$2,778.40 ","$1,111.36 ","$4,832.00 ",$800.81 ,$880.89 ,"$1,222.50 ","$4,107.20 ","$2,886.64 ","$4,348.80 ","$4,058.88 ","$3,865.60 ","$3,865.60 ","$1,111.36 ","$3,140.80 " ST. FRANCIS HOSPITAL - ACUTE,75001162,45384,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY - 45384,750,1 ,"$4,832.00 ","$3,140.80 ",$800.81 ,"$4,832.00 ","$3,479.04 ","$2,628.61 ","$1,111.36 ","$2,697.22 ","$1,111.36 ","$2,886.64 ","$2,886.64 ","$2,886.64 ","$2,886.64 ","$4,058.88 ","$1,111.36 ","$4,107.20 ","$4,058.88 ","$1,111.36 ","$3,624.00 ","$3,865.60 ","$3,865.60 ","$1,111.36 ","$3,865.60 ","$4,058.88 ","$4,058.88 ","$4,058.88 ","$4,348.80 ","$2,778.40 ","$1,111.36 ","$4,832.00 ",$800.81 ,$880.89 ,"$1,222.50 ","$4,107.20 ","$2,886.64 ","$4,348.80 ","$4,058.88 ","$3,865.60 ","$3,865.60 ","$1,111.36 ","$3,140.80 " ST. FRANCIS HOSPITAL - ACUTE,75001163,45385,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45385,750,1 ,"$5,141.00 ","$3,341.65 ",$800.81 ,"$5,141.00 ","$3,701.52 ","$2,796.70 ","$1,182.43 ","$2,869.71 ","$1,182.43 ","$3,071.23 ","$3,071.23 ","$3,071.23 ","$3,071.23 ","$4,318.44 ","$1,182.43 ","$4,369.85 ","$4,318.44 ","$1,182.43 ","$3,855.75 ","$4,112.80 ","$4,112.80 ","$1,182.43 ","$4,112.80 ","$4,318.44 ","$4,318.44 ","$4,318.44 ","$4,626.90 ","$2,956.08 ","$1,182.43 ","$5,141.00 ",$800.81 ,$880.89 ,"$1,300.67 ","$4,369.85 ","$3,071.23 ","$4,626.90 ","$4,318.44 ","$4,112.80 ","$4,112.80 ","$1,182.43 ","$3,341.65 " ST. FRANCIS HOSPITAL - ACUTE,75001165,45388,HC COLONOSCOPY W/ABLATION TUMOR - 45388,750,1 ,"$4,832.00 ","$3,140.80 ",$800.81 ,"$4,832.00 ","$3,479.04 ","$2,628.61 ","$1,111.36 ","$2,697.22 ","$1,111.36 ","$2,886.64 ","$2,886.64 ","$2,886.64 ","$2,886.64 ","$4,058.88 ","$1,111.36 ","$4,107.20 ","$4,058.88 ","$1,111.36 ","$3,624.00 ","$3,865.60 ","$3,865.60 ","$1,111.36 ","$3,865.60 ","$4,058.88 ","$4,058.88 ","$4,058.88 ","$4,348.80 ","$2,778.40 ","$1,111.36 ","$4,832.00 ",$800.81 ,$880.89 ,"$1,222.50 ","$4,107.20 ","$2,886.64 ","$4,348.80 ","$4,058.88 ","$3,865.60 ","$3,865.60 ","$1,111.36 ","$3,140.80 " ST. FRANCIS HOSPITAL - ACUTE,75001167,45390,HC COLONOSCOPY W/MUCOSAL RESECTION - 45390,750,1 ,"$4,254.00 ","$2,765.10 ",$800.81 ,"$4,254.00 ","$3,062.88 ","$2,314.18 ",$978.42 ,"$2,374.58 ",$978.42 ,"$2,541.34 ","$2,541.34 ","$2,541.34 ","$2,541.34 ","$3,573.36 ",$978.42 ,"$3,615.90 ","$3,573.36 ",$978.42 ,"$3,190.50 ","$3,403.20 ","$3,403.20 ",$978.42 ,"$3,403.20 ","$3,573.36 ","$3,573.36 ","$3,573.36 ","$3,828.60 ","$2,446.05 ",$978.42 ,"$4,254.00 ",$800.81 ,$880.89 ,"$1,076.26 ","$3,615.90 ","$2,541.34 ","$3,828.60 ","$3,573.36 ","$3,403.20 ","$3,403.20 ",$978.42 ,"$2,765.10 " ST. FRANCIS HOSPITAL - ACUTE,75001171,45398,HC COLONOSCOPY W/BAND LIGATION - 45398,750,1 ,"$4,285.00 ","$2,785.25 ",$800.81 ,"$4,285.00 ","$3,085.20 ","$2,331.04 ",$985.55 ,"$2,391.89 ",$985.55 ,"$2,559.86 ","$2,559.86 ","$2,559.86 ","$2,559.86 ","$3,599.40 ",$985.55 ,"$3,642.25 ","$3,599.40 ",$985.55 ,"$3,213.75 ","$3,428.00 ","$3,428.00 ",$985.55 ,"$3,428.00 ","$3,599.40 ","$3,599.40 ","$3,599.40 ","$3,856.50 ","$2,463.88 ",$985.55 ,"$4,285.00 ",$800.81 ,$880.89 ,"$1,084.11 ","$3,642.25 ","$2,559.86 ","$3,856.50 ","$3,599.40 ","$3,428.00 ","$3,428.00 ",$985.55 ,"$2,785.25 " ST. FRANCIS HOSPITAL - ACUTE,75001181,52000,HC CYSTOURETHROSCOPY - 52000,750,1 ,"$2,780.00 ","$1,807.00 ",$639.40 ,"$2,780.00 ","$2,001.60 ","$1,512.32 ",$639.40 ,"$1,551.80 ",$639.40 ,"$1,660.77 ","$1,660.77 ","$1,660.77 ","$1,660.77 ","$2,335.20 ",$639.40 ,"$2,363.00 ","$2,335.20 ",$639.40 ,"$2,085.00 ","$2,224.00 ","$2,224.00 ",$639.40 ,"$2,224.00 ","$2,335.20 ","$2,335.20 ","$2,335.20 ","$2,502.00 ","$1,598.50 ",$639.40 ,"$2,780.00 ","$1,041.03 ","$1,145.13 ",$703.34 ,"$2,363.00 ","$1,660.77 ","$2,502.00 ","$2,335.20 ","$2,224.00 ","$2,224.00 ",$639.40 ,"$1,807.00 " ST. FRANCIS HOSPITAL - ACUTE,75001183,52332,HC CYSTOURETHROSCOPY W/INS URETERAL STENT - 52332,750,1 ,"$3,795.00 ","$2,466.75 ",$872.85 ,"$3,795.00 ","$2,732.40 ","$2,064.48 ",$872.85 ,"$2,118.37 ",$872.85 ,"$2,267.13 ","$2,267.13 ","$2,267.13 ","$2,267.13 ","$3,187.80 ",$872.85 ,"$3,225.75 ","$3,187.80 ",$872.85 ,"$2,846.25 ","$3,036.00 ","$3,036.00 ",$872.85 ,"$3,036.00 ","$3,187.80 ","$3,187.80 ","$3,187.80 ","$3,415.50 ","$2,182.13 ",$872.85 ,"$3,795.00 ","$1,041.03 ","$1,145.13 ",$960.14 ,"$3,225.75 ","$2,267.13 ","$3,415.50 ","$3,187.80 ","$3,036.00 ","$3,036.00 ",$872.85 ,"$2,466.75 " ST. FRANCIS HOSPITAL - ACUTE,75001184,52352,HC CYSTOURETHROSCOPY W/STONE REMOVAL - 52352,750,1 ,"$3,921.00 ","$2,548.65 ",$901.83 ,"$3,921.00 ","$2,823.12 ","$2,133.02 ",$901.83 ,"$2,188.70 ",$901.83 ,"$2,342.41 ","$2,342.41 ","$2,342.41 ","$2,342.41 ","$3,293.64 ",$901.83 ,"$3,332.85 ","$3,293.64 ",$901.83 ,"$2,940.75 ","$3,136.80 ","$3,136.80 ",$901.83 ,"$3,136.80 ","$3,293.64 ","$3,293.64 ","$3,293.64 ","$3,528.90 ","$2,254.58 ",$901.83 ,"$3,921.00 ","$2,214.40 ","$2,435.84 ",$992.01 ,"$3,332.85 ","$2,342.41 ","$3,528.90 ","$3,293.64 ","$3,136.80 ","$3,136.80 ",$901.83 ,"$2,548.65 " ST. FRANCIS HOSPITAL - ACUTE,75001185,52353,HC CYSTOURETHROSCOPY W/LITHOTRIPSY - 52353,750,1 ,"$3,921.00 ","$2,548.65 ",$901.83 ,"$3,921.00 ","$2,823.12 ","$2,133.02 ",$901.83 ,"$2,188.70 ",$901.83 ,"$2,342.41 ","$2,342.41 ","$2,342.41 ","$2,342.41 ","$3,293.64 ",$901.83 ,"$3,332.85 ","$3,293.64 ",$901.83 ,"$2,940.75 ","$3,136.80 ","$3,136.80 ",$901.83 ,"$3,136.80 ","$3,293.64 ","$3,293.64 ","$3,293.64 ","$3,528.90 ","$2,254.58 ",$901.83 ,"$3,921.00 ","$2,214.40 ","$2,435.84 ",$992.01 ,"$3,332.85 ","$2,342.41 ","$3,528.90 ","$3,293.64 ","$3,136.80 ","$3,136.80 ",$901.83 ,"$2,548.65 " ST. FRANCIS HOSPITAL - ACUTE,75001193,91035,HC ACID REFLUX TEST MUCOSAL ELECTRODE- 91035,750,1 ,"$3,155.00 ","$2,050.75 ",$577.51 ,"$3,155.00 ","$2,271.60 ","$1,716.32 ",$725.65 ,"$1,761.12 ",$725.65 ,"$1,884.80 ","$1,884.80 ","$1,884.80 ","$1,884.80 ","$2,650.20 ",$725.65 ,"$2,681.75 ","$2,650.20 ",$725.65 ,"$2,366.25 ","$2,524.00 ","$2,524.00 ",$725.65 ,"$2,524.00 ","$2,650.20 ","$2,650.20 ","$2,650.20 ","$2,839.50 ","$1,814.13 ",$725.65 ,"$3,155.00 ",$577.51 ,$635.26 ,$798.22 ,"$2,681.75 ","$1,884.80 ","$2,839.50 ","$2,650.20 ","$2,524.00 ","$2,524.00 ",$725.65 ,"$2,050.75 " ST. FRANCIS HOSPITAL - ACUTE,75001200,G0104,HC COLONOSCOPY SCREEN W/FLEX SIGMOID - G0104,750,1 ,"$3,896.00 ","$2,532.40 ",$629.11 ,"$3,896.00 ","$2,805.12 ","$2,119.42 ",$896.08 ,"$2,174.75 ",$896.08 ,"$2,327.47 ","$2,327.47 ","$2,327.47 ","$2,327.47 ","$3,272.64 ",$896.08 ,"$3,311.60 ","$3,272.64 ",$896.08 ,"$2,922.00 ","$3,116.80 ","$3,116.80 ",$896.08 ,"$3,116.80 ","$3,272.64 ","$3,272.64 ","$3,272.64 ","$3,506.40 ","$2,240.20 ",$896.08 ,"$3,896.00 ",$629.11 ,$692.02 ,$985.69 ,"$3,311.60 ","$2,327.47 ","$3,506.40 ","$3,272.64 ","$3,116.80 ","$3,116.80 ",$896.08 ,"$2,532.40 " ST. FRANCIS HOSPITAL - ACUTE,76000014,62273,HC INJ EPIDURAL BLD/CLOT PATCH,760,1 ,$661.00 ,$429.65 ,$152.03 ,$841.45 ,$475.92 ,$359.58 ,$152.03 ,$368.97 ,$152.03 ,$394.88 ,$394.88 ,$394.88 ,$394.88 ,$555.24 ,$152.03 ,$561.85 ,$555.24 ,$152.03 ,$495.75 ,$528.80 ,$528.80 ,$152.03 ,$528.80 ,$555.24 ,$555.24 ,$555.24 ,$594.90 ,$380.08 ,$152.03 ,$661.00 ,$764.95 ,$841.45 ,$167.23 ,$561.85 ,$394.88 ,$594.90 ,$555.24 ,$528.80 ,$528.80 ,$152.03 ,$429.65 ST. FRANCIS HOSPITAL - ACUTE,76100055,99211,HC EXAM PELVIC STERILE,761,1 ,$449.00 ,$291.85 ,$103.27 ,$449.00 ,$323.28 ,$244.26 ,$103.27 ,$250.63 ,$103.27 ,$268.23 ,$268.23 ,$268.23 ,$268.23 ,$377.16 ,$103.27 ,$381.65 ,$377.16 ,$103.27 ,$336.75 ,$359.20 ,$359.20 ,$103.27 ,$359.20 ,$377.16 ,$377.16 ,$377.16 ,$404.10 ,$258.18 ,$103.27 ,$449.00 ,$134.83 ,$148.31 ,$113.60 ,$381.65 ,$268.23 ,$404.10 ,$377.16 ,$359.20 ,$359.20 ,$103.27 ,$291.85 ST. FRANCIS HOSPITAL - ACUTE,76200008,G0379,HC OBSERVATION DIRECT ADMIT,762,1 ,$81.00 ,$52.65 ,$18.63 ,$81.00 ,$58.32 ,$44.06 ,$18.63 ,$45.21 ,$18.63 ,$51.96 ,$51.96 ,$51.96 ,$51.96 ,$68.04 ,$18.63 ,$68.85 ,$68.04 ,$18.63 ,$60.75 ,$64.80 ,$64.80 ,$18.63 ,$64.80 ,$68.04 ,$68.04 ,$68.04 ,$72.90 ,$46.58 ,$18.63 ,$81.00 , N/A , N/A ,$20.49 ,$68.85 ,$51.96 ,$72.90 ,$68.04 ,$64.80 ,$64.80 ,$18.63 ,$52.65 ST. FRANCIS HOSPITAL - ACUTE,76200009,G0378,HC OBSERVATION HOURLY,762,1 ,$81.00 ,$52.65 ,$18.63 ,$81.00 ,$58.32 ,$44.06 ,$18.63 ,$45.21 ,$18.63 ,$51.96 ,$51.96 ,$51.96 ,$51.96 ,$68.04 ,$18.63 ,$68.85 ,$68.04 ,$18.63 ,$60.75 ,$64.80 ,$64.80 ,$18.63 ,$64.80 ,$68.04 ,$68.04 ,$68.04 ,$72.90 ,$46.58 ,$18.63 ,$81.00 , N/A , N/A ,$20.49 ,$68.85 ,$51.96 ,$72.90 ,$68.04 ,$64.80 ,$64.80 ,$18.63 ,$52.65 ST. FRANCIS HOSPITAL - ACUTE,76200020,G0378,HC OBSERVATION W/INTENSIVE CARE PER HR,762,1 ,$140.00 ,$91.00 ,$32.20 ,$140.00 ,$100.80 ,$76.16 ,$32.20 ,$78.15 ,$32.20 ,$89.81 ,$89.81 ,$89.81 ,$89.81 ,$117.60 ,$32.20 ,$119.00 ,$117.60 ,$32.20 ,$105.00 ,$112.00 ,$112.00 ,$32.20 ,$112.00 ,$117.60 ,$117.60 ,$117.60 ,$126.00 ,$80.50 ,$32.20 ,$140.00 , N/A , N/A ,$35.42 ,$119.00 ,$89.81 ,$126.00 ,$117.60 ,$112.00 ,$112.00 ,$32.20 ,$91.00 ST. FRANCIS HOSPITAL - ACUTE,77100000,90471,HC IMMUN ADMIN ONE VACC,771,1 ,$85.00 ,$55.25 ,$19.55 ,$85.00 ,$61.20 ,$46.24 ,$19.55 ,$47.45 ,$19.55 ,$50.78 ,$50.78 ,$50.78 ,$50.78 ,$71.40 ,$19.55 ,$72.25 ,$71.40 ,$19.55 ,$63.75 ,$68.00 ,$68.00 ,$19.55 ,$68.00 ,$71.40 ,$71.40 ,$71.40 ,$76.50 ,$48.88 ,$19.55 ,$85.00 , N/A , N/A ,$21.51 ,$72.25 ,$50.78 ,$76.50 ,$71.40 ,$68.00 ,$68.00 ,$19.55 ,$55.25 ST. FRANCIS HOSPITAL - ACUTE,77100002,90472,HC IMMUN ADMIN EA ADD VACC,771,1 ,$48.00 ,$31.20 ,$11.04 ,$48.00 ,$34.56 ,$26.11 ,$11.04 ,$26.79 ,$11.04 ,$28.68 ,$28.68 ,$28.68 ,$28.68 ,$40.32 ,$11.04 ,$40.80 ,$40.32 ,$11.04 ,$36.00 ,$38.40 ,$38.40 ,$11.04 ,$38.40 ,$40.32 ,$40.32 ,$40.32 ,$43.20 ,$27.60 ,$11.04 ,$48.00 , N/A , N/A ,$12.14 ,$40.80 ,$28.68 ,$43.20 ,$40.32 ,$38.40 ,$38.40 ,$11.04 ,$31.20 ST. FRANCIS HOSPITAL - ACUTE,77100003,G0008,HC ADMIN INFLUENZA VACCINE,771,1 ,$56.00 ,$36.40 ,$31.26 ,$56.00 ,$40.32 ,$30.46 , N/A ,$31.26 , N/A ,$33.45 ,$33.45 ,$33.45 ,$33.45 ,$47.04 , N/A ,$47.60 ,$47.04 , N/A ,$42.00 ,$44.80 ,$44.80 , N/A ,$44.80 ,$47.04 ,$47.04 ,$47.04 ,$50.40 , N/A , N/A ,$56.00 , N/A , N/A , N/A ,$47.60 ,$33.45 ,$50.40 ,$47.04 ,$44.80 ,$44.80 , N/A ,$36.40 ST. FRANCIS HOSPITAL - ACUTE,77100005,G0009,HC ADMIN PNEUMOCOCCAL VACCINE,771,1 ,$56.00 ,$36.40 ,$31.26 ,$56.00 ,$40.32 ,$30.46 , N/A ,$31.26 , N/A ,$33.45 ,$33.45 ,$33.45 ,$33.45 ,$47.04 , N/A ,$47.60 ,$47.04 , N/A ,$42.00 ,$44.80 ,$44.80 , N/A ,$44.80 ,$47.04 ,$47.04 ,$47.04 ,$50.40 , N/A , N/A ,$56.00 , N/A , N/A , N/A ,$47.60 ,$33.45 ,$50.40 ,$47.04 ,$44.80 ,$44.80 , N/A ,$36.40 ST. FRANCIS HOSPITAL - ACUTE,77100006,G0010,HC INJECTION-HEPATITIS B VACCINE,771,1 ,$56.00 ,$36.40 ,$12.88 ,$56.00 ,$40.32 ,$30.46 ,$12.88 ,$31.26 ,$12.88 ,$33.45 ,$33.45 ,$33.45 ,$33.45 ,$47.04 ,$12.88 ,$47.60 ,$47.04 ,$12.88 ,$42.00 ,$44.80 ,$44.80 ,$12.88 ,$44.80 ,$47.04 ,$47.04 ,$47.04 ,$50.40 ,$32.20 ,$12.88 ,$56.00 , N/A , N/A ,$14.17 ,$47.60 ,$33.45 ,$50.40 ,$47.04 ,$44.80 ,$44.80 ,$12.88 ,$36.40 ST. FRANCIS HOSPITAL - ACUTE,78000001,Q3014,HC TELEHEALTH ORIGINATING FAC FEE,780,1 ,$96.00 ,$62.40 ,$14.01 ,$96.00 ,$69.12 ,$52.22 ,$22.08 ,$53.59 ,$22.08 ,$57.35 ,$57.35 ,$57.35 ,$57.35 ,$80.64 ,$22.08 ,$81.60 ,$80.64 ,$22.08 ,$72.00 ,$76.80 ,$76.80 ,$22.08 ,$76.80 ,$80.64 ,$80.64 ,$80.64 ,$86.40 ,$55.20 ,$22.08 ,$96.00 ,$14.01 ,$15.41 ,$24.29 ,$81.60 ,$57.35 ,$86.40 ,$80.64 ,$76.80 ,$76.80 ,$22.08 ,$62.40 ST. FRANCIS HOSPITAL - ACUTE,92000002,59025,HC TEST NON STRESS FETAL,920,1 ,"$1,158.00 ",$752.70 ,$234.76 ,"$1,158.00 ",$833.76 ,$629.95 ,$266.34 ,$646.40 ,$266.34 ,$691.79 ,$691.79 ,$691.79 ,$691.79 ,$972.72 ,$266.34 ,$984.30 ,$972.72 ,$266.34 ,$868.50 ,$926.40 ,$926.40 ,$266.34 ,$926.40 ,$972.72 ,$972.72 ,$972.72 ,"$1,042.20 ",$665.85 ,$266.34 ,"$1,158.00 ",$234.76 ,$258.24 ,$292.97 ,$984.30 ,$691.79 ,"$1,042.20 ",$972.72 ,$926.40 ,$926.40 ,$266.34 ,$752.70 ST. FRANCIS HOSPITAL - ACUTE,92000031,59025,HC TEST NON STRESS FETAL EXTENDED,920,1 ,$417.00 ,$271.05 ,$95.91 ,$417.00 ,$300.24 ,$226.85 ,$95.91 ,$232.77 ,$95.91 ,$249.12 ,$249.12 ,$249.12 ,$249.12 ,$350.28 ,$95.91 ,$354.45 ,$350.28 ,$95.91 ,$312.75 ,$333.60 ,$333.60 ,$95.91 ,$333.60 ,$350.28 ,$350.28 ,$350.28 ,$375.30 ,$239.78 ,$95.91 ,$417.00 ,$234.76 ,$258.24 ,$105.50 ,$354.45 ,$249.12 ,$375.30 ,$350.28 ,$333.60 ,$333.60 ,$95.91 ,$271.05 ST. FRANCIS HOSPITAL - ACUTE,92100002,93880,HC DUPLEX CAROTID BILAT,921,1 ,"$1,542.00 ","$1,002.30 ",$145.88 ,"$1,542.00 ","$1,110.24 ",$838.85 ,$354.66 ,$860.74 ,$354.66 ,$921.19 ,$921.19 ,$921.19 ,$921.19 ,"$1,295.28 ",$354.66 ,"$1,310.70 ","$1,295.28 ",$354.66 ,"$1,156.50 ","$1,233.60 ","$1,233.60 ",$354.66 ,"$1,233.60 ","$1,295.28 ","$1,295.28 ","$1,295.28 ","$1,387.80 ",$886.65 ,$354.66 ,"$1,542.00 ",$145.88 ,$160.47 ,$390.13 ,"$1,310.70 ",$921.19 ,"$1,387.80 ","$1,295.28 ","$1,233.60 ","$1,233.60 ",$354.66 ,"$1,002.30 " ST. FRANCIS HOSPITAL - ACUTE,92100003,93882,HC DUPLEX CAROTID UNI,921,1 ,$771.00 ,$501.15 ,$145.88 ,$771.00 ,$555.12 ,$419.42 ,$177.33 ,$430.37 ,$177.33 ,$460.60 ,$460.60 ,$460.60 ,$460.60 ,$647.64 ,$177.33 ,$655.35 ,$647.64 ,$177.33 ,$578.25 ,$616.80 ,$616.80 ,$177.33 ,$616.80 ,$647.64 ,$647.64 ,$647.64 ,$693.90 ,$443.33 ,$177.33 ,$771.00 ,$145.88 ,$160.47 ,$195.06 ,$655.35 ,$460.60 ,$693.90 ,$647.64 ,$616.80 ,$616.80 ,$177.33 ,$501.15 ST. FRANCIS HOSPITAL - ACUTE,92100005,93922,HC ABI/PPG SINGLE LEVEL,921,1 ,$649.00 ,$421.85 ,$136.02 ,$649.00 ,$467.28 ,$353.06 ,$149.27 ,$362.27 ,$149.27 ,$387.71 ,$387.71 ,$387.71 ,$387.71 ,$545.16 ,$149.27 ,$551.65 ,$545.16 ,$149.27 ,$486.75 ,$519.20 ,$519.20 ,$149.27 ,$519.20 ,$545.16 ,$545.16 ,$545.16 ,$584.10 ,$373.18 ,$149.27 ,$649.00 ,$136.02 ,$149.62 ,$164.20 ,$551.65 ,$387.71 ,$584.10 ,$545.16 ,$519.20 ,$519.20 ,$149.27 ,$421.85 ST. FRANCIS HOSPITAL - ACUTE,92100030,93923,HC RESTING ARTERIAL LOWER BILATERAL,921,1 ,"$1,488.00 ",$967.20 ,$136.02 ,"$1,488.00 ","$1,071.36 ",$809.47 ,$342.24 ,$830.60 ,$342.24 ,$888.93 ,$888.93 ,$888.93 ,$888.93 ,"$1,249.92 ",$342.24 ,"$1,264.80 ","$1,249.92 ",$342.24 ,"$1,116.00 ","$1,190.40 ","$1,190.40 ",$342.24 ,"$1,190.40 ","$1,249.92 ","$1,249.92 ","$1,249.92 ","$1,339.20 ",$855.60 ,$342.24 ,"$1,488.00 ",$136.02 ,$149.62 ,$376.46 ,"$1,264.80 ",$888.93 ,"$1,339.20 ","$1,249.92 ","$1,190.40 ","$1,190.40 ",$342.24 ,$967.20 ST. FRANCIS HOSPITAL - ACUTE,92100032,93924,HC DOPPLER ARTERY LWR EXT STRESS,921,1 ,"$1,942.00 ","$1,262.30 ",$136.02 ,"$1,942.00 ","$1,398.24 ","$1,056.45 ",$446.66 ,"$1,084.02 ",$446.66 ,"$1,160.15 ","$1,160.15 ","$1,160.15 ","$1,160.15 ","$1,631.28 ",$446.66 ,"$1,650.70 ","$1,631.28 ",$446.66 ,"$1,456.50 ","$1,553.60 ","$1,553.60 ",$446.66 ,"$1,553.60 ","$1,631.28 ","$1,631.28 ","$1,631.28 ","$1,747.80 ","$1,116.65 ",$446.66 ,"$1,942.00 ",$136.02 ,$149.62 ,$491.33 ,"$1,650.70 ","$1,160.15 ","$1,747.80 ","$1,631.28 ","$1,553.60 ","$1,553.60 ",$446.66 ,"$1,262.30 " ST. FRANCIS HOSPITAL - ACUTE,92100034,93925,HC DUPLEX ARTERIAL LWR EXT BI,921,1 ,"$1,476.00 ",$959.40 ,$192.01 ,"$1,476.00 ","$1,062.72 ",$802.94 ,$339.48 ,$823.90 ,$339.48 ,$881.76 ,$881.76 ,$881.76 ,$881.76 ,"$1,239.84 ",$339.48 ,"$1,254.60 ","$1,239.84 ",$339.48 ,"$1,107.00 ","$1,180.80 ","$1,180.80 ",$339.48 ,"$1,180.80 ","$1,239.84 ","$1,239.84 ","$1,239.84 ","$1,328.40 ",$848.70 ,$339.48 ,"$1,476.00 ",$192.01 ,$211.21 ,$373.43 ,"$1,254.60 ",$881.76 ,"$1,328.40 ","$1,239.84 ","$1,180.80 ","$1,180.80 ",$339.48 ,$959.40 ST. FRANCIS HOSPITAL - ACUTE,92100035,93926,HC DUPLEX ARTRL LWR EXT UNI/LMT,921,1 ,$776.00 ,$504.40 ,$178.48 ,$776.00 ,$558.72 ,$422.14 ,$178.48 ,$433.16 ,$178.48 ,$463.58 ,$463.58 ,$463.58 ,$463.58 ,$651.84 ,$178.48 ,$659.60 ,$651.84 ,$178.48 ,$582.00 ,$620.80 ,$620.80 ,$178.48 ,$620.80 ,$651.84 ,$651.84 ,$651.84 ,$698.40 ,$446.20 ,$178.48 ,$776.00 ,$192.01 ,$211.21 ,$196.33 ,$659.60 ,$463.58 ,$698.40 ,$651.84 ,$620.80 ,$620.80 ,$178.48 ,$504.40 ST. FRANCIS HOSPITAL - ACUTE,92100037,93930,HC DUPLEX ARTERIAL UPR EXT BI,921,1 ,"$1,301.00 ",$845.65 ,$145.88 ,"$1,301.00 ",$936.72 ,$707.74 ,$299.23 ,$726.22 ,$299.23 ,$777.22 ,$777.22 ,$777.22 ,$777.22 ,"$1,092.84 ",$299.23 ,"$1,105.85 ","$1,092.84 ",$299.23 ,$975.75 ,"$1,040.80 ","$1,040.80 ",$299.23 ,"$1,040.80 ","$1,092.84 ","$1,092.84 ","$1,092.84 ","$1,170.90 ",$748.08 ,$299.23 ,"$1,301.00 ",$145.88 ,$160.47 ,$329.15 ,"$1,105.85 ",$777.22 ,"$1,170.90 ","$1,092.84 ","$1,040.80 ","$1,040.80 ",$299.23 ,$845.65 ST. FRANCIS HOSPITAL - ACUTE,92100038,93931,HC DUPLEX ARTRL UPR EXT UNI/LMT,921,1 ,$776.00 ,$504.40 ,$145.88 ,$776.00 ,$558.72 ,$422.14 ,$178.48 ,$433.16 ,$178.48 ,$463.58 ,$463.58 ,$463.58 ,$463.58 ,$651.84 ,$178.48 ,$659.60 ,$651.84 ,$178.48 ,$582.00 ,$620.80 ,$620.80 ,$178.48 ,$620.80 ,$651.84 ,$651.84 ,$651.84 ,$698.40 ,$446.20 ,$178.48 ,$776.00 ,$145.88 ,$160.47 ,$196.33 ,$659.60 ,$463.58 ,$698.40 ,$651.84 ,$620.80 ,$620.80 ,$178.48 ,$504.40 ST. FRANCIS HOSPITAL - ACUTE,92100041,93970,HC DUPLEX VENOUS EXT BI,921,1 ,"$1,856.00 ","$1,206.40 ",$192.01 ,"$1,856.00 ","$1,336.32 ","$1,009.66 ",$426.88 ,"$1,036.02 ",$426.88 ,"$1,108.77 ","$1,108.77 ","$1,108.77 ","$1,108.77 ","$1,559.04 ",$426.88 ,"$1,577.60 ","$1,559.04 ",$426.88 ,"$1,392.00 ","$1,484.80 ","$1,484.80 ",$426.88 ,"$1,484.80 ","$1,559.04 ","$1,559.04 ","$1,559.04 ","$1,670.40 ","$1,067.20 ",$426.88 ,"$1,856.00 ",$192.01 ,$211.21 ,$469.57 ,"$1,577.60 ","$1,108.77 ","$1,670.40 ","$1,559.04 ","$1,484.80 ","$1,484.80 ",$426.88 ,"$1,206.40 " ST. FRANCIS HOSPITAL - ACUTE,92100043,93971,HC DUPLEX VENOUS EXT UNI/LMTD,921,1 ,$890.00 ,$578.50 ,$192.01 ,$890.00 ,$640.80 ,$484.16 ,$204.70 ,$496.80 ,$204.70 ,$531.69 ,$531.69 ,$531.69 ,$531.69 ,$747.60 ,$204.70 ,$756.50 ,$747.60 ,$204.70 ,$667.50 ,$712.00 ,$712.00 ,$204.70 ,$712.00 ,$747.60 ,$747.60 ,$747.60 ,$801.00 ,$511.75 ,$204.70 ,$890.00 ,$192.01 ,$211.21 ,$225.17 ,$756.50 ,$531.69 ,$801.00 ,$747.60 ,$712.00 ,$712.00 ,$204.70 ,$578.50 ST. FRANCIS HOSPITAL - ACUTE,92100049,93923,HC RESTING ARTERIAL EXTREMITY COMP -52,921,1 ,$546.00 ,$354.90 ,$68.01 ,$546.00 ,$393.12 ,$297.02 ,$125.58 ,$304.78 ,$125.58 ,$326.18 ,$326.18 ,$326.18 ,$326.18 ,$458.64 ,$125.58 ,$464.10 ,$458.64 ,$125.58 ,$409.50 ,$436.80 ,$436.80 ,$125.58 ,$436.80 ,$458.64 ,$458.64 ,$458.64 ,$491.40 ,$313.95 ,$125.58 ,$546.00 ,$68.01 ,$74.81 ,$138.14 ,$464.10 ,$326.18 ,$491.40 ,$458.64 ,$436.80 ,$436.80 ,$125.58 ,$354.90 ST. FRANCIS HOSPITAL - ACUTE,92100051,93701,HC BIOIMPEDANCE DERIVED PHYSIO CV ANALYSIS,921,1 ,$272.00 ,$176.80 ,$2.26 ,$272.00 ,$195.84 ,$147.97 ,$62.56 ,$151.83 ,$62.56 ,$162.49 ,$162.49 ,$162.49 ,$162.49 ,$228.48 ,$62.56 ,$231.20 ,$228.48 ,$62.56 ,$204.00 ,$217.60 ,$217.60 ,$62.56 ,$217.60 ,$228.48 ,$228.48 ,$228.48 ,$244.80 ,$156.40 ,$62.56 ,$272.00 ,$2.26 ,$2.49 ,$68.82 ,$231.20 ,$162.49 ,$244.80 ,$228.48 ,$217.60 ,$217.60 ,$62.56 ,$176.80 ST. FRANCIS HOSPITAL - ACUTE,94000101,99195,HC PHLEBOTOMY THERAPEUTIC,940,1 ,$224.00 ,$145.60 ,$51.52 ,$224.00 ,$161.28 ,$121.86 ,$51.52 ,$125.04 ,$51.52 ,$133.82 ,$133.82 ,$133.82 ,$133.82 ,$188.16 ,$51.52 ,$190.40 ,$188.16 ,$51.52 ,$168.00 ,$179.20 ,$179.20 ,$51.52 ,$179.20 ,$188.16 ,$188.16 ,$188.16 ,$201.60 ,$128.80 ,$51.52 ,$224.00 ,$84.96 ,$93.46 ,$56.67 ,$190.40 ,$133.82 ,$201.60 ,$188.16 ,$179.20 ,$179.20 ,$51.52 ,$145.60 ST. FRANCIS HOSPITAL - ACUTE,94000111,96373,HC INJ TX/PROPH/DIAG INTRA-ARTERIAL,940,1 ,$244.00 ,$158.60 ,$56.12 ,$244.00 ,$175.68 ,$132.74 ,$56.12 ,$136.20 ,$56.12 ,$145.77 ,$145.77 ,$145.77 ,$145.77 ,$204.96 ,$56.12 ,$207.40 ,$204.96 ,$56.12 ,$183.00 ,$195.20 ,$195.20 ,$56.12 ,$195.20 ,$204.96 ,$204.96 ,$204.96 ,$219.60 ,$140.30 ,$56.12 ,$244.00 , N/A , N/A ,$61.73 ,$207.40 ,$145.77 ,$219.60 ,$204.96 ,$195.20 ,$195.20 ,$56.12 ,$158.60 ST. FRANCIS HOSPITAL - ACUTE,94000112,E0202,HC PHOTO THERAPY PER HOUR,940,1 ,$36.00 ,$23.40 ,$8.28 ,$36.00 ,$25.92 ,$19.58 ,$8.28 ,$20.10 ,$8.28 ,$21.51 ,$21.51 ,$21.51 ,$21.51 ,$30.24 ,$8.28 ,$30.60 ,$30.24 ,$8.28 ,$27.00 ,$28.80 ,$28.80 ,$8.28 ,$28.80 ,$30.24 ,$30.24 ,$30.24 ,$32.40 ,$20.70 ,$8.28 ,$36.00 , N/A , N/A ,$9.11 ,$30.60 ,$21.51 ,$32.40 ,$30.24 ,$28.80 ,$28.80 ,$8.28 ,$23.40 ST. FRANCIS HOSPITAL - ACUTE,94000114,20560,HC NEEDLE INSERTION W/O INJECTION 1-2 MUSCLES,940,1 ,$195.00 ,$126.75 ,$26.48 ,$195.00 ,$140.40 ,$106.08 ,$44.85 ,$108.85 ,$44.85 ,$116.49 ,$116.49 ,$116.49 ,$116.49 ,$163.80 ,$44.85 ,$165.75 ,$163.80 ,$44.85 ,$146.25 ,$156.00 ,$156.00 ,$44.85 ,$156.00 ,$163.80 ,$163.80 ,$163.80 ,$175.50 ,$112.13 ,$44.85 ,$195.00 ,$26.48 ,$29.13 ,$49.34 ,$165.75 ,$116.49 ,$175.50 ,$163.80 ,$156.00 ,$156.00 ,$44.85 ,$126.75 ST. FRANCIS HOSPITAL - ACUTE,94000115,20561,HC NEEDLE INSERTION W/O INJECTION 3+ MUSCLES,940,1 ,$195.00 ,$126.75 ,$26.48 ,$195.00 ,$140.40 ,$106.08 ,$44.85 ,$108.85 ,$44.85 ,$116.49 ,$116.49 ,$116.49 ,$116.49 ,$163.80 ,$44.85 ,$165.75 ,$163.80 ,$44.85 ,$146.25 ,$156.00 ,$156.00 ,$44.85 ,$156.00 ,$163.80 ,$163.80 ,$163.80 ,$175.50 ,$112.13 ,$44.85 ,$195.00 ,$26.48 ,$29.13 ,$49.34 ,$165.75 ,$116.49 ,$175.50 ,$163.80 ,$156.00 ,$156.00 ,$44.85 ,$126.75 ST. FRANCIS HOSPITAL - ACUTE,94200005,97802,HC NUTRITION THRPY EVAL 15 MIN,942,1 ,$87.00 ,$56.55 ,$20.01 ,$87.00 ,$62.64 ,$47.33 ,$20.01 ,$48.56 ,$20.01 ,$51.97 ,$51.97 ,$51.97 ,$51.97 ,$73.08 ,$20.01 ,$73.95 ,$73.08 ,$20.01 ,$65.25 ,$69.60 ,$69.60 ,$20.01 ,$69.60 ,$73.08 ,$73.08 ,$73.08 ,$78.30 ,$50.03 ,$20.01 ,$87.00 , N/A , N/A ,$22.01 ,$73.95 ,$51.97 ,$78.30 ,$73.08 ,$69.60 ,$69.60 ,$20.01 ,$56.55 ST. FRANCIS HOSPITAL - ACUTE,94200019,N/A,HC LACTATION CONSULT 30 MIN,942,1 ,$154.00 ,$100.10 ,$35.42 ,$154.00 ,$110.88 ,$83.78 ,$35.42 ,$85.96 ,$35.42 ,$92.00 ,$92.00 ,$92.00 ,$92.00 ,$129.36 ,$35.42 ,$130.90 ,$129.36 ,$35.42 ,$115.50 ,$123.20 ,$123.20 ,$35.42 ,$123.20 ,$129.36 ,$129.36 ,$129.36 ,$138.60 ,$88.55 ,$35.42 ,$154.00 , N/A , N/A ,$38.96 ,$130.90 ,$92.00 ,$138.60 ,$129.36 ,$123.20 ,$123.20 ,$35.42 ,$100.10 ST. FRANCIS HOSPITAL - ACUTE,94200020,N/A,HC LACTATION CONSULT 45 MIN,942,1 ,$216.00 ,$140.40 ,$49.68 ,$216.00 ,$155.52 ,$117.50 ,$49.68 ,$120.57 ,$49.68 ,$129.04 ,$129.04 ,$129.04 ,$129.04 ,$181.44 ,$49.68 ,$183.60 ,$181.44 ,$49.68 ,$162.00 ,$172.80 ,$172.80 ,$49.68 ,$172.80 ,$181.44 ,$181.44 ,$181.44 ,$194.40 ,$124.20 ,$49.68 ,$216.00 , N/A , N/A ,$54.65 ,$183.60 ,$129.04 ,$194.40 ,$181.44 ,$172.80 ,$172.80 ,$49.68 ,$140.40 ST. FRANCIS HOSPITAL - ACUTE,94200021,N/A,HC LACTATION CONSULT 60 MIN,942,1 ,$277.00 ,$180.05 ,$63.71 ,$277.00 ,$199.44 ,$150.69 ,$63.71 ,$154.62 ,$63.71 ,$165.48 ,$165.48 ,$165.48 ,$165.48 ,$232.68 ,$63.71 ,$235.45 ,$232.68 ,$63.71 ,$207.75 ,$221.60 ,$221.60 ,$63.71 ,$221.60 ,$232.68 ,$232.68 ,$232.68 ,$249.30 ,$159.28 ,$63.71 ,$277.00 , N/A , N/A ,$70.08 ,$235.45 ,$165.48 ,$249.30 ,$232.68 ,$221.60 ,$221.60 ,$63.71 ,$180.05 ST. FRANCIS HOSPITAL - ACUTE,94300004,93797,HC CARDIAC REHAB W/O EKG SESSION,943,1 ,$303.00 ,$196.95 ,$69.69 ,$303.00 ,$218.16 ,$164.83 ,$69.69 ,$169.13 ,$69.69 ,$181.01 ,$181.01 ,$181.01 ,$181.01 ,$254.52 ,$69.69 ,$257.55 ,$254.52 ,$69.69 ,$227.25 ,$242.40 ,$242.40 ,$69.69 ,$242.40 ,$254.52 ,$254.52 ,$254.52 ,$272.70 ,$174.23 ,$69.69 ,$303.00 , N/A , N/A ,$76.66 ,$257.55 ,$181.01 ,$272.70 ,$254.52 ,$242.40 ,$242.40 ,$69.69 ,$196.95 ST. FRANCIS HOSPITAL - ACUTE,94300008,G0424,HC PULMONARY REHAB PER HOUR,948,1 ,$286.00 ,$185.90 ,$65.78 ,$286.00 ,$205.92 ,$155.58 ,$65.78 ,$159.65 ,$65.78 ,$170.86 ,$170.86 ,$170.86 ,$170.86 ,$240.24 ,$65.78 ,$243.10 ,$240.24 ,$65.78 ,$214.50 ,$228.80 ,$228.80 ,$65.78 ,$228.80 ,$240.24 ,$240.24 ,$240.24 ,$257.40 ,$164.45 ,$65.78 ,$286.00 , N/A , N/A ,$72.36 ,$243.10 ,$170.86 ,$257.40 ,$240.24 ,$228.80 ,$228.80 ,$65.78 ,$185.90 ST. FRANCIS HOSPITAL - ACUTE,94300009,93798,HC CARDIAC REHAB W/EKG SESSION (ASSESSMENT),943,1 ,$303.00 ,$196.95 ,$69.69 ,$303.00 ,$218.16 ,$164.83 ,$69.69 ,$169.13 ,$69.69 ,$181.01 ,$181.01 ,$181.01 ,$181.01 ,$254.52 ,$69.69 ,$257.55 ,$254.52 ,$69.69 ,$227.25 ,$242.40 ,$242.40 ,$69.69 ,$242.40 ,$254.52 ,$254.52 ,$254.52 ,$272.70 ,$174.23 ,$69.69 ,$303.00 , N/A , N/A ,$76.66 ,$257.55 ,$181.01 ,$272.70 ,$254.52 ,$242.40 ,$242.40 ,$69.69 ,$196.95 ST. FRANCIS HOSPITAL - ACUTE,94300012,G0424,HC PULMONARY REHAB PER HOUR-KX,948,1 ,$286.00 ,$185.90 ,$65.78 ,$286.00 ,$205.92 ,$155.58 ,$65.78 ,$159.65 ,$65.78 ,$170.86 ,$170.86 ,$170.86 ,$170.86 ,$240.24 ,$65.78 ,$243.10 ,$240.24 ,$65.78 ,$214.50 ,$228.80 ,$228.80 ,$65.78 ,$228.80 ,$240.24 ,$240.24 ,$240.24 ,$257.40 ,$164.45 ,$65.78 ,$286.00 , N/A , N/A ,$72.36 ,$243.10 ,$170.86 ,$257.40 ,$240.24 ,$228.80 ,$228.80 ,$65.78 ,$185.90 ST. FRANCIS HOSPITAL - ACUTE,94300019,N/A,HC CARDIAC REHAB PHASE 3 FULL MONTH,943,1 ,$44.00 ,$28.60 ,$10.12 ,$44.00 ,$31.68 ,$23.94 ,$10.12 ,$24.56 ,$10.12 ,$26.29 ,$26.29 ,$26.29 ,$26.29 ,$36.96 ,$10.12 ,$37.40 ,$36.96 ,$10.12 ,$33.00 ,$35.20 ,$35.20 ,$10.12 ,$35.20 ,$36.96 ,$36.96 ,$36.96 ,$39.60 ,$25.30 ,$10.12 ,$44.00 , N/A , N/A ,$11.13 ,$37.40 ,$26.29 ,$39.60 ,$36.96 ,$35.20 ,$35.20 ,$10.12 ,$28.60 ST. FRANCIS HOSPITAL - ACUTE,94300021,N/A,HC CARDIAC REHAB EXERCISE PER VISIT,943,1 ,$5.00 ,$3.25 ,$1.15 ,$5.00 ,$3.60 ,$2.72 ,$1.15 ,$2.79 ,$1.15 ,$2.99 ,$2.99 ,$2.99 ,$2.99 ,$4.20 ,$1.15 ,$4.25 ,$4.20 ,$1.15 ,$3.75 ,$4.00 ,$4.00 ,$1.15 ,$4.00 ,$4.20 ,$4.20 ,$4.20 ,$4.50 ,$2.88 ,$1.15 ,$5.00 , N/A , N/A ,$1.27 ,$4.25 ,$2.99 ,$4.50 ,$4.20 ,$4.00 ,$4.00 ,$1.15 ,$3.25 ST. FRANCIS HOSPITAL - ACUTE,98500000,93010,PC EKG INTER AND REPORT PRO,985,1 ,$73.00 ,$47.45 ,$16.79 ,$73.00 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 ,$24.70 ,$27.17 ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45 ST. FRANCIS HOSPITAL - ACUTE,98500003,93018,PC CARDIOVASCULAR STRESS TEST,985,1 ,$73.00 ,$47.45 ,$16.79 ,$322.04 ,$52.56 ,$39.71 ,$16.79 ,$40.75 ,$16.79 ,$43.61 ,$43.61 ,$43.61 ,$43.61 ,$61.32 ,$16.79 ,$62.05 ,$61.32 ,$16.79 ,$54.75 ,$58.40 ,$58.40 ,$16.79 ,$58.40 ,$61.32 ,$61.32 ,$61.32 ,$65.70 ,$41.98 ,$16.79 ,$73.00 ,$292.76 ,$322.04 ,$18.47 ,$62.05 ,$43.61 ,$65.70 ,$61.32 ,$58.40 ,$58.40 ,$16.79 ,$47.45