HSHS GOOD SHEPHERD 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 ," 6 DEGREES HEALTH, INC ", AETNA , AETNA MEDICARE , AMISH COMMUNITY DISCOUNT , BC EXCHANGE , BCBS OF ILLINOIS PPO , BLUE CROSS BLUE SHEILD OF ILLINOIS DUAL , BLUE CROSS BLUE SHIELD IPA IL , BLUE CROSS BLUE SHIELD OF ILLINOIS MEDICARE ADV , CELTIC INSURANCE COMPANY , CIGNA , CLAIM DOC , CLEAR SPRING HEALTH MEDICARE ADV , HEALTH ALLIANCE MEDICAL PLAN EXCHANGE , HEALTH ALLIANCE MEDICARE , HEALTH ALLIANCE PPO , HEALTHLINK , HEALTHLINK PPO , HEALTHSCOPE , HFN , HOPETRUST , HUMANA , HUMANA MEDICARE , HUMANA MEDICARE ADVANTAGE , LIVE360 HSHS HEALTHY PLAN , LIVE360 MEDICARE COST PLAN , LIVE360 NON HSHS HEALTHY PLAN , MERIDIAN HMO MCD , MOLINA MEDICAID , MOLINA MEDICARE , MULTIPLAN , PLAIN CHURCH MEDICAL GROUP , PROVIDER NETWORK OF AMERICA , UHC CATERPILLAR , UNITED HEALTH ALL PAYOR , UNITED HEALTH CARE MEDICARE , WELLFIRST 
HSHS GOOD SHEPHERD HOSPITAL (ACU),N/A,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,120,1 ,"$60,517.70 ","$39,336.51 ","$2,728.76 ","$218,189.75 ","$218,189.75 ","$48,414.16 ","$85,530.38 ","$16,944.96 ","$47,954.23 ","$55,555.25 ","$59,307.35 ","$55,555.25 ","$59,307.35 ","$59,307.35 ","$44,783.10 ","$59,307.35 ","$86,385.69 ","$25,500.00 ","$85,530.38 ","$25,500.00 ","$41,212.55 ","$41,212.55 ","$48,414.16 ","$54,465.93 ","$60,517.70 ","$51,440.05 ","$87,275.90 ","$87,275.90 ","$51,440.05 ","$85,530.38 ","$25,175.36 ","$2,858.70 ","$2,728.76 ","$59,307.35 ","$10,500.00 ","$16,944.96 ","$54,465.93 ","$47,506.39 ","$49,987.62 ","$74,384.32 ","$39,336.51 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),N/A,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,120,1 ,"$15,305.70 ","$9,948.71 ","$1,400.00 ","$55,181.53 ","$55,181.53 ","$12,244.56 ","$22,072.61 ","$4,285.60 ","$12,128.24 ","$14,050.63 ","$15,305.70 ","$14,050.63 ","$15,305.70 ","$15,305.70 ","$11,326.22 ","$15,305.70 ","$22,293.34 ","$3,400.00 ","$22,072.61 ","$3,400.00 ","$15,305.70 ","$15,305.70 ","$12,244.56 ","$13,775.13 ","$15,305.70 ","$13,009.85 ","$22,072.61 ","$22,072.61 ","$13,009.85 ","$22,072.61 ","$6,367.17 ","$2,858.70 ","$2,728.76 ","$15,305.70 ","$1,400.00 ","$4,285.60 ","$13,775.13 ","$12,014.97 ","$12,642.51 ","$15,305.70 ","$9,948.71 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),N/A,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,120,1 ,"$11,455.16 ","$7,445.85 ","$1,400.00 ","$41,300.30 ","$41,300.30 ","$9,164.13 ","$16,520.12 ","$3,207.44 ","$9,077.07 ","$10,515.84 ","$11,455.16 ","$10,515.84 ","$11,455.16 ","$11,455.16 ","$8,476.82 ","$11,455.16 ","$16,685.32 ","$3,400.00 ","$16,520.12 ","$3,400.00 ","$11,455.16 ","$11,455.16 ","$9,164.13 ","$10,309.64 ","$11,455.16 ","$9,736.89 ","$16,520.12 ","$16,520.12 ","$9,736.89 ","$16,520.12 ","$4,765.35 ","$2,858.70 ","$2,728.76 ","$11,455.16 ","$1,400.00 ","$3,207.44 ","$10,309.64 ","$8,992.30 ","$9,461.96 ","$11,455.16 ","$7,445.85 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),N/A,460,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,120,1 ,"$23,694.57 ","$15,401.47 ","$2,100.00 ","$85,428.10 ","$85,428.10 ","$18,955.66 ","$33,487.82 ","$6,634.48 ","$18,775.58 ","$21,751.62 ","$23,220.68 ","$21,751.62 ","$23,220.68 ","$23,220.68 ","$17,533.98 ","$23,220.68 ","$33,822.69 ","$5,100.00 ","$33,487.82 ","$5,100.00 ","$23,694.57 ","$23,694.57 ","$18,955.66 ","$21,325.11 ","$23,694.57 ","$20,140.38 ","$34,171.24 ","$34,171.24 ","$20,140.38 ","$33,487.82 ","$9,856.94 ","$2,858.70 ","$2,728.76 ","$23,220.68 ","$2,100.00 ","$6,634.48 ","$21,325.11 ","$18,600.24 ","$19,571.71 ","$23,220.68 ","$15,401.47 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),N/A,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,120,1 ,"$6,828.61 ","$4,438.60 ","$1,400.00 ","$24,619.78 ","$24,619.78 ","$5,462.89 ","$9,847.91 ","$1,912.01 ","$5,410.99 ","$6,268.66 ","$6,828.61 ","$6,268.66 ","$6,828.61 ","$6,828.61 ","$5,053.17 ","$6,828.61 ","$9,946.39 ","$3,400.00 ","$9,847.91 ","$3,400.00 ","$6,828.61 ","$6,828.61 ","$5,462.89 ","$6,145.75 ","$6,828.61 ","$5,804.32 ","$9,847.91 ","$9,847.91 ","$5,804.32 ","$9,847.91 ","$2,840.70 ","$2,858.70 ","$2,728.76 ","$6,828.61 ","$1,400.00 ","$1,912.01 ","$6,145.75 ","$5,360.46 ","$5,640.43 ","$6,828.61 ","$4,438.60 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),12000001,N/A,HC DAILY SERVICE GENERAL,120,1 ,"$1,360.00 ",$884.00 ,$380.80 ,"$1,360.00 ", Inpatient Medicare +150% ,"$1,088.00 ", Inpatient Medicare ,$380.80 ,"$1,077.66 ","$1,248.48 ", Inpatient Medicare ,"$1,248.48 ", Inpatient Medicare , Inpatient Medicare +90% ,"$1,006.40 ", Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,700.00 ", Inpatient Medicare ,"$1,700.00 ","$10,859.00 ","$10,859.00 ","$1,088.00 ","$1,224.00 ", Inpatient Medicare +150% ,"$1,156.00 ", Inpatient Medicare , Inpatient Medicare ,"$1,156.00 ", Inpatient Medicare ,$565.76 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$700.00 ,$380.80 ,"$1,224.00 ","$1,067.60 ","$1,123.36 ", Inpatient Medicare ,$884.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),12000002,N/A,HC DAILY SERVICE SWING BED,120,1 ,$662.00 ,$430.30 ,$185.36 ,$662.00 , Inpatient Medicare +150% ,$529.60 , Inpatient Medicare ,$185.36 ,$524.57 ,$607.72 , Inpatient Medicare ,$607.72 , Inpatient Medicare , Inpatient Medicare +90% ,$489.88 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,700.00 ", Inpatient Medicare ,"$1,700.00 ","$10,859.00 ","$10,859.00 ",$529.60 ,$595.80 , Inpatient Medicare +150% ,$562.70 , Inpatient Medicare , Inpatient Medicare ,$562.70 , Inpatient Medicare ,$275.39 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$700.00 ,$185.36 ,$595.80 ,$519.67 ,$546.81 , Inpatient Medicare ,$430.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),12000006,N/A,HC DAILY SERVICE W/TELEMETRY,120,1 ,"$2,893.00 ","$1,880.45 ",$810.04 ,"$2,893.00 ", Inpatient Medicare +150% ,"$2,314.40 ", Inpatient Medicare ,$810.04 ,"$2,292.41 ","$2,655.77 ", Inpatient Medicare ,"$2,655.77 ", Inpatient Medicare , Inpatient Medicare +90% ,"$2,140.82 ", Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,700.00 ", Inpatient Medicare ,"$1,700.00 ","$10,859.00 ","$10,859.00 ","$2,314.40 ","$2,603.70 ", Inpatient Medicare +150% ,"$2,459.05 ", Inpatient Medicare , Inpatient Medicare ,"$2,459.05 ", Inpatient Medicare ,"$1,203.49 ", Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$700.00 ,$810.04 ,"$2,603.70 ","$2,271.00 ","$2,389.62 ", Inpatient Medicare ,"$1,880.45 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),12500001,N/A,HC DAILY HOSPICE ACUTE CARE,125,1 ,"$1,360.00 ",$884.00 ,$380.80 ,"$1,360.00 ", Inpatient Medicare +150% ,"$1,088.00 ", Inpatient Medicare ,$380.80 ,"$1,077.66 ","$1,248.48 ", Inpatient Medicare ,"$1,248.48 ", Inpatient Medicare , Inpatient Medicare +90% ,"$1,006.40 ", Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,700.00 ", Inpatient Medicare ,"$1,700.00 ","$10,859.00 ","$10,859.00 ","$1,088.00 ","$1,224.00 ", Inpatient Medicare +150% ,"$1,156.00 ", Inpatient Medicare , Inpatient Medicare ,"$1,156.00 ", Inpatient Medicare ,$565.76 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$700.00 ,$380.80 ,"$1,224.00 ","$1,067.60 ","$1,123.36 ", Inpatient Medicare ,$884.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),12600001,N/A,HC DAILY SERVICE DETOXIFICATION,126,1 ,"$1,360.00 ",$884.00 ,$380.80 ,"$1,360.00 ", Inpatient Medicare +150% ,"$1,088.00 ", Inpatient Medicare ,$380.80 ,"$1,077.66 ","$1,248.48 ", Inpatient Medicare ,"$1,248.48 ", Inpatient Medicare , Inpatient Medicare +90% ,"$1,006.40 ", Inpatient Medicare +150% , Inpatient Medicare +1% ,$600.00 , Inpatient Medicare ,$600.00 ,"$10,859.00 ","$10,859.00 ","$1,088.00 ","$1,224.00 ", Inpatient Medicare +150% ,"$1,156.00 ", Inpatient Medicare , Inpatient Medicare ,"$1,156.00 ", Inpatient Medicare ,$565.76 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$700.00 ,$380.80 ,"$1,224.00 ","$1,067.60 ","$1,123.36 ", Inpatient Medicare ,$884.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),26000000,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$444.00 ,$288.60 ,$124.32 ,$506.88 ,$506.88 ,$355.20 ,$189.31 ,$124.32 ,$351.83 ,$407.59 ,$189.31 ,$407.59 ,$189.31 ,$385.23 ,$328.56 ,$444.00 ,$202.75 ,$370.30 ,$189.31 , N/A ,$366.74 ,$366.74 ,$355.20 ,$399.60 ,$444.00 ,$377.40 ,$189.31 ,$189.31 ,$377.40 ,$202.75 ,$184.70 , N/A , N/A ,$212.22 ,$377.40 ,$124.32 ,$399.60 ,$348.54 ,$366.74 ,$189.31 ,$288.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),26000001,96361,HC HYDRATION THERAPY EA ADDL HR,260,1 ,$134.00 ,$87.10 ,$37.03 ,$134.00 ,$99.15 ,$107.20 ,$37.03 ,$37.52 ,$106.18 ,$123.01 ,$37.03 ,$123.01 ,$37.03 ,$75.35 ,$99.16 ,$99.15 ,$39.66 ,$111.76 ,$37.03 , N/A ,$110.68 ,$110.68 ,$107.20 ,$120.60 ,$92.58 ,$113.90 ,$37.03 ,$37.03 ,$113.90 ,$39.66 ,$55.74 , N/A , N/A ,$41.51 ,$113.90 ,$37.52 ,$120.60 ,$105.19 ,$110.68 ,$37.03 ,$87.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),26000002,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$359.00 ,$233.35 ,$100.52 ,$506.88 ,$506.88 ,$287.20 ,$189.31 ,$100.52 ,$284.47 ,$329.56 ,$189.31 ,$329.56 ,$189.31 ,$359.00 ,$265.66 ,$359.00 ,$202.75 ,$299.41 ,$189.31 , N/A ,$296.53 ,$296.53 ,$287.20 ,$323.10 ,$359.00 ,$305.15 ,$189.31 ,$189.31 ,$305.15 ,$202.75 ,$149.34 , N/A , N/A ,$212.22 ,$305.15 ,$100.52 ,$323.10 ,$281.82 ,$296.53 ,$189.31 ,$233.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),26000003,96366,HC INFUSION THERAPY EA ADDL HR,260,1 ,$159.00 ,$103.35 ,$37.03 ,$159.00 ,$99.15 ,$127.20 ,$37.03 ,$44.52 ,$125.99 ,$145.96 ,$37.03 ,$145.96 ,$37.03 ,$75.35 ,$117.66 ,$99.15 ,$39.66 ,$132.61 ,$37.03 , N/A ,$131.33 ,$131.33 ,$127.20 ,$143.10 ,$92.58 ,$135.15 ,$37.03 ,$37.03 ,$135.15 ,$39.66 ,$66.14 , N/A , N/A ,$41.51 ,$135.15 ,$44.52 ,$143.10 ,$124.82 ,$131.33 ,$37.03 ,$103.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),26000004,96367,HC IV INF ADDL SEQ INIT HR,260,1 ,$127.00 ,$82.55 ,$35.56 ,$153.63 ,$153.63 ,$101.60 ,$57.37 ,$35.56 ,$100.63 ,$116.59 ,$57.37 ,$116.59 ,$57.37 ,$116.76 ,$93.98 ,$127.00 ,$61.45 ,$105.92 ,$57.37 , N/A ,$104.90 ,$104.90 ,$101.60 ,$114.30 ,$127.00 ,$107.95 ,$57.37 ,$57.37 ,$107.95 ,$61.45 ,$52.83 , N/A , N/A ,$64.32 ,$107.95 ,$35.56 ,$114.30 ,$99.70 ,$104.90 ,$57.37 ,$82.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),26000005,96368,HC INFUS CONCURRENT,260,1 ,$128.00 ,$83.20 ,$35.84 ,$128.00 , N/A ,$102.40 , N/A ,$35.84 ,$101.43 ,$117.50 , N/A ,$117.50 , N/A , N/A ,$94.72 , N/A , N/A ,$106.75 , N/A , N/A ,$105.73 ,$105.73 ,$102.40 ,$115.20 , N/A ,$108.80 , N/A , N/A ,$108.80 , N/A ,$53.25 , N/A , N/A , N/A ,$108.80 ,$35.84 ,$115.20 ,$100.48 ,$105.73 , N/A ,$83.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),26000020,96373,HC THERAPEUTIC PROPHALYTIC INJ,260,1 ,$113.42 ,$73.72 ,$31.76 ,$506.88 ,$506.88 ,$90.74 ,$189.31 ,$31.76 ,$89.87 ,$104.12 ,$113.42 ,$104.12 ,$113.42 ,$113.42 ,$83.93 ,$113.42 ,$202.75 ,$94.59 ,$189.31 , N/A ,$93.68 ,$93.68 ,$90.74 ,$102.08 ,$113.42 ,$96.41 ,$189.31 ,$189.31 ,$96.41 ,$202.75 ,$47.18 , N/A , N/A ,$113.42 ,$96.41 ,$31.76 ,$102.08 ,$89.03 ,$93.68 ,$189.31 ,$73.72 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000015,N/A,HC SET IV EXTENSION,270,1 ,$8.95 ,$5.82 ,$2.51 ,$8.95 , N/A ,$7.16 , N/A ,$2.51 ,$7.09 ,$8.22 , N/A ,$8.22 , N/A , N/A ,$6.62 , N/A , N/A ,$7.46 , N/A , N/A ,$7.39 ,$7.39 ,$7.16 ,$8.06 , N/A ,$7.61 , N/A , N/A ,$7.61 , N/A ,$3.72 , N/A , N/A , N/A ,$7.61 ,$2.51 ,$8.06 ,$7.03 ,$7.39 , N/A ,$5.82 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000022,N/A,HC TRAY BIOPSY,270,1 ,$23.00 ,$14.95 ,$6.44 ,$23.00 , N/A ,$18.40 , N/A ,$6.44 ,$18.23 ,$21.11 , N/A ,$21.11 , N/A , N/A ,$17.02 , N/A , N/A ,$19.18 , N/A , N/A ,$19.00 ,$19.00 ,$18.40 ,$20.70 , N/A ,$19.55 , N/A , N/A ,$19.55 , N/A ,$9.57 , N/A , N/A , N/A ,$19.55 ,$6.44 ,$20.70 ,$18.06 ,$19.00 , N/A ,$14.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000032,N/A,HC ELECTRODE TIER 2,270,1 ,$53.00 ,$34.45 ,$14.84 ,$53.00 , N/A ,$42.40 , N/A ,$14.84 ,$42.00 ,$48.65 , N/A ,$48.65 , N/A , N/A ,$39.22 , N/A , N/A ,$44.20 , N/A , N/A ,$43.78 ,$43.78 ,$42.40 ,$47.70 , N/A ,$45.05 , N/A , N/A ,$45.05 , N/A ,$22.05 , N/A , N/A , N/A ,$45.05 ,$14.84 ,$47.70 ,$41.61 ,$43.78 , N/A ,$34.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000033,N/A,HC ELECTRODE TIER 3,270,1 ,$60.00 ,$39.00 ,$16.80 ,$60.00 , N/A ,$48.00 , N/A ,$16.80 ,$47.54 ,$55.08 , N/A ,$55.08 , N/A , N/A ,$44.40 , N/A , N/A ,$50.04 , N/A , N/A ,$49.56 ,$49.56 ,$48.00 ,$54.00 , N/A ,$51.00 , N/A , N/A ,$51.00 , N/A ,$24.96 , N/A , N/A , N/A ,$51.00 ,$16.80 ,$54.00 ,$47.10 ,$49.56 , N/A ,$39.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000054,N/A,HC KIT BLOOD GLUCOSE,270,1 ,$23.00 ,$14.95 ,$6.44 ,$23.00 , N/A ,$18.40 , N/A ,$6.44 ,$18.23 ,$21.11 , N/A ,$21.11 , N/A , N/A ,$17.02 , N/A , N/A ,$19.18 , N/A , N/A ,$19.00 ,$19.00 ,$18.40 ,$20.70 , N/A ,$19.55 , N/A , N/A ,$19.55 , N/A ,$9.57 , N/A , N/A , N/A ,$19.55 ,$6.44 ,$20.70 ,$18.06 ,$19.00 , N/A ,$14.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000136,N/A,HC BIOTESTCELL,270,1 ,$142.00 ,$92.30 ,$39.76 ,$142.00 , N/A ,$113.60 , N/A ,$39.76 ,$112.52 ,$130.36 , N/A ,$130.36 , N/A , N/A ,$105.08 , N/A , N/A ,$118.43 , N/A , N/A ,$117.29 ,$117.29 ,$113.60 ,$127.80 , N/A ,$120.70 , N/A , N/A ,$120.70 , N/A ,$59.07 , N/A , N/A , N/A ,$120.70 ,$39.76 ,$127.80 ,$111.47 ,$117.29 , N/A ,$92.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000137,N/A,HC COOLCUT ABLATOR,270,1 ,$142.00 ,$92.30 ,$39.76 ,$142.00 , N/A ,$113.60 , N/A ,$39.76 ,$112.52 ,$130.36 , N/A ,$130.36 , N/A , N/A ,$105.08 , N/A , N/A ,$118.43 , N/A , N/A ,$117.29 ,$117.29 ,$113.60 ,$127.80 , N/A ,$120.70 , N/A , N/A ,$120.70 , N/A ,$59.07 , N/A , N/A , N/A ,$120.70 ,$39.76 ,$127.80 ,$111.47 ,$117.29 , N/A ,$92.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000138,N/A,HC NANOSCOPE HANDPIECE,270,1 ,$24.00 ,$15.60 ,$6.72 ,$24.00 , N/A ,$19.20 , N/A ,$6.72 ,$19.02 ,$22.03 , N/A ,$22.03 , N/A , N/A ,$17.76 , N/A , N/A ,$20.02 , N/A , N/A ,$19.82 ,$19.82 ,$19.20 ,$21.60 , N/A ,$20.40 , N/A , N/A ,$20.40 , N/A ,$9.98 , N/A , N/A , N/A ,$20.40 ,$6.72 ,$21.60 ,$18.84 ,$19.82 , N/A ,$15.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000139,N/A,HC PADDED SPLINT ROLL,270,1 ,$114.00 ,$74.10 ,$31.92 ,$114.00 , N/A ,$91.20 , N/A ,$31.92 ,$90.33 ,$104.65 , N/A ,$104.65 , N/A , N/A ,$84.36 , N/A , N/A ,$95.08 , N/A , N/A ,$94.16 ,$94.16 ,$91.20 ,$102.60 , N/A ,$96.90 , N/A , N/A ,$96.90 , N/A ,$47.42 , N/A , N/A , N/A ,$96.90 ,$31.92 ,$102.60 ,$89.49 ,$94.16 , N/A ,$74.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000140,N/A,HC TORPEDO SHAVER,270,1 ,$303.00 ,$196.95 ,$84.84 ,$303.00 , N/A ,$242.40 , N/A ,$84.84 ,$240.10 ,$278.15 , N/A ,$278.15 , N/A , N/A ,$224.22 , N/A , N/A ,$252.70 , N/A , N/A ,$250.28 ,$250.28 ,$242.40 ,$272.70 , N/A ,$257.55 , N/A , N/A ,$257.55 , N/A ,$126.05 , N/A , N/A , N/A ,$257.55 ,$84.84 ,$272.70 ,$237.86 ,$250.28 , N/A ,$196.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000141,N/A,HC QUANTIFY PLUS CONTROL BILEVEL,270,1 ,$126.00 ,$81.90 ,$35.28 ,$126.00 , N/A ,$100.80 , N/A ,$35.28 ,$99.84 ,$115.67 , N/A ,$115.67 , N/A , N/A ,$93.24 , N/A , N/A ,$105.08 , N/A , N/A ,$104.08 ,$104.08 ,$100.80 ,$113.40 , N/A ,$107.10 , N/A , N/A ,$107.10 , N/A ,$52.42 , N/A , N/A , N/A ,$107.10 ,$35.28 ,$113.40 ,$98.91 ,$104.08 , N/A ,$81.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000142,N/A,HC ET ADULT- LG,270,1 ,$32.00 ,$20.80 ,$8.96 ,$32.00 , N/A ,$25.60 , N/A ,$8.96 ,$25.36 ,$29.38 , N/A ,$29.38 , N/A , N/A ,$23.68 , N/A , N/A ,$26.69 , N/A , N/A ,$26.43 ,$26.43 ,$25.60 ,$28.80 , N/A ,$27.20 , N/A , N/A ,$27.20 , N/A ,$13.31 , N/A , N/A , N/A ,$27.20 ,$8.96 ,$28.80 ,$25.12 ,$26.43 , N/A ,$20.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27000143,N/A,HC HUMIDITY BAGS,270,1 ,$1.00 ,$0.65 ,$0.28 ,$1.00 , N/A ,$0.80 , N/A ,$0.28 ,$0.79 ,$0.92 , N/A ,$0.92 , N/A , N/A ,$0.74 , N/A , N/A ,$0.83 , N/A , N/A ,$0.83 ,$0.83 ,$0.80 ,$0.90 , N/A ,$0.85 , N/A , N/A ,$0.85 , N/A ,$0.42 , N/A , N/A , N/A ,$0.85 ,$0.28 ,$0.90 ,$0.79 ,$0.83 , N/A ,$0.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27100115,N/A,HC PERITONEAL LVG TRAY/CATH,271,1 ,$67.00 ,$43.55 ,$18.76 ,$67.00 , N/A ,$53.60 , N/A ,$18.76 ,$53.09 ,$61.51 , N/A ,$61.51 , N/A , N/A ,$49.58 , N/A , N/A ,$55.88 , N/A , N/A ,$55.34 ,$55.34 ,$53.60 ,$60.30 , N/A ,$56.95 , N/A , N/A ,$56.95 , N/A ,$27.87 , N/A , N/A , N/A ,$56.95 ,$18.76 ,$60.30 ,$52.60 ,$55.34 , N/A ,$43.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27100118,N/A,HC POST OP SHOE,271,1 ,$24.00 ,$15.60 ,$6.72 ,$24.00 , N/A ,$19.20 , N/A ,$6.72 ,$19.02 ,$22.03 , N/A ,$22.03 , N/A , N/A ,$17.76 , N/A , N/A ,$20.02 , N/A , N/A ,$19.82 ,$19.82 ,$19.20 ,$21.60 , N/A ,$20.40 , N/A , N/A ,$20.40 , N/A ,$9.98 , N/A , N/A , N/A ,$20.40 ,$6.72 ,$21.60 ,$18.84 ,$19.82 , N/A ,$15.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27100149,N/A,HC SPLINT WRIST,271,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$20.00 , N/A ,$7.00 ,$19.81 ,$22.95 , N/A ,$22.95 , N/A , N/A ,$18.50 , N/A , N/A ,$20.85 , N/A , N/A ,$20.65 ,$20.65 ,$20.00 ,$22.50 , N/A ,$21.25 , N/A , N/A ,$21.25 , N/A ,$10.40 , N/A , N/A , N/A ,$21.25 ,$7.00 ,$22.50 ,$19.63 ,$20.65 , N/A ,$16.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27100188,N/A,HC SLING ARM,271,1 ,$27.00 ,$17.55 ,$7.56 ,$27.00 , N/A ,$21.60 , N/A ,$7.56 ,$21.39 ,$24.79 , N/A ,$24.79 , N/A , N/A ,$19.98 , N/A , N/A ,$22.52 , N/A , N/A ,$22.30 ,$22.30 ,$21.60 ,$24.30 , N/A ,$22.95 , N/A , N/A ,$22.95 , N/A ,$11.23 , N/A , N/A , N/A ,$22.95 ,$7.56 ,$24.30 ,$21.20 ,$22.30 , N/A ,$17.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27100204,N/A,HC CIRCUIT BREATHING,271,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$24.00 , N/A ,$8.40 ,$23.77 ,$27.54 , N/A ,$27.54 , N/A , N/A ,$22.20 , N/A , N/A ,$25.02 , N/A , N/A ,$24.78 ,$24.78 ,$24.00 ,$27.00 , N/A ,$25.50 , N/A , N/A ,$25.50 , N/A ,$12.48 , N/A , N/A , N/A ,$25.50 ,$8.40 ,$27.00 ,$23.55 ,$24.78 , N/A ,$19.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27100218,N/A,HC SET IV BLOOD ADMINISTRATION,271,1 ,$27.00 ,$17.55 ,$7.56 ,$27.00 , N/A ,$21.60 , N/A ,$7.56 ,$21.39 ,$24.79 , N/A ,$24.79 , N/A , N/A ,$19.98 , N/A , N/A ,$22.52 , N/A , N/A ,$22.30 ,$22.30 ,$21.60 ,$24.30 , N/A ,$22.95 , N/A , N/A ,$22.95 , N/A ,$11.23 , N/A , N/A , N/A ,$22.95 ,$7.56 ,$24.30 ,$21.20 ,$22.30 , N/A ,$17.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27100228,N/A,HC STOCK ANTIEMBOLISM THIGH,271,1 ,$16.00 ,$10.40 ,$4.48 ,$16.00 , N/A ,$12.80 , N/A ,$4.48 ,$12.68 ,$14.69 , N/A ,$14.69 , N/A , N/A ,$11.84 , N/A , N/A ,$13.34 , N/A , N/A ,$13.22 ,$13.22 ,$12.80 ,$14.40 , N/A ,$13.60 , N/A , N/A ,$13.60 , N/A ,$6.66 , N/A , N/A , N/A ,$13.60 ,$4.48 ,$14.40 ,$12.56 ,$13.22 , N/A ,$10.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27100284,N/A,HC PROBE/SENSOR PULSE OXIMETER S2,271,1 ,$33.00 ,$21.45 ,$9.24 ,$33.00 , N/A ,$26.40 , N/A ,$9.24 ,$26.15 ,$30.29 , N/A ,$30.29 , N/A , N/A ,$24.42 , N/A , N/A ,$27.52 , N/A , N/A ,$27.26 ,$27.26 ,$26.40 ,$29.70 , N/A ,$28.05 , N/A , N/A ,$28.05 , N/A ,$13.73 , N/A , N/A , N/A ,$28.05 ,$9.24 ,$29.70 ,$25.91 ,$27.26 , N/A ,$21.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27200054,C1751,HC KIT CATHETER,272,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 , N/A ,$96.00 , N/A ,$33.60 ,$95.09 ,$110.16 , N/A ,$110.16 , N/A , N/A ,$88.80 , N/A , N/A ,$100.08 , N/A , N/A ,$99.12 ,$99.12 ,$96.00 ,$108.00 , N/A ,$102.00 , N/A , N/A ,$102.00 , N/A ,$49.92 , N/A , N/A , N/A ,$102.00 ,$33.60 ,$108.00 ,$94.20 ,$99.12 , N/A ,$78.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27200226,N/A,HC ADHESIVE DERMABOND,272,1 ,$440.00 ,$286.00 ,$123.20 ,$440.00 , N/A ,$352.00 , N/A ,$123.20 ,$348.66 ,$403.92 , N/A ,$403.92 , N/A , N/A ,$325.60 , N/A , N/A ,$366.96 , N/A , N/A ,$363.44 ,$363.44 ,$352.00 ,$396.00 , N/A ,$374.00 , N/A , N/A ,$374.00 , N/A ,$183.04 , N/A , N/A , N/A ,$374.00 ,$123.20 ,$396.00 ,$345.40 ,$363.44 , N/A ,$286.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27200231,N/A,HC AEROCHAMBER,272,1 ,$47.62 ,$30.95 ,$13.33 ,$47.62 , N/A ,$38.10 , N/A ,$13.33 ,$37.73 ,$43.72 , N/A ,$43.72 , N/A , N/A ,$35.24 , N/A , N/A ,$39.72 , N/A , N/A ,$39.33 ,$39.33 ,$38.10 ,$42.86 , N/A ,$40.48 , N/A , N/A ,$40.48 , N/A ,$19.81 , N/A , N/A , N/A ,$40.48 ,$13.33 ,$42.86 ,$37.38 ,$39.33 , N/A ,$30.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27200238,N/A,HC AMBU BAG PEDIATRIC,272,1 ,$18.00 ,$11.70 ,$5.04 ,$18.00 , N/A ,$14.40 , N/A ,$5.04 ,$14.26 ,$16.52 , N/A ,$16.52 , N/A , N/A ,$13.32 , N/A , N/A ,$15.01 , N/A , N/A ,$14.87 ,$14.87 ,$14.40 ,$16.20 , N/A ,$15.30 , N/A , N/A ,$15.30 , N/A ,$7.49 , N/A , N/A , N/A ,$15.30 ,$5.04 ,$16.20 ,$14.13 ,$14.87 , N/A ,$11.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27200288,N/A,HC BAG AMBU,272,1 ,$132.00 ,$85.80 ,$36.96 ,$132.00 , N/A ,$105.60 , N/A ,$36.96 ,$104.60 ,$121.18 , N/A ,$121.18 , N/A , N/A ,$97.68 , N/A , N/A ,$110.09 , N/A , N/A ,$109.03 ,$109.03 ,$105.60 ,$118.80 , N/A ,$112.20 , N/A , N/A ,$112.20 , N/A ,$54.91 , N/A , N/A , N/A ,$112.20 ,$36.96 ,$118.80 ,$103.62 ,$109.03 , N/A ,$85.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27200297,N/A,HC BAG RESUSCITATION DISP,272,1 ,$16.00 ,$10.40 ,$4.48 ,$16.00 , N/A ,$12.80 , N/A ,$4.48 ,$12.68 ,$14.69 , N/A ,$14.69 , N/A , N/A ,$11.84 , N/A , N/A ,$13.34 , N/A , N/A ,$13.22 ,$13.22 ,$12.80 ,$14.40 , N/A ,$13.60 , N/A , N/A ,$13.60 , N/A ,$6.66 , N/A , N/A , N/A ,$13.60 ,$4.48 ,$14.40 ,$12.56 ,$13.22 , N/A ,$10.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27200568,N/A,HC BRA SURGICAL,272,1 ,$89.00 ,$57.85 ,$24.92 ,$89.00 , N/A ,$71.20 , N/A ,$24.92 ,$70.52 ,$81.70 , N/A ,$81.70 , N/A , N/A ,$65.86 , N/A , N/A ,$74.23 , N/A , N/A ,$73.51 ,$73.51 ,$71.20 ,$80.10 , N/A ,$75.65 , N/A , N/A ,$75.65 , N/A ,$37.02 , N/A , N/A , N/A ,$75.65 ,$24.92 ,$80.10 ,$69.87 ,$73.51 , N/A ,$57.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27201088,N/A,HC DISSECTOR BALLOON DISP,272,1 ,$198.00 ,$128.70 ,$55.44 ,$198.00 , N/A ,$158.40 , N/A ,$55.44 ,$156.90 ,$181.76 , N/A ,$181.76 , N/A , N/A ,$146.52 , N/A , N/A ,$165.13 , N/A , N/A ,$163.55 ,$163.55 ,$158.40 ,$178.20 , N/A ,$168.30 , N/A , N/A ,$168.30 , N/A ,$82.37 , N/A , N/A , N/A ,$168.30 ,$55.44 ,$178.20 ,$155.43 ,$163.55 , N/A ,$128.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27201471,N/A,HC JACKSON PRATT SUCTION DR,272,1 ,$35.00 ,$22.75 ,$9.80 ,$35.00 , N/A ,$28.00 , N/A ,$9.80 ,$27.73 ,$32.13 , N/A ,$32.13 , N/A , N/A ,$25.90 , N/A , N/A ,$29.19 , N/A , N/A ,$28.91 ,$28.91 ,$28.00 ,$31.50 , N/A ,$29.75 , N/A , N/A ,$29.75 , N/A ,$14.56 , N/A , N/A , N/A ,$29.75 ,$9.80 ,$31.50 ,$27.48 ,$28.91 , N/A ,$22.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27201542,N/A,HC KIT TIGHTROPE SYNDESMESIS REPAIR,272,1 ,"$1,335.00 ",$867.75 ,$373.80 ,"$1,335.00 ", N/A ,"$1,068.00 ", N/A ,$373.80 ,"$1,057.85 ","$1,225.53 ", N/A ,"$1,225.53 ", N/A , N/A ,$987.90 , N/A , N/A ,"$1,113.39 ", N/A , N/A ,"$1,102.71 ","$1,102.71 ","$1,068.00 ","$1,201.50 ", N/A ,"$1,134.75 ", N/A , N/A ,"$1,134.75 ", N/A ,$555.36 , N/A , N/A , N/A ,"$1,134.75 ",$373.80 ,"$1,201.50 ","$1,047.98 ","$1,102.71 ", N/A ,$867.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27201832,N/A,HC PEP DEVICE,272,1 ,$90.00 ,$58.50 ,$25.20 ,$90.00 , N/A ,$72.00 , N/A ,$25.20 ,$71.32 ,$82.62 , N/A ,$82.62 , N/A , N/A ,$66.60 , N/A , N/A ,$75.06 , N/A , N/A ,$74.34 ,$74.34 ,$72.00 ,$81.00 , N/A ,$76.50 , N/A , N/A ,$76.50 , N/A ,$37.44 , N/A , N/A , N/A ,$76.50 ,$25.20 ,$81.00 ,$70.65 ,$74.34 , N/A ,$58.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27201906,N/A,HC PROBE ELECTRODE SERVAS,272,1 ,"$1,004.00 ",$652.60 ,$281.12 ,"$1,004.00 ", N/A ,$803.20 , N/A ,$281.12 ,$795.57 ,$921.67 , N/A ,$921.67 , N/A , N/A ,$742.96 , N/A , N/A ,$837.34 , N/A , N/A ,$829.30 ,$829.30 ,$803.20 ,$903.60 , N/A ,$853.40 , N/A , N/A ,$853.40 , N/A ,$417.66 , N/A , N/A , N/A ,$853.40 ,$281.12 ,$903.60 ,$788.14 ,$829.30 , N/A ,$652.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27202609,N/A,HC SUTURE GRASPERS (ALL),272,1 ,$170.00 ,$110.50 ,$47.60 ,$170.00 , N/A ,$136.00 , N/A ,$47.60 ,$134.71 ,$156.06 , N/A ,$156.06 , N/A , N/A ,$125.80 , N/A , N/A ,$141.78 , N/A , N/A ,$140.42 ,$140.42 ,$136.00 ,$153.00 , N/A ,$144.50 , N/A , N/A ,$144.50 , N/A ,$70.72 , N/A , N/A , N/A ,$144.50 ,$47.60 ,$153.00 ,$133.45 ,$140.42 , N/A ,$110.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27202737,N/A,HC TRAY BIO-CORKSCREW INSTRUMENTS,272,1 ,$885.00 ,$575.25 ,$247.80 ,$885.00 , N/A ,$708.00 , N/A ,$247.80 ,$701.27 ,$812.43 , N/A ,$812.43 , N/A , N/A ,$654.90 , N/A , N/A ,$738.09 , N/A , N/A ,$731.01 ,$731.01 ,$708.00 ,$796.50 , N/A ,$752.25 , N/A , N/A ,$752.25 , N/A ,$368.16 , N/A , N/A , N/A ,$752.25 ,$247.80 ,$796.50 ,$694.73 ,$731.01 , N/A ,$575.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27202807,N/A,HC TRAY SPINAL,272,1 ,$27.00 ,$17.55 ,$7.56 ,$27.00 , N/A ,$21.60 , N/A ,$7.56 ,$21.39 ,$24.79 , N/A ,$24.79 , N/A , N/A ,$19.98 , N/A , N/A ,$22.52 , N/A , N/A ,$22.30 ,$22.30 ,$21.60 ,$24.30 , N/A ,$22.95 , N/A , N/A ,$22.95 , N/A ,$11.23 , N/A , N/A , N/A ,$22.95 ,$7.56 ,$24.30 ,$21.20 ,$22.30 , N/A ,$17.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27202955,N/A,HC ULTRASOUND GEL,272,1 ,$87.00 ,$56.55 ,$24.36 ,$87.00 , N/A ,$69.60 , N/A ,$24.36 ,$68.94 ,$79.87 , N/A ,$79.87 , N/A , N/A ,$64.38 , N/A , N/A ,$72.56 , N/A , N/A ,$71.86 ,$71.86 ,$69.60 ,$78.30 , N/A ,$73.95 , N/A , N/A ,$73.95 , N/A ,$36.19 , N/A , N/A , N/A ,$73.95 ,$24.36 ,$78.30 ,$68.30 ,$71.86 , N/A ,$56.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27203051,N/A,HC NASAL PACKING,272,1 ,$34.00 ,$22.10 ,$9.52 ,$34.00 , N/A ,$27.20 , N/A ,$9.52 ,$26.94 ,$31.21 , N/A ,$31.21 , N/A , N/A ,$25.16 , N/A , N/A ,$28.36 , N/A , N/A ,$28.08 ,$28.08 ,$27.20 ,$30.60 , N/A ,$28.90 , N/A , N/A ,$28.90 , N/A ,$14.14 , N/A , N/A , N/A ,$28.90 ,$9.52 ,$30.60 ,$26.69 ,$28.08 , N/A ,$22.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27203298,N/A,HC HEMOSTATIC PARTICLES,272,1 ,$165.00 ,$107.25 ,$46.20 ,$165.00 , N/A ,$132.00 , N/A ,$46.20 ,$130.75 ,$151.47 , N/A ,$151.47 , N/A , N/A ,$122.10 , N/A , N/A ,$137.61 , N/A , N/A ,$136.29 ,$136.29 ,$132.00 ,$148.50 , N/A ,$140.25 , N/A , N/A ,$140.25 , N/A ,$68.64 , N/A , N/A , N/A ,$140.25 ,$46.20 ,$148.50 ,$129.53 ,$136.29 , N/A ,$107.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27203510,N/A,HC CATHETER URETHRAL,272,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$16.00 , N/A ,$5.60 ,$15.85 ,$18.36 , N/A ,$18.36 , N/A , N/A ,$14.80 , N/A , N/A ,$16.68 , N/A , N/A ,$16.52 ,$16.52 ,$16.00 ,$18.00 , N/A ,$17.00 , N/A , N/A ,$17.00 , N/A ,$8.32 , N/A , N/A , N/A ,$17.00 ,$5.60 ,$18.00 ,$15.70 ,$16.52 , N/A ,$13.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27203607,N/A,HC CIRCUIT CPAP/BIPAP,272,1 ,$18.00 ,$11.70 ,$5.04 ,$18.00 , N/A ,$14.40 , N/A ,$5.04 ,$14.26 ,$16.52 , N/A ,$16.52 , N/A , N/A ,$13.32 , N/A , N/A ,$15.01 , N/A , N/A ,$14.87 ,$14.87 ,$14.40 ,$16.20 , N/A ,$15.30 , N/A , N/A ,$15.30 , N/A ,$7.49 , N/A , N/A , N/A ,$15.30 ,$5.04 ,$16.20 ,$14.13 ,$14.87 , N/A ,$11.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27203636,N/A,HC TRAY MYELOGRAM,272,1 ,$39.00 ,$25.35 ,$10.92 ,$39.00 , N/A ,$31.20 , N/A ,$10.92 ,$30.90 ,$35.80 , N/A ,$35.80 , N/A , N/A ,$28.86 , N/A , N/A ,$32.53 , N/A , N/A ,$32.21 ,$32.21 ,$31.20 ,$35.10 , N/A ,$33.15 , N/A , N/A ,$33.15 , N/A ,$16.22 , N/A , N/A , N/A ,$33.15 ,$10.92 ,$35.10 ,$30.62 ,$32.21 , N/A ,$25.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27204616,N/A,HC TUBING SUCTION,272,1 ,$23.00 ,$14.95 ,$6.44 ,$23.00 , N/A ,$18.40 , N/A ,$6.44 ,$18.23 ,$21.11 , N/A ,$21.11 , N/A , N/A ,$17.02 , N/A , N/A ,$19.18 , N/A , N/A ,$19.00 ,$19.00 ,$18.40 ,$20.70 , N/A ,$19.55 , N/A , N/A ,$19.55 , N/A ,$9.57 , N/A , N/A , N/A ,$19.55 ,$6.44 ,$20.70 ,$18.06 ,$19.00 , N/A ,$14.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27204866,N/A,HC AIRWAY INTUBATING W/OXYGEN DELIVERY,272,1 ,$145.09 ,$94.31 ,$40.63 ,$145.09 , N/A ,$116.07 , N/A ,$40.63 ,$114.97 ,$133.19 , N/A ,$133.19 , N/A , N/A ,$107.37 , N/A , N/A ,$121.01 , N/A , N/A ,$119.84 ,$119.84 ,$116.07 ,$130.58 , N/A ,$123.33 , N/A , N/A ,$123.33 , N/A ,$60.36 , N/A , N/A , N/A ,$123.33 ,$40.63 ,$130.58 ,$113.90 ,$119.84 , N/A ,$94.31 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27204936,N/A,HC NEEDLE NERVE BLOCK ECHOGENIC,272,1 ,$119.74 ,$77.83 ,$33.53 ,$119.74 , N/A ,$95.79 , N/A ,$33.53 ,$94.88 ,$109.92 , N/A ,$109.92 , N/A , N/A ,$88.61 , N/A , N/A ,$99.86 , N/A , N/A ,$98.91 ,$98.91 ,$95.79 ,$107.77 , N/A ,$101.78 , N/A , N/A ,$101.78 , N/A ,$49.81 , N/A , N/A , N/A ,$101.78 ,$33.53 ,$107.77 ,$94.00 ,$98.91 , N/A ,$77.83 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27204999,N/A,HC SENSOR PULSE OX,272,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$24.00 , N/A ,$8.40 ,$23.77 ,$27.54 , N/A ,$27.54 , N/A , N/A ,$22.20 , N/A , N/A ,$25.02 , N/A , N/A ,$24.78 ,$24.78 ,$24.00 ,$27.00 , N/A ,$25.50 , N/A , N/A ,$25.50 , N/A ,$12.48 , N/A , N/A , N/A ,$25.50 ,$8.40 ,$27.00 ,$23.55 ,$24.78 , N/A ,$19.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205023,N/A,HC SNARE OVAL,272,1 ,$45.00 ,$29.25 ,$12.60 ,$45.00 , N/A ,$36.00 , N/A ,$12.60 ,$35.66 ,$41.31 , N/A ,$41.31 , N/A , N/A ,$33.30 , N/A , N/A ,$37.53 , N/A , N/A ,$37.17 ,$37.17 ,$36.00 ,$40.50 , N/A ,$38.25 , N/A , N/A ,$38.25 , N/A ,$18.72 , N/A , N/A , N/A ,$38.25 ,$12.60 ,$40.50 ,$35.33 ,$37.17 , N/A ,$29.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205074,N/A,HC TUBE TRACH,272,1 ,$45.00 ,$29.25 ,$12.60 ,$45.00 , N/A ,$36.00 , N/A ,$12.60 ,$35.66 ,$41.31 , N/A ,$41.31 , N/A , N/A ,$33.30 , N/A , N/A ,$37.53 , N/A , N/A ,$37.17 ,$37.17 ,$36.00 ,$40.50 , N/A ,$38.25 , N/A , N/A ,$38.25 , N/A ,$18.72 , N/A , N/A , N/A ,$38.25 ,$12.60 ,$40.50 ,$35.33 ,$37.17 , N/A ,$29.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205269,N/A,HC CIRCUIT BREATHING W/EXPIRATORY VALVE,272,1 ,$57.00 ,$37.05 ,$15.96 ,$57.00 , N/A ,$45.60 , N/A ,$15.96 ,$45.17 ,$52.33 , N/A ,$52.33 , N/A , N/A ,$42.18 , N/A , N/A ,$47.54 , N/A , N/A ,$47.08 ,$47.08 ,$45.60 ,$51.30 , N/A ,$48.45 , N/A , N/A ,$48.45 , N/A ,$23.71 , N/A , N/A , N/A ,$48.45 ,$15.96 ,$51.30 ,$44.75 ,$47.08 , N/A ,$37.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205286,N/A,HC BAG INFUSION PRESSURE SMALL,272,1 ,$107.00 ,$69.55 ,$29.96 ,$107.00 , N/A ,$85.60 , N/A ,$29.96 ,$84.79 ,$98.23 , N/A ,$98.23 , N/A , N/A ,$79.18 , N/A , N/A ,$89.24 , N/A , N/A ,$88.38 ,$88.38 ,$85.60 ,$96.30 , N/A ,$90.95 , N/A , N/A ,$90.95 , N/A ,$44.51 , N/A , N/A , N/A ,$90.95 ,$29.96 ,$96.30 ,$84.00 ,$88.38 , N/A ,$69.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205386,N/A,HC HANDLE LARYNGEAL BLADE,272,1 ,$70.00 ,$45.50 ,$19.60 ,$70.00 , N/A ,$56.00 , N/A ,$19.60 ,$55.47 ,$64.26 , N/A ,$64.26 , N/A , N/A ,$51.80 , N/A , N/A ,$58.38 , N/A , N/A ,$57.82 ,$57.82 ,$56.00 ,$63.00 , N/A ,$59.50 , N/A , N/A ,$59.50 , N/A ,$29.12 , N/A , N/A , N/A ,$59.50 ,$19.60 ,$63.00 ,$54.95 ,$57.82 , N/A ,$45.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205411,N/A,HC DRESSING ELASTIC NET,272,1 ,$115.00 ,$74.75 ,$32.20 ,$115.00 , N/A ,$92.00 , N/A ,$32.20 ,$91.13 ,$105.57 , N/A ,$105.57 , N/A , N/A ,$85.10 , N/A , N/A ,$95.91 , N/A , N/A ,$94.99 ,$94.99 ,$92.00 ,$103.50 , N/A ,$97.75 , N/A , N/A ,$97.75 , N/A ,$47.84 , N/A , N/A , N/A ,$97.75 ,$32.20 ,$103.50 ,$90.28 ,$94.99 , N/A ,$74.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205436,N/A,HC THERAPY PUTTY,272,1 ,$34.00 ,$22.10 ,$9.52 ,$34.00 , N/A ,$27.20 , N/A ,$9.52 ,$26.94 ,$31.21 , N/A ,$31.21 , N/A , N/A ,$25.16 , N/A , N/A ,$28.36 , N/A , N/A ,$28.08 ,$28.08 ,$27.20 ,$30.60 , N/A ,$28.90 , N/A , N/A ,$28.90 , N/A ,$14.14 , N/A , N/A , N/A ,$28.90 ,$9.52 ,$30.60 ,$26.69 ,$28.08 , N/A ,$22.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205494,N/A,HC REPLACEMENT PROC MODULES,272,1 ,$55.00 ,$35.75 ,$15.40 ,$55.00 , N/A ,$44.00 , N/A ,$15.40 ,$43.58 ,$50.49 , N/A ,$50.49 , N/A , N/A ,$40.70 , N/A , N/A ,$45.87 , N/A , N/A ,$45.43 ,$45.43 ,$44.00 ,$49.50 , N/A ,$46.75 , N/A , N/A ,$46.75 , N/A ,$22.88 , N/A , N/A , N/A ,$46.75 ,$15.40 ,$49.50 ,$43.18 ,$45.43 , N/A ,$35.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205503,N/A,HC IMPLANT SYSTEM BIOCOMPOSITE,272,1 ,$26.00 ,$16.90 ,$7.28 ,$26.00 , N/A ,$20.80 , N/A ,$7.28 ,$20.60 ,$23.87 , N/A ,$23.87 , N/A , N/A ,$19.24 , N/A , N/A ,$21.68 , N/A , N/A ,$21.48 ,$21.48 ,$20.80 ,$23.40 , N/A ,$22.10 , N/A , N/A ,$22.10 , N/A ,$10.82 , N/A , N/A , N/A ,$22.10 ,$7.28 ,$23.40 ,$20.41 ,$21.48 , N/A ,$16.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205504,N/A,HC STEAM CHEMICAL INTEGRATOR,272,1 ,$22.00 ,$14.30 ,$6.16 ,$22.00 , N/A ,$17.60 , N/A ,$6.16 ,$17.43 ,$20.20 , N/A ,$20.20 , N/A , N/A ,$16.28 , N/A , N/A ,$18.35 , N/A , N/A ,$18.17 ,$18.17 ,$17.60 ,$19.80 , N/A ,$18.70 , N/A , N/A ,$18.70 , N/A ,$9.15 , N/A , N/A , N/A ,$18.70 ,$6.16 ,$19.80 ,$17.27 ,$18.17 , N/A ,$14.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205505,N/A,HC MEDI-FLOW LENS IRRIGATION SET,272,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$16.00 , N/A ,$5.60 ,$15.85 ,$18.36 , N/A ,$18.36 , N/A , N/A ,$14.80 , N/A , N/A ,$16.68 , N/A , N/A ,$16.52 ,$16.52 ,$16.00 ,$18.00 , N/A ,$17.00 , N/A , N/A ,$17.00 , N/A ,$8.32 , N/A , N/A , N/A ,$17.00 ,$5.60 ,$18.00 ,$15.70 ,$16.52 , N/A ,$13.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205506,N/A,HC HEAT SEAL STERILIZATION POUCH,272,1 ,$41.00 ,$26.65 ,$11.48 ,$41.00 , N/A ,$32.80 , N/A ,$11.48 ,$32.49 ,$37.64 , N/A ,$37.64 , N/A , N/A ,$30.34 , N/A , N/A ,$34.19 , N/A , N/A ,$33.87 ,$33.87 ,$32.80 ,$36.90 , N/A ,$34.85 , N/A , N/A ,$34.85 , N/A ,$17.06 , N/A , N/A , N/A ,$34.85 ,$11.48 ,$36.90 ,$32.19 ,$33.87 , N/A ,$26.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205507,N/A,HC HEAT SEAL STERILIZATION TUBING,272,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$24.00 , N/A ,$8.40 ,$23.77 ,$27.54 , N/A ,$27.54 , N/A , N/A ,$22.20 , N/A , N/A ,$25.02 , N/A , N/A ,$24.78 ,$24.78 ,$24.00 ,$27.00 , N/A ,$25.50 , N/A , N/A ,$25.50 , N/A ,$12.48 , N/A , N/A , N/A ,$25.50 ,$8.40 ,$27.00 ,$23.55 ,$24.78 , N/A ,$19.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205508,N/A,HC POUCH PEEL STERILIZATION,272,1 ,$28.00 ,$18.20 ,$7.84 ,$28.00 , N/A ,$22.40 , N/A ,$7.84 ,$22.19 ,$25.70 , N/A ,$25.70 , N/A , N/A ,$20.72 , N/A , N/A ,$23.35 , N/A , N/A ,$23.13 ,$23.13 ,$22.40 ,$25.20 , N/A ,$23.80 , N/A , N/A ,$23.80 , N/A ,$11.65 , N/A , N/A , N/A ,$23.80 ,$7.84 ,$25.20 ,$21.98 ,$23.13 , N/A ,$18.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27205509,N/A,HC CT SYRINGE KIT,272,1 ,$17.00 ,$11.05 ,$4.76 ,$17.00 , N/A ,$13.60 , N/A ,$4.76 ,$13.47 ,$15.61 , N/A ,$15.61 , N/A , N/A ,$12.58 , N/A , N/A ,$14.18 , N/A , N/A ,$14.04 ,$14.04 ,$13.60 ,$15.30 , N/A ,$14.45 , N/A , N/A ,$14.45 , N/A ,$7.07 , N/A , N/A , N/A ,$14.45 ,$4.76 ,$15.30 ,$13.35 ,$14.04 , N/A ,$11.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27400003,L0120,HC CERVICAL COLLAR,274,1 ,$168.00 ,$109.20 ,$47.04 ,$168.00 ,$149.73 ,$134.40 ,$55.92 ,$47.04 ,$133.12 ,$154.22 ,$55.92 ,$154.22 ,$55.92 ,$113.79 ,$124.32 ,$149.73 ,$59.89 ,$140.11 ,$55.92 , N/A ,$138.77 ,$138.77 ,$134.40 ,$151.20 ,$139.80 ,$142.80 ,$55.92 ,$55.92 ,$142.80 ,$59.89 ,$69.89 , N/A , N/A ,$62.69 ,$142.80 ,$47.04 ,$151.20 ,$131.88 ,$138.77 ,$55.92 ,$109.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27400019,L1830,HC KNEE IMMOBILIZER,274,1 ,$66.00 ,$42.90 ,$18.48 ,$189.78 ,$189.78 ,$52.80 ,$70.88 ,$18.48 ,$52.30 ,$60.59 ,$66.00 ,$60.59 ,$66.00 ,$66.00 ,$48.84 ,$66.00 ,$75.91 ,$55.04 ,$70.88 , N/A ,$54.52 ,$54.52 ,$52.80 ,$59.40 ,$66.00 ,$56.10 ,$70.88 ,$70.88 ,$56.10 ,$75.91 ,$27.46 , N/A , N/A ,$66.00 ,$56.10 ,$18.48 ,$59.40 ,$51.81 ,$54.52 ,$70.88 ,$42.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27400039,L3670,HC SHOULDER IMMOBILIZER FIT  AND  ADJ,274,1 ,$27.00 ,$17.55 ,$7.56 ,$248.28 ,$248.28 ,$21.60 ,$92.73 ,$7.56 ,$21.39 ,$24.79 ,$27.00 ,$24.79 ,$27.00 ,$27.00 ,$19.98 ,$27.00 ,$99.31 ,$22.52 ,$92.73 , N/A ,$22.30 ,$22.30 ,$21.60 ,$24.30 ,$27.00 ,$22.95 ,$92.73 ,$92.73 ,$22.95 ,$99.31 ,$11.23 , N/A , N/A ,$27.00 ,$22.95 ,$7.56 ,$24.30 ,$21.20 ,$22.30 ,$92.73 ,$17.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27400129,L1971,HC AFO ANKLE BRACE PREFAB,274,1 ,$45.00 ,$29.25 ,$12.60 ,"$1,083.43 ","$1,083.43 ",$36.00 ,$404.64 ,$12.60 ,$35.66 ,$41.31 ,$45.00 ,$41.31 ,$45.00 ,$45.00 ,$33.30 ,$45.00 ,$433.37 ,$37.53 ,$404.64 , N/A ,$37.17 ,$37.17 ,$36.00 ,$40.50 ,$45.00 ,$38.25 ,$404.64 ,$404.64 ,$38.25 ,$433.37 ,$18.72 , N/A , N/A ,$45.00 ,$38.25 ,$12.60 ,$40.50 ,$35.33 ,$37.17 ,$404.64 ,$29.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27470172,L0172,HC CERVICAL COLLAR SEMI-RIGID,274,1 ,$39.00 ,$25.35 ,$10.92 ,$340.95 ,$340.95 ,$31.20 ,$127.34 ,$10.92 ,$30.90 ,$35.80 ,$39.00 ,$35.80 ,$39.00 ,$39.00 ,$28.86 ,$39.00 ,$136.38 ,$32.53 ,$127.34 , N/A ,$32.21 ,$32.21 ,$31.20 ,$35.10 ,$39.00 ,$33.15 ,$127.34 ,$127.34 ,$33.15 ,$136.38 ,$16.22 , N/A , N/A ,$39.00 ,$33.15 ,$10.92 ,$35.10 ,$30.62 ,$32.21 ,$127.34 ,$25.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),27671780,C1780,"HC LENS, INTRAOCULAR (NEW TECHNOLOGY)",276,1 ,"$2,920.00 ","$1,898.00 ",$817.60 ,"$2,920.00 ", N/A ,"$2,336.00 ", N/A ,$817.60 ,"$2,313.81 ","$2,680.56 ", N/A ,"$2,680.56 ", N/A , N/A ,"$2,160.80 ", N/A , N/A ,"$2,435.28 ", N/A , N/A ,"$2,411.92 ","$2,411.92 ","$2,336.00 ","$2,628.00 ", N/A ,"$2,482.00 ", N/A , N/A ,"$2,482.00 ", N/A ,"$1,214.72 ", N/A , N/A , N/A ,"$2,482.00 ",$817.60 ,"$2,628.00 ","$2,292.20 ","$2,411.92 ", N/A ,"$1,898.00 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),27800181,C1763,HC ALLOGRAFT PASTE,278,1 ,"$5,073.00 ","$3,297.45 ","$1,420.44 ","$5,073.00 ", N/A ,"$4,058.40 ", N/A ,"$1,420.44 ","$4,019.85 ","$4,657.01 ", N/A ,"$4,657.01 ", N/A , N/A ,"$3,754.02 ", N/A , N/A ,"$4,230.88 ", N/A , N/A ,"$4,190.30 ","$4,190.30 ","$4,058.40 ","$4,565.70 ", N/A ,"$4,312.05 ", N/A , N/A ,"$4,312.05 ", N/A ,"$2,110.37 ", N/A , N/A , N/A ,"$4,312.05 ","$1,420.44 ","$4,565.70 ","$3,982.31 ","$4,190.30 ", N/A ,"$3,297.45 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),27880083,C1713,HC 2.4MM TI STRAIGHT PLATE 6H 36MM,278,1 ,"$1,124.00 ",$730.60 ,$314.72 ,"$1,124.00 ", N/A ,$899.20 , N/A ,$314.72 ,$890.66 ,"$1,031.83 ", N/A ,"$1,031.83 ", N/A , N/A ,$831.76 , N/A , N/A ,$937.42 , N/A , N/A ,$928.42 ,$928.42 ,$899.20 ,"$1,011.60 ", N/A ,$955.40 , N/A , N/A ,$955.40 , N/A ,$467.58 , N/A , N/A , N/A ,$955.40 ,$314.72 ,"$1,011.60 ",$882.34 ,$928.42 , N/A ,$730.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),29200003,N/A,HC CRUTCHES PER PAIR,271,1 ,$29.00 ,$18.85 ,$8.12 ,$29.00 , N/A ,$23.20 , N/A ,$8.12 ,$22.98 ,$26.62 , N/A ,$26.62 , N/A , N/A ,$21.46 , N/A , N/A ,$24.19 , N/A , N/A ,$23.95 ,$23.95 ,$23.20 ,$26.10 , N/A ,$24.65 , N/A , N/A ,$24.65 , N/A ,$12.06 , N/A , N/A , N/A ,$24.65 ,$8.12 ,$26.10 ,$22.77 ,$23.95 , N/A ,$18.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000009,36416,HC CAPILLARY COLLECTION,300,1 ,$35.00 ,$22.75 ,$9.80 ,$35.00 , N/A ,$28.00 , N/A ,$9.80 ,$27.73 ,$32.13 , N/A ,$32.13 , N/A , N/A ,$25.90 , N/A , N/A ,$29.19 , N/A , N/A ,$28.91 ,$28.91 ,$28.00 ,$31.50 , N/A ,$29.75 , N/A , N/A ,$29.75 , N/A ,$14.56 , N/A , N/A , N/A ,$29.75 ,$9.80 ,$31.50 ,$27.48 ,$28.91 , N/A ,$22.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000010,36415,HC VENIPUNCTURE,300,1 ,$9.00 ,$5.85 ,$2.52 ,$9.00 ,$7.50 ,$7.20 ,$3.00 ,$2.52 ,$7.13 ,$8.26 ,$3.00 ,$8.26 ,$3.00 ,$5.70 ,$6.66 ,$7.50 ,$3.00 , N/A ,$3.00 , N/A ,$7.43 ,$7.43 ,$7.20 ,$8.10 ,$7.50 ,$7.65 ,$3.00 ,$3.00 ,$7.65 ,$3.00 ,$3.74 , N/A , N/A ,$3.15 ,$7.65 ,$2.52 ,$8.10 ,$7.07 ,$7.43 ,$3.00 ,$5.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000013,36415,HC VENIPUNCTURE (DRAW FEE),300,1 ,$16.00 ,$10.40 ,$3.00 ,$16.00 ,$7.50 ,$12.80 ,$3.00 ,$4.48 ,$12.68 ,$14.69 ,$3.00 ,$14.69 ,$3.00 ,$5.70 ,$11.84 ,$7.50 ,$3.00 , N/A ,$3.00 , N/A ,$13.22 ,$13.22 ,$12.80 ,$14.40 ,$7.50 ,$13.60 ,$3.00 ,$3.00 ,$13.60 ,$3.00 ,$6.66 , N/A , N/A ,$3.15 ,$13.60 ,$4.48 ,$14.40 ,$12.56 ,$13.22 ,$3.00 ,$10.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000015,36600,HC ARTERIAL PUNCTURE,300,1 ,$8.00 ,$5.20 ,$2.24 ,$260.88 ,$260.88 ,$6.40 ,$104.35 ,$2.24 ,$6.34 ,$7.34 ,$8.00 ,$7.34 ,$8.00 ,$8.00 ,$5.92 ,$8.00 ,$104.35 ,$6.67 ,$104.35 , N/A ,$6.61 ,$6.61 ,$6.40 ,$7.20 ,$8.00 ,$6.80 ,$104.35 ,$104.35 ,$6.80 ,$104.35 ,$3.33 , N/A , N/A ,$8.00 ,$6.80 ,$2.24 ,$7.20 ,$6.28 ,$6.61 ,$104.35 ,$5.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000108,89220,HC SPUTUM COLLECTION,300,1 ,$64.00 ,$41.60 ,$17.92 ,$345.05 ,$345.05 ,$51.20 ,$138.02 ,$17.92 ,$50.71 ,$58.75 ,$64.00 ,$58.75 ,$64.00 ,$64.00 ,$47.36 ,$64.00 ,$138.02 ,$53.38 ,$138.02 , N/A ,$52.86 ,$52.86 ,$51.20 ,$57.60 ,$64.00 ,$54.40 ,$138.02 ,$138.02 ,$54.40 ,$138.02 ,$26.62 , N/A , N/A ,$64.00 ,$54.40 ,$17.92 ,$57.60 ,$50.24 ,$52.86 ,$138.02 ,$41.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000131,G0480,HC DRUG CONFIRMATION EA PROC 1-7 CLASSES-90,301,1 ,$137.00 ,$89.05 ,$38.36 ,$286.08 ,$286.08 ,$109.60 ,$114.43 ,$38.36 ,$108.56 ,$125.77 ,$114.43 ,$125.77 ,$114.43 ,$137.00 ,$101.38 ,$137.00 ,$114.43 ,$114.26 ,$114.43 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$137.00 ,$116.45 ,$114.43 ,$114.43 ,$116.45 ,$114.43 ,$56.99 , N/A , N/A ,$120.15 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$114.43 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000218,86927,HC FFP THAWING EACH UNIT,300,1 ,$171.00 ,$111.15 ,$47.88 ,$345.05 ,$345.05 ,$136.80 ,$138.02 ,$47.88 ,$135.50 ,$156.98 ,$138.02 ,$156.98 ,$138.02 ,$171.00 ,$126.54 ,$171.00 ,$138.02 ,$142.61 ,$138.02 , N/A ,$141.25 ,$141.25 ,$136.80 ,$153.90 ,$171.00 ,$145.35 ,$138.02 ,$138.02 ,$145.35 ,$138.02 ,$71.14 , N/A , N/A ,$144.92 ,$145.35 ,$47.88 ,$153.90 ,$134.24 ,$141.25 ,$138.02 ,$111.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000223,89051,HC CELL CT BODY FLUID W/DIFF,300,1 ,$107.00 ,$69.55 ,$5.60 ,$107.00 ,$14.00 ,$85.60 ,$5.60 ,$29.96 ,$84.79 ,$98.23 ,$5.60 ,$98.23 ,$5.60 ,$10.64 ,$79.18 ,$14.00 ,$5.60 ,$89.24 ,$5.60 , N/A ,$88.38 ,$88.38 ,$85.60 ,$96.30 ,$14.00 ,$90.95 ,$5.60 ,$5.60 ,$90.95 ,$5.60 ,$44.51 , N/A , N/A ,$5.88 ,$90.95 ,$29.96 ,$96.30 ,$84.00 ,$88.38 ,$5.60 ,$69.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000242,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$76.00 ,$49.40 ,$21.28 ,$260.88 ,$260.88 ,$60.80 ,$104.35 ,$21.28 ,$60.22 ,$69.77 ,$76.00 ,$69.77 ,$76.00 ,$76.00 ,$56.24 ,$76.00 ,$104.35 ,$63.38 ,$104.35 , N/A ,$62.78 ,$62.78 ,$60.80 ,$68.40 ,$76.00 ,$64.60 ,$104.35 ,$104.35 ,$64.60 ,$104.35 ,$31.62 , N/A , N/A ,$76.00 ,$64.60 ,$21.28 ,$68.40 ,$59.66 ,$62.78 ,$104.35 ,$49.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000245,89055,HC LEUKO ASSESS STOOL QN/SEMI,300,1 ,$7.00 ,$4.55 ,$1.96 ,$10.68 ,$10.68 ,$5.60 ,$4.27 ,$1.96 ,$5.55 ,$6.43 ,$4.27 ,$6.43 ,$4.27 ,$7.00 ,$5.18 ,$7.00 ,$4.27 ,$5.84 ,$4.27 , N/A ,$5.78 ,$5.78 ,$5.60 ,$6.30 ,$7.00 ,$5.95 ,$4.27 ,$4.27 ,$5.95 ,$4.27 ,$2.91 , N/A , N/A ,$4.48 ,$5.95 ,$1.96 ,$6.30 ,$5.50 ,$5.78 ,$4.27 ,$4.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30000250,89321,HC SEMEN PRESENCE/MOTILITY,300,1 ,$94.00 ,$61.10 ,$12.05 ,$94.00 ,$30.13 ,$75.20 ,$12.05 ,$26.32 ,$74.49 ,$86.29 ,$12.05 ,$86.29 ,$12.05 ,$22.90 ,$69.56 ,$30.13 ,$12.05 ,$78.40 ,$12.05 , N/A ,$77.64 ,$77.64 ,$75.20 ,$84.60 ,$30.13 ,$79.90 ,$12.05 ,$12.05 ,$79.90 ,$12.05 ,$39.10 , N/A , N/A ,$12.65 ,$79.90 ,$26.32 ,$84.60 ,$73.79 ,$77.64 ,$12.05 ,$61.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30002013,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$113.00 ,$73.45 ,$31.64 ,$260.88 ,$260.88 ,$90.40 ,$104.35 ,$31.64 ,$89.54 ,$103.73 ,$104.35 ,$103.73 ,$104.35 ,$113.00 ,$83.62 ,$113.00 ,$104.35 ,$94.24 ,$104.35 , N/A ,$93.34 ,$93.34 ,$90.40 ,$101.70 ,$113.00 ,$96.05 ,$104.35 ,$104.35 ,$96.05 ,$104.35 ,$47.01 , N/A , N/A ,$109.56 ,$96.05 ,$31.64 ,$101.70 ,$88.71 ,$93.34 ,$104.35 ,$73.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30002016,89051,HC CELL CT BODY FLUID W/DIFF T2,300,1 ,$107.00 ,$69.55 ,$5.60 ,$107.00 ,$14.00 ,$85.60 ,$5.60 ,$29.96 ,$84.79 ,$98.23 ,$5.60 ,$98.23 ,$5.60 ,$10.64 ,$79.18 ,$14.00 ,$5.60 ,$89.24 ,$5.60 , N/A ,$88.38 ,$88.38 ,$85.60 ,$96.30 ,$14.00 ,$90.95 ,$5.60 ,$5.60 ,$90.95 ,$5.60 ,$44.51 , N/A , N/A ,$5.88 ,$90.95 ,$29.96 ,$96.30 ,$84.00 ,$88.38 ,$5.60 ,$69.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30002018,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$107.00 ,$69.55 ,$7.33 ,$107.00 ,$18.33 ,$85.60 ,$7.33 ,$29.96 ,$84.79 ,$98.23 ,$7.33 ,$98.23 ,$7.33 ,$13.93 ,$79.18 ,$18.33 ,$7.33 ,$89.24 ,$7.33 , N/A ,$88.38 ,$88.38 ,$85.60 ,$96.30 ,$18.33 ,$90.95 ,$7.33 ,$7.33 ,$90.95 ,$7.33 ,$44.51 , N/A , N/A ,$7.70 ,$90.95 ,$29.96 ,$96.30 ,$84.00 ,$88.38 ,$7.33 ,$69.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30002019,89060,HC CRYSTAL ID LIGHT MICRO-90,300,1 ,$107.00 ,$69.55 ,$7.33 ,$107.00 ,$18.33 ,$85.60 ,$7.33 ,$29.96 ,$84.79 ,$98.23 ,$7.33 ,$98.23 ,$7.33 ,$13.93 ,$79.18 ,$18.33 ,$7.33 ,$89.24 ,$7.33 , N/A ,$88.38 ,$88.38 ,$85.60 ,$96.30 ,$18.33 ,$90.95 ,$7.33 ,$7.33 ,$90.95 ,$7.33 ,$44.51 , N/A , N/A ,$7.70 ,$90.95 ,$29.96 ,$96.30 ,$84.00 ,$88.38 ,$7.33 ,$69.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30002039,86999,HC TRANSFUSION UNLISTED PROCEDURE -90,300,1 ,$76.00 ,$49.40 ,$21.28 ,$76.00 ,$57.15 ,$60.80 ,$22.86 ,$21.28 ,$60.22 ,$69.77 ,$22.86 ,$69.77 ,$22.86 ,$43.43 ,$56.24 ,$57.15 ,$22.86 ,$63.38 ,$22.86 , N/A ,$62.78 ,$62.78 ,$60.80 ,$68.40 ,$57.15 ,$64.60 ,$22.86 ,$22.86 ,$64.60 ,$22.86 ,$31.62 , N/A , N/A ,$24.00 ,$64.60 ,$21.28 ,$68.40 ,$59.66 ,$62.78 ,$22.86 ,$49.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30002041,83921,HC SEMEN PRESENCE/MOTILITY,300,1 ,$94.00 ,$61.10 ,$21.21 ,$94.00 ,$53.03 ,$75.20 ,$21.21 ,$26.32 ,$74.49 ,$86.29 ,$21.21 ,$86.29 ,$21.21 ,$40.30 ,$69.56 ,$53.03 ,$21.21 ,$78.40 ,$21.21 , N/A ,$77.64 ,$77.64 ,$75.20 ,$84.60 ,$53.03 ,$79.90 ,$21.21 ,$21.21 ,$79.90 ,$21.21 ,$39.10 , N/A , N/A ,$22.27 ,$79.90 ,$26.32 ,$84.60 ,$73.79 ,$77.64 ,$21.21 ,$61.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100101,80048,HC BASIC METABOLIC PANEL,301,1 ,$236.00 ,$153.40 ,$8.46 ,$236.00 ,$21.15 ,$188.80 ,$8.46 ,$66.08 ,$187.01 ,$216.65 ,$8.46 ,$216.65 ,$8.46 ,$16.07 ,$174.64 ,$21.15 ,$8.46 ,$196.82 ,$8.46 , N/A ,$194.94 ,$194.94 ,$188.80 ,$212.40 ,$21.15 ,$200.60 ,$8.46 ,$8.46 ,$200.60 ,$8.46 ,$98.18 , N/A , N/A ,$8.88 ,$200.60 ,$66.08 ,$212.40 ,$185.26 ,$194.94 ,$8.46 ,$153.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100103,80051,HC ELECTROLYTE PANEL,301,1 ,$117.00 ,$76.05 ,$7.01 ,$117.00 ,$17.53 ,$93.60 ,$7.01 ,$32.76 ,$92.71 ,$107.41 ,$7.01 ,$107.41 ,$7.01 ,$13.32 ,$86.58 ,$17.53 ,$7.01 ,$97.58 ,$7.01 , N/A ,$96.64 ,$96.64 ,$93.60 ,$105.30 ,$17.53 ,$99.45 ,$7.01 ,$7.01 ,$99.45 ,$7.01 ,$48.67 , N/A , N/A ,$7.36 ,$99.45 ,$32.76 ,$105.30 ,$91.85 ,$96.64 ,$7.01 ,$76.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100104,80053,HC COMPREHENSIVE METABOL PANEL,301,1 ,$259.00 ,$168.35 ,$10.56 ,$259.00 ,$26.40 ,$207.20 ,$10.56 ,$72.52 ,$205.23 ,$237.76 ,$10.56 ,$237.76 ,$10.56 ,$20.06 ,$191.66 ,$26.40 ,$10.56 ,$216.01 ,$10.56 , N/A ,$213.93 ,$213.93 ,$207.20 ,$233.10 ,$26.40 ,$220.15 ,$10.56 ,$10.56 ,$220.15 ,$10.56 ,$107.74 , N/A , N/A ,$11.09 ,$220.15 ,$72.52 ,$233.10 ,$203.32 ,$213.93 ,$10.56 ,$168.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100107,80061,HC LIPID PANEL,301,1 ,$163.00 ,$105.95 ,$13.39 ,$163.00 ,$33.48 ,$130.40 ,$13.39 ,$45.64 ,$129.16 ,$149.63 ,$13.39 ,$149.63 ,$13.39 ,$25.44 ,$120.62 ,$33.48 ,$13.39 ,$135.94 ,$13.39 , N/A ,$134.64 ,$134.64 ,$130.40 ,$146.70 ,$33.48 ,$138.55 ,$13.39 ,$13.39 ,$138.55 ,$13.39 ,$67.81 , N/A , N/A ,$14.06 ,$138.55 ,$45.64 ,$146.70 ,$127.96 ,$134.64 ,$13.39 ,$105.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100108,80069,HC RENAL PANEL,301,1 ,$205.00 ,$133.25 ,$8.68 ,$205.00 ,$21.70 ,$164.00 ,$8.68 ,$57.40 ,$162.44 ,$188.19 ,$8.68 ,$188.19 ,$8.68 ,$16.49 ,$151.70 ,$21.70 ,$8.68 ,$170.97 ,$8.68 , N/A ,$169.33 ,$169.33 ,$164.00 ,$184.50 ,$21.70 ,$174.25 ,$8.68 ,$8.68 ,$174.25 ,$8.68 ,$85.28 , N/A , N/A ,$9.11 ,$174.25 ,$57.40 ,$184.50 ,$160.93 ,$169.33 ,$8.68 ,$133.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100110,80076,HC LIVER (HEPATIC) PANEL,301,1 ,$222.00 ,$144.30 ,$8.17 ,$222.00 ,$20.43 ,$177.60 ,$8.17 ,$62.16 ,$175.91 ,$203.80 ,$8.17 ,$203.80 ,$8.17 ,$15.52 ,$164.28 ,$20.43 ,$8.17 ,$185.15 ,$8.17 , N/A ,$183.37 ,$183.37 ,$177.60 ,$199.80 ,$20.43 ,$188.70 ,$8.17 ,$8.17 ,$188.70 ,$8.17 ,$92.35 , N/A , N/A ,$8.58 ,$188.70 ,$62.16 ,$199.80 ,$174.27 ,$183.37 ,$8.17 ,$144.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100116,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$246.00 ,$159.90 ,$14.57 ,$246.00 ,$36.43 ,$196.80 ,$14.57 ,$68.88 ,$194.93 ,$225.83 ,$14.57 ,$225.83 ,$14.57 ,$27.68 ,$182.04 ,$36.43 ,$14.57 ,$205.16 ,$14.57 , N/A ,$203.20 ,$203.20 ,$196.80 ,$221.40 ,$36.43 ,$209.10 ,$14.57 ,$14.57 ,$209.10 ,$14.57 ,$102.34 , N/A , N/A ,$15.30 ,$209.10 ,$68.88 ,$221.40 ,$193.11 ,$203.20 ,$14.57 ,$159.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100120,80162,HC DIGOXIN LEVELS,301,1 ,$193.00 ,$125.45 ,$13.28 ,$193.00 ,$33.20 ,$154.40 ,$13.28 ,$54.04 ,$152.93 ,$177.17 ,$13.28 ,$177.17 ,$13.28 ,$25.23 ,$142.82 ,$33.20 ,$13.28 ,$160.96 ,$13.28 , N/A ,$159.42 ,$159.42 ,$154.40 ,$173.70 ,$33.20 ,$164.05 ,$13.28 ,$13.28 ,$164.05 ,$13.28 ,$80.29 , N/A , N/A ,$13.94 ,$164.05 ,$54.04 ,$173.70 ,$151.51 ,$159.42 ,$13.28 ,$125.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100121,80164,HC VALPROIC ACID,301,1 ,$262.00 ,$170.30 ,$13.54 ,$262.00 ,$33.85 ,$209.60 ,$13.54 ,$73.36 ,$207.61 ,$240.52 ,$13.54 ,$240.52 ,$13.54 ,$25.73 ,$193.88 ,$33.85 ,$13.54 ,$218.51 ,$13.54 , N/A ,$216.41 ,$216.41 ,$209.60 ,$235.80 ,$33.85 ,$222.70 ,$13.54 ,$13.54 ,$222.70 ,$13.54 ,$108.99 , N/A , N/A ,$14.22 ,$222.70 ,$73.36 ,$235.80 ,$205.67 ,$216.41 ,$13.54 ,$170.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100124,80170,HC GENTAMICIN,301,1 ,$211.00 ,$137.15 ,$16.38 ,$211.00 ,$40.95 ,$168.80 ,$16.38 ,$59.08 ,$167.20 ,$193.70 ,$16.38 ,$193.70 ,$16.38 ,$31.12 ,$156.14 ,$40.95 ,$16.38 ,$175.97 ,$16.38 , N/A ,$174.29 ,$174.29 ,$168.80 ,$189.90 ,$40.95 ,$179.35 ,$16.38 ,$16.38 ,$179.35 ,$16.38 ,$87.78 , N/A , N/A ,$17.20 ,$179.35 ,$59.08 ,$189.90 ,$165.64 ,$174.29 ,$16.38 ,$137.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100127,80178,HC LITHIUM,301,1 ,$117.00 ,$76.05 ,$6.61 ,$117.00 ,$16.53 ,$93.60 ,$6.61 ,$32.76 ,$92.71 ,$107.41 ,$6.61 ,$107.41 ,$6.61 ,$12.56 ,$86.58 ,$16.53 ,$6.61 ,$97.58 ,$6.61 , N/A ,$96.64 ,$96.64 ,$93.60 ,$105.30 ,$16.53 ,$99.45 ,$6.61 ,$6.61 ,$99.45 ,$6.61 ,$48.67 , N/A , N/A ,$6.94 ,$99.45 ,$32.76 ,$105.30 ,$91.85 ,$96.64 ,$6.61 ,$76.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100130,80185,HC PHENYTOIN TOTAL,301,1 ,$57.00 ,$37.05 ,$13.25 ,$57.00 ,$33.13 ,$45.60 ,$13.25 ,$15.96 ,$45.17 ,$52.33 ,$13.25 ,$52.33 ,$13.25 ,$25.18 ,$42.18 ,$33.13 ,$13.25 ,$47.54 ,$13.25 , N/A ,$47.08 ,$47.08 ,$45.60 ,$51.30 ,$33.13 ,$48.45 ,$13.25 ,$13.25 ,$48.45 ,$13.25 ,$23.71 , N/A , N/A ,$13.91 ,$48.45 ,$15.96 ,$51.30 ,$44.75 ,$47.08 ,$13.25 ,$37.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100138,80198,HC THEOPHYLLINE,301,1 ,$196.00 ,$127.40 ,$14.14 ,$196.00 ,$35.35 ,$156.80 ,$14.14 ,$54.88 ,$155.31 ,$179.93 ,$14.14 ,$179.93 ,$14.14 ,$26.87 ,$145.04 ,$35.35 ,$14.14 ,$163.46 ,$14.14 , N/A ,$161.90 ,$161.90 ,$156.80 ,$176.40 ,$35.35 ,$166.60 ,$14.14 ,$14.14 ,$166.60 ,$14.14 ,$81.54 , N/A , N/A ,$14.85 ,$166.60 ,$54.88 ,$176.40 ,$153.86 ,$161.90 ,$14.14 ,$127.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100139,80200,HC TOBRAMYCIN,301,1 ,$253.00 ,$164.45 ,$16.13 ,$253.00 ,$40.33 ,$202.40 ,$16.13 ,$70.84 ,$200.48 ,$232.25 ,$16.13 ,$232.25 ,$16.13 ,$30.65 ,$187.22 ,$40.33 ,$16.13 ,$211.00 ,$16.13 , N/A ,$208.98 ,$208.98 ,$202.40 ,$227.70 ,$40.33 ,$215.05 ,$16.13 ,$16.13 ,$215.05 ,$16.13 ,$105.25 , N/A , N/A ,$16.94 ,$215.05 ,$70.84 ,$227.70 ,$198.61 ,$208.98 ,$16.13 ,$164.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100141,80202,HC VANCOMYCIN,301,1 ,$267.00 ,$173.55 ,$13.54 ,$267.00 ,$33.85 ,$213.60 ,$13.54 ,$74.76 ,$211.57 ,$245.11 ,$13.54 ,$245.11 ,$13.54 ,$25.73 ,$197.58 ,$33.85 ,$13.54 ,$222.68 ,$13.54 , N/A ,$220.54 ,$220.54 ,$213.60 ,$240.30 ,$33.85 ,$226.95 ,$13.54 ,$13.54 ,$226.95 ,$13.54 ,$111.07 , N/A , N/A ,$14.22 ,$226.95 ,$74.76 ,$240.30 ,$209.60 ,$220.54 ,$13.54 ,$173.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100157,82009,HC ACETONE SERUM,301,1 ,$62.00 ,$40.30 ,$4.52 ,$62.00 ,$11.30 ,$49.60 ,$4.52 ,$17.36 ,$49.13 ,$56.92 ,$4.52 ,$56.92 ,$4.52 ,$8.59 ,$45.88 ,$11.30 ,$4.52 ,$51.71 ,$4.52 , N/A ,$51.21 ,$51.21 ,$49.60 ,$55.80 ,$11.30 ,$52.70 ,$4.52 ,$4.52 ,$52.70 ,$4.52 ,$25.79 , N/A , N/A ,$4.75 ,$52.70 ,$17.36 ,$55.80 ,$48.67 ,$51.21 ,$4.52 ,$40.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100158,82010,HC ACETONE KETONES SERUM QN,301,1 ,$125.00 ,$81.25 ,$8.17 ,$125.00 ,$20.43 ,$100.00 ,$8.17 ,$35.00 ,$99.05 ,$114.75 ,$8.17 ,$114.75 ,$8.17 ,$15.52 ,$92.50 ,$20.43 ,$8.17 ,$104.25 ,$8.17 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$20.43 ,$106.25 ,$8.17 ,$8.17 ,$106.25 ,$8.17 ,$52.00 , N/A , N/A ,$8.58 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$8.17 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100165,82040,HC ALBUMIN SERUM,301,1 ,$99.00 ,$64.35 ,$4.95 ,$99.00 ,$12.38 ,$79.20 ,$4.95 ,$27.72 ,$78.45 ,$90.88 ,$4.95 ,$90.88 ,$4.95 ,$9.41 ,$73.26 ,$12.38 ,$4.95 ,$82.57 ,$4.95 , N/A ,$81.77 ,$81.77 ,$79.20 ,$89.10 ,$12.38 ,$84.15 ,$4.95 ,$4.95 ,$84.15 ,$4.95 ,$41.18 , N/A , N/A ,$5.20 ,$84.15 ,$27.72 ,$89.10 ,$77.72 ,$81.77 ,$4.95 ,$64.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100168,82043,HC MICROALBUMIN URINE QN,301,1 ,$29.00 ,$18.85 ,$5.78 ,$29.00 ,$14.45 ,$23.20 ,$5.78 ,$8.12 ,$22.98 ,$26.62 ,$5.78 ,$26.62 ,$5.78 ,$10.98 ,$21.46 ,$14.45 ,$5.78 ,$24.19 ,$5.78 , N/A ,$23.95 ,$23.95 ,$23.20 ,$26.10 ,$14.45 ,$24.65 ,$5.78 ,$5.78 ,$24.65 ,$5.78 ,$12.06 , N/A , N/A ,$6.07 ,$24.65 ,$8.12 ,$26.10 ,$22.77 ,$23.95 ,$5.78 ,$18.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100186,82140,HC AMMONIA,301,1 ,$115.00 ,$74.75 ,$14.57 ,$115.00 ,$36.43 ,$92.00 ,$14.57 ,$32.20 ,$91.13 ,$105.57 ,$14.57 ,$105.57 ,$14.57 ,$27.68 ,$85.10 ,$36.43 ,$14.57 ,$95.91 ,$14.57 , N/A ,$94.99 ,$94.99 ,$92.00 ,$103.50 ,$36.43 ,$97.75 ,$14.57 ,$14.57 ,$97.75 ,$14.57 ,$47.84 , N/A , N/A ,$15.30 ,$97.75 ,$32.20 ,$103.50 ,$90.28 ,$94.99 ,$14.57 ,$74.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100188,82150,HC AMYLASE,301,1 ,$175.00 ,$113.75 ,$6.48 ,$175.00 ,$16.20 ,$140.00 ,$6.48 ,$49.00 ,$138.67 ,$160.65 ,$6.48 ,$160.65 ,$6.48 ,$12.31 ,$129.50 ,$16.20 ,$6.48 ,$145.95 ,$6.48 , N/A ,$144.55 ,$144.55 ,$140.00 ,$157.50 ,$16.20 ,$148.75 ,$6.48 ,$6.48 ,$148.75 ,$6.48 ,$72.80 , N/A , N/A ,$6.80 ,$148.75 ,$49.00 ,$157.50 ,$137.38 ,$144.55 ,$6.48 ,$113.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100202,82247,HC BILIRUBIN TOTAL,301,1 ,$161.00 ,$104.65 ,$5.02 ,$161.00 ,$12.55 ,$128.80 ,$5.02 ,$45.08 ,$127.58 ,$147.80 ,$5.02 ,$147.80 ,$5.02 ,$9.54 ,$119.14 ,$12.55 ,$5.02 ,$134.27 ,$5.02 , N/A ,$132.99 ,$132.99 ,$128.80 ,$144.90 ,$12.55 ,$136.85 ,$5.02 ,$5.02 ,$136.85 ,$5.02 ,$66.98 , N/A , N/A ,$5.27 ,$136.85 ,$45.08 ,$144.90 ,$126.39 ,$132.99 ,$5.02 ,$104.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100203,82248,HC BILIRUBIN DIRECT,301,1 ,$72.00 ,$46.80 ,$5.02 ,$72.00 ,$12.55 ,$57.60 ,$5.02 ,$20.16 ,$57.05 ,$66.10 ,$5.02 ,$66.10 ,$5.02 ,$9.54 ,$53.28 ,$12.55 ,$5.02 ,$60.05 ,$5.02 , N/A ,$59.47 ,$59.47 ,$57.60 ,$64.80 ,$12.55 ,$61.20 ,$5.02 ,$5.02 ,$61.20 ,$5.02 ,$29.95 , N/A , N/A ,$5.27 ,$61.20 ,$20.16 ,$64.80 ,$56.52 ,$59.47 ,$5.02 ,$46.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100208,82274,HC OCCULT BLOOD FECAL HGB,301,1 ,$68.00 ,$44.20 ,$15.92 ,$68.00 ,$39.80 ,$54.40 ,$15.92 ,$19.04 ,$53.88 ,$62.42 ,$15.92 ,$62.42 ,$15.92 ,$30.25 ,$50.32 ,$39.80 ,$15.92 ,$56.71 ,$15.92 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$39.80 ,$57.80 ,$15.92 ,$15.92 ,$57.80 ,$15.92 ,$28.29 , N/A , N/A ,$16.72 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$15.92 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100212,82306,HC VITAMIN D 25 OH,301,1 ,$155.00 ,$100.75 ,$29.60 ,$155.00 ,$74.00 ,$124.00 ,$29.60 ,$43.40 ,$122.82 ,$142.29 ,$29.60 ,$142.29 ,$29.60 ,$56.24 ,$114.70 ,$74.00 ,$29.60 ,$129.27 ,$29.60 , N/A ,$128.03 ,$128.03 ,$124.00 ,$139.50 ,$74.00 ,$131.75 ,$29.60 ,$29.60 ,$131.75 ,$29.60 ,$64.48 , N/A , N/A ,$31.08 ,$131.75 ,$43.40 ,$139.50 ,$121.68 ,$128.03 ,$29.60 ,$100.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100214,82310,HC CALCIUM,301,1 ,$104.00 ,$67.60 ,$5.16 ,$104.00 ,$12.90 ,$83.20 ,$5.16 ,$29.12 ,$82.41 ,$95.47 ,$5.16 ,$95.47 ,$5.16 ,$9.80 ,$76.96 ,$12.90 ,$5.16 ,$86.74 ,$5.16 , N/A ,$85.90 ,$85.90 ,$83.20 ,$93.60 ,$12.90 ,$88.40 ,$5.16 ,$5.16 ,$88.40 ,$5.16 ,$43.26 , N/A , N/A ,$5.42 ,$88.40 ,$29.12 ,$93.60 ,$81.64 ,$85.90 ,$5.16 ,$67.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100215,82330,HC CALCIUM IONIZED,301,1 ,$310.00 ,$201.50 ,$13.68 ,$310.00 ,$34.20 ,$248.00 ,$13.68 ,$86.80 ,$245.64 ,$284.58 ,$13.68 ,$284.58 ,$13.68 ,$25.99 ,$229.40 ,$34.20 ,$13.68 ,$258.54 ,$13.68 , N/A ,$256.06 ,$256.06 ,$248.00 ,$279.00 ,$34.20 ,$263.50 ,$13.68 ,$13.68 ,$263.50 ,$13.68 ,$128.96 , N/A , N/A ,$14.36 ,$263.50 ,$86.80 ,$279.00 ,$243.35 ,$256.06 ,$13.68 ,$201.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100216,82340,HC CALCIUM URINE QN TIMED,301,1 ,$57.00 ,$37.05 ,$6.03 ,$57.00 ,$15.08 ,$45.60 ,$6.03 ,$15.96 ,$45.17 ,$52.33 ,$6.03 ,$52.33 ,$6.03 ,$11.46 ,$42.18 ,$15.08 ,$6.03 ,$47.54 ,$6.03 , N/A ,$47.08 ,$47.08 ,$45.60 ,$51.30 ,$15.08 ,$48.45 ,$6.03 ,$6.03 ,$48.45 ,$6.03 ,$23.71 , N/A , N/A ,$6.33 ,$48.45 ,$15.96 ,$51.30 ,$44.75 ,$47.08 ,$6.03 ,$37.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100222,82374,HC BICARBONATE,301,1 ,$148.00 ,$96.20 ,$4.88 ,$148.00 ,$12.20 ,$118.40 ,$4.88 ,$41.44 ,$117.28 ,$135.86 ,$4.88 ,$135.86 ,$4.88 ,$9.27 ,$109.52 ,$12.20 ,$4.88 ,$123.43 ,$4.88 , N/A ,$122.25 ,$122.25 ,$118.40 ,$133.20 ,$12.20 ,$125.80 ,$4.88 ,$4.88 ,$125.80 ,$4.88 ,$61.57 , N/A , N/A ,$5.12 ,$125.80 ,$41.44 ,$133.20 ,$116.18 ,$122.25 ,$4.88 ,$96.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100225,82375,HC CARBOXYHEMOGLOBIN,301,1 ,$105.00 ,$68.25 ,$12.32 ,$105.00 ,$30.80 ,$84.00 ,$12.32 ,$29.40 ,$83.20 ,$96.39 ,$12.32 ,$96.39 ,$12.32 ,$23.41 ,$77.70 ,$30.80 ,$12.32 ,$87.57 ,$12.32 , N/A ,$86.73 ,$86.73 ,$84.00 ,$94.50 ,$30.80 ,$89.25 ,$12.32 ,$12.32 ,$89.25 ,$12.32 ,$43.68 , N/A , N/A ,$12.94 ,$89.25 ,$29.40 ,$94.50 ,$82.43 ,$86.73 ,$12.32 ,$68.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100237,82435,HC CHLORIDE,301,1 ,$76.00 ,$49.40 ,$4.60 ,$76.00 ,$11.50 ,$60.80 ,$4.60 ,$21.28 ,$60.22 ,$69.77 ,$4.60 ,$69.77 ,$4.60 ,$8.74 ,$56.24 ,$11.50 ,$4.60 ,$63.38 ,$4.60 , N/A ,$62.78 ,$62.78 ,$60.80 ,$68.40 ,$11.50 ,$64.60 ,$4.60 ,$4.60 ,$64.60 ,$4.60 ,$31.62 , N/A , N/A ,$4.83 ,$64.60 ,$21.28 ,$68.40 ,$59.66 ,$62.78 ,$4.60 ,$49.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100241,82465,HC CHOLESTEROL,301,1 ,$89.00 ,$57.85 ,$4.35 ,$89.00 ,$10.88 ,$71.20 ,$4.35 ,$24.92 ,$70.52 ,$81.70 ,$4.35 ,$81.70 ,$4.35 ,$8.27 ,$65.86 ,$10.88 ,$4.35 ,$74.23 ,$4.35 , N/A ,$73.51 ,$73.51 ,$71.20 ,$80.10 ,$10.88 ,$75.65 ,$4.35 ,$4.35 ,$75.65 ,$4.35 ,$37.02 , N/A , N/A ,$4.57 ,$75.65 ,$24.92 ,$80.10 ,$69.87 ,$73.51 ,$4.35 ,$57.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100259,82550,HC CREATINE KINASE (CPK) TOTAL,301,1 ,$149.00 ,$96.85 ,$6.51 ,$149.00 ,$16.28 ,$119.20 ,$6.51 ,$41.72 ,$118.07 ,$136.78 ,$6.51 ,$136.78 ,$6.51 ,$12.37 ,$110.26 ,$16.28 ,$6.51 ,$124.27 ,$6.51 , N/A ,$123.07 ,$123.07 ,$119.20 ,$134.10 ,$16.28 ,$126.65 ,$6.51 ,$6.51 ,$126.65 ,$6.51 ,$61.98 , N/A , N/A ,$6.84 ,$126.65 ,$41.72 ,$134.10 ,$116.97 ,$123.07 ,$6.51 ,$96.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100261,82553,HC CREATINE KINASE MB FRAC,301,1 ,$247.00 ,$160.55 ,$11.55 ,$247.00 ,$28.88 ,$197.60 ,$11.55 ,$69.16 ,$195.72 ,$226.75 ,$11.55 ,$226.75 ,$11.55 ,$21.95 ,$182.78 ,$28.88 ,$11.55 ,$206.00 ,$11.55 , N/A ,$204.02 ,$204.02 ,$197.60 ,$222.30 ,$28.88 ,$209.95 ,$11.55 ,$11.55 ,$209.95 ,$11.55 ,$102.75 , N/A , N/A ,$12.13 ,$209.95 ,$69.16 ,$222.30 ,$193.90 ,$204.02 ,$11.55 ,$160.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100262,82565,HC CREATININE,301,1 ,$118.00 ,$76.70 ,$5.12 ,$118.00 ,$12.80 ,$94.40 ,$5.12 ,$33.04 ,$93.50 ,$108.32 ,$5.12 ,$108.32 ,$5.12 ,$9.73 ,$87.32 ,$12.80 ,$5.12 ,$98.41 ,$5.12 , N/A ,$97.47 ,$97.47 ,$94.40 ,$106.20 ,$12.80 ,$100.30 ,$5.12 ,$5.12 ,$100.30 ,$5.12 ,$49.09 , N/A , N/A ,$5.38 ,$100.30 ,$33.04 ,$106.20 ,$92.63 ,$97.47 ,$5.12 ,$76.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100264,82570,HC CREATININE OTH SOURCE,301,1 ,$42.00 ,$27.30 ,$5.18 ,$42.00 ,$12.95 ,$33.60 ,$5.18 ,$11.76 ,$33.28 ,$38.56 ,$5.18 ,$38.56 ,$5.18 ,$9.84 ,$31.08 ,$12.95 ,$5.18 ,$35.03 ,$5.18 , N/A ,$34.69 ,$34.69 ,$33.60 ,$37.80 ,$12.95 ,$35.70 ,$5.18 ,$5.18 ,$35.70 ,$5.18 ,$17.47 , N/A , N/A ,$5.44 ,$35.70 ,$11.76 ,$37.80 ,$32.97 ,$34.69 ,$5.18 ,$27.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100266,82575,HC CREATININE CLEARANCE,301,1 ,$251.00 ,$163.15 ,$9.46 ,$251.00 ,$23.65 ,$200.80 ,$9.46 ,$70.28 ,$198.89 ,$230.42 ,$9.46 ,$230.42 ,$9.46 ,$17.97 ,$185.74 ,$23.65 ,$9.46 ,$209.33 ,$9.46 , N/A ,$207.33 ,$207.33 ,$200.80 ,$225.90 ,$23.65 ,$213.35 ,$9.46 ,$9.46 ,$213.35 ,$9.46 ,$104.42 , N/A , N/A ,$9.93 ,$213.35 ,$70.28 ,$225.90 ,$197.04 ,$207.33 ,$9.46 ,$163.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100269,82607,HC VITAMIN B12,301,1 ,$119.00 ,$77.35 ,$15.08 ,$119.00 ,$37.70 ,$95.20 ,$15.08 ,$33.32 ,$94.30 ,$109.24 ,$15.08 ,$109.24 ,$15.08 ,$28.65 ,$88.06 ,$37.70 ,$15.08 ,$99.25 ,$15.08 , N/A ,$98.29 ,$98.29 ,$95.20 ,$107.10 ,$37.70 ,$101.15 ,$15.08 ,$15.08 ,$101.15 ,$15.08 ,$49.50 , N/A , N/A ,$15.83 ,$101.15 ,$33.32 ,$107.10 ,$93.42 ,$98.29 ,$15.08 ,$77.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100290,82728,HC FERRITIN,301,1 ,$267.00 ,$173.55 ,$13.63 ,$267.00 ,$34.08 ,$213.60 ,$13.63 ,$74.76 ,$211.57 ,$245.11 ,$13.63 ,$245.11 ,$13.63 ,$25.90 ,$197.58 ,$34.08 ,$13.63 ,$222.68 ,$13.63 , N/A ,$220.54 ,$220.54 ,$213.60 ,$240.30 ,$34.08 ,$226.95 ,$13.63 ,$13.63 ,$226.95 ,$13.63 ,$111.07 , N/A , N/A ,$14.31 ,$226.95 ,$74.76 ,$240.30 ,$209.60 ,$220.54 ,$13.63 ,$173.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100292,82746,HC FOLIC ACID SERUM,301,1 ,$116.00 ,$75.40 ,$14.70 ,$116.00 ,$36.75 ,$92.80 ,$14.70 ,$32.48 ,$91.92 ,$106.49 ,$14.70 ,$106.49 ,$14.70 ,$27.93 ,$85.84 ,$36.75 ,$14.70 ,$96.74 ,$14.70 , N/A ,$95.82 ,$95.82 ,$92.80 ,$104.40 ,$36.75 ,$98.60 ,$14.70 ,$14.70 ,$98.60 ,$14.70 ,$48.26 , N/A , N/A ,$15.44 ,$98.60 ,$32.48 ,$104.40 ,$91.06 ,$95.82 ,$14.70 ,$75.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100306,82803,HC BLOOD GAS PH PO2  AND /OR PCO2,301,1 ,$361.00 ,$234.65 ,$26.07 ,$361.00 ,$65.18 ,$288.80 ,$26.07 ,$101.08 ,$286.06 ,$331.40 ,$26.07 ,$331.40 ,$26.07 ,$49.53 ,$267.14 ,$65.18 ,$26.07 ,$301.07 ,$26.07 , N/A ,$298.19 ,$298.19 ,$288.80 ,$324.90 ,$65.18 ,$306.85 ,$26.07 ,$26.07 ,$306.85 ,$26.07 ,$150.18 , N/A , N/A ,$27.37 ,$306.85 ,$101.08 ,$324.90 ,$283.39 ,$298.19 ,$26.07 ,$234.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100307,82805,HC BLOOD GASES W/O2 SAT,301,1 ,$361.00 ,$234.65 ,$78.77 ,$361.00 ,$196.93 ,$288.80 ,$78.77 ,$101.08 ,$286.06 ,$331.40 ,$78.77 ,$331.40 ,$78.77 ,$149.66 ,$267.14 ,$196.93 ,$78.77 ,$301.07 ,$78.77 , N/A ,$298.19 ,$298.19 ,$288.80 ,$324.90 ,$196.93 ,$306.85 ,$78.77 ,$78.77 ,$306.85 ,$78.77 ,$150.18 , N/A , N/A ,$82.71 ,$306.85 ,$101.08 ,$324.90 ,$283.39 ,$298.19 ,$78.77 ,$234.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100311,82945,HC GLUCOSE BODY FLUID,301,1 ,$113.00 ,$73.45 ,$3.93 ,$113.00 ,$9.83 ,$90.40 ,$3.93 ,$31.64 ,$89.54 ,$103.73 ,$3.93 ,$103.73 ,$3.93 ,$7.47 ,$83.62 ,$9.83 ,$3.93 ,$94.24 ,$3.93 , N/A ,$93.34 ,$93.34 ,$90.40 ,$101.70 ,$9.83 ,$96.05 ,$3.93 ,$3.93 ,$96.05 ,$3.93 ,$47.01 , N/A , N/A ,$4.13 ,$96.05 ,$31.64 ,$101.70 ,$88.71 ,$93.34 ,$3.93 ,$73.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100312,82947,HC GLUCOSE,301,1 ,$68.00 ,$44.20 ,$3.93 ,$68.00 ,$9.83 ,$54.40 ,$3.93 ,$19.04 ,$53.88 ,$62.42 ,$3.93 ,$62.42 ,$3.93 ,$7.47 ,$50.32 ,$9.83 ,$3.93 ,$56.71 ,$3.93 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$9.83 ,$57.80 ,$3.93 ,$3.93 ,$57.80 ,$3.93 ,$28.29 , N/A , N/A ,$4.13 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$3.93 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100313,82950,HC GLUCOSE SCREEN,301,1 ,$89.00 ,$57.85 ,$4.75 ,$89.00 ,$11.88 ,$71.20 ,$4.75 ,$24.92 ,$70.52 ,$81.70 ,$4.75 ,$81.70 ,$4.75 ,$9.03 ,$65.86 ,$11.88 ,$4.75 ,$74.23 ,$4.75 , N/A ,$73.51 ,$73.51 ,$71.20 ,$80.10 ,$11.88 ,$75.65 ,$4.75 ,$4.75 ,$75.65 ,$4.75 ,$37.02 , N/A , N/A ,$4.99 ,$75.65 ,$24.92 ,$80.10 ,$69.87 ,$73.51 ,$4.75 ,$57.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100314,82951,HC GLUCOSE TOLERANCE,301,1 ,$209.00 ,$135.85 ,$12.87 ,$209.00 ,$32.18 ,$167.20 ,$12.87 ,$58.52 ,$165.61 ,$191.86 ,$12.87 ,$191.86 ,$12.87 ,$24.45 ,$154.66 ,$32.18 ,$12.87 ,$174.31 ,$12.87 , N/A ,$172.63 ,$172.63 ,$167.20 ,$188.10 ,$32.18 ,$177.65 ,$12.87 ,$12.87 ,$177.65 ,$12.87 ,$86.94 , N/A , N/A ,$13.51 ,$177.65 ,$58.52 ,$188.10 ,$164.07 ,$172.63 ,$12.87 ,$135.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100319,82977,HC GGT/GGTP,301,1 ,$131.00 ,$85.15 ,$7.20 ,$131.00 ,$18.00 ,$104.80 ,$7.20 ,$36.68 ,$103.80 ,$120.26 ,$7.20 ,$120.26 ,$7.20 ,$13.68 ,$96.94 ,$18.00 ,$7.20 ,$109.25 ,$7.20 , N/A ,$108.21 ,$108.21 ,$104.80 ,$117.90 ,$18.00 ,$111.35 ,$7.20 ,$7.20 ,$111.35 ,$7.20 ,$54.50 , N/A , N/A ,$7.56 ,$111.35 ,$36.68 ,$117.90 ,$102.84 ,$108.21 ,$7.20 ,$85.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100337,83036,HC GLYCOSYLATED HGB,301,1 ,$187.00 ,$121.55 ,$9.71 ,$187.00 ,$24.28 ,$149.60 ,$9.71 ,$52.36 ,$148.18 ,$171.67 ,$9.71 ,$171.67 ,$9.71 ,$18.45 ,$138.38 ,$24.28 ,$9.71 ,$155.96 ,$9.71 , N/A ,$154.46 ,$154.46 ,$149.60 ,$168.30 ,$24.28 ,$158.95 ,$9.71 ,$9.71 ,$158.95 ,$9.71 ,$77.79 , N/A , N/A ,$10.20 ,$158.95 ,$52.36 ,$168.30 ,$146.80 ,$154.46 ,$9.71 ,$121.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100338,83050,HC METHEMOGLOBIN,301,1 ,$105.00 ,$68.25 ,$8.20 ,$105.00 ,$20.50 ,$84.00 ,$8.20 ,$29.40 ,$83.20 ,$96.39 ,$8.20 ,$96.39 ,$8.20 ,$15.58 ,$77.70 ,$20.50 ,$8.20 ,$87.57 ,$8.20 , N/A ,$86.73 ,$86.73 ,$84.00 ,$94.50 ,$20.50 ,$89.25 ,$8.20 ,$8.20 ,$89.25 ,$8.20 ,$43.68 , N/A , N/A ,$8.61 ,$89.25 ,$29.40 ,$94.50 ,$82.43 ,$86.73 ,$8.20 ,$68.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100393,83540,HC IRON TOTAL,301,1 ,$118.00 ,$76.70 ,$6.47 ,$118.00 ,$16.18 ,$94.40 ,$6.47 ,$33.04 ,$93.50 ,$108.32 ,$6.47 ,$108.32 ,$6.47 ,$12.29 ,$87.32 ,$16.18 ,$6.47 ,$98.41 ,$6.47 , N/A ,$97.47 ,$97.47 ,$94.40 ,$106.20 ,$16.18 ,$100.30 ,$6.47 ,$6.47 ,$100.30 ,$6.47 ,$49.09 , N/A , N/A ,$6.79 ,$100.30 ,$33.04 ,$106.20 ,$92.63 ,$97.47 ,$6.47 ,$76.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100394,83550,HC IRON BINDING CAPACITY,301,1 ,$60.00 ,$39.00 ,$8.74 ,$60.00 ,$21.85 ,$48.00 ,$8.74 ,$16.80 ,$47.54 ,$55.08 ,$8.74 ,$55.08 ,$8.74 ,$16.61 ,$44.40 ,$21.85 ,$8.74 ,$50.04 ,$8.74 , N/A ,$49.56 ,$49.56 ,$48.00 ,$54.00 ,$21.85 ,$51.00 ,$8.74 ,$8.74 ,$51.00 ,$8.74 ,$24.96 , N/A , N/A ,$9.18 ,$51.00 ,$16.80 ,$54.00 ,$47.10 ,$49.56 ,$8.74 ,$39.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100396,83605,HC LACTATE/LACTIC ACID,301,1 ,$305.00 ,$198.25 ,$11.57 ,$305.00 ,$28.93 ,$244.00 ,$11.57 ,$85.40 ,$241.68 ,$279.99 ,$11.57 ,$279.99 ,$11.57 ,$21.98 ,$225.70 ,$28.93 ,$11.57 ,$254.37 ,$11.57 , N/A ,$251.93 ,$251.93 ,$244.00 ,$274.50 ,$28.93 ,$259.25 ,$11.57 ,$11.57 ,$259.25 ,$11.57 ,$126.88 , N/A , N/A ,$12.15 ,$259.25 ,$85.40 ,$274.50 ,$239.43 ,$251.93 ,$11.57 ,$198.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100397,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$197.00 ,$128.05 ,$6.04 ,$197.00 ,$15.10 ,$157.60 ,$6.04 ,$55.16 ,$156.10 ,$180.85 ,$6.04 ,$180.85 ,$6.04 ,$11.48 ,$145.78 ,$15.10 ,$6.04 ,$164.30 ,$6.04 , N/A ,$162.72 ,$162.72 ,$157.60 ,$177.30 ,$15.10 ,$167.45 ,$6.04 ,$6.04 ,$167.45 ,$6.04 ,$81.95 , N/A , N/A ,$6.34 ,$167.45 ,$55.16 ,$177.30 ,$154.65 ,$162.72 ,$6.04 ,$128.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100409,83690,HC LIPASE,301,1 ,$124.00 ,$80.60 ,$6.89 ,$124.00 ,$17.23 ,$99.20 ,$6.89 ,$34.72 ,$98.26 ,$113.83 ,$6.89 ,$113.83 ,$6.89 ,$13.09 ,$91.76 ,$17.23 ,$6.89 ,$103.42 ,$6.89 , N/A ,$102.42 ,$102.42 ,$99.20 ,$111.60 ,$17.23 ,$105.40 ,$6.89 ,$6.89 ,$105.40 ,$6.89 ,$51.58 , N/A , N/A ,$7.23 ,$105.40 ,$34.72 ,$111.60 ,$97.34 ,$102.42 ,$6.89 ,$80.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100415,83718,HC CHOLESTEROL HDL,301,1 ,$135.00 ,$87.75 ,$8.19 ,$135.00 ,$20.48 ,$108.00 ,$8.19 ,$37.80 ,$106.97 ,$123.93 ,$8.19 ,$123.93 ,$8.19 ,$15.56 ,$99.90 ,$20.48 ,$8.19 ,$112.59 ,$8.19 , N/A ,$111.51 ,$111.51 ,$108.00 ,$121.50 ,$20.48 ,$114.75 ,$8.19 ,$8.19 ,$114.75 ,$8.19 ,$56.16 , N/A , N/A ,$8.60 ,$114.75 ,$37.80 ,$121.50 ,$105.98 ,$111.51 ,$8.19 ,$87.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100417,83735,HC MAGNESIUM,301,1 ,$179.00 ,$116.35 ,$6.70 ,$179.00 ,$16.75 ,$143.20 ,$6.70 ,$50.12 ,$141.84 ,$164.32 ,$6.70 ,$164.32 ,$6.70 ,$12.73 ,$132.46 ,$16.75 ,$6.70 ,$149.29 ,$6.70 , N/A ,$147.85 ,$147.85 ,$143.20 ,$161.10 ,$16.75 ,$152.15 ,$6.70 ,$6.70 ,$152.15 ,$6.70 ,$74.46 , N/A , N/A ,$7.04 ,$152.15 ,$50.12 ,$161.10 ,$140.52 ,$147.85 ,$6.70 ,$116.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100438,83880,HC BNP NATRIURETIC PEPTIDE,301,1 ,$342.00 ,$222.30 ,$39.26 ,$342.00 ,$98.15 ,$273.60 ,$39.26 ,$95.76 ,$271.00 ,$313.96 ,$39.26 ,$313.96 ,$39.26 ,$74.59 ,$253.08 ,$98.15 ,$39.26 ,$285.23 ,$39.26 , N/A ,$282.49 ,$282.49 ,$273.60 ,$307.80 ,$98.15 ,$290.70 ,$39.26 ,$39.26 ,$290.70 ,$39.26 ,$142.27 , N/A , N/A ,$41.22 ,$290.70 ,$95.76 ,$307.80 ,$268.47 ,$282.49 ,$39.26 ,$222.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100679,84075,HC ALKALINE PHOSPHATASE,301,1 ,$133.00 ,$86.45 ,$5.18 ,$133.00 ,$12.95 ,$106.40 ,$5.18 ,$37.24 ,$105.39 ,$122.09 ,$5.18 ,$122.09 ,$5.18 ,$9.84 ,$98.42 ,$12.95 ,$5.18 ,$110.92 ,$5.18 , N/A ,$109.86 ,$109.86 ,$106.40 ,$119.70 ,$12.95 ,$113.05 ,$5.18 ,$5.18 ,$113.05 ,$5.18 ,$55.33 , N/A , N/A ,$5.44 ,$113.05 ,$37.24 ,$119.70 ,$104.41 ,$109.86 ,$5.18 ,$86.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100684,84100,HC PHOSPHORUS,301,1 ,$99.00 ,$64.35 ,$4.74 ,$99.00 ,$11.85 ,$79.20 ,$4.74 ,$27.72 ,$78.45 ,$90.88 ,$4.74 ,$90.88 ,$4.74 ,$9.01 ,$73.26 ,$11.85 ,$4.74 ,$82.57 ,$4.74 , N/A ,$81.77 ,$81.77 ,$79.20 ,$89.10 ,$11.85 ,$84.15 ,$4.74 ,$4.74 ,$84.15 ,$4.74 ,$41.18 , N/A , N/A ,$4.98 ,$84.15 ,$27.72 ,$89.10 ,$77.72 ,$81.77 ,$4.74 ,$64.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100691,84132,HC POTASSIUM,301,1 ,$83.00 ,$53.95 ,$4.76 ,$83.00 ,$11.90 ,$66.40 ,$4.76 ,$23.24 ,$65.77 ,$76.19 ,$4.76 ,$76.19 ,$4.76 ,$9.04 ,$61.42 ,$11.90 ,$4.76 ,$69.22 ,$4.76 , N/A ,$68.56 ,$68.56 ,$66.40 ,$74.70 ,$11.90 ,$70.55 ,$4.76 ,$4.76 ,$70.55 ,$4.76 ,$34.53 , N/A , N/A ,$5.00 ,$70.55 ,$23.24 ,$74.70 ,$65.16 ,$68.56 ,$4.76 ,$53.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100694,84133,HC POTASSIUM URINE,301,1 ,$34.00 ,$22.10 ,$4.73 ,$34.00 ,$11.83 ,$27.20 ,$4.73 ,$9.52 ,$26.94 ,$31.21 ,$4.73 ,$31.21 ,$4.73 ,$8.99 ,$25.16 ,$11.83 ,$4.73 ,$28.36 ,$4.73 , N/A ,$28.08 ,$28.08 ,$27.20 ,$30.60 ,$11.83 ,$28.90 ,$4.73 ,$4.73 ,$28.90 ,$4.73 ,$14.14 , N/A , N/A ,$4.97 ,$28.90 ,$9.52 ,$30.60 ,$26.69 ,$28.08 ,$4.73 ,$22.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100695,84134,HC PREALBUMIN,301,1 ,$160.00 ,$104.00 ,$14.59 ,$160.00 ,$36.48 ,$128.00 ,$14.59 ,$44.80 ,$126.78 ,$146.88 ,$14.59 ,$146.88 ,$14.59 ,$27.72 ,$118.40 ,$36.48 ,$14.59 ,$133.44 ,$14.59 , N/A ,$132.16 ,$132.16 ,$128.00 ,$144.00 ,$36.48 ,$136.00 ,$14.59 ,$14.59 ,$136.00 ,$14.59 ,$66.56 , N/A , N/A ,$15.32 ,$136.00 ,$44.80 ,$144.00 ,$125.60 ,$132.16 ,$14.59 ,$104.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100697,84146,HC PROLACTIN,301,1 ,$135.00 ,$87.75 ,$19.38 ,$135.00 ,$48.45 ,$108.00 ,$19.38 ,$37.80 ,$106.97 ,$123.93 ,$19.38 ,$123.93 ,$19.38 ,$36.82 ,$99.90 ,$48.45 ,$19.38 ,$112.59 ,$19.38 , N/A ,$111.51 ,$111.51 ,$108.00 ,$121.50 ,$48.45 ,$114.75 ,$19.38 ,$19.38 ,$114.75 ,$19.38 ,$56.16 , N/A , N/A ,$20.35 ,$114.75 ,$37.80 ,$121.50 ,$105.98 ,$111.51 ,$19.38 ,$87.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100698,84153,HC PSA TOTAL,301,1 ,$267.00 ,$173.55 ,$18.39 ,$267.00 ,$45.98 ,$213.60 ,$18.39 ,$74.76 ,$211.57 ,$245.11 ,$18.39 ,$245.11 ,$18.39 ,$34.94 ,$197.58 ,$45.98 ,$18.39 ,$222.68 ,$18.39 , N/A ,$220.54 ,$220.54 ,$213.60 ,$240.30 ,$45.98 ,$226.95 ,$18.39 ,$18.39 ,$226.95 ,$18.39 ,$111.07 , N/A , N/A ,$19.31 ,$226.95 ,$74.76 ,$240.30 ,$209.60 ,$220.54 ,$18.39 ,$173.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100700,84155,HC PROTEIN TOTAL,301,1 ,$83.00 ,$53.95 ,$3.67 ,$83.00 ,$9.18 ,$66.40 ,$3.67 ,$23.24 ,$65.77 ,$76.19 ,$3.67 ,$76.19 ,$3.67 ,$6.97 ,$61.42 ,$9.18 ,$3.67 ,$69.22 ,$3.67 , N/A ,$68.56 ,$68.56 ,$66.40 ,$74.70 ,$9.18 ,$70.55 ,$3.67 ,$3.67 ,$70.55 ,$3.67 ,$34.53 , N/A , N/A ,$3.85 ,$70.55 ,$23.24 ,$74.70 ,$65.16 ,$68.56 ,$3.67 ,$53.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100701,84156,HC PROTEIN TOTAL URINE,301,1 ,$20.00 ,$13.00 ,$3.67 ,$20.00 ,$9.18 ,$16.00 ,$3.67 ,$5.60 ,$15.85 ,$18.36 ,$3.67 ,$18.36 ,$3.67 ,$6.97 ,$14.80 ,$9.18 ,$3.67 ,$16.68 ,$3.67 , N/A ,$16.52 ,$16.52 ,$16.00 ,$18.00 ,$9.18 ,$17.00 ,$3.67 ,$3.67 ,$17.00 ,$3.67 ,$8.32 , N/A , N/A ,$3.85 ,$17.00 ,$5.60 ,$18.00 ,$15.70 ,$16.52 ,$3.67 ,$13.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100703,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$125.00 ,$81.25 ,$4.00 ,$125.00 ,$10.00 ,$100.00 ,$4.00 ,$35.00 ,$99.05 ,$114.75 ,$4.00 ,$114.75 ,$4.00 ,$7.60 ,$92.50 ,$10.00 ,$4.00 ,$104.25 ,$4.00 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$10.00 ,$106.25 ,$4.00 ,$4.00 ,$106.25 ,$4.00 ,$52.00 , N/A , N/A ,$4.20 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$4.00 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100721,84295,HC SODIUM,301,1 ,$78.00 ,$50.70 ,$4.81 ,$78.00 ,$12.03 ,$62.40 ,$4.81 ,$21.84 ,$61.81 ,$71.60 ,$4.81 ,$71.60 ,$4.81 ,$9.14 ,$57.72 ,$12.03 ,$4.81 ,$65.05 ,$4.81 , N/A ,$64.43 ,$64.43 ,$62.40 ,$70.20 ,$12.03 ,$66.30 ,$4.81 ,$4.81 ,$66.30 ,$4.81 ,$32.45 , N/A , N/A ,$5.05 ,$66.30 ,$21.84 ,$70.20 ,$61.23 ,$64.43 ,$4.81 ,$50.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100724,84300,HC SODIUM URINE,301,1 ,$46.00 ,$29.90 ,$5.06 ,$46.00 ,$12.65 ,$36.80 ,$5.06 ,$12.88 ,$36.45 ,$42.23 ,$5.06 ,$42.23 ,$5.06 ,$9.61 ,$34.04 ,$12.65 ,$5.06 ,$38.36 ,$5.06 , N/A ,$38.00 ,$38.00 ,$36.80 ,$41.40 ,$12.65 ,$39.10 ,$5.06 ,$5.06 ,$39.10 ,$5.06 ,$19.14 , N/A , N/A ,$5.31 ,$39.10 ,$12.88 ,$41.40 ,$36.11 ,$38.00 ,$5.06 ,$29.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100739,84436,HC THYROXINE (T-4) TOTAL,301,1 ,$110.00 ,$71.50 ,$6.87 ,$110.00 ,$17.18 ,$88.00 ,$6.87 ,$30.80 ,$87.16 ,$100.98 ,$6.87 ,$100.98 ,$6.87 ,$13.05 ,$81.40 ,$17.18 ,$6.87 ,$91.74 ,$6.87 , N/A ,$90.86 ,$90.86 ,$88.00 ,$99.00 ,$17.18 ,$93.50 ,$6.87 ,$6.87 ,$93.50 ,$6.87 ,$45.76 , N/A , N/A ,$7.21 ,$93.50 ,$30.80 ,$99.00 ,$86.35 ,$90.86 ,$6.87 ,$71.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100740,84439,HC T4 FREE,301,1 ,$95.00 ,$61.75 ,$9.02 ,$95.00 ,$22.55 ,$76.00 ,$9.02 ,$26.60 ,$75.28 ,$87.21 ,$9.02 ,$87.21 ,$9.02 ,$17.14 ,$70.30 ,$22.55 ,$9.02 ,$79.23 ,$9.02 , N/A ,$78.47 ,$78.47 ,$76.00 ,$85.50 ,$22.55 ,$80.75 ,$9.02 ,$9.02 ,$80.75 ,$9.02 ,$39.52 , N/A , N/A ,$9.47 ,$80.75 ,$26.60 ,$85.50 ,$74.58 ,$78.47 ,$9.02 ,$61.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100743,84443,HC THYROID STIMULATING HORM,301,1 ,$187.00 ,$121.55 ,$16.80 ,$187.00 ,$42.00 ,$149.60 ,$16.80 ,$52.36 ,$148.18 ,$171.67 ,$16.80 ,$171.67 ,$16.80 ,$31.92 ,$138.38 ,$42.00 ,$16.80 ,$155.96 ,$16.80 , N/A ,$154.46 ,$154.46 ,$149.60 ,$168.30 ,$42.00 ,$158.95 ,$16.80 ,$16.80 ,$158.95 ,$16.80 ,$77.79 , N/A , N/A ,$17.64 ,$158.95 ,$52.36 ,$168.30 ,$146.80 ,$154.46 ,$16.80 ,$121.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100746,84450,HC AST,301,1 ,$131.00 ,$85.15 ,$5.18 ,$131.00 ,$12.95 ,$104.80 ,$5.18 ,$36.68 ,$103.80 ,$120.26 ,$5.18 ,$120.26 ,$5.18 ,$9.84 ,$96.94 ,$12.95 ,$5.18 ,$109.25 ,$5.18 , N/A ,$108.21 ,$108.21 ,$104.80 ,$117.90 ,$12.95 ,$111.35 ,$5.18 ,$5.18 ,$111.35 ,$5.18 ,$54.50 , N/A , N/A ,$5.44 ,$111.35 ,$36.68 ,$117.90 ,$102.84 ,$108.21 ,$5.18 ,$85.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100747,84460,HC ALT,301,1 ,$125.00 ,$81.25 ,$5.30 ,$125.00 ,$13.25 ,$100.00 ,$5.30 ,$35.00 ,$99.05 ,$114.75 ,$5.30 ,$114.75 ,$5.30 ,$10.07 ,$92.50 ,$13.25 ,$5.30 ,$104.25 ,$5.30 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$13.25 ,$106.25 ,$5.30 ,$5.30 ,$106.25 ,$5.30 ,$52.00 , N/A , N/A ,$5.57 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$5.30 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100750,84478,HC TRIGLYCERIDES,301,1 ,$110.00 ,$71.50 ,$5.74 ,$110.00 ,$14.35 ,$88.00 ,$5.74 ,$30.80 ,$87.16 ,$100.98 ,$5.74 ,$100.98 ,$5.74 ,$10.91 ,$81.40 ,$14.35 ,$5.74 ,$91.74 ,$5.74 , N/A ,$90.86 ,$90.86 ,$88.00 ,$99.00 ,$14.35 ,$93.50 ,$5.74 ,$5.74 ,$93.50 ,$5.74 ,$45.76 , N/A , N/A ,$6.03 ,$93.50 ,$30.80 ,$99.00 ,$86.35 ,$90.86 ,$5.74 ,$71.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100758,84484,HC TROPONIN QN,301,1 ,$211.00 ,$137.15 ,$12.47 ,$211.00 ,$31.18 ,$168.80 ,$12.47 ,$59.08 ,$167.20 ,$193.70 ,$12.47 ,$193.70 ,$12.47 ,$23.69 ,$156.14 ,$31.18 ,$12.47 ,$175.97 ,$12.47 , N/A ,$174.29 ,$174.29 ,$168.80 ,$189.90 ,$31.18 ,$179.35 ,$12.47 ,$12.47 ,$179.35 ,$12.47 ,$87.78 , N/A , N/A ,$13.09 ,$179.35 ,$59.08 ,$189.90 ,$165.64 ,$174.29 ,$12.47 ,$137.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100761,84520,HC BUN,301,1 ,$102.00 ,$66.30 ,$3.95 ,$102.00 ,$9.88 ,$81.60 ,$3.95 ,$28.56 ,$80.82 ,$93.64 ,$3.95 ,$93.64 ,$3.95 ,$7.51 ,$75.48 ,$9.88 ,$3.95 ,$85.07 ,$3.95 , N/A ,$84.25 ,$84.25 ,$81.60 ,$91.80 ,$9.88 ,$86.70 ,$3.95 ,$3.95 ,$86.70 ,$3.95 ,$42.43 , N/A , N/A ,$4.15 ,$86.70 ,$28.56 ,$91.80 ,$80.07 ,$84.25 ,$3.95 ,$66.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100764,84540,HC UREA URINE,301,1 ,$162.00 ,$105.30 ,$5.56 ,$162.00 ,$13.90 ,$129.60 ,$5.56 ,$45.36 ,$128.37 ,$148.72 ,$5.56 ,$148.72 ,$5.56 ,$10.56 ,$119.88 ,$13.90 ,$5.56 ,$135.11 ,$5.56 , N/A ,$133.81 ,$133.81 ,$129.60 ,$145.80 ,$13.90 ,$137.70 ,$5.56 ,$5.56 ,$137.70 ,$5.56 ,$67.39 , N/A , N/A ,$5.84 ,$137.70 ,$45.36 ,$145.80 ,$127.17 ,$133.81 ,$5.56 ,$105.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100765,84550,HC URIC ACID,301,1 ,$99.00 ,$64.35 ,$4.52 ,$99.00 ,$11.30 ,$79.20 ,$4.52 ,$27.72 ,$78.45 ,$90.88 ,$4.52 ,$90.88 ,$4.52 ,$8.59 ,$73.26 ,$11.30 ,$4.52 ,$82.57 ,$4.52 , N/A ,$81.77 ,$81.77 ,$79.20 ,$89.10 ,$11.30 ,$84.15 ,$4.52 ,$4.52 ,$84.15 ,$4.52 ,$41.18 , N/A , N/A ,$4.75 ,$84.15 ,$27.72 ,$89.10 ,$77.72 ,$81.77 ,$4.52 ,$64.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100802,84702,HC HCG QN,301,1 ,$212.00 ,$137.80 ,$15.05 ,$212.00 ,$37.63 ,$169.60 ,$15.05 ,$59.36 ,$167.99 ,$194.62 ,$15.05 ,$194.62 ,$15.05 ,$28.60 ,$156.88 ,$37.63 ,$15.05 ,$176.81 ,$15.05 , N/A ,$175.11 ,$175.11 ,$169.60 ,$190.80 ,$37.63 ,$180.20 ,$15.05 ,$15.05 ,$180.20 ,$15.05 ,$88.19 , N/A , N/A ,$15.80 ,$180.20 ,$59.36 ,$190.80 ,$166.42 ,$175.11 ,$15.05 ,$137.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100808,84703,HC HCG QL,301,1 ,$140.00 ,$91.00 ,$7.52 ,$140.00 ,$18.80 ,$112.00 ,$7.52 ,$39.20 ,$110.94 ,$128.52 ,$7.52 ,$128.52 ,$7.52 ,$14.29 ,$103.60 ,$18.80 ,$7.52 ,$116.76 ,$7.52 , N/A ,$115.64 ,$115.64 ,$112.00 ,$126.00 ,$18.80 ,$119.00 ,$7.52 ,$7.52 ,$119.00 ,$7.52 ,$58.24 , N/A , N/A ,$7.90 ,$119.00 ,$39.20 ,$126.00 ,$109.90 ,$115.64 ,$7.52 ,$91.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30100845,82948,HC GLUCOSE BLOOD REAGENT STRIP,301,1 ,$15.00 ,$9.75 ,$4.20 ,$15.00 ,$12.60 ,$12.00 ,$5.04 ,$4.20 ,$11.89 ,$13.77 ,$5.04 ,$13.77 ,$5.04 ,$9.58 ,$11.10 ,$12.60 ,$5.04 ,$12.51 ,$5.04 , N/A ,$12.39 ,$12.39 ,$12.00 ,$13.50 ,$12.60 ,$12.75 ,$5.04 ,$5.04 ,$12.75 ,$5.04 ,$6.24 , N/A , N/A ,$5.29 ,$12.75 ,$4.20 ,$13.50 ,$11.78 ,$12.39 ,$5.04 ,$9.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101023,G0103,HC PSA ANNUAL SCREENING,301,1 ,$267.00 ,$173.55 ,$19.31 ,$267.00 ,$48.28 ,$213.60 ,$19.31 ,$74.76 ,$211.57 ,$245.11 ,$19.31 ,$245.11 ,$19.31 ,$36.69 ,$197.58 ,$48.28 ,$19.31 ,$222.68 ,$19.31 , N/A ,$220.54 ,$220.54 ,$213.60 ,$240.30 ,$48.28 ,$226.95 ,$19.31 ,$19.31 ,$226.95 ,$19.31 ,$111.07 , N/A , N/A ,$20.28 ,$226.95 ,$74.76 ,$240.30 ,$209.60 ,$220.54 ,$19.31 ,$173.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101087,80074,HC HEPATITIS PANEL ACUTE - 90,301,1 ,$169.00 ,$109.85 ,$47.32 ,$169.00 ,$119.08 ,$135.20 ,$47.63 ,$47.32 ,$133.92 ,$155.14 ,$47.63 ,$155.14 ,$47.63 ,$90.50 ,$125.06 ,$119.08 ,$47.63 ,$140.95 ,$47.63 , N/A ,$139.59 ,$139.59 ,$135.20 ,$152.10 ,$119.08 ,$143.65 ,$47.63 ,$47.63 ,$143.65 ,$47.63 ,$70.30 , N/A , N/A ,$50.01 ,$143.65 ,$47.32 ,$152.10 ,$132.67 ,$139.59 ,$47.63 ,$109.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101089,80150,HC AMIKACIN - 90,301,1 ,$95.00 ,$61.75 ,$15.08 ,$95.00 ,$37.70 ,$76.00 ,$15.08 ,$26.60 ,$75.28 ,$87.21 ,$15.08 ,$87.21 ,$15.08 ,$28.65 ,$70.30 ,$37.70 ,$15.08 ,$79.23 ,$15.08 , N/A ,$78.47 ,$78.47 ,$76.00 ,$85.50 ,$37.70 ,$80.75 ,$15.08 ,$15.08 ,$80.75 ,$15.08 ,$39.52 , N/A , N/A ,$15.83 ,$80.75 ,$26.60 ,$85.50 ,$74.58 ,$78.47 ,$15.08 ,$61.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101094,80158,HC CYCLOSPORINE - 90,301,1 ,$271.00 ,$176.15 ,$18.05 ,$271.00 ,$45.13 ,$216.80 ,$18.05 ,$75.88 ,$214.74 ,$248.78 ,$18.05 ,$248.78 ,$18.05 ,$34.30 ,$200.54 ,$45.13 ,$18.05 ,$226.01 ,$18.05 , N/A ,$223.85 ,$223.85 ,$216.80 ,$243.90 ,$45.13 ,$230.35 ,$18.05 ,$18.05 ,$230.35 ,$18.05 ,$112.74 , N/A , N/A ,$18.95 ,$230.35 ,$75.88 ,$243.90 ,$212.74 ,$223.85 ,$18.05 ,$176.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101095,80159,HC CLOZAPINE - 90,301,1 ,$145.00 ,$94.25 ,$20.15 ,$145.00 ,$50.38 ,$116.00 ,$20.15 ,$40.60 ,$114.90 ,$133.11 ,$20.15 ,$133.11 ,$20.15 ,$38.29 ,$107.30 ,$50.38 ,$20.15 ,$120.93 ,$20.15 , N/A ,$119.77 ,$119.77 ,$116.00 ,$130.50 ,$50.38 ,$123.25 ,$20.15 ,$20.15 ,$123.25 ,$20.15 ,$60.32 , N/A , N/A ,$21.16 ,$123.25 ,$40.60 ,$130.50 ,$113.83 ,$119.77 ,$20.15 ,$94.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101102,80171,HC GABAPENTIN PLASMA - 90,301,1 ,$208.00 ,$135.20 ,$21.67 ,$208.00 ,$54.18 ,$166.40 ,$21.67 ,$58.24 ,$164.82 ,$190.94 ,$21.67 ,$190.94 ,$21.67 ,$41.17 ,$153.92 ,$54.18 ,$21.67 ,$173.47 ,$21.67 , N/A ,$171.81 ,$171.81 ,$166.40 ,$187.20 ,$54.18 ,$176.80 ,$21.67 ,$21.67 ,$176.80 ,$21.67 ,$86.53 , N/A , N/A ,$22.75 ,$176.80 ,$58.24 ,$187.20 ,$163.28 ,$171.81 ,$21.67 ,$135.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101104,80175,HC LAMOTRIGINE - 90,301,1 ,$367.00 ,$238.55 ,$13.25 ,$367.00 ,$33.13 ,$293.60 ,$13.25 ,$102.76 ,$290.81 ,$336.91 ,$13.25 ,$336.91 ,$13.25 ,$25.18 ,$271.58 ,$33.13 ,$13.25 ,$306.08 ,$13.25 , N/A ,$303.14 ,$303.14 ,$293.60 ,$330.30 ,$33.13 ,$311.95 ,$13.25 ,$13.25 ,$311.95 ,$13.25 ,$152.67 , N/A , N/A ,$13.91 ,$311.95 ,$102.76 ,$330.30 ,$288.10 ,$303.14 ,$13.25 ,$238.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101106,80177,HC LEVETIRACETAM - 90,301,1 ,$307.00 ,$199.55 ,$13.25 ,$307.00 ,$33.13 ,$245.60 ,$13.25 ,$85.96 ,$243.27 ,$281.83 ,$13.25 ,$281.83 ,$13.25 ,$25.18 ,$227.18 ,$33.13 ,$13.25 ,$256.04 ,$13.25 , N/A ,$253.58 ,$253.58 ,$245.60 ,$276.30 ,$33.13 ,$260.95 ,$13.25 ,$13.25 ,$260.95 ,$13.25 ,$127.71 , N/A , N/A ,$13.91 ,$260.95 ,$85.96 ,$276.30 ,$241.00 ,$253.58 ,$13.25 ,$199.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101109,80183,HC OXCARBAZEPINE - 90,301,1 ,$186.00 ,$120.90 ,$13.25 ,$186.00 ,$33.13 ,$148.80 ,$13.25 ,$52.08 ,$147.39 ,$170.75 ,$13.25 ,$170.75 ,$13.25 ,$25.18 ,$137.64 ,$33.13 ,$13.25 ,$155.12 ,$13.25 , N/A ,$153.64 ,$153.64 ,$148.80 ,$167.40 ,$33.13 ,$158.10 ,$13.25 ,$13.25 ,$158.10 ,$13.25 ,$77.38 , N/A , N/A ,$13.91 ,$158.10 ,$52.08 ,$167.40 ,$146.01 ,$153.64 ,$13.25 ,$120.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101110,80184,HC PHENOBARBITAL - 90,301,1 ,$152.00 ,$98.80 ,$15.30 ,$152.00 ,$38.25 ,$121.60 ,$15.30 ,$42.56 ,$120.44 ,$139.54 ,$15.30 ,$139.54 ,$15.30 ,$29.07 ,$112.48 ,$38.25 ,$15.30 ,$126.77 ,$15.30 , N/A ,$125.55 ,$125.55 ,$121.60 ,$136.80 ,$38.25 ,$129.20 ,$15.30 ,$15.30 ,$129.20 ,$15.30 ,$63.23 , N/A , N/A ,$16.07 ,$129.20 ,$42.56 ,$136.80 ,$119.32 ,$125.55 ,$15.30 ,$98.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101114,80186,HC PHENYTOIN FREE - 90,301,1 ,$142.00 ,$92.30 ,$13.76 ,$142.00 ,$34.40 ,$113.60 ,$13.76 ,$39.76 ,$112.52 ,$130.36 ,$13.76 ,$130.36 ,$13.76 ,$26.14 ,$105.08 ,$34.40 ,$13.76 ,$118.43 ,$13.76 , N/A ,$117.29 ,$117.29 ,$113.60 ,$127.80 ,$34.40 ,$120.70 ,$13.76 ,$13.76 ,$120.70 ,$13.76 ,$59.07 , N/A , N/A ,$14.45 ,$120.70 ,$39.76 ,$127.80 ,$111.47 ,$117.29 ,$13.76 ,$92.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101115,80188,HC PRIMIDONE - 90,301,1 ,$259.00 ,$168.35 ,$16.59 ,$259.00 ,$41.48 ,$207.20 ,$16.59 ,$72.52 ,$205.23 ,$237.76 ,$16.59 ,$237.76 ,$16.59 ,$31.52 ,$191.66 ,$41.48 ,$16.59 ,$216.01 ,$16.59 , N/A ,$213.93 ,$213.93 ,$207.20 ,$233.10 ,$41.48 ,$220.15 ,$16.59 ,$16.59 ,$220.15 ,$16.59 ,$107.74 , N/A , N/A ,$17.42 ,$220.15 ,$72.52 ,$233.10 ,$203.32 ,$213.93 ,$16.59 ,$168.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101116,80192,HC PROCAINEAMIDE - 90,301,1 ,$262.00 ,$170.30 ,$16.75 ,$262.00 ,$41.88 ,$209.60 ,$16.75 ,$73.36 ,$207.61 ,$240.52 ,$16.75 ,$240.52 ,$16.75 ,$31.83 ,$193.88 ,$41.88 ,$16.75 ,$218.51 ,$16.75 , N/A ,$216.41 ,$216.41 ,$209.60 ,$235.80 ,$41.88 ,$222.70 ,$16.75 ,$16.75 ,$222.70 ,$16.75 ,$108.99 , N/A , N/A ,$17.59 ,$222.70 ,$73.36 ,$235.80 ,$205.67 ,$216.41 ,$16.75 ,$170.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101117,80194,HC QUINIDINE - 90,301,1 ,$207.00 ,$134.55 ,$14.60 ,$207.00 ,$36.50 ,$165.60 ,$14.60 ,$57.96 ,$164.03 ,$190.03 ,$14.60 ,$190.03 ,$14.60 ,$27.74 ,$153.18 ,$36.50 ,$14.60 ,$172.64 ,$14.60 , N/A ,$170.98 ,$170.98 ,$165.60 ,$186.30 ,$36.50 ,$175.95 ,$14.60 ,$14.60 ,$175.95 ,$14.60 ,$86.11 , N/A , N/A ,$15.33 ,$175.95 ,$57.96 ,$186.30 ,$162.50 ,$170.98 ,$14.60 ,$134.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101118,80195,HC RAPAMYCIN (SIROLIMUS) - 90,301,1 ,$240.00 ,$156.00 ,$13.73 ,$240.00 ,$34.33 ,$192.00 ,$13.73 ,$67.20 ,$190.18 ,$220.32 ,$13.73 ,$220.32 ,$13.73 ,$26.09 ,$177.60 ,$34.33 ,$13.73 ,$200.16 ,$13.73 , N/A ,$198.24 ,$198.24 ,$192.00 ,$216.00 ,$34.33 ,$204.00 ,$13.73 ,$13.73 ,$204.00 ,$13.73 ,$99.84 , N/A , N/A ,$14.42 ,$204.00 ,$67.20 ,$216.00 ,$188.40 ,$198.24 ,$13.73 ,$156.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101119,80197,HC TACROLIMUS - 90,301,1 ,$231.00 ,$150.15 ,$13.73 ,$231.00 ,$34.33 ,$184.80 ,$13.73 ,$64.68 ,$183.04 ,$212.06 ,$13.73 ,$212.06 ,$13.73 ,$26.09 ,$170.94 ,$34.33 ,$13.73 ,$192.65 ,$13.73 , N/A ,$190.81 ,$190.81 ,$184.80 ,$207.90 ,$34.33 ,$196.35 ,$13.73 ,$13.73 ,$196.35 ,$13.73 ,$96.10 , N/A , N/A ,$14.42 ,$196.35 ,$64.68 ,$207.90 ,$181.34 ,$190.81 ,$13.73 ,$150.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101122,80200,HC TOBRAMYCIN - 90,301,1 ,$253.00 ,$164.45 ,$16.13 ,$253.00 ,$40.33 ,$202.40 ,$16.13 ,$70.84 ,$200.48 ,$232.25 ,$16.13 ,$232.25 ,$16.13 ,$30.65 ,$187.22 ,$40.33 ,$16.13 ,$211.00 ,$16.13 , N/A ,$208.98 ,$208.98 ,$202.40 ,$227.70 ,$40.33 ,$215.05 ,$16.13 ,$16.13 ,$215.05 ,$16.13 ,$105.25 , N/A , N/A ,$16.94 ,$215.05 ,$70.84 ,$227.70 ,$198.61 ,$208.98 ,$16.13 ,$164.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101124,80201,HC TOPIRAMATE - 90,301,1 ,$244.00 ,$158.60 ,$11.92 ,$244.00 ,$29.80 ,$195.20 ,$11.92 ,$68.32 ,$193.35 ,$223.99 ,$11.92 ,$223.99 ,$11.92 ,$22.65 ,$180.56 ,$29.80 ,$11.92 ,$203.50 ,$11.92 , N/A ,$201.54 ,$201.54 ,$195.20 ,$219.60 ,$29.80 ,$207.40 ,$11.92 ,$11.92 ,$207.40 ,$11.92 ,$101.50 , N/A , N/A ,$12.52 ,$207.40 ,$68.32 ,$219.60 ,$191.54 ,$201.54 ,$11.92 ,$158.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101128,80299,HC THERAPEUTIC DRUG OTHER,301,1 ,$573.00 ,$372.45 ,$18.64 ,$573.00 ,$46.60 ,$458.40 ,$18.64 ,$160.44 ,$454.05 ,$526.01 ,$18.64 ,$526.01 ,$18.64 ,$35.42 ,$424.02 ,$46.60 ,$18.64 ,$477.88 ,$18.64 , N/A ,$473.30 ,$473.30 ,$458.40 ,$515.70 ,$46.60 ,$487.05 ,$18.64 ,$18.64 ,$487.05 ,$18.64 ,$238.37 , N/A , N/A ,$19.57 ,$487.05 ,$160.44 ,$515.70 ,$449.81 ,$473.30 ,$18.64 ,$372.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101130,80299,HC ITRACONAZOLE HPLC - 90,301,1 ,$234.00 ,$152.10 ,$18.64 ,$234.00 ,$46.60 ,$187.20 ,$18.64 ,$65.52 ,$185.42 ,$214.81 ,$18.64 ,$214.81 ,$18.64 ,$35.42 ,$173.16 ,$46.60 ,$18.64 ,$195.16 ,$18.64 , N/A ,$193.28 ,$193.28 ,$187.20 ,$210.60 ,$46.60 ,$198.90 ,$18.64 ,$18.64 ,$198.90 ,$18.64 ,$97.34 , N/A , N/A ,$19.57 ,$198.90 ,$65.52 ,$210.60 ,$183.69 ,$193.28 ,$18.64 ,$152.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101131,80299,HC THERAPEUTIC DRUG OTHER - 90,301,1 ,$234.00 ,$152.10 ,$18.64 ,$234.00 ,$46.60 ,$187.20 ,$18.64 ,$65.52 ,$185.42 ,$214.81 ,$18.64 ,$214.81 ,$18.64 ,$35.42 ,$173.16 ,$46.60 ,$18.64 ,$195.16 ,$18.64 , N/A ,$193.28 ,$193.28 ,$187.20 ,$210.60 ,$46.60 ,$198.90 ,$18.64 ,$18.64 ,$198.90 ,$18.64 ,$97.34 , N/A , N/A ,$19.57 ,$198.90 ,$65.52 ,$210.60 ,$183.69 ,$193.28 ,$18.64 ,$152.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101133,80306,HC DRUG SCREEN PRESUMPTIVE INSTRMNT ASSIST DIR OPTICAL T2,301,1 ,$150.00 ,$97.50 ,$17.14 ,$150.00 ,$42.85 ,$120.00 ,$17.14 ,$42.00 ,$118.86 ,$137.70 ,$17.14 ,$137.70 ,$17.14 ,$32.57 ,$111.00 ,$42.85 ,$17.14 ,$125.10 ,$17.14 , N/A ,$123.90 ,$123.90 ,$120.00 ,$135.00 ,$42.85 ,$127.50 ,$17.14 ,$17.14 ,$127.50 ,$17.14 ,$62.40 , N/A , N/A ,$18.00 ,$127.50 ,$42.00 ,$135.00 ,$117.75 ,$123.90 ,$17.14 ,$97.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101134,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T1,301,1 ,$237.00 ,$154.05 ,$62.14 ,$237.00 ,$155.35 ,$189.60 ,$62.14 ,$66.36 ,$187.80 ,$217.57 ,$62.14 ,$217.57 ,$62.14 ,$118.07 ,$175.38 ,$155.35 ,$62.14 ,$197.66 ,$62.14 , N/A ,$195.76 ,$195.76 ,$189.60 ,$213.30 ,$155.35 ,$201.45 ,$62.14 ,$62.14 ,$201.45 ,$62.14 ,$98.59 , N/A , N/A ,$65.25 ,$201.45 ,$66.36 ,$213.30 ,$186.05 ,$195.76 ,$62.14 ,$154.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101140,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T1-90,301,1 ,$95.00 ,$61.75 ,$26.60 ,$155.35 ,$155.35 ,$76.00 ,$62.14 ,$26.60 ,$75.28 ,$87.21 ,$62.14 ,$87.21 ,$62.14 ,$95.00 ,$70.30 ,$95.00 ,$62.14 ,$79.23 ,$62.14 , N/A ,$78.47 ,$78.47 ,$76.00 ,$85.50 ,$95.00 ,$80.75 ,$62.14 ,$62.14 ,$80.75 ,$62.14 ,$39.52 , N/A , N/A ,$65.25 ,$80.75 ,$26.60 ,$85.50 ,$74.58 ,$78.47 ,$62.14 ,$61.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101145,80320,HC ALCOHOLS - 90,301,1 ,$338.00 ,$219.70 ,$94.64 ,$338.00 , N/A ,$270.40 , N/A ,$94.64 ,$267.83 ,$310.28 , N/A ,$310.28 , N/A , N/A ,$250.12 , N/A , N/A ,$281.89 , N/A , N/A ,$279.19 ,$279.19 ,$270.40 ,$304.20 , N/A ,$287.30 , N/A , N/A ,$287.30 , N/A ,$140.61 , N/A , N/A , N/A ,$287.30 ,$94.64 ,$304.20 ,$265.33 ,$279.19 , N/A ,$219.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101146,80323,HC NICOTINE - 90,301,1 ,$220.00 ,$143.00 ,$61.60 ,$220.00 , N/A ,$176.00 , N/A ,$61.60 ,$174.33 ,$201.96 , N/A ,$201.96 , N/A , N/A ,$162.80 , N/A , N/A ,$183.48 , N/A , N/A ,$181.72 ,$181.72 ,$176.00 ,$198.00 , N/A ,$187.00 , N/A , N/A ,$187.00 , N/A ,$91.52 , N/A , N/A , N/A ,$187.00 ,$61.60 ,$198.00 ,$172.70 ,$181.72 , N/A ,$143.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101147,80323,HC NICOTINE URINE - 90,301,1 ,$233.00 ,$151.45 ,$65.24 ,$233.00 , N/A ,$186.40 , N/A ,$65.24 ,$184.63 ,$213.89 , N/A ,$213.89 , N/A , N/A ,$172.42 , N/A , N/A ,$194.32 , N/A , N/A ,$192.46 ,$192.46 ,$186.40 ,$209.70 , N/A ,$198.05 , N/A , N/A ,$198.05 , N/A ,$96.93 , N/A , N/A , N/A ,$198.05 ,$65.24 ,$209.70 ,$182.91 ,$192.46 , N/A ,$151.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101150,80346,HC BENZODIAZEPINES 1-12  -90,301,1 ,$119.00 ,$77.35 ,$33.32 ,$119.00 , N/A ,$95.20 , N/A ,$33.32 ,$94.30 ,$109.24 , N/A ,$109.24 , N/A , N/A ,$88.06 , N/A , N/A ,$99.25 , N/A , N/A ,$98.29 ,$98.29 ,$95.20 ,$107.10 , N/A ,$101.15 , N/A , N/A ,$101.15 , N/A ,$49.50 , N/A , N/A , N/A ,$101.15 ,$33.32 ,$107.10 ,$93.42 ,$98.29 , N/A ,$77.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101151,80349,HC CANNABINOIDS NATURAL -90,301,1 ,$265.00 ,$172.25 ,$74.20 ,$265.00 , N/A ,$212.00 , N/A ,$74.20 ,$209.99 ,$243.27 , N/A ,$243.27 , N/A , N/A ,$196.10 , N/A , N/A ,$221.01 , N/A , N/A ,$218.89 ,$218.89 ,$212.00 ,$238.50 , N/A ,$225.25 , N/A , N/A ,$225.25 , N/A ,$110.24 , N/A , N/A , N/A ,$225.25 ,$74.20 ,$238.50 ,$208.03 ,$218.89 , N/A ,$172.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101154,80361,HC OPIATES 1 OR MORE -90,301,1 ,$59.00 ,$38.35 ,$16.52 ,$59.00 , N/A ,$47.20 , N/A ,$16.52 ,$46.75 ,$54.16 , N/A ,$54.16 , N/A , N/A ,$43.66 , N/A , N/A ,$49.21 , N/A , N/A ,$48.73 ,$48.73 ,$47.20 ,$53.10 , N/A ,$50.15 , N/A , N/A ,$50.15 , N/A ,$24.54 , N/A , N/A , N/A ,$50.15 ,$16.52 ,$53.10 ,$46.32 ,$48.73 , N/A ,$38.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101157,82017,HC ACYLCARNITINES QN EA SPEC-90,301,1 ,$317.00 ,$206.05 ,$16.87 ,$317.00 ,$42.18 ,$253.60 ,$16.87 ,$88.76 ,$251.19 ,$291.01 ,$16.87 ,$291.01 ,$16.87 ,$32.05 ,$234.58 ,$42.18 ,$16.87 ,$264.38 ,$16.87 , N/A ,$261.84 ,$261.84 ,$253.60 ,$285.30 ,$42.18 ,$269.45 ,$16.87 ,$16.87 ,$269.45 ,$16.87 ,$131.87 , N/A , N/A ,$17.71 ,$269.45 ,$88.76 ,$285.30 ,$248.85 ,$261.84 ,$16.87 ,$206.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101158,82024,HC ACTH -90,301,1 ,$228.00 ,$148.20 ,$38.62 ,$228.00 ,$96.55 ,$182.40 ,$38.62 ,$63.84 ,$180.67 ,$209.30 ,$38.62 ,$209.30 ,$38.62 ,$73.38 ,$168.72 ,$96.55 ,$38.62 ,$190.15 ,$38.62 , N/A ,$188.33 ,$188.33 ,$182.40 ,$205.20 ,$96.55 ,$193.80 ,$38.62 ,$38.62 ,$193.80 ,$38.62 ,$94.85 , N/A , N/A ,$40.55 ,$193.80 ,$63.84 ,$205.20 ,$178.98 ,$188.33 ,$38.62 ,$148.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101159,82040,HC ALBUMIN-90,301,1 ,$99.00 ,$64.35 ,$4.95 ,$99.00 ,$12.38 ,$79.20 ,$4.95 ,$27.72 ,$78.45 ,$90.88 ,$4.95 ,$90.88 ,$4.95 ,$9.41 ,$73.26 ,$12.38 ,$4.95 ,$82.57 ,$4.95 , N/A ,$81.77 ,$81.77 ,$79.20 ,$89.10 ,$12.38 ,$84.15 ,$4.95 ,$4.95 ,$84.15 ,$4.95 ,$41.18 , N/A , N/A ,$5.20 ,$84.15 ,$27.72 ,$89.10 ,$77.72 ,$81.77 ,$4.95 ,$64.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101160,82042,HC ALBUMIN OTHER SOURCE-90,301,1 ,$162.00 ,$105.30 ,$7.78 ,$162.00 ,$19.45 ,$129.60 ,$7.78 ,$45.36 ,$128.37 ,$148.72 ,$7.78 ,$148.72 ,$7.78 ,$14.78 ,$119.88 ,$19.45 ,$7.78 ,$135.11 ,$7.78 , N/A ,$133.81 ,$133.81 ,$129.60 ,$145.80 ,$19.45 ,$137.70 ,$7.78 ,$7.78 ,$137.70 ,$7.78 ,$67.39 , N/A , N/A ,$8.17 ,$137.70 ,$45.36 ,$145.80 ,$127.17 ,$133.81 ,$7.78 ,$105.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101162,82085,HC ALDOLASE-90,301,1 ,$158.00 ,$102.70 ,$9.71 ,$158.00 ,$24.28 ,$126.40 ,$9.71 ,$44.24 ,$125.20 ,$145.04 ,$9.71 ,$145.04 ,$9.71 ,$18.45 ,$116.92 ,$24.28 ,$9.71 ,$131.77 ,$9.71 , N/A ,$130.51 ,$130.51 ,$126.40 ,$142.20 ,$24.28 ,$134.30 ,$9.71 ,$9.71 ,$134.30 ,$9.71 ,$65.73 , N/A , N/A ,$10.20 ,$134.30 ,$44.24 ,$142.20 ,$124.03 ,$130.51 ,$9.71 ,$102.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101163,82088,HC ALDOSTERONE-90,301,1 ,$184.00 ,$119.60 ,$40.75 ,$184.00 ,$101.88 ,$147.20 ,$40.75 ,$51.52 ,$145.80 ,$168.91 ,$40.75 ,$168.91 ,$40.75 ,$77.43 ,$136.16 ,$101.88 ,$40.75 ,$153.46 ,$40.75 , N/A ,$151.98 ,$151.98 ,$147.20 ,$165.60 ,$101.88 ,$156.40 ,$40.75 ,$40.75 ,$156.40 ,$40.75 ,$76.54 , N/A , N/A ,$42.79 ,$156.40 ,$51.52 ,$165.60 ,$144.44 ,$151.98 ,$40.75 ,$119.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101164,82103,HC ALPHA-1 ANTITRYPSIN TOTAL-90,301,1 ,$267.00 ,$173.55 ,$13.44 ,$267.00 ,$33.60 ,$213.60 ,$13.44 ,$74.76 ,$211.57 ,$245.11 ,$13.44 ,$245.11 ,$13.44 ,$25.54 ,$197.58 ,$33.60 ,$13.44 ,$222.68 ,$13.44 , N/A ,$220.54 ,$220.54 ,$213.60 ,$240.30 ,$33.60 ,$226.95 ,$13.44 ,$13.44 ,$226.95 ,$13.44 ,$111.07 , N/A , N/A ,$14.11 ,$226.95 ,$74.76 ,$240.30 ,$209.60 ,$220.54 ,$13.44 ,$173.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101165,82104,HC ALPHA-1 ANTITRYPSIN PHENO-90,301,1 ,$96.00 ,$62.40 ,$14.46 ,$96.00 ,$36.15 ,$76.80 ,$14.46 ,$26.88 ,$76.07 ,$88.13 ,$14.46 ,$88.13 ,$14.46 ,$27.47 ,$71.04 ,$36.15 ,$14.46 ,$80.06 ,$14.46 , N/A ,$79.30 ,$79.30 ,$76.80 ,$86.40 ,$36.15 ,$81.60 ,$14.46 ,$14.46 ,$81.60 ,$14.46 ,$39.94 , N/A , N/A ,$15.18 ,$81.60 ,$26.88 ,$86.40 ,$75.36 ,$79.30 ,$14.46 ,$62.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101166,82105,HC ALPHA FETOPROTEIN SERUM-90,301,1 ,$291.00 ,$189.15 ,$16.77 ,$291.00 ,$41.93 ,$232.80 ,$16.77 ,$81.48 ,$230.59 ,$267.14 ,$16.77 ,$267.14 ,$16.77 ,$31.86 ,$215.34 ,$41.93 ,$16.77 ,$242.69 ,$16.77 , N/A ,$240.37 ,$240.37 ,$232.80 ,$261.90 ,$41.93 ,$247.35 ,$16.77 ,$16.77 ,$247.35 ,$16.77 ,$121.06 , N/A , N/A ,$17.61 ,$247.35 ,$81.48 ,$261.90 ,$228.44 ,$240.37 ,$16.77 ,$189.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101169,82108,HC ALUMINUM-90,301,1 ,$217.00 ,$141.05 ,$25.48 ,$217.00 ,$63.70 ,$173.60 ,$25.48 ,$60.76 ,$171.95 ,$199.21 ,$25.48 ,$199.21 ,$25.48 ,$48.41 ,$160.58 ,$63.70 ,$25.48 ,$180.98 ,$25.48 , N/A ,$179.24 ,$179.24 ,$173.60 ,$195.30 ,$63.70 ,$184.45 ,$25.48 ,$25.48 ,$184.45 ,$25.48 ,$90.27 , N/A , N/A ,$26.75 ,$184.45 ,$60.76 ,$195.30 ,$170.35 ,$179.24 ,$25.48 ,$141.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101172,82131,HC AMINO ACID QN SINGLE-90,301,1 ,$654.00 ,$425.10 ,$22.98 ,$654.00 ,$57.45 ,$523.20 ,$22.98 ,$183.12 ,$518.23 ,$600.37 ,$22.98 ,$600.37 ,$22.98 ,$43.66 ,$483.96 ,$57.45 ,$22.98 ,$545.44 ,$22.98 , N/A ,$540.20 ,$540.20 ,$523.20 ,$588.60 ,$57.45 ,$555.90 ,$22.98 ,$22.98 ,$555.90 ,$22.98 ,$272.06 , N/A , N/A ,$24.13 ,$555.90 ,$183.12 ,$588.60 ,$513.39 ,$540.20 ,$22.98 ,$425.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101175,82139,HC AMINO ACIDS 6+ QN CSF-90,301,1 ,$455.00 ,$295.75 ,$16.87 ,$455.00 ,$42.18 ,$364.00 ,$16.87 ,$127.40 ,$360.54 ,$417.69 ,$16.87 ,$417.69 ,$16.87 ,$32.05 ,$336.70 ,$42.18 ,$16.87 ,$379.47 ,$16.87 , N/A ,$375.83 ,$375.83 ,$364.00 ,$409.50 ,$42.18 ,$386.75 ,$16.87 ,$16.87 ,$386.75 ,$16.87 ,$189.28 , N/A , N/A ,$17.71 ,$386.75 ,$127.40 ,$409.50 ,$357.18 ,$375.83 ,$16.87 ,$295.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101178,82157,HC ANDROSTENEDIONE-90,301,1 ,$309.00 ,$200.85 ,$29.28 ,$309.00 ,$73.20 ,$247.20 ,$29.28 ,$86.52 ,$244.85 ,$283.66 ,$29.28 ,$283.66 ,$29.28 ,$55.63 ,$228.66 ,$73.20 ,$29.28 ,$257.71 ,$29.28 , N/A ,$255.23 ,$255.23 ,$247.20 ,$278.10 ,$73.20 ,$262.65 ,$29.28 ,$29.28 ,$262.65 ,$29.28 ,$128.54 , N/A , N/A ,$30.74 ,$262.65 ,$86.52 ,$278.10 ,$242.57 ,$255.23 ,$29.28 ,$200.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101179,82164,HC ANGIOTENSIN 1 ENZYME (ACE)-90,301,1 ,$232.00 ,$150.80 ,$14.60 ,$232.00 ,$36.50 ,$185.60 ,$14.60 ,$64.96 ,$183.84 ,$212.98 ,$14.60 ,$212.98 ,$14.60 ,$27.74 ,$171.68 ,$36.50 ,$14.60 ,$193.49 ,$14.60 , N/A ,$191.63 ,$191.63 ,$185.60 ,$208.80 ,$36.50 ,$197.20 ,$14.60 ,$14.60 ,$197.20 ,$14.60 ,$96.51 , N/A , N/A ,$15.33 ,$197.20 ,$64.96 ,$208.80 ,$182.12 ,$191.63 ,$14.60 ,$150.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101180,82172,HC APOLIPOPROTEIN SERUM-90,301,1 ,$200.00 ,$130.00 ,$21.09 ,$200.00 ,$52.73 ,$160.00 ,$21.09 ,$56.00 ,$158.48 ,$183.60 ,$21.09 ,$183.60 ,$21.09 ,$40.07 ,$148.00 ,$52.73 ,$21.09 ,$166.80 ,$21.09 , N/A ,$165.20 ,$165.20 ,$160.00 ,$180.00 ,$52.73 ,$170.00 ,$21.09 ,$21.09 ,$170.00 ,$21.09 ,$83.20 , N/A , N/A ,$22.14 ,$170.00 ,$56.00 ,$180.00 ,$157.00 ,$165.20 ,$21.09 ,$130.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101181,82175,HC ARSENIC-90,301,1 ,$392.00 ,$254.80 ,$18.97 ,$392.00 ,$47.43 ,$313.60 ,$18.97 ,$109.76 ,$310.62 ,$359.86 ,$18.97 ,$359.86 ,$18.97 ,$36.04 ,$290.08 ,$47.43 ,$18.97 ,$326.93 ,$18.97 , N/A ,$323.79 ,$323.79 ,$313.60 ,$352.80 ,$47.43 ,$333.20 ,$18.97 ,$18.97 ,$333.20 ,$18.97 ,$163.07 , N/A , N/A ,$19.92 ,$333.20 ,$109.76 ,$352.80 ,$307.72 ,$323.79 ,$18.97 ,$254.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101182,82180,HC VITAMIN C (ASCORBIC ACID)-90,301,1 ,$108.00 ,$70.20 ,$9.89 ,$108.00 ,$24.73 ,$86.40 ,$9.89 ,$30.24 ,$85.58 ,$99.14 ,$9.89 ,$99.14 ,$9.89 ,$18.79 ,$79.92 ,$24.73 ,$9.89 ,$90.07 ,$9.89 , N/A ,$89.21 ,$89.21 ,$86.40 ,$97.20 ,$24.73 ,$91.80 ,$9.89 ,$9.89 ,$91.80 ,$9.89 ,$44.93 , N/A , N/A ,$10.38 ,$91.80 ,$30.24 ,$97.20 ,$84.78 ,$89.21 ,$9.89 ,$70.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101184,82232,HC BETA 2 MICROGLOBULIN-90,301,1 ,$187.00 ,$121.55 ,$16.18 ,$187.00 ,$40.45 ,$149.60 ,$16.18 ,$52.36 ,$148.18 ,$171.67 ,$16.18 ,$171.67 ,$16.18 ,$30.74 ,$138.38 ,$40.45 ,$16.18 ,$155.96 ,$16.18 , N/A ,$154.46 ,$154.46 ,$149.60 ,$168.30 ,$40.45 ,$158.95 ,$16.18 ,$16.18 ,$158.95 ,$16.18 ,$77.79 , N/A , N/A ,$16.99 ,$158.95 ,$52.36 ,$168.30 ,$146.80 ,$154.46 ,$16.18 ,$121.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101185,82239,HC BILE ACID TOTAL-90,301,1 ,$158.00 ,$102.70 ,$17.12 ,$158.00 ,$42.80 ,$126.40 ,$17.12 ,$44.24 ,$125.20 ,$145.04 ,$17.12 ,$145.04 ,$17.12 ,$32.53 ,$116.92 ,$42.80 ,$17.12 ,$131.77 ,$17.12 , N/A ,$130.51 ,$130.51 ,$126.40 ,$142.20 ,$42.80 ,$134.30 ,$17.12 ,$17.12 ,$134.30 ,$17.12 ,$65.73 , N/A , N/A ,$17.98 ,$134.30 ,$44.24 ,$142.20 ,$124.03 ,$130.51 ,$17.12 ,$102.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101186,82247,HC BILIRUBIN TOTAL-90,301,1 ,$89.00 ,$57.85 ,$5.02 ,$89.00 ,$12.55 ,$71.20 ,$5.02 ,$24.92 ,$70.52 ,$81.70 ,$5.02 ,$81.70 ,$5.02 ,$9.54 ,$65.86 ,$12.55 ,$5.02 ,$74.23 ,$5.02 , N/A ,$73.51 ,$73.51 ,$71.20 ,$80.10 ,$12.55 ,$75.65 ,$5.02 ,$5.02 ,$75.65 ,$5.02 ,$37.02 , N/A , N/A ,$5.27 ,$75.65 ,$24.92 ,$80.10 ,$69.87 ,$73.51 ,$5.02 ,$57.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101188,82270,HC OCCULT BLOOD FECAL SCRN,301,1 ,$60.00 ,$39.00 ,$4.38 ,$60.00 ,$10.95 ,$48.00 ,$4.38 ,$16.80 ,$47.54 ,$55.08 ,$4.38 ,$55.08 ,$4.38 ,$8.32 ,$44.40 ,$10.95 ,$4.38 ,$50.04 ,$4.38 , N/A ,$49.56 ,$49.56 ,$48.00 ,$54.00 ,$10.95 ,$51.00 ,$4.38 ,$4.38 ,$51.00 ,$4.38 ,$24.96 , N/A , N/A ,$4.60 ,$51.00 ,$16.80 ,$54.00 ,$47.10 ,$49.56 ,$4.38 ,$39.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101191,82271,HC OCCULT BLOOD GASTRIC,301,1 ,$57.00 ,$37.05 ,$5.32 ,$57.00 ,$13.30 ,$45.60 ,$5.32 ,$15.96 ,$45.17 ,$52.33 ,$5.32 ,$52.33 ,$5.32 ,$10.11 ,$42.18 ,$13.30 ,$5.32 ,$47.54 ,$5.32 , N/A ,$47.08 ,$47.08 ,$45.60 ,$51.30 ,$13.30 ,$48.45 ,$5.32 ,$5.32 ,$48.45 ,$5.32 ,$23.71 , N/A , N/A ,$5.59 ,$48.45 ,$15.96 ,$51.30 ,$44.75 ,$47.08 ,$5.32 ,$37.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101196,82300,HC CADMIUM-90,301,1 ,$110.00 ,$71.50 ,$23.64 ,$110.00 ,$59.10 ,$88.00 ,$23.64 ,$30.80 ,$87.16 ,$100.98 ,$23.64 ,$100.98 ,$23.64 ,$44.92 ,$81.40 ,$59.10 ,$23.64 ,$91.74 ,$23.64 , N/A ,$90.86 ,$90.86 ,$88.00 ,$99.00 ,$59.10 ,$93.50 ,$23.64 ,$23.64 ,$93.50 ,$23.64 ,$45.76 , N/A , N/A ,$24.82 ,$93.50 ,$30.80 ,$99.00 ,$86.35 ,$90.86 ,$23.64 ,$71.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101199,82308,HC CALCITONIN-90,301,1 ,$167.00 ,$108.55 ,$26.79 ,$167.00 ,$66.98 ,$133.60 ,$26.79 ,$46.76 ,$132.33 ,$153.31 ,$26.79 ,$153.31 ,$26.79 ,$50.90 ,$123.58 ,$66.98 ,$26.79 ,$139.28 ,$26.79 , N/A ,$137.94 ,$137.94 ,$133.60 ,$150.30 ,$66.98 ,$141.95 ,$26.79 ,$26.79 ,$141.95 ,$26.79 ,$69.47 , N/A , N/A ,$28.13 ,$141.95 ,$46.76 ,$150.30 ,$131.10 ,$137.94 ,$26.79 ,$108.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101204,82360,HC CALCULUS ANALYSIS QN-90,301,1 ,$170.00 ,$110.50 ,$12.87 ,$170.00 ,$32.18 ,$136.00 ,$12.87 ,$47.60 ,$134.71 ,$156.06 ,$12.87 ,$156.06 ,$12.87 ,$24.45 ,$125.80 ,$32.18 ,$12.87 ,$141.78 ,$12.87 , N/A ,$140.42 ,$140.42 ,$136.00 ,$153.00 ,$32.18 ,$144.50 ,$12.87 ,$12.87 ,$144.50 ,$12.87 ,$70.72 , N/A , N/A ,$13.51 ,$144.50 ,$47.60 ,$153.00 ,$133.45 ,$140.42 ,$12.87 ,$110.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101205,82365,HC CALCULUS ANLYS INFRARED-90,301,1 ,$155.00 ,$100.75 ,$12.90 ,$155.00 ,$32.25 ,$124.00 ,$12.90 ,$43.40 ,$122.82 ,$142.29 ,$12.90 ,$142.29 ,$12.90 ,$24.51 ,$114.70 ,$32.25 ,$12.90 ,$129.27 ,$12.90 , N/A ,$128.03 ,$128.03 ,$124.00 ,$139.50 ,$32.25 ,$131.75 ,$12.90 ,$12.90 ,$131.75 ,$12.90 ,$64.48 , N/A , N/A ,$13.55 ,$131.75 ,$43.40 ,$139.50 ,$121.68 ,$128.03 ,$12.90 ,$100.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101208,82378,HC CARBINOEMBRYONIC AG (CEA)-90,301,1 ,$170.00 ,$110.50 ,$18.96 ,$170.00 ,$47.40 ,$136.00 ,$18.96 ,$47.60 ,$134.71 ,$156.06 ,$18.96 ,$156.06 ,$18.96 ,$36.02 ,$125.80 ,$47.40 ,$18.96 ,$141.78 ,$18.96 , N/A ,$140.42 ,$140.42 ,$136.00 ,$153.00 ,$47.40 ,$144.50 ,$18.96 ,$18.96 ,$144.50 ,$18.96 ,$70.72 , N/A , N/A ,$19.91 ,$144.50 ,$47.60 ,$153.00 ,$133.45 ,$140.42 ,$18.96 ,$110.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101209,82379,HC CARNITINE TOTAL AND FREE QN-90,301,1 ,$308.00 ,$200.20 ,$16.87 ,$308.00 ,$42.18 ,$246.40 ,$16.87 ,$86.24 ,$244.06 ,$282.74 ,$16.87 ,$282.74 ,$16.87 ,$32.05 ,$227.92 ,$42.18 ,$16.87 ,$256.87 ,$16.87 , N/A ,$254.41 ,$254.41 ,$246.40 ,$277.20 ,$42.18 ,$261.80 ,$16.87 ,$16.87 ,$261.80 ,$16.87 ,$128.13 , N/A , N/A ,$17.71 ,$261.80 ,$86.24 ,$277.20 ,$241.78 ,$254.41 ,$16.87 ,$200.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101210,82380,HC CAROTENE-90,301,1 ,$170.00 ,$110.50 ,$9.22 ,$170.00 ,$23.05 ,$136.00 ,$9.22 ,$47.60 ,$134.71 ,$156.06 ,$9.22 ,$156.06 ,$9.22 ,$17.52 ,$125.80 ,$23.05 ,$9.22 ,$141.78 ,$9.22 , N/A ,$140.42 ,$140.42 ,$136.00 ,$153.00 ,$23.05 ,$144.50 ,$9.22 ,$9.22 ,$144.50 ,$9.22 ,$70.72 , N/A , N/A ,$9.68 ,$144.50 ,$47.60 ,$153.00 ,$133.45 ,$140.42 ,$9.22 ,$110.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101211,82384,HC CATECHOLAMINE FRACTION-90,301,1 ,$338.00 ,$219.70 ,$25.25 ,$338.00 ,$63.13 ,$270.40 ,$25.25 ,$94.64 ,$267.83 ,$310.28 ,$25.25 ,$310.28 ,$25.25 ,$47.98 ,$250.12 ,$63.13 ,$25.25 ,$281.89 ,$25.25 , N/A ,$279.19 ,$279.19 ,$270.40 ,$304.20 ,$63.13 ,$287.30 ,$25.25 ,$25.25 ,$287.30 ,$25.25 ,$140.61 , N/A , N/A ,$26.51 ,$287.30 ,$94.64 ,$304.20 ,$265.33 ,$279.19 ,$25.25 ,$219.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101212,82390,HC CERULOPLASMIN-90,301,1 ,$178.00 ,$115.70 ,$10.74 ,$178.00 ,$26.85 ,$142.40 ,$10.74 ,$49.84 ,$141.05 ,$163.40 ,$10.74 ,$163.40 ,$10.74 ,$20.41 ,$131.72 ,$26.85 ,$10.74 ,$148.45 ,$10.74 , N/A ,$147.03 ,$147.03 ,$142.40 ,$160.20 ,$26.85 ,$151.30 ,$10.74 ,$10.74 ,$151.30 ,$10.74 ,$74.05 , N/A , N/A ,$11.28 ,$151.30 ,$49.84 ,$160.20 ,$139.73 ,$147.03 ,$10.74 ,$115.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101215,82438,HC CHLORIDE OTHER SOURCE-90,301,1 ,"$1,143.00 ",$742.95 ,$5.00 ,"$1,143.00 ",$12.50 ,$914.40 ,$5.00 ,$320.04 ,$905.71 ,"$1,049.27 ",$5.00 ,"$1,049.27 ",$5.00 ,$9.50 ,$845.82 ,$12.50 ,$5.00 ,$953.26 ,$5.00 , N/A ,$944.12 ,$944.12 ,$914.40 ,"$1,028.70 ",$12.50 ,$971.55 ,$5.00 ,$5.00 ,$971.55 ,$5.00 ,$475.49 , N/A , N/A ,$5.25 ,$971.55 ,$320.04 ,"$1,028.70 ",$897.26 ,$944.12 ,$5.00 ,$742.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101216,82480,HC CHOLINESTERASE PSEUDO-90,301,1 ,$101.00 ,$65.65 ,$7.87 ,$101.00 ,$19.68 ,$80.80 ,$7.87 ,$28.28 ,$80.03 ,$92.72 ,$7.87 ,$92.72 ,$7.87 ,$14.95 ,$74.74 ,$19.68 ,$7.87 ,$84.23 ,$7.87 , N/A ,$83.43 ,$83.43 ,$80.80 ,$90.90 ,$19.68 ,$85.85 ,$7.87 ,$7.87 ,$85.85 ,$7.87 ,$42.02 , N/A , N/A ,$8.26 ,$85.85 ,$28.28 ,$90.90 ,$79.29 ,$83.43 ,$7.87 ,$65.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101218,82495,HC CHROMIUM SERUM-90,301,1 ,$104.00 ,$67.60 ,$20.28 ,$104.00 ,$50.70 ,$83.20 ,$20.28 ,$29.12 ,$82.41 ,$95.47 ,$20.28 ,$95.47 ,$20.28 ,$38.53 ,$76.96 ,$50.70 ,$20.28 ,$86.74 ,$20.28 , N/A ,$85.90 ,$85.90 ,$83.20 ,$93.60 ,$50.70 ,$88.40 ,$20.28 ,$20.28 ,$88.40 ,$20.28 ,$43.26 , N/A , N/A ,$21.29 ,$88.40 ,$29.12 ,$93.60 ,$81.64 ,$85.90 ,$20.28 ,$67.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101219,82507,HC CITRATE-90,301,1 ,$120.00 ,$78.00 ,$27.80 ,$120.00 ,$69.50 ,$96.00 ,$27.80 ,$33.60 ,$95.09 ,$110.16 ,$27.80 ,$110.16 ,$27.80 ,$52.82 ,$88.80 ,$69.50 ,$27.80 ,$100.08 ,$27.80 , N/A ,$99.12 ,$99.12 ,$96.00 ,$108.00 ,$69.50 ,$102.00 ,$27.80 ,$27.80 ,$102.00 ,$27.80 ,$49.92 , N/A , N/A ,$29.19 ,$102.00 ,$33.60 ,$108.00 ,$94.20 ,$99.12 ,$27.80 ,$78.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101220,82523,HC COLLAGEN CROSS LINKS ANY METHOD-90,301,1 ,$103.00 ,$66.95 ,$18.68 ,$103.00 ,$46.70 ,$82.40 ,$18.68 ,$28.84 ,$81.62 ,$94.55 ,$18.68 ,$94.55 ,$18.68 ,$35.49 ,$76.22 ,$46.70 ,$18.68 ,$85.90 ,$18.68 , N/A ,$85.08 ,$85.08 ,$82.40 ,$92.70 ,$46.70 ,$87.55 ,$18.68 ,$18.68 ,$87.55 ,$18.68 ,$42.85 , N/A , N/A ,$19.61 ,$87.55 ,$28.84 ,$92.70 ,$80.86 ,$85.08 ,$18.68 ,$66.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101221,82525,HC COPPER-90,301,1 ,$203.00 ,$131.95 ,$12.41 ,$203.00 ,$31.03 ,$162.40 ,$12.41 ,$56.84 ,$160.86 ,$186.35 ,$12.41 ,$186.35 ,$12.41 ,$23.58 ,$150.22 ,$31.03 ,$12.41 ,$169.30 ,$12.41 , N/A ,$167.68 ,$167.68 ,$162.40 ,$182.70 ,$31.03 ,$172.55 ,$12.41 ,$12.41 ,$172.55 ,$12.41 ,$84.45 , N/A , N/A ,$13.03 ,$172.55 ,$56.84 ,$182.70 ,$159.36 ,$167.68 ,$12.41 ,$131.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101222,82530,HC CORTISOL FREE-90,301,1 ,$195.00 ,$126.75 ,$16.71 ,$195.00 ,$41.78 ,$156.00 ,$16.71 ,$54.60 ,$154.52 ,$179.01 ,$16.71 ,$179.01 ,$16.71 ,$31.75 ,$144.30 ,$41.78 ,$16.71 ,$162.63 ,$16.71 , N/A ,$161.07 ,$161.07 ,$156.00 ,$175.50 ,$41.78 ,$165.75 ,$16.71 ,$16.71 ,$165.75 ,$16.71 ,$81.12 , N/A , N/A ,$17.55 ,$165.75 ,$54.60 ,$175.50 ,$153.08 ,$161.07 ,$16.71 ,$126.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101223,82533,HC CORTISOL TOTAL-90,301,1 ,$93.00 ,$60.45 ,$16.30 ,$93.00 ,$40.75 ,$74.40 ,$16.30 ,$26.04 ,$73.69 ,$85.37 ,$16.30 ,$85.37 ,$16.30 ,$30.97 ,$68.82 ,$40.75 ,$16.30 ,$77.56 ,$16.30 , N/A ,$76.82 ,$76.82 ,$74.40 ,$83.70 ,$40.75 ,$79.05 ,$16.30 ,$16.30 ,$79.05 ,$16.30 ,$38.69 , N/A , N/A ,$17.12 ,$79.05 ,$26.04 ,$83.70 ,$73.01 ,$76.82 ,$16.30 ,$60.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101224,82542,HC CHROMO SPECTROMETRY -90,301,1 ,$41.00 ,$26.65 ,$11.48 ,$60.23 ,$60.23 ,$32.80 ,$24.09 ,$11.48 ,$32.49 ,$37.64 ,$24.09 ,$37.64 ,$24.09 ,$41.00 ,$30.34 ,$41.00 ,$24.09 ,$34.19 ,$24.09 , N/A ,$33.87 ,$33.87 ,$32.80 ,$36.90 ,$41.00 ,$34.85 ,$24.09 ,$24.09 ,$34.85 ,$24.09 ,$17.06 , N/A , N/A ,$25.29 ,$34.85 ,$11.48 ,$36.90 ,$32.19 ,$33.87 ,$24.09 ,$26.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101226,82552,HC CREATINE KINASE (CPK) ISO-90,301,1 ,$343.00 ,$222.95 ,$13.39 ,$343.00 ,$33.48 ,$274.40 ,$13.39 ,$96.04 ,$271.79 ,$314.87 ,$13.39 ,$314.87 ,$13.39 ,$25.44 ,$253.82 ,$33.48 ,$13.39 ,$286.06 ,$13.39 , N/A ,$283.32 ,$283.32 ,$274.40 ,$308.70 ,$33.48 ,$291.55 ,$13.39 ,$13.39 ,$291.55 ,$13.39 ,$142.69 , N/A , N/A ,$14.06 ,$291.55 ,$96.04 ,$308.70 ,$269.26 ,$283.32 ,$13.39 ,$222.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101231,82570,HC CREATININE OTH SOURCE-90,301,1 ,$42.00 ,$27.30 ,$5.18 ,$42.00 ,$12.95 ,$33.60 ,$5.18 ,$11.76 ,$33.28 ,$38.56 ,$5.18 ,$38.56 ,$5.18 ,$9.84 ,$31.08 ,$12.95 ,$5.18 ,$35.03 ,$5.18 , N/A ,$34.69 ,$34.69 ,$33.60 ,$37.80 ,$12.95 ,$35.70 ,$5.18 ,$5.18 ,$35.70 ,$5.18 ,$17.47 , N/A , N/A ,$5.44 ,$35.70 ,$11.76 ,$37.80 ,$32.97 ,$34.69 ,$5.18 ,$27.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101233,82595,HC CRYOGLOBULIN QL OR SQN-90,301,1 ,$130.00 ,$84.50 ,$6.47 ,$130.00 ,$16.18 ,$104.00 ,$6.47 ,$36.40 ,$103.01 ,$119.34 ,$6.47 ,$119.34 ,$6.47 ,$12.29 ,$96.20 ,$16.18 ,$6.47 ,$108.42 ,$6.47 , N/A ,$107.38 ,$107.38 ,$104.00 ,$117.00 ,$16.18 ,$110.50 ,$6.47 ,$6.47 ,$110.50 ,$6.47 ,$54.08 , N/A , N/A ,$6.79 ,$110.50 ,$36.40 ,$117.00 ,$102.05 ,$107.38 ,$6.47 ,$84.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101236,82608,HC VITAMIN B-12 BINDING CAPACITY-90,301,1 ,$86.00 ,$55.90 ,$14.32 ,$86.00 ,$35.80 ,$68.80 ,$14.32 ,$24.08 ,$68.15 ,$78.95 ,$14.32 ,$78.95 ,$14.32 ,$27.21 ,$63.64 ,$35.80 ,$14.32 ,$71.72 ,$14.32 , N/A ,$71.04 ,$71.04 ,$68.80 ,$77.40 ,$35.80 ,$73.10 ,$14.32 ,$14.32 ,$73.10 ,$14.32 ,$35.78 , N/A , N/A ,$15.04 ,$73.10 ,$24.08 ,$77.40 ,$67.51 ,$71.04 ,$14.32 ,$55.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101237,82626,HC DHEA-90,301,1 ,$344.00 ,$223.60 ,$25.27 ,$344.00 ,$63.18 ,$275.20 ,$25.27 ,$96.32 ,$272.59 ,$315.79 ,$25.27 ,$315.79 ,$25.27 ,$48.01 ,$254.56 ,$63.18 ,$25.27 ,$286.90 ,$25.27 , N/A ,$284.14 ,$284.14 ,$275.20 ,$309.60 ,$63.18 ,$292.40 ,$25.27 ,$25.27 ,$292.40 ,$25.27 ,$143.10 , N/A , N/A ,$26.53 ,$292.40 ,$96.32 ,$309.60 ,$270.04 ,$284.14 ,$25.27 ,$223.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101238,82627,HC DHEA SULFATE-90,301,1 ,$232.00 ,$150.80 ,$22.23 ,$232.00 ,$55.58 ,$185.60 ,$22.23 ,$64.96 ,$183.84 ,$212.98 ,$22.23 ,$212.98 ,$22.23 ,$42.24 ,$171.68 ,$55.58 ,$22.23 ,$193.49 ,$22.23 , N/A ,$191.63 ,$191.63 ,$185.60 ,$208.80 ,$55.58 ,$197.20 ,$22.23 ,$22.23 ,$197.20 ,$22.23 ,$96.51 , N/A , N/A ,$23.34 ,$197.20 ,$64.96 ,$208.80 ,$182.12 ,$191.63 ,$22.23 ,$150.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101240,82652,HC VITAMIN D (1 25 DIHYDROXY)-90,301,1 ,$327.00 ,$212.55 ,$38.50 ,$327.00 ,$96.25 ,$261.60 ,$38.50 ,$91.56 ,$259.11 ,$300.19 ,$38.50 ,$300.19 ,$38.50 ,$73.15 ,$241.98 ,$96.25 ,$38.50 ,$272.72 ,$38.50 , N/A ,$270.10 ,$270.10 ,$261.60 ,$294.30 ,$96.25 ,$277.95 ,$38.50 ,$38.50 ,$277.95 ,$38.50 ,$136.03 , N/A , N/A ,$40.43 ,$277.95 ,$91.56 ,$294.30 ,$256.70 ,$270.10 ,$38.50 ,$212.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101241,82656,HC ELASTASE PANCREATIC EL1 FECAL QL OR SQN-90,301,1 ,$95.00 ,$61.75 ,$11.53 ,$95.00 ,$28.83 ,$76.00 ,$11.53 ,$26.60 ,$75.28 ,$87.21 ,$11.53 ,$87.21 ,$11.53 ,$21.91 ,$70.30 ,$28.83 ,$11.53 ,$79.23 ,$11.53 , N/A ,$78.47 ,$78.47 ,$76.00 ,$85.50 ,$28.83 ,$80.75 ,$11.53 ,$11.53 ,$80.75 ,$11.53 ,$39.52 , N/A , N/A ,$12.11 ,$80.75 ,$26.60 ,$85.50 ,$74.58 ,$78.47 ,$11.53 ,$61.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101242,82657,HC ENZYME ACT NONRAD SUBS-90,301,1 ,$409.00 ,$265.85 ,$22.17 ,$409.00 ,$55.43 ,$327.20 ,$22.17 ,$114.52 ,$324.09 ,$375.46 ,$22.17 ,$375.46 ,$22.17 ,$42.12 ,$302.66 ,$55.43 ,$22.17 ,$341.11 ,$22.17 , N/A ,$337.83 ,$337.83 ,$327.20 ,$368.10 ,$55.43 ,$347.65 ,$22.17 ,$22.17 ,$347.65 ,$22.17 ,$170.14 , N/A , N/A ,$23.28 ,$347.65 ,$114.52 ,$368.10 ,$321.07 ,$337.83 ,$22.17 ,$265.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101245,82668,HC ERYTHROPOIETIN-90,301,1 ,$262.00 ,$170.30 ,$18.79 ,$262.00 ,$46.98 ,$209.60 ,$18.79 ,$73.36 ,$207.61 ,$240.52 ,$18.79 ,$240.52 ,$18.79 ,$35.70 ,$193.88 ,$46.98 ,$18.79 ,$218.51 ,$18.79 , N/A ,$216.41 ,$216.41 ,$209.60 ,$235.80 ,$46.98 ,$222.70 ,$18.79 ,$18.79 ,$222.70 ,$18.79 ,$108.99 , N/A , N/A ,$19.73 ,$222.70 ,$73.36 ,$235.80 ,$205.67 ,$216.41 ,$18.79 ,$170.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101246,82670,HC ESTRADIOL-90,301,1 ,$368.00 ,$239.20 ,$27.94 ,$368.00 ,$69.85 ,$294.40 ,$27.94 ,$103.04 ,$291.60 ,$337.82 ,$27.94 ,$337.82 ,$27.94 ,$53.09 ,$272.32 ,$69.85 ,$27.94 ,$306.91 ,$27.94 , N/A ,$303.97 ,$303.97 ,$294.40 ,$331.20 ,$69.85 ,$312.80 ,$27.94 ,$27.94 ,$312.80 ,$27.94 ,$153.09 , N/A , N/A ,$29.34 ,$312.80 ,$103.04 ,$331.20 ,$288.88 ,$303.97 ,$27.94 ,$239.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101248,82671,HC ESTROGEN FRACTIONATED-90,301,1 ,$109.00 ,$70.85 ,$30.52 ,$109.00 ,$80.75 ,$87.20 ,$32.30 ,$30.52 ,$86.37 ,$100.06 ,$32.30 ,$100.06 ,$32.30 ,$61.37 ,$80.66 ,$80.75 ,$32.30 ,$90.91 ,$32.30 , N/A ,$90.03 ,$90.03 ,$87.20 ,$98.10 ,$80.75 ,$92.65 ,$32.30 ,$32.30 ,$92.65 ,$32.30 ,$45.34 , N/A , N/A ,$33.92 ,$92.65 ,$30.52 ,$98.10 ,$85.57 ,$90.03 ,$32.30 ,$70.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101249,82672,HC ESTROGEN TOTAL-90,301,1 ,$381.00 ,$247.65 ,$21.70 ,$381.00 ,$54.25 ,$304.80 ,$21.70 ,$106.68 ,$301.90 ,$349.76 ,$21.70 ,$349.76 ,$21.70 ,$41.23 ,$281.94 ,$54.25 ,$21.70 ,$317.75 ,$21.70 , N/A ,$314.71 ,$314.71 ,$304.80 ,$342.90 ,$54.25 ,$323.85 ,$21.70 ,$21.70 ,$323.85 ,$21.70 ,$158.50 , N/A , N/A ,$22.79 ,$323.85 ,$106.68 ,$342.90 ,$299.09 ,$314.71 ,$21.70 ,$247.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101250,82677,HC ESTRIOL-90,301,1 ,$70.00 ,$45.50 ,$19.60 ,$70.00 ,$60.45 ,$56.00 ,$24.18 ,$19.60 ,$55.47 ,$64.26 ,$24.18 ,$64.26 ,$24.18 ,$45.94 ,$51.80 ,$60.45 ,$24.18 ,$58.38 ,$24.18 , N/A ,$57.82 ,$57.82 ,$56.00 ,$63.00 ,$60.45 ,$59.50 ,$24.18 ,$24.18 ,$59.50 ,$24.18 ,$29.12 , N/A , N/A ,$25.39 ,$59.50 ,$19.60 ,$63.00 ,$54.95 ,$57.82 ,$24.18 ,$45.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101251,82679,HC ESTRONE-90,301,1 ,$108.00 ,$70.20 ,$24.95 ,$108.00 ,$62.38 ,$86.40 ,$24.95 ,$30.24 ,$85.58 ,$99.14 ,$24.95 ,$99.14 ,$24.95 ,$47.41 ,$79.92 ,$62.38 ,$24.95 ,$90.07 ,$24.95 , N/A ,$89.21 ,$89.21 ,$86.40 ,$97.20 ,$62.38 ,$91.80 ,$24.95 ,$24.95 ,$91.80 ,$24.95 ,$44.93 , N/A , N/A ,$26.20 ,$91.80 ,$30.24 ,$97.20 ,$84.78 ,$89.21 ,$24.95 ,$70.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101253,82705,HC FECAL FAT QUALITATIVE-90,301,1 ,$187.00 ,$121.55 ,$5.10 ,$187.00 ,$12.75 ,$149.60 ,$5.10 ,$52.36 ,$148.18 ,$171.67 ,$5.10 ,$171.67 ,$5.10 ,$9.69 ,$138.38 ,$12.75 ,$5.10 ,$155.96 ,$5.10 , N/A ,$154.46 ,$154.46 ,$149.60 ,$168.30 ,$12.75 ,$158.95 ,$5.10 ,$5.10 ,$158.95 ,$5.10 ,$77.79 , N/A , N/A ,$5.36 ,$158.95 ,$52.36 ,$168.30 ,$146.80 ,$154.46 ,$5.10 ,$121.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101259,82747,HC FOLIC ACID RBC-90,301,1 ,$97.00 ,$63.05 ,$17.65 ,$97.00 ,$44.13 ,$77.60 ,$17.65 ,$27.16 ,$76.86 ,$89.05 ,$17.65 ,$89.05 ,$17.65 ,$33.54 ,$71.78 ,$44.13 ,$17.65 ,$80.90 ,$17.65 , N/A ,$80.12 ,$80.12 ,$77.60 ,$87.30 ,$44.13 ,$82.45 ,$17.65 ,$17.65 ,$82.45 ,$17.65 ,$40.35 , N/A , N/A ,$18.53 ,$82.45 ,$27.16 ,$87.30 ,$76.15 ,$80.12 ,$17.65 ,$63.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101262,82784,HC GAMMAGLOBULIN-90,301,1 ,$151.00 ,$98.15 ,$9.30 ,$151.00 ,$23.25 ,$120.80 ,$9.30 ,$42.28 ,$119.65 ,$138.62 ,$9.30 ,$138.62 ,$9.30 ,$17.67 ,$111.74 ,$23.25 ,$9.30 ,$125.93 ,$9.30 , N/A ,$124.73 ,$124.73 ,$120.80 ,$135.90 ,$23.25 ,$128.35 ,$9.30 ,$9.30 ,$128.35 ,$9.30 ,$62.82 , N/A , N/A ,$9.77 ,$128.35 ,$42.28 ,$135.90 ,$118.54 ,$124.73 ,$9.30 ,$98.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101263,82785,HC GAMMAGLOBULIN IGE-90,301,1 ,$252.00 ,$163.80 ,$16.46 ,$252.00 ,$41.15 ,$201.60 ,$16.46 ,$70.56 ,$199.68 ,$231.34 ,$16.46 ,$231.34 ,$16.46 ,$31.27 ,$186.48 ,$41.15 ,$16.46 ,$210.17 ,$16.46 , N/A ,$208.15 ,$208.15 ,$201.60 ,$226.80 ,$41.15 ,$214.20 ,$16.46 ,$16.46 ,$214.20 ,$16.46 ,$104.83 , N/A , N/A ,$17.28 ,$214.20 ,$70.56 ,$226.80 ,$197.82 ,$208.15 ,$16.46 ,$163.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101265,82787,HC IMMUNOGLOBULIN SUBCLASSES-90,301,1 ,$261.00 ,$169.65 ,$8.02 ,$261.00 ,$20.05 ,$208.80 ,$8.02 ,$73.08 ,$206.82 ,$239.60 ,$8.02 ,$239.60 ,$8.02 ,$15.24 ,$193.14 ,$20.05 ,$8.02 ,$217.67 ,$8.02 , N/A ,$215.59 ,$215.59 ,$208.80 ,$234.90 ,$20.05 ,$221.85 ,$8.02 ,$8.02 ,$221.85 ,$8.02 ,$108.58 , N/A , N/A ,$8.42 ,$221.85 ,$73.08 ,$234.90 ,$204.89 ,$215.59 ,$8.02 ,$169.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101268,82941,HC GASTRIN-90,301,1 ,$87.00 ,$56.55 ,$17.63 ,$87.00 ,$44.08 ,$69.60 ,$17.63 ,$24.36 ,$68.94 ,$79.87 ,$17.63 ,$79.87 ,$17.63 ,$33.50 ,$64.38 ,$44.08 ,$17.63 ,$72.56 ,$17.63 , N/A ,$71.86 ,$71.86 ,$69.60 ,$78.30 ,$44.08 ,$73.95 ,$17.63 ,$17.63 ,$73.95 ,$17.63 ,$36.19 , N/A , N/A ,$18.51 ,$73.95 ,$24.36 ,$78.30 ,$68.30 ,$71.86 ,$17.63 ,$56.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101274,82955,HC G6PD ENZYME QN-90,301,1 ,$185.00 ,$120.25 ,$9.70 ,$185.00 ,$24.25 ,$148.00 ,$9.70 ,$51.80 ,$146.59 ,$169.83 ,$9.70 ,$169.83 ,$9.70 ,$18.43 ,$136.90 ,$24.25 ,$9.70 ,$154.29 ,$9.70 , N/A ,$152.81 ,$152.81 ,$148.00 ,$166.50 ,$24.25 ,$157.25 ,$9.70 ,$9.70 ,$157.25 ,$9.70 ,$76.96 , N/A , N/A ,$10.19 ,$157.25 ,$51.80 ,$166.50 ,$145.23 ,$152.81 ,$9.70 ,$120.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101275,82977,HC GGT/GGTP-90,301,1 ,$131.00 ,$85.15 ,$7.20 ,$131.00 ,$18.00 ,$104.80 ,$7.20 ,$36.68 ,$103.80 ,$120.26 ,$7.20 ,$120.26 ,$7.20 ,$13.68 ,$96.94 ,$18.00 ,$7.20 ,$109.25 ,$7.20 , N/A ,$108.21 ,$108.21 ,$104.80 ,$117.90 ,$18.00 ,$111.35 ,$7.20 ,$7.20 ,$111.35 ,$7.20 ,$54.50 , N/A , N/A ,$7.56 ,$111.35 ,$36.68 ,$117.90 ,$102.84 ,$108.21 ,$7.20 ,$85.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101276,82985,HC FRUCTOSAMINE-90,301,1 ,$96.00 ,$62.40 ,$16.76 ,$96.00 ,$41.90 ,$76.80 ,$16.76 ,$26.88 ,$76.07 ,$88.13 ,$16.76 ,$88.13 ,$16.76 ,$31.84 ,$71.04 ,$41.90 ,$16.76 ,$80.06 ,$16.76 , N/A ,$79.30 ,$79.30 ,$76.80 ,$86.40 ,$41.90 ,$81.60 ,$16.76 ,$16.76 ,$81.60 ,$16.76 ,$39.94 , N/A , N/A ,$17.60 ,$81.60 ,$26.88 ,$86.40 ,$75.36 ,$79.30 ,$16.76 ,$62.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101277,83001,HC FSH-90,301,1 ,$125.00 ,$81.25 ,$18.58 ,$125.00 ,$46.45 ,$100.00 ,$18.58 ,$35.00 ,$99.05 ,$114.75 ,$18.58 ,$114.75 ,$18.58 ,$35.30 ,$92.50 ,$46.45 ,$18.58 ,$104.25 ,$18.58 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$46.45 ,$106.25 ,$18.58 ,$18.58 ,$106.25 ,$18.58 ,$52.00 , N/A , N/A ,$19.51 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$18.58 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101278,83002,HC LUTEINIZING HORMONE (LH)-90,301,1 ,$125.00 ,$81.25 ,$18.52 ,$125.00 ,$46.30 ,$100.00 ,$18.52 ,$35.00 ,$99.05 ,$114.75 ,$18.52 ,$114.75 ,$18.52 ,$35.19 ,$92.50 ,$46.30 ,$18.52 ,$104.25 ,$18.52 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$46.30 ,$106.25 ,$18.52 ,$18.52 ,$106.25 ,$18.52 ,$52.00 , N/A , N/A ,$19.45 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$18.52 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101279,83003,HC GROWTH HORMONE (HGH)-90,301,1 ,$102.00 ,$66.30 ,$16.67 ,$102.00 ,$41.68 ,$81.60 ,$16.67 ,$28.56 ,$80.82 ,$93.64 ,$16.67 ,$93.64 ,$16.67 ,$31.67 ,$75.48 ,$41.68 ,$16.67 ,$85.07 ,$16.67 , N/A ,$84.25 ,$84.25 ,$81.60 ,$91.80 ,$41.68 ,$86.70 ,$16.67 ,$16.67 ,$86.70 ,$16.67 ,$42.43 , N/A , N/A ,$17.50 ,$86.70 ,$28.56 ,$91.80 ,$80.07 ,$84.25 ,$16.67 ,$66.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101281,83010,HC HAPTOGLOBIN-90,301,1 ,$57.00 ,$37.05 ,$12.58 ,$57.00 ,$31.45 ,$45.60 ,$12.58 ,$15.96 ,$45.17 ,$52.33 ,$12.58 ,$52.33 ,$12.58 ,$23.90 ,$42.18 ,$31.45 ,$12.58 ,$47.54 ,$12.58 , N/A ,$47.08 ,$47.08 ,$45.60 ,$51.30 ,$31.45 ,$48.45 ,$12.58 ,$12.58 ,$48.45 ,$12.58 ,$23.71 , N/A , N/A ,$13.21 ,$48.45 ,$15.96 ,$51.30 ,$44.75 ,$47.08 ,$12.58 ,$37.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101282,83013,HC H PYLORI BREATH TEST-90,301,1 ,$231.00 ,$150.15 ,$64.68 ,$231.00 ,$168.40 ,$184.80 ,$67.36 ,$64.68 ,$183.04 ,$212.06 ,$67.36 ,$212.06 ,$67.36 ,$127.98 ,$170.94 ,$168.40 ,$67.36 ,$192.65 ,$67.36 , N/A ,$190.81 ,$190.81 ,$184.80 ,$207.90 ,$168.40 ,$196.35 ,$67.36 ,$67.36 ,$196.35 ,$67.36 ,$96.10 , N/A , N/A ,$70.73 ,$196.35 ,$64.68 ,$207.90 ,$181.34 ,$190.81 ,$67.36 ,$150.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101283,83018,HC HEAVY METAL QN EACH-90,301,1 ,$115.00 ,$74.75 ,$21.96 ,$115.00 ,$54.90 ,$92.00 ,$21.96 ,$32.20 ,$91.13 ,$105.57 ,$21.96 ,$105.57 ,$21.96 ,$41.72 ,$85.10 ,$54.90 ,$21.96 ,$95.91 ,$21.96 , N/A ,$94.99 ,$94.99 ,$92.00 ,$103.50 ,$54.90 ,$97.75 ,$21.96 ,$21.96 ,$97.75 ,$21.96 ,$47.84 , N/A , N/A ,$23.06 ,$97.75 ,$32.20 ,$103.50 ,$90.28 ,$94.99 ,$21.96 ,$74.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101284,83020,HC HGB ELECTROPHORESIS-90,301,1 ,$301.00 ,$195.65 ,$12.87 ,$301.00 ,$32.18 ,$240.80 ,$12.87 ,$84.28 ,$238.51 ,$276.32 ,$12.87 ,$276.32 ,$12.87 ,$24.45 ,$222.74 ,$32.18 ,$12.87 ,$251.03 ,$12.87 , N/A ,$248.63 ,$248.63 ,$240.80 ,$270.90 ,$32.18 ,$255.85 ,$12.87 ,$12.87 ,$255.85 ,$12.87 ,$125.22 , N/A , N/A ,$13.51 ,$255.85 ,$84.28 ,$270.90 ,$236.29 ,$248.63 ,$12.87 ,$195.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101291,83088,HC HISTAMINE-90,301,1 ,$189.00 ,$122.85 ,$29.53 ,$189.00 ,$73.83 ,$151.20 ,$29.53 ,$52.92 ,$149.76 ,$173.50 ,$29.53 ,$173.50 ,$29.53 ,$56.11 ,$139.86 ,$73.83 ,$29.53 ,$157.63 ,$29.53 , N/A ,$156.11 ,$156.11 ,$151.20 ,$170.10 ,$73.83 ,$160.65 ,$29.53 ,$29.53 ,$160.65 ,$29.53 ,$78.62 , N/A , N/A ,$31.01 ,$160.65 ,$52.92 ,$170.10 ,$148.37 ,$156.11 ,$29.53 ,$122.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101292,83090,HC HOMOCYSTEINE-90,301,1 ,$156.00 ,$101.40 ,$17.92 ,$156.00 ,$44.80 ,$124.80 ,$17.92 ,$43.68 ,$123.61 ,$143.21 ,$17.92 ,$143.21 ,$17.92 ,$34.05 ,$115.44 ,$44.80 ,$17.92 ,$130.10 ,$17.92 , N/A ,$128.86 ,$128.86 ,$124.80 ,$140.40 ,$44.80 ,$132.60 ,$17.92 ,$17.92 ,$132.60 ,$17.92 ,$64.90 , N/A , N/A ,$18.82 ,$132.60 ,$43.68 ,$140.40 ,$122.46 ,$128.86 ,$17.92 ,$101.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101293,83150,HC HOMOVANILLIC ACID (HVA)-90,301,1 ,$416.00 ,$270.40 ,$22.41 ,$416.00 ,$56.03 ,$332.80 ,$22.41 ,$116.48 ,$329.64 ,$381.89 ,$22.41 ,$381.89 ,$22.41 ,$42.58 ,$307.84 ,$56.03 ,$22.41 ,$346.94 ,$22.41 , N/A ,$343.62 ,$343.62 ,$332.80 ,$374.40 ,$56.03 ,$353.60 ,$22.41 ,$22.41 ,$353.60 ,$22.41 ,$173.06 , N/A , N/A ,$23.53 ,$353.60 ,$116.48 ,$374.40 ,$326.56 ,$343.62 ,$22.41 ,$270.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101294,83497,HC HYDROXYINDOLACET 5 (HIAA)-90,301,1 ,$105.00 ,$68.25 ,$12.90 ,$105.00 ,$32.25 ,$84.00 ,$12.90 ,$29.40 ,$83.20 ,$96.39 ,$12.90 ,$96.39 ,$12.90 ,$24.51 ,$77.70 ,$32.25 ,$12.90 ,$87.57 ,$12.90 , N/A ,$86.73 ,$86.73 ,$84.00 ,$94.50 ,$32.25 ,$89.25 ,$12.90 ,$12.90 ,$89.25 ,$12.90 ,$43.68 , N/A , N/A ,$13.55 ,$89.25 ,$29.40 ,$94.50 ,$82.43 ,$86.73 ,$12.90 ,$68.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101295,83498,HC HYDROXYPROGESTERONE 17D-90,301,1 ,$144.00 ,$93.60 ,$27.17 ,$144.00 ,$67.93 ,$115.20 ,$27.17 ,$40.32 ,$114.11 ,$132.19 ,$27.17 ,$132.19 ,$27.17 ,$51.62 ,$106.56 ,$67.93 ,$27.17 ,$120.10 ,$27.17 , N/A ,$118.94 ,$118.94 ,$115.20 ,$129.60 ,$67.93 ,$122.40 ,$27.17 ,$27.17 ,$122.40 ,$27.17 ,$59.90 , N/A , N/A ,$28.53 ,$122.40 ,$40.32 ,$129.60 ,$113.04 ,$118.94 ,$27.17 ,$93.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101297,83516,HC MLT NON INFECT QL/SQ-90,301,1 ,$167.00 ,$108.55 ,$11.53 ,$167.00 ,$28.83 ,$133.60 ,$11.53 ,$46.76 ,$132.33 ,$153.31 ,$11.53 ,$153.31 ,$11.53 ,$21.91 ,$123.58 ,$28.83 ,$11.53 ,$139.28 ,$11.53 , N/A ,$137.94 ,$137.94 ,$133.60 ,$150.30 ,$28.83 ,$141.95 ,$11.53 ,$11.53 ,$141.95 ,$11.53 ,$69.47 , N/A , N/A ,$12.11 ,$141.95 ,$46.76 ,$150.30 ,$131.10 ,$137.94 ,$11.53 ,$108.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101300,83516,HC MLT NON INFECT QL/SQ TTG-90,301,1 ,$200.00 ,$130.00 ,$11.53 ,$200.00 ,$28.83 ,$160.00 ,$11.53 ,$56.00 ,$158.48 ,$183.60 ,$11.53 ,$183.60 ,$11.53 ,$21.91 ,$148.00 ,$28.83 ,$11.53 ,$166.80 ,$11.53 , N/A ,$165.20 ,$165.20 ,$160.00 ,$180.00 ,$28.83 ,$170.00 ,$11.53 ,$11.53 ,$170.00 ,$11.53 ,$83.20 , N/A , N/A ,$12.11 ,$170.00 ,$56.00 ,$180.00 ,$157.00 ,$165.20 ,$11.53 ,$130.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101302,83519,HC QN RIA-90,301,1 ,$237.00 ,$154.05 ,$18.40 ,$237.00 ,$46.00 ,$189.60 ,$18.40 ,$66.36 ,$187.80 ,$217.57 ,$18.40 ,$217.57 ,$18.40 ,$34.96 ,$175.38 ,$46.00 ,$18.40 ,$197.66 ,$18.40 , N/A ,$195.76 ,$195.76 ,$189.60 ,$213.30 ,$46.00 ,$201.45 ,$18.40 ,$18.40 ,$201.45 ,$18.40 ,$98.59 , N/A , N/A ,$19.32 ,$201.45 ,$66.36 ,$213.30 ,$186.05 ,$195.76 ,$18.40 ,$154.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101303,83520,HC IMMUNOASSAY QN OTHER-90,301,1 ,$187.00 ,$121.55 ,$17.27 ,$187.00 ,$43.18 ,$149.60 ,$17.27 ,$52.36 ,$148.18 ,$171.67 ,$17.27 ,$171.67 ,$17.27 ,$32.81 ,$138.38 ,$43.18 ,$17.27 ,$155.96 ,$17.27 , N/A ,$154.46 ,$154.46 ,$149.60 ,$168.30 ,$43.18 ,$158.95 ,$17.27 ,$17.27 ,$158.95 ,$17.27 ,$77.79 , N/A , N/A ,$18.13 ,$158.95 ,$52.36 ,$168.30 ,$146.80 ,$154.46 ,$17.27 ,$121.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101307,83525,HC INSULIN TOTAL-90,301,1 ,$210.00 ,$136.50 ,$11.43 ,$210.00 ,$28.58 ,$168.00 ,$11.43 ,$58.80 ,$166.40 ,$192.78 ,$11.43 ,$192.78 ,$11.43 ,$21.72 ,$155.40 ,$28.58 ,$11.43 ,$175.14 ,$11.43 , N/A ,$173.46 ,$173.46 ,$168.00 ,$189.00 ,$28.58 ,$178.50 ,$11.43 ,$11.43 ,$178.50 ,$11.43 ,$87.36 , N/A , N/A ,$12.00 ,$178.50 ,$58.80 ,$189.00 ,$164.85 ,$173.46 ,$11.43 ,$136.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101312,83615,HC LACTATE DEHYDRO (LDH)-90,301,1 ,$124.00 ,$80.60 ,$6.04 ,$124.00 ,$15.10 ,$99.20 ,$6.04 ,$34.72 ,$98.26 ,$113.83 ,$6.04 ,$113.83 ,$6.04 ,$11.48 ,$91.76 ,$15.10 ,$6.04 ,$103.42 ,$6.04 , N/A ,$102.42 ,$102.42 ,$99.20 ,$111.60 ,$15.10 ,$105.40 ,$6.04 ,$6.04 ,$105.40 ,$6.04 ,$51.58 , N/A , N/A ,$6.34 ,$105.40 ,$34.72 ,$111.60 ,$97.34 ,$102.42 ,$6.04 ,$80.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101313,83625,HC LDH ISOENZYMES-90,301,1 ,$311.00 ,$202.15 ,$12.79 ,$311.00 ,$31.98 ,$248.80 ,$12.79 ,$87.08 ,$246.44 ,$285.50 ,$12.79 ,$285.50 ,$12.79 ,$24.30 ,$230.14 ,$31.98 ,$12.79 ,$259.37 ,$12.79 , N/A ,$256.89 ,$256.89 ,$248.80 ,$279.90 ,$31.98 ,$264.35 ,$12.79 ,$12.79 ,$264.35 ,$12.79 ,$129.38 , N/A , N/A ,$13.43 ,$264.35 ,$87.08 ,$279.90 ,$244.14 ,$256.89 ,$12.79 ,$202.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101316,83655,HC LEAD-90,301,1 ,$175.00 ,$113.75 ,$12.11 ,$175.00 ,$30.28 ,$140.00 ,$12.11 ,$49.00 ,$138.67 ,$160.65 ,$12.11 ,$160.65 ,$12.11 ,$23.01 ,$129.50 ,$30.28 ,$12.11 ,$145.95 ,$12.11 , N/A ,$144.55 ,$144.55 ,$140.00 ,$157.50 ,$30.28 ,$148.75 ,$12.11 ,$12.11 ,$148.75 ,$12.11 ,$72.80 , N/A , N/A ,$12.72 ,$148.75 ,$49.00 ,$157.50 ,$137.38 ,$144.55 ,$12.11 ,$113.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101325,80335,HC ANTIDEPRESSANTS TRYCLIC 1-2  -90,301,1 ,$193.00 ,$125.45 ,$54.04 ,$193.00 , N/A ,$154.40 , N/A ,$54.04 ,$152.93 ,$177.17 , N/A ,$177.17 , N/A , N/A ,$142.82 , N/A , N/A ,$160.96 , N/A , N/A ,$159.42 ,$159.42 ,$154.40 ,$173.70 , N/A ,$164.05 , N/A , N/A ,$164.05 , N/A ,$80.29 , N/A , N/A , N/A ,$164.05 ,$54.04 ,$173.70 ,$151.51 ,$159.42 , N/A ,$125.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101327,83785,HC MANGANESE-90,301,1 ,$168.00 ,$109.20 ,$26.65 ,$168.00 ,$66.63 ,$134.40 ,$26.65 ,$47.04 ,$133.12 ,$154.22 ,$26.65 ,$154.22 ,$26.65 ,$50.64 ,$124.32 ,$66.63 ,$26.65 ,$140.11 ,$26.65 , N/A ,$138.77 ,$138.77 ,$134.40 ,$151.20 ,$66.63 ,$142.80 ,$26.65 ,$26.65 ,$142.80 ,$26.65 ,$69.89 , N/A , N/A ,$27.98 ,$142.80 ,$47.04 ,$151.20 ,$131.88 ,$138.77 ,$26.65 ,$109.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101328,83789,HC MASS SPEC QN EACH-90,301,1 ,$192.00 ,$124.80 ,$24.11 ,$192.00 ,$60.28 ,$153.60 ,$24.11 ,$53.76 ,$152.14 ,$176.26 ,$24.11 ,$176.26 ,$24.11 ,$45.81 ,$142.08 ,$60.28 ,$24.11 ,$160.13 ,$24.11 , N/A ,$158.59 ,$158.59 ,$153.60 ,$172.80 ,$60.28 ,$163.20 ,$24.11 ,$24.11 ,$163.20 ,$24.11 ,$79.87 , N/A , N/A ,$25.32 ,$163.20 ,$53.76 ,$172.80 ,$150.72 ,$158.59 ,$24.11 ,$124.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101329,83825,HC MERCURY-90,301,1 ,$250.00 ,$162.50 ,$16.26 ,$250.00 ,$40.65 ,$200.00 ,$16.26 ,$70.00 ,$198.10 ,$229.50 ,$16.26 ,$229.50 ,$16.26 ,$30.89 ,$185.00 ,$40.65 ,$16.26 ,$208.50 ,$16.26 , N/A ,$206.50 ,$206.50 ,$200.00 ,$225.00 ,$40.65 ,$212.50 ,$16.26 ,$16.26 ,$212.50 ,$16.26 ,$104.00 , N/A , N/A ,$17.07 ,$212.50 ,$70.00 ,$225.00 ,$196.25 ,$206.50 ,$16.26 ,$162.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101330,83835,HC METANEPHRINES-90,301,1 ,$193.00 ,$125.45 ,$16.94 ,$193.00 ,$42.35 ,$154.40 ,$16.94 ,$54.04 ,$152.93 ,$177.17 ,$16.94 ,$177.17 ,$16.94 ,$32.19 ,$142.82 ,$42.35 ,$16.94 ,$160.96 ,$16.94 , N/A ,$159.42 ,$159.42 ,$154.40 ,$173.70 ,$42.35 ,$164.05 ,$16.94 ,$16.94 ,$164.05 ,$16.94 ,$80.29 , N/A , N/A ,$17.79 ,$164.05 ,$54.04 ,$173.70 ,$151.51 ,$159.42 ,$16.94 ,$125.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101333,83873,HC MYELIN BASIC PROTEIN (CSF)-90,301,1 ,$119.00 ,$77.35 ,$17.20 ,$119.00 ,$43.00 ,$95.20 ,$17.20 ,$33.32 ,$94.30 ,$109.24 ,$17.20 ,$109.24 ,$17.20 ,$32.68 ,$88.06 ,$43.00 ,$17.20 ,$99.25 ,$17.20 , N/A ,$98.29 ,$98.29 ,$95.20 ,$107.10 ,$43.00 ,$101.15 ,$17.20 ,$17.20 ,$101.15 ,$17.20 ,$49.50 , N/A , N/A ,$18.06 ,$101.15 ,$33.32 ,$107.10 ,$93.42 ,$98.29 ,$17.20 ,$77.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101334,83874,HC MYOGLOBIN-90,301,1 ,$193.00 ,$125.45 ,$12.92 ,$193.00 ,$32.30 ,$154.40 ,$12.92 ,$54.04 ,$152.93 ,$177.17 ,$12.92 ,$177.17 ,$12.92 ,$24.55 ,$142.82 ,$32.30 ,$12.92 ,$160.96 ,$12.92 , N/A ,$159.42 ,$159.42 ,$154.40 ,$173.70 ,$32.30 ,$164.05 ,$12.92 ,$12.92 ,$164.05 ,$12.92 ,$80.29 , N/A , N/A ,$13.57 ,$164.05 ,$54.04 ,$173.70 ,$151.51 ,$159.42 ,$12.92 ,$125.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101337,83883,HC NEPHELOMETRY EA ANALYTE-90,301,1 ,$362.00 ,$235.30 ,$13.60 ,$362.00 ,$34.00 ,$289.60 ,$13.60 ,$101.36 ,$286.85 ,$332.32 ,$13.60 ,$332.32 ,$13.60 ,$25.84 ,$267.88 ,$34.00 ,$13.60 ,$301.91 ,$13.60 , N/A ,$299.01 ,$299.01 ,$289.60 ,$325.80 ,$34.00 ,$307.70 ,$13.60 ,$13.60 ,$307.70 ,$13.60 ,$150.59 , N/A , N/A ,$14.28 ,$307.70 ,$101.36 ,$325.80 ,$284.17 ,$299.01 ,$13.60 ,$235.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101339,83915,HC NUCLEOTIDASE 5 -90,301,1 ,$117.00 ,$76.05 ,$11.15 ,$117.00 ,$27.88 ,$93.60 ,$11.15 ,$32.76 ,$92.71 ,$107.41 ,$11.15 ,$107.41 ,$11.15 ,$21.19 ,$86.58 ,$27.88 ,$11.15 ,$97.58 ,$11.15 , N/A ,$96.64 ,$96.64 ,$93.60 ,$105.30 ,$27.88 ,$99.45 ,$11.15 ,$11.15 ,$99.45 ,$11.15 ,$48.67 , N/A , N/A ,$11.71 ,$99.45 ,$32.76 ,$105.30 ,$91.85 ,$96.64 ,$11.15 ,$76.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101340,83916,HC OLIGOCLONAL BANDS-90,301,1 ,$195.00 ,$126.75 ,$27.39 ,$195.00 ,$68.48 ,$156.00 ,$27.39 ,$54.60 ,$154.52 ,$179.01 ,$27.39 ,$179.01 ,$27.39 ,$52.04 ,$144.30 ,$68.48 ,$27.39 ,$162.63 ,$27.39 , N/A ,$161.07 ,$161.07 ,$156.00 ,$175.50 ,$68.48 ,$165.75 ,$27.39 ,$27.39 ,$165.75 ,$27.39 ,$81.12 , N/A , N/A ,$28.76 ,$165.75 ,$54.60 ,$175.50 ,$153.08 ,$161.07 ,$27.39 ,$126.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101341,83918,HC ORGANIC ACIDS QN-90,301,1 ,$350.00 ,$227.50 ,$23.60 ,$350.00 ,$59.00 ,$280.00 ,$23.60 ,$98.00 ,$277.34 ,$321.30 ,$23.60 ,$321.30 ,$23.60 ,$44.84 ,$259.00 ,$59.00 ,$23.60 ,$291.90 ,$23.60 , N/A ,$289.10 ,$289.10 ,$280.00 ,$315.00 ,$59.00 ,$297.50 ,$23.60 ,$23.60 ,$297.50 ,$23.60 ,$145.60 , N/A , N/A ,$24.78 ,$297.50 ,$98.00 ,$315.00 ,$274.75 ,$289.10 ,$23.60 ,$227.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101343,83935,HC OSMOLALITY URINE-90,301,1 ,$135.00 ,$87.75 ,$6.82 ,$135.00 ,$17.05 ,$108.00 ,$6.82 ,$37.80 ,$106.97 ,$123.93 ,$6.82 ,$123.93 ,$6.82 ,$12.96 ,$99.90 ,$17.05 ,$6.82 ,$112.59 ,$6.82 , N/A ,$111.51 ,$111.51 ,$108.00 ,$121.50 ,$17.05 ,$114.75 ,$6.82 ,$6.82 ,$114.75 ,$6.82 ,$56.16 , N/A , N/A ,$7.16 ,$114.75 ,$37.80 ,$121.50 ,$105.98 ,$111.51 ,$6.82 ,$87.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101345,83945,HC OXALATE-90,301,1 ,$121.00 ,$78.65 ,$14.45 ,$121.00 ,$36.13 ,$96.80 ,$14.45 ,$33.88 ,$95.88 ,$111.08 ,$14.45 ,$111.08 ,$14.45 ,$27.46 ,$89.54 ,$36.13 ,$14.45 ,$100.91 ,$14.45 , N/A ,$99.95 ,$99.95 ,$96.80 ,$108.90 ,$36.13 ,$102.85 ,$14.45 ,$14.45 ,$102.85 ,$14.45 ,$50.34 , N/A , N/A ,$15.17 ,$102.85 ,$33.88 ,$108.90 ,$94.99 ,$99.95 ,$14.45 ,$78.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101347,83970,HC PARATHYROID HORMONE (PTH)-90,301,1 ,$132.00 ,$85.80 ,$36.96 ,$132.00 ,$103.20 ,$105.60 ,$41.28 ,$36.96 ,$104.60 ,$121.18 ,$41.28 ,$121.18 ,$41.28 ,$78.43 ,$97.68 ,$103.20 ,$41.28 ,$110.09 ,$41.28 , N/A ,$109.03 ,$109.03 ,$105.60 ,$118.80 ,$103.20 ,$112.20 ,$41.28 ,$41.28 ,$112.20 ,$41.28 ,$54.91 , N/A , N/A ,$43.34 ,$112.20 ,$36.96 ,$118.80 ,$103.62 ,$109.03 ,$41.28 ,$85.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101349,83992,HC PHENCYCLIDINE (PCP)-90,301,1 ,$124.00 ,$80.60 ,$34.72 ,$124.00 , N/A ,$99.20 , N/A ,$34.72 ,$98.26 ,$113.83 , N/A ,$113.83 , N/A , N/A ,$91.76 , N/A , N/A ,$103.42 , N/A , N/A ,$102.42 ,$102.42 ,$99.20 ,$111.60 , N/A ,$105.40 , N/A , N/A ,$105.40 , N/A ,$51.58 , N/A , N/A , N/A ,$105.40 ,$34.72 ,$111.60 ,$97.34 ,$102.42 , N/A ,$80.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101351,83993,HC CALPROTECTIN STOOL-90,301,1 ,$536.00 ,$348.40 ,$19.63 ,$536.00 ,$49.08 ,$428.80 ,$19.63 ,$150.08 ,$424.73 ,$492.05 ,$19.63 ,$492.05 ,$19.63 ,$37.30 ,$396.64 ,$49.08 ,$19.63 ,$447.02 ,$19.63 , N/A ,$442.74 ,$442.74 ,$428.80 ,$482.40 ,$49.08 ,$455.60 ,$19.63 ,$19.63 ,$455.60 ,$19.63 ,$222.98 , N/A , N/A ,$20.61 ,$455.60 ,$150.08 ,$482.40 ,$420.76 ,$442.74 ,$19.63 ,$348.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101352,84030,HC NEWBORN SCREEN PKU-90,301,1 ,$131.00 ,$85.15 ,$5.50 ,$131.00 ,$13.75 ,$104.80 ,$5.50 ,$36.68 ,$103.80 ,$120.26 ,$5.50 ,$120.26 ,$5.50 ,$10.45 ,$96.94 ,$13.75 ,$5.50 ,$109.25 ,$5.50 , N/A ,$108.21 ,$108.21 ,$104.80 ,$117.90 ,$13.75 ,$111.35 ,$5.50 ,$5.50 ,$111.35 ,$5.50 ,$54.50 , N/A , N/A ,$5.78 ,$111.35 ,$36.68 ,$117.90 ,$102.84 ,$108.21 ,$5.50 ,$85.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101353,84066,HC PHOSPHATASE ACID PROSTATIC-90,301,1 ,$72.00 ,$46.80 ,$9.66 ,$72.00 ,$24.15 ,$57.60 ,$9.66 ,$20.16 ,$57.05 ,$66.10 ,$9.66 ,$66.10 ,$9.66 ,$18.35 ,$53.28 ,$24.15 ,$9.66 ,$60.05 ,$9.66 , N/A ,$59.47 ,$59.47 ,$57.60 ,$64.80 ,$24.15 ,$61.20 ,$9.66 ,$9.66 ,$61.20 ,$9.66 ,$29.95 , N/A , N/A ,$10.14 ,$61.20 ,$20.16 ,$64.80 ,$56.52 ,$59.47 ,$9.66 ,$46.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101354,84075,HC ALKALINE PHOSPHATASE-90,301,1 ,$133.00 ,$86.45 ,$5.18 ,$133.00 ,$12.95 ,$106.40 ,$5.18 ,$37.24 ,$105.39 ,$122.09 ,$5.18 ,$122.09 ,$5.18 ,$9.84 ,$98.42 ,$12.95 ,$5.18 ,$110.92 ,$5.18 , N/A ,$109.86 ,$109.86 ,$106.40 ,$119.70 ,$12.95 ,$113.05 ,$5.18 ,$5.18 ,$113.05 ,$5.18 ,$55.33 , N/A , N/A ,$5.44 ,$113.05 ,$37.24 ,$119.70 ,$104.41 ,$109.86 ,$5.18 ,$86.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101356,84080,HC ALK PHOS ISOENZ-90,301,1 ,$181.00 ,$117.65 ,$14.78 ,$181.00 ,$36.95 ,$144.80 ,$14.78 ,$50.68 ,$143.42 ,$166.16 ,$14.78 ,$166.16 ,$14.78 ,$28.08 ,$133.94 ,$36.95 ,$14.78 ,$150.95 ,$14.78 , N/A ,$149.51 ,$149.51 ,$144.80 ,$162.90 ,$36.95 ,$153.85 ,$14.78 ,$14.78 ,$153.85 ,$14.78 ,$75.30 , N/A , N/A ,$15.52 ,$153.85 ,$50.68 ,$162.90 ,$142.09 ,$149.51 ,$14.78 ,$117.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101361,84120,HC PORPHYRINS QN FRACT-90,301,1 ,$187.00 ,$121.55 ,$14.71 ,$187.00 ,$36.78 ,$149.60 ,$14.71 ,$52.36 ,$148.18 ,$171.67 ,$14.71 ,$171.67 ,$14.71 ,$27.95 ,$138.38 ,$36.78 ,$14.71 ,$155.96 ,$14.71 , N/A ,$154.46 ,$154.46 ,$149.60 ,$168.30 ,$36.78 ,$158.95 ,$14.71 ,$14.71 ,$158.95 ,$14.71 ,$77.79 , N/A , N/A ,$15.45 ,$158.95 ,$52.36 ,$168.30 ,$146.80 ,$154.46 ,$14.71 ,$121.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101366,84140,HC PREGNENOLONE-90,301,1 ,$108.00 ,$70.20 ,$20.67 ,$108.00 ,$51.68 ,$86.40 ,$20.67 ,$30.24 ,$85.58 ,$99.14 ,$20.67 ,$99.14 ,$20.67 ,$39.27 ,$79.92 ,$51.68 ,$20.67 ,$90.07 ,$20.67 , N/A ,$89.21 ,$89.21 ,$86.40 ,$97.20 ,$51.68 ,$91.80 ,$20.67 ,$20.67 ,$91.80 ,$20.67 ,$44.93 , N/A , N/A ,$21.70 ,$91.80 ,$30.24 ,$97.20 ,$84.78 ,$89.21 ,$20.67 ,$70.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101368,84144,HC PROGESTERONE-90,301,1 ,$112.00 ,$72.80 ,$20.86 ,$112.00 ,$52.15 ,$89.60 ,$20.86 ,$31.36 ,$88.75 ,$102.82 ,$20.86 ,$102.82 ,$20.86 ,$39.63 ,$82.88 ,$52.15 ,$20.86 ,$93.41 ,$20.86 , N/A ,$92.51 ,$92.51 ,$89.60 ,$100.80 ,$52.15 ,$95.20 ,$20.86 ,$20.86 ,$95.20 ,$20.86 ,$46.59 , N/A , N/A ,$21.90 ,$95.20 ,$31.36 ,$100.80 ,$87.92 ,$92.51 ,$20.86 ,$72.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101369,84145,HC PROCALCITONIN (PCT)-90,301,1 ,$509.00 ,$330.85 ,$27.22 ,$509.00 ,$68.05 ,$407.20 ,$27.22 ,$142.52 ,$403.33 ,$467.26 ,$27.22 ,$467.26 ,$27.22 ,$51.72 ,$376.66 ,$68.05 ,$27.22 ,$424.51 ,$27.22 , N/A ,$420.43 ,$420.43 ,$407.20 ,$458.10 ,$68.05 ,$432.65 ,$27.22 ,$27.22 ,$432.65 ,$27.22 ,$211.74 , N/A , N/A ,$28.58 ,$432.65 ,$142.52 ,$458.10 ,$399.57 ,$420.43 ,$27.22 ,$330.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101370,84153,HC PSA TOTAL-90,301,1 ,$46.00 ,$29.90 ,$12.88 ,$46.00 ,$45.98 ,$36.80 ,$18.39 ,$12.88 ,$36.45 ,$42.23 ,$18.39 ,$42.23 ,$18.39 ,$34.94 ,$34.04 ,$45.98 ,$18.39 ,$38.36 ,$18.39 , N/A ,$38.00 ,$38.00 ,$36.80 ,$41.40 ,$45.98 ,$39.10 ,$18.39 ,$18.39 ,$39.10 ,$18.39 ,$19.14 , N/A , N/A ,$19.31 ,$39.10 ,$12.88 ,$41.40 ,$36.11 ,$38.00 ,$18.39 ,$29.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101371,84154,HC PSA FREE-90,301,1 ,$162.00 ,$105.30 ,$18.39 ,$162.00 ,$45.98 ,$129.60 ,$18.39 ,$45.36 ,$128.37 ,$148.72 ,$18.39 ,$148.72 ,$18.39 ,$34.94 ,$119.88 ,$45.98 ,$18.39 ,$135.11 ,$18.39 , N/A ,$133.81 ,$133.81 ,$129.60 ,$145.80 ,$45.98 ,$137.70 ,$18.39 ,$18.39 ,$137.70 ,$18.39 ,$67.39 , N/A , N/A ,$19.31 ,$137.70 ,$45.36 ,$145.80 ,$127.17 ,$133.81 ,$18.39 ,$105.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101372,84155,HC PROTEIN TOTAL-90,301,1 ,$83.00 ,$53.95 ,$3.67 ,$83.00 ,$9.18 ,$66.40 ,$3.67 ,$23.24 ,$65.77 ,$76.19 ,$3.67 ,$76.19 ,$3.67 ,$6.97 ,$61.42 ,$9.18 ,$3.67 ,$69.22 ,$3.67 , N/A ,$68.56 ,$68.56 ,$66.40 ,$74.70 ,$9.18 ,$70.55 ,$3.67 ,$3.67 ,$70.55 ,$3.67 ,$34.53 , N/A , N/A ,$3.85 ,$70.55 ,$23.24 ,$74.70 ,$65.16 ,$68.56 ,$3.67 ,$53.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101373,84156,HC PROTEIN TOTAL URINE-90,301,1 ,$20.00 ,$13.00 ,$3.67 ,$20.00 ,$9.18 ,$16.00 ,$3.67 ,$5.60 ,$15.85 ,$18.36 ,$3.67 ,$18.36 ,$3.67 ,$6.97 ,$14.80 ,$9.18 ,$3.67 ,$16.68 ,$3.67 , N/A ,$16.52 ,$16.52 ,$16.00 ,$18.00 ,$9.18 ,$17.00 ,$3.67 ,$3.67 ,$17.00 ,$3.67 ,$8.32 , N/A , N/A ,$3.85 ,$17.00 ,$5.60 ,$18.00 ,$15.70 ,$16.52 ,$3.67 ,$13.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101374,84157,HC PROTEIN TOTAL OTH SRC-90,301,1 ,$125.00 ,$81.25 ,$4.00 ,$125.00 ,$10.00 ,$100.00 ,$4.00 ,$35.00 ,$99.05 ,$114.75 ,$4.00 ,$114.75 ,$4.00 ,$7.60 ,$92.50 ,$10.00 ,$4.00 ,$104.25 ,$4.00 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$10.00 ,$106.25 ,$4.00 ,$4.00 ,$106.25 ,$4.00 ,$52.00 , N/A , N/A ,$4.20 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$4.00 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101375,84165,HC PROTEIN ELECTROPHORESIS-90,301,1 ,$180.00 ,$117.00 ,$10.74 ,$180.00 ,$26.85 ,$144.00 ,$10.74 ,$50.40 ,$142.63 ,$165.24 ,$10.74 ,$165.24 ,$10.74 ,$20.41 ,$133.20 ,$26.85 ,$10.74 ,$150.12 ,$10.74 , N/A ,$148.68 ,$148.68 ,$144.00 ,$162.00 ,$26.85 ,$153.00 ,$10.74 ,$10.74 ,$153.00 ,$10.74 ,$74.88 , N/A , N/A ,$11.28 ,$153.00 ,$50.40 ,$162.00 ,$141.30 ,$148.68 ,$10.74 ,$117.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101377,84166,HC PROTEIN EP OTH FLUID-90,301,1 ,$180.00 ,$117.00 ,$17.83 ,$180.00 ,$44.58 ,$144.00 ,$17.83 ,$50.40 ,$142.63 ,$165.24 ,$17.83 ,$165.24 ,$17.83 ,$33.88 ,$133.20 ,$44.58 ,$17.83 ,$150.12 ,$17.83 , N/A ,$148.68 ,$148.68 ,$144.00 ,$162.00 ,$44.58 ,$153.00 ,$17.83 ,$17.83 ,$153.00 ,$17.83 ,$74.88 , N/A , N/A ,$18.72 ,$153.00 ,$50.40 ,$162.00 ,$141.30 ,$148.68 ,$17.83 ,$117.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101381,84202,HC PROTOPORPHYRIN-90,301,1 ,$162.00 ,$105.30 ,$14.35 ,$162.00 ,$35.88 ,$129.60 ,$14.35 ,$45.36 ,$128.37 ,$148.72 ,$14.35 ,$148.72 ,$14.35 ,$27.27 ,$119.88 ,$35.88 ,$14.35 ,$135.11 ,$14.35 , N/A ,$133.81 ,$133.81 ,$129.60 ,$145.80 ,$35.88 ,$137.70 ,$14.35 ,$14.35 ,$137.70 ,$14.35 ,$67.39 , N/A , N/A ,$15.07 ,$137.70 ,$45.36 ,$145.80 ,$127.17 ,$133.81 ,$14.35 ,$105.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101382,84206,HC PROINSULIN-90,301,1 ,$196.00 ,$127.40 ,$26.69 ,$196.00 ,$66.73 ,$156.80 ,$26.69 ,$54.88 ,$155.31 ,$179.93 ,$26.69 ,$179.93 ,$26.69 ,$50.71 ,$145.04 ,$66.73 ,$26.69 ,$163.46 ,$26.69 , N/A ,$161.90 ,$161.90 ,$156.80 ,$176.40 ,$66.73 ,$166.60 ,$26.69 ,$26.69 ,$166.60 ,$26.69 ,$81.54 , N/A , N/A ,$28.02 ,$166.60 ,$54.88 ,$176.40 ,$153.86 ,$161.90 ,$26.69 ,$127.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101383,84207,HC VITAMIN B6-90,301,1 ,$137.00 ,$89.05 ,$28.10 ,$137.00 ,$70.25 ,$109.60 ,$28.10 ,$38.36 ,$108.56 ,$125.77 ,$28.10 ,$125.77 ,$28.10 ,$53.39 ,$101.38 ,$70.25 ,$28.10 ,$114.26 ,$28.10 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$70.25 ,$116.45 ,$28.10 ,$28.10 ,$116.45 ,$28.10 ,$56.99 , N/A , N/A ,$29.51 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$28.10 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101386,84238,HC RECEPTOR ASSAY NON ENDO-90,301,1 ,$121.00 ,$78.65 ,$33.88 ,$121.00 ,$91.43 ,$96.80 ,$36.57 ,$33.88 ,$95.88 ,$111.08 ,$36.57 ,$111.08 ,$36.57 ,$69.48 ,$89.54 ,$91.43 ,$36.57 ,$100.91 ,$36.57 , N/A ,$99.95 ,$99.95 ,$96.80 ,$108.90 ,$91.43 ,$102.85 ,$36.57 ,$36.57 ,$102.85 ,$36.57 ,$50.34 , N/A , N/A ,$38.40 ,$102.85 ,$33.88 ,$108.90 ,$94.99 ,$99.95 ,$36.57 ,$78.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101387,84244,HC RENIN-90,301,1 ,$183.00 ,$118.95 ,$21.99 ,$183.00 ,$54.98 ,$146.40 ,$21.99 ,$51.24 ,$145.01 ,$167.99 ,$21.99 ,$167.99 ,$21.99 ,$41.78 ,$135.42 ,$54.98 ,$21.99 ,$152.62 ,$21.99 , N/A ,$151.16 ,$151.16 ,$146.40 ,$164.70 ,$54.98 ,$155.55 ,$21.99 ,$21.99 ,$155.55 ,$21.99 ,$76.13 , N/A , N/A ,$23.09 ,$155.55 ,$51.24 ,$164.70 ,$143.66 ,$151.16 ,$21.99 ,$118.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101388,84255,HC SELENIUM-90,301,1 ,$162.00 ,$105.30 ,$25.53 ,$162.00 ,$63.83 ,$129.60 ,$25.53 ,$45.36 ,$128.37 ,$148.72 ,$25.53 ,$148.72 ,$25.53 ,$48.51 ,$119.88 ,$63.83 ,$25.53 ,$135.11 ,$25.53 , N/A ,$133.81 ,$133.81 ,$129.60 ,$145.80 ,$63.83 ,$137.70 ,$25.53 ,$25.53 ,$137.70 ,$25.53 ,$67.39 , N/A , N/A ,$26.81 ,$137.70 ,$45.36 ,$145.80 ,$127.17 ,$133.81 ,$25.53 ,$105.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101390,84270,HC SEX HORMONE BIND GLOB-90,301,1 ,$126.00 ,$81.90 ,$21.73 ,$126.00 ,$54.33 ,$100.80 ,$21.73 ,$35.28 ,$99.84 ,$115.67 ,$21.73 ,$115.67 ,$21.73 ,$41.29 ,$93.24 ,$54.33 ,$21.73 ,$105.08 ,$21.73 , N/A ,$104.08 ,$104.08 ,$100.80 ,$113.40 ,$54.33 ,$107.10 ,$21.73 ,$21.73 ,$107.10 ,$21.73 ,$52.42 , N/A , N/A ,$22.82 ,$107.10 ,$35.28 ,$113.40 ,$98.91 ,$104.08 ,$21.73 ,$81.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101392,84260,HC SEROTONIN-90,301,1 ,$262.00 ,$170.30 ,$30.98 ,$262.00 ,$77.45 ,$209.60 ,$30.98 ,$73.36 ,$207.61 ,$240.52 ,$30.98 ,$240.52 ,$30.98 ,$58.86 ,$193.88 ,$77.45 ,$30.98 ,$218.51 ,$30.98 , N/A ,$216.41 ,$216.41 ,$209.60 ,$235.80 ,$77.45 ,$222.70 ,$30.98 ,$30.98 ,$222.70 ,$30.98 ,$108.99 , N/A , N/A ,$32.53 ,$222.70 ,$73.36 ,$235.80 ,$205.67 ,$216.41 ,$30.98 ,$170.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101395,84302,HC SODIUM OTHER FLUID-90,301,1 ,$196.00 ,$127.40 ,$4.86 ,$196.00 ,$12.15 ,$156.80 ,$4.86 ,$54.88 ,$155.31 ,$179.93 ,$4.86 ,$179.93 ,$4.86 ,$9.23 ,$145.04 ,$12.15 ,$4.86 ,$163.46 ,$4.86 , N/A ,$161.90 ,$161.90 ,$156.80 ,$176.40 ,$12.15 ,$166.60 ,$4.86 ,$4.86 ,$166.60 ,$4.86 ,$81.54 , N/A , N/A ,$5.10 ,$166.60 ,$54.88 ,$176.40 ,$153.86 ,$161.90 ,$4.86 ,$127.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101396,84305,HC SOMATOMEDIN-90,301,1 ,$279.00 ,$181.35 ,$21.26 ,$279.00 ,$53.15 ,$223.20 ,$21.26 ,$78.12 ,$221.08 ,$256.12 ,$21.26 ,$256.12 ,$21.26 ,$40.39 ,$206.46 ,$53.15 ,$21.26 ,$232.69 ,$21.26 , N/A ,$230.45 ,$230.45 ,$223.20 ,$251.10 ,$53.15 ,$237.15 ,$21.26 ,$21.26 ,$237.15 ,$21.26 ,$116.06 , N/A , N/A ,$22.32 ,$237.15 ,$78.12 ,$251.10 ,$219.02 ,$230.45 ,$21.26 ,$181.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101398,84311,HC SPECTROPHOTOMETRY-90,301,1 ,$273.00 ,$177.45 ,$8.10 ,$273.00 ,$20.25 ,$218.40 ,$8.10 ,$76.44 ,$216.33 ,$250.61 ,$8.10 ,$250.61 ,$8.10 ,$15.39 ,$202.02 ,$20.25 ,$8.10 ,$227.68 ,$8.10 , N/A ,$225.50 ,$225.50 ,$218.40 ,$245.70 ,$20.25 ,$232.05 ,$8.10 ,$8.10 ,$232.05 ,$8.10 ,$113.57 , N/A , N/A ,$8.51 ,$232.05 ,$76.44 ,$245.70 ,$214.31 ,$225.50 ,$8.10 ,$177.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101402,84376,HC SUGARS SINGLE QL-90,301,1 ,$89.00 ,$57.85 ,$5.50 ,$89.00 ,$13.75 ,$71.20 ,$5.50 ,$24.92 ,$70.52 ,$81.70 ,$5.50 ,$81.70 ,$5.50 ,$10.45 ,$65.86 ,$13.75 ,$5.50 ,$74.23 ,$5.50 , N/A ,$73.51 ,$73.51 ,$71.20 ,$80.10 ,$13.75 ,$75.65 ,$5.50 ,$5.50 ,$75.65 ,$5.50 ,$37.02 , N/A , N/A ,$5.78 ,$75.65 ,$24.92 ,$80.10 ,$69.87 ,$73.51 ,$5.50 ,$57.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101403,84378,HC SUGARS SINGLE QN-90,301,1 ,$185.00 ,$120.25 ,$11.53 ,$185.00 ,$28.83 ,$148.00 ,$11.53 ,$51.80 ,$146.59 ,$169.83 ,$11.53 ,$169.83 ,$11.53 ,$21.91 ,$136.90 ,$28.83 ,$11.53 ,$154.29 ,$11.53 , N/A ,$152.81 ,$152.81 ,$148.00 ,$166.50 ,$28.83 ,$157.25 ,$11.53 ,$11.53 ,$157.25 ,$11.53 ,$76.96 , N/A , N/A ,$12.11 ,$157.25 ,$51.80 ,$166.50 ,$145.23 ,$152.81 ,$11.53 ,$120.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101406,84402,HC TESTOSTERONE FREE-90,301,1 ,$230.00 ,$149.50 ,$25.47 ,$230.00 ,$63.68 ,$184.00 ,$25.47 ,$64.40 ,$182.25 ,$211.14 ,$25.47 ,$211.14 ,$25.47 ,$48.39 ,$170.20 ,$63.68 ,$25.47 ,$191.82 ,$25.47 , N/A ,$189.98 ,$189.98 ,$184.00 ,$207.00 ,$63.68 ,$195.50 ,$25.47 ,$25.47 ,$195.50 ,$25.47 ,$95.68 , N/A , N/A ,$26.74 ,$195.50 ,$64.40 ,$207.00 ,$180.55 ,$189.98 ,$25.47 ,$149.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101407,84403,HC TESTOSTERONE TOTAL-90,301,1 ,$299.00 ,$194.35 ,$25.81 ,$299.00 ,$64.53 ,$239.20 ,$25.81 ,$83.72 ,$236.93 ,$274.48 ,$25.81 ,$274.48 ,$25.81 ,$49.04 ,$221.26 ,$64.53 ,$25.81 ,$249.37 ,$25.81 , N/A ,$246.97 ,$246.97 ,$239.20 ,$269.10 ,$64.53 ,$254.15 ,$25.81 ,$25.81 ,$254.15 ,$25.81 ,$124.38 , N/A , N/A ,$27.10 ,$254.15 ,$83.72 ,$269.10 ,$234.72 ,$246.97 ,$25.81 ,$194.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101408,84425,HC VITAMIN B1-90,301,1 ,$425.00 ,$276.25 ,$21.23 ,$425.00 ,$53.08 ,$340.00 ,$21.23 ,$119.00 ,$336.77 ,$390.15 ,$21.23 ,$390.15 ,$21.23 ,$40.34 ,$314.50 ,$53.08 ,$21.23 ,$354.45 ,$21.23 , N/A ,$351.05 ,$351.05 ,$340.00 ,$382.50 ,$53.08 ,$361.25 ,$21.23 ,$21.23 ,$361.25 ,$21.23 ,$176.80 , N/A , N/A ,$22.29 ,$361.25 ,$119.00 ,$382.50 ,$333.63 ,$351.05 ,$21.23 ,$276.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101410,84432,HC THYROGLOBULIN-90,301,1 ,$128.00 ,$83.20 ,$16.06 ,$128.00 ,$40.15 ,$102.40 ,$16.06 ,$35.84 ,$101.43 ,$117.50 ,$16.06 ,$117.50 ,$16.06 ,$30.51 ,$94.72 ,$40.15 ,$16.06 ,$106.75 ,$16.06 , N/A ,$105.73 ,$105.73 ,$102.40 ,$115.20 ,$40.15 ,$108.80 ,$16.06 ,$16.06 ,$108.80 ,$16.06 ,$53.25 , N/A , N/A ,$16.86 ,$108.80 ,$35.84 ,$115.20 ,$100.48 ,$105.73 ,$16.06 ,$83.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101415,84442,HC THYROXINE BIND GLOB-90,301,1 ,$109.00 ,$70.85 ,$14.78 ,$109.00 ,$36.95 ,$87.20 ,$14.78 ,$30.52 ,$86.37 ,$100.06 ,$14.78 ,$100.06 ,$14.78 ,$28.08 ,$80.66 ,$36.95 ,$14.78 ,$90.91 ,$14.78 , N/A ,$90.03 ,$90.03 ,$87.20 ,$98.10 ,$36.95 ,$92.65 ,$14.78 ,$14.78 ,$92.65 ,$14.78 ,$45.34 , N/A , N/A ,$15.52 ,$92.65 ,$30.52 ,$98.10 ,$85.57 ,$90.03 ,$14.78 ,$70.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101417,84445,HC THYROID STIM IMMUNO GLOB-90,301,1 ,$226.00 ,$146.90 ,$50.86 ,$226.00 ,$127.15 ,$180.80 ,$50.86 ,$63.28 ,$179.08 ,$207.47 ,$50.86 ,$207.47 ,$50.86 ,$96.63 ,$167.24 ,$127.15 ,$50.86 ,$188.48 ,$50.86 , N/A ,$186.68 ,$186.68 ,$180.80 ,$203.40 ,$127.15 ,$192.10 ,$50.86 ,$50.86 ,$192.10 ,$50.86 ,$94.02 , N/A , N/A ,$53.40 ,$192.10 ,$63.28 ,$203.40 ,$177.41 ,$186.68 ,$50.86 ,$146.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101418,84446,HC VITAMIN E-90,301,1 ,$95.00 ,$61.75 ,$14.18 ,$95.00 ,$35.45 ,$76.00 ,$14.18 ,$26.60 ,$75.28 ,$87.21 ,$14.18 ,$87.21 ,$14.18 ,$26.94 ,$70.30 ,$35.45 ,$14.18 ,$79.23 ,$14.18 , N/A ,$78.47 ,$78.47 ,$76.00 ,$85.50 ,$35.45 ,$80.75 ,$14.18 ,$14.18 ,$80.75 ,$14.18 ,$39.52 , N/A , N/A ,$14.89 ,$80.75 ,$26.60 ,$85.50 ,$74.58 ,$78.47 ,$14.18 ,$61.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101419,84460,HC ALT-90,301,1 ,$125.00 ,$81.25 ,$5.30 ,$125.00 ,$13.25 ,$100.00 ,$5.30 ,$35.00 ,$99.05 ,$114.75 ,$5.30 ,$114.75 ,$5.30 ,$10.07 ,$92.50 ,$13.25 ,$5.30 ,$104.25 ,$5.30 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$13.25 ,$106.25 ,$5.30 ,$5.30 ,$106.25 ,$5.30 ,$52.00 , N/A , N/A ,$5.57 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$5.30 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101420,84466,HC TRANSFERRIN-90,301,1 ,$229.00 ,$148.85 ,$12.76 ,$229.00 ,$31.90 ,$183.20 ,$12.76 ,$64.12 ,$181.46 ,$210.22 ,$12.76 ,$210.22 ,$12.76 ,$24.24 ,$169.46 ,$31.90 ,$12.76 ,$190.99 ,$12.76 , N/A ,$189.15 ,$189.15 ,$183.20 ,$206.10 ,$31.90 ,$194.65 ,$12.76 ,$12.76 ,$194.65 ,$12.76 ,$95.26 , N/A , N/A ,$13.40 ,$194.65 ,$64.12 ,$206.10 ,$179.77 ,$189.15 ,$12.76 ,$148.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101422,84479,HC T3 UPTAKE-90,301,1 ,$114.00 ,$74.10 ,$6.47 ,$114.00 ,$16.18 ,$91.20 ,$6.47 ,$31.92 ,$90.33 ,$104.65 ,$6.47 ,$104.65 ,$6.47 ,$12.29 ,$84.36 ,$16.18 ,$6.47 ,$95.08 ,$6.47 , N/A ,$94.16 ,$94.16 ,$91.20 ,$102.60 ,$16.18 ,$96.90 ,$6.47 ,$6.47 ,$96.90 ,$6.47 ,$47.42 , N/A , N/A ,$6.79 ,$96.90 ,$31.92 ,$102.60 ,$89.49 ,$94.16 ,$6.47 ,$74.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101423,84480,HC T3 TOTAL-90,301,1 ,$295.00 ,$191.75 ,$14.18 ,$295.00 ,$35.45 ,$236.00 ,$14.18 ,$82.60 ,$233.76 ,$270.81 ,$14.18 ,$270.81 ,$14.18 ,$26.94 ,$218.30 ,$35.45 ,$14.18 ,$246.03 ,$14.18 , N/A ,$243.67 ,$243.67 ,$236.00 ,$265.50 ,$35.45 ,$250.75 ,$14.18 ,$14.18 ,$250.75 ,$14.18 ,$122.72 , N/A , N/A ,$14.89 ,$250.75 ,$82.60 ,$265.50 ,$231.58 ,$243.67 ,$14.18 ,$191.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101424,84481,HC T3 FREE-90,301,1 ,$173.00 ,$112.45 ,$16.94 ,$173.00 ,$42.35 ,$138.40 ,$16.94 ,$48.44 ,$137.09 ,$158.81 ,$16.94 ,$158.81 ,$16.94 ,$32.19 ,$128.02 ,$42.35 ,$16.94 ,$144.28 ,$16.94 , N/A ,$142.90 ,$142.90 ,$138.40 ,$155.70 ,$42.35 ,$147.05 ,$16.94 ,$16.94 ,$147.05 ,$16.94 ,$71.97 , N/A , N/A ,$17.79 ,$147.05 ,$48.44 ,$155.70 ,$135.81 ,$142.90 ,$16.94 ,$112.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101425,84482,HC T3 REVERSE-90,301,1 ,$123.00 ,$79.95 ,$15.76 ,$123.00 ,$39.40 ,$98.40 ,$15.76 ,$34.44 ,$97.47 ,$112.91 ,$15.76 ,$112.91 ,$15.76 ,$29.94 ,$91.02 ,$39.40 ,$15.76 ,$102.58 ,$15.76 , N/A ,$101.60 ,$101.60 ,$98.40 ,$110.70 ,$39.40 ,$104.55 ,$15.76 ,$15.76 ,$104.55 ,$15.76 ,$51.17 , N/A , N/A ,$16.55 ,$104.55 ,$34.44 ,$110.70 ,$96.56 ,$101.60 ,$15.76 ,$79.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101434,84560,HC URIC ACID OTH SRC-90,301,1 ,$45.00 ,$29.25 ,$5.08 ,$45.00 ,$12.70 ,$36.00 ,$5.08 ,$12.60 ,$35.66 ,$41.31 ,$5.08 ,$41.31 ,$5.08 ,$9.65 ,$33.30 ,$12.70 ,$5.08 ,$37.53 ,$5.08 , N/A ,$37.17 ,$37.17 ,$36.00 ,$40.50 ,$12.70 ,$38.25 ,$5.08 ,$5.08 ,$38.25 ,$5.08 ,$18.72 , N/A , N/A ,$5.33 ,$38.25 ,$12.60 ,$40.50 ,$35.33 ,$37.17 ,$5.08 ,$29.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101435,84585,HC VANILLYLMAND AC (VMA)-90,301,1 ,$291.00 ,$189.15 ,$15.50 ,$291.00 ,$38.75 ,$232.80 ,$15.50 ,$81.48 ,$230.59 ,$267.14 ,$15.50 ,$267.14 ,$15.50 ,$29.45 ,$215.34 ,$38.75 ,$15.50 ,$242.69 ,$15.50 , N/A ,$240.37 ,$240.37 ,$232.80 ,$261.90 ,$38.75 ,$247.35 ,$15.50 ,$15.50 ,$247.35 ,$15.50 ,$121.06 , N/A , N/A ,$16.28 ,$247.35 ,$81.48 ,$261.90 ,$228.44 ,$240.37 ,$15.50 ,$189.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101438,84590,HC VITAMIN A-90,301,1 ,$95.00 ,$61.75 ,$11.61 ,$95.00 ,$29.03 ,$76.00 ,$11.61 ,$26.60 ,$75.28 ,$87.21 ,$11.61 ,$87.21 ,$11.61 ,$22.06 ,$70.30 ,$29.03 ,$11.61 ,$79.23 ,$11.61 , N/A ,$78.47 ,$78.47 ,$76.00 ,$85.50 ,$29.03 ,$80.75 ,$11.61 ,$11.61 ,$80.75 ,$11.61 ,$39.52 , N/A , N/A ,$12.19 ,$80.75 ,$26.60 ,$85.50 ,$74.58 ,$78.47 ,$11.61 ,$61.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101440,84597,HC VITAMIN K-90,301,1 ,$715.00 ,$464.75 ,$13.72 ,$715.00 ,$34.30 ,$572.00 ,$13.72 ,$200.20 ,$566.57 ,$656.37 ,$13.72 ,$656.37 ,$13.72 ,$26.07 ,$529.10 ,$34.30 ,$13.72 ,$596.31 ,$13.72 , N/A ,$590.59 ,$590.59 ,$572.00 ,$643.50 ,$34.30 ,$607.75 ,$13.72 ,$13.72 ,$607.75 ,$13.72 ,$297.44 , N/A , N/A ,$14.41 ,$607.75 ,$200.20 ,$643.50 ,$561.28 ,$590.59 ,$13.72 ,$464.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101442,84630,HC ZINC-90,301,1 ,$158.00 ,$102.70 ,$11.39 ,$158.00 ,$28.48 ,$126.40 ,$11.39 ,$44.24 ,$125.20 ,$145.04 ,$11.39 ,$145.04 ,$11.39 ,$21.64 ,$116.92 ,$28.48 ,$11.39 ,$131.77 ,$11.39 , N/A ,$130.51 ,$130.51 ,$126.40 ,$142.20 ,$28.48 ,$134.30 ,$11.39 ,$11.39 ,$134.30 ,$11.39 ,$65.73 , N/A , N/A ,$11.96 ,$134.30 ,$44.24 ,$142.20 ,$124.03 ,$130.51 ,$11.39 ,$102.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101443,84681,HC C PEPTIDE-90,301,1 ,$346.00 ,$224.90 ,$20.81 ,$346.00 ,$52.03 ,$276.80 ,$20.81 ,$96.88 ,$274.17 ,$317.63 ,$20.81 ,$317.63 ,$20.81 ,$39.54 ,$256.04 ,$52.03 ,$20.81 ,$288.56 ,$20.81 , N/A ,$285.80 ,$285.80 ,$276.80 ,$311.40 ,$52.03 ,$294.10 ,$20.81 ,$20.81 ,$294.10 ,$20.81 ,$143.94 , N/A , N/A ,$21.85 ,$294.10 ,$96.88 ,$311.40 ,$271.61 ,$285.80 ,$20.81 ,$224.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101444,84702,HC HCG QN-90,301,1 ,$98.00 ,$63.70 ,$15.05 ,$98.00 ,$37.63 ,$78.40 ,$15.05 ,$27.44 ,$77.66 ,$89.96 ,$15.05 ,$89.96 ,$15.05 ,$28.60 ,$72.52 ,$37.63 ,$15.05 ,$81.73 ,$15.05 , N/A ,$80.95 ,$80.95 ,$78.40 ,$88.20 ,$37.63 ,$83.30 ,$15.05 ,$15.05 ,$83.30 ,$15.05 ,$40.77 , N/A , N/A ,$15.80 ,$83.30 ,$27.44 ,$88.20 ,$76.93 ,$80.95 ,$15.05 ,$63.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101450,G0480,HC DRUG SCRN DEFINT 1-7 CLASS T1,301,1 ,$368.00 ,$239.20 ,$103.04 ,$368.00 ,$286.08 ,$294.40 ,$114.43 ,$103.04 ,$291.60 ,$337.82 ,$114.43 ,$337.82 ,$114.43 ,$217.42 ,$272.32 ,$286.08 ,$114.43 ,$306.91 ,$114.43 , N/A ,$303.97 ,$303.97 ,$294.40 ,$331.20 ,$286.08 ,$312.80 ,$114.43 ,$114.43 ,$312.80 ,$114.43 ,$153.09 , N/A , N/A ,$120.15 ,$312.80 ,$103.04 ,$331.20 ,$288.88 ,$303.97 ,$114.43 ,$239.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101451,G0480,HC DRUG SCRN DEFINT 1-7 CLASS T2,301,1 ,$368.00 ,$239.20 ,$103.04 ,$368.00 ,$286.08 ,$294.40 ,$114.43 ,$103.04 ,$291.60 ,$337.82 ,$114.43 ,$337.82 ,$114.43 ,$217.42 ,$272.32 ,$286.08 ,$114.43 ,$306.91 ,$114.43 , N/A ,$303.97 ,$303.97 ,$294.40 ,$331.20 ,$286.08 ,$312.80 ,$114.43 ,$114.43 ,$312.80 ,$114.43 ,$153.09 , N/A , N/A ,$120.15 ,$312.80 ,$103.04 ,$331.20 ,$288.88 ,$303.97 ,$114.43 ,$239.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101452,G0480,HC DRUG SCRN DEFINT 1-7 CLASS T3,301,1 ,$192.00 ,$124.80 ,$53.76 ,$286.08 ,$286.08 ,$153.60 ,$114.43 ,$53.76 ,$152.14 ,$176.26 ,$114.43 ,$176.26 ,$114.43 ,$192.00 ,$142.08 ,$192.00 ,$114.43 ,$160.13 ,$114.43 , N/A ,$158.59 ,$158.59 ,$153.60 ,$172.80 ,$192.00 ,$163.20 ,$114.43 ,$114.43 ,$163.20 ,$114.43 ,$79.87 , N/A , N/A ,$120.15 ,$163.20 ,$53.76 ,$172.80 ,$150.72 ,$158.59 ,$114.43 ,$124.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101455,G0480,HC DRUG SCRN DEFNT 1-7 CLS T1-90,301,1 ,$368.00 ,$239.20 ,$103.04 ,$368.00 ,$286.08 ,$294.40 ,$114.43 ,$103.04 ,$291.60 ,$337.82 ,$114.43 ,$337.82 ,$114.43 ,$217.42 ,$272.32 ,$286.08 ,$114.43 ,$306.91 ,$114.43 , N/A ,$303.97 ,$303.97 ,$294.40 ,$331.20 ,$286.08 ,$312.80 ,$114.43 ,$114.43 ,$312.80 ,$114.43 ,$153.09 , N/A , N/A ,$120.15 ,$312.80 ,$103.04 ,$331.20 ,$288.88 ,$303.97 ,$114.43 ,$239.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101465,83921,HC ORGANIC ACIDS QN SINGLE-90,301,1 ,$149.00 ,$96.85 ,$21.21 ,$149.00 ,$53.03 ,$119.20 ,$21.21 ,$41.72 ,$118.07 ,$136.78 ,$21.21 ,$136.78 ,$21.21 ,$40.30 ,$110.26 ,$53.03 ,$21.21 ,$124.27 ,$21.21 , N/A ,$123.07 ,$123.07 ,$119.20 ,$134.10 ,$53.03 ,$126.65 ,$21.21 ,$21.21 ,$126.65 ,$21.21 ,$61.98 , N/A , N/A ,$22.27 ,$126.65 ,$41.72 ,$134.10 ,$116.97 ,$123.07 ,$21.21 ,$96.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101476,82610,HC CYSTATIN C -90,301,1 ,$121.00 ,$78.65 ,$18.52 ,$121.00 ,$46.30 ,$96.80 ,$18.52 ,$33.88 ,$95.88 ,$111.08 ,$18.52 ,$111.08 ,$18.52 ,$35.19 ,$89.54 ,$46.30 ,$18.52 ,$100.91 ,$18.52 , N/A ,$99.95 ,$99.95 ,$96.80 ,$108.90 ,$46.30 ,$102.85 ,$18.52 ,$18.52 ,$102.85 ,$18.52 ,$50.34 , N/A , N/A ,$19.45 ,$102.85 ,$33.88 ,$108.90 ,$94.99 ,$99.95 ,$18.52 ,$78.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101477,83519,HC QN RIA MUSK-90,301,1 ,$237.00 ,$154.05 ,$18.40 ,$237.00 ,$46.00 ,$189.60 ,$18.40 ,$66.36 ,$187.80 ,$217.57 ,$18.40 ,$217.57 ,$18.40 ,$34.96 ,$175.38 ,$46.00 ,$18.40 ,$197.66 ,$18.40 , N/A ,$195.76 ,$195.76 ,$189.60 ,$213.30 ,$46.00 ,$201.45 ,$18.40 ,$18.40 ,$201.45 ,$18.40 ,$98.59 , N/A , N/A ,$19.32 ,$201.45 ,$66.36 ,$213.30 ,$186.05 ,$195.76 ,$18.40 ,$154.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101503,G0328,HC OCCULT BLOOD FECAL SCRN - AMB-QW,301,1 ,$83.00 ,$53.95 ,$18.05 ,$83.00 ,$45.13 ,$66.40 ,$18.05 ,$23.24 ,$65.77 ,$76.19 ,$18.05 ,$76.19 ,$18.05 ,$34.30 ,$61.42 ,$45.13 ,$18.05 ,$69.22 ,$18.05 , N/A ,$68.56 ,$68.56 ,$66.40 ,$74.70 ,$45.13 ,$70.55 ,$18.05 ,$18.05 ,$70.55 ,$18.05 ,$34.53 , N/A , N/A ,$18.95 ,$70.55 ,$23.24 ,$74.70 ,$65.16 ,$68.56 ,$18.05 ,$53.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101509,82330,HC CALCIUM IONIZED STAT -90,301,1 ,$310.00 ,$201.50 ,$13.68 ,$310.00 ,$34.20 ,$248.00 ,$13.68 ,$86.80 ,$245.64 ,$284.58 ,$13.68 ,$284.58 ,$13.68 ,$25.99 ,$229.40 ,$34.20 ,$13.68 ,$258.54 ,$13.68 , N/A ,$256.06 ,$256.06 ,$248.00 ,$279.00 ,$34.20 ,$263.50 ,$13.68 ,$13.68 ,$263.50 ,$13.68 ,$128.96 , N/A , N/A ,$14.36 ,$263.50 ,$86.80 ,$279.00 ,$243.35 ,$256.06 ,$13.68 ,$201.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101511,80345,HC BARBITURATE -90,301,1 ,$110.00 ,$71.50 ,$30.80 ,$110.00 , N/A ,$88.00 , N/A ,$30.80 ,$87.16 ,$100.98 , N/A ,$100.98 , N/A , N/A ,$81.40 , N/A , N/A ,$91.74 , N/A , N/A ,$90.86 ,$90.86 ,$88.00 ,$99.00 , N/A ,$93.50 , N/A , N/A ,$93.50 , N/A ,$45.76 , N/A , N/A , N/A ,$93.50 ,$30.80 ,$99.00 ,$86.35 ,$90.86 , N/A ,$71.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101543,80074,HC HEPATITIS PANEL ACUTE,301,1 ,$169.00 ,$109.85 ,$47.32 ,$169.00 ,$119.08 ,$135.20 ,$47.63 ,$47.32 ,$133.92 ,$155.14 ,$47.63 ,$155.14 ,$47.63 ,$90.50 ,$125.06 ,$119.08 ,$47.63 ,$140.95 ,$47.63 , N/A ,$139.59 ,$139.59 ,$135.20 ,$152.10 ,$119.08 ,$143.65 ,$47.63 ,$47.63 ,$143.65 ,$47.63 ,$70.30 , N/A , N/A ,$50.01 ,$143.65 ,$47.32 ,$152.10 ,$132.67 ,$139.59 ,$47.63 ,$109.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101545,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$217.00 ,$141.05 ,$14.57 ,$217.00 ,$36.43 ,$173.60 ,$14.57 ,$60.76 ,$171.95 ,$199.21 ,$14.57 ,$199.21 ,$14.57 ,$27.68 ,$160.58 ,$36.43 ,$14.57 ,$180.98 ,$14.57 , N/A ,$179.24 ,$179.24 ,$173.60 ,$195.30 ,$36.43 ,$184.45 ,$14.57 ,$14.57 ,$184.45 ,$14.57 ,$90.27 , N/A , N/A ,$15.30 ,$184.45 ,$60.76 ,$195.30 ,$170.35 ,$179.24 ,$14.57 ,$141.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101547,80170,HC GENTAMICIN,301,1 ,$211.00 ,$137.15 ,$16.38 ,$211.00 ,$40.95 ,$168.80 ,$16.38 ,$59.08 ,$167.20 ,$193.70 ,$16.38 ,$193.70 ,$16.38 ,$31.12 ,$156.14 ,$40.95 ,$16.38 ,$175.97 ,$16.38 , N/A ,$174.29 ,$174.29 ,$168.80 ,$189.90 ,$40.95 ,$179.35 ,$16.38 ,$16.38 ,$179.35 ,$16.38 ,$87.78 , N/A , N/A ,$17.20 ,$179.35 ,$59.08 ,$189.90 ,$165.64 ,$174.29 ,$16.38 ,$137.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101548,80178,HC LITHIUM,301,1 ,$104.00 ,$67.60 ,$6.61 ,$104.00 ,$16.53 ,$83.20 ,$6.61 ,$29.12 ,$82.41 ,$95.47 ,$6.61 ,$95.47 ,$6.61 ,$12.56 ,$76.96 ,$16.53 ,$6.61 ,$86.74 ,$6.61 , N/A ,$85.90 ,$85.90 ,$83.20 ,$93.60 ,$16.53 ,$88.40 ,$6.61 ,$6.61 ,$88.40 ,$6.61 ,$43.26 , N/A , N/A ,$6.94 ,$88.40 ,$29.12 ,$93.60 ,$81.64 ,$85.90 ,$6.61 ,$67.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101549,80184,HC PHENOBARBITAL,301,1 ,$152.00 ,$98.80 ,$15.30 ,$152.00 ,$38.25 ,$121.60 ,$15.30 ,$42.56 ,$120.44 ,$139.54 ,$15.30 ,$139.54 ,$15.30 ,$29.07 ,$112.48 ,$38.25 ,$15.30 ,$126.77 ,$15.30 , N/A ,$125.55 ,$125.55 ,$121.60 ,$136.80 ,$38.25 ,$129.20 ,$15.30 ,$15.30 ,$129.20 ,$15.30 ,$63.23 , N/A , N/A ,$16.07 ,$129.20 ,$42.56 ,$136.80 ,$119.32 ,$125.55 ,$15.30 ,$98.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101551,80198,HC THEOPHYLLINE,301,1 ,$196.00 ,$127.40 ,$14.14 ,$196.00 ,$35.35 ,$156.80 ,$14.14 ,$54.88 ,$155.31 ,$179.93 ,$14.14 ,$179.93 ,$14.14 ,$26.87 ,$145.04 ,$35.35 ,$14.14 ,$163.46 ,$14.14 , N/A ,$161.90 ,$161.90 ,$156.80 ,$176.40 ,$35.35 ,$166.60 ,$14.14 ,$14.14 ,$166.60 ,$14.14 ,$81.54 , N/A , N/A ,$14.85 ,$166.60 ,$54.88 ,$176.40 ,$153.86 ,$161.90 ,$14.14 ,$127.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101553,80299,HC THERAPEUTIC DRUG OTHER,301,1 ,$234.00 ,$152.10 ,$18.64 ,$234.00 ,$46.60 ,$187.20 ,$18.64 ,$65.52 ,$185.42 ,$214.81 ,$18.64 ,$214.81 ,$18.64 ,$35.42 ,$173.16 ,$46.60 ,$18.64 ,$195.16 ,$18.64 , N/A ,$193.28 ,$193.28 ,$187.20 ,$210.60 ,$46.60 ,$198.90 ,$18.64 ,$18.64 ,$198.90 ,$18.64 ,$97.34 , N/A , N/A ,$19.57 ,$198.90 ,$65.52 ,$210.60 ,$183.69 ,$193.28 ,$18.64 ,$152.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101555,81479,HC IDH GENE MUTATION ASSAY - 90,301,1 ,"$1,183.00 ",$768.95 ,$331.24 ,"$1,183.00 ", N/A ,$946.40 , N/A ,$331.24 ,$937.41 ,"$1,085.99 ", N/A ,"$1,085.99 ", N/A , N/A ,$875.42 , N/A , N/A ,$986.62 , N/A , N/A ,$977.16 ,$977.16 ,$946.40 ,"$1,064.70 ", N/A ,"$1,005.55 ", N/A , N/A ,"$1,005.55 ", N/A ,$492.13 , N/A , N/A , N/A ,"$1,005.55 ",$331.24 ,"$1,064.70 ",$928.66 ,$977.16 , N/A ,$768.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101556,82042,HC ALBUMIN OTHER SOURCE,301,1 ,$162.00 ,$105.30 ,$7.78 ,$162.00 ,$19.45 ,$129.60 ,$7.78 ,$45.36 ,$128.37 ,$148.72 ,$7.78 ,$148.72 ,$7.78 ,$14.78 ,$119.88 ,$19.45 ,$7.78 ,$135.11 ,$7.78 , N/A ,$133.81 ,$133.81 ,$129.60 ,$145.80 ,$19.45 ,$137.70 ,$7.78 ,$7.78 ,$137.70 ,$7.78 ,$67.39 , N/A , N/A ,$8.17 ,$137.70 ,$45.36 ,$145.80 ,$127.17 ,$133.81 ,$7.78 ,$105.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101559,82150,HC AMYLASE,301,1 ,$175.00 ,$113.75 ,$6.48 ,$175.00 ,$16.20 ,$140.00 ,$6.48 ,$49.00 ,$138.67 ,$160.65 ,$6.48 ,$160.65 ,$6.48 ,$12.31 ,$129.50 ,$16.20 ,$6.48 ,$145.95 ,$6.48 , N/A ,$144.55 ,$144.55 ,$140.00 ,$157.50 ,$16.20 ,$148.75 ,$6.48 ,$6.48 ,$148.75 ,$6.48 ,$72.80 , N/A , N/A ,$6.80 ,$148.75 ,$49.00 ,$157.50 ,$137.38 ,$144.55 ,$6.48 ,$113.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101563,82274,HC OCCULT BLOOD FECAL HGB-QW,301,1 ,$68.00 ,$44.20 ,$15.92 ,$68.00 ,$39.80 ,$54.40 ,$15.92 ,$19.04 ,$53.88 ,$62.42 ,$15.92 ,$62.42 ,$15.92 ,$30.25 ,$50.32 ,$39.80 ,$15.92 ,$56.71 ,$15.92 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$39.80 ,$57.80 ,$15.92 ,$15.92 ,$57.80 ,$15.92 ,$28.29 , N/A , N/A ,$16.72 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$15.92 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101564,82306,HC VITAMIN D 25 OH,301,1 ,$155.00 ,$100.75 ,$29.60 ,$155.00 ,$74.00 ,$124.00 ,$29.60 ,$43.40 ,$122.82 ,$142.29 ,$29.60 ,$142.29 ,$29.60 ,$56.24 ,$114.70 ,$74.00 ,$29.60 ,$129.27 ,$29.60 , N/A ,$128.03 ,$128.03 ,$124.00 ,$139.50 ,$74.00 ,$131.75 ,$29.60 ,$29.60 ,$131.75 ,$29.60 ,$64.48 , N/A , N/A ,$31.08 ,$131.75 ,$43.40 ,$139.50 ,$121.68 ,$128.03 ,$29.60 ,$100.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101565,82310,HC CALCIUM,301,1 ,$104.00 ,$67.60 ,$5.16 ,$104.00 ,$12.90 ,$83.20 ,$5.16 ,$29.12 ,$82.41 ,$95.47 ,$5.16 ,$95.47 ,$5.16 ,$9.80 ,$76.96 ,$12.90 ,$5.16 ,$86.74 ,$5.16 , N/A ,$85.90 ,$85.90 ,$83.20 ,$93.60 ,$12.90 ,$88.40 ,$5.16 ,$5.16 ,$88.40 ,$5.16 ,$43.26 , N/A , N/A ,$5.42 ,$88.40 ,$29.12 ,$93.60 ,$81.64 ,$85.90 ,$5.16 ,$67.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101566,82340,HC CALCIUM URINE QN TIMED,301,1 ,$57.00 ,$37.05 ,$6.03 ,$57.00 ,$15.08 ,$45.60 ,$6.03 ,$15.96 ,$45.17 ,$52.33 ,$6.03 ,$52.33 ,$6.03 ,$11.46 ,$42.18 ,$15.08 ,$6.03 ,$47.54 ,$6.03 , N/A ,$47.08 ,$47.08 ,$45.60 ,$51.30 ,$15.08 ,$48.45 ,$6.03 ,$6.03 ,$48.45 ,$6.03 ,$23.71 , N/A , N/A ,$6.33 ,$48.45 ,$15.96 ,$51.30 ,$44.75 ,$47.08 ,$6.03 ,$37.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101568,82378,HC CARBINOEMBRYONIC AG (CEA),301,1 ,$170.00 ,$110.50 ,$18.96 ,$170.00 ,$47.40 ,$136.00 ,$18.96 ,$47.60 ,$134.71 ,$156.06 ,$18.96 ,$156.06 ,$18.96 ,$36.02 ,$125.80 ,$47.40 ,$18.96 ,$141.78 ,$18.96 , N/A ,$140.42 ,$140.42 ,$136.00 ,$153.00 ,$47.40 ,$144.50 ,$18.96 ,$18.96 ,$144.50 ,$18.96 ,$70.72 , N/A , N/A ,$19.91 ,$144.50 ,$47.60 ,$153.00 ,$133.45 ,$140.42 ,$18.96 ,$110.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101569,82436,HC CHLORIDE URINE,301,1 ,$27.00 ,$17.55 ,$5.75 ,$27.00 ,$14.38 ,$21.60 ,$5.75 ,$7.56 ,$21.39 ,$24.79 ,$5.75 ,$24.79 ,$5.75 ,$10.93 ,$19.98 ,$14.38 ,$5.75 ,$22.52 ,$5.75 , N/A ,$22.30 ,$22.30 ,$21.60 ,$24.30 ,$14.38 ,$22.95 ,$5.75 ,$5.75 ,$22.95 ,$5.75 ,$11.23 , N/A , N/A ,$6.04 ,$22.95 ,$7.56 ,$24.30 ,$21.20 ,$22.30 ,$5.75 ,$17.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101571,82533,HC CORTISOL TOTAL,301,1 ,$93.00 ,$60.45 ,$16.30 ,$93.00 ,$40.75 ,$74.40 ,$16.30 ,$26.04 ,$73.69 ,$85.37 ,$16.30 ,$85.37 ,$16.30 ,$30.97 ,$68.82 ,$40.75 ,$16.30 ,$77.56 ,$16.30 , N/A ,$76.82 ,$76.82 ,$74.40 ,$83.70 ,$40.75 ,$79.05 ,$16.30 ,$16.30 ,$79.05 ,$16.30 ,$38.69 , N/A , N/A ,$17.12 ,$79.05 ,$26.04 ,$83.70 ,$73.01 ,$76.82 ,$16.30 ,$60.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101572,82570,HC CREATININE OTH SOURCE,301,1 ,$42.00 ,$27.30 ,$5.18 ,$42.00 ,$12.95 ,$33.60 ,$5.18 ,$11.76 ,$33.28 ,$38.56 ,$5.18 ,$38.56 ,$5.18 ,$9.84 ,$31.08 ,$12.95 ,$5.18 ,$35.03 ,$5.18 , N/A ,$34.69 ,$34.69 ,$33.60 ,$37.80 ,$12.95 ,$35.70 ,$5.18 ,$5.18 ,$35.70 ,$5.18 ,$17.47 , N/A , N/A ,$5.44 ,$35.70 ,$11.76 ,$37.80 ,$32.97 ,$34.69 ,$5.18 ,$27.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101573,82607,HC VITAMIN B12,301,1 ,$119.00 ,$77.35 ,$15.08 ,$119.00 ,$37.70 ,$95.20 ,$15.08 ,$33.32 ,$94.30 ,$109.24 ,$15.08 ,$109.24 ,$15.08 ,$28.65 ,$88.06 ,$37.70 ,$15.08 ,$99.25 ,$15.08 , N/A ,$98.29 ,$98.29 ,$95.20 ,$107.10 ,$37.70 ,$101.15 ,$15.08 ,$15.08 ,$101.15 ,$15.08 ,$49.50 , N/A , N/A ,$15.83 ,$101.15 ,$33.32 ,$107.10 ,$93.42 ,$98.29 ,$15.08 ,$77.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101574,82670,HC ESTRADIOL,301,1 ,$368.00 ,$239.20 ,$27.94 ,$368.00 ,$69.85 ,$294.40 ,$27.94 ,$103.04 ,$291.60 ,$337.82 ,$27.94 ,$337.82 ,$27.94 ,$53.09 ,$272.32 ,$69.85 ,$27.94 ,$306.91 ,$27.94 , N/A ,$303.97 ,$303.97 ,$294.40 ,$331.20 ,$69.85 ,$312.80 ,$27.94 ,$27.94 ,$312.80 ,$27.94 ,$153.09 , N/A , N/A ,$29.34 ,$312.80 ,$103.04 ,$331.20 ,$288.88 ,$303.97 ,$27.94 ,$239.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101575,82728,HC FERRITIN,301,1 ,$267.00 ,$173.55 ,$13.63 ,$267.00 ,$34.08 ,$213.60 ,$13.63 ,$74.76 ,$211.57 ,$245.11 ,$13.63 ,$245.11 ,$13.63 ,$25.90 ,$197.58 ,$34.08 ,$13.63 ,$222.68 ,$13.63 , N/A ,$220.54 ,$220.54 ,$213.60 ,$240.30 ,$34.08 ,$226.95 ,$13.63 ,$13.63 ,$226.95 ,$13.63 ,$111.07 , N/A , N/A ,$14.31 ,$226.95 ,$74.76 ,$240.30 ,$209.60 ,$220.54 ,$13.63 ,$173.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101577,82746,HC FOLIC ACID SERUM,301,1 ,$116.00 ,$75.40 ,$14.70 ,$116.00 ,$36.75 ,$92.80 ,$14.70 ,$32.48 ,$91.92 ,$106.49 ,$14.70 ,$106.49 ,$14.70 ,$27.93 ,$85.84 ,$36.75 ,$14.70 ,$96.74 ,$14.70 , N/A ,$95.82 ,$95.82 ,$92.80 ,$104.40 ,$36.75 ,$98.60 ,$14.70 ,$14.70 ,$98.60 ,$14.70 ,$48.26 , N/A , N/A ,$15.44 ,$98.60 ,$32.48 ,$104.40 ,$91.06 ,$95.82 ,$14.70 ,$75.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101579,82784,HC GAMMAGLOBULIN,301,1 ,$151.00 ,$98.15 ,$9.30 ,$151.00 ,$23.25 ,$120.80 ,$9.30 ,$42.28 ,$119.65 ,$138.62 ,$9.30 ,$138.62 ,$9.30 ,$17.67 ,$111.74 ,$23.25 ,$9.30 ,$125.93 ,$9.30 , N/A ,$124.73 ,$124.73 ,$120.80 ,$135.90 ,$23.25 ,$128.35 ,$9.30 ,$9.30 ,$128.35 ,$9.30 ,$62.82 , N/A , N/A ,$9.77 ,$128.35 ,$42.28 ,$135.90 ,$118.54 ,$124.73 ,$9.30 ,$98.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101580,82785,HC GAMMAGLOBULIN IGE,301,1 ,$252.00 ,$163.80 ,$16.46 ,$252.00 ,$41.15 ,$201.60 ,$16.46 ,$70.56 ,$199.68 ,$231.34 ,$16.46 ,$231.34 ,$16.46 ,$31.27 ,$186.48 ,$41.15 ,$16.46 ,$210.17 ,$16.46 , N/A ,$208.15 ,$208.15 ,$201.60 ,$226.80 ,$41.15 ,$214.20 ,$16.46 ,$16.46 ,$214.20 ,$16.46 ,$104.83 , N/A , N/A ,$17.28 ,$214.20 ,$70.56 ,$226.80 ,$197.82 ,$208.15 ,$16.46 ,$163.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101581,82945,HC GLUCOSE BODY FLUID,301,1 ,$113.00 ,$73.45 ,$3.93 ,$113.00 ,$9.83 ,$90.40 ,$3.93 ,$31.64 ,$89.54 ,$103.73 ,$3.93 ,$103.73 ,$3.93 ,$7.47 ,$83.62 ,$9.83 ,$3.93 ,$94.24 ,$3.93 , N/A ,$93.34 ,$93.34 ,$90.40 ,$101.70 ,$9.83 ,$96.05 ,$3.93 ,$3.93 ,$96.05 ,$3.93 ,$47.01 , N/A , N/A ,$4.13 ,$96.05 ,$31.64 ,$101.70 ,$88.71 ,$93.34 ,$3.93 ,$73.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101584,82977,HC GGT / GGTP,301,1 ,$131.00 ,$85.15 ,$7.20 ,$131.00 ,$18.00 ,$104.80 ,$7.20 ,$36.68 ,$103.80 ,$120.26 ,$7.20 ,$120.26 ,$7.20 ,$13.68 ,$96.94 ,$18.00 ,$7.20 ,$109.25 ,$7.20 , N/A ,$108.21 ,$108.21 ,$104.80 ,$117.90 ,$18.00 ,$111.35 ,$7.20 ,$7.20 ,$111.35 ,$7.20 ,$54.50 , N/A , N/A ,$7.56 ,$111.35 ,$36.68 ,$117.90 ,$102.84 ,$108.21 ,$7.20 ,$85.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101585,83001,HC FSH,301,1 ,$125.00 ,$81.25 ,$18.58 ,$125.00 ,$46.45 ,$100.00 ,$18.58 ,$35.00 ,$99.05 ,$114.75 ,$18.58 ,$114.75 ,$18.58 ,$35.30 ,$92.50 ,$46.45 ,$18.58 ,$104.25 ,$18.58 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$46.45 ,$106.25 ,$18.58 ,$18.58 ,$106.25 ,$18.58 ,$52.00 , N/A , N/A ,$19.51 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$18.58 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101586,83002,HC LUTEINIZING HORMONE (LH),301,1 ,$125.00 ,$81.25 ,$18.52 ,$125.00 ,$46.30 ,$100.00 ,$18.52 ,$35.00 ,$99.05 ,$114.75 ,$18.52 ,$114.75 ,$18.52 ,$35.19 ,$92.50 ,$46.30 ,$18.52 ,$104.25 ,$18.52 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$46.30 ,$106.25 ,$18.52 ,$18.52 ,$106.25 ,$18.52 ,$52.00 , N/A , N/A ,$19.45 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$18.52 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101587,83010,HC HAPTOGLOBIN,301,1 ,$57.00 ,$37.05 ,$12.58 ,$57.00 ,$31.45 ,$45.60 ,$12.58 ,$15.96 ,$45.17 ,$52.33 ,$12.58 ,$52.33 ,$12.58 ,$23.90 ,$42.18 ,$31.45 ,$12.58 ,$47.54 ,$12.58 , N/A ,$47.08 ,$47.08 ,$45.60 ,$51.30 ,$31.45 ,$48.45 ,$12.58 ,$12.58 ,$48.45 ,$12.58 ,$23.71 , N/A , N/A ,$13.21 ,$48.45 ,$15.96 ,$51.30 ,$44.75 ,$47.08 ,$12.58 ,$37.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101591,83090,HC HOMOCYSTEINE,301,1 ,$156.00 ,$101.40 ,$17.92 ,$156.00 ,$44.80 ,$124.80 ,$17.92 ,$43.68 ,$123.61 ,$143.21 ,$17.92 ,$143.21 ,$17.92 ,$34.05 ,$115.44 ,$44.80 ,$17.92 ,$130.10 ,$17.92 , N/A ,$128.86 ,$128.86 ,$124.80 ,$140.40 ,$44.80 ,$132.60 ,$17.92 ,$17.92 ,$132.60 ,$17.92 ,$64.90 , N/A , N/A ,$18.82 ,$132.60 ,$43.68 ,$140.40 ,$122.46 ,$128.86 ,$17.92 ,$101.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101592,83540,HC IRON TOTAL,301,1 ,$118.00 ,$76.70 ,$6.47 ,$118.00 ,$16.18 ,$94.40 ,$6.47 ,$33.04 ,$93.50 ,$108.32 ,$6.47 ,$108.32 ,$6.47 ,$12.29 ,$87.32 ,$16.18 ,$6.47 ,$98.41 ,$6.47 , N/A ,$97.47 ,$97.47 ,$94.40 ,$106.20 ,$16.18 ,$100.30 ,$6.47 ,$6.47 ,$100.30 ,$6.47 ,$49.09 , N/A , N/A ,$6.79 ,$100.30 ,$33.04 ,$106.20 ,$92.63 ,$97.47 ,$6.47 ,$76.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101594,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$124.00 ,$80.60 ,$6.04 ,$124.00 ,$15.10 ,$99.20 ,$6.04 ,$34.72 ,$98.26 ,$113.83 ,$6.04 ,$113.83 ,$6.04 ,$11.48 ,$91.76 ,$15.10 ,$6.04 ,$103.42 ,$6.04 , N/A ,$102.42 ,$102.42 ,$99.20 ,$111.60 ,$15.10 ,$105.40 ,$6.04 ,$6.04 ,$105.40 ,$6.04 ,$51.58 , N/A , N/A ,$6.34 ,$105.40 ,$34.72 ,$111.60 ,$97.34 ,$102.42 ,$6.04 ,$80.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101597,83874,HC MYOGLOBIN,301,1 ,$193.00 ,$125.45 ,$12.92 ,$193.00 ,$32.30 ,$154.40 ,$12.92 ,$54.04 ,$152.93 ,$177.17 ,$12.92 ,$177.17 ,$12.92 ,$24.55 ,$142.82 ,$32.30 ,$12.92 ,$160.96 ,$12.92 , N/A ,$159.42 ,$159.42 ,$154.40 ,$173.70 ,$32.30 ,$164.05 ,$12.92 ,$12.92 ,$164.05 ,$12.92 ,$80.29 , N/A , N/A ,$13.57 ,$164.05 ,$54.04 ,$173.70 ,$151.51 ,$159.42 ,$12.92 ,$125.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101598,83930,HC OSMOLALITY BLOOD,301,1 ,$154.00 ,$100.10 ,$6.61 ,$154.00 ,$16.53 ,$123.20 ,$6.61 ,$43.12 ,$122.03 ,$141.37 ,$6.61 ,$141.37 ,$6.61 ,$12.56 ,$113.96 ,$16.53 ,$6.61 ,$128.44 ,$6.61 , N/A ,$127.20 ,$127.20 ,$123.20 ,$138.60 ,$16.53 ,$130.90 ,$6.61 ,$6.61 ,$130.90 ,$6.61 ,$64.06 , N/A , N/A ,$6.94 ,$130.90 ,$43.12 ,$138.60 ,$120.89 ,$127.20 ,$6.61 ,$100.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101599,83935,HC OSMOLALITY URINE,301,1 ,$135.00 ,$87.75 ,$6.82 ,$135.00 ,$17.05 ,$108.00 ,$6.82 ,$37.80 ,$106.97 ,$123.93 ,$6.82 ,$123.93 ,$6.82 ,$12.96 ,$99.90 ,$17.05 ,$6.82 ,$112.59 ,$6.82 , N/A ,$111.51 ,$111.51 ,$108.00 ,$121.50 ,$17.05 ,$114.75 ,$6.82 ,$6.82 ,$114.75 ,$6.82 ,$56.16 , N/A , N/A ,$7.16 ,$114.75 ,$37.80 ,$121.50 ,$105.98 ,$111.51 ,$6.82 ,$87.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101600,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$132.00 ,$85.80 ,$36.96 ,$132.00 ,$103.20 ,$105.60 ,$41.28 ,$36.96 ,$104.60 ,$121.18 ,$41.28 ,$121.18 ,$41.28 ,$78.43 ,$97.68 ,$103.20 ,$41.28 ,$110.09 ,$41.28 , N/A ,$109.03 ,$109.03 ,$105.60 ,$118.80 ,$103.20 ,$112.20 ,$41.28 ,$41.28 ,$112.20 ,$41.28 ,$54.91 , N/A , N/A ,$43.34 ,$112.20 ,$36.96 ,$118.80 ,$103.62 ,$109.03 ,$41.28 ,$85.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101602,84105,HC PHOSPHORUS UR,301,1 ,$49.00 ,$31.85 ,$5.78 ,$49.00 ,$14.45 ,$39.20 ,$5.78 ,$13.72 ,$38.83 ,$44.98 ,$5.78 ,$44.98 ,$5.78 ,$10.98 ,$36.26 ,$14.45 ,$5.78 ,$40.87 ,$5.78 , N/A ,$40.47 ,$40.47 ,$39.20 ,$44.10 ,$14.45 ,$41.65 ,$5.78 ,$5.78 ,$41.65 ,$5.78 ,$20.38 , N/A , N/A ,$6.07 ,$41.65 ,$13.72 ,$44.10 ,$38.47 ,$40.47 ,$5.78 ,$31.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101604,84133,HC POTASSIUM UR,301,1 ,$34.00 ,$22.10 ,$4.73 ,$34.00 ,$11.83 ,$27.20 ,$4.73 ,$9.52 ,$26.94 ,$31.21 ,$4.73 ,$31.21 ,$4.73 ,$8.99 ,$25.16 ,$11.83 ,$4.73 ,$28.36 ,$4.73 , N/A ,$28.08 ,$28.08 ,$27.20 ,$30.60 ,$11.83 ,$28.90 ,$4.73 ,$4.73 ,$28.90 ,$4.73 ,$14.14 , N/A , N/A ,$4.97 ,$28.90 ,$9.52 ,$30.60 ,$26.69 ,$28.08 ,$4.73 ,$22.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101605,84134,HC PREALBUMIN,301,1 ,$160.00 ,$104.00 ,$14.59 ,$160.00 ,$36.48 ,$128.00 ,$14.59 ,$44.80 ,$126.78 ,$146.88 ,$14.59 ,$146.88 ,$14.59 ,$27.72 ,$118.40 ,$36.48 ,$14.59 ,$133.44 ,$14.59 , N/A ,$132.16 ,$132.16 ,$128.00 ,$144.00 ,$36.48 ,$136.00 ,$14.59 ,$14.59 ,$136.00 ,$14.59 ,$66.56 , N/A , N/A ,$15.32 ,$136.00 ,$44.80 ,$144.00 ,$125.60 ,$132.16 ,$14.59 ,$104.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101606,84144,HC PROGESTERONE,301,1 ,$112.00 ,$72.80 ,$20.86 ,$112.00 ,$52.15 ,$89.60 ,$20.86 ,$31.36 ,$88.75 ,$102.82 ,$20.86 ,$102.82 ,$20.86 ,$39.63 ,$82.88 ,$52.15 ,$20.86 ,$93.41 ,$20.86 , N/A ,$92.51 ,$92.51 ,$89.60 ,$100.80 ,$52.15 ,$95.20 ,$20.86 ,$20.86 ,$95.20 ,$20.86 ,$46.59 , N/A , N/A ,$21.90 ,$95.20 ,$31.36 ,$100.80 ,$87.92 ,$92.51 ,$20.86 ,$72.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101607,84145,HC PROCALCITONIN (PCT),301,1 ,$509.00 ,$330.85 ,$27.22 ,$509.00 ,$68.05 ,$407.20 ,$27.22 ,$142.52 ,$403.33 ,$467.26 ,$27.22 ,$467.26 ,$27.22 ,$51.72 ,$376.66 ,$68.05 ,$27.22 ,$424.51 ,$27.22 , N/A ,$420.43 ,$420.43 ,$407.20 ,$458.10 ,$68.05 ,$432.65 ,$27.22 ,$27.22 ,$432.65 ,$27.22 ,$211.74 , N/A , N/A ,$28.58 ,$432.65 ,$142.52 ,$458.10 ,$399.57 ,$420.43 ,$27.22 ,$330.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101608,84146,HC PROLACTIN,301,1 ,$135.00 ,$87.75 ,$19.38 ,$135.00 ,$48.45 ,$108.00 ,$19.38 ,$37.80 ,$106.97 ,$123.93 ,$19.38 ,$123.93 ,$19.38 ,$36.82 ,$99.90 ,$48.45 ,$19.38 ,$112.59 ,$19.38 , N/A ,$111.51 ,$111.51 ,$108.00 ,$121.50 ,$48.45 ,$114.75 ,$19.38 ,$19.38 ,$114.75 ,$19.38 ,$56.16 , N/A , N/A ,$20.35 ,$114.75 ,$37.80 ,$121.50 ,$105.98 ,$111.51 ,$19.38 ,$87.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101609,84153,HC PSA TOTAL,301,1 ,$267.00 ,$173.55 ,$18.39 ,$267.00 ,$45.98 ,$213.60 ,$18.39 ,$74.76 ,$211.57 ,$245.11 ,$18.39 ,$245.11 ,$18.39 ,$34.94 ,$197.58 ,$45.98 ,$18.39 ,$222.68 ,$18.39 , N/A ,$220.54 ,$220.54 ,$213.60 ,$240.30 ,$45.98 ,$226.95 ,$18.39 ,$18.39 ,$226.95 ,$18.39 ,$111.07 , N/A , N/A ,$19.31 ,$226.95 ,$74.76 ,$240.30 ,$209.60 ,$220.54 ,$18.39 ,$173.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101610,84154,HC PSA FREE,301,1 ,$162.00 ,$105.30 ,$18.39 ,$162.00 ,$45.98 ,$129.60 ,$18.39 ,$45.36 ,$128.37 ,$148.72 ,$18.39 ,$148.72 ,$18.39 ,$34.94 ,$119.88 ,$45.98 ,$18.39 ,$135.11 ,$18.39 , N/A ,$133.81 ,$133.81 ,$129.60 ,$145.80 ,$45.98 ,$137.70 ,$18.39 ,$18.39 ,$137.70 ,$18.39 ,$67.39 , N/A , N/A ,$19.31 ,$137.70 ,$45.36 ,$145.80 ,$127.17 ,$133.81 ,$18.39 ,$105.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101611,84155,HC PROTEIN TOTAL,301,1 ,$83.00 ,$53.95 ,$3.67 ,$83.00 ,$9.18 ,$66.40 ,$3.67 ,$23.24 ,$65.77 ,$76.19 ,$3.67 ,$76.19 ,$3.67 ,$6.97 ,$61.42 ,$9.18 ,$3.67 ,$69.22 ,$3.67 , N/A ,$68.56 ,$68.56 ,$66.40 ,$74.70 ,$9.18 ,$70.55 ,$3.67 ,$3.67 ,$70.55 ,$3.67 ,$34.53 , N/A , N/A ,$3.85 ,$70.55 ,$23.24 ,$74.70 ,$65.16 ,$68.56 ,$3.67 ,$53.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101612,84156,HC PROTEIN TOTAL URINE,301,1 ,$20.00 ,$13.00 ,$3.67 ,$20.00 ,$9.18 ,$16.00 ,$3.67 ,$5.60 ,$15.85 ,$18.36 ,$3.67 ,$18.36 ,$3.67 ,$6.97 ,$14.80 ,$9.18 ,$3.67 ,$16.68 ,$3.67 , N/A ,$16.52 ,$16.52 ,$16.00 ,$18.00 ,$9.18 ,$17.00 ,$3.67 ,$3.67 ,$17.00 ,$3.67 ,$8.32 , N/A , N/A ,$3.85 ,$17.00 ,$5.60 ,$18.00 ,$15.70 ,$16.52 ,$3.67 ,$13.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101613,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$125.00 ,$81.25 ,$4.00 ,$125.00 ,$10.00 ,$100.00 ,$4.00 ,$35.00 ,$99.05 ,$114.75 ,$4.00 ,$114.75 ,$4.00 ,$7.60 ,$92.50 ,$10.00 ,$4.00 ,$104.25 ,$4.00 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$10.00 ,$106.25 ,$4.00 ,$4.00 ,$106.25 ,$4.00 ,$52.00 , N/A , N/A ,$4.20 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$4.00 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101614,84165,HC PROTEIN ELECTROPHORESIS,301,1 ,$180.00 ,$117.00 ,$10.74 ,$180.00 ,$26.85 ,$144.00 ,$10.74 ,$50.40 ,$142.63 ,$165.24 ,$10.74 ,$165.24 ,$10.74 ,$20.41 ,$133.20 ,$26.85 ,$10.74 ,$150.12 ,$10.74 , N/A ,$148.68 ,$148.68 ,$144.00 ,$162.00 ,$26.85 ,$153.00 ,$10.74 ,$10.74 ,$153.00 ,$10.74 ,$74.88 , N/A , N/A ,$11.28 ,$153.00 ,$50.40 ,$162.00 ,$141.30 ,$148.68 ,$10.74 ,$117.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101615,84166,HC PROTEIN EP OTH FLUID,301,1 ,$180.00 ,$117.00 ,$17.83 ,$180.00 ,$44.58 ,$144.00 ,$17.83 ,$50.40 ,$142.63 ,$165.24 ,$17.83 ,$165.24 ,$17.83 ,$33.88 ,$133.20 ,$44.58 ,$17.83 ,$150.12 ,$17.83 , N/A ,$148.68 ,$148.68 ,$144.00 ,$162.00 ,$44.58 ,$153.00 ,$17.83 ,$17.83 ,$153.00 ,$17.83 ,$74.88 , N/A , N/A ,$18.72 ,$153.00 ,$50.40 ,$162.00 ,$141.30 ,$148.68 ,$17.83 ,$117.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101616,84270,HC SEX HORMONE BIND GLOB,301,1 ,$126.00 ,$81.90 ,$21.73 ,$126.00 ,$54.33 ,$100.80 ,$21.73 ,$35.28 ,$99.84 ,$115.67 ,$21.73 ,$115.67 ,$21.73 ,$41.29 ,$93.24 ,$54.33 ,$21.73 ,$105.08 ,$21.73 , N/A ,$104.08 ,$104.08 ,$100.80 ,$113.40 ,$54.33 ,$107.10 ,$21.73 ,$21.73 ,$107.10 ,$21.73 ,$52.42 , N/A , N/A ,$22.82 ,$107.10 ,$35.28 ,$113.40 ,$98.91 ,$104.08 ,$21.73 ,$81.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101617,84300,HC SODIUM URINE,301,1 ,$46.00 ,$29.90 ,$5.06 ,$46.00 ,$12.65 ,$36.80 ,$5.06 ,$12.88 ,$36.45 ,$42.23 ,$5.06 ,$42.23 ,$5.06 ,$9.61 ,$34.04 ,$12.65 ,$5.06 ,$38.36 ,$5.06 , N/A ,$38.00 ,$38.00 ,$36.80 ,$41.40 ,$12.65 ,$39.10 ,$5.06 ,$5.06 ,$39.10 ,$5.06 ,$19.14 , N/A , N/A ,$5.31 ,$39.10 ,$12.88 ,$41.40 ,$36.11 ,$38.00 ,$5.06 ,$29.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101620,84436,HC THYROXINE (T-4) TOTAL,301,1 ,$110.00 ,$71.50 ,$6.87 ,$110.00 ,$17.18 ,$88.00 ,$6.87 ,$30.80 ,$87.16 ,$100.98 ,$6.87 ,$100.98 ,$6.87 ,$13.05 ,$81.40 ,$17.18 ,$6.87 ,$91.74 ,$6.87 , N/A ,$90.86 ,$90.86 ,$88.00 ,$99.00 ,$17.18 ,$93.50 ,$6.87 ,$6.87 ,$93.50 ,$6.87 ,$45.76 , N/A , N/A ,$7.21 ,$93.50 ,$30.80 ,$99.00 ,$86.35 ,$90.86 ,$6.87 ,$71.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101622,84466,HC TRANSFERRIN,301,1 ,$229.00 ,$148.85 ,$12.76 ,$229.00 ,$31.90 ,$183.20 ,$12.76 ,$64.12 ,$181.46 ,$210.22 ,$12.76 ,$210.22 ,$12.76 ,$24.24 ,$169.46 ,$31.90 ,$12.76 ,$190.99 ,$12.76 , N/A ,$189.15 ,$189.15 ,$183.20 ,$206.10 ,$31.90 ,$194.65 ,$12.76 ,$12.76 ,$194.65 ,$12.76 ,$95.26 , N/A , N/A ,$13.40 ,$194.65 ,$64.12 ,$206.10 ,$179.77 ,$189.15 ,$12.76 ,$148.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101623,84478,HC TRIGLYCERIDES,301,1 ,$110.00 ,$71.50 ,$5.74 ,$110.00 ,$14.35 ,$88.00 ,$5.74 ,$30.80 ,$87.16 ,$100.98 ,$5.74 ,$100.98 ,$5.74 ,$10.91 ,$81.40 ,$14.35 ,$5.74 ,$91.74 ,$5.74 , N/A ,$90.86 ,$90.86 ,$88.00 ,$99.00 ,$14.35 ,$93.50 ,$5.74 ,$5.74 ,$93.50 ,$5.74 ,$45.76 , N/A , N/A ,$6.03 ,$93.50 ,$30.80 ,$99.00 ,$86.35 ,$90.86 ,$5.74 ,$71.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101624,84480,HC T3 TOTAL,301,1 ,$295.00 ,$191.75 ,$14.18 ,$295.00 ,$35.45 ,$236.00 ,$14.18 ,$82.60 ,$233.76 ,$270.81 ,$14.18 ,$270.81 ,$14.18 ,$26.94 ,$218.30 ,$35.45 ,$14.18 ,$246.03 ,$14.18 , N/A ,$243.67 ,$243.67 ,$236.00 ,$265.50 ,$35.45 ,$250.75 ,$14.18 ,$14.18 ,$250.75 ,$14.18 ,$122.72 , N/A , N/A ,$14.89 ,$250.75 ,$82.60 ,$265.50 ,$231.58 ,$243.67 ,$14.18 ,$191.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101625,84481,HC T3 FREE,301,1 ,$173.00 ,$112.45 ,$16.94 ,$173.00 ,$42.35 ,$138.40 ,$16.94 ,$48.44 ,$137.09 ,$158.81 ,$16.94 ,$158.81 ,$16.94 ,$32.19 ,$128.02 ,$42.35 ,$16.94 ,$144.28 ,$16.94 , N/A ,$142.90 ,$142.90 ,$138.40 ,$155.70 ,$42.35 ,$147.05 ,$16.94 ,$16.94 ,$147.05 ,$16.94 ,$71.97 , N/A , N/A ,$17.79 ,$147.05 ,$48.44 ,$155.70 ,$135.81 ,$142.90 ,$16.94 ,$112.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101630,84702,HC HCG QN,301,1 ,$212.00 ,$137.80 ,$15.05 ,$212.00 ,$37.63 ,$169.60 ,$15.05 ,$59.36 ,$167.99 ,$194.62 ,$15.05 ,$194.62 ,$15.05 ,$28.60 ,$156.88 ,$37.63 ,$15.05 ,$176.81 ,$15.05 , N/A ,$175.11 ,$175.11 ,$169.60 ,$190.80 ,$37.63 ,$180.20 ,$15.05 ,$15.05 ,$180.20 ,$15.05 ,$88.19 , N/A , N/A ,$15.80 ,$180.20 ,$59.36 ,$190.80 ,$166.42 ,$175.11 ,$15.05 ,$137.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101632,G0328,HC OCCULT BLOOD FECAL SCRN - AMB-QW,301,1 ,$83.00 ,$53.95 ,$18.05 ,$83.00 ,$45.13 ,$66.40 ,$18.05 ,$23.24 ,$65.77 ,$76.19 ,$18.05 ,$76.19 ,$18.05 ,$34.30 ,$61.42 ,$45.13 ,$18.05 ,$69.22 ,$18.05 , N/A ,$68.56 ,$68.56 ,$66.40 ,$74.70 ,$45.13 ,$70.55 ,$18.05 ,$18.05 ,$70.55 ,$18.05 ,$34.53 , N/A , N/A ,$18.95 ,$70.55 ,$23.24 ,$74.70 ,$65.16 ,$68.56 ,$18.05 ,$53.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101634,80348,HC BUPRENORPHINE -90,301,1 ,$65.00 ,$42.25 ,$18.20 ,$65.00 , N/A ,$52.00 , N/A ,$18.20 ,$51.51 ,$59.67 , N/A ,$59.67 , N/A , N/A ,$48.10 , N/A , N/A ,$54.21 , N/A , N/A ,$53.69 ,$53.69 ,$52.00 ,$58.50 , N/A ,$55.25 , N/A , N/A ,$55.25 , N/A ,$27.04 , N/A , N/A , N/A ,$55.25 ,$18.20 ,$58.50 ,$51.03 ,$53.69 , N/A ,$42.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101636,83735,HC MAGNESIUM,301,1 ,$168.00 ,$109.20 ,$6.70 ,$168.00 ,$16.75 ,$134.40 ,$6.70 ,$47.04 ,$133.12 ,$154.22 ,$6.70 ,$154.22 ,$6.70 ,$12.73 ,$124.32 ,$16.75 ,$6.70 ,$140.11 ,$6.70 , N/A ,$138.77 ,$138.77 ,$134.40 ,$151.20 ,$16.75 ,$142.80 ,$6.70 ,$6.70 ,$142.80 ,$6.70 ,$69.89 , N/A , N/A ,$7.04 ,$142.80 ,$47.04 ,$151.20 ,$131.88 ,$138.77 ,$6.70 ,$109.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101643,81596,HC CHRONIC HEP C VIRUS ASSAYS-90,301,1 ,$434.00 ,$282.10 ,$72.19 ,$434.00 ,$180.48 ,$347.20 ,$72.19 ,$121.52 ,$343.90 ,$398.41 ,$72.19 ,$398.41 ,$72.19 ,$137.16 ,$321.16 ,$180.48 ,$72.19 ,$361.96 ,$72.19 , N/A ,$358.48 ,$358.48 ,$347.20 ,$390.60 ,$180.48 ,$368.90 ,$72.19 ,$72.19 ,$368.90 ,$72.19 ,$180.54 , N/A , N/A ,$75.80 ,$368.90 ,$121.52 ,$390.60 ,$340.69 ,$358.48 ,$72.19 ,$282.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101650,83516,HC MLT NON INFECT QL/SQ,301,1 ,$167.00 ,$108.55 ,$11.53 ,$167.00 ,$28.83 ,$133.60 ,$11.53 ,$46.76 ,$132.33 ,$153.31 ,$11.53 ,$153.31 ,$11.53 ,$21.91 ,$123.58 ,$28.83 ,$11.53 ,$139.28 ,$11.53 , N/A ,$137.94 ,$137.94 ,$133.60 ,$150.30 ,$28.83 ,$141.95 ,$11.53 ,$11.53 ,$141.95 ,$11.53 ,$69.47 , N/A , N/A ,$12.11 ,$141.95 ,$46.76 ,$150.30 ,$131.10 ,$137.94 ,$11.53 ,$108.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101653,82642,HC DIHYDROTESTOSTERONE-90,301,1 ,$72.00 ,$46.80 ,$20.16 ,$73.20 ,$73.20 ,$57.60 ,$29.28 ,$20.16 ,$57.05 ,$66.10 ,$29.28 ,$66.10 ,$29.28 ,$55.63 ,$53.28 ,$72.00 ,$29.28 ,$60.05 ,$29.28 , N/A ,$59.47 ,$59.47 ,$57.60 ,$64.80 ,$72.00 ,$61.20 ,$29.28 ,$29.28 ,$61.20 ,$29.28 ,$29.95 , N/A , N/A ,$30.74 ,$61.20 ,$20.16 ,$64.80 ,$56.52 ,$59.47 ,$29.28 ,$46.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101670,83930,HC OSMOLALITY BLOOD -90,301,1 ,$154.00 ,$100.10 ,$6.61 ,$154.00 ,$16.53 ,$123.20 ,$6.61 ,$43.12 ,$122.03 ,$141.37 ,$6.61 ,$141.37 ,$6.61 ,$12.56 ,$113.96 ,$16.53 ,$6.61 ,$128.44 ,$6.61 , N/A ,$127.20 ,$127.20 ,$123.20 ,$138.60 ,$16.53 ,$130.90 ,$6.61 ,$6.61 ,$130.90 ,$6.61 ,$64.06 , N/A , N/A ,$6.94 ,$130.90 ,$43.12 ,$138.60 ,$120.89 ,$127.20 ,$6.61 ,$100.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101671,80299,HC VORICONAZOLE-90,301,1 ,$188.00 ,$122.20 ,$18.64 ,$188.00 ,$46.60 ,$150.40 ,$18.64 ,$52.64 ,$148.97 ,$172.58 ,$18.64 ,$172.58 ,$18.64 ,$35.42 ,$139.12 ,$46.60 ,$18.64 ,$156.79 ,$18.64 , N/A ,$155.29 ,$155.29 ,$150.40 ,$169.20 ,$46.60 ,$159.80 ,$18.64 ,$18.64 ,$159.80 ,$18.64 ,$78.21 , N/A , N/A ,$19.57 ,$159.80 ,$52.64 ,$169.20 ,$147.58 ,$155.29 ,$18.64 ,$122.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101686,83721,HC CHOLESTEROL LDL -90,301,1 ,$110.00 ,$71.50 ,$10.50 ,$110.00 ,$26.25 ,$88.00 ,$10.50 ,$30.80 ,$87.16 ,$100.98 ,$10.50 ,$100.98 ,$10.50 ,$19.95 ,$81.40 ,$26.25 ,$10.50 ,$91.74 ,$10.50 , N/A ,$90.86 ,$90.86 ,$88.00 ,$99.00 ,$26.25 ,$93.50 ,$10.50 ,$10.50 ,$93.50 ,$10.50 ,$45.76 , N/A , N/A ,$11.03 ,$93.50 ,$30.80 ,$99.00 ,$86.35 ,$90.86 ,$10.50 ,$71.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101693,80326,HC DRUG SCREEN QUANT AMPHETAMINES >5-90,301,1 ,$124.00 ,$80.60 ,$34.72 ,$124.00 , N/A ,$99.20 , N/A ,$34.72 ,$98.26 ,$113.83 , N/A ,$113.83 , N/A , N/A ,$91.76 , N/A , N/A ,$103.42 , N/A , N/A ,$102.42 ,$102.42 ,$99.20 ,$111.60 , N/A ,$105.40 , N/A , N/A ,$105.40 , N/A ,$51.58 , N/A , N/A , N/A ,$105.40 ,$34.72 ,$111.60 ,$97.34 ,$102.42 , N/A ,$80.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101716,80187,HC POSACONAZOLE -90,301,1 ,$260.00 ,$169.00 ,$27.11 ,$260.00 ,$67.78 ,$208.00 ,$27.11 ,$72.80 ,$206.02 ,$238.68 ,$27.11 ,$238.68 ,$27.11 ,$51.51 ,$192.40 ,$67.78 ,$27.11 ,$216.84 ,$27.11 , N/A ,$214.76 ,$214.76 ,$208.00 ,$234.00 ,$67.78 ,$221.00 ,$27.11 ,$27.11 ,$221.00 ,$27.11 ,$108.16 , N/A , N/A ,$28.47 ,$221.00 ,$72.80 ,$234.00 ,$204.10 ,$214.76 ,$27.11 ,$169.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101723,82397,HC ANTIMULLERIAN ASSAY-90,301,1 ,$91.00 ,$59.15 ,$14.12 ,$91.00 ,$35.30 ,$72.80 ,$14.12 ,$25.48 ,$72.11 ,$83.54 ,$14.12 ,$83.54 ,$14.12 ,$26.83 ,$67.34 ,$35.30 ,$14.12 ,$75.89 ,$14.12 , N/A ,$75.17 ,$75.17 ,$72.80 ,$81.90 ,$35.30 ,$77.35 ,$14.12 ,$14.12 ,$77.35 ,$14.12 ,$37.86 , N/A , N/A ,$14.83 ,$77.35 ,$25.48 ,$81.90 ,$71.44 ,$75.17 ,$14.12 ,$59.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101734,82553,HC CREATINE KINASE MB FRAC-90,301,1 ,$247.00 ,$160.55 ,$11.55 ,$247.00 ,$28.88 ,$197.60 ,$11.55 ,$69.16 ,$195.72 ,$226.75 ,$11.55 ,$226.75 ,$11.55 ,$21.95 ,$182.78 ,$28.88 ,$11.55 ,$206.00 ,$11.55 , N/A ,$204.02 ,$204.02 ,$197.60 ,$222.30 ,$28.88 ,$209.95 ,$11.55 ,$11.55 ,$209.95 ,$11.55 ,$102.75 , N/A , N/A ,$12.13 ,$209.95 ,$69.16 ,$222.30 ,$193.90 ,$204.02 ,$11.55 ,$160.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101742,82382,HC CATECHOLAMINE URINE 24 HR,301,1 ,$253.00 ,$164.45 ,$27.30 ,$253.00 ,$68.25 ,$202.40 ,$27.30 ,$70.84 ,$200.48 ,$232.25 ,$27.30 ,$232.25 ,$27.30 ,$51.87 ,$187.22 ,$68.25 ,$27.30 ,$211.00 ,$27.30 , N/A ,$208.98 ,$208.98 ,$202.40 ,$227.70 ,$68.25 ,$215.05 ,$27.30 ,$27.30 ,$215.05 ,$27.30 ,$105.25 , N/A , N/A ,$28.67 ,$215.05 ,$70.84 ,$227.70 ,$198.61 ,$208.98 ,$27.30 ,$164.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101756,83721,HC CHOLESTEROL LDL LEVEL,301,1 ,$110.00 ,$71.50 ,$10.50 ,$110.00 ,$26.25 ,$88.00 ,$10.50 ,$30.80 ,$87.16 ,$100.98 ,$10.50 ,$100.98 ,$10.50 ,$19.95 ,$81.40 ,$26.25 ,$10.50 ,$91.74 ,$10.50 , N/A ,$90.86 ,$90.86 ,$88.00 ,$99.00 ,$26.25 ,$93.50 ,$10.50 ,$10.50 ,$93.50 ,$10.50 ,$45.76 , N/A , N/A ,$11.03 ,$93.50 ,$30.80 ,$99.00 ,$86.35 ,$90.86 ,$10.50 ,$71.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101757,84315,HC SPEC GRAVITY NON UR,301,1 ,$100.00 ,$65.00 ,$3.28 ,$100.00 ,$8.20 ,$80.00 ,$3.28 ,$28.00 ,$79.24 ,$91.80 ,$3.28 ,$91.80 ,$3.28 ,$6.23 ,$74.00 ,$8.20 ,$3.28 ,$83.40 ,$3.28 , N/A ,$82.60 ,$82.60 ,$80.00 ,$90.00 ,$8.20 ,$85.00 ,$3.28 ,$3.28 ,$85.00 ,$3.28 ,$41.60 , N/A , N/A ,$3.44 ,$85.00 ,$28.00 ,$90.00 ,$78.50 ,$82.60 ,$3.28 ,$65.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101758,82045,HC MICROALBUMIN URNINE QN,301,1 ,$29.00 ,$18.85 ,$8.12 ,$72.50 ,$72.50 ,$23.20 ,$29.00 ,$8.12 ,$22.98 ,$26.62 ,$29.00 ,$26.62 ,$29.00 ,$29.00 ,$21.46 ,$29.00 ,$29.00 ,$24.19 ,$29.00 , N/A ,$23.95 ,$23.95 ,$23.20 ,$26.10 ,$29.00 ,$24.65 ,$29.00 ,$29.00 ,$24.65 ,$29.00 ,$12.06 , N/A , N/A ,$29.00 ,$24.65 ,$8.12 ,$26.10 ,$22.77 ,$23.95 ,$29.00 ,$18.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101759,82575,HC CREATININE CLEARANCE,301,1 ,$251.00 ,$163.15 ,$9.46 ,$251.00 ,$23.65 ,$200.80 ,$9.46 ,$70.28 ,$198.89 ,$230.42 ,$9.46 ,$230.42 ,$9.46 ,$17.97 ,$185.74 ,$23.65 ,$9.46 ,$209.33 ,$9.46 , N/A ,$207.33 ,$207.33 ,$200.80 ,$225.90 ,$23.65 ,$213.35 ,$9.46 ,$9.46 ,$213.35 ,$9.46 ,$104.42 , N/A , N/A ,$9.93 ,$213.35 ,$70.28 ,$225.90 ,$197.04 ,$207.33 ,$9.46 ,$163.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30101769,0003M,HC NASH FIBROSURE- 90,301,1 ,$544.85 ,$354.15 ,$152.56 ,"$1,258.50 ","$1,258.50 ",$435.88 ,$503.40 ,$152.56 ,$431.74 ,$500.17 ,$503.40 ,$500.17 ,$503.40 ,$544.85 ,$403.19 ,$544.85 ,$503.40 ,$454.40 ,$503.40 , N/A ,$450.05 ,$450.05 ,$435.88 ,$490.37 ,$544.85 ,$463.12 ,$503.40 ,$503.40 ,$463.12 ,$503.40 ,$226.66 , N/A , N/A ,$528.57 ,$463.12 ,$152.56 ,$490.37 ,$427.71 ,$450.05 ,$503.40 ,$354.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200123,86140,HC C-REACTIVE PROTEIN,302,1 ,$141.00 ,$91.65 ,$5.18 ,$141.00 ,$12.95 ,$112.80 ,$5.18 ,$39.48 ,$111.73 ,$129.44 ,$5.18 ,$129.44 ,$5.18 ,$9.84 ,$104.34 ,$12.95 ,$5.18 ,$117.59 ,$5.18 , N/A ,$116.47 ,$116.47 ,$112.80 ,$126.90 ,$12.95 ,$119.85 ,$5.18 ,$5.18 ,$119.85 ,$5.18 ,$58.66 , N/A , N/A ,$5.44 ,$119.85 ,$39.48 ,$126.90 ,$110.69 ,$116.47 ,$5.18 ,$91.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200163,86308,HC HETEROPHILE SCR MONO,302,1 ,$134.00 ,$87.10 ,$5.18 ,$134.00 ,$12.95 ,$107.20 ,$5.18 ,$37.52 ,$106.18 ,$123.01 ,$5.18 ,$123.01 ,$5.18 ,$9.84 ,$99.16 ,$12.95 ,$5.18 ,$111.76 ,$5.18 , N/A ,$110.68 ,$110.68 ,$107.20 ,$120.60 ,$12.95 ,$113.90 ,$5.18 ,$5.18 ,$113.90 ,$5.18 ,$55.74 , N/A , N/A ,$5.44 ,$113.90 ,$37.52 ,$120.60 ,$105.19 ,$110.68 ,$5.18 ,$87.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200197,86430,HC RHEUMATOID FACTOR,302,1 ,$104.00 ,$67.60 ,$6.14 ,$104.00 ,$15.35 ,$83.20 ,$6.14 ,$29.12 ,$82.41 ,$95.47 ,$6.14 ,$95.47 ,$6.14 ,$11.67 ,$76.96 ,$15.35 ,$6.14 ,$86.74 ,$6.14 , N/A ,$85.90 ,$85.90 ,$83.20 ,$93.60 ,$15.35 ,$88.40 ,$6.14 ,$6.14 ,$88.40 ,$6.14 ,$43.26 , N/A , N/A ,$6.45 ,$88.40 ,$29.12 ,$93.60 ,$81.64 ,$85.90 ,$6.14 ,$67.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200251,86677,HC H PYLORI AB,302,1 ,$306.00 ,$198.90 ,$16.85 ,$306.00 ,$42.13 ,$244.80 ,$16.85 ,$85.68 ,$242.47 ,$280.91 ,$16.85 ,$280.91 ,$16.85 ,$32.02 ,$226.44 ,$42.13 ,$16.85 ,$255.20 ,$16.85 , N/A ,$252.76 ,$252.76 ,$244.80 ,$275.40 ,$42.13 ,$260.10 ,$16.85 ,$16.85 ,$260.10 ,$16.85 ,$127.30 , N/A , N/A ,$17.69 ,$260.10 ,$85.68 ,$275.40 ,$240.21 ,$252.76 ,$16.85 ,$198.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200286,86747,HC PARVOVIRUS AB,302,1 ,$46.00 ,$29.90 ,$12.88 ,$46.00 ,$37.58 ,$36.80 ,$15.03 ,$12.88 ,$36.45 ,$42.23 ,$15.03 ,$42.23 ,$15.03 ,$28.56 ,$34.04 ,$37.58 ,$15.03 ,$38.36 ,$15.03 , N/A ,$38.00 ,$38.00 ,$36.80 ,$41.40 ,$37.58 ,$39.10 ,$15.03 ,$15.03 ,$39.10 ,$15.03 ,$19.14 , N/A , N/A ,$15.78 ,$39.10 ,$12.88 ,$41.40 ,$36.11 ,$38.00 ,$15.03 ,$29.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200559,86850,HC AB SCREEN,302,1 ,$93.00 ,$60.45 ,$26.04 ,$114.95 ,$114.95 ,$74.40 ,$45.98 ,$26.04 ,$73.69 ,$85.37 ,$45.98 ,$85.37 ,$45.98 ,$87.36 ,$68.82 ,$93.00 ,$45.98 ,$77.56 ,$45.98 , N/A ,$76.82 ,$76.82 ,$74.40 ,$83.70 ,$93.00 ,$79.05 ,$45.98 ,$45.98 ,$79.05 ,$45.98 ,$38.69 , N/A , N/A ,$48.28 ,$79.05 ,$26.04 ,$83.70 ,$73.01 ,$76.82 ,$45.98 ,$60.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200562,86880,HC COOMBS DIRECT,302,1 ,$111.00 ,$72.15 ,$31.08 ,$128.78 ,$128.78 ,$88.80 ,$51.51 ,$31.08 ,$87.96 ,$101.90 ,$51.51 ,$101.90 ,$51.51 ,$97.87 ,$82.14 ,$111.00 ,$51.51 ,$92.57 ,$51.51 , N/A ,$91.69 ,$91.69 ,$88.80 ,$99.90 ,$111.00 ,$94.35 ,$51.51 ,$51.51 ,$94.35 ,$51.51 ,$46.18 , N/A , N/A ,$54.09 ,$94.35 ,$31.08 ,$99.90 ,$87.14 ,$91.69 ,$51.51 ,$72.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200563,86885,HC INDIRECT COOMBS,302,1 ,$138.00 ,$89.70 ,$38.64 ,$345.05 ,$345.05 ,$110.40 ,$138.02 ,$38.64 ,$109.35 ,$126.68 ,$138.00 ,$126.68 ,$138.00 ,$138.00 ,$102.12 ,$138.00 ,$138.02 ,$115.09 ,$138.02 , N/A ,$113.99 ,$113.99 ,$110.40 ,$124.20 ,$138.00 ,$117.30 ,$138.02 ,$138.02 ,$117.30 ,$138.02 ,$57.41 , N/A , N/A ,$138.00 ,$117.30 ,$38.64 ,$124.20 ,$108.33 ,$113.99 ,$138.02 ,$89.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200565,86900,HC BLOOD TYPING ABO,302,1 ,$68.00 ,$44.20 ,$19.04 ,$260.88 ,$260.88 ,$54.40 ,$104.35 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$104.35 ,$56.71 ,$104.35 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$104.35 ,$104.35 ,$57.80 ,$104.35 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$104.35 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200566,86901,HC BLOOD TYPING RH,302,1 ,$68.00 ,$44.20 ,$19.04 ,$78.30 ,$78.30 ,$54.40 ,$31.32 ,$19.04 ,$53.88 ,$62.42 ,$31.32 ,$62.42 ,$31.32 ,$59.51 ,$50.32 ,$68.00 ,$31.32 ,$56.71 ,$31.32 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$31.32 ,$31.32 ,$57.80 ,$31.32 ,$28.29 , N/A , N/A ,$32.89 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$31.32 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200568,86905,HC RBC ANTIGEN OTHER THAN ABO OR RH(D) EACH,302,1 ,$87.00 ,$56.55 ,$24.36 ,$673.80 ,$673.80 ,$69.60 ,$269.52 ,$24.36 ,$68.94 ,$79.87 ,$87.00 ,$79.87 ,$87.00 ,$87.00 ,$64.38 ,$87.00 ,$269.52 ,$72.56 ,$269.52 , N/A ,$71.86 ,$71.86 ,$69.60 ,$78.30 ,$87.00 ,$73.95 ,$269.52 ,$269.52 ,$73.95 ,$269.52 ,$36.19 , N/A , N/A ,$87.00 ,$73.95 ,$24.36 ,$78.30 ,$68.30 ,$71.86 ,$269.52 ,$56.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200571,86922,HC CROSSMATCH AHG,302,1 ,$185.00 ,$120.25 ,$51.80 ,$345.05 ,$345.05 ,$148.00 ,$138.02 ,$51.80 ,$146.59 ,$169.83 ,$138.02 ,$169.83 ,$138.02 ,$185.00 ,$136.90 ,$185.00 ,$138.02 ,$154.29 ,$138.02 , N/A ,$152.81 ,$152.81 ,$148.00 ,$166.50 ,$185.00 ,$157.25 ,$138.02 ,$138.02 ,$157.25 ,$138.02 ,$76.96 , N/A , N/A ,$144.92 ,$157.25 ,$51.80 ,$166.50 ,$145.23 ,$152.81 ,$138.02 ,$120.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200573,86978,HC RBC PRETREAT ABSOR,302,1 ,$121.00 ,$78.65 ,$31.32 ,$121.00 ,$78.30 ,$96.80 ,$31.32 ,$33.88 ,$95.88 ,$111.08 ,$31.32 ,$111.08 ,$31.32 ,$59.51 ,$89.54 ,$78.30 ,$31.32 ,$100.91 ,$31.32 , N/A ,$99.95 ,$99.95 ,$96.80 ,$108.90 ,$78.31 ,$102.85 ,$31.32 ,$31.32 ,$102.85 ,$31.32 ,$50.34 , N/A , N/A ,$32.89 ,$102.85 ,$33.88 ,$108.90 ,$94.99 ,$99.95 ,$31.32 ,$78.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200843,86000,HC AGGLUTININS FEBRILE EA AG-90,302,1 ,$391.00 ,$254.15 ,$6.98 ,$391.00 ,$17.45 ,$312.80 ,$6.98 ,$109.48 ,$309.83 ,$358.94 ,$6.98 ,$358.94 ,$6.98 ,$13.26 ,$289.34 ,$17.45 ,$6.98 ,$326.09 ,$6.98 , N/A ,$322.97 ,$322.97 ,$312.80 ,$351.90 ,$17.45 ,$332.35 ,$6.98 ,$6.98 ,$332.35 ,$6.98 ,$162.66 , N/A , N/A ,$7.33 ,$332.35 ,$109.48 ,$351.90 ,$306.94 ,$322.97 ,$6.98 ,$254.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200845,86003,HC RAST ALLERGEN IGE QN SQ EA-90,302,1 ,$230.00 ,$149.50 ,$5.22 ,$230.00 ,$13.05 ,$184.00 ,$5.22 ,$64.40 ,$182.25 ,$211.14 ,$5.22 ,$211.14 ,$5.22 ,$9.92 ,$170.20 ,$13.05 ,$5.22 ,$191.82 ,$5.22 , N/A ,$189.98 ,$189.98 ,$184.00 ,$207.00 ,$13.05 ,$195.50 ,$5.22 ,$5.22 ,$195.50 ,$5.22 ,$95.68 , N/A , N/A ,$5.48 ,$195.50 ,$64.40 ,$207.00 ,$180.55 ,$189.98 ,$5.22 ,$149.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200847,86021,HC LEUKO AB ID-90,302,1 ,$293.00 ,$190.45 ,$15.05 ,$293.00 ,$37.63 ,$234.40 ,$15.05 ,$82.04 ,$232.17 ,$268.97 ,$15.05 ,$268.97 ,$15.05 ,$28.60 ,$216.82 ,$37.63 ,$15.05 ,$244.36 ,$15.05 , N/A ,$242.02 ,$242.02 ,$234.40 ,$263.70 ,$37.63 ,$249.05 ,$15.05 ,$15.05 ,$249.05 ,$15.05 ,$121.89 , N/A , N/A ,$15.80 ,$249.05 ,$82.04 ,$263.70 ,$230.01 ,$242.02 ,$15.05 ,$190.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200851,86022,HC PLATELET AB ID-90,302,1 ,$118.00 ,$76.70 ,$18.37 ,$118.00 ,$45.93 ,$94.40 ,$18.37 ,$33.04 ,$93.50 ,$108.32 ,$18.37 ,$108.32 ,$18.37 ,$34.90 ,$87.32 ,$45.93 ,$18.37 ,$98.41 ,$18.37 , N/A ,$97.47 ,$97.47 ,$94.40 ,$106.20 ,$45.93 ,$100.30 ,$18.37 ,$18.37 ,$100.30 ,$18.37 ,$49.09 , N/A , N/A ,$19.29 ,$100.30 ,$33.04 ,$106.20 ,$92.63 ,$97.47 ,$18.37 ,$76.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200857,86023,HC PLATELET ASSOC AB ID IGG-90,302,1 ,$720.00 ,$468.00 ,$12.46 ,$720.00 ,$31.15 ,$576.00 ,$12.46 ,$201.60 ,$570.53 ,$660.96 ,$12.46 ,$660.96 ,$12.46 ,$23.67 ,$532.80 ,$31.15 ,$12.46 ,$600.48 ,$12.46 , N/A ,$594.72 ,$594.72 ,$576.00 ,$648.00 ,$31.15 ,$612.00 ,$12.46 ,$12.46 ,$612.00 ,$12.46 ,$299.52 , N/A , N/A ,$13.08 ,$612.00 ,$201.60 ,$648.00 ,$565.20 ,$594.72 ,$12.46 ,$468.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200858,86038,HC ANA SCREEN-90,302,1 ,$118.00 ,$76.70 ,$12.09 ,$118.00 ,$30.23 ,$94.40 ,$12.09 ,$33.04 ,$93.50 ,$108.32 ,$12.09 ,$108.32 ,$12.09 ,$22.97 ,$87.32 ,$30.23 ,$12.09 ,$98.41 ,$12.09 , N/A ,$97.47 ,$97.47 ,$94.40 ,$106.20 ,$30.23 ,$100.30 ,$12.09 ,$12.09 ,$100.30 ,$12.09 ,$49.09 , N/A , N/A ,$12.69 ,$100.30 ,$33.04 ,$106.20 ,$92.63 ,$97.47 ,$12.09 ,$76.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200859,86039,HC ANA TITER-90,302,1 ,$196.00 ,$127.40 ,$11.16 ,$196.00 ,$27.90 ,$156.80 ,$11.16 ,$54.88 ,$155.31 ,$179.93 ,$11.16 ,$179.93 ,$11.16 ,$21.20 ,$145.04 ,$27.90 ,$11.16 ,$163.46 ,$11.16 , N/A ,$161.90 ,$161.90 ,$156.80 ,$176.40 ,$27.90 ,$166.60 ,$11.16 ,$11.16 ,$166.60 ,$11.16 ,$81.54 , N/A , N/A ,$11.72 ,$166.60 ,$54.88 ,$176.40 ,$153.86 ,$161.90 ,$11.16 ,$127.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200860,86060,HC ASO-90,302,1 ,$161.00 ,$104.65 ,$7.30 ,$161.00 ,$18.25 ,$128.80 ,$7.30 ,$45.08 ,$127.58 ,$147.80 ,$7.30 ,$147.80 ,$7.30 ,$13.87 ,$119.14 ,$18.25 ,$7.30 ,$134.27 ,$7.30 , N/A ,$132.99 ,$132.99 ,$128.80 ,$144.90 ,$18.25 ,$136.85 ,$7.30 ,$7.30 ,$136.85 ,$7.30 ,$66.98 , N/A , N/A ,$7.67 ,$136.85 ,$45.08 ,$144.90 ,$126.39 ,$132.99 ,$7.30 ,$104.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200864,86146,HC BETA 2 GLYCO AB-90,302,1 ,$93.00 ,$60.45 ,$25.45 ,$93.00 ,$63.63 ,$74.40 ,$25.45 ,$26.04 ,$73.69 ,$85.37 ,$25.45 ,$85.37 ,$25.45 ,$48.36 ,$68.82 ,$63.63 ,$25.45 ,$77.56 ,$25.45 , N/A ,$76.82 ,$76.82 ,$74.40 ,$83.70 ,$63.63 ,$79.05 ,$25.45 ,$25.45 ,$79.05 ,$25.45 ,$38.69 , N/A , N/A ,$26.72 ,$79.05 ,$26.04 ,$83.70 ,$73.01 ,$76.82 ,$25.45 ,$60.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200865,86147,HC CARDIOLIPIN AB EA-90,302,1 ,$407.00 ,$264.55 ,$25.45 ,$407.00 ,$63.63 ,$325.60 ,$25.45 ,$113.96 ,$322.51 ,$373.63 ,$25.45 ,$373.63 ,$25.45 ,$48.36 ,$301.18 ,$63.63 ,$25.45 ,$339.44 ,$25.45 , N/A ,$336.18 ,$336.18 ,$325.60 ,$366.30 ,$63.63 ,$345.95 ,$25.45 ,$25.45 ,$345.95 ,$25.45 ,$169.31 , N/A , N/A ,$26.72 ,$345.95 ,$113.96 ,$366.30 ,$319.50 ,$336.18 ,$25.45 ,$264.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200868,86157,HC COLD AGGLUTININ TITER-90,302,1 ,$122.00 ,$79.30 ,$8.06 ,$122.00 ,$20.15 ,$97.60 ,$8.06 ,$34.16 ,$96.67 ,$112.00 ,$8.06 ,$112.00 ,$8.06 ,$15.31 ,$90.28 ,$20.15 ,$8.06 ,$101.75 ,$8.06 , N/A ,$100.77 ,$100.77 ,$97.60 ,$109.80 ,$20.15 ,$103.70 ,$8.06 ,$8.06 ,$103.70 ,$8.06 ,$50.75 , N/A , N/A ,$8.46 ,$103.70 ,$34.16 ,$109.80 ,$95.77 ,$100.77 ,$8.06 ,$79.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200869,86160,HC COMPLEMENT AG EA-90,302,1 ,$283.00 ,$183.95 ,$12.00 ,$283.00 ,$30.00 ,$226.40 ,$12.00 ,$79.24 ,$224.25 ,$259.79 ,$12.00 ,$259.79 ,$12.00 ,$22.80 ,$209.42 ,$30.00 ,$12.00 ,$236.02 ,$12.00 , N/A ,$233.76 ,$233.76 ,$226.40 ,$254.70 ,$30.00 ,$240.55 ,$12.00 ,$12.00 ,$240.55 ,$12.00 ,$117.73 , N/A , N/A ,$12.60 ,$240.55 ,$79.24 ,$254.70 ,$222.16 ,$233.76 ,$12.00 ,$183.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200871,86162,HC COMPLEMENT TOTAL-90,302,1 ,$411.00 ,$267.15 ,$20.32 ,$411.00 ,$50.80 ,$328.80 ,$20.32 ,$115.08 ,$325.68 ,$377.30 ,$20.32 ,$377.30 ,$20.32 ,$38.61 ,$304.14 ,$50.80 ,$20.32 ,$342.77 ,$20.32 , N/A ,$339.49 ,$339.49 ,$328.80 ,$369.90 ,$50.80 ,$349.35 ,$20.32 ,$20.32 ,$349.35 ,$20.32 ,$170.98 , N/A , N/A ,$21.34 ,$349.35 ,$115.08 ,$369.90 ,$322.64 ,$339.49 ,$20.32 ,$267.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200873,86200,HC CCP AB-90,302,1 ,$158.00 ,$102.70 ,$12.95 ,$158.00 ,$32.38 ,$126.40 ,$12.95 ,$44.24 ,$125.20 ,$145.04 ,$12.95 ,$145.04 ,$12.95 ,$24.61 ,$116.92 ,$32.38 ,$12.95 ,$131.77 ,$12.95 , N/A ,$130.51 ,$130.51 ,$126.40 ,$142.20 ,$32.38 ,$134.30 ,$12.95 ,$12.95 ,$134.30 ,$12.95 ,$65.73 , N/A , N/A ,$13.60 ,$134.30 ,$44.24 ,$142.20 ,$124.03 ,$130.51 ,$12.95 ,$102.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200874,86215,HC DEOXYRIBONUCLEASE AB-90,302,1 ,$63.00 ,$40.95 ,$13.25 ,$63.00 ,$33.13 ,$50.40 ,$13.25 ,$17.64 ,$49.92 ,$57.83 ,$13.25 ,$57.83 ,$13.25 ,$25.18 ,$46.62 ,$33.13 ,$13.25 ,$52.54 ,$13.25 , N/A ,$52.04 ,$52.04 ,$50.40 ,$56.70 ,$33.13 ,$53.55 ,$13.25 ,$13.25 ,$53.55 ,$13.25 ,$26.21 , N/A , N/A ,$13.91 ,$53.55 ,$17.64 ,$56.70 ,$49.46 ,$52.04 ,$13.25 ,$40.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200875,86225,HC DNA DOUBLE STRAND AB-90,302,1 ,$94.00 ,$61.10 ,$13.74 ,$94.00 ,$34.35 ,$75.20 ,$13.74 ,$26.32 ,$74.49 ,$86.29 ,$13.74 ,$86.29 ,$13.74 ,$26.11 ,$69.56 ,$34.35 ,$13.74 ,$78.40 ,$13.74 , N/A ,$77.64 ,$77.64 ,$75.20 ,$84.60 ,$34.35 ,$79.90 ,$13.74 ,$13.74 ,$79.90 ,$13.74 ,$39.10 , N/A , N/A ,$14.43 ,$79.90 ,$26.32 ,$84.60 ,$73.79 ,$77.64 ,$13.74 ,$61.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200876,86226,HC DNA SINGLE STRAND AB-90,302,1 ,$134.00 ,$87.10 ,$12.11 ,$134.00 ,$30.28 ,$107.20 ,$12.11 ,$37.52 ,$106.18 ,$123.01 ,$12.11 ,$123.01 ,$12.11 ,$23.01 ,$99.16 ,$30.28 ,$12.11 ,$111.76 ,$12.11 , N/A ,$110.68 ,$110.68 ,$107.20 ,$120.60 ,$30.28 ,$113.90 ,$12.11 ,$12.11 ,$113.90 ,$12.11 ,$55.74 , N/A , N/A ,$12.72 ,$113.90 ,$37.52 ,$120.60 ,$105.19 ,$110.68 ,$12.11 ,$87.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200877,86235,HC ENA AB-90,302,1 ,$166.00 ,$107.90 ,$17.93 ,$166.00 ,$44.83 ,$132.80 ,$17.93 ,$46.48 ,$131.54 ,$152.39 ,$17.93 ,$152.39 ,$17.93 ,$34.07 ,$122.84 ,$44.83 ,$17.93 ,$138.44 ,$17.93 , N/A ,$137.12 ,$137.12 ,$132.80 ,$149.40 ,$44.83 ,$141.10 ,$17.93 ,$17.93 ,$141.10 ,$17.93 ,$69.06 , N/A , N/A ,$18.83 ,$141.10 ,$46.48 ,$149.40 ,$130.31 ,$137.12 ,$17.93 ,$107.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200878,86255,HC FLUOR AB SCR-90,302,1 ,$241.00 ,$156.65 ,$12.05 ,$241.00 ,$30.13 ,$192.80 ,$12.05 ,$67.48 ,$190.97 ,$221.24 ,$12.05 ,$221.24 ,$12.05 ,$22.90 ,$178.34 ,$30.13 ,$12.05 ,$200.99 ,$12.05 , N/A ,$199.07 ,$199.07 ,$192.80 ,$216.90 ,$30.13 ,$204.85 ,$12.05 ,$12.05 ,$204.85 ,$12.05 ,$100.26 , N/A , N/A ,$12.65 ,$204.85 ,$67.48 ,$216.90 ,$189.19 ,$199.07 ,$12.05 ,$156.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200879,86256,HC FLUOR AB TITER-90,302,1 ,$289.00 ,$187.85 ,$12.05 ,$289.00 ,$30.13 ,$231.20 ,$12.05 ,$80.92 ,$229.00 ,$265.30 ,$12.05 ,$265.30 ,$12.05 ,$22.90 ,$213.86 ,$30.13 ,$12.05 ,$241.03 ,$12.05 , N/A ,$238.71 ,$238.71 ,$231.20 ,$260.10 ,$30.13 ,$245.65 ,$12.05 ,$12.05 ,$245.65 ,$12.05 ,$120.22 , N/A , N/A ,$12.65 ,$245.65 ,$80.92 ,$260.10 ,$226.87 ,$238.71 ,$12.05 ,$187.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200880,86300,HC TUMOR AG CA 15-3 (27.29)-90,302,1 ,$361.00 ,$234.65 ,$20.81 ,$361.00 ,$52.03 ,$288.80 ,$20.81 ,$101.08 ,$286.06 ,$331.40 ,$20.81 ,$331.40 ,$20.81 ,$39.54 ,$267.14 ,$52.03 ,$20.81 ,$301.07 ,$20.81 , N/A ,$298.19 ,$298.19 ,$288.80 ,$324.90 ,$52.03 ,$306.85 ,$20.81 ,$20.81 ,$306.85 ,$20.81 ,$150.18 , N/A , N/A ,$21.85 ,$306.85 ,$101.08 ,$324.90 ,$283.39 ,$298.19 ,$20.81 ,$234.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200881,86301,HC TUMOR AG CA 19-9  -90,302,1 ,$271.00 ,$176.15 ,$20.81 ,$271.00 ,$52.03 ,$216.80 ,$20.81 ,$75.88 ,$214.74 ,$248.78 ,$20.81 ,$248.78 ,$20.81 ,$39.54 ,$200.54 ,$52.03 ,$20.81 ,$226.01 ,$20.81 , N/A ,$223.85 ,$223.85 ,$216.80 ,$243.90 ,$52.03 ,$230.35 ,$20.81 ,$20.81 ,$230.35 ,$20.81 ,$112.74 , N/A , N/A ,$21.85 ,$230.35 ,$75.88 ,$243.90 ,$212.74 ,$223.85 ,$20.81 ,$176.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200882,86304,HC TUMOR AG CA 125 -90,302,1 ,$318.00 ,$206.70 ,$20.81 ,$318.00 ,$52.03 ,$254.40 ,$20.81 ,$89.04 ,$251.98 ,$291.92 ,$20.81 ,$291.92 ,$20.81 ,$39.54 ,$235.32 ,$52.03 ,$20.81 ,$265.21 ,$20.81 , N/A ,$262.67 ,$262.67 ,$254.40 ,$286.20 ,$52.03 ,$270.30 ,$20.81 ,$20.81 ,$270.30 ,$20.81 ,$132.29 , N/A , N/A ,$21.85 ,$270.30 ,$89.04 ,$286.20 ,$249.63 ,$262.67 ,$20.81 ,$206.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200883,86305,HC HE4 OVARIAN CANCER-90,302,1 ,$478.00 ,$310.70 ,$20.81 ,$478.00 ,$52.03 ,$382.40 ,$20.81 ,$133.84 ,$378.77 ,$438.80 ,$20.81 ,$438.80 ,$20.81 ,$39.54 ,$353.72 ,$52.03 ,$20.81 ,$398.65 ,$20.81 , N/A ,$394.83 ,$394.83 ,$382.40 ,$430.20 ,$52.03 ,$406.30 ,$20.81 ,$20.81 ,$406.30 ,$20.81 ,$198.85 , N/A , N/A ,$21.85 ,$406.30 ,$133.84 ,$430.20 ,$375.23 ,$394.83 ,$20.81 ,$310.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200886,86632,HC CHLAMYDIA AB IGM-90,302,1 ,$657.00 ,$427.05 ,$12.68 ,$657.00 ,$31.70 ,$525.60 ,$12.68 ,$183.96 ,$520.61 ,$603.13 ,$12.68 ,$603.13 ,$12.68 ,$24.09 ,$486.18 ,$31.70 ,$12.68 ,$547.94 ,$12.68 , N/A ,$542.68 ,$542.68 ,$525.60 ,$591.30 ,$31.70 ,$558.45 ,$12.68 ,$12.68 ,$558.45 ,$12.68 ,$273.31 , N/A , N/A ,$13.31 ,$558.45 ,$183.96 ,$591.30 ,$515.75 ,$542.68 ,$12.68 ,$427.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200887,86635,HC COCCIDIOIDES AB-90,302,1 ,$141.00 ,$91.65 ,$11.47 ,$141.00 ,$28.68 ,$112.80 ,$11.47 ,$39.48 ,$111.73 ,$129.44 ,$11.47 ,$129.44 ,$11.47 ,$21.79 ,$104.34 ,$28.68 ,$11.47 ,$117.59 ,$11.47 , N/A ,$116.47 ,$116.47 ,$112.80 ,$126.90 ,$28.68 ,$119.85 ,$11.47 ,$11.47 ,$119.85 ,$11.47 ,$58.66 , N/A , N/A ,$12.04 ,$119.85 ,$39.48 ,$126.90 ,$110.69 ,$116.47 ,$11.47 ,$91.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200888,86638,HC Q FEVER AB-90,302,1 ,$605.00 ,$393.25 ,$12.12 ,$605.00 ,$30.30 ,$484.00 ,$12.12 ,$169.40 ,$479.40 ,$555.39 ,$12.12 ,$555.39 ,$12.12 ,$23.03 ,$447.70 ,$30.30 ,$12.12 ,$504.57 ,$12.12 , N/A ,$499.73 ,$499.73 ,$484.00 ,$544.50 ,$30.30 ,$514.25 ,$12.12 ,$12.12 ,$514.25 ,$12.12 ,$251.68 , N/A , N/A ,$12.73 ,$514.25 ,$169.40 ,$544.50 ,$474.93 ,$499.73 ,$12.12 ,$393.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200890,86644,HC CMV AB-90,302,1 ,$211.00 ,$137.15 ,$14.39 ,$211.00 ,$35.98 ,$168.80 ,$14.39 ,$59.08 ,$167.20 ,$193.70 ,$14.39 ,$193.70 ,$14.39 ,$27.34 ,$156.14 ,$35.98 ,$14.39 ,$175.97 ,$14.39 , N/A ,$174.29 ,$174.29 ,$168.80 ,$189.90 ,$35.98 ,$179.35 ,$14.39 ,$14.39 ,$179.35 ,$14.39 ,$87.78 , N/A , N/A ,$15.11 ,$179.35 ,$59.08 ,$189.90 ,$165.64 ,$174.29 ,$14.39 ,$137.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200891,86645,HC CMV AB IGM-90,302,1 ,$211.00 ,$137.15 ,$16.85 ,$211.00 ,$42.13 ,$168.80 ,$16.85 ,$59.08 ,$167.20 ,$193.70 ,$16.85 ,$193.70 ,$16.85 ,$32.02 ,$156.14 ,$42.13 ,$16.85 ,$175.97 ,$16.85 , N/A ,$174.29 ,$174.29 ,$168.80 ,$189.90 ,$42.13 ,$179.35 ,$16.85 ,$16.85 ,$179.35 ,$16.85 ,$87.78 , N/A , N/A ,$17.69 ,$179.35 ,$59.08 ,$189.90 ,$165.64 ,$174.29 ,$16.85 ,$137.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200892,86648,HC DIPTHERIA-90,302,1 ,$162.00 ,$105.30 ,$15.21 ,$162.00 ,$38.03 ,$129.60 ,$15.21 ,$45.36 ,$128.37 ,$148.72 ,$15.21 ,$148.72 ,$15.21 ,$28.90 ,$119.88 ,$38.03 ,$15.21 ,$135.11 ,$15.21 , N/A ,$133.81 ,$133.81 ,$129.60 ,$145.80 ,$38.03 ,$137.70 ,$15.21 ,$15.21 ,$137.70 ,$15.21 ,$67.39 , N/A , N/A ,$15.97 ,$137.70 ,$45.36 ,$145.80 ,$127.17 ,$133.81 ,$15.21 ,$105.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200897,86658,HC ENTEROVIRUS AB-90,302,1 ,$334.00 ,$217.10 ,$13.03 ,$334.00 ,$32.58 ,$267.20 ,$13.03 ,$93.52 ,$264.66 ,$306.61 ,$13.03 ,$306.61 ,$13.03 ,$24.76 ,$247.16 ,$32.58 ,$13.03 ,$278.56 ,$13.03 , N/A ,$275.88 ,$275.88 ,$267.20 ,$300.60 ,$32.58 ,$283.90 ,$13.03 ,$13.03 ,$283.90 ,$13.03 ,$138.94 , N/A , N/A ,$13.68 ,$283.90 ,$93.52 ,$300.60 ,$262.19 ,$275.88 ,$13.03 ,$217.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200898,86663,HC EBV EARLY AG-90,302,1 ,$51.00 ,$33.15 ,$13.12 ,$51.00 ,$32.80 ,$40.80 ,$13.12 ,$14.28 ,$40.41 ,$46.82 ,$13.12 ,$46.82 ,$13.12 ,$24.93 ,$37.74 ,$32.80 ,$13.12 ,$42.53 ,$13.12 , N/A ,$42.13 ,$42.13 ,$40.80 ,$45.90 ,$32.80 ,$43.35 ,$13.12 ,$13.12 ,$43.35 ,$13.12 ,$21.22 , N/A , N/A ,$13.78 ,$43.35 ,$14.28 ,$45.90 ,$40.04 ,$42.13 ,$13.12 ,$33.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200899,86664,HC EBV NUCLEAR AG-90,302,1 ,$51.00 ,$33.15 ,$14.28 ,$51.00 ,$38.23 ,$40.80 ,$15.29 ,$14.28 ,$40.41 ,$46.82 ,$15.29 ,$46.82 ,$15.29 ,$29.05 ,$37.74 ,$38.23 ,$15.29 ,$42.53 ,$15.29 , N/A ,$42.13 ,$42.13 ,$40.80 ,$45.90 ,$38.23 ,$43.35 ,$15.29 ,$15.29 ,$43.35 ,$15.29 ,$21.22 , N/A , N/A ,$16.05 ,$43.35 ,$14.28 ,$45.90 ,$40.04 ,$42.13 ,$15.29 ,$33.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200900,86665,HC EBV VIRAL CAP-90,302,1 ,$51.00 ,$33.15 ,$14.28 ,$51.00 ,$45.35 ,$40.80 ,$18.14 ,$14.28 ,$40.41 ,$46.82 ,$18.14 ,$46.82 ,$18.14 ,$34.47 ,$37.74 ,$45.35 ,$18.14 ,$42.53 ,$18.14 , N/A ,$42.13 ,$42.13 ,$40.80 ,$45.90 ,$45.35 ,$43.35 ,$18.14 ,$18.14 ,$43.35 ,$18.14 ,$21.22 , N/A , N/A ,$19.05 ,$43.35 ,$14.28 ,$45.90 ,$40.04 ,$42.13 ,$18.14 ,$33.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200901,86666,HC EHRLICHIA AB-90,302,1 ,$222.00 ,$144.30 ,$10.18 ,$222.00 ,$25.45 ,$177.60 ,$10.18 ,$62.16 ,$175.91 ,$203.80 ,$10.18 ,$203.80 ,$10.18 ,$19.34 ,$164.28 ,$25.45 ,$10.18 ,$185.15 ,$10.18 , N/A ,$183.37 ,$183.37 ,$177.60 ,$199.80 ,$25.45 ,$188.70 ,$10.18 ,$10.18 ,$188.70 ,$10.18 ,$92.35 , N/A , N/A ,$10.69 ,$188.70 ,$62.16 ,$199.80 ,$174.27 ,$183.37 ,$10.18 ,$144.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200903,86671,HC FUNGUS AB NOS-90,302,1 ,$386.00 ,$250.90 ,$12.25 ,$386.00 ,$30.63 ,$308.80 ,$12.25 ,$108.08 ,$305.87 ,$354.35 ,$12.25 ,$354.35 ,$12.25 ,$23.28 ,$285.64 ,$30.63 ,$12.25 ,$321.92 ,$12.25 , N/A ,$318.84 ,$318.84 ,$308.80 ,$347.40 ,$30.63 ,$328.10 ,$12.25 ,$12.25 ,$328.10 ,$12.25 ,$160.58 , N/A , N/A ,$12.86 ,$328.10 ,$108.08 ,$347.40 ,$303.01 ,$318.84 ,$12.25 ,$250.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200907,86684,HC HAEMOPHILUS INFLUENZA AB-90,302,1 ,$388.00 ,$252.20 ,$15.84 ,$388.00 ,$39.60 ,$310.40 ,$15.84 ,$108.64 ,$307.45 ,$356.18 ,$15.84 ,$356.18 ,$15.84 ,$30.10 ,$287.12 ,$39.60 ,$15.84 ,$323.59 ,$15.84 , N/A ,$320.49 ,$320.49 ,$310.40 ,$349.20 ,$39.60 ,$329.80 ,$15.84 ,$15.84 ,$329.80 ,$15.84 ,$161.41 , N/A , N/A ,$16.63 ,$329.80 ,$108.64 ,$349.20 ,$304.58 ,$320.49 ,$15.84 ,$252.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200912,86695,HC HERPES SIMPLEX AB I-90,302,1 ,$212.00 ,$137.80 ,$13.19 ,$212.00 ,$32.98 ,$169.60 ,$13.19 ,$59.36 ,$167.99 ,$194.62 ,$13.19 ,$194.62 ,$13.19 ,$25.06 ,$156.88 ,$32.98 ,$13.19 ,$176.81 ,$13.19 , N/A ,$175.11 ,$175.11 ,$169.60 ,$190.80 ,$32.98 ,$180.20 ,$13.19 ,$13.19 ,$180.20 ,$13.19 ,$88.19 , N/A , N/A ,$13.85 ,$180.20 ,$59.36 ,$190.80 ,$166.42 ,$175.11 ,$13.19 ,$137.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200913,86696,HC HERPES SIMPLEX AB II-90,302,1 ,$212.00 ,$137.80 ,$19.35 ,$212.00 ,$48.38 ,$169.60 ,$19.35 ,$59.36 ,$167.99 ,$194.62 ,$19.35 ,$194.62 ,$19.35 ,$36.77 ,$156.88 ,$48.38 ,$19.35 ,$176.81 ,$19.35 , N/A ,$175.11 ,$175.11 ,$169.60 ,$190.80 ,$48.38 ,$180.20 ,$19.35 ,$19.35 ,$180.20 ,$19.35 ,$88.19 , N/A , N/A ,$20.32 ,$180.20 ,$59.36 ,$190.80 ,$166.42 ,$175.11 ,$19.35 ,$137.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200914,86698,HC HISTOPLASMA AB-90,302,1 ,$265.00 ,$172.25 ,$13.79 ,$265.00 ,$34.48 ,$212.00 ,$13.79 ,$74.20 ,$209.99 ,$243.27 ,$13.79 ,$243.27 ,$13.79 ,$26.20 ,$196.10 ,$34.48 ,$13.79 ,$221.01 ,$13.79 , N/A ,$218.89 ,$218.89 ,$212.00 ,$238.50 ,$34.48 ,$225.25 ,$13.79 ,$13.79 ,$225.25 ,$13.79 ,$110.24 , N/A , N/A ,$14.48 ,$225.25 ,$74.20 ,$238.50 ,$208.03 ,$218.89 ,$13.79 ,$172.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200915,86701,HC HIV-1 AB-90,302,1 ,$270.00 ,$175.50 ,$8.89 ,$270.00 ,$22.23 ,$216.00 ,$8.89 ,$75.60 ,$213.95 ,$247.86 ,$8.89 ,$247.86 ,$8.89 ,$16.89 ,$199.80 ,$22.23 ,$8.89 ,$225.18 ,$8.89 , N/A ,$223.02 ,$223.02 ,$216.00 ,$243.00 ,$22.23 ,$229.50 ,$8.89 ,$8.89 ,$229.50 ,$8.89 ,$112.32 , N/A , N/A ,$9.33 ,$229.50 ,$75.60 ,$243.00 ,$211.95 ,$223.02 ,$8.89 ,$175.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200918,86702,HC HIV-2 AB-90,302,1 ,$169.00 ,$109.85 ,$13.52 ,$169.00 ,$33.80 ,$135.20 ,$13.52 ,$47.32 ,$133.92 ,$155.14 ,$13.52 ,$155.14 ,$13.52 ,$25.69 ,$125.06 ,$33.80 ,$13.52 ,$140.95 ,$13.52 , N/A ,$139.59 ,$139.59 ,$135.20 ,$152.10 ,$33.80 ,$143.65 ,$13.52 ,$13.52 ,$143.65 ,$13.52 ,$70.30 , N/A , N/A ,$14.20 ,$143.65 ,$47.32 ,$152.10 ,$132.67 ,$139.59 ,$13.52 ,$109.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200919,86704,HC HEP CORE AB-90,302,1 ,$282.00 ,$183.30 ,$12.05 ,$282.00 ,$30.13 ,$225.60 ,$12.05 ,$78.96 ,$223.46 ,$258.88 ,$12.05 ,$258.88 ,$12.05 ,$22.90 ,$208.68 ,$30.13 ,$12.05 ,$235.19 ,$12.05 , N/A ,$232.93 ,$232.93 ,$225.60 ,$253.80 ,$30.13 ,$239.70 ,$12.05 ,$12.05 ,$239.70 ,$12.05 ,$117.31 , N/A , N/A ,$12.65 ,$239.70 ,$78.96 ,$253.80 ,$221.37 ,$232.93 ,$12.05 ,$183.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200921,86706,HC HEP B SURFACE AB-90,302,1 ,$246.00 ,$159.90 ,$10.74 ,$246.00 ,$26.85 ,$196.80 ,$10.74 ,$68.88 ,$194.93 ,$225.83 ,$10.74 ,$225.83 ,$10.74 ,$20.41 ,$182.04 ,$26.85 ,$10.74 ,$205.16 ,$10.74 , N/A ,$203.20 ,$203.20 ,$196.80 ,$221.40 ,$26.85 ,$209.10 ,$10.74 ,$10.74 ,$209.10 ,$10.74 ,$102.34 , N/A , N/A ,$11.28 ,$209.10 ,$68.88 ,$221.40 ,$193.11 ,$203.20 ,$10.74 ,$159.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200923,86707,HC HEP B E AB-90,302,1 ,$99.00 ,$64.35 ,$11.57 ,$99.00 ,$28.93 ,$79.20 ,$11.57 ,$27.72 ,$78.45 ,$90.88 ,$11.57 ,$90.88 ,$11.57 ,$21.98 ,$73.26 ,$28.93 ,$11.57 ,$82.57 ,$11.57 , N/A ,$81.77 ,$81.77 ,$79.20 ,$89.10 ,$28.93 ,$84.15 ,$11.57 ,$11.57 ,$84.15 ,$11.57 ,$41.18 , N/A , N/A ,$12.15 ,$84.15 ,$27.72 ,$89.10 ,$77.72 ,$81.77 ,$11.57 ,$64.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200924,86708,HC HEP A AB TOTAL-90,302,1 ,$261.00 ,$169.65 ,$12.39 ,$261.00 ,$30.98 ,$208.80 ,$12.39 ,$73.08 ,$206.82 ,$239.60 ,$12.39 ,$239.60 ,$12.39 ,$23.54 ,$193.14 ,$30.98 ,$12.39 ,$217.67 ,$12.39 , N/A ,$215.59 ,$215.59 ,$208.80 ,$234.90 ,$30.98 ,$221.85 ,$12.39 ,$12.39 ,$221.85 ,$12.39 ,$108.58 , N/A , N/A ,$13.01 ,$221.85 ,$73.08 ,$234.90 ,$204.89 ,$215.59 ,$12.39 ,$169.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200925,86709,HC HEP A AB IGM-90,302,1 ,$151.00 ,$98.15 ,$11.26 ,$151.00 ,$28.15 ,$120.80 ,$11.26 ,$42.28 ,$119.65 ,$138.62 ,$11.26 ,$138.62 ,$11.26 ,$21.39 ,$111.74 ,$28.15 ,$11.26 ,$125.93 ,$11.26 , N/A ,$124.73 ,$124.73 ,$120.80 ,$135.90 ,$28.15 ,$128.35 ,$11.26 ,$11.26 ,$128.35 ,$11.26 ,$62.82 , N/A , N/A ,$11.82 ,$128.35 ,$42.28 ,$135.90 ,$118.54 ,$124.73 ,$11.26 ,$98.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200926,86710,HC INFLUENZA AB-90,302,1 ,$466.00 ,$302.90 ,$13.55 ,$466.00 ,$33.88 ,$372.80 ,$13.55 ,$130.48 ,$369.26 ,$427.79 ,$13.55 ,$427.79 ,$13.55 ,$25.75 ,$344.84 ,$33.88 ,$13.55 ,$388.64 ,$13.55 , N/A ,$384.92 ,$384.92 ,$372.80 ,$419.40 ,$33.88 ,$396.10 ,$13.55 ,$13.55 ,$396.10 ,$13.55 ,$193.86 , N/A , N/A ,$14.23 ,$396.10 ,$130.48 ,$419.40 ,$365.81 ,$384.92 ,$13.55 ,$302.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200931,86735,HC MUMPS AB-90,302,1 ,$225.00 ,$146.25 ,$13.05 ,$225.00 ,$32.63 ,$180.00 ,$13.05 ,$63.00 ,$178.29 ,$206.55 ,$13.05 ,$206.55 ,$13.05 ,$24.80 ,$166.50 ,$32.63 ,$13.05 ,$187.65 ,$13.05 , N/A ,$185.85 ,$185.85 ,$180.00 ,$202.50 ,$32.63 ,$191.25 ,$13.05 ,$13.05 ,$191.25 ,$13.05 ,$93.60 , N/A , N/A ,$13.70 ,$191.25 ,$63.00 ,$202.50 ,$176.63 ,$185.85 ,$13.05 ,$146.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200932,86738,HC MYCOPLASMA AB-90,302,1 ,$192.00 ,$124.80 ,$13.24 ,$192.00 ,$33.10 ,$153.60 ,$13.24 ,$53.76 ,$152.14 ,$176.26 ,$13.24 ,$176.26 ,$13.24 ,$25.16 ,$142.08 ,$33.10 ,$13.24 ,$160.13 ,$13.24 , N/A ,$158.59 ,$158.59 ,$153.60 ,$172.80 ,$33.10 ,$163.20 ,$13.24 ,$13.24 ,$163.20 ,$13.24 ,$79.87 , N/A , N/A ,$13.90 ,$163.20 ,$53.76 ,$172.80 ,$150.72 ,$158.59 ,$13.24 ,$124.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200935,86747,HC PARVOVIRUS AB-90,302,1 ,$369.00 ,$239.85 ,$15.03 ,$369.00 ,$37.58 ,$295.20 ,$15.03 ,$103.32 ,$292.40 ,$338.74 ,$15.03 ,$338.74 ,$15.03 ,$28.56 ,$273.06 ,$37.58 ,$15.03 ,$307.75 ,$15.03 , N/A ,$304.79 ,$304.79 ,$295.20 ,$332.10 ,$37.58 ,$313.65 ,$15.03 ,$15.03 ,$313.65 ,$15.03 ,$153.50 , N/A , N/A ,$15.78 ,$313.65 ,$103.32 ,$332.10 ,$289.67 ,$304.79 ,$15.03 ,$239.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200937,86753,HC PROTOZOA AB-90,302,1 ,$120.00 ,$78.00 ,$12.39 ,$120.00 ,$30.98 ,$96.00 ,$12.39 ,$33.60 ,$95.09 ,$110.16 ,$12.39 ,$110.16 ,$12.39 ,$23.54 ,$88.80 ,$30.98 ,$12.39 ,$100.08 ,$12.39 , N/A ,$99.12 ,$99.12 ,$96.00 ,$108.00 ,$30.98 ,$102.00 ,$12.39 ,$12.39 ,$102.00 ,$12.39 ,$49.92 , N/A , N/A ,$13.01 ,$102.00 ,$33.60 ,$108.00 ,$94.20 ,$99.12 ,$12.39 ,$78.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200938,86756,HC RSV AB-90,302,1 ,$225.00 ,$146.25 ,$15.89 ,$225.00 ,$39.73 ,$180.00 ,$15.89 ,$63.00 ,$178.29 ,$206.55 ,$15.89 ,$206.55 ,$15.89 ,$30.19 ,$166.50 ,$39.73 ,$15.89 ,$187.65 ,$15.89 , N/A ,$185.85 ,$185.85 ,$180.00 ,$202.50 ,$39.73 ,$191.25 ,$15.89 ,$15.89 ,$191.25 ,$15.89 ,$93.60 , N/A , N/A ,$16.68 ,$191.25 ,$63.00 ,$202.50 ,$176.63 ,$185.85 ,$15.89 ,$146.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200940,86762,HC RUBELLA AB-90,302,1 ,$52.00 ,$33.80 ,$14.39 ,$52.00 ,$35.98 ,$41.60 ,$14.39 ,$14.56 ,$41.20 ,$47.74 ,$14.39 ,$47.74 ,$14.39 ,$27.34 ,$38.48 ,$35.98 ,$14.39 ,$43.37 ,$14.39 , N/A ,$42.95 ,$42.95 ,$41.60 ,$46.80 ,$35.98 ,$44.20 ,$14.39 ,$14.39 ,$44.20 ,$14.39 ,$21.63 , N/A , N/A ,$15.11 ,$44.20 ,$14.56 ,$46.80 ,$40.82 ,$42.95 ,$14.39 ,$33.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200941,86765,HC RUBEOLA AB-90,302,1 ,$91.00 ,$59.15 ,$12.88 ,$91.00 ,$32.20 ,$72.80 ,$12.88 ,$25.48 ,$72.11 ,$83.54 ,$12.88 ,$83.54 ,$12.88 ,$24.47 ,$67.34 ,$32.20 ,$12.88 ,$75.89 ,$12.88 , N/A ,$75.17 ,$75.17 ,$72.80 ,$81.90 ,$32.20 ,$77.35 ,$12.88 ,$12.88 ,$77.35 ,$12.88 ,$37.86 , N/A , N/A ,$13.52 ,$77.35 ,$25.48 ,$81.90 ,$71.44 ,$75.17 ,$12.88 ,$59.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200943,86774,HC TETANUS AB-90,302,1 ,$407.00 ,$264.55 ,$14.80 ,$407.00 ,$37.00 ,$325.60 ,$14.80 ,$113.96 ,$322.51 ,$373.63 ,$14.80 ,$373.63 ,$14.80 ,$28.12 ,$301.18 ,$37.00 ,$14.80 ,$339.44 ,$14.80 , N/A ,$336.18 ,$336.18 ,$325.60 ,$366.30 ,$37.00 ,$345.95 ,$14.80 ,$14.80 ,$345.95 ,$14.80 ,$169.31 , N/A , N/A ,$15.54 ,$345.95 ,$113.96 ,$366.30 ,$319.50 ,$336.18 ,$14.80 ,$264.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200945,86778,HC TOXOPLASMA AB IGM-90,302,1 ,$112.00 ,$72.80 ,$14.41 ,$112.00 ,$36.03 ,$89.60 ,$14.41 ,$31.36 ,$88.75 ,$102.82 ,$14.41 ,$102.82 ,$14.41 ,$27.38 ,$82.88 ,$36.03 ,$14.41 ,$93.41 ,$14.41 , N/A ,$92.51 ,$92.51 ,$89.60 ,$100.80 ,$36.03 ,$95.20 ,$14.41 ,$14.41 ,$95.20 ,$14.41 ,$46.59 , N/A , N/A ,$15.13 ,$95.20 ,$31.36 ,$100.80 ,$87.92 ,$92.51 ,$14.41 ,$72.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200946,86780,HC TREPONEMA P AB CONFIRM-90,302,1 ,$255.00 ,$165.75 ,$13.24 ,$255.00 ,$33.10 ,$204.00 ,$13.24 ,$71.40 ,$202.06 ,$234.09 ,$13.24 ,$234.09 ,$13.24 ,$25.16 ,$188.70 ,$33.10 ,$13.24 ,$212.67 ,$13.24 , N/A ,$210.63 ,$210.63 ,$204.00 ,$229.50 ,$33.10 ,$216.75 ,$13.24 ,$13.24 ,$216.75 ,$13.24 ,$106.08 , N/A , N/A ,$13.90 ,$216.75 ,$71.40 ,$229.50 ,$200.18 ,$210.63 ,$13.24 ,$165.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200948,86787,HC VARICELLA ZOSTER AB-90,302,1 ,$271.00 ,$176.15 ,$12.88 ,$271.00 ,$32.20 ,$216.80 ,$12.88 ,$75.88 ,$214.74 ,$248.78 ,$12.88 ,$248.78 ,$12.88 ,$24.47 ,$200.54 ,$32.20 ,$12.88 ,$226.01 ,$12.88 , N/A ,$223.85 ,$223.85 ,$216.80 ,$243.90 ,$32.20 ,$230.35 ,$12.88 ,$12.88 ,$230.35 ,$12.88 ,$112.74 , N/A , N/A ,$13.52 ,$230.35 ,$75.88 ,$243.90 ,$212.74 ,$223.85 ,$12.88 ,$176.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200949,86788,HC WEST NILE VIRUS AB IGM-90,302,1 ,$100.00 ,$65.00 ,$16.85 ,$100.00 ,$42.13 ,$80.00 ,$16.85 ,$28.00 ,$79.24 ,$91.80 ,$16.85 ,$91.80 ,$16.85 ,$32.02 ,$74.00 ,$42.13 ,$16.85 ,$83.40 ,$16.85 , N/A ,$82.60 ,$82.60 ,$80.00 ,$90.00 ,$42.13 ,$85.00 ,$16.85 ,$16.85 ,$85.00 ,$16.85 ,$41.60 , N/A , N/A ,$17.69 ,$85.00 ,$28.00 ,$90.00 ,$78.50 ,$82.60 ,$16.85 ,$65.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200950,86789,HC WEST NILE AB-90,302,1 ,$148.00 ,$96.20 ,$14.39 ,$148.00 ,$35.98 ,$118.40 ,$14.39 ,$41.44 ,$117.28 ,$135.86 ,$14.39 ,$135.86 ,$14.39 ,$27.34 ,$109.52 ,$35.98 ,$14.39 ,$123.43 ,$14.39 , N/A ,$122.25 ,$122.25 ,$118.40 ,$133.20 ,$35.98 ,$125.80 ,$14.39 ,$14.39 ,$125.80 ,$14.39 ,$61.57 , N/A , N/A ,$15.11 ,$125.80 ,$41.44 ,$133.20 ,$116.18 ,$122.25 ,$14.39 ,$96.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200951,86790,HC VIRUS AB NOT SPECIFIED-90,302,1 ,$423.00 ,$274.95 ,$12.88 ,$423.00 ,$32.20 ,$338.40 ,$12.88 ,$118.44 ,$335.19 ,$388.31 ,$12.88 ,$388.31 ,$12.88 ,$24.47 ,$313.02 ,$32.20 ,$12.88 ,$352.78 ,$12.88 , N/A ,$349.40 ,$349.40 ,$338.40 ,$380.70 ,$32.20 ,$359.55 ,$12.88 ,$12.88 ,$359.55 ,$12.88 ,$175.97 , N/A , N/A ,$13.52 ,$359.55 ,$118.44 ,$380.70 ,$332.06 ,$349.40 ,$12.88 ,$274.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200953,86800,HC THYROGLOBULIN AB-90,302,1 ,$95.00 ,$61.75 ,$15.91 ,$95.00 ,$39.78 ,$76.00 ,$15.91 ,$26.60 ,$75.28 ,$87.21 ,$15.91 ,$87.21 ,$15.91 ,$30.23 ,$70.30 ,$39.78 ,$15.91 ,$79.23 ,$15.91 , N/A ,$78.47 ,$78.47 ,$76.00 ,$85.50 ,$39.78 ,$80.75 ,$15.91 ,$15.91 ,$80.75 ,$15.91 ,$39.52 , N/A , N/A ,$16.71 ,$80.75 ,$26.60 ,$85.50 ,$74.58 ,$78.47 ,$15.91 ,$61.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200954,86803,HC HEP C AB-90,302,1 ,$127.00 ,$82.55 ,$14.27 ,$127.00 ,$35.68 ,$101.60 ,$14.27 ,$35.56 ,$100.63 ,$116.59 ,$14.27 ,$116.59 ,$14.27 ,$27.11 ,$93.98 ,$35.68 ,$14.27 ,$105.92 ,$14.27 , N/A ,$104.90 ,$104.90 ,$101.60 ,$114.30 ,$35.68 ,$107.95 ,$14.27 ,$14.27 ,$107.95 ,$14.27 ,$52.83 , N/A , N/A ,$14.98 ,$107.95 ,$35.56 ,$114.30 ,$99.70 ,$104.90 ,$14.27 ,$82.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200960,86812,HC HLA TYPING SINGLE A/B/C-90,302,1 ,$400.00 ,$260.00 ,$25.81 ,$400.00 ,$64.53 ,$320.00 ,$25.81 ,$112.00 ,$316.96 ,$367.20 ,$25.81 ,$367.20 ,$25.81 ,$49.04 ,$296.00 ,$64.53 ,$25.81 ,$333.60 ,$25.81 , N/A ,$330.40 ,$330.40 ,$320.00 ,$360.00 ,$64.53 ,$340.00 ,$25.81 ,$25.81 ,$340.00 ,$25.81 ,$166.40 , N/A , N/A ,$27.10 ,$340.00 ,$112.00 ,$360.00 ,$314.00 ,$330.40 ,$25.81 ,$260.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200966,86850,HC AB SCREEN-90,302,1 ,$93.00 ,$60.45 ,$26.04 ,$114.95 ,$114.95 ,$74.40 ,$45.98 ,$26.04 ,$73.69 ,$85.37 ,$45.98 ,$85.37 ,$45.98 ,$87.36 ,$68.82 ,$93.00 ,$45.98 ,$77.56 ,$45.98 , N/A ,$76.82 ,$76.82 ,$74.40 ,$83.70 ,$93.00 ,$79.05 ,$45.98 ,$45.98 ,$79.05 ,$45.98 ,$38.69 , N/A , N/A ,$48.28 ,$79.05 ,$26.04 ,$83.70 ,$73.01 ,$76.82 ,$45.98 ,$60.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200970,86860,HC ELUTION-90,302,1 ,$171.00 ,$111.15 ,$47.88 ,$345.05 ,$345.05 ,$136.80 ,$138.02 ,$47.88 ,$135.50 ,$156.98 ,$138.02 ,$156.98 ,$138.02 ,$171.00 ,$126.54 ,$171.00 ,$138.02 ,$142.61 ,$138.02 , N/A ,$141.25 ,$141.25 ,$136.80 ,$153.90 ,$171.00 ,$145.35 ,$138.02 ,$138.02 ,$145.35 ,$138.02 ,$71.14 , N/A , N/A ,$144.92 ,$145.35 ,$47.88 ,$153.90 ,$134.24 ,$141.25 ,$138.02 ,$111.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200972,86870,HC RBC AB ID PANEL-90,302,1 ,$140.00 ,$91.00 ,$39.20 ,$673.80 ,$673.80 ,$112.00 ,$269.52 ,$39.20 ,$110.94 ,$128.52 ,$140.00 ,$128.52 ,$140.00 ,$140.00 ,$103.60 ,$140.00 ,$269.52 ,$116.76 ,$269.52 , N/A ,$115.64 ,$115.64 ,$112.00 ,$126.00 ,$140.00 ,$119.00 ,$269.52 ,$269.52 ,$119.00 ,$269.52 ,$58.24 , N/A , N/A ,$140.00 ,$119.00 ,$39.20 ,$126.00 ,$109.90 ,$115.64 ,$269.52 ,$91.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200976,86880,HC COOMBS DIRECT-90,302,1 ,$77.00 ,$50.05 ,$21.56 ,$128.78 ,$128.78 ,$61.60 ,$51.51 ,$21.56 ,$61.01 ,$70.69 ,$51.51 ,$70.69 ,$51.51 ,$77.00 ,$56.98 ,$77.00 ,$51.51 ,$64.22 ,$51.51 , N/A ,$63.60 ,$63.60 ,$61.60 ,$69.30 ,$77.00 ,$65.45 ,$51.51 ,$51.51 ,$65.45 ,$51.51 ,$32.03 , N/A , N/A ,$54.09 ,$65.45 ,$21.56 ,$69.30 ,$60.45 ,$63.60 ,$51.51 ,$50.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200978,86886,HC INDIRECT TITER-90,302,1 ,$151.00 ,$98.15 ,$42.28 ,$345.05 ,$345.05 ,$120.80 ,$138.02 ,$42.28 ,$119.65 ,$138.62 ,$138.02 ,$138.62 ,$138.02 ,$151.00 ,$111.74 ,$151.00 ,$138.02 ,$125.93 ,$138.02 , N/A ,$124.73 ,$124.73 ,$120.80 ,$135.90 ,$151.00 ,$128.35 ,$138.02 ,$138.02 ,$128.35 ,$138.02 ,$62.82 , N/A , N/A ,$144.92 ,$128.35 ,$42.28 ,$135.90 ,$118.54 ,$124.73 ,$138.02 ,$98.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200981,86900,HC BLOOD TYPING ABO-90,302,1 ,$68.00 ,$44.20 ,$19.04 ,$260.88 ,$260.88 ,$54.40 ,$104.35 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$104.35 ,$56.71 ,$104.35 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$104.35 ,$104.35 ,$57.80 ,$104.35 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$104.35 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200983,86901,HC BLOOD TYPING RH-90,302,1 ,$68.00 ,$44.20 ,$19.04 ,$78.30 ,$78.30 ,$54.40 ,$31.32 ,$19.04 ,$53.88 ,$62.42 ,$31.32 ,$62.42 ,$31.32 ,$59.51 ,$50.32 ,$68.00 ,$31.32 ,$56.71 ,$31.32 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$31.32 ,$31.32 ,$57.80 ,$31.32 ,$28.29 , N/A , N/A ,$32.89 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$31.32 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200989,86902,HC RBC AG SCR RGT SERUM-90,302,1 ,$117.00 ,$76.05 ,$32.76 ,$673.80 ,$673.80 ,$93.60 ,$269.52 ,$32.76 ,$92.71 ,$107.41 ,$117.00 ,$107.41 ,$117.00 ,$117.00 ,$86.58 ,$117.00 ,$269.52 ,$97.58 ,$269.52 , N/A ,$96.64 ,$96.64 ,$93.60 ,$105.30 ,$117.00 ,$99.45 ,$269.52 ,$269.52 ,$99.45 ,$269.52 ,$48.67 , N/A , N/A ,$117.00 ,$99.45 ,$32.76 ,$105.30 ,$91.85 ,$96.64 ,$269.52 ,$76.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30200998,86906,HC RH PHENOTYPE COMPLETE-90,302,1 ,$94.00 ,$61.10 ,$26.32 ,$94.00 ,$78.30 ,$75.20 ,$31.32 ,$26.32 ,$74.49 ,$86.29 ,$31.32 ,$86.29 ,$31.32 ,$59.51 ,$69.56 ,$78.30 ,$31.32 ,$78.40 ,$31.32 , N/A ,$77.64 ,$77.64 ,$75.20 ,$84.60 ,$78.31 ,$79.90 ,$31.32 ,$31.32 ,$79.90 ,$31.32 ,$39.10 , N/A , N/A ,$32.89 ,$79.90 ,$26.32 ,$84.60 ,$73.79 ,$77.64 ,$31.32 ,$61.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201000,86922,HC CROSSMATCH AHG-90,302,1 ,$185.00 ,$120.25 ,$51.80 ,$185.00 , N/A ,$148.00 , N/A ,$51.80 ,$146.59 ,$169.83 ,$138.02 ,$169.83 ,$138.02 , N/A ,$136.90 , N/A , N/A ,$154.29 , N/A , N/A ,$152.81 ,$152.81 ,$148.00 ,$166.50 , N/A ,$157.25 ,$138.02 ,$138.02 ,$157.25 ,$138.02 ,$76.96 , N/A , N/A ,$144.92 ,$157.25 ,$51.80 ,$166.50 ,$145.23 ,$152.81 ,$138.02 ,$120.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201001,86940,HC HEOLYSIN AGG AUTO SCREEN-90,302,1 ,$146.00 ,$94.90 ,$8.77 ,$146.00 ,$21.93 ,$116.80 ,$8.77 ,$40.88 ,$115.69 ,$134.03 ,$8.77 ,$134.03 ,$8.77 ,$16.66 ,$108.04 ,$21.93 ,$8.77 ,$121.76 ,$8.77 , N/A ,$120.60 ,$120.60 ,$116.80 ,$131.40 ,$21.93 ,$124.10 ,$8.77 ,$8.77 ,$124.10 ,$8.77 ,$60.74 , N/A , N/A ,$9.21 ,$124.10 ,$40.88 ,$131.40 ,$114.61 ,$120.60 ,$8.77 ,$94.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201003,86970,HC RBC PRETREAT CHEM-90,302,1 ,$200.00 ,$130.00 ,$31.32 ,$200.00 ,$78.30 ,$160.00 ,$31.32 ,$56.00 ,$158.48 ,$183.60 ,$31.32 ,$183.60 ,$31.32 ,$59.51 ,$148.00 ,$78.30 ,$31.32 ,$166.80 ,$31.32 , N/A ,$165.20 ,$165.20 ,$160.00 ,$180.00 ,$78.31 ,$170.00 ,$31.32 ,$31.32 ,$170.00 ,$31.32 ,$83.20 , N/A , N/A ,$32.89 ,$170.00 ,$56.00 ,$180.00 ,$157.00 ,$165.20 ,$31.32 ,$130.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201004,86971,HC RBC PRETREAT ENZYME-90,302,1 ,$93.00 ,$60.45 ,$26.04 ,$673.80 ,$673.80 ,$74.40 ,$269.52 ,$26.04 ,$73.69 ,$85.37 ,$93.00 ,$85.37 ,$93.00 ,$93.00 ,$68.82 ,$93.00 ,$269.52 ,$77.56 ,$269.52 , N/A ,$76.82 ,$76.82 ,$74.40 ,$83.70 ,$93.00 ,$79.05 ,$269.52 ,$269.52 ,$79.05 ,$269.52 ,$38.69 , N/A , N/A ,$93.00 ,$79.05 ,$26.04 ,$83.70 ,$73.01 ,$76.82 ,$269.52 ,$60.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201005,86971,HC RBC PRETREAT ENZYME-90,302,1 ,$93.00 ,$60.45 ,$26.04 ,$673.80 ,$673.80 ,$74.40 ,$269.52 ,$26.04 ,$73.69 ,$85.37 ,$93.00 ,$85.37 ,$93.00 ,$93.00 ,$68.82 ,$93.00 ,$269.52 ,$77.56 ,$269.52 , N/A ,$76.82 ,$76.82 ,$74.40 ,$83.70 ,$93.00 ,$79.05 ,$269.52 ,$269.52 ,$79.05 ,$269.52 ,$38.69 , N/A , N/A ,$93.00 ,$79.05 ,$26.04 ,$83.70 ,$73.01 ,$76.82 ,$269.52 ,$60.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201007,86972,HC RBC PRETREAT DENSITY SEP-90,302,1 ,$85.00 ,$55.25 ,$23.80 ,$345.05 ,$345.05 ,$68.00 ,$138.02 ,$23.80 ,$67.35 ,$78.03 ,$85.00 ,$78.03 ,$85.00 ,$85.00 ,$62.90 ,$85.00 ,$138.02 ,$70.89 ,$138.02 , N/A ,$70.21 ,$70.21 ,$68.00 ,$76.50 ,$85.00 ,$72.25 ,$138.02 ,$138.02 ,$72.25 ,$138.02 ,$35.36 , N/A , N/A ,$85.00 ,$72.25 ,$23.80 ,$76.50 ,$66.73 ,$70.21 ,$138.02 ,$55.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201009,86975,HC INCUBATION OF SERUM W/DRUG-90,302,1 ,$199.00 ,$129.35 ,$55.72 ,$627.88 ,$627.88 ,$159.20 ,$251.15 ,$55.72 ,$157.69 ,$182.68 ,$199.00 ,$182.68 ,$199.00 ,$199.00 ,$147.26 ,$199.00 ,$251.15 ,$165.97 ,$251.15 , N/A ,$164.37 ,$164.37 ,$159.20 ,$179.10 ,$199.00 ,$169.15 ,$251.15 ,$251.15 ,$169.15 ,$251.15 ,$82.78 , N/A , N/A ,$199.00 ,$169.15 ,$55.72 ,$179.10 ,$156.22 ,$164.37 ,$251.15 ,$129.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201011,86976,HC RBC PRETREAT SERUM DIL-90,302,1 ,$10.00 ,$6.50 ,$2.80 ,$57.15 ,$57.15 ,$8.00 ,$22.86 ,$2.80 ,$7.92 ,$9.18 ,$10.00 ,$9.18 ,$10.00 ,$10.00 ,$7.40 ,$10.00 ,$22.86 ,$8.34 ,$22.86 , N/A ,$8.26 ,$8.26 ,$8.00 ,$9.00 ,$10.00 ,$8.50 ,$22.86 ,$22.86 ,$8.50 ,$22.86 ,$4.16 , N/A , N/A ,$10.00 ,$8.50 ,$2.80 ,$9.00 ,$7.85 ,$8.26 ,$22.86 ,$6.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201016,86977,HC RBC PRETREAT NEUTRAL SERUM INHIBIT-90,302,1 ,$72.00 ,$46.80 ,$20.16 ,$345.05 ,$345.05 ,$57.60 ,$138.02 ,$20.16 ,$57.05 ,$66.10 ,$72.00 ,$66.10 ,$72.00 ,$72.00 ,$53.28 ,$72.00 ,$138.02 ,$60.05 ,$138.02 , N/A ,$59.47 ,$59.47 ,$57.60 ,$64.80 ,$72.00 ,$61.20 ,$138.02 ,$138.02 ,$61.20 ,$138.02 ,$29.95 , N/A , N/A ,$72.00 ,$61.20 ,$20.16 ,$64.80 ,$56.52 ,$59.47 ,$138.02 ,$46.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201020,86978,HC RBC PRETREAT ABSOR-90,302,1 ,$121.00 ,$78.65 ,$31.32 ,$121.00 ,$78.30 ,$96.80 ,$31.32 ,$33.88 ,$95.88 ,$111.08 ,$31.32 ,$111.08 ,$31.32 ,$59.51 ,$89.54 ,$78.30 ,$31.32 ,$100.91 ,$31.32 , N/A ,$99.95 ,$99.95 ,$96.80 ,$108.90 ,$78.31 ,$102.85 ,$31.32 ,$31.32 ,$102.85 ,$31.32 ,$50.34 , N/A , N/A ,$32.89 ,$102.85 ,$33.88 ,$108.90 ,$94.99 ,$99.95 ,$31.32 ,$78.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201022,87801,HC INFECT MLT  ORG AMP-90,302,1 ,$614.00 ,$399.10 ,$70.20 ,$614.00 ,$175.50 ,$491.20 ,$70.20 ,$171.92 ,$486.53 ,$563.65 ,$70.20 ,$563.65 ,$70.20 ,$133.38 ,$454.36 ,$175.50 ,$70.20 ,$512.08 ,$70.20 , N/A ,$507.16 ,$507.16 ,$491.20 ,$552.60 ,$175.50 ,$521.90 ,$70.20 ,$70.20 ,$521.90 ,$70.20 ,$255.42 , N/A , N/A ,$73.71 ,$521.90 ,$171.92 ,$552.60 ,$481.99 ,$507.16 ,$70.20 ,$399.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201025,86316,HC TUMOR AG OTHER AG QN-90,302,1 ,$216.00 ,$140.40 ,$20.81 ,$216.00 ,$52.03 ,$172.80 ,$20.81 ,$60.48 ,$171.16 ,$198.29 ,$20.81 ,$198.29 ,$20.81 ,$39.54 ,$159.84 ,$52.03 ,$20.81 ,$180.14 ,$20.81 , N/A ,$178.42 ,$178.42 ,$172.80 ,$194.40 ,$52.03 ,$183.60 ,$20.81 ,$20.81 ,$183.60 ,$20.81 ,$89.86 , N/A , N/A ,$21.85 ,$183.60 ,$60.48 ,$194.40 ,$169.56 ,$178.42 ,$20.81 ,$140.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201029,86331,HC IMMUNODIFF EL EA AG AB QL-90,302,1 ,$205.00 ,$133.25 ,$11.98 ,$205.00 ,$29.95 ,$164.00 ,$11.98 ,$57.40 ,$162.44 ,$188.19 ,$11.98 ,$188.19 ,$11.98 ,$22.76 ,$151.70 ,$29.95 ,$11.98 ,$170.97 ,$11.98 , N/A ,$169.33 ,$169.33 ,$164.00 ,$184.50 ,$29.95 ,$174.25 ,$11.98 ,$11.98 ,$174.25 ,$11.98 ,$85.28 , N/A , N/A ,$12.58 ,$174.25 ,$57.40 ,$184.50 ,$160.93 ,$169.33 ,$11.98 ,$133.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201031,86334,HC IMMUNOFIX ELECTRO SERUM -90,302,1 ,$454.00 ,$295.10 ,$22.34 ,$454.00 ,$55.85 ,$363.20 ,$22.34 ,$127.12 ,$359.75 ,$416.77 ,$22.34 ,$416.77 ,$22.34 ,$42.45 ,$335.96 ,$55.85 ,$22.34 ,$378.64 ,$22.34 , N/A ,$375.00 ,$375.00 ,$363.20 ,$408.60 ,$55.85 ,$385.90 ,$22.34 ,$22.34 ,$385.90 ,$22.34 ,$188.86 , N/A , N/A ,$23.46 ,$385.90 ,$127.12 ,$408.60 ,$356.39 ,$375.00 ,$22.34 ,$295.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201032,86335,HC IMMUNOFIX ELECTRO OTH-90,302,1 ,$382.00 ,$248.30 ,$29.35 ,$382.00 ,$73.38 ,$305.60 ,$29.35 ,$106.96 ,$302.70 ,$350.68 ,$29.35 ,$350.68 ,$29.35 ,$55.77 ,$282.68 ,$73.38 ,$29.35 ,$318.59 ,$29.35 , N/A ,$315.53 ,$315.53 ,$305.60 ,$343.80 ,$73.38 ,$324.70 ,$29.35 ,$29.35 ,$324.70 ,$29.35 ,$158.91 , N/A , N/A ,$30.82 ,$324.70 ,$106.96 ,$343.80 ,$299.87 ,$315.53 ,$29.35 ,$248.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201033,86336,HC INHIBIN A-90,302,1 ,$102.00 ,$66.30 ,$15.59 ,$102.00 ,$38.98 ,$81.60 ,$15.59 ,$28.56 ,$80.82 ,$93.64 ,$15.59 ,$93.64 ,$15.59 ,$29.62 ,$75.48 ,$38.98 ,$15.59 ,$85.07 ,$15.59 , N/A ,$84.25 ,$84.25 ,$81.60 ,$91.80 ,$38.98 ,$86.70 ,$15.59 ,$15.59 ,$86.70 ,$15.59 ,$42.43 , N/A , N/A ,$16.37 ,$86.70 ,$28.56 ,$91.80 ,$80.07 ,$84.25 ,$15.59 ,$66.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201034,86337,HC INSULIN AB-90,302,1 ,$245.00 ,$159.25 ,$21.41 ,$245.00 ,$53.53 ,$196.00 ,$21.41 ,$68.60 ,$194.14 ,$224.91 ,$21.41 ,$224.91 ,$21.41 ,$40.68 ,$181.30 ,$53.53 ,$21.41 ,$204.33 ,$21.41 , N/A ,$202.37 ,$202.37 ,$196.00 ,$220.50 ,$53.53 ,$208.25 ,$21.41 ,$21.41 ,$208.25 ,$21.41 ,$101.92 , N/A , N/A ,$22.48 ,$208.25 ,$68.60 ,$220.50 ,$192.33 ,$202.37 ,$21.41 ,$159.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201035,86340,HC INTRINSIC FACTOR AB-90,302,1 ,$229.00 ,$148.85 ,$15.08 ,$229.00 ,$37.70 ,$183.20 ,$15.08 ,$64.12 ,$181.46 ,$210.22 ,$15.08 ,$210.22 ,$15.08 ,$28.65 ,$169.46 ,$37.70 ,$15.08 ,$190.99 ,$15.08 , N/A ,$189.15 ,$189.15 ,$183.20 ,$206.10 ,$37.70 ,$194.65 ,$15.08 ,$15.08 ,$194.65 ,$15.08 ,$95.26 , N/A , N/A ,$15.83 ,$194.65 ,$64.12 ,$206.10 ,$179.77 ,$189.15 ,$15.08 ,$148.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201036,86341,HC ISLET CELL AB-90,302,1 ,$125.00 ,$81.25 ,$23.57 ,$125.00 ,$58.93 ,$100.00 ,$23.57 ,$35.00 ,$99.05 ,$114.75 ,$23.57 ,$114.75 ,$23.57 ,$44.78 ,$92.50 ,$58.93 ,$23.57 ,$104.25 ,$23.57 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$58.93 ,$106.25 ,$23.57 ,$23.57 ,$106.25 ,$23.57 ,$52.00 , N/A , N/A ,$24.75 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$23.57 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201042,86357,HC CD8 TOTAL COUNT-90,302,1 ,$314.00 ,$204.10 ,$37.73 ,$314.00 ,$94.33 ,$251.20 ,$37.73 ,$87.92 ,$248.81 ,$288.25 ,$37.73 ,$288.25 ,$37.73 ,$71.69 ,$232.36 ,$94.33 ,$37.73 ,$261.88 ,$37.73 , N/A ,$259.36 ,$259.36 ,$251.20 ,$282.60 ,$94.33 ,$266.90 ,$37.73 ,$37.73 ,$266.90 ,$37.73 ,$130.62 , N/A , N/A ,$39.62 ,$266.90 ,$87.92 ,$282.60 ,$246.49 ,$259.36 ,$37.73 ,$204.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201045,86360,HC ABS T CELLS CD4 CD8 RATIO-90,302,1 ,$65.00 ,$42.25 ,$18.20 ,$117.45 ,$117.45 ,$52.00 ,$46.98 ,$18.20 ,$51.51 ,$59.67 ,$46.98 ,$59.67 ,$46.98 ,$65.00 ,$48.10 ,$65.00 ,$46.98 ,$54.21 ,$46.98 , N/A ,$53.69 ,$53.69 ,$52.00 ,$58.50 ,$65.00 ,$55.25 ,$46.98 ,$46.98 ,$55.25 ,$46.98 ,$27.04 , N/A , N/A ,$49.33 ,$55.25 ,$18.20 ,$58.50 ,$51.03 ,$53.69 ,$46.98 ,$42.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201046,86361,HC T CELLS CD4 COUNT-90,302,1 ,$155.00 ,$100.75 ,$26.78 ,$155.00 ,$66.95 ,$124.00 ,$26.78 ,$43.40 ,$122.82 ,$142.29 ,$26.78 ,$142.29 ,$26.78 ,$50.88 ,$114.70 ,$66.95 ,$26.78 ,$129.27 ,$26.78 , N/A ,$128.03 ,$128.03 ,$124.00 ,$139.50 ,$66.95 ,$131.75 ,$26.78 ,$26.78 ,$131.75 ,$26.78 ,$64.48 , N/A , N/A ,$28.12 ,$131.75 ,$43.40 ,$139.50 ,$121.68 ,$128.03 ,$26.78 ,$100.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201047,86376,HC MICROSOMAL AB-90,302,1 ,$102.00 ,$66.30 ,$14.55 ,$102.00 ,$36.38 ,$81.60 ,$14.55 ,$28.56 ,$80.82 ,$93.64 ,$14.55 ,$93.64 ,$14.55 ,$27.65 ,$75.48 ,$36.38 ,$14.55 ,$85.07 ,$14.55 , N/A ,$84.25 ,$84.25 ,$81.60 ,$91.80 ,$36.38 ,$86.70 ,$14.55 ,$14.55 ,$86.70 ,$14.55 ,$42.43 , N/A , N/A ,$15.28 ,$86.70 ,$28.56 ,$91.80 ,$80.07 ,$84.25 ,$14.55 ,$66.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201049,86403,HC PARTICLE AGG SCREEN-90,302,1 ,$206.00 ,$133.90 ,$11.54 ,$206.00 ,$28.85 ,$164.80 ,$11.54 ,$57.68 ,$163.23 ,$189.11 ,$11.54 ,$189.11 ,$11.54 ,$21.93 ,$152.44 ,$28.85 ,$11.54 ,$171.80 ,$11.54 , N/A ,$170.16 ,$170.16 ,$164.80 ,$185.40 ,$28.85 ,$175.10 ,$11.54 ,$11.54 ,$175.10 ,$11.54 ,$85.70 , N/A , N/A ,$12.12 ,$175.10 ,$57.68 ,$185.40 ,$161.71 ,$170.16 ,$11.54 ,$133.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201051,86406,HC PARTICLE AGGLUT TITER-90,302,1 ,$168.00 ,$109.20 ,$10.64 ,$168.00 ,$26.60 ,$134.40 ,$10.64 ,$47.04 ,$133.12 ,$154.22 ,$10.64 ,$154.22 ,$10.64 ,$20.22 ,$124.32 ,$26.60 ,$10.64 ,$140.11 ,$10.64 , N/A ,$138.77 ,$138.77 ,$134.40 ,$151.20 ,$26.60 ,$142.80 ,$10.64 ,$10.64 ,$142.80 ,$10.64 ,$69.89 , N/A , N/A ,$11.17 ,$142.80 ,$47.04 ,$151.20 ,$131.88 ,$138.77 ,$10.64 ,$109.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201052,86431,HC RHEUMATOID FACTOR QN-90,302,1 ,$156.00 ,$101.40 ,$5.67 ,$156.00 ,$14.18 ,$124.80 ,$5.67 ,$43.68 ,$123.61 ,$143.21 ,$5.67 ,$143.21 ,$5.67 ,$10.77 ,$115.44 ,$14.18 ,$5.67 ,$130.10 ,$5.67 , N/A ,$128.86 ,$128.86 ,$124.80 ,$140.40 ,$14.18 ,$132.60 ,$5.67 ,$5.67 ,$132.60 ,$5.67 ,$64.90 , N/A , N/A ,$5.95 ,$132.60 ,$43.68 ,$140.40 ,$122.46 ,$128.86 ,$5.67 ,$101.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201053,86480,HC TB QUANTIFERON GOLD-90,302,1 ,$211.00 ,$137.15 ,$59.08 ,$211.00 ,$154.95 ,$168.80 ,$61.98 ,$59.08 ,$167.20 ,$193.70 ,$61.98 ,$193.70 ,$61.98 ,$117.76 ,$156.14 ,$154.95 ,$61.98 ,$175.97 ,$61.98 , N/A ,$174.29 ,$174.29 ,$168.80 ,$189.90 ,$154.95 ,$179.35 ,$61.98 ,$61.98 ,$179.35 ,$61.98 ,$87.78 , N/A , N/A ,$65.08 ,$179.35 ,$59.08 ,$189.90 ,$165.64 ,$174.29 ,$61.98 ,$137.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201054,86592,HC SYPHILIS VDRL RPR QL-90,302,1 ,$79.00 ,$51.35 ,$4.27 ,$79.00 ,$10.68 ,$63.20 ,$4.27 ,$22.12 ,$62.60 ,$72.52 ,$4.27 ,$72.52 ,$4.27 ,$8.11 ,$58.46 ,$10.68 ,$4.27 ,$65.89 ,$4.27 , N/A ,$65.25 ,$65.25 ,$63.20 ,$71.10 ,$10.68 ,$67.15 ,$4.27 ,$4.27 ,$67.15 ,$4.27 ,$32.86 , N/A , N/A ,$4.48 ,$67.15 ,$22.12 ,$71.10 ,$62.02 ,$65.25 ,$4.27 ,$51.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201055,86603,HC ADENOVIRUS AB-90,302,1 ,$245.00 ,$159.25 ,$12.87 ,$245.00 ,$32.18 ,$196.00 ,$12.87 ,$68.60 ,$194.14 ,$224.91 ,$12.87 ,$224.91 ,$12.87 ,$24.45 ,$181.30 ,$32.18 ,$12.87 ,$204.33 ,$12.87 , N/A ,$202.37 ,$202.37 ,$196.00 ,$220.50 ,$32.18 ,$208.25 ,$12.87 ,$12.87 ,$208.25 ,$12.87 ,$101.92 , N/A , N/A ,$13.51 ,$208.25 ,$68.60 ,$220.50 ,$192.33 ,$202.37 ,$12.87 ,$159.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201056,86606,HC ASPERGILLUS AB-90,302,1 ,$343.00 ,$222.95 ,$15.05 ,$343.00 ,$37.63 ,$274.40 ,$15.05 ,$96.04 ,$271.79 ,$314.87 ,$15.05 ,$314.87 ,$15.05 ,$28.60 ,$253.82 ,$37.63 ,$15.05 ,$286.06 ,$15.05 , N/A ,$283.32 ,$283.32 ,$274.40 ,$308.70 ,$37.63 ,$291.55 ,$15.05 ,$15.05 ,$291.55 ,$15.05 ,$142.69 , N/A , N/A ,$15.80 ,$291.55 ,$96.04 ,$308.70 ,$269.26 ,$283.32 ,$15.05 ,$222.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201057,86609,HC BACTERIUM AB NOS-90,302,1 ,$396.00 ,$257.40 ,$12.88 ,$396.00 ,$32.20 ,$316.80 ,$12.88 ,$110.88 ,$313.79 ,$363.53 ,$12.88 ,$363.53 ,$12.88 ,$24.47 ,$293.04 ,$32.20 ,$12.88 ,$330.26 ,$12.88 , N/A ,$327.10 ,$327.10 ,$316.80 ,$356.40 ,$32.20 ,$336.60 ,$12.88 ,$12.88 ,$336.60 ,$12.88 ,$164.74 , N/A , N/A ,$13.52 ,$336.60 ,$110.88 ,$356.40 ,$310.86 ,$327.10 ,$12.88 ,$257.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201058,86611,HC BARTONELLA SCREEN AB-90,302,1 ,$158.00 ,$102.70 ,$10.18 ,$158.00 ,$25.45 ,$126.40 ,$10.18 ,$44.24 ,$125.20 ,$145.04 ,$10.18 ,$145.04 ,$10.18 ,$19.34 ,$116.92 ,$25.45 ,$10.18 ,$131.77 ,$10.18 , N/A ,$130.51 ,$130.51 ,$126.40 ,$142.20 ,$25.45 ,$134.30 ,$10.18 ,$10.18 ,$134.30 ,$10.18 ,$65.73 , N/A , N/A ,$10.69 ,$134.30 ,$44.24 ,$142.20 ,$124.03 ,$130.51 ,$10.18 ,$102.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201059,86611,HC BARTONELLA SCREEN AB IGG-90,302,1 ,$158.00 ,$102.70 ,$10.18 ,$158.00 ,$25.45 ,$126.40 ,$10.18 ,$44.24 ,$125.20 ,$145.04 ,$10.18 ,$145.04 ,$10.18 ,$19.34 ,$116.92 ,$25.45 ,$10.18 ,$131.77 ,$10.18 , N/A ,$130.51 ,$130.51 ,$126.40 ,$142.20 ,$25.45 ,$134.30 ,$10.18 ,$10.18 ,$134.30 ,$10.18 ,$65.73 , N/A , N/A ,$10.69 ,$134.30 ,$44.24 ,$142.20 ,$124.03 ,$130.51 ,$10.18 ,$102.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201060,86612,HC BLASTOMYCES AB-90,302,1 ,$129.00 ,$83.85 ,$12.90 ,$129.00 ,$32.25 ,$103.20 ,$12.90 ,$36.12 ,$102.22 ,$118.42 ,$12.90 ,$118.42 ,$12.90 ,$24.51 ,$95.46 ,$32.25 ,$12.90 ,$107.59 ,$12.90 , N/A ,$106.55 ,$106.55 ,$103.20 ,$116.10 ,$32.25 ,$109.65 ,$12.90 ,$12.90 ,$109.65 ,$12.90 ,$53.66 , N/A , N/A ,$13.55 ,$109.65 ,$36.12 ,$116.10 ,$101.27 ,$106.55 ,$12.90 ,$83.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201062,86617,HC LYME DISEASE AB CONFIRM-90,302,1 ,$232.00 ,$150.80 ,$15.49 ,$232.00 ,$38.73 ,$185.60 ,$15.49 ,$64.96 ,$183.84 ,$212.98 ,$15.49 ,$212.98 ,$15.49 ,$29.43 ,$171.68 ,$38.73 ,$15.49 ,$193.49 ,$15.49 , N/A ,$191.63 ,$191.63 ,$185.60 ,$208.80 ,$38.73 ,$197.20 ,$15.49 ,$15.49 ,$197.20 ,$15.49 ,$96.51 , N/A , N/A ,$16.26 ,$197.20 ,$64.96 ,$208.80 ,$182.12 ,$191.63 ,$15.49 ,$150.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201063,86618,HC LYME AB-90,302,1 ,$143.00 ,$92.95 ,$17.03 ,$143.00 ,$42.58 ,$114.40 ,$17.03 ,$40.04 ,$113.31 ,$131.27 ,$17.03 ,$131.27 ,$17.03 ,$32.36 ,$105.82 ,$42.58 ,$17.03 ,$119.26 ,$17.03 , N/A ,$118.12 ,$118.12 ,$114.40 ,$128.70 ,$42.58 ,$121.55 ,$17.03 ,$17.03 ,$121.55 ,$17.03 ,$59.49 , N/A , N/A ,$17.88 ,$121.55 ,$40.04 ,$128.70 ,$112.26 ,$118.12 ,$17.03 ,$92.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201067,86631,HC CHLAMYDIA AB-90,302,1 ,$205.00 ,$133.25 ,$11.82 ,$205.00 ,$29.55 ,$164.00 ,$11.82 ,$57.40 ,$162.44 ,$188.19 ,$11.82 ,$188.19 ,$11.82 ,$22.46 ,$151.70 ,$29.55 ,$11.82 ,$170.97 ,$11.82 , N/A ,$169.33 ,$169.33 ,$164.00 ,$184.50 ,$29.55 ,$174.25 ,$11.82 ,$11.82 ,$174.25 ,$11.82 ,$85.28 , N/A , N/A ,$12.41 ,$174.25 ,$57.40 ,$184.50 ,$160.93 ,$169.33 ,$11.82 ,$133.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201079,86711,HC AB JOHN CUNNINGHAM VIRUS-90,302,1 ,$32.00 ,$20.80 ,$8.96 ,$42.23 ,$42.23 ,$25.60 ,$16.89 ,$8.96 ,$25.36 ,$29.38 ,$16.89 ,$29.38 ,$16.89 ,$32.00 ,$23.68 ,$32.00 ,$16.89 ,$26.69 ,$16.89 , N/A ,$26.43 ,$26.43 ,$25.60 ,$28.80 ,$32.00 ,$27.20 ,$16.89 ,$16.89 ,$27.20 ,$16.89 ,$13.31 , N/A , N/A ,$17.73 ,$27.20 ,$8.96 ,$28.80 ,$25.12 ,$26.43 ,$16.89 ,$20.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201092,86593,HC SYPHILIS VDRL RPR QN-90,302,1 ,$56.00 ,$36.40 ,$4.40 ,$56.00 ,$11.00 ,$44.80 ,$4.40 ,$15.68 ,$44.37 ,$51.41 ,$4.40 ,$51.41 ,$4.40 ,$8.36 ,$41.44 ,$11.00 ,$4.40 ,$46.70 ,$4.40 , N/A ,$46.26 ,$46.26 ,$44.80 ,$50.40 ,$11.00 ,$47.60 ,$4.40 ,$4.40 ,$47.60 ,$4.40 ,$23.30 , N/A , N/A ,$4.62 ,$47.60 ,$15.68 ,$50.40 ,$43.96 ,$46.26 ,$4.40 ,$36.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201093,86003,HC ALLERGEN IGE QN EA,302,1 ,$230.00 ,$149.50 ,$5.22 ,$230.00 ,$13.05 ,$184.00 ,$5.22 ,$64.40 ,$182.25 ,$211.14 ,$5.22 ,$211.14 ,$5.22 ,$9.92 ,$170.20 ,$13.05 ,$5.22 ,$191.82 ,$5.22 , N/A ,$189.98 ,$189.98 ,$184.00 ,$207.00 ,$13.05 ,$195.50 ,$5.22 ,$5.22 ,$195.50 ,$5.22 ,$95.68 , N/A , N/A ,$5.48 ,$195.50 ,$64.40 ,$207.00 ,$180.55 ,$189.98 ,$5.22 ,$149.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201096,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$141.00 ,$91.65 ,$12.95 ,$141.00 ,$32.38 ,$112.80 ,$12.95 ,$39.48 ,$111.73 ,$129.44 ,$12.95 ,$129.44 ,$12.95 ,$24.61 ,$104.34 ,$32.38 ,$12.95 ,$117.59 ,$12.95 , N/A ,$116.47 ,$116.47 ,$112.80 ,$126.90 ,$32.38 ,$119.85 ,$12.95 ,$12.95 ,$119.85 ,$12.95 ,$58.66 , N/A , N/A ,$13.60 ,$119.85 ,$39.48 ,$126.90 ,$110.69 ,$116.47 ,$12.95 ,$91.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201098,86225,HC DNA DOUBLE STRAND AB,302,1 ,$94.00 ,$61.10 ,$13.74 ,$94.00 ,$34.35 ,$75.20 ,$13.74 ,$26.32 ,$74.49 ,$86.29 ,$13.74 ,$86.29 ,$13.74 ,$26.11 ,$69.56 ,$34.35 ,$13.74 ,$78.40 ,$13.74 , N/A ,$77.64 ,$77.64 ,$75.20 ,$84.60 ,$34.35 ,$79.90 ,$13.74 ,$13.74 ,$79.90 ,$13.74 ,$39.10 , N/A , N/A ,$14.43 ,$79.90 ,$26.32 ,$84.60 ,$73.79 ,$77.64 ,$13.74 ,$61.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201099,86235,HC ENA AB,302,1 ,$294.00 ,$191.10 ,$17.93 ,$294.00 ,$44.83 ,$235.20 ,$17.93 ,$82.32 ,$232.97 ,$269.89 ,$17.93 ,$269.89 ,$17.93 ,$34.07 ,$217.56 ,$44.83 ,$17.93 ,$245.20 ,$17.93 , N/A ,$242.84 ,$242.84 ,$235.20 ,$264.60 ,$44.83 ,$249.90 ,$17.93 ,$17.93 ,$249.90 ,$17.93 ,$122.30 , N/A , N/A ,$18.83 ,$249.90 ,$82.32 ,$264.60 ,$230.79 ,$242.84 ,$17.93 ,$191.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201100,86300,HC TUMOR AG CA 15-3 (27.29),302,1 ,$361.00 ,$234.65 ,$20.81 ,$361.00 ,$52.03 ,$288.80 ,$20.81 ,$101.08 ,$286.06 ,$331.40 ,$20.81 ,$331.40 ,$20.81 ,$39.54 ,$267.14 ,$52.03 ,$20.81 ,$301.07 ,$20.81 , N/A ,$298.19 ,$298.19 ,$288.80 ,$324.90 ,$52.03 ,$306.85 ,$20.81 ,$20.81 ,$306.85 ,$20.81 ,$150.18 , N/A , N/A ,$21.85 ,$306.85 ,$101.08 ,$324.90 ,$283.39 ,$298.19 ,$20.81 ,$234.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201101,86304,HC TUMOR AG CA 125,302,1 ,$318.00 ,$206.70 ,$20.81 ,$318.00 ,$52.03 ,$254.40 ,$20.81 ,$89.04 ,$251.98 ,$291.92 ,$20.81 ,$291.92 ,$20.81 ,$39.54 ,$235.32 ,$52.03 ,$20.81 ,$265.21 ,$20.81 , N/A ,$262.67 ,$262.67 ,$254.40 ,$286.20 ,$52.03 ,$270.30 ,$20.81 ,$20.81 ,$270.30 ,$20.81 ,$132.29 , N/A , N/A ,$21.85 ,$270.30 ,$89.04 ,$286.20 ,$249.63 ,$262.67 ,$20.81 ,$206.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201102,86334,HC IMMUNOFIX ELECTRO SERUM,302,1 ,$454.00 ,$295.10 ,$22.34 ,$454.00 ,$55.85 ,$363.20 ,$22.34 ,$127.12 ,$359.75 ,$416.77 ,$22.34 ,$416.77 ,$22.34 ,$42.45 ,$335.96 ,$55.85 ,$22.34 ,$378.64 ,$22.34 , N/A ,$375.00 ,$375.00 ,$363.20 ,$408.60 ,$55.85 ,$385.90 ,$22.34 ,$22.34 ,$385.90 ,$22.34 ,$188.86 , N/A , N/A ,$23.46 ,$385.90 ,$127.12 ,$408.60 ,$356.39 ,$375.00 ,$22.34 ,$295.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201103,86335,HC IMMUNOFIX ELECTRO OTH,302,1 ,$382.00 ,$248.30 ,$29.35 ,$382.00 ,$73.38 ,$305.60 ,$29.35 ,$106.96 ,$302.70 ,$350.68 ,$29.35 ,$350.68 ,$29.35 ,$55.77 ,$282.68 ,$73.38 ,$29.35 ,$318.59 ,$29.35 , N/A ,$315.53 ,$315.53 ,$305.60 ,$343.80 ,$73.38 ,$324.70 ,$29.35 ,$29.35 ,$324.70 ,$29.35 ,$158.91 , N/A , N/A ,$30.82 ,$324.70 ,$106.96 ,$343.80 ,$299.87 ,$315.53 ,$29.35 ,$248.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201106,86376,HC MICROSOMAL AB,302,1 ,$102.00 ,$66.30 ,$14.55 ,$102.00 ,$36.38 ,$81.60 ,$14.55 ,$28.56 ,$80.82 ,$93.64 ,$14.55 ,$93.64 ,$14.55 ,$27.65 ,$75.48 ,$36.38 ,$14.55 ,$85.07 ,$14.55 , N/A ,$84.25 ,$84.25 ,$81.60 ,$91.80 ,$36.38 ,$86.70 ,$14.55 ,$14.55 ,$86.70 ,$14.55 ,$42.43 , N/A , N/A ,$15.28 ,$86.70 ,$28.56 ,$91.80 ,$80.07 ,$84.25 ,$14.55 ,$66.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201108,86431,HC RHEUMATOID FACTOR QN,302,1 ,$156.00 ,$101.40 ,$5.67 ,$156.00 ,$14.18 ,$124.80 ,$5.67 ,$43.68 ,$123.61 ,$143.21 ,$5.67 ,$143.21 ,$5.67 ,$10.77 ,$115.44 ,$14.18 ,$5.67 ,$130.10 ,$5.67 , N/A ,$128.86 ,$128.86 ,$124.80 ,$140.40 ,$14.18 ,$132.60 ,$5.67 ,$5.67 ,$132.60 ,$5.67 ,$64.90 , N/A , N/A ,$5.95 ,$132.60 ,$43.68 ,$140.40 ,$122.46 ,$128.86 ,$5.67 ,$101.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201109,86480,HC TB QUANTIFERON GOLD,302,1 ,$211.00 ,$137.15 ,$59.08 ,$211.00 ,$154.95 ,$168.80 ,$61.98 ,$59.08 ,$167.20 ,$193.70 ,$61.98 ,$193.70 ,$61.98 ,$117.76 ,$156.14 ,$154.95 ,$61.98 ,$175.97 ,$61.98 , N/A ,$174.29 ,$174.29 ,$168.80 ,$189.90 ,$154.95 ,$179.35 ,$61.98 ,$61.98 ,$179.35 ,$61.98 ,$87.78 , N/A , N/A ,$65.08 ,$179.35 ,$59.08 ,$189.90 ,$165.64 ,$174.29 ,$61.98 ,$137.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201117,86644,HC CMV AB,302,1 ,$211.00 ,$137.15 ,$14.39 ,$211.00 ,$35.98 ,$168.80 ,$14.39 ,$59.08 ,$167.20 ,$193.70 ,$14.39 ,$193.70 ,$14.39 ,$27.34 ,$156.14 ,$35.98 ,$14.39 ,$175.97 ,$14.39 , N/A ,$174.29 ,$174.29 ,$168.80 ,$189.90 ,$35.98 ,$179.35 ,$14.39 ,$14.39 ,$179.35 ,$14.39 ,$87.78 , N/A , N/A ,$15.11 ,$179.35 ,$59.08 ,$189.90 ,$165.64 ,$174.29 ,$14.39 ,$137.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201118,86645,HC CMV AB IGM,302,1 ,$211.00 ,$137.15 ,$16.85 ,$211.00 ,$42.13 ,$168.80 ,$16.85 ,$59.08 ,$167.20 ,$193.70 ,$16.85 ,$193.70 ,$16.85 ,$32.02 ,$156.14 ,$42.13 ,$16.85 ,$175.97 ,$16.85 , N/A ,$174.29 ,$174.29 ,$168.80 ,$189.90 ,$42.13 ,$179.35 ,$16.85 ,$16.85 ,$179.35 ,$16.85 ,$87.78 , N/A , N/A ,$17.69 ,$179.35 ,$59.08 ,$189.90 ,$165.64 ,$174.29 ,$16.85 ,$137.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201119,86677,HC H PYLORI AB,302,1 ,$306.00 ,$198.90 ,$16.85 ,$306.00 ,$42.13 ,$244.80 ,$16.85 ,$85.68 ,$242.47 ,$280.91 ,$16.85 ,$280.91 ,$16.85 ,$32.02 ,$226.44 ,$42.13 ,$16.85 ,$255.20 ,$16.85 , N/A ,$252.76 ,$252.76 ,$244.80 ,$275.40 ,$42.13 ,$260.10 ,$16.85 ,$16.85 ,$260.10 ,$16.85 ,$127.30 , N/A , N/A ,$17.69 ,$260.10 ,$85.68 ,$275.40 ,$240.21 ,$252.76 ,$16.85 ,$198.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201121,86704,HC HEP CORE AB,302,1 ,$282.00 ,$183.30 ,$12.05 ,$282.00 ,$30.13 ,$225.60 ,$12.05 ,$78.96 ,$223.46 ,$258.88 ,$12.05 ,$258.88 ,$12.05 ,$22.90 ,$208.68 ,$30.13 ,$12.05 ,$235.19 ,$12.05 , N/A ,$232.93 ,$232.93 ,$225.60 ,$253.80 ,$30.13 ,$239.70 ,$12.05 ,$12.05 ,$239.70 ,$12.05 ,$117.31 , N/A , N/A ,$12.65 ,$239.70 ,$78.96 ,$253.80 ,$221.37 ,$232.93 ,$12.05 ,$183.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201122,86705,HC HEP B CORE IGM,302,1 ,$125.00 ,$81.25 ,$11.77 ,$125.00 ,$29.43 ,$100.00 ,$11.77 ,$35.00 ,$99.05 ,$114.75 ,$11.77 ,$114.75 ,$11.77 ,$22.36 ,$92.50 ,$29.43 ,$11.77 ,$104.25 ,$11.77 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$29.43 ,$106.25 ,$11.77 ,$11.77 ,$106.25 ,$11.77 ,$52.00 , N/A , N/A ,$12.36 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$11.77 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201123,86706,HC HEP B SURFACE AB,302,1 ,$246.00 ,$159.90 ,$10.74 ,$246.00 ,$26.85 ,$196.80 ,$10.74 ,$68.88 ,$194.93 ,$225.83 ,$10.74 ,$225.83 ,$10.74 ,$20.41 ,$182.04 ,$26.85 ,$10.74 ,$205.16 ,$10.74 , N/A ,$203.20 ,$203.20 ,$196.80 ,$221.40 ,$26.85 ,$209.10 ,$10.74 ,$10.74 ,$209.10 ,$10.74 ,$102.34 , N/A , N/A ,$11.28 ,$209.10 ,$68.88 ,$221.40 ,$193.11 ,$203.20 ,$10.74 ,$159.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201124,86708,HC HEP A AB TOTAL,302,1 ,$261.00 ,$169.65 ,$12.39 ,$261.00 ,$30.98 ,$208.80 ,$12.39 ,$73.08 ,$206.82 ,$239.60 ,$12.39 ,$239.60 ,$12.39 ,$23.54 ,$193.14 ,$30.98 ,$12.39 ,$217.67 ,$12.39 , N/A ,$215.59 ,$215.59 ,$208.80 ,$234.90 ,$30.98 ,$221.85 ,$12.39 ,$12.39 ,$221.85 ,$12.39 ,$108.58 , N/A , N/A ,$13.01 ,$221.85 ,$73.08 ,$234.90 ,$204.89 ,$215.59 ,$12.39 ,$169.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201125,86709,HC HEP A AB (HAAB) IGM,302,1 ,$151.00 ,$98.15 ,$11.26 ,$151.00 ,$28.15 ,$120.80 ,$11.26 ,$42.28 ,$119.65 ,$138.62 ,$11.26 ,$138.62 ,$11.26 ,$21.39 ,$111.74 ,$28.15 ,$11.26 ,$125.93 ,$11.26 , N/A ,$124.73 ,$124.73 ,$120.80 ,$135.90 ,$28.15 ,$128.35 ,$11.26 ,$11.26 ,$128.35 ,$11.26 ,$62.82 , N/A , N/A ,$11.82 ,$128.35 ,$42.28 ,$135.90 ,$118.54 ,$124.73 ,$11.26 ,$98.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201126,86735,HC MUMPS AB,302,1 ,$225.00 ,$146.25 ,$13.05 ,$225.00 ,$32.63 ,$180.00 ,$13.05 ,$63.00 ,$178.29 ,$206.55 ,$13.05 ,$206.55 ,$13.05 ,$24.80 ,$166.50 ,$32.63 ,$13.05 ,$187.65 ,$13.05 , N/A ,$185.85 ,$185.85 ,$180.00 ,$202.50 ,$32.63 ,$191.25 ,$13.05 ,$13.05 ,$191.25 ,$13.05 ,$93.60 , N/A , N/A ,$13.70 ,$191.25 ,$63.00 ,$202.50 ,$176.63 ,$185.85 ,$13.05 ,$146.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201127,86762,HC RUBELLA AB,302,1 ,$52.00 ,$33.80 ,$14.39 ,$52.00 ,$35.98 ,$41.60 ,$14.39 ,$14.56 ,$41.20 ,$47.74 ,$14.39 ,$47.74 ,$14.39 ,$27.34 ,$38.48 ,$35.98 ,$14.39 ,$43.37 ,$14.39 , N/A ,$42.95 ,$42.95 ,$41.60 ,$46.80 ,$35.98 ,$44.20 ,$14.39 ,$14.39 ,$44.20 ,$14.39 ,$21.63 , N/A , N/A ,$15.11 ,$44.20 ,$14.56 ,$46.80 ,$40.82 ,$42.95 ,$14.39 ,$33.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201128,86765,HC RUBEOLA AB,302,1 ,$91.00 ,$59.15 ,$12.88 ,$91.00 ,$32.20 ,$72.80 ,$12.88 ,$25.48 ,$72.11 ,$83.54 ,$12.88 ,$83.54 ,$12.88 ,$24.47 ,$67.34 ,$32.20 ,$12.88 ,$75.89 ,$12.88 , N/A ,$75.17 ,$75.17 ,$72.80 ,$81.90 ,$32.20 ,$77.35 ,$12.88 ,$12.88 ,$77.35 ,$12.88 ,$37.86 , N/A , N/A ,$13.52 ,$77.35 ,$25.48 ,$81.90 ,$71.44 ,$75.17 ,$12.88 ,$59.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201129,86780,HC TREPONEMA P AB CONFIRM,302,1 ,$255.00 ,$165.75 ,$13.24 ,$255.00 ,$33.10 ,$204.00 ,$13.24 ,$71.40 ,$202.06 ,$234.09 ,$13.24 ,$234.09 ,$13.24 ,$25.16 ,$188.70 ,$33.10 ,$13.24 ,$212.67 ,$13.24 , N/A ,$210.63 ,$210.63 ,$204.00 ,$229.50 ,$33.10 ,$216.75 ,$13.24 ,$13.24 ,$216.75 ,$13.24 ,$106.08 , N/A , N/A ,$13.90 ,$216.75 ,$71.40 ,$229.50 ,$200.18 ,$210.63 ,$13.24 ,$165.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201130,86787,HC VARICELLA ZOSTER AB,302,1 ,$271.00 ,$176.15 ,$12.88 ,$271.00 ,$32.20 ,$216.80 ,$12.88 ,$75.88 ,$214.74 ,$248.78 ,$12.88 ,$248.78 ,$12.88 ,$24.47 ,$200.54 ,$32.20 ,$12.88 ,$226.01 ,$12.88 , N/A ,$223.85 ,$223.85 ,$216.80 ,$243.90 ,$32.20 ,$230.35 ,$12.88 ,$12.88 ,$230.35 ,$12.88 ,$112.74 , N/A , N/A ,$13.52 ,$230.35 ,$75.88 ,$243.90 ,$212.74 ,$223.85 ,$12.88 ,$176.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201131,86800,HC THYROGLOBULIN AB,302,1 ,$95.00 ,$61.75 ,$15.91 ,$95.00 ,$39.78 ,$76.00 ,$15.91 ,$26.60 ,$75.28 ,$87.21 ,$15.91 ,$87.21 ,$15.91 ,$30.23 ,$70.30 ,$39.78 ,$15.91 ,$79.23 ,$15.91 , N/A ,$78.47 ,$78.47 ,$76.00 ,$85.50 ,$39.78 ,$80.75 ,$15.91 ,$15.91 ,$80.75 ,$15.91 ,$39.52 , N/A , N/A ,$16.71 ,$80.75 ,$26.60 ,$85.50 ,$74.58 ,$78.47 ,$15.91 ,$61.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201132,86803,HC HEP C AB,302,1 ,$127.00 ,$82.55 ,$14.27 ,$127.00 ,$35.68 ,$101.60 ,$14.27 ,$35.56 ,$100.63 ,$116.59 ,$14.27 ,$116.59 ,$14.27 ,$27.11 ,$93.98 ,$35.68 ,$14.27 ,$105.92 ,$14.27 , N/A ,$104.90 ,$104.90 ,$101.60 ,$114.30 ,$35.68 ,$107.95 ,$14.27 ,$14.27 ,$107.95 ,$14.27 ,$52.83 , N/A , N/A ,$14.98 ,$107.95 ,$35.56 ,$114.30 ,$99.70 ,$104.90 ,$14.27 ,$82.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201134,86902,HC RBC AG SCR RGT SERUM T1-90,302,1 ,$246.00 ,$159.90 ,$68.88 ,$673.80 ,$673.80 ,$196.80 ,$269.52 ,$68.88 ,$194.93 ,$225.83 ,$246.00 ,$225.83 ,$246.00 ,$246.00 ,$182.04 ,$246.00 ,$269.52 ,$205.16 ,$269.52 , N/A ,$203.20 ,$203.20 ,$196.80 ,$221.40 ,$246.00 ,$209.10 ,$269.52 ,$269.52 ,$209.10 ,$269.52 ,$102.34 , N/A , N/A ,$246.00 ,$209.10 ,$68.88 ,$221.40 ,$193.11 ,$203.20 ,$269.52 ,$159.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201135,86902,HC RBC AG SCR RGT SERUM T2-90,302,1 ,$246.00 ,$159.90 ,$68.88 ,$673.80 ,$673.80 ,$196.80 ,$269.52 ,$68.88 ,$194.93 ,$225.83 ,$246.00 ,$225.83 ,$246.00 ,$246.00 ,$182.04 ,$246.00 ,$269.52 ,$205.16 ,$269.52 , N/A ,$203.20 ,$203.20 ,$196.80 ,$221.40 ,$246.00 ,$209.10 ,$269.52 ,$269.52 ,$209.10 ,$269.52 ,$102.34 , N/A , N/A ,$246.00 ,$209.10 ,$68.88 ,$221.40 ,$193.11 ,$203.20 ,$269.52 ,$159.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201136,86902,HC RBC AG SCR RGT SERUM T3-90,302,1 ,$246.00 ,$159.90 ,$68.88 ,$673.80 ,$673.80 ,$196.80 ,$269.52 ,$68.88 ,$194.93 ,$225.83 ,$246.00 ,$225.83 ,$246.00 ,$246.00 ,$182.04 ,$246.00 ,$269.52 ,$205.16 ,$269.52 , N/A ,$203.20 ,$203.20 ,$196.80 ,$221.40 ,$246.00 ,$209.10 ,$269.52 ,$269.52 ,$209.10 ,$269.52 ,$102.34 , N/A , N/A ,$246.00 ,$209.10 ,$68.88 ,$221.40 ,$193.11 ,$203.20 ,$269.52 ,$159.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201137,86902,HC RBC AG SCR RGT SERUM T4-90,302,1 ,$246.00 ,$159.90 ,$68.88 ,$673.80 ,$673.80 ,$196.80 ,$269.52 ,$68.88 ,$194.93 ,$225.83 ,$246.00 ,$225.83 ,$246.00 ,$246.00 ,$182.04 ,$246.00 ,$269.52 ,$205.16 ,$269.52 , N/A ,$203.20 ,$203.20 ,$196.80 ,$221.40 ,$246.00 ,$209.10 ,$269.52 ,$269.52 ,$209.10 ,$269.52 ,$102.34 , N/A , N/A ,$246.00 ,$209.10 ,$68.88 ,$221.40 ,$193.11 ,$203.20 ,$269.52 ,$159.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201138,86905,HC RBC AG TYPING NON ABO/RH T1-90,302,1 ,$203.00 ,$131.95 ,$56.84 ,$673.80 ,$673.80 ,$162.40 ,$269.52 ,$56.84 ,$160.86 ,$186.35 ,$203.00 ,$186.35 ,$203.00 ,$203.00 ,$150.22 ,$203.00 ,$269.52 ,$169.30 ,$269.52 , N/A ,$167.68 ,$167.68 ,$162.40 ,$182.70 ,$203.00 ,$172.55 ,$269.52 ,$269.52 ,$172.55 ,$269.52 ,$84.45 , N/A , N/A ,$203.00 ,$172.55 ,$56.84 ,$182.70 ,$159.36 ,$167.68 ,$269.52 ,$131.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201139,86905,HC RBC AG TYPING NON ABO/RH T2-90,302,1 ,$203.00 ,$131.95 ,$56.84 ,$673.80 ,$673.80 ,$162.40 ,$269.52 ,$56.84 ,$160.86 ,$186.35 ,$203.00 ,$186.35 ,$203.00 ,$203.00 ,$150.22 ,$203.00 ,$269.52 ,$169.30 ,$269.52 , N/A ,$167.68 ,$167.68 ,$162.40 ,$182.70 ,$203.00 ,$172.55 ,$269.52 ,$269.52 ,$172.55 ,$269.52 ,$84.45 , N/A , N/A ,$203.00 ,$172.55 ,$56.84 ,$182.70 ,$159.36 ,$167.68 ,$269.52 ,$131.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201140,86905,HC RBC AG TYPING NON ABO/RH T3-90,302,1 ,$203.00 ,$131.95 ,$56.84 ,$673.80 ,$673.80 ,$162.40 ,$269.52 ,$56.84 ,$160.86 ,$186.35 ,$203.00 ,$186.35 ,$203.00 ,$203.00 ,$150.22 ,$203.00 ,$269.52 ,$169.30 ,$269.52 , N/A ,$167.68 ,$167.68 ,$162.40 ,$182.70 ,$203.00 ,$172.55 ,$269.52 ,$269.52 ,$172.55 ,$269.52 ,$84.45 , N/A , N/A ,$203.00 ,$172.55 ,$56.84 ,$182.70 ,$159.36 ,$167.68 ,$269.52 ,$131.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201141,86905,HC RBC AG TYPING NON ABO/RH T4-90,302,1 ,$203.00 ,$131.95 ,$56.84 ,$673.80 ,$673.80 ,$162.40 ,$269.52 ,$56.84 ,$160.86 ,$186.35 ,$203.00 ,$186.35 ,$203.00 ,$203.00 ,$150.22 ,$203.00 ,$269.52 ,$169.30 ,$269.52 , N/A ,$167.68 ,$167.68 ,$162.40 ,$182.70 ,$203.00 ,$172.55 ,$269.52 ,$269.52 ,$172.55 ,$269.52 ,$84.45 , N/A , N/A ,$203.00 ,$172.55 ,$56.84 ,$182.70 ,$159.36 ,$167.68 ,$269.52 ,$131.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201147,86870,HC RBC AB ID PANEL SERUM-90,302,1 ,$140.00 ,$91.00 ,$39.20 ,$673.80 ,$673.80 ,$112.00 ,$269.52 ,$39.20 ,$110.94 ,$128.52 ,$140.00 ,$128.52 ,$140.00 ,$140.00 ,$103.60 ,$140.00 ,$269.52 ,$116.76 ,$269.52 , N/A ,$115.64 ,$115.64 ,$112.00 ,$126.00 ,$140.00 ,$119.00 ,$269.52 ,$269.52 ,$119.00 ,$269.52 ,$58.24 , N/A , N/A ,$140.00 ,$119.00 ,$39.20 ,$126.00 ,$109.90 ,$115.64 ,$269.52 ,$91.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201148,83986,HC PH BODY FLUID,302,1 ,$39.00 ,$25.35 ,$3.58 ,$39.00 ,$8.95 ,$31.20 ,$3.58 ,$10.92 ,$30.90 ,$35.80 ,$3.58 ,$35.80 ,$3.58 ,$6.80 ,$28.86 ,$8.95 ,$3.58 ,$32.53 ,$3.58 , N/A ,$32.21 ,$32.21 ,$31.20 ,$35.10 ,$8.95 ,$33.15 ,$3.58 ,$3.58 ,$33.15 ,$3.58 ,$16.22 , N/A , N/A ,$3.76 ,$33.15 ,$10.92 ,$35.10 ,$30.62 ,$32.21 ,$3.58 ,$25.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201174,86160,HC COMPLIMENT AG,302,1 ,$283.00 ,$183.95 ,$12.00 ,$283.00 ,$30.00 ,$226.40 ,$12.00 ,$79.24 ,$224.25 ,$259.79 ,$12.00 ,$259.79 ,$12.00 ,$22.80 ,$209.42 ,$30.00 ,$12.00 ,$236.02 ,$12.00 , N/A ,$233.76 ,$233.76 ,$226.40 ,$254.70 ,$30.00 ,$240.55 ,$12.00 ,$12.00 ,$240.55 ,$12.00 ,$117.73 , N/A , N/A ,$12.60 ,$240.55 ,$79.24 ,$254.70 ,$222.16 ,$233.76 ,$12.00 ,$183.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201175,86850,HC MV AB,302,1 ,$168.00 ,$109.20 ,$45.98 ,$168.00 ,$114.95 ,$134.40 ,$45.98 ,$47.04 ,$133.12 ,$154.22 ,$45.98 ,$154.22 ,$45.98 ,$87.36 ,$124.32 ,$114.95 ,$45.98 ,$140.11 ,$45.98 , N/A ,$138.77 ,$138.77 ,$134.40 ,$151.20 ,$114.96 ,$142.80 ,$45.98 ,$45.98 ,$142.80 ,$45.98 ,$69.89 , N/A , N/A ,$48.28 ,$142.80 ,$47.04 ,$151.20 ,$131.88 ,$138.77 ,$45.98 ,$109.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201176,86778,HC TOXOPLASMA AB IGM,302,1 ,$233.00 ,$151.45 ,$14.41 ,$233.00 ,$36.03 ,$186.40 ,$14.41 ,$65.24 ,$184.63 ,$213.89 ,$14.41 ,$213.89 ,$14.41 ,$27.38 ,$172.42 ,$36.03 ,$14.41 ,$194.32 ,$14.41 , N/A ,$192.46 ,$192.46 ,$186.40 ,$209.70 ,$36.03 ,$198.05 ,$14.41 ,$14.41 ,$198.05 ,$14.41 ,$96.93 , N/A , N/A ,$15.13 ,$198.05 ,$65.24 ,$209.70 ,$182.91 ,$192.46 ,$14.41 ,$151.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201177,86777,HC TOXAPLASMA AB,302,1 ,$168.00 ,$109.20 ,$14.39 ,$168.00 ,$35.98 ,$134.40 ,$14.39 ,$47.04 ,$133.12 ,$154.22 ,$14.39 ,$154.22 ,$14.39 ,$27.34 ,$124.32 ,$35.98 ,$14.39 ,$140.11 ,$14.39 , N/A ,$138.77 ,$138.77 ,$134.40 ,$151.20 ,$35.98 ,$142.80 ,$14.39 ,$14.39 ,$142.80 ,$14.39 ,$69.89 , N/A , N/A ,$15.11 ,$142.80 ,$47.04 ,$151.20 ,$131.88 ,$138.77 ,$14.39 ,$109.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30201178,86140,HC C-REACTIVE PROTEIN,302,1 ,$141.00 ,$91.65 ,$5.18 ,$141.00 ,$12.95 ,$112.80 ,$5.18 ,$39.48 ,$111.73 ,$129.44 ,$5.18 ,$129.44 ,$5.18 ,$9.84 ,$104.34 ,$12.95 ,$5.18 ,$117.59 ,$5.18 , N/A ,$116.47 ,$116.47 ,$112.80 ,$126.90 ,$12.95 ,$119.85 ,$5.18 ,$5.18 ,$119.85 ,$5.18 ,$58.66 , N/A , N/A ,$5.44 ,$119.85 ,$39.48 ,$126.90 ,$110.69 ,$116.47 ,$5.18 ,$91.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500103,85007,HC BLOOD COUNT MAN DIFF WBC,305,1 ,$38.00 ,$24.70 ,$3.80 ,$38.00 ,$9.50 ,$30.40 ,$3.80 ,$10.64 ,$30.11 ,$34.88 ,$3.80 ,$34.88 ,$3.80 ,$7.22 ,$28.12 ,$9.50 ,$3.80 ,$31.69 ,$3.80 , N/A ,$31.39 ,$31.39 ,$30.40 ,$34.20 ,$9.50 ,$32.30 ,$3.80 ,$3.80 ,$32.30 ,$3.80 ,$15.81 , N/A , N/A ,$3.99 ,$32.30 ,$10.64 ,$34.20 ,$29.83 ,$31.39 ,$3.80 ,$24.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500104,85014,HC HEMATOCRIT,305,1 ,$43.00 ,$27.95 ,$2.37 ,$43.00 ,$5.93 ,$34.40 ,$2.37 ,$12.04 ,$34.07 ,$39.47 ,$2.37 ,$39.47 ,$2.37 ,$4.50 ,$31.82 ,$5.93 ,$2.37 ,$35.86 ,$2.37 , N/A ,$35.52 ,$35.52 ,$34.40 ,$38.70 ,$5.93 ,$36.55 ,$2.37 ,$2.37 ,$36.55 ,$2.37 ,$17.89 , N/A , N/A ,$2.49 ,$36.55 ,$12.04 ,$38.70 ,$33.76 ,$35.52 ,$2.37 ,$27.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500106,85018,HC HGB,305,1 ,$43.00 ,$27.95 ,$2.37 ,$43.00 ,$5.93 ,$34.40 ,$2.37 ,$12.04 ,$34.07 ,$39.47 ,$2.37 ,$39.47 ,$2.37 ,$4.50 ,$31.82 ,$5.93 ,$2.37 ,$35.86 ,$2.37 , N/A ,$35.52 ,$35.52 ,$34.40 ,$38.70 ,$5.93 ,$36.55 ,$2.37 ,$2.37 ,$36.55 ,$2.37 ,$17.89 , N/A , N/A ,$2.49 ,$36.55 ,$12.04 ,$38.70 ,$33.76 ,$35.52 ,$2.37 ,$27.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500107,85025,HC CBC AUTO W/AUTO DIFF,305,1 ,$97.00 ,$63.05 ,$7.77 ,$97.00 ,$19.43 ,$77.60 ,$7.77 ,$27.16 ,$76.86 ,$89.05 ,$7.77 ,$89.05 ,$7.77 ,$14.76 ,$71.78 ,$19.43 ,$7.77 ,$80.90 ,$7.77 , N/A ,$80.12 ,$80.12 ,$77.60 ,$87.30 ,$19.43 ,$82.45 ,$7.77 ,$7.77 ,$82.45 ,$7.77 ,$40.35 , N/A , N/A ,$8.16 ,$82.45 ,$27.16 ,$87.30 ,$76.15 ,$80.12 ,$7.77 ,$63.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500108,85027,HC CBC W/O DIFF,305,1 ,$92.00 ,$59.80 ,$6.47 ,$92.00 ,$16.18 ,$73.60 ,$6.47 ,$25.76 ,$72.90 ,$84.46 ,$6.47 ,$84.46 ,$6.47 ,$12.29 ,$68.08 ,$16.18 ,$6.47 ,$76.73 ,$6.47 , N/A ,$75.99 ,$75.99 ,$73.60 ,$82.80 ,$16.18 ,$78.20 ,$6.47 ,$6.47 ,$78.20 ,$6.47 ,$38.27 , N/A , N/A ,$6.79 ,$78.20 ,$25.76 ,$82.80 ,$72.22 ,$75.99 ,$6.47 ,$59.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500111,85045,HC RETIC COUNT AUTO,305,1 ,$94.00 ,$61.10 ,$3.99 ,$94.00 ,$9.98 ,$75.20 ,$3.99 ,$26.32 ,$74.49 ,$86.29 ,$3.99 ,$86.29 ,$3.99 ,$7.58 ,$69.56 ,$9.98 ,$3.99 ,$78.40 ,$3.99 , N/A ,$77.64 ,$77.64 ,$75.20 ,$84.60 ,$9.98 ,$79.90 ,$3.99 ,$3.99 ,$79.90 ,$3.99 ,$39.10 , N/A , N/A ,$4.19 ,$79.90 ,$26.32 ,$84.60 ,$73.79 ,$77.64 ,$3.99 ,$61.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500113,85049,HC PLATELET COUNT AUTO,305,1 ,$95.00 ,$61.75 ,$4.48 ,$95.00 ,$11.20 ,$76.00 ,$4.48 ,$26.60 ,$75.28 ,$87.21 ,$4.48 ,$87.21 ,$4.48 ,$8.51 ,$70.30 ,$11.20 ,$4.48 ,$79.23 ,$4.48 , N/A ,$78.47 ,$78.47 ,$76.00 ,$85.50 ,$11.20 ,$80.75 ,$4.48 ,$4.48 ,$80.75 ,$4.48 ,$39.52 , N/A , N/A ,$4.70 ,$80.75 ,$26.60 ,$85.50 ,$74.58 ,$78.47 ,$4.48 ,$61.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500115,85060,HC BLOOD SMEAR INTERP,305,1 ,$89.00 ,$57.85 ,$24.92 ,$89.00 , N/A ,$71.20 , N/A ,$24.92 ,$70.52 ,$81.70 , N/A ,$81.70 , N/A , N/A ,$65.86 , N/A , N/A ,$74.23 , N/A , N/A ,$73.51 ,$73.51 ,$71.20 ,$80.10 , N/A ,$75.65 , N/A , N/A ,$75.65 , N/A ,$37.02 , N/A , N/A , N/A ,$75.65 ,$24.92 ,$80.10 ,$69.87 ,$73.51 , N/A ,$57.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500175,85379,HC D DIMER QN,305,1 ,$63.00 ,$40.95 ,$10.18 ,$63.00 ,$25.45 ,$50.40 ,$10.18 ,$17.64 ,$49.92 ,$57.83 ,$10.18 ,$57.83 ,$10.18 ,$19.34 ,$46.62 ,$25.45 ,$10.18 ,$52.54 ,$10.18 , N/A ,$52.04 ,$52.04 ,$50.40 ,$56.70 ,$25.45 ,$53.55 ,$10.18 ,$10.18 ,$53.55 ,$10.18 ,$26.21 , N/A , N/A ,$10.69 ,$53.55 ,$17.64 ,$56.70 ,$49.46 ,$52.04 ,$10.18 ,$40.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500196,85610,HC PROTHROMBIN TIME (PT),305,1 ,$88.00 ,$57.20 ,$4.29 ,$88.00 ,$10.73 ,$70.40 ,$4.29 ,$24.64 ,$69.73 ,$80.78 ,$4.29 ,$80.78 ,$4.29 ,$8.15 ,$65.12 ,$10.73 ,$4.29 ,$73.39 ,$4.29 , N/A ,$72.69 ,$72.69 ,$70.40 ,$79.20 ,$10.73 ,$74.80 ,$4.29 ,$4.29 ,$74.80 ,$4.29 ,$36.61 , N/A , N/A ,$4.50 ,$74.80 ,$24.64 ,$79.20 ,$69.08 ,$72.69 ,$4.29 ,$57.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500204,85651,HC SED RATE RBC NON AUTO,305,1 ,$88.00 ,$57.20 ,$4.27 ,$88.00 ,$10.68 ,$70.40 ,$4.27 ,$24.64 ,$69.73 ,$80.78 ,$4.27 ,$80.78 ,$4.27 ,$8.11 ,$65.12 ,$10.68 ,$4.27 ,$73.39 ,$4.27 , N/A ,$72.69 ,$72.69 ,$70.40 ,$79.20 ,$10.68 ,$74.80 ,$4.27 ,$4.27 ,$74.80 ,$4.27 ,$36.61 , N/A , N/A ,$4.48 ,$74.80 ,$24.64 ,$79.20 ,$69.08 ,$72.69 ,$4.27 ,$57.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500205,85652,HC SED RATE AUTO,305,1 ,$88.00 ,$57.20 ,$2.70 ,$88.00 ,$6.75 ,$70.40 ,$2.70 ,$24.64 ,$69.73 ,$80.78 ,$2.70 ,$80.78 ,$2.70 ,$5.13 ,$65.12 ,$6.75 ,$2.70 ,$73.39 ,$2.70 , N/A ,$72.69 ,$72.69 ,$70.40 ,$79.20 ,$6.75 ,$74.80 ,$2.70 ,$2.70 ,$74.80 ,$2.70 ,$36.61 , N/A , N/A ,$2.84 ,$74.80 ,$24.64 ,$79.20 ,$69.08 ,$72.69 ,$2.70 ,$57.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500206,85660,HC SICKLE CELL RBC,305,1 ,$61.00 ,$39.65 ,$5.51 ,$61.00 ,$13.78 ,$48.80 ,$5.51 ,$17.08 ,$48.34 ,$56.00 ,$5.51 ,$56.00 ,$5.51 ,$10.47 ,$45.14 ,$13.78 ,$5.51 ,$50.87 ,$5.51 , N/A ,$50.39 ,$50.39 ,$48.80 ,$54.90 ,$13.78 ,$51.85 ,$5.51 ,$5.51 ,$51.85 ,$5.51 ,$25.38 , N/A , N/A ,$5.79 ,$51.85 ,$17.08 ,$54.90 ,$47.89 ,$50.39 ,$5.51 ,$39.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500208,85705,HC HEX PHOSPHOLIPID NEUT,305,1 ,$504.00 ,$327.60 ,$9.63 ,$504.00 ,$24.08 ,$403.20 ,$9.63 ,$141.12 ,$399.37 ,$462.67 ,$9.63 ,$462.67 ,$9.63 ,$18.30 ,$372.96 ,$24.08 ,$9.63 ,$420.34 ,$9.63 , N/A ,$416.30 ,$416.30 ,$403.20 ,$453.60 ,$24.08 ,$428.40 ,$9.63 ,$9.63 ,$428.40 ,$9.63 ,$209.66 , N/A , N/A ,$10.11 ,$428.40 ,$141.12 ,$453.60 ,$395.64 ,$416.30 ,$9.63 ,$327.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500211,85730,HC PTT,305,1 ,$126.00 ,$81.90 ,$6.01 ,$126.00 ,$15.03 ,$100.80 ,$6.01 ,$35.28 ,$99.84 ,$115.67 ,$6.01 ,$115.67 ,$6.01 ,$11.42 ,$93.24 ,$15.03 ,$6.01 ,$105.08 ,$6.01 , N/A ,$104.08 ,$104.08 ,$100.80 ,$113.40 ,$15.03 ,$107.10 ,$6.01 ,$6.01 ,$107.10 ,$6.01 ,$52.42 , N/A , N/A ,$6.31 ,$107.10 ,$35.28 ,$113.40 ,$98.91 ,$104.08 ,$6.01 ,$81.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500234,85014,HC HEMATOCRIT-90,305,1 ,$43.00 ,$27.95 ,$2.37 ,$43.00 ,$5.93 ,$34.40 ,$2.37 ,$12.04 ,$34.07 ,$39.47 ,$2.37 ,$39.47 ,$2.37 ,$4.50 ,$31.82 ,$5.93 ,$2.37 ,$35.86 ,$2.37 , N/A ,$35.52 ,$35.52 ,$34.40 ,$38.70 ,$5.93 ,$36.55 ,$2.37 ,$2.37 ,$36.55 ,$2.37 ,$17.89 , N/A , N/A ,$2.49 ,$36.55 ,$12.04 ,$38.70 ,$33.76 ,$35.52 ,$2.37 ,$27.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500238,85018,HC HGB-90,305,1 ,$43.00 ,$27.95 ,$2.37 ,$43.00 ,$5.93 ,$34.40 ,$2.37 ,$12.04 ,$34.07 ,$39.47 ,$2.37 ,$39.47 ,$2.37 ,$4.50 ,$31.82 ,$5.93 ,$2.37 ,$35.86 ,$2.37 , N/A ,$35.52 ,$35.52 ,$34.40 ,$38.70 ,$5.93 ,$36.55 ,$2.37 ,$2.37 ,$36.55 ,$2.37 ,$17.89 , N/A , N/A ,$2.49 ,$36.55 ,$12.04 ,$38.70 ,$33.76 ,$35.52 ,$2.37 ,$27.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500244,85041,HC BLOOD COUNT RBC AUTO-90,305,1 ,$50.00 ,$32.50 ,$3.02 ,$50.00 ,$7.55 ,$40.00 ,$3.02 ,$14.00 ,$39.62 ,$45.90 ,$3.02 ,$45.90 ,$3.02 ,$5.74 ,$37.00 ,$7.55 ,$3.02 ,$41.70 ,$3.02 , N/A ,$41.30 ,$41.30 ,$40.00 ,$45.00 ,$7.55 ,$42.50 ,$3.02 ,$3.02 ,$42.50 ,$3.02 ,$20.80 , N/A , N/A ,$3.17 ,$42.50 ,$14.00 ,$45.00 ,$39.25 ,$41.30 ,$3.02 ,$32.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500249,85210,HC FACTOR II-90,305,1 ,$126.00 ,$81.90 ,$12.98 ,$126.00 ,$32.45 ,$100.80 ,$12.98 ,$35.28 ,$99.84 ,$115.67 ,$12.98 ,$115.67 ,$12.98 ,$24.66 ,$93.24 ,$32.45 ,$12.98 ,$105.08 ,$12.98 , N/A ,$104.08 ,$104.08 ,$100.80 ,$113.40 ,$32.45 ,$107.10 ,$12.98 ,$12.98 ,$107.10 ,$12.98 ,$52.42 , N/A , N/A ,$13.63 ,$107.10 ,$35.28 ,$113.40 ,$98.91 ,$104.08 ,$12.98 ,$81.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500250,85220,HC FACTOR V-90,305,1 ,$628.00 ,$408.20 ,$17.65 ,$628.00 ,$44.13 ,$502.40 ,$17.65 ,$175.84 ,$497.63 ,$576.50 ,$17.65 ,$576.50 ,$17.65 ,$33.54 ,$464.72 ,$44.13 ,$17.65 ,$523.75 ,$17.65 , N/A ,$518.73 ,$518.73 ,$502.40 ,$565.20 ,$44.13 ,$533.80 ,$17.65 ,$17.65 ,$533.80 ,$17.65 ,$261.25 , N/A , N/A ,$18.53 ,$533.80 ,$175.84 ,$565.20 ,$492.98 ,$518.73 ,$17.65 ,$408.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500251,85230,HC FACTOR VII-90,305,1 ,$712.00 ,$462.80 ,$17.90 ,$712.00 ,$44.75 ,$569.60 ,$17.90 ,$199.36 ,$564.19 ,$653.62 ,$17.90 ,$653.62 ,$17.90 ,$34.01 ,$526.88 ,$44.75 ,$17.90 ,$593.81 ,$17.90 , N/A ,$588.11 ,$588.11 ,$569.60 ,$640.80 ,$44.75 ,$605.20 ,$17.90 ,$17.90 ,$605.20 ,$17.90 ,$296.19 , N/A , N/A ,$18.80 ,$605.20 ,$199.36 ,$640.80 ,$558.92 ,$588.11 ,$17.90 ,$462.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500252,85240,HC FACTOR VIII AHG-90,305,1 ,$238.00 ,$154.70 ,$17.90 ,$238.00 ,$44.75 ,$190.40 ,$17.90 ,$66.64 ,$188.59 ,$218.48 ,$17.90 ,$218.48 ,$17.90 ,$34.01 ,$176.12 ,$44.75 ,$17.90 ,$198.49 ,$17.90 , N/A ,$196.59 ,$196.59 ,$190.40 ,$214.20 ,$44.75 ,$202.30 ,$17.90 ,$17.90 ,$202.30 ,$17.90 ,$99.01 , N/A , N/A ,$18.80 ,$202.30 ,$66.64 ,$214.20 ,$186.83 ,$196.59 ,$17.90 ,$154.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500253,85245,HC FACTOR VIII VW RISTO-90,305,1 ,$191.00 ,$124.15 ,$22.94 ,$191.00 ,$57.35 ,$152.80 ,$22.94 ,$53.48 ,$151.35 ,$175.34 ,$22.94 ,$175.34 ,$22.94 ,$43.59 ,$141.34 ,$57.35 ,$22.94 ,$159.29 ,$22.94 , N/A ,$157.77 ,$157.77 ,$152.80 ,$171.90 ,$57.35 ,$162.35 ,$22.94 ,$22.94 ,$162.35 ,$22.94 ,$79.46 , N/A , N/A ,$24.09 ,$162.35 ,$53.48 ,$171.90 ,$149.94 ,$157.77 ,$22.94 ,$124.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500254,85246,HC FACTOR VIII VW AG-90,305,1 ,$301.00 ,$195.65 ,$22.94 ,$301.00 ,$57.35 ,$240.80 ,$22.94 ,$84.28 ,$238.51 ,$276.32 ,$22.94 ,$276.32 ,$22.94 ,$43.59 ,$222.74 ,$57.35 ,$22.94 ,$251.03 ,$22.94 , N/A ,$248.63 ,$248.63 ,$240.80 ,$270.90 ,$57.35 ,$255.85 ,$22.94 ,$22.94 ,$255.85 ,$22.94 ,$125.22 , N/A , N/A ,$24.09 ,$255.85 ,$84.28 ,$270.90 ,$236.29 ,$248.63 ,$22.94 ,$195.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500256,85250,HC FACTOR IX-90,305,1 ,$188.00 ,$122.20 ,$19.04 ,$188.00 ,$47.60 ,$150.40 ,$19.04 ,$52.64 ,$148.97 ,$172.58 ,$19.04 ,$172.58 ,$19.04 ,$36.18 ,$139.12 ,$47.60 ,$19.04 ,$156.79 ,$19.04 , N/A ,$155.29 ,$155.29 ,$150.40 ,$169.20 ,$47.60 ,$159.80 ,$19.04 ,$19.04 ,$159.80 ,$19.04 ,$78.21 , N/A , N/A ,$19.99 ,$159.80 ,$52.64 ,$169.20 ,$147.58 ,$155.29 ,$19.04 ,$122.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500257,85260,HC FACTOR X-90,305,1 ,$600.00 ,$390.00 ,$17.90 ,$600.00 ,$44.75 ,$480.00 ,$17.90 ,$168.00 ,$475.44 ,$550.80 ,$17.90 ,$550.80 ,$17.90 ,$34.01 ,$444.00 ,$44.75 ,$17.90 ,$500.40 ,$17.90 , N/A ,$495.60 ,$495.60 ,$480.00 ,$540.00 ,$44.75 ,$510.00 ,$17.90 ,$17.90 ,$510.00 ,$17.90 ,$249.60 , N/A , N/A ,$18.80 ,$510.00 ,$168.00 ,$540.00 ,$471.00 ,$495.60 ,$17.90 ,$390.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500258,85270,HC FACTOR XI-90,305,1 ,$165.00 ,$107.25 ,$17.90 ,$165.00 ,$44.75 ,$132.00 ,$17.90 ,$46.20 ,$130.75 ,$151.47 ,$17.90 ,$151.47 ,$17.90 ,$34.01 ,$122.10 ,$44.75 ,$17.90 ,$137.61 ,$17.90 , N/A ,$136.29 ,$136.29 ,$132.00 ,$148.50 ,$44.75 ,$140.25 ,$17.90 ,$17.90 ,$140.25 ,$17.90 ,$68.64 , N/A , N/A ,$18.80 ,$140.25 ,$46.20 ,$148.50 ,$129.53 ,$136.29 ,$17.90 ,$107.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500259,85280,HC FACTOR XI-90,305,1 ,$165.00 ,$107.25 ,$19.35 ,$165.00 ,$48.38 ,$132.00 ,$19.35 ,$46.20 ,$130.75 ,$151.47 ,$19.35 ,$151.47 ,$19.35 ,$36.77 ,$122.10 ,$48.38 ,$19.35 ,$137.61 ,$19.35 , N/A ,$136.29 ,$136.29 ,$132.00 ,$148.50 ,$48.38 ,$140.25 ,$19.35 ,$19.35 ,$140.25 ,$19.35 ,$68.64 , N/A , N/A ,$20.32 ,$140.25 ,$46.20 ,$148.50 ,$129.53 ,$136.29 ,$19.35 ,$107.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500261,85300,HC ANTITHROMBIN III ACT-90,305,1 ,$285.00 ,$185.25 ,$11.85 ,$285.00 ,$29.63 ,$228.00 ,$11.85 ,$79.80 ,$225.83 ,$261.63 ,$11.85 ,$261.63 ,$11.85 ,$22.52 ,$210.90 ,$29.63 ,$11.85 ,$237.69 ,$11.85 , N/A ,$235.41 ,$235.41 ,$228.00 ,$256.50 ,$29.63 ,$242.25 ,$11.85 ,$11.85 ,$242.25 ,$11.85 ,$118.56 , N/A , N/A ,$12.44 ,$242.25 ,$79.80 ,$256.50 ,$223.73 ,$235.41 ,$11.85 ,$185.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500262,85301,HC ANTITHROMBIN III AG-90,305,1 ,$85.00 ,$55.25 ,$10.81 ,$85.00 ,$27.03 ,$68.00 ,$10.81 ,$23.80 ,$67.35 ,$78.03 ,$10.81 ,$78.03 ,$10.81 ,$20.54 ,$62.90 ,$27.03 ,$10.81 ,$70.89 ,$10.81 , N/A ,$70.21 ,$70.21 ,$68.00 ,$76.50 ,$27.03 ,$72.25 ,$10.81 ,$10.81 ,$72.25 ,$10.81 ,$35.36 , N/A , N/A ,$11.35 ,$72.25 ,$23.80 ,$76.50 ,$66.73 ,$70.21 ,$10.81 ,$55.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500263,85302,HC PROTEIN C AG-90,305,1 ,$270.00 ,$175.50 ,$12.01 ,$270.00 ,$30.03 ,$216.00 ,$12.01 ,$75.60 ,$213.95 ,$247.86 ,$12.01 ,$247.86 ,$12.01 ,$22.82 ,$199.80 ,$30.03 ,$12.01 ,$225.18 ,$12.01 , N/A ,$223.02 ,$223.02 ,$216.00 ,$243.00 ,$30.03 ,$229.50 ,$12.01 ,$12.01 ,$229.50 ,$12.01 ,$112.32 , N/A , N/A ,$12.61 ,$229.50 ,$75.60 ,$243.00 ,$211.95 ,$223.02 ,$12.01 ,$175.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500264,85303,HC PROTEIN C ACTIVITY-90,305,1 ,$548.00 ,$356.20 ,$13.84 ,$548.00 ,$34.60 ,$438.40 ,$13.84 ,$153.44 ,$434.24 ,$503.06 ,$13.84 ,$503.06 ,$13.84 ,$26.30 ,$405.52 ,$34.60 ,$13.84 ,$457.03 ,$13.84 , N/A ,$452.65 ,$452.65 ,$438.40 ,$493.20 ,$34.60 ,$465.80 ,$13.84 ,$13.84 ,$465.80 ,$13.84 ,$227.97 , N/A , N/A ,$14.53 ,$465.80 ,$153.44 ,$493.20 ,$430.18 ,$452.65 ,$13.84 ,$356.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500265,85305,HC PROTEIN S TOTAL-90,305,1 ,$97.00 ,$63.05 ,$11.61 ,$97.00 ,$29.03 ,$77.60 ,$11.61 ,$27.16 ,$76.86 ,$89.05 ,$11.61 ,$89.05 ,$11.61 ,$22.06 ,$71.78 ,$29.03 ,$11.61 ,$80.90 ,$11.61 , N/A ,$80.12 ,$80.12 ,$77.60 ,$87.30 ,$29.03 ,$82.45 ,$11.61 ,$11.61 ,$82.45 ,$11.61 ,$40.35 , N/A , N/A ,$12.19 ,$82.45 ,$27.16 ,$87.30 ,$76.15 ,$80.12 ,$11.61 ,$63.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500266,85306,HC PROTEIN S FREE-90,305,1 ,$255.00 ,$165.75 ,$15.32 ,$255.00 ,$38.30 ,$204.00 ,$15.32 ,$71.40 ,$202.06 ,$234.09 ,$15.32 ,$234.09 ,$15.32 ,$29.11 ,$188.70 ,$38.30 ,$15.32 ,$212.67 ,$15.32 , N/A ,$210.63 ,$210.63 ,$204.00 ,$229.50 ,$38.30 ,$216.75 ,$15.32 ,$15.32 ,$216.75 ,$15.32 ,$106.08 , N/A , N/A ,$16.09 ,$216.75 ,$71.40 ,$229.50 ,$200.18 ,$210.63 ,$15.32 ,$165.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500267,85307,HC ACTIVATED PROTEIN C RESIST-90,305,1 ,$128.00 ,$83.20 ,$15.32 ,$128.00 ,$38.30 ,$102.40 ,$15.32 ,$35.84 ,$101.43 ,$117.50 ,$15.32 ,$117.50 ,$15.32 ,$29.11 ,$94.72 ,$38.30 ,$15.32 ,$106.75 ,$15.32 , N/A ,$105.73 ,$105.73 ,$102.40 ,$115.20 ,$38.30 ,$108.80 ,$15.32 ,$15.32 ,$108.80 ,$15.32 ,$53.25 , N/A , N/A ,$16.09 ,$108.80 ,$35.84 ,$115.20 ,$100.48 ,$105.73 ,$15.32 ,$83.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500269,85362,HC FDP/FSP AGGLUT SQ-90,305,1 ,$168.00 ,$109.20 ,$6.89 ,$168.00 ,$17.23 ,$134.40 ,$6.89 ,$47.04 ,$133.12 ,$154.22 ,$6.89 ,$154.22 ,$6.89 ,$13.09 ,$124.32 ,$17.23 ,$6.89 ,$140.11 ,$6.89 , N/A ,$138.77 ,$138.77 ,$134.40 ,$151.20 ,$17.23 ,$142.80 ,$6.89 ,$6.89 ,$142.80 ,$6.89 ,$69.89 , N/A , N/A ,$7.23 ,$142.80 ,$47.04 ,$151.20 ,$131.88 ,$138.77 ,$6.89 ,$109.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500283,85520,HC HEPARIN ASSAY-90,305,1 ,$220.00 ,$143.00 ,$13.09 ,$220.00 ,$32.73 ,$176.00 ,$13.09 ,$61.60 ,$174.33 ,$201.96 ,$13.09 ,$201.96 ,$13.09 ,$24.87 ,$162.80 ,$32.73 ,$13.09 ,$183.48 ,$13.09 , N/A ,$181.72 ,$181.72 ,$176.00 ,$198.00 ,$32.73 ,$187.00 ,$13.09 ,$13.09 ,$187.00 ,$13.09 ,$91.52 , N/A , N/A ,$13.74 ,$187.00 ,$61.60 ,$198.00 ,$172.70 ,$181.72 ,$13.09 ,$143.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500297,85613,HC RUSSELL VIPER VENOM SCR T1-90,305,1 ,$45.00 ,$29.25 ,$9.58 ,$45.00 ,$23.95 ,$36.00 ,$9.58 ,$12.60 ,$35.66 ,$41.31 ,$9.58 ,$41.31 ,$9.58 ,$18.20 ,$33.30 ,$23.95 ,$9.58 ,$37.53 ,$9.58 , N/A ,$37.17 ,$37.17 ,$36.00 ,$40.50 ,$23.95 ,$38.25 ,$9.58 ,$9.58 ,$38.25 ,$9.58 ,$18.72 , N/A , N/A ,$10.06 ,$38.25 ,$12.60 ,$40.50 ,$35.33 ,$37.17 ,$9.58 ,$29.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500301,85660,HC SICKLE CELL RBC-90,305,1 ,$61.00 ,$39.65 ,$5.51 ,$61.00 ,$13.78 ,$48.80 ,$5.51 ,$17.08 ,$48.34 ,$56.00 ,$5.51 ,$56.00 ,$5.51 ,$10.47 ,$45.14 ,$13.78 ,$5.51 ,$50.87 ,$5.51 , N/A ,$50.39 ,$50.39 ,$48.80 ,$54.90 ,$13.78 ,$51.85 ,$5.51 ,$5.51 ,$51.85 ,$5.51 ,$25.38 , N/A , N/A ,$5.79 ,$51.85 ,$17.08 ,$54.90 ,$47.89 ,$50.39 ,$5.51 ,$39.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500304,85670,HC THROMBIN TIME PLASMA-90,305,1 ,$171.00 ,$111.15 ,$5.77 ,$171.00 ,$14.43 ,$136.80 ,$5.77 ,$47.88 ,$135.50 ,$156.98 ,$5.77 ,$156.98 ,$5.77 ,$10.96 ,$126.54 ,$14.43 ,$5.77 ,$142.61 ,$5.77 , N/A ,$141.25 ,$141.25 ,$136.80 ,$153.90 ,$14.43 ,$145.35 ,$5.77 ,$5.77 ,$145.35 ,$5.77 ,$71.14 , N/A , N/A ,$6.06 ,$145.35 ,$47.88 ,$153.90 ,$134.24 ,$141.25 ,$5.77 ,$111.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500305,85730,HC PTT-90,305,1 ,$126.00 ,$81.90 ,$6.01 ,$126.00 ,$15.03 ,$100.80 ,$6.01 ,$35.28 ,$99.84 ,$115.67 ,$6.01 ,$115.67 ,$6.01 ,$11.42 ,$93.24 ,$15.03 ,$6.01 ,$105.08 ,$6.01 , N/A ,$104.08 ,$104.08 ,$100.80 ,$113.40 ,$15.03 ,$107.10 ,$6.01 ,$6.01 ,$107.10 ,$6.01 ,$52.42 , N/A , N/A ,$6.31 ,$107.10 ,$35.28 ,$113.40 ,$98.91 ,$104.08 ,$6.01 ,$81.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500310,85810,HC VISCOSITY-90,305,1 ,$233.00 ,$151.45 ,$11.67 ,$233.00 ,$29.18 ,$186.40 ,$11.67 ,$65.24 ,$184.63 ,$213.89 ,$11.67 ,$213.89 ,$11.67 ,$22.17 ,$172.42 ,$29.18 ,$11.67 ,$194.32 ,$11.67 , N/A ,$192.46 ,$192.46 ,$186.40 ,$209.70 ,$29.18 ,$198.05 ,$11.67 ,$11.67 ,$198.05 ,$11.67 ,$96.93 , N/A , N/A ,$12.25 ,$198.05 ,$65.24 ,$209.70 ,$182.91 ,$192.46 ,$11.67 ,$151.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500341,85046,HC BLOOD COUNT RETICULOCYTES AUTO,305,1 ,$94.00 ,$61.10 ,$5.57 ,$94.00 ,$13.93 ,$75.20 ,$5.57 ,$26.32 ,$74.49 ,$86.29 ,$5.57 ,$86.29 ,$5.57 ,$10.58 ,$69.56 ,$13.93 ,$5.57 ,$78.40 ,$5.57 , N/A ,$77.64 ,$77.64 ,$75.20 ,$84.60 ,$13.93 ,$79.90 ,$5.57 ,$5.57 ,$79.90 ,$5.57 ,$39.10 , N/A , N/A ,$5.85 ,$79.90 ,$26.32 ,$84.60 ,$73.79 ,$77.64 ,$5.57 ,$61.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500830,85362,HC FDP/FSP AGGLUT SQ,305,1 ,$168.00 ,$109.20 ,$6.89 ,$168.00 ,$17.23 ,$134.40 ,$6.89 ,$47.04 ,$133.12 ,$154.22 ,$6.89 ,$154.22 ,$6.89 ,$13.09 ,$124.32 ,$17.23 ,$6.89 ,$140.11 ,$6.89 , N/A ,$138.77 ,$138.77 ,$134.40 ,$151.20 ,$17.23 ,$142.80 ,$6.89 ,$6.89 ,$142.80 ,$6.89 ,$69.89 , N/A , N/A ,$7.23 ,$142.80 ,$47.04 ,$151.20 ,$131.88 ,$138.77 ,$6.89 ,$109.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500831,85384,HC FIBRINOGEN,305,1 ,$128.00 ,$83.20 ,$9.72 ,$128.00 ,$24.30 ,$102.40 ,$9.72 ,$35.84 ,$101.43 ,$117.50 ,$9.72 ,$117.50 ,$9.72 ,$18.47 ,$94.72 ,$24.30 ,$9.72 ,$106.75 ,$9.72 , N/A ,$105.73 ,$105.73 ,$102.40 ,$115.20 ,$24.30 ,$108.80 ,$9.72 ,$9.72 ,$108.80 ,$9.72 ,$53.25 , N/A , N/A ,$10.21 ,$108.80 ,$35.84 ,$115.20 ,$100.48 ,$105.73 ,$9.72 ,$83.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30500833,85520,HC HEPARIN ASSAY,305,1 ,$220.00 ,$143.00 ,$13.09 ,$220.00 ,$32.73 ,$176.00 ,$13.09 ,$61.60 ,$174.33 ,$201.96 ,$13.09 ,$201.96 ,$13.09 ,$24.87 ,$162.80 ,$32.73 ,$13.09 ,$183.48 ,$13.09 , N/A ,$181.72 ,$181.72 ,$176.00 ,$198.00 ,$32.73 ,$187.00 ,$13.09 ,$13.09 ,$187.00 ,$13.09 ,$91.52 , N/A , N/A ,$13.74 ,$187.00 ,$61.60 ,$198.00 ,$172.70 ,$181.72 ,$13.09 ,$143.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600102,87040,HC BLOOD CULTURE,306,1 ,$317.00 ,$206.05 ,$10.32 ,$317.00 ,$25.80 ,$253.60 ,$10.32 ,$88.76 ,$251.19 ,$291.01 ,$10.32 ,$291.01 ,$10.32 ,$19.61 ,$234.58 ,$25.80 ,$10.32 ,$264.38 ,$10.32 , N/A ,$261.84 ,$261.84 ,$253.60 ,$285.30 ,$25.80 ,$269.45 ,$10.32 ,$10.32 ,$269.45 ,$10.32 ,$131.87 , N/A , N/A ,$10.84 ,$269.45 ,$88.76 ,$285.30 ,$248.85 ,$261.84 ,$10.32 ,$206.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600109,87070,HC BODY FLUID CULTURE,306,1 ,$201.00 ,$130.65 ,$8.62 ,$201.00 ,$21.55 ,$160.80 ,$8.62 ,$56.28 ,$159.27 ,$184.52 ,$8.62 ,$184.52 ,$8.62 ,$16.38 ,$148.74 ,$21.55 ,$8.62 ,$167.63 ,$8.62 , N/A ,$166.03 ,$166.03 ,$160.80 ,$180.90 ,$21.55 ,$170.85 ,$8.62 ,$8.62 ,$170.85 ,$8.62 ,$83.62 , N/A , N/A ,$9.05 ,$170.85 ,$56.28 ,$180.90 ,$157.79 ,$166.03 ,$8.62 ,$130.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600138,87102,HC CULTURE FUNGUS OTHER,306,1 ,$270.00 ,$175.50 ,$8.41 ,$270.00 ,$21.03 ,$216.00 ,$8.41 ,$75.60 ,$213.95 ,$247.86 ,$8.41 ,$247.86 ,$8.41 ,$15.98 ,$199.80 ,$21.03 ,$8.41 ,$225.18 ,$8.41 , N/A ,$223.02 ,$223.02 ,$216.00 ,$243.00 ,$21.03 ,$229.50 ,$8.41 ,$8.41 ,$229.50 ,$8.41 ,$112.32 , N/A , N/A ,$8.83 ,$229.50 ,$75.60 ,$243.00 ,$211.95 ,$223.02 ,$8.41 ,$175.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600145,87107,HC CULTURE FUNGUS ID MOLD,306,1 ,$144.00 ,$93.60 ,$10.32 ,$144.00 ,$25.80 ,$115.20 ,$10.32 ,$40.32 ,$114.11 ,$132.19 ,$10.32 ,$132.19 ,$10.32 ,$19.61 ,$106.56 ,$25.80 ,$10.32 ,$120.10 ,$10.32 , N/A ,$118.94 ,$118.94 ,$115.20 ,$129.60 ,$25.80 ,$122.40 ,$10.32 ,$10.32 ,$122.40 ,$10.32 ,$59.90 , N/A , N/A ,$10.84 ,$122.40 ,$40.32 ,$129.60 ,$113.04 ,$118.94 ,$10.32 ,$93.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600161,87168,HC EXAM ARTHROPOD,306,1 ,$43.00 ,$27.95 ,$4.27 ,$43.00 ,$10.68 ,$34.40 ,$4.27 ,$12.04 ,$34.07 ,$39.47 ,$4.27 ,$39.47 ,$4.27 ,$8.11 ,$31.82 ,$10.68 ,$4.27 ,$35.86 ,$4.27 , N/A ,$35.52 ,$35.52 ,$34.40 ,$38.70 ,$10.68 ,$36.55 ,$4.27 ,$4.27 ,$36.55 ,$4.27 ,$17.89 , N/A , N/A ,$4.48 ,$36.55 ,$12.04 ,$38.70 ,$33.76 ,$35.52 ,$4.27 ,$27.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600163,87172,HC PINWORM EXAM,306,1 ,$77.00 ,$50.05 ,$4.27 ,$77.00 ,$10.68 ,$61.60 ,$4.27 ,$21.56 ,$61.01 ,$70.69 ,$4.27 ,$70.69 ,$4.27 ,$8.11 ,$56.98 ,$10.68 ,$4.27 ,$64.22 ,$4.27 , N/A ,$63.60 ,$63.60 ,$61.60 ,$69.30 ,$10.68 ,$65.45 ,$4.27 ,$4.27 ,$65.45 ,$4.27 ,$32.03 , N/A , N/A ,$4.48 ,$65.45 ,$21.56 ,$69.30 ,$60.45 ,$63.60 ,$4.27 ,$50.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600172,87186,HC SENSITIVITY MIC,306,1 ,$172.00 ,$111.80 ,$8.65 ,$172.00 ,$21.63 ,$137.60 ,$8.65 ,$48.16 ,$136.29 ,$157.90 ,$8.65 ,$157.90 ,$8.65 ,$16.44 ,$127.28 ,$21.63 ,$8.65 ,$143.45 ,$8.65 , N/A ,$142.07 ,$142.07 ,$137.60 ,$154.80 ,$21.63 ,$146.20 ,$8.65 ,$8.65 ,$146.20 ,$8.65 ,$71.55 , N/A , N/A ,$9.08 ,$146.20 ,$48.16 ,$154.80 ,$135.02 ,$142.07 ,$8.65 ,$111.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600174,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$16.00 ,$10.40 ,$4.27 ,$16.00 ,$10.68 ,$12.80 ,$4.27 ,$4.48 ,$12.68 ,$14.69 ,$4.27 ,$14.69 ,$4.27 ,$8.11 ,$11.84 ,$10.68 ,$4.27 ,$13.34 ,$4.27 , N/A ,$13.22 ,$13.22 ,$12.80 ,$14.40 ,$10.68 ,$13.60 ,$4.27 ,$4.27 ,$13.60 ,$4.27 ,$6.66 , N/A , N/A ,$4.48 ,$13.60 ,$4.48 ,$14.40 ,$12.56 ,$13.22 ,$4.27 ,$10.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600183,87210,HC SMEAR WET MOUNT,306,1 ,$94.00 ,$61.10 ,$5.82 ,$94.00 ,$14.55 ,$75.20 ,$5.82 ,$26.32 ,$74.49 ,$86.29 ,$5.82 ,$86.29 ,$5.82 ,$11.06 ,$69.56 ,$14.55 ,$5.82 ,$78.40 ,$5.82 , N/A ,$77.64 ,$77.64 ,$75.20 ,$84.60 ,$14.55 ,$79.90 ,$5.82 ,$5.82 ,$79.90 ,$5.82 ,$39.10 , N/A , N/A ,$6.11 ,$79.90 ,$26.32 ,$84.60 ,$73.79 ,$77.64 ,$5.82 ,$61.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600185,87220,HC TISSUE KOH PREP,306,1 ,$88.00 ,$57.20 ,$4.27 ,$88.00 ,$10.68 ,$70.40 ,$4.27 ,$24.64 ,$69.73 ,$80.78 ,$4.27 ,$80.78 ,$4.27 ,$8.11 ,$65.12 ,$10.68 ,$4.27 ,$73.39 ,$4.27 , N/A ,$72.69 ,$72.69 ,$70.40 ,$79.20 ,$10.68 ,$74.80 ,$4.27 ,$4.27 ,$74.80 ,$4.27 ,$36.61 , N/A , N/A ,$4.48 ,$74.80 ,$24.64 ,$79.20 ,$69.08 ,$72.69 ,$4.27 ,$57.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600213,87324,HC EIA QL CLOS DIFF TOXIN AG,306,1 ,$381.00 ,$247.65 ,$11.98 ,$381.00 ,$29.95 ,$304.80 ,$11.98 ,$106.68 ,$301.90 ,$349.76 ,$11.98 ,$349.76 ,$11.98 ,$22.76 ,$281.94 ,$29.95 ,$11.98 ,$317.75 ,$11.98 , N/A ,$314.71 ,$314.71 ,$304.80 ,$342.90 ,$29.95 ,$323.85 ,$11.98 ,$11.98 ,$323.85 ,$11.98 ,$158.50 , N/A , N/A ,$12.58 ,$323.85 ,$106.68 ,$342.90 ,$299.09 ,$314.71 ,$11.98 ,$247.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600217,87338,HC EIA QL H PYLORI AG STOOL,306,1 ,$364.00 ,$236.60 ,$14.38 ,$364.00 ,$35.95 ,$291.20 ,$14.38 ,$101.92 ,$288.43 ,$334.15 ,$14.38 ,$334.15 ,$14.38 ,$27.32 ,$269.36 ,$35.95 ,$14.38 ,$303.58 ,$14.38 , N/A ,$300.66 ,$300.66 ,$291.20 ,$327.60 ,$35.95 ,$309.40 ,$14.38 ,$14.38 ,$309.40 ,$14.38 ,$151.42 , N/A , N/A ,$15.10 ,$309.40 ,$101.92 ,$327.60 ,$285.74 ,$300.66 ,$14.38 ,$236.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600225,87400,HC EIA QL INFLUENZA A/B AG,306,1 ,$58.00 ,$37.70 ,$14.13 ,$58.00 ,$35.33 ,$46.40 ,$14.13 ,$16.24 ,$45.96 ,$53.24 ,$14.13 ,$53.24 ,$14.13 ,$26.85 ,$42.92 ,$35.33 ,$14.13 ,$48.37 ,$14.13 , N/A ,$47.91 ,$47.91 ,$46.40 ,$52.20 ,$35.33 ,$49.30 ,$14.13 ,$14.13 ,$49.30 ,$14.13 ,$24.13 , N/A , N/A ,$14.84 ,$49.30 ,$16.24 ,$52.20 ,$45.53 ,$47.91 ,$14.13 ,$37.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600226,87420,HC RSV AG QL,306,1 ,$569.00 ,$369.85 ,$13.91 ,$569.00 ,$34.78 ,$455.20 ,$13.91 ,$159.32 ,$450.88 ,$522.34 ,$13.91 ,$522.34 ,$13.91 ,$26.43 ,$421.06 ,$34.78 ,$13.91 ,$474.55 ,$13.91 , N/A ,$469.99 ,$469.99 ,$455.20 ,$512.10 ,$34.78 ,$483.65 ,$13.91 ,$13.91 ,$483.65 ,$13.91 ,$236.70 , N/A , N/A ,$14.61 ,$483.65 ,$159.32 ,$512.10 ,$446.67 ,$469.99 ,$13.91 ,$369.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600227,87425,HC EIA QL ROTAVIRUS AG,306,1 ,$292.00 ,$189.80 ,$11.98 ,$292.00 ,$29.95 ,$233.60 ,$11.98 ,$81.76 ,$231.38 ,$268.06 ,$11.98 ,$268.06 ,$11.98 ,$22.76 ,$216.08 ,$29.95 ,$11.98 ,$243.53 ,$11.98 , N/A ,$241.19 ,$241.19 ,$233.60 ,$262.80 ,$29.95 ,$248.20 ,$11.98 ,$11.98 ,$248.20 ,$11.98 ,$121.47 , N/A , N/A ,$12.58 ,$248.20 ,$81.76 ,$262.80 ,$229.22 ,$241.19 ,$11.98 ,$189.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600237,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$146.00 ,$94.90 ,$37.27 ,$146.00 ,$93.18 ,$116.80 ,$37.27 ,$40.88 ,$115.69 ,$134.03 ,$37.27 ,$134.03 ,$37.27 ,$70.81 ,$108.04 ,$93.18 ,$37.27 ,$121.76 ,$37.27 , N/A ,$120.60 ,$120.60 ,$116.80 ,$131.40 ,$93.18 ,$124.10 ,$37.27 ,$37.27 ,$124.10 ,$37.27 ,$60.74 , N/A , N/A ,$39.13 ,$124.10 ,$40.88 ,$131.40 ,$114.61 ,$120.60 ,$37.27 ,$94.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600252,87624,HC HPV AMP,306,1 ,$147.00 ,$95.55 ,$35.09 ,$147.00 ,$87.73 ,$117.60 ,$35.09 ,$41.16 ,$116.48 ,$134.95 ,$35.09 ,$134.95 ,$35.09 ,$66.67 ,$108.78 ,$87.73 ,$35.09 ,$122.60 ,$35.09 , N/A ,$121.42 ,$121.42 ,$117.60 ,$132.30 ,$87.73 ,$124.95 ,$35.09 ,$35.09 ,$124.95 ,$35.09 ,$61.15 , N/A , N/A ,$36.84 ,$124.95 ,$41.16 ,$132.30 ,$115.40 ,$121.42 ,$35.09 ,$95.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600255,87641,HC MRSA AMP,306,1 ,$249.00 ,$161.85 ,$35.09 ,$249.00 ,$87.73 ,$199.20 ,$35.09 ,$69.72 ,$197.31 ,$228.58 ,$35.09 ,$228.58 ,$35.09 ,$66.67 ,$184.26 ,$87.73 ,$35.09 ,$207.67 ,$35.09 , N/A ,$205.67 ,$205.67 ,$199.20 ,$224.10 ,$87.73 ,$211.65 ,$35.09 ,$35.09 ,$211.65 ,$35.09 ,$103.58 , N/A , N/A ,$36.84 ,$211.65 ,$69.72 ,$224.10 ,$195.47 ,$205.67 ,$35.09 ,$161.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600270,87880,HC OPTICAL STREP,306,1 ,$126.00 ,$81.90 ,$16.53 ,$126.00 ,$41.33 ,$100.80 ,$16.53 ,$35.28 ,$99.84 ,$115.67 ,$16.53 ,$115.67 ,$16.53 ,$31.41 ,$93.24 ,$41.33 ,$16.53 ,$105.08 ,$16.53 , N/A ,$104.08 ,$104.08 ,$100.80 ,$113.40 ,$41.33 ,$107.10 ,$16.53 ,$16.53 ,$107.10 ,$16.53 ,$52.42 , N/A , N/A ,$17.36 ,$107.10 ,$35.28 ,$113.40 ,$98.91 ,$104.08 ,$16.53 ,$81.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600283,87804,HC QL INFLUENZA A/B,306,1 ,$70.00 ,$45.50 ,$16.55 ,$70.00 ,$41.38 ,$56.00 ,$16.55 ,$19.60 ,$55.47 ,$64.26 ,$16.55 ,$64.26 ,$16.55 ,$31.45 ,$51.80 ,$41.38 ,$16.55 ,$58.38 ,$16.55 , N/A ,$57.82 ,$57.82 ,$56.00 ,$63.00 ,$41.38 ,$59.50 ,$16.55 ,$16.55 ,$59.50 ,$16.55 ,$29.12 , N/A , N/A ,$17.38 ,$59.50 ,$19.60 ,$63.00 ,$54.95 ,$57.82 ,$16.55 ,$45.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600318,87449,HC EIA QL MLT AG INF,306,1 ,$291.00 ,$189.15 ,$11.98 ,$291.00 ,$29.95 ,$232.80 ,$11.98 ,$81.48 ,$230.59 ,$267.14 ,$11.98 ,$267.14 ,$11.98 ,$22.76 ,$215.34 ,$29.95 ,$11.98 ,$242.69 ,$11.98 , N/A ,$240.37 ,$240.37 ,$232.80 ,$261.90 ,$29.95 ,$247.35 ,$11.98 ,$11.98 ,$247.35 ,$11.98 ,$121.06 , N/A , N/A ,$12.58 ,$247.35 ,$81.48 ,$261.90 ,$228.44 ,$240.37 ,$11.98 ,$189.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600348,87483,HC INFECT AMP CNS DNA/RNA 14 TARGETS,306,1 ,"$1,700.00 ","$1,105.00 ",$416.78 ,"$1,700.00 ","$1,041.95 ","$1,360.00 ",$416.78 ,$476.00 ,"$1,347.08 ","$1,560.60 ",$416.78 ,"$1,560.60 ",$416.78 ,$791.88 ,"$1,258.00 ","$1,041.95 ",$416.78 ,"$1,417.80 ",$416.78 , N/A ,"$1,404.20 ","$1,404.20 ","$1,360.00 ","$1,530.00 ","$1,041.95 ","$1,445.00 ",$416.78 ,$416.78 ,"$1,445.00 ",$416.78 ,$707.20 , N/A , N/A ,$437.62 ,"$1,445.00 ",$476.00 ,"$1,530.00 ","$1,334.50 ","$1,404.20 ",$416.78 ,"$1,105.00 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600359,87081,HC CULTURE SCR PRESUMP PATHOGENS-90,306,1 ,$152.00 ,$98.80 ,$6.63 ,$152.00 ,$16.58 ,$121.60 ,$6.63 ,$42.56 ,$120.44 ,$139.54 ,$6.63 ,$139.54 ,$6.63 ,$12.60 ,$112.48 ,$16.58 ,$6.63 ,$126.77 ,$6.63 , N/A ,$125.55 ,$125.55 ,$121.60 ,$136.80 ,$16.58 ,$129.20 ,$6.63 ,$6.63 ,$129.20 ,$6.63 ,$63.23 , N/A , N/A ,$6.96 ,$129.20 ,$42.56 ,$136.80 ,$119.32 ,$125.55 ,$6.63 ,$98.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600360,87081,HC CULTURE SCR PRESUMP PATHOGENS T1,306,1 ,$152.00 ,$98.80 ,$6.63 ,$152.00 ,$16.58 ,$121.60 ,$6.63 ,$42.56 ,$120.44 ,$139.54 ,$6.63 ,$139.54 ,$6.63 ,$12.60 ,$112.48 ,$16.58 ,$6.63 ,$126.77 ,$6.63 , N/A ,$125.55 ,$125.55 ,$121.60 ,$136.80 ,$16.58 ,$129.20 ,$6.63 ,$6.63 ,$129.20 ,$6.63 ,$63.23 , N/A , N/A ,$6.96 ,$129.20 ,$42.56 ,$136.80 ,$119.32 ,$125.55 ,$6.63 ,$98.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600368,87116,HC CULTURE AFB/TB/MYCOBACT-90,306,1 ,$88.00 ,$57.20 ,$10.80 ,$88.00 ,$27.00 ,$70.40 ,$10.80 ,$24.64 ,$69.73 ,$80.78 ,$10.80 ,$80.78 ,$10.80 ,$20.52 ,$65.12 ,$27.00 ,$10.80 ,$73.39 ,$10.80 , N/A ,$72.69 ,$72.69 ,$70.40 ,$79.20 ,$27.00 ,$74.80 ,$10.80 ,$10.80 ,$74.80 ,$10.80 ,$36.61 , N/A , N/A ,$11.34 ,$74.80 ,$24.64 ,$79.20 ,$69.08 ,$72.69 ,$10.80 ,$57.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600370,87140,HC CULTURE TYPE IF EA ANTISERUM-90,306,1 ,$88.00 ,$57.20 ,$5.57 ,$88.00 ,$13.93 ,$70.40 ,$5.57 ,$24.64 ,$69.73 ,$80.78 ,$5.57 ,$80.78 ,$5.57 ,$10.58 ,$65.12 ,$13.93 ,$5.57 ,$73.39 ,$5.57 , N/A ,$72.69 ,$72.69 ,$70.40 ,$79.20 ,$13.93 ,$74.80 ,$5.57 ,$5.57 ,$74.80 ,$5.57 ,$36.61 , N/A , N/A ,$5.85 ,$74.80 ,$24.64 ,$79.20 ,$69.08 ,$72.69 ,$5.57 ,$57.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600377,87153,HC ID NUCLEAR ACID SEQ METH ID-90,306,1 ,$503.00 ,$326.95 ,$115.36 ,$503.00 ,$288.40 ,$402.40 ,$115.36 ,$140.84 ,$398.58 ,$461.75 ,$115.36 ,$461.75 ,$115.36 ,$219.18 ,$372.22 ,$288.40 ,$115.36 ,$419.50 ,$115.36 , N/A ,$415.48 ,$415.48 ,$402.40 ,$452.70 ,$288.40 ,$427.55 ,$115.36 ,$115.36 ,$427.55 ,$115.36 ,$209.25 , N/A , N/A ,$121.13 ,$427.55 ,$140.84 ,$452.70 ,$394.86 ,$415.48 ,$115.36 ,$326.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600380,87177,HC SMEAR OVA PARASITE CONC/ID-90,306,1 ,$89.00 ,$57.85 ,$8.90 ,$89.00 ,$22.25 ,$71.20 ,$8.90 ,$24.92 ,$70.52 ,$81.70 ,$8.90 ,$81.70 ,$8.90 ,$16.91 ,$65.86 ,$22.25 ,$8.90 ,$74.23 ,$8.90 , N/A ,$73.51 ,$73.51 ,$71.20 ,$80.10 ,$22.25 ,$75.65 ,$8.90 ,$8.90 ,$75.65 ,$8.90 ,$37.02 , N/A , N/A ,$9.35 ,$75.65 ,$24.92 ,$80.10 ,$69.87 ,$73.51 ,$8.90 ,$57.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600395,87206,HC SMEAR ACID FAST/FLUOR-90,306,1 ,$426.00 ,$276.90 ,$5.39 ,$426.00 ,$13.48 ,$340.80 ,$5.39 ,$119.28 ,$337.56 ,$391.07 ,$5.39 ,$391.07 ,$5.39 ,$10.24 ,$315.24 ,$13.48 ,$5.39 ,$355.28 ,$5.39 , N/A ,$351.88 ,$351.88 ,$340.80 ,$383.40 ,$13.48 ,$362.10 ,$5.39 ,$5.39 ,$362.10 ,$5.39 ,$177.22 , N/A , N/A ,$5.66 ,$362.10 ,$119.28 ,$383.40 ,$334.41 ,$351.88 ,$5.39 ,$276.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600397,87207,HC SPECIAL STAIN INCL BODIES/PARASITES-90,306,1 ,$91.00 ,$59.15 ,$5.99 ,$91.00 ,$14.98 ,$72.80 ,$5.99 ,$25.48 ,$72.11 ,$83.54 ,$5.99 ,$83.54 ,$5.99 ,$11.38 ,$67.34 ,$14.98 ,$5.99 ,$75.89 ,$5.99 , N/A ,$75.17 ,$75.17 ,$72.80 ,$81.90 ,$14.98 ,$77.35 ,$5.99 ,$5.99 ,$77.35 ,$5.99 ,$37.86 , N/A , N/A ,$6.29 ,$77.35 ,$25.48 ,$81.90 ,$71.44 ,$75.17 ,$5.99 ,$59.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600399,87209,HC OVA  AND  PARASITE W/STAIN-90,306,1 ,$66.00 ,$42.90 ,$17.98 ,$66.00 ,$44.95 ,$52.80 ,$17.98 ,$18.48 ,$52.30 ,$60.59 ,$17.98 ,$60.59 ,$17.98 ,$34.16 ,$48.84 ,$44.95 ,$17.98 ,$55.04 ,$17.98 , N/A ,$54.52 ,$54.52 ,$52.80 ,$59.40 ,$44.95 ,$56.10 ,$17.98 ,$17.98 ,$56.10 ,$17.98 ,$27.46 , N/A , N/A ,$18.88 ,$56.10 ,$18.48 ,$59.40 ,$51.81 ,$54.52 ,$17.98 ,$42.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600402,87252,HC CULTURE VIRUS ID TISSUE-90,306,1 ,$322.00 ,$209.30 ,$26.07 ,$322.00 ,$65.18 ,$257.60 ,$26.07 ,$90.16 ,$255.15 ,$295.60 ,$26.07 ,$295.60 ,$26.07 ,$49.53 ,$238.28 ,$65.18 ,$26.07 ,$268.55 ,$26.07 , N/A ,$265.97 ,$265.97 ,$257.60 ,$289.80 ,$65.18 ,$273.70 ,$26.07 ,$26.07 ,$273.70 ,$26.07 ,$133.95 , N/A , N/A ,$27.37 ,$273.70 ,$90.16 ,$289.80 ,$252.77 ,$265.97 ,$26.07 ,$209.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600405,87254,HC VIRUS ISOL SHELL ID-90,306,1 ,$201.00 ,$130.65 ,$19.56 ,$201.00 ,$48.90 ,$160.80 ,$19.56 ,$56.28 ,$159.27 ,$184.52 ,$19.56 ,$184.52 ,$19.56 ,$37.16 ,$148.74 ,$48.90 ,$19.56 ,$167.63 ,$19.56 , N/A ,$166.03 ,$166.03 ,$160.80 ,$180.90 ,$48.90 ,$170.85 ,$19.56 ,$19.56 ,$170.85 ,$19.56 ,$83.62 , N/A , N/A ,$20.54 ,$170.85 ,$56.28 ,$180.90 ,$157.79 ,$166.03 ,$19.56 ,$130.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600414,87299,HC ANTIBODY DETECT IF NOS-90,306,1 ,$108.00 ,$70.20 ,$16.10 ,$108.00 ,$40.25 ,$86.40 ,$16.10 ,$30.24 ,$85.58 ,$99.14 ,$16.10 ,$99.14 ,$16.10 ,$30.59 ,$79.92 ,$40.25 ,$16.10 ,$90.07 ,$16.10 , N/A ,$89.21 ,$89.21 ,$86.40 ,$97.20 ,$40.25 ,$91.80 ,$16.10 ,$16.10 ,$91.80 ,$16.10 ,$44.93 , N/A , N/A ,$16.91 ,$91.80 ,$30.24 ,$97.20 ,$84.78 ,$89.21 ,$16.10 ,$70.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600421,87340,HC EIA QL HEPATITIS B AG-90,306,1 ,$216.00 ,$140.40 ,$10.33 ,$216.00 ,$25.83 ,$172.80 ,$10.33 ,$60.48 ,$171.16 ,$198.29 ,$10.33 ,$198.29 ,$10.33 ,$19.63 ,$159.84 ,$25.83 ,$10.33 ,$180.14 ,$10.33 , N/A ,$178.42 ,$178.42 ,$172.80 ,$194.40 ,$25.83 ,$183.60 ,$10.33 ,$10.33 ,$183.60 ,$10.33 ,$89.86 , N/A , N/A ,$10.85 ,$183.60 ,$60.48 ,$194.40 ,$169.56 ,$178.42 ,$10.33 ,$140.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600424,87350,HC HEPATITIS BE AG QL-90,306,1 ,$134.00 ,$87.10 ,$11.53 ,$134.00 ,$28.83 ,$107.20 ,$11.53 ,$37.52 ,$106.18 ,$123.01 ,$11.53 ,$123.01 ,$11.53 ,$21.91 ,$99.16 ,$28.83 ,$11.53 ,$111.76 ,$11.53 , N/A ,$110.68 ,$110.68 ,$107.20 ,$120.60 ,$28.83 ,$113.90 ,$11.53 ,$11.53 ,$113.90 ,$11.53 ,$55.74 , N/A , N/A ,$12.11 ,$113.90 ,$37.52 ,$120.60 ,$105.19 ,$110.68 ,$11.53 ,$87.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600426,87385,HC EIA QL HISTOPLASMA AG-90,306,1 ,$613.00 ,$398.45 ,$13.25 ,$613.00 ,$33.13 ,$490.40 ,$13.25 ,$171.64 ,$485.74 ,$562.73 ,$13.25 ,$562.73 ,$13.25 ,$25.18 ,$453.62 ,$33.13 ,$13.25 ,$511.24 ,$13.25 , N/A ,$506.34 ,$506.34 ,$490.40 ,$551.70 ,$33.13 ,$521.05 ,$13.25 ,$13.25 ,$521.05 ,$13.25 ,$255.01 , N/A , N/A ,$13.91 ,$521.05 ,$171.64 ,$551.70 ,$481.21 ,$506.34 ,$13.25 ,$398.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600432,87449,HC EIA QL MLT AG INF-90,306,1 ,$371.00 ,$241.15 ,$11.98 ,$371.00 ,$29.95 ,$296.80 ,$11.98 ,$103.88 ,$293.98 ,$340.58 ,$11.98 ,$340.58 ,$11.98 ,$22.76 ,$274.54 ,$29.95 ,$11.98 ,$309.41 ,$11.98 , N/A ,$306.45 ,$306.45 ,$296.80 ,$333.90 ,$29.95 ,$315.35 ,$11.98 ,$11.98 ,$315.35 ,$11.98 ,$154.34 , N/A , N/A ,$12.58 ,$315.35 ,$103.88 ,$333.90 ,$291.24 ,$306.45 ,$11.98 ,$241.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600438,87491,HC CHLAMYDIA TRACH AMP-90,306,1 ,$257.00 ,$167.05 ,$35.09 ,$257.00 ,$87.73 ,$205.60 ,$35.09 ,$71.96 ,$203.65 ,$235.93 ,$35.09 ,$235.93 ,$35.09 ,$66.67 ,$190.18 ,$87.73 ,$35.09 ,$214.34 ,$35.09 , N/A ,$212.28 ,$212.28 ,$205.60 ,$231.30 ,$87.73 ,$218.45 ,$35.09 ,$35.09 ,$218.45 ,$35.09 ,$106.91 , N/A , N/A ,$36.84 ,$218.45 ,$71.96 ,$231.30 ,$201.75 ,$212.28 ,$35.09 ,$167.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600442,87496,HC INFECT AMP (CMV) MENI-90,306,1 ,$83.00 ,$53.95 ,$23.24 ,$87.73 ,$87.73 ,$66.40 ,$35.09 ,$23.24 ,$65.77 ,$76.19 ,$35.09 ,$76.19 ,$35.09 ,$66.67 ,$61.42 ,$83.00 ,$35.09 ,$69.22 ,$35.09 , N/A ,$68.56 ,$68.56 ,$66.40 ,$74.70 ,$83.00 ,$70.55 ,$35.09 ,$35.09 ,$70.55 ,$35.09 ,$34.53 , N/A , N/A ,$36.84 ,$70.55 ,$23.24 ,$74.70 ,$65.16 ,$68.56 ,$35.09 ,$53.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600443,87497,HC CMV QN-90,306,1 ,$980.00 ,$637.00 ,$42.84 ,$980.00 ,$107.10 ,$784.00 ,$42.84 ,$274.40 ,$776.55 ,$899.64 ,$42.84 ,$899.64 ,$42.84 ,$81.40 ,$725.20 ,$107.10 ,$42.84 ,$817.32 ,$42.84 , N/A ,$809.48 ,$809.48 ,$784.00 ,$882.00 ,$107.10 ,$833.00 ,$42.84 ,$42.84 ,$833.00 ,$42.84 ,$407.68 , N/A , N/A ,$44.98 ,$833.00 ,$274.40 ,$882.00 ,$769.30 ,$809.48 ,$42.84 ,$637.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600444,87498,HC ENTEROVIRUS AMP PROBE-90,306,1 ,$391.00 ,$254.15 ,$35.09 ,$391.00 ,$87.73 ,$312.80 ,$35.09 ,$109.48 ,$309.83 ,$358.94 ,$35.09 ,$358.94 ,$35.09 ,$66.67 ,$289.34 ,$87.73 ,$35.09 ,$326.09 ,$35.09 , N/A ,$322.97 ,$322.97 ,$312.80 ,$351.90 ,$87.73 ,$332.35 ,$35.09 ,$35.09 ,$332.35 ,$35.09 ,$162.66 , N/A , N/A ,$36.84 ,$332.35 ,$109.48 ,$351.90 ,$306.94 ,$322.97 ,$35.09 ,$254.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600448,87517,HC HEPATITIS B QN-90,306,1 ,$493.00 ,$320.45 ,$42.84 ,$493.00 ,$107.10 ,$394.40 ,$42.84 ,$138.04 ,$390.65 ,$452.57 ,$42.84 ,$452.57 ,$42.84 ,$81.40 ,$364.82 ,$107.10 ,$42.84 ,$411.16 ,$42.84 , N/A ,$407.22 ,$407.22 ,$394.40 ,$443.70 ,$107.10 ,$419.05 ,$42.84 ,$42.84 ,$419.05 ,$42.84 ,$205.09 , N/A , N/A ,$44.98 ,$419.05 ,$138.04 ,$443.70 ,$387.01 ,$407.22 ,$42.84 ,$320.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600449,87521,HC HEPATITIS C PROBE AND RVRS TRNSC-90,306,1 ,"$1,167.00 ",$758.55 ,$35.09 ,"$1,167.00 ",$87.73 ,$933.60 ,$35.09 ,$326.76 ,$924.73 ,"$1,071.31 ",$35.09 ,"$1,071.31 ",$35.09 ,$66.67 ,$863.58 ,$87.73 ,$35.09 ,$973.28 ,$35.09 , N/A ,$963.94 ,$963.94 ,$933.60 ,"$1,050.30 ",$87.73 ,$991.95 ,$35.09 ,$35.09 ,$991.95 ,$35.09 ,$485.47 , N/A , N/A ,$36.84 ,$991.95 ,$326.76 ,"$1,050.30 ",$916.10 ,$963.94 ,$35.09 ,$758.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600451,87522,HC HEPATITIS C QN-90,306,1 ,$900.00 ,$585.00 ,$42.84 ,$900.00 ,$107.10 ,$720.00 ,$42.84 ,$252.00 ,$713.16 ,$826.20 ,$42.84 ,$826.20 ,$42.84 ,$81.40 ,$666.00 ,$107.10 ,$42.84 ,$750.60 ,$42.84 , N/A ,$743.40 ,$743.40 ,$720.00 ,$810.00 ,$107.10 ,$765.00 ,$42.84 ,$42.84 ,$765.00 ,$42.84 ,$374.40 , N/A , N/A ,$44.98 ,$765.00 ,$252.00 ,$810.00 ,$706.50 ,$743.40 ,$42.84 ,$585.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600453,87529,HC HERPES SIMPLEX AMP-90,306,1 ,$510.00 ,$331.50 ,$35.09 ,$510.00 ,$87.73 ,$408.00 ,$35.09 ,$142.80 ,$404.12 ,$468.18 ,$35.09 ,$468.18 ,$35.09 ,$66.67 ,$377.40 ,$87.73 ,$35.09 ,$425.34 ,$35.09 , N/A ,$421.26 ,$421.26 ,$408.00 ,$459.00 ,$87.73 ,$433.50 ,$35.09 ,$35.09 ,$433.50 ,$35.09 ,$212.16 , N/A , N/A ,$36.84 ,$433.50 ,$142.80 ,$459.00 ,$400.35 ,$421.26 ,$35.09 ,$331.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600458,87536,HC HIV-1 QN-90,306,1 ,$373.00 ,$242.45 ,$85.10 ,$373.00 ,$212.75 ,$298.40 ,$85.10 ,$104.44 ,$295.57 ,$342.41 ,$85.10 ,$342.41 ,$85.10 ,$161.69 ,$276.02 ,$212.75 ,$85.10 ,$311.08 ,$85.10 , N/A ,$308.10 ,$308.10 ,$298.40 ,$335.70 ,$212.75 ,$317.05 ,$85.10 ,$85.10 ,$317.05 ,$85.10 ,$155.17 , N/A , N/A ,$89.36 ,$317.05 ,$104.44 ,$335.70 ,$292.81 ,$308.10 ,$85.10 ,$242.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600460,87591,HC NEISSERIA AMP-90,306,1 ,$114.00 ,$74.10 ,$31.92 ,$114.00 ,$87.73 ,$91.20 ,$35.09 ,$31.92 ,$90.33 ,$104.65 ,$35.09 ,$104.65 ,$35.09 ,$66.67 ,$84.36 ,$87.73 ,$35.09 ,$95.08 ,$35.09 , N/A ,$94.16 ,$94.16 ,$91.20 ,$102.60 ,$87.73 ,$96.90 ,$35.09 ,$35.09 ,$96.90 ,$35.09 ,$47.42 , N/A , N/A ,$36.84 ,$96.90 ,$31.92 ,$102.60 ,$89.49 ,$94.16 ,$35.09 ,$74.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600465,87633,HC IF AG RESP VIRUS MAP 12-25 TARGETS-90,306,1 ,$766.00 ,$497.90 ,$214.48 ,"$1,041.95 ","$1,041.95 ",$612.80 ,$416.78 ,$214.48 ,$606.98 ,$703.19 ,$416.78 ,$703.19 ,$416.78 ,$766.00 ,$566.84 ,$766.00 ,$416.78 ,$638.84 ,$416.78 , N/A ,$632.72 ,$632.72 ,$612.80 ,$689.40 ,$766.00 ,$651.10 ,$416.78 ,$416.78 ,$651.10 ,$416.78 ,$318.66 , N/A , N/A ,$437.62 ,$651.10 ,$214.48 ,$689.40 ,$601.31 ,$632.72 ,$416.78 ,$497.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600471,87798,HC INFECT AMP-90,306,1 ,$317.00 ,$206.05 ,$35.09 ,$317.00 ,$87.73 ,$253.60 ,$35.09 ,$88.76 ,$251.19 ,$291.01 ,$35.09 ,$291.01 ,$35.09 ,$66.67 ,$234.58 ,$87.73 ,$35.09 ,$264.38 ,$35.09 , N/A ,$261.84 ,$261.84 ,$253.60 ,$285.30 ,$87.73 ,$269.45 ,$35.09 ,$35.09 ,$269.45 ,$35.09 ,$131.87 , N/A , N/A ,$36.84 ,$269.45 ,$88.76 ,$285.30 ,$248.85 ,$261.84 ,$35.09 ,$206.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600478,87799,HC INFECT AGENT QN-90,306,1 ,$426.00 ,$276.90 ,$42.84 ,$426.00 ,$107.10 ,$340.80 ,$42.84 ,$119.28 ,$337.56 ,$391.07 ,$42.84 ,$391.07 ,$42.84 ,$81.40 ,$315.24 ,$107.10 ,$42.84 ,$355.28 ,$42.84 , N/A ,$351.88 ,$351.88 ,$340.80 ,$383.40 ,$107.10 ,$362.10 ,$42.84 ,$42.84 ,$362.10 ,$42.84 ,$177.22 , N/A , N/A ,$44.98 ,$362.10 ,$119.28 ,$383.40 ,$334.41 ,$351.88 ,$42.84 ,$276.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600480,87899,HC INFECT AGENT DETECT OPTICAL-90,306,1 ,$86.00 ,$55.90 ,$16.07 ,$86.00 ,$40.18 ,$68.80 ,$16.07 ,$24.08 ,$68.15 ,$78.95 ,$16.07 ,$78.95 ,$16.07 ,$30.53 ,$63.64 ,$40.18 ,$16.07 ,$71.72 ,$16.07 , N/A ,$71.04 ,$71.04 ,$68.80 ,$77.40 ,$40.18 ,$73.10 ,$16.07 ,$16.07 ,$73.10 ,$16.07 ,$35.78 , N/A , N/A ,$16.87 ,$73.10 ,$24.08 ,$77.40 ,$67.51 ,$71.04 ,$16.07 ,$55.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600483,87902,HC GENTOYPE HEP C-90,306,1 ,$857.00 ,$557.05 ,$239.96 ,$857.00 ,$643.63 ,$685.60 ,$257.45 ,$239.96 ,$679.09 ,$786.73 ,$257.45 ,$786.73 ,$257.45 ,$489.16 ,$634.18 ,$643.63 ,$257.45 ,$714.74 ,$257.45 , N/A ,$707.88 ,$707.88 ,$685.60 ,$771.30 ,$643.63 ,$728.45 ,$257.45 ,$257.45 ,$728.45 ,$257.45 ,$356.51 , N/A , N/A ,$270.32 ,$728.45 ,$239.96 ,$771.30 ,$672.75 ,$707.88 ,$257.45 ,$557.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600492,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS-90,306,1 ,$832.00 ,$540.80 ,$232.96 ,"$1,041.95 ","$1,041.95 ",$665.60 ,$416.78 ,$232.96 ,$659.28 ,$763.78 ,$416.78 ,$763.78 ,$416.78 ,$791.88 ,$615.68 ,$832.00 ,$416.78 ,$693.89 ,$416.78 , N/A ,$687.23 ,$687.23 ,$665.60 ,$748.80 ,$832.00 ,$707.20 ,$416.78 ,$416.78 ,$707.20 ,$416.78 ,$346.11 , N/A , N/A ,$437.62 ,$707.20 ,$232.96 ,$748.80 ,$653.12 ,$687.23 ,$416.78 ,$540.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600503,87389,HC HIV-1 AG W/HIV-1  AND  HIV-2 AB-90,306,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 ,$60.20 ,$60.00 ,$24.08 ,$21.00 ,$59.43 ,$68.85 ,$24.08 ,$68.85 ,$24.08 ,$45.75 ,$55.50 ,$60.20 ,$24.08 ,$62.55 ,$24.08 , N/A ,$61.95 ,$61.95 ,$60.00 ,$67.50 ,$60.20 ,$63.75 ,$24.08 ,$24.08 ,$63.75 ,$24.08 ,$31.20 , N/A , N/A ,$25.28 ,$63.75 ,$21.00 ,$67.50 ,$58.88 ,$61.95 ,$24.08 ,$48.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600505,87329,HC EIA QL GIARDIA AG-90,306,1 ,$182.00 ,$118.30 ,$11.98 ,$182.00 ,$29.95 ,$145.60 ,$11.98 ,$50.96 ,$144.22 ,$167.08 ,$11.98 ,$167.08 ,$11.98 ,$22.76 ,$134.68 ,$29.95 ,$11.98 ,$151.79 ,$11.98 , N/A ,$150.33 ,$150.33 ,$145.60 ,$163.80 ,$29.95 ,$154.70 ,$11.98 ,$11.98 ,$154.70 ,$11.98 ,$75.71 , N/A , N/A ,$12.58 ,$154.70 ,$50.96 ,$163.80 ,$142.87 ,$150.33 ,$11.98 ,$118.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600509,87661,HC TRICHOMONAS VAG AMP PROBE,306,1 ,$58.00 ,$37.70 ,$16.24 ,$87.73 ,$87.73 ,$46.40 ,$35.09 ,$16.24 ,$45.96 ,$53.24 ,$35.09 ,$53.24 ,$35.09 ,$58.00 ,$42.92 ,$58.00 ,$35.09 ,$48.37 ,$35.09 , N/A ,$47.91 ,$47.91 ,$46.40 ,$52.20 ,$58.00 ,$49.30 ,$35.09 ,$35.09 ,$49.30 ,$35.09 ,$24.13 , N/A , N/A ,$36.84 ,$49.30 ,$16.24 ,$52.20 ,$45.53 ,$47.91 ,$35.09 ,$37.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600516,87040,HC BACTERIA BLOOD CULTURE T1,306,1 ,$317.00 ,$206.05 ,$10.32 ,$317.00 ,$25.80 ,$253.60 ,$10.32 ,$88.76 ,$251.19 ,$291.01 ,$10.32 ,$291.01 ,$10.32 ,$19.61 ,$234.58 ,$25.80 ,$10.32 ,$264.38 ,$10.32 , N/A ,$261.84 ,$261.84 ,$253.60 ,$285.30 ,$25.80 ,$269.45 ,$10.32 ,$10.32 ,$269.45 ,$10.32 ,$131.87 , N/A , N/A ,$10.84 ,$269.45 ,$88.76 ,$285.30 ,$248.85 ,$261.84 ,$10.32 ,$206.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600517,87045,HC STOOL CULTURE,306,1 ,$185.00 ,$120.25 ,$9.44 ,$185.00 ,$23.60 ,$148.00 ,$9.44 ,$51.80 ,$146.59 ,$169.83 ,$9.44 ,$169.83 ,$9.44 ,$17.94 ,$136.90 ,$23.60 ,$9.44 ,$154.29 ,$9.44 , N/A ,$152.81 ,$152.81 ,$148.00 ,$166.50 ,$23.60 ,$157.25 ,$9.44 ,$9.44 ,$157.25 ,$9.44 ,$76.96 , N/A , N/A ,$9.91 ,$157.25 ,$51.80 ,$166.50 ,$145.23 ,$152.81 ,$9.44 ,$120.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600518,87046,HC STOOL CULTURE OTH SRC,306,1 ,$12.00 ,$7.80 ,$3.36 ,$23.60 ,$23.60 ,$9.60 ,$9.44 ,$3.36 ,$9.51 ,$11.02 ,$9.44 ,$11.02 ,$9.44 ,$12.00 ,$8.88 ,$12.00 ,$9.44 ,$10.01 ,$9.44 , N/A ,$9.91 ,$9.91 ,$9.60 ,$10.80 ,$12.00 ,$10.20 ,$9.44 ,$9.44 ,$10.20 ,$9.44 ,$4.99 , N/A , N/A ,$9.91 ,$10.20 ,$3.36 ,$10.80 ,$9.42 ,$9.91 ,$9.44 ,$7.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600519,87070,HC BODY FLUID CULTURE,306,1 ,$201.00 ,$130.65 ,$8.62 ,$201.00 ,$21.55 ,$160.80 ,$8.62 ,$56.28 ,$159.27 ,$184.52 ,$8.62 ,$184.52 ,$8.62 ,$16.38 ,$148.74 ,$21.55 ,$8.62 ,$167.63 ,$8.62 , N/A ,$166.03 ,$166.03 ,$160.80 ,$180.90 ,$21.55 ,$170.85 ,$8.62 ,$8.62 ,$170.85 ,$8.62 ,$83.62 , N/A , N/A ,$9.05 ,$170.85 ,$56.28 ,$180.90 ,$157.79 ,$166.03 ,$8.62 ,$130.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600522,87075,HC CULTURE ANAEROBIC,306,1 ,$265.00 ,$172.25 ,$9.47 ,$265.00 ,$23.68 ,$212.00 ,$9.47 ,$74.20 ,$209.99 ,$243.27 ,$9.47 ,$243.27 ,$9.47 ,$17.99 ,$196.10 ,$23.68 ,$9.47 ,$221.01 ,$9.47 , N/A ,$218.89 ,$218.89 ,$212.00 ,$238.50 ,$23.68 ,$225.25 ,$9.47 ,$9.47 ,$225.25 ,$9.47 ,$110.24 , N/A , N/A ,$9.94 ,$225.25 ,$74.20 ,$238.50 ,$208.03 ,$218.89 ,$9.47 ,$172.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600523,87076,HC CULTURE ANAEROBIC ID,306,1 ,$103.00 ,$66.95 ,$8.08 ,$103.00 ,$20.20 ,$82.40 ,$8.08 ,$28.84 ,$81.62 ,$94.55 ,$8.08 ,$94.55 ,$8.08 ,$15.35 ,$76.22 ,$20.20 ,$8.08 ,$85.90 ,$8.08 , N/A ,$85.08 ,$85.08 ,$82.40 ,$92.70 ,$20.20 ,$87.55 ,$8.08 ,$8.08 ,$87.55 ,$8.08 ,$42.85 , N/A , N/A ,$8.48 ,$87.55 ,$28.84 ,$92.70 ,$80.86 ,$85.08 ,$8.08 ,$66.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600524,87077,HC CULTURE AEROBIC ID ADDL,306,1 ,$36.00 ,$23.40 ,$8.08 ,$36.00 ,$20.20 ,$28.80 ,$8.08 ,$10.08 ,$28.53 ,$33.05 ,$8.08 ,$33.05 ,$8.08 ,$15.35 ,$26.64 ,$20.20 ,$8.08 ,$30.02 ,$8.08 , N/A ,$29.74 ,$29.74 ,$28.80 ,$32.40 ,$20.20 ,$30.60 ,$8.08 ,$8.08 ,$30.60 ,$8.08 ,$14.98 , N/A , N/A ,$8.48 ,$30.60 ,$10.08 ,$32.40 ,$28.26 ,$29.74 ,$8.08 ,$23.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600526,87081,HC CULTURE SCR PRESUMP PATHOGENS,306,1 ,$152.00 ,$98.80 ,$6.63 ,$152.00 ,$16.58 ,$121.60 ,$6.63 ,$42.56 ,$120.44 ,$139.54 ,$6.63 ,$139.54 ,$6.63 ,$12.60 ,$112.48 ,$16.58 ,$6.63 ,$126.77 ,$6.63 , N/A ,$125.55 ,$125.55 ,$121.60 ,$136.80 ,$16.58 ,$129.20 ,$6.63 ,$6.63 ,$129.20 ,$6.63 ,$63.23 , N/A , N/A ,$6.96 ,$129.20 ,$42.56 ,$136.80 ,$119.32 ,$125.55 ,$6.63 ,$98.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600527,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$170.00 ,$110.50 ,$8.07 ,$170.00 ,$20.18 ,$136.00 ,$8.07 ,$47.60 ,$134.71 ,$156.06 ,$8.07 ,$156.06 ,$8.07 ,$15.33 ,$125.80 ,$20.18 ,$8.07 ,$141.78 ,$8.07 , N/A ,$140.42 ,$140.42 ,$136.00 ,$153.00 ,$20.18 ,$144.50 ,$8.07 ,$8.07 ,$144.50 ,$8.07 ,$70.72 , N/A , N/A ,$8.47 ,$144.50 ,$47.60 ,$153.00 ,$133.45 ,$140.42 ,$8.07 ,$110.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600528,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$53.00 ,$34.45 ,$8.09 ,$53.00 ,$20.23 ,$42.40 ,$8.09 ,$14.84 ,$42.00 ,$48.65 ,$8.09 ,$48.65 ,$8.09 ,$15.37 ,$39.22 ,$20.23 ,$8.09 ,$44.20 ,$8.09 , N/A ,$43.78 ,$43.78 ,$42.40 ,$47.70 ,$20.23 ,$45.05 ,$8.09 ,$8.09 ,$45.05 ,$8.09 ,$22.05 , N/A , N/A ,$8.49 ,$45.05 ,$14.84 ,$47.70 ,$41.61 ,$43.78 ,$8.09 ,$34.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600529,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL -90,306,1 ,$227.00 ,$147.55 ,$7.71 ,$227.00 ,$19.28 ,$181.60 ,$7.71 ,$63.56 ,$179.87 ,$208.39 ,$7.71 ,$208.39 ,$7.71 ,$14.65 ,$167.98 ,$19.28 ,$7.71 ,$189.32 ,$7.71 , N/A ,$187.50 ,$187.50 ,$181.60 ,$204.30 ,$19.28 ,$192.95 ,$7.71 ,$7.71 ,$192.95 ,$7.71 ,$94.43 , N/A , N/A ,$8.10 ,$192.95 ,$63.56 ,$204.30 ,$178.20 ,$187.50 ,$7.71 ,$147.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600533,87106,HC CULTURE FUNGUS ID YEAST,306,1 ,$77.00 ,$50.05 ,$10.32 ,$77.00 ,$25.80 ,$61.60 ,$10.32 ,$21.56 ,$61.01 ,$70.69 ,$10.32 ,$70.69 ,$10.32 ,$19.61 ,$56.98 ,$25.80 ,$10.32 ,$64.22 ,$10.32 , N/A ,$63.60 ,$63.60 ,$61.60 ,$69.30 ,$25.80 ,$65.45 ,$10.32 ,$10.32 ,$65.45 ,$10.32 ,$32.03 , N/A , N/A ,$10.84 ,$65.45 ,$21.56 ,$69.30 ,$60.45 ,$63.60 ,$10.32 ,$50.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600534,87107,HC CULTURE FUNGUS ID MOLD,306,1 ,$144.00 ,$93.60 ,$10.32 ,$144.00 ,$25.80 ,$115.20 ,$10.32 ,$40.32 ,$114.11 ,$132.19 ,$10.32 ,$132.19 ,$10.32 ,$19.61 ,$106.56 ,$25.80 ,$10.32 ,$120.10 ,$10.32 , N/A ,$118.94 ,$118.94 ,$115.20 ,$129.60 ,$25.80 ,$122.40 ,$10.32 ,$10.32 ,$122.40 ,$10.32 ,$59.90 , N/A , N/A ,$10.84 ,$122.40 ,$40.32 ,$129.60 ,$113.04 ,$118.94 ,$10.32 ,$93.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600536,87147,HC CULTURE TYPE SEROLOGIC,306,1 ,$54.00 ,$35.10 ,$5.18 ,$54.00 ,$12.95 ,$43.20 ,$5.18 ,$15.12 ,$42.79 ,$49.57 ,$5.18 ,$49.57 ,$5.18 ,$9.84 ,$39.96 ,$12.95 ,$5.18 ,$45.04 ,$5.18 , N/A ,$44.60 ,$44.60 ,$43.20 ,$48.60 ,$12.95 ,$45.90 ,$5.18 ,$5.18 ,$45.90 ,$5.18 ,$22.46 , N/A , N/A ,$5.44 ,$45.90 ,$15.12 ,$48.60 ,$42.39 ,$44.60 ,$5.18 ,$35.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600537,87149,HC CULTURE TYPING ID NUCLEIC ACID,306,1 ,$203.00 ,$131.95 ,$20.05 ,$203.00 ,$50.13 ,$162.40 ,$20.05 ,$56.84 ,$160.86 ,$186.35 ,$20.05 ,$186.35 ,$20.05 ,$38.10 ,$150.22 ,$50.13 ,$20.05 ,$169.30 ,$20.05 , N/A ,$167.68 ,$167.68 ,$162.40 ,$182.70 ,$50.13 ,$172.55 ,$20.05 ,$20.05 ,$172.55 ,$20.05 ,$84.45 , N/A , N/A ,$21.05 ,$172.55 ,$56.84 ,$182.70 ,$159.36 ,$167.68 ,$20.05 ,$131.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600539,87153,HC ID NUCLEAR ACID SEQ METH ID,306,1 ,$503.00 ,$326.95 ,$115.36 ,$503.00 ,$288.40 ,$402.40 ,$115.36 ,$140.84 ,$398.58 ,$461.75 ,$115.36 ,$461.75 ,$115.36 ,$219.18 ,$372.22 ,$288.40 ,$115.36 ,$419.50 ,$115.36 , N/A ,$415.48 ,$415.48 ,$402.40 ,$452.70 ,$288.40 ,$427.55 ,$115.36 ,$115.36 ,$427.55 ,$115.36 ,$209.25 , N/A , N/A ,$121.13 ,$427.55 ,$140.84 ,$452.70 ,$394.86 ,$415.48 ,$115.36 ,$326.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600544,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$88.00 ,$57.20 ,$4.75 ,$88.00 ,$11.88 ,$70.40 ,$4.75 ,$24.64 ,$69.73 ,$80.78 ,$4.75 ,$80.78 ,$4.75 ,$9.03 ,$65.12 ,$11.88 ,$4.75 ,$73.39 ,$4.75 , N/A ,$72.69 ,$72.69 ,$70.40 ,$79.20 ,$11.88 ,$74.80 ,$4.75 ,$4.75 ,$74.80 ,$4.75 ,$36.61 , N/A , N/A ,$4.99 ,$74.80 ,$24.64 ,$79.20 ,$69.08 ,$72.69 ,$4.75 ,$57.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600545,87184,HC SENSITIVITY DISK KB,306,1 ,$88.00 ,$57.20 ,$7.48 ,$88.00 ,$18.70 ,$70.40 ,$7.48 ,$24.64 ,$69.73 ,$80.78 ,$7.48 ,$80.78 ,$7.48 ,$14.21 ,$65.12 ,$18.70 ,$7.48 ,$73.39 ,$7.48 , N/A ,$72.69 ,$72.69 ,$70.40 ,$79.20 ,$18.70 ,$74.80 ,$7.48 ,$7.48 ,$74.80 ,$7.48 ,$36.61 , N/A , N/A ,$7.85 ,$74.80 ,$24.64 ,$79.20 ,$69.08 ,$72.69 ,$7.48 ,$57.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600546,87185,HC BETA LACTAMASE,306,1 ,$37.00 ,$24.05 ,$4.75 ,$37.00 ,$11.88 ,$29.60 ,$4.75 ,$10.36 ,$29.32 ,$33.97 ,$4.75 ,$33.97 ,$4.75 ,$9.03 ,$27.38 ,$11.88 ,$4.75 ,$30.86 ,$4.75 , N/A ,$30.56 ,$30.56 ,$29.60 ,$33.30 ,$11.88 ,$31.45 ,$4.75 ,$4.75 ,$31.45 ,$4.75 ,$15.39 , N/A , N/A ,$4.99 ,$31.45 ,$10.36 ,$33.30 ,$29.05 ,$30.56 ,$4.75 ,$24.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600547,87186,HC SENSITIVITY MIC,306,1 ,$171.00 ,$111.15 ,$8.65 ,$171.00 ,$21.63 ,$136.80 ,$8.65 ,$47.88 ,$135.50 ,$156.98 ,$8.65 ,$156.98 ,$8.65 ,$16.44 ,$126.54 ,$21.63 ,$8.65 ,$142.61 ,$8.65 , N/A ,$141.25 ,$141.25 ,$136.80 ,$153.90 ,$21.63 ,$145.35 ,$8.65 ,$8.65 ,$145.35 ,$8.65 ,$71.14 , N/A , N/A ,$9.08 ,$145.35 ,$47.88 ,$153.90 ,$134.24 ,$141.25 ,$8.65 ,$111.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600549,87188,HC MACROTUBE DIL METH EA AGNT,306,1 ,$181.00 ,$117.65 ,$6.64 ,$181.00 ,$16.60 ,$144.80 ,$6.64 ,$50.68 ,$143.42 ,$166.16 ,$6.64 ,$166.16 ,$6.64 ,$12.62 ,$133.94 ,$16.60 ,$6.64 ,$150.95 ,$6.64 , N/A ,$149.51 ,$149.51 ,$144.80 ,$162.90 ,$16.60 ,$153.85 ,$6.64 ,$6.64 ,$153.85 ,$6.64 ,$75.30 , N/A , N/A ,$6.97 ,$153.85 ,$50.68 ,$162.90 ,$142.09 ,$149.51 ,$6.64 ,$117.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600550,87190,HC SENSITIVITY AFB,306,1 ,$134.00 ,$87.10 ,$7.31 ,$134.00 ,$18.28 ,$107.20 ,$7.31 ,$37.52 ,$106.18 ,$123.01 ,$7.31 ,$123.01 ,$7.31 ,$13.89 ,$99.16 ,$18.28 ,$7.31 ,$111.76 ,$7.31 , N/A ,$110.68 ,$110.68 ,$107.20 ,$120.60 ,$18.28 ,$113.90 ,$7.31 ,$7.31 ,$113.90 ,$7.31 ,$55.74 , N/A , N/A ,$7.68 ,$113.90 ,$37.52 ,$120.60 ,$105.19 ,$110.68 ,$7.31 ,$87.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600551,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$123.00 ,$79.95 ,$4.27 ,$123.00 ,$10.68 ,$98.40 ,$4.27 ,$34.44 ,$97.47 ,$112.91 ,$4.27 ,$112.91 ,$4.27 ,$8.11 ,$91.02 ,$10.68 ,$4.27 ,$102.58 ,$4.27 , N/A ,$101.60 ,$101.60 ,$98.40 ,$110.70 ,$10.68 ,$104.55 ,$4.27 ,$4.27 ,$104.55 ,$4.27 ,$51.17 , N/A , N/A ,$4.48 ,$104.55 ,$34.44 ,$110.70 ,$96.56 ,$101.60 ,$4.27 ,$79.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600552,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$89.00 ,$57.85 ,$5.39 ,$89.00 ,$13.48 ,$71.20 ,$5.39 ,$24.92 ,$70.52 ,$81.70 ,$5.39 ,$81.70 ,$5.39 ,$10.24 ,$65.86 ,$13.48 ,$5.39 ,$74.23 ,$5.39 , N/A ,$73.51 ,$73.51 ,$71.20 ,$80.10 ,$13.48 ,$75.65 ,$5.39 ,$5.39 ,$75.65 ,$5.39 ,$37.02 , N/A , N/A ,$5.66 ,$75.65 ,$24.92 ,$80.10 ,$69.87 ,$73.51 ,$5.39 ,$57.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600555,87255,HC VIRUS ID NON-IMMUNOLOGIC OTHER THAN CYTOPATHIC-90,306,1 ,$253.00 ,$164.45 ,$33.86 ,$253.00 ,$84.65 ,$202.40 ,$33.86 ,$70.84 ,$200.48 ,$232.25 ,$33.86 ,$232.25 ,$33.86 ,$64.33 ,$187.22 ,$84.65 ,$33.86 ,$211.00 ,$33.86 , N/A ,$208.98 ,$208.98 ,$202.40 ,$227.70 ,$84.65 ,$215.05 ,$33.86 ,$33.86 ,$215.05 ,$33.86 ,$105.25 , N/A , N/A ,$35.55 ,$215.05 ,$70.84 ,$227.70 ,$198.61 ,$208.98 ,$33.86 ,$164.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600558,87338,HC EIA QL H PYLORI AG STOOL,306,1 ,$364.00 ,$236.60 ,$14.38 ,$364.00 ,$35.95 ,$291.20 ,$14.38 ,$101.92 ,$288.43 ,$334.15 ,$14.38 ,$334.15 ,$14.38 ,$27.32 ,$269.36 ,$35.95 ,$14.38 ,$303.58 ,$14.38 , N/A ,$300.66 ,$300.66 ,$291.20 ,$327.60 ,$35.95 ,$309.40 ,$14.38 ,$14.38 ,$309.40 ,$14.38 ,$151.42 , N/A , N/A ,$15.10 ,$309.40 ,$101.92 ,$327.60 ,$285.74 ,$300.66 ,$14.38 ,$236.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600559,87340,HC EIA QL HEPATITIS B AG,306,1 ,$216.00 ,$140.40 ,$10.33 ,$216.00 ,$25.83 ,$172.80 ,$10.33 ,$60.48 ,$171.16 ,$198.29 ,$10.33 ,$198.29 ,$10.33 ,$19.63 ,$159.84 ,$25.83 ,$10.33 ,$180.14 ,$10.33 , N/A ,$178.42 ,$178.42 ,$172.80 ,$194.40 ,$25.83 ,$183.60 ,$10.33 ,$10.33 ,$183.60 ,$10.33 ,$89.86 , N/A , N/A ,$10.85 ,$183.60 ,$60.48 ,$194.40 ,$169.56 ,$178.42 ,$10.33 ,$140.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600561,87389,HC HIV-1 AG W/HIV-1  AND  HIV-2 AB,306,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 ,$60.20 ,$60.00 ,$24.08 ,$21.00 ,$59.43 ,$68.85 ,$24.08 ,$68.85 ,$24.08 ,$45.75 ,$55.50 ,$60.20 ,$24.08 ,$62.55 ,$24.08 , N/A ,$61.95 ,$61.95 ,$60.00 ,$67.50 ,$60.20 ,$63.75 ,$24.08 ,$24.08 ,$63.75 ,$24.08 ,$31.20 , N/A , N/A ,$25.28 ,$63.75 ,$21.00 ,$67.50 ,$58.88 ,$61.95 ,$24.08 ,$48.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600567,87483,HC INFECT AMP CNS DNA/RNA 14 TARGETS,306,1 ,"$1,700.00 ","$1,105.00 ",$416.78 ,"$1,700.00 ","$1,041.95 ","$1,360.00 ",$416.78 ,$476.00 ,"$1,347.08 ","$1,560.60 ",$416.78 ,"$1,560.60 ",$416.78 ,$791.88 ,"$1,258.00 ","$1,041.95 ",$416.78 ,"$1,417.80 ",$416.78 , N/A ,"$1,404.20 ","$1,404.20 ","$1,360.00 ","$1,530.00 ","$1,041.95 ","$1,445.00 ",$416.78 ,$416.78 ,"$1,445.00 ",$416.78 ,$707.20 , N/A , N/A ,$437.62 ,"$1,445.00 ",$476.00 ,"$1,530.00 ","$1,334.50 ","$1,404.20 ",$416.78 ,"$1,105.00 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600568,87486,HC CHLAMYDIA PNEUM AMP PROBE,306,1 ,$241.00 ,$156.65 ,$35.09 ,$241.00 ,$87.73 ,$192.80 ,$35.09 ,$67.48 ,$190.97 ,$221.24 ,$35.09 ,$221.24 ,$35.09 ,$66.67 ,$178.34 ,$87.73 ,$35.09 ,$200.99 ,$35.09 , N/A ,$199.07 ,$199.07 ,$192.80 ,$216.90 ,$87.73 ,$204.85 ,$35.09 ,$35.09 ,$204.85 ,$35.09 ,$100.26 , N/A , N/A ,$36.84 ,$204.85 ,$67.48 ,$216.90 ,$189.19 ,$199.07 ,$35.09 ,$156.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600570,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$257.00 ,$167.05 ,$35.09 ,$257.00 ,$87.73 ,$205.60 ,$35.09 ,$71.96 ,$203.65 ,$235.93 ,$35.09 ,$235.93 ,$35.09 ,$66.67 ,$190.18 ,$87.73 ,$35.09 ,$214.34 ,$35.09 , N/A ,$212.28 ,$212.28 ,$205.60 ,$231.30 ,$87.73 ,$218.45 ,$35.09 ,$35.09 ,$218.45 ,$35.09 ,$106.91 , N/A , N/A ,$36.84 ,$218.45 ,$71.96 ,$231.30 ,$201.75 ,$212.28 ,$35.09 ,$167.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600571,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS,306,1 ,$832.00 ,$540.80 ,$232.96 ,"$1,041.95 ","$1,041.95 ",$665.60 ,$416.78 ,$232.96 ,$659.28 ,$763.78 ,$416.78 ,$763.78 ,$416.78 ,$791.88 ,$615.68 ,$832.00 ,$416.78 ,$693.89 ,$416.78 , N/A ,$687.23 ,$687.23 ,$665.60 ,$748.80 ,$832.00 ,$707.20 ,$416.78 ,$416.78 ,$707.20 ,$416.78 ,$346.11 , N/A , N/A ,$437.62 ,$707.20 ,$232.96 ,$748.80 ,$653.12 ,$687.23 ,$416.78 ,$540.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600573,87581,HC IF AG PROBE MYCOPLASMA PNEUMONIAE,306,1 ,$275.00 ,$178.75 ,$35.09 ,$275.00 ,$87.73 ,$220.00 ,$35.09 ,$77.00 ,$217.91 ,$252.45 ,$35.09 ,$252.45 ,$35.09 ,$66.67 ,$203.50 ,$87.73 ,$35.09 ,$229.35 ,$35.09 , N/A ,$227.15 ,$227.15 ,$220.00 ,$247.50 ,$87.73 ,$233.75 ,$35.09 ,$35.09 ,$233.75 ,$35.09 ,$114.40 , N/A , N/A ,$36.84 ,$233.75 ,$77.00 ,$247.50 ,$215.88 ,$227.15 ,$35.09 ,$178.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600575,87591,HC NEISSERIA AMP,306,1 ,$114.00 ,$74.10 ,$31.92 ,$114.00 ,$87.73 ,$91.20 ,$35.09 ,$31.92 ,$90.33 ,$104.65 ,$35.09 ,$104.65 ,$35.09 ,$66.67 ,$84.36 ,$87.73 ,$35.09 ,$95.08 ,$35.09 , N/A ,$94.16 ,$94.16 ,$91.20 ,$102.60 ,$87.73 ,$96.90 ,$35.09 ,$35.09 ,$96.90 ,$35.09 ,$47.42 , N/A , N/A ,$36.84 ,$96.90 ,$31.92 ,$102.60 ,$89.49 ,$94.16 ,$35.09 ,$74.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600576,87624,HC HPV HIGH RISK ALL OTHERS,306,1 ,$147.00 ,$95.55 ,$35.09 ,$147.00 ,$87.73 ,$117.60 ,$35.09 ,$41.16 ,$116.48 ,$134.95 ,$35.09 ,$134.95 ,$35.09 ,$66.67 ,$108.78 ,$87.73 ,$35.09 ,$122.60 ,$35.09 , N/A ,$121.42 ,$121.42 ,$117.60 ,$132.30 ,$87.73 ,$124.95 ,$35.09 ,$35.09 ,$124.95 ,$35.09 ,$61.15 , N/A , N/A ,$36.84 ,$124.95 ,$41.16 ,$132.30 ,$115.40 ,$121.42 ,$35.09 ,$95.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600577,87633,HC IF AG RESP VIRUS MAP 12-25 TARGETS,306,1 ,$766.00 ,$497.90 ,$214.48 ,"$1,041.95 ","$1,041.95 ",$612.80 ,$416.78 ,$214.48 ,$606.98 ,$703.19 ,$416.78 ,$703.19 ,$416.78 ,$766.00 ,$566.84 ,$766.00 ,$416.78 ,$638.84 ,$416.78 , N/A ,$632.72 ,$632.72 ,$612.80 ,$689.40 ,$766.00 ,$651.10 ,$416.78 ,$416.78 ,$651.10 ,$416.78 ,$318.66 , N/A , N/A ,$437.62 ,$651.10 ,$214.48 ,$689.40 ,$601.31 ,$632.72 ,$416.78 ,$497.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600578,87641,HC MRSA AMP,306,1 ,$249.00 ,$161.85 ,$35.09 ,$249.00 ,$87.73 ,$199.20 ,$35.09 ,$69.72 ,$197.31 ,$228.58 ,$35.09 ,$228.58 ,$35.09 ,$66.67 ,$184.26 ,$87.73 ,$35.09 ,$207.67 ,$35.09 , N/A ,$205.67 ,$205.67 ,$199.20 ,$224.10 ,$87.73 ,$211.65 ,$35.09 ,$35.09 ,$211.65 ,$35.09 ,$103.58 , N/A , N/A ,$36.84 ,$211.65 ,$69.72 ,$224.10 ,$195.47 ,$205.67 ,$35.09 ,$161.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600579,87653,HC INFECT AMP (GRP B STREP),306,1 ,$40.00 ,$26.00 ,$11.20 ,$87.73 ,$87.73 ,$32.00 ,$35.09 ,$11.20 ,$31.70 ,$36.72 ,$35.09 ,$36.72 ,$35.09 ,$40.00 ,$29.60 ,$40.00 ,$35.09 ,$33.36 ,$35.09 , N/A ,$33.04 ,$33.04 ,$32.00 ,$36.00 ,$40.00 ,$34.00 ,$35.09 ,$35.09 ,$34.00 ,$35.09 ,$16.64 , N/A , N/A ,$36.84 ,$34.00 ,$11.20 ,$36.00 ,$31.40 ,$33.04 ,$35.09 ,$26.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600581,87798,HC INFECT AMP,306,1 ,$243.00 ,$157.95 ,$35.09 ,$243.00 ,$87.73 ,$194.40 ,$35.09 ,$68.04 ,$192.55 ,$223.07 ,$35.09 ,$223.07 ,$35.09 ,$66.67 ,$179.82 ,$87.73 ,$35.09 ,$202.66 ,$35.09 , N/A ,$200.72 ,$200.72 ,$194.40 ,$218.70 ,$87.73 ,$206.55 ,$35.09 ,$35.09 ,$206.55 ,$35.09 ,$101.09 , N/A , N/A ,$36.84 ,$206.55 ,$68.04 ,$218.70 ,$190.76 ,$200.72 ,$35.09 ,$157.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600582,87798,HC INFECT AMP DRUG RESIST TB,306,1 ,$317.00 ,$206.05 ,$35.09 ,$317.00 ,$87.73 ,$253.60 ,$35.09 ,$88.76 ,$251.19 ,$291.01 ,$35.09 ,$291.01 ,$35.09 ,$66.67 ,$234.58 ,$87.73 ,$35.09 ,$264.38 ,$35.09 , N/A ,$261.84 ,$261.84 ,$253.60 ,$285.30 ,$87.73 ,$269.45 ,$35.09 ,$35.09 ,$269.45 ,$35.09 ,$131.87 , N/A , N/A ,$36.84 ,$269.45 ,$88.76 ,$285.30 ,$248.85 ,$261.84 ,$35.09 ,$206.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600607,87661,HC TRICHOMONAS BAG AMP PROBE,306,1 ,$58.00 ,$37.70 ,$16.24 ,$87.73 ,$87.73 ,$46.40 ,$35.09 ,$16.24 ,$45.96 ,$53.24 ,$35.09 ,$53.24 ,$35.09 ,$58.00 ,$42.92 ,$58.00 ,$35.09 ,$48.37 ,$35.09 , N/A ,$47.91 ,$47.91 ,$46.40 ,$52.20 ,$58.00 ,$49.30 ,$35.09 ,$35.09 ,$49.30 ,$35.09 ,$24.13 , N/A , N/A ,$36.84 ,$49.30 ,$16.24 ,$52.20 ,$45.53 ,$47.91 ,$35.09 ,$37.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600613,87205,HC URINE FOR EOSINOPHILS-90,306,1 ,$123.00 ,$79.95 ,$4.27 ,$123.00 ,$10.68 ,$98.40 ,$4.27 ,$34.44 ,$97.47 ,$112.91 ,$4.27 ,$112.91 ,$4.27 ,$8.11 ,$91.02 ,$10.68 ,$4.27 ,$102.58 ,$4.27 , N/A ,$101.60 ,$101.60 ,$98.40 ,$110.70 ,$10.68 ,$104.55 ,$4.27 ,$4.27 ,$104.55 ,$4.27 ,$51.17 , N/A , N/A ,$4.48 ,$104.55 ,$34.44 ,$110.70 ,$96.56 ,$101.60 ,$4.27 ,$79.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600623,87635,HC COVID-19 LAB TEST CDC-90,306,1 ,$430.00 ,$279.50 ,$51.31 ,$430.00 ,$128.28 ,$344.00 ,$51.31 ,$120.40 ,$340.73 ,$394.74 ,$51.31 ,$394.74 ,$51.31 ,$97.49 ,$318.20 ,$128.28 ,$51.31 ,$358.62 ,$51.31 , N/A ,$355.18 ,$355.18 ,$344.00 ,$387.00 ,$128.28 ,$365.50 ,$51.31 ,$51.31 ,$365.50 ,$51.31 ,$178.88 , N/A , N/A ,$53.88 ,$365.50 ,$120.40 ,$387.00 ,$337.55 ,$355.18 ,$51.31 ,$279.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600630,87481,HC IADNA CANDIDA SPECIES AMPLIFIED PROBE TQ,306,1 ,$194.00 ,$126.10 ,$35.09 ,$194.00 ,$87.73 ,$155.20 ,$35.09 ,$54.32 ,$153.73 ,$178.09 ,$35.09 ,$178.09 ,$35.09 ,$66.67 ,$143.56 ,$87.73 ,$35.09 ,$161.80 ,$35.09 , N/A ,$160.24 ,$160.24 ,$155.20 ,$174.60 ,$87.73 ,$164.90 ,$35.09 ,$35.09 ,$164.90 ,$35.09 ,$80.70 , N/A , N/A ,$36.84 ,$164.90 ,$54.32 ,$174.60 ,$152.29 ,$160.24 ,$35.09 ,$126.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600636,87811,HC COVID ANTIGEN TEST,306,1 ,$125.00 ,$81.25 ,$35.00 ,$125.00 ,$103.45 ,$100.00 ,$41.38 ,$35.00 ,$99.05 ,$114.75 ,$41.38 ,$114.75 ,$41.38 ,$78.62 ,$92.50 ,$103.45 ,$41.38 ,$104.25 ,$41.38 , N/A ,$103.25 ,$103.25 ,$100.00 ,$112.50 ,$103.45 ,$106.25 ,$41.38 ,$41.38 ,$106.25 ,$41.38 ,$52.00 , N/A , N/A ,$43.45 ,$106.25 ,$35.00 ,$112.50 ,$98.13 ,$103.25 ,$41.38 ,$81.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600642,81513,HC APTIMA BV MAAA SPEC CD,306,1 ,$134.00 ,$87.10 ,$37.52 ,$335.00 ,$335.00 ,$107.20 ,$134.00 ,$37.52 ,$106.18 ,$123.01 ,$134.00 ,$123.01 ,$134.00 ,$134.00 ,$99.16 ,$134.00 ,$134.00 ,$111.76 ,$134.00 , N/A ,$110.68 ,$110.68 ,$107.20 ,$120.60 ,$134.00 ,$113.90 ,$134.00 ,$134.00 ,$113.90 ,$134.00 ,$55.74 , N/A , N/A ,$134.00 ,$113.90 ,$37.52 ,$120.60 ,$105.19 ,$110.68 ,$134.00 ,$87.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600644,86769,HC SARS - COV-2 COVID 19 ANTIBODY,306,1 ,$130.00 ,$84.50 ,$36.40 ,$130.00 ,$105.33 ,$104.00 ,$42.13 ,$36.40 ,$103.01 ,$119.34 ,$42.13 ,$119.34 ,$42.13 ,$80.05 ,$96.20 ,$105.33 ,$42.13 ,$108.42 ,$42.13 , N/A ,$107.38 ,$107.38 ,$104.00 ,$117.00 ,$105.33 ,$110.50 ,$42.13 ,$42.13 ,$110.50 ,$42.13 ,$54.08 , N/A , N/A ,$44.24 ,$110.50 ,$36.40 ,$117.00 ,$102.05 ,$107.38 ,$42.13 ,$84.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30600645,85999,HC URINE FOR EOSINOPHILS,306,1 ,$123.00 ,$79.95 ,$34.44 ,$123.00 , N/A ,$98.40 , N/A ,$34.44 ,$97.47 ,$112.91 , N/A ,$112.91 , N/A , N/A ,$91.02 , N/A , N/A ,$102.58 , N/A , N/A ,$101.60 ,$101.60 ,$98.40 ,$110.70 , N/A ,$104.55 , N/A , N/A ,$104.55 , N/A ,$51.17 , N/A , N/A , N/A ,$104.55 ,$34.44 ,$110.70 ,$96.56 ,$101.60 , N/A ,$79.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30682004,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$146.00 ,$94.90 ,$37.27 ,$146.00 ,$93.18 ,$116.80 ,$37.27 ,$40.88 ,$115.69 ,$134.03 ,$37.27 ,$134.03 ,$37.27 ,$70.81 ,$108.04 ,$93.18 ,$37.27 ,$121.76 ,$37.27 , N/A ,$120.60 ,$120.60 ,$116.80 ,$131.40 ,$93.18 ,$124.10 ,$37.27 ,$37.27 ,$124.10 ,$37.27 ,$60.74 , N/A , N/A ,$39.13 ,$124.10 ,$40.88 ,$131.40 ,$114.61 ,$120.60 ,$37.27 ,$94.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30682010,87635,HC COVID-19 LAB TEST NON-CDC-90,306,1 ,$430.00 ,$279.50 ,$51.31 ,$430.00 ,$128.28 ,$344.00 ,$51.31 ,$120.40 ,$340.73 ,$394.74 ,$51.31 ,$394.74 ,$51.31 ,$97.49 ,$318.20 ,$128.28 ,$51.31 ,$358.62 ,$51.31 , N/A ,$355.18 ,$355.18 ,$344.00 ,$387.00 ,$128.28 ,$365.50 ,$51.31 ,$51.31 ,$365.50 ,$51.31 ,$178.88 , N/A , N/A ,$53.88 ,$365.50 ,$120.40 ,$387.00 ,$337.55 ,$355.18 ,$51.31 ,$279.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30682012,87635,HC COVID-19 LAB TEST,306,1 ,$430.00 ,$279.50 ,$51.31 ,$430.00 ,$128.28 ,$344.00 ,$51.31 ,$120.40 ,$340.73 ,$394.74 ,$51.31 ,$394.74 ,$51.31 ,$97.49 ,$318.20 ,$128.28 ,$51.31 ,$358.62 ,$51.31 , N/A ,$355.18 ,$355.18 ,$344.00 ,$387.00 ,$128.28 ,$365.50 ,$51.31 ,$51.31 ,$365.50 ,$51.31 ,$178.88 , N/A , N/A ,$53.88 ,$365.50 ,$120.40 ,$387.00 ,$337.55 ,$355.18 ,$51.31 ,$279.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30682015,86769,HC SARS-COV-2 COVID-19 ANTIBODY-90,306,1 ,$130.00 ,$84.50 ,$36.40 ,$130.00 ,$105.33 ,$104.00 ,$42.13 ,$36.40 ,$103.01 ,$119.34 ,$42.13 ,$119.34 ,$42.13 ,$80.05 ,$96.20 ,$105.33 ,$42.13 ,$108.42 ,$42.13 , N/A ,$107.38 ,$107.38 ,$104.00 ,$117.00 ,$105.33 ,$110.50 ,$42.13 ,$42.13 ,$110.50 ,$42.13 ,$54.08 , N/A , N/A ,$44.24 ,$110.50 ,$36.40 ,$117.00 ,$102.05 ,$107.38 ,$42.13 ,$84.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30682022,87102,HC CULTURE FUNGUS OTHER-90,306,1 ,$270.00 ,$175.50 ,$8.41 ,$270.00 ,$21.03 ,$216.00 ,$8.41 ,$75.60 ,$213.95 ,$247.86 ,$8.41 ,$247.86 ,$8.41 ,$15.98 ,$199.80 ,$21.03 ,$8.41 ,$225.18 ,$8.41 , N/A ,$223.02 ,$223.02 ,$216.00 ,$243.00 ,$21.03 ,$229.50 ,$8.41 ,$8.41 ,$229.50 ,$8.41 ,$112.32 , N/A , N/A ,$8.83 ,$229.50 ,$75.60 ,$243.00 ,$211.95 ,$223.02 ,$8.41 ,$175.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30682025,87635,HC COVID-19 LAB TEST - 2 DAY COMPLETION,306,1 ,$82.00 ,$53.30 ,$22.96 ,$128.28 ,$128.28 ,$65.60 ,$51.31 ,$22.96 ,$64.98 ,$75.28 ,$51.31 ,$75.28 ,$51.31 ,$82.00 ,$60.68 ,$82.00 ,$51.31 ,$68.39 ,$51.31 , N/A ,$67.73 ,$67.73 ,$65.60 ,$73.80 ,$82.00 ,$69.70 ,$51.31 ,$51.31 ,$69.70 ,$51.31 ,$34.11 , N/A , N/A ,$53.88 ,$69.70 ,$22.96 ,$73.80 ,$64.37 ,$67.73 ,$51.31 ,$53.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30700101,81001,HC URINALYSIS AUTO W/MICRO,307,1 ,$74.00 ,$48.10 ,$3.17 ,$74.00 ,$7.93 ,$59.20 ,$3.17 ,$20.72 ,$58.64 ,$67.93 ,$3.17 ,$67.93 ,$3.17 ,$6.02 ,$54.76 ,$7.93 ,$3.17 ,$61.72 ,$3.17 , N/A ,$61.12 ,$61.12 ,$59.20 ,$66.60 ,$7.93 ,$62.90 ,$3.17 ,$3.17 ,$62.90 ,$3.17 ,$30.78 , N/A , N/A ,$3.33 ,$62.90 ,$20.72 ,$66.60 ,$58.09 ,$61.12 ,$3.17 ,$48.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30700104,81003,HC URINALYSIS AUTO W/O MICRO,307,1 ,$55.00 ,$35.75 ,$2.25 ,$55.00 ,$5.63 ,$44.00 ,$2.25 ,$15.40 ,$43.58 ,$50.49 ,$2.25 ,$50.49 ,$2.25 ,$4.28 ,$40.70 ,$5.63 ,$2.25 ,$45.87 ,$2.25 , N/A ,$45.43 ,$45.43 ,$44.00 ,$49.50 ,$5.63 ,$46.75 ,$2.25 ,$2.25 ,$46.75 ,$2.25 ,$22.88 , N/A , N/A ,$2.36 ,$46.75 ,$15.40 ,$49.50 ,$43.18 ,$45.43 ,$2.25 ,$35.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30700115,81015,HC URINALYSIS MICRO ONLY,307,1 ,$29.00 ,$18.85 ,$3.05 ,$29.00 ,$7.63 ,$23.20 ,$3.05 ,$8.12 ,$22.98 ,$26.62 ,$3.05 ,$26.62 ,$3.05 ,$5.80 ,$21.46 ,$7.63 ,$3.05 ,$24.19 ,$3.05 , N/A ,$23.95 ,$23.95 ,$23.20 ,$26.10 ,$7.63 ,$24.65 ,$3.05 ,$3.05 ,$24.65 ,$3.05 ,$12.06 , N/A , N/A ,$3.20 ,$24.65 ,$8.12 ,$26.10 ,$22.77 ,$23.95 ,$3.05 ,$18.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30700120,81002,HC URANALYSIS NON AUTO W/O MICRO,307,1 ,$41.00 ,$26.65 ,$3.48 ,$41.00 ,$8.70 ,$32.80 ,$3.48 ,$11.48 ,$32.49 ,$37.64 ,$3.48 ,$37.64 ,$3.48 ,$6.61 ,$30.34 ,$8.70 ,$3.48 ,$34.19 ,$3.48 , N/A ,$33.87 ,$33.87 ,$32.80 ,$36.90 ,$8.70 ,$34.85 ,$3.48 ,$3.48 ,$34.85 ,$3.48 ,$17.06 , N/A , N/A ,$3.65 ,$34.85 ,$11.48 ,$36.90 ,$32.19 ,$33.87 ,$3.48 ,$26.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30700121,81001,HC URINALYSIS AUTO W/MICRO,307,1 ,$74.00 ,$48.10 ,$3.17 ,$74.00 ,$7.93 ,$59.20 ,$3.17 ,$20.72 ,$58.64 ,$67.93 ,$3.17 ,$67.93 ,$3.17 ,$6.02 ,$54.76 ,$7.93 ,$3.17 ,$61.72 ,$3.17 , N/A ,$61.12 ,$61.12 ,$59.20 ,$66.60 ,$7.93 ,$62.90 ,$3.17 ,$3.17 ,$62.90 ,$3.17 ,$30.78 , N/A , N/A ,$3.33 ,$62.90 ,$20.72 ,$66.60 ,$58.09 ,$61.12 ,$3.17 ,$48.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30700122,81002,HC URINALYSIS NON AUTO W/O MICRO -90,307,1 ,$41.00 ,$26.65 ,$3.48 ,$41.00 ,$8.70 ,$32.80 ,$3.48 ,$11.48 ,$32.49 ,$37.64 ,$3.48 ,$37.64 ,$3.48 ,$6.61 ,$30.34 ,$8.70 ,$3.48 ,$34.19 ,$3.48 , N/A ,$33.87 ,$33.87 ,$32.80 ,$36.90 ,$8.70 ,$34.85 ,$3.48 ,$3.48 ,$34.85 ,$3.48 ,$17.06 , N/A , N/A ,$3.65 ,$34.85 ,$11.48 ,$36.90 ,$32.19 ,$33.87 ,$3.48 ,$26.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30700128,81025,HC URINE PREGNANCY TEST,307,1 ,$143.00 ,$92.95 ,$8.61 ,$143.00 ,$21.53 ,$114.40 ,$8.61 ,$40.04 ,$113.31 ,$131.27 ,$8.61 ,$131.27 ,$8.61 ,$16.36 ,$105.82 ,$21.53 ,$8.61 ,$119.26 ,$8.61 , N/A ,$118.12 ,$118.12 ,$114.40 ,$128.70 ,$21.53 ,$121.55 ,$8.61 ,$8.61 ,$121.55 ,$8.61 ,$59.49 , N/A , N/A ,$9.04 ,$121.55 ,$40.04 ,$128.70 ,$112.26 ,$118.12 ,$8.61 ,$92.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),30700131,81050,HC VOLUME MEASUREMENT URINE,307,1 ,$16.00 ,$10.40 ,$3.64 ,$16.00 ,$9.10 ,$12.80 ,$3.64 ,$4.48 ,$12.68 ,$14.69 ,$3.64 ,$14.69 ,$3.64 ,$6.92 ,$11.84 ,$9.10 ,$3.64 ,$13.34 ,$3.64 , N/A ,$13.22 ,$13.22 ,$12.80 ,$14.40 ,$9.10 ,$13.60 ,$3.64 ,$3.64 ,$13.60 ,$3.64 ,$6.66 , N/A , N/A ,$3.82 ,$13.60 ,$4.48 ,$14.40 ,$12.56 ,$13.22 ,$3.64 ,$10.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000129,81206,HC BCR/ABL1 GENE MAJOR BP QL/QN DIAG -90,310,1 ,$346.00 ,$224.90 ,$96.88 ,$409.90 ,$409.90 ,$276.80 ,$163.96 ,$96.88 ,$274.17 ,$317.63 ,$163.96 ,$317.63 ,$163.96 ,$311.52 ,$256.04 ,$346.00 ,$163.96 ,$288.56 ,$163.96 , N/A ,$285.80 ,$285.80 ,$276.80 ,$311.40 ,$346.00 ,$294.10 ,$163.96 ,$163.96 ,$294.10 ,$163.96 ,$143.94 , N/A , N/A ,$172.16 ,$294.10 ,$96.88 ,$311.40 ,$271.61 ,$285.80 ,$163.96 ,$224.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000131,81207,HC BCR/ABL1 GENE MINOR BP DIAG -90,310,1 ,$288.00 ,$187.20 ,$80.64 ,$362.10 ,$362.10 ,$230.40 ,$144.84 ,$80.64 ,$228.21 ,$264.38 ,$144.84 ,$264.38 ,$144.84 ,$275.20 ,$213.12 ,$288.00 ,$144.84 ,$240.19 ,$144.84 , N/A ,$237.89 ,$237.89 ,$230.40 ,$259.20 ,$288.00 ,$244.80 ,$144.84 ,$144.84 ,$244.80 ,$144.84 ,$119.81 , N/A , N/A ,$152.08 ,$244.80 ,$80.64 ,$259.20 ,$226.08 ,$237.89 ,$144.84 ,$187.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000137,81220,HC CYSTIC FIBROSIS GENE COMMON VARIANTS -90,310,1 ,"$1,143.00 ",$742.95 ,$320.04 ,"$1,391.50 ","$1,391.50 ",$914.40 ,$556.60 ,$320.04 ,$905.71 ,"$1,049.27 ",$556.60 ,"$1,049.27 ",$556.60 ,"$1,057.54 ",$845.82 ,"$1,143.00 ",$556.60 ,$953.26 ,$556.60 , N/A ,$944.12 ,$944.12 ,$914.40 ,"$1,028.70 ","$1,143.00 ",$971.55 ,$556.60 ,$556.60 ,$971.55 ,$556.60 ,$475.49 , N/A , N/A ,$584.43 ,$971.55 ,$320.04 ,"$1,028.70 ",$897.26 ,$944.12 ,$556.60 ,$742.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000143,81240,HC F2 GENE ANAL 20210G A VAR -90,310,1 ,$123.00 ,$79.95 ,$34.44 ,$164.23 ,$164.23 ,$98.40 ,$65.69 ,$34.44 ,$97.47 ,$112.91 ,$65.69 ,$112.91 ,$65.69 ,$123.00 ,$91.02 ,$123.00 ,$65.69 ,$102.58 ,$65.69 , N/A ,$101.60 ,$101.60 ,$98.40 ,$110.70 ,$123.00 ,$104.55 ,$65.69 ,$65.69 ,$104.55 ,$65.69 ,$51.17 , N/A , N/A ,$68.97 ,$104.55 ,$34.44 ,$110.70 ,$96.56 ,$101.60 ,$65.69 ,$79.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000145,81241,HC F5 GENE ANAL LEIDEN VAR -90,310,1 ,$461.00 ,$299.65 ,$73.37 ,$461.00 ,$183.43 ,$368.80 ,$73.37 ,$129.08 ,$365.30 ,$423.20 ,$73.37 ,$423.20 ,$73.37 ,$139.40 ,$341.14 ,$183.43 ,$73.37 ,$384.47 ,$73.37 , N/A ,$380.79 ,$380.79 ,$368.80 ,$414.90 ,$183.43 ,$391.85 ,$73.37 ,$73.37 ,$391.85 ,$73.37 ,$191.78 , N/A , N/A ,$77.04 ,$391.85 ,$129.08 ,$414.90 ,$361.89 ,$380.79 ,$73.37 ,$299.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000149,81256,HC HFE GENE ANALYSIS -90,310,1 ,$712.00 ,$462.80 ,$65.36 ,$712.00 ,$163.40 ,$569.60 ,$65.36 ,$199.36 ,$564.19 ,$653.62 ,$65.36 ,$653.62 ,$65.36 ,$124.18 ,$526.88 ,$163.40 ,$65.36 ,$593.81 ,$65.36 , N/A ,$588.11 ,$588.11 ,$569.60 ,$640.80 ,$163.40 ,$605.20 ,$65.36 ,$65.36 ,$605.20 ,$65.36 ,$296.19 , N/A , N/A ,$68.63 ,$605.20 ,$199.36 ,$640.80 ,$558.92 ,$588.11 ,$65.36 ,$462.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000154,81270,HC JAK2 GENE ANALYSIS-90,310,1 ,"$1,253.00 ",$814.45 ,$91.66 ,"$1,253.00 ",$229.15 ,"$1,002.40 ",$91.66 ,$350.84 ,$992.88 ,"$1,150.25 ",$91.66 ,"$1,150.25 ",$91.66 ,$174.15 ,$927.22 ,$229.15 ,$91.66 ,"$1,045.00 ",$91.66 , N/A ,"$1,034.98 ","$1,034.98 ","$1,002.40 ","$1,127.70 ",$229.15 ,"$1,065.05 ",$91.66 ,$91.66 ,"$1,065.05 ",$91.66 ,$521.25 , N/A , N/A ,$96.24 ,"$1,065.05 ",$350.84 ,"$1,127.70 ",$983.61 ,"$1,034.98 ",$91.66 ,$814.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000157,81291,HC MTHFR GENE ANALYSIS-90,310,1 ,$450.00 ,$292.50 ,$65.34 ,$450.00 ,$163.35 ,$360.00 ,$65.34 ,$126.00 ,$356.58 ,$413.10 ,$65.34 ,$413.10 ,$65.34 ,$124.15 ,$333.00 ,$163.35 ,$65.34 ,$375.30 ,$65.34 , N/A ,$371.70 ,$371.70 ,$360.00 ,$405.00 ,$163.35 ,$382.50 ,$65.34 ,$65.34 ,$382.50 ,$65.34 ,$187.20 , N/A , N/A ,$68.61 ,$382.50 ,$126.00 ,$405.00 ,$353.25 ,$371.70 ,$65.34 ,$292.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000181,81400,HC MOLECULAR PATH PROC LEVEL 1-90,310,1 ,$489.00 ,$317.85 ,$63.96 ,$489.00 ,$159.90 ,$391.20 ,$63.96 ,$136.92 ,$387.48 ,$448.90 ,$63.96 ,$448.90 ,$63.96 ,$121.52 ,$361.86 ,$159.90 ,$63.96 ,$407.83 ,$63.96 , N/A ,$403.91 ,$403.91 ,$391.20 ,$440.10 ,$159.90 ,$415.65 ,$63.96 ,$63.96 ,$415.65 ,$63.96 ,$203.42 , N/A , N/A ,$67.16 ,$415.65 ,$136.92 ,$440.10 ,$383.87 ,$403.91 ,$63.96 ,$317.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000183,81401,HC MOLECULAR PATH PROC LEVEL 2-90,310,1 ,$447.00 ,$290.55 ,$125.16 ,$447.00 , N/A ,$357.60 , N/A ,$125.16 ,$354.20 ,$410.35 , N/A ,$410.35 , N/A , N/A ,$330.78 , N/A , N/A ,$372.80 , N/A , N/A ,$369.22 ,$369.22 ,$357.60 ,$402.30 , N/A ,$379.95 , N/A , N/A ,$379.95 , N/A ,$185.95 , N/A , N/A , N/A ,$379.95 ,$125.16 ,$402.30 ,$350.90 ,$369.22 , N/A ,$290.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000184,81403,HC MOLECULAR PATH PROC LEVEL 4-90,310,1 ,$383.00 ,$248.95 ,$107.24 ,$383.00 , N/A ,$306.40 , N/A ,$107.24 ,$303.49 ,$351.59 , N/A ,$351.59 , N/A , N/A ,$283.42 , N/A , N/A ,$319.42 , N/A , N/A ,$316.36 ,$316.36 ,$306.40 ,$344.70 , N/A ,$325.55 , N/A , N/A ,$325.55 , N/A ,$159.33 , N/A , N/A , N/A ,$325.55 ,$107.24 ,$344.70 ,$300.66 ,$316.36 , N/A ,$248.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000193,81508,HC FETAL CONGENTIAL ABNORM 2 PROTEINS-90,310,1 ,$285.00 ,$185.25 ,$54.30 ,$285.00 ,$135.75 ,$228.00 ,$54.30 ,$79.80 ,$225.83 ,$261.63 ,$54.30 ,$261.63 ,$54.30 ,$103.17 ,$210.90 ,$135.75 ,$54.30 ,$237.69 ,$54.30 , N/A ,$235.41 ,$235.41 ,$228.00 ,$256.50 ,$135.75 ,$242.25 ,$54.30 ,$54.30 ,$242.25 ,$54.30 ,$118.56 , N/A , N/A ,$57.02 ,$242.25 ,$79.80 ,$256.50 ,$223.73 ,$235.41 ,$54.30 ,$185.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000194,81511,HC FETAL CONGENTIAL ABNORM 4 ANALYTES-90,310,1 ,$451.00 ,$293.15 ,$126.28 ,$451.00 ,$383.75 ,$360.80 ,$153.50 ,$126.28 ,$357.37 ,$414.02 ,$153.50 ,$414.02 ,$153.50 ,$291.65 ,$333.74 ,$383.75 ,$153.50 ,$376.13 ,$153.50 , N/A ,$372.53 ,$372.53 ,$360.80 ,$405.90 ,$383.75 ,$383.35 ,$153.50 ,$153.50 ,$383.35 ,$153.50 ,$187.62 , N/A , N/A ,$161.18 ,$383.35 ,$126.28 ,$405.90 ,$354.04 ,$372.53 ,$153.50 ,$293.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000205,81219,HC CALR GENE ANALYSIS EXON 9-90,310,1 ,$380.00 ,$247.00 ,$106.40 ,$380.00 ,$304.08 ,$304.00 ,$121.63 ,$106.40 ,$301.11 ,$348.84 ,$121.63 ,$348.84 ,$121.63 ,$231.10 ,$281.20 ,$304.08 ,$121.63 ,$316.92 ,$121.63 , N/A ,$313.88 ,$313.88 ,$304.00 ,$342.00 ,$304.08 ,$323.00 ,$121.63 ,$121.63 ,$323.00 ,$121.63 ,$158.08 , N/A , N/A ,$127.71 ,$323.00 ,$106.40 ,$342.00 ,$298.30 ,$313.88 ,$121.63 ,$247.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000208,81402,HC MOLECULAR PATHOLOGY PROC LEVEL 3-90,310,1 ,$112.00 ,$72.80 ,$31.36 ,$112.00 , N/A ,$89.60 , N/A ,$31.36 ,$88.75 ,$102.82 , N/A ,$102.82 , N/A , N/A ,$82.88 , N/A , N/A ,$93.41 , N/A , N/A ,$92.51 ,$92.51 ,$89.60 ,$100.80 , N/A ,$95.20 , N/A , N/A ,$95.20 , N/A ,$46.59 , N/A , N/A , N/A ,$95.20 ,$31.36 ,$100.80 ,$87.92 ,$92.51 , N/A ,$72.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000216,81382,HC HLA CLASS 2 HIGH RESOLUTION ONE LOCUS EA - 90,310,1 ,$326.00 ,$211.90 ,$91.28 ,$326.00 ,$309.20 ,$260.80 ,$123.68 ,$91.28 ,$258.32 ,$299.27 ,$123.68 ,$299.27 ,$123.68 ,$234.99 ,$241.24 ,$309.20 ,$123.68 ,$271.88 ,$123.68 , N/A ,$269.28 ,$269.28 ,$260.80 ,$293.40 ,$309.20 ,$277.10 ,$123.68 ,$123.68 ,$277.10 ,$123.68 ,$135.62 , N/A , N/A ,$129.86 ,$277.10 ,$91.28 ,$293.40 ,$255.91 ,$269.28 ,$123.68 ,$211.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000245,81271,HC HTT GENE ANALYSIS DETECT ABNORMAL ALLELES-90,310,1 ,$363.00 ,$235.95 ,$101.64 ,$363.00 ,$342.50 ,$290.40 ,$137.00 ,$101.64 ,$287.64 ,$333.23 ,$137.00 ,$333.23 ,$137.00 ,$260.30 ,$268.62 ,$342.50 ,$137.00 ,$302.74 ,$137.00 , N/A ,$299.84 ,$299.84 ,$290.40 ,$326.70 ,$342.50 ,$308.55 ,$137.00 ,$137.00 ,$308.55 ,$137.00 ,$151.01 , N/A , N/A ,$143.85 ,$308.55 ,$101.64 ,$326.70 ,$284.96 ,$299.84 ,$137.00 ,$235.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000257,81512,HC FETAL CONGENITAL ABNORMAL ASSAY 5 ANALYTES-90,310,1 ,"$1,287.00 ",$836.55 ,$69.52 ,"$1,287.00 ",$173.80 ,"$1,029.60 ",$69.52 ,$360.36 ,"$1,019.82 ","$1,181.47 ",$69.52 ,"$1,181.47 ",$69.52 ,$132.09 ,$952.38 ,$173.80 ,$69.52 ,"$1,073.36 ",$69.52 , N/A ,"$1,063.06 ","$1,063.06 ","$1,029.60 ","$1,158.30 ",$173.80 ,"$1,093.95 ",$69.52 ,$69.52 ,"$1,093.95 ",$69.52 ,$535.39 , N/A , N/A ,$73.00 ,"$1,093.95 ",$360.36 ,"$1,158.30 ","$1,010.30 ","$1,063.06 ",$69.52 ,$836.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31000280,81403,HC MOLECULAR PATHOLOGY PROC LEVEL 4-90,310,1 ,$383.00 ,$248.95 ,$107.24 ,$383.00 , N/A ,$306.40 , N/A ,$107.24 ,$303.49 ,$351.59 , N/A ,$351.59 , N/A , N/A ,$283.42 , N/A , N/A ,$319.42 , N/A , N/A ,$316.36 ,$316.36 ,$306.40 ,$344.70 , N/A ,$325.55 , N/A , N/A ,$325.55 , N/A ,$159.33 , N/A , N/A , N/A ,$325.55 ,$107.24 ,$344.70 ,$300.66 ,$316.36 , N/A ,$248.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100104,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$131.00 ,$85.15 ,$36.68 ,$131.00 ,$114.95 ,$104.80 ,$45.98 ,$36.68 ,$103.80 ,$120.26 ,$45.98 ,$120.26 ,$45.98 ,$87.36 ,$96.94 ,$114.95 ,$45.98 ,$109.25 ,$45.98 , N/A ,$108.21 ,$108.21 ,$104.80 ,$117.90 ,$114.96 ,$111.35 ,$45.98 ,$45.98 ,$111.35 ,$45.98 ,$54.50 , N/A , N/A ,$48.28 ,$111.35 ,$36.68 ,$117.90 ,$102.84 ,$108.21 ,$45.98 ,$85.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100242,88175,HC CYTOPATH PAP DIAG INIT/REDO,311,1 ,$147.00 ,$95.55 ,$26.61 ,$147.00 ,$66.53 ,$117.60 ,$26.61 ,$41.16 ,$116.48 ,$134.95 ,$26.61 ,$134.95 ,$26.61 ,$50.56 ,$108.78 ,$66.53 ,$26.61 ,$122.60 ,$26.61 , N/A ,$121.42 ,$121.42 ,$117.60 ,$132.30 ,$66.53 ,$124.95 ,$26.61 ,$26.61 ,$124.95 ,$26.61 ,$61.15 , N/A , N/A ,$27.94 ,$124.95 ,$41.16 ,$132.30 ,$115.40 ,$121.42 ,$26.61 ,$95.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100244,88184,HC FLOW CYTO 1ST MARKER-90,311,1 ,$234.00 ,$152.10 ,$65.52 ,$673.80 ,$673.80 ,$187.20 ,$269.52 ,$65.52 ,$185.42 ,$214.81 ,$234.00 ,$214.81 ,$234.00 ,$234.00 ,$173.16 ,$234.00 ,$269.52 ,$195.16 ,$269.52 , N/A ,$193.28 ,$193.28 ,$187.20 ,$210.60 ,$234.00 ,$198.90 ,$269.52 ,$269.52 ,$198.90 ,$269.52 ,$97.34 , N/A , N/A ,$234.00 ,$198.90 ,$65.52 ,$210.60 ,$183.69 ,$193.28 ,$269.52 ,$152.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100246,88185,HC FLOW CYTO EA ADD MARKER-90,311,1 ,$216.00 ,$140.40 ,$60.48 ,$216.00 , N/A ,$172.80 , N/A ,$60.48 ,$171.16 ,$198.29 , N/A ,$198.29 , N/A , N/A ,$159.84 , N/A , N/A ,$180.14 , N/A , N/A ,$178.42 ,$178.42 ,$172.80 ,$194.40 , N/A ,$183.60 , N/A , N/A ,$183.60 , N/A ,$89.86 , N/A , N/A , N/A ,$183.60 ,$60.48 ,$194.40 ,$169.56 ,$178.42 , N/A ,$140.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100255,88237,HC TISSUE CULT BONE/BLD-90,311,1 ,$765.00 ,$497.25 ,$143.75 ,$765.00 ,$359.38 ,$612.00 ,$143.75 ,$214.20 ,$606.19 ,$702.27 ,$143.75 ,$702.27 ,$143.75 ,$273.13 ,$566.10 ,$359.38 ,$143.75 ,$638.01 ,$143.75 , N/A ,$631.89 ,$631.89 ,$612.00 ,$688.50 ,$359.38 ,$650.25 ,$143.75 ,$143.75 ,$650.25 ,$143.75 ,$318.24 , N/A , N/A ,$150.94 ,$650.25 ,$214.20 ,$688.50 ,$600.53 ,$631.89 ,$143.75 ,$497.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100261,88271,HC MCG DNA PROBE(FISH)-90,311,1 ,"$1,311.00 ",$852.15 ,$21.42 ,"$1,311.00 ",$53.55 ,"$1,048.80 ",$21.42 ,$367.08 ,"$1,038.84 ","$1,203.50 ",$21.42 ,"$1,203.50 ",$21.42 ,$40.70 ,$970.14 ,$53.55 ,$21.42 ,"$1,093.37 ",$21.42 , N/A ,"$1,082.89 ","$1,082.89 ","$1,048.80 ","$1,179.90 ",$53.55 ,"$1,114.35 ",$21.42 ,$21.42 ,"$1,114.35 ",$21.42 ,$545.38 , N/A , N/A ,$22.49 ,"$1,114.35 ",$367.08 ,"$1,179.90 ","$1,029.14 ","$1,082.89 ",$21.42 ,$852.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100269,88275,HC MCG INTERPH INSITU 100 -90,311,1 ,$285.00 ,$185.25 ,$51.19 ,$285.00 ,$127.98 ,$228.00 ,$51.19 ,$79.80 ,$225.83 ,$261.63 ,$51.19 ,$261.63 ,$51.19 ,$97.26 ,$210.90 ,$127.98 ,$51.19 ,$237.69 ,$51.19 , N/A ,$235.41 ,$235.41 ,$228.00 ,$256.50 ,$127.98 ,$242.25 ,$51.19 ,$51.19 ,$242.25 ,$51.19 ,$118.56 , N/A , N/A ,$53.75 ,$242.25 ,$79.80 ,$256.50 ,$223.73 ,$235.41 ,$51.19 ,$185.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100270,88275,HC MCG INTERPH INSITU FISH 100-90,311,1 ,$285.00 ,$185.25 ,$51.19 ,$285.00 ,$127.98 ,$228.00 ,$51.19 ,$79.80 ,$225.83 ,$261.63 ,$51.19 ,$261.63 ,$51.19 ,$97.26 ,$210.90 ,$127.98 ,$51.19 ,$237.69 ,$51.19 , N/A ,$235.41 ,$235.41 ,$228.00 ,$256.50 ,$127.98 ,$242.25 ,$51.19 ,$51.19 ,$242.25 ,$51.19 ,$118.56 , N/A , N/A ,$53.75 ,$242.25 ,$79.80 ,$256.50 ,$223.73 ,$235.41 ,$51.19 ,$185.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100280,G0145,HC CYTOPATH PAP SCREEN INIT/REDO,311,1 ,$147.00 ,$95.55 ,$26.49 ,$147.00 ,$66.23 ,$117.60 ,$26.49 ,$41.16 ,$116.48 ,$134.95 ,$26.49 ,$134.95 ,$26.49 ,$50.33 ,$108.78 ,$66.23 ,$26.49 ,$122.60 ,$26.49 , N/A ,$121.42 ,$121.42 ,$117.60 ,$132.30 ,$66.23 ,$124.95 ,$26.49 ,$26.49 ,$124.95 ,$26.49 ,$61.15 , N/A , N/A ,$27.81 ,$124.95 ,$41.16 ,$132.30 ,$115.40 ,$121.42 ,$26.49 ,$95.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100283,88120,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC-90,311,1 ,"$1,212.00 ",$787.80 ,$138.02 ,"$1,212.00 ",$345.05 ,$969.60 ,$138.02 ,$339.36 ,$960.39 ,"$1,112.62 ",$138.02 ,"$1,112.62 ",$138.02 ,$262.24 ,$896.88 ,$345.05 ,$138.02 ,"$1,010.81 ",$138.02 , N/A ,"$1,001.11 ","$1,001.11 ",$969.60 ,"$1,090.80 ",$345.04 ,"$1,030.20 ",$138.02 ,$138.02 ,"$1,030.20 ",$138.02 ,$504.19 , N/A , N/A ,$144.92 ,"$1,030.20 ",$339.36 ,"$1,090.80 ",$951.42 ,"$1,001.11 ",$138.02 ,$787.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100293,88175,HC CYTOPATH PAP DIAG INIT/REDO,311,1 ,$147.00 ,$95.55 ,$26.61 ,$147.00 ,$66.53 ,$117.60 ,$26.61 ,$41.16 ,$116.48 ,$134.95 ,$26.61 ,$134.95 ,$26.61 ,$50.56 ,$108.78 ,$66.53 ,$26.61 ,$122.60 ,$26.61 , N/A ,$121.42 ,$121.42 ,$117.60 ,$132.30 ,$66.53 ,$124.95 ,$26.61 ,$26.61 ,$124.95 ,$26.61 ,$61.15 , N/A , N/A ,$27.94 ,$124.95 ,$41.16 ,$132.30 ,$115.40 ,$121.42 ,$26.61 ,$95.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100294,88184,HC FLOW CYTO 1ST MARKER,311,1 ,$234.00 ,$152.10 ,$65.52 ,$673.80 ,$673.80 ,$187.20 ,$269.52 ,$65.52 ,$185.42 ,$214.81 ,$234.00 ,$214.81 ,$234.00 ,$234.00 ,$173.16 ,$234.00 ,$269.52 ,$195.16 ,$269.52 , N/A ,$193.28 ,$193.28 ,$187.20 ,$210.60 ,$234.00 ,$198.90 ,$269.52 ,$269.52 ,$198.90 ,$269.52 ,$97.34 , N/A , N/A ,$234.00 ,$198.90 ,$65.52 ,$210.60 ,$183.69 ,$193.28 ,$269.52 ,$152.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100295,88185,HC FLOW CYTO EA ADD MARKER,311,1 ,$216.00 ,$140.40 ,$60.48 ,$216.00 , N/A ,$172.80 , N/A ,$60.48 ,$171.16 ,$198.29 , N/A ,$198.29 , N/A , N/A ,$159.84 , N/A , N/A ,$180.14 , N/A , N/A ,$178.42 ,$178.42 ,$172.80 ,$194.40 , N/A ,$183.60 , N/A , N/A ,$183.60 , N/A ,$89.86 , N/A , N/A , N/A ,$183.60 ,$60.48 ,$194.40 ,$169.56 ,$178.42 , N/A ,$140.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100299,88104,HC CYTOPATH FLD SMEAR,311,1 ,$146.00 ,$94.90 ,$31.32 ,$146.00 ,$78.30 ,$116.80 ,$31.32 ,$40.88 ,$115.69 ,$134.03 ,$31.32 ,$134.03 ,$31.32 ,$59.51 ,$108.04 ,$78.30 ,$31.32 ,$121.76 ,$31.32 , N/A ,$120.60 ,$120.60 ,$116.80 ,$131.40 ,$78.31 ,$124.10 ,$31.32 ,$31.32 ,$124.10 ,$31.32 ,$60.74 , N/A , N/A ,$32.89 ,$124.10 ,$40.88 ,$131.40 ,$114.61 ,$120.60 ,$31.32 ,$94.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100300,88106,HC CYTOPATH FLUID SIMP FILTER,311,1 ,$142.00 ,$92.30 ,$22.86 ,$142.00 ,$57.15 ,$113.60 ,$22.86 ,$39.76 ,$112.52 ,$130.36 ,$22.86 ,$130.36 ,$22.86 ,$43.43 ,$105.08 ,$57.15 ,$22.86 ,$118.43 ,$22.86 , N/A ,$117.29 ,$117.29 ,$113.60 ,$127.80 ,$57.15 ,$120.70 ,$22.86 ,$22.86 ,$120.70 ,$22.86 ,$59.07 , N/A , N/A ,$24.00 ,$120.70 ,$39.76 ,$127.80 ,$111.47 ,$117.29 ,$22.86 ,$92.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100301,88175,HC CYTOPATH PAP SCREEN INIT/REDO,311,1 ,$147.00 ,$95.55 ,$26.61 ,$147.00 ,$66.53 ,$117.60 ,$26.61 ,$41.16 ,$116.48 ,$134.95 ,$26.61 ,$134.95 ,$26.61 ,$50.56 ,$108.78 ,$66.53 ,$26.61 ,$122.60 ,$26.61 , N/A ,$121.42 ,$121.42 ,$117.60 ,$132.30 ,$66.53 ,$124.95 ,$26.61 ,$26.61 ,$124.95 ,$26.61 ,$61.15 , N/A , N/A ,$27.94 ,$124.95 ,$41.16 ,$132.30 ,$115.40 ,$121.42 ,$26.61 ,$95.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100303,88172,HC FINE NEEDLE EVAL,311,1 ,$273.00 ,$177.45 ,$76.44 ,$345.05 ,$345.05 ,$218.40 ,$138.02 ,$76.44 ,$216.33 ,$250.61 ,$138.02 ,$250.61 ,$138.02 ,$262.24 ,$202.02 ,$273.00 ,$138.02 ,$227.68 ,$138.02 , N/A ,$225.50 ,$225.50 ,$218.40 ,$245.70 ,$273.00 ,$232.05 ,$138.02 ,$138.02 ,$232.05 ,$138.02 ,$113.57 , N/A , N/A ,$144.92 ,$232.05 ,$76.44 ,$245.70 ,$214.31 ,$225.50 ,$138.02 ,$177.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100304,88173,HC FINE NEEDLE INTERP,311,1 ,$111.00 ,$72.15 ,$31.08 ,$114.95 ,$114.95 ,$88.80 ,$45.98 ,$31.08 ,$87.96 ,$101.90 ,$45.98 ,$101.90 ,$45.98 ,$87.36 ,$82.14 ,$111.00 ,$45.98 ,$92.57 ,$45.98 , N/A ,$91.69 ,$91.69 ,$88.80 ,$99.90 ,$111.00 ,$94.35 ,$45.98 ,$45.98 ,$94.35 ,$45.98 ,$46.18 , N/A , N/A ,$48.28 ,$94.35 ,$31.08 ,$99.90 ,$87.14 ,$91.69 ,$45.98 ,$72.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31100310,88121,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC COMP ASSIST-90,311,1 ,$334.00 ,$217.10 ,$93.52 ,$673.80 ,$673.80 ,$267.20 ,$269.52 ,$93.52 ,$264.66 ,$306.61 ,$269.52 ,$306.61 ,$269.52 ,$334.00 ,$247.16 ,$334.00 ,$269.52 ,$278.56 ,$269.52 , N/A ,$275.88 ,$275.88 ,$267.20 ,$300.60 ,$334.00 ,$283.90 ,$269.52 ,$269.52 ,$283.90 ,$269.52 ,$138.94 , N/A , N/A ,$283.00 ,$283.90 ,$93.52 ,$300.60 ,$262.19 ,$275.88 ,$269.52 ,$217.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200159,88321,HC CONSULT REFERRED SLIDES,312,1 ,$345.00 ,$224.25 ,$31.32 ,$345.00 ,$78.30 ,$276.00 ,$31.32 ,$96.60 ,$273.38 ,$316.71 ,$31.32 ,$316.71 ,$31.32 ,$59.51 ,$255.30 ,$78.30 ,$31.32 ,$287.73 ,$31.32 , N/A ,$284.97 ,$284.97 ,$276.00 ,$310.50 ,$78.31 ,$293.25 ,$31.32 ,$31.32 ,$293.25 ,$31.32 ,$143.52 , N/A , N/A ,$32.89 ,$293.25 ,$96.60 ,$310.50 ,$270.83 ,$284.97 ,$31.32 ,$224.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200283,88374,HC MORPH ANLY AUTO EA MULTIPLX-90,312,1 ,$854.00 ,$555.10 ,$138.02 ,$854.00 ,$345.05 ,$683.20 ,$138.02 ,$239.12 ,$676.71 ,$783.97 ,$138.02 ,$783.97 ,$138.02 ,$262.24 ,$631.96 ,$345.05 ,$138.02 ,$712.24 ,$138.02 , N/A ,$705.40 ,$705.40 ,$683.20 ,$768.60 ,$345.04 ,$725.90 ,$138.02 ,$138.02 ,$725.90 ,$138.02 ,$355.26 , N/A , N/A ,$144.92 ,$725.90 ,$239.12 ,$768.60 ,$670.39 ,$705.40 ,$138.02 ,$555.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200296,88311,HC DECALCIFICATION,312,1 ,$58.00 ,$37.70 ,$16.24 ,$58.00 , N/A ,$46.40 , N/A ,$16.24 ,$45.96 ,$53.24 , N/A ,$53.24 , N/A , N/A ,$42.92 , N/A , N/A ,$48.37 , N/A , N/A ,$47.91 ,$47.91 ,$46.40 ,$52.20 , N/A ,$49.30 , N/A , N/A ,$49.30 , N/A ,$24.13 , N/A , N/A , N/A ,$49.30 ,$16.24 ,$52.20 ,$45.53 ,$47.91 , N/A ,$37.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200297,88302,HC GROSS  AND  MICRO LEVEL II,312,1 ,$129.00 ,$83.85 ,$22.86 ,$129.00 ,$57.15 ,$103.20 ,$22.86 ,$36.12 ,$102.22 ,$118.42 ,$22.86 ,$118.42 ,$22.86 ,$43.43 ,$95.46 ,$57.15 ,$22.86 ,$107.59 ,$22.86 , N/A ,$106.55 ,$106.55 ,$103.20 ,$116.10 ,$57.15 ,$109.65 ,$22.86 ,$22.86 ,$109.65 ,$22.86 ,$53.66 , N/A , N/A ,$24.00 ,$109.65 ,$36.12 ,$116.10 ,$101.27 ,$106.55 ,$22.86 ,$83.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200298,88304,HC GROSS  AND  MICRO LEVEL III,312,1 ,$146.00 ,$94.90 ,$40.88 ,$146.00 ,$114.95 ,$116.80 ,$45.98 ,$40.88 ,$115.69 ,$134.03 ,$45.98 ,$134.03 ,$45.98 ,$87.36 ,$108.04 ,$114.95 ,$45.98 ,$121.76 ,$45.98 , N/A ,$120.60 ,$120.60 ,$116.80 ,$131.40 ,$114.96 ,$124.10 ,$45.98 ,$45.98 ,$124.10 ,$45.98 ,$60.74 , N/A , N/A ,$48.28 ,$124.10 ,$40.88 ,$131.40 ,$114.61 ,$120.60 ,$45.98 ,$94.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200299,88305,HC GROSS  AND  MICRO LEVEL IV,312,1 ,$175.00 ,$113.75 ,$45.98 ,$175.00 ,$114.95 ,$140.00 ,$45.98 ,$49.00 ,$138.67 ,$160.65 ,$45.98 ,$160.65 ,$45.98 ,$87.36 ,$129.50 ,$114.95 ,$45.98 ,$145.95 ,$45.98 , N/A ,$144.55 ,$144.55 ,$140.00 ,$157.50 ,$114.96 ,$148.75 ,$45.98 ,$45.98 ,$148.75 ,$45.98 ,$72.80 , N/A , N/A ,$48.28 ,$148.75 ,$49.00 ,$157.50 ,$137.38 ,$144.55 ,$45.98 ,$113.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200300,88307,HC GROSS  AND  MICRO LEVEL V,312,1 ,$307.00 ,$199.55 ,$85.96 ,$673.80 ,$673.80 ,$245.60 ,$269.52 ,$85.96 ,$243.27 ,$281.83 ,$269.52 ,$281.83 ,$269.52 ,$307.00 ,$227.18 ,$307.00 ,$269.52 ,$256.04 ,$269.52 , N/A ,$253.58 ,$253.58 ,$245.60 ,$276.30 ,$307.00 ,$260.95 ,$269.52 ,$269.52 ,$260.95 ,$269.52 ,$127.71 , N/A , N/A ,$283.00 ,$260.95 ,$85.96 ,$276.30 ,$241.00 ,$253.58 ,$269.52 ,$199.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200301,88309,HC GROSS  AND  MICRO LEVEL VI,312,1 ,$403.00 ,$261.95 ,$112.84 ,"$1,516.10 ","$1,516.10 ",$322.40 ,$606.44 ,$112.84 ,$319.34 ,$369.95 ,$403.00 ,$369.95 ,$403.00 ,$403.00 ,$298.22 ,$403.00 ,$606.44 ,$336.10 ,$606.44 , N/A ,$332.88 ,$332.88 ,$322.40 ,$362.70 ,$403.00 ,$342.55 ,$606.44 ,$606.44 ,$342.55 ,$606.44 ,$167.65 , N/A , N/A ,$403.00 ,$342.55 ,$112.84 ,$362.70 ,$316.36 ,$332.88 ,$606.44 ,$261.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200302,88300,HC GROSS ONLY LEVEL I,312,1 ,$84.00 ,$54.60 ,$22.86 ,$84.00 ,$57.15 ,$67.20 ,$22.86 ,$23.52 ,$66.56 ,$77.11 ,$22.86 ,$77.11 ,$22.86 ,$43.43 ,$62.16 ,$57.15 ,$22.86 ,$70.06 ,$22.86 , N/A ,$69.38 ,$69.38 ,$67.20 ,$75.60 ,$57.15 ,$71.40 ,$22.86 ,$22.86 ,$71.40 ,$22.86 ,$34.94 , N/A , N/A ,$24.00 ,$71.40 ,$23.52 ,$75.60 ,$65.94 ,$69.38 ,$22.86 ,$54.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200303,88312,HC SPECIAL STAIN I,312,1 ,$156.00 ,$101.40 ,$43.68 ,$156.00 ,$114.95 ,$124.80 ,$45.98 ,$43.68 ,$123.61 ,$143.21 ,$45.98 ,$143.21 ,$45.98 ,$87.36 ,$115.44 ,$114.95 ,$45.98 ,$130.10 ,$45.98 , N/A ,$128.86 ,$128.86 ,$124.80 ,$140.40 ,$114.96 ,$132.60 ,$45.98 ,$45.98 ,$132.60 ,$45.98 ,$64.90 , N/A , N/A ,$48.28 ,$132.60 ,$43.68 ,$140.40 ,$122.46 ,$128.86 ,$45.98 ,$101.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200304,88313,HC SPECIAL STAIN II,312,1 ,$166.00 ,$107.90 ,$31.32 ,$166.00 ,$78.30 ,$132.80 ,$31.32 ,$46.48 ,$131.54 ,$152.39 ,$31.32 ,$152.39 ,$31.32 ,$59.51 ,$122.84 ,$78.30 ,$31.32 ,$138.44 ,$31.32 , N/A ,$137.12 ,$137.12 ,$132.80 ,$149.40 ,$78.31 ,$141.10 ,$31.32 ,$31.32 ,$141.10 ,$31.32 ,$69.06 , N/A , N/A ,$32.89 ,$141.10 ,$46.48 ,$149.40 ,$130.31 ,$137.12 ,$31.32 ,$107.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200305,88342,HC IMMUNOHISOCHEMIST EA AB REPEAT,312,1 ,$147.00 ,$95.55 ,$41.16 ,$345.05 ,$345.05 ,$117.60 ,$138.02 ,$41.16 ,$116.48 ,$134.95 ,$138.02 ,$134.95 ,$138.02 ,$147.00 ,$108.78 ,$147.00 ,$138.02 ,$122.60 ,$138.02 , N/A ,$121.42 ,$121.42 ,$117.60 ,$132.30 ,$147.00 ,$124.95 ,$138.02 ,$138.02 ,$124.95 ,$138.02 ,$61.15 , N/A , N/A ,$144.92 ,$124.95 ,$41.16 ,$132.30 ,$115.40 ,$121.42 ,$138.02 ,$95.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200306,88344,HC IMMUNOHISTOCHEM EA AB STAIN,312,1 ,$596.00 ,$387.40 ,$166.88 ,$673.80 ,$673.80 ,$476.80 ,$269.52 ,$166.88 ,$472.27 ,$547.13 ,$269.52 ,$547.13 ,$269.52 ,$512.09 ,$441.04 ,$596.00 ,$269.52 ,$497.06 ,$269.52 , N/A ,$492.30 ,$492.30 ,$476.80 ,$536.40 ,$596.00 ,$506.60 ,$269.52 ,$269.52 ,$506.60 ,$269.52 ,$247.94 , N/A , N/A ,$283.00 ,$506.60 ,$166.88 ,$536.40 ,$467.86 ,$492.30 ,$269.52 ,$387.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200307,88341,HC IMMUNOHISOCHEMIS EA AD SGL STN,312,1 ,$147.00 ,$95.55 ,$41.16 ,$147.00 , N/A ,$117.60 , N/A ,$41.16 ,$116.48 ,$134.95 , N/A ,$134.95 , N/A , N/A ,$108.78 , N/A , N/A ,$122.60 , N/A , N/A ,$121.42 ,$121.42 ,$117.60 ,$132.30 , N/A ,$124.95 , N/A , N/A ,$124.95 , N/A ,$61.15 , N/A , N/A , N/A ,$124.95 ,$41.16 ,$132.30 ,$115.40 ,$121.42 , N/A ,$95.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),31200308,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$131.00 ,$85.15 ,$36.68 ,$131.00 ,$114.95 ,$104.80 ,$45.98 ,$36.68 ,$103.80 ,$120.26 ,$45.98 ,$120.26 ,$45.98 ,$87.36 ,$96.94 ,$114.95 ,$45.98 ,$109.25 ,$45.98 , N/A ,$108.21 ,$108.21 ,$104.80 ,$117.90 ,$114.96 ,$111.35 ,$45.98 ,$45.98 ,$111.35 ,$45.98 ,$54.50 , N/A , N/A ,$48.28 ,$111.35 ,$36.68 ,$117.90 ,$102.84 ,$108.21 ,$45.98 ,$85.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000019,32551,HC CHEST TUBE INSERTION 32551,320,1 ,$971.00 ,$631.15 ,$271.88 ,"$3,484.25 ","$3,484.25 ",$776.80 ,"$1,301.30 ",$271.88 ,$769.42 ,$891.38 ,$971.00 ,$891.38 ,$971.00 ,$971.00 ,$718.54 ,$971.00 ,"$1,393.70 ",$809.81 ,"$1,301.30 ", N/A ,$802.05 ,$802.05 ,$776.80 ,$873.90 ,$971.00 ,$825.35 ,"$1,301.30 ","$1,301.30 ",$825.35 ,"$1,393.70 ",$403.94 , N/A , N/A ,$971.00 ,$825.35 ,$271.88 ,$873.90 ,$762.24 ,$802.05 ,"$1,301.30 ",$631.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000035,43752,HC PLACE TUBE NASOGASTRIC,320,1 ,$398.00 ,$258.70 ,$111.44 ,$672.45 ,$672.45 ,$318.40 ,$251.15 ,$111.44 ,$315.38 ,$365.36 ,$251.15 ,$365.36 ,$251.15 ,$398.00 ,$294.52 ,$398.00 ,$268.98 ,$331.93 ,$251.15 , N/A ,$328.75 ,$328.75 ,$318.40 ,$358.20 ,$398.00 ,$338.30 ,$251.15 ,$251.15 ,$338.30 ,$268.98 ,$165.57 , N/A , N/A ,$281.54 ,$338.30 ,$111.44 ,$358.20 ,$312.43 ,$328.75 ,$251.15 ,$258.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000063,49465,HC INJ CNTR W/FLUOR EVAL G/D/J TB,320,1 ,$625.00 ,$406.25 ,$175.00 ,$625.00 ,$570.13 ,$500.00 ,$212.93 ,$175.00 ,$495.25 ,$573.75 ,$212.93 ,$573.75 ,$212.93 ,$433.30 ,$462.50 ,$570.13 ,$228.05 ,$521.25 ,$212.93 , N/A ,$516.25 ,$516.25 ,$500.00 ,$562.50 ,$532.33 ,$531.25 ,$212.93 ,$212.93 ,$531.25 ,$228.05 ,$260.00 , N/A , N/A ,$238.70 ,$531.25 ,$175.00 ,$562.50 ,$490.63 ,$516.25 ,$212.93 ,$406.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000098,70030,HC XRAY EYE (FOREIGN BODY),320,1 ,$278.00 ,$180.70 ,$74.85 ,$278.00 ,$200.43 ,$222.40 ,$74.85 ,$77.84 ,$220.29 ,$255.20 ,$74.85 ,$255.20 ,$74.85 ,$152.32 ,$205.72 ,$200.43 ,$80.17 ,$231.85 ,$74.85 , N/A ,$229.63 ,$229.63 ,$222.40 ,$250.20 ,$187.13 ,$236.30 ,$74.85 ,$74.85 ,$236.30 ,$80.17 ,$115.65 , N/A , N/A ,$83.91 ,$236.30 ,$77.84 ,$250.20 ,$218.23 ,$229.63 ,$74.85 ,$180.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000100,70110,HC MANDIBLE MIN 4 VIEWS,320,1 ,$563.00 ,$365.95 ,$100.75 ,$563.00 ,$269.75 ,$450.40 ,$100.75 ,$157.64 ,$446.12 ,$516.83 ,$100.75 ,$516.83 ,$100.75 ,$205.01 ,$416.62 ,$269.75 ,$107.90 ,$469.54 ,$100.75 , N/A ,$465.04 ,$465.04 ,$450.40 ,$506.70 ,$251.87 ,$478.55 ,$100.75 ,$100.75 ,$478.55 ,$107.90 ,$234.21 , N/A , N/A ,$112.94 ,$478.55 ,$157.64 ,$506.70 ,$441.96 ,$465.04 ,$100.75 ,$365.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000101,70130,HC MASTOIDS MN 3VW PER SIDE,320,1 ,$496.00 ,$322.40 ,$100.75 ,$496.00 ,$269.75 ,$396.80 ,$100.75 ,$138.88 ,$393.03 ,$455.33 ,$100.75 ,$455.33 ,$100.75 ,$205.01 ,$367.04 ,$269.75 ,$107.90 ,$413.66 ,$100.75 , N/A ,$409.70 ,$409.70 ,$396.80 ,$446.40 ,$251.87 ,$421.60 ,$100.75 ,$100.75 ,$421.60 ,$107.90 ,$206.34 , N/A , N/A ,$112.94 ,$421.60 ,$138.88 ,$446.40 ,$389.36 ,$409.70 ,$100.75 ,$322.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000103,70140,HC FACIAL BONES < 3 VIEWS,320,1 ,$443.00 ,$287.95 ,$74.85 ,$443.00 ,$200.43 ,$354.40 ,$74.85 ,$124.04 ,$351.03 ,$406.67 ,$74.85 ,$406.67 ,$74.85 ,$152.32 ,$327.82 ,$200.43 ,$80.17 ,$369.46 ,$74.85 , N/A ,$365.92 ,$365.92 ,$354.40 ,$398.70 ,$187.13 ,$376.55 ,$74.85 ,$74.85 ,$376.55 ,$80.17 ,$184.29 , N/A , N/A ,$83.91 ,$376.55 ,$124.04 ,$398.70 ,$347.76 ,$365.92 ,$74.85 ,$287.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000104,70150,HC FACIAL BONES MIN 3 VIEWS,320,1 ,$552.00 ,$358.80 ,$100.75 ,$552.00 ,$269.75 ,$441.60 ,$100.75 ,$154.56 ,$437.40 ,$506.74 ,$100.75 ,$506.74 ,$100.75 ,$205.01 ,$408.48 ,$269.75 ,$107.90 ,$460.37 ,$100.75 , N/A ,$455.95 ,$455.95 ,$441.60 ,$496.80 ,$251.87 ,$469.20 ,$100.75 ,$100.75 ,$469.20 ,$107.90 ,$229.63 , N/A , N/A ,$112.94 ,$469.20 ,$154.56 ,$496.80 ,$433.32 ,$455.95 ,$100.75 ,$358.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000105,70160,HC NASAL BONES MIN 3 VIEWS,320,1 ,$424.00 ,$275.60 ,$74.85 ,$424.00 ,$200.43 ,$339.20 ,$74.85 ,$118.72 ,$335.98 ,$389.23 ,$74.85 ,$389.23 ,$74.85 ,$152.32 ,$313.76 ,$200.43 ,$80.17 ,$353.62 ,$74.85 , N/A ,$350.22 ,$350.22 ,$339.20 ,$381.60 ,$187.13 ,$360.40 ,$74.85 ,$74.85 ,$360.40 ,$80.17 ,$176.38 , N/A , N/A ,$83.91 ,$360.40 ,$118.72 ,$381.60 ,$332.84 ,$350.22 ,$74.85 ,$275.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000106,70200,HC XRAY ORBITS (EYE) (MIN 4 V),320,1 ,$278.00 ,$180.70 ,$77.84 ,$278.00 ,$269.75 ,$222.40 ,$100.75 ,$77.84 ,$220.29 ,$255.20 ,$100.75 ,$255.20 ,$100.75 ,$205.01 ,$205.72 ,$269.75 ,$107.90 ,$231.85 ,$100.75 , N/A ,$229.63 ,$229.63 ,$222.40 ,$250.20 ,$251.87 ,$236.30 ,$100.75 ,$100.75 ,$236.30 ,$107.90 ,$115.65 , N/A , N/A ,$112.94 ,$236.30 ,$77.84 ,$250.20 ,$218.23 ,$229.63 ,$100.75 ,$180.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000107,70210,HC XRAY SINUS WATERS VIEW,320,1 ,$220.00 ,$143.00 ,$61.60 ,$220.00 ,$200.43 ,$176.00 ,$74.85 ,$61.60 ,$174.33 ,$201.96 ,$74.85 ,$201.96 ,$74.85 ,$152.32 ,$162.80 ,$200.43 ,$80.17 ,$183.48 ,$74.85 , N/A ,$181.72 ,$181.72 ,$176.00 ,$198.00 ,$187.13 ,$187.00 ,$74.85 ,$74.85 ,$187.00 ,$80.17 ,$91.52 , N/A , N/A ,$83.91 ,$187.00 ,$61.60 ,$198.00 ,$172.70 ,$181.72 ,$74.85 ,$143.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000108,70220,HC SINUSES MIN 3 VIEWS,320,1 ,$552.00 ,$358.80 ,$74.85 ,$552.00 ,$200.43 ,$441.60 ,$74.85 ,$154.56 ,$437.40 ,$506.74 ,$74.85 ,$506.74 ,$74.85 ,$152.32 ,$408.48 ,$200.43 ,$80.17 ,$460.37 ,$74.85 , N/A ,$455.95 ,$455.95 ,$441.60 ,$496.80 ,$187.13 ,$469.20 ,$74.85 ,$74.85 ,$469.20 ,$80.17 ,$229.63 , N/A , N/A ,$83.91 ,$469.20 ,$154.56 ,$496.80 ,$433.32 ,$455.95 ,$74.85 ,$358.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000110,70250,HC SKULL LESS THAN 4 VIEWS,320,1 ,$559.00 ,$363.35 ,$100.75 ,$559.00 ,$269.75 ,$447.20 ,$100.75 ,$156.52 ,$442.95 ,$513.16 ,$100.75 ,$513.16 ,$100.75 ,$205.01 ,$413.66 ,$269.75 ,$107.90 ,$466.21 ,$100.75 , N/A ,$461.73 ,$461.73 ,$447.20 ,$503.10 ,$251.87 ,$475.15 ,$100.75 ,$100.75 ,$475.15 ,$107.90 ,$232.54 , N/A , N/A ,$112.94 ,$475.15 ,$156.52 ,$503.10 ,$438.82 ,$461.73 ,$100.75 ,$363.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000112,70260,HC SKULL MIN 4 VIEWS,320,1 ,$602.00 ,$391.30 ,$100.75 ,$602.00 ,$269.75 ,$481.60 ,$100.75 ,$168.56 ,$477.02 ,$552.64 ,$100.75 ,$552.64 ,$100.75 ,$205.01 ,$445.48 ,$269.75 ,$107.90 ,$502.07 ,$100.75 , N/A ,$497.25 ,$497.25 ,$481.60 ,$541.80 ,$251.87 ,$511.70 ,$100.75 ,$100.75 ,$511.70 ,$107.90 ,$250.43 , N/A , N/A ,$112.94 ,$511.70 ,$168.56 ,$541.80 ,$472.57 ,$497.25 ,$100.75 ,$391.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000113,70330,HC TEMPOROMANDIBULAR JOINTS BILAT,320,1 ,$528.00 ,$343.20 ,$74.85 ,$528.00 ,$200.43 ,$422.40 ,$74.85 ,$147.84 ,$418.39 ,$484.70 ,$74.85 ,$484.70 ,$74.85 ,$152.32 ,$390.72 ,$200.43 ,$80.17 ,$440.35 ,$74.85 , N/A ,$436.13 ,$436.13 ,$422.40 ,$475.20 ,$187.13 ,$448.80 ,$74.85 ,$74.85 ,$448.80 ,$80.17 ,$219.65 , N/A , N/A ,$83.91 ,$448.80 ,$147.84 ,$475.20 ,$414.48 ,$436.13 ,$74.85 ,$343.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000116,70360,HC XRAY NECK SOFT TISSUE,320,1 ,$324.00 ,$210.60 ,$74.85 ,$324.00 ,$200.43 ,$259.20 ,$74.85 ,$90.72 ,$256.74 ,$297.43 ,$74.85 ,$297.43 ,$74.85 ,$152.32 ,$239.76 ,$200.43 ,$80.17 ,$270.22 ,$74.85 , N/A ,$267.62 ,$267.62 ,$259.20 ,$291.60 ,$187.13 ,$275.40 ,$74.85 ,$74.85 ,$275.40 ,$80.17 ,$134.78 , N/A , N/A ,$83.91 ,$275.40 ,$90.72 ,$291.60 ,$254.34 ,$267.62 ,$74.85 ,$210.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000121,71045,HC XR CHEST 1V,320,1 ,$258.00 ,$167.70 ,$72.24 ,$258.00 ,$200.43 ,$206.40 ,$74.85 ,$72.24 ,$204.44 ,$236.84 ,$74.85 ,$236.84 ,$74.85 ,$152.32 ,$190.92 ,$200.43 ,$80.17 ,$215.17 ,$74.85 , N/A ,$213.11 ,$213.11 ,$206.40 ,$232.20 ,$187.13 ,$219.30 ,$74.85 ,$74.85 ,$219.30 ,$80.17 ,$107.33 , N/A , N/A ,$83.91 ,$219.30 ,$72.24 ,$232.20 ,$202.53 ,$213.11 ,$74.85 ,$167.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000127,71046,HC XR CHEST 2V,320,1 ,$324.00 ,$210.60 ,$74.85 ,$324.00 ,$200.43 ,$259.20 ,$74.85 ,$90.72 ,$256.74 ,$297.43 ,$74.85 ,$297.43 ,$74.85 ,$152.32 ,$239.76 ,$200.43 ,$80.17 ,$270.22 ,$74.85 , N/A ,$267.62 ,$267.62 ,$259.20 ,$291.60 ,$187.13 ,$275.40 ,$74.85 ,$74.85 ,$275.40 ,$80.17 ,$134.78 , N/A , N/A ,$83.91 ,$275.40 ,$90.72 ,$291.60 ,$254.34 ,$267.62 ,$74.85 ,$210.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000130,71047,HC XR CHEST 2V W/LORDOTIC,320,1 ,$586.00 ,$380.90 ,$74.85 ,$586.00 ,$200.43 ,$468.80 ,$74.85 ,$164.08 ,$464.35 ,$537.95 ,$74.85 ,$537.95 ,$74.85 ,$152.32 ,$433.64 ,$200.43 ,$80.17 ,$488.72 ,$74.85 , N/A ,$484.04 ,$484.04 ,$468.80 ,$527.40 ,$187.13 ,$498.10 ,$74.85 ,$74.85 ,$498.10 ,$80.17 ,$243.78 , N/A , N/A ,$83.91 ,$498.10 ,$164.08 ,$527.40 ,$460.01 ,$484.04 ,$74.85 ,$380.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000131,71048,HC XR CHEST PA/LAT W/OBLIQUES,320,1 ,$258.00 ,$167.70 ,$72.24 ,$269.75 ,$269.75 ,$206.40 ,$100.75 ,$72.24 ,$204.44 ,$236.84 ,$100.75 ,$236.84 ,$100.75 ,$205.01 ,$190.92 ,$258.00 ,$107.90 ,$215.17 ,$100.75 , N/A ,$213.11 ,$213.11 ,$206.40 ,$232.20 ,$251.87 ,$219.30 ,$100.75 ,$100.75 ,$219.30 ,$107.90 ,$107.33 , N/A , N/A ,$112.94 ,$219.30 ,$72.24 ,$232.20 ,$202.53 ,$213.11 ,$100.75 ,$167.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000133,71048,HC XR CHEST 4+V,320,1 ,$258.00 ,$167.70 ,$72.24 ,$269.75 ,$269.75 ,$206.40 ,$100.75 ,$72.24 ,$204.44 ,$236.84 ,$100.75 ,$236.84 ,$100.75 ,$205.01 ,$190.92 ,$258.00 ,$107.90 ,$215.17 ,$100.75 , N/A ,$213.11 ,$213.11 ,$206.40 ,$232.20 ,$251.87 ,$219.30 ,$100.75 ,$100.75 ,$219.30 ,$107.90 ,$107.33 , N/A , N/A ,$112.94 ,$219.30 ,$72.24 ,$232.20 ,$202.53 ,$213.11 ,$100.75 ,$167.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000135,71046,HC XR CHEST SPECIAL VIEWS,320,1 ,$324.00 ,$210.60 ,$74.85 ,$324.00 ,$200.43 ,$259.20 ,$74.85 ,$90.72 ,$256.74 ,$297.43 ,$74.85 ,$297.43 ,$74.85 ,$152.32 ,$239.76 ,$200.43 ,$80.17 ,$270.22 ,$74.85 , N/A ,$267.62 ,$267.62 ,$259.20 ,$291.60 ,$187.13 ,$275.40 ,$74.85 ,$74.85 ,$275.40 ,$80.17 ,$134.78 , N/A , N/A ,$83.91 ,$275.40 ,$90.72 ,$291.60 ,$254.34 ,$267.62 ,$74.85 ,$210.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000137,71100,HC XR RIBS 2V UNI,320,1 ,$324.00 ,$210.60 ,$74.85 ,$324.00 ,$200.43 ,$259.20 ,$74.85 ,$90.72 ,$256.74 ,$297.43 ,$74.85 ,$297.43 ,$74.85 ,$152.32 ,$239.76 ,$200.43 ,$80.17 ,$270.22 ,$74.85 , N/A ,$267.62 ,$267.62 ,$259.20 ,$291.60 ,$187.13 ,$275.40 ,$74.85 ,$74.85 ,$275.40 ,$80.17 ,$134.78 , N/A , N/A ,$83.91 ,$275.40 ,$90.72 ,$291.60 ,$254.34 ,$267.62 ,$74.85 ,$210.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000138,71101,HC XR RIBS W/CXR 3+V UNI,320,1 ,$456.00 ,$296.40 ,$100.75 ,$456.00 ,$269.75 ,$364.80 ,$100.75 ,$127.68 ,$361.33 ,$418.61 ,$100.75 ,$418.61 ,$100.75 ,$205.01 ,$337.44 ,$269.75 ,$107.90 ,$380.30 ,$100.75 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$251.87 ,$387.60 ,$100.75 ,$100.75 ,$387.60 ,$107.90 ,$189.70 , N/A , N/A ,$112.94 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$100.75 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000139,71110,HC XR RIBS 3 V BIL,320,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000140,71111,HC XR RIBS W/CXR 4+V BI,320,1 ,$635.00 ,$412.75 ,$100.75 ,$635.00 ,$269.75 ,$508.00 ,$100.75 ,$177.80 ,$503.17 ,$582.93 ,$100.75 ,$582.93 ,$100.75 ,$205.01 ,$469.90 ,$269.75 ,$107.90 ,$529.59 ,$100.75 , N/A ,$524.51 ,$524.51 ,$508.00 ,$571.50 ,$251.87 ,$539.75 ,$100.75 ,$100.75 ,$539.75 ,$107.90 ,$264.16 , N/A , N/A ,$112.94 ,$539.75 ,$177.80 ,$571.50 ,$498.48 ,$524.51 ,$100.75 ,$412.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000141,71120,HC XR STERNUM 2+V,320,1 ,$424.00 ,$275.60 ,$74.85 ,$424.00 ,$200.43 ,$339.20 ,$74.85 ,$118.72 ,$335.98 ,$389.23 ,$74.85 ,$389.23 ,$74.85 ,$152.32 ,$313.76 ,$200.43 ,$80.17 ,$353.62 ,$74.85 , N/A ,$350.22 ,$350.22 ,$339.20 ,$381.60 ,$187.13 ,$360.40 ,$74.85 ,$74.85 ,$360.40 ,$80.17 ,$176.38 , N/A , N/A ,$83.91 ,$360.40 ,$118.72 ,$381.60 ,$332.84 ,$350.22 ,$74.85 ,$275.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000142,71130,HC XR STERNOCLAVIC JT 3+V,320,1 ,$456.00 ,$296.40 ,$74.85 ,$456.00 ,$200.43 ,$364.80 ,$74.85 ,$127.68 ,$361.33 ,$418.61 ,$74.85 ,$418.61 ,$74.85 ,$152.32 ,$337.44 ,$200.43 ,$80.17 ,$380.30 ,$74.85 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$187.13 ,$387.60 ,$74.85 ,$74.85 ,$387.60 ,$80.17 ,$189.70 , N/A , N/A ,$83.91 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$74.85 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000144,71250,HC CT CHEST W/O CONTRAST,350,1 ,"$2,293.00 ","$1,490.45 ",$100.75 ,"$2,293.00 ",$269.75 ,"$1,834.40 ",$100.75 ,$642.04 ,"$1,816.97 ","$2,104.97 ",$100.75 ,"$2,104.97 ",$100.75 ,$205.01 ,"$1,696.82 ",$269.75 ,$107.90 ,"$1,912.36 ",$100.75 , N/A ,"$1,894.02 ","$1,894.02 ","$1,834.40 ","$2,063.70 ",$251.87 ,"$1,949.05 ",$100.75 ,$100.75 ,"$1,949.05 ",$107.90 ,$953.89 , N/A , N/A ,$112.94 ,"$1,949.05 ",$642.04 ,"$2,063.70 ","$1,069.00 ","$1,894.02 ",$100.75 ,"$1,490.45 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000146,71260,HC CT CHEST W/CONTRAST,350,1 ,"$3,056.00 ","$1,986.40 ",$165.30 ,"$3,056.00 ",$442.60 ,"$2,444.80 ",$165.30 ,$855.68 ,"$2,421.57 ","$2,805.41 ",$165.30 ,"$2,805.41 ",$165.30 ,$336.38 ,"$2,261.44 ",$442.60 ,$177.04 ,"$2,548.70 ",$165.30 , N/A ,"$2,524.26 ","$2,524.26 ","$2,444.80 ","$2,750.40 ",$413.25 ,"$2,597.60 ",$165.30 ,$165.30 ,"$2,597.60 ",$177.04 ,"$1,271.30 ", N/A , N/A ,$185.30 ,"$2,597.60 ",$855.68 ,"$2,750.40 ","$1,069.00 ","$2,524.26 ",$165.30 ,"$1,986.40 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000148,71270,HC CT CHEST W AND W/O CONTRAST,350,1 ,"$2,576.00 ","$1,674.40 ",$165.30 ,"$2,576.00 ",$442.60 ,"$2,060.80 ",$165.30 ,$721.28 ,"$2,041.22 ","$2,364.77 ",$165.30 ,"$2,364.77 ",$165.30 ,$336.38 ,"$1,906.24 ",$442.60 ,$177.04 ,"$2,148.38 ",$165.30 , N/A ,"$2,127.78 ","$2,127.78 ","$2,060.80 ","$2,318.40 ",$413.25 ,"$2,189.60 ",$165.30 ,$165.30 ,"$2,189.60 ",$177.04 ,"$1,071.62 ", N/A , N/A ,$185.30 ,"$2,189.60 ",$721.28 ,"$2,318.40 ","$1,069.00 ","$2,127.78 ",$165.30 ,"$1,674.40 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000150,71275,HC CTA CHEST W AND W/O CONTRAST,350,1 ,"$3,055.00 ","$1,985.75 ",$165.30 ,"$3,055.00 ",$442.60 ,"$2,444.00 ",$165.30 ,$855.40 ,"$2,420.78 ","$2,804.49 ",$165.30 ,"$2,804.49 ",$165.30 ,$336.38 ,"$2,260.70 ",$442.60 ,$177.04 ,"$2,547.87 ",$165.30 , N/A ,"$2,523.43 ","$2,523.43 ","$2,444.00 ","$2,749.50 ",$413.25 ,"$2,596.75 ",$165.30 ,$165.30 ,"$2,596.75 ",$177.04 ,"$1,270.88 ", N/A , N/A ,$185.30 ,"$2,596.75 ",$855.40 ,"$2,749.50 ","$1,069.00 ","$2,523.43 ",$165.30 ,"$1,985.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000153,71552,HC MRI CHEST W AND W/O CONTRAST,610,1 ,"$4,943.00 ","$3,212.95 ",$340.78 ,"$4,943.00 ",$912.43 ,"$3,954.40 ",$340.78 ,"$1,384.04 ","$3,916.83 ","$4,537.67 ",$340.78 ,"$4,537.67 ",$340.78 ,$693.44 ,"$3,657.82 ",$912.43 ,$364.97 ,"$4,122.46 ",$340.78 , N/A ,"$4,082.92 ","$4,082.92 ","$3,954.40 ","$4,448.70 ",$851.94 ,"$4,201.55 ",$340.78 ,$340.78 ,"$4,201.55 ",$364.97 ,"$2,056.29 ", N/A , N/A ,$382.01 ,"$4,201.55 ","$1,384.04 ","$4,448.70 ","$1,296.00 ","$4,082.92 ",$340.78 ,"$3,212.95 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000155,72020,HC XR SPINE 1V ANY LEVEL,320,1 ,$278.00 ,$180.70 ,$74.85 ,$278.00 ,$200.43 ,$222.40 ,$74.85 ,$77.84 ,$220.29 ,$255.20 ,$74.85 ,$255.20 ,$74.85 ,$152.32 ,$205.72 ,$200.43 ,$80.17 ,$231.85 ,$74.85 , N/A ,$229.63 ,$229.63 ,$222.40 ,$250.20 ,$187.13 ,$236.30 ,$74.85 ,$74.85 ,$236.30 ,$80.17 ,$115.65 , N/A , N/A ,$83.91 ,$236.30 ,$77.84 ,$250.20 ,$218.23 ,$229.63 ,$74.85 ,$180.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000156,72020,HC XR C-SPINE 1V,320,1 ,$220.00 ,$143.00 ,$61.60 ,$220.00 ,$200.43 ,$176.00 ,$74.85 ,$61.60 ,$174.33 ,$201.96 ,$74.85 ,$201.96 ,$74.85 ,$152.32 ,$162.80 ,$200.43 ,$80.17 ,$183.48 ,$74.85 , N/A ,$181.72 ,$181.72 ,$176.00 ,$198.00 ,$187.13 ,$187.00 ,$74.85 ,$74.85 ,$187.00 ,$80.17 ,$91.52 , N/A , N/A ,$83.91 ,$187.00 ,$61.60 ,$198.00 ,$172.70 ,$181.72 ,$74.85 ,$143.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000161,72020,HC XR L-SPINE 1V,320,1 ,$220.00 ,$143.00 ,$61.60 ,$220.00 ,$200.43 ,$176.00 ,$74.85 ,$61.60 ,$174.33 ,$201.96 ,$74.85 ,$201.96 ,$74.85 ,$152.32 ,$162.80 ,$200.43 ,$80.17 ,$183.48 ,$74.85 , N/A ,$181.72 ,$181.72 ,$176.00 ,$198.00 ,$187.13 ,$187.00 ,$74.85 ,$74.85 ,$187.00 ,$80.17 ,$91.52 , N/A , N/A ,$83.91 ,$187.00 ,$61.60 ,$198.00 ,$172.70 ,$181.72 ,$74.85 ,$143.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000164,72040,HC XR C-SPINE 2-3V,320,1 ,$772.00 ,$501.80 ,$74.85 ,$772.00 ,$200.43 ,$617.60 ,$74.85 ,$216.16 ,$611.73 ,$708.70 ,$74.85 ,$708.70 ,$74.85 ,$152.32 ,$571.28 ,$200.43 ,$80.17 ,$643.85 ,$74.85 , N/A ,$637.67 ,$637.67 ,$617.60 ,$694.80 ,$187.13 ,$656.20 ,$74.85 ,$74.85 ,$656.20 ,$80.17 ,$321.15 , N/A , N/A ,$83.91 ,$656.20 ,$216.16 ,$694.80 ,$606.02 ,$637.67 ,$74.85 ,$501.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000168,72050,HC XR C-SPINE 4-5 VIEW,320,1 ,$635.00 ,$412.75 ,$100.75 ,$635.00 ,$269.75 ,$508.00 ,$100.75 ,$177.80 ,$503.17 ,$582.93 ,$100.75 ,$582.93 ,$100.75 ,$205.01 ,$469.90 ,$269.75 ,$107.90 ,$529.59 ,$100.75 , N/A ,$524.51 ,$524.51 ,$508.00 ,$571.50 ,$251.87 ,$539.75 ,$100.75 ,$100.75 ,$539.75 ,$107.90 ,$264.16 , N/A , N/A ,$112.94 ,$539.75 ,$177.80 ,$571.50 ,$498.48 ,$524.51 ,$100.75 ,$412.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000170,72052,HC XR C-SPINE 6+ VIEWS,320,1 ,$679.00 ,$441.35 ,$100.75 ,$679.00 ,$269.75 ,$543.20 ,$100.75 ,$190.12 ,$538.04 ,$623.32 ,$100.75 ,$623.32 ,$100.75 ,$205.01 ,$502.46 ,$269.75 ,$107.90 ,$566.29 ,$100.75 , N/A ,$560.85 ,$560.85 ,$543.20 ,$611.10 ,$251.87 ,$577.15 ,$100.75 ,$100.75 ,$577.15 ,$107.90 ,$282.46 , N/A , N/A ,$112.94 ,$577.15 ,$190.12 ,$611.10 ,$533.02 ,$560.85 ,$100.75 ,$441.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000172,72070,HC XR T-SPINE 2V,320,1 ,$304.00 ,$197.60 ,$85.12 ,$304.00 ,$269.75 ,$243.20 ,$100.75 ,$85.12 ,$240.89 ,$279.07 ,$100.75 ,$279.07 ,$100.75 ,$205.01 ,$224.96 ,$269.75 ,$107.90 ,$253.54 ,$100.75 , N/A ,$251.10 ,$251.10 ,$243.20 ,$273.60 ,$251.87 ,$258.40 ,$100.75 ,$100.75 ,$258.40 ,$107.90 ,$126.46 , N/A , N/A ,$112.94 ,$258.40 ,$85.12 ,$273.60 ,$238.64 ,$251.10 ,$100.75 ,$197.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000174,72072,HC XR T-SPINE 3V,320,1 ,$456.00 ,$296.40 ,$100.75 ,$456.00 ,$269.75 ,$364.80 ,$100.75 ,$127.68 ,$361.33 ,$418.61 ,$100.75 ,$418.61 ,$100.75 ,$205.01 ,$337.44 ,$269.75 ,$107.90 ,$380.30 ,$100.75 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$251.87 ,$387.60 ,$100.75 ,$100.75 ,$387.60 ,$107.90 ,$189.70 , N/A , N/A ,$112.94 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$100.75 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000178,72100,HC XR L-SPINE 2-3V,320,1 ,$464.00 ,$301.60 ,$100.75 ,$464.00 ,$269.75 ,$371.20 ,$100.75 ,$129.92 ,$367.67 ,$425.95 ,$100.75 ,$425.95 ,$100.75 ,$205.01 ,$343.36 ,$269.75 ,$107.90 ,$386.98 ,$100.75 , N/A ,$383.26 ,$383.26 ,$371.20 ,$417.60 ,$251.87 ,$394.40 ,$100.75 ,$100.75 ,$394.40 ,$107.90 ,$193.02 , N/A , N/A ,$112.94 ,$394.40 ,$129.92 ,$417.60 ,$364.24 ,$383.26 ,$100.75 ,$301.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000181,72110,HC XR L-SPINE 4+V,320,1 ,$702.00 ,$456.30 ,$100.75 ,$702.00 ,$269.75 ,$561.60 ,$100.75 ,$196.56 ,$556.26 ,$644.44 ,$100.75 ,$644.44 ,$100.75 ,$205.01 ,$519.48 ,$269.75 ,$107.90 ,$585.47 ,$100.75 , N/A ,$579.85 ,$579.85 ,$561.60 ,$631.80 ,$251.87 ,$596.70 ,$100.75 ,$100.75 ,$596.70 ,$107.90 ,$292.03 , N/A , N/A ,$112.94 ,$596.70 ,$196.56 ,$631.80 ,$551.07 ,$579.85 ,$100.75 ,$456.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000183,72120,HC XR L-SPINE BENDING ONLY MIN 4V,320,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000184,72114,HC XR L-SPINE CMPL W/BEND MIN 6 VIEW,320,1 ,$821.00 ,$533.65 ,$100.75 ,$821.00 ,$269.75 ,$656.80 ,$100.75 ,$229.88 ,$650.56 ,$753.68 ,$100.75 ,$753.68 ,$100.75 ,$205.01 ,$607.54 ,$269.75 ,$107.90 ,$684.71 ,$100.75 , N/A ,$678.15 ,$678.15 ,$656.80 ,$738.90 ,$251.87 ,$697.85 ,$100.75 ,$100.75 ,$697.85 ,$107.90 ,$341.54 , N/A , N/A ,$112.94 ,$697.85 ,$229.88 ,$738.90 ,$644.49 ,$678.15 ,$100.75 ,$533.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000186,72170,HC XR PELVIS 1-2V,320,1 ,$324.00 ,$210.60 ,$90.72 ,$324.00 ,$269.75 ,$259.20 ,$100.75 ,$90.72 ,$256.74 ,$297.43 ,$100.75 ,$297.43 ,$100.75 ,$205.01 ,$239.76 ,$269.75 ,$107.90 ,$270.22 ,$100.75 , N/A ,$267.62 ,$267.62 ,$259.20 ,$291.60 ,$251.87 ,$275.40 ,$100.75 ,$100.75 ,$275.40 ,$107.90 ,$134.78 , N/A , N/A ,$112.94 ,$275.40 ,$90.72 ,$291.60 ,$254.34 ,$267.62 ,$100.75 ,$210.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000189,72190,HC XR PELVIS CMPL 3+V,320,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000190,72202,HC XR SACROILI JT 3+V,320,1 ,$496.00 ,$322.40 ,$100.75 ,$496.00 ,$269.75 ,$396.80 ,$100.75 ,$138.88 ,$393.03 ,$455.33 ,$100.75 ,$455.33 ,$100.75 ,$205.01 ,$367.04 ,$269.75 ,$107.90 ,$413.66 ,$100.75 , N/A ,$409.70 ,$409.70 ,$396.80 ,$446.40 ,$251.87 ,$421.60 ,$100.75 ,$100.75 ,$421.60 ,$107.90 ,$206.34 , N/A , N/A ,$112.94 ,$421.60 ,$138.88 ,$446.40 ,$389.36 ,$409.70 ,$100.75 ,$322.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000191,72220,HC XR SACRUM/COCCYX 2+V,320,1 ,$456.00 ,$296.40 ,$74.85 ,$456.00 ,$200.43 ,$364.80 ,$74.85 ,$127.68 ,$361.33 ,$418.61 ,$74.85 ,$418.61 ,$74.85 ,$152.32 ,$337.44 ,$200.43 ,$80.17 ,$380.30 ,$74.85 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$187.13 ,$387.60 ,$74.85 ,$74.85 ,$387.60 ,$80.17 ,$189.70 , N/A , N/A ,$83.91 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$74.85 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000201,73000,HC XRAY CLAVICLE,320,1 ,$424.00 ,$275.60 ,$74.85 ,$424.00 ,$200.43 ,$339.20 ,$74.85 ,$118.72 ,$335.98 ,$389.23 ,$74.85 ,$389.23 ,$74.85 ,$152.32 ,$313.76 ,$200.43 ,$80.17 ,$353.62 ,$74.85 , N/A ,$350.22 ,$350.22 ,$339.20 ,$381.60 ,$187.13 ,$360.40 ,$74.85 ,$74.85 ,$360.40 ,$80.17 ,$176.38 , N/A , N/A ,$83.91 ,$360.40 ,$118.72 ,$381.60 ,$332.84 ,$350.22 ,$74.85 ,$275.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000204,73010,HC XRAY SCAPULA,320,1 ,$456.00 ,$296.40 ,$100.75 ,$456.00 ,$269.75 ,$364.80 ,$100.75 ,$127.68 ,$361.33 ,$418.61 ,$100.75 ,$418.61 ,$100.75 ,$205.01 ,$337.44 ,$269.75 ,$107.90 ,$380.30 ,$100.75 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$251.87 ,$387.60 ,$100.75 ,$100.75 ,$387.60 ,$107.90 ,$189.70 , N/A , N/A ,$112.94 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$100.75 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$206.00 ,$133.90 ,$57.68 ,$206.00 ,$200.43 ,$164.80 ,$74.85 ,$57.68 ,$163.23 ,$189.11 ,$74.85 ,$189.11 ,$74.85 ,$152.32 ,$152.44 ,$200.43 ,$80.17 ,$171.80 ,$74.85 , N/A ,$170.16 ,$170.16 ,$164.80 ,$185.40 ,$187.13 ,$175.10 ,$74.85 ,$74.85 ,$175.10 ,$80.17 ,$85.70 , N/A , N/A ,$83.91 ,$175.10 ,$57.68 ,$185.40 ,$161.71 ,$170.16 ,$74.85 ,$133.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$456.00 ,$296.40 ,$74.85 ,$456.00 ,$200.43 ,$364.80 ,$74.85 ,$127.68 ,$361.33 ,$418.61 ,$74.85 ,$418.61 ,$74.85 ,$152.32 ,$337.44 ,$200.43 ,$80.17 ,$380.30 ,$74.85 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$187.13 ,$387.60 ,$74.85 ,$74.85 ,$387.60 ,$80.17 ,$189.70 , N/A , N/A ,$83.91 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$74.85 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000213,73050,HC XR AC JOINTS BI W/W/O WTS,320,1 ,$464.00 ,$301.60 ,$74.85 ,$464.00 ,$200.43 ,$371.20 ,$74.85 ,$129.92 ,$367.67 ,$425.95 ,$74.85 ,$425.95 ,$74.85 ,$152.32 ,$343.36 ,$200.43 ,$80.17 ,$386.98 ,$74.85 , N/A ,$383.26 ,$383.26 ,$371.20 ,$417.60 ,$187.13 ,$394.40 ,$74.85 ,$74.85 ,$394.40 ,$80.17 ,$193.02 , N/A , N/A ,$83.91 ,$394.40 ,$129.92 ,$417.60 ,$364.24 ,$383.26 ,$74.85 ,$301.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$389.00 ,$252.85 ,$74.85 ,$389.00 ,$200.43 ,$311.20 ,$74.85 ,$108.92 ,$308.24 ,$357.10 ,$74.85 ,$357.10 ,$74.85 ,$152.32 ,$287.86 ,$200.43 ,$80.17 ,$324.43 ,$74.85 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$187.13 ,$330.65 ,$74.85 ,$74.85 ,$330.65 ,$80.17 ,$161.82 , N/A , N/A ,$83.91 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$74.85 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$324.00 ,$210.60 ,$74.85 ,$324.00 ,$200.43 ,$259.20 ,$74.85 ,$90.72 ,$256.74 ,$297.43 ,$74.85 ,$297.43 ,$74.85 ,$152.32 ,$239.76 ,$200.43 ,$80.17 ,$270.22 ,$74.85 , N/A ,$267.62 ,$267.62 ,$259.20 ,$291.60 ,$187.13 ,$275.40 ,$74.85 ,$74.85 ,$275.40 ,$80.17 ,$134.78 , N/A , N/A ,$83.91 ,$275.40 ,$90.72 ,$291.60 ,$254.34 ,$267.62 ,$74.85 ,$210.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$389.00 ,$252.85 ,$74.85 ,$389.00 ,$200.43 ,$311.20 ,$74.85 ,$108.92 ,$308.24 ,$357.10 ,$74.85 ,$357.10 ,$74.85 ,$152.32 ,$287.86 ,$200.43 ,$80.17 ,$324.43 ,$74.85 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$187.13 ,$330.65 ,$74.85 ,$74.85 ,$330.65 ,$80.17 ,$161.82 , N/A , N/A ,$83.91 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$74.85 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$389.00 ,$252.85 ,$74.85 ,$389.00 ,$200.43 ,$311.20 ,$74.85 ,$108.92 ,$308.24 ,$357.10 ,$74.85 ,$357.10 ,$74.85 ,$152.32 ,$287.86 ,$200.43 ,$80.17 ,$324.43 ,$74.85 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$187.13 ,$330.65 ,$74.85 ,$74.85 ,$330.65 ,$80.17 ,$161.82 , N/A , N/A ,$83.91 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$74.85 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000226,73092,HC XRAY INFANT UP EXTRM MIN 2V,320,1 ,$389.00 ,$252.85 ,$100.75 ,$389.00 ,$269.75 ,$311.20 ,$100.75 ,$108.92 ,$308.24 ,$357.10 ,$100.75 ,$357.10 ,$100.75 ,$205.01 ,$287.86 ,$269.75 ,$107.90 ,$324.43 ,$100.75 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$251.87 ,$330.65 ,$100.75 ,$100.75 ,$330.65 ,$107.90 ,$161.82 , N/A , N/A ,$112.94 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$100.75 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$368.00 ,$239.20 ,$74.85 ,$368.00 ,$200.43 ,$294.40 ,$74.85 ,$103.04 ,$291.60 ,$337.82 ,$74.85 ,$337.82 ,$74.85 ,$152.32 ,$272.32 ,$200.43 ,$80.17 ,$306.91 ,$74.85 , N/A ,$303.97 ,$303.97 ,$294.40 ,$331.20 ,$187.13 ,$312.80 ,$74.85 ,$74.85 ,$312.80 ,$80.17 ,$153.09 , N/A , N/A ,$83.91 ,$312.80 ,$103.04 ,$331.20 ,$288.88 ,$303.97 ,$74.85 ,$239.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$389.00 ,$252.85 ,$74.85 ,$389.00 ,$200.43 ,$311.20 ,$74.85 ,$108.92 ,$308.24 ,$357.10 ,$74.85 ,$357.10 ,$74.85 ,$152.32 ,$287.86 ,$200.43 ,$80.17 ,$324.43 ,$74.85 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$187.13 ,$330.65 ,$74.85 ,$74.85 ,$330.65 ,$80.17 ,$161.82 , N/A , N/A ,$83.91 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$74.85 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$327.00 ,$212.55 ,$91.56 ,$327.00 ,$269.75 ,$261.60 ,$100.75 ,$91.56 ,$259.11 ,$300.19 ,$100.75 ,$300.19 ,$100.75 ,$205.01 ,$241.98 ,$269.75 ,$107.90 ,$272.72 ,$100.75 , N/A ,$270.10 ,$270.10 ,$261.60 ,$294.30 ,$251.87 ,$277.95 ,$100.75 ,$100.75 ,$277.95 ,$107.90 ,$136.03 , N/A , N/A ,$112.94 ,$277.95 ,$91.56 ,$294.30 ,$256.70 ,$270.10 ,$100.75 ,$212.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$389.00 ,$252.85 ,$74.85 ,$389.00 ,$200.43 ,$311.20 ,$74.85 ,$108.92 ,$308.24 ,$357.10 ,$74.85 ,$357.10 ,$74.85 ,$152.32 ,$287.86 ,$200.43 ,$80.17 ,$324.43 ,$74.85 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$187.13 ,$330.65 ,$74.85 ,$74.85 ,$330.65 ,$80.17 ,$161.82 , N/A , N/A ,$83.91 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$74.85 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000241,73140,HC XRAY FINGER MIN 2 VIEWS,320,1 ,$324.00 ,$210.60 ,$74.85 ,$324.00 ,$200.43 ,$259.20 ,$74.85 ,$90.72 ,$256.74 ,$297.43 ,$74.85 ,$297.43 ,$74.85 ,$152.32 ,$239.76 ,$200.43 ,$80.17 ,$270.22 ,$74.85 , N/A ,$267.62 ,$267.62 ,$259.20 ,$291.60 ,$187.13 ,$275.40 ,$74.85 ,$74.85 ,$275.40 ,$80.17 ,$134.78 , N/A , N/A ,$83.91 ,$275.40 ,$90.72 ,$291.60 ,$254.34 ,$267.62 ,$74.85 ,$210.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$391.00 ,$254.15 ,$74.85 ,$391.00 ,$200.43 ,$312.80 ,$74.85 ,$109.48 ,$309.83 ,$358.94 ,$74.85 ,$358.94 ,$74.85 ,$152.32 ,$289.34 ,$200.43 ,$80.17 ,$326.09 ,$74.85 , N/A ,$322.97 ,$322.97 ,$312.80 ,$351.90 ,$187.13 ,$332.35 ,$74.85 ,$74.85 ,$332.35 ,$80.17 ,$162.66 , N/A , N/A ,$83.91 ,$332.35 ,$109.48 ,$351.90 ,$306.94 ,$322.97 ,$74.85 ,$254.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000263,73562,HC XRAY KNEE (3 V),320,1 ,$424.00 ,$275.60 ,$74.85 ,$424.00 ,$200.43 ,$339.20 ,$74.85 ,$118.72 ,$335.98 ,$389.23 ,$74.85 ,$389.23 ,$74.85 ,$152.32 ,$313.76 ,$200.43 ,$80.17 ,$353.62 ,$74.85 , N/A ,$350.22 ,$350.22 ,$339.20 ,$381.60 ,$187.13 ,$360.40 ,$74.85 ,$74.85 ,$360.40 ,$80.17 ,$176.38 , N/A , N/A ,$83.91 ,$360.40 ,$118.72 ,$381.60 ,$332.84 ,$350.22 ,$74.85 ,$275.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$463.00 ,$300.95 ,$100.75 ,$463.00 ,$269.75 ,$370.40 ,$100.75 ,$129.64 ,$366.88 ,$425.03 ,$100.75 ,$425.03 ,$100.75 ,$205.01 ,$342.62 ,$269.75 ,$107.90 ,$386.14 ,$100.75 , N/A ,$382.44 ,$382.44 ,$370.40 ,$416.70 ,$251.87 ,$393.55 ,$100.75 ,$100.75 ,$393.55 ,$107.90 ,$192.61 , N/A , N/A ,$112.94 ,$393.55 ,$129.64 ,$416.70 ,$363.46 ,$382.44 ,$100.75 ,$300.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000267,73565,HC XR KNEE STAND,320,1 ,$424.00 ,$275.60 ,$74.85 ,$424.00 ,$200.43 ,$339.20 ,$74.85 ,$118.72 ,$335.98 ,$389.23 ,$74.85 ,$389.23 ,$74.85 ,$152.32 ,$313.76 ,$200.43 ,$80.17 ,$353.62 ,$74.85 , N/A ,$350.22 ,$350.22 ,$339.20 ,$381.60 ,$187.13 ,$360.40 ,$74.85 ,$74.85 ,$360.40 ,$80.17 ,$176.38 , N/A , N/A ,$83.91 ,$360.40 ,$118.72 ,$381.60 ,$332.84 ,$350.22 ,$74.85 ,$275.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$389.00 ,$252.85 ,$74.85 ,$389.00 ,$200.43 ,$311.20 ,$74.85 ,$108.92 ,$308.24 ,$357.10 ,$74.85 ,$357.10 ,$74.85 ,$152.32 ,$287.86 ,$200.43 ,$80.17 ,$324.43 ,$74.85 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$187.13 ,$330.65 ,$74.85 ,$74.85 ,$330.65 ,$80.17 ,$161.82 , N/A , N/A ,$83.91 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$74.85 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$314.00 ,$204.10 ,$74.85 ,$314.00 ,$200.43 ,$251.20 ,$74.85 ,$87.92 ,$248.81 ,$288.25 ,$74.85 ,$288.25 ,$74.85 ,$152.32 ,$232.36 ,$200.43 ,$80.17 ,$261.88 ,$74.85 , N/A ,$259.36 ,$259.36 ,$251.20 ,$282.60 ,$187.13 ,$266.90 ,$74.85 ,$74.85 ,$266.90 ,$80.17 ,$130.62 , N/A , N/A ,$83.91 ,$266.90 ,$87.92 ,$282.60 ,$246.49 ,$259.36 ,$74.85 ,$204.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$371.00 ,$241.15 ,$74.85 ,$371.00 ,$200.43 ,$296.80 ,$74.85 ,$103.88 ,$293.98 ,$340.58 ,$74.85 ,$340.58 ,$74.85 ,$152.32 ,$274.54 ,$200.43 ,$80.17 ,$309.41 ,$74.85 , N/A ,$306.45 ,$306.45 ,$296.80 ,$333.90 ,$187.13 ,$315.35 ,$74.85 ,$74.85 ,$315.35 ,$80.17 ,$154.34 , N/A , N/A ,$83.91 ,$315.35 ,$103.88 ,$333.90 ,$291.24 ,$306.45 ,$74.85 ,$241.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000279,73620,HC XRAY FOOT (2 V),320,1 ,$528.00 ,$343.20 ,$74.85 ,$528.00 ,$200.43 ,$422.40 ,$74.85 ,$147.84 ,$418.39 ,$484.70 ,$74.85 ,$484.70 ,$74.85 ,$152.32 ,$390.72 ,$200.43 ,$80.17 ,$440.35 ,$74.85 , N/A ,$436.13 ,$436.13 ,$422.40 ,$475.20 ,$187.13 ,$448.80 ,$74.85 ,$74.85 ,$448.80 ,$80.17 ,$219.65 , N/A , N/A ,$83.91 ,$448.80 ,$147.84 ,$475.20 ,$414.48 ,$436.13 ,$74.85 ,$343.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$389.00 ,$252.85 ,$74.85 ,$389.00 ,$200.43 ,$311.20 ,$74.85 ,$108.92 ,$308.24 ,$357.10 ,$74.85 ,$357.10 ,$74.85 ,$152.32 ,$287.86 ,$200.43 ,$80.17 ,$324.43 ,$74.85 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$187.13 ,$330.65 ,$74.85 ,$74.85 ,$330.65 ,$80.17 ,$161.82 , N/A , N/A ,$83.91 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$74.85 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$389.00 ,$252.85 ,$74.85 ,$389.00 ,$200.43 ,$311.20 ,$74.85 ,$108.92 ,$308.24 ,$357.10 ,$74.85 ,$357.10 ,$74.85 ,$152.32 ,$287.86 ,$200.43 ,$80.17 ,$324.43 ,$74.85 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$187.13 ,$330.65 ,$74.85 ,$74.85 ,$330.65 ,$80.17 ,$161.82 , N/A , N/A ,$83.91 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$74.85 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$324.00 ,$210.60 ,$74.85 ,$324.00 ,$200.43 ,$259.20 ,$74.85 ,$90.72 ,$256.74 ,$297.43 ,$74.85 ,$297.43 ,$74.85 ,$152.32 ,$239.76 ,$200.43 ,$80.17 ,$270.22 ,$74.85 , N/A ,$267.62 ,$267.62 ,$259.20 ,$291.60 ,$187.13 ,$275.40 ,$74.85 ,$74.85 ,$275.40 ,$80.17 ,$134.78 , N/A , N/A ,$83.91 ,$275.40 ,$90.72 ,$291.60 ,$254.34 ,$267.62 ,$74.85 ,$210.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000289,74018,HC XRAY ABDOMEN 1V,320,1 ,$435.00 ,$282.75 ,$74.85 ,$435.00 ,$200.43 ,$348.00 ,$74.85 ,$121.80 ,$344.69 ,$399.33 ,$74.85 ,$399.33 ,$74.85 ,$152.32 ,$321.90 ,$200.43 ,$80.17 ,$362.79 ,$74.85 , N/A ,$359.31 ,$359.31 ,$348.00 ,$391.50 ,$187.13 ,$369.75 ,$74.85 ,$74.85 ,$369.75 ,$80.17 ,$180.96 , N/A , N/A ,$83.91 ,$369.75 ,$121.80 ,$391.50 ,$341.48 ,$359.31 ,$74.85 ,$282.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000294,74019,HC XRAY ABDOMEN AP  AND  LAT (2 V OR 3 V),320,1 ,$397.00 ,$258.05 ,$100.75 ,$397.00 ,$269.75 ,$317.60 ,$100.75 ,$111.16 ,$314.58 ,$364.45 ,$100.75 ,$364.45 ,$100.75 ,$205.01 ,$293.78 ,$269.75 ,$107.90 ,$331.10 ,$100.75 , N/A ,$327.92 ,$327.92 ,$317.60 ,$357.30 ,$251.87 ,$337.45 ,$100.75 ,$100.75 ,$337.45 ,$107.90 ,$165.15 , N/A , N/A ,$112.94 ,$337.45 ,$111.16 ,$357.30 ,$311.65 ,$327.92 ,$100.75 ,$258.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000298,74022,HC XRAY ABDOMEN AP/DECUB/ERECT/CXR,320,1 ,$523.00 ,$339.95 ,$100.75 ,$523.00 ,$269.75 ,$418.40 ,$100.75 ,$146.44 ,$414.43 ,$480.11 ,$100.75 ,$480.11 ,$100.75 ,$205.01 ,$387.02 ,$269.75 ,$107.90 ,$436.18 ,$100.75 , N/A ,$432.00 ,$432.00 ,$418.40 ,$470.70 ,$251.87 ,$444.55 ,$100.75 ,$100.75 ,$444.55 ,$107.90 ,$217.57 , N/A , N/A ,$112.94 ,$444.55 ,$146.44 ,$470.70 ,$410.56 ,$432.00 ,$100.75 ,$339.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000300,74220,HC XRAY ESOPHAGUS,320,1 ,$491.00 ,$319.15 ,$137.48 ,$491.00 ,$442.60 ,$392.80 ,$165.30 ,$137.48 ,$389.07 ,$450.74 ,$165.30 ,$450.74 ,$165.30 ,$336.38 ,$363.34 ,$442.60 ,$177.04 ,$409.49 ,$165.30 , N/A ,$405.57 ,$405.57 ,$392.80 ,$441.90 ,$413.25 ,$417.35 ,$165.30 ,$165.30 ,$417.35 ,$177.04 ,$204.26 , N/A , N/A ,$185.30 ,$417.35 ,$137.48 ,$441.90 ,$385.44 ,$405.57 ,$165.30 ,$319.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000301,74230,HC VIDEO FLUORO SWALLOWING,320,1 ,$812.00 ,$527.80 ,$165.30 ,$812.00 ,$442.60 ,$649.60 ,$165.30 ,$227.36 ,$643.43 ,$745.42 ,$165.30 ,$745.42 ,$165.30 ,$336.38 ,$600.88 ,$442.60 ,$177.04 ,$677.21 ,$165.30 , N/A ,$670.71 ,$670.71 ,$649.60 ,$730.80 ,$413.25 ,$690.20 ,$165.30 ,$165.30 ,$690.20 ,$177.04 ,$337.79 , N/A , N/A ,$185.30 ,$690.20 ,$227.36 ,$730.80 ,$637.42 ,$670.71 ,$165.30 ,$527.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000302,74240,HC XRAY UPPER GI TRACT,320,1 ,$926.00 ,$601.90 ,$165.30 ,$926.00 ,$442.60 ,$740.80 ,$165.30 ,$259.28 ,$733.76 ,$850.07 ,$165.30 ,$850.07 ,$165.30 ,$336.38 ,$685.24 ,$442.60 ,$177.04 ,$772.28 ,$165.30 , N/A ,$764.88 ,$764.88 ,$740.80 ,$833.40 ,$413.25 ,$787.10 ,$165.30 ,$165.30 ,$787.10 ,$177.04 ,$385.22 , N/A , N/A ,$185.30 ,$787.10 ,$259.28 ,$833.40 ,$726.91 ,$764.88 ,$165.30 ,$601.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000306,74246,HC UPPER GI TRACT - NO KUB,320,1 ,$856.00 ,$556.40 ,$165.30 ,$856.00 ,$442.60 ,$684.80 ,$165.30 ,$239.68 ,$678.29 ,$785.81 ,$165.30 ,$785.81 ,$165.30 ,$336.38 ,$633.44 ,$442.60 ,$177.04 ,$713.90 ,$165.30 , N/A ,$707.06 ,$707.06 ,$684.80 ,$770.40 ,$413.25 ,$727.60 ,$165.30 ,$165.30 ,$727.60 ,$177.04 ,$356.10 , N/A , N/A ,$185.30 ,$727.60 ,$239.68 ,$770.40 ,$671.96 ,$707.06 ,$165.30 ,$556.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000307,74246,HC XRAY ESOPHAGUS/UGI W AIR,320,1 ,$856.00 ,$556.40 ,$165.30 ,$856.00 ,$442.60 ,$684.80 ,$165.30 ,$239.68 ,$678.29 ,$785.81 ,$165.30 ,$785.81 ,$165.30 ,$336.38 ,$633.44 ,$442.60 ,$177.04 ,$713.90 ,$165.30 , N/A ,$707.06 ,$707.06 ,$684.80 ,$770.40 ,$413.25 ,$727.60 ,$165.30 ,$165.30 ,$727.60 ,$177.04 ,$356.10 , N/A , N/A ,$185.30 ,$727.60 ,$239.68 ,$770.40 ,$671.96 ,$707.06 ,$165.30 ,$556.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000312,74018,HC SITZ MARKER STUDY,320,1 ,$435.00 ,$282.75 ,$74.85 ,$435.00 ,$200.43 ,$348.00 ,$74.85 ,$121.80 ,$344.69 ,$399.33 ,$74.85 ,$399.33 ,$74.85 ,$152.32 ,$321.90 ,$200.43 ,$80.17 ,$362.79 ,$74.85 , N/A ,$359.31 ,$359.31 ,$348.00 ,$391.50 ,$187.13 ,$369.75 ,$74.85 ,$74.85 ,$369.75 ,$80.17 ,$180.96 , N/A , N/A ,$83.91 ,$369.75 ,$121.80 ,$391.50 ,$341.48 ,$359.31 ,$74.85 ,$282.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000315,74270,HC XRAY COLON BARIUM,320,1 ,$810.00 ,$526.50 ,$165.30 ,$810.00 ,$442.60 ,$648.00 ,$165.30 ,$226.80 ,$641.84 ,$743.58 ,$165.30 ,$743.58 ,$165.30 ,$336.38 ,$599.40 ,$442.60 ,$177.04 ,$675.54 ,$165.30 , N/A ,$669.06 ,$669.06 ,$648.00 ,$729.00 ,$413.25 ,$688.50 ,$165.30 ,$165.30 ,$688.50 ,$177.04 ,$336.96 , N/A , N/A ,$185.30 ,$688.50 ,$226.80 ,$729.00 ,$635.85 ,$669.06 ,$165.30 ,$526.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000318,74270,HC XRAY BARM ENEMA/COLSTMY,320,1 ,$810.00 ,$526.50 ,$165.30 ,$810.00 ,$442.60 ,$648.00 ,$165.30 ,$226.80 ,$641.84 ,$743.58 ,$165.30 ,$743.58 ,$165.30 ,$336.38 ,$599.40 ,$442.60 ,$177.04 ,$675.54 ,$165.30 , N/A ,$669.06 ,$669.06 ,$648.00 ,$729.00 ,$413.25 ,$688.50 ,$165.30 ,$165.30 ,$688.50 ,$177.04 ,$336.96 , N/A , N/A ,$185.30 ,$688.50 ,$226.80 ,$729.00 ,$635.85 ,$669.06 ,$165.30 ,$526.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000319,74270,HC XRAY BARM ENEMA WATER SOL,320,1 ,$810.00 ,$526.50 ,$165.30 ,$810.00 ,$442.60 ,$648.00 ,$165.30 ,$226.80 ,$641.84 ,$743.58 ,$165.30 ,$743.58 ,$165.30 ,$336.38 ,$599.40 ,$442.60 ,$177.04 ,$675.54 ,$165.30 , N/A ,$669.06 ,$669.06 ,$648.00 ,$729.00 ,$413.25 ,$688.50 ,$165.30 ,$165.30 ,$688.50 ,$177.04 ,$336.96 , N/A , N/A ,$185.30 ,$688.50 ,$226.80 ,$729.00 ,$635.85 ,$669.06 ,$165.30 ,$526.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000320,74280,HC XRAY COLON BARIUM AIR CONTRAST,320,1 ,"$1,158.00 ",$752.70 ,$165.30 ,"$1,158.00 ",$442.60 ,$926.40 ,$165.30 ,$324.24 ,$917.60 ,"$1,063.04 ",$165.30 ,"$1,063.04 ",$165.30 ,$336.38 ,$856.92 ,$442.60 ,$177.04 ,$965.77 ,$165.30 , N/A ,$956.51 ,$956.51 ,$926.40 ,"$1,042.20 ",$413.25 ,$984.30 ,$165.30 ,$165.30 ,$984.30 ,$177.04 ,$481.73 , N/A , N/A ,$185.30 ,$984.30 ,$324.24 ,"$1,042.20 ",$909.03 ,$956.51 ,$165.30 ,$752.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000323,74300,HC CHOLANGIOGRAPHY OPERATIVE,320,1 ,$563.00 ,$365.95 ,$157.64 ,$563.00 , N/A ,$450.40 , N/A ,$157.64 ,$446.12 ,$516.83 , N/A ,$516.83 , N/A , N/A ,$416.62 , N/A , N/A ,$469.54 , N/A , N/A ,$465.04 ,$465.04 ,$450.40 ,$506.70 , N/A ,$478.55 , N/A , N/A ,$478.55 , N/A ,$234.21 , N/A , N/A , N/A ,$478.55 ,$157.64 ,$506.70 ,$441.96 ,$465.04 , N/A ,$365.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000335,74400,HC XRAY IVP W OR W/O TOMO,320,1 ,$880.00 ,$572.00 ,$165.30 ,$880.00 ,$442.60 ,$704.00 ,$165.30 ,$246.40 ,$697.31 ,$807.84 ,$165.30 ,$807.84 ,$165.30 ,$336.38 ,$651.20 ,$442.60 ,$177.04 ,$733.92 ,$165.30 , N/A ,$726.88 ,$726.88 ,$704.00 ,$792.00 ,$413.25 ,$748.00 ,$165.30 ,$165.30 ,$748.00 ,$177.04 ,$366.08 , N/A , N/A ,$185.30 ,$748.00 ,$246.40 ,$792.00 ,$690.80 ,$726.88 ,$165.30 ,$572.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000447,76000,HC FLUOROSCOPY UP TO 1 HR 76000,320,1 ,$453.00 ,$294.45 ,$126.84 ,$570.13 ,$570.13 ,$362.40 ,$212.93 ,$126.84 ,$358.96 ,$415.85 ,$212.93 ,$415.85 ,$212.93 ,$433.30 ,$335.22 ,$453.00 ,$228.05 ,$377.80 ,$212.93 , N/A ,$374.18 ,$374.18 ,$362.40 ,$407.70 ,$453.00 ,$385.05 ,$212.93 ,$212.93 ,$385.05 ,$228.05 ,$188.45 , N/A , N/A ,$238.70 ,$385.05 ,$126.84 ,$407.70 ,$355.61 ,$374.18 ,$212.93 ,$294.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000464,76010,HC BABYGRAM,320,1 ,$220.00 ,$143.00 ,$61.60 ,$220.00 ,$200.43 ,$176.00 ,$74.85 ,$61.60 ,$174.33 ,$201.96 ,$74.85 ,$201.96 ,$74.85 ,$152.32 ,$162.80 ,$200.43 ,$80.17 ,$183.48 ,$74.85 , N/A ,$181.72 ,$181.72 ,$176.00 ,$198.00 ,$187.13 ,$187.00 ,$74.85 ,$74.85 ,$187.00 ,$80.17 ,$91.52 , N/A , N/A ,$83.91 ,$187.00 ,$61.60 ,$198.00 ,$172.70 ,$181.72 ,$74.85 ,$143.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000476,77002,HC FLUORO NEEDLE PLACEMENT,320,1 ,$234.00 ,$152.10 ,$65.52 ,$234.00 , N/A ,$187.20 , N/A ,$65.52 ,$185.42 ,$214.81 , N/A ,$214.81 , N/A , N/A ,$173.16 , N/A , N/A ,$195.16 , N/A , N/A ,$193.28 ,$193.28 ,$187.20 ,$210.60 , N/A ,$198.90 , N/A , N/A ,$198.90 , N/A ,$97.34 , N/A , N/A , N/A ,$198.90 ,$65.52 ,$210.60 ,$183.69 ,$193.28 , N/A ,$152.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000492,77073,HC BONE LENGTH STUDIES,320,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000494,77075,HC BONE SURVEY COMPLETE,320,1 ,"$1,273.00 ",$827.45 ,$100.75 ,"$1,273.00 ",$269.75 ,"$1,018.40 ",$100.75 ,$356.44 ,"$1,008.73 ","$1,168.61 ",$100.75 ,"$1,168.61 ",$100.75 ,$205.01 ,$942.02 ,$269.75 ,$107.90 ,"$1,061.68 ",$100.75 , N/A ,"$1,051.50 ","$1,051.50 ","$1,018.40 ","$1,145.70 ",$251.87 ,"$1,082.05 ",$100.75 ,$100.75 ,"$1,082.05 ",$107.90 ,$529.57 , N/A , N/A ,$112.94 ,"$1,082.05 ",$356.44 ,"$1,145.70 ",$999.31 ,"$1,051.50 ",$100.75 ,$827.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000495,77076,HC OSSEOUS SURVEY INFANT,320,1 ,"$1,273.00 ",$827.45 ,$100.75 ,"$1,273.00 ",$269.75 ,"$1,018.40 ",$100.75 ,$356.44 ,"$1,008.73 ","$1,168.61 ",$100.75 ,"$1,168.61 ",$100.75 ,$205.01 ,$942.02 ,$269.75 ,$107.90 ,"$1,061.68 ",$100.75 , N/A ,"$1,051.50 ","$1,051.50 ","$1,018.40 ","$1,145.70 ",$251.87 ,"$1,082.05 ",$100.75 ,$100.75 ,"$1,082.05 ",$107.90 ,$529.57 , N/A , N/A ,$112.94 ,"$1,082.05 ",$356.44 ,"$1,145.70 ",$999.31 ,"$1,051.50 ",$100.75 ,$827.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000496,77080,HC BONE DENSITY DXA,320,1 ,$531.00 ,$345.15 ,$100.75 ,$531.00 ,$269.75 ,$424.80 ,$100.75 ,$148.68 ,$420.76 ,$487.46 ,$100.75 ,$487.46 ,$100.75 ,$205.01 ,$392.94 ,$269.75 ,$107.90 ,$442.85 ,$100.75 , N/A ,$438.61 ,$438.61 ,$424.80 ,$477.90 ,$251.87 ,$451.35 ,$100.75 ,$100.75 ,$451.35 ,$107.90 ,$220.90 , N/A , N/A ,$112.94 ,$451.35 ,$148.68 ,$477.90 ,$416.84 ,$438.61 ,$100.75 ,$345.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000500,76000,HC FLUOROSCOPY UP TO 1 HR SNIFF DIAPHRM,320,1 ,$258.00 ,$167.70 ,$72.24 ,$570.13 ,$570.13 ,$206.40 ,$212.93 ,$72.24 ,$204.44 ,$236.84 ,$212.93 ,$236.84 ,$212.93 ,$258.00 ,$190.92 ,$258.00 ,$228.05 ,$215.17 ,$212.93 , N/A ,$213.11 ,$213.11 ,$206.40 ,$232.20 ,$258.00 ,$219.30 ,$212.93 ,$212.93 ,$219.30 ,$228.05 ,$107.33 , N/A , N/A ,$238.70 ,$219.30 ,$72.24 ,$232.20 ,$202.53 ,$213.11 ,$212.93 ,$167.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000504,20550,HC INJ SINGLE TENDON/LIGAMENT,320,1 ,$608.00 ,$395.20 ,$170.24 ,$647.35 ,$647.35 ,$486.40 ,$241.77 ,$170.24 ,$481.78 ,$558.14 ,$241.77 ,$558.14 ,$241.77 ,$491.99 ,$449.92 ,$608.00 ,$258.94 ,$507.07 ,$241.77 , N/A ,$502.21 ,$502.21 ,$486.40 ,$547.20 ,$604.44 ,$516.80 ,$241.77 ,$241.77 ,$516.80 ,$258.94 ,$252.93 , N/A , N/A ,$271.03 ,$516.80 ,$170.24 ,$547.20 ,$477.28 ,$502.21 ,$241.77 ,$395.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000505,20552,HC INJ TRIGGER PT 1-2 MUSCLE(S),320,1 ,$544.00 ,$353.60 ,$152.32 ,$647.35 ,$647.35 ,$435.20 ,$241.77 ,$152.32 ,$431.07 ,$499.39 ,$241.77 ,$499.39 ,$241.77 ,$491.99 ,$402.56 ,$544.00 ,$258.94 ,$453.70 ,$241.77 , N/A ,$449.34 ,$449.34 ,$435.20 ,$489.60 ,$544.00 ,$462.40 ,$241.77 ,$241.77 ,$462.40 ,$258.94 ,$226.30 , N/A , N/A ,$271.03 ,$462.40 ,$152.32 ,$489.60 ,$427.04 ,$449.34 ,$241.77 ,$353.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000509,77072,HC BONE AGE STUDIES,320,1 ,$502.00 ,$326.30 ,$100.75 ,$502.00 ,$269.75 ,$401.60 ,$100.75 ,$140.56 ,$397.78 ,$460.84 ,$100.75 ,$460.84 ,$100.75 ,$205.01 ,$371.48 ,$269.75 ,$107.90 ,$418.67 ,$100.75 , N/A ,$414.65 ,$414.65 ,$401.60 ,$451.80 ,$251.87 ,$426.70 ,$100.75 ,$100.75 ,$426.70 ,$107.90 ,$208.83 , N/A , N/A ,$112.94 ,$426.70 ,$140.56 ,$451.80 ,$394.07 ,$414.65 ,$100.75 ,$326.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000542,20551,HC INJ TENDON ORIGIN,320,1 ,$608.00 ,$395.20 ,$170.24 ,$647.35 ,$647.35 ,$486.40 ,$241.77 ,$170.24 ,$481.78 ,$558.14 ,$241.77 ,$558.14 ,$241.77 ,$491.99 ,$449.92 ,$608.00 ,$258.94 ,$507.07 ,$241.77 , N/A ,$502.21 ,$502.21 ,$486.40 ,$547.20 ,$604.44 ,$516.80 ,$241.77 ,$241.77 ,$516.80 ,$258.94 ,$252.93 , N/A , N/A ,$271.03 ,$516.80 ,$170.24 ,$547.20 ,$477.28 ,$502.21 ,$241.77 ,$395.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000543,72074,HC XR T-SPINE 4 + VIEWS,320,1 ,$773.00 ,$502.45 ,$100.75 ,$773.00 ,$269.75 ,$618.40 ,$100.75 ,$216.44 ,$612.53 ,$709.61 ,$100.75 ,$709.61 ,$100.75 ,$205.01 ,$572.02 ,$269.75 ,$107.90 ,$644.68 ,$100.75 , N/A ,$638.50 ,$638.50 ,$618.40 ,$695.70 ,$251.87 ,$657.05 ,$100.75 ,$100.75 ,$657.05 ,$107.90 ,$321.57 , N/A , N/A ,$112.94 ,$657.05 ,$216.44 ,$695.70 ,$606.81 ,$638.50 ,$100.75 ,$502.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000551,77077,HC XR JOINT SRVY SINGLE 2 JOINTS,320,1 ,$509.00 ,$330.85 ,$100.75 ,$509.00 ,$269.75 ,$407.20 ,$100.75 ,$142.52 ,$403.33 ,$467.26 ,$100.75 ,$467.26 ,$100.75 ,$205.01 ,$376.66 ,$269.75 ,$107.90 ,$424.51 ,$100.75 , N/A ,$420.43 ,$420.43 ,$407.20 ,$458.10 ,$251.87 ,$432.65 ,$100.75 ,$100.75 ,$432.65 ,$107.90 ,$211.74 , N/A , N/A ,$112.94 ,$432.65 ,$142.52 ,$458.10 ,$399.57 ,$420.43 ,$100.75 ,$330.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000552,70100,HC XR MANDIBLE <3V,320,1 ,$220.00 ,$143.00 ,$61.60 ,$220.00 ,$200.43 ,$176.00 ,$74.85 ,$61.60 ,$174.33 ,$201.96 ,$74.85 ,$201.96 ,$74.85 ,$152.32 ,$162.80 ,$200.43 ,$80.17 ,$183.48 ,$74.85 , N/A ,$181.72 ,$181.72 ,$176.00 ,$198.00 ,$187.13 ,$187.00 ,$74.85 ,$74.85 ,$187.00 ,$80.17 ,$91.52 , N/A , N/A ,$83.91 ,$187.00 ,$61.60 ,$198.00 ,$172.70 ,$181.72 ,$74.85 ,$143.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000567,70100,HC XR MANDIBLE 1-3 VIEW,320,1 ,$220.00 ,$143.00 ,$61.60 ,$220.00 ,$200.43 ,$176.00 ,$74.85 ,$61.60 ,$174.33 ,$201.96 ,$74.85 ,$201.96 ,$74.85 ,$152.32 ,$162.80 ,$200.43 ,$80.17 ,$183.48 ,$74.85 , N/A ,$181.72 ,$181.72 ,$176.00 ,$198.00 ,$187.13 ,$187.00 ,$74.85 ,$74.85 ,$187.00 ,$80.17 ,$91.52 , N/A , N/A ,$83.91 ,$187.00 ,$61.60 ,$198.00 ,$172.70 ,$181.72 ,$74.85 ,$143.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000571,72082,HC XR SPINE/CERV SCOLIOSIS 2-3VW,320,1 ,$456.00 ,$296.40 ,$100.75 ,$456.00 ,$269.75 ,$364.80 ,$100.75 ,$127.68 ,$361.33 ,$418.61 ,$100.75 ,$418.61 ,$100.75 ,$205.01 ,$337.44 ,$269.75 ,$107.90 ,$380.30 ,$100.75 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$251.87 ,$387.60 ,$100.75 ,$100.75 ,$387.60 ,$107.90 ,$189.70 , N/A , N/A ,$112.94 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$100.75 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000572,72083,HC XR SPINE/CERV SCOLIOSIS 4-5VW,320,1 ,$456.00 ,$296.40 ,$100.75 ,$456.00 ,$269.75 ,$364.80 ,$100.75 ,$127.68 ,$361.33 ,$418.61 ,$100.75 ,$418.61 ,$100.75 ,$205.01 ,$337.44 ,$269.75 ,$107.90 ,$380.30 ,$100.75 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$251.87 ,$387.60 ,$100.75 ,$100.75 ,$387.60 ,$107.90 ,$189.70 , N/A , N/A ,$112.94 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$100.75 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000573,72084,HC XR SPINE/CERV SCOLIOSIS 6+VW,320,1 ,$456.00 ,$296.40 ,$100.75 ,$456.00 ,$269.75 ,$364.80 ,$100.75 ,$127.68 ,$361.33 ,$418.61 ,$100.75 ,$418.61 ,$100.75 ,$205.01 ,$337.44 ,$269.75 ,$107.90 ,$380.30 ,$100.75 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$251.87 ,$387.60 ,$100.75 ,$100.75 ,$387.60 ,$107.90 ,$189.70 , N/A , N/A ,$112.94 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$100.75 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000574,73501,HC XR HIP W/PELVIS UNI 1VIEW,320,1 ,$165.00 ,$107.25 ,$46.20 ,$200.43 ,$200.43 ,$132.00 ,$74.85 ,$46.20 ,$130.75 ,$151.47 ,$74.85 ,$151.47 ,$74.85 ,$152.32 ,$122.10 ,$165.00 ,$80.17 ,$137.61 ,$74.85 , N/A ,$136.29 ,$136.29 ,$132.00 ,$148.50 ,$165.00 ,$140.25 ,$74.85 ,$74.85 ,$140.25 ,$80.17 ,$68.64 , N/A , N/A ,$83.91 ,$140.25 ,$46.20 ,$148.50 ,$129.53 ,$136.29 ,$74.85 ,$107.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000575,73502,HC XR HIP W/PELVIS UNI 2-3VWS,320,1 ,$373.00 ,$242.45 ,$74.85 ,$373.00 ,$200.43 ,$298.40 ,$74.85 ,$104.44 ,$295.57 ,$342.41 ,$74.85 ,$342.41 ,$74.85 ,$152.32 ,$276.02 ,$200.43 ,$80.17 ,$311.08 ,$74.85 , N/A ,$308.10 ,$308.10 ,$298.40 ,$335.70 ,$187.13 ,$317.05 ,$74.85 ,$74.85 ,$317.05 ,$80.17 ,$155.17 , N/A , N/A ,$83.91 ,$317.05 ,$104.44 ,$335.70 ,$292.81 ,$308.10 ,$74.85 ,$242.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000577,73521,HC XR HIP W/PELVIS BIL 2 VIEWS,320,1 ,$778.00 ,$505.70 ,$100.75 ,$778.00 ,$269.75 ,$622.40 ,$100.75 ,$217.84 ,$616.49 ,$714.20 ,$100.75 ,$714.20 ,$100.75 ,$205.01 ,$575.72 ,$269.75 ,$107.90 ,$648.85 ,$100.75 , N/A ,$642.63 ,$642.63 ,$622.40 ,$700.20 ,$251.87 ,$661.30 ,$100.75 ,$100.75 ,$661.30 ,$107.90 ,$323.65 , N/A , N/A ,$112.94 ,$661.30 ,$217.84 ,$700.20 ,$610.73 ,$642.63 ,$100.75 ,$505.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000578,73522,HC XR HIP W/PELVIS BIL 3-4VIEWS,320,1 ,$778.00 ,$505.70 ,$100.75 ,$778.00 ,$269.75 ,$622.40 ,$100.75 ,$217.84 ,$616.49 ,$714.20 ,$100.75 ,$714.20 ,$100.75 ,$205.01 ,$575.72 ,$269.75 ,$107.90 ,$648.85 ,$100.75 , N/A ,$642.63 ,$642.63 ,$622.40 ,$700.20 ,$251.87 ,$661.30 ,$100.75 ,$100.75 ,$661.30 ,$107.90 ,$323.65 , N/A , N/A ,$112.94 ,$661.30 ,$217.84 ,$700.20 ,$610.73 ,$642.63 ,$100.75 ,$505.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000579,73523,HC XR HIP W/PELVIS BIL 5+VIEWS,320,1 ,$778.00 ,$505.70 ,$100.75 ,$778.00 ,$269.75 ,$622.40 ,$100.75 ,$217.84 ,$616.49 ,$714.20 ,$100.75 ,$714.20 ,$100.75 ,$205.01 ,$575.72 ,$269.75 ,$107.90 ,$648.85 ,$100.75 , N/A ,$642.63 ,$642.63 ,$622.40 ,$700.20 ,$251.87 ,$661.30 ,$100.75 ,$100.75 ,$661.30 ,$107.90 ,$323.65 , N/A , N/A ,$112.94 ,$661.30 ,$217.84 ,$700.20 ,$610.73 ,$642.63 ,$100.75 ,$505.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000580,73551,HC XR FEMUR 1VIEW,320,1 ,$389.00 ,$252.85 ,$74.85 ,$389.00 ,$200.43 ,$311.20 ,$74.85 ,$108.92 ,$308.24 ,$357.10 ,$74.85 ,$357.10 ,$74.85 ,$152.32 ,$287.86 ,$200.43 ,$80.17 ,$324.43 ,$74.85 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$187.13 ,$330.65 ,$74.85 ,$74.85 ,$330.65 ,$80.17 ,$161.82 , N/A , N/A ,$83.91 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$74.85 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$389.00 ,$252.85 ,$74.85 ,$389.00 ,$200.43 ,$311.20 ,$74.85 ,$108.92 ,$308.24 ,$357.10 ,$74.85 ,$357.10 ,$74.85 ,$152.32 ,$287.86 ,$200.43 ,$80.17 ,$324.43 ,$74.85 , N/A ,$321.31 ,$321.31 ,$311.20 ,$350.10 ,$187.13 ,$330.65 ,$74.85 ,$74.85 ,$330.65 ,$80.17 ,$161.82 , N/A , N/A ,$83.91 ,$330.65 ,$108.92 ,$350.10 ,$305.37 ,$321.31 ,$74.85 ,$252.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000583,72200,HC XR SACROILIC JOINT <3VIEWS,320,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000595,76000,HC FLUOROSCOPY >1HR,320,1 ,$258.00 ,$167.70 ,$72.24 ,$570.13 ,$570.13 ,$206.40 ,$212.93 ,$72.24 ,$204.44 ,$236.84 ,$212.93 ,$236.84 ,$212.93 ,$258.00 ,$190.92 ,$258.00 ,$228.05 ,$215.17 ,$212.93 , N/A ,$213.11 ,$213.11 ,$206.40 ,$232.20 ,$258.00 ,$219.30 ,$212.93 ,$212.93 ,$219.30 ,$228.05 ,$107.33 , N/A , N/A ,$238.70 ,$219.30 ,$72.24 ,$232.20 ,$202.53 ,$213.11 ,$212.93 ,$167.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),32000612,74248,HC XRAY SMALL INTESTINE FOLLOW THRU STUDY,320,1 ,"$1,664.00 ","$1,081.60 ",$465.92 ,"$1,664.00 ", N/A ,"$1,331.20 ", N/A ,$465.92 ,"$1,318.55 ","$1,527.55 ", N/A ,"$1,527.55 ", N/A , N/A ,"$1,231.36 ", N/A , N/A ,"$1,387.78 ", N/A , N/A ,"$1,374.46 ","$1,374.46 ","$1,331.20 ","$1,497.60 ", N/A ,"$1,414.40 ", N/A , N/A ,"$1,414.40 ", N/A ,$692.22 , N/A , N/A , N/A ,"$1,414.40 ",$465.92 ,"$1,497.60 ","$1,306.24 ","$1,374.46 ", N/A ,"$1,081.60 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),33500005,96413,HC CHEMO IV INFUSION SGL/INIT<1H,335,1 ,$403.00 ,$261.95 ,$112.84 ,$790.03 ,$790.03 ,$322.40 ,$295.06 ,$112.84 ,$319.34 ,$369.95 ,$295.06 ,$369.95 ,$295.06 ,$403.00 ,$298.22 ,$403.00 ,$316.01 ,$336.10 ,$295.06 , N/A ,$332.88 ,$332.88 ,$322.40 ,$362.70 ,$403.00 ,$342.55 ,$295.06 ,$295.06 ,$342.55 ,$316.01 ,$167.65 , N/A , N/A ,$330.76 ,$342.55 ,$112.84 ,$362.70 ,$316.36 ,$332.88 ,$295.06 ,$261.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),33500006,96415,HC CHEMO IV INFUSION ADDL HR,335,1 ,$148.00 ,$96.20 ,$41.44 ,$153.63 ,$153.63 ,$118.40 ,$57.37 ,$41.44 ,$117.28 ,$135.86 ,$57.37 ,$135.86 ,$57.37 ,$116.76 ,$109.52 ,$148.00 ,$61.45 ,$123.43 ,$57.37 , N/A ,$122.25 ,$122.25 ,$118.40 ,$133.20 ,$143.44 ,$125.80 ,$57.37 ,$57.37 ,$125.80 ,$61.45 ,$61.57 , N/A , N/A ,$64.32 ,$125.80 ,$41.44 ,$133.20 ,$116.18 ,$122.25 ,$57.37 ,$96.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000004,78014,HC NM THYROID IMAGING SGL OR MULT UPTAKE 78014,340,1 ,"$1,024.00 ",$665.60 ,$286.72 ,"$1,024.00 ",$934.03 ,$819.20 ,$348.84 ,$286.72 ,$811.42 ,$940.03 ,$348.84 ,$940.03 ,$348.84 ,$709.86 ,$757.76 ,$934.03 ,$373.61 ,$854.02 ,$348.84 , N/A ,$845.82 ,$845.82 ,$819.20 ,$921.60 ,$872.10 ,$870.40 ,$348.84 ,$348.84 ,$870.40 ,$373.61 ,$425.98 , N/A , N/A ,$391.05 ,$870.40 ,$286.72 ,$921.60 ,$803.84 ,$845.82 ,$348.84 ,$665.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000006,78013,HC NM THYROID SCAN,340,1 ,"$1,024.00 ",$665.60 ,$286.72 ,"$1,024.00 ",$934.03 ,$819.20 ,$348.84 ,$286.72 ,$811.42 ,$940.03 ,$348.84 ,$940.03 ,$348.84 ,$709.86 ,$757.76 ,$934.03 ,$373.61 ,$854.02 ,$348.84 , N/A ,$845.82 ,$845.82 ,$819.20 ,$921.60 ,$872.10 ,$870.40 ,$348.84 ,$348.84 ,$870.40 ,$373.61 ,$425.98 , N/A , N/A ,$391.05 ,$870.40 ,$286.72 ,$921.60 ,$803.84 ,$845.82 ,$348.84 ,$665.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000009,78070,HC PARATHRYOID IMAGING 78070,340,1 ,"$1,722.00 ","$1,119.30 ",$348.84 ,"$1,722.00 ",$934.03 ,"$1,377.60 ",$348.84 ,$482.16 ,"$1,364.51 ","$1,580.80 ",$348.84 ,"$1,580.80 ",$348.84 ,$709.86 ,"$1,274.28 ",$934.03 ,$373.61 ,"$1,436.15 ",$348.84 , N/A ,"$1,422.37 ","$1,422.37 ","$1,377.60 ","$1,549.80 ",$872.10 ,"$1,463.70 ",$348.84 ,$348.84 ,"$1,463.70 ",$373.61 ,$716.35 , N/A , N/A ,$391.05 ,"$1,463.70 ",$482.16 ,"$1,549.80 ","$1,351.77 ","$1,422.37 ",$348.84 ,"$1,119.30 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000019,78215,HC LIVER SPLEEN STATIC,340,1 ,"$1,543.00 ","$1,002.95 ",$348.84 ,"$1,543.00 ",$934.03 ,"$1,234.40 ",$348.84 ,$432.04 ,"$1,222.67 ","$1,416.47 ",$348.84 ,"$1,416.47 ",$348.84 ,$709.86 ,"$1,141.82 ",$934.03 ,$373.61 ,"$1,286.86 ",$348.84 , N/A ,"$1,274.52 ","$1,274.52 ","$1,234.40 ","$1,388.70 ",$872.10 ,"$1,311.55 ",$348.84 ,$348.84 ,"$1,311.55 ",$373.61 ,$641.89 , N/A , N/A ,$391.05 ,"$1,311.55 ",$432.04 ,"$1,388.70 ","$1,211.26 ","$1,274.52 ",$348.84 ,"$1,002.95 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000022,78226,HC HEPATOBILIARY SCAN,340,1 ,"$1,568.00 ","$1,019.20 ",$348.84 ,"$1,568.00 ",$934.03 ,"$1,254.40 ",$348.84 ,$439.04 ,"$1,242.48 ","$1,439.42 ",$348.84 ,"$1,439.42 ",$348.84 ,$709.86 ,"$1,160.32 ",$934.03 ,$373.61 ,"$1,307.71 ",$348.84 , N/A ,"$1,295.17 ","$1,295.17 ","$1,254.40 ","$1,411.20 ",$872.10 ,"$1,332.80 ",$348.84 ,$348.84 ,"$1,332.80 ",$373.61 ,$652.29 , N/A , N/A ,$391.05 ,"$1,332.80 ",$439.04 ,"$1,411.20 ","$1,230.88 ","$1,295.17 ",$348.84 ,"$1,019.20 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000026,78264,HC GASTRIC EMPTYING STUDY,340,1 ,"$2,663.00 ","$1,730.95 ",$348.84 ,"$2,663.00 ",$934.03 ,"$2,130.40 ",$348.84 ,$745.64 ,"$2,110.16 ","$2,444.63 ",$348.84 ,"$2,444.63 ",$348.84 ,$709.86 ,"$1,970.62 ",$934.03 ,$373.61 ,"$2,220.94 ",$348.84 , N/A ,"$2,199.64 ","$2,199.64 ","$2,130.40 ","$2,396.70 ",$872.10 ,"$2,263.55 ",$348.84 ,$348.84 ,"$2,263.55 ",$373.61 ,"$1,107.81 ", N/A , N/A ,$391.05 ,"$2,263.55 ",$745.64 ,"$2,396.70 ","$2,090.46 ","$2,199.64 ",$348.84 ,"$1,730.95 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000027,78278,HC GI BLEED SCAN,340,1 ,"$1,349.00 ",$876.85 ,$348.84 ,"$1,349.00 ",$934.03 ,"$1,079.20 ",$348.84 ,$377.72 ,"$1,068.95 ","$1,238.38 ",$348.84 ,"$1,238.38 ",$348.84 ,$709.86 ,$998.26 ,$934.03 ,$373.61 ,"$1,125.07 ",$348.84 , N/A ,"$1,114.27 ","$1,114.27 ","$1,079.20 ","$1,214.10 ",$872.10 ,"$1,146.65 ",$348.84 ,$348.84 ,"$1,146.65 ",$373.61 ,$561.18 , N/A , N/A ,$391.05 ,"$1,146.65 ",$377.72 ,"$1,214.10 ","$1,058.97 ","$1,114.27 ",$348.84 ,$876.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000028,78290,HC SM BOWEL MECKEL'S SCAN,340,1 ,"$1,024.00 ",$665.60 ,$286.72 ,"$1,024.00 ",$934.03 ,$819.20 ,$348.84 ,$286.72 ,$811.42 ,$940.03 ,$348.84 ,$940.03 ,$348.84 ,$709.86 ,$757.76 ,$934.03 ,$373.61 ,$854.02 ,$348.84 , N/A ,$845.82 ,$845.82 ,$819.20 ,$921.60 ,$872.10 ,$870.40 ,$348.84 ,$348.84 ,$870.40 ,$373.61 ,$425.98 , N/A , N/A ,$391.05 ,$870.40 ,$286.72 ,$921.60 ,$803.84 ,$845.82 ,$348.84 ,$665.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000029,78300,HC BONE SCAN LIMITED,340,1 ,"$1,349.00 ",$876.85 ,$348.84 ,"$1,349.00 ",$934.03 ,"$1,079.20 ",$348.84 ,$377.72 ,"$1,068.95 ","$1,238.38 ",$348.84 ,"$1,238.38 ",$348.84 ,$709.86 ,$998.26 ,$934.03 ,$373.61 ,"$1,125.07 ",$348.84 , N/A ,"$1,114.27 ","$1,114.27 ","$1,079.20 ","$1,214.10 ",$872.10 ,"$1,146.65 ",$348.84 ,$348.84 ,"$1,146.65 ",$373.61 ,$561.18 , N/A , N/A ,$391.05 ,"$1,146.65 ",$377.72 ,"$1,214.10 ","$1,058.97 ","$1,114.27 ",$348.84 ,$876.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000030,78305,HC BONE SCAN MULTIPLE,340,1 ,"$1,763.00 ","$1,145.95 ",$348.84 ,"$1,763.00 ",$934.03 ,"$1,410.40 ",$348.84 ,$493.64 ,"$1,397.00 ","$1,618.43 ",$348.84 ,"$1,618.43 ",$348.84 ,$709.86 ,"$1,304.62 ",$934.03 ,$373.61 ,"$1,470.34 ",$348.84 , N/A ,"$1,456.24 ","$1,456.24 ","$1,410.40 ","$1,586.70 ",$872.10 ,"$1,498.55 ",$348.84 ,$348.84 ,"$1,498.55 ",$373.61 ,$733.41 , N/A , N/A ,$391.05 ,"$1,498.55 ",$493.64 ,"$1,586.70 ","$1,383.96 ","$1,456.24 ",$348.84 ,"$1,145.95 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000031,78306,HC BONE SCAN WHOLE BODY,340,1 ,"$2,051.00 ","$1,333.15 ",$348.84 ,"$2,051.00 ",$934.03 ,"$1,640.80 ",$348.84 ,$574.28 ,"$1,625.21 ","$1,882.82 ",$348.84 ,"$1,882.82 ",$348.84 ,$709.86 ,"$1,517.74 ",$934.03 ,$373.61 ,"$1,710.53 ",$348.84 , N/A ,"$1,694.13 ","$1,694.13 ","$1,640.80 ","$1,845.90 ",$872.10 ,"$1,743.35 ",$348.84 ,$348.84 ,"$1,743.35 ",$373.61 ,$853.22 , N/A , N/A ,$391.05 ,"$1,743.35 ",$574.28 ,"$1,845.90 ","$1,610.04 ","$1,694.13 ",$348.84 ,"$1,333.15 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000033,78315,HC BONE SCAN/3 PHASE,340,1 ,"$1,984.00 ","$1,289.60 ",$348.84 ,"$1,984.00 ",$934.03 ,"$1,587.20 ",$348.84 ,$555.52 ,"$1,572.12 ","$1,821.31 ",$348.84 ,"$1,821.31 ",$348.84 ,$709.86 ,"$1,468.16 ",$934.03 ,$373.61 ,"$1,654.66 ",$348.84 , N/A ,"$1,638.78 ","$1,638.78 ","$1,587.20 ","$1,785.60 ",$872.10 ,"$1,686.40 ",$348.84 ,$348.84 ,"$1,686.40 ",$373.61 ,$825.34 , N/A , N/A ,$391.05 ,"$1,686.40 ",$555.52 ,"$1,785.60 ","$1,557.44 ","$1,638.78 ",$348.84 ,"$1,289.60 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000035,78451,HC HT MUSCLE IMAGE SPECT SINGLE,340,1 ,"$5,131.00 ","$3,335.15 ","$1,209.30 ","$5,131.00 ","$3,237.90 ","$4,104.80 ","$1,209.30 ","$1,436.68 ","$4,065.80 ","$4,710.26 ","$1,209.30 ","$4,710.26 ","$1,209.30 ","$2,460.80 ","$3,796.94 ","$3,237.90 ","$1,295.16 ","$4,279.25 ","$1,209.30 ", N/A ,"$4,238.21 ","$4,238.21 ","$4,104.80 ","$4,617.90 ","$3,023.25 ","$4,361.35 ","$1,209.30 ","$1,209.30 ","$4,361.35 ","$1,295.16 ","$2,134.50 ", N/A , N/A ,"$1,355.62 ","$4,361.35 ","$1,436.68 ","$4,617.90 ","$4,027.84 ","$4,238.21 ","$1,209.30 ","$3,335.15 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000037,78452,HC HT MUSCLE IMAGE SPECT MULTI,340,1 ,"$7,059.00 ","$4,588.35 ","$1,209.30 ","$7,059.00 ","$3,237.90 ","$5,647.20 ","$1,209.30 ","$1,976.52 ","$5,593.55 ","$6,480.16 ","$1,209.30 ","$6,480.16 ","$1,209.30 ","$2,460.80 ","$5,223.66 ","$3,237.90 ","$1,295.16 ","$5,887.21 ","$1,209.30 ", N/A ,"$5,830.73 ","$5,830.73 ","$5,647.20 ","$6,353.10 ","$3,023.25 ","$6,000.15 ","$1,209.30 ","$1,209.30 ","$6,000.15 ","$1,295.16 ","$2,936.54 ", N/A , N/A ,"$1,355.62 ","$6,000.15 ","$1,976.52 ","$6,353.10 ","$5,541.32 ","$5,830.73 ","$1,209.30 ","$4,588.35 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000044,78472,HC MUGA RESTING SGL,340,1 ,"$2,034.00 ","$1,322.10 ",$348.84 ,"$2,034.00 ",$934.03 ,"$1,627.20 ",$348.84 ,$569.52 ,"$1,611.74 ","$1,867.21 ",$348.84 ,"$1,867.21 ",$348.84 ,$709.86 ,"$1,505.16 ",$934.03 ,$373.61 ,"$1,696.36 ",$348.84 , N/A ,"$1,680.08 ","$1,680.08 ","$1,627.20 ","$1,830.60 ",$872.10 ,"$1,728.90 ",$348.84 ,$348.84 ,"$1,728.90 ",$373.61 ,$846.14 , N/A , N/A ,$391.05 ,"$1,728.90 ",$569.52 ,"$1,830.60 ","$1,596.69 ","$1,680.08 ",$348.84 ,"$1,322.10 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000047,78580,HC LUNG PERFUS,340,1 ,"$1,568.00 ","$1,019.20 ",$348.84 ,"$1,568.00 ",$934.03 ,"$1,254.40 ",$348.84 ,$439.04 ,"$1,242.48 ","$1,439.42 ",$348.84 ,"$1,439.42 ",$348.84 ,$709.86 ,"$1,160.32 ",$934.03 ,$373.61 ,"$1,307.71 ",$348.84 , N/A ,"$1,295.17 ","$1,295.17 ","$1,254.40 ","$1,411.20 ",$872.10 ,"$1,332.80 ",$348.84 ,$348.84 ,"$1,332.80 ",$373.61 ,$652.29 , N/A , N/A ,$391.05 ,"$1,332.80 ",$439.04 ,"$1,411.20 ","$1,230.88 ","$1,295.17 ",$348.84 ,"$1,019.20 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000048,78582,HC LUNG SCAN-VENT/PERF,340,1 ,"$2,366.00 ","$1,537.90 ",$452.85 ,"$2,366.00 ","$1,212.50 ","$1,892.80 ",$452.85 ,$662.48 ,"$1,874.82 ","$2,171.99 ",$452.85 ,"$2,171.99 ",$452.85 ,$921.50 ,"$1,750.84 ","$1,212.50 ",$485.00 ,"$1,973.24 ",$452.85 , N/A ,"$1,954.32 ","$1,954.32 ","$1,892.80 ","$2,129.40 ","$1,132.13 ","$2,011.10 ",$452.85 ,$452.85 ,"$2,011.10 ",$485.00 ,$984.26 , N/A , N/A ,$507.65 ,"$2,011.10 ",$662.48 ,"$2,129.40 ","$1,857.31 ","$1,954.32 ",$452.85 ,"$1,537.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000052,78579,HC LUNG SCAN-VENTILATION,340,1 ,"$1,532.00 ",$995.80 ,$348.84 ,"$1,532.00 ",$934.03 ,"$1,225.60 ",$348.84 ,$428.96 ,"$1,213.96 ","$1,406.38 ",$348.84 ,"$1,406.38 ",$348.84 ,$709.86 ,"$1,133.68 ",$934.03 ,$373.61 ,"$1,277.69 ",$348.84 , N/A ,"$1,265.43 ","$1,265.43 ","$1,225.60 ","$1,378.80 ",$872.10 ,"$1,302.20 ",$348.84 ,$348.84 ,"$1,302.20 ",$373.61 ,$637.31 , N/A , N/A ,$391.05 ,"$1,302.20 ",$428.96 ,"$1,378.80 ","$1,202.62 ","$1,265.43 ",$348.84 ,$995.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000062,78707,HC KIDNEY SCAN W/FLOW AND FUNCTION,340,1 ,"$1,329.00 ",$863.85 ,$372.12 ,"$1,329.00 ","$1,212.50 ","$1,063.20 ",$452.85 ,$372.12 ,"$1,053.10 ","$1,220.02 ",$452.85 ,"$1,220.02 ",$452.85 ,$921.50 ,$983.46 ,"$1,212.50 ",$485.00 ,"$1,108.39 ",$452.85 , N/A ,"$1,097.75 ","$1,097.75 ","$1,063.20 ","$1,196.10 ","$1,132.13 ","$1,129.65 ",$452.85 ,$452.85 ,"$1,129.65 ",$485.00 ,$552.86 , N/A , N/A ,$507.65 ,"$1,129.65 ",$372.12 ,"$1,196.10 ","$1,043.27 ","$1,097.75 ",$452.85 ,$863.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000063,78708,HC KIDNEY W/PHARMACLGCL INTER,340,1 ,$822.00 ,$534.30 ,$230.16 ,"$1,212.50 ","$1,212.50 ",$657.60 ,$452.85 ,$230.16 ,$651.35 ,$754.60 ,$452.85 ,$754.60 ,$452.85 ,$822.00 ,$608.28 ,$822.00 ,$485.00 ,$685.55 ,$452.85 , N/A ,$678.97 ,$678.97 ,$657.60 ,$739.80 ,$822.00 ,$698.70 ,$452.85 ,$452.85 ,$698.70 ,$485.00 ,$341.95 , N/A , N/A ,$507.65 ,$698.70 ,$230.16 ,$739.80 ,$645.27 ,$678.97 ,$452.85 ,$534.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000065,78709,HC KIDNEY W AND W/O PHARM INTERVEN,340,1 ,"$1,566.00 ","$1,017.90 ",$438.48 ,"$1,566.00 ","$1,212.50 ","$1,252.80 ",$452.85 ,$438.48 ,"$1,240.90 ","$1,437.59 ",$452.85 ,"$1,437.59 ",$452.85 ,$921.50 ,"$1,158.84 ","$1,212.50 ",$485.00 ,"$1,306.04 ",$452.85 , N/A ,"$1,293.52 ","$1,293.52 ","$1,252.80 ","$1,409.40 ","$1,132.13 ","$1,331.10 ",$452.85 ,$452.85 ,"$1,331.10 ",$485.00 ,$651.46 , N/A , N/A ,$507.65 ,"$1,331.10 ",$438.48 ,"$1,409.40 ","$1,229.31 ","$1,293.52 ",$452.85 ,"$1,017.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000071,78803,HC TUMOR IMAGING (SPECT),340,1 ,"$2,558.00 ","$1,662.70 ",$716.24 ,"$3,237.90 ","$3,237.90 ","$2,046.40 ","$1,209.30 ",$716.24 ,"$2,026.96 ","$2,348.24 ","$1,209.30 ","$2,348.24 ","$1,209.30 ","$2,460.80 ","$1,892.92 ","$2,558.00 ","$1,295.16 ","$2,133.37 ","$1,209.30 ", N/A ,"$2,112.91 ","$2,112.91 ","$2,046.40 ","$2,302.20 ","$2,558.00 ","$2,174.30 ","$1,209.30 ","$1,209.30 ","$2,174.30 ","$1,295.16 ","$1,064.13 ", N/A , N/A ,"$1,355.62 ","$2,174.30 ",$716.24 ,"$2,302.20 ","$2,008.03 ","$2,112.91 ","$1,209.30 ","$1,662.70 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000092,78227,HC NM HEPATOBILIARY DUCTS W/PHARM,340,1 ,"$1,568.00 ","$1,019.20 ",$439.04 ,"$1,568.00 ","$1,212.50 ","$1,254.40 ",$452.85 ,$439.04 ,"$1,242.48 ","$1,439.42 ",$452.85 ,"$1,439.42 ",$452.85 ,$921.50 ,"$1,160.32 ","$1,212.50 ",$485.00 ,"$1,307.71 ",$452.85 , N/A ,"$1,295.17 ","$1,295.17 ","$1,254.40 ","$1,411.20 ","$1,132.13 ","$1,332.80 ",$452.85 ,$452.85 ,"$1,332.80 ",$485.00 ,$652.29 , N/A , N/A ,$507.65 ,"$1,332.80 ",$439.04 ,"$1,411.20 ","$1,230.88 ","$1,295.17 ",$452.85 ,"$1,019.20 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),34000093,78071,HC PARATHYROID IMG W/SPECT 78071,340,1 ,"$1,024.00 ",$665.60 ,$286.72 ,"$1,024.00 ",$934.03 ,$819.20 ,$348.84 ,$286.72 ,$811.42 ,$940.03 ,$348.84 ,$940.03 ,$348.84 ,$709.86 ,$757.76 ,$934.03 ,$373.61 ,$854.02 ,$348.84 , N/A ,$845.82 ,$845.82 ,$819.20 ,$921.60 ,$872.10 ,$870.40 ,$348.84 ,$348.84 ,$870.40 ,$373.61 ,$425.98 , N/A , N/A ,$391.05 ,$870.40 ,$286.72 ,$921.60 ,$803.84 ,$845.82 ,$348.84 ,$665.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34300002,A9500,HC DIAGNUCLIDE CARDIO UP TO 40MCI,343,1 ,$325.00 ,$211.25 ,$91.00 ,$325.00 , N/A ,$260.00 , N/A ,$91.00 ,$257.53 ,$298.35 , N/A ,$298.35 , N/A , N/A ,$240.50 , N/A , N/A ,$271.05 , N/A , N/A ,$268.45 ,$268.45 ,$260.00 ,$292.50 , N/A ,$276.25 , N/A , N/A ,$276.25 , N/A ,$135.20 , N/A , N/A , N/A ,$276.25 ,$91.00 ,$292.50 ,$255.13 ,$325.00 , N/A ,$211.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34300004,A9503,HC DIAGNUCLIDE MDP UP TO 30MCI,343,1 ,$152.00 ,$98.80 ,$26.83 ,$152.00 , N/A ,$121.60 , N/A ,$42.56 ,$120.44 ,$139.54 , N/A ,$139.54 , N/A , N/A ,$112.48 , N/A , N/A ,$126.77 , N/A , N/A ,$125.55 ,$125.55 ,$121.60 ,$136.80 , N/A ,$129.20 , N/A , N/A ,$129.20 , N/A ,$63.23 , N/A , N/A , N/A ,$129.20 ,$42.56 ,$136.80 ,$119.32 ,$26.83 , N/A ,$98.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34300016,A9537,HC DIAGNUCLIDE CHOLETEC HEPAT PER DOSE,343,1 ,$126.00 ,$81.90 ,$35.28 ,$126.00 , N/A ,$100.80 , N/A ,$35.28 ,$99.84 ,$115.67 , N/A ,$115.67 , N/A , N/A ,$93.24 , N/A , N/A ,$105.08 , N/A , N/A ,$104.08 ,$104.08 ,$100.80 ,$113.40 , N/A ,$107.10 , N/A , N/A ,$107.10 , N/A ,$52.42 , N/A , N/A , N/A ,$107.10 ,$35.28 ,$113.40 ,$98.91 ,$126.00 , N/A ,$81.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34300019,A9540,HC DIAGNUCLIDE MAA LUNG SCAN PER DOSE<10MCI,343,1 ,$362.00 ,$235.30 ,$55.95 ,$362.00 , N/A ,$289.60 , N/A ,$101.36 ,$286.85 ,$332.32 , N/A ,$332.32 , N/A , N/A ,$267.88 , N/A , N/A ,$301.91 , N/A , N/A ,$299.01 ,$299.01 ,$289.60 ,$325.80 , N/A ,$307.70 , N/A , N/A ,$307.70 , N/A ,$150.59 , N/A , N/A , N/A ,$307.70 ,$101.36 ,$325.80 ,$284.17 ,$55.95 , N/A ,$235.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34300020,A9541,HC DIAGNUCLIDE SULFUR COLLOID UP TO 20MCI,343,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$180.00 , N/A ,$63.00 ,$178.29 ,$206.55 , N/A ,$206.55 , N/A , N/A ,$166.50 , N/A , N/A ,$187.65 , N/A , N/A ,$185.85 ,$185.85 ,$180.00 ,$202.50 , N/A ,$191.25 , N/A , N/A ,$191.25 , N/A ,$93.60 , N/A , N/A , N/A ,$191.25 ,$63.00 ,$202.50 ,$176.63 ,$225.00 , N/A ,$146.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34300058,A9500,HC SESTAMIBI PER STUDY DOSE,343,1 ,$325.00 ,$211.25 ,$91.00 ,$325.00 , N/A ,$260.00 , N/A ,$91.00 ,$257.53 ,$298.35 , N/A ,$298.35 , N/A , N/A ,$240.50 , N/A , N/A ,$271.05 , N/A , N/A ,$268.45 ,$268.45 ,$260.00 ,$292.50 , N/A ,$276.25 , N/A , N/A ,$276.25 , N/A ,$135.20 , N/A , N/A , N/A ,$276.25 ,$91.00 ,$292.50 ,$255.13 ,$325.00 , N/A ,$211.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),34300063,A9567,HC DIAGNUCLIDE TC-99 PETETATE AERO PER STUDY UP TO 75MCI,343,1 ,$214.00 ,$139.10 ,$35.97 ,$214.00 , N/A ,$171.20 , N/A ,$59.92 ,$169.57 ,$196.45 , N/A ,$196.45 , N/A , N/A ,$158.36 , N/A , N/A ,$178.48 , N/A , N/A ,$176.76 ,$176.76 ,$171.20 ,$192.60 , N/A ,$181.90 , N/A , N/A ,$181.90 , N/A ,$89.02 , N/A , N/A , N/A ,$181.90 ,$59.92 ,$192.60 ,$167.99 ,$35.97 , N/A ,$139.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000020,49405,HC PERC DRN ABSC/HEM/CYST VISCERAL,350,1 ,"$3,820.00 ","$2,483.00 ","$1,069.00 ","$3,820.00 ","$3,486.25 ","$3,056.00 ","$1,302.06 ","$1,069.60 ","$3,026.97 ","$3,506.76 ","$1,302.06 ","$3,506.76 ","$1,302.06 ","$2,649.55 ","$2,826.80 ","$3,486.25 ","$1,394.50 ","$3,185.88 ","$1,302.06 ", N/A ,"$3,155.32 ","$3,155.32 ","$3,056.00 ","$3,438.00 ","$3,255.14 ","$3,247.00 ","$1,302.06 ","$1,302.06 ","$3,247.00 ","$1,394.50 ","$1,589.12 ", N/A , N/A ,"$1,459.61 ","$3,247.00 ","$1,069.60 ","$3,438.00 ","$1,069.00 ","$3,155.32 ","$1,302.06 ","$2,483.00 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000036,70450,HC CT HEAD/BRAIN W/O CONTRAST,350,1 ,"$1,991.00 ","$1,294.15 ",$100.75 ,"$1,991.00 ",$269.75 ,"$1,592.80 ",$100.75 ,$557.48 ,"$1,577.67 ","$1,827.74 ",$100.75 ,"$1,827.74 ",$100.75 ,$205.01 ,"$1,473.34 ",$269.75 ,$107.90 ,"$1,660.49 ",$100.75 , N/A ,"$1,644.57 ","$1,644.57 ","$1,592.80 ","$1,791.90 ",$251.87 ,"$1,692.35 ",$100.75 ,$100.75 ,"$1,692.35 ",$107.90 ,$828.26 , N/A , N/A ,$112.94 ,"$1,692.35 ",$557.48 ,"$1,791.90 ","$1,069.00 ","$1,644.57 ",$100.75 ,"$1,294.15 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000037,70460,HC CT HEAD/BRAIN W/CONTRAST,350,1 ,"$1,991.00 ","$1,294.15 ",$165.30 ,"$1,991.00 ",$442.60 ,"$1,592.80 ",$165.30 ,$557.48 ,"$1,577.67 ","$1,827.74 ",$165.30 ,"$1,827.74 ",$165.30 ,$336.38 ,"$1,473.34 ",$442.60 ,$177.04 ,"$1,660.49 ",$165.30 , N/A ,"$1,644.57 ","$1,644.57 ","$1,592.80 ","$1,791.90 ",$413.25 ,"$1,692.35 ",$165.30 ,$165.30 ,"$1,692.35 ",$177.04 ,$828.26 , N/A , N/A ,$185.30 ,"$1,692.35 ",$557.48 ,"$1,791.90 ","$1,069.00 ","$1,644.57 ",$165.30 ,"$1,294.15 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000038,70470,HC CT HEAD/BRAIN W AND W/O CONTRAST,350,1 ,"$2,550.00 ","$1,657.50 ",$165.30 ,"$2,550.00 ",$442.60 ,"$2,040.00 ",$165.30 ,$714.00 ,"$2,020.62 ","$2,340.90 ",$165.30 ,"$2,340.90 ",$165.30 ,$336.38 ,"$1,887.00 ",$442.60 ,$177.04 ,"$2,126.70 ",$165.30 , N/A ,"$2,106.30 ","$2,106.30 ","$2,040.00 ","$2,295.00 ",$413.25 ,"$2,167.50 ",$165.30 ,$165.30 ,"$2,167.50 ",$177.04 ,"$1,060.80 ", N/A , N/A ,$185.30 ,"$2,167.50 ",$714.00 ,"$2,295.00 ","$1,069.00 ","$2,106.30 ",$165.30 ,"$1,657.50 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000039,70480,HC CT ORBIT/IAC/EAR W/O CONTRAST,350,1 ,"$1,991.00 ","$1,294.15 ",$100.75 ,"$1,991.00 ",$269.75 ,"$1,592.80 ",$100.75 ,$557.48 ,"$1,577.67 ","$1,827.74 ",$100.75 ,"$1,827.74 ",$100.75 ,$205.01 ,"$1,473.34 ",$269.75 ,$107.90 ,"$1,660.49 ",$100.75 , N/A ,"$1,644.57 ","$1,644.57 ","$1,592.80 ","$1,791.90 ",$251.87 ,"$1,692.35 ",$100.75 ,$100.75 ,"$1,692.35 ",$107.90 ,$828.26 , N/A , N/A ,$112.94 ,"$1,692.35 ",$557.48 ,"$1,791.90 ","$1,069.00 ","$1,644.57 ",$100.75 ,"$1,294.15 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000041,70481,HC CT ORBIT/IAC/EAR W/CONTRAST,350,1 ,"$1,991.00 ","$1,294.15 ",$165.30 ,"$1,991.00 ",$442.60 ,"$1,592.80 ",$165.30 ,$557.48 ,"$1,577.67 ","$1,827.74 ",$165.30 ,"$1,827.74 ",$165.30 ,$336.38 ,"$1,473.34 ",$442.60 ,$177.04 ,"$1,660.49 ",$165.30 , N/A ,"$1,644.57 ","$1,644.57 ","$1,592.80 ","$1,791.90 ",$413.25 ,"$1,692.35 ",$165.30 ,$165.30 ,"$1,692.35 ",$177.04 ,$828.26 , N/A , N/A ,$185.30 ,"$1,692.35 ",$557.48 ,"$1,791.90 ","$1,069.00 ","$1,644.57 ",$165.30 ,"$1,294.15 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000042,70482,HC CT ORBIT/IAC/EAR W AND W/O CONTRAST,350,1 ,"$2,576.00 ","$1,674.40 ",$165.30 ,"$2,576.00 ",$442.60 ,"$2,060.80 ",$165.30 ,$721.28 ,"$2,041.22 ","$2,364.77 ",$165.30 ,"$2,364.77 ",$165.30 ,$336.38 ,"$1,906.24 ",$442.60 ,$177.04 ,"$2,148.38 ",$165.30 , N/A ,"$2,127.78 ","$2,127.78 ","$2,060.80 ","$2,318.40 ",$413.25 ,"$2,189.60 ",$165.30 ,$165.30 ,"$2,189.60 ",$177.04 ,"$1,071.62 ", N/A , N/A ,$185.30 ,"$2,189.60 ",$721.28 ,"$2,318.40 ","$1,069.00 ","$2,127.78 ",$165.30 ,"$1,674.40 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000043,70486,HC CT MAX/FACIAL W/O CONTRAST,350,1 ,"$1,361.00 ",$884.65 ,$100.75 ,"$1,361.00 ",$269.75 ,"$1,088.80 ",$100.75 ,$381.08 ,"$1,078.46 ","$1,249.40 ",$100.75 ,"$1,249.40 ",$100.75 ,$205.01 ,"$1,007.14 ",$269.75 ,$107.90 ,"$1,135.07 ",$100.75 , N/A ,"$1,124.19 ","$1,124.19 ","$1,088.80 ","$1,224.90 ",$251.87 ,"$1,156.85 ",$100.75 ,$100.75 ,"$1,156.85 ",$107.90 ,$566.18 , N/A , N/A ,$112.94 ,"$1,156.85 ",$381.08 ,"$1,224.90 ","$1,069.00 ","$1,124.19 ",$100.75 ,$884.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000045,70487,HC CT MAX/FACIAL W/CONTRAST,350,1 ,"$1,991.00 ","$1,294.15 ",$165.30 ,"$1,991.00 ",$442.60 ,"$1,592.80 ",$165.30 ,$557.48 ,"$1,577.67 ","$1,827.74 ",$165.30 ,"$1,827.74 ",$165.30 ,$336.38 ,"$1,473.34 ",$442.60 ,$177.04 ,"$1,660.49 ",$165.30 , N/A ,"$1,644.57 ","$1,644.57 ","$1,592.80 ","$1,791.90 ",$413.25 ,"$1,692.35 ",$165.30 ,$165.30 ,"$1,692.35 ",$177.04 ,$828.26 , N/A , N/A ,$185.30 ,"$1,692.35 ",$557.48 ,"$1,791.90 ","$1,069.00 ","$1,644.57 ",$165.30 ,"$1,294.15 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000046,70488,HC CT MAX/FACIAL W AND W/O CONTRAST,350,1 ,"$2,576.00 ","$1,674.40 ",$165.30 ,"$2,576.00 ",$442.60 ,"$2,060.80 ",$165.30 ,$721.28 ,"$2,041.22 ","$2,364.77 ",$165.30 ,"$2,364.77 ",$165.30 ,$336.38 ,"$1,906.24 ",$442.60 ,$177.04 ,"$2,148.38 ",$165.30 , N/A ,"$2,127.78 ","$2,127.78 ","$2,060.80 ","$2,318.40 ",$413.25 ,"$2,189.60 ",$165.30 ,$165.30 ,"$2,189.60 ",$177.04 ,"$1,071.62 ", N/A , N/A ,$185.30 ,"$2,189.60 ",$721.28 ,"$2,318.40 ","$1,069.00 ","$2,127.78 ",$165.30 ,"$1,674.40 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000047,70490,HC CT NECK SFT TISS W/O CONTRAST,350,1 ,"$1,991.00 ","$1,294.15 ",$100.75 ,"$1,991.00 ",$269.75 ,"$1,592.80 ",$100.75 ,$557.48 ,"$1,577.67 ","$1,827.74 ",$100.75 ,"$1,827.74 ",$100.75 ,$205.01 ,"$1,473.34 ",$269.75 ,$107.90 ,"$1,660.49 ",$100.75 , N/A ,"$1,644.57 ","$1,644.57 ","$1,592.80 ","$1,791.90 ",$251.87 ,"$1,692.35 ",$100.75 ,$100.75 ,"$1,692.35 ",$107.90 ,$828.26 , N/A , N/A ,$112.94 ,"$1,692.35 ",$557.48 ,"$1,791.90 ","$1,069.00 ","$1,644.57 ",$100.75 ,"$1,294.15 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000048,70491,HC CT NECK SFT TISS W/CONTRAST,350,1 ,"$2,099.00 ","$1,364.35 ",$165.30 ,"$2,099.00 ",$442.60 ,"$1,679.20 ",$165.30 ,$587.72 ,"$1,663.25 ","$1,926.88 ",$165.30 ,"$1,926.88 ",$165.30 ,$336.38 ,"$1,553.26 ",$442.60 ,$177.04 ,"$1,750.57 ",$165.30 , N/A ,"$1,733.77 ","$1,733.77 ","$1,679.20 ","$1,889.10 ",$413.25 ,"$1,784.15 ",$165.30 ,$165.30 ,"$1,784.15 ",$177.04 ,$873.18 , N/A , N/A ,$185.30 ,"$1,784.15 ",$587.72 ,"$1,889.10 ","$1,069.00 ","$1,733.77 ",$165.30 ,"$1,364.35 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000049,70492,HC CT NECK SFT TISS W AND WO CONTRAST,350,1 ,"$2,162.00 ","$1,405.30 ",$165.30 ,"$2,162.00 ",$442.60 ,"$1,729.60 ",$165.30 ,$605.36 ,"$1,713.17 ","$1,984.72 ",$165.30 ,"$1,984.72 ",$165.30 ,$336.38 ,"$1,599.88 ",$442.60 ,$177.04 ,"$1,803.11 ",$165.30 , N/A ,"$1,785.81 ","$1,785.81 ","$1,729.60 ","$1,945.80 ",$413.25 ,"$1,837.70 ",$165.30 ,$165.30 ,"$1,837.70 ",$177.04 ,$899.39 , N/A , N/A ,$185.30 ,"$1,837.70 ",$605.36 ,"$1,945.80 ","$1,069.00 ","$1,785.81 ",$165.30 ,"$1,405.30 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000050,70496,HC CT ANGIO HEAD W/WO,350,1 ,"$3,055.00 ","$1,985.75 ",$165.30 ,"$3,055.00 ",$442.60 ,"$2,444.00 ",$165.30 ,$855.40 ,"$2,420.78 ","$2,804.49 ",$165.30 ,"$2,804.49 ",$165.30 ,$336.38 ,"$2,260.70 ",$442.60 ,$177.04 ,"$2,547.87 ",$165.30 , N/A ,"$2,523.43 ","$2,523.43 ","$2,444.00 ","$2,749.50 ",$413.25 ,"$2,596.75 ",$165.30 ,$165.30 ,"$2,596.75 ",$177.04 ,"$1,270.88 ", N/A , N/A ,$185.30 ,"$2,596.75 ",$855.40 ,"$2,749.50 ","$1,069.00 ","$2,523.43 ",$165.30 ,"$1,985.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000051,70498,HC CT ANGIO NECK W/WO CONTRAST,350,1 ,"$2,576.00 ","$1,674.40 ",$165.30 ,"$2,576.00 ",$442.60 ,"$2,060.80 ",$165.30 ,$721.28 ,"$2,041.22 ","$2,364.77 ",$165.30 ,"$2,364.77 ",$165.30 ,$336.38 ,"$1,906.24 ",$442.60 ,$177.04 ,"$2,148.38 ",$165.30 , N/A ,"$2,127.78 ","$2,127.78 ","$2,060.80 ","$2,318.40 ",$413.25 ,"$2,189.60 ",$165.30 ,$165.30 ,"$2,189.60 ",$177.04 ,"$1,071.62 ", N/A , N/A ,$185.30 ,"$2,189.60 ",$721.28 ,"$2,318.40 ","$1,069.00 ","$2,127.78 ",$165.30 ,"$1,674.40 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000052,70540,HC MRI ORBIT/FACE/NECK W/O CON,610,1 ,"$3,596.00 ","$2,337.40 ",$212.93 ,"$3,596.00 ",$570.13 ,"$2,876.80 ",$212.93 ,"$1,006.88 ","$2,849.47 ","$3,301.13 ",$212.93 ,"$3,301.13 ",$212.93 ,$433.30 ,"$2,661.04 ",$570.13 ,$228.05 ,"$2,999.06 ",$212.93 , N/A ,"$2,970.30 ","$2,970.30 ","$2,876.80 ","$3,236.40 ",$532.33 ,"$3,056.60 ",$212.93 ,$212.93 ,"$3,056.60 ",$228.05 ,"$1,495.94 ", N/A , N/A ,$238.70 ,"$3,056.60 ","$1,006.88 ","$3,236.40 ","$1,296.00 ","$2,970.30 ",$212.93 ,"$2,337.40 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000053,72125,HC CT C-SPINE W/O CONTRAST,350,1 ,"$2,336.00 ","$1,518.40 ",$100.75 ,"$2,336.00 ",$269.75 ,"$1,868.80 ",$100.75 ,$654.08 ,"$1,851.05 ","$2,144.45 ",$100.75 ,"$2,144.45 ",$100.75 ,$205.01 ,"$1,728.64 ",$269.75 ,$107.90 ,"$1,948.22 ",$100.75 , N/A ,"$1,929.54 ","$1,929.54 ","$1,868.80 ","$2,102.40 ",$251.87 ,"$1,985.60 ",$100.75 ,$100.75 ,"$1,985.60 ",$107.90 ,$971.78 , N/A , N/A ,$112.94 ,"$1,985.60 ",$654.08 ,"$2,102.40 ","$1,069.00 ","$1,929.54 ",$100.75 ,"$1,518.40 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000055,72126,HC CT C-SPINE W/CONTRAST,350,1 ,$877.00 ,$570.05 ,$245.56 ,$912.43 ,$912.43 ,$701.60 ,$340.78 ,$245.56 ,$694.93 ,$805.09 ,$340.78 ,$805.09 ,$340.78 ,$693.44 ,$648.98 ,$877.00 ,$364.97 ,$731.42 ,$340.78 , N/A ,$724.40 ,$724.40 ,$701.60 ,$789.30 ,$851.94 ,$745.45 ,$340.78 ,$340.78 ,$745.45 ,$364.97 ,$364.83 , N/A , N/A ,$382.01 ,$745.45 ,$245.56 ,$789.30 ,$877.00 ,$724.40 ,$340.78 ,$570.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000056,72127,HC CT C-SPINE W AND W/O CONTRAST,350,1 ,$919.00 ,$597.35 ,$165.30 ,$919.00 ,$442.60 ,$735.20 ,$165.30 ,$257.32 ,$728.22 ,$843.64 ,$165.30 ,$843.64 ,$165.30 ,$336.38 ,$680.06 ,$442.60 ,$177.04 ,$766.45 ,$165.30 , N/A ,$759.09 ,$759.09 ,$735.20 ,$827.10 ,$413.25 ,$781.15 ,$165.30 ,$165.30 ,$781.15 ,$177.04 ,$382.30 , N/A , N/A ,$185.30 ,$781.15 ,$257.32 ,$827.10 ,$919.00 ,$759.09 ,$165.30 ,$597.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000057,72128,HC CT T-SPINE W/O CONTRAST,350,1 ,"$2,336.00 ","$1,518.40 ",$100.75 ,"$2,336.00 ",$269.75 ,"$1,868.80 ",$100.75 ,$654.08 ,"$1,851.05 ","$2,144.45 ",$100.75 ,"$2,144.45 ",$100.75 ,$205.01 ,"$1,728.64 ",$269.75 ,$107.90 ,"$1,948.22 ",$100.75 , N/A ,"$1,929.54 ","$1,929.54 ","$1,868.80 ","$2,102.40 ",$251.87 ,"$1,985.60 ",$100.75 ,$100.75 ,"$1,985.60 ",$107.90 ,$971.78 , N/A , N/A ,$112.94 ,"$1,985.60 ",$654.08 ,"$2,102.40 ","$1,069.00 ","$1,929.54 ",$100.75 ,"$1,518.40 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000059,72129,HC CT T-SPINE W/CONTRAST,350,1 ,$485.00 ,$315.25 ,$135.80 ,$485.00 ,$442.60 ,$388.00 ,$165.30 ,$135.80 ,$384.31 ,$445.23 ,$165.30 ,$445.23 ,$165.30 ,$336.38 ,$358.90 ,$442.60 ,$177.04 ,$404.49 ,$165.30 , N/A ,$400.61 ,$400.61 ,$388.00 ,$436.50 ,$413.25 ,$412.25 ,$165.30 ,$165.30 ,$412.25 ,$177.04 ,$201.76 , N/A , N/A ,$185.30 ,$412.25 ,$135.80 ,$436.50 ,$485.00 ,$400.61 ,$165.30 ,$315.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000060,72130,HC CT T-SPINE W AND W/O CONTRAST,350,1 ,$485.00 ,$315.25 ,$135.80 ,$485.00 ,$442.60 ,$388.00 ,$165.30 ,$135.80 ,$384.31 ,$445.23 ,$165.30 ,$445.23 ,$165.30 ,$336.38 ,$358.90 ,$442.60 ,$177.04 ,$404.49 ,$165.30 , N/A ,$400.61 ,$400.61 ,$388.00 ,$436.50 ,$413.25 ,$412.25 ,$165.30 ,$165.30 ,$412.25 ,$177.04 ,$201.76 , N/A , N/A ,$185.30 ,$412.25 ,$135.80 ,$436.50 ,$485.00 ,$400.61 ,$165.30 ,$315.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000061,72131,HC CT L-SPINE W/O CONTRAST,350,1 ,"$2,354.00 ","$1,530.10 ",$100.75 ,"$2,354.00 ",$269.75 ,"$1,883.20 ",$100.75 ,$659.12 ,"$1,865.31 ","$2,160.97 ",$100.75 ,"$2,160.97 ",$100.75 ,$205.01 ,"$1,741.96 ",$269.75 ,$107.90 ,"$1,963.24 ",$100.75 , N/A ,"$1,944.40 ","$1,944.40 ","$1,883.20 ","$2,118.60 ",$251.87 ,"$2,000.90 ",$100.75 ,$100.75 ,"$2,000.90 ",$107.90 ,$979.26 , N/A , N/A ,$112.94 ,"$2,000.90 ",$659.12 ,"$2,118.60 ","$1,069.00 ","$1,944.40 ",$100.75 ,"$1,530.10 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000062,72132,HC CT L-SPINE W/CONTRAST,350,1 ,"$4,386.00 ","$2,850.90 ",$340.78 ,"$4,386.00 ",$912.43 ,"$3,508.80 ",$340.78 ,"$1,228.08 ","$3,475.47 ","$4,026.35 ",$340.78 ,"$4,026.35 ",$340.78 ,$693.44 ,"$3,245.64 ",$912.43 ,$364.97 ,"$3,657.92 ",$340.78 , N/A ,"$3,622.84 ","$3,622.84 ","$3,508.80 ","$3,947.40 ",$851.94 ,"$3,728.10 ",$340.78 ,$340.78 ,"$3,728.10 ",$364.97 ,"$1,824.58 ", N/A , N/A ,$382.01 ,"$3,728.10 ","$1,228.08 ","$3,947.40 ","$1,069.00 ","$3,622.84 ",$340.78 ,"$2,850.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000063,72133,HC CT L-SPINE W AND W/O CONTRAST,350,1 ,$485.00 ,$315.25 ,$135.80 ,$485.00 ,$442.60 ,$388.00 ,$165.30 ,$135.80 ,$384.31 ,$445.23 ,$165.30 ,$445.23 ,$165.30 ,$336.38 ,$358.90 ,$442.60 ,$177.04 ,$404.49 ,$165.30 , N/A ,$400.61 ,$400.61 ,$388.00 ,$436.50 ,$413.25 ,$412.25 ,$165.30 ,$165.30 ,$412.25 ,$177.04 ,$201.76 , N/A , N/A ,$185.30 ,$412.25 ,$135.80 ,$436.50 ,$485.00 ,$400.61 ,$165.30 ,$315.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000064,72191,HC CTA PELVIS W AND W/O CONTRAST,350,1 ,"$3,290.00 ","$2,138.50 ",$165.30 ,"$3,290.00 ",$442.60 ,"$2,632.00 ",$165.30 ,$921.20 ,"$2,607.00 ","$3,020.22 ",$165.30 ,"$3,020.22 ",$165.30 ,$336.38 ,"$2,434.60 ",$442.60 ,$177.04 ,"$2,743.86 ",$165.30 , N/A ,"$2,717.54 ","$2,717.54 ","$2,632.00 ","$2,961.00 ",$413.25 ,"$2,796.50 ",$165.30 ,$165.30 ,"$2,796.50 ",$177.04 ,"$1,368.64 ", N/A , N/A ,$185.30 ,"$2,796.50 ",$921.20 ,"$2,961.00 ","$1,069.00 ","$2,717.54 ",$165.30 ,"$2,138.50 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000065,72192,HC CT PELVIS W/O CONTRAST,350,1 ,"$2,184.00 ","$1,419.60 ",$100.75 ,"$2,184.00 ",$269.75 ,"$1,747.20 ",$100.75 ,$611.52 ,"$1,730.60 ","$2,004.91 ",$100.75 ,"$2,004.91 ",$100.75 ,$205.01 ,"$1,616.16 ",$269.75 ,$107.90 ,"$1,821.46 ",$100.75 , N/A ,"$1,803.98 ","$1,803.98 ","$1,747.20 ","$1,965.60 ",$251.87 ,"$1,856.40 ",$100.75 ,$100.75 ,"$1,856.40 ",$107.90 ,$908.54 , N/A , N/A ,$112.94 ,"$1,856.40 ",$611.52 ,"$1,965.60 ","$1,069.00 ","$1,803.98 ",$100.75 ,"$1,419.60 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000066,72193,HC CT PELVIS W/CONTRAST,350,1 ,"$2,526.00 ","$1,641.90 ",$165.30 ,"$2,526.00 ",$442.60 ,"$2,020.80 ",$165.30 ,$707.28 ,"$2,001.60 ","$2,318.87 ",$165.30 ,"$2,318.87 ",$165.30 ,$336.38 ,"$1,869.24 ",$442.60 ,$177.04 ,"$2,106.68 ",$165.30 , N/A ,"$2,086.48 ","$2,086.48 ","$2,020.80 ","$2,273.40 ",$413.25 ,"$2,147.10 ",$165.30 ,$165.30 ,"$2,147.10 ",$177.04 ,"$1,050.82 ", N/A , N/A ,$185.30 ,"$2,147.10 ",$707.28 ,"$2,273.40 ","$1,069.00 ","$2,086.48 ",$165.30 ,"$1,641.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000067,72194,HC CT PELVIS W AND W/O CONTRAST,350,1 ,"$2,453.00 ","$1,594.45 ",$165.30 ,"$2,453.00 ",$442.60 ,"$1,962.40 ",$165.30 ,$686.84 ,"$1,943.76 ","$2,251.85 ",$165.30 ,"$2,251.85 ",$165.30 ,$336.38 ,"$1,815.22 ",$442.60 ,$177.04 ,"$2,045.80 ",$165.30 , N/A ,"$2,026.18 ","$2,026.18 ","$1,962.40 ","$2,207.70 ",$413.25 ,"$2,085.05 ",$165.30 ,$165.30 ,"$2,085.05 ",$177.04 ,"$1,020.45 ", N/A , N/A ,$185.30 ,"$2,085.05 ",$686.84 ,"$2,207.70 ","$1,069.00 ","$2,026.18 ",$165.30 ,"$1,594.45 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$2,099.00 ","$1,364.35 ",$100.75 ,"$2,099.00 ",$269.75 ,"$1,679.20 ",$100.75 ,$587.72 ,"$1,663.25 ","$1,926.88 ",$100.75 ,"$1,926.88 ",$100.75 ,$205.01 ,"$1,553.26 ",$269.75 ,$107.90 ,"$1,750.57 ",$100.75 , N/A ,"$1,733.77 ","$1,733.77 ","$1,679.20 ","$1,889.10 ",$251.87 ,"$1,784.15 ",$100.75 ,$100.75 ,"$1,784.15 ",$107.90 ,$873.18 , N/A , N/A ,$112.94 ,"$1,784.15 ",$587.72 ,"$1,889.10 ","$1,069.00 ","$1,733.77 ",$100.75 ,"$1,364.35 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000071,73201,HC CT UPPER EXTRM W CONT,350,1 ,"$1,357.00 ",$882.05 ,$340.78 ,"$1,357.00 ",$912.43 ,"$1,085.60 ",$340.78 ,$379.96 ,"$1,075.29 ","$1,245.73 ",$340.78 ,"$1,245.73 ",$340.78 ,$693.44 ,"$1,004.18 ",$912.43 ,$364.97 ,"$1,131.74 ",$340.78 , N/A ,"$1,120.88 ","$1,120.88 ","$1,085.60 ","$1,221.30 ",$851.94 ,"$1,153.45 ",$340.78 ,$340.78 ,"$1,153.45 ",$364.97 ,$564.51 , N/A , N/A ,$382.01 ,"$1,153.45 ",$379.96 ,"$1,221.30 ","$1,069.00 ","$1,120.88 ",$340.78 ,$882.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$1,421.00 ",$923.65 ,$165.30 ,"$1,421.00 ",$442.60 ,"$1,136.80 ",$165.30 ,$397.88 ,"$1,126.00 ","$1,304.48 ",$165.30 ,"$1,304.48 ",$165.30 ,$336.38 ,"$1,051.54 ",$442.60 ,$177.04 ,"$1,185.11 ",$165.30 , N/A ,"$1,173.75 ","$1,173.75 ","$1,136.80 ","$1,278.90 ",$413.25 ,"$1,207.85 ",$165.30 ,$165.30 ,"$1,207.85 ",$177.04 ,$591.14 , N/A , N/A ,$185.30 ,"$1,207.85 ",$397.88 ,"$1,278.90 ","$1,069.00 ","$1,173.75 ",$165.30 ,$923.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000073,73206,HC CT ANGIO UPPER EXTREM W/WO CONT,350,1 ,"$3,055.00 ","$1,985.75 ",$165.30 ,"$3,055.00 ",$442.60 ,"$2,444.00 ",$165.30 ,$855.40 ,"$2,420.78 ","$2,804.49 ",$165.30 ,"$2,804.49 ",$165.30 ,$336.38 ,"$2,260.70 ",$442.60 ,$177.04 ,"$2,547.87 ",$165.30 , N/A ,"$2,523.43 ","$2,523.43 ","$2,444.00 ","$2,749.50 ",$413.25 ,"$2,596.75 ",$165.30 ,$165.30 ,"$2,596.75 ",$177.04 ,"$1,270.88 ", N/A , N/A ,$185.30 ,"$2,596.75 ",$855.40 ,"$2,749.50 ","$1,069.00 ","$2,523.43 ",$165.30 ,"$1,985.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$2,099.00 ","$1,364.35 ",$100.75 ,"$2,099.00 ",$269.75 ,"$1,679.20 ",$100.75 ,$587.72 ,"$1,663.25 ","$1,926.88 ",$100.75 ,"$1,926.88 ",$100.75 ,$205.01 ,"$1,553.26 ",$269.75 ,$107.90 ,"$1,750.57 ",$100.75 , N/A ,"$1,733.77 ","$1,733.77 ","$1,679.20 ","$1,889.10 ",$251.87 ,"$1,784.15 ",$100.75 ,$100.75 ,"$1,784.15 ",$107.90 ,$873.18 , N/A , N/A ,$112.94 ,"$1,784.15 ",$587.72 ,"$1,889.10 ","$1,069.00 ","$1,733.77 ",$100.75 ,"$1,364.35 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000075,73701,HC CT LOWER EXTREMITY W/CON,350,1 ,"$2,106.00 ","$1,368.90 ",$165.30 ,"$2,106.00 ",$442.60 ,"$1,684.80 ",$165.30 ,$589.68 ,"$1,668.79 ","$1,933.31 ",$165.30 ,"$1,933.31 ",$165.30 ,$336.38 ,"$1,558.44 ",$442.60 ,$177.04 ,"$1,756.40 ",$165.30 , N/A ,"$1,739.56 ","$1,739.56 ","$1,684.80 ","$1,895.40 ",$413.25 ,"$1,790.10 ",$165.30 ,$165.30 ,"$1,790.10 ",$177.04 ,$876.10 , N/A , N/A ,$185.30 ,"$1,790.10 ",$589.68 ,"$1,895.40 ","$1,069.00 ","$1,739.56 ",$165.30 ,"$1,368.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000077,73702,HC CT LOWER EXTR W/WO CONTR,350,1 ,"$1,154.00 ",$750.10 ,$165.30 ,"$1,154.00 ",$442.60 ,$923.20 ,$165.30 ,$323.12 ,$914.43 ,"$1,059.37 ",$165.30 ,"$1,059.37 ",$165.30 ,$336.38 ,$853.96 ,$442.60 ,$177.04 ,$962.44 ,$165.30 , N/A ,$953.20 ,$953.20 ,$923.20 ,"$1,038.60 ",$413.25 ,$980.90 ,$165.30 ,$165.30 ,$980.90 ,$177.04 ,$480.06 , N/A , N/A ,$185.30 ,$980.90 ,$323.12 ,"$1,038.60 ","$1,069.00 ",$953.20 ,$165.30 ,$750.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$3,055.00 ","$1,985.75 ",$165.30 ,"$3,055.00 ",$442.60 ,"$2,444.00 ",$165.30 ,$855.40 ,"$2,420.78 ","$2,804.49 ",$165.30 ,"$2,804.49 ",$165.30 ,$336.38 ,"$2,260.70 ",$442.60 ,$177.04 ,"$2,547.87 ",$165.30 , N/A ,"$2,523.43 ","$2,523.43 ","$2,444.00 ","$2,749.50 ",$413.25 ,"$2,596.75 ",$165.30 ,$165.30 ,"$2,596.75 ",$177.04 ,"$1,270.88 ", N/A , N/A ,$185.30 ,"$2,596.75 ",$855.40 ,"$2,749.50 ","$1,069.00 ","$2,523.43 ",$165.30 ,"$1,985.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000079,74150,HC CT ABD W/O CONTRAST,350,1 ,"$2,453.00 ","$1,594.45 ",$100.75 ,"$2,453.00 ",$269.75 ,"$1,962.40 ",$100.75 ,$686.84 ,"$1,943.76 ","$2,251.85 ",$100.75 ,"$2,251.85 ",$100.75 ,$205.01 ,"$1,815.22 ",$269.75 ,$107.90 ,"$2,045.80 ",$100.75 , N/A ,"$2,026.18 ","$2,026.18 ","$1,962.40 ","$2,207.70 ",$251.87 ,"$2,085.05 ",$100.75 ,$100.75 ,"$2,085.05 ",$107.90 ,"$1,020.45 ", N/A , N/A ,$112.94 ,"$2,085.05 ",$686.84 ,"$2,207.70 ","$1,069.00 ","$2,026.18 ",$100.75 ,"$1,594.45 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000080,74160,HC CT ABDOMEN W/CONTRAST,350,1 ,"$3,098.00 ","$2,013.70 ",$165.30 ,"$3,098.00 ",$442.60 ,"$2,478.40 ",$165.30 ,$867.44 ,"$2,454.86 ","$2,843.96 ",$165.30 ,"$2,843.96 ",$165.30 ,$336.38 ,"$2,292.52 ",$442.60 ,$177.04 ,"$2,583.73 ",$165.30 , N/A ,"$2,558.95 ","$2,558.95 ","$2,478.40 ","$2,788.20 ",$413.25 ,"$2,633.30 ",$165.30 ,$165.30 ,"$2,633.30 ",$177.04 ,"$1,288.77 ", N/A , N/A ,$185.30 ,"$2,633.30 ",$867.44 ,"$2,788.20 ","$1,069.00 ","$2,558.95 ",$165.30 ,"$2,013.70 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000081,74170,HC CT ABDOMEN W AND W/O CONTRAST,350,1 ,"$2,679.00 ","$1,741.35 ",$165.30 ,"$2,679.00 ",$442.60 ,"$2,143.20 ",$165.30 ,$750.12 ,"$2,122.84 ","$2,459.32 ",$165.30 ,"$2,459.32 ",$165.30 ,$336.38 ,"$1,982.46 ",$442.60 ,$177.04 ,"$2,234.29 ",$165.30 , N/A ,"$2,212.85 ","$2,212.85 ","$2,143.20 ","$2,411.10 ",$413.25 ,"$2,277.15 ",$165.30 ,$165.30 ,"$2,277.15 ",$177.04 ,"$1,114.46 ", N/A , N/A ,$185.30 ,"$2,277.15 ",$750.12 ,"$2,411.10 ","$1,069.00 ","$2,212.85 ",$165.30 ,"$1,741.35 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000082,74175,HC CTA ABDOMEN W AND W/O CONTRAST,350,1 ,"$3,055.00 ","$1,985.75 ",$165.30 ,"$3,055.00 ",$442.60 ,"$2,444.00 ",$165.30 ,$855.40 ,"$2,420.78 ","$2,804.49 ",$165.30 ,"$2,804.49 ",$165.30 ,$336.38 ,"$2,260.70 ",$442.60 ,$177.04 ,"$2,547.87 ",$165.30 , N/A ,"$2,523.43 ","$2,523.43 ","$2,444.00 ","$2,749.50 ",$413.25 ,"$2,596.75 ",$165.30 ,$165.30 ,"$2,596.75 ",$177.04 ,"$1,270.88 ", N/A , N/A ,$185.30 ,"$2,596.75 ",$855.40 ,"$2,749.50 ","$1,069.00 ","$2,523.43 ",$165.30 ,"$1,985.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000083,74176,HC CT ABDOMEN/PELVIS W/O CONTRAST,350,1 ,"$4,869.00 ","$3,164.85 ",$212.93 ,"$4,869.00 ",$570.13 ,"$3,895.20 ",$212.93 ,"$1,363.32 ","$3,858.20 ","$4,469.74 ",$212.93 ,"$4,469.74 ",$212.93 ,$433.30 ,"$3,603.06 ",$570.13 ,$228.05 ,"$4,060.75 ",$212.93 , N/A ,"$4,021.79 ","$4,021.79 ","$3,895.20 ","$4,382.10 ",$532.33 ,"$4,138.65 ",$212.93 ,$212.93 ,"$4,138.65 ",$228.05 ,"$2,025.50 ", N/A , N/A ,$238.70 ,"$4,138.65 ","$1,363.32 ","$4,382.10 ","$1,069.00 ","$4,021.79 ",$212.93 ,"$3,164.85 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000084,74177,HC CT ABDOMEN/PELVIS W/CONTRAST,350,1 ,"$5,779.00 ","$3,756.35 ",$340.78 ,"$5,779.00 ",$912.43 ,"$4,623.20 ",$340.78 ,"$1,618.12 ","$4,579.28 ","$5,305.12 ",$340.78 ,"$5,305.12 ",$340.78 ,$693.44 ,"$4,276.46 ",$912.43 ,$364.97 ,"$4,819.69 ",$340.78 , N/A ,"$4,773.45 ","$4,773.45 ","$4,623.20 ","$5,201.10 ",$851.94 ,"$4,912.15 ",$340.78 ,$340.78 ,"$4,912.15 ",$364.97 ,"$2,404.06 ", N/A , N/A ,$382.01 ,"$4,912.15 ","$1,618.12 ","$5,201.10 ","$1,069.00 ","$4,773.45 ",$340.78 ,"$3,756.35 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000085,74178,HC CT ABDOMEN/PELVIS W AND W/O CONTR,350,1 ,"$5,388.00 ","$3,502.20 ",$340.78 ,"$5,388.00 ",$912.43 ,"$4,310.40 ",$340.78 ,"$1,508.64 ","$4,269.45 ","$4,946.18 ",$340.78 ,"$4,946.18 ",$340.78 ,$693.44 ,"$3,987.12 ",$912.43 ,$364.97 ,"$4,493.59 ",$340.78 , N/A ,"$4,450.49 ","$4,450.49 ","$4,310.40 ","$4,849.20 ",$851.94 ,"$4,579.80 ",$340.78 ,$340.78 ,"$4,579.80 ",$364.97 ,"$2,241.41 ", N/A , N/A ,$382.01 ,"$4,579.80 ","$1,508.64 ","$4,849.20 ","$1,069.00 ","$4,450.49 ",$340.78 ,"$3,502.20 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000087,75571,HC CT HRT W/O DYE W/CA TEST,350,1 ,$46.00 ,$29.90 ,$12.88 ,$200.43 ,$200.43 ,$36.80 ,$74.85 ,$12.88 ,$36.45 ,$42.23 ,$46.00 ,$42.23 ,$46.00 ,$46.00 ,$34.04 ,$46.00 ,$80.17 ,$38.36 ,$74.85 , N/A ,$38.00 ,$38.00 ,$36.80 ,$41.40 ,$46.00 ,$39.10 ,$74.85 ,$74.85 ,$39.10 ,$80.17 ,$19.14 , N/A , N/A ,$46.00 ,$39.10 ,$12.88 ,$41.40 ,$46.00 ,$38.00 ,$74.85 ,$29.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000098,75635,HC CTA ABDOMEN AORTA ILIOFEM RUNOFF,350,1 ,"$6,345.00 ","$4,124.25 ",$165.30 ,"$6,345.00 ",$442.60 ,"$5,076.00 ",$165.30 ,"$1,776.60 ","$5,027.78 ","$5,824.71 ",$165.30 ,"$5,824.71 ",$165.30 ,$336.38 ,"$4,695.30 ",$442.60 ,$177.04 ,"$5,291.73 ",$165.30 , N/A ,"$5,240.97 ","$5,240.97 ","$5,076.00 ","$5,710.50 ",$413.25 ,"$5,393.25 ",$165.30 ,$165.30 ,"$5,393.25 ",$177.04 ,"$2,639.52 ", N/A , N/A ,$185.30 ,"$5,393.25 ","$1,776.60 ","$5,710.50 ","$1,069.00 ","$5,240.97 ",$165.30 ,"$4,124.25 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000120,74174,HC CT ANGIO ABD/PELV W  AND  WO CONTRAST,350,1 ,"$5,661.00 ","$3,679.65 ",$340.78 ,"$5,661.00 ",$912.43 ,"$4,528.80 ",$340.78 ,"$1,585.08 ","$4,485.78 ","$5,196.80 ",$340.78 ,"$5,196.80 ",$340.78 ,$693.44 ,"$4,189.14 ",$912.43 ,$364.97 ,"$4,721.27 ",$340.78 , N/A ,"$4,675.99 ","$4,675.99 ","$4,528.80 ","$5,094.90 ",$851.94 ,"$4,811.85 ",$340.78 ,$340.78 ,"$4,811.85 ",$364.97 ,"$2,354.98 ", N/A , N/A ,$382.01 ,"$4,811.85 ","$1,585.08 ","$5,094.90 ","$1,069.00 ","$4,675.99 ",$340.78 ,"$3,679.65 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),35000154,71271,HC CT THORAX LOW DOSE LUNG SCN W/O CONTAST,350,1 ,$220.00 ,$143.00 ,$61.60 ,$269.75 ,$269.75 ,$176.00 ,$100.75 ,$61.60 ,$174.33 ,$201.96 ,$100.75 ,$201.96 ,$100.75 ,$205.01 ,$162.80 ,$220.00 ,$107.90 ,$183.48 ,$100.75 , N/A ,$181.72 ,$181.72 ,$176.00 ,$198.00 ,$220.00 ,$187.00 ,$100.75 ,$100.75 ,$187.00 ,$107.90 ,$91.52 , N/A , N/A ,$112.94 ,$187.00 ,$61.60 ,$198.00 ,$220.00 ,$181.72 ,$100.75 ,$143.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000030,10160,HC ASP ABSC/HEMA/CYST/BULLA FAC,360,1 ,$508.00 ,$330.20 ,$142.24 ,$856.40 ,$856.40 ,$406.40 ,$319.85 ,$142.24 ,$402.54 ,$466.34 ,$319.85 ,$466.34 ,$319.85 ,$508.00 ,$375.92 ,$508.00 ,$342.56 ,$423.67 ,$319.85 , N/A ,$419.61 ,$419.61 ,$406.40 ,$457.20 ,$508.00 ,$431.80 ,$319.85 ,$319.85 ,$431.80 ,$342.56 ,$211.33 , N/A , N/A ,$358.56 ,$431.80 ,$142.24 ,$457.20 ,$398.78 ,$419.61 ,$319.85 ,$330.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000123,36556,HC INS CATH CV NON-TUNL >5 YR,360,1 ,"$1,997.00 ","$1,298.05 ",$559.16 ,"$7,092.98 ","$7,092.98 ","$1,597.60 ","$2,649.10 ",$559.16 ,"$1,582.42 ","$1,833.25 ","$1,997.00 ","$1,833.25 ","$1,997.00 ","$1,997.00 ","$1,477.78 ","$1,997.00 ","$2,837.19 ","$1,665.50 ","$2,649.10 ", N/A ,"$1,649.52 ","$1,649.52 ","$1,597.60 ","$1,797.30 ","$1,997.00 ","$1,697.45 ","$2,649.10 ","$2,649.10 ","$1,697.45 ","$2,837.19 ",$830.75 , N/A , N/A ,"$1,997.00 ","$1,697.45 ",$559.16 ,"$1,797.30 ","$1,567.65 ","$1,649.52 ","$2,649.10 ","$1,298.05 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000125,36558,HC INSERT TUNNELED CVC > 5 YEARS OLD,360,1 ,"$2,119.00 ","$1,377.35 ",$593.32 ,"$7,092.98 ","$7,092.98 ","$1,695.20 ","$2,649.10 ",$593.32 ,"$1,679.10 ","$1,945.24 ","$2,119.00 ","$1,945.24 ","$2,119.00 ","$2,119.00 ","$1,568.06 ","$2,119.00 ","$2,837.19 ","$1,767.25 ","$2,649.10 ", N/A ,"$1,750.29 ","$1,750.29 ","$1,695.20 ","$1,907.10 ","$2,119.00 ","$1,801.15 ","$2,649.10 ","$2,649.10 ","$1,801.15 ","$2,837.19 ",$881.50 , N/A , N/A ,"$2,119.00 ","$1,801.15 ",$593.32 ,"$1,907.10 ","$1,663.42 ","$1,750.29 ","$2,649.10 ","$1,377.35 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000132,36569,HC INS PER CV CATH W/O PORT 5>,360,1 ,"$1,201.00 ",$780.65 ,$336.28 ,"$3,484.25 ","$3,484.25 ",$960.80 ,"$1,301.30 ",$336.28 ,$951.67 ,"$1,102.52 ","$1,201.00 ","$1,102.52 ","$1,201.00 ","$1,201.00 ",$888.74 ,"$1,201.00 ","$1,393.70 ","$1,001.63 ","$1,301.30 ", N/A ,$992.03 ,$992.03 ,$960.80 ,"$1,080.90 ","$1,201.00 ","$1,020.85 ","$1,301.30 ","$1,301.30 ","$1,020.85 ","$1,393.70 ",$499.62 , N/A , N/A ,"$1,201.00 ","$1,020.85 ",$336.28 ,"$1,080.90 ",$942.79 ,$992.03 ,"$1,301.30 ",$780.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000194,62270,HC LUMBAR PUNCTURE,360,1 ,$800.00 ,$520.00 ,$224.00 ,"$1,573.38 ","$1,573.38 ",$640.00 ,$587.62 ,$224.00 ,$633.92 ,$734.40 ,$587.62 ,$734.40 ,$587.62 ,$800.00 ,$592.00 ,$800.00 ,$629.35 ,$667.20 ,$587.62 , N/A ,$660.80 ,$660.80 ,$640.00 ,$720.00 ,$800.00 ,$680.00 ,$587.62 ,$587.62 ,$680.00 ,$629.35 ,$332.80 , N/A , N/A ,$658.73 ,$680.00 ,$224.00 ,$720.00 ,$628.00 ,$660.80 ,$587.62 ,$520.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000546,11750,HC REMOVE NAIL BED,360,1 ,$741.00 ,$481.65 ,$207.48 ,$856.40 ,$856.40 ,$592.80 ,$319.85 ,$207.48 ,$587.17 ,$680.24 ,$319.85 ,$680.24 ,$319.85 ,$650.86 ,$548.34 ,$741.00 ,$342.56 ,$617.99 ,$319.85 , N/A ,$612.07 ,$612.07 ,$592.80 ,$666.90 ,$741.00 ,$629.85 ,$319.85 ,$319.85 ,$629.85 ,$342.56 ,$308.26 , N/A , N/A ,$358.56 ,$629.85 ,$207.48 ,$666.90 ,$581.69 ,$612.07 ,$319.85 ,$481.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000581,30801,HC ABLATION SOFT TISSUE INF TURBINATES UNI/BIL,360,1 ,$665.00 ,$432.25 ,$186.20 ,"$3,351.73 ","$3,351.73 ",$532.00 ,"$1,251.81 ",$186.20 ,$526.95 ,$610.47 ,$665.00 ,$610.47 ,$665.00 ,$665.00 ,$492.10 ,$665.00 ,"$1,340.69 ",$554.61 ,"$1,251.81 ", N/A ,$549.29 ,$549.29 ,$532.00 ,$598.50 ,$665.00 ,$565.25 ,"$1,251.81 ","$1,251.81 ",$565.25 ,"$1,340.69 ",$276.64 , N/A , N/A ,$665.00 ,$565.25 ,$186.20 ,$598.50 ,$522.03 ,$549.29 ,"$1,251.81 ",$432.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000771,23552,HC TX CLAVICAL DISC,360,1 ,"$17,946.00 ","$11,664.90 ","$5,024.88 ","$17,946.00 ","$15,519.78 ","$14,356.80 ","$5,796.37 ","$5,024.88 ","$14,220.41 ","$16,474.43 ","$5,796.37 ","$16,474.43 ","$5,796.37 ","$11,795.03 ","$13,280.04 ","$15,519.78 ","$6,207.91 ","$14,966.96 ","$5,796.37 ", N/A ,"$14,823.40 ","$14,823.40 ","$14,356.80 ","$16,151.40 ","$14,490.92 ","$15,254.10 ","$5,796.37 ","$5,796.37 ","$15,254.10 ","$6,207.91 ","$7,465.54 ", N/A , N/A ,"$6,497.73 ","$15,254.10 ","$5,024.88 ","$16,151.40 ","$14,087.61 ","$14,823.40 ","$5,796.37 ","$11,664.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000772,29824,HC SURG ARTHO SHLDR DSTL CLAV,360,1 ,"$8,492.00 ","$5,519.80 ","$2,377.76 ","$8,492.00 ","$7,016.90 ","$6,793.60 ","$2,620.69 ","$2,377.76 ","$6,729.06 ","$7,795.66 ","$2,620.69 ","$7,795.66 ","$2,620.69 ","$5,332.84 ","$6,284.08 ","$7,016.90 ","$2,806.76 ","$7,082.33 ","$2,620.69 ", N/A ,"$7,014.39 ","$7,014.39 ","$6,793.60 ","$7,642.80 ","$6,551.74 ","$7,218.20 ","$2,620.69 ","$2,620.69 ","$7,218.20 ","$2,806.76 ","$3,532.67 ", N/A , N/A ,"$2,937.80 ","$7,218.20 ","$2,377.76 ","$7,642.80 ","$6,666.22 ","$7,014.39 ","$2,620.69 ","$5,519.80 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000773,14041,HC TISS TRANS WND 10.1-30 SQ CM,360,1 ,"$5,300.00 ","$3,445.00 ","$1,484.00 ","$5,300.00 ","$4,243.85 ","$4,240.00 ","$1,585.00 ","$1,484.00 ","$4,199.72 ","$4,865.40 ","$1,585.00 ","$4,865.40 ","$1,585.00 ","$3,225.33 ","$3,922.00 ","$4,243.85 ","$1,697.54 ","$4,420.20 ","$1,585.00 ", N/A ,"$4,377.80 ","$4,377.80 ","$4,240.00 ","$4,770.00 ","$3,962.51 ","$4,505.00 ","$1,585.00 ","$1,585.00 ","$4,505.00 ","$1,697.54 ","$2,204.80 ", N/A , N/A ,"$1,776.79 ","$4,505.00 ","$1,484.00 ","$4,770.00 ","$4,160.50 ","$4,377.80 ","$1,585.00 ","$3,445.00 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000774,24071,HC EXC ARM/ELBOW LES CM 3CM/>,360,1 ,"$7,111.00 ","$4,622.15 ","$1,991.08 ","$7,111.00 ","$5,874.88 ","$5,688.80 ","$2,194.17 ","$1,991.08 ","$5,634.76 ","$6,527.90 ","$2,194.17 ","$6,527.90 ","$2,194.17 ","$4,464.91 ","$5,262.14 ","$5,874.88 ","$2,349.95 ","$5,930.57 ","$2,194.17 ", N/A ,"$5,873.69 ","$5,873.69 ","$5,688.80 ","$6,399.90 ","$5,485.42 ","$6,044.35 ","$2,194.17 ","$2,194.17 ","$6,044.35 ","$2,349.95 ","$2,958.18 ", N/A , N/A ,"$2,459.66 ","$6,044.35 ","$1,991.08 ","$6,399.90 ","$5,582.14 ","$5,873.69 ","$2,194.17 ","$4,622.15 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36000775,22901,HC EXC TUMOR 5CM> ABD WALL,360,1 ,"$7,111.00 ","$4,622.15 ","$1,991.08 ","$7,111.00 ","$5,874.88 ","$5,688.80 ","$2,194.17 ","$1,991.08 ","$5,634.76 ","$6,527.90 ","$2,194.17 ","$6,527.90 ","$2,194.17 ","$4,464.91 ","$5,262.14 ","$5,874.88 ","$2,349.95 ","$5,930.57 ","$2,194.17 ", N/A ,"$5,873.69 ","$5,873.69 ","$5,688.80 ","$6,399.90 ","$5,485.42 ","$6,044.35 ","$2,194.17 ","$2,194.17 ","$6,044.35 ","$2,349.95 ","$2,958.18 ", N/A , N/A ,"$2,459.66 ","$6,044.35 ","$1,991.08 ","$6,399.90 ","$5,582.14 ","$5,873.69 ","$2,194.17 ","$4,622.15 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36060014,N/A,HC OR LEVEL 1 ADDL 15MIN,360,1 ,$769.00 ,$499.85 ,$215.32 ,$769.00 , N/A ,$615.20 , N/A ,$215.32 ,$609.36 ,$705.94 , N/A ,$705.94 , N/A , N/A ,$569.06 , N/A , N/A ,$641.35 , N/A , N/A ,$635.19 ,$635.19 ,$615.20 ,$692.10 , N/A ,$653.65 , N/A , N/A ,$653.65 , N/A ,$319.90 , N/A , N/A , N/A ,$653.65 ,$215.32 ,$692.10 ,$603.67 ,$635.19 , N/A ,$499.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36060016,N/A,HC OR LEVEL 2 ADDL 15MIN,360,1 ,"$1,008.00 ",$655.20 ,$282.24 ,"$1,008.00 ", N/A ,$806.40 , N/A ,$282.24 ,$798.74 ,$925.34 , N/A ,$925.34 , N/A , N/A ,$745.92 , N/A , N/A ,$840.67 , N/A , N/A ,$832.61 ,$832.61 ,$806.40 ,$907.20 , N/A ,$856.80 , N/A , N/A ,$856.80 , N/A ,$419.33 , N/A , N/A , N/A ,$856.80 ,$282.24 ,$907.20 ,$791.28 ,$832.61 , N/A ,$655.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36060018,N/A,HC OR LEVEL 3 ADDL 15MIN,360,1 ,"$1,216.00 ",$790.40 ,$340.48 ,"$1,216.00 ", N/A ,$972.80 , N/A ,$340.48 ,$963.56 ,"$1,116.29 ", N/A ,"$1,116.29 ", N/A , N/A ,$899.84 , N/A , N/A ,"$1,014.14 ", N/A , N/A ,"$1,004.42 ","$1,004.42 ",$972.80 ,"$1,094.40 ", N/A ,"$1,033.60 ", N/A , N/A ,"$1,033.60 ", N/A ,$505.86 , N/A , N/A , N/A ,"$1,033.60 ",$340.48 ,"$1,094.40 ",$954.56 ,"$1,004.42 ", N/A ,$790.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36060020,N/A,HC OR LEVEL 4 ADDL 15MIN,360,1 ,"$1,356.00 ",$881.40 ,$379.68 ,"$1,356.00 ", N/A ,"$1,084.80 ", N/A ,$379.68 ,"$1,074.49 ","$1,244.81 ", N/A ,"$1,244.81 ", N/A , N/A ,"$1,003.44 ", N/A , N/A ,"$1,130.90 ", N/A , N/A ,"$1,120.06 ","$1,120.06 ","$1,084.80 ","$1,220.40 ", N/A ,"$1,152.60 ", N/A , N/A ,"$1,152.60 ", N/A ,$564.10 , N/A , N/A , N/A ,"$1,152.60 ",$379.68 ,"$1,220.40 ","$1,064.46 ","$1,120.06 ", N/A ,$881.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36060022,N/A,HC OR LEVEL 5 ADDL 15MIN,360,1 ,"$1,567.00 ","$1,018.55 ",$438.76 ,"$1,567.00 ", N/A ,"$1,253.60 ", N/A ,$438.76 ,"$1,241.69 ","$1,438.51 ", N/A ,"$1,438.51 ", N/A , N/A ,"$1,159.58 ", N/A , N/A ,"$1,306.88 ", N/A , N/A ,"$1,294.34 ","$1,294.34 ","$1,253.60 ","$1,410.30 ", N/A ,"$1,331.95 ", N/A , N/A ,"$1,331.95 ", N/A ,$651.87 , N/A , N/A , N/A ,"$1,331.95 ",$438.76 ,"$1,410.30 ","$1,230.10 ","$1,294.34 ", N/A ,"$1,018.55 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36060025,N/A,HC OR LEVEL 1 INITIAL 30MIN,360,1 ,"$3,254.00 ","$2,115.10 ",$911.12 ,"$3,254.00 ", N/A ,"$2,603.20 ", N/A ,$911.12 ,"$2,578.47 ","$2,987.17 ", N/A ,"$2,987.17 ", N/A , N/A ,"$2,407.96 ", N/A , N/A ,"$2,713.84 ", N/A , N/A ,"$2,687.80 ","$2,687.80 ","$2,603.20 ","$2,928.60 ", N/A ,"$2,765.90 ", N/A , N/A ,"$2,765.90 ", N/A ,"$1,353.66 ", N/A , N/A , N/A ,"$2,765.90 ",$911.12 ,"$2,928.60 ","$2,554.39 ","$2,687.80 ", N/A ,"$2,115.10 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36060026,N/A,HC OR LEVEL 2 INITIAL 30MIN,360,1 ,"$5,368.00 ","$3,489.20 ","$1,503.04 ","$5,368.00 ", N/A ,"$4,294.40 ", N/A ,"$1,503.04 ","$4,253.60 ","$4,927.82 ", N/A ,"$4,927.82 ", N/A , N/A ,"$3,972.32 ", N/A , N/A ,"$4,476.91 ", N/A , N/A ,"$4,433.97 ","$4,433.97 ","$4,294.40 ","$4,831.20 ", N/A ,"$4,562.80 ", N/A , N/A ,"$4,562.80 ", N/A ,"$2,233.09 ", N/A , N/A , N/A ,"$4,562.80 ","$1,503.04 ","$4,831.20 ","$4,213.88 ","$4,433.97 ", N/A ,"$3,489.20 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36060027,N/A,HC OR LEVEL 3 INITIAL 30MIN,360,1 ,"$5,596.00 ","$3,637.40 ","$1,566.88 ","$5,596.00 ", N/A ,"$4,476.80 ", N/A ,"$1,566.88 ","$4,434.27 ","$5,137.13 ", N/A ,"$5,137.13 ", N/A , N/A ,"$4,141.04 ", N/A , N/A ,"$4,667.06 ", N/A , N/A ,"$4,622.30 ","$4,622.30 ","$4,476.80 ","$5,036.40 ", N/A ,"$4,756.60 ", N/A , N/A ,"$4,756.60 ", N/A ,"$2,327.94 ", N/A , N/A , N/A ,"$4,756.60 ","$1,566.88 ","$5,036.40 ","$4,392.86 ","$4,622.30 ", N/A ,"$3,637.40 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36060028,N/A,HC OR LEVEL 4 INITIAL 30MIN,360,1 ,"$5,829.00 ","$3,788.85 ","$1,632.12 ","$5,829.00 ", N/A ,"$4,663.20 ", N/A ,"$1,632.12 ","$4,618.90 ","$5,351.02 ", N/A ,"$5,351.02 ", N/A , N/A ,"$4,313.46 ", N/A , N/A ,"$4,861.39 ", N/A , N/A ,"$4,814.75 ","$4,814.75 ","$4,663.20 ","$5,246.10 ", N/A ,"$4,954.65 ", N/A , N/A ,"$4,954.65 ", N/A ,"$2,424.86 ", N/A , N/A , N/A ,"$4,954.65 ","$1,632.12 ","$5,246.10 ","$4,575.77 ","$4,814.75 ", N/A ,"$3,788.85 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36060029,N/A,HC OR LEVEL 5 INITIAL 30MIN,360,1 ,"$6,347.00 ","$4,125.55 ","$1,777.16 ","$6,347.00 ", N/A ,"$5,077.60 ", N/A ,"$1,777.16 ","$5,029.36 ","$5,826.55 ", N/A ,"$5,826.55 ", N/A , N/A ,"$4,696.78 ", N/A , N/A ,"$5,293.40 ", N/A , N/A ,"$5,242.62 ","$5,242.62 ","$5,077.60 ","$5,712.30 ", N/A ,"$5,394.95 ", N/A , N/A ,"$5,394.95 ", N/A ,"$2,640.35 ", N/A , N/A , N/A ,"$5,394.95 ","$1,777.16 ","$5,712.30 ","$4,982.40 ","$5,242.62 ", N/A ,"$4,125.55 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36063345,11043,"HC DEBRIDEMENT, MUSCLE AND/OR FASCIA",360,1 ,"$1,794.00 ","$1,166.10 ",$484.66 ,"$1,794.00 ","$1,297.68 ","$1,435.20 ",$484.66 ,$502.32 ,"$1,421.57 ","$1,646.89 ",$484.66 ,"$1,646.89 ",$484.66 ,$986.23 ,"$1,327.56 ","$1,297.68 ",$519.07 ,"$1,496.20 ",$484.66 , N/A ,"$1,481.84 ","$1,481.84 ","$1,435.20 ","$1,614.60 ","$1,211.66 ","$1,524.90 ",$484.66 ,$484.66 ,"$1,524.90 ",$519.07 ,$746.30 , N/A , N/A ,$543.31 ,"$1,524.90 ",$502.32 ,"$1,614.60 ","$1,408.29 ","$1,481.84 ",$484.66 ,"$1,166.10 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36080008,64417,HC NERVE BLOCK AXILLARY NERVE,360,1 ,"$2,333.00 ","$1,516.45 ",$653.24 ,"$2,333.00 ","$2,039.68 ","$1,866.40 ",$761.79 ,$653.24 ,"$1,848.67 ","$2,141.69 ",$761.79 ,"$2,141.69 ",$761.79 ,"$1,550.15 ","$1,726.42 ","$2,039.68 ",$815.87 ,"$1,945.72 ",$761.79 , N/A ,"$1,927.06 ","$1,927.06 ","$1,866.40 ","$2,099.70 ","$1,904.46 ","$1,983.05 ",$761.79 ,$761.79 ,"$1,983.05 ",$815.87 ,$970.53 , N/A , N/A ,$853.96 ,"$1,983.05 ",$653.24 ,"$2,099.70 ","$1,831.41 ","$1,927.06 ",$761.79 ,"$1,516.45 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),36100044,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-BIL,361,1 ,$928.00 ,$603.20 ,$259.84 ,$971.03 ,$971.03 ,$742.40 ,$362.66 ,$259.84 ,$735.35 ,$851.90 ,$362.66 ,$851.90 ,$362.66 ,$737.98 ,$686.72 ,$928.00 ,$388.41 ,$773.95 ,$362.66 , N/A ,$766.53 ,$766.53 ,$742.40 ,$835.20 ,$906.66 ,$788.80 ,$362.66 ,$362.66 ,$788.80 ,$388.41 ,$386.05 , N/A , N/A ,$406.54 ,$788.80 ,$259.84 ,$835.20 ,$728.48 ,$766.53 ,$362.66 ,$603.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36100067,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-LT,361,1 ,$896.00 ,$582.40 ,$241.77 ,$896.00 ,$647.35 ,$716.80 ,$241.77 ,$250.88 ,$709.99 ,$822.53 ,$241.77 ,$822.53 ,$241.77 ,$491.99 ,$663.04 ,$647.35 ,$258.94 ,$747.26 ,$241.77 , N/A ,$740.10 ,$740.10 ,$716.80 ,$806.40 ,$604.44 ,$761.60 ,$241.77 ,$241.77 ,$761.60 ,$258.94 ,$372.74 , N/A , N/A ,$271.03 ,$761.60 ,$250.88 ,$806.40 ,$703.36 ,$740.10 ,$241.77 ,$582.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),36100068,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-RT,361,1 ,$896.00 ,$582.40 ,$241.77 ,$896.00 ,$647.35 ,$716.80 ,$241.77 ,$250.88 ,$709.99 ,$822.53 ,$241.77 ,$822.53 ,$241.77 ,$491.99 ,$663.04 ,$647.35 ,$258.94 ,$747.26 ,$241.77 , N/A ,$740.10 ,$740.10 ,$716.80 ,$806.40 ,$604.44 ,$761.60 ,$241.77 ,$241.77 ,$761.60 ,$258.94 ,$372.74 , N/A , N/A ,$271.03 ,$761.60 ,$250.88 ,$806.40 ,$703.36 ,$740.10 ,$241.77 ,$582.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),37000013,31500,HC INTUBATION ENDOTRACHEAL,361,1 ,$847.00 ,$550.55 ,$195.78 ,$847.00 ,$524.20 ,$677.60 ,$195.78 ,$237.16 ,$671.16 ,$777.55 ,$195.78 ,$777.55 ,$195.78 ,$398.39 ,$626.78 ,$524.20 ,$209.68 ,$706.40 ,$195.78 , N/A ,$699.62 ,$699.62 ,$677.60 ,$762.30 ,$489.45 ,$719.95 ,$195.78 ,$195.78 ,$719.95 ,$209.68 ,$352.35 , N/A , N/A ,$219.47 ,$719.95 ,$237.16 ,$762.30 ,$664.90 ,$699.62 ,$195.78 ,$550.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),37000061,N/A,HC ANESTHESIA GENERAL INITIAL 15MIN,370,1 ,$597.00 ,$388.05 ,$167.16 ,$597.00 , N/A ,$477.60 , N/A ,$167.16 ,$473.06 ,$548.05 , N/A ,$548.05 , N/A , N/A ,$441.78 , N/A , N/A ,$497.90 , N/A , N/A ,$493.12 ,$493.12 ,$477.60 ,$537.30 , N/A ,$507.45 , N/A , N/A ,$507.45 , N/A ,$248.35 , N/A , N/A , N/A ,$507.45 ,$167.16 ,$537.30 ,$468.65 ,$493.12 , N/A ,$388.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),37000062,N/A,HC ANESTHESIA GENERAL ADDL 15MIN,370,1 ,$405.00 ,$263.25 ,$113.40 ,$405.00 , N/A ,$324.00 , N/A ,$113.40 ,$320.92 ,$371.79 , N/A ,$371.79 , N/A , N/A ,$299.70 , N/A , N/A ,$337.77 , N/A , N/A ,$334.53 ,$334.53 ,$324.00 ,$364.50 , N/A ,$344.25 , N/A , N/A ,$344.25 , N/A ,$168.48 , N/A , N/A , N/A ,$344.25 ,$113.40 ,$364.50 ,$317.93 ,$334.53 , N/A ,$263.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),37000063,N/A,HC ANESTHESIA REGIONAL BLOCK INITIAL 15MIN,370,1 ,$527.00 ,$342.55 ,$147.56 ,$527.00 , N/A ,$421.60 , N/A ,$147.56 ,$417.59 ,$483.79 , N/A ,$483.79 , N/A , N/A ,$389.98 , N/A , N/A ,$439.52 , N/A , N/A ,$435.30 ,$435.30 ,$421.60 ,$474.30 , N/A ,$447.95 , N/A , N/A ,$447.95 , N/A ,$219.23 , N/A , N/A , N/A ,$447.95 ,$147.56 ,$474.30 ,$413.70 ,$435.30 , N/A ,$342.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),37000064,N/A,HC ANESTHESIA REGIONAL BLOCK ADDL 15MIN,370,1 ,$527.00 ,$342.55 ,$147.56 ,$527.00 , N/A ,$421.60 , N/A ,$147.56 ,$417.59 ,$483.79 , N/A ,$483.79 , N/A , N/A ,$389.98 , N/A , N/A ,$439.52 , N/A , N/A ,$435.30 ,$435.30 ,$421.60 ,$474.30 , N/A ,$447.95 , N/A , N/A ,$447.95 , N/A ,$219.23 , N/A , N/A , N/A ,$447.95 ,$147.56 ,$474.30 ,$413.70 ,$435.30 , N/A ,$342.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),37000076,N/A,HC MONITORED ANESTHESIA INITIAL 15 MINS,370,1 ,$457.00 ,$297.05 ,$127.96 ,$457.00 , N/A ,$365.60 , N/A ,$127.96 ,$362.13 ,$419.53 , N/A ,$419.53 , N/A , N/A ,$338.18 , N/A , N/A ,$381.14 , N/A , N/A ,$377.48 ,$377.48 ,$365.60 ,$411.30 , N/A ,$388.45 , N/A , N/A ,$388.45 , N/A ,$190.11 , N/A , N/A , N/A ,$388.45 ,$127.96 ,$411.30 ,$358.75 ,$377.48 , N/A ,$297.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),37000077,N/A,HC MONITORED ANESTHESIA ADDL 15 MINS,370,1 ,$252.00 ,$163.80 ,$70.56 ,$252.00 , N/A ,$201.60 , N/A ,$70.56 ,$199.68 ,$231.34 , N/A ,$231.34 , N/A , N/A ,$186.48 , N/A , N/A ,$210.17 , N/A , N/A ,$208.15 ,$208.15 ,$201.60 ,$226.80 , N/A ,$214.20 , N/A , N/A ,$214.20 , N/A ,$104.83 , N/A , N/A , N/A ,$214.20 ,$70.56 ,$226.80 ,$197.82 ,$208.15 , N/A ,$163.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),37080001,64415,HC INTRASCALENE BLOCK SINGLE,360,1 ,$757.00 ,$492.05 ,$211.96 ,"$2,039.68 ","$2,039.68 ",$605.60 ,$761.79 ,$211.96 ,$599.85 ,$694.93 ,$757.00 ,$694.93 ,$757.00 ,$757.00 ,$560.18 ,$757.00 ,$815.87 ,$631.34 ,$761.79 , N/A ,$625.28 ,$625.28 ,$605.60 ,$681.30 ,$757.00 ,$643.45 ,$761.79 ,$761.79 ,$643.45 ,$815.87 ,$314.91 , N/A , N/A ,$757.00 ,$643.45 ,$211.96 ,$681.30 ,$594.25 ,$625.28 ,$761.79 ,$492.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000148,P9017,HC FRESH FROZEN PLASMA EA,390,1 ,$323.00 ,$209.95 ,$84.40 ,$323.00 ,$225.98 ,$258.40 ,$84.40 ,$90.44 ,$255.95 ,$296.51 ,$84.40 ,$296.51 ,$84.40 ,$171.74 ,$239.02 ,$225.98 ,$90.39 ,$269.38 ,$84.40 , N/A ,$266.80 ,$266.80 ,$258.40 ,$290.70 ,$211.00 ,$274.55 ,$84.40 ,$84.40 ,$274.55 ,$90.39 ,$134.37 , N/A , N/A ,$94.61 ,$274.55 ,$90.44 ,$290.70 ,$253.56 ,$266.80 ,$84.40 ,$209.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000152,P9033,HC PLATELETS L/R IRR EA,390,1 ,"$1,430.00 ",$929.50 ,$217.66 ,"$1,430.00 ",$582.78 ,"$1,144.00 ",$217.66 ,$400.40 ,"$1,133.13 ","$1,312.74 ",$217.66 ,"$1,312.74 ",$217.66 ,$442.91 ,"$1,058.20 ",$582.78 ,$233.11 ,"$1,192.62 ",$217.66 , N/A ,"$1,181.18 ","$1,181.18 ","$1,144.00 ","$1,287.00 ",$544.15 ,"$1,215.50 ",$217.66 ,$217.66 ,"$1,215.50 ",$233.11 ,$594.88 , N/A , N/A ,$244.00 ,"$1,215.50 ",$400.40 ,"$1,287.00 ","$1,122.55 ","$1,181.18 ",$217.66 ,$929.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000160,P9059,HC PLASMA FROZEN 8-24 HRS EA UNIT,390,1 ,$333.00 ,$216.45 ,$72.64 ,$333.00 ,$194.50 ,$266.40 ,$72.64 ,$93.24 ,$263.87 ,$305.69 ,$72.64 ,$305.69 ,$72.64 ,$147.82 ,$246.42 ,$194.50 ,$77.80 ,$277.72 ,$72.64 , N/A ,$275.06 ,$275.06 ,$266.40 ,$299.70 ,$181.60 ,$283.05 ,$72.64 ,$72.64 ,$283.05 ,$77.80 ,$138.53 , N/A , N/A ,$81.43 ,$283.05 ,$93.24 ,$299.70 ,$261.41 ,$275.06 ,$72.64 ,$216.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000164,P9016,HC RED CELLS L/R EA T1,390,1 ,$478.00 ,$310.70 ,$133.84 ,$515.13 ,$515.13 ,$382.40 ,$192.39 ,$133.84 ,$378.77 ,$438.80 ,$192.39 ,$438.80 ,$192.39 ,$391.50 ,$353.72 ,$478.00 ,$206.05 ,$398.65 ,$192.39 , N/A ,$394.83 ,$394.83 ,$382.40 ,$430.20 ,$478.00 ,$406.30 ,$192.39 ,$192.39 ,$406.30 ,$206.05 ,$198.85 , N/A , N/A ,$215.67 ,$406.30 ,$133.84 ,$430.20 ,$375.23 ,$394.83 ,$192.39 ,$310.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000172,P9034,HC PLATELETS PHER EA,390,1 ,"$1,000.00 ",$650.00 ,$280.00 ,"$1,000.00 ",$885.73 ,$800.00 ,$330.80 ,$280.00 ,$792.40 ,$918.00 ,$330.80 ,$918.00 ,$330.80 ,$673.15 ,$740.00 ,$885.73 ,$354.29 ,$834.00 ,$330.80 , N/A ,$826.00 ,$826.00 ,$800.00 ,$900.00 ,$827.00 ,$850.00 ,$330.80 ,$330.80 ,$850.00 ,$354.29 ,$416.00 , N/A , N/A ,$370.83 ,$850.00 ,$280.00 ,$900.00 ,$785.00 ,$826.00 ,$330.80 ,$650.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000173,P9035,HC PLATELETS PHER L/R EA T1,390,1 ,"$2,335.00 ","$1,517.75 ",$496.91 ,"$2,335.00 ","$1,330.48 ","$1,868.00 ",$496.91 ,$653.80 ,"$1,850.25 ","$2,143.53 ",$496.91 ,"$2,143.53 ",$496.91 ,"$1,011.16 ","$1,727.90 ","$1,330.48 ",$532.19 ,"$1,947.39 ",$496.91 , N/A ,"$1,928.71 ","$1,928.71 ","$1,868.00 ","$2,101.50 ","$1,242.28 ","$1,984.75 ",$496.91 ,$496.91 ,"$1,984.75 ",$532.19 ,$971.36 , N/A , N/A ,$557.04 ,"$1,984.75 ",$653.80 ,"$2,101.50 ","$1,832.98 ","$1,928.71 ",$496.91 ,"$1,517.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000179,P9037,HC PLATELETS PHER L/R IRR EA T1,390,1 ,"$2,554.00 ","$1,660.10 ",$630.32 ,"$2,554.00 ","$1,687.68 ","$2,043.20 ",$630.32 ,$715.12 ,"$2,023.79 ","$2,344.57 ",$630.32 ,"$2,344.57 ",$630.32 ,"$1,282.63 ","$1,889.96 ","$1,687.68 ",$675.07 ,"$2,130.04 ",$630.32 , N/A ,"$2,109.60 ","$2,109.60 ","$2,043.20 ","$2,298.60 ","$1,575.80 ","$2,170.90 ",$630.32 ,$630.32 ,"$2,170.90 ",$675.07 ,"$1,062.46 ", N/A , N/A ,$706.59 ,"$2,170.90 ",$715.12 ,"$2,298.60 ","$2,004.89 ","$2,109.60 ",$630.32 ,"$1,660.10 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000187,P9040,HC RED CELLS L/R IRR EA T1,390,1 ,"$1,077.00 ",$700.05 ,$266.03 ,"$1,077.00 ",$712.30 ,$861.60 ,$266.03 ,$301.56 ,$853.41 ,$988.69 ,$266.03 ,$988.69 ,$266.03 ,$541.35 ,$796.98 ,$712.30 ,$284.92 ,$898.22 ,$266.03 , N/A ,$889.60 ,$889.60 ,$861.60 ,$969.30 ,$665.08 ,$915.45 ,$266.03 ,$266.03 ,$915.45 ,$284.92 ,$448.03 , N/A , N/A ,$298.22 ,$915.45 ,$301.56 ,$969.30 ,$845.45 ,$889.60 ,$266.03 ,$700.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000198,P9058,HC RBC LEUKORED CMV NEG IRRAD,390,1 ,"$1,192.00 ",$774.80 ,$248.99 ,"$1,192.00 ",$666.68 ,$953.60 ,$248.99 ,$333.76 ,$944.54 ,"$1,094.26 ",$248.99 ,"$1,094.26 ",$248.99 ,$506.67 ,$882.08 ,$666.68 ,$266.67 ,$994.13 ,$248.99 , N/A ,$984.59 ,$984.59 ,$953.60 ,"$1,072.80 ",$622.48 ,"$1,013.20 ",$248.99 ,$248.99 ,"$1,013.20 ",$266.67 ,$495.87 , N/A , N/A ,$279.12 ,"$1,013.20 ",$333.76 ,"$1,072.80 ",$935.72 ,$984.59 ,$248.99 ,$774.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000205,P9073,HC PLATELETS PHERESIS PATH REDUCED EA UN T1,390,1 ,"$2,259.00 ","$1,468.35 ",$596.13 ,"$2,259.00 ","$1,596.15 ","$1,807.20 ",$596.13 ,$632.52 ,"$1,790.03 ","$2,073.76 ",$596.13 ,"$2,073.76 ",$596.13 ,"$1,213.07 ","$1,671.66 ","$1,596.15 ",$638.46 ,"$1,884.01 ",$596.13 , N/A ,"$1,865.93 ","$1,865.93 ","$1,807.20 ","$2,033.10 ","$1,490.33 ","$1,920.15 ",$596.13 ,$596.13 ,"$1,920.15 ",$638.46 ,$939.74 , N/A , N/A ,$668.26 ,"$1,920.15 ",$632.52 ,"$2,033.10 ","$1,773.32 ","$1,865.93 ",$596.13 ,"$1,468.35 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),39000212,P9053,HC PLATELETS LEUKOCUTES RED CMV NEG IRR,390,1 ,"$2,470.00 ","$1,605.50 ",$456.71 ,"$2,470.00 ","$1,222.85 ","$1,976.00 ",$456.71 ,$691.60 ,"$1,957.23 ","$2,267.46 ",$456.71 ,"$2,267.46 ",$456.71 ,$929.37 ,"$1,827.80 ","$1,222.85 ",$489.14 ,"$2,059.98 ",$456.71 , N/A ,"$2,040.22 ","$2,040.22 ","$1,976.00 ","$2,223.00 ","$1,141.78 ","$2,099.50 ",$456.71 ,$456.71 ,"$2,099.50 ",$489.14 ,"$1,027.52 ", N/A , N/A ,$511.97 ,"$2,099.50 ",$691.60 ,"$2,223.00 ","$1,938.95 ","$2,040.22 ",$456.71 ,"$1,605.50 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),39100001,36430,HC BLOOD PROD ADMIN,391,1 ,"$1,250.00 ",$812.50 ,$350.00 ,"$1,250.00 ",$983.45 ,"$1,000.00 ",$367.31 ,$350.00 ,$990.50 ,"$1,147.50 ",$367.31 ,"$1,147.50 ",$367.31 ,$747.42 ,$925.00 ,$983.45 ,$393.38 ,"$1,042.50 ",$367.31 , N/A ,"$1,032.50 ","$1,032.50 ","$1,000.00 ","$1,125.00 ",$918.26 ,"$1,062.50 ",$367.31 ,$367.31 ,"$1,062.50 ",$393.38 ,$520.00 , N/A , N/A ,$411.75 ,"$1,062.50 ",$350.00 ,"$1,125.00 ",$981.25 ,"$1,032.50 ",$367.31 ,$812.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40100003,77066,HC MAMMOGRAM DIAG BILAT W/CAD,401,1 ,$604.00 ,$392.60 ,$105.51 ,$604.00 ,$263.78 ,$483.20 ,$105.51 ,$169.12 ,$478.61 ,$554.47 ,$105.51 ,$554.47 ,$105.51 ,$200.47 ,$446.96 ,$263.78 ,$105.51 ,$503.74 ,$105.51 , N/A ,$498.90 ,$498.90 ,$483.20 ,$543.60 ,$263.78 ,$513.40 ,$105.51 ,$105.51 ,$513.40 ,$105.51 ,$251.26 , N/A , N/A ,$110.79 ,$513.40 ,$169.12 ,$543.60 ,$474.14 ,$498.90 ,$105.51 ,$392.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40100004,77066,HC MAMMOGRAM DIAG BILAT W/CAD ADDNT VIEW,401,1 ,$604.00 ,$392.60 ,$105.51 ,$604.00 ,$263.78 ,$483.20 ,$105.51 ,$169.12 ,$478.61 ,$554.47 ,$105.51 ,$554.47 ,$105.51 ,$200.47 ,$446.96 ,$263.78 ,$105.51 ,$503.74 ,$105.51 , N/A ,$498.90 ,$498.90 ,$483.20 ,$543.60 ,$263.78 ,$513.40 ,$105.51 ,$105.51 ,$513.40 ,$105.51 ,$251.26 , N/A , N/A ,$110.79 ,$513.40 ,$169.12 ,$543.60 ,$474.14 ,$498.90 ,$105.51 ,$392.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40100005,77066,HC MAMMOGRAM DIAG BILAT W/CAD IMPLANT,401,1 ,$604.00 ,$392.60 ,$105.51 ,$604.00 ,$263.78 ,$483.20 ,$105.51 ,$169.12 ,$478.61 ,$554.47 ,$105.51 ,$554.47 ,$105.51 ,$200.47 ,$446.96 ,$263.78 ,$105.51 ,$503.74 ,$105.51 , N/A ,$498.90 ,$498.90 ,$483.20 ,$543.60 ,$263.78 ,$513.40 ,$105.51 ,$105.51 ,$513.40 ,$105.51 ,$251.26 , N/A , N/A ,$110.79 ,$513.40 ,$169.12 ,$543.60 ,$474.14 ,$498.90 ,$105.51 ,$392.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40100007,77065,HC MAMMOGRAM DIAG UNIL W/CAD,401,1 ,$479.00 ,$311.35 ,$82.78 ,$479.00 ,$206.95 ,$383.20 ,$82.78 ,$134.12 ,$379.56 ,$439.72 ,$82.78 ,$439.72 ,$82.78 ,$157.28 ,$354.46 ,$206.95 ,$82.78 ,$399.49 ,$82.78 , N/A ,$395.65 ,$395.65 ,$383.20 ,$431.10 ,$206.95 ,$407.15 ,$82.78 ,$82.78 ,$407.15 ,$82.78 ,$199.26 , N/A , N/A ,$86.92 ,$407.15 ,$134.12 ,$431.10 ,$376.02 ,$395.65 ,$82.78 ,$311.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40100008,77065,HC MAMMOGRAM DIAG UNIL W/CAD  ADDNT VIEW,401,1 ,$479.00 ,$311.35 ,$82.78 ,$479.00 ,$206.95 ,$383.20 ,$82.78 ,$134.12 ,$379.56 ,$439.72 ,$82.78 ,$439.72 ,$82.78 ,$157.28 ,$354.46 ,$206.95 ,$82.78 ,$399.49 ,$82.78 , N/A ,$395.65 ,$395.65 ,$383.20 ,$431.10 ,$206.95 ,$407.15 ,$82.78 ,$82.78 ,$407.15 ,$82.78 ,$199.26 , N/A , N/A ,$86.92 ,$407.15 ,$134.12 ,$431.10 ,$376.02 ,$395.65 ,$82.78 ,$311.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40100009,77065,HC MAMMOGRAM DIAG UNIL W/CAD IMPLANT,401,1 ,$479.00 ,$311.35 ,$82.78 ,$479.00 ,$206.95 ,$383.20 ,$82.78 ,$134.12 ,$379.56 ,$439.72 ,$82.78 ,$439.72 ,$82.78 ,$157.28 ,$354.46 ,$206.95 ,$82.78 ,$399.49 ,$82.78 , N/A ,$395.65 ,$395.65 ,$383.20 ,$431.10 ,$206.95 ,$407.15 ,$82.78 ,$82.78 ,$407.15 ,$82.78 ,$199.26 , N/A , N/A ,$86.92 ,$407.15 ,$134.12 ,$431.10 ,$376.02 ,$395.65 ,$82.78 ,$311.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200007,51798,HC US BLADDER SCAN,402,1 ,$296.00 ,$192.40 ,$51.51 ,$296.00 ,$137.93 ,$236.80 ,$51.51 ,$82.88 ,$234.55 ,$271.73 ,$51.51 ,$271.73 ,$51.51 ,$104.82 ,$219.04 ,$137.93 ,$55.17 ,$246.86 ,$51.51 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$128.78 ,$251.60 ,$51.51 ,$51.51 ,$251.60 ,$55.17 ,$123.14 , N/A , N/A ,$57.74 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$51.51 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200013,76536,HC US SOFT TISSUE HEAD/NECK,402,1 ,$741.00 ,$481.65 ,$100.75 ,$741.00 ,$269.75 ,$592.80 ,$100.75 ,$207.48 ,$587.17 ,$680.24 ,$100.75 ,$680.24 ,$100.75 ,$205.01 ,$548.34 ,$269.75 ,$107.90 ,$617.99 ,$100.75 , N/A ,$612.07 ,$612.07 ,$592.80 ,$666.90 ,$251.87 ,$629.85 ,$100.75 ,$100.75 ,$629.85 ,$107.90 ,$308.26 , N/A , N/A ,$112.94 ,$629.85 ,$207.48 ,$666.90 ,$581.69 ,$612.07 ,$100.75 ,$481.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200014,76604,HC US CHEST,402,1 ,$456.00 ,$296.40 ,$100.75 ,$456.00 ,$269.75 ,$364.80 ,$100.75 ,$127.68 ,$361.33 ,$418.61 ,$100.75 ,$418.61 ,$100.75 ,$205.01 ,$337.44 ,$269.75 ,$107.90 ,$380.30 ,$100.75 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$251.87 ,$387.60 ,$100.75 ,$100.75 ,$387.60 ,$107.90 ,$189.70 , N/A , N/A ,$112.94 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$100.75 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200015,76641,HC US BREAST COMPLETE,402,1 ,$829.00 ,$538.85 ,$100.75 ,$829.00 ,$269.75 ,$663.20 ,$100.75 ,$232.12 ,$656.90 ,$761.02 ,$100.75 ,$761.02 ,$100.75 ,$205.01 ,$613.46 ,$269.75 ,$107.90 ,$691.39 ,$100.75 , N/A ,$684.75 ,$684.75 ,$663.20 ,$746.10 ,$251.87 ,$704.65 ,$100.75 ,$100.75 ,$704.65 ,$107.90 ,$344.86 , N/A , N/A ,$112.94 ,$704.65 ,$232.12 ,$746.10 ,$650.77 ,$684.75 ,$100.75 ,$538.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200016,76642,HC US BREAST LIMITED,402,1 ,$829.00 ,$538.85 ,$74.85 ,$829.00 ,$200.43 ,$663.20 ,$74.85 ,$232.12 ,$656.90 ,$761.02 ,$74.85 ,$761.02 ,$74.85 ,$152.32 ,$613.46 ,$200.43 ,$80.17 ,$691.39 ,$74.85 , N/A ,$684.75 ,$684.75 ,$663.20 ,$746.10 ,$187.13 ,$704.65 ,$74.85 ,$74.85 ,$704.65 ,$80.17 ,$344.86 , N/A , N/A ,$83.91 ,$704.65 ,$232.12 ,$746.10 ,$650.77 ,$684.75 ,$74.85 ,$538.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200017,76700,HC US ABDOMEN CMPL,402,1 ,"$1,019.00 ",$662.35 ,$100.75 ,"$1,019.00 ",$269.75 ,$815.20 ,$100.75 ,$285.32 ,$807.46 ,$935.44 ,$100.75 ,$935.44 ,$100.75 ,$205.01 ,$754.06 ,$269.75 ,$107.90 ,$849.85 ,$100.75 , N/A ,$841.69 ,$841.69 ,$815.20 ,$917.10 ,$251.87 ,$866.15 ,$100.75 ,$100.75 ,$866.15 ,$107.90 ,$423.90 , N/A , N/A ,$112.94 ,$866.15 ,$285.32 ,$917.10 ,$799.92 ,$841.69 ,$100.75 ,$662.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200018,76705,HC US ABDOMEN LTD,402,1 ,$810.00 ,$526.50 ,$100.75 ,$810.00 ,$269.75 ,$648.00 ,$100.75 ,$226.80 ,$641.84 ,$743.58 ,$100.75 ,$743.58 ,$100.75 ,$205.01 ,$599.40 ,$269.75 ,$107.90 ,$675.54 ,$100.75 , N/A ,$669.06 ,$669.06 ,$648.00 ,$729.00 ,$251.87 ,$688.50 ,$100.75 ,$100.75 ,$688.50 ,$107.90 ,$336.96 , N/A , N/A ,$112.94 ,$688.50 ,$226.80 ,$729.00 ,$635.85 ,$669.06 ,$100.75 ,$526.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200019,76770,HC US RETROPERITIONEAL,402,1 ,$741.00 ,$481.65 ,$100.75 ,$741.00 ,$269.75 ,$592.80 ,$100.75 ,$207.48 ,$587.17 ,$680.24 ,$100.75 ,$680.24 ,$100.75 ,$205.01 ,$548.34 ,$269.75 ,$107.90 ,$617.99 ,$100.75 , N/A ,$612.07 ,$612.07 ,$592.80 ,$666.90 ,$251.87 ,$629.85 ,$100.75 ,$100.75 ,$629.85 ,$107.90 ,$308.26 , N/A , N/A ,$112.94 ,$629.85 ,$207.48 ,$666.90 ,$581.69 ,$612.07 ,$100.75 ,$481.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200020,76775,HC US RETROPERITONEAL LTD,402,1 ,$921.00 ,$598.65 ,$100.75 ,$921.00 ,$269.75 ,$736.80 ,$100.75 ,$257.88 ,$729.80 ,$845.48 ,$100.75 ,$845.48 ,$100.75 ,$205.01 ,$681.54 ,$269.75 ,$107.90 ,$768.11 ,$100.75 , N/A ,$760.75 ,$760.75 ,$736.80 ,$828.90 ,$251.87 ,$782.85 ,$100.75 ,$100.75 ,$782.85 ,$107.90 ,$383.14 , N/A , N/A ,$112.94 ,$782.85 ,$257.88 ,$828.90 ,$722.99 ,$760.75 ,$100.75 ,$598.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200021,76776,HC US KIDNEY TRANSPLANT W/DOPPLER,402,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200023,76801,HC US PREGNANCY <14 WEEKS SGL,402,1 ,$627.00 ,$407.55 ,$100.75 ,$627.00 ,$269.75 ,$501.60 ,$100.75 ,$175.56 ,$496.83 ,$575.59 ,$100.75 ,$575.59 ,$100.75 ,$205.01 ,$463.98 ,$269.75 ,$107.90 ,$522.92 ,$100.75 , N/A ,$517.90 ,$517.90 ,$501.60 ,$564.30 ,$251.87 ,$532.95 ,$100.75 ,$100.75 ,$532.95 ,$107.90 ,$260.83 , N/A , N/A ,$112.94 ,$532.95 ,$175.56 ,$564.30 ,$492.20 ,$517.90 ,$100.75 ,$407.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200024,76802,HC US PREGNANCY <14 WEEKS ADDL,402,1 ,$471.00 ,$306.15 ,$131.88 ,$471.00 , N/A ,$376.80 , N/A ,$131.88 ,$373.22 ,$432.38 , N/A ,$432.38 , N/A , N/A ,$348.54 , N/A , N/A ,$392.81 , N/A , N/A ,$389.05 ,$389.05 ,$376.80 ,$423.90 , N/A ,$400.35 , N/A , N/A ,$400.35 , N/A ,$195.94 , N/A , N/A , N/A ,$400.35 ,$131.88 ,$423.90 ,$369.74 ,$389.05 , N/A ,$306.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200025,76805,HC US PREGNANCY >14 WEEKS SGL,402,1 ,$627.00 ,$407.55 ,$100.75 ,$627.00 ,$269.75 ,$501.60 ,$100.75 ,$175.56 ,$496.83 ,$575.59 ,$100.75 ,$575.59 ,$100.75 ,$205.01 ,$463.98 ,$269.75 ,$107.90 ,$522.92 ,$100.75 , N/A ,$517.90 ,$517.90 ,$501.60 ,$564.30 ,$251.87 ,$532.95 ,$100.75 ,$100.75 ,$532.95 ,$107.90 ,$260.83 , N/A , N/A ,$112.94 ,$532.95 ,$175.56 ,$564.30 ,$492.20 ,$517.90 ,$100.75 ,$407.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200030,76816,HC US OB GROWTH FOLLOWUP,402,1 ,$911.00 ,$592.15 ,$100.75 ,$911.00 ,$269.75 ,$728.80 ,$100.75 ,$255.08 ,$721.88 ,$836.30 ,$100.75 ,$836.30 ,$100.75 ,$205.01 ,$674.14 ,$269.75 ,$107.90 ,$759.77 ,$100.75 , N/A ,$752.49 ,$752.49 ,$728.80 ,$819.90 ,$251.87 ,$774.35 ,$100.75 ,$100.75 ,$774.35 ,$107.90 ,$378.98 , N/A , N/A ,$112.94 ,$774.35 ,$255.08 ,$819.90 ,$715.14 ,$752.49 ,$100.75 ,$592.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200031,76815,HC US FETAL HEART BEAT,402,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200032,76817,HC US PREGNANCY TRANSVAGINAL,402,1 ,$847.00 ,$550.55 ,$100.75 ,$847.00 ,$269.75 ,$677.60 ,$100.75 ,$237.16 ,$671.16 ,$777.55 ,$100.75 ,$777.55 ,$100.75 ,$205.01 ,$626.78 ,$269.75 ,$107.90 ,$706.40 ,$100.75 , N/A ,$699.62 ,$699.62 ,$677.60 ,$762.30 ,$251.87 ,$719.95 ,$100.75 ,$100.75 ,$719.95 ,$107.90 ,$352.35 , N/A , N/A ,$112.94 ,$719.95 ,$237.16 ,$762.30 ,$664.90 ,$699.62 ,$100.75 ,$550.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200034,76819,HC US FETAL BIO PROFILE W/O NST,402,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200038,76830,HC US TRANSVAGINAL,402,1 ,$847.00 ,$550.55 ,$100.75 ,$847.00 ,$269.75 ,$677.60 ,$100.75 ,$237.16 ,$671.16 ,$777.55 ,$100.75 ,$777.55 ,$100.75 ,$205.01 ,$626.78 ,$269.75 ,$107.90 ,$706.40 ,$100.75 , N/A ,$699.62 ,$699.62 ,$677.60 ,$762.30 ,$251.87 ,$719.95 ,$100.75 ,$100.75 ,$719.95 ,$107.90 ,$352.35 , N/A , N/A ,$112.94 ,$719.95 ,$237.16 ,$762.30 ,$664.90 ,$699.62 ,$100.75 ,$550.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200040,76856,HC US PELVIS NON OB,402,1 ,$926.00 ,$601.90 ,$100.75 ,$926.00 ,$269.75 ,$740.80 ,$100.75 ,$259.28 ,$733.76 ,$850.07 ,$100.75 ,$850.07 ,$100.75 ,$205.01 ,$685.24 ,$269.75 ,$107.90 ,$772.28 ,$100.75 , N/A ,$764.88 ,$764.88 ,$740.80 ,$833.40 ,$251.87 ,$787.10 ,$100.75 ,$100.75 ,$787.10 ,$107.90 ,$385.22 , N/A , N/A ,$112.94 ,$787.10 ,$259.28 ,$833.40 ,$726.91 ,$764.88 ,$100.75 ,$601.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200041,76857,HC US PELVIS NON-OB LTD,402,1 ,$741.00 ,$481.65 ,$100.75 ,$741.00 ,$269.75 ,$592.80 ,$100.75 ,$207.48 ,$587.17 ,$680.24 ,$100.75 ,$680.24 ,$100.75 ,$205.01 ,$548.34 ,$269.75 ,$107.90 ,$617.99 ,$100.75 , N/A ,$612.07 ,$612.07 ,$592.80 ,$666.90 ,$251.87 ,$629.85 ,$100.75 ,$100.75 ,$629.85 ,$107.90 ,$308.26 , N/A , N/A ,$112.94 ,$629.85 ,$207.48 ,$666.90 ,$581.69 ,$612.07 ,$100.75 ,$481.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200042,76870,HC US SCROTUM,402,1 ,$706.00 ,$458.90 ,$100.75 ,$706.00 ,$269.75 ,$564.80 ,$100.75 ,$197.68 ,$559.43 ,$648.11 ,$100.75 ,$648.11 ,$100.75 ,$205.01 ,$522.44 ,$269.75 ,$107.90 ,$588.80 ,$100.75 , N/A ,$583.16 ,$583.16 ,$564.80 ,$635.40 ,$251.87 ,$600.10 ,$100.75 ,$100.75 ,$600.10 ,$107.90 ,$293.70 , N/A , N/A ,$112.94 ,$600.10 ,$197.68 ,$635.40 ,$554.21 ,$583.16 ,$100.75 ,$458.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200046,76882,HC US EXTREMITY NON VASCULAR LMTD,402,1 ,$456.00 ,$296.40 ,$100.75 ,$456.00 ,$269.75 ,$364.80 ,$100.75 ,$127.68 ,$361.33 ,$418.61 ,$100.75 ,$418.61 ,$100.75 ,$205.01 ,$337.44 ,$269.75 ,$107.90 ,$380.30 ,$100.75 , N/A ,$376.66 ,$376.66 ,$364.80 ,$410.40 ,$251.87 ,$387.60 ,$100.75 ,$100.75 ,$387.60 ,$107.90 ,$189.70 , N/A , N/A ,$112.94 ,$387.60 ,$127.68 ,$410.40 ,$357.96 ,$376.66 ,$100.75 ,$296.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200053,76942,HC US GUIDED NEEDLE PLCMT,402,1 ,"$1,019.00 ",$662.35 ,$285.32 ,"$1,019.00 ", N/A ,$815.20 , N/A ,$285.32 ,$807.46 ,$935.44 , N/A ,$935.44 , N/A , N/A ,$754.06 , N/A , N/A ,$849.85 , N/A , N/A ,$841.69 ,$841.69 ,$815.20 ,$917.10 , N/A ,$866.15 , N/A , N/A ,$866.15 , N/A ,$423.90 , N/A , N/A , N/A ,$866.15 ,$285.32 ,$917.10 ,$799.92 ,$841.69 , N/A ,$662.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200064,93975,HC DUPLEX ABD/PEL/RETRO CMPL,402,1 ,"$1,884.00 ","$1,224.60 ",$212.93 ,"$1,884.00 ",$570.13 ,"$1,507.20 ",$212.93 ,$527.52 ,"$1,492.88 ","$1,729.51 ",$212.93 ,"$1,729.51 ",$212.93 ,$433.30 ,"$1,394.16 ",$570.13 ,$228.05 ,"$1,571.26 ",$212.93 , N/A ,"$1,556.18 ","$1,556.18 ","$1,507.20 ","$1,695.60 ",$532.33 ,"$1,601.40 ",$212.93 ,$212.93 ,"$1,601.40 ",$228.05 ,$783.74 , N/A , N/A ,$238.70 ,"$1,601.40 ",$527.52 ,"$1,695.60 ","$1,478.94 ","$1,556.18 ",$212.93 ,"$1,224.60 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200068,93976,HC DUPLEX ABD/PEL/RETRO LTD,402,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200071,93976,HC DUPLEX ABD/PEL/RETRO SCAN LTD AORTA,402,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200073,93978,HC DUPLEX AORTA/IVC/GRAFT CMPL,921,1 ,$741.00 ,$481.65 ,$207.48 ,$741.00 ,$570.13 ,$592.80 ,$212.93 ,$207.48 ,$587.17 ,$680.24 ,$212.93 ,$680.24 ,$212.93 ,$433.30 ,$548.34 ,$570.13 ,$228.05 ,$617.99 ,$212.93 , N/A ,$612.07 ,$612.07 ,$592.80 ,$666.90 ,$532.33 ,$629.85 ,$212.93 ,$212.93 ,$629.85 ,$228.05 ,$308.26 , N/A , N/A ,$238.70 ,$629.85 ,$207.48 ,$666.90 ,$581.69 ,$612.07 ,$212.93 ,$481.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200074,93979,HC DUPLEX AORTA/IVC/GRAFT LTD,402,1 ,$741.00 ,$481.65 ,$100.75 ,$741.00 ,$269.75 ,$592.80 ,$100.75 ,$207.48 ,$587.17 ,$680.24 ,$100.75 ,$680.24 ,$100.75 ,$205.01 ,$548.34 ,$269.75 ,$107.90 ,$617.99 ,$100.75 , N/A ,$612.07 ,$612.07 ,$592.80 ,$666.90 ,$251.87 ,$629.85 ,$100.75 ,$100.75 ,$629.85 ,$107.90 ,$308.26 , N/A , N/A ,$112.94 ,$629.85 ,$207.48 ,$666.90 ,$581.69 ,$612.07 ,$100.75 ,$481.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40200075,76706,HC US AORTA (SCREENING),402,1 ,$628.00 ,$408.20 ,$100.75 ,$628.00 ,$269.75 ,$502.40 ,$100.75 ,$175.84 ,$497.63 ,$576.50 ,$100.75 ,$576.50 ,$100.75 ,$205.01 ,$464.72 ,$269.75 ,$107.90 ,$523.75 ,$100.75 , N/A ,$518.73 ,$518.73 ,$502.40 ,$565.20 ,$251.87 ,$533.80 ,$100.75 ,$100.75 ,$533.80 ,$107.90 ,$261.25 , N/A , N/A ,$112.94 ,$533.80 ,$175.84 ,$565.20 ,$492.98 ,$518.73 ,$100.75 ,$408.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40300003,77067,HC MAMMOGRAM SCREEN DIGI W/CAD,403,1 ,$363.00 ,$235.95 ,$87.20 ,$363.00 ,$218.00 ,$290.40 ,$87.20 ,$101.64 ,$287.64 ,$333.23 ,$87.20 ,$333.23 ,$87.20 ,$165.68 ,$268.62 ,$218.00 ,$87.20 ,$302.74 ,$87.20 , N/A ,$299.84 ,$299.84 ,$290.40 ,$326.70 ,$218.00 ,$308.55 ,$87.20 ,$87.20 ,$308.55 ,$87.20 ,$151.01 , N/A , N/A ,$91.56 ,$308.55 ,$101.64 ,$326.70 ,$284.96 ,$299.84 ,$87.20 ,$235.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$429.00 ,$278.85 ,$87.20 ,$429.00 ,$218.00 ,$343.20 ,$87.20 ,$120.12 ,$339.94 ,$393.82 ,$87.20 ,$393.82 ,$87.20 ,$165.68 ,$317.46 ,$218.00 ,$87.20 ,$357.79 ,$87.20 , N/A ,$354.35 ,$354.35 ,$343.20 ,$386.10 ,$218.00 ,$364.65 ,$87.20 ,$87.20 ,$364.65 ,$87.20 ,$178.46 , N/A , N/A ,$91.56 ,$364.65 ,$120.12 ,$386.10 ,$336.77 ,$354.35 ,$87.20 ,$278.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000005,92950,HC CPR,480,1 ,$297.00 ,$193.05 ,$83.16 ,$655.75 ,$655.75 ,$237.60 ,$244.91 ,$83.16 ,$235.34 ,$272.65 ,$244.91 ,$272.65 ,$244.91 ,$297.00 ,$219.78 ,$297.00 ,$262.30 ,$247.70 ,$244.91 , N/A ,$245.32 ,$245.32 ,$237.60 ,$267.30 ,$297.00 ,$252.45 ,$244.91 ,$244.91 ,$252.45 ,$262.30 ,$123.55 , N/A , N/A ,$274.54 ,$252.45 ,$83.16 ,$267.30 ,$233.15 ,$245.32 ,$244.91 ,$193.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000009,94002,HC VENT MANGMNT INPT/OBS INIT DAY,410,1 ,$900.00 ,$585.00 ,$252.00 ,"$1,207.08 ","$1,207.08 ",$720.00 ,$450.82 ,$252.00 ,$713.16 ,$826.20 ,$450.82 ,$826.20 ,$450.82 ,$900.00 ,$666.00 ,$900.00 ,$482.83 ,$750.60 ,$450.82 , N/A ,$743.40 ,$743.40 ,$720.00 ,$810.00 ,$900.00 ,$765.00 ,$450.82 ,$450.82 ,$765.00 ,$482.83 ,$374.40 , N/A , N/A ,$505.37 ,$765.00 ,$252.00 ,$810.00 ,$706.50 ,$743.40 ,$450.82 ,$585.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000010,94002,HC VENTIL HI FREQ INTL DAY,410,1 ,$900.00 ,$585.00 ,$252.00 ,"$1,207.08 ","$1,207.08 ",$720.00 ,$450.82 ,$252.00 ,$713.16 ,$826.20 ,$450.82 ,$826.20 ,$450.82 ,$900.00 ,$666.00 ,$900.00 ,$482.83 ,$750.60 ,$450.82 , N/A ,$743.40 ,$743.40 ,$720.00 ,$810.00 ,$900.00 ,$765.00 ,$450.82 ,$450.82 ,$765.00 ,$482.83 ,$374.40 , N/A , N/A ,$505.37 ,$765.00 ,$252.00 ,$810.00 ,$706.50 ,$743.40 ,$450.82 ,$585.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000013,94660,HC VENT NONINVAS ADULT INTL DAY,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000014,94002,HC VENT WEANING FIRST DAY,410,1 ,$900.00 ,$585.00 ,$252.00 ,"$1,207.08 ","$1,207.08 ",$720.00 ,$450.82 ,$252.00 ,$713.16 ,$826.20 ,$450.82 ,$826.20 ,$450.82 ,$900.00 ,$666.00 ,$900.00 ,$482.83 ,$750.60 ,$450.82 , N/A ,$743.40 ,$743.40 ,$720.00 ,$810.00 ,$900.00 ,$765.00 ,$450.82 ,$450.82 ,$765.00 ,$482.83 ,$374.40 , N/A , N/A ,$505.37 ,$765.00 ,$252.00 ,$810.00 ,$706.50 ,$743.40 ,$450.82 ,$585.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000015,94002,HC VENT NEONATAL INTL DAY,410,1 ,$900.00 ,$585.00 ,$252.00 ,"$1,207.08 ","$1,207.08 ",$720.00 ,$450.82 ,$252.00 ,$713.16 ,$826.20 ,$450.82 ,$826.20 ,$450.82 ,$900.00 ,$666.00 ,$900.00 ,$482.83 ,$750.60 ,$450.82 , N/A ,$743.40 ,$743.40 ,$720.00 ,$810.00 ,$900.00 ,$765.00 ,$450.82 ,$450.82 ,$765.00 ,$482.83 ,$374.40 , N/A , N/A ,$505.37 ,$765.00 ,$252.00 ,$810.00 ,$706.50 ,$743.40 ,$450.82 ,$585.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000029,94660,HC VENT NONINVAS ADLT SUBQ DAY,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000034,94640,HC IPPB,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000035,94640,HC NEBULIZER TREATMENT EACH,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000037,94640,HC INCENTIVE SPIROMETER TRT,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000038,94640,HC AEROSOL GENTR SHORT-TERM,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000040,94640,HC EZ PAP TREATMENT,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000041,94640,HC MDI/DPI TX INITIAL,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000046,94640,HC HIGH EFF NEB AERO EACH,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000050,94644,HC AEROSOL CONTINUOUS 1ST HR,410,1 ,$234.00 ,$152.10 ,$65.52 ,$279.40 ,$279.40 ,$187.20 ,$104.35 ,$65.52 ,$185.42 ,$214.81 ,$104.35 ,$214.81 ,$104.35 ,$212.34 ,$173.16 ,$234.00 ,$111.76 ,$195.16 ,$104.35 , N/A ,$193.28 ,$193.28 ,$187.20 ,$210.60 ,$234.00 ,$198.90 ,$104.35 ,$104.35 ,$198.90 ,$111.76 ,$97.34 , N/A , N/A ,$116.97 ,$198.90 ,$65.52 ,$210.60 ,$183.69 ,$193.28 ,$104.35 ,$152.10 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000051,94645,HC AEROSOL CONTINUOUS ADDL HR,410,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$60.00 , N/A ,$21.00 ,$59.43 ,$68.85 , N/A ,$68.85 , N/A , N/A ,$55.50 , N/A , N/A ,$62.55 , N/A , N/A ,$61.95 ,$61.95 ,$60.00 ,$67.50 , N/A ,$63.75 , N/A , N/A ,$63.75 , N/A ,$31.20 , N/A , N/A , N/A ,$63.75 ,$21.00 ,$67.50 ,$58.88 ,$61.95 , N/A ,$48.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000052,94660,HC CPAP,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000053,94660,HC CPAP DAILY EST PT,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000058,94667,HC CHEST PHYSIOTHRPY INIT,410,1 ,$106.00 ,$68.90 ,$29.68 ,$279.40 ,$279.40 ,$84.80 ,$104.35 ,$29.68 ,$83.99 ,$97.31 ,$104.35 ,$97.31 ,$104.35 ,$106.00 ,$78.44 ,$106.00 ,$111.76 ,$88.40 ,$104.35 , N/A ,$87.56 ,$87.56 ,$84.80 ,$95.40 ,$106.00 ,$90.10 ,$104.35 ,$104.35 ,$90.10 ,$111.76 ,$44.10 , N/A , N/A ,$106.00 ,$90.10 ,$29.68 ,$95.40 ,$83.21 ,$87.56 ,$104.35 ,$68.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000059,94667,HC CHEST PHYSIOTHRPY INIT ACAPELLA,410,1 ,$106.00 ,$68.90 ,$29.68 ,$279.40 ,$279.40 ,$84.80 ,$104.35 ,$29.68 ,$83.99 ,$97.31 ,$104.35 ,$97.31 ,$104.35 ,$106.00 ,$78.44 ,$106.00 ,$111.76 ,$88.40 ,$104.35 , N/A ,$87.56 ,$87.56 ,$84.80 ,$95.40 ,$106.00 ,$90.10 ,$104.35 ,$104.35 ,$90.10 ,$111.76 ,$44.10 , N/A , N/A ,$106.00 ,$90.10 ,$29.68 ,$95.40 ,$83.21 ,$87.56 ,$104.35 ,$68.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000060,94668,HC CHEST PHYSIOTHRPY SUBSQ,410,1 ,$79.00 ,$51.35 ,$22.12 ,$279.40 ,$279.40 ,$63.20 ,$104.35 ,$22.12 ,$62.60 ,$72.52 ,$79.00 ,$72.52 ,$79.00 ,$79.00 ,$58.46 ,$79.00 ,$111.76 ,$65.89 ,$104.35 , N/A ,$65.25 ,$65.25 ,$63.20 ,$71.10 ,$79.00 ,$67.15 ,$104.35 ,$104.35 ,$67.15 ,$111.76 ,$32.86 , N/A , N/A ,$79.00 ,$67.15 ,$22.12 ,$71.10 ,$62.02 ,$65.25 ,$104.35 ,$51.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000061,94668,HC CHEST PHYSIOTHRPY SUBSQ ACAPELLA,410,1 ,$79.00 ,$51.35 ,$22.12 ,$279.40 ,$279.40 ,$63.20 ,$104.35 ,$22.12 ,$62.60 ,$72.52 ,$79.00 ,$72.52 ,$79.00 ,$79.00 ,$58.46 ,$79.00 ,$111.76 ,$65.89 ,$104.35 , N/A ,$65.25 ,$65.25 ,$63.20 ,$71.10 ,$79.00 ,$67.15 ,$104.35 ,$104.35 ,$67.15 ,$111.76 ,$32.86 , N/A , N/A ,$79.00 ,$67.15 ,$22.12 ,$71.10 ,$62.02 ,$65.25 ,$104.35 ,$51.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000070,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$142.00 ,$92.30 ,$31.32 ,$142.00 ,$83.88 ,$113.60 ,$31.32 ,$39.76 ,$112.52 ,$130.36 ,$31.32 ,$130.36 ,$31.32 ,$63.75 ,$105.08 ,$83.88 ,$33.55 ,$118.43 ,$31.32 , N/A ,$117.29 ,$117.29 ,$113.60 ,$127.80 ,$78.31 ,$120.70 ,$31.32 ,$31.32 ,$120.70 ,$33.55 ,$59.07 , N/A , N/A ,$35.11 ,$120.70 ,$39.76 ,$127.80 ,$111.47 ,$117.29 ,$31.32 ,$92.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000074,94640,HC IPPB SUBSQ,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000075,94640,HC IPV INIT,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000076,94640,HC NEBULIZER SUBSQ,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000077,94762,HC PULSE OX PER DAY,410,1 ,$175.00 ,$113.75 ,$49.00 ,$345.93 ,$345.93 ,$140.00 ,$129.20 ,$49.00 ,$138.67 ,$160.65 ,$129.20 ,$160.65 ,$129.20 ,$175.00 ,$129.50 ,$175.00 ,$138.37 ,$145.95 ,$129.20 , N/A ,$144.55 ,$144.55 ,$140.00 ,$157.50 ,$175.00 ,$148.75 ,$129.20 ,$129.20 ,$148.75 ,$138.37 ,$72.80 , N/A , N/A ,$144.83 ,$148.75 ,$49.00 ,$157.50 ,$137.38 ,$144.55 ,$129.20 ,$113.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000082,94640,HC EZPAP TREATMENT SUBSQ,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000083,94660,HC CPAP/BIPAP SUBSQ,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000090,94640,HC MDI/DPI INHAL TX SUBSQ,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),41000092,94640,HC AEROSOL INHALATION SUBSQ,410,1 ,$68.00 ,$44.20 ,$19.04 ,$465.73 ,$465.73 ,$54.40 ,$173.94 ,$19.04 ,$53.88 ,$62.42 ,$68.00 ,$62.42 ,$68.00 ,$68.00 ,$50.32 ,$68.00 ,$186.29 ,$56.71 ,$173.94 , N/A ,$56.17 ,$56.17 ,$54.40 ,$61.20 ,$68.00 ,$57.80 ,$173.94 ,$173.94 ,$57.80 ,$186.29 ,$28.29 , N/A , N/A ,$68.00 ,$57.80 ,$19.04 ,$61.20 ,$53.38 ,$56.17 ,$173.94 ,$44.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000025,97032,HC ELECTRIC STIM EACH 15 MIN,420,1 ,$177.00 ,$115.05 ,$14.43 ,$177.00 ,$36.08 ,$141.60 ,$14.43 ,$49.56 ,$140.25 ,$162.49 ,$14.43 ,$162.49 ,$14.43 ,$27.42 ,$130.98 ,$36.08 ,$14.43 ,$147.62 ,$14.43 , N/A ,$146.20 ,$146.20 ,$141.60 ,$159.30 ,$36.08 ,$150.45 ,$14.43 ,$14.43 ,$150.45 ,$14.43 ,$73.63 , N/A , N/A ,$15.15 ,$150.45 ,$49.56 ,$159.30 ,$138.95 ,$146.20 ,$14.43 ,$115.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000031,97033,HC IONTOPHORESIS; EA 15 MIN,420,1 ,$188.00 ,$122.20 ,$19.19 ,$188.00 ,$47.98 ,$150.40 ,$19.19 ,$52.64 ,$148.97 ,$172.58 ,$19.19 ,$172.58 ,$19.19 ,$36.46 ,$139.12 ,$47.98 ,$19.19 ,$156.79 ,$19.19 , N/A ,$155.29 ,$155.29 ,$150.40 ,$169.20 ,$47.98 ,$159.80 ,$19.19 ,$19.19 ,$159.80 ,$19.19 ,$78.21 , N/A , N/A ,$20.15 ,$159.80 ,$52.64 ,$169.20 ,$147.58 ,$155.29 ,$19.19 ,$122.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000033,97035,HC ULTRASOUND EA 15MIN,420,1 ,$137.00 ,$89.05 ,$13.99 ,$137.00 ,$34.98 ,$109.60 ,$13.99 ,$38.36 ,$108.56 ,$125.77 ,$13.99 ,$125.77 ,$13.99 ,$26.58 ,$101.38 ,$34.98 ,$13.99 ,$114.26 ,$13.99 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$34.98 ,$116.45 ,$13.99 ,$13.99 ,$116.45 ,$13.99 ,$56.99 , N/A , N/A ,$14.69 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$13.99 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000037,97110,HC THERA EXER; EA 15 MIN,420,1 ,$146.00 ,$94.90 ,$29.02 ,$146.00 ,$72.55 ,$116.80 ,$29.02 ,$40.88 ,$115.69 ,$134.03 ,$29.02 ,$134.03 ,$29.02 ,$55.14 ,$108.04 ,$72.55 ,$29.02 ,$121.76 ,$29.02 , N/A ,$120.60 ,$120.60 ,$116.80 ,$131.40 ,$72.55 ,$124.10 ,$29.02 ,$29.02 ,$124.10 ,$29.02 ,$60.74 , N/A , N/A ,$30.47 ,$124.10 ,$40.88 ,$131.40 ,$114.61 ,$120.60 ,$29.02 ,$94.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000045,97112,HC NEUROMUSCULAR RE ED EA 15 MIN,420,1 ,$137.00 ,$89.05 ,$33.59 ,$137.00 ,$83.98 ,$109.60 ,$33.59 ,$38.36 ,$108.56 ,$125.77 ,$33.59 ,$125.77 ,$33.59 ,$63.82 ,$101.38 ,$83.98 ,$33.59 ,$114.26 ,$33.59 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$83.98 ,$116.45 ,$33.59 ,$33.59 ,$116.45 ,$33.59 ,$56.99 , N/A , N/A ,$35.27 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$33.59 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000049,97116,HC AMBULATION GAIT TRAIN EA 15 MIN,420,1 ,$128.00 ,$83.20 ,$29.02 ,$128.00 ,$72.55 ,$102.40 ,$29.02 ,$35.84 ,$101.43 ,$117.50 ,$29.02 ,$117.50 ,$29.02 ,$55.14 ,$94.72 ,$72.55 ,$29.02 ,$106.75 ,$29.02 , N/A ,$105.73 ,$105.73 ,$102.40 ,$115.20 ,$72.55 ,$108.80 ,$29.02 ,$29.02 ,$108.80 ,$29.02 ,$53.25 , N/A , N/A ,$30.47 ,$108.80 ,$35.84 ,$115.20 ,$100.48 ,$105.73 ,$29.02 ,$83.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000056,97140,HC MANUAL THERAPY EA 15 MIN,420,1 ,$118.00 ,$76.70 ,$26.75 ,$118.00 ,$66.88 ,$94.40 ,$26.75 ,$33.04 ,$93.50 ,$108.32 ,$26.75 ,$108.32 ,$26.75 ,$50.83 ,$87.32 ,$66.88 ,$26.75 ,$98.41 ,$26.75 , N/A ,$97.47 ,$97.47 ,$94.40 ,$106.20 ,$66.88 ,$100.30 ,$26.75 ,$26.75 ,$100.30 ,$26.75 ,$49.09 , N/A , N/A ,$28.09 ,$100.30 ,$33.04 ,$106.20 ,$92.63 ,$97.47 ,$26.75 ,$76.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000065,97530,HC THERAPEUTIC ACTIVITIES EA 15 MIN,420,1 ,$137.00 ,$89.05 ,$36.24 ,$137.00 ,$90.60 ,$109.60 ,$36.24 ,$38.36 ,$108.56 ,$125.77 ,$36.24 ,$125.77 ,$36.24 ,$68.86 ,$101.38 ,$90.60 ,$36.24 ,$114.26 ,$36.24 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$90.60 ,$116.45 ,$36.24 ,$36.24 ,$116.45 ,$36.24 ,$56.99 , N/A , N/A ,$38.05 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$36.24 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000084,97602,HC DEBRIDEMENT NONSELECTIVE,420,1 ,$197.00 ,$128.05 ,$55.16 ,$197.00 , N/A ,$157.60 , N/A ,$55.16 ,$156.10 ,$180.85 , N/A ,$180.85 , N/A , N/A ,$145.78 , N/A , N/A ,$164.30 , N/A , N/A ,$162.72 ,$162.72 ,$157.60 ,$177.30 , N/A ,$167.45 , N/A , N/A ,$167.45 , N/A ,$81.95 , N/A , N/A , N/A ,$167.45 ,$55.16 ,$177.30 ,$154.65 ,$162.72 , N/A ,$128.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000151,29581,HC APPL MULTI COMP WRAP PT/OT,420,1 ,"$2,155.00 ","$1,400.75 ",$130.74 ,"$2,155.00 ",$326.85 ,"$1,724.00 ",$130.74 ,$603.40 ,"$1,707.62 ","$1,978.29 ",$130.74 ,"$1,978.29 ",$130.74 ,$248.41 ,"$1,594.70 ",$326.85 ,$130.74 ,"$1,797.27 ",$130.74 , N/A ,"$1,780.03 ","$1,780.03 ","$1,724.00 ","$1,939.50 ",$326.85 ,"$1,831.75 ",$130.74 ,$130.74 ,"$1,831.75 ",$130.74 ,$896.48 , N/A , N/A ,$137.28 ,"$1,831.75 ",$603.40 ,"$1,939.50 ","$1,691.68 ","$1,780.03 ",$130.74 ,"$1,400.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),42000218,97014,HC ELEC STIM UNATTENDED 15MIN,420,1 ,$143.00 ,$92.95 ,$40.04 ,$143.00 , N/A ,$114.40 , N/A ,$40.04 ,$113.31 ,$131.27 , N/A ,$131.27 , N/A , N/A ,$105.82 , N/A , N/A ,$119.26 , N/A , N/A ,$118.12 ,$118.12 ,$114.40 ,$128.70 , N/A ,$121.55 , N/A , N/A ,$121.55 , N/A ,$59.49 , N/A , N/A , N/A ,$121.55 ,$40.04 ,$128.70 ,$112.26 ,$118.12 , N/A ,$92.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400004,97001,HC PT EVALUATION,424,1 ,$228.35 ,$148.43 ,$63.94 ,$228.35 , N/A ,$182.68 , N/A ,$63.94 ,$180.94 ,$209.63 , N/A ,$209.63 , N/A , N/A ,$168.98 , N/A , N/A ,$190.44 , N/A , N/A ,$188.62 ,$188.62 ,$182.68 ,$205.52 , N/A ,$194.10 , N/A , N/A ,$194.10 , N/A ,$94.99 , N/A , N/A , N/A ,$194.10 ,$63.94 ,$205.52 ,$179.25 ,$188.62 , N/A ,$148.43 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400043,97161,HC PT EVAL LOW COMPLEXITY 15MIN,424,1 ,$228.35 ,$148.43 ,$63.94 ,$246.90 ,$246.90 ,$182.68 ,$98.76 ,$63.94 ,$180.94 ,$209.63 ,$98.76 ,$209.63 ,$98.76 ,$187.64 ,$168.98 ,$228.35 ,$98.76 ,$190.44 ,$98.76 , N/A ,$188.62 ,$188.62 ,$182.68 ,$205.52 ,$228.35 ,$194.10 ,$98.76 ,$98.76 ,$194.10 ,$98.76 ,$94.99 , N/A , N/A ,$103.70 ,$194.10 ,$63.94 ,$205.52 ,$179.25 ,$188.62 ,$98.76 ,$148.43 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400044,97161,HC PT EVAL LOW COMPLEXITY 30MIN,424,1 ,$228.35 ,$148.43 ,$63.94 ,$246.90 ,$246.90 ,$182.68 ,$98.76 ,$63.94 ,$180.94 ,$209.63 ,$98.76 ,$209.63 ,$98.76 ,$187.64 ,$168.98 ,$228.35 ,$98.76 ,$190.44 ,$98.76 , N/A ,$188.62 ,$188.62 ,$182.68 ,$205.52 ,$228.35 ,$194.10 ,$98.76 ,$98.76 ,$194.10 ,$98.76 ,$94.99 , N/A , N/A ,$103.70 ,$194.10 ,$63.94 ,$205.52 ,$179.25 ,$188.62 ,$98.76 ,$148.43 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400045,97161,HC PT EVAL LOW COMPLEXITY 45MIN,424,1 ,$235.00 ,$152.75 ,$65.80 ,$246.90 ,$246.90 ,$188.00 ,$98.76 ,$65.80 ,$186.21 ,$215.73 ,$98.76 ,$215.73 ,$98.76 ,$187.64 ,$173.90 ,$235.00 ,$98.76 ,$195.99 ,$98.76 , N/A ,$194.11 ,$194.11 ,$188.00 ,$211.50 ,$235.00 ,$199.75 ,$98.76 ,$98.76 ,$199.75 ,$98.76 ,$97.76 , N/A , N/A ,$103.70 ,$199.75 ,$65.80 ,$211.50 ,$184.48 ,$194.11 ,$98.76 ,$152.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400055,97162,HC PT EVAL MOD COMPLEXITY 15MIN,424,1 ,$228.35 ,$148.43 ,$63.94 ,$246.90 ,$246.90 ,$182.68 ,$98.76 ,$63.94 ,$180.94 ,$209.63 ,$98.76 ,$209.63 ,$98.76 ,$187.64 ,$168.98 ,$228.35 ,$98.76 ,$190.44 ,$98.76 , N/A ,$188.62 ,$188.62 ,$182.68 ,$205.52 ,$228.35 ,$194.10 ,$98.76 ,$98.76 ,$194.10 ,$98.76 ,$94.99 , N/A , N/A ,$103.70 ,$194.10 ,$63.94 ,$205.52 ,$179.25 ,$188.62 ,$98.76 ,$148.43 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400056,97162,HC PT EVAL MOD COMPLEXITY 30MIN,424,1 ,$228.35 ,$148.43 ,$63.94 ,$246.90 ,$246.90 ,$182.68 ,$98.76 ,$63.94 ,$180.94 ,$209.63 ,$98.76 ,$209.63 ,$98.76 ,$187.64 ,$168.98 ,$228.35 ,$98.76 ,$190.44 ,$98.76 , N/A ,$188.62 ,$188.62 ,$182.68 ,$205.52 ,$228.35 ,$194.10 ,$98.76 ,$98.76 ,$194.10 ,$98.76 ,$94.99 , N/A , N/A ,$103.70 ,$194.10 ,$63.94 ,$205.52 ,$179.25 ,$188.62 ,$98.76 ,$148.43 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400057,97162,HC PT EVAL MOD COMPLEXITY 45MIN,424,1 ,$228.35 ,$148.43 ,$63.94 ,$246.90 ,$246.90 ,$182.68 ,$98.76 ,$63.94 ,$180.94 ,$209.63 ,$98.76 ,$209.63 ,$98.76 ,$187.64 ,$168.98 ,$228.35 ,$98.76 ,$190.44 ,$98.76 , N/A ,$188.62 ,$188.62 ,$182.68 ,$205.52 ,$228.35 ,$194.10 ,$98.76 ,$98.76 ,$194.10 ,$98.76 ,$94.99 , N/A , N/A ,$103.70 ,$194.10 ,$63.94 ,$205.52 ,$179.25 ,$188.62 ,$98.76 ,$148.43 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400058,97162,HC PT EVAL MOD COMPLEXITY 60MIN,424,1 ,$228.35 ,$148.43 ,$63.94 ,$246.90 ,$246.90 ,$182.68 ,$98.76 ,$63.94 ,$180.94 ,$209.63 ,$98.76 ,$209.63 ,$98.76 ,$187.64 ,$168.98 ,$228.35 ,$98.76 ,$190.44 ,$98.76 , N/A ,$188.62 ,$188.62 ,$182.68 ,$205.52 ,$228.35 ,$194.10 ,$98.76 ,$98.76 ,$194.10 ,$98.76 ,$94.99 , N/A , N/A ,$103.70 ,$194.10 ,$63.94 ,$205.52 ,$179.25 ,$188.62 ,$98.76 ,$148.43 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400067,97163,HC PT EVAL HIGH COMPLEXITY 15MIN,424,1 ,$235.00 ,$152.75 ,$65.80 ,$246.90 ,$246.90 ,$188.00 ,$98.76 ,$65.80 ,$186.21 ,$215.73 ,$98.76 ,$215.73 ,$98.76 ,$187.64 ,$173.90 ,$235.00 ,$98.76 ,$195.99 ,$98.76 , N/A ,$194.11 ,$194.11 ,$188.00 ,$211.50 ,$235.00 ,$199.75 ,$98.76 ,$98.76 ,$199.75 ,$98.76 ,$97.76 , N/A , N/A ,$103.70 ,$199.75 ,$65.80 ,$211.50 ,$184.48 ,$194.11 ,$98.76 ,$152.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400068,97163,HC PT EVAL HIGH COMPLEXITY 30MIN,424,1 ,$235.00 ,$152.75 ,$65.80 ,$246.90 ,$246.90 ,$188.00 ,$98.76 ,$65.80 ,$186.21 ,$215.73 ,$98.76 ,$215.73 ,$98.76 ,$187.64 ,$173.90 ,$235.00 ,$98.76 ,$195.99 ,$98.76 , N/A ,$194.11 ,$194.11 ,$188.00 ,$211.50 ,$235.00 ,$199.75 ,$98.76 ,$98.76 ,$199.75 ,$98.76 ,$97.76 , N/A , N/A ,$103.70 ,$199.75 ,$65.80 ,$211.50 ,$184.48 ,$194.11 ,$98.76 ,$152.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400069,97163,HC PT EVAL HIGH COMPLEXITY 45MIN,424,1 ,$235.00 ,$152.75 ,$65.80 ,$246.90 ,$246.90 ,$188.00 ,$98.76 ,$65.80 ,$186.21 ,$215.73 ,$98.76 ,$215.73 ,$98.76 ,$187.64 ,$173.90 ,$235.00 ,$98.76 ,$195.99 ,$98.76 , N/A ,$194.11 ,$194.11 ,$188.00 ,$211.50 ,$235.00 ,$199.75 ,$98.76 ,$98.76 ,$199.75 ,$98.76 ,$97.76 , N/A , N/A ,$103.70 ,$199.75 ,$65.80 ,$211.50 ,$184.48 ,$194.11 ,$98.76 ,$152.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400079,97164,HC PT RE-EVAL 15MIN,424,1 ,$132.86 ,$86.36 ,$37.20 ,$169.20 ,$169.20 ,$106.29 ,$67.68 ,$37.20 ,$105.28 ,$121.97 ,$67.68 ,$121.97 ,$67.68 ,$128.59 ,$98.32 ,$132.86 ,$67.68 ,$110.81 ,$67.68 , N/A ,$109.74 ,$109.74 ,$106.29 ,$119.57 ,$132.86 ,$112.93 ,$67.68 ,$67.68 ,$112.93 ,$67.68 ,$55.27 , N/A , N/A ,$71.06 ,$112.93 ,$37.20 ,$119.57 ,$104.30 ,$109.74 ,$67.68 ,$86.36 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400080,97164,HC PT RE-EVAL 30MIN,424,1 ,$132.86 ,$86.36 ,$37.20 ,$169.20 ,$169.20 ,$106.29 ,$67.68 ,$37.20 ,$105.28 ,$121.97 ,$67.68 ,$121.97 ,$67.68 ,$128.59 ,$98.32 ,$132.86 ,$67.68 ,$110.81 ,$67.68 , N/A ,$109.74 ,$109.74 ,$106.29 ,$119.57 ,$132.86 ,$112.93 ,$67.68 ,$67.68 ,$112.93 ,$67.68 ,$55.27 , N/A , N/A ,$71.06 ,$112.93 ,$37.20 ,$119.57 ,$104.30 ,$109.74 ,$67.68 ,$86.36 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400081,97164,HC PT RE-EVAL 45MIN,424,1 ,$132.86 ,$86.36 ,$37.20 ,$169.20 ,$169.20 ,$106.29 ,$67.68 ,$37.20 ,$105.28 ,$121.97 ,$67.68 ,$121.97 ,$67.68 ,$128.59 ,$98.32 ,$132.86 ,$67.68 ,$110.81 ,$67.68 , N/A ,$109.74 ,$109.74 ,$106.29 ,$119.57 ,$132.86 ,$112.93 ,$67.68 ,$67.68 ,$112.93 ,$67.68 ,$55.27 , N/A , N/A ,$71.06 ,$112.93 ,$37.20 ,$119.57 ,$104.30 ,$109.74 ,$67.68 ,$86.36 
HSHS GOOD SHEPHERD HOSPITAL (ACU),42400082,97164,HC PT RE-EVAL 60MIN,424,1 ,$132.86 ,$86.36 ,$37.20 ,$169.20 ,$169.20 ,$106.29 ,$67.68 ,$37.20 ,$105.28 ,$121.97 ,$67.68 ,$121.97 ,$67.68 ,$128.59 ,$98.32 ,$132.86 ,$67.68 ,$110.81 ,$67.68 , N/A ,$109.74 ,$109.74 ,$106.29 ,$119.57 ,$132.86 ,$112.93 ,$67.68 ,$67.68 ,$112.93 ,$67.68 ,$55.27 , N/A , N/A ,$71.06 ,$112.93 ,$37.20 ,$119.57 ,$104.30 ,$109.74 ,$67.68 ,$86.36 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43000016,97535,HC SELF CARE ADL TRAINING EA 15MIN,430,1 ,$132.86 ,$86.36 ,$32.17 ,$132.86 ,$80.43 ,$106.29 ,$32.17 ,$37.20 ,$105.28 ,$121.97 ,$32.17 ,$121.97 ,$32.17 ,$61.12 ,$98.32 ,$80.43 ,$32.17 ,$110.81 ,$32.17 , N/A ,$109.74 ,$109.74 ,$106.29 ,$119.57 ,$80.43 ,$112.93 ,$32.17 ,$32.17 ,$112.93 ,$32.17 ,$55.27 , N/A , N/A ,$33.78 ,$112.93 ,$37.20 ,$119.57 ,$104.30 ,$109.74 ,$32.17 ,$86.36 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43000024,97542,HC SEATING CLINIC EA 15 MIN,430,1 ,$106.97 ,$69.53 ,$29.95 ,$106.97 ,$78.30 ,$85.58 ,$31.32 ,$29.95 ,$84.76 ,$98.20 ,$31.32 ,$98.20 ,$31.32 ,$59.51 ,$79.16 ,$78.30 ,$31.32 ,$89.21 ,$31.32 , N/A ,$88.36 ,$88.36 ,$85.58 ,$96.27 ,$78.30 ,$90.92 ,$31.32 ,$31.32 ,$90.92 ,$31.32 ,$44.50 , N/A , N/A ,$32.89 ,$90.92 ,$29.95 ,$96.27 ,$83.97 ,$88.36 ,$31.32 ,$69.53 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43000038,97018,HC PARAFFIN BATH THERAPY 15MIN,430,1 ,$175.00 ,$113.75 ,$5.64 ,$175.00 ,$14.10 ,$140.00 ,$5.64 ,$49.00 ,$138.67 ,$160.65 ,$5.64 ,$160.65 ,$5.64 ,$10.72 ,$129.50 ,$14.10 ,$5.64 ,$145.95 ,$5.64 , N/A ,$144.55 ,$144.55 ,$140.00 ,$157.50 ,$14.10 ,$148.75 ,$5.64 ,$5.64 ,$148.75 ,$5.64 ,$72.80 , N/A , N/A ,$5.92 ,$148.75 ,$49.00 ,$157.50 ,$137.38 ,$144.55 ,$5.64 ,$113.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43000039,97018,HC PARAFFIN BATH THERAPY 30MIN,430,1 ,$175.00 ,$113.75 ,$5.64 ,$175.00 ,$14.10 ,$140.00 ,$5.64 ,$49.00 ,$138.67 ,$160.65 ,$5.64 ,$160.65 ,$5.64 ,$10.72 ,$129.50 ,$14.10 ,$5.64 ,$145.95 ,$5.64 , N/A ,$144.55 ,$144.55 ,$140.00 ,$157.50 ,$14.10 ,$148.75 ,$5.64 ,$5.64 ,$148.75 ,$5.64 ,$72.80 , N/A , N/A ,$5.92 ,$148.75 ,$49.00 ,$157.50 ,$137.38 ,$144.55 ,$5.64 ,$113.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400007,97003,HC OT EVAL ORTHOTICS,434,1 ,$223.00 ,$144.95 ,$62.44 ,$223.00 , N/A ,$178.40 , N/A ,$62.44 ,$176.71 ,$204.71 , N/A ,$204.71 , N/A , N/A ,$165.02 , N/A , N/A ,$185.98 , N/A , N/A ,$184.20 ,$184.20 ,$178.40 ,$200.70 , N/A ,$189.55 , N/A , N/A ,$189.55 , N/A ,$92.77 , N/A , N/A , N/A ,$189.55 ,$62.44 ,$200.70 ,$175.06 ,$184.20 , N/A ,$144.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400019,97004,HC OT RE EVAL ACUTE,434,1 ,$110.00 ,$71.50 ,$30.80 ,$110.00 , N/A ,$88.00 , N/A ,$30.80 ,$87.16 ,$100.98 , N/A ,$100.98 , N/A , N/A ,$81.40 , N/A , N/A ,$91.74 , N/A , N/A ,$90.86 ,$90.86 ,$88.00 ,$99.00 , N/A ,$93.50 , N/A , N/A ,$93.50 , N/A ,$45.76 , N/A , N/A , N/A ,$93.50 ,$30.80 ,$99.00 ,$86.35 ,$90.86 , N/A ,$71.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400034,97165,HC OT EVAL LOW COMPLEXITY 15MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400035,97165,HC OT EVAL LOW COMPLEXITY 30MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400036,97165,HC OT EVAL LOW COMPLEXITY 45MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400037,97165,HC OT EVAL LOW COMPLEXITY 60MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400046,97166,HC OT EVAL MOD COMPLEXITY 15MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400047,97166,HC OT EVAL MOD COMPLEXITY 30MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400048,97166,HC OT EVAL MOD COMPLEXITY 45MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400049,97166,HC OT EVAL MOD COMPLEXITY 60MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400050,97166,HC OT EVAL MOD COMPLEXITY 75MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400051,97166,HC OT EVAL MOD COMPLEXITY 90MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400052,97166,HC OT EVAL MOD COMPLEXITY 105MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400058,97167,HC OT EVAL HIGH COMPLEXITY 15MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400059,97167,HC OT EVAL HIGH COMPLEXITY 30MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400060,97167,HC OT EVAL HIGH COMPLEXITY 45MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400061,97167,HC OT EVAL HIGH COMPLEXITY 60MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400062,97167,HC OT EVAL HIGH COMPLEXITY 75MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400063,97167,HC OT EVAL HIGH COMPLEXITY 90MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400064,97167,HC OT EVAL HIGH COMPLEXITY 105MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400065,97167,HC OT EVAL HIGH COMPLEXITY 120MIN,434,1 ,$216.41 ,$140.67 ,$60.59 ,$248.50 ,$248.50 ,$173.13 ,$99.40 ,$60.59 ,$171.48 ,$198.66 ,$99.40 ,$198.66 ,$99.40 ,$188.86 ,$160.14 ,$216.41 ,$99.40 ,$180.49 ,$99.40 , N/A ,$178.75 ,$178.75 ,$173.13 ,$194.77 ,$216.41 ,$183.95 ,$99.40 ,$99.40 ,$183.95 ,$99.40 ,$90.03 , N/A , N/A ,$104.37 ,$183.95 ,$60.59 ,$194.77 ,$169.88 ,$178.75 ,$99.40 ,$140.67 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400070,97168,HC OT RE-EVAL 15MIN,434,1 ,$137.00 ,$89.05 ,$38.36 ,$170.00 ,$170.00 ,$109.60 ,$68.00 ,$38.36 ,$108.56 ,$125.77 ,$68.00 ,$125.77 ,$68.00 ,$129.20 ,$101.38 ,$137.00 ,$68.00 ,$114.26 ,$68.00 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$137.00 ,$116.45 ,$68.00 ,$68.00 ,$116.45 ,$68.00 ,$56.99 , N/A , N/A ,$71.40 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$68.00 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400071,97168,HC OT RE-EVAL 30MIN,434,1 ,$137.00 ,$89.05 ,$38.36 ,$170.00 ,$170.00 ,$109.60 ,$68.00 ,$38.36 ,$108.56 ,$125.77 ,$68.00 ,$125.77 ,$68.00 ,$129.20 ,$101.38 ,$137.00 ,$68.00 ,$114.26 ,$68.00 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$137.00 ,$116.45 ,$68.00 ,$68.00 ,$116.45 ,$68.00 ,$56.99 , N/A , N/A ,$71.40 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$68.00 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400072,97168,HC OT RE-EVAL 45MIN,434,1 ,$137.00 ,$89.05 ,$38.36 ,$170.00 ,$170.00 ,$109.60 ,$68.00 ,$38.36 ,$108.56 ,$125.77 ,$68.00 ,$125.77 ,$68.00 ,$129.20 ,$101.38 ,$137.00 ,$68.00 ,$114.26 ,$68.00 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$137.00 ,$116.45 ,$68.00 ,$68.00 ,$116.45 ,$68.00 ,$56.99 , N/A , N/A ,$71.40 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$68.00 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400073,97168,HC OT RE-EVAL 60MIN,434,1 ,$137.00 ,$89.05 ,$38.36 ,$170.00 ,$170.00 ,$109.60 ,$68.00 ,$38.36 ,$108.56 ,$125.77 ,$68.00 ,$125.77 ,$68.00 ,$129.20 ,$101.38 ,$137.00 ,$68.00 ,$114.26 ,$68.00 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$137.00 ,$116.45 ,$68.00 ,$68.00 ,$116.45 ,$68.00 ,$56.99 , N/A , N/A ,$71.40 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$68.00 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400074,97168,HC OT RE-EVAL 75MIN,434,1 ,$137.00 ,$89.05 ,$38.36 ,$170.00 ,$170.00 ,$109.60 ,$68.00 ,$38.36 ,$108.56 ,$125.77 ,$68.00 ,$125.77 ,$68.00 ,$129.20 ,$101.38 ,$137.00 ,$68.00 ,$114.26 ,$68.00 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$137.00 ,$116.45 ,$68.00 ,$68.00 ,$116.45 ,$68.00 ,$56.99 , N/A , N/A ,$71.40 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$68.00 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400075,97168,HC OT RE-EVAL 90MIN,434,1 ,$137.00 ,$89.05 ,$38.36 ,$170.00 ,$170.00 ,$109.60 ,$68.00 ,$38.36 ,$108.56 ,$125.77 ,$68.00 ,$125.77 ,$68.00 ,$129.20 ,$101.38 ,$137.00 ,$68.00 ,$114.26 ,$68.00 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$137.00 ,$116.45 ,$68.00 ,$68.00 ,$116.45 ,$68.00 ,$56.99 , N/A , N/A ,$71.40 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$68.00 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),43400076,97168,HC OT RE-EVAL 105MIN,434,1 ,$137.00 ,$89.05 ,$38.36 ,$170.00 ,$170.00 ,$109.60 ,$68.00 ,$38.36 ,$108.56 ,$125.77 ,$68.00 ,$125.77 ,$68.00 ,$129.20 ,$101.38 ,$137.00 ,$68.00 ,$114.26 ,$68.00 , N/A ,$113.16 ,$113.16 ,$109.60 ,$123.30 ,$137.00 ,$116.45 ,$68.00 ,$68.00 ,$116.45 ,$68.00 ,$56.99 , N/A , N/A ,$71.40 ,$116.45 ,$38.36 ,$123.30 ,$107.55 ,$113.16 ,$68.00 ,$89.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44000000,92507,HC SPEECH THERAPY TREATMENT 15MIN,440,1 ,$398.34 ,$258.92 ,$75.75 ,$398.34 ,$189.38 ,$318.67 ,$75.75 ,$111.54 ,$315.64 ,$365.68 ,$75.75 ,$365.68 ,$75.75 ,$143.93 ,$294.77 ,$189.38 ,$75.75 ,$332.22 ,$75.75 , N/A ,$329.03 ,$329.03 ,$318.67 ,$358.51 ,$189.38 ,$338.59 ,$75.75 ,$75.75 ,$338.59 ,$75.75 ,$165.71 , N/A , N/A ,$79.54 ,$338.59 ,$111.54 ,$358.51 ,$312.70 ,$329.03 ,$75.75 ,$258.92 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44000001,92507,HC SPEECH THERAPY TREATMENT 30MIN,440,1 ,$398.34 ,$258.92 ,$75.75 ,$398.34 ,$189.38 ,$318.67 ,$75.75 ,$111.54 ,$315.64 ,$365.68 ,$75.75 ,$365.68 ,$75.75 ,$143.93 ,$294.77 ,$189.38 ,$75.75 ,$332.22 ,$75.75 , N/A ,$329.03 ,$329.03 ,$318.67 ,$358.51 ,$189.38 ,$338.59 ,$75.75 ,$75.75 ,$338.59 ,$75.75 ,$165.71 , N/A , N/A ,$79.54 ,$338.59 ,$111.54 ,$358.51 ,$312.70 ,$329.03 ,$75.75 ,$258.92 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44000009,92526,HC DYSPHAGIA TREATMENT 15MIN,440,1 ,$398.34 ,$258.92 ,$83.77 ,$398.34 ,$209.43 ,$318.67 ,$83.77 ,$111.54 ,$315.64 ,$365.68 ,$83.77 ,$365.68 ,$83.77 ,$159.16 ,$294.77 ,$209.43 ,$83.77 ,$332.22 ,$83.77 , N/A ,$329.03 ,$329.03 ,$318.67 ,$358.51 ,$209.43 ,$338.59 ,$83.77 ,$83.77 ,$338.59 ,$83.77 ,$165.71 , N/A , N/A ,$87.96 ,$338.59 ,$111.54 ,$358.51 ,$312.70 ,$329.03 ,$83.77 ,$258.92 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44000015,92526,HC DYSPHAGIA TREATMENT 30MIN,440,1 ,$398.34 ,$258.92 ,$83.77 ,$398.34 ,$209.43 ,$318.67 ,$83.77 ,$111.54 ,$315.64 ,$365.68 ,$83.77 ,$365.68 ,$83.77 ,$159.16 ,$294.77 ,$209.43 ,$83.77 ,$332.22 ,$83.77 , N/A ,$329.03 ,$329.03 ,$318.67 ,$358.51 ,$209.43 ,$338.59 ,$83.77 ,$83.77 ,$338.59 ,$83.77 ,$165.71 , N/A , N/A ,$87.96 ,$338.59 ,$111.54 ,$358.51 ,$312.70 ,$329.03 ,$83.77 ,$258.92 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44000016,92526,HC DYSPHAGIA TREATMENT 45MIN,440,1 ,$398.34 ,$258.92 ,$83.77 ,$398.34 ,$209.43 ,$318.67 ,$83.77 ,$111.54 ,$315.64 ,$365.68 ,$83.77 ,$365.68 ,$83.77 ,$159.16 ,$294.77 ,$209.43 ,$83.77 ,$332.22 ,$83.77 , N/A ,$329.03 ,$329.03 ,$318.67 ,$358.51 ,$209.43 ,$338.59 ,$83.77 ,$83.77 ,$338.59 ,$83.77 ,$165.71 , N/A , N/A ,$87.96 ,$338.59 ,$111.54 ,$358.51 ,$312.70 ,$329.03 ,$83.77 ,$258.92 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44000017,92526,HC DYSPHAGIA TREATMENT 60MIN,440,1 ,$398.34 ,$258.92 ,$83.77 ,$398.34 ,$209.43 ,$318.67 ,$83.77 ,$111.54 ,$315.64 ,$365.68 ,$83.77 ,$365.68 ,$83.77 ,$159.16 ,$294.77 ,$209.43 ,$83.77 ,$332.22 ,$83.77 , N/A ,$329.03 ,$329.03 ,$318.67 ,$358.51 ,$209.43 ,$338.59 ,$83.77 ,$83.77 ,$338.59 ,$83.77 ,$165.71 , N/A , N/A ,$87.96 ,$338.59 ,$111.54 ,$358.51 ,$312.70 ,$329.03 ,$83.77 ,$258.92 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400017,92610,HC DYSPHAGIA EVALUATION 15MIN,444,1 ,$182.03 ,$118.32 ,$50.97 ,$210.38 ,$210.38 ,$145.62 ,$84.15 ,$50.97 ,$144.24 ,$167.10 ,$84.15 ,$167.10 ,$84.15 ,$159.89 ,$134.70 ,$182.03 ,$84.15 ,$151.81 ,$84.15 , N/A ,$150.36 ,$150.36 ,$145.62 ,$163.83 ,$182.03 ,$154.73 ,$84.15 ,$84.15 ,$154.73 ,$84.15 ,$75.72 , N/A , N/A ,$88.36 ,$154.73 ,$50.97 ,$163.83 ,$142.89 ,$150.36 ,$84.15 ,$118.32 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400018,92610,HC DYSPHAGIA EVALUATION  30MIN,444,1 ,$182.03 ,$118.32 ,$50.97 ,$210.38 ,$210.38 ,$145.62 ,$84.15 ,$50.97 ,$144.24 ,$167.10 ,$84.15 ,$167.10 ,$84.15 ,$159.89 ,$134.70 ,$182.03 ,$84.15 ,$151.81 ,$84.15 , N/A ,$150.36 ,$150.36 ,$145.62 ,$163.83 ,$182.03 ,$154.73 ,$84.15 ,$84.15 ,$154.73 ,$84.15 ,$75.72 , N/A , N/A ,$88.36 ,$154.73 ,$50.97 ,$163.83 ,$142.89 ,$150.36 ,$84.15 ,$118.32 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400020,92610,HC DYSPHAGIA EVALUATION 60MIN,444,1 ,$182.03 ,$118.32 ,$50.97 ,$210.38 ,$210.38 ,$145.62 ,$84.15 ,$50.97 ,$144.24 ,$167.10 ,$84.15 ,$167.10 ,$84.15 ,$159.89 ,$134.70 ,$182.03 ,$84.15 ,$151.81 ,$84.15 , N/A ,$150.36 ,$150.36 ,$145.62 ,$163.83 ,$182.03 ,$154.73 ,$84.15 ,$84.15 ,$154.73 ,$84.15 ,$75.72 , N/A , N/A ,$88.36 ,$154.73 ,$50.97 ,$163.83 ,$142.89 ,$150.36 ,$84.15 ,$118.32 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400041,92522,HC EVALUATE SPEECH PRODUCTION 15MIN,444,1 ,$148.22 ,$96.34 ,$41.50 ,$276.30 ,$276.30 ,$118.58 ,$110.52 ,$41.50 ,$117.45 ,$136.07 ,$110.52 ,$136.07 ,$110.52 ,$148.22 ,$109.68 ,$148.22 ,$110.52 ,$123.62 ,$110.52 , N/A ,$122.43 ,$122.43 ,$118.58 ,$133.40 ,$148.22 ,$125.99 ,$110.52 ,$110.52 ,$125.99 ,$110.52 ,$61.66 , N/A , N/A ,$116.05 ,$125.99 ,$41.50 ,$133.40 ,$116.35 ,$122.43 ,$110.52 ,$96.34 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400042,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 15MIN,444,1 ,$159.37 ,$103.59 ,$44.62 ,$559.90 ,$559.90 ,$127.50 ,$223.96 ,$44.62 ,$126.28 ,$146.30 ,$159.37 ,$146.30 ,$159.37 ,$159.37 ,$117.93 ,$159.37 ,$223.96 ,$132.91 ,$223.96 , N/A ,$131.64 ,$131.64 ,$127.50 ,$143.43 ,$159.37 ,$135.46 ,$223.96 ,$223.96 ,$135.46 ,$223.96 ,$66.30 , N/A , N/A ,$159.37 ,$135.46 ,$44.62 ,$143.43 ,$125.11 ,$131.64 ,$223.96 ,$103.59 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400055,92522,HC EVALUATE SPEECH PRODUCTION 30MIN,444,1 ,$148.22 ,$96.34 ,$41.50 ,$276.30 ,$276.30 ,$118.58 ,$110.52 ,$41.50 ,$117.45 ,$136.07 ,$110.52 ,$136.07 ,$110.52 ,$148.22 ,$109.68 ,$148.22 ,$110.52 ,$123.62 ,$110.52 , N/A ,$122.43 ,$122.43 ,$118.58 ,$133.40 ,$148.22 ,$125.99 ,$110.52 ,$110.52 ,$125.99 ,$110.52 ,$61.66 , N/A , N/A ,$116.05 ,$125.99 ,$41.50 ,$133.40 ,$116.35 ,$122.43 ,$110.52 ,$96.34 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400056,92522,HC EVALUATE SPEECH PRODUCTION 45MIN,444,1 ,$148.22 ,$96.34 ,$41.50 ,$276.30 ,$276.30 ,$118.58 ,$110.52 ,$41.50 ,$117.45 ,$136.07 ,$110.52 ,$136.07 ,$110.52 ,$148.22 ,$109.68 ,$148.22 ,$110.52 ,$123.62 ,$110.52 , N/A ,$122.43 ,$122.43 ,$118.58 ,$133.40 ,$148.22 ,$125.99 ,$110.52 ,$110.52 ,$125.99 ,$110.52 ,$61.66 , N/A , N/A ,$116.05 ,$125.99 ,$41.50 ,$133.40 ,$116.35 ,$122.43 ,$110.52 ,$96.34 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400057,92522,HC EVALUATE SPEECH PRODUCTION 60MIN,444,1 ,$148.22 ,$96.34 ,$41.50 ,$276.30 ,$276.30 ,$118.58 ,$110.52 ,$41.50 ,$117.45 ,$136.07 ,$110.52 ,$136.07 ,$110.52 ,$148.22 ,$109.68 ,$148.22 ,$110.52 ,$123.62 ,$110.52 , N/A ,$122.43 ,$122.43 ,$118.58 ,$133.40 ,$148.22 ,$125.99 ,$110.52 ,$110.52 ,$125.99 ,$110.52 ,$61.66 , N/A , N/A ,$116.05 ,$125.99 ,$41.50 ,$133.40 ,$116.35 ,$122.43 ,$110.52 ,$96.34 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400058,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 30MIN,444,1 ,$159.37 ,$103.59 ,$44.62 ,$559.90 ,$559.90 ,$127.50 ,$223.96 ,$44.62 ,$126.28 ,$146.30 ,$159.37 ,$146.30 ,$159.37 ,$159.37 ,$117.93 ,$159.37 ,$223.96 ,$132.91 ,$223.96 , N/A ,$131.64 ,$131.64 ,$127.50 ,$143.43 ,$159.37 ,$135.46 ,$223.96 ,$223.96 ,$135.46 ,$223.96 ,$66.30 , N/A , N/A ,$159.37 ,$135.46 ,$44.62 ,$143.43 ,$125.11 ,$131.64 ,$223.96 ,$103.59 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400059,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 45MIN,444,1 ,$159.37 ,$103.59 ,$44.62 ,$559.90 ,$559.90 ,$127.50 ,$223.96 ,$44.62 ,$126.28 ,$146.30 ,$159.37 ,$146.30 ,$159.37 ,$159.37 ,$117.93 ,$159.37 ,$223.96 ,$132.91 ,$223.96 , N/A ,$131.64 ,$131.64 ,$127.50 ,$143.43 ,$159.37 ,$135.46 ,$223.96 ,$223.96 ,$135.46 ,$223.96 ,$66.30 , N/A , N/A ,$159.37 ,$135.46 ,$44.62 ,$143.43 ,$125.11 ,$131.64 ,$223.96 ,$103.59 
HSHS GOOD SHEPHERD HOSPITAL (ACU),44400060,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 60MIN,444,1 ,$159.37 ,$103.59 ,$44.62 ,$559.90 ,$559.90 ,$127.50 ,$223.96 ,$44.62 ,$126.28 ,$146.30 ,$159.37 ,$146.30 ,$159.37 ,$159.37 ,$117.93 ,$159.37 ,$223.96 ,$132.91 ,$223.96 , N/A ,$131.64 ,$131.64 ,$127.50 ,$143.43 ,$159.37 ,$135.46 ,$223.96 ,$223.96 ,$135.46 ,$223.96 ,$66.30 , N/A , N/A ,$159.37 ,$135.46 ,$44.62 ,$143.43 ,$125.11 ,$131.64 ,$223.96 ,$103.59 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000002,10061,HC I AND D ABSC CMPLX,450,1 ,$571.00 ,$371.15 ,$159.88 ,$856.40 ,$856.40 ,$456.80 ,$319.85 ,$159.88 ,$452.46 ,$524.18 ,$319.85 ,$524.18 ,$319.85 ,$571.00 ,$422.54 ,$571.00 ,$342.56 ,$476.21 ,$319.85 , N/A ,$471.65 ,$471.65 ,$456.80 ,$513.90 ,$571.00 ,$485.35 ,$319.85 ,$319.85 ,$485.35 ,$342.56 ,$237.54 , N/A , N/A ,$358.56 ,$485.35 ,$159.88 ,$513.90 ,$448.24 ,$471.65 ,$319.85 ,$371.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000003,10080,HC I AND D CYST PILONIDAL SMP,450,1 ,$517.78 ,$336.56 ,$144.98 ,"$1,541.88 ","$1,541.88 ",$414.22 ,$575.86 ,$144.98 ,$410.29 ,$475.32 ,$517.78 ,$475.32 ,$517.78 ,$517.78 ,$383.16 ,$517.78 ,$616.75 ,$431.83 ,$575.86 , N/A ,$427.69 ,$427.69 ,$414.22 ,$466.00 ,$517.78 ,$440.11 ,$575.86 ,$575.86 ,$440.11 ,$616.75 ,$215.40 , N/A , N/A ,$517.78 ,$440.11 ,$144.98 ,$466.00 ,$406.46 ,$427.69 ,$575.86 ,$336.56 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000005,10120,HC INCISION/REM FB SUBQ SMP,450,1 ,$517.78 ,$336.56 ,$144.98 ,$856.40 ,$856.40 ,$414.22 ,$319.85 ,$144.98 ,$410.29 ,$475.32 ,$319.85 ,$475.32 ,$319.85 ,$517.78 ,$383.16 ,$517.78 ,$342.56 ,$431.83 ,$319.85 , N/A ,$427.69 ,$427.69 ,$414.22 ,$466.00 ,$517.78 ,$440.11 ,$319.85 ,$319.85 ,$440.11 ,$342.56 ,$215.40 , N/A , N/A ,$358.56 ,$440.11 ,$144.98 ,$466.00 ,$406.46 ,$427.69 ,$319.85 ,$336.56 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000009,11730,HC AVULSION NAIL PLATE SINGLE FAC,450,1 ,$235.67 ,$153.19 ,$65.99 ,$444.95 ,$444.95 ,$188.54 ,$166.18 ,$65.99 ,$186.74 ,$216.35 ,$166.18 ,$216.35 ,$166.18 ,$235.67 ,$174.40 ,$235.67 ,$177.98 ,$196.55 ,$166.18 , N/A ,$194.66 ,$194.66 ,$188.54 ,$212.10 ,$235.67 ,$200.32 ,$166.18 ,$166.18 ,$200.32 ,$177.98 ,$98.04 , N/A , N/A ,$186.29 ,$200.32 ,$65.99 ,$212.10 ,$185.00 ,$194.66 ,$166.18 ,$153.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000011,11740,HC EVAC HEMATOMA SUBUNGAL,450,1 ,$191.71 ,$124.61 ,$53.68 ,$279.40 ,$279.40 ,$153.37 ,$104.35 ,$53.68 ,$151.91 ,$175.99 ,$104.35 ,$175.99 ,$104.35 ,$191.71 ,$141.87 ,$191.71 ,$111.76 ,$159.89 ,$104.35 , N/A ,$158.35 ,$158.35 ,$153.37 ,$172.54 ,$191.71 ,$162.95 ,$104.35 ,$104.35 ,$162.95 ,$111.76 ,$79.75 , N/A , N/A ,$116.97 ,$162.95 ,$53.68 ,$172.54 ,$150.49 ,$158.35 ,$104.35 ,$124.61 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000012,11760,HC REPAIR NAIL BED,450,1 ,"$1,423.00 ",$924.95 ,$398.44 ,"$1,423.00 ","$1,297.68 ","$1,138.40 ",$484.66 ,$398.44 ,"$1,127.59 ","$1,306.31 ",$484.66 ,"$1,306.31 ",$484.66 ,$986.23 ,"$1,053.02 ","$1,297.68 ",$519.07 ,"$1,186.78 ",$484.66 , N/A ,"$1,175.40 ","$1,175.40 ","$1,138.40 ","$1,280.70 ","$1,211.66 ","$1,209.55 ",$484.66 ,$484.66 ,"$1,209.55 ",$519.07 ,$591.97 , N/A , N/A ,$543.31 ,"$1,209.55 ",$398.44 ,"$1,280.70 ","$1,117.06 ","$1,175.40 ",$484.66 ,$924.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000014,12001,HC SIMP S/N/AX/GN/TRK/EXT 2.5CM <,450,1 ,$623.03 ,$404.97 ,$166.18 ,$623.03 ,$444.95 ,$498.42 ,$166.18 ,$174.45 ,$493.69 ,$571.94 ,$166.18 ,$571.94 ,$166.18 ,$338.16 ,$461.04 ,$444.95 ,$177.98 ,$519.61 ,$166.18 , N/A ,$514.62 ,$514.62 ,$498.42 ,$560.73 ,$415.45 ,$529.58 ,$166.18 ,$166.18 ,$529.58 ,$177.98 ,$259.18 , N/A , N/A ,$186.29 ,$529.58 ,$174.45 ,$560.73 ,$489.08 ,$514.62 ,$166.18 ,$404.97 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000015,12002,HC SIMP S/N/AX/GN/TRK/EXT 2.6-7.5,450,1 ,$629.06 ,$408.89 ,$166.18 ,$629.06 ,$444.95 ,$503.25 ,$166.18 ,$176.14 ,$498.47 ,$577.48 ,$166.18 ,$577.48 ,$166.18 ,$338.16 ,$465.50 ,$444.95 ,$177.98 ,$524.64 ,$166.18 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$415.45 ,$534.70 ,$166.18 ,$166.18 ,$534.70 ,$177.98 ,$261.69 , N/A , N/A ,$186.29 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$166.18 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000016,12004,HC SIMP S/N/AX/GN/TRK/EXT7.6-12.5,450,1 ,$629.06 ,$408.89 ,$166.18 ,$629.06 ,$444.95 ,$503.25 ,$166.18 ,$176.14 ,$498.47 ,$577.48 ,$166.18 ,$577.48 ,$166.18 ,$338.16 ,$465.50 ,$444.95 ,$177.98 ,$524.64 ,$166.18 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$415.45 ,$534.70 ,$166.18 ,$166.18 ,$534.70 ,$177.98 ,$261.69 , N/A , N/A ,$186.29 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$166.18 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000017,12005,HC SIMP S/N/AX/GN/TRK/EXT 12.6-20,450,1 ,$629.06 ,$408.89 ,$176.14 ,$856.40 ,$856.40 ,$503.25 ,$319.85 ,$176.14 ,$498.47 ,$577.48 ,$319.85 ,$577.48 ,$319.85 ,$629.06 ,$465.50 ,$629.06 ,$342.56 ,$524.64 ,$319.85 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$629.06 ,$534.70 ,$319.85 ,$319.85 ,$534.70 ,$342.56 ,$261.69 , N/A , N/A ,$358.56 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$319.85 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000018,12006,HC SIMP S/N/AX/GN/TRK/EXT 20.1-30,450,1 ,$629.06 ,$408.89 ,$176.14 ,$856.40 ,$856.40 ,$503.25 ,$319.85 ,$176.14 ,$498.47 ,$577.48 ,$319.85 ,$577.48 ,$319.85 ,$629.06 ,$465.50 ,$629.06 ,$342.56 ,$524.64 ,$319.85 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$629.06 ,$534.70 ,$319.85 ,$319.85 ,$534.70 ,$342.56 ,$261.69 , N/A , N/A ,$358.56 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$319.85 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000020,12011,HC SIMP F/E/E/N/L/MM 2.5CM OR <,450,1 ,$629.06 ,$408.89 ,$166.18 ,$629.06 ,$444.95 ,$503.25 ,$166.18 ,$176.14 ,$498.47 ,$577.48 ,$166.18 ,$577.48 ,$166.18 ,$338.16 ,$465.50 ,$444.95 ,$177.98 ,$524.64 ,$166.18 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$415.45 ,$534.70 ,$166.18 ,$166.18 ,$534.70 ,$177.98 ,$261.69 , N/A , N/A ,$186.29 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$166.18 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000021,12013,HC SIMP F/E/E/N/L/MM 2.6CM TO 5CM,450,1 ,$629.06 ,$408.89 ,$166.18 ,$629.06 ,$444.95 ,$503.25 ,$166.18 ,$176.14 ,$498.47 ,$577.48 ,$166.18 ,$577.48 ,$166.18 ,$338.16 ,$465.50 ,$444.95 ,$177.98 ,$524.64 ,$166.18 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$415.45 ,$534.70 ,$166.18 ,$166.18 ,$534.70 ,$177.98 ,$261.69 , N/A , N/A ,$186.29 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$166.18 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000022,12014,HC SIMP F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$629.06 ,$408.89 ,$166.18 ,$629.06 ,$444.95 ,$503.25 ,$166.18 ,$176.14 ,$498.47 ,$577.48 ,$166.18 ,$577.48 ,$166.18 ,$338.16 ,$465.50 ,$444.95 ,$177.98 ,$524.64 ,$166.18 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$415.45 ,$534.70 ,$166.18 ,$166.18 ,$534.70 ,$177.98 ,$261.69 , N/A , N/A ,$186.29 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$166.18 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000023,12015,HC SIMP F/E/E/N/L/MM 7.6 -12.5CM,450,1 ,$629.06 ,$408.89 ,$166.18 ,$629.06 ,$444.95 ,$503.25 ,$166.18 ,$176.14 ,$498.47 ,$577.48 ,$166.18 ,$577.48 ,$166.18 ,$338.16 ,$465.50 ,$444.95 ,$177.98 ,$524.64 ,$166.18 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$415.45 ,$534.70 ,$166.18 ,$166.18 ,$534.70 ,$177.98 ,$261.69 , N/A , N/A ,$186.29 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$166.18 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000024,12016,HC SIMP F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$648.00 ,$421.20 ,$181.44 ,$856.40 ,$856.40 ,$518.40 ,$319.85 ,$181.44 ,$513.48 ,$594.86 ,$319.85 ,$594.86 ,$319.85 ,$648.00 ,$479.52 ,$648.00 ,$342.56 ,$540.43 ,$319.85 , N/A ,$535.25 ,$535.25 ,$518.40 ,$583.20 ,$648.00 ,$550.80 ,$319.85 ,$319.85 ,$550.80 ,$342.56 ,$269.57 , N/A , N/A ,$358.56 ,$550.80 ,$181.44 ,$583.20 ,$508.68 ,$535.25 ,$319.85 ,$421.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000028,12021,HC SIMP SUPERFICIAL DEHISCENC/PAK,450,1 ,$599.06 ,$389.39 ,$167.74 ,$856.40 ,$856.40 ,$479.25 ,$319.85 ,$167.74 ,$474.70 ,$549.94 ,$319.85 ,$549.94 ,$319.85 ,$599.06 ,$443.30 ,$599.06 ,$342.56 ,$499.62 ,$319.85 , N/A ,$494.82 ,$494.82 ,$479.25 ,$539.15 ,$599.06 ,$509.20 ,$319.85 ,$319.85 ,$509.20 ,$342.56 ,$249.21 , N/A , N/A ,$358.56 ,$509.20 ,$167.74 ,$539.15 ,$470.26 ,$494.82 ,$319.85 ,$389.39 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000030,12032,HC INTRM S/A/T/EXT 2.6-7.5CM,450,1 ,$629.06 ,$408.89 ,$176.14 ,$856.40 ,$856.40 ,$503.25 ,$319.85 ,$176.14 ,$498.47 ,$577.48 ,$319.85 ,$577.48 ,$319.85 ,$629.06 ,$465.50 ,$629.06 ,$342.56 ,$524.64 ,$319.85 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$629.06 ,$534.70 ,$319.85 ,$319.85 ,$534.70 ,$342.56 ,$261.69 , N/A , N/A ,$358.56 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$319.85 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000031,12034,HC INTRM S/A/T/EXT 7.6-12.5CM,450,1 ,$629.06 ,$408.89 ,$176.14 ,$856.40 ,$856.40 ,$503.25 ,$319.85 ,$176.14 ,$498.47 ,$577.48 ,$319.85 ,$577.48 ,$319.85 ,$629.06 ,$465.50 ,$629.06 ,$342.56 ,$524.64 ,$319.85 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$629.06 ,$534.70 ,$319.85 ,$319.85 ,$534.70 ,$342.56 ,$261.69 , N/A , N/A ,$358.56 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$319.85 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000032,12035,HC INTRM S/A/T/EXT 12.6-20.0CM,450,1 ,$629.06 ,$408.89 ,$176.14 ,$856.40 ,$856.40 ,$503.25 ,$319.85 ,$176.14 ,$498.47 ,$577.48 ,$319.85 ,$577.48 ,$319.85 ,$629.06 ,$465.50 ,$629.06 ,$342.56 ,$524.64 ,$319.85 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$629.06 ,$534.70 ,$319.85 ,$319.85 ,$534.70 ,$342.56 ,$261.69 , N/A , N/A ,$358.56 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$319.85 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000036,12042,HC INTRM N/H/F/GEN 2.6-7.5CM,450,1 ,$629.06 ,$408.89 ,$176.14 ,$856.40 ,$856.40 ,$503.25 ,$319.85 ,$176.14 ,$498.47 ,$577.48 ,$319.85 ,$577.48 ,$319.85 ,$629.06 ,$465.50 ,$629.06 ,$342.56 ,$524.64 ,$319.85 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$629.06 ,$534.70 ,$319.85 ,$319.85 ,$534.70 ,$342.56 ,$261.69 , N/A , N/A ,$358.56 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$319.85 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000041,12051,HC INTRM F/E/E/N/L/MM 2.5CM OR <,450,1 ,$629.06 ,$408.89 ,$176.14 ,$856.40 ,$856.40 ,$503.25 ,$319.85 ,$176.14 ,$498.47 ,$577.48 ,$319.85 ,$577.48 ,$319.85 ,$629.06 ,$465.50 ,$629.06 ,$342.56 ,$524.64 ,$319.85 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$629.06 ,$534.70 ,$319.85 ,$319.85 ,$534.70 ,$342.56 ,$261.69 , N/A , N/A ,$358.56 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$319.85 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000042,12052,HC INTRM F/E/E/N/L/MM 2.6-5.0CM,450,1 ,$629.06 ,$408.89 ,$176.14 ,$856.40 ,$856.40 ,$503.25 ,$319.85 ,$176.14 ,$498.47 ,$577.48 ,$319.85 ,$577.48 ,$319.85 ,$629.06 ,$465.50 ,$629.06 ,$342.56 ,$524.64 ,$319.85 , N/A ,$519.60 ,$519.60 ,$503.25 ,$566.15 ,$629.06 ,$534.70 ,$319.85 ,$319.85 ,$534.70 ,$342.56 ,$261.69 , N/A , N/A ,$358.56 ,$534.70 ,$176.14 ,$566.15 ,$493.81 ,$519.60 ,$319.85 ,$408.89 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000061,16000,HC TX BURN 1ST DEGREE INIT,450,1 ,$373.23 ,$242.60 ,$104.50 ,$444.95 ,$444.95 ,$298.58 ,$166.18 ,$104.50 ,$295.75 ,$342.63 ,$166.18 ,$342.63 ,$166.18 ,$338.16 ,$276.19 ,$373.23 ,$177.98 ,$311.27 ,$166.18 , N/A ,$308.29 ,$308.29 ,$298.58 ,$335.91 ,$373.23 ,$317.25 ,$166.18 ,$166.18 ,$317.25 ,$177.98 ,$155.26 , N/A , N/A ,$186.29 ,$317.25 ,$104.50 ,$335.91 ,$292.99 ,$308.29 ,$166.18 ,$242.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000062,16020,HC DRESS/DEB BURN <5% TOTAL SM,450,1 ,$375.05 ,$243.78 ,$105.01 ,$444.95 ,$444.95 ,$300.04 ,$166.18 ,$105.01 ,$297.19 ,$344.30 ,$166.18 ,$344.30 ,$166.18 ,$338.16 ,$277.54 ,$375.05 ,$177.98 ,$312.79 ,$166.18 , N/A ,$309.79 ,$309.79 ,$300.04 ,$337.55 ,$375.05 ,$318.79 ,$166.18 ,$166.18 ,$318.79 ,$177.98 ,$156.02 , N/A , N/A ,$186.29 ,$318.79 ,$105.01 ,$337.55 ,$294.41 ,$309.79 ,$166.18 ,$243.78 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,$328.00 ,$213.20 ,$91.84 ,$647.35 ,$647.35 ,$262.40 ,$241.77 ,$91.84 ,$259.91 ,$301.10 ,$241.77 ,$301.10 ,$241.77 ,$328.00 ,$242.72 ,$328.00 ,$258.94 ,$273.55 ,$241.77 , N/A ,$270.93 ,$270.93 ,$262.40 ,$295.20 ,$328.00 ,$278.80 ,$241.77 ,$241.77 ,$278.80 ,$258.94 ,$136.45 , N/A , N/A ,$271.03 ,$278.80 ,$91.84 ,$295.20 ,$257.48 ,$270.93 ,$241.77 ,$213.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,$372.72 ,$242.27 ,$104.36 ,$647.35 ,$647.35 ,$298.18 ,$241.77 ,$104.36 ,$295.34 ,$342.16 ,$241.77 ,$342.16 ,$241.77 ,$372.72 ,$275.81 ,$372.72 ,$258.94 ,$310.85 ,$241.77 , N/A ,$307.87 ,$307.87 ,$298.18 ,$335.45 ,$372.72 ,$316.81 ,$241.77 ,$241.77 ,$316.81 ,$258.94 ,$155.05 , N/A , N/A ,$271.03 ,$316.81 ,$104.36 ,$335.45 ,$292.59 ,$307.87 ,$241.77 ,$242.27 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000074,23650,HC TX DISL SHLDR W/MAN CLS,450,1 ,$424.57 ,$275.97 ,$118.88 ,$510.70 ,$510.70 ,$339.66 ,$190.73 ,$118.88 ,$336.43 ,$389.76 ,$190.73 ,$389.76 ,$190.73 ,$388.13 ,$314.18 ,$424.57 ,$204.28 ,$354.09 ,$190.73 , N/A ,$350.69 ,$350.69 ,$339.66 ,$382.11 ,$424.57 ,$360.88 ,$190.73 ,$190.73 ,$360.88 ,$204.28 ,$176.62 , N/A , N/A ,$213.81 ,$360.88 ,$118.88 ,$382.11 ,$333.29 ,$350.69 ,$190.73 ,$275.97 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000076,24600,HC TX DISL ELBOW W/O ANES CLS,450,1 ,$561.84 ,$365.20 ,$157.32 ,$561.84 ,$510.70 ,$449.47 ,$190.73 ,$157.32 ,$445.20 ,$515.77 ,$190.73 ,$515.77 ,$190.73 ,$388.13 ,$415.76 ,$510.70 ,$204.28 ,$468.57 ,$190.73 , N/A ,$464.08 ,$464.08 ,$449.47 ,$505.66 ,$476.84 ,$477.56 ,$190.73 ,$190.73 ,$477.56 ,$204.28 ,$233.73 , N/A , N/A ,$213.81 ,$477.56 ,$157.32 ,$505.66 ,$441.04 ,$464.08 ,$190.73 ,$365.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,$579.00 ,$376.35 ,$162.12 ,$579.00 ,$510.70 ,$463.20 ,$190.73 ,$162.12 ,$458.80 ,$531.52 ,$190.73 ,$531.52 ,$190.73 ,$388.13 ,$428.46 ,$510.70 ,$204.28 ,$482.89 ,$190.73 , N/A ,$478.25 ,$478.25 ,$463.20 ,$521.10 ,$476.84 ,$492.15 ,$190.73 ,$190.73 ,$492.15 ,$204.28 ,$240.86 , N/A , N/A ,$213.81 ,$492.15 ,$162.12 ,$521.10 ,$454.52 ,$478.25 ,$190.73 ,$376.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000082,25605,HC CL TX DIS RADIAL FX/EPIP SEP,450,1 ,"$1,371.31 ",$891.35 ,$383.97 ,"$3,451.13 ","$3,451.13 ","$1,097.05 ","$1,288.94 ",$383.97 ,"$1,086.63 ","$1,258.86 ","$1,288.94 ","$1,258.86 ","$1,288.94 ","$1,371.31 ","$1,014.77 ","$1,371.31 ","$1,380.45 ","$1,143.67 ","$1,288.94 ", N/A ,"$1,132.70 ","$1,132.70 ","$1,097.05 ","$1,234.18 ","$1,371.31 ","$1,165.61 ","$1,288.94 ","$1,288.94 ","$1,165.61 ","$1,380.45 ",$570.47 , N/A , N/A ,"$1,371.31 ","$1,165.61 ",$383.97 ,"$1,234.18 ","$1,076.48 ","$1,132.70 ","$1,288.94 ",$891.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000090,26770,HC TX DISL (I-P) HAND W/O ANES,450,1 ,$424.57 ,$275.97 ,$118.88 ,$510.70 ,$510.70 ,$339.66 ,$190.73 ,$118.88 ,$336.43 ,$389.76 ,$190.73 ,$389.76 ,$190.73 ,$388.13 ,$314.18 ,$424.57 ,$204.28 ,$354.09 ,$190.73 , N/A ,$350.69 ,$350.69 ,$339.66 ,$382.11 ,$424.57 ,$360.88 ,$190.73 ,$190.73 ,$360.88 ,$204.28 ,$176.62 , N/A , N/A ,$213.81 ,$360.88 ,$118.88 ,$382.11 ,$333.29 ,$350.69 ,$190.73 ,$275.97 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000094,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT,450,1 ,"$1,155.00 ",$750.75 ,$190.73 ,"$1,155.00 ",$510.70 ,$924.00 ,$190.73 ,$323.40 ,$915.22 ,"$1,060.29 ",$190.73 ,"$1,060.29 ",$190.73 ,$388.13 ,$854.70 ,$510.70 ,$204.28 ,$963.27 ,$190.73 , N/A ,$954.03 ,$954.03 ,$924.00 ,"$1,039.50 ",$476.84 ,$981.75 ,$190.73 ,$190.73 ,$981.75 ,$204.28 ,$480.48 , N/A , N/A ,$213.81 ,$981.75 ,$323.40 ,"$1,039.50 ",$906.68 ,$954.03 ,$190.73 ,$750.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000096,27560,HC TX DSL PTLR W/O ANS CL,450,1 ,$561.84 ,$365.20 ,$157.32 ,$561.84 ,$510.70 ,$449.47 ,$190.73 ,$157.32 ,$445.20 ,$515.77 ,$190.73 ,$515.77 ,$190.73 ,$388.13 ,$415.76 ,$510.70 ,$204.28 ,$468.57 ,$190.73 , N/A ,$464.08 ,$464.08 ,$449.47 ,$505.66 ,$476.84 ,$477.56 ,$190.73 ,$190.73 ,$477.56 ,$204.28 ,$233.73 , N/A , N/A ,$213.81 ,$477.56 ,$157.32 ,$505.66 ,$441.04 ,$464.08 ,$190.73 ,$365.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000097,28190,HC REM FB FOOT SUBQ,450,1 ,"$1,035.76 ",$673.24 ,$290.01 ,"$1,541.88 ","$1,541.88 ",$828.61 ,$575.86 ,$290.01 ,$820.74 ,$950.83 ,$575.86 ,$950.83 ,$575.86 ,"$1,035.76 ",$766.46 ,"$1,035.76 ",$616.75 ,$863.82 ,$575.86 , N/A ,$855.54 ,$855.54 ,$828.61 ,$932.18 ,"$1,035.76 ",$880.40 ,$575.86 ,$575.86 ,$880.40 ,$616.75 ,$430.88 , N/A , N/A ,$645.54 ,$880.40 ,$290.01 ,$932.18 ,$813.07 ,$855.54 ,$575.86 ,$673.24 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000098,29065,HC APPL CAST ARM LONG,450,1 ,$340.37 ,$221.24 ,$95.30 ,$597.75 ,$597.75 ,$272.30 ,$223.24 ,$95.30 ,$269.71 ,$312.46 ,$223.24 ,$312.46 ,$223.24 ,$340.37 ,$251.87 ,$340.37 ,$239.10 ,$283.87 ,$223.24 , N/A ,$281.15 ,$281.15 ,$272.30 ,$306.33 ,$340.37 ,$289.31 ,$223.24 ,$223.24 ,$289.31 ,$239.10 ,$141.59 , N/A , N/A ,$250.26 ,$289.31 ,$95.30 ,$306.33 ,$267.19 ,$281.15 ,$223.24 ,$221.24 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000099,29075,HC CAST APPL; ELBOW TO FINGERS,450,1 ,$354.71 ,$230.56 ,$99.32 ,$597.75 ,$597.75 ,$283.77 ,$223.24 ,$99.32 ,$281.07 ,$325.62 ,$223.24 ,$325.62 ,$223.24 ,$354.71 ,$262.49 ,$354.71 ,$239.10 ,$295.83 ,$223.24 , N/A ,$292.99 ,$292.99 ,$283.77 ,$319.24 ,$354.71 ,$301.50 ,$223.24 ,$223.24 ,$301.50 ,$239.10 ,$147.56 , N/A , N/A ,$250.26 ,$301.50 ,$99.32 ,$319.24 ,$278.45 ,$292.99 ,$223.24 ,$230.56 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000100,29105,HC APPL SPLNT ARM LONG,450,1 ,$420.00 ,$273.00 ,$117.60 ,$420.00 ,$350.05 ,$336.00 ,$130.74 ,$117.60 ,$332.81 ,$385.56 ,$130.74 ,$385.56 ,$130.74 ,$266.04 ,$310.80 ,$350.05 ,$140.02 ,$350.28 ,$130.74 , N/A ,$346.92 ,$346.92 ,$336.00 ,$378.00 ,$326.85 ,$357.00 ,$130.74 ,$130.74 ,$357.00 ,$140.02 ,$174.72 , N/A , N/A ,$146.56 ,$357.00 ,$117.60 ,$378.00 ,$329.70 ,$346.92 ,$130.74 ,$273.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,$213.87 ,$139.02 ,$59.88 ,$279.40 ,$279.40 ,$171.10 ,$104.35 ,$59.88 ,$169.47 ,$196.33 ,$104.35 ,$196.33 ,$104.35 ,$212.34 ,$158.26 ,$213.87 ,$111.76 ,$178.37 ,$104.35 , N/A ,$176.66 ,$176.66 ,$171.10 ,$192.48 ,$213.87 ,$181.79 ,$104.35 ,$104.35 ,$181.79 ,$111.76 ,$88.97 , N/A , N/A ,$116.97 ,$181.79 ,$59.88 ,$192.48 ,$167.89 ,$176.66 ,$104.35 ,$139.02 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000102,29126,HC APPL SHRT ARM SPLNT DYNAM,450,1 ,$407.58 ,$264.93 ,$104.35 ,$407.58 ,$279.40 ,$326.06 ,$104.35 ,$114.12 ,$322.97 ,$374.16 ,$104.35 ,$374.16 ,$104.35 ,$212.34 ,$301.61 ,$279.40 ,$111.76 ,$339.92 ,$104.35 , N/A ,$336.66 ,$336.66 ,$326.06 ,$366.82 ,$260.87 ,$346.44 ,$104.35 ,$104.35 ,$346.44 ,$111.76 ,$169.55 , N/A , N/A ,$116.97 ,$346.44 ,$114.12 ,$366.82 ,$319.95 ,$336.66 ,$104.35 ,$264.93 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000103,29130,HC APPL SPLNT FINGER STATIC,450,1 ,$384.00 ,$249.60 ,$104.35 ,$384.00 ,$279.40 ,$307.20 ,$104.35 ,$107.52 ,$304.28 ,$352.51 ,$104.35 ,$352.51 ,$104.35 ,$212.34 ,$284.16 ,$279.40 ,$111.76 ,$320.26 ,$104.35 , N/A ,$317.18 ,$317.18 ,$307.20 ,$345.60 ,$260.87 ,$326.40 ,$104.35 ,$104.35 ,$326.40 ,$111.76 ,$159.74 , N/A , N/A ,$116.97 ,$326.40 ,$107.52 ,$345.60 ,$301.44 ,$317.18 ,$104.35 ,$249.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000106,29405,HC APPL CAST SHORT LEG,450,1 ,$496.22 ,$322.54 ,$138.94 ,$597.75 ,$597.75 ,$396.98 ,$223.24 ,$138.94 ,$393.20 ,$455.53 ,$223.24 ,$455.53 ,$223.24 ,$454.29 ,$367.20 ,$496.22 ,$239.10 ,$413.85 ,$223.24 , N/A ,$409.88 ,$409.88 ,$396.98 ,$446.60 ,$496.22 ,$421.79 ,$223.24 ,$223.24 ,$421.79 ,$239.10 ,$206.43 , N/A , N/A ,$250.26 ,$421.79 ,$138.94 ,$446.60 ,$389.53 ,$409.88 ,$223.24 ,$322.54 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000107,29505,HC APPL LONG LEG SPLNT,450,1 ,$407.58 ,$264.93 ,$114.12 ,$407.58 ,$350.05 ,$326.06 ,$130.74 ,$114.12 ,$322.97 ,$374.16 ,$130.74 ,$374.16 ,$130.74 ,$266.04 ,$301.61 ,$350.05 ,$140.02 ,$339.92 ,$130.74 , N/A ,$336.66 ,$336.66 ,$326.06 ,$366.82 ,$326.85 ,$346.44 ,$130.74 ,$130.74 ,$346.44 ,$140.02 ,$169.55 , N/A , N/A ,$146.56 ,$346.44 ,$114.12 ,$366.82 ,$319.95 ,$336.66 ,$130.74 ,$264.93 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,$282.30 ,$183.50 ,$79.04 ,$350.05 ,$350.05 ,$225.84 ,$130.74 ,$79.04 ,$223.69 ,$259.15 ,$130.74 ,$259.15 ,$130.74 ,$266.04 ,$208.90 ,$282.30 ,$140.02 ,$235.44 ,$130.74 , N/A ,$233.18 ,$233.18 ,$225.84 ,$254.07 ,$282.30 ,$239.96 ,$130.74 ,$130.74 ,$239.96 ,$140.02 ,$117.44 , N/A , N/A ,$146.56 ,$239.96 ,$79.04 ,$254.07 ,$221.61 ,$233.18 ,$130.74 ,$183.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000110,30300,HC REM FB INTRANASAL,450,1 ,$435.07 ,$282.80 ,$104.35 ,$435.07 ,$279.40 ,$348.06 ,$104.35 ,$121.82 ,$344.75 ,$399.39 ,$104.35 ,$399.39 ,$104.35 ,$212.34 ,$321.95 ,$279.40 ,$111.76 ,$362.85 ,$104.35 , N/A ,$359.37 ,$359.37 ,$348.06 ,$391.56 ,$260.87 ,$369.81 ,$104.35 ,$104.35 ,$369.81 ,$111.76 ,$180.99 , N/A , N/A ,$116.97 ,$369.81 ,$121.82 ,$391.56 ,$341.53 ,$359.37 ,$104.35 ,$282.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$572.32 ,$372.01 ,$104.35 ,$572.32 ,$279.40 ,$457.86 ,$104.35 ,$160.25 ,$453.51 ,$525.39 ,$104.35 ,$525.39 ,$104.35 ,$212.34 ,$423.52 ,$279.40 ,$111.76 ,$477.31 ,$104.35 , N/A ,$472.74 ,$472.74 ,$457.86 ,$515.09 ,$260.87 ,$486.47 ,$104.35 ,$104.35 ,$486.47 ,$111.76 ,$238.09 , N/A , N/A ,$116.97 ,$486.47 ,$160.25 ,$515.09 ,$449.27 ,$472.74 ,$104.35 ,$372.01 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000113,30905,HC CNTRL NOSEBLEED POST INIT,450,1 ,$572.32 ,$372.01 ,$104.35 ,$572.32 ,$279.40 ,$457.86 ,$104.35 ,$160.25 ,$453.51 ,$525.39 ,$104.35 ,$525.39 ,$104.35 ,$212.34 ,$423.52 ,$279.40 ,$111.76 ,$477.31 ,$104.35 , N/A ,$472.74 ,$472.74 ,$457.86 ,$515.09 ,$260.87 ,$486.47 ,$104.35 ,$104.35 ,$486.47 ,$111.76 ,$238.09 , N/A , N/A ,$116.97 ,$486.47 ,$160.25 ,$515.09 ,$449.27 ,$472.74 ,$104.35 ,$372.01 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000116,31720,HC ASP CATH NASOTRACHEAL,450,1 ,$33.92 ,$22.05 ,$9.50 ,$465.73 ,$465.73 ,$27.14 ,$173.94 ,$9.50 ,$26.88 ,$31.14 ,$33.92 ,$31.14 ,$33.92 ,$33.92 ,$25.10 ,$33.92 ,$186.29 ,$28.29 ,$173.94 , N/A ,$28.02 ,$28.02 ,$27.14 ,$30.53 ,$33.92 ,$28.83 ,$173.94 ,$173.94 ,$28.83 ,$186.29 ,$14.11 , N/A , N/A ,$33.92 ,$28.83 ,$9.50 ,$30.53 ,$26.63 ,$28.02 ,$173.94 ,$22.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000133,40650,HC RPR LIP FULL THICK VERMILN,450,1 ,"$2,024.73 ","$1,316.07 ",$418.53 ,"$2,024.73 ","$1,120.60 ","$1,619.78 ",$418.53 ,$566.92 ,"$1,604.40 ","$1,858.70 ",$418.53 ,"$1,858.70 ",$418.53 ,$851.66 ,"$1,498.30 ","$1,120.60 ",$448.24 ,"$1,688.62 ",$418.53 , N/A ,"$1,672.43 ","$1,672.43 ","$1,619.78 ","$1,822.26 ","$1,046.32 ","$1,721.02 ",$418.53 ,$418.53 ,"$1,721.02 ",$448.24 ,$842.29 , N/A , N/A ,$469.17 ,"$1,721.02 ",$566.92 ,"$1,822.26 ","$1,589.41 ","$1,672.43 ",$418.53 ,"$1,316.07 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000139,41800,HC DRAIN ABSC/CYST DENTOALVLR,450,1 ,$915.00 ,$594.75 ,$104.35 ,$915.00 ,$279.40 ,$732.00 ,$104.35 ,$256.20 ,$725.05 ,$839.97 ,$104.35 ,$839.97 ,$104.35 ,$212.34 ,$677.10 ,$279.40 ,$111.76 ,$763.11 ,$104.35 , N/A ,$755.79 ,$755.79 ,$732.00 ,$823.50 ,$260.87 ,$777.75 ,$104.35 ,$104.35 ,$777.75 ,$111.76 ,$380.64 , N/A , N/A ,$116.97 ,$777.75 ,$256.20 ,$823.50 ,$718.28 ,$755.79 ,$104.35 ,$594.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000143,43753,HC GASTRIC LAVAGE,450,1 ,$165.61 ,$107.65 ,$46.37 ,$655.75 ,$655.75 ,$132.49 ,$244.91 ,$46.37 ,$131.23 ,$152.03 ,$165.61 ,$152.03 ,$165.61 ,$165.61 ,$122.55 ,$165.61 ,$262.30 ,$138.12 ,$244.91 , N/A ,$136.79 ,$136.79 ,$132.49 ,$149.05 ,$165.61 ,$140.77 ,$244.91 ,$244.91 ,$140.77 ,$262.30 ,$68.89 , N/A , N/A ,$165.61 ,$140.77 ,$46.37 ,$149.05 ,$130.00 ,$136.79 ,$244.91 ,$107.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000156,51700,HC IRRIG/LAVG/INSTL BLADDER,450,1 ,$693.00 ,$450.45 ,$194.04 ,$693.00 ,$659.33 ,$554.40 ,$246.25 ,$194.04 ,$549.13 ,$636.17 ,$246.25 ,$636.17 ,$246.25 ,$501.09 ,$512.82 ,$659.33 ,$263.73 ,$577.96 ,$246.25 , N/A ,$572.42 ,$572.42 ,$554.40 ,$623.70 ,$615.63 ,$589.05 ,$246.25 ,$246.25 ,$589.05 ,$263.73 ,$288.29 , N/A , N/A ,$276.05 ,$589.05 ,$194.04 ,$623.70 ,$544.01 ,$572.42 ,$246.25 ,$450.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000163,56405,HC I AND D ABSC VULVA/PERINEAL,450,1 ,$635.00 ,$412.75 ,$177.80 ,$698.80 ,$698.80 ,$508.00 ,$260.99 ,$177.80 ,$503.17 ,$582.93 ,$260.99 ,$582.93 ,$260.99 ,$531.09 ,$469.90 ,$635.00 ,$279.52 ,$529.59 ,$260.99 , N/A ,$524.51 ,$524.51 ,$508.00 ,$571.50 ,$635.00 ,$539.75 ,$260.99 ,$260.99 ,$539.75 ,$279.52 ,$264.16 , N/A , N/A ,$292.57 ,$539.75 ,$177.80 ,$571.50 ,$498.48 ,$524.51 ,$260.99 ,$412.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000164,56420,HC I AND D ABSC GLAND BARTHOLIN'S,450,1 ,$635.00 ,$412.75 ,$157.65 ,$635.00 ,$422.13 ,$508.00 ,$157.65 ,$177.80 ,$503.17 ,$582.93 ,$157.65 ,$582.93 ,$157.65 ,$320.82 ,$469.90 ,$422.13 ,$168.85 ,$529.59 ,$157.65 , N/A ,$524.51 ,$524.51 ,$508.00 ,$571.50 ,$394.13 ,$539.75 ,$157.65 ,$157.65 ,$539.75 ,$168.85 ,$264.16 , N/A , N/A ,$176.73 ,$539.75 ,$177.80 ,$571.50 ,$498.48 ,$524.51 ,$157.65 ,$412.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000170,64450,HC INJ ANES NERVE PERIPHERAL,450,1 ,$996.00 ,$647.40 ,$278.88 ,"$1,573.38 ","$1,573.38 ",$796.80 ,$587.62 ,$278.88 ,$789.23 ,$914.33 ,$587.62 ,$914.33 ,$587.62 ,$996.00 ,$737.04 ,$996.00 ,$629.35 ,$830.66 ,$587.62 , N/A ,$822.70 ,$822.70 ,$796.80 ,$896.40 ,$996.00 ,$846.60 ,$587.62 ,$587.62 ,$846.60 ,$629.35 ,$414.34 , N/A , N/A ,$658.73 ,$846.60 ,$278.88 ,$896.40 ,$781.86 ,$822.70 ,$587.62 ,$647.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000171,65205,HC REM EYE FB CONJUCT SUPER,450,1 ,$683.52 ,$444.29 ,$104.35 ,$683.52 ,$279.40 ,$546.82 ,$104.35 ,$191.39 ,$541.62 ,$627.47 ,$104.35 ,$627.47 ,$104.35 ,$212.34 ,$505.80 ,$279.40 ,$111.76 ,$570.06 ,$104.35 , N/A ,$564.59 ,$564.59 ,$546.82 ,$615.17 ,$260.87 ,$580.99 ,$104.35 ,$104.35 ,$580.99 ,$111.76 ,$284.34 , N/A , N/A ,$116.97 ,$580.99 ,$191.39 ,$615.17 ,$536.56 ,$564.59 ,$104.35 ,$444.29 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000181,69200,HC FB REMOVAL EAR,450,1 ,$277.00 ,$180.05 ,$77.56 ,$279.40 ,$279.40 ,$221.60 ,$104.35 ,$77.56 ,$219.49 ,$254.29 ,$104.35 ,$254.29 ,$104.35 ,$212.34 ,$204.98 ,$277.00 ,$111.76 ,$231.02 ,$104.35 , N/A ,$228.80 ,$228.80 ,$221.60 ,$249.30 ,$260.87 ,$235.45 ,$104.35 ,$104.35 ,$235.45 ,$111.76 ,$115.23 , N/A , N/A ,$116.97 ,$235.45 ,$77.56 ,$249.30 ,$217.45 ,$228.80 ,$104.35 ,$180.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000183,69210,HC REMOVE CERUMEN IMPACTED BY INSTRUMENTATION,450,1 ,$277.00 ,$180.05 ,$51.51 ,$277.00 ,$137.93 ,$221.60 ,$51.51 ,$77.56 ,$219.49 ,$254.29 ,$51.51 ,$254.29 ,$51.51 ,$104.82 ,$204.98 ,$137.93 ,$55.17 ,$231.02 ,$51.51 , N/A ,$228.80 ,$228.80 ,$221.60 ,$249.30 ,$128.78 ,$235.45 ,$51.51 ,$51.51 ,$235.45 ,$55.17 ,$115.23 , N/A , N/A ,$57.74 ,$235.45 ,$77.56 ,$249.30 ,$217.45 ,$228.80 ,$51.51 ,$180.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000188,99281,HC ER LEVEL 1,450,1 ,$243.85 ,$158.50 ,$67.12 ,$243.85 ,$179.73 ,$195.08 ,$67.12 ,$68.28 ,$193.23 ,$223.85 ,$67.12 ,$223.85 ,$67.12 ,$136.59 ,$180.45 ,$179.73 ,$71.89 ,$203.37 ,$67.12 , N/A ,$201.42 ,$201.42 ,$195.08 ,$219.47 ,$167.81 ,$207.27 ,$67.12 ,$67.12 ,$207.27 ,$71.89 ,$101.44 , N/A , N/A ,$75.25 ,$207.27 ,$68.28 ,$219.47 ,$191.42 ,$201.42 ,$67.12 ,$158.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000189,99282,HC ER LEVEL 2,450,1 ,$328.92 ,$213.80 ,$92.10 ,$328.92 ,$325.45 ,$263.14 ,$121.55 ,$92.10 ,$260.64 ,$301.95 ,$121.55 ,$301.95 ,$121.55 ,$247.34 ,$243.40 ,$325.45 ,$130.18 ,$274.32 ,$121.55 , N/A ,$271.69 ,$271.69 ,$263.14 ,$296.03 ,$303.88 ,$279.58 ,$121.55 ,$121.55 ,$279.58 ,$130.18 ,$136.83 , N/A , N/A ,$136.26 ,$279.58 ,$92.10 ,$296.03 ,$258.20 ,$271.69 ,$121.55 ,$213.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000190,99283,HC ER LEVEL 3,450,1 ,$624.65 ,$406.02 ,$174.90 ,$624.65 ,$573.40 ,$499.72 ,$214.16 ,$174.90 ,$494.97 ,$573.43 ,$214.16 ,$573.43 ,$214.16 ,$435.78 ,$462.24 ,$573.40 ,$229.36 ,$520.96 ,$214.16 , N/A ,$515.96 ,$515.96 ,$499.72 ,$562.19 ,$535.39 ,$530.95 ,$214.16 ,$214.16 ,$530.95 ,$229.36 ,$259.85 , N/A , N/A ,$240.07 ,$530.95 ,$174.90 ,$562.19 ,$490.35 ,$515.96 ,$214.16 ,$406.02 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000191,99284,HC ER LEVEL 4,450,1 ,$731.25 ,$475.31 ,$204.75 ,$901.35 ,$901.35 ,$585.00 ,$336.63 ,$204.75 ,$579.44 ,$671.29 ,$336.63 ,$671.29 ,$336.63 ,$685.03 ,$541.13 ,$731.25 ,$360.54 ,$609.86 ,$336.63 , N/A ,$604.01 ,$604.01 ,$585.00 ,$658.13 ,$731.25 ,$621.56 ,$336.63 ,$336.63 ,$621.56 ,$360.54 ,$304.20 , N/A , N/A ,$377.37 ,$621.56 ,$204.75 ,$658.13 ,$574.03 ,$604.01 ,$336.63 ,$475.31 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000192,99285,HC ER LEVEL 5,450,1 ,$928.15 ,$603.30 ,$259.88 ,"$1,293.75 ","$1,293.75 ",$742.52 ,$483.20 ,$259.88 ,$735.47 ,$852.04 ,$483.20 ,$852.04 ,$483.20 ,$928.15 ,$686.83 ,$928.15 ,$517.50 ,$774.08 ,$483.20 , N/A ,$766.65 ,$766.65 ,$742.52 ,$835.34 ,$928.15 ,$788.93 ,$483.20 ,$483.20 ,$788.93 ,$517.50 ,$386.11 , N/A , N/A ,$541.66 ,$788.93 ,$259.88 ,$835.34 ,$728.60 ,$766.65 ,$483.20 ,$603.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000193,99291,HC CRITICAL CARE 30-74 MIN,450,1 ,"$3,706.15 ","$2,409.00 ",$689.31 ,"$3,706.15 ","$1,845.63 ","$2,964.92 ",$689.31 ,"$1,037.72 ","$2,936.75 ","$3,402.25 ",$689.31 ,"$3,402.25 ",$689.31 ,"$1,402.68 ","$2,742.55 ","$1,845.63 ",$738.25 ,"$3,090.93 ",$689.31 , N/A ,"$3,061.28 ","$3,061.28 ","$2,964.92 ","$3,335.54 ","$1,723.27 ","$3,150.23 ",$689.31 ,$689.31 ,"$3,150.23 ",$738.25 ,"$1,541.76 ", N/A , N/A ,$772.71 ,"$3,150.23 ","$1,037.72 ","$3,335.54 ","$2,909.33 ","$3,061.28 ",$689.31 ,"$2,409.00 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000195,99292,HC CRITICAL CARE EA ADDN'T 30 MIN,450,1 ,$338.11 ,$219.77 ,$94.67 ,$338.11 , N/A ,$270.49 , N/A ,$94.67 ,$267.92 ,$310.39 , N/A ,$310.39 , N/A , N/A ,$250.20 , N/A , N/A ,$281.98 , N/A , N/A ,$279.28 ,$279.28 ,$270.49 ,$304.30 , N/A ,$287.39 , N/A , N/A ,$287.39 , N/A ,$140.65 , N/A , N/A , N/A ,$287.39 ,$94.67 ,$304.30 ,$265.42 ,$279.28 , N/A ,$219.77 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000197,26700,HC TX DISL (M-P) W/O ANES CLS,450,1 ,$424.57 ,$275.97 ,$118.88 ,$510.70 ,$510.70 ,$339.66 ,$190.73 ,$118.88 ,$336.43 ,$389.76 ,$190.73 ,$389.76 ,$190.73 ,$388.13 ,$314.18 ,$424.57 ,$204.28 ,$354.09 ,$190.73 , N/A ,$350.69 ,$350.69 ,$339.66 ,$382.11 ,$424.57 ,$360.88 ,$190.73 ,$190.73 ,$360.88 ,$204.28 ,$176.62 , N/A , N/A ,$213.81 ,$360.88 ,$118.88 ,$382.11 ,$333.29 ,$350.69 ,$190.73 ,$275.97 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000225,23540,HC CLOSED ACROM.W/O MANIP,450,1 ,$424.57 ,$275.97 ,$118.88 ,$510.70 ,$510.70 ,$339.66 ,$190.73 ,$118.88 ,$336.43 ,$389.76 ,$190.73 ,$389.76 ,$190.73 ,$388.13 ,$314.18 ,$424.57 ,$204.28 ,$354.09 ,$190.73 , N/A ,$350.69 ,$350.69 ,$339.66 ,$382.11 ,$424.57 ,$360.88 ,$190.73 ,$190.73 ,$360.88 ,$204.28 ,$176.62 , N/A , N/A ,$213.81 ,$360.88 ,$118.88 ,$382.11 ,$333.29 ,$350.69 ,$190.73 ,$275.97 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000230,26605,HC CLSD METACARPAL FX W/MANIP,450,1 ,$561.84 ,$365.20 ,$157.32 ,$561.84 ,$510.70 ,$449.47 ,$190.73 ,$157.32 ,$445.20 ,$515.77 ,$190.73 ,$515.77 ,$190.73 ,$388.13 ,$415.76 ,$510.70 ,$204.28 ,$468.57 ,$190.73 , N/A ,$464.08 ,$464.08 ,$449.47 ,$505.66 ,$476.84 ,$477.56 ,$190.73 ,$190.73 ,$477.56 ,$204.28 ,$233.73 , N/A , N/A ,$213.81 ,$477.56 ,$157.32 ,$505.66 ,$441.04 ,$464.08 ,$190.73 ,$365.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000234,25560,HC RADIUS AND ULNA FX W/O MANIP,450,1 ,$278.00 ,$180.70 ,$77.84 ,$510.70 ,$510.70 ,$222.40 ,$190.73 ,$77.84 ,$220.29 ,$255.20 ,$190.73 ,$255.20 ,$190.73 ,$278.00 ,$205.72 ,$278.00 ,$204.28 ,$231.85 ,$190.73 , N/A ,$229.63 ,$229.63 ,$222.40 ,$250.20 ,$278.00 ,$236.30 ,$190.73 ,$190.73 ,$236.30 ,$204.28 ,$115.65 , N/A , N/A ,$213.81 ,$236.30 ,$77.84 ,$250.20 ,$218.23 ,$229.63 ,$190.73 ,$180.70 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000252,20520,HC MUSCLE FB REM W/ INC,450,1 ,$797.84 ,$518.60 ,$223.40 ,"$3,486.25 ","$3,486.25 ",$638.27 ,"$1,302.06 ",$223.40 ,$632.21 ,$732.42 ,$797.84 ,$732.42 ,$797.84 ,$797.84 ,$590.40 ,$797.84 ,"$1,394.50 ",$665.40 ,"$1,302.06 ", N/A ,$659.02 ,$659.02 ,$638.27 ,$718.06 ,$797.84 ,$678.16 ,"$1,302.06 ","$1,302.06 ",$678.16 ,"$1,394.50 ",$331.90 , N/A , N/A ,$797.84 ,$678.16 ,$223.40 ,$718.06 ,$626.30 ,$659.02 ,"$1,302.06 ",$518.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000309,28660,HC CLOSED TX I-P JOINT DISLOCATION W/O ANES,450,1 ,$424.57 ,$275.97 ,$118.88 ,$510.70 ,$510.70 ,$339.66 ,$190.73 ,$118.88 ,$336.43 ,$389.76 ,$190.73 ,$389.76 ,$190.73 ,$388.13 ,$314.18 ,$424.57 ,$204.28 ,$354.09 ,$190.73 , N/A ,$350.69 ,$350.69 ,$339.66 ,$382.11 ,$424.57 ,$360.88 ,$190.73 ,$190.73 ,$360.88 ,$204.28 ,$176.62 , N/A , N/A ,$213.81 ,$360.88 ,$118.88 ,$382.11 ,$333.29 ,$350.69 ,$190.73 ,$275.97 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000328,27550,HC CLSD TX KNEE DISLOC W/O ANESTH,450,1 ,$579.00 ,$376.35 ,$162.12 ,$579.00 ,$510.70 ,$463.20 ,$190.73 ,$162.12 ,$458.80 ,$531.52 ,$190.73 ,$531.52 ,$190.73 ,$388.13 ,$428.46 ,$510.70 ,$204.28 ,$482.89 ,$190.73 , N/A ,$478.25 ,$478.25 ,$463.20 ,$521.10 ,$476.84 ,$492.15 ,$190.73 ,$190.73 ,$492.15 ,$204.28 ,$240.86 , N/A , N/A ,$213.81 ,$492.15 ,$162.12 ,$521.10 ,$454.52 ,$478.25 ,$190.73 ,$376.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000338,30906,HC CONTROL NASAL HEMORRHAGE SUBSQ,450,1 ,$572.32 ,$372.01 ,$160.25 ,$572.32 ,$524.20 ,$457.86 ,$195.78 ,$160.25 ,$453.51 ,$525.39 ,$195.78 ,$525.39 ,$195.78 ,$398.39 ,$423.52 ,$524.20 ,$209.68 ,$477.31 ,$195.78 , N/A ,$472.74 ,$472.74 ,$457.86 ,$515.09 ,$489.45 ,$486.47 ,$195.78 ,$195.78 ,$486.47 ,$209.68 ,$238.09 , N/A , N/A ,$219.47 ,$486.47 ,$160.25 ,$515.09 ,$449.27 ,$472.74 ,$195.78 ,$372.01 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000357,23650,HC TX DISL SHLDR W/MAN CLS-LT,450,1 ,$424.57 ,$275.97 ,$118.88 ,$510.70 ,$510.70 ,$339.66 ,$190.73 ,$118.88 ,$336.43 ,$389.76 ,$190.73 ,$389.76 ,$190.73 ,$388.13 ,$314.18 ,$424.57 ,$204.28 ,$354.09 ,$190.73 , N/A ,$350.69 ,$350.69 ,$339.66 ,$382.11 ,$424.57 ,$360.88 ,$190.73 ,$190.73 ,$360.88 ,$204.28 ,$176.62 , N/A , N/A ,$213.81 ,$360.88 ,$118.88 ,$382.11 ,$333.29 ,$350.69 ,$190.73 ,$275.97 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000358,23650,HC TX DISL SHLDR W/MAN CLS-RT,450,1 ,$424.57 ,$275.97 ,$118.88 ,$510.70 ,$510.70 ,$339.66 ,$190.73 ,$118.88 ,$336.43 ,$389.76 ,$190.73 ,$389.76 ,$190.73 ,$388.13 ,$314.18 ,$424.57 ,$204.28 ,$354.09 ,$190.73 , N/A ,$350.69 ,$350.69 ,$339.66 ,$382.11 ,$424.57 ,$360.88 ,$190.73 ,$190.73 ,$360.88 ,$204.28 ,$176.62 , N/A , N/A ,$213.81 ,$360.88 ,$118.88 ,$382.11 ,$333.29 ,$350.69 ,$190.73 ,$275.97 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000365,24600,HC TX DISL ELBOW W/O ANES CLS-LT,450,1 ,$561.84 ,$365.20 ,$157.32 ,$561.84 ,$510.70 ,$449.47 ,$190.73 ,$157.32 ,$445.20 ,$515.77 ,$190.73 ,$515.77 ,$190.73 ,$388.13 ,$415.76 ,$510.70 ,$204.28 ,$468.57 ,$190.73 , N/A ,$464.08 ,$464.08 ,$449.47 ,$505.66 ,$476.84 ,$477.56 ,$190.73 ,$190.73 ,$477.56 ,$204.28 ,$233.73 , N/A , N/A ,$213.81 ,$477.56 ,$157.32 ,$505.66 ,$441.04 ,$464.08 ,$190.73 ,$365.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000366,24600,HC TX DISL ELBOW W/O ANES CLS-RT,450,1 ,$561.84 ,$365.20 ,$157.32 ,$561.84 ,$510.70 ,$449.47 ,$190.73 ,$157.32 ,$445.20 ,$515.77 ,$190.73 ,$515.77 ,$190.73 ,$388.13 ,$415.76 ,$510.70 ,$204.28 ,$468.57 ,$190.73 , N/A ,$464.08 ,$464.08 ,$449.47 ,$505.66 ,$476.84 ,$477.56 ,$190.73 ,$190.73 ,$477.56 ,$204.28 ,$233.73 , N/A , N/A ,$213.81 ,$477.56 ,$157.32 ,$505.66 ,$441.04 ,$464.08 ,$190.73 ,$365.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000375,25605,"HC CLOSED TX DIST RAD/ULNA FX,MANIPUL-LT",450,1 ,"$1,371.31 ",$891.35 ,$383.97 ,"$3,451.13 ","$3,451.13 ","$1,097.05 ","$1,288.94 ",$383.97 ,"$1,086.63 ","$1,258.86 ","$1,288.94 ","$1,258.86 ","$1,288.94 ","$1,371.31 ","$1,014.77 ","$1,371.31 ","$1,380.45 ","$1,143.67 ","$1,288.94 ", N/A ,"$1,132.70 ","$1,132.70 ","$1,097.05 ","$1,234.18 ","$1,371.31 ","$1,165.61 ","$1,288.94 ","$1,288.94 ","$1,165.61 ","$1,380.45 ",$570.47 , N/A , N/A ,"$1,371.31 ","$1,165.61 ",$383.97 ,"$1,234.18 ","$1,076.48 ","$1,132.70 ","$1,288.94 ",$891.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000376,25605,"HC CLOSED TX DIST RAD/ULNA FX,MANIPUL-RT",450,1 ,"$1,371.31 ",$891.35 ,$383.97 ,"$3,451.13 ","$3,451.13 ","$1,097.05 ","$1,288.94 ",$383.97 ,"$1,086.63 ","$1,258.86 ","$1,288.94 ","$1,258.86 ","$1,288.94 ","$1,371.31 ","$1,014.77 ","$1,371.31 ","$1,380.45 ","$1,143.67 ","$1,288.94 ", N/A ,"$1,132.70 ","$1,132.70 ","$1,097.05 ","$1,234.18 ","$1,371.31 ","$1,165.61 ","$1,288.94 ","$1,288.94 ","$1,165.61 ","$1,380.45 ",$570.47 , N/A , N/A ,"$1,371.31 ","$1,165.61 ",$383.97 ,"$1,234.18 ","$1,076.48 ","$1,132.70 ","$1,288.94 ",$891.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000381,26605,HC CLSD METACARPAL FX W/MANIP-LT,450,1 ,$561.84 ,$365.20 ,$157.32 ,$561.84 ,$510.70 ,$449.47 ,$190.73 ,$157.32 ,$445.20 ,$515.77 ,$190.73 ,$515.77 ,$190.73 ,$388.13 ,$415.76 ,$510.70 ,$204.28 ,$468.57 ,$190.73 , N/A ,$464.08 ,$464.08 ,$449.47 ,$505.66 ,$476.84 ,$477.56 ,$190.73 ,$190.73 ,$477.56 ,$204.28 ,$233.73 , N/A , N/A ,$213.81 ,$477.56 ,$157.32 ,$505.66 ,$441.04 ,$464.08 ,$190.73 ,$365.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000382,26605,HC CLSD METACARPAL FX W/MANIP-RT,450,1 ,$561.84 ,$365.20 ,$157.32 ,$561.84 ,$510.70 ,$449.47 ,$190.73 ,$157.32 ,$445.20 ,$515.77 ,$190.73 ,$515.77 ,$190.73 ,$388.13 ,$415.76 ,$510.70 ,$204.28 ,$468.57 ,$190.73 , N/A ,$464.08 ,$464.08 ,$449.47 ,$505.66 ,$476.84 ,$477.56 ,$190.73 ,$190.73 ,$477.56 ,$204.28 ,$233.73 , N/A , N/A ,$213.81 ,$477.56 ,$157.32 ,$505.66 ,$441.04 ,$464.08 ,$190.73 ,$365.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000391,27560,HC TX DSL PTLR W/O ANS CL-LT,450,1 ,$561.84 ,$365.20 ,$157.32 ,$561.84 ,$510.70 ,$449.47 ,$190.73 ,$157.32 ,$445.20 ,$515.77 ,$190.73 ,$515.77 ,$190.73 ,$388.13 ,$415.76 ,$510.70 ,$204.28 ,$468.57 ,$190.73 , N/A ,$464.08 ,$464.08 ,$449.47 ,$505.66 ,$476.84 ,$477.56 ,$190.73 ,$190.73 ,$477.56 ,$204.28 ,$233.73 , N/A , N/A ,$213.81 ,$477.56 ,$157.32 ,$505.66 ,$441.04 ,$464.08 ,$190.73 ,$365.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000392,27560,HC TX DSL PTLR W/O ANS CL-RT,450,1 ,$561.84 ,$365.20 ,$157.32 ,$561.84 ,$510.70 ,$449.47 ,$190.73 ,$157.32 ,$445.20 ,$515.77 ,$190.73 ,$515.77 ,$190.73 ,$388.13 ,$415.76 ,$510.70 ,$204.28 ,$468.57 ,$190.73 , N/A ,$464.08 ,$464.08 ,$449.47 ,$505.66 ,$476.84 ,$477.56 ,$190.73 ,$190.73 ,$477.56 ,$204.28 ,$233.73 , N/A , N/A ,$213.81 ,$477.56 ,$157.32 ,$505.66 ,$441.04 ,$464.08 ,$190.73 ,$365.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000407,29126,HC APPL SHRT ARM SPLNT DYNAM-LT,450,1 ,$407.58 ,$264.93 ,$104.35 ,$407.58 ,$279.40 ,$326.06 ,$104.35 ,$114.12 ,$322.97 ,$374.16 ,$104.35 ,$374.16 ,$104.35 ,$212.34 ,$301.61 ,$279.40 ,$111.76 ,$339.92 ,$104.35 , N/A ,$336.66 ,$336.66 ,$326.06 ,$366.82 ,$260.87 ,$346.44 ,$104.35 ,$104.35 ,$346.44 ,$111.76 ,$169.55 , N/A , N/A ,$116.97 ,$346.44 ,$114.12 ,$366.82 ,$319.95 ,$336.66 ,$104.35 ,$264.93 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000408,29126,HC APPL SHRT ARM SPLNT DYNAM-RT,450,1 ,$407.58 ,$264.93 ,$104.35 ,$407.58 ,$279.40 ,$326.06 ,$104.35 ,$114.12 ,$322.97 ,$374.16 ,$104.35 ,$374.16 ,$104.35 ,$212.34 ,$301.61 ,$279.40 ,$111.76 ,$339.92 ,$104.35 , N/A ,$336.66 ,$336.66 ,$326.06 ,$366.82 ,$260.87 ,$346.44 ,$104.35 ,$104.35 ,$346.44 ,$111.76 ,$169.55 , N/A , N/A ,$116.97 ,$346.44 ,$114.12 ,$366.82 ,$319.95 ,$336.66 ,$104.35 ,$264.93 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000417,29505,HC APPL LONG LEG SPLNT-LT,450,1 ,$407.58 ,$264.93 ,$114.12 ,$407.58 ,$350.05 ,$326.06 ,$130.74 ,$114.12 ,$322.97 ,$374.16 ,$130.74 ,$374.16 ,$130.74 ,$266.04 ,$301.61 ,$350.05 ,$140.02 ,$339.92 ,$130.74 , N/A ,$336.66 ,$336.66 ,$326.06 ,$366.82 ,$326.85 ,$346.44 ,$130.74 ,$130.74 ,$346.44 ,$140.02 ,$169.55 , N/A , N/A ,$146.56 ,$346.44 ,$114.12 ,$366.82 ,$319.95 ,$336.66 ,$130.74 ,$264.93 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000418,29505,HC APPL LONG LEG SPLNT-RT,450,1 ,$407.58 ,$264.93 ,$114.12 ,$407.58 ,$350.05 ,$326.06 ,$130.74 ,$114.12 ,$322.97 ,$374.16 ,$130.74 ,$374.16 ,$130.74 ,$266.04 ,$301.61 ,$350.05 ,$140.02 ,$339.92 ,$130.74 , N/A ,$336.66 ,$336.66 ,$326.06 ,$366.82 ,$326.85 ,$346.44 ,$130.74 ,$130.74 ,$346.44 ,$140.02 ,$169.55 , N/A , N/A ,$146.56 ,$346.44 ,$114.12 ,$366.82 ,$319.95 ,$336.66 ,$130.74 ,$264.93 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000419,29515,HC APPL SHRT LEG SPLNT FAC-LT,450,1 ,$282.30 ,$183.50 ,$79.04 ,$350.05 ,$350.05 ,$225.84 ,$130.74 ,$79.04 ,$223.69 ,$259.15 ,$130.74 ,$259.15 ,$130.74 ,$266.04 ,$208.90 ,$282.30 ,$140.02 ,$235.44 ,$130.74 , N/A ,$233.18 ,$233.18 ,$225.84 ,$254.07 ,$282.30 ,$239.96 ,$130.74 ,$130.74 ,$239.96 ,$140.02 ,$117.44 , N/A , N/A ,$146.56 ,$239.96 ,$79.04 ,$254.07 ,$221.61 ,$233.18 ,$130.74 ,$183.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000420,29515,HC APPL SHRT LEG SPLNT FAC-RT,450,1 ,$282.30 ,$183.50 ,$79.04 ,$350.05 ,$350.05 ,$225.84 ,$130.74 ,$79.04 ,$223.69 ,$259.15 ,$130.74 ,$259.15 ,$130.74 ,$266.04 ,$208.90 ,$282.30 ,$140.02 ,$235.44 ,$130.74 , N/A ,$233.18 ,$233.18 ,$225.84 ,$254.07 ,$282.30 ,$239.96 ,$130.74 ,$130.74 ,$239.96 ,$140.02 ,$117.44 , N/A , N/A ,$146.56 ,$239.96 ,$79.04 ,$254.07 ,$221.61 ,$233.18 ,$130.74 ,$183.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000423,30300,HC REMOVE NASAL FOREIGN BODY-LT,450,1 ,$435.07 ,$282.80 ,$104.35 ,$435.07 ,$279.40 ,$348.06 ,$104.35 ,$121.82 ,$344.75 ,$399.39 ,$104.35 ,$399.39 ,$104.35 ,$212.34 ,$321.95 ,$279.40 ,$111.76 ,$362.85 ,$104.35 , N/A ,$359.37 ,$359.37 ,$348.06 ,$391.56 ,$260.87 ,$369.81 ,$104.35 ,$104.35 ,$369.81 ,$111.76 ,$180.99 , N/A , N/A ,$116.97 ,$369.81 ,$121.82 ,$391.56 ,$341.53 ,$359.37 ,$104.35 ,$282.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000424,30300,HC REMOVE NASAL FOREIGN BODY-RT,450,1 ,$435.07 ,$282.80 ,$104.35 ,$435.07 ,$279.40 ,$348.06 ,$104.35 ,$121.82 ,$344.75 ,$399.39 ,$104.35 ,$399.39 ,$104.35 ,$212.34 ,$321.95 ,$279.40 ,$111.76 ,$362.85 ,$104.35 , N/A ,$359.37 ,$359.37 ,$348.06 ,$391.56 ,$260.87 ,$369.81 ,$104.35 ,$104.35 ,$369.81 ,$111.76 ,$180.99 , N/A , N/A ,$116.97 ,$369.81 ,$121.82 ,$391.56 ,$341.53 ,$359.37 ,$104.35 ,$282.80 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000425,30901,HC CNTRL NOSEBLEED ANT SMP-LT,450,1 ,$572.32 ,$372.01 ,$104.35 ,$572.32 ,$279.40 ,$457.86 ,$104.35 ,$160.25 ,$453.51 ,$525.39 ,$104.35 ,$525.39 ,$104.35 ,$212.34 ,$423.52 ,$279.40 ,$111.76 ,$477.31 ,$104.35 , N/A ,$472.74 ,$472.74 ,$457.86 ,$515.09 ,$260.87 ,$486.47 ,$104.35 ,$104.35 ,$486.47 ,$111.76 ,$238.09 , N/A , N/A ,$116.97 ,$486.47 ,$160.25 ,$515.09 ,$449.27 ,$472.74 ,$104.35 ,$372.01 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000426,30901,HC CNTRL NOSEBLEED ANT SMP-RT,450,1 ,$572.32 ,$372.01 ,$104.35 ,$572.32 ,$279.40 ,$457.86 ,$104.35 ,$160.25 ,$453.51 ,$525.39 ,$104.35 ,$525.39 ,$104.35 ,$212.34 ,$423.52 ,$279.40 ,$111.76 ,$477.31 ,$104.35 , N/A ,$472.74 ,$472.74 ,$457.86 ,$515.09 ,$260.87 ,$486.47 ,$104.35 ,$104.35 ,$486.47 ,$111.76 ,$238.09 , N/A , N/A ,$116.97 ,$486.47 ,$160.25 ,$515.09 ,$449.27 ,$472.74 ,$104.35 ,$372.01 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000431,32551,HC TUBE THORACOSTOMY-LT,450,1 ,$942.45 ,$612.59 ,$263.89 ,"$3,484.25 ","$3,484.25 ",$753.96 ,"$1,301.30 ",$263.89 ,$746.80 ,$865.17 ,$942.45 ,$865.17 ,$942.45 ,$942.45 ,$697.41 ,$942.45 ,"$1,393.70 ",$786.00 ,"$1,301.30 ", N/A ,$778.46 ,$778.46 ,$753.96 ,$848.21 ,$942.45 ,$801.08 ,"$1,301.30 ","$1,301.30 ",$801.08 ,"$1,393.70 ",$392.06 , N/A , N/A ,$942.45 ,$801.08 ,$263.89 ,$848.21 ,$739.82 ,$778.46 ,"$1,301.30 ",$612.59 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000432,32551,HC TUBE THORACOSTOMY-RT,450,1 ,$942.45 ,$612.59 ,$263.89 ,"$3,484.25 ","$3,484.25 ",$753.96 ,"$1,301.30 ",$263.89 ,$746.80 ,$865.17 ,$942.45 ,$865.17 ,$942.45 ,$942.45 ,$697.41 ,$942.45 ,"$1,393.70 ",$786.00 ,"$1,301.30 ", N/A ,$778.46 ,$778.46 ,$753.96 ,$848.21 ,$942.45 ,$801.08 ,"$1,301.30 ","$1,301.30 ",$801.08 ,"$1,393.70 ",$392.06 , N/A , N/A ,$942.45 ,$801.08 ,$263.89 ,$848.21 ,$739.82 ,$778.46 ,"$1,301.30 ",$612.59 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000493,36600,HC ARTERIAL PUNCTURE,450,1 ,$153.09 ,$99.51 ,$42.87 ,$279.40 ,$279.40 ,$122.47 ,$104.35 ,$42.87 ,$121.31 ,$140.54 ,$104.35 ,$140.54 ,$104.35 ,$153.09 ,$113.29 ,$153.09 ,$111.76 ,$127.68 ,$104.35 , N/A ,$126.45 ,$126.45 ,$122.47 ,$137.78 ,$153.09 ,$130.13 ,$104.35 ,$104.35 ,$130.13 ,$111.76 ,$63.69 , N/A , N/A ,$116.97 ,$130.13 ,$42.87 ,$137.78 ,$120.18 ,$126.45 ,$104.35 ,$99.51 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000515,32551,HC TUBE THORACOSTOMY-BIL,450,1 ,$942.45 ,$612.59 ,$263.89 ,"$7,092.98 ","$7,092.98 ",$753.96 ,"$2,649.10 ",$263.89 ,$746.80 ,$865.17 ,$942.45 ,$865.17 ,$942.45 ,$942.45 ,$697.41 ,$942.45 ,"$2,837.19 ",$786.00 ,"$2,649.10 ", N/A ,$778.46 ,$778.46 ,$753.96 ,$848.21 ,$942.45 ,$801.08 ,"$2,649.10 ","$2,649.10 ",$801.08 ,"$2,837.19 ",$392.06 , N/A , N/A ,$942.45 ,$801.08 ,$263.89 ,$848.21 ,$739.82 ,$778.46 ,"$2,649.10 ",$612.59 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000554,29581,HC APPLY MULTI COMP LOWER LEG-LT,450,1 ,$405.87 ,$263.82 ,$113.64 ,$405.87 ,$350.05 ,$324.70 ,$130.74 ,$113.64 ,$321.61 ,$372.59 ,$130.74 ,$372.59 ,$130.74 ,$266.04 ,$300.34 ,$350.05 ,$140.02 ,$338.50 ,$130.74 , N/A ,$335.25 ,$335.25 ,$324.70 ,$365.28 ,$326.85 ,$344.99 ,$130.74 ,$130.74 ,$344.99 ,$140.02 ,$168.84 , N/A , N/A ,$146.56 ,$344.99 ,$113.64 ,$365.28 ,$318.61 ,$335.25 ,$130.74 ,$263.82 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000555,29581,HC APPLY MULTI COMP LOWER LEG-RT,450,1 ,$405.87 ,$263.82 ,$113.64 ,$405.87 ,$350.05 ,$324.70 ,$130.74 ,$113.64 ,$321.61 ,$372.59 ,$130.74 ,$372.59 ,$130.74 ,$266.04 ,$300.34 ,$350.05 ,$140.02 ,$338.50 ,$130.74 , N/A ,$335.25 ,$335.25 ,$324.70 ,$365.28 ,$326.85 ,$344.99 ,$130.74 ,$130.74 ,$344.99 ,$140.02 ,$168.84 , N/A , N/A ,$146.56 ,$344.99 ,$113.64 ,$365.28 ,$318.61 ,$335.25 ,$130.74 ,$263.82 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000561,28190,HC REMOVE FB FOOT SUBCUT,450,1 ,"$1,035.76 ",$673.24 ,$290.01 ,"$1,541.88 ","$1,541.88 ",$828.61 ,$575.86 ,$290.01 ,$820.74 ,$950.83 ,$575.86 ,$950.83 ,$575.86 ,"$1,035.76 ",$766.46 ,"$1,035.76 ",$616.75 ,$863.82 ,$575.86 , N/A ,$855.54 ,$855.54 ,$828.61 ,$932.18 ,"$1,035.76 ",$880.40 ,$575.86 ,$575.86 ,$880.40 ,$616.75 ,$430.88 , N/A , N/A ,$645.54 ,$880.40 ,$290.01 ,$932.18 ,$813.07 ,$855.54 ,$575.86 ,$673.24 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000562,28190,HC REMOVE FB FOOT SUBCUT,450,1 ,"$1,035.76 ",$673.24 ,$290.01 ,"$1,541.88 ","$1,541.88 ",$828.61 ,$575.86 ,$290.01 ,$820.74 ,$950.83 ,$575.86 ,$950.83 ,$575.86 ,"$1,035.76 ",$766.46 ,"$1,035.76 ",$616.75 ,$863.82 ,$575.86 , N/A ,$855.54 ,$855.54 ,$828.61 ,$932.18 ,"$1,035.76 ",$880.40 ,$575.86 ,$575.86 ,$880.40 ,$616.75 ,$430.88 , N/A , N/A ,$645.54 ,$880.40 ,$290.01 ,$932.18 ,$813.07 ,$855.54 ,$575.86 ,$673.24 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000584,10060,HC I AND D SKIN ABSCESS-LT,450,1 ,$517.78 ,$336.56 ,$144.98 ,$517.78 ,$444.95 ,$414.22 ,$166.18 ,$144.98 ,$410.29 ,$475.32 ,$166.18 ,$475.32 ,$166.18 ,$338.16 ,$383.16 ,$444.95 ,$177.98 ,$431.83 ,$166.18 , N/A ,$427.69 ,$427.69 ,$414.22 ,$466.00 ,$415.45 ,$440.11 ,$166.18 ,$166.18 ,$440.11 ,$177.98 ,$215.40 , N/A , N/A ,$186.29 ,$440.11 ,$144.98 ,$466.00 ,$406.46 ,$427.69 ,$166.18 ,$336.56 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45000585,10060,HC I AND D SKIN ABSCESS-RT,450,1 ,$517.78 ,$336.56 ,$144.98 ,$517.78 ,$444.95 ,$414.22 ,$166.18 ,$144.98 ,$410.29 ,$475.32 ,$166.18 ,$475.32 ,$166.18 ,$338.16 ,$383.16 ,$444.95 ,$177.98 ,$431.83 ,$166.18 , N/A ,$427.69 ,$427.69 ,$414.22 ,$466.00 ,$415.45 ,$440.11 ,$166.18 ,$166.18 ,$440.11 ,$177.98 ,$215.40 , N/A , N/A ,$186.29 ,$440.11 ,$144.98 ,$466.00 ,$406.46 ,$427.69 ,$166.18 ,$336.56 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45001281,25520,HC TX FX RADIUS SHAFT W/DISLOC CLOSED,450,1 ,$579.00 ,$376.35 ,$162.12 ,"$3,451.13 ","$3,451.13 ",$463.20 ,"$1,288.94 ",$162.12 ,$458.80 ,$531.52 ,$579.00 ,$531.52 ,$579.00 ,$579.00 ,$428.46 ,$579.00 ,"$1,380.45 ",$482.89 ,"$1,288.94 ", N/A ,$478.25 ,$478.25 ,$463.20 ,$521.10 ,$579.00 ,$492.15 ,"$1,288.94 ","$1,288.94 ",$492.15 ,"$1,380.45 ",$240.86 , N/A , N/A ,$579.00 ,$492.15 ,$162.12 ,$521.10 ,$454.52 ,$478.25 ,"$1,288.94 ",$376.35 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45001331,43762,HC REPLACE GASTRO TUBE PERC,450,1 ,$723.00 ,$469.95 ,$202.44 ,$723.00 ,$659.33 ,$578.40 ,$246.25 ,$202.44 ,$572.91 ,$663.71 ,$246.25 ,$663.71 ,$246.25 ,$501.09 ,$535.02 ,$659.33 ,$263.73 ,$602.98 ,$246.25 , N/A ,$597.20 ,$597.20 ,$578.40 ,$650.70 ,$615.63 ,$614.55 ,$246.25 ,$246.25 ,$614.55 ,$263.73 ,$300.77 , N/A , N/A ,$276.05 ,$614.55 ,$202.44 ,$650.70 ,$567.56 ,$597.20 ,$246.25 ,$469.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),45080001,10060,HC I AND D ABSC SMP,450,1 ,$349.03 ,$226.87 ,$97.73 ,$444.95 ,$444.95 ,$279.22 ,$166.18 ,$97.73 ,$276.57 ,$320.41 ,$166.18 ,$320.41 ,$166.18 ,$338.16 ,$258.28 ,$349.03 ,$177.98 ,$291.09 ,$166.18 , N/A ,$288.30 ,$288.30 ,$279.22 ,$314.13 ,$349.03 ,$296.68 ,$166.18 ,$166.18 ,$296.68 ,$177.98 ,$145.20 , N/A , N/A ,$186.29 ,$296.68 ,$97.73 ,$314.13 ,$273.99 ,$288.30 ,$166.18 ,$226.87 
HSHS GOOD SHEPHERD HOSPITAL (ACU),46000002,94010,HC SPIROMETRY/PFT PKG,460,1 ,$349.03 ,$226.87 ,$97.73 ,$349.03 ,$345.93 ,$279.22 ,$129.20 ,$97.73 ,$276.57 ,$320.41 ,$129.20 ,$320.41 ,$129.20 ,$262.90 ,$258.28 ,$345.93 ,$138.37 ,$291.09 ,$129.20 , N/A ,$288.30 ,$288.30 ,$279.22 ,$314.13 ,$323.00 ,$296.68 ,$129.20 ,$129.20 ,$296.68 ,$138.37 ,$145.20 , N/A , N/A ,$144.83 ,$296.68 ,$97.73 ,$314.13 ,$273.99 ,$288.30 ,$129.20 ,$226.87 
HSHS GOOD SHEPHERD HOSPITAL (ACU),46000004,94060,HC SPIROMETRY/PFT PRE  AND  POST,460,1 ,$526.65 ,$342.32 ,$147.46 ,$655.75 ,$655.75 ,$421.32 ,$244.91 ,$147.46 ,$417.32 ,$483.46 ,$244.91 ,$483.46 ,$244.91 ,$498.37 ,$389.72 ,$526.65 ,$262.30 ,$439.23 ,$244.91 , N/A ,$435.01 ,$435.01 ,$421.32 ,$473.99 ,$526.65 ,$447.65 ,$244.91 ,$244.91 ,$447.65 ,$262.30 ,$219.09 , N/A , N/A ,$274.54 ,$447.65 ,$147.46 ,$473.99 ,$413.42 ,$435.01 ,$244.91 ,$342.32 
HSHS GOOD SHEPHERD HOSPITAL (ACU),46000005,94060,HC SPIROMETRY/PFT PRE  AND  POST UPDRAFT,460,1 ,$813.95 ,$529.07 ,$227.91 ,$813.95 ,$655.75 ,$651.16 ,$244.91 ,$227.91 ,$644.97 ,$747.21 ,$244.91 ,$747.21 ,$244.91 ,$498.37 ,$602.32 ,$655.75 ,$262.30 ,$678.83 ,$244.91 , N/A ,$672.32 ,$672.32 ,$651.16 ,$732.56 ,$612.27 ,$691.86 ,$244.91 ,$244.91 ,$691.86 ,$262.30 ,$338.60 , N/A , N/A ,$274.54 ,$691.86 ,$227.91 ,$732.56 ,$638.95 ,$672.32 ,$244.91 ,$529.07 
HSHS GOOD SHEPHERD HOSPITAL (ACU),46000013,94726,HC PLETHYSMOGRAPHY,460,1 ,$237.49 ,$154.37 ,$66.50 ,$655.75 ,$655.75 ,$189.99 ,$244.91 ,$66.50 ,$188.19 ,$218.02 ,$237.49 ,$218.02 ,$237.49 ,$237.49 ,$175.74 ,$237.49 ,$262.30 ,$198.07 ,$244.91 , N/A ,$196.17 ,$196.17 ,$189.99 ,$213.74 ,$237.49 ,$201.87 ,$244.91 ,$244.91 ,$201.87 ,$262.30 ,$98.80 , N/A , N/A ,$237.49 ,$201.87 ,$66.50 ,$213.74 ,$186.43 ,$196.17 ,$244.91 ,$154.37 
HSHS GOOD SHEPHERD HOSPITAL (ACU),46000014,94618,HC WALK TEST 6 MIN,460,1 ,$313.00 ,$203.45 ,$87.64 ,$313.00 ,$279.40 ,$250.40 ,$104.35 ,$87.64 ,$248.02 ,$287.33 ,$104.35 ,$287.33 ,$104.35 ,$212.34 ,$231.62 ,$279.40 ,$111.76 ,$261.04 ,$104.35 , N/A ,$258.54 ,$258.54 ,$250.40 ,$281.70 ,$260.87 ,$266.05 ,$104.35 ,$104.35 ,$266.05 ,$111.76 ,$130.21 , N/A , N/A ,$116.97 ,$266.05 ,$87.64 ,$281.70 ,$245.71 ,$258.54 ,$104.35 ,$203.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),46000017,94729,HC CARBON MONOXIDE DIFF (DLCO),460,1 ,$268.63 ,$174.61 ,$75.22 ,$268.63 , N/A ,$214.90 , N/A ,$75.22 ,$212.86 ,$246.60 , N/A ,$246.60 , N/A , N/A ,$198.79 , N/A , N/A ,$224.04 , N/A , N/A ,$221.89 ,$221.89 ,$214.90 ,$241.77 , N/A ,$228.34 , N/A , N/A ,$228.34 , N/A ,$111.75 , N/A , N/A , N/A ,$228.34 ,$75.22 ,$241.77 ,$210.87 ,$221.89 , N/A ,$174.61 
HSHS GOOD SHEPHERD HOSPITAL (ACU),46000018,94762,HC OXIMETRY OVERNIGHT,460,1 ,$175.00 ,$113.75 ,$49.00 ,$345.93 ,$345.93 ,$140.00 ,$129.20 ,$49.00 ,$138.67 ,$160.65 ,$129.20 ,$160.65 ,$129.20 ,$175.00 ,$129.50 ,$175.00 ,$138.37 ,$145.95 ,$129.20 , N/A ,$144.55 ,$144.55 ,$140.00 ,$157.50 ,$175.00 ,$148.75 ,$129.20 ,$129.20 ,$148.75 ,$138.37 ,$72.80 , N/A , N/A ,$144.83 ,$148.75 ,$49.00 ,$157.50 ,$137.38 ,$144.55 ,$129.20 ,$113.75 
HSHS GOOD SHEPHERD HOSPITAL (ACU),46000021,94760,HC PULSE OX SINGLE,460,1 ,$70.89 ,$46.08 ,$19.85 ,$70.89 , N/A ,$56.71 , N/A ,$19.85 ,$56.17 ,$65.08 , N/A ,$65.08 , N/A , N/A ,$52.46 , N/A , N/A ,$59.12 , N/A , N/A ,$58.56 ,$58.56 ,$56.71 ,$63.80 , N/A ,$60.26 , N/A , N/A ,$60.26 , N/A ,$29.49 , N/A , N/A , N/A ,$60.26 ,$19.85 ,$63.80 ,$55.65 ,$58.56 , N/A ,$46.08 
HSHS GOOD SHEPHERD HOSPITAL (ACU),46000022,94200,HC MAXIMAL VOL VENTILATION,942,1 ,$90.84 ,$59.05 ,$25.44 ,$137.93 ,$137.93 ,$72.67 ,$51.51 ,$25.44 ,$71.98 ,$83.39 ,$51.51 ,$83.39 ,$51.51 ,$90.84 ,$67.22 ,$90.84 ,$55.17 ,$75.76 ,$51.51 , N/A ,$75.03 ,$75.03 ,$72.67 ,$81.76 ,$90.84 ,$77.21 ,$51.51 ,$51.51 ,$77.21 ,$55.17 ,$37.79 , N/A , N/A ,$57.74 ,$77.21 ,$25.44 ,$81.76 ,$71.31 ,$75.03 ,$51.51 ,$59.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),46000023,94761,HC PULSE OX MULTI DETERMIN,360,1 ,$113.86 ,$74.01 ,$31.88 ,$113.86 , N/A ,$91.09 , N/A ,$31.88 ,$90.22 ,$104.52 , N/A ,$104.52 , N/A , N/A ,$84.26 , N/A , N/A ,$94.96 , N/A , N/A ,$94.05 ,$94.05 ,$91.09 ,$102.47 , N/A ,$96.78 , N/A , N/A ,$96.78 , N/A ,$47.37 , N/A , N/A , N/A ,$96.78 ,$31.88 ,$102.47 ,$89.38 ,$94.05 , N/A ,$74.01 
HSHS GOOD SHEPHERD HOSPITAL (ACU),48000005,92960,HC CARDIOVERSION EXTERNAL,480,1 ,"$1,059.57 ",$688.72 ,$296.68 ,"$1,391.93 ","$1,391.93 ",$847.66 ,$519.86 ,$296.68 ,$839.60 ,$972.69 ,$519.86 ,$972.69 ,$519.86 ,"$1,057.86 ",$784.08 ,"$1,059.57 ",$556.77 ,$883.68 ,$519.86 , N/A ,$875.20 ,$875.20 ,$847.66 ,$953.61 ,"$1,059.57 ",$900.63 ,$519.86 ,$519.86 ,$900.63 ,$556.77 ,$440.78 , N/A , N/A ,$582.76 ,$900.63 ,$296.68 ,$953.61 ,$831.76 ,$875.20 ,$519.86 ,$688.72 
HSHS GOOD SHEPHERD HOSPITAL (ACU),48200000,93017,HC STRESS TEST TRACING ONLY,482,1 ,"$1,719.85 ","$1,117.90 ",$244.91 ,"$1,719.85 ",$655.75 ,"$1,375.88 ",$244.91 ,$481.56 ,"$1,362.81 ","$1,578.82 ",$244.91 ,"$1,578.82 ",$244.91 ,$498.37 ,"$1,272.69 ",$655.75 ,$262.30 ,"$1,434.35 ",$244.91 , N/A ,"$1,420.60 ","$1,420.60 ","$1,375.88 ","$1,547.87 ",$612.27 ,"$1,461.87 ",$244.91 ,$244.91 ,"$1,461.87 ",$262.30 ,$715.46 , N/A , N/A ,$274.54 ,"$1,461.87 ",$481.56 ,"$1,547.87 ","$1,350.08 ","$1,420.60 ",$244.91 ,"$1,117.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),48300000,93306,HC ECHO/CARDIAC DOP/COLOR FLOW,483,1 ,"$3,181.00 ","$2,067.65 ",$447.14 ,"$3,181.00 ","$1,197.23 ","$2,544.80 ",$447.14 ,$890.68 ,"$2,520.62 ","$2,920.16 ",$447.14 ,"$2,920.16 ",$447.14 ,$909.89 ,"$2,353.94 ","$1,197.23 ",$478.89 ,"$2,652.95 ",$447.14 , N/A ,"$2,627.51 ","$2,627.51 ","$2,544.80 ","$2,862.90 ","$1,117.86 ","$2,703.85 ",$447.14 ,$447.14 ,"$2,703.85 ",$478.89 ,"$1,323.30 ", N/A , N/A ,$501.25 ,"$2,703.85 ",$890.68 ,"$2,862.90 ","$2,497.09 ","$2,627.51 ",$447.14 ,"$2,067.65 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),48300001,93307,HC ECHOCARDIOGRAM 2D W/O DOP,483,1 ,$741.00 ,$481.65 ,$207.48 ,$741.00 ,$570.13 ,$592.80 ,$212.93 ,$207.48 ,$587.17 ,$680.24 ,$212.93 ,$680.24 ,$212.93 ,$433.30 ,$548.34 ,$570.13 ,$228.05 ,$617.99 ,$212.93 , N/A ,$612.07 ,$612.07 ,$592.80 ,$666.90 ,$532.33 ,$629.85 ,$212.93 ,$212.93 ,$629.85 ,$228.05 ,$308.26 , N/A , N/A ,$238.70 ,$629.85 ,$207.48 ,$666.90 ,$581.69 ,$612.07 ,$212.93 ,$481.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),48300002,93308,HC ECHO 2D W/W/O M-MODE LTD,483,1 ,$556.00 ,$361.40 ,$155.68 ,$570.13 ,$570.13 ,$444.80 ,$212.93 ,$155.68 ,$440.57 ,$510.41 ,$212.93 ,$510.41 ,$212.93 ,$433.30 ,$411.44 ,$556.00 ,$228.05 ,$463.70 ,$212.93 , N/A ,$459.26 ,$459.26 ,$444.80 ,$500.40 ,$532.33 ,$472.60 ,$212.93 ,$212.93 ,$472.60 ,$228.05 ,$231.30 , N/A , N/A ,$238.70 ,$472.60 ,$155.68 ,$500.40 ,$436.46 ,$459.26 ,$212.93 ,$361.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000045,36593,HC DECLOTTING/ACCESS DEVICE/CATH,510,1 ,$81.53 ,$52.99 ,$22.83 ,$790.03 ,$790.03 ,$65.22 ,$295.06 ,$22.83 ,$64.60 ,$74.84 ,$81.53 ,$74.84 ,$81.53 ,$81.53 ,$60.33 ,$81.53 ,$316.01 ,$68.00 ,$295.06 , N/A ,$67.34 ,$67.34 ,$65.22 ,$73.38 ,$81.53 ,$69.30 ,$295.06 ,$295.06 ,$69.30 ,$316.01 ,$33.92 , N/A , N/A ,$81.53 ,$69.30 ,$22.83 ,$73.38 ,$64.00 ,$67.34 ,$295.06 ,$52.99 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000063,96372,HC INJECTION IM/SUBQ,260,1 ,$155.40 ,$101.01 ,$43.51 ,$155.40 ,$153.63 ,$124.32 ,$57.37 ,$43.51 ,$123.14 ,$142.66 ,$57.37 ,$142.66 ,$57.37 ,$116.76 ,$115.00 ,$153.63 ,$61.45 ,$129.60 ,$57.37 , N/A ,$128.36 ,$128.36 ,$124.32 ,$139.86 ,$143.44 ,$132.09 ,$57.37 ,$57.37 ,$132.09 ,$61.45 ,$64.65 , N/A , N/A ,$64.32 ,$132.09 ,$43.51 ,$139.86 ,$121.99 ,$128.36 ,$57.37 ,$101.01 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000065,96374,HC INJ IV PUSH SINGL/INITIAL,260,1 ,$404.57 ,$262.97 ,$113.28 ,$506.88 ,$506.88 ,$323.66 ,$189.31 ,$113.28 ,$320.58 ,$371.40 ,$189.31 ,$371.40 ,$189.31 ,$385.23 ,$299.38 ,$404.57 ,$202.75 ,$337.41 ,$189.31 , N/A ,$334.17 ,$334.17 ,$323.66 ,$364.11 ,$404.57 ,$343.88 ,$189.31 ,$189.31 ,$343.88 ,$202.75 ,$168.30 , N/A , N/A ,$212.22 ,$343.88 ,$113.28 ,$364.11 ,$317.59 ,$334.17 ,$189.31 ,$262.97 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000066,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$404.57 ,$262.97 ,$37.03 ,$404.57 ,$99.15 ,$323.66 ,$37.03 ,$113.28 ,$320.58 ,$371.40 ,$37.03 ,$371.40 ,$37.03 ,$75.35 ,$299.38 ,$99.15 ,$39.66 ,$337.41 ,$37.03 , N/A ,$334.17 ,$334.17 ,$323.66 ,$364.11 ,$92.58 ,$343.88 ,$37.03 ,$37.03 ,$343.88 ,$39.66 ,$168.30 , N/A , N/A ,$41.51 ,$343.88 ,$113.28 ,$364.11 ,$317.59 ,$334.17 ,$37.03 ,$262.97 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000067,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$371.00 ,$241.15 ,$103.88 ,$371.00 , N/A ,$296.80 , N/A ,$103.88 ,$293.98 ,$340.58 , N/A ,$340.58 , N/A , N/A ,$274.54 , N/A , N/A ,$309.41 , N/A , N/A ,$306.45 ,$306.45 ,$296.80 ,$333.90 , N/A ,$315.35 , N/A , N/A ,$315.35 , N/A ,$154.34 , N/A , N/A , N/A ,$315.35 ,$103.88 ,$333.90 ,$291.24 ,$306.45 , N/A ,$241.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000068,96523,HC IRRIGAT IMPLANT VEN ACCESS DEV,510,1 ,$122.67 ,$79.74 ,$34.35 ,$137.93 ,$137.93 ,$98.14 ,$51.51 ,$34.35 ,$97.20 ,$112.61 ,$51.51 ,$112.61 ,$51.51 ,$104.82 ,$90.78 ,$122.67 ,$55.17 ,$102.31 ,$51.51 , N/A ,$101.33 ,$101.33 ,$98.14 ,$110.40 ,$122.67 ,$104.27 ,$51.51 ,$51.51 ,$104.27 ,$55.17 ,$51.03 , N/A , N/A ,$57.74 ,$104.27 ,$34.35 ,$110.40 ,$96.30 ,$101.33 ,$51.51 ,$79.74 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000104,99203,HC CLINIC VISIT INTERM NEW,510,1 ,$263.42 ,$171.22 ,$73.76 ,$263.42 , N/A ,$210.74 , N/A ,$73.76 ,$208.73 ,$241.82 , N/A ,$241.82 , N/A , N/A ,$194.93 , N/A , N/A ,$219.69 , N/A , N/A ,$217.58 ,$217.58 ,$210.74 ,$237.08 , N/A ,$223.91 , N/A , N/A ,$223.91 , N/A ,$109.58 , N/A , N/A , N/A ,$223.91 ,$73.76 ,$237.08 ,$206.78 ,$217.58 , N/A ,$171.22 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000109,99204,HC CLINIC VISIT COMPLEX NEW,510,1 ,$451.22 ,$293.29 ,$126.34 ,$451.22 , N/A ,$360.98 , N/A ,$126.34 ,$357.55 ,$414.22 , N/A ,$414.22 , N/A , N/A ,$333.90 , N/A , N/A ,$376.32 , N/A , N/A ,$372.71 ,$372.71 ,$360.98 ,$406.10 , N/A ,$383.54 , N/A , N/A ,$383.54 , N/A ,$187.71 , N/A , N/A , N/A ,$383.54 ,$126.34 ,$406.10 ,$354.21 ,$372.71 , N/A ,$293.29 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000114,99211,HC CLINIC VISIT BRIEF EST,510,1 ,$78.02 ,$50.71 ,$21.85 ,$78.02 , N/A ,$62.42 , N/A ,$21.85 ,$61.82 ,$71.62 , N/A ,$71.62 , N/A , N/A ,$57.73 , N/A , N/A ,$65.07 , N/A , N/A ,$64.44 ,$64.44 ,$62.42 ,$70.22 , N/A ,$66.32 , N/A , N/A ,$66.32 , N/A ,$32.46 , N/A , N/A , N/A ,$66.32 ,$21.85 ,$70.22 ,$61.25 ,$64.44 , N/A ,$50.71 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000120,99212,HC CLINIC VISIT LIMIT EST,510,1 ,$87.37 ,$56.79 ,$24.46 ,$87.37 , N/A ,$69.90 , N/A ,$24.46 ,$69.23 ,$80.21 , N/A ,$80.21 , N/A , N/A ,$64.65 , N/A , N/A ,$72.87 , N/A , N/A ,$72.17 ,$72.17 ,$69.90 ,$78.63 , N/A ,$74.26 , N/A , N/A ,$74.26 , N/A ,$36.35 , N/A , N/A , N/A ,$74.26 ,$24.46 ,$78.63 ,$68.59 ,$72.17 , N/A ,$56.79 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000131,99213,HC CLINIC VISIT INTERM EST,510,1 ,$176.05 ,$114.43 ,$49.29 ,$176.05 , N/A ,$140.84 , N/A ,$49.29 ,$139.50 ,$161.61 , N/A ,$161.61 , N/A , N/A ,$130.28 , N/A , N/A ,$146.83 , N/A , N/A ,$145.42 ,$145.42 ,$140.84 ,$158.45 , N/A ,$149.64 , N/A , N/A ,$149.64 , N/A ,$73.24 , N/A , N/A , N/A ,$149.64 ,$49.29 ,$158.45 ,$138.20 ,$145.42 , N/A ,$114.43 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000136,99214,HC CLINIC VISIT COMPLX EST,510,1 ,$269.94 ,$175.46 ,$75.58 ,$269.94 , N/A ,$215.95 , N/A ,$75.58 ,$213.90 ,$247.80 , N/A ,$247.80 , N/A , N/A ,$199.76 , N/A , N/A ,$225.13 , N/A , N/A ,$222.97 ,$222.97 ,$215.95 ,$242.95 , N/A ,$229.45 , N/A , N/A ,$229.45 , N/A ,$112.30 , N/A , N/A , N/A ,$229.45 ,$75.58 ,$242.95 ,$211.90 ,$222.97 , N/A ,$175.46 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000147,P9612,HC CATH FOR SPECIMEN COLLECTION,300,1 ,$21.72 ,$14.12 ,$3.00 ,$21.72 ,$7.50 ,$17.38 ,$3.00 ,$6.08 ,$17.21 ,$19.94 ,$3.00 ,$19.94 ,$3.00 ,$5.70 ,$16.07 ,$7.50 ,$3.00 ,$18.11 ,$3.00 , N/A ,$17.94 ,$17.94 ,$17.38 ,$19.55 ,$7.50 ,$18.46 ,$3.00 ,$3.00 ,$18.46 ,$3.00 ,$9.04 , N/A , N/A ,$3.15 ,$18.46 ,$6.08 ,$19.55 ,$17.05 ,$17.94 ,$3.00 ,$14.12 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000171,51701,HC CATH BLADDER NON-INDWELLING,510,1 ,$153.00 ,$99.45 ,$42.84 ,$279.40 ,$279.40 ,$122.40 ,$104.35 ,$42.84 ,$121.24 ,$140.45 ,$104.35 ,$140.45 ,$104.35 ,$153.00 ,$113.22 ,$153.00 ,$111.76 ,$127.60 ,$104.35 , N/A ,$126.38 ,$126.38 ,$122.40 ,$137.70 ,$153.00 ,$130.05 ,$104.35 ,$104.35 ,$130.05 ,$111.76 ,$63.65 , N/A , N/A ,$116.97 ,$130.05 ,$42.84 ,$137.70 ,$120.11 ,$126.38 ,$104.35 ,$99.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000172,51702,HC CATH BLADDER SMP,510,1 ,$211.68 ,$137.59 ,$59.27 ,$279.40 ,$279.40 ,$169.34 ,$104.35 ,$59.27 ,$167.74 ,$194.32 ,$104.35 ,$194.32 ,$104.35 ,$211.68 ,$156.64 ,$211.68 ,$111.76 ,$176.54 ,$104.35 , N/A ,$174.85 ,$174.85 ,$169.34 ,$190.51 ,$211.68 ,$179.93 ,$104.35 ,$104.35 ,$179.93 ,$111.76 ,$88.06 , N/A , N/A ,$116.97 ,$179.93 ,$59.27 ,$190.51 ,$166.17 ,$174.85 ,$104.35 ,$137.59 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51000173,51703,HC CATH BLADDER CPLX,510,1 ,$561.84 ,$365.20 ,$129.20 ,$561.84 ,$345.93 ,$449.47 ,$129.20 ,$157.32 ,$445.20 ,$515.77 ,$129.20 ,$515.77 ,$129.20 ,$262.90 ,$415.76 ,$345.93 ,$138.37 ,$468.57 ,$129.20 , N/A ,$464.08 ,$464.08 ,$449.47 ,$505.66 ,$323.00 ,$477.56 ,$129.20 ,$129.20 ,$477.56 ,$138.37 ,$233.73 , N/A , N/A ,$144.83 ,$477.56 ,$157.32 ,$505.66 ,$441.04 ,$464.08 ,$129.20 ,$365.20 
HSHS GOOD SHEPHERD HOSPITAL (ACU),51070001,98960,HC EDUCATION SELF MGNT NON PHY HLTCARE PROF,510,1 ,$50.00 ,$32.50 ,$14.00 ,$50.00 , N/A ,$40.00 , N/A ,$14.00 ,$39.62 ,$45.90 , N/A ,$45.90 , N/A , N/A ,$37.00 , N/A , N/A ,$41.70 , N/A , N/A ,$41.30 ,$41.30 ,$40.00 ,$45.00 , N/A ,$42.50 , N/A , N/A ,$42.50 , N/A ,$20.80 , N/A , N/A , N/A ,$42.50 ,$14.00 ,$45.00 ,$39.25 ,$41.30 , N/A ,$32.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000000,70543,HC MRI ORBIT/FACE/NECK W AND W/O CON,610,1 ,"$4,799.47 ","$3,119.66 ",$340.78 ,"$4,799.47 ",$912.43 ,"$3,839.58 ",$340.78 ,"$1,343.85 ","$3,803.10 ","$4,405.91 ",$340.78 ,"$4,405.91 ",$340.78 ,$693.44 ,"$3,551.61 ",$912.43 ,$364.97 ,"$4,002.76 ",$340.78 , N/A ,"$3,964.36 ","$3,964.36 ","$3,839.58 ","$4,319.52 ",$851.94 ,"$4,079.55 ",$340.78 ,$340.78 ,"$4,079.55 ",$364.97 ,"$1,996.58 ", N/A , N/A ,$382.01 ,"$4,079.55 ","$1,343.85 ","$4,319.52 ","$1,296.00 ","$3,964.36 ",$340.78 ,"$3,119.66 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000001,70544,HC MRA HEAD W/O CONTRAST,610,1 ,"$3,357.38 ","$2,182.30 ",$212.93 ,"$3,357.38 ",$570.13 ,"$2,685.90 ",$212.93 ,$940.07 ,"$2,660.39 ","$3,082.07 ",$212.93 ,"$3,082.07 ",$212.93 ,$433.30 ,"$2,484.46 ",$570.13 ,$228.05 ,"$2,800.05 ",$212.93 , N/A ,"$2,773.20 ","$2,773.20 ","$2,685.90 ","$3,021.64 ",$532.33 ,"$2,853.77 ",$212.93 ,$212.93 ,"$2,853.77 ",$228.05 ,"$1,396.67 ", N/A , N/A ,$238.70 ,"$2,853.77 ",$940.07 ,"$3,021.64 ","$1,296.00 ","$2,773.20 ",$212.93 ,"$2,182.30 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000002,70545,HC MRA HEAD W/CONTRAST,610,1 ,"$4,248.00 ","$2,761.20 ",$340.78 ,"$4,248.00 ",$912.43 ,"$3,398.40 ",$340.78 ,"$1,189.44 ","$3,366.12 ","$3,899.66 ",$340.78 ,"$3,899.66 ",$340.78 ,$693.44 ,"$3,143.52 ",$912.43 ,$364.97 ,"$3,542.83 ",$340.78 , N/A ,"$3,508.85 ","$3,508.85 ","$3,398.40 ","$3,823.20 ",$851.94 ,"$3,610.80 ",$340.78 ,$340.78 ,"$3,610.80 ",$364.97 ,"$1,767.17 ", N/A , N/A ,$382.01 ,"$3,610.80 ","$1,189.44 ","$3,823.20 ","$1,296.00 ","$3,508.85 ",$340.78 ,"$2,761.20 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000003,70546,HC MRA HEAD W AND W/O CONTRAST,610,1 ,"$4,665.36 ","$3,032.48 ",$340.78 ,"$4,665.36 ",$912.43 ,"$3,732.29 ",$340.78 ,"$1,306.30 ","$3,696.83 ","$4,282.80 ",$340.78 ,"$4,282.80 ",$340.78 ,$693.44 ,"$3,452.37 ",$912.43 ,$364.97 ,"$3,890.91 ",$340.78 , N/A ,"$3,853.59 ","$3,853.59 ","$3,732.29 ","$4,198.82 ",$851.94 ,"$3,965.56 ",$340.78 ,$340.78 ,"$3,965.56 ",$364.97 ,"$1,940.79 ", N/A , N/A ,$382.01 ,"$3,965.56 ","$1,306.30 ","$4,198.82 ","$1,296.00 ","$3,853.59 ",$340.78 ,"$3,032.48 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000005,70547,HC MRA NECK W/O CONTRAST,610,1 ,"$3,458.00 ","$2,247.70 ",$212.93 ,"$3,458.00 ",$570.13 ,"$2,766.40 ",$212.93 ,$968.24 ,"$2,740.12 ","$3,174.44 ",$212.93 ,"$3,174.44 ",$212.93 ,$433.30 ,"$2,558.92 ",$570.13 ,$228.05 ,"$2,883.97 ",$212.93 , N/A ,"$2,856.31 ","$2,856.31 ","$2,766.40 ","$3,112.20 ",$532.33 ,"$2,939.30 ",$212.93 ,$212.93 ,"$2,939.30 ",$228.05 ,"$1,438.53 ", N/A , N/A ,$238.70 ,"$2,939.30 ",$968.24 ,"$3,112.20 ","$1,296.00 ","$2,856.31 ",$212.93 ,"$2,247.70 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000006,70548,HC MRA NECK W/CONTRAST,610,1 ,"$4,248.00 ","$2,761.20 ",$340.78 ,"$4,248.00 ",$912.43 ,"$3,398.40 ",$340.78 ,"$1,189.44 ","$3,366.12 ","$3,899.66 ",$340.78 ,"$3,899.66 ",$340.78 ,$693.44 ,"$3,143.52 ",$912.43 ,$364.97 ,"$3,542.83 ",$340.78 , N/A ,"$3,508.85 ","$3,508.85 ","$3,398.40 ","$3,823.20 ",$851.94 ,"$3,610.80 ",$340.78 ,$340.78 ,"$3,610.80 ",$364.97 ,"$1,767.17 ", N/A , N/A ,$382.01 ,"$3,610.80 ","$1,189.44 ","$3,823.20 ","$1,296.00 ","$3,508.85 ",$340.78 ,"$2,761.20 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000007,70549,HC MRA NECK W AND W/O CONTRAST,610,1 ,"$4,665.36 ","$3,032.48 ",$340.78 ,"$4,665.36 ",$912.43 ,"$3,732.29 ",$340.78 ,"$1,306.30 ","$3,696.83 ","$4,282.80 ",$340.78 ,"$4,282.80 ",$340.78 ,$693.44 ,"$3,452.37 ",$912.43 ,$364.97 ,"$3,890.91 ",$340.78 , N/A ,"$3,853.59 ","$3,853.59 ","$3,732.29 ","$4,198.82 ",$851.94 ,"$3,965.56 ",$340.78 ,$340.78 ,"$3,965.56 ",$364.97 ,"$1,940.79 ", N/A , N/A ,$382.01 ,"$3,965.56 ","$1,306.30 ","$4,198.82 ","$1,296.00 ","$3,853.59 ",$340.78 ,"$3,032.48 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000008,70551,HC MRI BRAIN W/O CONTRAST,610,1 ,"$3,491.22 ","$2,269.29 ",$212.93 ,"$3,491.22 ",$570.13 ,"$2,792.98 ",$212.93 ,$977.54 ,"$2,766.44 ","$3,204.94 ",$212.93 ,"$3,204.94 ",$212.93 ,$433.30 ,"$2,583.50 ",$570.13 ,$228.05 ,"$2,911.68 ",$212.93 , N/A ,"$2,883.75 ","$2,883.75 ","$2,792.98 ","$3,142.10 ",$532.33 ,"$2,967.54 ",$212.93 ,$212.93 ,"$2,967.54 ",$228.05 ,"$1,452.35 ", N/A , N/A ,$238.70 ,"$2,967.54 ",$977.54 ,"$3,142.10 ","$1,296.00 ","$2,883.75 ",$212.93 ,"$2,269.29 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000010,70553,HC MRI BRAIN W AND W/O CONTRAST,610,1 ,"$4,799.47 ","$3,119.66 ",$340.78 ,"$4,799.47 ",$912.43 ,"$3,839.58 ",$340.78 ,"$1,343.85 ","$3,803.10 ","$4,405.91 ",$340.78 ,"$4,405.91 ",$340.78 ,$693.44 ,"$3,551.61 ",$912.43 ,$364.97 ,"$4,002.76 ",$340.78 , N/A ,"$3,964.36 ","$3,964.36 ","$3,839.58 ","$4,319.52 ",$851.94 ,"$4,079.55 ",$340.78 ,$340.78 ,"$4,079.55 ",$364.97 ,"$1,996.58 ", N/A , N/A ,$382.01 ,"$4,079.55 ","$1,343.85 ","$4,319.52 ","$1,296.00 ","$3,964.36 ",$340.78 ,"$3,119.66 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000011,72141,HC MRI C-SPINE W/O CONTRAST,610,1 ,"$4,386.00 ","$2,850.90 ",$212.93 ,"$4,386.00 ",$570.13 ,"$3,508.80 ",$212.93 ,"$1,228.08 ","$3,475.47 ","$4,026.35 ",$212.93 ,"$4,026.35 ",$212.93 ,$433.30 ,"$3,245.64 ",$570.13 ,$228.05 ,"$3,657.92 ",$212.93 , N/A ,"$3,622.84 ","$3,622.84 ","$3,508.80 ","$3,947.40 ",$532.33 ,"$3,728.10 ",$212.93 ,$212.93 ,"$3,728.10 ",$228.05 ,"$1,824.58 ", N/A , N/A ,$238.70 ,"$3,728.10 ","$1,228.08 ","$3,947.40 ","$1,296.00 ","$3,622.84 ",$212.93 ,"$2,850.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000012,72142,HC MRI C-SPINE W/CON,610,1 ,"$4,386.00 ","$2,850.90 ",$340.78 ,"$4,386.00 ",$912.43 ,"$3,508.80 ",$340.78 ,"$1,228.08 ","$3,475.47 ","$4,026.35 ",$340.78 ,"$4,026.35 ",$340.78 ,$693.44 ,"$3,245.64 ",$912.43 ,$364.97 ,"$3,657.92 ",$340.78 , N/A ,"$3,622.84 ","$3,622.84 ","$3,508.80 ","$3,947.40 ",$851.94 ,"$3,728.10 ",$340.78 ,$340.78 ,"$3,728.10 ",$364.97 ,"$1,824.58 ", N/A , N/A ,$382.01 ,"$3,728.10 ","$1,228.08 ","$3,947.40 ","$1,296.00 ","$3,622.84 ",$340.78 ,"$2,850.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000013,72146,HC MRI T-SPINE W/O CONTRAST,610,1 ,"$3,491.22 ","$2,269.29 ",$212.93 ,"$3,491.22 ",$570.13 ,"$2,792.98 ",$212.93 ,$977.54 ,"$2,766.44 ","$3,204.94 ",$212.93 ,"$3,204.94 ",$212.93 ,$433.30 ,"$2,583.50 ",$570.13 ,$228.05 ,"$2,911.68 ",$212.93 , N/A ,"$2,883.75 ","$2,883.75 ","$2,792.98 ","$3,142.10 ",$532.33 ,"$2,967.54 ",$212.93 ,$212.93 ,"$2,967.54 ",$228.05 ,"$1,452.35 ", N/A , N/A ,$238.70 ,"$2,967.54 ",$977.54 ,"$3,142.10 ","$1,296.00 ","$2,883.75 ",$212.93 ,"$2,269.29 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000016,72148,HC MRI L-SPINE W/O CONTRAST,610,1 ,"$3,491.22 ","$2,269.29 ",$212.93 ,"$3,491.22 ",$570.13 ,"$2,792.98 ",$212.93 ,$977.54 ,"$2,766.44 ","$3,204.94 ",$212.93 ,"$3,204.94 ",$212.93 ,$433.30 ,"$2,583.50 ",$570.13 ,$228.05 ,"$2,911.68 ",$212.93 , N/A ,"$2,883.75 ","$2,883.75 ","$2,792.98 ","$3,142.10 ",$532.33 ,"$2,967.54 ",$212.93 ,$212.93 ,"$2,967.54 ",$228.05 ,"$1,452.35 ", N/A , N/A ,$238.70 ,"$2,967.54 ",$977.54 ,"$3,142.10 ","$1,296.00 ","$2,883.75 ",$212.93 ,"$2,269.29 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000017,72149,HC MRI L-SPINE W/CON,610,1 ,"$4,258.14 ","$2,767.79 ",$340.78 ,"$4,258.14 ",$912.43 ,"$3,406.51 ",$340.78 ,"$1,192.28 ","$3,374.15 ","$3,908.97 ",$340.78 ,"$3,908.97 ",$340.78 ,$693.44 ,"$3,151.02 ",$912.43 ,$364.97 ,"$3,551.29 ",$340.78 , N/A ,"$3,517.22 ","$3,517.22 ","$3,406.51 ","$3,832.33 ",$851.94 ,"$3,619.42 ",$340.78 ,$340.78 ,"$3,619.42 ",$364.97 ,"$1,771.39 ", N/A , N/A ,$382.01 ,"$3,619.42 ","$1,192.28 ","$3,832.33 ","$1,296.00 ","$3,517.22 ",$340.78 ,"$2,767.79 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000018,72156,HC MRI C-SPINE W AND W/O CON,610,1 ,"$4,799.47 ","$3,119.66 ",$340.78 ,"$4,799.47 ",$912.43 ,"$3,839.58 ",$340.78 ,"$1,343.85 ","$3,803.10 ","$4,405.91 ",$340.78 ,"$4,405.91 ",$340.78 ,$693.44 ,"$3,551.61 ",$912.43 ,$364.97 ,"$4,002.76 ",$340.78 , N/A ,"$3,964.36 ","$3,964.36 ","$3,839.58 ","$4,319.52 ",$851.94 ,"$4,079.55 ",$340.78 ,$340.78 ,"$4,079.55 ",$364.97 ,"$1,996.58 ", N/A , N/A ,$382.01 ,"$4,079.55 ","$1,343.85 ","$4,319.52 ","$1,296.00 ","$3,964.36 ",$340.78 ,"$3,119.66 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000020,72158,HC MRI L-SPINE W AND W/O CON,610,1 ,"$4,949.11 ","$3,216.92 ",$340.78 ,"$4,949.11 ",$912.43 ,"$3,959.29 ",$340.78 ,"$1,385.75 ","$3,921.67 ","$4,543.28 ",$340.78 ,"$4,543.28 ",$340.78 ,$693.44 ,"$3,662.34 ",$912.43 ,$364.97 ,"$4,127.56 ",$340.78 , N/A ,"$4,087.96 ","$4,087.96 ","$3,959.29 ","$4,454.20 ",$851.94 ,"$4,206.74 ",$340.78 ,$340.78 ,"$4,206.74 ",$364.97 ,"$2,058.83 ", N/A , N/A ,$382.01 ,"$4,206.74 ","$1,385.75 ","$4,454.20 ","$1,296.00 ","$4,087.96 ",$340.78 ,"$3,216.92 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000021,72195,HC MRI PELVIS W/O CON,610,1 ,"$3,491.22 ","$2,269.29 ",$212.93 ,"$3,491.22 ",$570.13 ,"$2,792.98 ",$212.93 ,$977.54 ,"$2,766.44 ","$3,204.94 ",$212.93 ,"$3,204.94 ",$212.93 ,$433.30 ,"$2,583.50 ",$570.13 ,$228.05 ,"$2,911.68 ",$212.93 , N/A ,"$2,883.75 ","$2,883.75 ","$2,792.98 ","$3,142.10 ",$532.33 ,"$2,967.54 ",$212.93 ,$212.93 ,"$2,967.54 ",$228.05 ,"$1,452.35 ", N/A , N/A ,$238.70 ,"$2,967.54 ",$977.54 ,"$3,142.10 ","$1,296.00 ","$2,883.75 ",$212.93 ,"$2,269.29 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000022,72196,HC MRI PELVIS W/CON,610,1 ,"$1,000.00 ",$650.00 ,$280.00 ,"$1,000.00 ",$912.43 ,$800.00 ,$340.78 ,$280.00 ,$792.40 ,$918.00 ,$340.78 ,$918.00 ,$340.78 ,$693.44 ,$740.00 ,$912.43 ,$364.97 ,$834.00 ,$340.78 , N/A ,$826.00 ,$826.00 ,$800.00 ,$900.00 ,$851.94 ,$850.00 ,$340.78 ,$340.78 ,$850.00 ,$364.97 ,$416.00 , N/A , N/A ,$382.01 ,$850.00 ,$280.00 ,$900.00 ,"$1,000.00 ",$826.00 ,$340.78 ,$650.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000023,72197,HC MRI PELVIS W AND W/O CON,610,1 ,"$4,799.47 ","$3,119.66 ",$340.78 ,"$4,799.47 ",$912.43 ,"$3,839.58 ",$340.78 ,"$1,343.85 ","$3,803.10 ","$4,405.91 ",$340.78 ,"$4,405.91 ",$340.78 ,$693.44 ,"$3,551.61 ",$912.43 ,$364.97 ,"$4,002.76 ",$340.78 , N/A ,"$3,964.36 ","$3,964.36 ","$3,839.58 ","$4,319.52 ",$851.94 ,"$4,079.55 ",$340.78 ,$340.78 ,"$4,079.55 ",$364.97 ,"$1,996.58 ", N/A , N/A ,$382.01 ,"$4,079.55 ","$1,343.85 ","$4,319.52 ","$1,296.00 ","$3,964.36 ",$340.78 ,"$3,119.66 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000024,73218,HC MRI UPPR EXT NONJOINT W/O CONTRAST,610,1 ,"$3,491.22 ","$2,269.29 ",$212.93 ,"$3,491.22 ",$570.13 ,"$2,792.98 ",$212.93 ,$977.54 ,"$2,766.44 ","$3,204.94 ",$212.93 ,"$3,204.94 ",$212.93 ,$433.30 ,"$2,583.50 ",$570.13 ,$228.05 ,"$2,911.68 ",$212.93 , N/A ,"$2,883.75 ","$2,883.75 ","$2,792.98 ","$3,142.10 ",$532.33 ,"$2,967.54 ",$212.93 ,$212.93 ,"$2,967.54 ",$228.05 ,"$1,452.35 ", N/A , N/A ,$238.70 ,"$2,967.54 ",$977.54 ,"$3,142.10 ","$1,296.00 ","$2,883.75 ",$212.93 ,"$2,269.29 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000026,73220,HC MRI UPPR EXT NONJOINT W AND W/O CONTRAST,610,1 ,"$4,674.00 ","$3,038.10 ",$340.78 ,"$4,674.00 ",$912.43 ,"$3,739.20 ",$340.78 ,"$1,308.72 ","$3,703.68 ","$4,290.73 ",$340.78 ,"$4,290.73 ",$340.78 ,$693.44 ,"$3,458.76 ",$912.43 ,$364.97 ,"$3,898.12 ",$340.78 , N/A ,"$3,860.72 ","$3,860.72 ","$3,739.20 ","$4,206.60 ",$851.94 ,"$3,972.90 ",$340.78 ,$340.78 ,"$3,972.90 ",$364.97 ,"$1,944.38 ", N/A , N/A ,$382.01 ,"$3,972.90 ","$1,308.72 ","$4,206.60 ","$1,296.00 ","$3,860.72 ",$340.78 ,"$3,038.10 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000027,73221,HC MRI UPPR EXT JOINT W/O CONTRAST,610,1 ,"$3,491.22 ","$2,269.29 ",$212.93 ,"$3,491.22 ",$570.13 ,"$2,792.98 ",$212.93 ,$977.54 ,"$2,766.44 ","$3,204.94 ",$212.93 ,"$3,204.94 ",$212.93 ,$433.30 ,"$2,583.50 ",$570.13 ,$228.05 ,"$2,911.68 ",$212.93 , N/A ,"$2,883.75 ","$2,883.75 ","$2,792.98 ","$3,142.10 ",$532.33 ,"$2,967.54 ",$212.93 ,$212.93 ,"$2,967.54 ",$228.05 ,"$1,452.35 ", N/A , N/A ,$238.70 ,"$2,967.54 ",$977.54 ,"$3,142.10 ","$1,296.00 ","$2,883.75 ",$212.93 ,"$2,269.29 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000028,73222,HC MRI UPPR EXT JOINT W/CONTRAST,610,1 ,"$4,674.00 ","$3,038.10 ",$662.06 ,"$4,674.00 ","$1,772.68 ","$3,739.20 ",$662.06 ,"$1,308.72 ","$3,703.68 ","$4,290.73 ",$662.06 ,"$4,290.73 ",$662.06 ,"$1,347.23 ","$3,458.76 ","$1,772.68 ",$709.07 ,"$3,898.12 ",$662.06 , N/A ,"$3,860.72 ","$3,860.72 ","$3,739.20 ","$4,206.60 ","$1,655.15 ","$3,972.90 ",$662.06 ,$662.06 ,"$3,972.90 ",$709.07 ,"$1,944.38 ", N/A , N/A ,$742.17 ,"$3,972.90 ","$1,308.72 ","$4,206.60 ","$1,296.00 ","$3,860.72 ",$662.06 ,"$3,038.10 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000029,73223,HC MRI UPPR EXT JOINT W AND W/O CONTRAST,610,1 ,"$4,799.47 ","$3,119.66 ",$340.78 ,"$4,799.47 ",$912.43 ,"$3,839.58 ",$340.78 ,"$1,343.85 ","$3,803.10 ","$4,405.91 ",$340.78 ,"$4,405.91 ",$340.78 ,$693.44 ,"$3,551.61 ",$912.43 ,$364.97 ,"$4,002.76 ",$340.78 , N/A ,"$3,964.36 ","$3,964.36 ","$3,839.58 ","$4,319.52 ",$851.94 ,"$4,079.55 ",$340.78 ,$340.78 ,"$4,079.55 ",$364.97 ,"$1,996.58 ", N/A , N/A ,$382.01 ,"$4,079.55 ","$1,343.85 ","$4,319.52 ","$1,296.00 ","$3,964.36 ",$340.78 ,"$3,119.66 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000030,73718,HC MRI LE NONJOINT WO CONTRAST,610,1 ,"$3,491.22 ","$2,269.29 ",$212.93 ,"$3,491.22 ",$570.13 ,"$2,792.98 ",$212.93 ,$977.54 ,"$2,766.44 ","$3,204.94 ",$212.93 ,"$3,204.94 ",$212.93 ,$433.30 ,"$2,583.50 ",$570.13 ,$228.05 ,"$2,911.68 ",$212.93 , N/A ,"$2,883.75 ","$2,883.75 ","$2,792.98 ","$3,142.10 ",$532.33 ,"$2,967.54 ",$212.93 ,$212.93 ,"$2,967.54 ",$228.05 ,"$1,452.35 ", N/A , N/A ,$238.70 ,"$2,967.54 ",$977.54 ,"$3,142.10 ","$1,296.00 ","$2,883.75 ",$212.93 ,"$2,269.29 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000033,73720,HC MRI LE NONJOINT W/WO CONTRAST,610,1 ,"$4,538.32 ","$2,949.91 ",$340.78 ,"$4,538.32 ",$912.43 ,"$3,630.66 ",$340.78 ,"$1,270.73 ","$3,596.16 ","$4,166.18 ",$340.78 ,"$4,166.18 ",$340.78 ,$693.44 ,"$3,358.36 ",$912.43 ,$364.97 ,"$3,784.96 ",$340.78 , N/A ,"$3,748.65 ","$3,748.65 ","$3,630.66 ","$4,084.49 ",$851.94 ,"$3,857.57 ",$340.78 ,$340.78 ,"$3,857.57 ",$364.97 ,"$1,887.94 ", N/A , N/A ,$382.01 ,"$3,857.57 ","$1,270.73 ","$4,084.49 ","$1,296.00 ","$3,748.65 ",$340.78 ,"$2,949.91 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000034,73721,HC MRI LWR EXT JOINT W/O CONTRAST,610,1 ,"$3,491.22 ","$2,269.29 ",$212.93 ,"$3,491.22 ",$570.13 ,"$2,792.98 ",$212.93 ,$977.54 ,"$2,766.44 ","$3,204.94 ",$212.93 ,"$3,204.94 ",$212.93 ,$433.30 ,"$2,583.50 ",$570.13 ,$228.05 ,"$2,911.68 ",$212.93 , N/A ,"$2,883.75 ","$2,883.75 ","$2,792.98 ","$3,142.10 ",$532.33 ,"$2,967.54 ",$212.93 ,$212.93 ,"$2,967.54 ",$228.05 ,"$1,452.35 ", N/A , N/A ,$238.70 ,"$2,967.54 ",$977.54 ,"$3,142.10 ","$1,296.00 ","$2,883.75 ",$212.93 ,"$2,269.29 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000035,73722,HC MRI LWR EXT JOINT W/CONTRAST,610,1 ,"$5,733.00 ","$3,726.45 ",$662.06 ,"$5,733.00 ","$1,772.68 ","$4,586.40 ",$662.06 ,"$1,605.24 ","$4,542.83 ","$5,262.89 ",$662.06 ,"$5,262.89 ",$662.06 ,"$1,347.23 ","$4,242.42 ","$1,772.68 ",$709.07 ,"$4,781.32 ",$662.06 , N/A ,"$4,735.46 ","$4,735.46 ","$4,586.40 ","$5,159.70 ","$1,655.15 ","$4,873.05 ",$662.06 ,$662.06 ,"$4,873.05 ",$709.07 ,"$2,384.93 ", N/A , N/A ,$742.17 ,"$4,873.05 ","$1,605.24 ","$5,159.70 ","$1,296.00 ","$4,735.46 ",$662.06 ,"$3,726.45 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000036,73723,HC MRI LWR EXT JOINT W AND W/O CONTRAST,610,1 ,"$4,799.47 ","$3,119.66 ",$340.78 ,"$4,799.47 ",$912.43 ,"$3,839.58 ",$340.78 ,"$1,343.85 ","$3,803.10 ","$4,405.91 ",$340.78 ,"$4,405.91 ",$340.78 ,$693.44 ,"$3,551.61 ",$912.43 ,$364.97 ,"$4,002.76 ",$340.78 , N/A ,"$3,964.36 ","$3,964.36 ","$3,839.58 ","$4,319.52 ",$851.94 ,"$4,079.55 ",$340.78 ,$340.78 ,"$4,079.55 ",$364.97 ,"$1,996.58 ", N/A , N/A ,$382.01 ,"$4,079.55 ","$1,343.85 ","$4,319.52 ","$1,296.00 ","$3,964.36 ",$340.78 ,"$3,119.66 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000038,74181,HC MRI ABDOMEN W/O CON,610,1 ,"$3,491.22 ","$2,269.29 ",$212.93 ,"$3,491.22 ",$570.13 ,"$2,792.98 ",$212.93 ,$977.54 ,"$2,766.44 ","$3,204.94 ",$212.93 ,"$3,204.94 ",$212.93 ,$433.30 ,"$2,583.50 ",$570.13 ,$228.05 ,"$2,911.68 ",$212.93 , N/A ,"$2,883.75 ","$2,883.75 ","$2,792.98 ","$3,142.10 ",$532.33 ,"$2,967.54 ",$212.93 ,$212.93 ,"$2,967.54 ",$228.05 ,"$1,452.35 ", N/A , N/A ,$238.70 ,"$2,967.54 ",$977.54 ,"$3,142.10 ","$1,296.00 ","$2,883.75 ",$212.93 ,"$2,269.29 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000039,74182,HC MRI ABDOMEN W/CON,610,1 ,"$4,386.00 ","$2,850.90 ",$340.78 ,"$4,386.00 ",$912.43 ,"$3,508.80 ",$340.78 ,"$1,228.08 ","$3,475.47 ","$4,026.35 ",$340.78 ,"$4,026.35 ",$340.78 ,$693.44 ,"$3,245.64 ",$912.43 ,$364.97 ,"$3,657.92 ",$340.78 , N/A ,"$3,622.84 ","$3,622.84 ","$3,508.80 ","$3,947.40 ",$851.94 ,"$3,728.10 ",$340.78 ,$340.78 ,"$3,728.10 ",$364.97 ,"$1,824.58 ", N/A , N/A ,$382.01 ,"$3,728.10 ","$1,228.08 ","$3,947.40 ","$1,296.00 ","$3,622.84 ",$340.78 ,"$2,850.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000040,74183,HC MRI ABDOMEN W AND W/O CON,610,1 ,"$4,538.32 ","$2,949.91 ",$340.78 ,"$4,538.32 ",$912.43 ,"$3,630.66 ",$340.78 ,"$1,270.73 ","$3,596.16 ","$4,166.18 ",$340.78 ,"$4,166.18 ",$340.78 ,$693.44 ,"$3,358.36 ",$912.43 ,$364.97 ,"$3,784.96 ",$340.78 , N/A ,"$3,748.65 ","$3,748.65 ","$3,630.66 ","$4,084.49 ",$851.94 ,"$3,857.57 ",$340.78 ,$340.78 ,"$3,857.57 ",$364.97 ,"$1,887.94 ", N/A , N/A ,$382.01 ,"$3,857.57 ","$1,270.73 ","$4,084.49 ","$1,296.00 ","$3,748.65 ",$340.78 ,"$2,949.91 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000051,C8900,HC MRA ABDOMEN W/CONTRAST,610,1 ,"$1,000.00 ",$650.00 ,$280.00 ,"$1,000.00 ",$912.43 ,$800.00 ,$340.78 ,$280.00 ,$792.40 ,$918.00 ,$340.78 ,$918.00 ,$340.78 ,$693.44 ,$740.00 ,$912.43 ,$364.97 ,$834.00 ,$340.78 , N/A ,$826.00 ,$826.00 ,$800.00 ,$900.00 ,$851.94 ,$850.00 ,$340.78 ,$340.78 ,$850.00 ,$364.97 ,$416.00 , N/A , N/A ,$382.01 ,$850.00 ,$280.00 ,$900.00 ,"$1,000.00 ",$826.00 ,$340.78 ,$650.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000052,C8901,HC MRA ABDOMEN W/O CONTRAST,610,1 ,$625.00 ,$406.25 ,$175.00 ,$625.00 ,$570.13 ,$500.00 ,$212.93 ,$175.00 ,$495.25 ,$573.75 ,$212.93 ,$573.75 ,$212.93 ,$433.30 ,$462.50 ,$570.13 ,$228.05 ,$521.25 ,$212.93 , N/A ,$516.25 ,$516.25 ,$500.00 ,$562.50 ,$532.33 ,$531.25 ,$212.93 ,$212.93 ,$531.25 ,$228.05 ,$260.00 , N/A , N/A ,$238.70 ,$531.25 ,$175.00 ,$562.50 ,$625.00 ,$516.25 ,$212.93 ,$406.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000053,C8902,HC MRA ABDOMEN W AND W/O CON,610,1 ,"$1,000.00 ",$650.00 ,$280.00 ,"$1,000.00 ",$912.43 ,$800.00 ,$340.78 ,$280.00 ,$792.40 ,$918.00 ,$340.78 ,$918.00 ,$340.78 ,$693.44 ,$740.00 ,$912.43 ,$364.97 ,$834.00 ,$340.78 , N/A ,$826.00 ,$826.00 ,$800.00 ,$900.00 ,$851.94 ,$850.00 ,$340.78 ,$340.78 ,$850.00 ,$364.97 ,$416.00 , N/A , N/A ,$382.01 ,$850.00 ,$280.00 ,$900.00 ,"$1,000.00 ",$826.00 ,$340.78 ,$650.00 
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000073,70553,HC MRI BRAIN W AND W/O CONTRAST PITUITARY,610,1 ,"$4,386.00 ","$2,850.90 ",$340.78 ,"$4,386.00 ",$912.43 ,"$3,508.80 ",$340.78 ,"$1,228.08 ","$3,475.47 ","$4,026.35 ",$340.78 ,"$4,026.35 ",$340.78 ,$693.44 ,"$3,245.64 ",$912.43 ,$364.97 ,"$3,657.92 ",$340.78 , N/A ,"$3,622.84 ","$3,622.84 ","$3,508.80 ","$3,947.40 ",$851.94 ,"$3,728.10 ",$340.78 ,$340.78 ,"$3,728.10 ",$364.97 ,"$1,824.58 ", N/A , N/A ,$382.01 ,"$3,728.10 ","$1,228.08 ","$3,947.40 ","$1,296.00 ","$3,622.84 ",$340.78 ,"$2,850.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),61000076,70542,HC MRI ORBIT/FACE/NECK W/CONTRAST,610,1 ,"$4,386.00 ","$2,850.90 ",$340.78 ,"$4,386.00 ",$912.43 ,"$3,508.80 ",$340.78 ,"$1,228.08 ","$3,475.47 ","$4,026.35 ",$340.78 ,"$4,026.35 ",$340.78 ,$693.44 ,"$3,245.64 ",$912.43 ,$364.97 ,"$3,657.92 ",$340.78 , N/A ,"$3,622.84 ","$3,622.84 ","$3,508.80 ","$3,947.40 ",$851.94 ,"$3,728.10 ",$340.78 ,$340.78 ,"$3,728.10 ",$364.97 ,"$1,824.58 ", N/A , N/A ,$382.01 ,"$3,728.10 ","$1,228.08 ","$3,947.40 ","$1,296.00 ","$3,622.84 ",$340.78 ,"$2,850.90 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),63600029,J7325,HC HYALURONAN OR DERIVATIVE; SYN,636,1 ,$95.99 ,$62.39 ,$10.43 ,$95.99 ,$26.08 ,$76.79 ,$11.17 ,$26.88 ,$76.06 ,$88.12 ,$10.43 ,$88.12 ,$10.43 ,$19.82 ,$71.03 ,$26.08 ,$10.43 ,$80.06 ,$11.17 , N/A ,$79.29 ,$79.29 ,$76.79 ,$86.39 ,$26.09 ,$81.59 ,$10.43 ,$10.43 ,$81.59 ,$10.43 ,$39.93 , N/A , N/A ,$10.96 ,$81.59 ,$26.88 ,$86.39 ,$75.35 ,$17.21 ,$10.43 ,$62.39 
HSHS GOOD SHEPHERD HOSPITAL (ACU),71000230,N/A,HC PHASE II RECOVERY 15 MIN,710,1 ,$165.00 ,$107.25 ,$46.20 ,$165.00 , N/A ,$132.00 , N/A ,$46.20 ,$130.75 ,$151.47 , N/A ,$151.47 , N/A , N/A ,$122.10 , N/A , N/A ,$137.61 , N/A , N/A ,$136.29 ,$136.29 ,$132.00 ,$148.50 , N/A ,$140.25 , N/A , N/A ,$140.25 , N/A ,$68.64 , N/A , N/A , N/A ,$140.25 ,$46.20 ,$148.50 ,$129.53 ,$136.29 , N/A ,$107.25 
HSHS GOOD SHEPHERD HOSPITAL (ACU),71000233,N/A,HC PHASE I RECOVERY 30 MIN,710,1 ,"$1,267.00 ",$823.55 ,$354.76 ,"$1,267.00 ", N/A ,"$1,013.60 ", N/A ,$354.76 ,"$1,003.97 ","$1,163.11 ", N/A ,"$1,163.11 ", N/A , N/A ,$937.58 , N/A , N/A ,"$1,056.68 ", N/A , N/A ,"$1,046.54 ","$1,046.54 ","$1,013.60 ","$1,140.30 ", N/A ,"$1,076.95 ", N/A , N/A ,"$1,076.95 ", N/A ,$527.07 , N/A , N/A , N/A ,"$1,076.95 ",$354.76 ,"$1,140.30 ",$994.60 ,"$1,046.54 ", N/A ,$823.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),71000234,N/A,HC PHASE I RECOVERY 15 MIN,710,1 ,"$1,267.00 ",$823.55 ,$354.76 ,"$1,267.00 ", N/A ,"$1,013.60 ", N/A ,$354.76 ,"$1,003.97 ","$1,163.11 ", N/A ,"$1,163.11 ", N/A , N/A ,$937.58 , N/A , N/A ,"$1,056.68 ", N/A , N/A ,"$1,046.54 ","$1,046.54 ","$1,013.60 ","$1,140.30 ", N/A ,"$1,076.95 ", N/A , N/A ,"$1,076.95 ", N/A ,$527.07 , N/A , N/A , N/A ,"$1,076.95 ",$354.76 ,"$1,140.30 ",$994.60 ,"$1,046.54 ", N/A ,$823.55 
HSHS GOOD SHEPHERD HOSPITAL (ACU),73000002,93005,HC EKG,730,1 ,$336.38 ,$218.65 ,$51.51 ,$336.38 ,$137.93 ,$269.10 ,$51.51 ,$94.19 ,$266.55 ,$308.80 ,$51.51 ,$308.80 ,$51.51 ,$104.82 ,$248.92 ,$137.93 ,$55.17 ,$280.54 ,$51.51 , N/A ,$277.85 ,$277.85 ,$269.10 ,$302.74 ,$128.78 ,$285.92 ,$51.51 ,$51.51 ,$285.92 ,$55.17 ,$139.93 , N/A , N/A ,$57.74 ,$285.92 ,$94.19 ,$302.74 ,$264.06 ,$277.85 ,$51.51 ,$218.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),73000008,G0404,HC EKG WELCOME TO MEDICARE,730,1 ,$359.72 ,$233.82 ,$22.86 ,$359.72 ,$61.20 ,$287.78 ,$22.86 ,$100.72 ,$285.04 ,$330.22 ,$22.86 ,$330.22 ,$22.86 ,$46.51 ,$266.19 ,$61.20 ,$24.48 ,$300.01 ,$22.86 , N/A ,$297.13 ,$297.13 ,$287.78 ,$323.75 ,$57.15 ,$305.76 ,$22.86 ,$22.86 ,$305.76 ,$24.48 ,$149.64 , N/A , N/A ,$25.63 ,$305.76 ,$100.72 ,$323.75 ,$282.38 ,$297.13 ,$22.86 ,$233.82 
HSHS GOOD SHEPHERD HOSPITAL (ACU),73100000,93225,HC HOLTER MONITOR RECORDING,731,1 ,"$1,802.36 ","$1,171.53 ",$104.35 ,"$1,802.36 ",$279.40 ,"$1,441.89 ",$104.35 ,$504.66 ,"$1,428.19 ","$1,654.57 ",$104.35 ,"$1,654.57 ",$104.35 ,$212.34 ,"$1,333.75 ",$279.40 ,$111.76 ,"$1,503.17 ",$104.35 , N/A ,"$1,488.75 ","$1,488.75 ","$1,441.89 ","$1,622.12 ",$260.87 ,"$1,532.01 ",$104.35 ,$104.35 ,"$1,532.01 ",$111.76 ,$749.78 , N/A , N/A ,$116.97 ,"$1,532.01 ",$504.66 ,"$1,622.12 ","$1,414.85 ","$1,488.75 ",$104.35 ,"$1,171.53 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),73100004,93270,HC CARDIAC EVENT RECORDER,731,1 ,$804.01 ,$522.61 ,$34.46 ,$804.01 ,$92.28 ,$643.21 ,$34.46 ,$225.12 ,$637.10 ,$738.08 ,$34.46 ,$738.08 ,$34.46 ,$70.13 ,$594.97 ,$92.28 ,$36.91 ,$670.54 ,$34.46 , N/A ,$664.11 ,$664.11 ,$643.21 ,$723.61 ,$86.15 ,$683.41 ,$34.46 ,$34.46 ,$683.41 ,$36.91 ,$334.47 , N/A , N/A ,$38.63 ,$683.41 ,$225.12 ,$723.61 ,$631.15 ,$664.11 ,$34.46 ,$522.61 
HSHS GOOD SHEPHERD HOSPITAL (ACU),74000003,95806,HC SLEEP STUDY UNATTENDED,740,1 ,$402.00 ,$261.30 ,$112.56 ,$402.00 ,$345.93 ,$321.60 ,$129.20 ,$112.56 ,$318.54 ,$369.04 ,$129.20 ,$369.04 ,$129.20 ,$262.90 ,$297.48 ,$345.93 ,$138.37 ,$335.27 ,$129.20 , N/A ,$332.05 ,$332.05 ,$321.60 ,$361.80 ,$323.00 ,$341.70 ,$129.20 ,$129.20 ,$341.70 ,$138.37 ,$167.23 , N/A , N/A ,$144.83 ,$341.70 ,$112.56 ,$361.80 ,$315.57 ,$332.05 ,$129.20 ,$261.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),74000006,95810,HC SLEEP STUDY,740,1 ,"$5,825.18 ","$3,786.37 ",$851.38 ,"$5,825.18 ","$2,279.58 ","$4,660.14 ",$851.38 ,"$1,631.05 ","$4,615.87 ","$5,347.52 ",$851.38 ,"$5,347.52 ",$851.38 ,"$1,732.48 ","$4,310.63 ","$2,279.58 ",$911.83 ,"$4,858.20 ",$851.38 , N/A ,"$4,811.60 ","$4,811.60 ","$4,660.14 ","$5,242.66 ","$2,128.45 ","$4,951.40 ",$851.38 ,$851.38 ,"$4,951.40 ",$911.83 ,"$2,423.27 ", N/A , N/A ,$954.40 ,"$4,951.40 ","$1,631.05 ","$5,242.66 ","$4,572.77 ","$4,811.60 ",$851.38 ,"$3,786.37 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),74000009,95811,HC SLEEP STUDY W/CPAP,740,1 ,"$7,119.86 ","$4,627.91 ",$851.38 ,"$7,119.86 ","$2,279.58 ","$5,695.89 ",$851.38 ,"$1,993.56 ","$5,641.78 ","$6,536.03 ",$851.38 ,"$6,536.03 ",$851.38 ,"$1,732.48 ","$5,268.70 ","$2,279.58 ",$911.83 ,"$5,937.96 ",$851.38 , N/A ,"$5,881.00 ","$5,881.00 ","$5,695.89 ","$6,407.87 ","$2,128.45 ","$6,051.88 ",$851.38 ,$851.38 ,"$6,051.88 ",$911.83 ,"$2,961.86 ", N/A , N/A ,$954.40 ,"$6,051.88 ","$1,993.56 ","$6,407.87 ","$5,589.09 ","$5,881.00 ",$851.38 ,"$4,627.91 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),74000014,95816,HC EEG AWAKE/DROWSY,740,1 ,"$1,042.73 ",$677.77 ,$244.91 ,"$1,042.73 ",$655.75 ,$834.18 ,$244.91 ,$291.96 ,$826.26 ,$957.23 ,$244.91 ,$957.23 ,$244.91 ,$498.37 ,$771.62 ,$655.75 ,$262.30 ,$869.64 ,$244.91 , N/A ,$861.30 ,$861.30 ,$834.18 ,$938.46 ,$612.27 ,$886.32 ,$244.91 ,$244.91 ,$886.32 ,$262.30 ,$433.78 , N/A , N/A ,$274.54 ,$886.32 ,$291.96 ,$938.46 ,$818.54 ,$861.30 ,$244.91 ,$677.77 
HSHS GOOD SHEPHERD HOSPITAL (ACU),74000016,95819,HC EEG AWAKE/ASLEEP,740,1 ,"$1,521.42 ",$988.92 ,$244.91 ,"$1,521.42 ",$655.75 ,"$1,217.14 ",$244.91 ,$426.00 ,"$1,205.57 ","$1,396.66 ",$244.91 ,"$1,396.66 ",$244.91 ,$498.37 ,"$1,125.85 ",$655.75 ,$262.30 ,"$1,268.86 ",$244.91 , N/A ,"$1,256.69 ","$1,256.69 ","$1,217.14 ","$1,369.28 ",$612.27 ,"$1,293.21 ",$244.91 ,$244.91 ,"$1,293.21 ",$262.30 ,$632.91 , N/A , N/A ,$274.54 ,"$1,293.21 ",$426.00 ,"$1,369.28 ","$1,194.31 ","$1,256.69 ",$244.91 ,$988.92 
HSHS GOOD SHEPHERD HOSPITAL (ACU),74000035,G0399,HC SLEEP STUDY HOME ADULT,740,1 ,$402.00 ,$261.30 ,$112.56 ,$402.00 ,$345.93 ,$321.60 ,$129.20 ,$112.56 ,$318.54 ,$369.04 ,$129.20 ,$369.04 ,$129.20 ,$262.90 ,$297.48 ,$345.93 ,$138.37 ,$335.27 ,$129.20 , N/A ,$332.05 ,$332.05 ,$321.60 ,$361.80 ,$323.00 ,$341.70 ,$129.20 ,$129.20 ,$341.70 ,$138.37 ,$167.23 , N/A , N/A ,$144.83 ,$341.70 ,$112.56 ,$361.80 ,$315.57 ,$332.05 ,$129.20 ,$261.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001071,N/A,HC EGD W/BALLOON DILAT >30MM - 43233,750,1 ,"$4,415.00 ","$2,869.75 ","$1,236.20 ","$4,415.00 ", N/A ,"$3,532.00 ", N/A ,"$1,236.20 ","$3,498.45 ","$4,052.97 ", N/A ,"$4,052.97 ", N/A , N/A ,"$3,267.10 ", N/A , N/A ,"$3,682.11 ", N/A , N/A ,"$3,646.79 ","$3,646.79 ","$3,532.00 ","$3,973.50 ", N/A ,"$3,752.75 ", N/A , N/A ,"$3,752.75 ", N/A ,"$1,836.64 ", N/A , N/A , N/A ,"$3,752.75 ","$1,236.20 ","$3,973.50 ","$3,465.78 ","$3,646.79 ", N/A ,"$2,869.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001072,N/A,HC EGD W/BRUSH/WASH - 43235,750,1 ,"$2,198.00 ","$1,428.70 ",$615.44 ,"$2,198.00 ", N/A ,"$1,758.40 ", N/A ,$615.44 ,"$1,741.70 ","$2,017.76 ", N/A ,"$2,017.76 ", N/A , N/A ,"$1,626.52 ", N/A , N/A ,"$1,833.13 ", N/A , N/A ,"$1,815.55 ","$1,815.55 ","$1,758.40 ","$1,978.20 ", N/A ,"$1,868.30 ", N/A , N/A ,"$1,868.30 ", N/A ,$914.37 , N/A , N/A , N/A ,"$1,868.30 ",$615.44 ,"$1,978.20 ","$1,725.43 ","$1,815.55 ", N/A ,"$1,428.70 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001076,N/A,HC EGD W/BIOPSY SGL/MULT - 43239,750,1 ,"$2,198.00 ","$1,428.70 ",$615.44 ,"$2,198.00 ", N/A ,"$1,758.40 ", N/A ,$615.44 ,"$1,741.70 ","$2,017.76 ", N/A ,"$2,017.76 ", N/A , N/A ,"$1,626.52 ", N/A , N/A ,"$1,833.13 ", N/A , N/A ,"$1,815.55 ","$1,815.55 ","$1,758.40 ","$1,978.20 ", N/A ,"$1,868.30 ", N/A , N/A ,"$1,868.30 ", N/A ,$914.37 , N/A , N/A , N/A ,"$1,868.30 ",$615.44 ,"$1,978.20 ","$1,725.43 ","$1,815.55 ", N/A ,"$1,428.70 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001082,N/A,HC EGD W/PLACEMENT G-TUBE - 43246,750,1 ,"$4,412.00 ","$2,867.80 ","$1,235.36 ","$4,412.00 ", N/A ,"$3,529.60 ", N/A ,"$1,235.36 ","$3,496.07 ","$4,050.22 ", N/A ,"$4,050.22 ", N/A , N/A ,"$3,264.88 ", N/A , N/A ,"$3,679.61 ", N/A , N/A ,"$3,644.31 ","$3,644.31 ","$3,529.60 ","$3,970.80 ", N/A ,"$3,750.20 ", N/A , N/A ,"$3,750.20 ", N/A ,"$1,835.39 ", N/A , N/A , N/A ,"$3,750.20 ","$1,235.36 ","$3,970.80 ","$3,463.42 ","$3,644.31 ", N/A ,"$2,867.80 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001083,N/A,HC EGD W/FB REMOVAL - 43247,750,1 ,"$2,198.00 ","$1,428.70 ",$615.44 ,"$2,198.00 ", N/A ,"$1,758.40 ", N/A ,$615.44 ,"$1,741.70 ","$2,017.76 ", N/A ,"$2,017.76 ", N/A , N/A ,"$1,626.52 ", N/A , N/A ,"$1,833.13 ", N/A , N/A ,"$1,815.55 ","$1,815.55 ","$1,758.40 ","$1,978.20 ", N/A ,"$1,868.30 ", N/A , N/A ,"$1,868.30 ", N/A ,$914.37 , N/A , N/A , N/A ,"$1,868.30 ",$615.44 ,"$1,978.20 ","$1,725.43 ","$1,815.55 ", N/A ,"$1,428.70 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001085,N/A,HC EGD W/BALLOON DILAT <30MM - 43249,750,1 ,"$2,815.00 ","$1,829.75 ",$788.20 ,"$2,815.00 ", N/A ,"$2,252.00 ", N/A ,$788.20 ,"$2,230.61 ","$2,584.17 ", N/A ,"$2,584.17 ", N/A , N/A ,"$2,083.10 ", N/A , N/A ,"$2,347.71 ", N/A , N/A ,"$2,325.19 ","$2,325.19 ","$2,252.00 ","$2,533.50 ", N/A ,"$2,392.75 ", N/A , N/A ,"$2,392.75 ", N/A ,"$1,171.04 ", N/A , N/A , N/A ,"$2,392.75 ",$788.20 ,"$2,533.50 ","$2,209.78 ","$2,325.19 ", N/A ,"$1,829.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001086,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN HOT BIOPSY - 43250,750,1 ,"$2,512.00 ","$1,632.80 ",$703.36 ,"$2,512.00 ", N/A ,"$2,009.60 ", N/A ,$703.36 ,"$1,990.51 ","$2,306.02 ", N/A ,"$2,306.02 ", N/A , N/A ,"$1,858.88 ", N/A , N/A ,"$2,095.01 ", N/A , N/A ,"$2,074.91 ","$2,074.91 ","$2,009.60 ","$2,260.80 ", N/A ,"$2,135.20 ", N/A , N/A ,"$2,135.20 ", N/A ,"$1,044.99 ", N/A , N/A , N/A ,"$2,135.20 ",$703.36 ,"$2,260.80 ","$1,971.92 ","$2,074.91 ", N/A ,"$1,632.80 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001087,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN SNARE TECH - 43251,750,1 ,"$2,508.00 ","$1,630.20 ",$702.24 ,"$2,508.00 ", N/A ,"$2,006.40 ", N/A ,$702.24 ,"$1,987.34 ","$2,302.34 ", N/A ,"$2,302.34 ", N/A , N/A ,"$1,855.92 ", N/A , N/A ,"$2,091.67 ", N/A , N/A ,"$2,071.61 ","$2,071.61 ","$2,006.40 ","$2,257.20 ", N/A ,"$2,131.80 ", N/A , N/A ,"$2,131.80 ", N/A ,"$1,043.33 ", N/A , N/A , N/A ,"$2,131.80 ",$702.24 ,"$2,257.20 ","$1,968.78 ","$2,071.61 ", N/A ,"$1,630.20 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001142,N/A,HC SIGMOIDOSCOPY DX W/BRUSH/WASH - 45330,750,1 ,$882.00 ,$573.30 ,$246.96 ,$882.00 , N/A ,$705.60 , N/A ,$246.96 ,$698.90 ,$809.68 , N/A ,$809.68 , N/A , N/A ,$652.68 , N/A , N/A ,$735.59 , N/A , N/A ,$728.53 ,$728.53 ,$705.60 ,$793.80 , N/A ,$749.70 , N/A , N/A ,$749.70 , N/A ,$366.91 , N/A , N/A , N/A ,$749.70 ,$246.96 ,$793.80 ,$692.37 ,$728.53 , N/A ,$573.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001157,N/A,HC COLONOSCOPY DX W/SPECIMEN BRUSH/WASH - 45378,750,1 ,"$2,903.00 ","$1,886.95 ",$812.84 ,"$2,903.00 ", N/A ,"$2,322.40 ", N/A ,$812.84 ,"$2,300.34 ","$2,664.95 ", N/A ,"$2,664.95 ", N/A , N/A ,"$2,148.22 ", N/A , N/A ,"$2,421.10 ", N/A , N/A ,"$2,397.88 ","$2,397.88 ","$2,322.40 ","$2,612.70 ", N/A ,"$2,467.55 ", N/A , N/A ,"$2,467.55 ", N/A ,"$1,207.65 ", N/A , N/A , N/A ,"$2,467.55 ",$812.84 ,"$2,612.70 ","$2,278.86 ","$2,397.88 ", N/A ,"$1,886.95 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001159,N/A,HC COLONOSCOPY W/BIOPSY SGL/MULT - 45380,750,1 ,"$2,815.00 ","$1,829.75 ",$788.20 ,"$2,815.00 ", N/A ,"$2,252.00 ", N/A ,$788.20 ,"$2,230.61 ","$2,584.17 ", N/A ,"$2,584.17 ", N/A , N/A ,"$2,083.10 ", N/A , N/A ,"$2,347.71 ", N/A , N/A ,"$2,325.19 ","$2,325.19 ","$2,252.00 ","$2,533.50 ", N/A ,"$2,392.75 ", N/A , N/A ,"$2,392.75 ", N/A ,"$1,171.04 ", N/A , N/A , N/A ,"$2,392.75 ",$788.20 ,"$2,533.50 ","$2,209.78 ","$2,325.19 ", N/A ,"$1,829.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001160,N/A,HC COLONOSCOPY W/SUBMUCOSAL INJ - 45381,750,1 ,"$3,485.00 ","$2,265.25 ",$975.80 ,"$3,485.00 ", N/A ,"$2,788.00 ", N/A ,$975.80 ,"$2,761.51 ","$3,199.23 ", N/A ,"$3,199.23 ", N/A , N/A ,"$2,578.90 ", N/A , N/A ,"$2,906.49 ", N/A , N/A ,"$2,878.61 ","$2,878.61 ","$2,788.00 ","$3,136.50 ", N/A ,"$2,962.25 ", N/A , N/A ,"$2,962.25 ", N/A ,"$1,449.76 ", N/A , N/A , N/A ,"$2,962.25 ",$975.80 ,"$3,136.50 ","$2,735.73 ","$2,878.61 ", N/A ,"$2,265.25 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001162,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY - 45384,750,1 ,"$2,815.00 ","$1,829.75 ",$788.20 ,"$2,815.00 ", N/A ,"$2,252.00 ", N/A ,$788.20 ,"$2,230.61 ","$2,584.17 ", N/A ,"$2,584.17 ", N/A , N/A ,"$2,083.10 ", N/A , N/A ,"$2,347.71 ", N/A , N/A ,"$2,325.19 ","$2,325.19 ","$2,252.00 ","$2,533.50 ", N/A ,"$2,392.75 ", N/A , N/A ,"$2,392.75 ", N/A ,"$1,171.04 ", N/A , N/A , N/A ,"$2,392.75 ",$788.20 ,"$2,533.50 ","$2,209.78 ","$2,325.19 ", N/A ,"$1,829.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001163,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45385,750,1 ,"$2,815.00 ","$1,829.75 ",$788.20 ,"$2,815.00 ", N/A ,"$2,252.00 ", N/A ,$788.20 ,"$2,230.61 ","$2,584.17 ", N/A ,"$2,584.17 ", N/A , N/A ,"$2,083.10 ", N/A , N/A ,"$2,347.71 ", N/A , N/A ,"$2,325.19 ","$2,325.19 ","$2,252.00 ","$2,533.50 ", N/A ,"$2,392.75 ", N/A , N/A ,"$2,392.75 ", N/A ,"$1,171.04 ", N/A , N/A , N/A ,"$2,392.75 ",$788.20 ,"$2,533.50 ","$2,209.78 ","$2,325.19 ", N/A ,"$1,829.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001164,N/A,HC COLONOSCOPY W/BALLOON DILATION - 45386,750,1 ,"$2,815.00 ","$1,829.75 ",$788.20 ,"$2,815.00 ", N/A ,"$2,252.00 ", N/A ,$788.20 ,"$2,230.61 ","$2,584.17 ", N/A ,"$2,584.17 ", N/A , N/A ,"$2,083.10 ", N/A , N/A ,"$2,347.71 ", N/A , N/A ,"$2,325.19 ","$2,325.19 ","$2,252.00 ","$2,533.50 ", N/A ,"$2,392.75 ", N/A , N/A ,"$2,392.75 ", N/A ,"$1,171.04 ", N/A , N/A , N/A ,"$2,392.75 ",$788.20 ,"$2,533.50 ","$2,209.78 ","$2,325.19 ", N/A ,"$1,829.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001171,N/A,HC COLONOSCOPY W/BAND LIGATION - 45398,750,1 ,"$2,815.00 ","$1,829.75 ",$788.20 ,"$2,815.00 ", N/A ,"$2,252.00 ", N/A ,$788.20 ,"$2,230.61 ","$2,584.17 ", N/A ,"$2,584.17 ", N/A , N/A ,"$2,083.10 ", N/A , N/A ,"$2,347.71 ", N/A , N/A ,"$2,325.19 ","$2,325.19 ","$2,252.00 ","$2,533.50 ", N/A ,"$2,392.75 ", N/A , N/A ,"$2,392.75 ", N/A ,"$1,171.04 ", N/A , N/A , N/A ,"$2,392.75 ",$788.20 ,"$2,533.50 ","$2,209.78 ","$2,325.19 ", N/A ,"$1,829.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001173,N/A,HC HERMORRHOIDECTOMY INTERNAL W/LIGATION - 46221,750,1 ,"$2,155.00 ","$1,400.75 ",$603.40 ,"$2,155.00 ", N/A ,"$1,724.00 ", N/A ,$603.40 ,"$1,707.62 ","$1,978.29 ", N/A ,"$1,978.29 ", N/A , N/A ,"$1,594.70 ", N/A , N/A ,"$1,797.27 ", N/A , N/A ,"$1,780.03 ","$1,780.03 ","$1,724.00 ","$1,939.50 ", N/A ,"$1,831.75 ", N/A , N/A ,"$1,831.75 ", N/A ,$896.48 , N/A , N/A , N/A ,"$1,831.75 ",$603.40 ,"$1,939.50 ","$1,691.68 ","$1,780.03 ", N/A ,"$1,400.75 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001200,G0104,HC COLONOSCOPY SCREEN W/FLEX SIGMOID - G0104,750,1 ,"$2,765.00 ","$1,797.25 ",$734.38 ,"$2,765.00 ","$1,966.30 ","$2,212.00 ",$734.38 ,$774.20 ,"$2,190.99 ","$2,538.27 ",$734.38 ,"$2,538.27 ",$734.38 ,"$1,494.39 ","$2,046.10 ","$1,966.30 ",$786.52 ,"$2,306.01 ",$734.38 , N/A ,"$2,283.89 ","$2,283.89 ","$2,212.00 ","$2,488.50 ","$1,835.94 ","$2,350.25 ",$734.38 ,$734.38 ,"$2,350.25 ",$786.52 ,"$1,150.24 ", N/A , N/A ,$823.24 ,"$2,350.25 ",$774.20 ,"$2,488.50 ","$2,170.53 ","$2,283.89 ",$734.38 ,"$1,797.25 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001214,G0105,HC COLON SCREENING HIGH RISK- G0105,750,1 ,"$2,765.00 ","$1,797.25 ",$734.38 ,"$2,765.00 ","$1,966.30 ","$2,212.00 ",$734.38 ,$774.20 ,"$2,190.99 ","$2,538.27 ",$734.38 ,"$2,538.27 ",$734.38 ,"$1,494.39 ","$2,046.10 ","$1,966.30 ",$786.52 ,"$2,306.01 ",$734.38 , N/A ,"$2,283.89 ","$2,283.89 ","$2,212.00 ","$2,488.50 ","$1,835.94 ","$2,350.25 ",$734.38 ,$734.38 ,"$2,350.25 ",$786.52 ,"$1,150.24 ", N/A , N/A ,$823.24 ,"$2,350.25 ",$774.20 ,"$2,488.50 ","$2,170.53 ","$2,283.89 ",$734.38 ,"$1,797.25 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),75001215,G0121,HC COLONOSCOPY SCREENING LOW RISK- G0121,750,1 ,"$2,608.00 ","$1,695.20 ",$730.24 ,"$2,608.00 ","$1,966.30 ","$2,086.40 ",$734.38 ,$730.24 ,"$2,066.58 ","$2,394.14 ",$734.38 ,"$2,394.14 ",$734.38 ,"$1,494.39 ","$1,929.92 ","$1,966.30 ",$786.52 ,"$2,175.07 ",$734.38 , N/A ,"$2,154.21 ","$2,154.21 ","$2,086.40 ","$2,347.20 ","$1,835.94 ","$2,216.80 ",$734.38 ,$734.38 ,"$2,216.80 ",$786.52 ,"$1,084.93 ", N/A , N/A ,$823.24 ,"$2,216.80 ",$730.24 ,"$2,347.20 ","$2,047.28 ","$2,154.21 ",$734.38 ,"$1,695.20 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),76000014,62273,HC INJ EPIDURAL BLD/CLOT PATCH,760,1 ,"$1,723.00 ","$1,119.95 ",$482.44 ,"$1,723.00 ","$1,573.38 ","$1,378.40 ",$587.62 ,$482.44 ,"$1,365.31 ","$1,581.71 ",$587.62 ,"$1,581.71 ",$587.62 ,"$1,195.77 ","$1,275.02 ","$1,573.38 ",$629.35 ,"$1,436.98 ",$587.62 , N/A ,"$1,423.20 ","$1,423.20 ","$1,378.40 ","$1,550.70 ","$1,469.06 ","$1,464.55 ",$587.62 ,$587.62 ,"$1,464.55 ",$629.35 ,$716.77 , N/A , N/A ,$658.73 ,"$1,464.55 ",$482.44 ,"$1,550.70 ","$1,352.56 ","$1,423.20 ",$587.62 ,"$1,119.95 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),76200008,G0379,HC OBSERVATION DIRECT ADMIT,762,1 ,$262.00 ,$170.30 ,$73.36 ,$262.00 , N/A ,$209.60 , N/A ,$73.36 ,$207.61 ,$240.52 , N/A ,$240.52 , N/A , N/A ,$193.88 , N/A , N/A ,$218.51 , N/A , N/A ,$216.41 ,$216.41 ,$209.60 ,$235.80 , N/A ,$222.70 , N/A , N/A ,$222.70 , N/A ,$108.99 , N/A , N/A , N/A ,$222.70 ,$73.36 ,$235.80 ,$205.67 ,$216.41 , N/A ,$170.30 
HSHS GOOD SHEPHERD HOSPITAL (ACU),76200009,G0378,HC OBSERVATION HOURLY,762,1 ,$70.00 ,$45.50 ,$19.60 ,$70.00 , N/A ,$56.00 , N/A ,$19.60 ,$55.47 ,$64.26 , N/A ,$64.26 , N/A , N/A ,$51.80 , N/A , N/A ,$58.38 , N/A , N/A ,$57.82 ,$57.82 ,$56.00 ,$63.00 , N/A ,$59.50 , N/A , N/A ,$59.50 , N/A ,$29.12 , N/A , N/A , N/A ,$59.50 ,$19.60 ,$63.00 ,$54.95 ,$57.82 , N/A ,$45.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),76200022,G0378,HC OBSERVATION W/TELEMETRY PER HR,762,1 ,$70.00 ,$45.50 ,$19.60 ,$70.00 , N/A ,$56.00 , N/A ,$19.60 ,$55.47 ,$64.26 , N/A ,$64.26 , N/A , N/A ,$51.80 , N/A , N/A ,$58.38 , N/A , N/A ,$57.82 ,$57.82 ,$56.00 ,$63.00 , N/A ,$59.50 , N/A , N/A ,$59.50 , N/A ,$29.12 , N/A , N/A , N/A ,$59.50 ,$19.60 ,$63.00 ,$54.95 ,$57.82 , N/A ,$45.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),77100000,90471,HC IMMUN ADMIN ONE VACC,771,1 ,$40.18 ,$26.12 ,$11.25 ,$153.63 ,$153.63 ,$32.14 ,$57.37 ,$11.25 ,$31.84 ,$36.89 ,$40.18 ,$36.89 ,$40.18 ,$40.18 ,$29.73 ,$40.18 ,$61.45 ,$33.51 ,$57.37 , N/A ,$33.19 ,$33.19 ,$32.14 ,$36.16 ,$40.18 ,$34.15 ,$57.37 ,$57.37 ,$34.15 ,$61.45 ,$16.71 , N/A , N/A ,$40.18 ,$34.15 ,$11.25 ,$36.16 ,$31.54 ,$33.19 ,$57.37 ,$26.12 
HSHS GOOD SHEPHERD HOSPITAL (ACU),77100003,G0008,HC ADMIN INFLUENZA VACCINE,771,1 ,$43.00 ,$27.95 ,$12.04 ,$99.15 ,$99.15 ,$34.40 ,$37.03 ,$12.04 ,$34.07 ,$39.47 ,$37.03 ,$39.47 ,$37.03 ,$43.00 ,$31.82 ,$43.00 ,$39.66 ,$35.86 ,$37.03 , N/A ,$35.52 ,$35.52 ,$34.40 ,$38.70 ,$43.00 ,$36.55 ,$37.03 ,$37.03 ,$36.55 ,$39.66 ,$17.89 , N/A , N/A ,$41.51 ,$36.55 ,$12.04 ,$38.70 ,$33.76 ,$35.52 ,$37.03 ,$27.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),77100005,G0009,HC ADMIN PNEUMOCOCCAL VACCINE,771,1 ,$43.00 ,$27.95 ,$12.04 ,$99.15 ,$99.15 ,$34.40 ,$37.03 ,$12.04 ,$34.07 ,$39.47 ,$37.03 ,$39.47 ,$37.03 ,$43.00 ,$31.82 ,$43.00 ,$39.66 ,$35.86 ,$37.03 , N/A ,$35.52 ,$35.52 ,$34.40 ,$38.70 ,$43.00 ,$36.55 ,$37.03 ,$37.03 ,$36.55 ,$39.66 ,$17.89 , N/A , N/A ,$41.51 ,$36.55 ,$12.04 ,$38.70 ,$33.76 ,$35.52 ,$37.03 ,$27.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),77100006,G0010,HC INJECTION-HEPATITIS B VACCINE,771,1 ,$43.00 ,$27.95 ,$12.04 ,$99.15 ,$99.15 ,$34.40 ,$37.03 ,$12.04 ,$34.07 ,$39.47 ,$37.03 ,$39.47 ,$37.03 ,$43.00 ,$31.82 ,$43.00 ,$39.66 ,$35.86 ,$37.03 , N/A ,$35.52 ,$35.52 ,$34.40 ,$38.70 ,$43.00 ,$36.55 ,$37.03 ,$37.03 ,$36.55 ,$39.66 ,$17.89 , N/A , N/A ,$41.51 ,$36.55 ,$12.04 ,$38.70 ,$33.76 ,$35.52 ,$37.03 ,$27.95 
HSHS GOOD SHEPHERD HOSPITAL (ACU),90000002,90791,HC EVAL PSYCH DIAG,900,1 ,$54.11 ,$35.17 ,$15.15 ,$331.53 ,$331.53 ,$43.29 ,$123.82 ,$15.15 ,$42.88 ,$49.67 ,$54.11 ,$49.67 ,$54.11 ,$54.11 ,$40.04 ,$54.11 ,$132.61 ,$45.13 ,$123.82 , N/A ,$44.69 ,$44.69 ,$43.29 ,$48.70 ,$54.11 ,$45.99 ,$123.82 ,$123.82 ,$45.99 ,$132.61 ,$22.51 , N/A , N/A ,$54.11 ,$45.99 ,$15.15 ,$48.70 ,$42.48 ,$44.69 ,$123.82 ,$35.17 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92000006,96111,HC COMP DEVELOPMNT BAYLEY EVAL EP,920,1 ,$335.03 ,$217.77 ,$93.81 ,$335.03 , N/A ,$268.02 , N/A ,$93.81 ,$265.48 ,$307.56 , N/A ,$307.56 , N/A , N/A ,$247.92 , N/A , N/A ,$279.42 , N/A , N/A ,$276.73 ,$276.73 ,$268.02 ,$301.53 , N/A ,$284.78 , N/A , N/A ,$284.78 , N/A ,$139.37 , N/A , N/A , N/A ,$284.78 ,$93.81 ,$301.53 ,$263.00 ,$276.73 , N/A ,$217.77 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100002,93880,HC DUPLEX CAROTID BILAT,921,1 ,"$1,087.92 ",$707.15 ,$212.93 ,"$1,087.92 ",$570.13 ,$870.34 ,$212.93 ,$304.62 ,$862.07 ,$998.71 ,$212.93 ,$998.71 ,$212.93 ,$433.30 ,$805.06 ,$570.13 ,$228.05 ,$907.33 ,$212.93 , N/A ,$898.62 ,$898.62 ,$870.34 ,$979.13 ,$532.33 ,$924.73 ,$212.93 ,$212.93 ,$924.73 ,$228.05 ,$452.57 , N/A , N/A ,$238.70 ,$924.73 ,$304.62 ,$979.13 ,$854.02 ,$898.62 ,$212.93 ,$707.15 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100003,93882,HC DUPLEX CAROTID UNI,921,1 ,"$1,253.00 ",$814.45 ,$100.75 ,"$1,253.00 ",$269.75 ,"$1,002.40 ",$100.75 ,$350.84 ,$992.88 ,"$1,150.25 ",$100.75 ,"$1,150.25 ",$100.75 ,$205.01 ,$927.22 ,$269.75 ,$107.90 ,"$1,045.00 ",$100.75 , N/A ,"$1,034.98 ","$1,034.98 ","$1,002.40 ","$1,127.70 ",$251.87 ,"$1,065.05 ",$100.75 ,$100.75 ,"$1,065.05 ",$107.90 ,$521.25 , N/A , N/A ,$112.94 ,"$1,065.05 ",$350.84 ,"$1,127.70 ",$983.61 ,"$1,034.98 ",$100.75 ,$814.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100005,93922,HC ABI/PPG SINGLE LEVEL,921,1 ,$289.92 ,$188.45 ,$81.18 ,$289.92 ,$279.40 ,$231.94 ,$104.35 ,$81.18 ,$229.73 ,$266.15 ,$104.35 ,$266.15 ,$104.35 ,$212.34 ,$214.54 ,$279.40 ,$111.76 ,$241.79 ,$104.35 , N/A ,$239.47 ,$239.47 ,$231.94 ,$260.93 ,$260.87 ,$246.43 ,$104.35 ,$104.35 ,$246.43 ,$111.76 ,$120.61 , N/A , N/A ,$116.97 ,$246.43 ,$81.18 ,$260.93 ,$227.59 ,$239.47 ,$104.35 ,$188.45 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100034,93925,HC DUPLEX ARTERIAL LWR EXT BI,921,1 ,"$1,955.06 ","$1,270.79 ",$212.93 ,"$1,955.06 ",$570.13 ,"$1,564.05 ",$212.93 ,$547.42 ,"$1,549.19 ","$1,794.75 ",$212.93 ,"$1,794.75 ",$212.93 ,$433.30 ,"$1,446.74 ",$570.13 ,$228.05 ,"$1,630.52 ",$212.93 , N/A ,"$1,614.88 ","$1,614.88 ","$1,564.05 ","$1,759.55 ",$532.33 ,"$1,661.80 ",$212.93 ,$212.93 ,"$1,661.80 ",$228.05 ,$813.31 , N/A , N/A ,$238.70 ,"$1,661.80 ",$547.42 ,"$1,759.55 ","$1,534.72 ","$1,614.88 ",$212.93 ,"$1,270.79 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100035,93926,HC DUPLEX ARTRL LWR EXT UNI/LMT,921,1 ,"$1,216.10 ",$790.47 ,$100.75 ,"$1,216.10 ",$269.75 ,$972.88 ,$100.75 ,$340.51 ,$963.64 ,"$1,116.38 ",$100.75 ,"$1,116.38 ",$100.75 ,$205.01 ,$899.91 ,$269.75 ,$107.90 ,"$1,014.23 ",$100.75 , N/A ,"$1,004.50 ","$1,004.50 ",$972.88 ,"$1,094.49 ",$251.87 ,"$1,033.69 ",$100.75 ,$100.75 ,"$1,033.69 ",$107.90 ,$505.90 , N/A , N/A ,$112.94 ,"$1,033.69 ",$340.51 ,"$1,094.49 ",$954.64 ,"$1,004.50 ",$100.75 ,$790.47 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100037,93930,HC DUPLEX ARTERIAL UPR EXT BI,921,1 ,"$1,570.81 ","$1,021.03 ",$212.93 ,"$1,570.81 ",$570.13 ,"$1,256.65 ",$212.93 ,$439.83 ,"$1,244.71 ","$1,442.00 ",$212.93 ,"$1,442.00 ",$212.93 ,$433.30 ,"$1,162.40 ",$570.13 ,$228.05 ,"$1,310.06 ",$212.93 , N/A ,"$1,297.49 ","$1,297.49 ","$1,256.65 ","$1,413.73 ",$532.33 ,"$1,335.19 ",$212.93 ,$212.93 ,"$1,335.19 ",$228.05 ,$653.46 , N/A , N/A ,$238.70 ,"$1,335.19 ",$439.83 ,"$1,413.73 ","$1,233.09 ","$1,297.49 ",$212.93 ,"$1,021.03 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100038,93931,HC DUPLEX ARTRL UPR EXT UNI/LMT,921,1 ,"$1,066.00 ",$692.90 ,$100.75 ,"$1,066.00 ",$269.75 ,$852.80 ,$100.75 ,$298.48 ,$844.70 ,$978.59 ,$100.75 ,$978.59 ,$100.75 ,$205.01 ,$788.84 ,$269.75 ,$107.90 ,$889.04 ,$100.75 , N/A ,$880.52 ,$880.52 ,$852.80 ,$959.40 ,$251.87 ,$906.10 ,$100.75 ,$100.75 ,$906.10 ,$107.90 ,$443.46 , N/A , N/A ,$112.94 ,$906.10 ,$298.48 ,$959.40 ,$836.81 ,$880.52 ,$100.75 ,$692.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100039,93931,HC DUPLEX ARTRL UPR EXT PSEUD ONLY,921,1 ,"$1,066.00 ",$692.90 ,$100.75 ,"$1,066.00 ",$269.75 ,$852.80 ,$100.75 ,$298.48 ,$844.70 ,$978.59 ,$100.75 ,$978.59 ,$100.75 ,$205.01 ,$788.84 ,$269.75 ,$107.90 ,$889.04 ,$100.75 , N/A ,$880.52 ,$880.52 ,$852.80 ,$959.40 ,$251.87 ,$906.10 ,$100.75 ,$100.75 ,$906.10 ,$107.90 ,$443.46 , N/A , N/A ,$112.94 ,$906.10 ,$298.48 ,$959.40 ,$836.81 ,$880.52 ,$100.75 ,$692.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100041,93970,HC DUPLEX VENOUS EXT BI,921,1 ,"$1,716.00 ","$1,115.40 ",$212.93 ,"$1,716.00 ",$570.13 ,"$1,372.80 ",$212.93 ,$480.48 ,"$1,359.76 ","$1,575.29 ",$212.93 ,"$1,575.29 ",$212.93 ,$433.30 ,"$1,269.84 ",$570.13 ,$228.05 ,"$1,431.14 ",$212.93 , N/A ,"$1,417.42 ","$1,417.42 ","$1,372.80 ","$1,544.40 ",$532.33 ,"$1,458.60 ",$212.93 ,$212.93 ,"$1,458.60 ",$228.05 ,$713.86 , N/A , N/A ,$238.70 ,"$1,458.60 ",$480.48 ,"$1,544.40 ","$1,347.06 ","$1,417.42 ",$212.93 ,"$1,115.40 "
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100043,93971,HC DUPLEX VENOUS EXT UNI/LMTD,921,1 ,$900.44 ,$585.29 ,$100.75 ,$900.44 ,$269.75 ,$720.35 ,$100.75 ,$252.12 ,$713.51 ,$826.60 ,$100.75 ,$826.60 ,$100.75 ,$205.01 ,$666.33 ,$269.75 ,$107.90 ,$750.97 ,$100.75 , N/A ,$743.76 ,$743.76 ,$720.35 ,$810.40 ,$251.87 ,$765.37 ,$100.75 ,$100.75 ,$765.37 ,$107.90 ,$374.58 , N/A , N/A ,$112.94 ,$765.37 ,$252.12 ,$810.40 ,$706.85 ,$743.76 ,$100.75 ,$585.29 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92100046,93990,HC DUPLEX HEMODIALYSIS ACCESS,921,1 ,$296.00 ,$192.40 ,$82.88 ,$296.00 ,$269.75 ,$236.80 ,$100.75 ,$82.88 ,$234.55 ,$271.73 ,$100.75 ,$271.73 ,$100.75 ,$205.01 ,$219.04 ,$269.75 ,$107.90 ,$246.86 ,$100.75 , N/A ,$244.50 ,$244.50 ,$236.80 ,$266.40 ,$251.87 ,$251.60 ,$100.75 ,$100.75 ,$251.60 ,$107.90 ,$123.14 , N/A , N/A ,$112.94 ,$251.60 ,$82.88 ,$266.40 ,$232.36 ,$244.50 ,$100.75 ,$192.40 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92200011,95886,HC EMG ADD ON >5 MUSCLES,922,1 ,$308.46 ,$200.50 ,$86.37 ,$308.46 , N/A ,$246.77 , N/A ,$86.37 ,$244.42 ,$283.17 , N/A ,$283.17 , N/A , N/A ,$228.26 , N/A , N/A ,$257.26 , N/A , N/A ,$254.79 ,$254.79 ,$246.77 ,$277.61 , N/A ,$262.19 , N/A , N/A ,$262.19 , N/A ,$128.32 , N/A , N/A , N/A ,$262.19 ,$86.37 ,$277.61 ,$242.14 ,$254.79 , N/A ,$200.50 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92200023,95909,HC NVR CNDJ TST 5-6 STUDIES,922,1 ,$194.83 ,$126.64 ,$54.55 ,$655.75 ,$655.75 ,$155.86 ,$244.91 ,$54.55 ,$154.38 ,$178.85 ,$194.83 ,$178.85 ,$194.83 ,$194.83 ,$144.17 ,$194.83 ,$262.30 ,$162.49 ,$244.91 , N/A ,$160.93 ,$160.93 ,$155.86 ,$175.35 ,$194.83 ,$165.61 ,$244.91 ,$244.91 ,$165.61 ,$262.30 ,$81.05 , N/A , N/A ,$194.83 ,$165.61 ,$54.55 ,$175.35 ,$152.94 ,$160.93 ,$244.91 ,$126.64 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92200024,95910,HC NVR CNDJ TST 7-8 STUDIES,922,1 ,$211.06 ,$137.19 ,$59.10 ,$655.75 ,$655.75 ,$168.85 ,$244.91 ,$59.10 ,$167.24 ,$193.75 ,$211.06 ,$193.75 ,$211.06 ,$211.06 ,$156.18 ,$211.06 ,$262.30 ,$176.02 ,$244.91 , N/A ,$174.34 ,$174.34 ,$168.85 ,$189.95 ,$211.06 ,$179.40 ,$244.91 ,$244.91 ,$179.40 ,$262.30 ,$87.80 , N/A , N/A ,$211.06 ,$179.40 ,$59.10 ,$189.95 ,$165.68 ,$174.34 ,$244.91 ,$137.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92200025,95911,HC NVR CNDJ TST 9-10 STUDIES,922,1 ,$227.28 ,$147.73 ,$63.64 ,"$1,209.48 ","$1,209.48 ",$181.82 ,$451.72 ,$63.64 ,$180.10 ,$208.64 ,$227.28 ,$208.64 ,$227.28 ,$227.28 ,$168.19 ,$227.28 ,$483.79 ,$189.55 ,$451.72 , N/A ,$187.73 ,$187.73 ,$181.82 ,$204.55 ,$227.28 ,$193.19 ,$451.72 ,$451.72 ,$193.19 ,$483.79 ,$94.55 , N/A , N/A ,$227.28 ,$193.19 ,$63.64 ,$204.55 ,$178.41 ,$187.73 ,$451.72 ,$147.73 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92200026,95912,HC NVR CNDJ TST 11-12 STUDIES,922,1 ,$243.53 ,$158.29 ,$68.19 ,"$1,209.48 ","$1,209.48 ",$194.82 ,$451.72 ,$68.19 ,$192.97 ,$223.56 ,$243.53 ,$223.56 ,$243.53 ,$243.53 ,$180.21 ,$243.53 ,$483.79 ,$203.10 ,$451.72 , N/A ,$201.16 ,$201.16 ,$194.82 ,$219.18 ,$243.53 ,$207.00 ,$451.72 ,$451.72 ,$207.00 ,$483.79 ,$101.31 , N/A , N/A ,$243.53 ,$207.00 ,$68.19 ,$219.18 ,$191.17 ,$201.16 ,$451.72 ,$158.29 
HSHS GOOD SHEPHERD HOSPITAL (ACU),92200027,95913,HC NVR CNDJ TST 13 AND > STUDIES,922,1 ,$259.77 ,$168.85 ,$72.74 ,"$1,209.48 ","$1,209.48 ",$207.82 ,$451.72 ,$72.74 ,$205.84 ,$238.47 ,$259.77 ,$238.47 ,$259.77 ,$259.77 ,$192.23 ,$259.77 ,$483.79 ,$216.65 ,$451.72 , N/A ,$214.57 ,$214.57 ,$207.82 ,$233.79 ,$259.77 ,$220.80 ,$451.72 ,$451.72 ,$220.80 ,$483.79 ,$108.06 , N/A , N/A ,$259.77 ,$220.80 ,$72.74 ,$233.79 ,$203.92 ,$214.57 ,$451.72 ,$168.85 
HSHS GOOD SHEPHERD HOSPITAL (ACU),94000104,96372,HC INJECTION IM/SUBQ,940,1 ,$155.40 ,$101.01 ,$43.51 ,$155.40 ,$153.63 ,$124.32 ,$57.37 ,$43.51 ,$123.14 ,$142.66 ,$57.37 ,$142.66 ,$57.37 ,$116.76 ,$115.00 ,$153.63 ,$61.45 ,$129.60 ,$57.37 , N/A ,$128.36 ,$128.36 ,$124.32 ,$139.86 ,$143.44 ,$132.09 ,$57.37 ,$57.37 ,$132.09 ,$61.45 ,$64.65 , N/A , N/A ,$64.32 ,$132.09 ,$43.51 ,$139.86 ,$121.99 ,$128.36 ,$57.37 ,$101.01 
HSHS GOOD SHEPHERD HOSPITAL (ACU),94000110,99195,HC THERAPEUTIC PHLEBOTOMY,940,1 ,$208.01 ,$135.21 ,$58.24 ,$279.40 ,$279.40 ,$166.41 ,$104.35 ,$58.24 ,$164.83 ,$190.95 ,$104.35 ,$190.95 ,$104.35 ,$208.01 ,$153.93 ,$208.01 ,$111.76 ,$173.48 ,$104.35 , N/A ,$171.82 ,$171.82 ,$166.41 ,$187.21 ,$208.01 ,$176.81 ,$104.35 ,$104.35 ,$176.81 ,$111.76 ,$86.53 , N/A , N/A ,$116.97 ,$176.81 ,$58.24 ,$187.21 ,$163.29 ,$171.82 ,$104.35 ,$135.21 
HSHS GOOD SHEPHERD HOSPITAL (ACU),94200005,97802,HC NUTRITION THRPY EVAL 15 MIN,942,1 ,$87.16 ,$56.65 ,$24.40 ,$87.16 ,$76.28 ,$69.73 ,$30.51 ,$24.40 ,$69.07 ,$80.01 ,$30.51 ,$80.01 ,$30.51 ,$57.97 ,$64.50 ,$76.28 ,$30.51 ,$72.69 ,$30.51 , N/A ,$71.99 ,$71.99 ,$69.73 ,$78.44 ,$30.51 ,$74.09 ,$30.51 ,$30.51 ,$74.09 ,$30.51 ,$36.26 , N/A , N/A ,$30.51 ,$74.09 ,$24.40 ,$78.44 ,$68.42 ,$71.99 ,$30.51 ,$56.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),94300009,93798,HC CARDIAC REHAB W/EKG SESSION (ASSESSMENT),943,1 ,$123.06 ,$79.99 ,$34.46 ,$287.60 ,$287.60 ,$98.45 ,$107.42 ,$34.46 ,$97.51 ,$112.97 ,$107.42 ,$112.97 ,$107.42 ,$123.06 ,$91.06 ,$123.06 ,$115.04 ,$102.63 ,$107.42 , N/A ,$101.65 ,$101.65 ,$98.45 ,$110.75 ,$123.06 ,$104.60 ,$107.42 ,$107.42 ,$104.60 ,$115.04 ,$51.19 , N/A , N/A ,$120.42 ,$104.60 ,$34.46 ,$110.75 ,$96.60 ,$101.65 ,$107.42 ,$79.99 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96000048,99422,PC ONLINE DIG E/M SVC 11-20 MIN-95,960,1 ,$44.08 ,$28.65 ,$12.34 ,$44.08 , N/A ,$35.26 , N/A ,$12.34 ,$34.93 ,$40.47 , N/A ,$40.47 , N/A , N/A ,$32.62 , N/A , N/A ,$36.76 , N/A , N/A ,$36.41 ,$36.41 ,$35.26 ,$39.67 , N/A ,$37.47 , N/A , N/A ,$37.47 , N/A ,$34.74 , N/A , N/A , N/A ,$37.47 ,$12.34 ,$39.67 ,$34.60 , N/A , N/A ,$28.65 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400286,100,PC ANESTH SALIVARY GLAND W/BX-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400287,120,PC ANESTH EXT/MID/INR EAR W/BX NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400288,140,PC ANESTH EYE NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400289,142,PC ANESTH EYE LENS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400290,160,PC ANESTH NOSE/SINUS NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400291,164,PC ANESTH NOSE/SINUS SOFT TISS W/BIOPSY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400292,170,PC ANESTH MOUTH W/BIOPSY NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400293,190,PC ANESTH FACE BONE/SKULL NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400294,300,PC ANESTH HEAD/NECK/TRUNK NOS-QZ,964,1 ,$193.92 ,$126.05 ,$54.30 ,$193.92 , N/A ,$155.14 , N/A ,$54.30 ,$153.66 ,$178.02 , N/A ,$178.02 , N/A , N/A ,$143.50 , N/A , N/A ,$161.73 , N/A , N/A ,$160.18 ,$160.18 ,$155.14 ,$174.53 , N/A ,$164.83 , N/A , N/A ,$164.83 , N/A ,$135.74 , N/A , N/A , N/A ,$164.83 ,$54.30 ,$174.53 ,$152.23 , N/A , N/A ,$126.05 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400295,320,PC ANESTH NECK ORGANS >1YR NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400296,400,PC ANESTH INTEG EXTRM/TRUNK NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400297,404,PC ANESTH BREAST RADICAL/MOD RAD-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400298,406,PC ANESTH BREAST/RAD/MOD RAD W/DISSECTION-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400299,410,PC ANESTH ELEC CONV ARRHYTHMIAS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400300,450,PC ANESTH CLAVICLE/SCAPULA NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400301,520,PC ANESTH CHEST CLOSED NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400302,635,PC ANESTH LUMBAR PUNCTURE DIAG/THERAP-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400303,700,PC ANESTH ABD WALL/UPPER ANTR NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400304,730,PC ANESTH ABD WALL/UPPER POSTR NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400306,750,PC ANESTH RPR HERNIA UPPER ABD NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400307,752,PC ANESTH RPR HERNIA LUMB/VENTR WND DEH-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400308,790,PC ANESTH UPPER ABD W/LAP NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400310,800,PC ANESTH ABD WALL LOW ANTR NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400312,820,PC ANESTH ABD WALL LOWER POSTR-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400313,830,PC ANESTH RPR HERNIA LOW ABD NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400314,832,PC ANESTH RPR HERNIA VENTRAL/INCISONAL-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400315,840,PC ANESTH LOWER ABD W/LAP NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400316,844,PC ANESTH ABDOMINOPERINEAL RESECTION-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400317,846,PC ANESTH HYSTERECTOMY RADICAL-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400319,860,PC ANESTH LOWER ABD EXTRAPERIT NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400320,862,PC ANESTH RENAL PROC/DONOR NEPHRECTOMY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400322,865,PC ANESTH PROSTATECTOMY RADICAL-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400324,873,PC ANESTH LITHOTRIPSY W/O WATER BATH-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400325,902,PC ANESTH ANORECTAL PROC-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400327,908,PC ANESTH PERINEAL PROSTATECTOMY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400328,910,PC ANESTH TRANSURETHRAL PROC NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400329,912,PC ANESTH TRANSURETHRAL RESECT BLADDER TUMR-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400330,914,PC ANESTH TRANSURETRAL RESECT PROSTATE-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400332,920,PC ANESTH GENITALIA MALE NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400339,940,PC ANESTH VAGINAL PROCS W/BX NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400340,942,PC ANESTH VAGINAL COLPECT/VAG/COLPRHY PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400341,944,PC ANESTH VAGINAL HYSTERECTOMY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400342,948,PC ANESTH CERVICAL CERCLAGE-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400344,952,PC ANESTH HYSTEROSCOPY/HYSTERGRAPH-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400345,1200,PC ANESTH HIP JOINT CLOSED PROC-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400346,1232,PC ANESTH FEMUR AMPUTATION-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400347,1250,PC ANESTH UPPER LEG PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400349,1320,PC ANESTH KNEE/POPLITEAL PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400350,1340,PC ANESTH FEMUR CLOSED PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400351,1360,PC ANESTH FEMUR OPEN PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400352,1380,PC ANESTH KNEE JOINT CLOSED-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400353,1382,PC ANESTH KNEE ARTHROSCOPIC DIAG PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400354,1390,PC ANESTH KNEE CLOSED PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400355,1392,PC ANESTH KNEE OPEN PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400356,1400,PC ANESTH KNEE ARTHROSOPIC OPEN PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400358,1462,PC ANESTH LWR LEG/ANKLE/FOOT CLOSED-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400359,1464,PC ANESTH ANKLE/FOOT ARTHROSCOPIC-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400360,1470,PC ANESTH LWR LEG NERV/MUSC/TEND NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400361,1472,PC ANESTH RPR ACHILLES TENDN W/OR W/O GRAFT-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400362,1480,PC ANESTH LWR LEG/ANKLE/FOOT OPEN NOS-QZ,964,1 ,$205.47 ,$133.56 ,$57.53 ,$205.47 , N/A ,$164.38 , N/A ,$57.53 ,$162.81 ,$188.62 , N/A ,$188.62 , N/A , N/A ,$152.05 , N/A , N/A ,$171.36 , N/A , N/A ,$169.72 ,$169.72 ,$164.38 ,$184.92 , N/A ,$174.65 , N/A , N/A ,$174.65 , N/A ,$143.83 , N/A , N/A , N/A ,$174.65 ,$57.53 ,$184.92 ,$161.29 , N/A , N/A ,$133.56 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400363,1482,PC ANESTH LWR LEG RADICAL RESECTION-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400366,1610,PC ANESTH SHLDR NERV/MUSC/TEND-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400367,1620,PC ANESTH SHLDR CLOSED PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400368,1630,PC ANESTH SHLDR ARTHROSCOPIC NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400369,1710,PC ANESTH UPPR ARM/ELBW NERV/MUSC/TEND NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400370,1730,PC ANESTH HUMERUS/ELBOW CLOSED PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400371,1740,PC ANESTH ELBOW ARTHROSCOPIC PROC NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400372,1770,PC ANESTH UPPR ARM/ELBOW NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400373,1780,PC ANESTH VEINS UPPR ARM/ELBOW NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400374,1810,PC ANESTH LOWR ARM NERV/MUSC/TEND PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400375,1820,PC ANESTH LOWER ARM CLOSED PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400376,1830,PC ANESTH LOWER ARM ARTHRO/ENDOSC-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400377,1840,PC ANESTH LOWER ARM ARTERIES PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400378,1850,PC ANESTH VEINS LOWER ARM NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400379,1922,PC ANESTH NO-INVAS IMAGE OR RAD THPY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400380,1961,PC ANESTH CESAREAN DELIVERY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400383,1968,PC ANESTH CESAREAN DELIVERY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400384,1999,PC ANESTH UNLISTED PROC-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400388,126,PC ANESTH TYMPANOTOMY -QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400408,103,PC ANESTH EYELID BLEPHAROPLASTY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400409,104,PC ANESTH ELECTROCONVULSIVE THERAPY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400410,124,PC ANESTH EAR PROC W/BX OTOSCOPY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400411,210,PC ANESTH INTRACRANIAL PROCS NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400412,211,PC ANESTH INTRACRANIAL PROC HEMATOMA-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400413,214,PC ANESTH INTRACRANIAL PROC BURR HOLES W/VENTRICULOGRAPHY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400414,216,PC ANESTH INTRACRANIAL PROCS VASCULAR-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400415,218,PC ANESTH INTRACRANIAL PROCS SITTING POSITION-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400416,220,PC ANESTH INTRACRANIAL SHUNTING PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400417,350,PC ANESTH NECK VESSEL NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400418,352,PC ANESTH NECK VESSEL SIMPLE LIGATION-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400419,402,PC ANESTH BREAST RECONSTRUCT PROC-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400420,500,PC ANESTH ESOPHAGEAL PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400421,522,PC ANESTH CHEST BIOPSY PLEURA-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400422,528,PC ANESTH CHEST MEDIAST/DX THORASC W/LUNG VENTIL-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400423,530,PC ANESTH PACEMAKER INSERTION-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400424,532,PC ANESTH VASCULAR ACCESS CENTRAL VENOUS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400425,534,PC ANESTH INSERT CARDIOVERTER/DEFIBRILLATOR-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400426,541,PC ANESTH THORACOTOMY VENTILATION SINGLE LUNG-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400427,560,PC ANESTH HEART PROC W/O PUMP OXYGENATOR-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400428,600,PC ANESTH CERVICAL SPINE/CORD NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400429,620,PC ANESTH THORACIC SPINE/CORD NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400430,625,PC ANESTH THORACIC SPINE W/O LUNG VENTILATION-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400431,630,PC ANESTH LUMBAR PROCS NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400432,640,PC ANESTH SPINE MANIPULATION/CLOSED PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400433,670,PC ANESTH EXTENSIVE SPINE/CORD PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400434,702,PC ANESTH LIVER BIOPSY PERC-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400435,731,PC ANESTH UPPER GI ENDO PROC NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400436,732,PC ANESTH UPPER GI ERCP-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400437,754,PC ANESTH HERNIA UPPR ABDOMEN OMPHALOCELE-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400438,811,PC ANESTH LOWER ENDO PROCS NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400439,812,PC ANESTH SCREENING COLONOSCOPY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400440,813,PC ANESTH UPPER/LOWER GI ENDO PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400441,872,PC ANESTH LITHO EXTRACORPOREAL SHOCK WAVE W/BATH-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400442,918,PC ANESTH TRANSURETHRAL STONE REMOVAL-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400443,1112,PC ANESTH BONE MARROW ASPIRATION/BIOPSY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400444,1120,PC ANESTH BONY PELVIS PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400445,1202,PC ANESTH ARTHROSCOPY HIP-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400446,1210,PC ANESTH OPEN HIP JOINT NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400447,1214,PC ANESTH HIP ARTHROPLASTY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400448,1215,PC ANESTH OPEN REVISE TOTAL HIP ARTHROPLASTY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400449,1220,PC ANESTH CLOSED PROCS FEMUR-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400450,1230,PC ANESTH OPEN FEMUR PROCS NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400451,1270,PC ANESTH ARTERIES UPPER LEG W/GRAFT NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400452,1274,PC ANESTH FEMORAL ARTERY EMBOLECTOMY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400453,1402,PC ANESTH TOTAL KNEE ARTHROPLASTY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400454,1440,PC ANESTH KNEE/POPLITEAL ARTERIES NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400455,1474,PC ANESTH GASTROCNEMIUS RECESSION-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400456,1484,PC ANESTH LOWER LEG PROCS OSTEOTOMY/OSTEOPLASTY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400457,1502,PC ANESTH LOWER LEG ARTERY EMBOLECTOMY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400458,1622,PC ANESTH SHOULDER ARTHROSCOPY DX-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400459,1638,PC ANESTH TOTAL SHOULDER REPLACMENT-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400460,1670,PC ANESTH SHOULDER/AXILLA VEIN PROCS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400461,1712,PC ANESTH TENOTOMY UPPER ARM OPEN-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400462,1716,PC ANESTH BICEPS TENDON REPAIR-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400463,1772,PC ANESTH EMBOLECTOMY UPPER ARM/ELBOW-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400464,1844,PC ANESTH VASCULAR SHUNT OR REVISION-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400465,1916,PC ANESTH ARTERIOGRAPHY/VENOGRAPHY DX-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400466,1920,PC ANESTH HEART CATH W/ANGIOGRAPHY/VENTRICULOGRAPHY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400467,1924,PC ANESTH ARTERIAL INTERVEN RAD PROCS THERAPEUTIC-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400468,1925,PC ANESTH ARTERIAL INTERVEN RAD PROCS CAROTID/CORONARY-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400469,1926,PC ANESTH ARTERIAL INTERVEN RAD PROCS INTRACRANIAL/CARDIAC/AORTIC-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400470,1930,PC ANESTH VENOUS/LYMPHATIC SYSTEM THERAP NOS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400471,1935,PC ANESTH SPINE/SPINAL CORD PERC IMAGE GUIDED PROCS DX-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400472,1936,PC ANESTH SPINE/SPINAL CORD PERC IMAGE GUIDED PROCS THERAP-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400474,1965,PC ANESTH ABORTION IMCOMPLETE/MISSED-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400475,1966,PC ANESTH ABORTION INDUCED-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400476,1991,PC ANESTH NERVE BLOCK/INJ DX/THER NON PRONE DIFF PHYS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400477,1992,PC ANESTH NERVE BLOCK/INJ DX/THER PRONE DIFF PHYS-QZ,964,1 ,$195.68 ,$127.19 ,$54.79 ,$195.68 , N/A ,$156.54 , N/A ,$54.79 ,$155.06 ,$179.63 , N/A ,$179.63 , N/A , N/A ,$144.80 , N/A , N/A ,$163.20 , N/A , N/A ,$161.63 ,$161.63 ,$156.54 ,$176.11 , N/A ,$166.33 , N/A , N/A ,$166.33 , N/A ,$136.98 , N/A , N/A , N/A ,$166.33 ,$54.79 ,$176.11 ,$153.61 , N/A , N/A ,$127.19 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400484,120,PC ANESTH EXT/MID/INR EAR W/BX NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400485,140,PC ANESTH EYE NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400486,160,PC ANESTH NOSE/SINUS NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400487,170,PC ANESTH MOUTH W/BIOPSY NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400488,190,PC ANESTH FACE BONE/SKULL NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400489,300,PC ANESTH HEAD/NECK/TRUNK NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400490,320,PC ANESTH NECK ORGANS >1YR NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400491,400,PC ANESTH INTEG EXTRM/TRUNK NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400492,404,PC ANESTH BREAST RADICAL/MOD RAD-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400493,406,PC ANESTH BREAST/RAD/MOD RAD W/DISSECTION-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400494,410,PC ANESTH ELEC CONV ARRHYTHMIAS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400495,450,PC ANESTH CLAVICLE/SCAPULA NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400496,520,PC ANESTH CHEST CLOSED NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400497,635,PC ANESTH LUMBAR PUNCTURE DIAG/THERAP-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400498,700,PC ANESTH ABD WALL/UPPER ANTR NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400499,730,PC ANESTH ABD WALL/UPPER POSTR NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400500,750,PC ANESTH RPR HERNIA UPPER ABD NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400501,752,PC ANESTH RPR HERNIA LUMB/VENTR WND DEH-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400502,790,PC ANESTH UPPER ABD W/LAP NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400503,800,PC ANESTH ABD WALL LOW ANTR NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400504,820,PC ANESTH ABD WALL LOWER POSTR-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400505,830,PC ANESTH RPR HERNIA LOW ABD NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400506,832,PC ANESTH RPR HERNIA VENTRAL/INCISONAL-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400507,840,PC ANESTH LOWER ABD W/LAP NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400508,844,PC ANESTH ABDOMINOPERINEAL RESECTION-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400509,846,PC ANESTH HYSTERECTOMY RADICAL-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400510,860,PC ANESTH LOWER ABD EXTRAPERIT NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400511,862,PC ANESTH RENAL PROC/DONOR NEPHRECTOMY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400512,865,PC ANESTH PROSTATECTOMY RADICAL-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400513,873,PC ANESTH LITHOTRIPSY W/O WATER BATH-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400514,902,PC ANESTH ANORECTAL PROC-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400515,908,PC ANESTH PERINEAL PROSTATECTOMY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400516,910,PC ANESTH TRANSURETHRAL PROC NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400517,912,PC ANESTH TRANSURETHRAL RESECT BLADDER TUMR-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400518,914,PC ANESTH TRANSURETRAL RESECT PROSTATE-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400519,920,PC ANESTH GENITALIA MALE NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400520,940,PC ANESTH VAGINAL PROCS W/BX NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400521,942,PC ANESTH VAGINAL COLPECT/VAG/COLPRHY PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400522,944,PC ANESTH VAGINAL HYSTERECTOMY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400523,948,PC ANESTH CERVICAL CERCLAGE-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400524,952,PC ANESTH HYSTEROSCOPY/HYSTERGRAPH-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400525,1200,PC ANESTH HIP JOINT CLOSED PROC-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400526,1232,PC ANESTH FEMUR AMPUTATION-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400527,1250,PC ANESTH UPPER LEG PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400528,1320,PC ANESTH KNEE/POPLITEAL PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400529,1340,PC ANESTH FEMUR CLOSED PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400530,1360,PC ANESTH FEMUR OPEN PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400531,1380,PC ANESTH KNEE JOINT CLOSED-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400532,1382,PC ANESTH KNEE ARTHROSCOPIC DIAG PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400533,1390,PC ANESTH KNEE CLOSED PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400534,1392,PC ANESTH KNEE OPEN PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400535,1400,PC ANESTH KNEE ARTHROSOPIC OPEN PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400536,1462,PC ANESTH LWR LEG/ANKLE/FOOT CLOSED-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400537,1464,PC ANESTH ANKLE/FOOT ARTHROSCOPIC-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400538,1470,PC ANESTH LWR LEG NERV/MUSC/TEND NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400539,1472,PC ANESTH RPR ACHILLES TENDN W/OR W/O GRAFT-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400540,1480,PC ANESTH LWR LEG/ANKLE/FOOT OPEN NOS-QX,964,1 ,$193.92 ,$63.03 ,$27.15 ,$143.50 , N/A ,$77.57 , N/A ,$27.15 ,$76.83 ,$89.01 , N/A ,$89.01 , N/A , N/A ,$143.50 , N/A , N/A ,$80.87 , N/A , N/A ,$80.09 ,$80.09 ,$77.57 ,$87.27 , N/A ,$82.42 , N/A , N/A ,$82.42 , N/A ,$67.87 , N/A , N/A , N/A ,$82.42 ,$27.15 ,$87.27 ,$76.12 , N/A , N/A ,$63.03 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400541,1482,PC ANESTH LWR LEG RADICAL RESECTION-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400542,1610,PC ANESTH SHLDR NERV/MUSC/TEND-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400543,1620,PC ANESTH SHLDR CLOSED PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400544,1630,PC ANESTH SHLDR ARTHROSCOPIC NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400545,1710,PC ANESTH UPPR ARM/ELBW NERV/MUSC/TEND NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400546,1730,PC ANESTH HUMERUS/ELBOW CLOSED PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400547,1740,PC ANESTH ELBOW ARTHROSCOPIC PROC NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400548,1770,PC ANESTH UPPR ARM/ELBOW NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400549,1780,PC ANESTH VEINS UPPR ARM/ELBOW NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400550,1810,PC ANESTH LOWR ARM NERV/MUSC/TEND PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400551,1820,PC ANESTH LOWER ARM CLOSED PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400552,1830,PC ANESTH LOWER ARM ARTHRO/ENDOSC-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400553,1840,PC ANESTH LOWER ARM ARTERIES PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400554,1850,PC ANESTH VEINS LOWER ARM NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400555,1922,PC ANESTH NO-INVAS IMAGE OR RAD THPY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400556,1961,PC ANESTH CESAREAN DELIVERY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400558,1968,PC ANESTH CESAREAN DELIVERY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400559,1999,PC ANESTH UNLISTED PROC-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400560,126,PC ANESTH TYMPANOTOMY -QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400561,103,PC ANESTH EYELID BLEPHAROPLASTY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400562,104,PC ANESTH ELECTROCONVULSIVE THERAPY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400563,124,PC ANESTH EAR PROC W/BX OTOSCOPY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400564,210,PC ANESTH INTRACRANIAL PROCS NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400565,211,PC ANESTH INTRACRANIAL PROC HEMATOMA-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400566,214,PC ANESTH INTRACRANIAL PROC BURR HOLES W/VENTRICULOGRAPHY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400567,216,PC ANESTH INTRACRANIAL PROCS VASCULAR-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400568,218,PC ANESTH INTRACRANIAL PROCS SITTING POSITION-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400569,220,PC ANESTH INTRACRANIAL SHUNTING PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400570,350,PC ANESTH NECK VESSEL NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400571,352,PC ANESTH NECK VESSEL SIMPLE LIGATION-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400572,402,PC ANESTH BREAST RECONSTRUCT PROC-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400573,500,PC ANESTH ESOPHAGEAL PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400574,522,PC ANESTH CHEST BIOPSY PLEURA-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400575,528,PC ANESTH CHEST MEDIAST/DX THORASC W/LUNG VENTIL-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400576,530,PC ANESTH PACEMAKER INSERTION-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400577,532,PC ANESTH VASCULAR ACCESS CENTRAL VENOUS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400578,534,PC ANESTH INSERT CARDIOVERTER/DEFIBRILLATOR-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400579,541,PC ANESTH THORACOTOMY VENTILATION SINGLE LUNG-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400580,560,PC ANESTH HEART PROC W/O PUMP OXYGENATOR-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400581,600,PC ANESTH CERVICAL SPINE/CORD NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400582,620,PC ANESTH THORACIC SPINE/CORD NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400583,625,PC ANESTH THORACIC SPINE W/O LUNG VENTILATION-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400584,630,PC ANESTH LUMBAR PROCS NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400585,640,PC ANESTH SPINE MANIPULATION/CLOSED PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400586,670,PC ANESTH EXTENSIVE SPINE/CORD PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400587,702,PC ANESTH LIVER BIOPSY PERC-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400588,731,PC ANESTH UPPER GI ENDO PROC NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400589,732,PC ANESTH UPPER GI ERCP-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400590,754,PC ANESTH HERNIA UPPR ABDOMEN OMPHALOCELE-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400591,811,PC ANESTH LOWER ENDO PROCS NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400592,812,PC ANESTH SCREENING COLONOSCOPY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400593,813,PC ANESTH UPPER/LOWER GI ENDO PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400594,872,PC ANESTH LITHO EXTRACORPOREAL SHOCK WAVE W/BATH-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400595,918,PC ANESTH TRANSURETHRAL STONE REMOVAL-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400596,1112,PC ANESTH BONE MARROW ASPIRATION/BIOPSY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400597,1120,PC ANESTH BONY PELVIS PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400598,1202,PC ANESTH ARTHROSCOPY HIP-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400599,1210,PC ANESTH OPEN HIP JOINT NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400600,1214,PC ANESTH HIP ARTHROPLASTY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400601,1215,PC ANESTH OPEN REVISE TOTAL HIP ARTHROPLASTY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400602,1220,PC ANESTH CLOSED PROCS FEMUR-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400603,1230,PC ANESTH OPEN FEMUR PROCS NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400604,1270,PC ANESTH ARTERIES UPPER LEG W/GRAFT NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400605,1274,PC ANESTH FEMORAL ARTERY EMBOLECTOMY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400606,1402,PC ANESTH TOTAL KNEE ARTHROPLASTY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400607,1440,PC ANESTH KNEE/POPLITEAL ARTERIES NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400608,1474,PC ANESTH GASTROCNEMIUS RECESSION-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400609,1484,PC ANESTH LOWER LEG PROCS OSTEOTOMY/OSTEOPLASTY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400610,1502,PC ANESTH LOWER LEG ARTERY EMBOLECTOMY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400611,1622,PC ANESTH SHOULDER ARTHROSCOPY DX-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400612,1638,PC ANESTH TOTAL SHOULDER REPLACMENT-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400613,1670,PC ANESTH SHOULDER/AXILLA VEIN PROCS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400614,1712,PC ANESTH TENOTOMY UPPER ARM OPEN-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400615,1716,PC ANESTH BICEPS TENDON REPAIR-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400616,1772,PC ANESTH EMBOLECTOMY UPPER ARM/ELBOW-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400617,1844,PC ANESTH VASCULAR SHUNT OR REVISION-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400618,1916,PC ANESTH ARTERIOGRAPHY/VENOGRAPHY DX-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400619,1920,PC ANESTH HEART CATH W/ANGIOGRAPHY/VENTRICULOGRAPHY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400620,1924,PC ANESTH ARTERIAL INTERVEN RAD PROCS THERAPEUTIC-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400621,1925,PC ANESTH ARTERIAL INTERVEN RAD PROCS CAROTID/CORONARY-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400622,1926,PC ANESTH ARTERIAL INTERVEN RAD PROCS INTRACRANIAL/CARDIAC/AORTIC-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400623,1930,PC ANESTH VENOUS/LYMPHATIC SYSTEM THERAP NOS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400624,1935,PC ANESTH SPINE/SPINAL CORD PERC IMAGE GUIDED PROCS DX-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400625,1936,PC ANESTH SPINE/SPINAL CORD PERC IMAGE GUIDED PROCS THERAP-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400627,1965,PC ANESTH ABORTION IMCOMPLETE/MISSED-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400628,1966,PC ANESTH ABORTION INDUCED-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400629,1991,PC ANESTH NERVE BLOCK/INJ DX/THER NON PRONE DIFF PHYS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400630,1992,PC ANESTH NERVE BLOCK/INJ DX/THER PRONE DIFF PHYS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400631,1990,PC ANESTH ORGAN HARVEST-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400636,100,PC ANESTH SALIVARY GLAND W/BX-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400637,1744,PC ANESTH REPAIR HUMERUS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400640,142,PC ANESTH EYE LENS-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),96400642,810,PC ANESTH INTESTINE LOW ENDOSC PROC-QX,964,1 ,$195.68 ,$63.60 ,$27.40 ,$144.80 , N/A ,$78.27 , N/A ,$27.40 ,$77.53 ,$89.82 , N/A ,$89.82 , N/A , N/A ,$144.80 , N/A , N/A ,$81.60 , N/A , N/A ,$80.82 ,$80.82 ,$78.27 ,$88.06 , N/A ,$83.17 , N/A , N/A ,$83.17 , N/A ,$68.49 , N/A , N/A , N/A ,$83.17 ,$27.40 ,$88.06 ,$76.81 , N/A , N/A ,$63.60 
HSHS GOOD SHEPHERD HOSPITAL (ACU),98180094,20610,PC DRAIN/INJECT LARGE JOINT/BURSA,981,1 ,$372.72 ,$242.27 ,$80.88 ,$647.35 ,$647.35 ,$298.18 ,$241.77 ,$104.36 ,$295.34 ,$342.16 ,$241.77 ,$342.16 ,$241.77 ,$372.72 ,$275.81 ,$372.72 ,$258.94 ,$310.85 ,$241.77 , N/A ,$307.87 ,$307.87 ,$298.18 ,$335.45 ,$372.72 ,$316.81 ,$241.77 ,$241.77 ,$316.81 ,$258.94 ,$80.88 , N/A , N/A ,$271.03 ,$316.81 ,$104.36 ,$335.45 ,$292.59 , N/A , N/A ,$242.27 
HSHS GOOD SHEPHERD HOSPITAL (ACU),98180625,20610,PC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-LT,981,1 ,$372.72 ,$242.27 ,$80.88 ,$647.35 ,$647.35 ,$298.18 ,$241.77 ,$104.36 ,$295.34 ,$342.16 ,$241.77 ,$342.16 ,$241.77 ,$372.72 ,$275.81 ,$372.72 ,$258.94 ,$310.85 ,$241.77 , N/A ,$307.87 ,$307.87 ,$298.18 ,$335.45 ,$372.72 ,$316.81 ,$241.77 ,$241.77 ,$316.81 ,$258.94 ,$80.88 , N/A , N/A ,$271.03 ,$316.81 ,$104.36 ,$335.45 ,$292.59 , N/A , N/A ,$242.27 
HSHS GOOD SHEPHERD HOSPITAL (ACU),98180626,20610,PC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-RT,981,1 ,$372.72 ,$242.27 ,$80.88 ,$647.35 ,$647.35 ,$298.18 ,$241.77 ,$104.36 ,$295.34 ,$342.16 ,$241.77 ,$342.16 ,$241.77 ,$372.72 ,$275.81 ,$372.72 ,$258.94 ,$310.85 ,$241.77 , N/A ,$307.87 ,$307.87 ,$298.18 ,$335.45 ,$372.72 ,$316.81 ,$241.77 ,$241.77 ,$316.81 ,$258.94 ,$80.88 , N/A , N/A ,$271.03 ,$316.81 ,$104.36 ,$335.45 ,$292.59 , N/A , N/A ,$242.27 
HSHS GOOD SHEPHERD HOSPITAL (ACU),98500002,93016,PC CARDIAC STRESS TEST SUPERVISION,985,1 ,$106.00 ,$68.90 ,$29.68 ,$106.00 , N/A ,$84.80 , N/A ,$29.68 ,$83.99 ,$97.31 , N/A ,$97.31 , N/A , N/A ,$78.44 , N/A , N/A ,$88.40 , N/A , N/A ,$87.56 ,$87.56 ,$84.80 ,$95.40 , N/A ,$90.10 , N/A , N/A ,$90.10 , N/A ,$41.22 , N/A , N/A , N/A ,$90.10 ,$29.68 ,$95.40 ,$83.21 , N/A , N/A ,$68.90 
HSHS GOOD SHEPHERD HOSPITAL (ACU),98500003,93018,PC CARDIOVASCULAR STRESS TEST,985,1 ,$97.00 ,$63.05 ,$27.16 ,$97.00 , N/A ,$77.60 , N/A ,$27.16 ,$76.86 ,$89.05 , N/A ,$89.05 , N/A , N/A ,$71.78 , N/A , N/A ,$80.90 , N/A , N/A ,$80.12 ,$80.12 ,$77.60 ,$87.30 , N/A ,$82.45 , N/A , N/A ,$82.45 , N/A ,$27.42 , N/A , N/A , N/A ,$82.45 ,$27.16 ,$87.30 ,$76.15 , N/A , N/A ,$63.05